<a id="pl.1.4"></a><var>1.4</var>health care events, suicide prevention, doula services, developmental disabilities, <br/>
<a id="pl.1.5"></a><var>1.5</var>mental health commitment, alternative care services, self-directed options, <br/>
<a id="pl.1.6"></a><var>1.6</var>nursing facilities, ICF/MR facilities, and data management; requiring a safe <br/>
<a id="pl.1.7"></a><var>1.7</var>patient handling plan; establishing a health department work group and an <br/>
<a id="pl.1.8"></a><var>1.8</var>Alzheimer's disease work group;amending Minnesota Statutes 2008, sections <br/>
<a id="pl.1.9"></a><var>1.9</var>43A.318, subdivision 2; 62Q.525, subdivision 2; 144.7065, subdivisions 8, 10; <br/>
<a id="pl.1.10"></a><var>1.10</var>145.56, subdivisions 1, 2; 148.995, subdivisions 2, 4; 182.6551; 182.6552, <br/>
<a id="pl.1.11"></a><var>1.11</var>by adding a subdivision; 252.27, subdivision 1a; 252.282, subdivisions 3, 5; <br/>
<a id="pl.1.12"></a><var>1.12</var>253B.095, subdivision 1; 256B.0657, subdivision 5; 256B.0913, subdivisions <br/>
<a id="pl.1.13"></a><var>1.13</var>4, 5a, 12; 256B.0915, subdivision 2; 256B.431, subdivision 10; 256B.433, <br/>
<a id="pl.1.14"></a><var>1.14</var>subdivision 1; 256B.441, subdivisions 5, 11; 256B.5011, subdivision 2; <br/>
<a id="pl.1.15"></a><var>1.15</var>256B.5012, subdivisions 6, 7; 256B.5013, subdivisions 1, 6; 256B.69, <br/>
<a id="pl.1.16"></a><var>1.16</var>subdivision 9b; 403.03; 626.557, subdivision 12b; proposing coding for new law <br/>
<a id="pl.1.17"></a><var>1.17</var>in Minnesota Statutes, chapter 182; repealing Minnesota Statutes 2008, section <br/>
<a id="pl.1.18"></a><var>1.18</var>256B.5013, subdivisions 2, 3, 5.<br/>
<a id="pl.1.19"></a><var>1.19</var>May 17, 2009<br/>
<a id="pl.1.20"></a><var>1.20</var>The Honorable Margaret Anderson Kelliher<br/>
<a id="pl.1.21"></a><var>1.21</var>Speaker of the House of Representatives<br/>
<a id="pl.1.22"></a><var>1.22</var>The Honorable James P. Metzen<br/>
<a id="pl.1.23"></a><var>1.23</var>President of the Senate<br/>
<a id="pl.1.24"></a><var>1.24</var>We, the undersigned conferees for H. F. No. 1760 report that we have agreed upon <br/>
<a id="pl.1.25"></a><var>1.25</var>the items in dispute and recommend as follows:<br/>
<a id="pl.1.26"></a><var>1.26</var>That the Senate recede from its amendments and that H. F. No. 1760 be further <br/>
<a id="pl.1.27"></a><var>1.27</var>amended as follows:<br/>
<a id="pl.1.28"></a><var>1.28</var>Delete everything after the enacting clause and insert:<br/>
<br/>
<a id="bill.0.1.0"></a><a id="pl.1.29"></a><var>1.29</var>    "Section 1. Minnesota Statutes 2008, section 62A.65, subdivision 4, is amended to read:<br/>
<a id="pl.1.30"></a><var>1.30</var>    Subd. 4. <b>Gender rating prohibited.</b> (a) No individual health plan offered, sold, <br/>
<a id="pl.1.31"></a><var>1.31</var>issued, or renewed to a Minnesota resident may determine the premium rate or any other <br/>
<a id="pl.1.32"></a><var>1.32</var>underwriting decision, including initial issuance, through a method that is in any way <br/>
<a id="pl.1.33"></a><var>1.33</var>based upon the gender of any person covered or to be covered under the health plan. This <br/>
<a id="pl.2.1"></a><var>2.1</var>subdivision prohibits the use of marital status or generalized differences in expected costs <br/>
<a id="pl.2.2"></a><var>2.2</var>between principal insureds and their spouses.<br/>
<a id="pl.2.3"></a><var>2.3</var>(b) No health carrier may refuse to initially offer, sell, or issue an individual health <br/>
<a id="pl.2.4"></a><var>2.4</var>plan to a Minnesota resident solely on the basis that the individual had a previous cesarean <br/>
<a id="pl.2.5"></a><var>2.5</var>delivery.<br/>
<br/>
<a id="bill.0.2.0"></a><a id="pl.2.6"></a><var>2.6</var>    Sec. 2. Minnesota Statutes 2008, section 62M.09, subdivision 3a, is amended to read:<br/>
<a id="pl.2.7"></a><var>2.7</var>    Subd. 3a. <b>Mental health and substance abuse reviews.</b> (a) A peer of the treating <br/>
<a id="pl.2.8"></a><var>2.8</var>mental health or substance abuse provider or a physician must review requests for <br/>
<a id="pl.2.9"></a><var>2.9</var>outpatient services in which the utilization review organization has concluded that a <br/>
<a id="pl.2.10"></a><var>2.10</var>determination not to certify a mental health or substance abuse service for clinical reasons <br/>
<a id="pl.2.11"></a><var>2.11</var>is appropriate, provided that any final determination not to certify treatment is made <br/>
<a id="pl.2.12"></a><var>2.12</var>by a psychiatrist certified by the American Board of Psychiatry and Neurology and <br/>
<a id="pl.2.13"></a><var>2.13</var>appropriately licensed in this state or by a doctoral-level psychologist licensed in this state <br/>
<a id="pl.2.14"></a><var>2.14</var>if the treating provider is a psychologist. <br/>
<a id="pl.2.15"></a><var>2.15</var>(b) Notwithstanding the notification requirements of section 
         <statute_ref>62M.05</statute_ref>, a utilization <br/>
<a id="pl.2.16"></a><var>2.16</var>review organization that has made an initial decision to certify in accordance with the <br/>
<a id="pl.2.17"></a><var>2.17</var>requirements of section 
         <statute_ref>62M.05</statute_ref> may elect to provide notification of a determination to <br/>
<a id="pl.2.18"></a><var>2.18</var>continue coverage through facsimile or mail. <br/>
<a id="pl.2.19"></a><var>2.19</var>(c) This subdivision does not apply to determinations made in connection with <br/>
<a id="pl.2.20"></a><var>2.20</var>policies issued by a health plan company that is assessed less than three percent of the <br/>
<a id="pl.2.21"></a><var>2.21</var>total amount assessed by the Minnesota Comprehensive Health Association. <br/>
<br/>
<a id="bill.0.3.0"></a><a id="pl.2.22"></a><var>2.22</var>    Sec. 3. Minnesota Statutes 2008, section 62Q.525, subdivision 2, is amended to read:<br/>
<a id="pl.2.23"></a><var>2.23</var>    Subd. 2. <b>Definitions.</b> (a) For purposes of this section, the terms defined in this <br/>
<a id="pl.2.24"></a><var>2.24</var>subdivision have the meanings given them.<br/>
<a id="pl.2.25"></a><var>2.25</var>(b) "Medical literature" means articles from major peer reviewed medical journals <br/>
<a id="pl.2.26"></a><var>2.26</var>that have recognized the drug or combination of drugs' safety and effectiveness for <br/>
<a id="pl.2.27"></a><var>2.27</var>treatment of the indication for which it has been prescribed. Each article shall meet the <br/>
<a id="pl.2.28"></a><var>2.28</var>uniform requirements for manuscripts submitted to biomedical journals established by <br/>
<a id="pl.2.29"></a><var>2.29</var>the International Committee of Medical Journal Editors or be published in a journal <br/>
<a id="pl.2.30"></a><var>2.30</var>specified by the United States Secretary of Health and Human Services pursuant to United <br/>
<a id="pl.2.31"></a><var>2.31</var>States Code, title 42, section 1395x, paragraph (t), clause (2), item (B), as amended, as <br/>
<a id="pl.2.32"></a><var>2.32</var>acceptable peer review medical literature. Each article must use generally acceptable <br/>
<a id="pl.2.33"></a><var>2.33</var>scientific standards and must not use case reports to satisfy this criterion.<br/>
<a id="pl.2.34"></a><var>2.34</var>(c) "Off-label use of drugs" means when drugs are prescribed for treatments other <br/>
<a id="pl.2.35"></a><var>2.35</var>than those stated in the labeling approved by the federal Food and Drug Administration.<br/>
<a id="pl.3.1"></a><var>3.1</var>(d) "Standard reference compendia" means:<br/>
<a id="pl.3.2"></a><var>3.2</var>(1) the United States Pharmacopeia Drug Information; or<br/>
<a id="pl.3.3"></a><var>3.3</var>(2) the American Hospital Formulary Service Drug Information any authoritative <br/>
<a id="pl.3.4"></a><var>3.4</var>compendia as identified by the Medicare program for use in the determination of a <br/>
<a id="pl.3.5"></a><var>3.5</var>medically accepted indication of drugs and biologicals used off-label.<br/>
<br/>
<a id="bill.0.4.0"></a><a id="pl.3.6"></a><var>3.6</var>    Sec. 4. Minnesota Statutes 2008, section 62U.01, subdivision 8, is amended to read:<br/>
<a id="pl.3.7"></a><var>3.7</var>    Subd. 8. <b>Health plan company.</b> "Health plan company" has the meaning provided <br/>
<a id="pl.3.8"></a><var>3.8</var>in section 
         <statute_ref>62Q.01, subdivision 4</statute_ref>. For the purposes of this chapter, health plan company <br/>
<a id="pl.3.9"></a><var>3.9</var>shall include county-based purchasing arrangements authorized under section 256B.692.<br/>
<br/>
<a id="bill.0.5.0"></a><a id="pl.3.10"></a><var>3.10</var>    Sec. 5. Minnesota Statutes 2008, section 62U.09, subdivision 2, is amended to read:<br/>
<a id="pl.3.11"></a><var>3.11</var>    Subd. 2. <b>Members.</b> (a) The Health Care Reform Review Council shall consist of 14 <br/>
<a id="pl.3.12"></a><var>3.12</var>16 members who are appointed as follows:<br/>
<a id="pl.3.13"></a><var>3.13</var>    (1) two members appointed by the Minnesota Medical Association, at least one <br/>
<a id="pl.3.14"></a><var>3.14</var>of whom must represent rural physicians; <br/>
<a id="pl.3.15"></a><var>3.15</var>    (2) one member appointed by the Minnesota Nurses Association;<br/>
<a id="pl.3.16"></a><var>3.16</var>    (3) two members appointed by the Minnesota Hospital Association, at least one of <br/>
<a id="pl.3.17"></a><var>3.17</var>whom must be a rural hospital administrator;<br/>
<a id="pl.3.18"></a><var>3.18</var>    (4) one member appointed by the Minnesota Academy of Physician Assistants;<br/>
<a id="pl.3.19"></a><var>3.19</var>    (5) one member appointed by the Minnesota Business Partnership;<br/>
<a id="pl.3.20"></a><var>3.20</var>    (6) one member appointed by the Minnesota Chamber of Commerce;<br/>
<a id="pl.3.21"></a><var>3.21</var>    (7) one member appointed by the SEIU Minnesota State Council; <br/>
<a id="pl.3.22"></a><var>3.22</var>    (8) one member appointed by the AFL-CIO;<br/>
<a id="pl.3.23"></a><var>3.23</var>    (9) one member appointed by the Minnesota Council of Health Plans;<br/>
<a id="pl.3.24"></a><var>3.24</var>    (10) one member appointed by the Smart Buy Alliance;<br/>
<a id="pl.3.25"></a><var>3.25</var>    (11) one member appointed by the Minnesota Medical Group Management <br/>
<a id="pl.3.26"></a><var>3.26</var>Association; and<br/>
<a id="pl.3.27"></a><var>3.27</var>    (12) one consumer member appointed by AARP Minnesota;<br/>
<a id="pl.3.28"></a><var>3.28</var>(13) one member appointed by the Minnesota Psychological Association; and<br/>
<a id="pl.3.29"></a><var>3.29</var>(14) one member appointed by the Minnesota Chiropractic Association.<br/>
<a id="pl.3.30"></a><var>3.30</var>    (b) If a member is no longer able or eligible to participate, a new member shall be <br/>
<a id="pl.3.31"></a><var>3.31</var>appointed by the entity that appointed the outgoing member.<br/>
<br/>
<a id="bill.0.6.0"></a><a id="pl.3.32"></a><var>3.32</var>    Sec. 6. Minnesota Statutes 2008, section 144.1501, subdivision 1, is amended to read:<br/>
<a id="pl.3.33"></a><var>3.33</var>    Subdivision 1. <b>Definitions.</b> (a) For purposes of this section, the following definitions <br/>
<a id="pl.3.34"></a><var>3.34</var>apply.<br/>
<a id="pl.4.1"></a><var>4.1</var>(b) "Dentist" means an individual who is licensed to practice dentistry.<br/>
<a id="pl.4.2"></a><var>4.2</var>(c) "Designated rural area" means:<br/>
<a id="pl.4.3"></a><var>4.3</var>(1) an area in Minnesota outside the counties of Anoka, Carver, Dakota, Hennepin, <br/>
<a id="pl.4.4"></a><var>4.4</var>Ramsey, Scott, and Washington, excluding the cities of Duluth, Mankato, Moorhead, <br/>
<a id="pl.4.5"></a><var>4.5</var>Rochester, and St. Cloud; or<br/>
<a id="pl.4.6"></a><var>4.6</var>(2) a municipal corporation, as defined under section 
         <statute_ref>471.634</statute_ref>, that is physically <br/>
<a id="pl.4.7"></a><var>4.7</var>located, in whole or in part, in an area defined as a designated rural area under clause (1).<br/>
<a id="pl.4.8"></a><var>4.8</var>(d) "Emergency circumstances" means those conditions that make it impossible for <br/>
<a id="pl.4.9"></a><var>4.9</var>the participant to fulfill the service commitment, including death, total and permanent <br/>
<a id="pl.4.10"></a><var>4.10</var>disability, or temporary disability lasting more than two years.<br/>
<a id="pl.4.11"></a><var>4.11</var>(e) "Medical resident" means an individual participating in a medical residency in <br/>
<a id="pl.4.12"></a><var>4.12</var>family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.<br/>
<a id="pl.4.13"></a><var>4.13</var>(f) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse <br/>
<a id="pl.4.14"></a><var>4.14</var>anesthetist, advanced clinical nurse specialist, or physician assistant.<br/>
<a id="pl.4.15"></a><var>4.15</var>(g) "Nurse" means an individual who has completed training and received all <br/>
<a id="pl.4.16"></a><var>4.16</var>licensing or certification necessary to perform duties as a licensed practical nurse or <br/>
<a id="pl.4.17"></a><var>4.17</var>registered nurse.<br/>
<a id="pl.4.18"></a><var>4.18</var>(h) "Nurse-midwife" means a registered nurse who has graduated from a program of <br/>
<a id="pl.4.19"></a><var>4.19</var>study designed to prepare registered nurses for advanced practice as nurse-midwives.<br/>
<a id="pl.4.20"></a><var>4.20</var>(i) "Nurse practitioner" means a registered nurse who has graduated from a program <br/>
<a id="pl.4.21"></a><var>4.21</var>of study designed to prepare registered nurses for advanced practice as nurse practitioners.<br/>
<a id="pl.4.22"></a><var>4.22</var>(j) "Pharmacist" means an individual with a valid license issued under chapter 151.<br/>
<a id="pl.4.23"></a><var>4.23</var>(k) "Physician" means an individual who is licensed to practice medicine in the areas <br/>
<a id="pl.4.24"></a><var>4.24</var>of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.<br/>
<a id="pl.4.25"></a><var>4.25</var>(l) "Physician assistant" means a person registered licensed under chapter 147A.<br/>
<a id="pl.4.26"></a><var>4.26</var>(m) "Qualified educational loan" means a government, commercial, or foundation <br/>
<a id="pl.4.27"></a><var>4.27</var>loan for actual costs paid for tuition, reasonable education expenses, and reasonable living <br/>
<a id="pl.4.28"></a><var>4.28</var>expenses related to the graduate or undergraduate education of a health care professional.<br/>
<a id="pl.4.29"></a><var>4.29</var>(n) "Underserved urban community" means a Minnesota urban area or population <br/>
<a id="pl.4.30"></a><var>4.30</var>included in the list of designated primary medical care health professional shortage areas <br/>
<a id="pl.4.31"></a><var>4.31</var>(HPSAs), medically underserved areas (MUAs), or medically underserved populations <br/>
<a id="pl.4.32"></a><var>4.32</var>(MUPs) maintained and updated by the United States Department of Health and Human <br/>
<a id="pl.4.33"></a><var>4.33</var>Services.<br/>
<br/>
<a id="bill.0.7.0"></a><a id="pl.4.34"></a><var>4.34</var>    Sec. 7. Minnesota Statutes 2008, section 144.7065, subdivision 8, is amended to read:<br/>
<a id="pl.4.35"></a><var>4.35</var>    Subd. 8. <b>Root cause analysis; corrective action plan.</b> Following the occurrence of <br/>
<a id="pl.4.36"></a><var>4.36</var>an adverse health care event, the facility must conduct a root cause analysis of the event. <br/>
<a id="pl.5.1"></a><var>5.1</var>In conducting the root cause analysis, the facility must consider as one of the factors <br/>
<a id="pl.5.2"></a><var>5.2</var>staffing levels and the impact of staffing levels on the event. Following the analysis, the <br/>
<a id="pl.5.3"></a><var>5.3</var>facility must: (1) implement a corrective action plan to implement the findings of the <br/>
<a id="pl.5.4"></a><var>5.4</var>analysis or (2) report to the commissioner any reasons for not taking corrective action. If <br/>
<a id="pl.5.5"></a><var>5.5</var>the root cause analysis and the implementation of a corrective action plan are complete at <br/>
<a id="pl.5.6"></a><var>5.6</var>the time an event must be reported, the findings of the analysis and the corrective action <br/>
<a id="pl.5.7"></a><var>5.7</var>plan must be included in the report of the event. The findings of the root cause analysis <br/>
<a id="pl.5.8"></a><var>5.8</var>and a copy of the corrective action plan must otherwise be filed with the commissioner <br/>
<a id="pl.5.9"></a><var>5.9</var>within 60 days of the event.<br/>
<br/>
<a id="bill.0.8.0"></a><a id="pl.5.10"></a><var>5.10</var>    Sec. 8. Minnesota Statutes 2008, section 144.7065, subdivision 10, is amended to read:<br/>
<a id="pl.5.11"></a><var>5.11</var>    Subd. 10. <b>Relation to other law; data classification.</b> (a) Adverse health events <br/>
<a id="pl.5.12"></a><var>5.12</var>described in subdivisions 2 to 6 do not constitute "maltreatment," "neglect," or "a physical <br/>
<a id="pl.5.13"></a><var>5.13</var>injury that is not reasonably explained" under section 
         <statute_ref>626.556</statute_ref> or 
         <statute_ref>626.557</statute_ref> and are excluded <br/>
<a id="pl.5.14"></a><var>5.14</var>from the reporting requirements of sections 
         <statute_ref>626.556</statute_ref> and 
         <statute_ref>626.557</statute_ref>, provided the facility <br/>
<a id="pl.5.15"></a><var>5.15</var>makes a determination within 24 hours of the discovery of the event that this section is <br/>
<a id="pl.5.16"></a><var>5.16</var>applicable and the facility files the reports required under this section in a timely fashion.  <br/>
<a id="pl.5.17"></a><var>5.17</var>(b) A facility that has determined that an event described in subdivisions 2 to 6 <br/>
<a id="pl.5.18"></a><var>5.18</var>has occurred must inform persons who are mandated reporters under section 
         <statute_ref>626.556, <br/>
<a id="pl.5.19"></a><var>5.19</var>subdivision 3
         </statute_ref>, or 
         <statute_ref>626.5572, subdivision 16</statute_ref>, of that determination. A mandated reporter <br/>
<a id="pl.5.20"></a><var>5.20</var>otherwise required to report under section 
         <statute_ref>626.556, subdivision 3</statute_ref>, or 
         <statute_ref>626.557, subdivision <br/>
<a id="pl.5.21"></a><var>5.21</var>3
         </statute_ref>, paragraph (e), is relieved of the duty to report an event that the facility determines under <br/>
<a id="pl.5.22"></a><var>5.22</var>paragraph (a) to be reportable under subdivisions 2 to 6.  <br/>
<a id="pl.5.23"></a><var>5.23</var>(c) The protections and immunities applicable to voluntary reports under sections <br/>
<statute_ref><a id="pl.5.24"></a><var>5.24</var>626.556
         </statute_ref> and 
         <statute_ref>626.557</statute_ref> are not affected by this section.  <br/>
<a id="pl.5.25"></a><var>5.25</var>(d) Notwithstanding section 
         <statute_ref>626.556</statute_ref>, 
         <statute_ref>626.557</statute_ref>, or any other provision of Minnesota <br/>
<a id="pl.5.26"></a><var>5.26</var>statute or rule to the contrary, neither a lead agency under section 
         <statute_ref>626.556, subdivision 3c</statute_ref>, <br/>
<a id="pl.5.27"></a><var>5.27</var>or 
         <statute_ref>626.5572, subdivision 13</statute_ref>, the commissioner of health, nor the director of the Office of <br/>
<a id="pl.5.28"></a><var>5.28</var>Health Facility Complaints is required to conduct an investigation of or obtain or create <br/>
<a id="pl.5.29"></a><var>5.29</var>investigative data or reports regarding an event described in subdivisions 2 to 6. If the <br/>
<a id="pl.5.30"></a><var>5.30</var>facility satisfies the requirements described in paragraph (a), the review or investigation <br/>
<a id="pl.5.31"></a><var>5.31</var>shall be conducted and data or reports shall be obtained or created only under sections <br/>
<statute_ref><a id="pl.5.32"></a><var>5.32</var>144.706
         </statute_ref> to 
         <statute_ref>144.7069</statute_ref>, except as permitted or required under sections 
         <statute_ref>144.50</statute_ref> to 
         <statute_ref>144.564</statute_ref>, <br/>
<a id="pl.5.33"></a><var>5.33</var>or as necessary to carry out the state's certification responsibility under the provisions of <br/>
<a id="pl.5.34"></a><var>5.34</var>sections 1864 and 1867 of the Social Security Act.   If a licensed health care provider <br/>
<a id="pl.5.35"></a><var>5.35</var>reports an event to the facility required to be reported under subdivisions 2 to 6, in a <br/>
<a id="pl.5.36"></a><var>5.36</var>timely manner, the provider's licensing board is not required to conduct an investigation of <br/>
<a id="pl.6.1"></a><var>6.1</var>or obtain or create investigative data or reports regarding the individual reporting of the <br/>
<a id="pl.6.2"></a><var>6.2</var>events described in subdivisions 2 to 6.<br/>
<a id="pl.6.3"></a><var>6.3</var>(e) Data contained in the following records are nonpublic and, to the extent they <br/>
<a id="pl.6.4"></a><var>6.4</var>contain data on individuals, confidential data on individuals, as defined in section 
         <statute_ref>13.02</statute_ref>:  <br/>
<a id="pl.6.5"></a><var>6.5</var>(1) reports provided to the commissioner under sections 
         <statute_ref>147.155</statute_ref>, 
         <statute_ref>147A.155</statute_ref>, <br/>
<statute_ref><a id="pl.6.6"></a><var>6.6</var>148.267
         </statute_ref>, 
         <statute_ref>151.301</statute_ref>, and 
         <statute_ref>153.255</statute_ref>;  <br/>
<a id="pl.6.7"></a><var>6.7</var>(2) event reports, findings of root cause analyses, and corrective action plans filed by <br/>
<a id="pl.6.8"></a><var>6.8</var>a facility under this section; and<br/>
<a id="pl.6.9"></a><var>6.9</var>(3) records created or obtained by the commissioner in reviewing or investigating <br/>
<a id="pl.6.10"></a><var>6.10</var>the reports, findings, and plans described in clause (2).<br/>
<a id="pl.6.11"></a><var>6.11</var>For purposes of the nonpublic data classification contained in this paragraph, the <br/>
<a id="pl.6.12"></a><var>6.12</var>reporting facility shall be deemed the subject of the data.<br/>
<br/>
<a id="bill.0.9.0"></a><a id="pl.6.13"></a><var>6.13</var>    Sec. 9. Minnesota Statutes 2008, section 144E.001, subdivision 3a, is amended to read:<br/>
<a id="pl.6.14"></a><var>6.14</var>    Subd. 3a. <b>Ambulance service personnel.</b> "Ambulance service personnel" means <br/>
<a id="pl.6.15"></a><var>6.15</var>individuals who are authorized by a licensed ambulance service to provide emergency <br/>
<a id="pl.6.16"></a><var>6.16</var>care for the ambulance service and are:<br/>
<a id="pl.6.17"></a><var>6.17</var>(1) EMTs, EMT-Is, or EMT-Ps;<br/>
<a id="pl.6.18"></a><var>6.18</var>(2) Minnesota registered nurses who are: (i) EMTs, are currently practicing <br/>
<a id="pl.6.19"></a><var>6.19</var>nursing, and have passed a paramedic practical skills test, as approved by the board <br/>
<a id="pl.6.20"></a><var>6.20</var>and administered by a training program approved by the board; (ii) on the roster of an <br/>
<a id="pl.6.21"></a><var>6.21</var>ambulance service on or before January 1, 2000; or (iii) after petitioning the board, <br/>
<a id="pl.6.22"></a><var>6.22</var>deemed by the board to have training and skills equivalent to an EMT, as determined on <br/>
<a id="pl.6.23"></a><var>6.23</var>a case-by-case basis; or<br/>
<a id="pl.6.24"></a><var>6.24</var>(3) Minnesota registered licensed physician assistants who are: (i) EMTs, are <br/>
<a id="pl.6.25"></a><var>6.25</var>currently practicing as physician assistants, and have passed a paramedic practical skills <br/>
<a id="pl.6.26"></a><var>6.26</var>test, as approved by the board and administered by a training program approved by the <br/>
<a id="pl.6.27"></a><var>6.27</var>board; (ii) on the roster of an ambulance service on or before January 1, 2000; or (iii) after <br/>
<a id="pl.6.28"></a><var>6.28</var>petitioning the board, deemed by the board to have training and skills equivalent to an <br/>
<a id="pl.6.29"></a><var>6.29</var>EMT, as determined on a case-by-case basis.<br/>
<br/>
<a id="bill.0.10.0"></a><a id="pl.6.30"></a><var>6.30</var>    Sec. 10. Minnesota Statutes 2008, section 144E.001, subdivision 9c, is amended to <br/>
<a id="pl.6.31"></a><var>6.31</var>read:<br/>
<a id="pl.6.32"></a><var>6.32</var>    Subd. 9c. <b>Physician assistant.</b> "Physician assistant" means a person registered <br/>
<a id="pl.6.33"></a><var>6.33</var>licensed to practice as a physician assistant under chapter 147A.<br/>
<br/>
<a id="bill.0.11.0"></a><a id="pl.6.34"></a><var>6.34</var>    Sec. 11. Minnesota Statutes 2008, section 145.56, subdivision 1, is amended to read:<br/>
<a id="pl.7.1"></a><var>7.1</var>    Subdivision 1. <b>Suicide prevention plan.</b> The commissioner of health shall refine, <br/>
<a id="pl.7.2"></a><var>7.2</var>coordinate, and implement the state's suicide prevention plan using an evidence-based, <br/>
<a id="pl.7.3"></a><var>7.3</var>public health approach for a life span plan focused on awareness and prevention, in <br/>
<a id="pl.7.4"></a><var>7.4</var>collaboration with the commissioner of human services; the commissioner of public <br/>
<a id="pl.7.5"></a><var>7.5</var>safety; the commissioner of education; the chancellor of Minnesota State Colleges and <br/>
<a id="pl.7.6"></a><var>7.6</var>Universities; the president of the University of Minnesota; and appropriate agencies, <br/>
<a id="pl.7.7"></a><var>7.7</var>organizations, and institutions in the community.<br/>
<br/>
<a id="bill.0.12.0"></a><a id="pl.7.8"></a><var>7.8</var>    Sec. 12. Minnesota Statutes 2008, section 145.56, subdivision 2, is amended to read:<br/>
<a id="pl.7.9"></a><var>7.9</var>    Subd. 2. <b>Community-based programs.</b> To the extent funds are appropriated for the <br/>
<a id="pl.7.10"></a><var>7.10</var>purposes of this subdivision, the commissioner shall establish a grant program to fund:<br/>
<a id="pl.7.11"></a><var>7.11</var>(1) community-based programs to provide education, outreach, and advocacy <br/>
<a id="pl.7.12"></a><var>7.12</var>services to populations who may be at risk for suicide;<br/>
<a id="pl.7.13"></a><var>7.13</var>(2) community-based programs that educate community helpers and gatekeepers, <br/>
<a id="pl.7.14"></a><var>7.14</var>such as family members, spiritual leaders, coaches, and business owners, employers, and <br/>
<a id="pl.7.15"></a><var>7.15</var>coworkers on how to prevent suicide by encouraging help-seeking behaviors;<br/>
<a id="pl.7.16"></a><var>7.16</var>(3) community-based programs that educate populations at risk for suicide and <br/>
<a id="pl.7.17"></a><var>7.17</var>community helpers and gatekeepers that must include information on the symptoms <br/>
<a id="pl.7.18"></a><var>7.18</var>of depression and other psychiatric illnesses, the warning signs of suicide, skills for <br/>
<a id="pl.7.19"></a><var>7.19</var>preventing suicides, and making or seeking effective referrals to intervention and <br/>
<a id="pl.7.20"></a><var>7.20</var>community resources; and<br/>
<a id="pl.7.21"></a><var>7.21</var>(4) community-based programs to provide evidence-based suicide prevention and <br/>
<a id="pl.7.22"></a><var>7.22</var>intervention education to school staff, parents, and students in grades kindergarten through <br/>
<a id="pl.7.23"></a><var>7.23</var>12, and for students attending Minnesota colleges and universities.<br/>
<br/>
<a id="bill.0.13.0"></a><a id="pl.7.24"></a><var>7.24</var>    Sec. 13. Minnesota Statutes 2008, section 147.09, is amended to read:<br/>
<a id="pl.7.25"></a><var>7.25</var><b>147.09 EXEMPTIONS.</b><br/>
<a id="pl.7.26"></a><var>7.26</var>Section 147.081 does not apply to, control, prevent or restrict the practice, service, <br/>
<a id="pl.7.27"></a><var>7.27</var>or activities of:<br/>
<a id="pl.7.28"></a><var>7.28</var>(1) A person who is a commissioned medical officer of, a member of, or employed <br/>
<a id="pl.7.29"></a><var>7.29</var>by, the armed forces of the United States, the United States Public Health Service, the <br/>
<a id="pl.7.30"></a><var>7.30</var>Veterans Administration, any federal institution or any federal agency while engaged in <br/>
<a id="pl.7.31"></a><var>7.31</var>the performance of official duties within this state, if the person is licensed elsewhere.<br/>
<a id="pl.7.32"></a><var>7.32</var>(2) A licensed physician from a state or country who is in actual consultation here.<br/>
<a id="pl.7.33"></a><var>7.33</var>(3) A licensed or registered physician who treats the physician's home state patients <br/>
<a id="pl.7.34"></a><var>7.34</var>or other participating patients while the physicians and those patients are participating <br/>
<a id="pl.7.35"></a><var>7.35</var>together in outdoor recreation in this state as defined by section 
         <statute_ref>86A.03, subdivision 3</statute_ref>. <br/>
<a id="pl.8.1"></a><var>8.1</var>A physician shall first register with the board on a form developed by the board for that <br/>
<a id="pl.8.2"></a><var>8.2</var>purpose. The board shall not be required to promulgate the contents of that form by rule. <br/>
<a id="pl.8.3"></a><var>8.3</var>No fee shall be charged for this registration.<br/>
<a id="pl.8.4"></a><var>8.4</var>(4) A student practicing under the direct supervision of a preceptor while the student <br/>
<a id="pl.8.5"></a><var>8.5</var>is enrolled in and regularly attending a recognized medical school.<br/>
<a id="pl.8.6"></a><var>8.6</var>(5) A student who is in continuing training and performing the duties of an intern or <br/>
<a id="pl.8.7"></a><var>8.7</var>resident or engaged in postgraduate work considered by the board to be the equivalent of <br/>
<a id="pl.8.8"></a><var>8.8</var>an internship or residency in any hospital or institution approved for training by the board, <br/>
<a id="pl.8.9"></a><var>8.9</var>provided the student has a residency permit issued by the board under section 
         <statute_ref>147.0391</statute_ref>.<br/>
<a id="pl.8.10"></a><var>8.10</var>(6) A person employed in a scientific, sanitary, or teaching capacity by the state <br/>
<a id="pl.8.11"></a><var>8.11</var>university, the Department of Education, a public or private school, college, or other <br/>
<a id="pl.8.12"></a><var>8.12</var>bona fide educational institution, a nonprofit organization, which has tax-exempt status <br/>
<a id="pl.8.13"></a><var>8.13</var>in accordance with the Internal Revenue Code, section 501(c)(3), and is organized and <br/>
<a id="pl.8.14"></a><var>8.14</var>operated primarily for the purpose of conducting scientific research directed towards <br/>
<a id="pl.8.15"></a><var>8.15</var>discovering the causes of and cures for human diseases, or the state Department of Health, <br/>
<a id="pl.8.16"></a><var>8.16</var>whose duties are entirely of a research, public health, or educational character, while <br/>
<a id="pl.8.17"></a><var>8.17</var>engaged in such duties; provided that if the research includes the study of humans, such <br/>
<a id="pl.8.18"></a><var>8.18</var>research shall be conducted under the supervision of one or more physicians licensed <br/>
<a id="pl.8.19"></a><var>8.19</var>under this chapter.<br/>
<a id="pl.8.20"></a><var>8.20</var>(7) Physician's Physician  assistants registered licensed in this state.<br/>
<a id="pl.8.21"></a><var>8.21</var>(8) A doctor of osteopathy duly licensed by the state Board of Osteopathy under <br/>
<a id="pl.8.22"></a><var>8.22</var>Minnesota Statutes 1961, sections 
         <statute_ref>148.11</statute_ref> to 
         <statute_ref>148.16</statute_ref>, prior to May 1, 1963, who has not <br/>
<a id="pl.8.23"></a><var>8.23</var>been granted a license to practice medicine in accordance with this chapter provided that <br/>
<a id="pl.8.24"></a><var>8.24</var>the doctor confines activities within the scope of the license.<br/>
<a id="pl.8.25"></a><var>8.25</var>(9) Any person licensed by a health-related licensing board, as defined in section <br/>
<statute_ref><a id="pl.8.26"></a><var>8.26</var>214.01, subdivision 2
         </statute_ref>, or registered by the commissioner of health pursuant to section <br/>
<statute_ref><a id="pl.8.27"></a><var>8.27</var>214.13
         </statute_ref>, including psychological practitioners with respect to the use of hypnosis; provided <br/>
<a id="pl.8.28"></a><var>8.28</var>that the person confines activities within the scope of the license.<br/>
<a id="pl.8.29"></a><var>8.29</var>(10) A person who practices ritual circumcision pursuant to the requirements or <br/>
<a id="pl.8.30"></a><var>8.30</var>tenets of any established religion.<br/>
<a id="pl.8.31"></a><var>8.31</var>(11) A Christian Scientist or other person who endeavors to prevent or cure disease <br/>
<a id="pl.8.32"></a><var>8.32</var>or suffering exclusively by mental or spiritual means or by prayer.<br/>
<a id="pl.8.33"></a><var>8.33</var>(12) A physician licensed to practice medicine in another state who is in this state <br/>
<a id="pl.8.34"></a><var>8.34</var>for the sole purpose of providing medical services at a competitive athletic event. The <br/>
<a id="pl.8.35"></a><var>8.35</var>physician may practice medicine only on participants in the athletic event. A physician <br/>
<a id="pl.8.36"></a><var>8.36</var>shall first register with the board on a form developed by the board for that purpose. The <br/>
<a id="pl.9.1"></a><var>9.1</var>board shall not be required to adopt the contents of the form by rule. The physician shall <br/>
<a id="pl.9.2"></a><var>9.2</var>provide evidence satisfactory to the board of a current unrestricted license in another state. <br/>
<a id="pl.9.3"></a><var>9.3</var>The board shall charge a fee of $50 for the registration.<br/>
<a id="pl.9.4"></a><var>9.4</var>(13) A psychologist licensed under section 
         <statute_ref>148.907</statute_ref> or a social worker licensed <br/>
<a id="pl.9.5"></a><var>9.5</var>under chapter 148D who uses or supervises the use of a penile or vaginal plethysmograph <br/>
<a id="pl.9.6"></a><var>9.6</var>in assessing and treating individuals suspected of engaging in aberrant sexual behavior <br/>
<a id="pl.9.7"></a><var>9.7</var>and sex offenders.<br/>
<a id="pl.9.8"></a><var>9.8</var>(14) Any person issued a training course certificate or credentialed by the Emergency <br/>
<a id="pl.9.9"></a><var>9.9</var>Medical Services Regulatory Board established in chapter 144E, provided the person <br/>
<a id="pl.9.10"></a><var>9.10</var>confines activities within the scope of training at the certified or credentialed level.<br/>
<a id="pl.9.11"></a><var>9.11</var>(15) An unlicensed complementary and alternative health care practitioner practicing <br/>
<a id="pl.9.12"></a><var>9.12</var>according to chapter 146A.<br/>
<br/>
<a id="bill.0.14.0"></a><a id="pl.9.13"></a><var>9.13</var>    Sec. 14. Minnesota Statutes 2008, section 147A.01, is amended to read:<br/>
<a id="pl.9.14"></a><var>9.14</var><b>147A.01 DEFINITIONS.</b><br/>
<a id="pl.9.15"></a><var>9.15</var>    Subdivision 1. <b>Scope.</b> For the purpose of this chapter the terms defined in this <br/>
<a id="pl.9.16"></a><var>9.16</var>section have the meanings given them.<br/>
<a id="pl.9.17"></a><var>9.17</var>    Subd. 2. <b>Active status.</b> "Active status" means the status of a person who has met all <br/>
<a id="pl.9.18"></a><var>9.18</var>the qualifications of a physician assistant, has a physician-physician assistant agreement in <br/>
<a id="pl.9.19"></a><var>9.19</var>force, and is registered.<br/>
<a id="pl.9.20"></a><var>9.20</var>    Subd. 3. <b>Administer.</b> "Administer" means the delivery by a physician assistant <br/>
<a id="pl.9.21"></a><var>9.21</var>authorized to prescribe legend drugs, a single dose of a legend drug, including controlled <br/>
<a id="pl.9.22"></a><var>9.22</var>substances, to a patient by injection, inhalation, ingestion, or by any other immediate <br/>
<a id="pl.9.23"></a><var>9.23</var>means, and the delivery by a physician assistant ordered by a physician a single dose of a <br/>
<a id="pl.9.24"></a><var>9.24</var>legend drug by injection, inhalation, ingestion, or by any other immediate means.<br/>
<a id="pl.9.25"></a><var>9.25</var>    Subd. 4. <b>Agreement.</b> "Agreement" means the document described in section <br/>
<statute_ref><a id="pl.9.26"></a><var>9.26</var>147A.20
         </statute_ref>.  <br/>
<a id="pl.9.27"></a><var>9.27</var>    Subd. 5. <b>Alternate supervising physician.</b> "Alternate supervising physician" <br/>
<a id="pl.9.28"></a><var>9.28</var>means a Minnesota licensed physician listed in the physician-physician assistant <br/>
<a id="pl.9.29"></a><var>9.29</var>delegation agreement, or supplemental listing, who is responsible for supervising <br/>
<a id="pl.9.30"></a><var>9.30</var>the physician assistant when the main primary supervising physician is unavailable. <br/>
<a id="pl.9.31"></a><var>9.31</var>The alternate supervising physician shall accept full medical responsibility for the <br/>
<a id="pl.9.32"></a><var>9.32</var>performance, practice, and activities of the physician assistant while under the supervision <br/>
<a id="pl.9.33"></a><var>9.33</var>of the alternate supervising physician.<br/>
<a id="pl.9.34"></a><var>9.34</var>    Subd. 6. <b>Board.</b> "Board" means the Board of Medical Practice or its designee.<br/>
<a id="pl.10.1"></a><var>10.1</var>    Subd. 7. <b>Controlled substances.</b> "Controlled substances" has the meaning given it <br/>
<a id="pl.10.2"></a><var>10.2</var>in section 
         <statute_ref>152.01, subdivision 4</statute_ref>.  <br/>
<a id="pl.10.3"></a><var>10.3</var>    Subd. 8. <b>Delegation form.</b> "Delegation form" means the form used to indicate the <br/>
<a id="pl.10.4"></a><var>10.4</var>categories of drugs for which the authority to prescribe, administer, and dispense has been <br/>
<a id="pl.10.5"></a><var>10.5</var>delegated to the physician assistant and signed by the supervising physician, any alternate <br/>
<a id="pl.10.6"></a><var>10.6</var>supervising physicians, and the physician assistant. This form is part of the agreement <br/>
<a id="pl.10.7"></a><var>10.7</var>described in section 
<statute_ref>147A.20</statute_ref>, and shall be maintained by the supervising physician and <br/>
<a id="pl.10.8"></a><var>10.8</var>physician assistant at the address of record. Copies shall be provided to the board upon <br/>
<a id="pl.10.9"></a><var>10.9</var>request. "Addendum to the delegation form" means a separate listing of the schedules <br/>
<a id="pl.10.10"></a><var>10.10</var>and categories of controlled substances, if any, for which the physician assistant has been <br/>
<a id="pl.10.11"></a><var>10.11</var>delegated the authority to prescribe, administer, and dispense. The addendum shall be <br/>
<a id="pl.10.12"></a><var>10.12</var>maintained as a separate document as described above.  <br/>
<a id="pl.10.13"></a><var>10.13</var>    Subd. 9. <b>Diagnostic order.</b> "Diagnostic order" means a directive to perform <br/>
<a id="pl.10.14"></a><var>10.14</var>a procedure or test, the purpose of which is to determine the cause and nature of a <br/>
<a id="pl.10.15"></a><var>10.15</var>pathological condition or disease.<br/>
<a id="pl.10.16"></a><var>10.16</var>    Subd. 10. <b>Drug.</b> "Drug" has the meaning given it in section 
         <statute_ref>151.01, subdivision 5</statute_ref>, <br/>
<a id="pl.10.17"></a><var>10.17</var>including controlled substances as defined in section 
         <statute_ref>152.01, subdivision 4</statute_ref>.  <br/>
<a id="pl.10.18"></a><var>10.18</var>    Subd. 11. <b>Drug category.</b> "Drug category" means one of the categories listed on the <br/>
<a id="pl.10.19"></a><var>10.19</var>physician-physician assistant delegation form agreement.<br/>
<a id="pl.10.20"></a><var>10.20</var>    Subd. 12. <b>Inactive </b><b>status</b><b>.</b> "Inactive status" means the status of a person who has <br/>
<a id="pl.10.21"></a><var>10.21</var>met all the qualifications of a physician assistant, and is registered, but does not have a <br/>
<a id="pl.10.22"></a><var>10.22</var>physician-physician assistant agreement in force a licensed physician assistant whose <br/>
<a id="pl.10.23"></a><var>10.23</var>license has been placed on inactive status under section 147A.05.<br/>
<a id="pl.10.24"></a><var>10.24</var>    Subd. 13. <b>Internal protocol.</b> "Internal protocol" means a document written by <br/>
<a id="pl.10.25"></a><var>10.25</var>the supervising physician and the physician assistant which specifies the policies and <br/>
<a id="pl.10.26"></a><var>10.26</var>procedures which will apply to the physician assistant's prescribing, administering, <br/>
<a id="pl.10.27"></a><var>10.27</var>and dispensing of legend drugs and medical devices, including controlled substances <br/>
<a id="pl.10.28"></a><var>10.28</var>as defined in section 
<statute_ref>152.01, subdivision 4</statute_ref>, and lists the specific categories of drugs <br/>
<a id="pl.10.29"></a><var>10.29</var>and medical devices, with any exceptions or conditions, that the physician assistant <br/>
<a id="pl.10.30"></a><var>10.30</var>is authorized to prescribe, administer, and dispense. The supervising physician and <br/>
<a id="pl.10.31"></a><var>10.31</var>physician assistant shall maintain the protocol at the address of record. Copies shall be <br/>
<a id="pl.10.32"></a><var>10.32</var>provided to the board upon request.  <br/>
<a id="pl.10.33"></a><var>10.33</var>    Subd. 14. <b>Legend drug.</b> "Legend drug" has the meaning given it in section 
         <statute_ref>151.01, <br/>
<a id="pl.10.34"></a><var>10.34</var>subdivision 17
         </statute_ref>.  <br/>
<a id="pl.11.1"></a><var>11.1</var>    Subd. 14a. <b>Licensed.</b> "Licensed" means meeting the qualifications in section <br/>
<a id="pl.11.2"></a><var>11.2</var>147A.02 and being issued a license by the board.<br/>
<a id="pl.11.3"></a><var>11.3</var>    Subd. 14b. <b>Licensure.</b> "Licensure" means the process by which the board <br/>
<a id="pl.11.4"></a><var>11.4</var>determines that an applicant has met the standards and qualifications in this chapter.<br/>
<a id="pl.11.5"></a><var>11.5</var>    Subd. 15. <b>Locum tenens permit.</b> "Locum tenens permit" means time specific <br/>
<a id="pl.11.6"></a><var>11.6</var>temporary permission for a physician assistant to practice as a physician assistant in <br/>
<a id="pl.11.7"></a><var>11.7</var>a setting other than the practice setting established in the physician-physician assistant <br/>
<a id="pl.11.8"></a><var>11.8</var>agreement.<br/>
<a id="pl.11.9"></a><var>11.9</var>    Subd. 16. <b>Medical device.</b> "Medical device" means durable medical equipment and <br/>
<a id="pl.11.10"></a><var>11.10</var>assistive or rehabilitative appliances, objects, or products that are required to implement <br/>
<a id="pl.11.11"></a><var>11.11</var>the overall plan of care for the patient and that are restricted by federal law to use upon <br/>
<a id="pl.11.12"></a><var>11.12</var>prescription by a licensed practitioner.<br/>
