1.1CONFERENCE COMMITTEE REPORT ON H. F. No. 17601.2A bill for an act1.3relating to human services; changing provisions for long-term care, adverse 1.4health care events, suicide prevention, doula services, developmental disabilities, 1.5mental health commitment, alternative care services, self-directed options, 1.6nursing facilities, ICF/MR facilities, and data management; requiring a safe 1.7patient handling plan; establishing a health department work group and an 1.8Alzheimer's disease work group;amending Minnesota Statutes 2008, sections 1.943A.318, subdivision 2; 62Q.525, subdivision 2; 144.7065, subdivisions 8, 10; 1.10145.56, subdivisions 1, 2; 148.995, subdivisions 2, 4; 182.6551; 182.6552, 1.11by adding a subdivision; 252.27, subdivision 1a; 252.282, subdivisions 3, 5; 1.12253B.095, subdivision 1; 256B.0657, subdivision 5; 256B.0913, subdivisions 1.134, 5a, 12; 256B.0915, subdivision 2; 256B.431, subdivision 10; 256B.433, 1.14subdivision 1; 256B.441, subdivisions 5, 11; 256B.5011, subdivision 2; 1.15256B.5012, subdivisions 6, 7; 256B.5013, subdivisions 1, 6; 256B.69, 1.16subdivision 9b; 403.03; 626.557, subdivision 12b; proposing coding for new law 1.17in Minnesota Statutes, chapter 182; repealing Minnesota Statutes 2008, section 1.18256B.5013, subdivisions 2, 3, 5.1.19May 17, 20091.20The Honorable Margaret Anderson Kelliher1.21Speaker of the House of Representatives1.22The Honorable James P. Metzen1.23President of the Senate1.24We, the undersigned conferees for H. F. No. 1760 report that we have agreed upon 1.25the items in dispute and recommend as follows:1.26That the Senate recede from its amendments and that H. F. No. 1760 be further 1.27amended as follows:1.28Delete everything after the enacting clause and insert:1.29    "Section 1. Minnesota Statutes 2008, section 62A.65, subdivision 4, is amended to read:1.30    Subd. 4. Gender rating prohibited.(a) No individual health plan offered, sold, 1.31issued, or renewed to a Minnesota resident may determine the premium rate or any other 1.32underwriting decision, including initial issuance, through a method that is in any way 1.33based upon the gender of any person covered or to be covered under the health plan. This 2.1subdivision prohibits the use of marital status or generalized differences in expected costs 2.2between principal insureds and their spouses.2.3(b) No health carrier may refuse to initially offer, sell, or issue an individual health 2.4plan to a Minnesota resident solely on the basis that the individual had a previous cesarean 2.5delivery.2.6    Sec. 2. Minnesota Statutes 2008, section 62M.09, subdivision 3a, is amended to read:2.7    Subd. 3a. Mental health and substance abuse reviews.(a) A peer of the treating 2.8mental health or substance abuse provider or a physician must review requests for 2.9outpatient services in which the utilization review organization has concluded that a 2.10determination not to certify a mental health or substance abuse service for clinical reasons 2.11is appropriate, provided that any final determination not to certify treatment is made 2.12by a psychiatrist certified by the American Board of Psychiatry and Neurology and 2.13appropriately licensed in this state or by a doctoral-level psychologist licensed in this state 2.14if the treating provider is a psychologist. 2.15(b) Notwithstanding the notification requirements of section 
         62M.05, a utilization 2.16review organization that has made an initial decision to certify in accordance with the 2.17requirements of section 
         62M.05 may elect to provide notification of a determination to 2.18continue coverage through facsimile or mail. 2.19(c) This subdivision does not apply to determinations made in connection with 2.20policies issued by a health plan company that is assessed less than three percent of the 2.21total amount assessed by the Minnesota Comprehensive Health Association. 2.22    Sec. 3. Minnesota Statutes 2008, section 62Q.525, subdivision 2, is amended to read:2.23    Subd. 2. Definitions. (a) For purposes of this section, the terms defined in this 2.24subdivision have the meanings given them.2.25(b) "Medical literature" means articles from major peer reviewed medical journals 2.26that have recognized the drug or combination of drugs' safety and effectiveness for 2.27treatment of the indication for which it has been prescribed. Each article shall meet the 2.28uniform requirements for manuscripts submitted to biomedical journals established by 2.29the International Committee of Medical Journal Editors or be published in a journal 2.30specified by the United States Secretary of Health and Human Services pursuant to United 2.31States Code, title 42, section 1395x, paragraph (t), clause (2), item (B), as amended, as 2.32acceptable peer review medical literature. Each article must use generally acceptable 2.33scientific standards and must not use case reports to satisfy this criterion.2.34(c) "Off-label use of drugs" means when drugs are prescribed for treatments other 2.35than those stated in the labeling approved by the federal Food and Drug Administration.3.1(d) "Standard reference compendia" means:3.2(1) the United States Pharmacopeia Drug Information; or3.3(2) the American Hospital Formulary Service Drug Information any authoritative 3.4compendia as identified by the Medicare program for use in the determination of a 3.5medically accepted indication of drugs and biologicals used off-label.3.6    Sec. 4. Minnesota Statutes 2008, section 62U.01, subdivision 8, is amended to read:3.7    Subd. 8. Health plan company. "Health plan company" has the meaning provided 3.8in section 