<a id="pl.11.13"></a><var>11.13</var>    Subd. 16a. <b>Notice of intent to practice.</b> "Notice of intent to practice" means <br/>
<a id="pl.11.14"></a><var>11.14</var>a document sent to the board by a licensed physician assistant that documents the <br/>
<a id="pl.11.15"></a><var>11.15</var>adoption of a physician-physician assistant delegation agreement and provides the names, <br/>
<a id="pl.11.16"></a><var>11.16</var>addresses, and information required by section 147A.20.<br/>
<a id="pl.11.17"></a><var>11.17</var>    Subd. 17. <b>Physician.</b> "Physician" means a person currently licensed in good <br/>
<a id="pl.11.18"></a><var>11.18</var>standing as a physician or osteopath under chapter 147.<br/>
<a id="pl.11.19"></a><var>11.19</var>    Subd. 17a. <b>Physician-physician assistant delegation agreement.</b><br/>
<a id="pl.11.20"></a><var>11.20</var>"Physician-physician assistant delegation agreement" means the document prepared and <br/>
<a id="pl.11.21"></a><var>11.21</var>signed by the physician and physician assistant affirming the supervisory relationship and <br/>
<a id="pl.11.22"></a><var>11.22</var>defining the physician assistant scope of practice. Alternate supervising physicians must be <br/>
<a id="pl.11.23"></a><var>11.23</var>identified on the delegation agreement or a supplemental listing with signed attestation that <br/>
<a id="pl.11.24"></a><var>11.24</var>each shall accept full medical responsibility for the performance, practice, and activities of <br/>
<a id="pl.11.25"></a><var>11.25</var>the physician assistant while under the supervision of the alternate supervising physician. <br/>
<a id="pl.11.26"></a><var>11.26</var>The physician-physician assistant delegation agreement outlines the role of the physician <br/>
<a id="pl.11.27"></a><var>11.27</var>assistant in the practice, describes the means of supervision, and specifies the categories of <br/>
<a id="pl.11.28"></a><var>11.28</var>drugs, controlled substances, and medical devices that the supervising physician delegates <br/>
<a id="pl.11.29"></a><var>11.29</var>to the physician assistant to prescribe. The physician-physician assistant delegation <br/>
<a id="pl.11.30"></a><var>11.30</var>agreement must comply with the requirements of section 147A.20, be kept on file at the <br/>
<a id="pl.11.31"></a><var>11.31</var>address of record, and be made available to the board or its representative upon request.<br/>
<a id="pl.11.32"></a><var>11.32</var>    Subd. 18. <b>Physician assistant or </b><b>registered</b><b> licensed</b><b> physician assistant.</b><br/>
<a id="pl.11.33"></a><var>11.33</var>"Physician assistant" or "registered licensed physician assistant" means a person registered <br/>
<a id="pl.11.34"></a><var>11.34</var>licensed pursuant to this chapter who is qualified by academic or practical training or <br/>
<a id="pl.12.1"></a><var>12.1</var>both to provide patient services as specified in this chapter, under the supervision of a <br/>
<a id="pl.12.2"></a><var>12.2</var>supervising physician meets the qualifications in section 147A.02.<br/>
<a id="pl.12.3"></a><var>12.3</var>    Subd. 19. <b>Practice setting description.</b> "Practice setting description" means a <br/>
<a id="pl.12.4"></a><var>12.4</var>signed record submitted to the board on forms provided by the board, on which:<br/>
<a id="pl.12.5"></a><var>12.5</var>(1) the supervising physician assumes full medical responsibility for the medical <br/>
<a id="pl.12.6"></a><var>12.6</var>care rendered by a physician assistant;<br/>
<a id="pl.12.7"></a><var>12.7</var>(2) is recorded the address and phone number of record of each supervising <br/>
<a id="pl.12.8"></a><var>12.8</var>physician and alternate, and the physicians' medical license numbers and DEA number;<br/>
<a id="pl.12.9"></a><var>12.9</var>(3) is recorded the address and phone number of record of the physician assistant <br/>
<a id="pl.12.10"></a><var>12.10</var>and the physician assistant's registration number and DEA number;<br/>
<a id="pl.12.11"></a><var>12.11</var>(4) is recorded whether the physician assistant has been delegated prescribing, <br/>
<a id="pl.12.12"></a><var>12.12</var>administering, and dispensing authority;<br/>
<a id="pl.12.13"></a><var>12.13</var>(5) is recorded the practice setting, address or addresses and phone number or <br/>
<a id="pl.12.14"></a><var>12.14</var>numbers of the physician assistant; and<br/>
<a id="pl.12.15"></a><var>12.15</var>(6) is recorded a statement of the type, amount, and frequency of supervision.<br/>
<a id="pl.12.16"></a><var>12.16</var>    Subd. 20. <b>Prescribe.</b> "Prescribe" means to direct, order, or designate by means of a <br/>
<a id="pl.12.17"></a><var>12.17</var>prescription the preparation, use of, or manner of using a drug or medical device.<br/>
<a id="pl.12.18"></a><var>12.18</var>    Subd. 21. <b>Prescription.</b> "Prescription" means a signed written order, or an oral <br/>
<a id="pl.12.19"></a><var>12.19</var>order reduced to writing, or an electronic order meeting current and prevailing standards <br/>
<a id="pl.12.20"></a><var>12.20</var>given by a physician assistant authorized to prescribe drugs for patients in the course <br/>
<a id="pl.12.21"></a><var>12.21</var>of the physician assistant's practice, issued for an individual patient and containing the <br/>
<a id="pl.12.22"></a><var>12.22</var>information required in the physician-physician assistant delegation form agreement.<br/>
<a id="pl.12.23"></a><var>12.23</var>    Subd. 22. <b>Registration.</b> "Registration" is the process by which the board determines <br/>
<a id="pl.12.24"></a><var>12.24</var>that an applicant has been found to meet the standards and qualifications found in this <br/>
<a id="pl.12.25"></a><var>12.25</var>chapter.<br/>
<a id="pl.12.26"></a><var>12.26</var>    Subd. 23. <b>Supervising physician.</b> "Supervising physician" means a Minnesota <br/>
<a id="pl.12.27"></a><var>12.27</var>licensed physician who accepts full medical responsibility for the performance, practice, <br/>
<a id="pl.12.28"></a><var>12.28</var>and activities of a physician assistant under an agreement as described in section 
         <statute_ref>147A.20</statute_ref>. <br/>
<a id="pl.12.29"></a><var>12.29</var>The supervising physician who completes and signs the delegation agreement may be <br/>
<a id="pl.12.30"></a><var>12.30</var>referred to as the primary supervising physician. A supervising physician shall not <br/>
<a id="pl.12.31"></a><var>12.31</var>supervise more than two five full-time equivalent physician assistants simultaneously.  <br/>
<a id="pl.12.32"></a><var>12.32</var>With the approval of the board, or in a disaster or emergency situation pursuant to section <br/>
<a id="pl.12.33"></a><var>12.33</var>147A.23, a supervising physician may supervise more than five full-time equivalent <br/>
<a id="pl.12.34"></a><var>12.34</var>physician assistants simultaneously.<br/>
<a id="pl.13.1"></a><var>13.1</var>    Subd. 24. <b>Supervision.</b> "Supervision" means overseeing the activities of, and <br/>
<a id="pl.13.2"></a><var>13.2</var>accepting responsibility for, the medical services rendered by a physician assistant. The <br/>
<a id="pl.13.3"></a><var>13.3</var>constant physical presence of the supervising physician is not required so long as the <br/>
<a id="pl.13.4"></a><var>13.4</var>supervising physician and physician assistant are or can be easily in contact with one <br/>
<a id="pl.13.5"></a><var>13.5</var>another by radio, telephone, or other telecommunication device. The scope and nature of <br/>
<a id="pl.13.6"></a><var>13.6</var>the supervision shall be defined by the individual physician-physician assistant delegation <br/>
<a id="pl.13.7"></a><var>13.7</var>agreement.<br/>
<a id="pl.13.8"></a><var>13.8</var>    Subd. 25. <b>Temporary </b><b>registration</b><b> license</b><b>.</b> "Temporary registration" means the <br/>
<a id="pl.13.9"></a><var>13.9</var>status of a person who has satisfied the education requirement specified in this chapter; <br/>
<a id="pl.13.10"></a><var>13.10</var>is enrolled in the next examination required in this chapter; or is awaiting examination <br/>
<a id="pl.13.11"></a><var>13.11</var>results; has a physician-physician assistant agreement in force as required by this chapter, <br/>
<a id="pl.13.12"></a><var>13.12</var>and has submitted a practice setting description to the board. Such provisional registration <br/>
<a id="pl.13.13"></a><var>13.13</var>shall expire 90 days after completion of the next examination sequence, or after one year, <br/>
<a id="pl.13.14"></a><var>13.14</var>whichever is sooner, for those enrolled in the next examination; and upon receipt of the <br/>
<a id="pl.13.15"></a><var>13.15</var>examination results for those awaiting examination results. The registration shall be <br/>
<a id="pl.13.16"></a><var>13.16</var>granted by the board or its designee. "Temporary license" means a license granted to a <br/>
<a id="pl.13.17"></a><var>13.17</var>physician assistant who meets all of the qualifications for licensure but has not yet been <br/>
<a id="pl.13.18"></a><var>13.18</var>approved for licensure at a meeting of the board.<br/>
<a id="pl.13.19"></a><var>13.19</var>    Subd. 26. <b>Therapeutic order.</b> "Therapeutic order" means an order given to another <br/>
<a id="pl.13.20"></a><var>13.20</var>for the purpose of treating or curing a patient in the course of a physician assistant's <br/>
<a id="pl.13.21"></a><var>13.21</var>practice. Therapeutic orders may be written or verbal, but do not include the prescribing <br/>
<a id="pl.13.22"></a><var>13.22</var>of legend drugs or medical devices unless prescribing authority has been delegated within <br/>
<a id="pl.13.23"></a><var>13.23</var>the physician-physician assistant delegation agreement.<br/>
<a id="pl.13.24"></a><var>13.24</var>    Subd. 27. <b>Verbal order.</b> "Verbal order" means an oral order given to another for <br/>
<a id="pl.13.25"></a><var>13.25</var>the purpose of treating or curing a patient in the course of a physician assistant's practice. <br/>
<a id="pl.13.26"></a><var>13.26</var>Verbal orders do not include the prescribing of legend drugs unless prescribing authority <br/>
<a id="pl.13.27"></a><var>13.27</var>has been delegated within the physician-physician assistant delegation agreement.<br/>
<br/>
<a id="bill.0.15.0"></a><a id="pl.13.28"></a><var>13.28</var>    Sec. 15. Minnesota Statutes 2008, section 147A.02, is amended to read:<br/>
<a id="pl.13.29"></a><var>13.29</var><b>147A.02 QUALIFICATIONS FOR </b><b>REGISTRATION</b><b> LICENSURE</b><b>.</b><br/>
<a id="pl.13.30"></a><var>13.30</var>Except as otherwise provided in this chapter, an individual shall be registered <br/>
<a id="pl.13.31"></a><var>13.31</var>licensed by the board before the individual may practice as a physician assistant.<br/>
<a id="pl.13.32"></a><var>13.32</var>The board may grant registration a license as a physician assistant to an applicant <br/>
<a id="pl.13.33"></a><var>13.33</var>who:<br/>
<a id="pl.13.34"></a><var>13.34</var>(1) submits an application on forms approved by the board;<br/>
<a id="pl.13.35"></a><var>13.35</var>(2) pays the appropriate fee as determined by the board;<br/>
<a id="pl.14.1"></a><var>14.1</var>(3) has current certification from the National Commission on Certification of <br/>
<a id="pl.14.2"></a><var>14.2</var>Physician Assistants, or its successor agency as approved by the board;<br/>
<a id="pl.14.3"></a><var>14.3</var>(4) certifies that the applicant is mentally and physically able to engage safely in <br/>
<a id="pl.14.4"></a><var>14.4</var>practice as a physician assistant;<br/>
<a id="pl.14.5"></a><var>14.5</var>(5) has no licensure, certification, or registration as a physician assistant under <br/>
<a id="pl.14.6"></a><var>14.6</var>current discipline, revocation, suspension, or probation for cause resulting from the <br/>
<a id="pl.14.7"></a><var>14.7</var>applicant's practice as a physician assistant, unless the board considers the condition <br/>
<a id="pl.14.8"></a><var>14.8</var>and agrees to licensure;<br/>
<a id="pl.14.9"></a><var>14.9</var>(6) submits any other information the board deems necessary to evaluate the <br/>
<a id="pl.14.10"></a><var>14.10</var>applicant's qualifications; and<br/>
<a id="pl.14.11"></a><var>14.11</var>(7) has been approved by the board.<br/>
<a id="pl.14.12"></a><var>14.12</var>All persons registered as physician assistants as of June 30, 1995, are eligible for <br/>
<a id="pl.14.13"></a><var>14.13</var>continuing registration license  renewal. All persons applying for registration licensure <br/>
<a id="pl.14.14"></a><var>14.14</var>after that date shall be registered licensed according to this chapter.<br/>
<br/>
<a id="bill.0.16.0"></a><a id="pl.14.15"></a><var>14.15</var>    Sec. 16. Minnesota Statutes 2008, section 147A.03, is amended to read:<br/>
<a id="pl.14.16"></a><var>14.16</var><b>147A.03 PROTECTED TITLES AND RESTRICTIONS ON USE.</b><br/>
<a id="pl.14.17"></a><var>14.17</var>    Subdivision 1. <b>Protected titles.</b> No individual may use the titles "Minnesota <br/>
<a id="pl.14.18"></a><var>14.18</var>Registered Licensed Physician Assistant," "Registered Licensed Physician Assistant," <br/>
<a id="pl.14.19"></a><var>14.19</var>"Physician Assistant," or "PA" in connection with the individual's name, or any other <br/>
<a id="pl.14.20"></a><var>14.20</var>words, letters, abbreviations, or insignia indicating or implying that the individual is <br/>
<a id="pl.14.21"></a><var>14.21</var>registered with licensed by the state unless they have been registered licensed according <br/>
<a id="pl.14.22"></a><var>14.22</var>to this chapter.<br/>
<a id="pl.14.23"></a><var>14.23</var>    Subd. 2. <b>Health care practitioners.</b> Individuals practicing in a health care <br/>
<a id="pl.14.24"></a><var>14.24</var>occupation are not restricted in the provision of services included in this chapter as long as <br/>
<a id="pl.14.25"></a><var>14.25</var>they do not hold themselves out as physician assistants by or through the titles provided in <br/>
<a id="pl.14.26"></a><var>14.26</var>subdivision 1 in association with provision of these services.<br/>
<a id="pl.14.27"></a><var>14.27</var>    Subd. 3. <b>Identification of registered practitioners.</b> Physician assistants in <br/>
<a id="pl.14.28"></a><var>14.28</var>Minnesota shall wear name tags which identify them as physician assistants.<br/>
<a id="pl.14.29"></a><var>14.29</var>    Subd. 4. <b>Sanctions.</b> Individuals who hold themselves out as physician assistants by <br/>
<a id="pl.14.30"></a><var>14.30</var>or through any of the titles provided in subdivision 1 without prior registration licensure <br/>
<a id="pl.14.31"></a><var>14.31</var>shall be subject to sanctions or actions against continuing the activity according to section <br/>
<statute_ref><a id="pl.14.32"></a><var>14.32</var>214.11
         </statute_ref>, or other authority.  <br/>
<br/>
<a id="bill.0.17.0"></a><a id="pl.14.33"></a><var>14.33</var>    Sec. 17. Minnesota Statutes 2008, section 147A.04, is amended to read:<br/>
<a id="pl.14.34"></a><var>14.34</var><b>147A.04 TEMPORARY </b><b>PERMIT</b><b> LICENSE</b><b>.</b><br/>
<a id="pl.15.1"></a><var>15.1</var>The board may issue a temporary permit license to practice to a physician assistant <br/>
<a id="pl.15.2"></a><var>15.2</var>eligible for registration licensure under this chapter only if the application for registration <br/>
<a id="pl.15.3"></a><var>15.3</var>licensure is complete, all requirements have been met, and a nonrefundable fee set by <br/>
<a id="pl.15.4"></a><var>15.4</var>the board has been paid. The permit temporary license remains valid only until the <br/>
<a id="pl.15.5"></a><var>15.5</var>next meeting of the board at which a decision is made on the application for registration <br/>
<a id="pl.15.6"></a><var>15.6</var>licensure.<br/>
<br/>
<a id="bill.0.18.0"></a><a id="pl.15.7"></a><var>15.7</var>    Sec. 18. Minnesota Statutes 2008, section 147A.05, is amended to read:<br/>
<a id="pl.15.8"></a><var>15.8</var><b>147A.05 INACTIVE </b><b>REGISTRATION</b><b> LICENSE</b><b>.</b><br/>
<a id="pl.15.9"></a><var>15.9</var>Physician assistants who notify the board in writing on forms prescribed by the board <br/>
<a id="pl.15.10"></a><var>15.10</var>may elect to place their registrations license on an inactive status. Physician assistants <br/>
<a id="pl.15.11"></a><var>15.11</var>with an inactive registration license shall be excused from payment of renewal fees and <br/>
<a id="pl.15.12"></a><var>15.12</var>shall not practice as physician assistants. Persons who engage in practice while their <br/>
<a id="pl.15.13"></a><var>15.13</var>registrations are license is lapsed or on inactive status shall be considered to be practicing <br/>
<a id="pl.15.14"></a><var>15.14</var>without registration a license, which shall be grounds for discipline under section 
         <statute_ref>147A.13</statute_ref>. <br/>
<a id="pl.15.15"></a><var>15.15</var>Physician assistants who provide care under the provisions of section 147A.23 shall not <br/>
<a id="pl.15.16"></a><var>15.16</var>be considered practicing without a license or subject to disciplinary action. Physician <br/>
<a id="pl.15.17"></a><var>15.17</var>assistants requesting restoration from inactive status who notify the board of their intent to <br/>
<a id="pl.15.18"></a><var>15.18</var>resume active practice shall be required to pay the current renewal fees and all unpaid back <br/>
<a id="pl.15.19"></a><var>15.19</var>fees and shall be required to meet the criteria for renewal specified in section 
         <statute_ref>147A.07</statute_ref>.  <br/>
<br/>
<a id="bill.0.19.0"></a><a id="pl.15.20"></a><var>15.20</var>    Sec. 19. Minnesota Statutes 2008, section 147A.06, is amended to read:<br/>
<a id="pl.15.21"></a><var>15.21</var><b>147A.06 CANCELLATION OF </b><b>REGISTRATION</b><b> LICENSE</b><b> FOR </b><br/>
<a id="pl.15.22"></a><var>15.22</var><b>NONRENEWAL.</b><br/>
<a id="pl.15.23"></a><var>15.23</var>The board shall not renew, reissue, reinstate, or restore a registration license that <br/>
<a id="pl.15.24"></a><var>15.24</var>has lapsed on or after July 1, 1996, and has not been renewed within two annual renewal <br/>
<a id="pl.15.25"></a><var>15.25</var>cycles starting July 1, 1997. A registrant licensee whose registration license is canceled <br/>
<a id="pl.15.26"></a><var>15.26</var>for nonrenewal must obtain a new registration license by applying for registration <br/>
<a id="pl.15.27"></a><var>15.27</var>licensure and fulfilling all requirements then in existence for an initial registration license <br/>
<a id="pl.15.28"></a><var>15.28</var>to practice as a physician assistant.<br/>
<br/>
<a id="bill.0.20.0"></a><a id="pl.15.29"></a><var>15.29</var>    Sec. 20. Minnesota Statutes 2008, section 147A.07, is amended to read:<br/>
<a id="pl.15.30"></a><var>15.30</var><b>147A.07 RENEWAL.</b><br/>
<a id="pl.15.31"></a><var>15.31</var>A person who holds a registration license as a physician assistant shall annually, <br/>
<a id="pl.15.32"></a><var>15.32</var>upon notification from the board, renew the registration license by:<br/>
<a id="pl.15.33"></a><var>15.33</var>(1) submitting the appropriate fee as determined by the board;<br/>
<a id="pl.15.34"></a><var>15.34</var>(2) completing the appropriate forms; and<br/>
<a id="pl.16.1"></a><var>16.1</var>(3) meeting any other requirements of the board;<br/>
<a id="pl.16.2"></a><var>16.2</var>(4) submitting a revised and updated practice setting description showing evidence <br/>
<a id="pl.16.3"></a><var>16.3</var>of annual review of the physician-physician assistant supervisory agreement.<br/>
<br/>
<a id="bill.0.21.0"></a><a id="pl.16.4"></a><var>16.4</var>    Sec. 21. Minnesota Statutes 2008, section 147A.08, is amended to read:<br/>
<a id="pl.16.5"></a><var>16.5</var><b>147A.08 EXEMPTIONS.</b><br/>
<a id="pl.16.6"></a><var>16.6</var>(a) This chapter does not apply to, control, prevent, or restrict the practice, service, <br/>
<a id="pl.16.7"></a><var>16.7</var>or activities of persons listed in section 
         <statute_ref>147.09</statute_ref>, clauses (1) to (6) and (8) to (13), persons <br/>
<a id="pl.16.8"></a><var>16.8</var>regulated under section 
         <statute_ref>214.01, subdivision 2</statute_ref>, or persons defined in section 
         <statute_ref>144.1501, <br/>
<a id="pl.16.9"></a><var>16.9</var>subdivision 1
         </statute_ref>, paragraphs (f), (h), and (i).<br/>
<a id="pl.16.10"></a><var>16.10</var>(b) Nothing in this chapter shall be construed to require registration licensure of:<br/>
<a id="pl.16.11"></a><var>16.11</var>(1) a physician assistant student enrolled in a physician assistant or surgeon assistant <br/>
<a id="pl.16.12"></a><var>16.12</var>educational program accredited by the Committee on Allied Health Education and <br/>
<a id="pl.16.13"></a><var>16.13</var>Accreditation Review Commission on Education for the Physician Assistant or by its <br/>
<a id="pl.16.14"></a><var>16.14</var>successor agency approved by the board;<br/>
<a id="pl.16.15"></a><var>16.15</var>(2) a physician assistant employed in the service of the federal government while <br/>
<a id="pl.16.16"></a><var>16.16</var>performing duties incident to that employment; or<br/>
<a id="pl.16.17"></a><var>16.17</var>(3) technicians, other assistants, or employees of physicians who perform delegated <br/>
<a id="pl.16.18"></a><var>16.18</var>tasks in the office of a physician but who do not identify themselves as a physician <br/>
<a id="pl.16.19"></a><var>16.19</var>assistant.<br/>
<br/>
<a id="bill.0.22.0"></a><a id="pl.16.20"></a><var>16.20</var>    Sec. 22. Minnesota Statutes 2008, section 147A.09, is amended to read:<br/>
<a id="pl.16.21"></a><var>16.21</var><b>147A.09 SCOPE OF PRACTICE, DELEGATION.</b><br/>
<a id="pl.16.22"></a><var>16.22</var>    Subdivision 1. <b>Scope of practice.</b> Physician assistants shall practice medicine <br/>
<a id="pl.16.23"></a><var>16.23</var>only with physician supervision. Physician assistants may perform those duties and <br/>
<a id="pl.16.24"></a><var>16.24</var>responsibilities as delegated in the physician-physician assistant delegation agreement <br/>
<a id="pl.16.25"></a><var>16.25</var>and delegation forms maintained at the address of record by the supervising physician <br/>
<a id="pl.16.26"></a><var>16.26</var>and physician assistant, including the prescribing, administering, and dispensing of drugs, <br/>
<a id="pl.16.27"></a><var>16.27</var>controlled substances, and medical devices and drugs, excluding anesthetics, other than <br/>
<a id="pl.16.28"></a><var>16.28</var>local anesthetics, injected in connection with an operating room procedure, inhaled <br/>
<a id="pl.16.29"></a><var>16.29</var>anesthesia and spinal anesthesia.<br/>
<a id="pl.16.30"></a><var>16.30</var>Patient service must be limited to:<br/>
<a id="pl.16.31"></a><var>16.31</var>(1) services within the training and experience of the physician assistant;<br/>
<a id="pl.16.32"></a><var>16.32</var>(2) services customary to the practice of the supervising physician or alternate <br/>
<a id="pl.16.33"></a><var>16.33</var>supervising physician;<br/>
<a id="pl.16.34"></a><var>16.34</var>(3) services delegated by the supervising physician or alternate supervising physician <br/>
<a id="pl.16.35"></a><var>16.35</var>under the physician-physician assistant delegation agreement; and<br/>
<a id="pl.17.1"></a><var>17.1</var>(4) services within the parameters of the laws, rules, and standards of the facilities <br/>
<a id="pl.17.2"></a><var>17.2</var>in which the physician assistant practices.<br/>
<a id="pl.17.3"></a><var>17.3</var>Nothing in this chapter authorizes physician assistants to perform duties regulated <br/>
<a id="pl.17.4"></a><var>17.4</var>by the boards listed in section 
         <statute_ref>214.01, subdivision 2</statute_ref>, other than the Board of Medical <br/>
<a id="pl.17.5"></a><var>17.5</var>Practice, and except as provided in this section.  <br/>
<a id="pl.17.6"></a><var>17.6</var>    Subd. 2. <b>Delegation.</b> Patient services may include, but are not limited to, the <br/>
<a id="pl.17.7"></a><var>17.7</var>following, as delegated by the supervising physician and authorized in the delegation <br/>
<a id="pl.17.8"></a><var>17.8</var>agreement:<br/>
<a id="pl.17.9"></a><var>17.9</var>(1) taking patient histories and developing medical status reports;<br/>
<a id="pl.17.10"></a><var>17.10</var>(2) performing physical examinations;<br/>
<a id="pl.17.11"></a><var>17.11</var>(3) interpreting and evaluating patient data;<br/>
<a id="pl.17.12"></a><var>17.12</var>(4) ordering or performing diagnostic procedures, including radiography the use of <br/>
<a id="pl.17.13"></a><var>17.13</var>radiographic imaging systems in compliance with Minnesota Rules 2007, chapter 4732;<br/>
<a id="pl.17.14"></a><var>17.14</var>(5) ordering or performing therapeutic procedures including the use of ionizing <br/>
<a id="pl.17.15"></a><var>17.15</var>radiation in compliance with Minnesota Rules 2007, chapter 4732;<br/>
<a id="pl.17.16"></a><var>17.16</var>(6) providing instructions regarding patient care, disease prevention, and health <br/>
<a id="pl.17.17"></a><var>17.17</var>promotion;<br/>
<a id="pl.17.18"></a><var>17.18</var>(7) assisting the supervising physician in patient care in the home and in health <br/>
<a id="pl.17.19"></a><var>17.19</var>care facilities;<br/>
<a id="pl.17.20"></a><var>17.20</var>(8) creating and maintaining appropriate patient records;<br/>
<a id="pl.17.21"></a><var>17.21</var>(9) transmitting or executing specific orders at the direction of the supervising <br/>
<a id="pl.17.22"></a><var>17.22</var>physician;<br/>
<a id="pl.17.23"></a><var>17.23</var>(10) prescribing, administering, and dispensing legend drugs, controlled substances, <br/>
<a id="pl.17.24"></a><var>17.24</var>and medical devices if this function has been delegated by the supervising physician <br/>
<a id="pl.17.25"></a><var>17.25</var>pursuant to and subject to the limitations of section 
         <statute_ref>147A.18</statute_ref> and chapter 151. For <br/>
<a id="pl.17.26"></a><var>17.26</var>physician assistants who have been delegated the authority to prescribe controlled <br/>
<a id="pl.17.27"></a><var>17.27</var>substances shall maintain a separate addendum to the delegation form which lists all <br/>
<a id="pl.17.28"></a><var>17.28</var>schedules and categories such delegation shall be included in the physician-physician <br/>
<a id="pl.17.29"></a><var>17.29</var>assistant delegation agreement, and all schedules of controlled substances which the <br/>
<a id="pl.17.30"></a><var>17.30</var>physician assistant has the authority to prescribe. This addendum shall be maintained with <br/>
<a id="pl.17.31"></a><var>17.31</var>the physician-physician assistant agreement, and the delegation form at the address of <br/>
<a id="pl.17.32"></a><var>17.32</var>record shall be specified;  <br/>
<a id="pl.17.33"></a><var>17.33</var>(11) for physician assistants not delegated prescribing authority, administering <br/>
<a id="pl.17.34"></a><var>17.34</var>legend drugs and medical devices following prospective review for each patient by and <br/>
<a id="pl.17.35"></a><var>17.35</var>upon direction of the supervising physician;<br/>
<a id="pl.18.1"></a><var>18.1</var>(12) functioning as an emergency medical technician with permission of the <br/>
<a id="pl.18.2"></a><var>18.2</var>ambulance service and in compliance with section 
         <statute_ref>144E.127</statute_ref>, and ambulance service rules <br/>
<a id="pl.18.3"></a><var>18.3</var>adopted by the commissioner of health;  <br/>
<a id="pl.18.4"></a><var>18.4</var>(13) initiating evaluation and treatment procedures essential to providing an <br/>
<a id="pl.18.5"></a><var>18.5</var>appropriate response to emergency situations; and<br/>
<a id="pl.18.6"></a><var>18.6</var>(14) certifying a physical disability patient's eligibility for a disability parking <br/>
<a id="pl.18.7"></a><var>18.7</var>certificate under section 
         <statute_ref>169.345, subdivision 2a 2;<br/>
</statute_ref><a id="pl.18.8"></a><var>18.8</var>(15) assisting at surgery; and<br/>
<a id="pl.18.9"></a><var>18.9</var>(16) providing medical authorization for admission for emergency care and <br/>
<a id="pl.18.10"></a><var>18.10</var>treatment of a patient under section 253B.05, subdivision 2.  <br/>
<a id="pl.18.11"></a><var>18.11</var>Orders of physician assistants shall be considered the orders of their supervising <br/>
<a id="pl.18.12"></a><var>18.12</var>physicians in all practice-related activities, including, but not limited to, the ordering of <br/>
<a id="pl.18.13"></a><var>18.13</var>diagnostic, therapeutic, and other medical services.<br/>
<br/>
<a id="bill.0.23.0"></a><a id="pl.18.14"></a><var>18.14</var>    Sec. 23. Minnesota Statutes 2008, section 147A.11, is amended to read:<br/>
<a id="pl.18.15"></a><var>18.15</var><b>147A.11 EXCLUSIONS OF LIMITATIONS ON EMPLOYMENT.</b><br/>
<a id="pl.18.16"></a><var>18.16</var>Nothing in this chapter shall be construed to limit the employment arrangement of a <br/>
<a id="pl.18.17"></a><var>18.17</var>physician assistant registered licensed under this chapter.<br/>
<br/>
<a id="bill.0.24.0"></a><a id="pl.18.18"></a><var>18.18</var>    Sec. 24. Minnesota Statutes 2008, section 147A.13, is amended to read:<br/>
<a id="pl.18.19"></a><var>18.19</var><b>147A.13 GROUNDS FOR DISCIPLINARY ACTION.</b><br/>
<a id="pl.18.20"></a><var>18.20</var>    Subdivision 1. <b>Grounds listed.</b> The board may refuse to grant registration licensure <br/>
<a id="pl.18.21"></a><var>18.21</var>or may impose disciplinary action as described in this subdivision against any physician <br/>
<a id="pl.18.22"></a><var>18.22</var>assistant. The following conduct is prohibited and is grounds for disciplinary action:<br/>
<a id="pl.18.23"></a><var>18.23</var>(1) failure to demonstrate the qualifications or satisfy the requirements for <br/>
<a id="pl.18.24"></a><var>18.24</var>registration licensure contained in this chapter or rules of the board. The burden of proof <br/>
<a id="pl.18.25"></a><var>18.25</var>shall be upon the applicant to demonstrate such qualifications or satisfaction of such <br/>
<a id="pl.18.26"></a><var>18.26</var>requirements;<br/>
<a id="pl.18.27"></a><var>18.27</var>(2) obtaining registration a license by fraud or cheating, or attempting to subvert <br/>
<a id="pl.18.28"></a><var>18.28</var>the examination process. Conduct which subverts or attempts to subvert the examination <br/>
<a id="pl.18.29"></a><var>18.29</var>process includes, but is not limited to:<br/>
<a id="pl.18.30"></a><var>18.30</var>(i) conduct which violates the security of the examination materials, such as <br/>
<a id="pl.18.31"></a><var>18.31</var>removing examination materials from the examination room or having unauthorized <br/>
<a id="pl.18.32"></a><var>18.32</var>possession of any portion of a future, current, or previously administered licensing <br/>
<a id="pl.18.33"></a><var>18.33</var>examination;<br/>
<a id="pl.18.34"></a><var>18.34</var>(ii) conduct which violates the standard of test administration, such as <br/>
<a id="pl.18.35"></a><var>18.35</var>communicating with another examinee during administration of the examination, copying <br/>
<a id="pl.19.1"></a><var>19.1</var>another examinee's answers, permitting another examinee to copy one's answers, or <br/>
<a id="pl.19.2"></a><var>19.2</var>possessing unauthorized materials; and<br/>
<a id="pl.19.3"></a><var>19.3</var>(iii) impersonating an examinee or permitting an impersonator to take the <br/>
<a id="pl.19.4"></a><var>19.4</var>examination on one's own behalf;<br/>
<a id="pl.19.5"></a><var>19.5</var>(3) conviction, during the previous five years, of a felony reasonably related to the <br/>
<a id="pl.19.6"></a><var>19.6</var>practice of physician assistant. Conviction as used in this subdivision includes a conviction <br/>
<a id="pl.19.7"></a><var>19.7</var>of an offense which if committed in this state would be deemed a felony without regard to <br/>
<a id="pl.19.8"></a><var>19.8</var>its designation elsewhere, or a criminal proceeding where a finding or verdict of guilt is <br/>
<a id="pl.19.9"></a><var>19.9</var>made or returned but the adjudication of guilt is either withheld or not entered;<br/>
<a id="pl.19.10"></a><var>19.10</var>(4) revocation, suspension, restriction, limitation, or other disciplinary action against <br/>
<a id="pl.19.11"></a><var>19.11</var>the person's physician assistant credentials in another state or jurisdiction, failure to <br/>
<a id="pl.19.12"></a><var>19.12</var>report to the board that charges regarding the person's credentials have been brought in <br/>
<a id="pl.19.13"></a><var>19.13</var>another state or jurisdiction, or having been refused registration licensure by any other <br/>
<a id="pl.19.14"></a><var>19.14</var>state or jurisdiction;<br/>
<a id="pl.19.15"></a><var>19.15</var>(5) advertising which is false or misleading, violates any rule of the board, or claims <br/>
<a id="pl.19.16"></a><var>19.16</var>without substantiation the positive cure of any disease or professional superiority to or <br/>
<a id="pl.19.17"></a><var>19.17</var>greater skill than that possessed by another physician assistant;<br/>
<a id="pl.19.18"></a><var>19.18</var>(6) violating a rule adopted by the board or an order of the board, a state, or federal <br/>
<a id="pl.19.19"></a><var>19.19</var>law which relates to the practice of a physician assistant, or in part regulates the practice <br/>
<a id="pl.19.20"></a><var>19.20</var>of a physician assistant, including without limitation sections 
         <statute_ref>148A.02</statute_ref>, 
         <statute_ref>609.344</statute_ref>, and <br/>
<statute_ref><a id="pl.19.21"></a><var>19.21</var>609.345
         </statute_ref>, or a state or federal narcotics or controlled substance law; <br/>
<a id="pl.19.22"></a><var>19.22</var>(7) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm <br/>
<a id="pl.19.23"></a><var>19.23</var>the public, or demonstrating a willful or careless disregard for the health, welfare, or <br/>
<a id="pl.19.24"></a><var>19.24</var>safety of a patient; or practice which is professionally incompetent, in that it may create <br/>
<a id="pl.19.25"></a><var>19.25</var>unnecessary danger to any patient's life, health, or safety, in any of which cases, proof <br/>
<a id="pl.19.26"></a><var>19.26</var>of actual injury need not be established;<br/>
<a id="pl.19.27"></a><var>19.27</var>(8) failure to adhere to the provisions of the physician-physician assistant delegation <br/>
<a id="pl.19.28"></a><var>19.28</var>agreement;<br/>
<a id="pl.19.29"></a><var>19.29</var>(9) engaging in the practice of medicine beyond that allowed by the <br/>
<a id="pl.19.30"></a><var>19.30</var>physician-physician assistant delegation agreement, including the delegation form or <br/>
<a id="pl.19.31"></a><var>19.31</var>the addendum to the delegation form, or aiding or abetting an unlicensed person in the <br/>
<a id="pl.19.32"></a><var>19.32</var>practice of medicine;<br/>
<a id="pl.19.33"></a><var>19.33</var>(10) adjudication as mentally incompetent, mentally ill or developmentally disabled, <br/>
<a id="pl.19.34"></a><var>19.34</var>or as a chemically dependent person, a person dangerous to the public, a sexually <br/>
<a id="pl.19.35"></a><var>19.35</var>dangerous person, or a person who has a sexual psychopathic personality by a court of <br/>
<a id="pl.20.1"></a><var>20.1</var>competent jurisdiction, within or without this state. Such adjudication shall automatically <br/>
<a id="pl.20.2"></a><var>20.2</var>suspend a registration license for its duration unless the board orders otherwise;<br/>
<a id="pl.20.3"></a><var>20.3</var>(11) engaging in unprofessional conduct. Unprofessional conduct includes any <br/>
<a id="pl.20.4"></a><var>20.4</var>departure from or the failure to conform to the minimal standards of acceptable and <br/>
<a id="pl.20.5"></a><var>20.5</var>prevailing practice in which proceeding actual injury to a patient need not be established;<br/>
<a id="pl.20.6"></a><var>20.6</var>(12) inability to practice with reasonable skill and safety to patients by reason of <br/>
<a id="pl.20.7"></a><var>20.7</var>illness, drunkenness, use of drugs, narcotics, chemicals, or any other type of material, or <br/>
<a id="pl.20.8"></a><var>20.8</var>as a result of any mental or physical condition, including deterioration through the aging <br/>
<a id="pl.20.9"></a><var>20.9</var>process or loss of motor skills;<br/>
<a id="pl.20.10"></a><var>20.10</var>(13) revealing a privileged communication from or relating to a patient except when <br/>
<a id="pl.20.11"></a><var>20.11</var>otherwise required or permitted by law;<br/>
<a id="pl.20.12"></a><var>20.12</var>(14) any use of identification of a physician assistant by the title "Physician," <br/>
<a id="pl.20.13"></a><var>20.13</var>"Doctor," or "Dr." in a patient care setting or in a communication directed to the general <br/>
<a id="pl.20.14"></a><var>20.14</var>public;<br/>
<a id="pl.20.15"></a><var>20.15</var>(15) improper management of medical records, including failure to maintain <br/>
<a id="pl.20.16"></a><var>20.16</var>adequate medical records, to comply with a patient's request made pursuant to sections <br/>
<statute_ref><a id="pl.20.17"></a><var>20.17</var>144.291
         </statute_ref> to 144.298, or to furnish a medical record or report required by law; <br/>
<a id="pl.20.18"></a><var>20.18</var>(16) engaging in abusive or fraudulent billing practices, including violations of the <br/>
<a id="pl.20.19"></a><var>20.19</var>federal Medicare and Medicaid laws or state medical assistance laws;<br/>
<a id="pl.20.20"></a><var>20.20</var>(17) becoming addicted or habituated to a drug or intoxicant;<br/>
<a id="pl.20.21"></a><var>20.21</var>(18) prescribing a drug or device for other than medically accepted therapeutic, <br/>
<a id="pl.20.22"></a><var>20.22</var>experimental, or investigative purposes authorized by a state or federal agency or referring <br/>
<a id="pl.20.23"></a><var>20.23</var>a patient to any health care provider as defined in sections 
         <statute_ref>144.291</statute_ref> to 144.298 for services <br/>
<a id="pl.20.24"></a><var>20.24</var>or tests not medically indicated at the time of referral; <br/>
<a id="pl.20.25"></a><var>20.25</var>(19) engaging in conduct with a patient which is sexual or may reasonably be <br/>
<a id="pl.20.26"></a><var>20.26</var>interpreted by the patient as sexual, or in any verbal behavior which is seductive or <br/>
<a id="pl.20.27"></a><var>20.27</var>sexually demeaning to a patient;<br/>
<a id="pl.20.28"></a><var>20.28</var>(20) failure to make reports as required by section 
         <statute_ref>147A.14</statute_ref> or to cooperate with an <br/>
<a id="pl.20.29"></a><var>20.29</var>investigation of the board as required by section 
         <statute_ref>147A.15, subdivision 3</statute_ref>; <br/>
<a id="pl.20.30"></a><var>20.30</var>(21) knowingly providing false or misleading information that is directly related <br/>
<a id="pl.20.31"></a><var>20.31</var>to the care of that patient unless done for an accepted therapeutic purpose such as the <br/>
<a id="pl.20.32"></a><var>20.32</var>administration of a placebo;<br/>
<a id="pl.20.33"></a><var>20.33</var>(22) aiding suicide or aiding attempted suicide in violation of section 
         <statute_ref>609.215</statute_ref> as <br/>
<a id="pl.20.34"></a><var>20.34</var>established by any of the following: <br/>
<a id="pl.20.35"></a><var>20.35</var>(i) a copy of the record of criminal conviction or plea of guilty for a felony in <br/>
<a id="pl.20.36"></a><var>20.36</var>violation of section 
         <statute_ref>609.215, subdivision 1</statute_ref> or 2; <br/>
<a id="pl.21.1"></a><var>21.1</var>(ii) a copy of the record of a judgment of contempt of court for violating an <br/>
<a id="pl.21.2"></a><var>21.2</var>injunction issued under section 
         <statute_ref>609.215, subdivision 4</statute_ref>; <br/>
<a id="pl.21.3"></a><var>21.3</var>(iii) a copy of the record of a judgment assessing damages under section 
         <statute_ref>609.215, <br/>
<a id="pl.21.4"></a><var>21.4</var>subdivision 5
         </statute_ref>; or <br/>
<a id="pl.21.5"></a><var>21.5</var>(iv) a finding by the board that the person violated section 
         <statute_ref>609.215, subdivision 1</statute_ref> or <br/>
<a id="pl.21.6"></a><var>21.6</var>2. The board shall investigate any complaint of a violation of section 
         <statute_ref>609.215, subdivision <br/>
<a id="pl.21.7"></a><var>21.7</var>1
         </statute_ref> or 2; or <br/>
<a id="pl.21.8"></a><var>21.8</var>(23) failure to maintain annually reviewed and updated physician-physician <br/>
<a id="pl.21.9"></a><var>21.9</var>assistant delegation agreements, internal protocols, or prescribing delegation forms for <br/>
<a id="pl.21.10"></a><var>21.10</var>each physician-physician assistant practice relationship, or failure to provide copies of <br/>
<a id="pl.21.11"></a><var>21.11</var>such documents upon request by the board.<br/>
<a id="pl.21.12"></a><var>21.12</var>    Subd. 2. <b>Effective dates, automatic suspension.</b> A suspension, revocation, <br/>
<a id="pl.21.13"></a><var>21.13</var>condition, limitation, qualification, or restriction of a registration license shall be in effect <br/>
<a id="pl.21.14"></a><var>21.14</var>pending determination of an appeal unless the court, upon petition and for good cause <br/>
<a id="pl.21.15"></a><var>21.15</var>shown, orders otherwise.<br/>
<a id="pl.21.16"></a><var>21.16</var>A physician assistant registration license is automatically suspended if:<br/>
<a id="pl.21.17"></a><var>21.17</var>(1) a guardian of a registrant licensee is appointed by order of a court pursuant to <br/>
<a id="pl.21.18"></a><var>21.18</var>sections 
         <statute_ref>524.5-101</statute_ref> to 
         <statute_ref>524.5-502</statute_ref>, for reasons other than the minority of the registrant <br/>
<a id="pl.21.19"></a><var>21.19</var>licensee; or <br/>
<a id="pl.21.20"></a><var>21.20</var>(2) the registrant licensee is committed by order of a court pursuant to chapter <br/>
<a id="pl.21.21"></a><var>21.21</var>253B. The registration license remains suspended until the registrant licensee is restored <br/>
<a id="pl.21.22"></a><var>21.22</var>to capacity by a court and, upon petition by the registrant licensee, the suspension is <br/>
<a id="pl.21.23"></a><var>21.23</var>terminated by the board after a hearing.<br/>
<a id="pl.21.24"></a><var>21.24</var>    Subd. 3. <b>Conditions on reissued </b><b>registration</b><b> license</b><b>.</b> In its discretion, the board <br/>
<a id="pl.21.25"></a><var>21.25</var>may restore and reissue a physician assistant registration license, but may impose as a <br/>
<a id="pl.21.26"></a><var>21.26</var>condition any disciplinary or corrective measure which it might originally have imposed.<br/>
<a id="pl.21.27"></a><var>21.27</var>    Subd. 4. <b>Temporary suspension of </b><b>registration</b><b> license</b><b>.</b> In addition to any other <br/>
<a id="pl.21.28"></a><var>21.28</var>remedy provided by law, the board may, without a hearing, temporarily suspend the <br/>
<a id="pl.21.29"></a><var>21.29</var>registration license of a physician assistant if the board finds that the physician assistant has <br/>
<a id="pl.21.30"></a><var>21.30</var>violated a statute or rule which the board is empowered to enforce and continued practice <br/>
<a id="pl.21.31"></a><var>21.31</var>by the physician assistant would create a serious risk of harm to the public. The suspension <br/>
<a id="pl.21.32"></a><var>21.32</var>shall take effect upon written notice to the physician assistant, specifying the statute or <br/>
<a id="pl.21.33"></a><var>21.33</var>rule violated. The suspension shall remain in effect until the board issues a final order <br/>
<a id="pl.21.34"></a><var>21.34</var>in the matter after a hearing. At the time it issues the suspension notice, the board shall <br/>
<a id="pl.21.35"></a><var>21.35</var>schedule a disciplinary hearing to be held pursuant to the Administrative Procedure Act.<br/>
<a id="pl.22.1"></a><var>22.1</var>The physician assistant shall be provided with at least 20 days' notice of any hearing <br/>
<a id="pl.22.2"></a><var>22.2</var>held pursuant to this subdivision. The hearing shall be scheduled to begin no later than 30 <br/>
<a id="pl.22.3"></a><var>22.3</var>days after the issuance of the suspension order.<br/>
<a id="pl.22.4"></a><var>22.4</var>    Subd. 5. <b>Evidence.</b> In disciplinary actions alleging a violation of subdivision <br/>
<a id="pl.22.5"></a><var>22.5</var>1, clause (3) or (4), a copy of the judgment or proceeding under the seal of the court <br/>
<a id="pl.22.6"></a><var>22.6</var>administrator or of the administrative agency which entered it shall be admissible into <br/>
<a id="pl.22.7"></a><var>22.7</var>evidence without further authentication and shall constitute prima facie evidence of the <br/>
<a id="pl.22.8"></a><var>22.8</var>contents thereof.<br/>
<a id="pl.22.9"></a><var>22.9</var>    Subd. 6. <b>Mental examination; access to medical data.</b> (a) If the board has <br/>
<a id="pl.22.10"></a><var>22.10</var>probable cause to believe that a physician assistant comes under subdivision 1, clause <br/>
<a id="pl.22.11"></a><var>22.11</var>(1), it may direct the physician assistant to submit to a mental or physical examination. <br/>
<a id="pl.22.12"></a><var>22.12</var>For the purpose of this subdivision, every physician assistant registered licensed under <br/>
<a id="pl.22.13"></a><var>22.13</var>this chapter is deemed to have consented to submit to a mental or physical examination <br/>
<a id="pl.22.14"></a><var>22.14</var>when directed in writing by the board and further to have waived all objections to the <br/>
<a id="pl.22.15"></a><var>22.15</var>admissibility of the examining physicians' testimony or examination reports on the ground <br/>
<a id="pl.22.16"></a><var>22.16</var>that the same constitute a privileged communication. Failure of a physician assistant to <br/>
<a id="pl.22.17"></a><var>22.17</var>submit to an examination when directed constitutes an admission of the allegations against <br/>
<a id="pl.22.18"></a><var>22.18</var>the physician assistant, unless the failure was due to circumstance beyond the physician <br/>
<a id="pl.22.19"></a><var>22.19</var>assistant's control, in which case a default and final order may be entered without the <br/>
<a id="pl.22.20"></a><var>22.20</var>taking of testimony or presentation of evidence. A physician assistant affected under this <br/>
<a id="pl.22.21"></a><var>22.21</var>subdivision shall at reasonable intervals be given an opportunity to demonstrate that <br/>
<a id="pl.22.22"></a><var>22.22</var>the physician assistant can resume competent practice with reasonable skill and safety <br/>
<a id="pl.22.23"></a><var>22.23</var>to patients. In any proceeding under this subdivision, neither the record of proceedings <br/>
<a id="pl.22.24"></a><var>22.24</var>nor the orders entered by the board shall be used against a physician assistant in any <br/>
<a id="pl.22.25"></a><var>22.25</var>other proceeding.<br/>
<a id="pl.22.26"></a><var>22.26</var>(b) In addition to ordering a physical or mental examination, the board may, <br/>
<a id="pl.22.27"></a><var>22.27</var>notwithstanding sections 
         <statute_ref>13.384</statute_ref>, 
         <statute_ref>144.651</statute_ref>, or any other law limiting access to medical or <br/>
<a id="pl.22.28"></a><var>22.28</var>other health data, obtain medical data and health records relating to a registrant licensee or <br/>
<a id="pl.22.29"></a><var>22.29</var>applicant without the registrant's licensee's or applicant's consent if the board has probable <br/>
<a id="pl.22.30"></a><var>22.30</var>cause to believe that a physician assistant comes under subdivision 1, clause (1). <br/>
<a id="pl.22.31"></a><var>22.31</var>The medical data may be requested from a provider, as defined in section 
         <statute_ref>144.291, <br/>
<a id="pl.22.32"></a><var>22.32</var>subdivision 2
         </statute_ref>, paragraph (h), an insurance company, or a government agency, including <br/>
<a id="pl.22.33"></a><var>22.33</var>the Department of Human Services. A provider, insurance company, or government <br/>
<a id="pl.22.34"></a><var>22.34</var>agency shall comply with any written request of the board under this subdivision and is not <br/>
<a id="pl.22.35"></a><var>22.35</var>liable in any action for damages for releasing the data requested by the board if the data <br/>
<a id="pl.22.36"></a><var>22.36</var>are released pursuant to a written request under this subdivision, unless the information <br/>
<a id="pl.23.1"></a><var>23.1</var>is false and the provider giving the information knew, or had reason to believe, the <br/>
<a id="pl.23.2"></a><var>23.2</var>information was false. Information obtained under this subdivision is classified as private <br/>
<a id="pl.23.3"></a><var>23.3</var>under chapter 13. <br/>
<a id="pl.23.4"></a><var>23.4</var>    Subd. 7. <b>Tax clearance certificate.</b> (a) In addition to the provisions of subdivision <br/>
<a id="pl.23.5"></a><var>23.5</var>1, the board may not issue or renew a registration license if the commissioner of revenue <br/>
<a id="pl.23.6"></a><var>23.6</var>notifies the board and the registrant licensee or applicant for registration licensure that the <br/>
<a id="pl.23.7"></a><var>23.7</var>registrant licensee or applicant owes the state delinquent taxes in the amount of $500 or <br/>
<a id="pl.23.8"></a><var>23.8</var>more. The board may issue or renew the registration license only if:<br/>
<a id="pl.23.9"></a><var>23.9</var>(1) the commissioner of revenue issues a tax clearance certificate; and<br/>
<a id="pl.23.10"></a><var>23.10</var>(2) the commissioner of revenue, the registrant licensee, or the applicant forwards a <br/>
<a id="pl.23.11"></a><var>23.11</var>copy of the clearance to the board.<br/>
<a id="pl.23.12"></a><var>23.12</var>The commissioner of revenue may issue a clearance certificate only if the registrant <br/>
<a id="pl.23.13"></a><var>23.13</var>licensee or applicant does not owe the state any uncontested delinquent taxes.<br/>
<a id="pl.23.14"></a><var>23.14</var>(b) For purposes of this subdivision, the following terms have the meanings given:<br/>
<a id="pl.23.15"></a><var>23.15</var>(1) "Taxes" are all taxes payable to the commissioner of revenue, including penalties <br/>
<a id="pl.23.16"></a><var>23.16</var>and interest due on those taxes, and<br/>
<a id="pl.23.17"></a><var>23.17</var>(2) "Delinquent taxes" do not include a tax liability if:<br/>
<a id="pl.23.18"></a><var>23.18</var>(i) an administrative or court action that contests the amount or validity of the <br/>
<a id="pl.23.19"></a><var>23.19</var>liability has been filed or served;<br/>
<a id="pl.23.20"></a><var>23.20</var>(ii) the appeal period to contest the tax liability has not expired; or<br/>
<a id="pl.23.21"></a><var>23.21</var>(iii) the licensee or applicant has entered into a payment agreement to pay the <br/>
<a id="pl.23.22"></a><var>23.22</var>liability and is current with the payments.<br/>
<a id="pl.23.23"></a><var>23.23</var>(c) When a registrant licensee or applicant is required to obtain a clearance certificate <br/>
<a id="pl.23.24"></a><var>23.24</var>under this subdivision, a contested case hearing must be held if the registrant licensee or <br/>
<a id="pl.23.25"></a><var>23.25</var>applicant requests a hearing in writing to the commissioner of revenue within 30 days of <br/>
<a id="pl.23.26"></a><var>23.26</var>the date of the notice provided in paragraph (a). The hearing must be held within 45 days <br/>
<a id="pl.23.27"></a><var>23.27</var>of the date the commissioner of revenue refers the case to the Office of Administrative <br/>
<a id="pl.23.28"></a><var>23.28</var>Hearings. Notwithstanding any law to the contrary, the licensee or applicant must be <br/>
<a id="pl.23.29"></a><var>23.29</var>served with 20 days' notice in writing specifying the time and place of the hearing and <br/>
<a id="pl.23.30"></a><var>23.30</var>the allegations against the registrant or applicant. The notice may be served personally or <br/>
<a id="pl.23.31"></a><var>23.31</var>by mail.<br/>
<a id="pl.23.32"></a><var>23.32</var>(d) The board shall require all registrants licensees or applicants to provide their <br/>
<a id="pl.23.33"></a><var>23.33</var>Social Security number and Minnesota business identification number on all registration <br/>
<a id="pl.23.34"></a><var>23.34</var>license applications. Upon request of the commissioner of revenue, the board must <br/>
<a id="pl.23.35"></a><var>23.35</var>provide to the commissioner of revenue a list of all registrants licensees and applicants, <br/>
<a id="pl.23.36"></a><var>23.36</var>including their names and addresses, Social Security numbers, and business identification <br/>
<a id="pl.24.1"></a><var>24.1</var>numbers. The commissioner of revenue may request a list of the registrants licensees and <br/>
<a id="pl.24.2"></a><var>24.2</var>applicants no more than once each calendar year.<br/>
<a id="pl.24.3"></a><var>24.3</var>    Subd. 8. <b>Limitation.</b> No board proceeding against a licensee shall be instituted <br/>
<a id="pl.24.4"></a><var>24.4</var>unless commenced within seven years from the date of commission of some portion of the <br/>
<a id="pl.24.5"></a><var>24.5</var>offense except for alleged violations of subdivision 1, paragraph (19), or subdivision 7.<br/>
<br/>
<a id="bill.0.25.0"></a><a id="pl.24.6"></a><var>24.6</var>    Sec. 25. Minnesota Statutes 2008, section 147A.16, is amended to read:<br/>
<a id="pl.24.7"></a><var>24.7</var><b>147A.16 FORMS OF DISCIPLINARY ACTION.</b><br/>
<a id="pl.24.8"></a><var>24.8</var>When the board finds that a registered licensed physician assistant has violated a <br/>
<a id="pl.24.9"></a><var>24.9</var>provision of this chapter, it may do one or more of the following:<br/>
<a id="pl.24.10"></a><var>24.10</var>(1) revoke the registration license;<br/>
<a id="pl.24.11"></a><var>24.11</var>(2) suspend the registration license;<br/>
<a id="pl.24.12"></a><var>24.12</var>(3) impose limitations or conditions on the physician assistant's practice, including <br/>
<a id="pl.24.13"></a><var>24.13</var>limiting the scope of practice to designated field specialties; impose retraining or <br/>
<a id="pl.24.14"></a><var>24.14</var>rehabilitation requirements; require practice under additional supervision; or condition <br/>
<a id="pl.24.15"></a><var>24.15</var>continued practice on demonstration of knowledge or skills by appropriate examination <br/>
<a id="pl.24.16"></a><var>24.16</var>or other review of skill and competence;<br/>
<a id="pl.24.17"></a><var>24.17</var>(4) impose a civil penalty not exceeding $10,000 for each separate violation, the <br/>
<a id="pl.24.18"></a><var>24.18</var>amount of the civil penalty to be fixed so as to deprive the physician assistant of any <br/>
<a id="pl.24.19"></a><var>24.19</var>economic advantage gained by reason of the violation charged or to reimburse the board <br/>
<a id="pl.24.20"></a><var>24.20</var>for the cost of the investigation and proceeding;<br/>
<a id="pl.24.21"></a><var>24.21</var>(5) order the physician assistant to provide unremunerated professional service <br/>
<a id="pl.24.22"></a><var>24.22</var>under supervision at a designated public hospital, clinic, or other health care institution; or<br/>
<a id="pl.24.23"></a><var>24.23</var>(6) censure or reprimand the registered licensed physician assistant.<br/>
<a id="pl.24.24"></a><var>24.24</var>Upon judicial review of any board disciplinary action taken under this chapter, the <br/>
<a id="pl.24.25"></a><var>24.25</var>reviewing court shall seal the administrative record, except for the board's final decision, <br/>
<a id="pl.24.26"></a><var>24.26</var>and shall not make the administrative record available to the public.<br/>
<br/>
<a id="bill.0.26.0"></a><a id="pl.24.27"></a><var>24.27</var>    Sec. 26. Minnesota Statutes 2008, section 147A.18, is amended to read:<br/>
<a id="pl.24.28"></a><var>24.28</var><b>147A.18 DELEGATED AUTHORITY TO PRESCRIBE, DISPENSE, AND </b><br/>
<a id="pl.24.29"></a><var>24.29</var><b>ADMINISTER DRUGS AND MEDICAL DEVICES.</b><br/>
<a id="pl.24.30"></a><var>24.30</var>    Subdivision 1. <b>Delegation.</b> (a) A supervising physician may delegate to a <br/>
<a id="pl.24.31"></a><var>24.31</var>physician assistant who is registered with licensed by the board, certified by the National <br/>
<a id="pl.24.32"></a><var>24.32</var>Commission on Certification of Physician Assistants or successor agency approved by the <br/>
<a id="pl.24.33"></a><var>24.33</var>board, and who is under the supervising physician's supervision, the authority to prescribe, <br/>
<a id="pl.24.34"></a><var>24.34</var>dispense, and administer legend drugs, medical devices, and controlled substances, and <br/>
<a id="pl.24.35"></a><var>24.35</var>medical devices subject to the requirements in this section. The authority to dispense <br/>
<a id="pl.25.1"></a><var>25.1</var>includes, but is not limited to, the authority to request, receive, and dispense sample drugs. <br/>
<a id="pl.25.2"></a><var>25.2</var>This authority to dispense extends only to those drugs described in the written agreement <br/>
<a id="pl.25.3"></a><var>25.3</var>developed under paragraph (b).<br/>
<a id="pl.25.4"></a><var>25.4</var>(b) The delegation agreement between the physician assistant and supervising <br/>
<a id="pl.25.5"></a><var>25.5</var>physician and any alternate supervising physicians must include a statement by the <br/>
<a id="pl.25.6"></a><var>25.6</var>supervising physician regarding delegation or nondelegation of the functions of <br/>
<a id="pl.25.7"></a><var>25.7</var>prescribing, dispensing, and administering of legend drugs, controlled substances,  and <br/>
<a id="pl.25.8"></a><var>25.8</var>medical devices to the physician assistant. The statement must include a protocol <br/>
<a id="pl.25.9"></a><var>25.9</var>indicating categories of drugs for which the supervising physician delegates prescriptive <br/>
<a id="pl.25.10"></a><var>25.10</var>and dispensing authority including controlled substances when applicable. The delegation <br/>
<a id="pl.25.11"></a><var>25.11</var>must be appropriate to the physician assistant's practice and within the scope of the <br/>
<a id="pl.25.12"></a><var>25.12</var>physician assistant's training. Physician assistants who have been delegated the authority <br/>
<a id="pl.25.13"></a><var>25.13</var>to prescribe, dispense, and administer legend drugs, controlled substances, and medical <br/>
<a id="pl.25.14"></a><var>25.14</var>devices shall provide evidence of current certification by the National Commission <br/>
<a id="pl.25.15"></a><var>25.15</var>on Certification of Physician Assistants or its successor agency when registering or <br/>
<a id="pl.25.16"></a><var>25.16</var>reregistering applying for licensure or license renewal as physician assistants. Physician <br/>
<a id="pl.25.17"></a><var>25.17</var>assistants who have been delegated the authority to prescribe controlled substances must <br/>
<a id="pl.25.18"></a><var>25.18</var>present evidence of the certification and also hold a valid DEA certificate registration. <br/>
<a id="pl.25.19"></a><var>25.19</var>Supervising physicians shall retrospectively review the prescribing, dispensing, and <br/>
<a id="pl.25.20"></a><var>25.20</var>administering of legend and controlled drugs, controlled substances, and medical devices <br/>
<a id="pl.25.21"></a><var>25.21</var>by physician assistants, when this authority has been delegated to the physician assistant as <br/>
<a id="pl.25.22"></a><var>25.22</var>part of the physician-physician assistant delegation agreement between the physician and <br/>
<a id="pl.25.23"></a><var>25.23</var>the physician assistant. This review must take place as outlined in the internal protocol. <br/>
<a id="pl.25.24"></a><var>25.24</var>The process and schedule for the review must be outlined in the physician-physician <br/>
<a id="pl.25.25"></a><var>25.25</var>assistant delegation agreement.<br/>
<a id="pl.25.26"></a><var>25.26</var>(c) The board may establish by rule:<br/>
<a id="pl.25.27"></a><var>25.27</var>(1) a system of identifying physician assistants eligible to prescribe, administer, and <br/>
<a id="pl.25.28"></a><var>25.28</var>dispense legend drugs and medical devices;<br/>
<a id="pl.25.29"></a><var>25.29</var>(2) a system of identifying physician assistants eligible to prescribe, administer, and <br/>
<a id="pl.25.30"></a><var>25.30</var>dispense controlled substances;<br/>
<a id="pl.25.31"></a><var>25.31</var>(3) a method of determining the categories of legend and controlled drugs, controlled <br/>
<a id="pl.25.32"></a><var>25.32</var>substances, and medical devices that each physician assistant is allowed to prescribe, <br/>
<a id="pl.25.33"></a><var>25.33</var>administer, and dispense; and<br/>
<a id="pl.25.34"></a><var>25.34</var>(4) a system of transmitting to pharmacies a listing of physician assistants eligible to <br/>
<a id="pl.25.35"></a><var>25.35</var>prescribe legend and controlled drugs, controlled substances, and medical devices.<br/>
<a id="pl.26.1"></a><var>26.1</var>    Subd. 2. <b>Termination and reinstatement of prescribing authority.</b> (a) The <br/>
<a id="pl.26.2"></a><var>26.2</var>authority of a physician assistant to prescribe, dispense, and administer legend drugs, <br/>
<a id="pl.26.3"></a><var>26.3</var>controlled substances, and medical devices shall end immediately when:<br/>
<a id="pl.26.4"></a><var>26.4</var>(1) the physician-physician assistant delegation agreement is terminated;<br/>
<a id="pl.26.5"></a><var>26.5</var>(2) the authority to prescribe, dispense, and administer is terminated or withdrawn <br/>
<a id="pl.26.6"></a><var>26.6</var>by the supervising physician; or<br/>
<a id="pl.26.7"></a><var>26.7</var>(3) the physician assistant reverts to assistant's license is placed on  inactive status, <br/>
<a id="pl.26.8"></a><var>26.8</var>loses National Commission on Certification of Physician Assistants or successor agency <br/>
<a id="pl.26.9"></a><var>26.9</var>certification, or loses or terminates registration status;<br/>
<a id="pl.26.10"></a><var>26.10</var>(4) the physician assistant loses National Commission on Certification of Physician <br/>
<a id="pl.26.11"></a><var>26.11</var>Assistants or successor agency certification; or<br/>
<a id="pl.26.12"></a><var>26.12</var>(5) the physician assistant loses or terminates licensure status.<br/>
<a id="pl.26.13"></a><var>26.13</var>(b) The physician assistant must notify the board in writing within ten days of the <br/>
<a id="pl.26.14"></a><var>26.14</var>occurrence of any of the circumstances listed in paragraph (a).<br/>
<a id="pl.26.15"></a><var>26.15</var>(c) Physician assistants whose authority to prescribe, dispense, and administer <br/>
<a id="pl.26.16"></a><var>26.16</var>has been terminated shall reapply for reinstatement of prescribing authority under this <br/>
<a id="pl.26.17"></a><var>26.17</var>section and meet any requirements established by the board prior to reinstatement of the <br/>
<a id="pl.26.18"></a><var>26.18</var>prescribing, dispensing, and administering authority.<br/>
<a id="pl.26.19"></a><var>26.19</var>    Subd. 3. <b>Other requirements and restrictions.</b> (a) The supervising physician and <br/>
<a id="pl.26.20"></a><var>26.20</var>the physician assistant must complete, sign, and date an internal protocol which lists each <br/>
<a id="pl.26.21"></a><var>26.21</var>category of drug or medical device, or controlled substance the physician assistant may <br/>
<a id="pl.26.22"></a><var>26.22</var>prescribe, dispense, and administer. The supervising physician and physician assistant <br/>
<a id="pl.26.23"></a><var>26.23</var>shall submit the internal protocol to the board upon request. The supervising physician <br/>
<a id="pl.26.24"></a><var>26.24</var>may amend the internal protocol as necessary, within the limits of the completed delegation <br/>
<a id="pl.26.25"></a><var>26.25</var>form in subdivision 5. The supervising physician and physician assistant must sign and <br/>
<a id="pl.26.26"></a><var>26.26</var>date any amendments to the internal protocol. Any amendments resulting in a change to <br/>
<a id="pl.26.27"></a><var>26.27</var>an addition or deletion to categories delegated in the delegation form in subdivision 5 must <br/>
<a id="pl.26.28"></a><var>26.28</var>be submitted to the board according to this chapter, along with the fee required.<br/>
<a id="pl.26.29"></a><var>26.29</var>(b) The supervising physician and physician assistant shall review delegation of <br/>
<a id="pl.26.30"></a><var>26.30</var>prescribing, dispensing, and administering authority on an annual basis at the time of <br/>
<a id="pl.26.31"></a><var>26.31</var>reregistration. The internal protocol must be signed and dated by the supervising physician <br/>
<a id="pl.26.32"></a><var>26.32</var>and physician assistant after review. Any amendments to the internal protocol resulting in <br/>
<a id="pl.26.33"></a><var>26.33</var>changes to the delegation form in subdivision 5 must be submitted to the board according <br/>
<a id="pl.26.34"></a><var>26.34</var>to this chapter, along with the fee required.<br/>
<a id="pl.26.35"></a><var>26.35</var>(c) (a) Each prescription initiated by a physician assistant shall indicate the <br/>
<a id="pl.26.36"></a><var>26.36</var>following:<br/>
<a id="pl.27.1"></a><var>27.1</var>(1) the date of issue;<br/>
<a id="pl.27.2"></a><var>27.2</var>(2) the name and address of the patient;<br/>
<a id="pl.27.3"></a><var>27.3</var>(3) the name and quantity of the drug prescribed;<br/>
<a id="pl.27.4"></a><var>27.4</var>(4) directions for use; and<br/>
<a id="pl.27.5"></a><var>27.5</var>(5) the name and address of the prescribing physician assistant.<br/>
<a id="pl.27.6"></a><var>27.6</var>(d) (b) In prescribing, dispensing, and administering legend drugs, controlled <br/>
<a id="pl.27.7"></a><var>27.7</var>substances, and medical devices, including controlled substances as defined in section <br/>
<a id="pl.27.8"></a><var>27.8</var><statute_ref>152.01, subdivision 4</statute_ref>, a physician assistant must conform with the agreement, chapter <br/>
<a id="pl.27.9"></a><var>27.9</var>151, and this chapter.<br/>
<a id="pl.27.10"></a><var>27.10</var>    Subd. 4. <b>Notification of pharmacies.</b> (a) The board shall annually provide to the <br/>
<a id="pl.27.11"></a><var>27.11</var>Board of Pharmacy and to registered pharmacies within the state a list of those physician <br/>
<a id="pl.27.12"></a><var>27.12</var>assistants who are authorized to prescribe, administer, and dispense legend drugs and <br/>
<a id="pl.27.13"></a><var>27.13</var>medical devices, or controlled substances.<br/>
<a id="pl.27.14"></a><var>27.14</var>(b) The board shall provide to the Board of Pharmacy a list of physician assistants <br/>
<a id="pl.27.15"></a><var>27.15</var>authorized to prescribe legend drugs and medical devices every two months if additional <br/>
<a id="pl.27.16"></a><var>27.16</var>physician assistants are authorized to prescribe or if physician assistants have authorization <br/>
<a id="pl.27.17"></a><var>27.17</var>to prescribe withdrawn.<br/>
<a id="pl.27.18"></a><var>27.18</var>(c) The list must include the name, address, telephone number, and Minnesota <br/>
<a id="pl.27.19"></a><var>27.19</var>registration number of the physician assistant, and the name, address, telephone number, <br/>
<a id="pl.27.20"></a><var>27.20</var>and Minnesota license number of the supervising physician.<br/>
<a id="pl.27.21"></a><var>27.21</var>(d) The board shall provide the form in subdivision 5 to pharmacies upon request.<br/>
<a id="pl.27.22"></a><var>27.22</var>(e) The board shall make available prototype forms of the physician-physician <br/>
<a id="pl.27.23"></a><var>27.23</var>assistant agreement, the internal protocol, the delegation form, and the addendum form.<br/>
<a id="pl.27.24"></a><var>27.24</var>    Subd. 5. <b>Delegation form for physician assistant prescribing.</b> The delegation <br/>
<a id="pl.27.25"></a><var>27.25</var>form for physician assistant prescribing must contain a listing by drug category of the <br/>
<a id="pl.27.26"></a><var>27.26</var>legend drugs and controlled substances for which prescribing authority has been delegated <br/>
<a id="pl.27.27"></a><var>27.27</var>to the physician assistant.<br/>
<br/>
<a id="bill.0.27.0"></a><a id="pl.27.28"></a><var>27.28</var>    Sec. 27. Minnesota Statutes 2008, section 147A.19, is amended to read:<br/>
<a id="pl.27.29"></a><var>27.29</var><b>147A.19 IDENTIFICATION REQUIREMENTS.</b><br/>
<a id="pl.27.30"></a><var>27.30</var>Physician assistants registered licensed under this chapter shall keep their <br/>
<a id="pl.27.31"></a><var>27.31</var>registration license available for inspection at their primary place of business and shall, <br/>
<a id="pl.27.32"></a><var>27.32</var>when engaged in their professional activities, wear a name tag identifying themselves as <br/>
<a id="pl.27.33"></a><var>27.33</var>a "physician assistant."<br/>
<br/>
<a id="bill.0.28.0"></a><a id="pl.27.34"></a><var>27.34</var>    Sec. 28. Minnesota Statutes 2008, section 147A.20, is amended to read:<br/>
<a id="pl.28.1"></a><var>28.1</var><b>147A.20 </b><b>PHYSICIAN AND PHYSICIAN</b><b> PHYSICIAN-PHYSICIAN</b><b> </b><br/>
<a id="pl.28.2"></a><var>28.2</var><b>ASSISTANT AGREEMENT</b><b> DOCUMENTS</b><b>.</b><br/>
<a id="pl.28.3"></a><var>28.3</var>    Subdivision 1. <b>Physician-physician assistant delegation agreement.</b> (a) A <br/>
<a id="pl.28.4"></a><var>28.4</var>physician assistant and supervising physician must sign an a physician-physician assistant <br/>
<a id="pl.28.5"></a><var>28.5</var>delegation agreement which specifies scope of practice and amount and manner of <br/>
<a id="pl.28.6"></a><var>28.6</var>supervision as required by the board. The agreement must contain:<br/>
<a id="pl.28.7"></a><var>28.7</var>(1) a description of the practice setting;<br/>
<a id="pl.28.8"></a><var>28.8</var>(2) a statement of practice type/specialty;<br/>
<a id="pl.28.9"></a><var>28.9</var>(3) a listing of categories of delegated duties;<br/>
<a id="pl.28.10"></a><var>28.10</var>(4) (3) a description of supervision type, amount, and frequency; and<br/>
<a id="pl.28.11"></a><var>28.11</var>(5) (4) a description of the process and schedule for review of prescribing, <br/>
<a id="pl.28.12"></a><var>28.12</var>dispensing, and administering legend and controlled drugs and medical devices by the <br/>
<a id="pl.28.13"></a><var>28.13</var>physician assistant authorized to prescribe.<br/>
<a id="pl.28.14"></a><var>28.14</var>(b) The agreement must be maintained by the supervising physician and physician <br/>
<a id="pl.28.15"></a><var>28.15</var>assistant and made available to the board upon request. If there is a delegation of <br/>
<a id="pl.28.16"></a><var>28.16</var>prescribing, administering, and dispensing of legend drugs, controlled substances, and <br/>
<a id="pl.28.17"></a><var>28.17</var>medical devices, the agreement shall include an internal protocol and delegation form a <br/>
<a id="pl.28.18"></a><var>28.18</var>description of the prescriptive authority delegated to the physician assistant. Physician <br/>
<a id="pl.28.19"></a><var>28.19</var>assistants shall have a separate agreement for each place of employment. Agreements <br/>
<a id="pl.28.20"></a><var>28.20</var>must be reviewed and updated on an annual basis. The supervising physician and <br/>
<a id="pl.28.21"></a><var>28.21</var>physician assistant must maintain the physician-physician assistant delegation agreement, <br/>
<a id="pl.28.22"></a><var>28.22</var>delegation form, and internal protocol at the address of record. Copies shall be provided to <br/>
<a id="pl.28.23"></a><var>28.23</var>the board upon request.<br/>
<a id="pl.28.24"></a><var>28.24</var>(c) Physician assistants must provide written notification to the board within 30 <br/>
<a id="pl.28.25"></a><var>28.25</var>days of the following:<br/>
<a id="pl.28.26"></a><var>28.26</var>(1) name change;<br/>
<a id="pl.28.27"></a><var>28.27</var>(2) address of record change; and<br/>
<a id="pl.28.28"></a><var>28.28</var>(3) telephone number of record change; and<br/>
<a id="pl.28.29"></a><var>28.29</var>(4) addition or deletion of alternate supervising physician provided that the <br/>
<a id="pl.28.30"></a><var>28.30</var>information submitted includes, for an additional alternate physician, an affidavit of <br/>
<a id="pl.28.31"></a><var>28.31</var>consent to act as an alternate supervising physician signed by the alternate supervising <br/>
<a id="pl.28.32"></a><var>28.32</var>physician.<br/>
<a id="pl.28.33"></a><var>28.33</var>(d) Modifications requiring submission prior to the effective date are changes to the <br/>
<a id="pl.28.34"></a><var>28.34</var>practice setting description which include:<br/>
<a id="pl.28.35"></a><var>28.35</var>(1) supervising physician change, excluding alternate supervising physicians; or<br/>
<a id="pl.29.1"></a><var>29.1</var>(2) delegation of prescribing, administering, or dispensing of legend drugs, <br/>
<a id="pl.29.2"></a><var>29.2</var>controlled substances, or medical devices.<br/>
<a id="pl.29.3"></a><var>29.3</var>(e) The agreement must be completed and the practice setting description submitted <br/>
<a id="pl.29.4"></a><var>29.4</var>to the board before providing medical care as a physician assistant.<br/>
<a id="pl.29.5"></a><var>29.5</var>(d) Any alternate supervising physicians must be identified in the physician-physician <br/>
<a id="pl.29.6"></a><var>29.6</var>assistant delegation agreement, or a supplemental listing, and must sign the agreement <br/>
<a id="pl.29.7"></a><var>29.7</var>attesting that they shall provide the physician assistant with supervision in compliance <br/>
<a id="pl.29.8"></a><var>29.8</var>with this chapter, the delegation agreement, and board rules.<br/>
<a id="pl.29.9"></a><var>29.9</var>    Subd. 2. <b>Notification of intent to practice.</b> A licensed physician assistant shall <br/>
<a id="pl.29.10"></a><var>29.10</var>submit a notification of intent to practice to the board prior to beginning practice. The <br/>
<a id="pl.29.11"></a><var>29.11</var>notification shall include the name, business address, and telephone number of the <br/>
<a id="pl.29.12"></a><var>29.12</var>supervising physician and the physician assistant. Individuals who practice without <br/>
<a id="pl.29.13"></a><var>29.13</var>submitting a notification of intent to practice shall be subject to disciplinary action under <br/>
<a id="pl.29.14"></a><var>29.14</var>section 147A.13 for practicing without a license, unless the care is provided in response to <br/>
<a id="pl.29.15"></a><var>29.15</var>a disaster or emergency situation pursuant to section 147A.23.<br/>
<br/>
<a id="bill.0.29.0"></a><a id="pl.29.16"></a><var>29.16</var>    Sec. 29. Minnesota Statutes 2008, section 147A.21, is amended to read:<br/>
<a id="pl.29.17"></a><var>29.17</var><b>147A.21 RULEMAKING AUTHORITY.</b><br/>
<a id="pl.29.18"></a><var>29.18</var>The board shall adopt rules:<br/>
<a id="pl.29.19"></a><var>29.19</var>(1) setting registration license fees;<br/>
<a id="pl.29.20"></a><var>29.20</var>(2) setting renewal fees;<br/>
<a id="pl.29.21"></a><var>29.21</var>(3) setting fees for locum tenens permits;<br/>
<a id="pl.29.22"></a><var>29.22</var>(4) setting fees for temporary registration licenses; and<br/>
<a id="pl.29.23"></a><var>29.23</var>(5) (4) establishing renewal dates.<br/>
<br/>
<a id="bill.0.30.0"></a><a id="pl.29.24"></a><var>29.24</var>    Sec. 30. Minnesota Statutes 2008, section 147A.23, is amended to read:<br/>
<a id="pl.29.25"></a><var>29.25</var><b>147A.23 RESPONDING TO DISASTER SITUATIONS.</b><br/>
<a id="pl.29.26"></a><var>29.26</var>(a) A registered physician assistant or a physician assistant duly licensed or <br/>
<a id="pl.29.27"></a><var>29.27</var>credentialed in a United States jurisdiction or by a federal employer who is responding <br/>
<a id="pl.29.28"></a><var>29.28</var>to a need for medical care created by an emergency according to section 604A.01, or a <br/>
<a id="pl.29.29"></a><var>29.29</var>state or local disaster may render such care as the physician assistant is able trained to <br/>
<a id="pl.29.30"></a><var>29.30</var>provide, under the physician assistant's license, registration, or credential, without the <br/>
<a id="pl.29.31"></a><var>29.31</var>need of a physician and physician physician-physician assistant delegation agreement or <br/>
<a id="pl.29.32"></a><var>29.32</var>a notice of intent to practice as required under section 
         <statute_ref>147A.20</statute_ref>. Physician supervision, <br/>
<a id="pl.29.33"></a><var>29.33</var>as required under section 
<statute_ref>147A.09</statute_ref>, must be provided under the direction of a physician <br/>
<a id="pl.29.34"></a><var>29.34</var>licensed under chapter 147 who is involved with the disaster response. The physician <br/>
<a id="pl.29.35"></a><var>29.35</var>assistant must establish a temporary supervisory agreement with the physician providing <br/>
<a id="pl.30.1"></a><var>30.1</var>supervision before rendering care. A physician assistant may provide emergency care <br/>
<a id="pl.30.2"></a><var>30.2</var>without physician supervision or under the supervision that is available. <br/>
<a id="pl.30.3"></a><var>30.3</var>(b) The physician who provides supervision to a physician assistant while the <br/>
<a id="pl.30.4"></a><var>30.4</var>physician assistant is rendering care in a disaster in accordance with this section may do <br/>
<a id="pl.30.5"></a><var>30.5</var>so without meeting the requirements of section 
         <statute_ref>147A.20</statute_ref>.  <br/>
<a id="pl.30.6"></a><var>30.6</var>(c) The supervising physician who otherwise provides supervision to a physician <br/>
<a id="pl.30.7"></a><var>30.7</var>assistant under a physician and physician physician-physician assistant delegation <br/>
<a id="pl.30.8"></a><var>30.8</var>agreement described in section 
         <statute_ref>147A.20</statute_ref> shall not be held medically responsible for the <br/>
<a id="pl.30.9"></a><var>30.9</var>care rendered by a physician assistant pursuant to paragraph (a). Services provided by <br/>
<a id="pl.30.10"></a><var>30.10</var>a physician assistant under paragraph (a) shall be considered outside the scope of the <br/>
<a id="pl.30.11"></a><var>30.11</var>relationship between the supervising physician and the physician assistant.  <br/>
<br/>
<a id="bill.0.31.0"></a><a id="pl.30.12"></a><var>30.12</var>    Sec. 31. Minnesota Statutes 2008, section 147A.24, is amended to read:<br/>
<a id="pl.30.13"></a><var>30.13</var><b>147A.24 CONTINUING EDUCATION REQUIREMENTS.</b><br/>
<a id="pl.30.14"></a><var>30.14</var>    Subdivision 1. <b>Amount of education required.</b> Applicants for registration license <br/>
<a id="pl.30.15"></a><var>30.15</var>renewal or reregistration must either meet standards for continuing education through <br/>
<a id="pl.30.16"></a><var>30.16</var>current certification by the National Commission on Certification of Physician Assistants, <br/>
<a id="pl.30.17"></a><var>30.17</var>or its successor agency as approved by the board, or attest to and document provide <br/>
<a id="pl.30.18"></a><var>30.18</var>evidence of successful completion of at least 50 contact hours of continuing education <br/>
<a id="pl.30.19"></a><var>30.19</var>within the two years immediately preceding registration license renewal, reregistration, <br/>
<a id="pl.30.20"></a><var>30.20</var>or attest to and document taking the national certifying examination required by this <br/>
<a id="pl.30.21"></a><var>30.21</var>chapter within the past two years.<br/>
<a id="pl.30.22"></a><var>30.22</var>    Subd. 2. <b>Type of education required.</b> Approved Continuing education is approved <br/>
<a id="pl.30.23"></a><var>30.23</var>if it is equivalent to category 1 credit hours as defined by the American Osteopathic <br/>
<a id="pl.30.24"></a><var>30.24</var>Association Bureau of Professional Education, the Royal College of Physicians and <br/>
<a id="pl.30.25"></a><var>30.25</var>Surgeons of Canada, the American Academy of Physician Assistants, or by organizations <br/>
<a id="pl.30.26"></a><var>30.26</var>that have reciprocal arrangements with the physician recognition award program of the <br/>
<a id="pl.30.27"></a><var>30.27</var>American Medical Association.<br/>
<br/>
<a id="bill.0.32.0"></a><a id="pl.30.28"></a><var>30.28</var>    Sec. 32. Minnesota Statutes 2008, section 147A.26, is amended to read:<br/>
<a id="pl.30.29"></a><var>30.29</var><b>147A.26 PROCEDURES.</b><br/>
<a id="pl.30.30"></a><var>30.30</var>The board shall establish, in writing, internal operating procedures for receiving and <br/>
<a id="pl.30.31"></a><var>30.31</var>investigating complaints, accepting and processing applications, granting registrations <br/>
<a id="pl.30.32"></a><var>30.32</var>licenses, and imposing enforcement actions. The written internal operating procedures <br/>
<a id="pl.30.33"></a><var>30.33</var>may include procedures for sharing complaint information with government agencies in <br/>
<a id="pl.30.34"></a><var>30.34</var>this and other states. Procedures for sharing complaint information must be consistent <br/>
<a id="pl.30.35"></a><var>30.35</var>with the requirements for handling government data under chapter 13.<br/>
<br/>
<a id="bill.0.33.0"></a><a id="pl.31.1"></a><var>31.1</var>    Sec. 33. Minnesota Statutes 2008, section 147A.27, is amended to read:<br/>
<a id="pl.31.2"></a><var>31.2</var><b>147A.27 PHYSICIAN ASSISTANT ADVISORY COUNCIL.</b><br/>
<a id="pl.31.3"></a><var>31.3</var>    Subdivision 1. <b>Membership.</b> (a) The Physician Assistant Advisory Council is <br/>
<a id="pl.31.4"></a><var>31.4</var>created and is composed of seven persons appointed by the board. The seven persons <br/>
<a id="pl.31.5"></a><var>31.5</var>must include:<br/>
<a id="pl.31.6"></a><var>31.6</var>(1) two public members, as defined in section 
         <statute_ref>214.02</statute_ref>;  <br/>
<a id="pl.31.7"></a><var>31.7</var>(2) three physician assistants registered licensed under this chapter who meet the <br/>
<a id="pl.31.8"></a><var>31.8</var>criteria for a new applicant under section 147A.02; and<br/>
<a id="pl.31.9"></a><var>31.9</var>(3) two licensed physicians with experience supervising physician assistants.<br/>
<a id="pl.31.10"></a><var>31.10</var>(b) No member shall serve more than a total of two consecutive  terms. If a member <br/>
<a id="pl.31.11"></a><var>31.11</var>is appointed for a partial term and serves more than half of that term it shall be considered <br/>
<a id="pl.31.12"></a><var>31.12</var>a full term. Members serving on the council as of July 1, 2000, shall be allowed to <br/>
<a id="pl.31.13"></a><var>31.13</var>complete their current terms.<br/>
<a id="pl.31.14"></a><var>31.14</var>    Subd. 2. <b>Organization.</b> The council shall be organized and administered under <br/>
<a id="pl.31.15"></a><var>31.15</var>section 
         <statute_ref>15.059</statute_ref>.<br/>
<a id="pl.31.16"></a><var>31.16</var>    Subd. 3. <b>Duties.</b> The council shall advise the board regarding:<br/>
<a id="pl.31.17"></a><var>31.17</var>(1) physician assistant registration licensure standards;<br/>
<a id="pl.31.18"></a><var>31.18</var>(2) enforcement of grounds for discipline;<br/>
<a id="pl.31.19"></a><var>31.19</var>(3) distribution of information regarding physician assistant registration licensure <br/>
<a id="pl.31.20"></a><var>31.20</var>standards;<br/>
<a id="pl.31.21"></a><var>31.21</var>(4) applications and recommendations of applicants for registration licensure or <br/>
<a id="pl.31.22"></a><var>31.22</var>registration license renewal; and<br/>
<a id="pl.31.23"></a><var>31.23</var>(5) complaints and recommendations to the board regarding disciplinary matters and <br/>
<a id="pl.31.24"></a><var>31.24</var>proceedings concerning applicants and registrants licensees according to sections 
         <statute_ref>214.10</statute_ref>; <br/>
<statute_ref><a id="pl.31.25"></a><var>31.25</var>214.103
         </statute_ref>; and 
         <statute_ref>214.13, subdivisions 6 and 7; and<br/>
</statute_ref><a id="pl.31.26"></a><var>31.26</var>(6) issues related to physician assistant practice and regulation.  <br/>
<a id="pl.31.27"></a><var>31.27</var>The council shall perform other duties authorized for the council by chapter 214 <br/>
<a id="pl.31.28"></a><var>31.28</var>as directed by the board.<br/>
<br/>
<a id="bill.0.34.0"></a><a id="pl.31.29"></a><var>31.29</var>    Sec. 34. Minnesota Statutes 2008, section 148.06, subdivision 1, is amended to read:<br/>
<a id="pl.31.30"></a><var>31.30</var>    Subdivision 1. <b>License required; qualifications.</b> No person shall practice <br/>
<a id="pl.31.31"></a><var>31.31</var>chiropractic in this state without first being licensed by the state Board of Chiropractic <br/>
<a id="pl.31.32"></a><var>31.32</var>Examiners. The applicant shall have earned at least one-half of all academic credits <br/>
<a id="pl.31.33"></a><var>31.33</var>required for awarding of a baccalaureate degree from the University of Minnesota, or <br/>
<a id="pl.31.34"></a><var>31.34</var>other university, college, or community college of equal standing, in subject matter <br/>
<a id="pl.31.35"></a><var>31.35</var>determined by the board, and taken a four-year resident course of at least eight months <br/>
<a id="pl.32.1"></a><var>32.1</var>each in a school or college of chiropractic or in a chiropractic program that is accredited <br/>
<a id="pl.32.2"></a><var>32.2</var>by the Council on Chiropractic Education, holds a recognition agreement with the <br/>
<a id="pl.32.3"></a><var>32.3</var>Council on Chiropractic Education, or is accredited by an agency approved by the United <br/>
<a id="pl.32.4"></a><var>32.4</var>States Office of Education or their successors as of January 1, 1988, or is approved by a <br/>
<a id="pl.32.5"></a><var>32.5</var>Council on Chiropractic Education member organization of the Council on Chiropractic <br/>
<a id="pl.32.6"></a><var>32.6</var>International. The board may issue licenses to practice chiropractic without compliance <br/>
<a id="pl.32.7"></a><var>32.7</var>with prechiropractic or academic requirements listed above if in the opinion of the board <br/>
<a id="pl.32.8"></a><var>32.8</var>the applicant has the qualifications equivalent to those required of other applicants, the <br/>
<a id="pl.32.9"></a><var>32.9</var>applicant satisfactorily passes written and practical examinations as required by the Board <br/>
<a id="pl.32.10"></a><var>32.10</var>of Chiropractic Examiners, and the applicant is a graduate of a college of chiropractic <br/>
<a id="pl.32.11"></a><var>32.11</var>with a recognition agreement with the Council on Chiropractic Education approved by a <br/>
<a id="pl.32.12"></a><var>32.12</var>Council on Chiropractic Education member organization of the Council on Chiropractic <br/>
<a id="pl.32.13"></a><var>32.13</var>International. The board may recommend a two-year prechiropractic course of instruction <br/>
<a id="pl.32.14"></a><var>32.14</var>to any university, college, or community college which in its judgment would satisfy the <br/>
<a id="pl.32.15"></a><var>32.15</var>academic prerequisite for licensure as established by this section.<br/>
<a id="pl.32.16"></a><var>32.16</var>An examination for a license shall be in writing and shall include testing in:<br/>
<a id="pl.32.17"></a><var>32.17</var>(a) The basic sciences including but not limited to anatomy, physiology, bacteriology, <br/>
<a id="pl.32.18"></a><var>32.18</var>pathology, hygiene, and chemistry as related to the human body or mind;<br/>
<a id="pl.32.19"></a><var>32.19</var>(b) The clinical sciences including but not limited to the science and art of <br/>
<a id="pl.32.20"></a><var>32.20</var>chiropractic, chiropractic physiotherapy, diagnosis, roentgenology, and nutrition; and<br/>
<a id="pl.32.21"></a><var>32.21</var>(c) Professional ethics and any other subjects that the board may deem advisable.<br/>
<a id="pl.32.22"></a><var>32.22</var>The board may consider a valid certificate of examination from the National Board <br/>
<a id="pl.32.23"></a><var>32.23</var>of Chiropractic Examiners as evidence of compliance with the examination requirements <br/>
<a id="pl.32.24"></a><var>32.24</var>of this subdivision. The applicant shall be required to give practical demonstration in <br/>
<a id="pl.32.25"></a><var>32.25</var>vertebral palpation, neurology, adjusting and any other subject that the board may deem <br/>
<a id="pl.32.26"></a><var>32.26</var>advisable. A license, countersigned by the members of the board and authenticated by the <br/>
<a id="pl.32.27"></a><var>32.27</var>seal thereof, shall be granted to each applicant who correctly answers 75 percent of the <br/>
<a id="pl.32.28"></a><var>32.28</var>questions propounded in each of the subjects required by this subdivision and meets the <br/>
<a id="pl.32.29"></a><var>32.29</var>standards of practical demonstration established by the board. Each application shall be <br/>
<a id="pl.32.30"></a><var>32.30</var>accompanied by a fee set by the board. The fee shall not be returned but the applicant <br/>
<a id="pl.32.31"></a><var>32.31</var>may, within one year, apply for examination without the payment of an additional fee. The <br/>
<a id="pl.32.32"></a><var>32.32</var>board may grant a license to an applicant who holds a valid license to practice chiropractic <br/>
<a id="pl.32.33"></a><var>32.33</var>issued by the appropriate licensing board of another state, provided the applicant meets <br/>
<a id="pl.32.34"></a><var>32.34</var>the other requirements of this section and satisfactorily passes a practical examination <br/>
<a id="pl.32.35"></a><var>32.35</var>approved by the board. The burden of proof is on the applicant to demonstrate these <br/>
<a id="pl.32.36"></a><var>32.36</var>qualifications or satisfaction of these requirements.<br/>
<br/>
<a id="bill.0.35.0"></a><a id="pl.33.1"></a><var>33.1</var>    Sec. 35. <b>[148.107] RECORD KEEPING.</b><br/>
<a id="pl.33.2"></a><var>33.2</var>All items in this section should be contained in the patient record, including, but not <br/>
<a id="pl.33.3"></a><var>33.3</var>limited to, paragraphs (a), (b), (c), (e), (g), and (i).<br/>
<a id="pl.33.4"></a><var>33.4</var>(a) A description of past conditions and trauma, past treatment received, current <br/>
<a id="pl.33.5"></a><var>33.5</var>treatment being received from other health care providers, and a description of the patient's <br/>
<a id="pl.33.6"></a><var>33.6</var>current condition including onset and description of trauma if trauma occurred.<br/>
<a id="pl.33.7"></a><var>33.7</var>(b) Examinations performed to determine a preliminary or final diagnosis based on <br/>
<a id="pl.33.8"></a><var>33.8</var>indicated diagnostic tests, with a record of findings of each test performed.<br/>
<a id="pl.33.9"></a><var>33.9</var>(c) A diagnosis supported by documented subjective and objective findings, or <br/>
<a id="pl.33.10"></a><var>33.10</var>clearly qualified as an opinion.<br/>
<a id="pl.33.11"></a><var>33.11</var>(d) A treatment plan that describes the procedures and treatment used for the <br/>
<a id="pl.33.12"></a><var>33.12</var>conditions identified, including approximate frequency of care.<br/>
<a id="pl.33.13"></a><var>33.13</var>(e) Daily notes documenting current subjective complaints as described by the <br/>
<a id="pl.33.14"></a><var>33.14</var>patient, any change in objective findings if noted during that visit, a listing of all <br/>
<a id="pl.33.15"></a><var>33.15</var>procedures provided during that visit, and all information that is exchanged and will affect <br/>
<a id="pl.33.16"></a><var>33.16</var>that patient's treatment.<br/>
<a id="pl.33.17"></a><var>33.17</var>(f) A description by the chiropractor or written by the patient each time an incident <br/>
<a id="pl.33.18"></a><var>33.18</var>occurs that results in an aggravation of the patient's condition or a new developing <br/>
<a id="pl.33.19"></a><var>33.19</var>condition.<br/>
<a id="pl.33.20"></a><var>33.20</var>(g) Results of reexaminations that are performed to evaluate significant changes in <br/>
<a id="pl.33.21"></a><var>33.21</var>a patient's condition, including tests that were positive or deviated from results used to <br/>
<a id="pl.33.22"></a><var>33.22</var>indicate normal findings.<br/>
<a id="pl.33.23"></a><var>33.23</var>(h) When symbols or abbreviations are used, a key that explains their meanings must <br/>
<a id="pl.33.24"></a><var>33.24</var>accompany each file when requested in writing by the patient or a third party.<br/>
<a id="pl.33.25"></a><var>33.25</var>(i) Documentation that family history has been evaluated.<br/>
<br/>
<a id="bill.0.36.0"></a><a id="pl.33.26"></a><var>33.26</var>    Sec. 36. Minnesota Statutes 2008, section 148.624, subdivision 2, is amended to read:<br/>
<a id="pl.33.27"></a><var>33.27</var>    Subd. 2. <b>Nutrition.</b> The board shall issue a license as a nutritionist to a person who <br/>
<a id="pl.33.28"></a><var>33.28</var>files a completed application, pays all required fees, and certifies and furnishes evidence <br/>
<a id="pl.33.29"></a><var>33.29</var>satisfactory to the board that the applicant:<br/>
<a id="pl.33.30"></a><var>33.30</var>(1) meets the following qualifications:<br/>
<a id="pl.33.31"></a><var>33.31</var>(i) has received a master's or doctoral degree from an accredited or approved college <br/>
<a id="pl.33.32"></a><var>33.32</var>or university with a major in human nutrition, public health nutrition, clinical nutrition, <br/>
<a id="pl.33.33"></a><var>33.33</var>nutrition education, community nutrition, or food and nutrition; and<br/>
<a id="pl.33.34"></a><var>33.34</var>(ii) has completed a documented supervised preprofessional practice experience <br/>
<a id="pl.33.35"></a><var>33.35</var>component in dietetic practice of not less than 900 hours under the supervision of a <br/>
<a id="pl.33.36"></a><var>33.36</var>registered dietitian, a state licensed nutrition professional, or an individual with a doctoral <br/>
<a id="pl.34.1"></a><var>34.1</var>degree conferred by a United States regionally accredited college or university with a <br/>
<a id="pl.34.2"></a><var>34.2</var>major course of study in human nutrition, nutrition education, food and nutrition, dietetics, <br/>
<a id="pl.34.3"></a><var>34.3</var>or food systems management. Supervised practice experience must be completed in the <br/>
<a id="pl.34.4"></a><var>34.4</var>United States or its territories. Supervisors who obtain their doctoral degree outside the <br/>
<a id="pl.34.5"></a><var>34.5</var>United States and its territories must have their degrees validated as equivalent to the <br/>
<a id="pl.34.6"></a><var>34.6</var>doctoral degree conferred by a United States regionally accredited college or university; or<br/>
<a id="pl.34.7"></a><var>34.7</var>(2) has qualified as a diplomate of the American Board of Nutrition, Springfield, <br/>
<a id="pl.34.8"></a><var>34.8</var>Virginia received certification as a Certified Nutrition Specialist by the Certification Board <br/>
<a id="pl.34.9"></a><var>34.9</var>for Nutrition Specialists.<br/>
<br/>
<a id="bill.0.37.0"></a><a id="pl.34.10"></a><var>34.10</var>    Sec. 37. Minnesota Statutes 2008, section 148.89, subdivision 5, is amended to read:<br/>
<a id="pl.34.11"></a><var>34.11</var>    Subd. 5. <b>Practice of psychology.</b> "Practice of psychology" means the observation, <br/>
<a id="pl.34.12"></a><var>34.12</var>description, evaluation, interpretation, or modification of human behavior by the <br/>
<a id="pl.34.13"></a><var>34.13</var>application of psychological principles, methods, or procedures for any reason, including <br/>
<a id="pl.34.14"></a><var>34.14</var>to prevent, eliminate, or manage symptomatic, maladaptive, or undesired behavior and to <br/>
<a id="pl.34.15"></a><var>34.15</var>enhance interpersonal relationships, work, life and developmental adjustment, personal <br/>
<a id="pl.34.16"></a><var>34.16</var>and organizational effectiveness, behavioral health, and mental health. The practice of <br/>
<a id="pl.34.17"></a><var>34.17</var>psychology includes, but is not limited to, the following services, regardless of whether <br/>
<a id="pl.34.18"></a><var>34.18</var>the provider receives payment for the services:<br/>
<a id="pl.34.19"></a><var>34.19</var>(1) psychological research and teaching of psychology;<br/>
<a id="pl.34.20"></a><var>34.20</var>(2) assessment, including psychological testing and other means of evaluating <br/>
<a id="pl.34.21"></a><var>34.21</var>personal characteristics such as intelligence, personality, abilities, interests, aptitudes, and <br/>
<a id="pl.34.22"></a><var>34.22</var>neuropsychological functioning;<br/>
<a id="pl.34.23"></a><var>34.23</var>(3) a psychological report, whether written or oral, including testimony of a provider <br/>
<a id="pl.34.24"></a><var>34.24</var>as an expert witness, concerning the characteristics of an individual or entity;<br/>
<a id="pl.34.25"></a><var>34.25</var>(4) psychotherapy, including but not limited to, categories such as behavioral, <br/>
<a id="pl.34.26"></a><var>34.26</var>cognitive, emotive, systems, psychophysiological, or insight-oriented therapies; <br/>
<a id="pl.34.27"></a><var>34.27</var>counseling; hypnosis; and diagnosis and treatment of:<br/>
<a id="pl.34.28"></a><var>34.28</var>(i) mental and emotional disorder or disability;<br/>
<a id="pl.34.29"></a><var>34.29</var>(ii) alcohol and substance dependence or abuse;<br/>
<a id="pl.34.30"></a><var>34.30</var>(iii) disorders of habit or conduct;<br/>
<a id="pl.34.31"></a><var>34.31</var>(iv) the psychological aspects of physical illness or condition, accident, injury, or <br/>
<a id="pl.34.32"></a><var>34.32</var>disability, including the psychological impact of medications;<br/>
<a id="pl.34.33"></a><var>34.33</var>(v) life adjustment issues, including work-related and bereavement issues; and<br/>
<a id="pl.34.34"></a><var>34.34</var>(vi) child, family, or relationship issues;<br/>
<a id="pl.34.35"></a><var>34.35</var>(5) psychoeducational services and treatment; and<br/>
<a id="pl.34.36"></a><var>34.36</var>(6) consultation and supervision.<br/>
<br/>
<a id="bill.0.38.0"></a><a id="pl.35.1"></a><var>35.1</var>    Sec. 38. Minnesota Statutes 2008, section 148.995, subdivision 2, is amended to read:<br/>
<a id="pl.35.2"></a><var>35.2</var>    Subd. 2. <b>Certified doula.</b> "Certified doula" means an individual who has received <br/>
<a id="pl.35.3"></a><var>35.3</var>a certification to perform doula services from the International Childbirth Education <br/>
<a id="pl.35.4"></a><var>35.4</var>Association, the Doulas of North America (DONA), the Association of Labor Assistants <br/>
<a id="pl.35.5"></a><var>35.5</var>and Childbirth Educators (ALACE), Birthworks, Childbirth and Postpartum Professional <br/>
<a id="pl.35.6"></a><var>35.6</var>Association (CAPPA), or Childbirth International, or International Center for Traditional <br/>
<a id="pl.35.7"></a><var>35.7</var>Childbearing.<br/>
<br/>
<a id="bill.0.39.0"></a><a id="pl.35.8"></a><var>35.8</var>    Sec. 39. Minnesota Statutes 2008, section 148.995, subdivision 4, is amended to read:<br/>
<a id="pl.35.9"></a><var>35.9</var>    Subd. 4. <b>Doula services.</b> "Doula services" means continuous emotional and <br/>
<a id="pl.35.10"></a><var>35.10</var>physical support during pregnancy, labor, birth, and postpartum throughout labor and <br/>
<a id="pl.35.11"></a><var>35.11</var>birth, and intermittently during the prenatal and postpartum periods.<br/>
<br/>
<a id="bill.0.40.0"></a><a id="pl.35.12"></a><var>35.12</var>    Sec. 40. Minnesota Statutes 2008, section 150A.01, subdivision 8, is amended to read:<br/>
<a id="pl.35.13"></a><var>35.13</var>    Subd. 8. <b>Registered</b><b> Licensed</b><b> dental assistant.</b> "Registered Licensed dental <br/>
<a id="pl.35.14"></a><var>35.14</var>assistant" means a person registered licensed pursuant to section 
         <statute_ref>150A.06</statute_ref>.<br/>
<br/>
<a id="bill.0.41.0"></a><a id="pl.35.15"></a><var>35.15</var>    Sec. 41. Minnesota Statutes 2008, section 150A.02, subdivision 1, is amended to read:<br/>
<a id="pl.35.16"></a><var>35.16</var>    Subdivision 1. <b>Generally.</b> There is hereby created a Board of Dentistry whose duty <br/>
<a id="pl.35.17"></a><var>35.17</var>it shall be to carry out the purposes and enforce the provisions of sections 
         <statute_ref>150A.01</statute_ref> to <br/>
<statute_ref><a id="pl.35.18"></a><var>35.18</var>150A.12
         </statute_ref>. The board shall consist of two public members as defined by section 
         <statute_ref>214.02</statute_ref>, <br/>
<a id="pl.35.19"></a><var>35.19</var>five qualified resident dentists, one qualified resident registered licensed dental assistant, <br/>
<a id="pl.35.20"></a><var>35.20</var>and one qualified resident dental hygienist appointed by the governor. Membership terms, <br/>
<a id="pl.35.21"></a><var>35.21</var>compensation of members, removal of members, the filling of membership vacancies, and <br/>
<a id="pl.35.22"></a><var>35.22</var>fiscal year and reporting requirements shall be as provided in sections 
         <statute_ref>214.07</statute_ref> to 
         <statute_ref>214.09</statute_ref>. <br/>
<a id="pl.35.23"></a><var>35.23</var>The provision of staff, administrative services and office space; the review and processing <br/>
<a id="pl.35.24"></a><var>35.24</var>of board complaints; the setting of board fees; and other provisions relating to board <br/>
<a id="pl.35.25"></a><var>35.25</var>operations shall be as provided in chapter 214. Each board member who is a dentist, <br/>
<a id="pl.35.26"></a><var>35.26</var>registered licensed dental assistant, or dental hygienist shall have been lawfully in active <br/>
<a id="pl.35.27"></a><var>35.27</var>practice in this state for five years immediately preceding appointment; and no board <br/>
<a id="pl.35.28"></a><var>35.28</var>member shall be eligible for appointment to more than two consecutive four-year terms, <br/>
<a id="pl.35.29"></a><var>35.29</var>and members serving on the board at the time of the enactment hereof shall be eligible <br/>
<a id="pl.35.30"></a><var>35.30</var>to reappointment provided they shall not have served more than nine consecutive years <br/>
<a id="pl.35.31"></a><var>35.31</var>at the expiration of the term to which they are to be appointed. At least 90 days prior to <br/>
<a id="pl.35.32"></a><var>35.32</var>the expiration of the terms of dentists, registered licensed dental assistants, or dental <br/>
<a id="pl.35.33"></a><var>35.33</var>hygienists, the Minnesota Dental Association, Minnesota Dental Assistants Association, <br/>
<a id="pl.35.34"></a><var>35.34</var>or the Minnesota State Dental Hygiene Association shall recommend to the governor for <br/>
<a id="pl.36.1"></a><var>36.1</var>each term expiring not less than two dentists, two registered licensed dental assistants, <br/>
<a id="pl.36.2"></a><var>36.2</var>or two dental hygienists, respectively, who are qualified to serve on the board, and from <br/>
<a id="pl.36.3"></a><var>36.3</var>the list so recommended the governor may appoint members to the board for the term of <br/>
<a id="pl.36.4"></a><var>36.4</var>four years, the appointments to be made within 30 days after the expiration of the terms. <br/>
<a id="pl.36.5"></a><var>36.5</var>Within 60 days after the occurrence of a dentist, registered licensed dental assistant or <br/>
<a id="pl.36.6"></a><var>36.6</var>dental hygienist vacancy, prior to the expiration of the term, in the board, the Minnesota <br/>
<a id="pl.36.7"></a><var>36.7</var>Dental Association, the Minnesota Dental Assistants Association, or the Minnesota State <br/>
<a id="pl.36.8"></a><var>36.8</var>Dental Hygiene Association shall recommend to the governor not less than two dentists, <br/>
<a id="pl.36.9"></a><var>36.9</var>two registered licensed dental assistants, or two dental hygienists, who are qualified to <br/>
<a id="pl.36.10"></a><var>36.10</var>serve on the board and from the list so recommended the governor, within 30 days after <br/>
<a id="pl.36.11"></a><var>36.11</var>receiving such list of dentists, may appoint one member to the board for the unexpired <br/>
<a id="pl.36.12"></a><var>36.12</var>term occasioned by such vacancy. Any appointment to fill a vacancy shall be made <br/>
<a id="pl.36.13"></a><var>36.13</var>within 90 days after the occurrence of such vacancy. The first four-year term of the <br/>
<a id="pl.36.14"></a><var>36.14</var>dental hygienist and of the registered licensed dental assistant shall commence on the <br/>
<a id="pl.36.15"></a><var>36.15</var>first Monday in January, 1977.<br/>
<br/>
<a id="bill.0.42.0"></a><a id="pl.36.16"></a><var>36.16</var>    Sec. 42. Minnesota Statutes 2008, section 150A.05, subdivision 2, is amended to read:<br/>
<a id="pl.36.17"></a><var>36.17</var>    Subd. 2. <b>Exemptions and exceptions of certain practices and operations.</b><br/>
<a id="pl.36.18"></a><var>36.18</var>Sections 
         <statute_ref>150A.01</statute_ref> to 
         <statute_ref>150A.12</statute_ref> do not apply to:<br/>
<a id="pl.36.19"></a><var>36.19</var>(1) the practice of dentistry or dental hygiene in any branch of the armed services of <br/>
<a id="pl.36.20"></a><var>36.20</var>the United States, the United States Public Health Service, or the United States Veterans <br/>
<a id="pl.36.21"></a><var>36.21</var>Administration;<br/>
<a id="pl.36.22"></a><var>36.22</var>(2) the practice of dentistry, dental hygiene, or dental assisting by undergraduate <br/>
<a id="pl.36.23"></a><var>36.23</var>dental students, dental hygiene students, and dental assisting students of the University <br/>
<a id="pl.36.24"></a><var>36.24</var>of Minnesota, schools of dental hygiene, or schools of dental assisting approved by the <br/>
<a id="pl.36.25"></a><var>36.25</var>board, when acting under the direction and indirect supervision of a Minnesota licensed <br/>
<a id="pl.36.26"></a><var>36.26</var>dentist or a and under the instruction of a licensed dentist, licensed dental hygienist acting <br/>
<a id="pl.36.27"></a><var>36.27</var>as an instructor, or licensed dental assistant;<br/>
<a id="pl.36.28"></a><var>36.28</var>(3) the practice of dentistry by licensed dentists of other states or countries while <br/>
<a id="pl.36.29"></a><var>36.29</var>appearing as clinicians under the auspices of a duly approved dental school or college, or a <br/>
<a id="pl.36.30"></a><var>36.30</var>reputable dental society, or a reputable dental study club composed of dentists;<br/>
<a id="pl.36.31"></a><var>36.31</var>(4) the actions of persons while they are taking examinations for licensure <br/>
<a id="pl.36.32"></a><var>36.32</var>or registration administered or approved by the board pursuant to sections 
         <statute_ref>150A.03, <br/>
<a id="pl.36.33"></a><var>36.33</var>subdivision 1
         </statute_ref>, and 
         <statute_ref>150A.06, subdivisions 1, 2, and 2a</statute_ref>;<br/>
<a id="pl.36.34"></a><var>36.34</var>(5) the practice of dentistry by dentists and dental hygienists licensed by other states <br/>
<a id="pl.36.35"></a><var>36.35</var>during their functioning as examiners responsible for conducting licensure or registration <br/>
<a id="pl.36.36"></a><var>36.36</var>examinations administered by regional and national testing agencies with whom the <br/>
<a id="pl.37.1"></a><var>37.1</var>board is authorized to affiliate and participate under section 
         <statute_ref>150A.03, subdivision 1</statute_ref>, <br/>
<a id="pl.37.2"></a><var>37.2</var>and the practice of dentistry by the regional and national testing agencies during their <br/>
<a id="pl.37.3"></a><var>37.3</var>administering examinations pursuant to section 
         <statute_ref>150A.03, subdivision 1</statute_ref>;<br/>
<a id="pl.37.4"></a><var>37.4</var>(6) the use of X-rays or other diagnostic imaging modalities for making radiographs <br/>
<a id="pl.37.5"></a><var>37.5</var>or other similar records in a hospital under the supervision of a physician or dentist or <br/>
<a id="pl.37.6"></a><var>37.6</var>by a person who is credentialed to use diagnostic imaging modalities or X-ray machines <br/>
<a id="pl.37.7"></a><var>37.7</var>for dental treatment, roentgenograms, or dental diagnostic purposes by a credentialing <br/>
<a id="pl.37.8"></a><var>37.8</var>agency other than the Board of Dentistry; or<br/>
<a id="pl.37.9"></a><var>37.9</var>(7) the service, other than service performed directly upon the person of a patient, of <br/>
<a id="pl.37.10"></a><var>37.10</var>constructing, altering, repairing, or duplicating any denture, partial denture, crown, bridge, <br/>
<a id="pl.37.11"></a><var>37.11</var>splint, orthodontic, prosthetic, or other dental appliance, when performed according <br/>
<a id="pl.37.12"></a><var>37.12</var>to a written work order from a licensed dentist in accordance with section 
         <statute_ref>150A.10, <br/>
<a id="pl.37.13"></a><var>37.13</var>subdivision 3
         </statute_ref>.<br/>
<br/>
<a id="bill.0.43.0"></a><a id="pl.37.14"></a><var>37.14</var>    Sec. 43. Minnesota Statutes 2008, section 150A.06, subdivision 2a, is amended to read:<br/>
<a id="pl.37.15"></a><var>37.15</var>    Subd. 2a. <b>Registered</b><b> Licensed</b><b> dental assistant.</b> A person of good moral character, <br/>
<a id="pl.37.16"></a><var>37.16</var>who has graduated from a dental assisting program accredited by the Commission on <br/>
<a id="pl.37.17"></a><var>37.17</var>Dental Accreditation of the American Dental Association, may apply for registration <br/>
<a id="pl.37.18"></a><var>37.18</var>licensure. The applicant must submit an application and fee as prescribed by the board <br/>
<a id="pl.37.19"></a><var>37.19</var>and the diploma or certificate of dental assisting. In the case of examinations conducted <br/>
<a id="pl.37.20"></a><var>37.20</var>pursuant to section 
         <statute_ref>150A.03, subdivision 1</statute_ref>, applicants shall take the examination before <br/>
<a id="pl.37.21"></a><var>37.21</var>applying to the board for registration licensure. The examination shall include an <br/>
<a id="pl.37.22"></a><var>37.22</var>examination of the applicant's knowledge of the laws of Minnesota relating to dentistry <br/>
<a id="pl.37.23"></a><var>37.23</var>and the rules of the board. An applicant is ineligible to retake the registration licensure <br/>
<a id="pl.37.24"></a><var>37.24</var>examination required by the board after failing it twice until further education and training <br/>
<a id="pl.37.25"></a><var>37.25</var>are obtained as specified by board rule. A separate, nonrefundable fee may be charged for <br/>
<a id="pl.37.26"></a><var>37.26</var>each time a person applies. An applicant who passes the examination in compliance with <br/>
<a id="pl.37.27"></a><var>37.27</var>subdivision 2b, abides by professional ethical conduct requirements, and meets all the <br/>
<a id="pl.37.28"></a><var>37.28</var>other requirements of the board shall be registered licensed as a dental assistant.<br/>
<br/>
<a id="bill.0.44.0"></a><a id="pl.37.29"></a><var>37.29</var>    Sec. 44. Minnesota Statutes 2008, section 150A.06, subdivision 2b, is amended to read:<br/>
<a id="pl.37.30"></a><var>37.30</var>    Subd. 2b. <b>Examination.</b> When the Board of Dentistry administers the examination <br/>
<a id="pl.37.31"></a><var>37.31</var>for licensure or registration, only those board members or board-appointed deputy <br/>
<a id="pl.37.32"></a><var>37.32</var>examiners qualified for the particular examination may administer it. An examination <br/>
<a id="pl.37.33"></a><var>37.33</var>which the board requires as a condition of licensure or registration must have been taken <br/>
<a id="pl.37.34"></a><var>37.34</var>within the five years before the board receives the application for licensure or registration.<br/>
<br/>
<a id="bill.0.45.0"></a><a id="pl.37.35"></a><var>37.35</var>    Sec. 45. Minnesota Statutes 2008, section 150A.06, subdivision 2c, is amended to read:<br/>
<a id="pl.38.1"></a><var>38.1</var>    Subd. 2c. <b>Guest license </b><b>or registration</b><b>.</b> (a) The board shall grant a guest license to <br/>
<a id="pl.38.2"></a><var>38.2</var>practice as a dentist or, dental hygienist, or a guest registration to practice as a licensed <br/>
<a id="pl.38.3"></a><var>38.3</var>dental assistant if the following conditions are met:<br/>
<a id="pl.38.4"></a><var>38.4</var>(1) the dentist, dental hygienist, or dental assistant is currently licensed or registered <br/>
<a id="pl.38.5"></a><var>38.5</var>in good standing in North Dakota, South Dakota, Iowa, or Wisconsin;<br/>
<a id="pl.38.6"></a><var>38.6</var>(2) the dentist, dental hygienist, or dental assistant is currently engaged in the practice <br/>
<a id="pl.38.7"></a><var>38.7</var>of that person's respective profession in North Dakota, South Dakota, Iowa, or Wisconsin;<br/>
<a id="pl.38.8"></a><var>38.8</var>(3) the dentist, dental hygienist, or dental assistant will limit that person's practice to <br/>
<a id="pl.38.9"></a><var>38.9</var>a public health setting in Minnesota that (i) is approved by the board; (ii) was established <br/>
<a id="pl.38.10"></a><var>38.10</var>by a nonprofit organization that is tax exempt under chapter 501(c)(3) of the Internal <br/>
<a id="pl.38.11"></a><var>38.11</var>Revenue Code of 1986; and (iii) provides dental care to patients who have difficulty <br/>
<a id="pl.38.12"></a><var>38.12</var>accessing dental care;<br/>
<a id="pl.38.13"></a><var>38.13</var>(4) the dentist, dental hygienist, or dental assistant agrees to treat indigent patients <br/>
<a id="pl.38.14"></a><var>38.14</var>who meet the eligibility criteria established by the clinic; and<br/>
<a id="pl.38.15"></a><var>38.15</var>(5) the dentist, dental hygienist, or dental assistant has applied to the board for a <br/>
<a id="pl.38.16"></a><var>38.16</var>guest license or registration and has paid a nonrefundable license fee to the board not <br/>
<a id="pl.38.17"></a><var>38.17</var>to exceed $75.<br/>
<a id="pl.38.18"></a><var>38.18</var>(b) A guest license or registration must be renewed annually with the board and an <br/>
<a id="pl.38.19"></a><var>38.19</var>annual renewal fee not to exceed $75 must be paid to the board.<br/>
<a id="pl.38.20"></a><var>38.20</var>(c) A dentist, dental hygienist, or dental assistant practicing under a guest license <br/>
<a id="pl.38.21"></a><var>38.21</var>or registration under this subdivision shall have the same obligations as a dentist, dental <br/>
<a id="pl.38.22"></a><var>38.22</var>hygienist, or dental assistant who is licensed in Minnesota and shall be subject to the laws <br/>
<a id="pl.38.23"></a><var>38.23</var>and rules of Minnesota and the regulatory authority of the board. If the board suspends <br/>
<a id="pl.38.24"></a><var>38.24</var>or revokes the guest license or registration of, or otherwise disciplines, a dentist, dental <br/>
<a id="pl.38.25"></a><var>38.25</var>hygienist, or dental assistant practicing under this subdivision, the board shall promptly <br/>
<a id="pl.38.26"></a><var>38.26</var>report such disciplinary action to the dentist's, dental hygienist's, or dental assistant's <br/>
<a id="pl.38.27"></a><var>38.27</var>regulatory board in the border state.<br/>
<br/>
<a id="bill.0.46.0"></a><a id="pl.38.28"></a><var>38.28</var>    Sec. 46. Minnesota Statutes 2008, section 150A.06, subdivision 2d, is amended to read:<br/>
<a id="pl.38.29"></a><var>38.29</var>    Subd. 2d. <b>Continuing education and professional development waiver.</b> (a) The <br/>
<a id="pl.38.30"></a><var>38.30</var>board shall grant a waiver to the continuing education requirements under this chapter <br/>
<a id="pl.38.31"></a><var>38.31</var>for a licensed dentist, licensed dental hygienist, or registered licensed dental assistant <br/>
<a id="pl.38.32"></a><var>38.32</var>who documents to the satisfaction of the board that the dentist, dental hygienist, or <br/>
<a id="pl.38.33"></a><var>38.33</var>registered licensed dental assistant has retired from active practice in the state and limits <br/>
<a id="pl.38.34"></a><var>38.34</var>the provision of dental care services to those offered without compensation in a public <br/>
<a id="pl.38.35"></a><var>38.35</var>health, community, or tribal clinic or a nonprofit organization that provides services to <br/>
<a id="pl.39.1"></a><var>39.1</var>the indigent or to recipients of medical assistance, general assistance medical care, or <br/>
<a id="pl.39.2"></a><var>39.2</var>MinnesotaCare programs.<br/>
<a id="pl.39.3"></a><var>39.3</var>(b) The board may require written documentation from the volunteer and retired <br/>
<a id="pl.39.4"></a><var>39.4</var>dentist, dental hygienist, or registered licensed dental assistant prior to granting this waiver.<br/>
<a id="pl.39.5"></a><var>39.5</var>(c) The board shall require the volunteer and retired dentist, dental hygienist, or <br/>
<a id="pl.39.6"></a><var>39.6</var>registered licensed dental assistant to meet the following requirements:<br/>
<a id="pl.39.7"></a><var>39.7</var>(1) a licensee or registrant seeking a waiver under this subdivision must complete <br/>
<a id="pl.39.8"></a><var>39.8</var>and document at least five hours of approved courses in infection control, medical <br/>
<a id="pl.39.9"></a><var>39.9</var>emergencies, and medical management for the continuing education cycle; and<br/>
<a id="pl.39.10"></a><var>39.10</var>(2) provide documentation of certification in advanced or basic cardiac life <br/>
<a id="pl.39.11"></a><var>39.11</var>support recognized by current CPR certification from completion of the American Heart <br/>
<a id="pl.39.12"></a><var>39.12</var>Association healthcare provider course, the American Red Cross professional rescuer <br/>
<a id="pl.39.13"></a><var>39.13</var>course, or an equivalent entity.<br/>
<br/>
<a id="bill.0.47.0"></a><a id="pl.39.14"></a><var>39.14</var>    Sec. 47. Minnesota Statutes 2008, section 150A.06, subdivision 4a, is amended to read:<br/>
<a id="pl.39.15"></a><var>39.15</var>    Subd. 4a. <b>Appeal of denial of application.</b> A person whose application for <br/>
<a id="pl.39.16"></a><var>39.16</var>licensure or registration by credentials has been denied may appeal the decision to the <br/>
<a id="pl.39.17"></a><var>39.17</var>board. The board shall establish an appeals process and inform a denied candidate of the <br/>
<a id="pl.39.18"></a><var>39.18</var>right to appeal and the process for filing the appeal.<br/>
<br/>
<a id="bill.0.48.0"></a><a id="pl.39.19"></a><var>39.19</var>    Sec. 48. Minnesota Statutes 2008, section 150A.06, subdivision 5, is amended to read:<br/>
<a id="pl.39.20"></a><var>39.20</var>    Subd. 5. <b>Fraud in securing licenses </b><b>or registrations</b><b>.</b> Every person implicated <br/>
<a id="pl.39.21"></a><var>39.21</var>in employing fraud or deception in applying for or securing a license or registration to <br/>
<a id="pl.39.22"></a><var>39.22</var>practice dentistry, dental hygiene, or dental assisting or in annually renewing a license <br/>
<a id="pl.39.23"></a><var>39.23</var>or registration under sections 
         <statute_ref>150A.01</statute_ref> to 
         <statute_ref>150A.12</statute_ref> is guilty of a gross misdemeanor.<br/>
<br/>
<a id="bill.0.49.0"></a><a id="pl.39.24"></a><var>39.24</var>    Sec. 49. Minnesota Statutes 2008, section 150A.06, subdivision 7, is amended to read:<br/>
<a id="pl.39.25"></a><var>39.25</var>    Subd. 7. <b>Additional remedies for licensure </b><b>and registration</b><b>.</b> On a case-by-case <br/>
<a id="pl.39.26"></a><var>39.26</var>basis, for initial or renewal of licensure or registration, the board may add additional <br/>
<a id="pl.39.27"></a><var>39.27</var>remedies for deficiencies found based on the applicant's performance, character, and <br/>
<a id="pl.39.28"></a><var>39.28</var>education.<br/>
<br/>
<a id="bill.0.50.0"></a><a id="pl.39.29"></a><var>39.29</var>    Sec. 50. Minnesota Statutes 2008, section 150A.06, subdivision 8, is amended to read:<br/>
<a id="pl.39.30"></a><var>39.30</var>    Subd. 8. <b>Registration</b><b> Licensure</b><b> by credentials.</b> (a) Any dental assistant may, upon <br/>
<a id="pl.39.31"></a><var>39.31</var>application and payment of a fee established by the board, apply for registration licensure <br/>
<a id="pl.39.32"></a><var>39.32</var>based on an evaluation of the applicant's education, experience, and performance record in <br/>
<a id="pl.39.33"></a><var>39.33</var>lieu of completing a board-approved dental assisting program for expanded functions as <br/>
<a id="pl.39.34"></a><var>39.34</var>defined in rule, and may be interviewed by the board to determine if the applicant:<br/>
<a id="pl.40.1"></a><var>40.1</var>(1) has graduated from an accredited dental assisting program accredited by the <br/>
<a id="pl.40.2"></a><var>40.2</var>Commission of Dental Accreditation of the American Dental Association, or is currently <br/>
<a id="pl.40.3"></a><var>40.3</var>certified by the Dental Assisting National Board;<br/>
<a id="pl.40.4"></a><var>40.4</var>(2) is not subject to any pending or final disciplinary action in another state or <br/>
<a id="pl.40.5"></a><var>40.5</var>Canadian province, or if not currently certified or registered, previously had a certification <br/>
<a id="pl.40.6"></a><var>40.6</var>or registration in another state or Canadian province in good standing that was not subject <br/>
<a id="pl.40.7"></a><var>40.7</var>to any final or pending disciplinary action at the time of surrender;<br/>
<a id="pl.40.8"></a><var>40.8</var>(3) is of good moral character and abides by professional ethical conduct <br/>
<a id="pl.40.9"></a><var>40.9</var>requirements;<br/>
<a id="pl.40.10"></a><var>40.10</var>(4) at board discretion, has passed a board-approved English proficiency test if <br/>
<a id="pl.40.11"></a><var>40.11</var>English is not the applicant's primary language; and<br/>
<a id="pl.40.12"></a><var>40.12</var>(5) has met all expanded functions curriculum equivalency requirements of a <br/>
<a id="pl.40.13"></a><var>40.13</var>Minnesota board-approved dental assisting program.<br/>
<a id="pl.40.14"></a><var>40.14</var>(b) The board, at its discretion, may waive specific registration licensure <br/>
<a id="pl.40.15"></a><var>40.15</var>requirements in paragraph (a).<br/>
<a id="pl.40.16"></a><var>40.16</var>(c) An applicant who fulfills the conditions of this subdivision and demonstrates <br/>
<a id="pl.40.17"></a><var>40.17</var>the minimum knowledge in dental subjects required for registration licensure under <br/>
<a id="pl.40.18"></a><var>40.18</var>subdivision 2a must be registered licensed to practice the applicant's profession.<br/>
<a id="pl.40.19"></a><var>40.19</var>(d) If the applicant does not demonstrate the minimum knowledge in dental subjects <br/>
<a id="pl.40.20"></a><var>40.20</var>required for registration licensure under subdivision 2a, the application must be denied. <br/>
<a id="pl.40.21"></a><var>40.21</var>If registration licensure is denied, the board may notify the applicant of any specific <br/>
<a id="pl.40.22"></a><var>40.22</var>remedy that the applicant could take which, when passed, would qualify the applicant <br/>
<a id="pl.40.23"></a><var>40.23</var>for registration licensure. A denial does not prohibit the applicant from applying for <br/>
<a id="pl.40.24"></a><var>40.24</var>registration licensure under subdivision 2a.<br/>
<a id="pl.40.25"></a><var>40.25</var>(e) A candidate whose application has been denied may appeal the decision to the <br/>
<a id="pl.40.26"></a><var>40.26</var>board according to subdivision 4a.<br/>
<br/>
<a id="bill.0.51.0"></a><a id="pl.40.27"></a><var>40.27</var>    Sec. 51. Minnesota Statutes 2008, section 150A.08, subdivision 1, is amended to read:<br/>
<a id="pl.40.28"></a><var>40.28</var>    Subdivision 1. <b>Grounds.</b> The board may refuse or by order suspend or revoke, limit <br/>
<a id="pl.40.29"></a><var>40.29</var>or modify by imposing conditions it deems necessary, any license to practice dentistry <br/>
<a id="pl.40.30"></a><var>40.30</var>or, dental hygiene, or the registration of any dental assistant assisting upon any of the <br/>
<a id="pl.40.31"></a><var>40.31</var>following grounds:<br/>
<a id="pl.40.32"></a><var>40.32</var>(1) fraud or deception in connection with the practice of dentistry or the securing of <br/>
<a id="pl.40.33"></a><var>40.33</var>a license or registration certificate;<br/>
<a id="pl.40.34"></a><var>40.34</var>(2) conviction, including a finding or verdict of guilt, an admission of guilt, or a no <br/>
<a id="pl.40.35"></a><var>40.35</var>contest plea, in any court of a felony or gross misdemeanor reasonably related to the <br/>
<a id="pl.40.36"></a><var>40.36</var>practice of dentistry as evidenced by a certified copy of the conviction;<br/>
<a id="pl.41.1"></a><var>41.1</var>(3) conviction, including a finding or verdict of guilt, an admission of guilt, or a <br/>
<a id="pl.41.2"></a><var>41.2</var>no contest plea, in any court of an offense involving moral turpitude as evidenced by a <br/>
<a id="pl.41.3"></a><var>41.3</var>certified copy of the conviction;<br/>
<a id="pl.41.4"></a><var>41.4</var>(4) habitual overindulgence in the use of intoxicating liquors;<br/>
<a id="pl.41.5"></a><var>41.5</var>(5) improper or unauthorized prescription, dispensing, administering, or personal <br/>
<a id="pl.41.6"></a><var>41.6</var>or other use of any legend drug as defined in chapter 151, of any chemical as defined in <br/>
<a id="pl.41.7"></a><var>41.7</var>chapter 151, or of any controlled substance as defined in chapter 152;<br/>
<a id="pl.41.8"></a><var>41.8</var>(6) conduct unbecoming a person licensed to practice dentistry or, dental hygiene, <br/>
<a id="pl.41.9"></a><var>41.9</var>or registered as a dental assistant assisting, or conduct contrary to the best interest of the <br/>
<a id="pl.41.10"></a><var>41.10</var>public, as such conduct is defined by the rules of the board;<br/>
<a id="pl.41.11"></a><var>41.11</var>(7) gross immorality;<br/>
<a id="pl.41.12"></a><var>41.12</var>(8) any physical, mental, emotional, or other disability which adversely affects a <br/>
<a id="pl.41.13"></a><var>41.13</var>dentist's, dental hygienist's, or registered dental assistant's ability to perform the service <br/>
<a id="pl.41.14"></a><var>41.14</var>for which the person is licensed or registered;<br/>
<a id="pl.41.15"></a><var>41.15</var>(9) revocation or suspension of a license, registration, or equivalent authority to <br/>
<a id="pl.41.16"></a><var>41.16</var>practice, or other disciplinary action or denial of a license or registration application taken <br/>
<a id="pl.41.17"></a><var>41.17</var>by a licensing, registering, or credentialing authority of another state, territory, or country <br/>
<a id="pl.41.18"></a><var>41.18</var>as evidenced by a certified copy of the licensing authority's order, if the disciplinary action <br/>
<a id="pl.41.19"></a><var>41.19</var>or application denial was based on facts that would provide a basis for disciplinary action <br/>
<a id="pl.41.20"></a><var>41.20</var>under this chapter and if the action was taken only after affording the credentialed person <br/>
<a id="pl.41.21"></a><var>41.21</var>or applicant notice and opportunity to refute the allegations or pursuant to stipulation <br/>
<a id="pl.41.22"></a><var>41.22</var>or other agreement;<br/>
<a id="pl.41.23"></a><var>41.23</var>(10) failure to maintain adequate safety and sanitary conditions for a dental office in <br/>
<a id="pl.41.24"></a><var>41.24</var>accordance with the standards established by the rules of the board;<br/>
<a id="pl.41.25"></a><var>41.25</var>(11) employing, assisting, or enabling in any manner an unlicensed person to <br/>
<a id="pl.41.26"></a><var>41.26</var>practice dentistry;<br/>
<a id="pl.41.27"></a><var>41.27</var>(12) failure or refusal to attend, testify, and produce records as directed by the board <br/>
<a id="pl.41.28"></a><var>41.28</var>under subdivision 7;<br/>
<a id="pl.41.29"></a><var>41.29</var>(13) violation of, or failure to comply with, any other provisions of sections 
         <statute_ref>150A.01</statute_ref> <br/>
<a id="pl.41.30"></a><var>41.30</var>to 
         <statute_ref>150A.12</statute_ref>, the rules of the Board of Dentistry, or any disciplinary order issued by the <br/>
<a id="pl.41.31"></a><var>41.31</var>board, sections 
         <statute_ref>144.291</statute_ref> to 144.298 or 
         <statute_ref>595.02, subdivision 1</statute_ref>, paragraph (d), or for any <br/>
<a id="pl.41.32"></a><var>41.32</var>other just cause related to the practice of dentistry. Suspension, revocation, modification <br/>
<a id="pl.41.33"></a><var>41.33</var>or limitation of any license shall not be based upon any judgment as to therapeutic or <br/>
<a id="pl.41.34"></a><var>41.34</var>monetary value of any individual drug prescribed or any individual treatment rendered, <br/>
<a id="pl.41.35"></a><var>41.35</var>but only upon a repeated pattern of conduct;<br/>
<a id="pl.42.1"></a><var>42.1</var>(14) knowingly providing false or misleading information that is directly related <br/>
<a id="pl.42.2"></a><var>42.2</var>to the care of that patient unless done for an accepted therapeutic purpose such as the <br/>
<a id="pl.42.3"></a><var>42.3</var>administration of a placebo; or<br/>
<a id="pl.42.4"></a><var>42.4</var>(15) aiding suicide or aiding attempted suicide in violation of section 
         <statute_ref>609.215</statute_ref> as <br/>
<a id="pl.42.5"></a><var>42.5</var>established by any of the following:<br/>
<a id="pl.42.6"></a><var>42.6</var>(i) a copy of the record of criminal conviction or plea of guilty for a felony in <br/>
<a id="pl.42.7"></a><var>42.7</var>violation of section 
         <statute_ref>609.215, subdivision 1</statute_ref> or 2;<br/>
<a id="pl.42.8"></a><var>42.8</var>(ii) a copy of the record of a judgment of contempt of court for violating an <br/>
<a id="pl.42.9"></a><var>42.9</var>injunction issued under section 
         <statute_ref>609.215, subdivision 4</statute_ref>;<br/>
<a id="pl.42.10"></a><var>42.10</var>(iii) a copy of the record of a judgment assessing damages under section 
         <statute_ref>609.215, <br/>
<a id="pl.42.11"></a><var>42.11</var>subdivision 5
         </statute_ref>; or<br/>
<a id="pl.42.12"></a><var>42.12</var>(iv) a finding by the board that the person violated section 
         <statute_ref>609.215, subdivision <br/>
<a id="pl.42.13"></a><var>42.13</var>1
         </statute_ref> or 2. The board shall investigate any complaint of a violation of section 
         <statute_ref>609.215, <br/>
<a id="pl.42.14"></a><var>42.14</var>subdivision 1
         </statute_ref> or 2.<br/>
<br/>
<a id="bill.0.52.0"></a><a id="pl.42.15"></a><var>42.15</var>    Sec. 52. Minnesota Statutes 2008, section 150A.08, subdivision 3, is amended to read:<br/>
<a id="pl.42.16"></a><var>42.16</var>    Subd. 3. <b>Reinstatement.</b> Any licensee or registrant whose license or registration has <br/>
<a id="pl.42.17"></a><var>42.17</var>been suspended or revoked may have the license or registration reinstated or a new license <br/>
<a id="pl.42.18"></a><var>42.18</var>or registration issued, as the case may be, when the board deems the action is warranted.<br/>
<br/>
<a id="bill.0.53.0"></a><a id="pl.42.19"></a><var>42.19</var>    Sec. 53. Minnesota Statutes 2008, section 150A.08, subdivision 3a, is amended to read:<br/>
<a id="pl.42.20"></a><var>42.20</var>    Subd. 3a. <b>Costs; additional penalties.</b> (a) The board may impose a civil penalty <br/>
<a id="pl.42.21"></a><var>42.21</var>not exceeding $10,000 for each separate violation, the amount of the civil penalty to <br/>
<a id="pl.42.22"></a><var>42.22</var>be fixed so as to deprive a licensee or registrant of any economic advantage gained by <br/>
<a id="pl.42.23"></a><var>42.23</var>reason of the violation, to discourage similar violations by the licensee or registrant or any <br/>
<a id="pl.42.24"></a><var>42.24</var>other licensee or registrant, or to reimburse the board for the cost of the investigation and <br/>
<a id="pl.42.25"></a><var>42.25</var>proceeding, including, but not limited to, fees paid for services provided by the Office of <br/>
<a id="pl.42.26"></a><var>42.26</var>Administrative Hearings, legal and investigative services provided by the Office of the <br/>
<a id="pl.42.27"></a><var>42.27</var>Attorney General, court reporters, witnesses, reproduction of records, board members' <br/>
<a id="pl.42.28"></a><var>42.28</var>per diem compensation, board staff time, and travel costs and expenses incurred by board <br/>
<a id="pl.42.29"></a><var>42.29</var>staff and board members.<br/>
<a id="pl.42.30"></a><var>42.30</var>(b) In addition to costs and penalties imposed under paragraph (a), the board may <br/>
<a id="pl.42.31"></a><var>42.31</var>also:<br/>
<a id="pl.42.32"></a><var>42.32</var>(1) order the dentist, dental hygienist, or dental assistant to provide unremunerated <br/>
<a id="pl.42.33"></a><var>42.33</var>service;<br/>
<a id="pl.42.34"></a><var>42.34</var>(2) censure or reprimand the dentist, dental hygienist, or dental assistant; or<br/>
<a id="pl.42.35"></a><var>42.35</var>(3) any other action as allowed by law and justified by the facts of the case.<br/>
<br/>
<a id="bill.0.54.0"></a><a id="pl.43.1"></a><var>43.1</var>    Sec. 54. Minnesota Statutes 2008, section 150A.08, subdivision 5, is amended to read:<br/>
<a id="pl.43.2"></a><var>43.2</var>    Subd. 5. <b>Medical examinations.</b> If the board has probable cause to believe that a <br/>
<a id="pl.43.3"></a><var>43.3</var>dentist, dental hygienist, registered dental assistant, or applicant engages in acts described <br/>
<a id="pl.43.4"></a><var>43.4</var>in subdivision 1, clause (4) or (5), or has a condition described in subdivision 1, clause (8), <br/>
<a id="pl.43.5"></a><var>43.5</var>it shall direct the dentist, dental hygienist, assistant, or applicant to submit to a mental <br/>
<a id="pl.43.6"></a><var>43.6</var>or physical examination or a chemical dependency assessment. For the purpose of this <br/>
<a id="pl.43.7"></a><var>43.7</var>subdivision, every dentist, hygienist, or dental assistant licensed or registered under <br/>
<a id="pl.43.8"></a><var>43.8</var>this chapter or person submitting an application for a license or registration is deemed <br/>
<a id="pl.43.9"></a><var>43.9</var>to have given consent to submit to a mental or physical examination when directed <br/>
<a id="pl.43.10"></a><var>43.10</var>in writing by the board and to have waived all objections in any proceeding under this <br/>
<a id="pl.43.11"></a><var>43.11</var>section to the admissibility of the examining physician's testimony or examination reports <br/>
<a id="pl.43.12"></a><var>43.12</var>on the ground that they constitute a privileged communication. Failure to submit to an <br/>
<a id="pl.43.13"></a><var>43.13</var>examination without just cause may result in an application being denied or a default and <br/>
<a id="pl.43.14"></a><var>43.14</var>final order being entered without the taking of testimony or presentation of evidence, <br/>
<a id="pl.43.15"></a><var>43.15</var>other than evidence which may be submitted by affidavit, that the licensee, registrant, or <br/>
<a id="pl.43.16"></a><var>43.16</var>applicant did not submit to the examination. A dentist, dental hygienist, registered dental <br/>
<a id="pl.43.17"></a><var>43.17</var>assistant, or applicant affected under this section shall at reasonable intervals be afforded <br/>
<a id="pl.43.18"></a><var>43.18</var>an opportunity to demonstrate ability to start or resume the competent practice of dentistry <br/>
<a id="pl.43.19"></a><var>43.19</var>or perform the duties of a dental hygienist or registered dental assistant with reasonable <br/>
<a id="pl.43.20"></a><var>43.20</var>skill and safety to patients. In any proceeding under this subdivision, neither the record of <br/>
<a id="pl.43.21"></a><var>43.21</var>proceedings nor the orders entered by the board is admissible, is subject to subpoena, or <br/>
<a id="pl.43.22"></a><var>43.22</var>may be used against the dentist, dental hygienist, registered dental assistant, or applicant in <br/>
<a id="pl.43.23"></a><var>43.23</var>any proceeding not commenced by the board. Information obtained under this subdivision <br/>
<a id="pl.43.24"></a><var>43.24</var>shall be classified as private pursuant to the Minnesota Government Data Practices Act.<br/>
<br/>
<a id="bill.0.55.0"></a><a id="pl.43.25"></a><var>43.25</var>    Sec. 55. Minnesota Statutes 2008, section 150A.08, subdivision 6, is amended to read:<br/>
<a id="pl.43.26"></a><var>43.26</var>    Subd. 6. <b>Medical records.</b> Notwithstanding contrary provisions of sections 
         <statute_ref>13.384</statute_ref> <br/>
<a id="pl.43.27"></a><var>43.27</var>and 
         <statute_ref>144.651</statute_ref> or any other statute limiting access to medical or other health data, the <br/>
<a id="pl.43.28"></a><var>43.28</var>board may obtain medical data and health records of a licensee, registrant, or applicant <br/>
<a id="pl.43.29"></a><var>43.29</var>without the licensee's, registrant's, or applicant's consent if the information is requested <br/>
<a id="pl.43.30"></a><var>43.30</var>by the board as part of the process specified in subdivision 5. The medical data may be <br/>
<a id="pl.43.31"></a><var>43.31</var>requested from a provider, as defined in section 
         <statute_ref>144.291, subdivision 2</statute_ref>, paragraph (h), <br/>
<a id="pl.43.32"></a><var>43.32</var>an insurance company, or a government agency, including the Department of Human <br/>
<a id="pl.43.33"></a><var>43.33</var>Services. A provider, insurance company, or government agency shall comply with <br/>
<a id="pl.43.34"></a><var>43.34</var>any written request of the board under this subdivision and shall not be liable in any <br/>
<a id="pl.43.35"></a><var>43.35</var>action for damages for releasing the data requested by the board if the data are released <br/>
<a id="pl.44.1"></a><var>44.1</var>pursuant to a written request under this subdivision, unless the information is false and <br/>
<a id="pl.44.2"></a><var>44.2</var>the provider giving the information knew, or had reason to believe, the information was <br/>
<a id="pl.44.3"></a><var>44.3</var>false. Information obtained under this subdivision shall be classified as private under the <br/>
<a id="pl.44.4"></a><var>44.4</var>Minnesota Government Data Practices Act.<br/>
<br/>
<a id="bill.0.56.0"></a><a id="pl.44.5"></a><var>44.5</var>    Sec. 56. Minnesota Statutes 2008, section 150A.08, subdivision 8, is amended to read:<br/>
<a id="pl.44.6"></a><var>44.6</var>    Subd. 8. <b>Suspension of license.</b> In addition to any other remedy provided by <br/>
<a id="pl.44.7"></a><var>44.7</var>law, the board may, through its designated board members pursuant to section 
         <statute_ref>214.10, <br/>
<a id="pl.44.8"></a><var>44.8</var>subdivision 2
         </statute_ref>, temporarily suspend a license or registration without a hearing if the <br/>
<a id="pl.44.9"></a><var>44.9</var>board finds that the licensee or registrant has violated a statute or rule which the board is <br/>
<a id="pl.44.10"></a><var>44.10</var>empowered to enforce and continued practice by the licensee or registrant would create an <br/>
<a id="pl.44.11"></a><var>44.11</var>imminent risk of harm to others. The suspension shall take effect upon written notice to <br/>
<a id="pl.44.12"></a><var>44.12</var>the licensee or registrant served by first class mail specifying the statute or rule violated, <br/>
<a id="pl.44.13"></a><var>44.13</var>and the time, date, and place of the hearing before the board. If the notice is returned by <br/>
<a id="pl.44.14"></a><var>44.14</var>the post office, the notice shall be effective upon reasonable attempts to locate and serve <br/>
<a id="pl.44.15"></a><var>44.15</var>the licensee or registrant. Within ten days of service of the notice, the board shall hold a <br/>
<a id="pl.44.16"></a><var>44.16</var>hearing before its own members on the sole issue of whether there is a reasonable basis to <br/>
<a id="pl.44.17"></a><var>44.17</var>continue, modify, or lift the suspension. Evidence presented by the board, or licensee, <br/>
<a id="pl.44.18"></a><var>44.18</var>or registrant, shall be in affidavit form only. The licensee or registrant or counsel of the <br/>
<a id="pl.44.19"></a><var>44.19</var>licensee or registrant may appear for oral argument. Within five working days after the <br/>
<a id="pl.44.20"></a><var>44.20</var>hearing, the board shall issue its order and, if the suspension is continued, the board <br/>
<a id="pl.44.21"></a><var>44.21</var>shall schedule a disciplinary hearing to be held pursuant to the Administrative Procedure <br/>
<a id="pl.44.22"></a><var>44.22</var>Act within 45 days of issuance of the order. The administrative law judge shall issue a <br/>
<a id="pl.44.23"></a><var>44.23</var>report within 30 days of the closing of the contested case hearing record. The board <br/>
<a id="pl.44.24"></a><var>44.24</var>shall issue a final order within 30 days of receiving that report. The board may allow a <br/>
<a id="pl.44.25"></a><var>44.25</var>person who was licensed by any state to practice dentistry and whose license has been <br/>
<a id="pl.44.26"></a><var>44.26</var>suspended to practice dentistry under the supervision of a licensed dentist for the purpose <br/>
<a id="pl.44.27"></a><var>44.27</var>of demonstrating competence and eligibility for reinstatement.<br/>
<br/>
<a id="bill.0.57.0"></a><a id="pl.44.28"></a><var>44.28</var>    Sec. 57. Minnesota Statutes 2008, section 150A.081, is amended to read:<br/>
<a id="pl.44.29"></a><var>44.29</var><b>150A.081 ACCESS TO MEDICAL DATA.</b><br/>
<a id="pl.44.30"></a><var>44.30</var>    Subdivision 1. <b>Access to data on licensee </b><b>or registrant</b><b>.</b> When the board has <br/>
<a id="pl.44.31"></a><var>44.31</var>probable cause to believe that a licensee's or registrant's condition meets a ground listed in <br/>
<a id="pl.44.32"></a><var>44.32</var>section 
         <statute_ref>150A.08, subdivision 1</statute_ref>, clause (4) or (8), it may, notwithstanding sections 
         <statute_ref>13.384</statute_ref>, <br/>
<statute_ref><a id="pl.44.33"></a><var>44.33</var>144.651
         </statute_ref>, or any other law limiting access to medical data, obtain medical or health records <br/>
<a id="pl.44.34"></a><var>44.34</var>on the licensee or registrant without the licensee's or registrant's consent. The medical data <br/>
<a id="pl.44.35"></a><var>44.35</var>may be requested from a provider, as defined in section 
         <statute_ref>144.291, subdivision 2</statute_ref>, paragraph <br/>
<a id="pl.45.1"></a><var>45.1</var>(h), an insurance company, or a government agency. A provider, insurance company, or <br/>
<a id="pl.45.2"></a><var>45.2</var>government agency shall comply with a written request of the board under this subdivision <br/>
<a id="pl.45.3"></a><var>45.3</var>and is not liable in any action for damages for releasing the data requested by the board <br/>
<a id="pl.45.4"></a><var>45.4</var>if the data are released under the written request, unless the information is false and the <br/>
<a id="pl.45.5"></a><var>45.5</var>entity providing the information knew, or had reason to believe, the information was false. <br/>
<a id="pl.45.6"></a><var>45.6</var>    Subd. 2. <b>Access to data on patients.</b> The board has access to medical records of <br/>
<a id="pl.45.7"></a><var>45.7</var>a patient treated by a licensee or registrant under review if the patient signs a written <br/>
<a id="pl.45.8"></a><var>45.8</var>consent permitting access. If the patient has not given consent, the licensee or registrant <br/>
<a id="pl.45.9"></a><var>45.9</var>must delete data from which a patient may be identified before releasing medical records <br/>
<a id="pl.45.10"></a><var>45.10</var>to the board.<br/>
<a id="pl.45.11"></a><var>45.11</var>    Subd. 3. <b>Data classification; release of certain health data not required.</b><br/>
<a id="pl.45.12"></a><var>45.12</var>Information obtained under this section is classified as private data on individuals under <br/>
<a id="pl.45.13"></a><var>45.13</var>chapter 13. Under this section, the commissioner of health is not required to release health <br/>
<a id="pl.45.14"></a><var>45.14</var>data collected and maintained under section 
         <statute_ref>13.3805, subdivision 2</statute_ref>.<br/>
<br/>
<a id="bill.0.58.0"></a><a id="pl.45.15"></a><var>45.15</var>    Sec. 58. Minnesota Statutes 2008, section 150A.09, subdivision 1, is amended to read:<br/>
<a id="pl.45.16"></a><var>45.16</var>    Subdivision 1. <b>Registration information and procedure.</b> On or before the license <br/>
<a id="pl.45.17"></a><var>45.17</var>or registration certificate expiration date every licensed dentist, dental hygienist, and <br/>
<a id="pl.45.18"></a><var>45.18</var>registered dental assistant shall transmit to the executive secretary of the board, pertinent <br/>
<a id="pl.45.19"></a><var>45.19</var>information required by the board, together with the fee established by the board. At least <br/>
<a id="pl.45.20"></a><var>45.20</var>30 days before a license or registration certificate expiration date, the board shall send <br/>
<a id="pl.45.21"></a><var>45.21</var>a written notice stating the amount and due date of the fee and the information to be <br/>
<a id="pl.45.22"></a><var>45.22</var>provided to every licensed dentist, dental hygienist, and registered dental assistant.<br/>
<br/>
<a id="bill.0.59.0"></a><a id="pl.45.23"></a><var>45.23</var>    Sec. 59. Minnesota Statutes 2008, section 150A.09, subdivision 3, is amended to read:<br/>
<a id="pl.45.24"></a><var>45.24</var>    Subd. 3. <b>Current address, change of address.</b> Every dentist, dental hygienist, and <br/>
<a id="pl.45.25"></a><var>45.25</var>registered dental assistant shall maintain with the board a correct and current mailing <br/>
<a id="pl.45.26"></a><var>45.26</var>address. For dentists engaged in the practice of dentistry, the address shall be that of the <br/>
<a id="pl.45.27"></a><var>45.27</var>location of the primary dental practice. Within 30 days after changing addresses, every <br/>
<a id="pl.45.28"></a><var>45.28</var>dentist, dental hygienist, and registered dental assistant shall provide the board written <br/>
<a id="pl.45.29"></a><var>45.29</var>notice of the new address either personally or by first class mail.<br/>
<br/>
<a id="bill.0.60.0"></a><a id="pl.45.30"></a><var>45.30</var>    Sec. 60. Minnesota Statutes 2008, section 150A.091, subdivision 2, is amended to read:<br/>
<a id="pl.45.31"></a><var>45.31</var>    Subd. 2. <b>Application fees.</b> Each applicant for licensure or registration shall submit <br/>
<a id="pl.45.32"></a><var>45.32</var>with a license or registration permit application a nonrefundable fee in the following <br/>
<a id="pl.45.33"></a><var>45.33</var>amounts in order to administratively process an application:<br/>
<a id="pl.45.34"></a><var>45.34</var>(1) dentist, $140;<br/>
<a id="pl.46.1"></a><var>46.1</var>(2) limited faculty dentist, $140;<br/>
<a id="pl.46.2"></a><var>46.2</var>(3) resident dentist, $55;<br/>
<a id="pl.46.3"></a><var>46.3</var>(4) dental hygienist, $55;<br/>
<a id="pl.46.4"></a><var>46.4</var>(5) registered licensed dental assistant, $35 $55; and<br/>
<a id="pl.46.5"></a><var>46.5</var>(6) dental assistant with a limited registration permit as described in Minnesota <br/>
<a id="pl.46.6"></a><var>46.6</var>Rules, part 3100.8500, subpart 3, $15.<br/>
<br/>
<a id="bill.0.61.0"></a><a id="pl.46.7"></a><var>46.7</var>    Sec. 61. Minnesota Statutes 2008, section 150A.091, subdivision 3, is amended to read:<br/>
<a id="pl.46.8"></a><var>46.8</var>    Subd. 3. <b>Initial license or </b><b>registration</b><b> permit</b><b> fees.</b> Along with the application fee, <br/>
<a id="pl.46.9"></a><var>46.9</var>each of the following licensees or registrants applicants shall submit a separate prorated <br/>
<a id="pl.46.10"></a><var>46.10</var>initial license or registration permit fee. The prorated initial fee shall be established by the <br/>
<a id="pl.46.11"></a><var>46.11</var>board based on the number of months of the licensee's or registrant's applicant's initial <br/>
<a id="pl.46.12"></a><var>46.12</var>term as described in Minnesota Rules, part 3100.1700, subpart 1a, not to exceed the <br/>
<a id="pl.46.13"></a><var>46.13</var>following monthly fee amounts:<br/>
<a id="pl.46.14"></a><var>46.14</var>(1) dentist, $14 times the number of months of the initial term;<br/>
<a id="pl.46.15"></a><var>46.15</var>(2) dental hygienist, $5 times the number of months of the initial term;<br/>
<a id="pl.46.16"></a><var>46.16</var>(3) registered licensed dental assistant, $3 times the number of months of initial <br/>
<a id="pl.46.17"></a><var>46.17</var>term; and<br/>
<a id="pl.46.18"></a><var>46.18</var>(4) dental assistant with a limited registration permit as described in Minnesota <br/>
<a id="pl.46.19"></a><var>46.19</var>Rules, part 3100.8500, subpart 3, $1 times the number of months of the initial term.<br/>
<br/>
<a id="bill.0.62.0"></a><a id="pl.46.20"></a><var>46.20</var>    Sec. 62. Minnesota Statutes 2008, section 150A.091, subdivision 5, is amended to read:<br/>
<a id="pl.46.21"></a><var>46.21</var>    Subd. 5. <b>Biennial license or </b><b>registration</b><b> permit</b><b> fees.</b> Each of the following <br/>
<a id="pl.46.22"></a><var>46.22</var>licensees or registrants applicants shall submit with a biennial license or registration permit <br/>
<a id="pl.46.23"></a><var>46.23</var>renewal application a fee as established by the board, not to exceed the following amounts:<br/>
<a id="pl.46.24"></a><var>46.24</var>(1) dentist, $336;<br/>
<a id="pl.46.25"></a><var>46.25</var>(2) dental hygienist, $118;<br/>
<a id="pl.46.26"></a><var>46.26</var>(3) registered licensed dental assistant, $80; and<br/>
<a id="pl.46.27"></a><var>46.27</var>(4) dental assistant with a limited registration permit as described in Minnesota <br/>
<a id="pl.46.28"></a><var>46.28</var>Rules, part 3100.8500, subpart 3, $24.<br/>
<br/>
<a id="bill.0.63.0"></a><a id="pl.46.29"></a><var>46.29</var>    Sec. 63. Minnesota Statutes 2008, section 150A.091, subdivision 7, is amended to read:<br/>
<a id="pl.46.30"></a><var>46.30</var>    Subd. 7. <b>Biennial license or </b><b>registration</b><b> permit</b><b> late fee.</b> Applications for renewal <br/>
<a id="pl.46.31"></a><var>46.31</var>of any license or registration permit received after the time specified in Minnesota Rules, <br/>
<a id="pl.46.32"></a><var>46.32</var>part 3100.1700, must be assessed a late fee equal to 25 percent of the biennial renewal fee.<br/>
<br/>
<a id="bill.0.64.0"></a><a id="pl.46.33"></a><var>46.33</var>    Sec. 64. Minnesota Statutes 2008, section 150A.091, subdivision 8, is amended to read:<br/>
<a id="pl.47.1"></a><var>47.1</var>    Subd. 8. <b>Duplicate license or </b><b>registration</b><b> certificate</b><b> fee.</b> Each licensee or <br/>
<a id="pl.47.2"></a><var>47.2</var>registrant applicant shall submit, with a request for issuance of a duplicate of the original <br/>
<a id="pl.47.3"></a><var>47.3</var>license or registration, or of an annual or biennial renewal of it certificate for a license <br/>
<a id="pl.47.4"></a><var>47.4</var>or permit, a fee in the following amounts:<br/>
<a id="pl.47.5"></a><var>47.5</var>(1) original dentist or, dental hygiene, or dental assistant license, $35; and<br/>
<a id="pl.47.6"></a><var>47.6</var>(2) initial and renewal registration certificates and license annual or biennial renewal <br/>
<a id="pl.47.7"></a><var>47.7</var>certificates, $10.<br/>
<br/>
<a id="bill.0.65.0"></a><a id="pl.47.8"></a><var>47.8</var>    Sec. 65. Minnesota Statutes 2008, section 150A.091, subdivision 9, is amended to read:<br/>
<a id="pl.47.9"></a><var>47.9</var>    Subd. 9. <b>Licensure </b><b>and registration</b><b> by credentials.</b> Each applicant for licensure <br/>
<a id="pl.47.10"></a><var>47.10</var>as a dentist or, dental hygienist, or for registration as a registered dental assistant by <br/>
<a id="pl.47.11"></a><var>47.11</var>credentials pursuant to section 
         <statute_ref>150A.06, subdivisions 4 and 8</statute_ref>, and Minnesota Rules, part <br/>
<a id="pl.47.12"></a><var>47.12</var>3100.1400, shall submit with the license or registration application a fee in the following <br/>
<a id="pl.47.13"></a><var>47.13</var>amounts:<br/>
<a id="pl.47.14"></a><var>47.14</var>(1) dentist, $725;<br/>
<a id="pl.47.15"></a><var>47.15</var>(2) dental hygienist, $175; and<br/>
<a id="pl.47.16"></a><var>47.16</var>(3) registered dental assistant, $35.<br/>
<br/>
<a id="bill.0.66.0"></a><a id="pl.47.17"></a><var>47.17</var>    Sec. 66. Minnesota Statutes 2008, section 150A.091, is amended by adding a <br/>
<a id="pl.47.18"></a><var>47.18</var>subdivision to read:<br/>
<a id="pl.47.19"></a><var>47.19</var>    Subd. 9a. <b>Credential review; nonaccredited dental institution.</b> Applicants who <br/>
<a id="pl.47.20"></a><var>47.20</var>have graduated from a nonaccredited dental college desiring licensure as a dentist pursuant <br/>
<a id="pl.47.21"></a><var>47.21</var>to section 150A.06, subdivision 1, shall submit an application for credential review and an <br/>
<a id="pl.47.22"></a><var>47.22</var>application fee not to exceed the amount of $200.<br/>
<br/>
<a id="bill.0.67.0"></a><a id="pl.47.23"></a><var>47.23</var>    Sec. 67. Minnesota Statutes 2008, section 150A.091, is amended by adding a <br/>
<a id="pl.47.24"></a><var>47.24</var>subdivision to read:<br/>
<a id="pl.47.25"></a><var>47.25</var>    Subd. 9b. <b>Limited general license.</b> Each applicant for licensure as a limited general <br/>
<a id="pl.47.26"></a><var>47.26</var>dentist pursuant to section 150A.06, subdivision 9, shall submit the applicable fees <br/>
<a id="pl.47.27"></a><var>47.27</var>established by the board not to exceed the following amounts:<br/>
<a id="pl.47.28"></a><var>47.28</var>(1) initial limited general license application, $140;<br/>
<a id="pl.47.29"></a><var>47.29</var>(2) annual limited general license renewal application, $155; and<br/>
<a id="pl.47.30"></a><var>47.30</var>(3) late fee assessment for renewal application equal to 50 percent of the annual <br/>
<a id="pl.47.31"></a><var>47.31</var>limited general license renewal fee.<br/>
<br/>
<a id="bill.0.68.0"></a><a id="pl.47.32"></a><var>47.32</var>    Sec. 68. Minnesota Statutes 2008, section 150A.091, subdivision 10, is amended to <br/>
<a id="pl.47.33"></a><var>47.33</var>read:<br/>
<a id="pl.48.1"></a><var>48.1</var>    Subd. 10. <b>Reinstatement fee.</b> No dentist, dental hygienist, or registered dental <br/>
<a id="pl.48.2"></a><var>48.2</var>assistant whose license or registration has been suspended or revoked may have the <br/>
<a id="pl.48.3"></a><var>48.3</var>license or registration reinstated or a new license or registration issued until a fee has been <br/>
<a id="pl.48.4"></a><var>48.4</var>submitted to the board in the following amounts:<br/>
<a id="pl.48.5"></a><var>48.5</var>(1) dentist, $140;<br/>
<a id="pl.48.6"></a><var>48.6</var>(2) dental hygienist, $55; and<br/>
<a id="pl.48.7"></a><var>48.7</var>(3) registered dental assistant, $35.<br/>
<br/>
<a id="bill.0.69.0"></a><a id="pl.48.8"></a><var>48.8</var>    Sec. 69. Minnesota Statutes 2008, section 150A.091, subdivision 11, is amended to <br/>
<a id="pl.48.9"></a><var>48.9</var>read:<br/>
<a id="pl.48.10"></a><var>48.10</var>    Subd. 11. <b>Certificate application fee for anesthesia/sedation.</b> Each dentist <br/>
<a id="pl.48.11"></a><var>48.11</var>shall submit with a general anesthesia or conscious moderate sedation application or a <br/>
<a id="pl.48.12"></a><var>48.12</var>contracted sedation provider application a fee as established by the board not to exceed <br/>
<a id="pl.48.13"></a><var>48.13</var>the following amounts:<br/>
<a id="pl.48.14"></a><var>48.14</var>(1) for both a general anesthesia and conscious moderate sedation application, $50 <br/>
<a id="pl.48.15"></a><var>48.15</var>$250;<br/>
<a id="pl.48.16"></a><var>48.16</var>(2) for a general anesthesia application only, $50 $250; and<br/>
<a id="pl.48.17"></a><var>48.17</var>(3) for a conscious moderate sedation application only, $50. $250; and<br/>
<a id="pl.48.18"></a><var>48.18</var>(4) for a contracted sedation provider application, $250.<br/>
<br/>
<a id="bill.0.70.0"></a><a id="pl.48.19"></a><var>48.19</var>    Sec. 70. Minnesota Statutes 2008, section 150A.091, is amended by adding a <br/>
<a id="pl.48.20"></a><var>48.20</var>subdivision to read:<br/>
<a id="pl.48.21"></a><var>48.21</var>    Subd. 11a. <b>Certificate for anesthesia/sedation late fee.</b> Applications for renewal <br/>
<a id="pl.48.22"></a><var>48.22</var>of a general anesthesia or moderate sedation certificate or a contracted sedation provider <br/>
<a id="pl.48.23"></a><var>48.23</var>certificate received after the time specified in Minnesota Rules, part 3100.3600, subparts <br/>
<a id="pl.48.24"></a><var>48.24</var>9 and 9b, must be assessed a late fee equal to 50 percent of the biennial renewal fee for <br/>
<a id="pl.48.25"></a><var>48.25</var>an anesthesia/sedation certificate.<br/>
<br/>
<a id="bill.0.71.0"></a><a id="pl.48.26"></a><var>48.26</var>    Sec. 71. Minnesota Statutes 2008, section 150A.091, is amended by adding a <br/>
<a id="pl.48.27"></a><var>48.27</var>subdivision to read:<br/>
<a id="pl.48.28"></a><var>48.28</var>    Subd. 11b. <b>Recertification fee for anesthesia/sedation.</b> No dentist whose general <br/>
<a id="pl.48.29"></a><var>48.29</var>anesthesia or moderate sedation certificate has been terminated by the board or voluntarily <br/>
<a id="pl.48.30"></a><var>48.30</var>terminated by the dentist may become recertified until a fee has been submitted to the <br/>
<a id="pl.48.31"></a><var>48.31</var>board not to exceed the amount of $500.<br/>
<br/>
<a id="bill.0.72.0"></a><a id="pl.48.32"></a><var>48.32</var>    Sec. 72. Minnesota Statutes 2008, section 150A.091, subdivision 12, is amended to <br/>
<a id="pl.48.33"></a><var>48.33</var>read:<br/>
<a id="pl.49.1"></a><var>49.1</var>    Subd. 12. <b>Duplicate certificate fee for anesthesia/sedation.</b> Each dentist shall <br/>
<a id="pl.49.2"></a><var>49.2</var>submit with a request for issuance of a duplicate of the original general anesthesia or <br/>
<a id="pl.49.3"></a><var>49.3</var>conscious moderate sedation certificate or contracted sedation provider certificate a fee in <br/>
<a id="pl.49.4"></a><var>49.4</var>the amount of $10.<br/>
<br/>
<a id="bill.0.73.0"></a><a id="pl.49.5"></a><var>49.5</var>    Sec. 73. Minnesota Statutes 2008, section 150A.091, subdivision 14, is amended to <br/>
<a id="pl.49.6"></a><var>49.6</var>read:<br/>
<a id="pl.49.7"></a><var>49.7</var>    Subd. 14. <b>Affidavit of licensure.</b> Each licensee or registrant shall submit with a <br/>
<a id="pl.49.8"></a><var>49.8</var>request for an affidavit of licensure a fee in the amount of $10.<br/>
<br/>
<a id="bill.0.74.0"></a><a id="pl.49.9"></a><var>49.9</var>    Sec. 74. Minnesota Statutes 2008, section 150A.091, subdivision 15, is amended to <br/>
<a id="pl.49.10"></a><var>49.10</var>read:<br/>
<a id="pl.49.11"></a><var>49.11</var>    Subd. 15. <b>Verification of licensure.</b> Each institution or corporation shall submit <br/>
<a id="pl.49.12"></a><var>49.12</var>with a request for verification of a license or registration a fee in the amount of $5 for <br/>
<a id="pl.49.13"></a><var>49.13</var>each license or registration to be verified.<br/>
<br/>
<a id="bill.0.75.0"></a><a id="pl.49.14"></a><var>49.14</var>    Sec. 75. Minnesota Statutes 2008, section 150A.10, subdivision 1a, is amended to read:<br/>
<a id="pl.49.15"></a><var>49.15</var>    Subd. 1a. <b>Limited authorization for dental hygienists.</b> (a) Notwithstanding <br/>
<a id="pl.49.16"></a><var>49.16</var>subdivision 1, a dental hygienist licensed under this chapter may be employed or retained <br/>
<a id="pl.49.17"></a><var>49.17</var>by a health care facility, program, or nonprofit organization to perform dental hygiene <br/>
<a id="pl.49.18"></a><var>49.18</var>services described under paragraph (b) without the patient first being examined by a <br/>
<a id="pl.49.19"></a><var>49.19</var>licensed dentist if the dental hygienist:<br/>
<a id="pl.49.20"></a><var>49.20</var>(1) has been engaged in the active practice of clinical dental hygiene for not less than <br/>
<a id="pl.49.21"></a><var>49.21</var>2,400 hours in the past 18 months or a career total of 3,000 hours, including a minimum of <br/>
<a id="pl.49.22"></a><var>49.22</var>200 hours of clinical practice in two of the past three years;<br/>
<a id="pl.49.23"></a><var>49.23</var>(2) has entered into a collaborative agreement with a licensed dentist that designates <br/>
<a id="pl.49.24"></a><var>49.24</var>authorization for the services provided by the dental hygienist;<br/>
<a id="pl.49.25"></a><var>49.25</var>(3) has documented participation in courses in infection control and medical <br/>
<a id="pl.49.26"></a><var>49.26</var>emergencies within each continuing education cycle; and<br/>
<a id="pl.49.27"></a><var>49.27</var>(4) maintains current certification in advanced or basic cardiac life support as <br/>
<a id="pl.49.28"></a><var>49.28</var>recognized by the American Heart Association, the American Red Cross, or another <br/>
<a id="pl.49.29"></a><var>49.29</var>agency that is equivalent to the CPR certification from completion of the American Heart <br/>
<a id="pl.49.30"></a><var>49.30</var>Association or healthcare provider course, the American Red Cross professional rescuer <br/>
<a id="pl.49.31"></a><var>49.31</var>course, or an equivalent entity.<br/>
<a id="pl.49.32"></a><var>49.32</var>(b) The dental hygiene services authorized to be performed by a dental hygienist <br/>
<a id="pl.49.33"></a><var>49.33</var>under this subdivision are limited to:<br/>
<a id="pl.49.34"></a><var>49.34</var>(1) oral health promotion and disease prevention education;<br/>
<a id="pl.50.1"></a><var>50.1</var>(2) removal of deposits and stains from the surfaces of the teeth;<br/>
<a id="pl.50.2"></a><var>50.2</var>(3) application of topical preventive or prophylactic agents, including fluoride <br/>
<a id="pl.50.3"></a><var>50.3</var>varnishes and pit and fissure sealants;<br/>
<a id="pl.50.4"></a><var>50.4</var>(4) polishing and smoothing restorations;<br/>
<a id="pl.50.5"></a><var>50.5</var>(5) removal of marginal overhangs;<br/>
<a id="pl.50.6"></a><var>50.6</var>(6) performance of preliminary charting;<br/>
<a id="pl.50.7"></a><var>50.7</var>(7) taking of radiographs; and<br/>
<a id="pl.50.8"></a><var>50.8</var>(8) performance of scaling and root planing.<br/>
<a id="pl.50.9"></a><var>50.9</var>The dental hygienist may administer injections of local anesthetic agents or nitrous <br/>
<a id="pl.50.10"></a><var>50.10</var>oxide inhalation analgesia as specifically delegated in the collaborative agreement with <br/>
<a id="pl.50.11"></a><var>50.11</var>a licensed dentist. The dentist need not first examine the patient or be present. If the <br/>
<a id="pl.50.12"></a><var>50.12</var>patient is considered medically compromised, the collaborative dentist shall review the <br/>
<a id="pl.50.13"></a><var>50.13</var>patient record, including the medical history, prior to the provision of these services. <br/>
<a id="pl.50.14"></a><var>50.14</var>Collaborating dental hygienists may work with unregistered unlicensed and registered <br/>
<a id="pl.50.15"></a><var>50.15</var>licensed dental assistants who may only perform duties for which registration licensure <br/>
<a id="pl.50.16"></a><var>50.16</var>is not required. The performance of dental hygiene services in a health care facility, <br/>
<a id="pl.50.17"></a><var>50.17</var>program, or nonprofit organization as authorized under this subdivision is limited to <br/>
<a id="pl.50.18"></a><var>50.18</var>patients, students, and residents of the facility, program, or organization.<br/>
<a id="pl.50.19"></a><var>50.19</var>(c) A collaborating dentist must be licensed under this chapter and may enter into <br/>
<a id="pl.50.20"></a><var>50.20</var>a collaborative agreement with no more than four dental hygienists unless otherwise <br/>
<a id="pl.50.21"></a><var>50.21</var>authorized by the board. The board shall develop parameters and a process for obtaining <br/>
<a id="pl.50.22"></a><var>50.22</var>authorization to collaborate with more than four dental hygienists. The collaborative <br/>
<a id="pl.50.23"></a><var>50.23</var>agreement must include:<br/>
<a id="pl.50.24"></a><var>50.24</var>(1) consideration for medically compromised patients and medical conditions for <br/>
<a id="pl.50.25"></a><var>50.25</var>which a dental evaluation and treatment plan must occur prior to the provision of dental <br/>
<a id="pl.50.26"></a><var>50.26</var>hygiene services;<br/>
<a id="pl.50.27"></a><var>50.27</var>(2) age- and procedure-specific standard collaborative practice protocols, including <br/>
<a id="pl.50.28"></a><var>50.28</var>recommended intervals for the performance of dental hygiene services and a period of <br/>
<a id="pl.50.29"></a><var>50.29</var>time in which an examination by a dentist should occur;<br/>
<a id="pl.50.30"></a><var>50.30</var>(3) copies of consent to treatment form provided to the patient by the dental <br/>
<a id="pl.50.31"></a><var>50.31</var>hygienist;<br/>
<a id="pl.50.32"></a><var>50.32</var>(4) specific protocols for the placement of pit and fissure sealants and requirements <br/>
<a id="pl.50.33"></a><var>50.33</var>for follow-up care to assure the efficacy of the sealants after application; and<br/>
<a id="pl.50.34"></a><var>50.34</var>(5) a procedure for creating and maintaining dental records for the patients that are <br/>
<a id="pl.50.35"></a><var>50.35</var>treated by the dental hygienist. This procedure must specify where these records are <br/>
<a id="pl.50.36"></a><var>50.36</var>to be located.<br/>
<a id="pl.51.1"></a><var>51.1</var>The collaborative agreement must be signed and maintained by the dentist, the dental <br/>
<a id="pl.51.2"></a><var>51.2</var>hygienist, and the facility, program, or organization; must be reviewed annually by the <br/>
<a id="pl.51.3"></a><var>51.3</var>collaborating dentist and dental hygienist; and must be made available to the board <br/>
<a id="pl.51.4"></a><var>51.4</var>upon request.<br/>
<a id="pl.51.5"></a><var>51.5</var>(d) Before performing any services authorized under this subdivision, a dental <br/>
<a id="pl.51.6"></a><var>51.6</var>hygienist must provide the patient with a consent to treatment form which must include a <br/>
<a id="pl.51.7"></a><var>51.7</var>statement advising the patient that the dental hygiene services provided are not a substitute <br/>
<a id="pl.51.8"></a><var>51.8</var>for a dental examination by a licensed dentist. If the dental hygienist makes any referrals <br/>
<a id="pl.51.9"></a><var>51.9</var>to the patient for further dental procedures, the dental hygienist must fill out a referral form <br/>
<a id="pl.51.10"></a><var>51.10</var>and provide a copy of the form to the collaborating dentist.<br/>
<a id="pl.51.11"></a><var>51.11</var>(e) For the purposes of this subdivision, a "health care facility, program, or <br/>
<a id="pl.51.12"></a><var>51.12</var>nonprofit organization" is limited to a hospital; nursing home; home health agency; group <br/>
<a id="pl.51.13"></a><var>51.13</var>home serving the elderly, disabled, or juveniles; state-operated facility licensed by the <br/>
<a id="pl.51.14"></a><var>51.14</var>commissioner of human services or the commissioner of corrections; and federal, state, or <br/>
<a id="pl.51.15"></a><var>51.15</var>local public health facility, community clinic, tribal clinic, school authority, Head Start <br/>
<a id="pl.51.16"></a><var>51.16</var>program, or nonprofit organization that serves individuals who are uninsured or who are <br/>
<a id="pl.51.17"></a><var>51.17</var>Minnesota health care public program recipients.<br/>
<a id="pl.51.18"></a><var>51.18</var>(f) For purposes of this subdivision, a "collaborative agreement" means a written <br/>
<a id="pl.51.19"></a><var>51.19</var>agreement with a licensed dentist who authorizes and accepts responsibility for the <br/>
<a id="pl.51.20"></a><var>51.20</var>services performed by the dental hygienist. The services authorized under this subdivision <br/>
<a id="pl.51.21"></a><var>51.21</var>and the collaborative agreement may be performed without the presence of a licensed <br/>
<a id="pl.51.22"></a><var>51.22</var>dentist and may be performed at a location other than the usual place of practice of the <br/>
<a id="pl.51.23"></a><var>51.23</var>dentist or dental hygienist and without a dentist's diagnosis and treatment plan, unless <br/>
<a id="pl.51.24"></a><var>51.24</var>specified in the collaborative agreement.<br/>
<br/>
<a id="bill.0.76.0"></a><a id="pl.51.25"></a><var>51.25</var>    Sec. 76. Minnesota Statutes 2008, section 150A.10, subdivision 2, is amended to read:<br/>
<a id="pl.51.26"></a><var>51.26</var>    Subd. 2. <b>Dental assistants.</b> Every licensed dentist who uses the services of any <br/>
<a id="pl.51.27"></a><var>51.27</var>unlicensed person for the purpose of assistance in the practice of dentistry shall be <br/>
<a id="pl.51.28"></a><var>51.28</var>responsible for the acts of such unlicensed person while engaged in such assistance. <br/>
<a id="pl.51.29"></a><var>51.29</var>Such dentist shall permit such unlicensed assistant to perform only those acts which are <br/>
<a id="pl.51.30"></a><var>51.30</var>authorized to be delegated to unlicensed assistants by the Board of Dentistry. Such acts <br/>
<a id="pl.51.31"></a><var>51.31</var>shall be performed under supervision of a licensed dentist. The board may permit differing <br/>
<a id="pl.51.32"></a><var>51.32</var>levels of dental assistance based upon recognized educational standards, approved by the <br/>
<a id="pl.51.33"></a><var>51.33</var>board, for the training of dental assistants. The board may also define by rule the scope of <br/>
<a id="pl.51.34"></a><var>51.34</var>practice of registered licensed and nonregistered unlicensed dental assistants. The board <br/>
<a id="pl.51.35"></a><var>51.35</var>by rule may require continuing education for differing levels of dental assistants, as a <br/>
<a id="pl.51.36"></a><var>51.36</var>condition to their registration license or authority to perform their authorized duties. Any <br/>
<a id="pl.52.1"></a><var>52.1</var>licensed dentist who shall permit such unlicensed assistant to perform any dental service <br/>
<a id="pl.52.2"></a><var>52.2</var>other than that authorized by the board shall be deemed to be enabling an unlicensed <br/>
<a id="pl.52.3"></a><var>52.3</var>person to practice dentistry, and commission of such an act by such unlicensed assistant <br/>
<a id="pl.52.4"></a><var>52.4</var>shall constitute a violation of sections 
         <statute_ref>150A.01</statute_ref> to 
         <statute_ref>150A.12</statute_ref>.  <br/>
<br/>
<a id="bill.0.77.0"></a><a id="pl.52.5"></a><var>52.5</var>    Sec. 77. Minnesota Statutes 2008, section 150A.10, subdivision 4, is amended to read:<br/>
<a id="pl.52.6"></a><var>52.6</var>    Subd. 4. <b>Restorative procedures.</b> (a) Notwithstanding subdivisions 1, 1a, and <br/>
<a id="pl.52.7"></a><var>52.7</var>2, a licensed dental hygienist or a registered licensed dental assistant may perform the <br/>
<a id="pl.52.8"></a><var>52.8</var>following restorative procedures:<br/>
<a id="pl.52.9"></a><var>52.9</var>(1) place, contour, and adjust amalgam restorations;<br/>
<a id="pl.52.10"></a><var>52.10</var>(2) place, contour, and adjust glass ionomer;<br/>
<a id="pl.52.11"></a><var>52.11</var>(3) adapt and cement stainless steel crowns; and<br/>
<a id="pl.52.12"></a><var>52.12</var>(4) place, contour, and adjust class I and class V supragingival composite restorations <br/>
<a id="pl.52.13"></a><var>52.13</var>where the margins are entirely within the enamel.<br/>
<a id="pl.52.14"></a><var>52.14</var>(b) The restorative procedures described in paragraph (a) may be performed only if:<br/>
<a id="pl.52.15"></a><var>52.15</var>(1) the licensed dental hygienist or the registered licensed dental assistant has <br/>
<a id="pl.52.16"></a><var>52.16</var>completed a board-approved course on the specific procedures;<br/>
<a id="pl.52.17"></a><var>52.17</var>(2) the board-approved course includes a component that sufficiently prepares the <br/>
<a id="pl.52.18"></a><var>52.18</var>licensed dental hygienist or registered licensed dental assistant to adjust the occlusion <br/>
<a id="pl.52.19"></a><var>52.19</var>on the newly placed restoration;<br/>
<a id="pl.52.20"></a><var>52.20</var>(3) a licensed dentist has authorized the procedure to be performed; and<br/>
<a id="pl.52.21"></a><var>52.21</var>(4) a licensed dentist is available in the clinic while the procedure is being performed.<br/>
<a id="pl.52.22"></a><var>52.22</var>(c) The dental faculty who teaches the educators of the board-approved courses <br/>
<a id="pl.52.23"></a><var>52.23</var>specified in paragraph (b) must have prior experience teaching these procedures in an <br/>
<a id="pl.52.24"></a><var>52.24</var>accredited dental education program.<br/>
<br/>
<a id="bill.0.78.0"></a><a id="pl.52.25"></a><var>52.25</var>    Sec. 78. Minnesota Statutes 2008, section 150A.12, is amended to read:<br/>
<a id="pl.52.26"></a><var>52.26</var><b>150A.12 VIOLATION AND DEFENSES.</b><br/>
<a id="pl.52.27"></a><var>52.27</var>Every person who violates any of the provisions of sections 
         <statute_ref>150A.01</statute_ref> to 
         <statute_ref>150A.12</statute_ref> <br/>
<a id="pl.52.28"></a><var>52.28</var>for which no specific penalty is provided herein, shall be guilty of a gross misdemeanor; <br/>
<a id="pl.52.29"></a><var>52.29</var>and, upon conviction, punished by a fine of not more than $3,000 or by imprisonment in <br/>
<a id="pl.52.30"></a><var>52.30</var>the county jail for not more than one year or by both such fine and imprisonment. In the <br/>
<a id="pl.52.31"></a><var>52.31</var>prosecution of any person for violation of sections 
         <statute_ref>150A.01</statute_ref> to 
         <statute_ref>150A.12</statute_ref>, it shall not be <br/>
<a id="pl.52.32"></a><var>52.32</var>necessary to allege or prove lack of a valid license to practice dentistry or, dental hygiene, <br/>
<a id="pl.52.33"></a><var>52.33</var>or dental assisting, but such matter shall be a matter of defense to be established by the <br/>
<a id="pl.52.34"></a><var>52.34</var>defendant.<br/>
<br/>
<a id="bill.0.79.0"></a><a id="pl.52.35"></a><var>52.35</var>    Sec. 79. Minnesota Statutes 2008, section 150A.13, is amended to read:<br/>
<a id="pl.53.1"></a><var>53.1</var><b>150A.13 REPORTING OBLIGATIONS.</b><br/>
<a id="pl.53.2"></a><var>53.2</var>    Subdivision 1. <b>Permission to report.</b> A person who has knowledge of a registrant <br/>
<a id="pl.53.3"></a><var>53.3</var>or a licensee unable to practice with reasonable skill and safety by reason of illness, use of <br/>
<a id="pl.53.4"></a><var>53.4</var>alcohol, drugs, chemicals, or any other materials, or as a result of any mental, physical, or <br/>
<a id="pl.53.5"></a><var>53.5</var>psychological condition may report the registrant or licensee to the board.<br/>
<a id="pl.53.6"></a><var>53.6</var>    Subd. 2. <b>Institutions.</b> A hospital, clinic, or other health care institution or <br/>
<a id="pl.53.7"></a><var>53.7</var>organization located in this state shall report to the board any action taken by the agency, <br/>
<a id="pl.53.8"></a><var>53.8</var>institution, or organization or any of its administrators or dental or other committees to <br/>
<a id="pl.53.9"></a><var>53.9</var>revoke, suspend, restrict, or condition a registrant's or licensee's privilege to practice <br/>
<a id="pl.53.10"></a><var>53.10</var>or treat patients or clients in the institution, or as part of the organization, any denial <br/>
<a id="pl.53.11"></a><var>53.11</var>of privileges, or any other disciplinary action against a registrant or licensee described <br/>
<a id="pl.53.12"></a><var>53.12</var>under subdivision 1. The institution or organization shall also report the resignation of <br/>
<a id="pl.53.13"></a><var>53.13</var>any registrants or licensees prior to the conclusion of any disciplinary action proceeding <br/>
<a id="pl.53.14"></a><var>53.14</var>against a registrant or licensee described under subdivision 1.<br/>
<a id="pl.53.15"></a><var>53.15</var>    Subd. 3. <b>Dental societies.</b> A state or local dental society or professional dental <br/>
<a id="pl.53.16"></a><var>53.16</var>association shall report to the board any termination, revocation, or suspension of <br/>
<a id="pl.53.17"></a><var>53.17</var>membership or any other disciplinary action taken against a registrant or licensee. If the <br/>
<a id="pl.53.18"></a><var>53.18</var>society or association has received a complaint against a registrant or licensee described <br/>
<a id="pl.53.19"></a><var>53.19</var>under subdivision 1, on which it has not taken any disciplinary action, the society or <br/>
<a id="pl.53.20"></a><var>53.20</var>association shall report the complaint and the reason why it has not taken action on it or <br/>
<a id="pl.53.21"></a><var>53.21</var>shall direct the complainant to the board. This subdivision does not apply to a society <br/>
<a id="pl.53.22"></a><var>53.22</var>or association when it performs peer review functions as an agent of an outside entity, <br/>
<a id="pl.53.23"></a><var>53.23</var>organization, or system.<br/>
<a id="pl.53.24"></a><var>53.24</var>    Subd. 4. <b>Licensed professionals.</b> (a) A licensed or registered health professional <br/>
<a id="pl.53.25"></a><var>53.25</var>shall report to the board personal knowledge of any conduct by any person who the <br/>
<a id="pl.53.26"></a><var>53.26</var>licensed or registered health professional reasonably believes is a registrant or licensee <br/>
<a id="pl.53.27"></a><var>53.27</var>described under subdivision 1.<br/>
<a id="pl.53.28"></a><var>53.28</var>(b) Notwithstanding paragraph (a), a licensed health professional shall report to the <br/>
<a id="pl.53.29"></a><var>53.29</var>board knowledge of any actions which institutions must report under subdivision 2.<br/>
<a id="pl.53.30"></a><var>53.30</var>    Subd. 5. <b>Insurers and other entities making liability payments.</b> (a) Four times <br/>
<a id="pl.53.31"></a><var>53.31</var>each year as prescribed by the board, each insurer authorized to sell insurance described in <br/>
<a id="pl.53.32"></a><var>53.32</var>section 
         <statute_ref>60A.06, subdivision 1</statute_ref>, clause (13), and providing professional liability insurance <br/>
<a id="pl.53.33"></a><var>53.33</var>to registrants or licensees, shall submit to the board a report concerning the registrants and <br/>
<a id="pl.53.34"></a><var>53.34</var>licensees against whom malpractice settlements or awards have been made to the plaintiff. <br/>
<a id="pl.53.35"></a><var>53.35</var>The report must contain at least the following information:  <br/>
<a id="pl.54.1"></a><var>54.1</var>(1) the total number of malpractice settlements or awards made;<br/>
<a id="pl.54.2"></a><var>54.2</var>(2) the date the malpractice settlements or awards were made;<br/>
<a id="pl.54.3"></a><var>54.3</var>(3) the allegations contained in the claim or complaint leading to the settlements or <br/>
<a id="pl.54.4"></a><var>54.4</var>awards made;<br/>
<a id="pl.54.5"></a><var>54.5</var>(4) the dollar amount of each malpractice settlement or award;<br/>
<a id="pl.54.6"></a><var>54.6</var>(5) the regular address of the practice of the registrant or licensee against whom an <br/>
<a id="pl.54.7"></a><var>54.7</var>award was made or with whom a settlement was made; and<br/>
<a id="pl.54.8"></a><var>54.8</var>(6) the name of the registrant or licensee against whom an award was made or <br/>
<a id="pl.54.9"></a><var>54.9</var>with whom a settlement was made.<br/>
<a id="pl.54.10"></a><var>54.10</var>(b) A dental clinic, hospital, political subdivision, or other entity which makes <br/>
<a id="pl.54.11"></a><var>54.11</var>professional liability insurance payments on behalf of registrants or licensees shall submit <br/>
<a id="pl.54.12"></a><var>54.12</var>to the board a report concerning malpractice settlements or awards paid on behalf of <br/>
<a id="pl.54.13"></a><var>54.13</var>registrants or licensees, and any settlements or awards paid by a clinic, hospital, political <br/>
<a id="pl.54.14"></a><var>54.14</var>subdivision, or other entity on its own behalf because of care rendered by registrants or <br/>
<a id="pl.54.15"></a><var>54.15</var>licensees. This requirement excludes forgiveness of bills. The report shall be made to the <br/>
<a id="pl.54.16"></a><var>54.16</var>board within 30 days of payment of all or part of any settlement or award.<br/>
<a id="pl.54.17"></a><var>54.17</var>    Subd. 6. <b>Courts.</b> The court administrator of district court or any other court of <br/>
<a id="pl.54.18"></a><var>54.18</var>competent jurisdiction shall report to the board any judgment or other determination <br/>
<a id="pl.54.19"></a><var>54.19</var>of the court that adjudges or includes a finding that a registrant or licensee is mentally <br/>
<a id="pl.54.20"></a><var>54.20</var>ill, mentally incompetent, guilty of a felony, guilty of a violation of federal or state <br/>
<a id="pl.54.21"></a><var>54.21</var>narcotics laws or controlled substances act, or guilty of an abuse or fraud under Medicare <br/>
<a id="pl.54.22"></a><var>54.22</var>or Medicaid; or that appoints a guardian of the registrant or licensee pursuant to sections <br/>
<statute_ref><a id="pl.54.23"></a><var>54.23</var>524.5-101
         </statute_ref> to 
         <statute_ref>524.5-502</statute_ref>, or commits a registrant or licensee pursuant to chapter 253B.  <br/>
<a id="pl.54.24"></a><var>54.24</var>    Subd. 7. <b>Self-reporting.</b> A registrant or licensee shall report to the board any <br/>
<a id="pl.54.25"></a><var>54.25</var>personal action that would require that a report be filed by any person, health care facility, <br/>
<a id="pl.54.26"></a><var>54.26</var>business, or organization pursuant to subdivisions 2 to 6.<br/>
<a id="pl.54.27"></a><var>54.27</var>    Subd. 8. <b>Deadlines; forms.</b> Reports required by subdivisions 2 to 7 must be <br/>
<a id="pl.54.28"></a><var>54.28</var>submitted not later than 30 days after the occurrence of the reportable event or transaction. <br/>
<a id="pl.54.29"></a><var>54.29</var>The board may provide forms for the submission of reports required by this section, may <br/>
<a id="pl.54.30"></a><var>54.30</var>require that reports be submitted on the forms provided, and may adopt rules necessary <br/>
<a id="pl.54.31"></a><var>54.31</var>to assure prompt and accurate reporting.<br/>
<a id="pl.54.32"></a><var>54.32</var>    Subd. 9. <b>Subpoenas.</b> The board may issue subpoenas for the production of any <br/>
<a id="pl.54.33"></a><var>54.33</var>reports required by subdivisions 2 to 7 or any related documents.<br/>
<br/>
<a id="bill.0.80.0"></a><a id="pl.54.34"></a><var>54.34</var>    Sec. 80. Minnesota Statutes 2008, section 169.345, subdivision 2, is amended to read:<br/>
<a id="pl.55.1"></a><var>55.1</var>    Subd. 2. <b>Definitions.</b> (a) For the purpose of section 
         <statute_ref>168.021</statute_ref> and this section, the <br/>
<a id="pl.55.2"></a><var>55.2</var>following terms have the meanings given them in this subdivision.<br/>
<a id="pl.55.3"></a><var>55.3</var>(b) "Health professional" means a licensed physician, registered licensed physician <br/>
<a id="pl.55.4"></a><var>55.4</var>assistant, advanced practice registered nurse, or licensed chiropractor.<br/>
<a id="pl.55.5"></a><var>55.5</var>(c) "Long-term certificate" means a certificate issued for a period greater than 12 <br/>
<a id="pl.55.6"></a><var>55.6</var>months but not greater than 71 months.<br/>
<a id="pl.55.7"></a><var>55.7</var>(d) "Organization certificate" means a certificate issued to an entity other than a <br/>
<a id="pl.55.8"></a><var>55.8</var>natural person for a period of three years.<br/>
<a id="pl.55.9"></a><var>55.9</var>(e) "Permit" refers to a permit that is issued for a period of 30 days, in lieu of the <br/>
<a id="pl.55.10"></a><var>55.10</var>certificate referred to in subdivision 3, while the application is being processed.<br/>
<a id="pl.55.11"></a><var>55.11</var>(f) "Physically disabled person" means a person who:<br/>
<a id="pl.55.12"></a><var>55.12</var>(1) because of disability cannot walk without significant risk of falling;<br/>
<a id="pl.55.13"></a><var>55.13</var>(2) because of disability cannot walk 200 feet without stopping to rest;<br/>
<a id="pl.55.14"></a><var>55.14</var>(3) because of disability cannot walk without the aid of another person, a walker, a <br/>
<a id="pl.55.15"></a><var>55.15</var>cane, crutches, braces, a prosthetic device, or a wheelchair;<br/>
<a id="pl.55.16"></a><var>55.16</var>(4) is restricted by a respiratory disease to such an extent that the person's forced <br/>
<a id="pl.55.17"></a><var>55.17</var>(respiratory) expiratory volume for one second, when measured by spirometry, is less <br/>
<a id="pl.55.18"></a><var>55.18</var>than one liter;<br/>
<a id="pl.55.19"></a><var>55.19</var>(5) has an arterial oxygen tension (PAO2) of less than 60 mm/Hg on room air at rest;<br/>
<a id="pl.55.20"></a><var>55.20</var>(6) uses portable oxygen;<br/>
<a id="pl.55.21"></a><var>55.21</var>(7) has a cardiac condition to the extent that the person's functional limitations are <br/>
<a id="pl.55.22"></a><var>55.22</var>classified in severity as class III or class IV according to standards set by the American <br/>
<a id="pl.55.23"></a><var>55.23</var>Heart Association;<br/>
<a id="pl.55.24"></a><var>55.24</var>(8) has lost an arm or a leg and does not have or cannot use an artificial limb; or<br/>
<a id="pl.55.25"></a><var>55.25</var>(9) has a disability that would be aggravated by walking 200 feet under normal <br/>
<a id="pl.55.26"></a><var>55.26</var>environmental conditions to an extent that would be life threatening.<br/>
<a id="pl.55.27"></a><var>55.27</var>(g) "Short-term certificate" means a certificate issued for a period greater than six <br/>
<a id="pl.55.28"></a><var>55.28</var>months but not greater than 12 months.<br/>
<a id="pl.55.29"></a><var>55.29</var>(h) "Six-year certificate" means a certificate issued for a period of six years.<br/>
<a id="pl.55.30"></a><var>55.30</var>(i) "Temporary certificate" means a certificate issued for a period not greater than <br/>
<a id="pl.55.31"></a><var>55.31</var>six months.<br/>
<br/>
<a id="bill.0.81.0"></a><a id="pl.55.32"></a><var>55.32</var>    Sec. 81. Minnesota Statutes 2008, section 182.6551, is amended to read:<br/>
<a id="pl.55.33"></a><var>55.33</var><b>182.6551 CITATION; SAFE PATIENT HANDLING ACT.</b><br/>
<a id="pl.55.34"></a><var>55.34</var>    Sections 
         <statute_ref>182.6551</statute_ref> to 
         <statute_ref>182.6553</statute_ref> 182.6554 may be cited as the "Safe Patient Handling <br/>
<a id="pl.55.35"></a><var>55.35</var>Act."<br/>
<br/>
<a id="bill.0.82.0"></a><a id="pl.56.1"></a><var>56.1</var>    Sec. 82. Minnesota Statutes 2008, section 182.6552, is amended by adding a <br/>
<a id="pl.56.2"></a><var>56.2</var>subdivision to read:<br/>
<a id="pl.56.3"></a><var>56.3</var>    Subd. 5. <b>Clinical settings that move patients.</b> "Clinical settings that move <br/>
<a id="pl.56.4"></a><var>56.4</var>patients" means physician, dental, and other outpatient care facilities, except for outpatient <br/>
<a id="pl.56.5"></a><var>56.5</var>surgical settings, where service requires movement of patients from point to point as part <br/>
<a id="pl.56.6"></a><var>56.6</var>of the scope of service.<br/>
<br/>
<a id="bill.0.83.0"></a><a id="pl.56.7"></a><var>56.7</var>    Sec. 83. <b>[182.6554] SAFE PATIENT HANDLING IN CLINICAL SETTINGS.</b><br/>
<a id="pl.56.8"></a><var>56.8</var>    Subdivision 1. <b>Safe patient handling plan required.</b> (a) By July 1, 2010, every <br/>
<a id="pl.56.9"></a><var>56.9</var>clinical setting that moves patients in the state shall develop a written safe patient handling <br/>
<a id="pl.56.10"></a><var>56.10</var>plan to achieve by January 1, 2012, the goal of ensuring the safe handling of patients by <br/>
<a id="pl.56.11"></a><var>56.11</var>minimizing manual lifting of patients by direct patient care workers and by utilizing <br/>
<a id="pl.56.12"></a><var>56.12</var>safe patient handling equipment.<br/>
<a id="pl.56.13"></a><var>56.13</var>    (b) The plan shall address:<br/>
<a id="pl.56.14"></a><var>56.14</var>    (1) assessment of risks with regard to patient handling that considers the patient <br/>
<a id="pl.56.15"></a><var>56.15</var>population and environment of care;<br/>
<a id="pl.56.16"></a><var>56.16</var>    (2) the acquisition of an adequate supply of appropriate safe patient handling <br/>
<a id="pl.56.17"></a><var>56.17</var>equipment;<br/>
<a id="pl.56.18"></a><var>56.18</var>    (3) initial and ongoing training of direct patient care workers on the use of this <br/>
<a id="pl.56.19"></a><var>56.19</var>equipment;<br/>
<a id="pl.56.20"></a><var>56.20</var>    (4) procedures to ensure that physical plant modifications and major construction <br/>
<a id="pl.56.21"></a><var>56.21</var>projects are consistent with plan goals; and<br/>
<a id="pl.56.22"></a><var>56.22</var>    (5) periodic evaluations of the safe patient handling plan. <br/>
<a id="pl.56.23"></a><var>56.23</var>(c) A health care organization with more than one covered clinical setting that <br/>
<a id="pl.56.24"></a><var>56.24</var>moves patients may establish a plan at each clinical setting or establish one plan to serve <br/>
<a id="pl.56.25"></a><var>56.25</var>this function for all the clinical settings.<br/>
<a id="pl.56.26"></a><var>56.26</var>    Subd. 2. <b>Facilities with existing programs.</b> A clinical setting that moves patients <br/>
<a id="pl.56.27"></a><var>56.27</var>that has already adopted a safe patient handling plan that satisfies the requirements of <br/>
<a id="pl.56.28"></a><var>56.28</var>subdivision 1, or a clinical setting that moves patients that is covered by a safe patient <br/>
<a id="pl.56.29"></a><var>56.29</var>handling plan that is covered under and consistent with section 182.6553, is considered <br/>
<a id="pl.56.30"></a><var>56.30</var>to be in compliance with the requirements of this section. <br/>
<a id="pl.56.31"></a><var>56.31</var>    Subd. 3. <b>Training materials.</b> The commissioner shall make training materials on <br/>
<a id="pl.56.32"></a><var>56.32</var>implementation of this section available at no cost to all clinical settings that move patients <br/>
<a id="pl.56.33"></a><var>56.33</var>as part of the training and education duties of the commissioner under section 182.673.<br/>
<a id="pl.56.34"></a><var>56.34</var>    Subd. 4. <b>Enforcement.</b> This section shall be enforced by the commissioner under <br/>
<a id="pl.56.35"></a><var>56.35</var>section 182.661. An initial violation of this section shall not be assessed a penalty. A <br/>
<a id="pl.57.1"></a><var>57.1</var>subsequent violation of this section is subject to the penalties provided under section <br/>
<a id="pl.57.2"></a><var>57.2</var>182.666.<br/>
<br/>
<a id="bill.0.84.0"></a><a id="pl.57.3"></a><var>57.3</var>    Sec. 84. Minnesota Statutes 2008, section 252.27, subdivision 1a, is amended to read:<br/>
<a id="pl.57.4"></a><var>57.4</var>    Subd. 1a. <b>Definitions.</b> A "related condition" is a condition (1) that is found to be <br/>
<a id="pl.57.5"></a><var>57.5</var>closely related to developmental disability, including, but not limited to, cerebral palsy, <br/>
<a id="pl.57.6"></a><var>57.6</var>epilepsy, autism, fetal alcohol spectrum disorder, and Prader-Willi syndrome, and (2) that <br/>
<a id="pl.57.7"></a><var>57.7</var>meets all of the following criteria:<br/>
<a id="pl.57.8"></a><var>57.8</var>(1) (i) is severe and chronic;<br/>
<a id="pl.57.9"></a><var>57.9</var>(2) (ii) results in impairment of general intellectual functioning or adaptive behavior <br/>
<a id="pl.57.10"></a><var>57.10</var>similar to that of persons with developmental disabilities;<br/>
<a id="pl.57.11"></a><var>57.11</var>(3) (iii) requires treatment or services similar to those required for persons with <br/>
<a id="pl.57.12"></a><var>57.12</var>developmental disabilities;<br/>
<a id="pl.57.13"></a><var>57.13</var>(4) (iv) is manifested before the person reaches 22 years of age;<br/>
<a id="pl.57.14"></a><var>57.14</var>(5) (v) is likely to continue indefinitely;<br/>
<a id="pl.57.15"></a><var>57.15</var>(6) (vi) results in substantial functional limitations in three or more of the following <br/>
<a id="pl.57.16"></a><var>57.16</var>areas of major life activity: (i) (A) self-care, (ii) (B) understanding and use of language, <br/>
<a id="pl.57.17"></a><var>57.17</var>(iii) (C) learning, (iv) (D) mobility, (v) (E) self-direction, (vi) (F) capacity for independent <br/>
<a id="pl.57.18"></a><var>57.18</var>living; and<br/>
<a id="pl.57.19"></a><var>57.19</var>(7) (vii) is not attributable to mental illness as defined in section 
         <statute_ref>245.462, subdivision <br/>
<a id="pl.57.20"></a><var>57.20</var>20
         </statute_ref>, or an emotional disturbance as defined in section 
         <statute_ref>245.4871, subdivision 15</statute_ref>. <br/>
<a id="pl.57.21"></a><var>57.21</var>For purposes of clause (7) item (vii), notwithstanding section 
         <statute_ref>245.462, subdivision 20</statute_ref>, <br/>
<a id="pl.57.22"></a><var>57.22</var>or 
         <statute_ref>245.4871, subdivision 15</statute_ref>, "mental illness" does not include autism or other pervasive <br/>
<a id="pl.57.23"></a><var>57.23</var>developmental disorders.<br/>
<br/>
<a id="bill.0.85.0"></a><a id="pl.57.24"></a><var>57.24</var>    Sec. 85. Minnesota Statutes 2008, section 252.282, subdivision 3, is amended to read:<br/>
<a id="pl.57.25"></a><var>57.25</var>    Subd. 3. <b>Recommendations.</b> (a) Upon completion of the local system needs <br/>
<a id="pl.57.26"></a><var>57.26</var>planning assessment, the host county shall make recommendations by May 15, 2000, and <br/>
<a id="pl.57.27"></a><var>57.27</var>by July 1 every two years thereafter beginning in 2001. If no change is recommended, a <br/>
<a id="pl.57.28"></a><var>57.28</var>copy of the assessment along with corresponding documentation shall be provided to the <br/>
<a id="pl.57.29"></a><var>57.29</var>commissioner by July 1 prior to the contract year.<br/>
<a id="pl.57.30"></a><var>57.30</var>(b) Except as provided in section 
<statute_ref>252.292, subdivision 4</statute_ref>, recommendations <br/>
<a id="pl.57.31"></a><var>57.31</var>regarding closures, relocations, or downsizings that include a rate increase shall be <br/>
<a id="pl.57.32"></a><var>57.32</var>submitted to the statewide advisory committee for review, along with the assessment, plan, <br/>
<a id="pl.57.33"></a><var>57.33</var>and corresponding documentation that supports the payment rate adjustment request.  <br/>
<a id="pl.57.34"></a><var>57.34</var>(c) (b) Recommendations for closures, relocations, and downsizings that do not <br/>
<a id="pl.57.35"></a><var>57.35</var>include a rate increase and for modification of existing services for which a change in the <br/>
<a id="pl.58.1"></a><var>58.1</var>framework of service delivery is necessary shall be provided to the commissioner by July <br/>
<a id="pl.58.2"></a><var>58.2</var>1 prior to the contract year or at least 90 days prior to the anticipated change, along with <br/>
<a id="pl.58.3"></a><var>58.3</var>the assessment and corresponding documentation.<br/>
<br/>
<a id="bill.0.86.0"></a><a id="pl.58.4"></a><var>58.4</var>    Sec. 86. Minnesota Statutes 2008, section 252.282, subdivision 5, is amended to read:<br/>
<a id="pl.58.5"></a><var>58.5</var>    Subd. 5. <b>Responsibilities of commissioner.</b> (a) In collaboration with counties and <br/>
<a id="pl.58.6"></a><var>58.6</var>providers, the commissioner shall ensure that services recognize the preferences and needs <br/>
<a id="pl.58.7"></a><var>58.7</var>of persons with developmental disabilities and related conditions through a recurring <br/>
<a id="pl.58.8"></a><var>58.8</var>systemic review and assessment of ICF/MR facilities within the state.<br/>
<a id="pl.58.9"></a><var>58.9</var>    (b) The commissioner shall publish a notice in the State Register no less than <br/>
<a id="pl.58.10"></a><var>58.10</var>biannually to announce the opportunity for counties or providers to submit requests for <br/>
<a id="pl.58.11"></a><var>58.11</var>payment rate adjustments associated with plans for downsizing, relocation, and closure of <br/>
<a id="pl.58.12"></a><var>58.12</var>ICF/MR facilities.<br/>
<a id="pl.58.13"></a><var>58.13</var>    (c) The commissioner shall designate funding parameters to counties and to the <br/>
<a id="pl.58.14"></a><var>58.14</var>statewide advisory committee for the overall implementation of system needs within the <br/>
<a id="pl.58.15"></a><var>58.15</var>fiscal resources allocated by the legislature.<br/>
<a id="pl.58.16"></a><var>58.16</var>    (d) (b) The commissioner shall contract with ICF/MR providers. Contracts shall <br/>
<a id="pl.58.17"></a><var>58.17</var>be for two-year periods.<br/>
<br/>
<a id="bill.0.87.0"></a><a id="pl.58.18"></a><var>58.18</var>    Sec. 87. Minnesota Statutes 2008, section 253B.02, subdivision 7, is amended to read:<br/>
<a id="pl.58.19"></a><var>58.19</var>    Subd. 7. <b>Examiner.</b> "Examiner" means a person who is knowledgeable, trained, and <br/>
<a id="pl.58.20"></a><var>58.20</var>practicing in the diagnosis and assessment or in the treatment of the alleged impairment, <br/>
<a id="pl.58.21"></a><var>58.21</var>and who is:<br/>
<a id="pl.58.22"></a><var>58.22</var>(1) a licensed physician;<br/>
<a id="pl.58.23"></a><var>58.23</var>(2) a licensed psychologist who has a doctoral degree in psychology or who became <br/>
<a id="pl.58.24"></a><var>58.24</var>a licensed consulting psychologist before July 2, 1975; or<br/>
<a id="pl.58.25"></a><var>58.25</var>(3) an advanced practice registered nurse certified in mental health or a licensed <br/>
<a id="pl.58.26"></a><var>58.26</var>physician assistant, except that only a physician or psychologist meeting these <br/>
<a id="pl.58.27"></a><var>58.27</var>requirements may be appointed by the court as described by sections 
         <statute_ref>253B.07, subdivision <br/>
<a id="pl.58.28"></a><var>58.28</var>3
         </statute_ref>; 
         <statute_ref>253B.092, subdivision 8</statute_ref>, paragraph (b); 
         <statute_ref>253B.17, subdivision 3</statute_ref>; 
         <statute_ref>253B.18, subdivision <br/>
<a id="pl.58.29"></a><var>58.29</var>2
         </statute_ref>; and 
         <statute_ref>253B.19, subdivisions 1 and 2</statute_ref>, and only a physician or psychologist may conduct <br/>
<a id="pl.58.30"></a><var>58.30</var>an assessment as described by Minnesota Rules of Criminal Procedure, rule 20.<br/>
<br/>
<a id="bill.0.88.0"></a><a id="pl.58.31"></a><var>58.31</var>    Sec. 88. Minnesota Statutes 2008, section 253B.05, subdivision 2, is amended to read:<br/>
<a id="pl.58.32"></a><var>58.32</var>    Subd. 2. <b>Peace or health officer authority.</b> (a) A peace or health officer may take a <br/>
<a id="pl.58.33"></a><var>58.33</var>person into custody and transport the person to a licensed physician or treatment facility if <br/>
<a id="pl.58.34"></a><var>58.34</var>the officer has reason to believe, either through direct observation of the person's behavior, <br/>
<a id="pl.59.1"></a><var>59.1</var>or upon reliable information of the person's recent behavior and knowledge of the person's <br/>
<a id="pl.59.2"></a><var>59.2</var>past behavior or psychiatric treatment, that the person is mentally ill or developmentally <br/>
<a id="pl.59.3"></a><var>59.3</var>disabled and in danger of injuring self or others if not immediately detained. A peace or <br/>
<a id="pl.59.4"></a><var>59.4</var>health officer or a person working under such officer's supervision, may take a person <br/>
<a id="pl.59.5"></a><var>59.5</var>who is believed to be chemically dependent or is intoxicated in public into custody and <br/>
<a id="pl.59.6"></a><var>59.6</var>transport the person to a treatment facility. If the person is intoxicated in public or is <br/>
<a id="pl.59.7"></a><var>59.7</var>believed to be chemically dependent and is not in danger of causing self-harm or harm to <br/>
<a id="pl.59.8"></a><var>59.8</var>any person or property, the peace or health officer may transport the person home. The <br/>
<a id="pl.59.9"></a><var>59.9</var>peace or health officer shall make written application for admission of the person to the <br/>
<a id="pl.59.10"></a><var>59.10</var>treatment facility. The application shall contain the peace or health officer's statement <br/>
<a id="pl.59.11"></a><var>59.11</var>specifying the reasons for and circumstances under which the person was taken into <br/>
<a id="pl.59.12"></a><var>59.12</var>custody. If danger to specific individuals is a basis for the emergency hold, the statement <br/>
<a id="pl.59.13"></a><var>59.13</var>must include identifying information on those individuals, to the extent practicable. A <br/>
<a id="pl.59.14"></a><var>59.14</var>copy of the statement shall be made available to the person taken into custody.<br/>
<a id="pl.59.15"></a><var>59.15</var>(b) As far as is practicable, a peace officer who provides transportation for a person <br/>
<a id="pl.59.16"></a><var>59.16</var>placed in a facility under this subdivision may not be in uniform and may not use a vehicle <br/>
<a id="pl.59.17"></a><var>59.17</var>visibly marked as a law enforcement vehicle.<br/>
<a id="pl.59.18"></a><var>59.18</var>(c) A person may be admitted to a treatment facility for emergency care and <br/>
<a id="pl.59.19"></a><var>59.19</var>treatment under this subdivision with the consent of the head of the facility under the <br/>
<a id="pl.59.20"></a><var>59.20</var>following circumstances: (1) a written statement shall only be made by the following <br/>
<a id="pl.59.21"></a><var>59.21</var>individuals who are knowledgeable, trained, and practicing in the diagnosis and treatment <br/>
<a id="pl.59.22"></a><var>59.22</var>of mental illness or developmental disability; the medical officer, or the officer's designee <br/>
<a id="pl.59.23"></a><var>59.23</var>on duty at the facility, including a licensed physician, a registered licensed physician <br/>
<a id="pl.59.24"></a><var>59.24</var>assistant, or an advanced practice registered nurse who after preliminary examination has <br/>
<a id="pl.59.25"></a><var>59.25</var>determined that the person has symptoms of mental illness or developmental disability <br/>
<a id="pl.59.26"></a><var>59.26</var>and appears to be in danger of harming self or others if not immediately detained; or (2) a <br/>
<a id="pl.59.27"></a><var>59.27</var>written statement is made by the institution program director or the director's designee <br/>
<a id="pl.59.28"></a><var>59.28</var>on duty at the facility after preliminary examination that the person has symptoms <br/>
<a id="pl.59.29"></a><var>59.29</var>of chemical dependency and appears to be in danger of harming self or others if not <br/>
<a id="pl.59.30"></a><var>59.30</var>immediately detained or is intoxicated in public.<br/>
<br/>
<a id="bill.0.89.0"></a><a id="pl.59.31"></a><var>59.31</var>    Sec. 89. Minnesota Statutes 2008, section 256B.0625, subdivision 28a, is amended to <br/>
<a id="pl.59.32"></a><var>59.32</var>read:<br/>
<a id="pl.59.33"></a><var>59.33</var>    Subd. 28a. <b>Registered</b><b> Licensed</b><b> physician assistant services.</b> Medical assistance <br/>
<a id="pl.59.34"></a><var>59.34</var>covers services performed by a registered licensed physician assistant if the service is <br/>
<a id="pl.59.35"></a><var>59.35</var>otherwise covered under this chapter as a physician service and if the service is within the <br/>
<a id="pl.59.36"></a><var>59.36</var>scope of practice of a registered licensed physician assistant as defined in section 
         <statute_ref>147A.09</statute_ref>. <br/>
<br/>
<a id="bill.0.90.0"></a><a id="pl.60.1"></a><var>60.1</var>    Sec. 90. Minnesota Statutes 2008, section 256B.0657, subdivision 5, is amended to <br/>
<a id="pl.60.2"></a><var>60.2</var>read:<br/>
<a id="pl.60.3"></a><var>60.3</var>    Subd. 5. <b>Self-directed supports option plan requirements.</b> (a) The plan for the <br/>
<a id="pl.60.4"></a><var>60.4</var>self-directed supports option must meet the following requirements:<br/>
<a id="pl.60.5"></a><var>60.5</var>    (1) the plan must be completed using a person-centered process that:<br/>
<a id="pl.60.6"></a><var>60.6</var>    (i) builds upon the recipient's capacity to engage in activities that promote <br/>
<a id="pl.60.7"></a><var>60.7</var>community life;<br/>
<a id="pl.60.8"></a><var>60.8</var>    (ii) respects the recipient's preferences, choices, and abilities;<br/>
<a id="pl.60.9"></a><var>60.9</var>    (iii) involves families, friends, and professionals in the planning or delivery of <br/>
<a id="pl.60.10"></a><var>60.10</var>services or supports as desired or required by the recipient; and <br/>
<a id="pl.60.11"></a><var>60.11</var>    (iv) addresses the need for personal care assistant services identified in the recipient's <br/>
<a id="pl.60.12"></a><var>60.12</var>self-directed supports option assessment;<br/>
<a id="pl.60.13"></a><var>60.13</var>    (2) the plan shall be developed by the recipient or by the guardian of an adult <br/>
<a id="pl.60.14"></a><var>60.14</var>recipient or by a parent or guardian of a minor child, with the assistance of an enrolled <br/>
<a id="pl.60.15"></a><var>60.15</var>medical assistance home care targeted case manager and may be assisted by a provider <br/>
<a id="pl.60.16"></a><var>60.16</var>who meets the requirements established for using a person-centered planning process and <br/>
<a id="pl.60.17"></a><var>60.17</var>shall be reviewed at least annually upon reassessment or when there is a significant change <br/>
<a id="pl.60.18"></a><var>60.18</var>in the recipient's condition; and <br/>
<a id="pl.60.19"></a><var>60.19</var>    (3) the plan must include the total budget amount available divided into monthly <br/>
<a id="pl.60.20"></a><var>60.20</var>amounts that cover the number of months of personal care assistant services authorization <br/>
<a id="pl.60.21"></a><var>60.21</var>included in the budget. The amount used each month may vary, but additional funds shall <br/>
<a id="pl.60.22"></a><var>60.22</var>not be provided above the annual personal care assistant services authorized amount <br/>
<a id="pl.60.23"></a><var>60.23</var>unless a change in condition is documented.<br/>
<a id="pl.60.24"></a><var>60.24</var>    (b) The commissioner shall:<br/>
<a id="pl.60.25"></a><var>60.25</var>    (1) establish the format and criteria for the plan as well as the requirements for <br/>
<a id="pl.60.26"></a><var>60.26</var>providers who assist with plan development;<br/>
<a id="pl.60.27"></a><var>60.27</var>    (2) review the assessment and plan and, within 30 days after receiving the <br/>
<a id="pl.60.28"></a><var>60.28</var>assessment and plan, make a decision on approval of the plan;<br/>
<a id="pl.60.29"></a><var>60.29</var>    (3) notify the recipient, parent, or guardian of approval or denial of the plan and <br/>
<a id="pl.60.30"></a><var>60.30</var>provide notice of the right to appeal under section 
         <statute_ref>256.045</statute_ref>; and <br/>
<a id="pl.60.31"></a><var>60.31</var>    (4) provide a copy of the plan to the fiscal support entity selected by the recipient.<br/>
<br/>
<a id="bill.0.91.0"></a><a id="pl.60.32"></a><var>60.32</var>    Sec. 91. Minnesota Statutes 2008, section 256B.0751, subdivision 1, is amended to <br/>
<a id="pl.60.33"></a><var>60.33</var>read:<br/>
<a id="pl.60.34"></a><var>60.34</var>    Subdivision 1. <b>Definitions.</b> (a) For purposes of sections 
         <statute_ref>256B.0751</statute_ref> to 
         <statute_ref>256B.0753</statute_ref>, <br/>
<a id="pl.60.35"></a><var>60.35</var>the following definitions apply.<br/>
<a id="pl.61.1"></a><var>61.1</var>    (b) "Commissioner" means the commissioner of human services.<br/>
<a id="pl.61.2"></a><var>61.2</var>    (c) "Commissioners" means the commissioner of humans services and the <br/>
<a id="pl.61.3"></a><var>61.3</var>commissioner of health, acting jointly.<br/>
<a id="pl.61.4"></a><var>61.4</var>    (d) "Health plan company" has the meaning provided in section 
         <statute_ref>62Q.01, subdivision <br/>
</statute_ref><a id="pl.61.5"></a><var>61.5</var>4.<br/>
<a id="pl.61.6"></a><var>61.6</var>    (e) "Personal clinician" means a physician licensed under chapter 147, a physician <br/>
<a id="pl.61.7"></a><var>61.7</var>assistant registered licensed and practicing under chapter 147A, or an advanced practice <br/>
<a id="pl.61.8"></a><var>61.8</var>nurse licensed and registered to practice under chapter 148.<br/>
<a id="pl.61.9"></a><var>61.9</var>    (f) "State health care program" means the medical assistance, MinnesotaCare, and <br/>
<a id="pl.61.10"></a><var>61.10</var>general assistance medical care programs.<br/>
<br/>
<a id="bill.0.92.0"></a><a id="pl.61.11"></a><var>61.11</var>    Sec. 92. Minnesota Statutes 2008, section 256B.0913, subdivision 4, is amended to <br/>
<a id="pl.61.12"></a><var>61.12</var>read:<br/>
<a id="pl.61.13"></a><var>61.13</var>    Subd. 4. <b>Eligibility for funding for services for nonmedical assistance recipients.</b><br/>
<a id="pl.61.14"></a><var>61.14</var>    (a) Funding for services under the alternative care program is available to persons who <br/>
<a id="pl.61.15"></a><var>61.15</var>meet the following criteria:<br/>
<a id="pl.61.16"></a><var>61.16</var>    (1) the person has been determined by a community assessment under section <br/>
<statute_ref><a id="pl.61.17"></a><var>61.17</var>256B.0911
         </statute_ref> to be a person who would require the level of care provided in a nursing <br/>
<a id="pl.61.18"></a><var>61.18</var>facility, but for the provision of services under the alternative care program;<br/>
<a id="pl.61.19"></a><var>61.19</var>    (2) the person is age 65 or older;<br/>
<a id="pl.61.20"></a><var>61.20</var>    (3) the person would be eligible for medical assistance within 135 days of admission <br/>
<a id="pl.61.21"></a><var>61.21</var>to a nursing facility;<br/>
<a id="pl.61.22"></a><var>61.22</var>    (4) the person is not ineligible for the payment of long-term care services by the <br/>
<a id="pl.61.23"></a><var>61.23</var>medical assistance program due to an asset transfer penalty under section 
         <statute_ref>256B.0595</statute_ref> or <br/>
<a id="pl.61.24"></a><var>61.24</var>equity interest in the home exceeding $500,000 as stated in section 
         <statute_ref>256B.056</statute_ref>;<br/>
<a id="pl.61.25"></a><var>61.25</var>    (5) the person needs long-term care services that are not funded through other <br/>
<a id="pl.61.26"></a><var>61.26</var>state or federal funding, or other health insurance or other third-party insurance such as <br/>
<a id="pl.61.27"></a><var>61.27</var>long-term care insurance;<br/>
<a id="pl.61.28"></a><var>61.28</var>    (6) the monthly cost of the alternative care services funded by the program for <br/>
<a id="pl.61.29"></a><var>61.29</var>this person does not exceed 75 percent of the monthly limit described under section <br/>
<statute_ref><a id="pl.61.30"></a><var>61.30</var>256B.0915, subdivision 3a
         </statute_ref>. This monthly limit does not prohibit the alternative care <br/>
<a id="pl.61.31"></a><var>61.31</var>client from payment for additional services, but in no case may the cost of additional <br/>
<a id="pl.61.32"></a><var>61.32</var>services purchased under this section exceed the difference between the client's monthly <br/>
<a id="pl.61.33"></a><var>61.33</var>service limit defined under section 
         <statute_ref>256B.0915, subdivision 3</statute_ref>, and the alternative care <br/>
<a id="pl.61.34"></a><var>61.34</var>program monthly service limit defined in this paragraph. If care-related supplies and <br/>
<a id="pl.61.35"></a><var>61.35</var>equipment or environmental modifications and adaptations are or will be purchased for <br/>
<a id="pl.61.36"></a><var>61.36</var>an alternative care services recipient, the costs may be prorated on a monthly basis for <br/>
<a id="pl.62.1"></a><var>62.1</var>up to 12 consecutive months beginning with the month of purchase. If the monthly cost <br/>
<a id="pl.62.2"></a><var>62.2</var>of a recipient's other alternative care services exceeds the monthly limit established in <br/>
<a id="pl.62.3"></a><var>62.3</var>this paragraph, the annual cost of the alternative care services shall be determined. In this <br/>
<a id="pl.62.4"></a><var>62.4</var>event, the annual cost of alternative care services shall not exceed 12 times the monthly <br/>
<a id="pl.62.5"></a><var>62.5</var>limit described in this paragraph; and<br/>
<a id="pl.62.6"></a><var>62.6</var>    (7) the person is making timely payments of the assessed monthly fee.<br/>
<a id="pl.62.7"></a><var>62.7</var>A person is ineligible if payment of the fee is over 60 days past due, unless the person <br/>
<a id="pl.62.8"></a><var>62.8</var>agrees to:<br/>
<a id="pl.62.9"></a><var>62.9</var>    (i) the appointment of a representative payee;<br/>
<a id="pl.62.10"></a><var>62.10</var>    (ii) automatic payment from a financial account;<br/>
<a id="pl.62.11"></a><var>62.11</var>    (iii) the establishment of greater family involvement in the financial management of <br/>
<a id="pl.62.12"></a><var>62.12</var>payments; or<br/>
<a id="pl.62.13"></a><var>62.13</var>    (iv) another method acceptable to the lead agency to ensure prompt fee payments.<br/>
<a id="pl.62.14"></a><var>62.14</var>    The lead agency may extend the client's eligibility as necessary while making <br/>
<a id="pl.62.15"></a><var>62.15</var>arrangements to facilitate payment of past-due amounts and future premium payments. <br/>
<a id="pl.62.16"></a><var>62.16</var>Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be <br/>
<a id="pl.62.17"></a><var>62.17</var>reinstated for a period of 30 days.<br/>
<a id="pl.62.18"></a><var>62.18</var>    (b) Alternative care funding under this subdivision is not available for a person <br/>
<a id="pl.62.19"></a><var>62.19</var>who is a medical assistance recipient or who would be eligible for medical assistance <br/>
<a id="pl.62.20"></a><var>62.20</var>without a spenddown or waiver obligation. A person whose initial application for medical <br/>
<a id="pl.62.21"></a><var>62.21</var>assistance and the elderly waiver program is being processed may be served under the <br/>
<a id="pl.62.22"></a><var>62.22</var>alternative care program for a period up to 60 days. If the individual is found to be eligible <br/>
<a id="pl.62.23"></a><var>62.23</var>for medical assistance, medical assistance must be billed for services payable under the <br/>
<a id="pl.62.24"></a><var>62.24</var>federally approved elderly waiver plan and delivered from the date the individual was <br/>
<a id="pl.62.25"></a><var>62.25</var>found eligible for the federally approved elderly waiver plan. Notwithstanding this <br/>
<a id="pl.62.26"></a><var>62.26</var>provision, alternative care funds may not be used to pay for any service the cost of which: <br/>
<a id="pl.62.27"></a><var>62.27</var>(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; <br/>
<a id="pl.62.28"></a><var>62.28</var>or (iii) is used to pay a medical assistance income spenddown for a person who is eligible <br/>
<a id="pl.62.29"></a><var>62.29</var>to participate in the federally approved elderly waiver program under the special income <br/>
<a id="pl.62.30"></a><var>62.30</var>standard provision.<br/>
<a id="pl.62.31"></a><var>62.31</var>    (c) Alternative care funding is not available for a person who resides in a licensed <br/>
<a id="pl.62.32"></a><var>62.32</var>nursing home, certified boarding care home, hospital, or intermediate care facility, except <br/>
<a id="pl.62.33"></a><var>62.33</var>for case management services which are provided in support of the discharge planning <br/>
<a id="pl.62.34"></a><var>62.34</var>process for a nursing home resident or certified boarding care home resident to assist with <br/>
<a id="pl.62.35"></a><var>62.35</var>a relocation process to a community-based setting.<br/>
<a id="pl.63.1"></a><var>63.1</var>    (d) Alternative care funding is not available for a person whose income is greater <br/>
<a id="pl.63.2"></a><var>63.2</var>than the maintenance needs allowance under section 
         <statute_ref>256B.0915, subdivision 1d</statute_ref>, but equal <br/>
<a id="pl.63.3"></a><var>63.3</var>to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal <br/>
<a id="pl.63.4"></a><var>63.4</var>year for which alternative care eligibility is determined, who would be eligible for the <br/>
<a id="pl.63.5"></a><var>63.5</var>elderly waiver with a waiver obligation.<br/>
<br/>
<a id="bill.0.93.0"></a><a id="pl.63.6"></a><var>63.6</var>    Sec. 93. Minnesota Statutes 2008, section 256B.0913, subdivision 5a, is amended to <br/>
<a id="pl.63.7"></a><var>63.7</var>read:<br/>
<a id="pl.63.8"></a><var>63.8</var>    Subd. 5a. <b>Services; service definitions; service standards.</b> (a) Unless specified in <br/>
<a id="pl.63.9"></a><var>63.9</var>statute, the services, service definitions, and standards for alternative care services shall <br/>
<a id="pl.63.10"></a><var>63.10</var>be the same as the services, service definitions, and standards specified in the federally <br/>
<a id="pl.63.11"></a><var>63.11</var>approved elderly waiver plan, except alternative care does not cover transitional support <br/>
<a id="pl.63.12"></a><var>63.12</var>services, assisted living services, adult foster care services, and residential care and <br/>
<a id="pl.63.13"></a><var>63.13</var>benefits defined under section 
         <statute_ref>256B.0625</statute_ref> that meet primary and acute health care needs.<br/>
<a id="pl.63.14"></a><var>63.14</var>    (b) The lead agency must ensure that the funds are not used to supplant or <br/>
<a id="pl.63.15"></a><var>63.15</var>supplement services available through other public assistance or services programs, <br/>
<a id="pl.63.16"></a><var>63.16</var>including supplementation of client co-pays, deductibles, premiums, or other cost-sharing <br/>
<a id="pl.63.17"></a><var>63.17</var>arrangements for health-related benefits and services or entitlement programs and <br/>
<a id="pl.63.18"></a><var>63.18</var>services that are available to the person, but in which they have elected not to enroll. <br/>
<a id="pl.63.19"></a><var>63.19</var>The lead agency must ensure that the benefit department recovery system in the Medicaid <br/>
<a id="pl.63.20"></a><var>63.20</var>Management Information System (MMIS) has the necessary information on any other <br/>
<a id="pl.63.21"></a><var>63.21</var>health insurance or third-party insurance policy to which the client may have access. For a <br/>
<a id="pl.63.22"></a><var>63.22</var>provider of supplies and equipment when the monthly cost of the supplies and equipment <br/>
<a id="pl.63.23"></a><var>63.23</var>is less than $250, persons or agencies must be employed by or under a contract with the <br/>
<a id="pl.63.24"></a><var>63.24</var>lead agency or the public health nursing agency of the local board of health in order to <br/>
<a id="pl.63.25"></a><var>63.25</var>receive funding under the alternative care program. Supplies and equipment may be <br/>
<a id="pl.63.26"></a><var>63.26</var>purchased from a vendor not certified to participate in the Medicaid program if the cost for <br/>
<a id="pl.63.27"></a><var>63.27</var>the item is less than that of a Medicaid vendor.<br/>
<a id="pl.63.28"></a><var>63.28</var>    (c) Personal care services must meet the service standards defined in the federally <br/>
<a id="pl.63.29"></a><var>63.29</var>approved elderly waiver plan, except that a lead agency may contract with a client's <br/>
<a id="pl.63.30"></a><var>63.30</var>relative who meets the relative hardship waiver requirements or a relative who meets the <br/>
<a id="pl.63.31"></a><var>63.31</var>criteria and is also the responsible party under an individual service plan that ensures the <br/>
<a id="pl.63.32"></a><var>63.32</var>client's health and safety and supervision of the personal care services by a qualified <br/>
<a id="pl.63.33"></a><var>63.33</var>professional as defined in section 
         <statute_ref>256B.0625, subdivision 19c</statute_ref>. Relative hardship is <br/>
<a id="pl.63.34"></a><var>63.34</var>established by the lead agency when the client's care causes a relative caregiver to do any <br/>
<a id="pl.63.35"></a><var>63.35</var>of the following: resign from a paying job, reduce work hours resulting in lost wages, <br/>
<a id="pl.63.36"></a><var>63.36</var>obtain a leave of absence resulting in lost wages, incur substantial client-related expenses, <br/>
<a id="pl.64.1"></a><var>64.1</var>provide services to address authorized, unstaffed direct care time, or meet special needs of <br/>
<a id="pl.64.2"></a><var>64.2</var>the client unmet in the formal service plan.<br/>
<br/>
<a id="bill.0.94.0"></a><a id="pl.64.3"></a><var>64.3</var>    Sec. 94. Minnesota Statutes 2008, section 256B.0913, subdivision 12, is amended to <br/>
<a id="pl.64.4"></a><var>64.4</var>read:<br/>
<a id="pl.64.5"></a><var>64.5</var>    Subd. 12. <b>Client fees.</b> (a) A fee is required for all alternative care eligible clients <br/>
<a id="pl.64.6"></a><var>64.6</var>to help pay for the cost of participating in the program. The amount of the fee for the <br/>
<a id="pl.64.7"></a><var>64.7</var>alternative care client shall be determined as follows:<br/>
<a id="pl.64.8"></a><var>64.8</var>    (1) when the alternative care client's income less recurring and predictable medical <br/>
<a id="pl.64.9"></a><var>64.9</var>expenses is less than 100 percent of the federal poverty guideline effective on July 1 of <br/>
<a id="pl.64.10"></a><var>64.10</var>the state fiscal year in which the fee is being computed, and total assets are less than <br/>
<a id="pl.64.11"></a><var>64.11</var>$10,000, the fee is zero;<br/>
<a id="pl.64.12"></a><var>64.12</var>    (2) when the alternative care client's income less recurring and predictable medical <br/>
<a id="pl.64.13"></a><var>64.13</var>expenses is equal to or greater than 100 percent but less than 150 percent of the federal <br/>
<a id="pl.64.14"></a><var>64.14</var>poverty guideline effective on July 1 of the state fiscal year in which the fee is being <br/>
<a id="pl.64.15"></a><var>64.15</var>computed, and total assets are less than $10,000, the fee is five percent of the cost of <br/>
<a id="pl.64.16"></a><var>64.16</var>alternative care services;<br/>
<a id="pl.64.17"></a><var>64.17</var>    (3) when the alternative care client's income less recurring and predictable medical <br/>
<a id="pl.64.18"></a><var>64.18</var>expenses is equal to or greater than 150 percent but less than 200 percent of the federal <br/>
<a id="pl.64.19"></a><var>64.19</var>poverty guidelines effective on July 1 of the state fiscal year in which the fee is being <br/>
<a id="pl.64.20"></a><var>64.20</var>computed and assets are less than $10,000, the fee is 15 percent of the cost of alternative <br/>
<a id="pl.64.21"></a><var>64.21</var>care services;<br/>
<a id="pl.64.22"></a><var>64.22</var>    (4) when the alternative care client's income less recurring and predictable medical <br/>
<a id="pl.64.23"></a><var>64.23</var>expenses is equal to or greater than 200 percent of the federal poverty guidelines effective <br/>
<a id="pl.64.24"></a><var>64.24</var>on July 1 of the state fiscal year in which the fee is being computed and assets are less than <br/>
<a id="pl.64.25"></a><var>64.25</var>$10,000, the fee is 30 percent of the cost of alternative care services; and<br/>
<a id="pl.64.26"></a><var>64.26</var>    (5) when the alternative care client's assets are equal to or greater than $10,000, the <br/>
<a id="pl.64.27"></a><var>64.27</var>fee is 30 percent of the cost of alternative care services.<br/>
<a id="pl.64.28"></a><var>64.28</var>    For married persons, total assets are defined as the total marital assets less the <br/>
<a id="pl.64.29"></a><var>64.29</var>estimated community spouse asset allowance, under section 
         <statute_ref>256B.059</statute_ref>, if applicable. For <br/>
<a id="pl.64.30"></a><var>64.30</var>married persons, total income is defined as the client's income less the monthly spousal <br/>
<a id="pl.64.31"></a><var>64.31</var>allotment, under section 
         <statute_ref>256B.058</statute_ref>. <br/>
<a id="pl.64.32"></a><var>64.32</var>    All alternative care services shall be included in the estimated costs for the purpose <br/>
<a id="pl.64.33"></a><var>64.33</var>of determining the fee.<br/>
<a id="pl.64.34"></a><var>64.34</var>    Fees are due and payable each month alternative care services are received unless the <br/>
<a id="pl.64.35"></a><var>64.35</var>actual cost of the services is less than the fee, in which case the fee is the lesser amount.<br/>
<a id="pl.64.36"></a><var>64.36</var>    (b) The fee shall be waived by the commissioner when:<br/>
<a id="pl.65.1"></a><var>65.1</var>    (1) a person is residing in a nursing facility;<br/>
<a id="pl.65.2"></a><var>65.2</var>    (2) a married couple is requesting an asset assessment under the spousal <br/>
<a id="pl.65.3"></a><var>65.3</var>impoverishment provisions;<br/>
<a id="pl.65.4"></a><var>65.4</var>    (3) a person is found eligible for alternative care, but is not yet receiving alternative <br/>
<a id="pl.65.5"></a><var>65.5</var>care services including case management services; or<br/>
<a id="pl.65.6"></a><var>65.6</var>    (4) a person has chosen to participate in a consumer-directed service plan for which <br/>
<a id="pl.65.7"></a><var>65.7</var>the cost is no greater than the total cost of the person's alternative care service plan less <br/>
<a id="pl.65.8"></a><var>65.8</var>the monthly fee amount that would otherwise be assessed.<br/>
<a id="pl.65.9"></a><var>65.9</var>    (c) The commissioner will bill and collect the fee from the client. Money collected <br/>
<a id="pl.65.10"></a><var>65.10</var>must be deposited in the general fund and is appropriated to the commissioner for the <br/>
<a id="pl.65.11"></a><var>65.11</var>alternative care program. The client must supply the lead agency with the client's Social <br/>
<a id="pl.65.12"></a><var>65.12</var>Security number at the time of application. The lead agency shall supply the commissioner <br/>
<a id="pl.65.13"></a><var>65.13</var>with the client's Social Security number and other information the commissioner requires <br/>
<a id="pl.65.14"></a><var>65.14</var>to collect the fee from the client. The commissioner shall collect unpaid fees using the <br/>
<a id="pl.65.15"></a><var>65.15</var>Revenue Recapture Act in chapter 270A and other methods available to the commissioner. <br/>
<a id="pl.65.16"></a><var>65.16</var>The commissioner may require lead agencies to inform clients of the collection procedures <br/>
<a id="pl.65.17"></a><var>65.17</var>that may be used by the state if a fee is not paid. This paragraph does not apply to <br/>
<a id="pl.65.18"></a><var>65.18</var>alternative care pilot projects authorized in Laws 1993, First Special Session chapter 1, <br/>
<a id="pl.65.19"></a><var>65.19</var>article 5, section 133, if a county operating under the pilot project reports the following <br/>
<a id="pl.65.20"></a><var>65.20</var>dollar amounts to the commissioner quarterly:<br/>
<a id="pl.65.21"></a><var>65.21</var>    (1) total fees billed to clients;<br/>
<a id="pl.65.22"></a><var>65.22</var>    (2) total collections of fees billed; and<br/>
<a id="pl.65.23"></a><var>65.23</var>    (3) balance of fees owed by clients.<br/>
<a id="pl.65.24"></a><var>65.24</var>If a lead agency does not adhere to these reporting requirements, the commissioner may <br/>
<a id="pl.65.25"></a><var>65.25</var>terminate the billing, collecting, and remitting portions of the pilot project and require the <br/>
<a id="pl.65.26"></a><var>65.26</var>lead agency involved to operate under the procedures set forth in this paragraph.<br/>
<br/>
<a id="bill.0.95.0"></a><a id="pl.65.27"></a><var>65.27</var>    Sec. 95. Minnesota Statutes 2008, section 256B.0915, subdivision 2, is amended to <br/>
<a id="pl.65.28"></a><var>65.28</var>read:<br/>
<a id="pl.65.29"></a><var>65.29</var>    Subd. 2. <b>Spousal impoverishment policies.</b> The commissioner shall apply:<br/>
<a id="pl.65.30"></a><var>65.30</var>    (1) the spousal impoverishment criteria as authorized under United States Code, title <br/>
<a id="pl.65.31"></a><var>65.31</var>42, section 1396r-5, and as implemented in sections 
         <statute_ref>256B.0575</statute_ref>, 
         <statute_ref>256B.058</statute_ref>, and 
         <statute_ref>256B.059</statute_ref>;, <br/>
<a id="pl.65.32"></a><var>65.32</var>except that individuals with income at or below the special income standard according <br/>
<a id="pl.65.33"></a><var>65.33</var>to Code of Federal Regulations, title 42, section 435.236, receive the maintenance needs <br/>
<a id="pl.65.34"></a><var>65.34</var>amount in subdivision 1d.<br/>
<a id="pl.65.35"></a><var>65.35</var>    (2) the personal needs allowance permitted in section 
<statute_ref>256B.0575</statute_ref>; and<br/>
<a id="pl.66.1"></a><var>66.1</var>    (3) an amount equivalent to the group residential housing rate as set by section <br/>
<a id="pl.66.2"></a><var>66.2</var><statute_ref>256I.03, subdivision 5</statute_ref>, and according to the approved federal waiver and medical <br/>
<a id="pl.66.3"></a><var>66.3</var>assistance state plan. <br/>
<br/>
<a id="bill.0.96.0"></a><a id="pl.66.4"></a><var>66.4</var>    Sec. 96. Minnesota Statutes 2008, section 256B.431, subdivision 10, is amended to <br/>
<a id="pl.66.5"></a><var>66.5</var>read:<br/>
<a id="pl.66.6"></a><var>66.6</var>    Subd. 10. <b>Property rate adjustments and construction projects.</b> A nursing <br/>
<a id="pl.66.7"></a><var>66.7</var>facility's facility completing a construction project that is eligible for a rate adjustment <br/>
<a id="pl.66.8"></a><var>66.8</var>under section 256B.434, subdivision 4f, and that was not approved through the moratorium <br/>
<a id="pl.66.9"></a><var>66.9</var>exception process in section 144A.073 must request for from the commissioner a <br/>
<a id="pl.66.10"></a><var>66.10</var>property-related payment rate adjustment and the related supporting documentation of <br/>
<a id="pl.66.11"></a><var>66.11</var>project construction cost information must be submitted to the commissioner. If the <br/>
<a id="pl.66.12"></a><var>66.12</var>request is made within 60 days after the construction project's completion date to be <br/>
<a id="pl.66.13"></a><var>66.13</var>considered eligible for a property-related payment rate adjustment the effective date of <br/>
<a id="pl.66.14"></a><var>66.14</var>the rate adjustment is the first of the month following the completion date. If the request <br/>
<a id="pl.66.15"></a><var>66.15</var>is made more than 60 days after the completion date, the rate adjustment is effective on <br/>
<a id="pl.66.16"></a><var>66.16</var>the first of the month following the request. The commissioner shall provide a rate notice <br/>
<a id="pl.66.17"></a><var>66.17</var>reflecting the allowable costs within 60 days after receiving all the necessary information <br/>
<a id="pl.66.18"></a><var>66.18</var>to compute the rate adjustment. No sooner than the effective date of the rate adjustment <br/>
<a id="pl.66.19"></a><var>66.19</var>for the building construction project, a nursing facility may adjust its rates by the amount <br/>
<a id="pl.66.20"></a><var>66.20</var>anticipated to be allowed. Any amounts collected from private pay residents in excess of <br/>
<a id="pl.66.21"></a><var>66.21</var>the allowable rate must be repaid to private pay residents with interest at the rate used by <br/>
<a id="pl.66.22"></a><var>66.22</var>the commissioner of revenue for the late payment of taxes and in effect on the date the <br/>
<a id="pl.66.23"></a><var>66.23</var>rate increase is effective. Construction projects with completion dates within one year <br/>
<a id="pl.66.24"></a><var>66.24</var>of the completion date associated with the property rate adjustment request and phased <br/>
<a id="pl.66.25"></a><var>66.25</var>projects with project completion dates within three years of the last phase of the phased <br/>
<a id="pl.66.26"></a><var>66.26</var>project must be aggregated for purposes of the minimum thresholds in subdivisions 16 <br/>
<a id="pl.66.27"></a><var>66.27</var>and 17, and the maximum threshold in section 
         <statute_ref>144A.071, subdivision 2</statute_ref>. "Construction <br/>
<a id="pl.66.28"></a><var>66.28</var>project" and "project construction costs" have the meanings given them in Minnesota <br/>
<a id="pl.66.29"></a><var>66.29</var>Statutes, section 
         <statute_ref>144A.071, subdivision 1a</statute_ref>. <br/>
<br/>
<a id="bill.0.97.0"></a><a id="pl.66.30"></a><var>66.30</var>    Sec. 97. Minnesota Statutes 2008, section 256B.433, subdivision 1, is amended to read:<br/>
<a id="pl.66.31"></a><var>66.31</var>    Subdivision 1. <b>Setting payment; monitoring use of therapy services.</b> The <br/>
<a id="pl.66.32"></a><var>66.32</var>commissioner shall promulgate adopt rules pursuant to under the Administrative <br/>
<a id="pl.66.33"></a><var>66.33</var>Procedure Act to set the amount and method of payment for ancillary materials and <br/>
<a id="pl.66.34"></a><var>66.34</var>services provided to recipients residing in nursing facilities. Payment for materials and <br/>
<a id="pl.66.35"></a><var>66.35</var>services may be made to either the nursing facility in the operating cost per diem, to the <br/>
<a id="pl.67.1"></a><var>67.1</var>vendor of ancillary services pursuant to Minnesota Rules, parts 9505.0170 to 9505.0475, <br/>
<a id="pl.67.2"></a><var>67.2</var>or to a nursing facility pursuant to Minnesota Rules, parts 9505.0170 to 9505.0475. <br/>
<a id="pl.67.3"></a><var>67.3</var>Payment for the same or similar service to a recipient shall not be made to both the nursing <br/>
<a id="pl.67.4"></a><var>67.4</var>facility and the vendor. The commissioner shall ensure the avoidance of double payments <br/>
<a id="pl.67.5"></a><var>67.5</var>through audits and adjustments to the nursing facility's annual cost report as required by <br/>
<a id="pl.67.6"></a><var>67.6</var>section 
         <statute_ref>256B.47</statute_ref>, and that charges and arrangements for ancillary materials and services <br/>
<a id="pl.67.7"></a><var>67.7</var>are cost-effective and as would be incurred by a prudent and cost-conscious buyer. <br/>
<a id="pl.67.8"></a><var>67.8</var>Therapy services provided to a recipient must be medically necessary and appropriate <br/>
<a id="pl.67.9"></a><var>67.9</var>to the medical condition of the recipient. If the vendor, nursing facility, or ordering <br/>
<a id="pl.67.10"></a><var>67.10</var>physician cannot provide adequate medical necessity justification, as determined by the <br/>
<a id="pl.67.11"></a><var>67.11</var>commissioner, the commissioner may recover or disallow the payment for the services <br/>
<a id="pl.67.12"></a><var>67.12</var>and may require prior authorization for therapy services as a condition of payment or <br/>
<a id="pl.67.13"></a><var>67.13</var>may impose administrative sanctions to limit the vendor, nursing facility, or ordering <br/>
<a id="pl.67.14"></a><var>67.14</var>physician's participation in the medical assistance program. If the provider number of a <br/>
<a id="pl.67.15"></a><var>67.15</var>nursing facility is used to bill services provided by a vendor of therapy services that is <br/>
<a id="pl.67.16"></a><var>67.16</var>not related to the nursing facility by ownership, control, affiliation, or employment status, <br/>
<a id="pl.67.17"></a><var>67.17</var>no withholding of payment shall be imposed against the nursing facility for services not <br/>
<a id="pl.67.18"></a><var>67.18</var>medically necessary except for funds due the unrelated vendor of therapy services as <br/>
<a id="pl.67.19"></a><var>67.19</var>provided in subdivision 3, paragraph (c). For the purpose of this subdivision, no monetary <br/>
<a id="pl.67.20"></a><var>67.20</var>recovery may be imposed against the nursing facility for funds paid to the unrelated <br/>
<a id="pl.67.21"></a><var>67.21</var>vendor of therapy services as provided in subdivision 3, paragraph (c), for services not <br/>
<a id="pl.67.22"></a><var>67.22</var>medically necessary. For purposes of this section and section 
         <statute_ref>256B.47</statute_ref>, therapy includes <br/>
<a id="pl.67.23"></a><var>67.23</var>physical therapy, occupational therapy, speech therapy, audiology, and mental health <br/>
<a id="pl.67.24"></a><var>67.24</var>services that are covered services according to Minnesota Rules, parts 9505.0170 to <br/>
<a id="pl.67.25"></a><var>67.25</var>9505.0475, and that could be reimbursed separately from the nursing facility per diem. <br/>
<a id="pl.67.26"></a><var>67.26</var>For purposes of this subdivision, "ancillary services" include transportation defined as <br/>
<a id="pl.67.27"></a><var>67.27</var>a covered service in section 256B.0625, subdivision 17. <br/>
<br/>
<a id="bill.0.98.0"></a><a id="pl.67.28"></a><var>67.28</var>    Sec. 98. Minnesota Statutes 2008, section 256B.441, subdivision 5, is amended to read:<br/>
<a id="pl.67.29"></a><var>67.29</var>    Subd. 5. <b>Administrative costs.</b> "Administrative costs" means the direct costs for <br/>
<a id="pl.67.30"></a><var>67.30</var>administering the overall activities of the nursing home. These costs include salaries and <br/>
<a id="pl.67.31"></a><var>67.31</var>wages of the administrator, assistant administrator, business office employees, security <br/>
<a id="pl.67.32"></a><var>67.32</var>guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases <br/>
<a id="pl.67.33"></a><var>67.33</var>related to business office functions, licenses, and permits except as provided in the external <br/>
<a id="pl.67.34"></a><var>67.34</var>fixed costs category, employee recognition, travel including meals and lodging, all training <br/>
<a id="pl.67.35"></a><var>67.35</var>except as specified in subdivision 11, voice and data communication or transmission, <br/>
<a id="pl.67.36"></a><var>67.36</var>office supplies, liability insurance and other forms of insurance not designated to other <br/>
<a id="pl.68.1"></a><var>68.1</var>areas, personnel recruitment, legal services, accounting services, management or business <br/>
<a id="pl.68.2"></a><var>68.2</var>consultants, data processing, information technology, Web site, central or home office <br/>
<a id="pl.68.3"></a><var>68.3</var>costs, business meetings and seminars, postage, fees for professional organizations, <br/>
<a id="pl.68.4"></a><var>68.4</var>subscriptions, security services, advertising, board of director's fees, working capital <br/>
<a id="pl.68.5"></a><var>68.5</var>interest expense, and bad debts and bad debt collection fees.<br/>
<br/>
<a id="bill.0.99.0"></a><a id="pl.68.6"></a><var>68.6</var>    Sec. 99. Minnesota Statutes 2008, section 256B.441, subdivision 11, is amended to <br/>
<a id="pl.68.7"></a><var>68.7</var>read:<br/>
<a id="pl.68.8"></a><var>68.8</var>    Subd. 11. <b>Direct care costs.</b> "Direct care costs" means costs for the wages of <br/>
<a id="pl.68.9"></a><var>68.9</var>nursing administration, staff education, direct care registered nurses, licensed practical <br/>
<a id="pl.68.10"></a><var>68.10</var>nurses, certified nursing assistants, trained medication aides, employees conducting <br/>
<a id="pl.68.11"></a><var>68.11</var>training in resident care topics and associated fringe benefits and payroll taxes; services <br/>
<a id="pl.68.12"></a><var>68.12</var>from a supplemental nursing services agency; supplies that are stocked at nursing stations <br/>
<a id="pl.68.13"></a><var>68.13</var>or on the floor and distributed or used individually, including, but not limited to: alcohol, <br/>
<a id="pl.68.14"></a><var>68.14</var>applicators, cotton balls, incontinence pads, disposable ice bags, dressings, bandages, <br/>
<a id="pl.68.15"></a><var>68.15</var>water pitchers, tongue depressors, disposable gloves, enemas, enema equipment, soap, <br/>
<a id="pl.68.16"></a><var>68.16</var>medication cups, diapers, plastic waste bags, sanitary products, thermometers, hypodermic <br/>
<a id="pl.68.17"></a><var>68.17</var>needles and syringes, clinical reagents or similar diagnostic agents, drugs that are not paid <br/>
<a id="pl.68.18"></a><var>68.18</var>on a separate fee schedule by the medical assistance program or any other payer, and <br/>
<a id="pl.68.19"></a><var>68.19</var>technology related to the provision of nursing care to residents, such as electronic charting <br/>
<a id="pl.68.20"></a><var>68.20</var>systems; costs of materials used for resident care training, and training courses outside of <br/>
<a id="pl.68.21"></a><var>68.21</var>the facility attended by direct care staff on resident care topics.<br/>
<br/>
<a id="bill.0.100.0"></a><a id="pl.68.22"></a><var>68.22</var>    Sec. 100. Minnesota Statutes 2008, section 256B.5011, subdivision 2, is amended to <br/>
<a id="pl.68.23"></a><var>68.23</var>read:<br/>
<a id="pl.68.24"></a><var>68.24</var>    Subd. 2. <b>Contract provisions.</b> (a) The service contract with each intermediate <br/>
<a id="pl.68.25"></a><var>68.25</var>care facility must include provisions for:<br/>
<a id="pl.68.26"></a><var>68.26</var>(1) modifying payments when significant changes occur in the needs of the <br/>
<a id="pl.68.27"></a><var>68.27</var>consumers;<br/>
<a id="pl.68.28"></a><var>68.28</var>(2) the establishment and use of a quality improvement plan. Using criteria and <br/>
<a id="pl.68.29"></a><var>68.29</var>options for performance measures developed by the commissioner, each intermediate care <br/>
<a id="pl.68.30"></a><var>68.30</var>facility must identify a minimum of one performance measure on which to focus its efforts <br/>
<a id="pl.68.31"></a><var>68.31</var>for quality improvement during the contract period;<br/>
<a id="pl.68.32"></a><var>68.32</var>(3) (2) appropriate and necessary statistical information required by the <br/>
<a id="pl.68.33"></a><var>68.33</var>commissioner;<br/>
<a id="pl.68.34"></a><var>68.34</var>(4) (3) annual aggregate facility financial information; and<br/>
<a id="pl.69.1"></a><var>69.1</var>(5) (4) additional requirements for intermediate care facilities not meeting the <br/>
<a id="pl.69.2"></a><var>69.2</var>standards set forth in the service contract.<br/>
<a id="pl.69.3"></a><var>69.3</var>(b) The commissioner of human services and the commissioner of health, in <br/>
<a id="pl.69.4"></a><var>69.4</var>consultation with representatives from counties, advocacy organizations, and the provider <br/>
<a id="pl.69.5"></a><var>69.5</var>community, shall review the consolidated standards under chapter 245B and the supervised <br/>
<a id="pl.69.6"></a><var>69.6</var>living facility rule under Minnesota Rules, chapter 4665, to determine what provisions <br/>
<a id="pl.69.7"></a><var>69.7</var>in Minnesota Rules, chapter 4665, may be waived by the commissioner of health for <br/>
<a id="pl.69.8"></a><var>69.8</var>intermediate care facilities in order to enable facilities to implement the performance <br/>
<a id="pl.69.9"></a><var>69.9</var>measures in their contract and provide quality services to residents without a duplication <br/>
<a id="pl.69.10"></a><var>69.10</var>of or increase in regulatory requirements.<br/>
<br/>
<a id="bill.0.101.0"></a><a id="pl.69.11"></a><var>69.11</var>    Sec. 101. Minnesota Statutes 2008, section 256B.5012, subdivision 6, is amended to <br/>
<a id="pl.69.12"></a><var>69.12</var>read:<br/>
<a id="pl.69.13"></a><var>69.13</var>    Subd. 6. <b>ICF/MR rate increases October 1, 2005, and October 1, 2006.</b> (a) For <br/>
<a id="pl.69.14"></a><var>69.14</var>the rate periods beginning October 1, 2005, and October 1, 2006, the commissioner shall <br/>
<a id="pl.69.15"></a><var>69.15</var>make available to each facility reimbursed under this section an adjustment to the total <br/>
<a id="pl.69.16"></a><var>69.16</var>operating payment rate of 
         <statute_ref>2.2553</statute_ref> percent.<br/>
<a id="pl.69.17"></a><var>69.17</var>(b) 75 percent of the money resulting from the rate adjustment under paragraph (a) <br/>
<a id="pl.69.18"></a><var>69.18</var>must be used to increase wages and benefits and pay associated costs for  employees, <br/>
<a id="pl.69.19"></a><var>69.19</var>except for administrative and central office employees. 75 percent of the money received <br/>
<a id="pl.69.20"></a><var>69.20</var>by a facility as a result of the rate adjustment provided in paragraph (a) must be used only <br/>
<a id="pl.69.21"></a><var>69.21</var>for wage, benefit, and staff increases implemented on or after the effective date of the rate <br/>
<a id="pl.69.22"></a><var>69.22</var>increase each year, and must not be used for increases implemented prior to that date. The <br/>
<a id="pl.69.23"></a><var>69.23</var>wage adjustment eligible employees may receive may vary based on merit, seniority, or <br/>
<a id="pl.69.24"></a><var>69.24</var>other factors determined by the provider.<br/>
<a id="pl.69.25"></a><var>69.25</var>(c) For each facility, the commissioner shall make available an adjustment, based <br/>
<a id="pl.69.26"></a><var>69.26</var>on occupied beds,  using the percentage specified in paragraph (a) multiplied by the total <br/>
<a id="pl.69.27"></a><var>69.27</var>payment rate, including variable rate but excluding the property-related payment rate, in <br/>
<a id="pl.69.28"></a><var>69.28</var>effect on the preceding day. The total payment rate shall include the adjustment provided <br/>
<a id="pl.69.29"></a><var>69.29</var>in section 
         <statute_ref>256B.501, subdivision 12</statute_ref>.<br/>
<a id="pl.69.30"></a><var>69.30</var>(d) A facility whose payment rates are governed by closure agreements, or <br/>
<a id="pl.69.31"></a><var>69.31</var>receivership agreements, or Minnesota Rules, part 
<statute_ref>9553.0075</statute_ref>, is not eligible for an <br/>
<a id="pl.69.32"></a><var>69.32</var>adjustment otherwise granted under this subdivision.<br/>
<a id="pl.69.33"></a><var>69.33</var>(e) A facility may apply for the portion of the payment rate adjustment provided <br/>
<a id="pl.69.34"></a><var>69.34</var>under paragraph (a) for employee wages and benefits and associated costs. The application <br/>
<a id="pl.69.35"></a><var>69.35</var>must be made to the commissioner and contain a plan by which the facility will distribute <br/>
<a id="pl.69.36"></a><var>69.36</var>the funds according to paragraph (b). For facilities in which the employees are represented <br/>
<a id="pl.70.1"></a><var>70.1</var>by an exclusive bargaining representative, an agreement negotiated and agreed to by the <br/>
<a id="pl.70.2"></a><var>70.2</var>employer and the exclusive bargaining representative constitutes the plan. A negotiated <br/>
<a id="pl.70.3"></a><var>70.3</var>agreement may constitute the plan only if the agreement is finalized after the date of <br/>
<a id="pl.70.4"></a><var>70.4</var>enactment of all rate increases for the rate year. The commissioner shall review the plan to <br/>
<a id="pl.70.5"></a><var>70.5</var>ensure that the payment rate adjustment per diem is used as provided in this subdivision. <br/>
<a id="pl.70.6"></a><var>70.6</var>To be eligible, a facility must submit its plan by March 31, 2006, and December 31, <br/>
<a id="pl.70.7"></a><var>70.7</var>2006, respectively. If a facility's plan is effective for its employees after the first day of <br/>
<a id="pl.70.8"></a><var>70.8</var>the applicable rate period that the funds are available, the payment rate adjustment per <br/>
<a id="pl.70.9"></a><var>70.9</var>diem is effective the same date as its plan.<br/>
<a id="pl.70.10"></a><var>70.10</var>(f) A copy of the approved distribution plan must be made available to all employees <br/>
<a id="pl.70.11"></a><var>70.11</var>by giving each employee a copy or by posting it in an area of the facility to which all <br/>
<a id="pl.70.12"></a><var>70.12</var>employees have access. If an employee does not receive the wage and benefit adjustment <br/>
<a id="pl.70.13"></a><var>70.13</var>described in the facility's approved plan and is unable to resolve the problem with the <br/>
<a id="pl.70.14"></a><var>70.14</var>facility's management or through the employee's union representative, the employee <br/>
<a id="pl.70.15"></a><var>70.15</var>may contact the commissioner at an address or telephone number provided by the <br/>
<a id="pl.70.16"></a><var>70.16</var>commissioner and included in the approved plan.<br/>
<br/>
<a id="bill.0.102.0"></a><a id="pl.70.17"></a><var>70.17</var>    Sec. 102. Minnesota Statutes 2008, section 256B.5012, subdivision 7, is amended to <br/>
<a id="pl.70.18"></a><var>70.18</var>read:<br/>
<a id="pl.70.19"></a><var>70.19</var>    Subd. 7. <b>ICF/MR rate increases effective October 1, 2007, and October 1, 2008.</b><br/>
<a id="pl.70.20"></a><var>70.20</var>    (a) For the rate year beginning October 1, 2007, the commissioner shall make available to <br/>
<a id="pl.70.21"></a><var>70.21</var>each facility reimbursed under this section operating payment rate adjustments equal to <br/>
<a id="pl.70.22"></a><var>70.22</var>2.0 percent of the operating payment rates in effect on September 30, 2007. For the rate <br/>
<a id="pl.70.23"></a><var>70.23</var>year beginning October 1, 2008, the commissioner shall make available to each facility <br/>
<a id="pl.70.24"></a><var>70.24</var>reimbursed under this section operating payment rate adjustments equal to 2.0 percent <br/>
<a id="pl.70.25"></a><var>70.25</var>of the operating payment rates in effect on September 30, 2008. For each facility, the <br/>
<a id="pl.70.26"></a><var>70.26</var>commissioner shall make available an adjustment, based on occupied beds, using the <br/>
<a id="pl.70.27"></a><var>70.27</var>percentage specified in this paragraph multiplied by the total payment rate, including the <br/>
<a id="pl.70.28"></a><var>70.28</var>variable rate but excluding the property-related payment rate, in effect on the preceding <br/>
<a id="pl.70.29"></a><var>70.29</var>day. The total payment rate shall include the adjustment provided in section 
         <statute_ref>256B.501, <br/>
<a id="pl.70.30"></a><var>70.30</var>subdivision 12
         </statute_ref>. A facility whose payment rates are governed by closure agreements, <br/>
<a id="pl.70.31"></a><var>70.31</var>or receivership agreements, or Minnesota Rules, part 9553.0075, is not eligible for an <br/>
<a id="pl.70.32"></a><var>70.32</var>adjustment otherwise granted under this subdivision.<br/>
<a id="pl.70.33"></a><var>70.33</var>    (b) Seventy-five percent of the money resulting from the rate adjustments under <br/>
<a id="pl.70.34"></a><var>70.34</var>paragraph (a) must be used for increases in compensation-related costs for employees <br/>
<a id="pl.70.35"></a><var>70.35</var>directly employed by the facility on or after the effective date of the rate adjustments, <br/>
<a id="pl.70.36"></a><var>70.36</var>except:<br/>
<a id="pl.71.1"></a><var>71.1</var>    (1) the administrator;<br/>
<a id="pl.71.2"></a><var>71.2</var>    (2) persons employed in the central office of a corporation that has an ownership <br/>
<a id="pl.71.3"></a><var>71.3</var>interest in the facility or exercises control over the facility; and <br/>
<a id="pl.71.4"></a><var>71.4</var>    (3) persons paid by the facility under a management contract.<br/>
<a id="pl.71.5"></a><var>71.5</var>    (c) Two-thirds of the money available under paragraph (b) must be used for wage <br/>
<a id="pl.71.6"></a><var>71.6</var>increases for all employees directly employed by the facility on or after the effective <br/>
<a id="pl.71.7"></a><var>71.7</var>date of the rate adjustments, except those listed in paragraph (b), clauses (1) to (3). The <br/>
<a id="pl.71.8"></a><var>71.8</var>wage adjustment that employees receive under this paragraph must be paid as an equal <br/>
<a id="pl.71.9"></a><var>71.9</var>hourly percentage wage increase for all eligible employees. All wage increases under this <br/>
<a id="pl.71.10"></a><var>71.10</var>paragraph must be effective on the same date. Only costs associated with the portion of <br/>
<a id="pl.71.11"></a><var>71.11</var>the equal hourly percentage wage increase that goes to all employees shall qualify under <br/>
<a id="pl.71.12"></a><var>71.12</var>this paragraph. Costs associated with wage increases in excess of the amount of the equal <br/>
<a id="pl.71.13"></a><var>71.13</var>hourly percentage wage increase provided to all employees shall be allowed only for <br/>
<a id="pl.71.14"></a><var>71.14</var>meeting the requirements in paragraph (b). This paragraph shall not apply to employees <br/>
<a id="pl.71.15"></a><var>71.15</var>covered by a collective bargaining agreement.<br/>
<a id="pl.71.16"></a><var>71.16</var>    (d) The commissioner shall allow as compensation-related costs all costs for:<br/>
<a id="pl.71.17"></a><var>71.17</var>    (1) wages and salaries;<br/>
<a id="pl.71.18"></a><var>71.18</var>    (2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers' <br/>
<a id="pl.71.19"></a><var>71.19</var>compensation;<br/>
<a id="pl.71.20"></a><var>71.20</var>    (3) the employer's share of health and dental insurance, life insurance, disability <br/>
<a id="pl.71.21"></a><var>71.21</var>insurance, long-term care insurance, uniform allowance, and pensions; and<br/>
<a id="pl.71.22"></a><var>71.22</var>    (4) other benefits provided, subject to the approval of the commissioner.<br/>
<a id="pl.71.23"></a><var>71.23</var>    (e) The portion of the rate adjustments under paragraph (a) that is not subject to the <br/>
<a id="pl.71.24"></a><var>71.24</var>requirements in paragraphs (b) and (c) shall be provided to facilities effective October <br/>
<a id="pl.71.25"></a><var>71.25</var>1 of each year.<br/>
<a id="pl.71.26"></a><var>71.26</var>    (f) Facilities may apply for the portion of the rate adjustments under paragraph <br/>
<a id="pl.71.27"></a><var>71.27</var>(a) that is subject to the requirements in paragraphs (b) and (c). The application <br/>
<a id="pl.71.28"></a><var>71.28</var>must be submitted to the commissioner within six months of the effective date of the <br/>
<a id="pl.71.29"></a><var>71.29</var>rate adjustments, and the facility must provide additional information required by <br/>
<a id="pl.71.30"></a><var>71.30</var>the commissioner within nine months of the effective date of the rate adjustments. <br/>
<a id="pl.71.31"></a><var>71.31</var>The commissioner must respond to all applications within three weeks of receipt. <br/>
<a id="pl.71.32"></a><var>71.32</var>The commissioner may waive the deadlines in this paragraph under extraordinary <br/>
<a id="pl.71.33"></a><var>71.33</var>circumstances, to be determined at the sole discretion of the commissioner. The <br/>
<a id="pl.71.34"></a><var>71.34</var>application must contain:<br/>
<a id="pl.71.35"></a><var>71.35</var>    (1) an estimate of the amounts of money that must be used as specified in paragraphs <br/>
<a id="pl.71.36"></a><var>71.36</var>(b) and (c);<br/>
<a id="pl.72.1"></a><var>72.1</var>    (2) a detailed distribution plan specifying the allowable compensation-related and <br/>
<a id="pl.72.2"></a><var>72.2</var>wage increases the facility will implement to use the funds available in clause (1);<br/>
<a id="pl.72.3"></a><var>72.3</var>    (3) a description of how the facility will notify eligible employees of the contents of <br/>
<a id="pl.72.4"></a><var>72.4</var>the approved application, which must provide for giving each eligible employee a copy of <br/>
<a id="pl.72.5"></a><var>72.5</var>the approved application, excluding the information required in clause (1), or posting a <br/>
<a id="pl.72.6"></a><var>72.6</var>copy of the approved application, excluding the information required in clause (1), for <br/>
<a id="pl.72.7"></a><var>72.7</var>a period of at least six weeks in an area of the facility to which all eligible employees <br/>
<a id="pl.72.8"></a><var>72.8</var>have access; and<br/>
<a id="pl.72.9"></a><var>72.9</var>    (4) instructions for employees who believe they have not received the <br/>
<a id="pl.72.10"></a><var>72.10</var>compensation-related or wage increases specified in clause (2), as approved by the <br/>
<a id="pl.72.11"></a><var>72.11</var>commissioner, and which must include a mailing address, e-mail address, and the <br/>
<a id="pl.72.12"></a><var>72.12</var>telephone number that may be used by the employee to contact the commissioner or the <br/>
<a id="pl.72.13"></a><var>72.13</var>commissioner's representative.<br/>
<a id="pl.72.14"></a><var>72.14</var>    (g) The commissioner shall ensure that cost increases in distribution plans under <br/>
<a id="pl.72.15"></a><var>72.15</var>paragraph (f), clause (2), that may be included in approved applications, comply with <br/>
<a id="pl.72.16"></a><var>72.16</var>requirements in clauses (1) to (4):<br/>
<a id="pl.72.17"></a><var>72.17</var>    (1) costs to be incurred during the applicable rate year resulting from wage and <br/>
<a id="pl.72.18"></a><var>72.18</var>salary increases effective after October 1, 2006, and prior to the first day of the facility's <br/>
<a id="pl.72.19"></a><var>72.19</var>payroll period that includes October 1 of each year shall be allowed if they were not used <br/>
<a id="pl.72.20"></a><var>72.20</var>in the prior year's application and they meet the requirements of paragraphs (b) and (c);<br/>
<a id="pl.72.21"></a><var>72.21</var>    (2) a portion of the costs resulting from tenure-related wage or salary increases <br/>
<a id="pl.72.22"></a><var>72.22</var>may be considered to be allowable wage increases, according to formulas that the <br/>
<a id="pl.72.23"></a><var>72.23</var>commissioner shall provide, where employee retention is above the average statewide <br/>
<a id="pl.72.24"></a><var>72.24</var>rate of retention of direct care employees;<br/>
<a id="pl.72.25"></a><var>72.25</var>    (3) the annualized amount of increases in costs for the employer's share of health <br/>
<a id="pl.72.26"></a><var>72.26</var>and dental insurance, life insurance, disability insurance, and workers' compensation shall <br/>
<a id="pl.72.27"></a><var>72.27</var>be allowable compensation-related increases if they are effective on or after April 1 of <br/>
<a id="pl.72.28"></a><var>72.28</var>the year in which the rate adjustments are effective and prior to April 1 of the following <br/>
<a id="pl.72.29"></a><var>72.29</var>year; and <br/>
<a id="pl.72.30"></a><var>72.30</var>    (4) for facilities in which employees are represented by an exclusive bargaining <br/>
<a id="pl.72.31"></a><var>72.31</var>representative, the commissioner shall approve the application only upon receipt of a letter <br/>
<a id="pl.72.32"></a><var>72.32</var>of acceptance of the distribution plan, as regards members of the bargaining unit, signed <br/>
<a id="pl.72.33"></a><var>72.33</var>by the exclusive bargaining agent and dated after May 25, 2007. Upon receipt of the letter <br/>
<a id="pl.72.34"></a><var>72.34</var>of acceptance, the commissioner shall deem all requirements of this section as having <br/>
<a id="pl.72.35"></a><var>72.35</var>been met in regard to the members of the bargaining unit.<br/>
<a id="pl.73.1"></a><var>73.1</var>    (h) The commissioner shall review applications received under paragraph (f) and <br/>
<a id="pl.73.2"></a><var>73.2</var>shall provide the portion of the rate adjustments under paragraphs (b) and (c) if the <br/>
<a id="pl.73.3"></a><var>73.3</var>requirements of this subdivision have been met. The rate adjustments shall be effective <br/>
<a id="pl.73.4"></a><var>73.4</var>October 1 of each year. Notwithstanding paragraph (a), if the approved application <br/>
<a id="pl.73.5"></a><var>73.5</var>distributes less money than is available, the amount of the rate adjustment shall be reduced <br/>
<a id="pl.73.6"></a><var>73.6</var>so that the amount of money made available is equal to the amount to be distributed.<br/>
<br/>
<a id="bill.0.103.0"></a><a id="pl.73.7"></a><var>73.7</var>    Sec. 103. Minnesota Statutes 2008, section 256B.5013, subdivision 1, is amended to <br/>
<a id="pl.73.8"></a><var>73.8</var>read:<br/>
<a id="pl.73.9"></a><var>73.9</var>    Subdivision 1. <b>Variable rate adjustments.</b> (a) For rate years beginning on or after <br/>
<a id="pl.73.10"></a><var>73.10</var>October 1, 2000, when there is a documented increase in the needs of a current ICF/MR <br/>
<a id="pl.73.11"></a><var>73.11</var>recipient, the county of financial responsibility may recommend a variable rate to enable <br/>
<a id="pl.73.12"></a><var>73.12</var>the facility to meet the individual's increased needs. Variable rate adjustments made under <br/>
<a id="pl.73.13"></a><var>73.13</var>this subdivision replace payments for persons with special needs under section 
         <statute_ref>256B.501, <br/>
<a id="pl.73.14"></a><var>73.14</var>subdivision 8
         </statute_ref>, and payments for persons with special needs for crisis intervention services <br/>
<a id="pl.73.15"></a><var>73.15</var>under section 
         <statute_ref>256B.501, subdivision 8a</statute_ref>. Effective July 1, 2003, facilities with a base rate <br/>
<a id="pl.73.16"></a><var>73.16</var>above the 50th percentile of the statewide average reimbursement rate for a Class A <br/>
<a id="pl.73.17"></a><var>73.17</var>facility or Class B facility, whichever matches the facility licensure, are not eligible for a <br/>
<a id="pl.73.18"></a><var>73.18</var>variable rate adjustment. Variable rate adjustments may not exceed a 12-month period, <br/>
<a id="pl.73.19"></a><var>73.19</var>except when approved for purposes established in paragraph (b), clause (1). Variable rate <br/>
<a id="pl.73.20"></a><var>73.20</var>adjustments approved solely on the basis of changes on a developmental disabilities <br/>
<a id="pl.73.21"></a><var>73.21</var>screening document will end June 30, 2002. <br/>
<a id="pl.73.22"></a><var>73.22</var>(b) A variable rate may be recommended by the county of financial responsibility <br/>
<a id="pl.73.23"></a><var>73.23</var>for increased needs in the following situations:<br/>
<a id="pl.73.24"></a><var>73.24</var>(1) a need for resources due to an individual's full or partial retirement from <br/>
<a id="pl.73.25"></a><var>73.25</var>participation in a day training and habilitation service when the individual: (i) has reached <br/>
<a id="pl.73.26"></a><var>73.26</var>the age of 65 or has a change in health condition that makes it difficult for the person <br/>
<a id="pl.73.27"></a><var>73.27</var>to participate in day training and habilitation services over an extended period of time <br/>
<a id="pl.73.28"></a><var>73.28</var>because it is medically contraindicated; and (ii) has expressed a desire for change through <br/>
<a id="pl.73.29"></a><var>73.29</var>the developmental disability screening process under section 
         <statute_ref>256B.092</statute_ref>; <br/>
<a id="pl.73.30"></a><var>73.30</var>(2) a need for additional resources for intensive short-term programming which is <br/>
<a id="pl.73.31"></a><var>73.31</var>necessary prior to an individual's discharge to a less restrictive, more integrated setting;<br/>
<a id="pl.73.32"></a><var>73.32</var>(3) a demonstrated medical need that significantly impacts the type or amount of <br/>
<a id="pl.73.33"></a><var>73.33</var>services needed by the individual; or<br/>
<a id="pl.73.34"></a><var>73.34</var>(4) a demonstrated behavioral need that significantly impacts the type or amount of <br/>
<a id="pl.73.35"></a><var>73.35</var>services needed by the individual.<br/>
<a id="pl.74.1"></a><var>74.1</var>(c) The county of financial responsibility must justify the purpose, the projected <br/>
<a id="pl.74.2"></a><var>74.2</var>length of time, and the additional funding needed for the facility to meet the needs of <br/>
<a id="pl.74.3"></a><var>74.3</var>the individual.<br/>
<a id="pl.74.4"></a><var>74.4</var>(d) The facility shall provide a quarterly an annual report to the county case manager <br/>
<a id="pl.74.5"></a><var>74.5</var>on the use of the variable rate funds and the status of the individual on whose behalf the <br/>
<a id="pl.74.6"></a><var>74.6</var>funds were approved. The county case manager will forward the facility's report with a <br/>
<a id="pl.74.7"></a><var>74.7</var>recommendation to the commissioner to approve or disapprove a continuation of the <br/>
<a id="pl.74.8"></a><var>74.8</var>variable rate.<br/>
<a id="pl.74.9"></a><var>74.9</var>(e) Funds made available through the variable rate process that are not used by <br/>
<a id="pl.74.10"></a><var>74.10</var>the facility to meet the needs of the individual for whom they were approved shall be <br/>
<a id="pl.74.11"></a><var>74.11</var>returned to the state.<br/>
<br/>
<a id="bill.0.104.0"></a><a id="pl.74.12"></a><var>74.12</var>    Sec. 104. Minnesota Statutes 2008, section 256B.5013, subdivision 6, is amended to <br/>
<a id="pl.74.13"></a><var>74.13</var>read:<br/>
<a id="pl.74.14"></a><var>74.14</var>    Subd. 6. <b>Commissioner's responsibilities.</b> The commissioner shall:<br/>
<a id="pl.74.15"></a><var>74.15</var>(1) make a determination to approve, deny, or modify a request for a variable rate <br/>
<a id="pl.74.16"></a><var>74.16</var>adjustment within 30 days of the receipt of the completed application;<br/>
<a id="pl.74.17"></a><var>74.17</var>(2) notify the ICF/MR facility and county case manager of the duration and <br/>
<a id="pl.74.18"></a><var>74.18</var>conditions of variable rate adjustment approvals; and<br/>
<a id="pl.74.19"></a><var>74.19</var>(3) modify MMIS II service agreements to reimburse ICF/MR facilities for approved <br/>
<a id="pl.74.20"></a><var>74.20</var>variable rates;.<br/>
<a id="pl.74.21"></a><var>74.21</var>(4) provide notification of legislatively appropriated funding for facility closures, <br/>
<a id="pl.74.22"></a><var>74.22</var>downsizings, and relocations;<br/>
<a id="pl.74.23"></a><var>74.23</var>(5) assess the fiscal impacts of the proposals for closures, downsizings, and <br/>
<a id="pl.74.24"></a><var>74.24</var>relocations forwarded for consideration through the state advisory committee; and<br/>
<a id="pl.74.25"></a><var>74.25</var>(6) review the payment rate process on a biannual basis and make recommendations <br/>
<a id="pl.74.26"></a><var>74.26</var>to the legislature for necessary adjustments to the review and approval process.<br/>
<br/>
<a id="bill.0.105.0"></a><a id="pl.74.27"></a><var>74.27</var>    Sec. 105. Minnesota Statutes 2008, section 256B.69, subdivision 9b, is amended to <br/>
<a id="pl.74.28"></a><var>74.28</var>read:<br/>
<a id="pl.74.29"></a><var>74.29</var>    Subd. 9b. <b>Reporting provider payment rates.</b> (a) According to guidelines <br/>
<a id="pl.74.30"></a><var>74.30</var>developed by the commissioner, in consultation with health care providers, managed care <br/>
<a id="pl.74.31"></a><var>74.31</var>plans, and county-based purchasing plans, each managed care plan and county-based <br/>
<a id="pl.74.32"></a><var>74.32</var>purchasing plan must annually provide to the commissioner, at the commissioner's request, <br/>
<a id="pl.74.33"></a><var>74.33</var>detailed or aggregate information on reimbursement rates paid by the managed care plan <br/>
<a id="pl.74.34"></a><var>74.34</var>under this section or the county-based purchasing plan under section 
         <statute_ref>256B.692</statute_ref> to provider <br/>
<a id="pl.74.35"></a><var>74.35</var>types providers and vendors for administrative services under contract with the plan.<br/>
<a id="pl.75.1"></a><var>75.1</var>(b) Each managed care plan and county-based purchasing plan must annually <br/>
<a id="pl.75.2"></a><var>75.2</var>provide to the commissioner, in the form and manner specified by the commissioner:<br/>
<a id="pl.75.3"></a><var>75.3</var>(1) the amount of the payment made to the plan under this section that is paid to <br/>
<a id="pl.75.4"></a><var>75.4</var>health care providers for patient care;<br/>
<a id="pl.75.5"></a><var>75.5</var>(2) aggregate provider payment data, categorized by inpatient payments and <br/>
<a id="pl.75.6"></a><var>75.6</var>outpatient payments, with the outpatient payments categorized by payments to primary <br/>
<a id="pl.75.7"></a><var>75.7</var>care providers and nonprimary care providers;<br/>
<a id="pl.75.8"></a><var>75.8</var>(3) the process by which increases or decreases in payments made to the plan <br/>
<a id="pl.75.9"></a><var>75.9</var>under this section, that are based on actuarial analysis related to provider cost increases <br/>
<a id="pl.75.10"></a><var>75.10</var>or decreases, or that are required by legislative action, are passed through to health care <br/>
<a id="pl.75.11"></a><var>75.11</var>providers, categorized by payments to primary care providers and nonprimary care <br/>
<a id="pl.75.12"></a><var>75.12</var>providers; and<br/>
<a id="pl.75.13"></a><var>75.13</var>(4) specific information on the methodology used to establish provider <br/>
<a id="pl.75.14"></a><var>75.14</var>reimbursement rates paid by the managed health care plan and county-based purchasing <br/>
<a id="pl.75.15"></a><var>75.15</var>plan.<br/>
<a id="pl.75.16"></a><var>75.16</var>Data provided to the commissioner under this subdivision must allow the <br/>
<a id="pl.75.17"></a><var>75.17</var>commissioner to conduct the analyses required under paragraph (d).<br/>
<a id="pl.75.18"></a><var>75.18</var>    (b) (c) Data provided to the commissioner under this subdivision are nonpublic <br/>
<a id="pl.75.19"></a><var>75.19</var>data as defined in section 
         <statute_ref>13.02</statute_ref>.<br/>
<a id="pl.75.20"></a><var>75.20</var>(d) The commissioner shall analyze data provided under this subdivision to assist the <br/>
<a id="pl.75.21"></a><var>75.21</var>legislature in providing oversight and accountability related to expenditures under this <br/>
<a id="pl.75.22"></a><var>75.22</var>section. The analysis must include information on payments to physicians, physician <br/>
<a id="pl.75.23"></a><var>75.23</var>extenders, and hospitals, and may include other provider types as determined by the <br/>
<a id="pl.75.24"></a><var>75.24</var>commissioner. The commissioner shall also array aggregate provider reimbursement rates <br/>
<a id="pl.75.25"></a><var>75.25</var>by health plan, by primary care, and nonprimary care categories. The commissioner shall <br/>
<a id="pl.75.26"></a><var>75.26</var>report the analysis to the legislature annually, beginning December 15, 2010, and each <br/>
<a id="pl.75.27"></a><var>75.27</var>December 15 thereafter. The commissioner shall also make this information available on <br/>
<a id="pl.75.28"></a><var>75.28</var>the agency's Web site to managed care and county-based purchasing plans, health care <br/>
<a id="pl.75.29"></a><var>75.29</var>providers, and the public.<br/>
<br/>
<a id="bill.0.106.0"></a><a id="pl.75.30"></a><var>75.30</var>    Sec. 106. Minnesota Statutes 2008, section 403.03, is amended to read:<br/>
<a id="pl.75.31"></a><var>75.31</var><b>403.03 911 SERVICES TO BE PROVIDED.</b><br/>
<a id="pl.75.32"></a><var>75.32</var>Services available through a 911 system shall must include police, firefighting, <br/>
<a id="pl.75.33"></a><var>75.33</var>and emergency medical and ambulance services. Other emergency and civil defense <br/>
<a id="pl.75.34"></a><var>75.34</var>services may be incorporated into the 911 system at the discretion of the public agency <br/>
<a id="pl.75.35"></a><var>75.35</var>operating the public safety answering point. The 911 system may include a referral to <br/>
<a id="pl.75.36"></a><var>75.36</var>mental health crisis teams, where available.<br/>
<br/>
<a id="bill.0.107.0"></a><a id="pl.76.1"></a><var>76.1</var>    Sec. 107. Minnesota Statutes 2008, section 626.557, subdivision 12b, is amended to <br/>
<a id="pl.76.2"></a><var>76.2</var>read:<br/>
<a id="pl.76.3"></a><var>76.3</var>    Subd. 12b. <b>Data management.</b> (a) In performing any of the duties of this section as <br/>
<a id="pl.76.4"></a><var>76.4</var>a lead agency, the county social service agency shall maintain appropriate records. Data <br/>
<a id="pl.76.5"></a><var>76.5</var>collected by the county social service agency under this section are welfare data under <br/>
<a id="pl.76.6"></a><var>76.6</var>section 
         <statute_ref>13.46</statute_ref>. Notwithstanding section 
         <statute_ref>13.46, subdivision 1</statute_ref>, paragraph (a), data under this <br/>
<a id="pl.76.7"></a><var>76.7</var>paragraph that are inactive investigative data on an individual who is a vendor of services <br/>
<a id="pl.76.8"></a><var>76.8</var>are private data on individuals, as defined in section 
         <statute_ref>13.02</statute_ref>. The identity of the reporter <br/>
<a id="pl.76.9"></a><var>76.9</var>may only be disclosed as provided in paragraph (c).<br/>
<a id="pl.76.10"></a><var>76.10</var>Data maintained by the common entry point are confidential data on individuals or <br/>
<a id="pl.76.11"></a><var>76.11</var>protected nonpublic data as defined in section 
         <statute_ref>13.02</statute_ref>. Notwithstanding section 
         <statute_ref>138.163</statute_ref>, <br/>
<a id="pl.76.12"></a><var>76.12</var>the common entry point shall destroy data maintain data for  three calendar years after date <br/>
<a id="pl.76.13"></a><var>76.13</var>of receipt and then destroy the data unless otherwise directed by federal requirements.<br/>
<a id="pl.76.14"></a><var>76.14</var>(b) The commissioners of health and human services shall prepare an investigation <br/>
<a id="pl.76.15"></a><var>76.15</var>memorandum for each report alleging maltreatment investigated under this section. <br/>
<a id="pl.76.16"></a><var>76.16</var>County social service agencies must maintain private data on individuals but are not <br/>
<a id="pl.76.17"></a><var>76.17</var>required to prepare an investigation memorandum. During an investigation by the <br/>
<a id="pl.76.18"></a><var>76.18</var>commissioner of health or the commissioner of human services, data collected under this <br/>
<a id="pl.76.19"></a><var>76.19</var>section are confidential data on individuals or protected nonpublic data as defined in <br/>
<a id="pl.76.20"></a><var>76.20</var>section 
         <statute_ref>13.02</statute_ref>. Upon completion of the investigation, the data are classified as provided in <br/>
<a id="pl.76.21"></a><var>76.21</var>clauses (1) to (3) and paragraph (c).<br/>
<a id="pl.76.22"></a><var>76.22</var>(1) The investigation memorandum must contain the following data, which are <br/>
<a id="pl.76.23"></a><var>76.23</var>public:<br/>
<a id="pl.76.24"></a><var>76.24</var>(i) the name of the facility investigated;<br/>
<a id="pl.76.25"></a><var>76.25</var>(ii) a statement of the nature of the alleged maltreatment;<br/>
<a id="pl.76.26"></a><var>76.26</var>(iii) pertinent information obtained from medical or other records reviewed;<br/>
<a id="pl.76.27"></a><var>76.27</var>(iv) the identity of the investigator;<br/>
<a id="pl.76.28"></a><var>76.28</var>(v) a summary of the investigation's findings;<br/>
<a id="pl.76.29"></a><var>76.29</var>(vi) statement of whether the report was found to be substantiated, inconclusive, <br/>
<a id="pl.76.30"></a><var>76.30</var>false, or that no determination will be made;<br/>
<a id="pl.76.31"></a><var>76.31</var>(vii) a statement of any action taken by the facility;<br/>
<a id="pl.76.32"></a><var>76.32</var>(viii) a statement of any action taken by the lead agency; and<br/>
<a id="pl.76.33"></a><var>76.33</var>(ix) when a lead agency's determination has substantiated maltreatment, a statement <br/>
<a id="pl.76.34"></a><var>76.34</var>of whether an individual, individuals, or a facility were responsible for the substantiated <br/>
<a id="pl.76.35"></a><var>76.35</var>maltreatment, if known.<br/>
<a id="pl.77.1"></a><var>77.1</var>The investigation memorandum must be written in a manner which protects the <br/>
<a id="pl.77.2"></a><var>77.2</var>identity of the reporter and of the vulnerable adult and may not contain the names or, to <br/>
<a id="pl.77.3"></a><var>77.3</var>the extent possible, data on individuals or private data listed in clause (2).<br/>
<a id="pl.77.4"></a><var>77.4</var>(2) Data on individuals collected and maintained in the investigation memorandum <br/>
<a id="pl.77.5"></a><var>77.5</var>are private data, including:<br/>
<a id="pl.77.6"></a><var>77.6</var>(i) the name of the vulnerable adult;<br/>
<a id="pl.77.7"></a><var>77.7</var>(ii) the identity of the individual alleged to be the perpetrator;<br/>
<a id="pl.77.8"></a><var>77.8</var>(iii) the identity of the individual substantiated as the perpetrator; and<br/>
<a id="pl.77.9"></a><var>77.9</var>(iv) the identity of all individuals interviewed as part of the investigation.<br/>
<a id="pl.77.10"></a><var>77.10</var>(3) Other data on individuals maintained as part of an investigation under this section <br/>
<a id="pl.77.11"></a><var>77.11</var>are private data on individuals upon completion of the investigation.<br/>
<a id="pl.77.12"></a><var>77.12</var>(c) The subject of the report may compel disclosure of the name of the reporter only <br/>
<a id="pl.77.13"></a><var>77.13</var>with the consent of the reporter or upon a written finding by a court that the report was <br/>
<a id="pl.77.14"></a><var>77.14</var>false and there is evidence that the report was made in bad faith. This subdivision does <br/>
<a id="pl.77.15"></a><var>77.15</var>not alter disclosure responsibilities or obligations under the Rules of Criminal Procedure, <br/>
<a id="pl.77.16"></a><var>77.16</var>except that where the identity of the reporter is relevant to a criminal prosecution, the <br/>
<a id="pl.77.17"></a><var>77.17</var>district court shall do an in-camera review prior to determining whether to order disclosure <br/>
<a id="pl.77.18"></a><var>77.18</var>of the identity of the reporter.<br/>
<a id="pl.77.19"></a><var>77.19</var>(d) Notwithstanding section 
         <statute_ref>138.163</statute_ref>, data maintained under this section by the <br/>
<a id="pl.77.20"></a><var>77.20</var>commissioners of health and human services must be destroyed maintained under the <br/>
<a id="pl.77.21"></a><var>77.21</var>following schedule and then destroyed unless otherwise directed by federal requirements:<br/>
<a id="pl.77.22"></a><var>77.22</var>(1) data from reports determined to be false, two maintained for three years after the <br/>
<a id="pl.77.23"></a><var>77.23</var>finding was made;<br/>
<a id="pl.77.24"></a><var>77.24</var>(2) data from reports determined to be inconclusive, maintained for four years after <br/>
<a id="pl.77.25"></a><var>77.25</var>the finding was made;<br/>
<a id="pl.77.26"></a><var>77.26</var>(3) data from reports determined to be substantiated, maintained for seven years <br/>
<a id="pl.77.27"></a><var>77.27</var>after the finding was made; and<br/>
<a id="pl.77.28"></a><var>77.28</var>(4) data from reports which were not investigated by a lead agency and for which <br/>
<a id="pl.77.29"></a><var>77.29</var>there is no final disposition, two maintained for three years from the date of the report.<br/>
<a id="pl.77.30"></a><var>77.30</var>(e) The commissioners of health and human services shall each annually report to <br/>
<a id="pl.77.31"></a><var>77.31</var>the legislature and the governor on the number and type of reports of alleged maltreatment <br/>
<a id="pl.77.32"></a><var>77.32</var>involving licensed facilities reported under this section, the number of those requiring <br/>
<a id="pl.77.33"></a><var>77.33</var>investigation under this section, and the resolution of those investigations. The report <br/>
<a id="pl.77.34"></a><var>77.34</var>shall identify:<br/>
<a id="pl.77.35"></a><var>77.35</var>(1) whether and where backlogs of cases result in a failure to conform with statutory <br/>
<a id="pl.77.36"></a><var>77.36</var>time frames;<br/>
<a id="pl.78.1"></a><var>78.1</var>(2) where adequate coverage requires additional appropriations and staffing; and<br/>
<a id="pl.78.2"></a><var>78.2</var>(3) any other trends that affect the safety of vulnerable adults.<br/>
<a id="pl.78.3"></a><var>78.3</var>(f) Each lead agency must have a record retention policy.<br/>
<a id="pl.78.4"></a><var>78.4</var>(g) Lead agencies, prosecuting authorities, and law enforcement agencies may <br/>
<a id="pl.78.5"></a><var>78.5</var>exchange not public data, as defined in section 
         <statute_ref>13.02</statute_ref>, if the agency or authority requesting <br/>
<a id="pl.78.6"></a><var>78.6</var>the data determines that the data are pertinent and necessary to the requesting agency in <br/>
<a id="pl.78.7"></a><var>78.7</var>initiating, furthering, or completing an investigation under this section. Data collected <br/>
<a id="pl.78.8"></a><var>78.8</var>under this section must be made available to prosecuting authorities and law enforcement <br/>
<a id="pl.78.9"></a><var>78.9</var>officials, local county agencies, and licensing agencies investigating the alleged <br/>
<a id="pl.78.10"></a><var>78.10</var>maltreatment under this section. The lead agency shall exchange not public data with the <br/>
<a id="pl.78.11"></a><var>78.11</var>vulnerable adult maltreatment review panel established in section 
         <statute_ref>256.021</statute_ref> if the data are <br/>
<a id="pl.78.12"></a><var>78.12</var>pertinent and necessary for a review requested under that section. Upon completion of the <br/>
<a id="pl.78.13"></a><var>78.13</var>review, not public data received by the review panel must be returned to the lead agency.<br/>
<a id="pl.78.14"></a><var>78.14</var>(h) Each lead agency shall keep records of the length of time it takes to complete its <br/>
<a id="pl.78.15"></a><var>78.15</var>investigations.<br/>
<a id="pl.78.16"></a><var>78.16</var>(i) A lead agency may notify other affected parties and their authorized representative <br/>
<a id="pl.78.17"></a><var>78.17</var>if the agency has reason to believe maltreatment has occurred and determines the <br/>
<a id="pl.78.18"></a><var>78.18</var>information will safeguard the well-being of the affected parties or dispel widespread <br/>
<a id="pl.78.19"></a><var>78.19</var>rumor or unrest in the affected facility.<br/>
<a id="pl.78.20"></a><var>78.20</var>(j) Under any notification provision of this section, where federal law specifically <br/>
<a id="pl.78.21"></a><var>78.21</var>prohibits the disclosure of patient identifying information, a lead agency may not provide <br/>
<a id="pl.78.22"></a><var>78.22</var>any notice unless the vulnerable adult has consented to disclosure in a manner which <br/>
<a id="pl.78.23"></a><var>78.23</var>conforms to federal requirements.<br/>
<br/>
<a id="bill.0.108.0"></a><a id="pl.78.24"></a><var>78.24</var>    Sec. 108. <b>STUDY OF ALLOWING LONG-TERM CARE INSURANCE TO BE </b><br/>
<a id="pl.78.25"></a><var>78.25</var><b>PURCHASED BY LOCAL GOVERNMENT EMPLOYEES.</b><br/>
<a id="pl.78.26"></a><var>78.26</var>The commissioner of management and budget, in conjunction with two <br/>
<a id="pl.78.27"></a><var>78.27</var>representatives of state government employees, with one each to be designated by the <br/>
<a id="pl.78.28"></a><var>78.28</var>American Federation of State, County, and Municipal Employees and the Minnesota <br/>
<a id="pl.78.29"></a><var>78.29</var>Association of Professional Employees; one representative of local government employees <br/>
<a id="pl.78.30"></a><var>78.30</var>to be designated by the American Federation of State, County, and Municipal Employees; <br/>
<a id="pl.78.31"></a><var>78.31</var>and one representative each designated by the League of Minnesota Cities and the <br/>
<a id="pl.78.32"></a><var>78.32</var>Association of Minnesota Counties, shall study allowing local government employees to <br/>
<a id="pl.78.33"></a><var>78.33</var>purchase long-term care insurance authorized under Minnesota Statutes, section 43A.318, <br/>
<a id="pl.78.34"></a><var>78.34</var>subdivision 2. On or before February 15, 2010, the commissioner shall report on their <br/>
<a id="pl.78.35"></a><var>78.35</var>findings and recommendations to the chairs of the house of representatives Health Care <br/>
<a id="pl.79.1"></a><var>79.1</var>and Human Services Policy and Oversight Committee and the senate Health, Housing, <br/>
<a id="pl.79.2"></a><var>79.2</var>and Family Security Committee.<br/>
<br/>
<a id="bill.0.109.0"></a><a id="pl.79.3"></a><var>79.3</var>    Sec. 109. <b>HEALTH DEPARTMENT WORKGROUP.</b><br/>
<a id="pl.79.4"></a><var>79.4</var>The commissioner of health shall consult with hospitals, RN staff nurses, and <br/>
<a id="pl.79.5"></a><var>79.5</var>quality assurance staff working in facilities that report under Minnesota Statutes, section <br/>
<a id="pl.79.6"></a><var>79.6</var>144.7065, subdivision 8, and other stakeholders, taking into account geographic balance, <br/>
<a id="pl.79.7"></a><var>79.7</var>to define and develop questions related to staffing for inclusion in the root cause analysis <br/>
<a id="pl.79.8"></a><var>79.8</var>tool required under that subdivision.<br/>
<br/>
<a id="bill.0.110.0"></a><a id="pl.79.9"></a><var>79.9</var>    Sec. 110. <b>ALZHEIMER'S DISEASE WORKING GROUP.</b><br/>
<a id="pl.79.10"></a><var>79.10</var>    Subdivision 1. <b>Establishment; members.</b> The Minnesota Board on Aging must <br/>
<a id="pl.79.11"></a><var>79.11</var>appoint, unless otherwise provided, an Alzheimer's disease working group that consists of <br/>
<a id="pl.79.12"></a><var>79.12</var>no more than 20 members including, but not limited to:<br/>
<a id="pl.79.13"></a><var>79.13</var>(1) at least one caregiver of a person who has been diagnosed with Alzheimer's <br/>
<a id="pl.79.14"></a><var>79.14</var>disease;<br/>
<a id="pl.79.15"></a><var>79.15</var>(2) at least one person who has been diagnosed with Alzheimer's disease;<br/>
<a id="pl.79.16"></a><var>79.16</var>(3) a representative of the nursing facility industry;<br/>
<a id="pl.79.17"></a><var>79.17</var>(4) a representative of the assisted living industry;<br/>
<a id="pl.79.18"></a><var>79.18</var>(5) a representative of the adult day services industry;<br/>
<a id="pl.79.19"></a><var>79.19</var>(6) a representative of the medical care provider community;<br/>
<a id="pl.79.20"></a><var>79.20</var>(7) a psychologist who specializes in dementia care;<br/>
<a id="pl.79.21"></a><var>79.21</var>(8) an Alzheimer's researcher;<br/>
<a id="pl.79.22"></a><var>79.22</var>(9) a representative of the Alzheimer's Association;<br/>
<a id="pl.79.23"></a><var>79.23</var>(10) the commissioner of human services or a designee;<br/>
<a id="pl.79.24"></a><var>79.24</var>(11) the commissioner of health or a designee;<br/>
<a id="pl.79.25"></a><var>79.25</var>(12) the ombudsman for long-term care or a designee; and<br/>
<a id="pl.79.26"></a><var>79.26</var>(13) at least two public members named by the governor.<br/>
<a id="pl.79.27"></a><var>79.27</var>The appointing authorities under this subdivision must complete their appointments no <br/>
<a id="pl.79.28"></a><var>79.28</var>later than September 1, 2009.<br/>
<a id="pl.79.29"></a><var>79.29</var>    Subd. 2. <b>Duties; recommendations.</b> The Alzheimer's disease working group must <br/>
<a id="pl.79.30"></a><var>79.30</var>examine the array of needs of individuals diagnosed with Alzheimer's disease, services <br/>
<a id="pl.79.31"></a><var>79.31</var>available to meet these needs, and the capacity of the state and current providers to meet <br/>
<a id="pl.79.32"></a><var>79.32</var>these and future needs. The working group shall consider and make recommendations and <br/>
<a id="pl.79.33"></a><var>79.33</var>findings on the following issues:<br/>
<a id="pl.79.34"></a><var>79.34</var>(1) trends in the state's Alzheimer's population and service needs including, but <br/>
<a id="pl.79.35"></a><var>79.35</var>not limited to:<br/>
<a id="pl.80.1"></a><var>80.1</var>(i) the state's role in long-term care, family caregiver support, and assistance to <br/>
<a id="pl.80.2"></a><var>80.2</var>persons with early-stage and early-onset of Alzheimer's disease;<br/>
<a id="pl.80.3"></a><var>80.3</var>(ii) state policy regarding persons with Alzheimer's disease and dementia; and<br/>
<a id="pl.80.4"></a><var>80.4</var>(iii) establishment of a surveillance system to provide proper estimates of the <br/>
<a id="pl.80.5"></a><var>80.5</var>number of persons in the state with Alzheimer's disease, and the changing population <br/>
<a id="pl.80.6"></a><var>80.6</var>with dementia;<br/>
<a id="pl.80.7"></a><var>80.7</var>(2) existing resources, services, and capacity including, but not limited to:<br/>
<a id="pl.80.8"></a><var>80.8</var>(i) type, cost, and availability of dementia services;<br/>
<a id="pl.80.9"></a><var>80.9</var>(ii) dementia-specific training requirements for long-term care staff;<br/>
<a id="pl.80.10"></a><var>80.10</var>(iii) quality care measures for residential care facilities;<br/>
<a id="pl.80.11"></a><var>80.11</var>(iv) availability of home and community-based resources for persons with <br/>
<a id="pl.80.12"></a><var>80.12</var>Alzheimer's disease, including respite care;<br/>
<a id="pl.80.13"></a><var>80.13</var>(v) number and availability of long-term care dementia units;<br/>
<a id="pl.80.14"></a><var>80.14</var>(vi) adequacy and appropriateness of geriatric psychiatric units for persons with <br/>
<a id="pl.80.15"></a><var>80.15</var>behavior disorders associated with Alzheimer's and related dementia;<br/>
<a id="pl.80.16"></a><var>80.16</var>(vii) assisted living residential options for persons with dementia; and<br/>
<a id="pl.80.17"></a><var>80.17</var>(viii) state support of Alzheimer's research through Minnesota universities and <br/>
<a id="pl.80.18"></a><var>80.18</var>other resources; and<br/>
<a id="pl.80.19"></a><var>80.19</var>(3) needed policies or responses including, but not limited to, the provision of <br/>
<a id="pl.80.20"></a><var>80.20</var>coordinated services and supports to persons and families living with Alzheimer's and <br/>
<a id="pl.80.21"></a><var>80.21</var>related disorders, the capacity to meet these needs, and strategies to address identified <br/>
<a id="pl.80.22"></a><var>80.22</var>gaps in services.<br/>
<a id="pl.80.23"></a><var>80.23</var>    Subd. 3. <b>Meetings.</b> The board must select a designee to convene the first meeting of <br/>
<a id="pl.80.24"></a><var>80.24</var>the working group no later than September 1, 2009. Meetings of the working group must <br/>
<a id="pl.80.25"></a><var>80.25</var>be open to the public, and to the extent practicable, technological means, such as Web casts, <br/>
<a id="pl.80.26"></a><var>80.26</var>shall be used to reach the greatest number of people throughout the state. The members of <br/>
<a id="pl.80.27"></a><var>80.27</var>the working group shall select a chair from their membership at the first meeting.<br/>
<a id="pl.80.28"></a><var>80.28</var>    Subd. 4. <b>Report.</b> The Board on Aging must submit a report providing the findings <br/>
<a id="pl.80.29"></a><var>80.29</var>and recommendations of the working group, including any draft legislation necessary <br/>
<a id="pl.80.30"></a><var>80.30</var>to implement the recommendations, to the governor and chairs and ranking minority <br/>
<a id="pl.80.31"></a><var>80.31</var>members of the legislative committees with jurisdiction over health care no later than <br/>
<a id="pl.80.32"></a><var>80.32</var>January 15, 2011.<br/>
<a id="pl.80.33"></a><var>80.33</var>    Subd. 5. <b>Private funding.</b> To the extent available, the Board on Aging may utilize <br/>
<a id="pl.80.34"></a><var>80.34</var>funding provided by private foundations and other private funding sources to complete the <br/>
<a id="pl.80.35"></a><var>80.35</var>duties of the Alzheimer's disease working group.<br/>
<a id="pl.81.1"></a><var>81.1</var>    Subd. 6. <b>Expiration.</b> This section expires when the report under subdivision 4 is <br/>
<a id="pl.81.2"></a><var>81.2</var>submitted.<br/>
<br/>
<a id="bill.0.111.0"></a><a id="pl.81.3"></a><var>81.3</var>    Sec. 111. <b>DEADLINE FOR APPOINTMENT.</b><br/>
<a id="pl.81.4"></a><var>81.4</var>(a) The Minnesota Psychological Association must complete the appointment <br/>
<a id="pl.81.5"></a><var>81.5</var>required under Minnesota Statutes, section 62U.09, subdivision 2, paragraph (a), clause <br/>
<a id="pl.81.6"></a><var>81.6</var>(13), no later than October 1, 2009.<br/>
<a id="pl.81.7"></a><var>81.7</var>(b) The Minnesota Chiropractic Association must complete the appointment <br/>
<a id="pl.81.8"></a><var>81.8</var>required under Minnesota Statutes, section 62U.09, subdivision2, paragraph (a), clause <br/>
<a id="pl.81.9"></a><var>81.9</var>(14), no later than October 1, 2009.<br/>
<br/>
<a id="bill.0.112.0"></a><a id="pl.81.10"></a><var>81.10</var>    Sec. 112. <b> REPEALER.</b><br/>
<a id="pl.81.11"></a><var>81.11</var>Minnesota Statutes 2008, sections 147A.22; 148.627; 150A.09, subdivision 6; and <br/>
<a id="pl.81.12"></a><var>81.12</var>256B.5013, subdivisions 2, 3, and 5, are repealed."<br/>
<a id="pl.81.13"></a><var>81.13</var>Delete the title and insert:<br/>

<a id="pl.81.16"></a><var>81.16</var>provisions; changing health plan requirements; modifying nursing facility <br/>
<a id="pl.81.17"></a><var>81.17</var>provisions; requiring licensure of physician assistants; requiring patient record <br/>
<a id="pl.81.18"></a><var>81.18</var>keeping; changing the definition of doula services; requiring licensure of dental <br/>
<a id="pl.81.19"></a><var>81.19</var>assistants; changing health occupation fees; imposing late fees; establishing safe <br/>
<a id="pl.81.20"></a><var>81.20</var>patient handling in clinical settings; changing medical assistant reimbursement <br/>
<a id="pl.81.21"></a><var>81.21</var>provisions; requiring annual payment reports from manage care plans and <br/>
<a id="pl.81.22"></a><var>81.22</var>county-based purchasing plans; requiring a study of long-term care insurance and <br/>
<a id="pl.81.23"></a><var>81.23</var>local government employees; creating workgroups; requiring reports;amending <br/>
<a id="pl.81.24"></a><var>81.24</var>Minnesota Statutes 2008, sections 62A.65, subdivision 4; 62M.09, subdivision <br/>
<a id="pl.81.25"></a><var>81.25</var>3a; 62Q.525, subdivision 2; 62U.01, subdivision 8; 62U.09, subdivision 2; <br/>
<a id="pl.81.26"></a><var>81.26</var>144.1501, subdivision 1; 144.7065, subdivisions 8, 10; 144E.001, subdivisions <br/>
<a id="pl.81.27"></a><var>81.27</var>3a, 9c; 145.56, subdivisions 1, 2; 147.09; 147A.01; 147A.02; 147A.03; 147A.04; <br/>
<a id="pl.81.28"></a><var>81.28</var>147A.05; 147A.06; 147A.07; 147A.08; 147A.09; 147A.11; 147A.13; 147A.16; <br/>
<a id="pl.81.29"></a><var>81.29</var>147A.18; 147A.19; 147A.20; 147A.21; 147A.23; 147A.24; 147A.26; 147A.27; <br/>
<a id="pl.81.30"></a><var>81.30</var>148.06, subdivision 1; 148.624, subdivision 2; 148.89, subdivision 5; 148.995, <br/>
<a id="pl.81.31"></a><var>81.31</var>subdivisions 2, 4; 150A.01, subdivision 8; 150A.02, subdivision 1; 150A.05, <br/>
<a id="pl.81.32"></a><var>81.32</var>subdivision 2; 150A.06, subdivisions 2a, 2b, 2c, 2d, 4a, 5, 7, 8; 150A.08, <br/>
<a id="pl.81.33"></a><var>81.33</var>subdivisions 1, 3, 3a, 5, 6, 8; 150A.081; 150A.09, subdivisions 1, 3; 150A.091, <br/>
<a id="pl.81.34"></a><var>81.34</var>subdivisions 2, 3, 5, 7, 8, 9, 10, 11, 12, 14, 15, by adding subdivisions; 150A.10, <br/>
<a id="pl.81.35"></a><var>81.35</var>subdivisions 1a, 2, 4; 150A.12; 150A.13; 169.345, subdivision 2; 182.6551; <br/>
<a id="pl.81.36"></a><var>81.36</var>182.6552, by adding a subdivision; 252.27, subdivision 1a; 252.282, subdivisions <br/>
<a id="pl.81.37"></a><var>81.37</var>3, 5; 253B.02, subdivision 7; 253B.05, subdivision 2; 256B.0625, subdivision <br/>
<a id="pl.81.38"></a><var>81.38</var>28a; 256B.0657, subdivision 5; 256B.0751, subdivision 1; 256B.0913, <br/>
<a id="pl.81.39"></a><var>81.39</var>subdivisions 4, 5a, 12; 256B.0915, subdivision 2; 256B.431, subdivision 10; <br/>
<a id="pl.81.40"></a><var>81.40</var>256B.433, subdivision 1; 256B.441, subdivisions 5, 11; 256B.5011, subdivision <br/>
<a id="pl.81.41"></a><var>81.41</var>2; 256B.5012, subdivisions 6, 7; 256B.5013, subdivisions 1, 6; 256B.69, <br/>
<a id="pl.81.42"></a><var>81.42</var>subdivision 9b; 403.03; 626.557, subdivision 12b; proposing coding for new law <br/>
<a id="pl.81.43"></a><var>81.43</var>in Minnesota Statutes, chapters 148; 182; repealing Minnesota Statutes 2008, <br/>
<a id="pl.81.44"></a><var>81.44</var>sections 147A.22; 148.627; 150A.09, subdivision 6; 256B.5013, subdivisions <br/>
<a id="pl.81.45"></a><var>81.45</var>2, 3, 5."<br/>
         		We request the adoption of this report and repassage of the bill.House Conferees: (Signed) Paul Thissen, Maria Ruud, Julie Bunn, Patti Fritz, Tim KellySenate Conferees: (Signed) Tony Lourey, John Marty, Linda Higgins, Yvonne Prettner Solon, Michelle Fischbach
         <table>
<col width="50px"/>
<col width="252px"/>
<col width="42px"/>
<col width="252px"/>
<tr>
<td><a id="pl.82.1"></a><var>82.1</var><br/>
</td>
<td colspan="3">We request the adoption of this report and repassage of the bill.<br/>
</td>
</tr>
<tr>
<td><a id="pl.82.2"></a><var>82.2</var><br/>
</td>
<td>House Conferees:<span width="2em"></span>(Signed)<br/>
</td>
<td></td>
<td></td>
</tr>
<tr>
<td><a id="pl.82.3"></a><var>82.3</var><br/>
</td>
<td><span>
                     							.....
                     						</span><br/>
</td>
<td></td>
<td><span>
                     							.....
                     						</span><br/>
</td>
</tr>
<tr>
<td><a id="pl.82.4"></a><var>82.4</var><br/>
</td>
<td>Paul Thissen<br/>
</td>
<td></td>
<td>Maria Ruud<br/>
</td>
</tr>
<tr>
<td><a id="pl.82.5"></a><var>82.5</var><br/>
</td>
<td><span>
                     							.....
                     						</span><br/>
</td>
<td></td>
<td><span>
                     							.....
                     						</span><br/>
</td>
</tr>
<tr>
<td><a id="pl.82.6"></a><var>82.6</var><br/>
</td>
<td>Julie Bunn<br/>
</td>
<td></td>
<td>Patti Fritz<br/>
</td>
</tr>
<tr>
<td><a id="pl.82.7"></a><var>82.7</var><br/>
</td>
<td><span>
                     							.....
                     						</span><br/>
</td>
<td></td>
<td></td>
</tr>
<tr>
<td><a id="pl.82.8"></a><var>82.8</var><br/>
</td>
<td>Tim Kelly<br/>
</td>
<td></td>
<td></td>
</tr>
<tr>
<td><a id="pl.82.9"></a><var>82.9</var><br/>
</td>
<td>Senate Conferees:<span width="2em"></span>(Signed)<br/>
</td>
<td></td>
<td></td>
</tr>
<tr>
<td><a id="pl.82.10"></a><var>82.10</var><br/>
</td>
<td><span>
                     							.....
                     						</span><br/>
</td>
<td></td>
<td><span>
                     							.....
                     						</span><br/>
</td>
</tr>
<tr>
<td><a id="pl.82.11"></a><var>82.11</var><br/>
</td>
<td>Tony Lourey<br/>
</td>
<td></td>
<td>John Marty<br/>
</td>
</tr>
<tr>
<td><a id="pl.82.12"></a><var>82.12</var><br/>
</td>
<td><span>
                     							.....
                     						</span><br/>
</td>
<td></td>
<td><span>
                     							.....
                     						</span><br/>
</td>
</tr>
<tr>
<td><a id="pl.82.13"></a><var>82.13</var><br/>
</td>
<td>Linda Higgins<br/>
</td>
<td></td>
<td>Yvonne Prettner Solon<br/>
</td>
</tr>
<tr>
<td><a id="pl.82.14"></a><var>82.14</var><br/>
</td>
<td><span>
                     							.....
                     						</span><br/>
</td>
<td></td>
<td></td>
</tr>
<tr>
<td><a id="pl.82.15"></a><var>82.15</var><br/>
</td>
<td>Michelle Fischbach<br/>
</td>
<td></td>
<td></td>
</tr>
</table>