         62Q.01, subdivision 4. For the purposes of this chapter, health plan company 3.9shall include county-based purchasing arrangements authorized under section 256B.692.3.10    Sec. 5. Minnesota Statutes 2008, section 62U.09, subdivision 2, is amended to read:3.11    Subd. 2. Members. (a) The Health Care Reform Review Council shall consist of 143.1216 members who are appointed as follows:3.13    (1) two members appointed by the Minnesota Medical Association, at least one 3.14of whom must represent rural physicians; 3.15    (2) one member appointed by the Minnesota Nurses Association;3.16    (3) two members appointed by the Minnesota Hospital Association, at least one of 3.17whom must be a rural hospital administrator;3.18    (4) one member appointed by the Minnesota Academy of Physician Assistants;3.19    (5) one member appointed by the Minnesota Business Partnership;3.20    (6) one member appointed by the Minnesota Chamber of Commerce;3.21    (7) one member appointed by the SEIU Minnesota State Council; 3.22    (8) one member appointed by the AFL-CIO;3.23    (9) one member appointed by the Minnesota Council of Health Plans;3.24    (10) one member appointed by the Smart Buy Alliance;3.25    (11) one member appointed by the Minnesota Medical Group Management 3.26Association; and3.27    (12) one consumer member appointed by AARP Minnesota;3.28(13) one member appointed by the Minnesota Psychological Association; and3.29(14) one member appointed by the Minnesota Chiropractic Association.3.30    (b) If a member is no longer able or eligible to participate, a new member shall be 3.31appointed by the entity that appointed the outgoing member.3.32    Sec. 6. Minnesota Statutes 2008, section 144.1501, subdivision 1, is amended to read:3.33    Subdivision 1. Definitions. (a) For purposes of this section, the following definitions 3.34apply.4.1(b) "Dentist" means an individual who is licensed to practice dentistry.4.2(c) "Designated rural area" means:4.3(1) an area in Minnesota outside the counties of Anoka, Carver, Dakota, Hennepin, 4.4Ramsey, Scott, and Washington, excluding the cities of Duluth, Mankato, Moorhead, 4.5Rochester, and St. Cloud; or4.6(2) a municipal corporation, as defined under section 
         471.634, that is physically 4.7located, in whole or in part, in an area defined as a designated rural area under clause (1).4.8(d) "Emergency circumstances" means those conditions that make it impossible for 4.9the participant to fulfill the service commitment, including death, total and permanent 4.10disability, or temporary disability lasting more than two years.4.11(e) "Medical resident" means an individual participating in a medical residency in 4.12family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.4.13(f) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse 4.14anesthetist, advanced clinical nurse specialist, or physician assistant.4.15(g) "Nurse" means an individual who has completed training and received all 4.16licensing or certification necessary to perform duties as a licensed practical nurse or 4.17registered nurse.4.18(h) "Nurse-midwife" means a registered nurse who has graduated from a program of 4.19study designed to prepare registered nurses for advanced practice as nurse-midwives.4.20(i) "Nurse practitioner" means a registered nurse who has graduated from a program 4.21of study designed to prepare registered nurses for advanced practice as nurse practitioners.4.22(j) "Pharmacist" means an individual with a valid license issued under chapter 151.4.23(k) "Physician" means an individual who is licensed to practice medicine in the areas 4.24of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.4.25(l) "Physician assistant" means a person registered licensed under chapter 147A.4.26(m) "Qualified educational loan" means a government, commercial, or foundation 4.27loan for actual costs paid for tuition, reasonable education expenses, and reasonable living 4.28expenses related to the graduate or undergraduate education of a health care professional.4.29(n) "Underserved urban community" means a Minnesota urban area or population 4.30included in the list of designated primary medical care health professional shortage areas 4.31(HPSAs), medically underserved areas (MUAs), or medically underserved populations 4.32(MUPs) maintained and updated by the United States Department of Health and Human 4.33Services.4.34    Sec. 7. Minnesota Statutes 2008, section 144.7065, subdivision 8, is amended to read:4.35    Subd. 8. Root cause analysis; corrective action plan. Following the occurrence of 4.36an adverse health care event, the facility must conduct a root cause analysis of the event. 5.1In conducting the root cause analysis, the facility must consider as one of the factors 5.2staffing levels and the impact of staffing levels on the event. Following the analysis, the 5.3facility must: (1) implement a corrective action plan to implement the findings of the 5.4analysis or (2) report to the commissioner any reasons for not taking corrective action. If 5.5the root cause analysis and the implementation of a corrective action plan are complete at 5.6the time an event must be reported, the findings of the analysis and the corrective action 5.7plan must be included in the report of the event. The findings of the root cause analysis 5.8and a copy of the corrective action plan must otherwise be filed with the commissioner 5.9within 60 days of the event.5.10    Sec. 8. Minnesota Statutes 2008, section 144.7065, subdivision 10, is amended to read:5.11    Subd. 10. Relation to other law; data classification. (a) Adverse health events 5.12described in subdivisions 2 to 6 do not constitute "maltreatment," "neglect," or "a physical 5.13injury that is not reasonably explained" under section 
         626.556 or 
         626.557 and are excluded 5.14from the reporting requirements of sections 
         626.556 and 
         626.557, provided the facility 5.15makes a determination within 24 hours of the discovery of the event that this section is 5.16applicable and the facility files the reports required under this section in a timely fashion.  5.17(b) A facility that has determined that an event described in subdivisions 2 to 6 5.18has occurred must inform persons who are mandated reporters under section 
         626.556, 5.19subdivision 3
         , or 
         626.5572, subdivision 16, of that determination. A mandated reporter 5.20otherwise required to report under section 
         626.556, subdivision 3, or 
         626.557, subdivision 5.213
         , paragraph (e), is relieved of the duty to report an event that the facility determines under 5.22paragraph (a) to be reportable under subdivisions 2 to 6.  5.23(c) The protections and immunities applicable to voluntary reports under sections 5.24626.556
          and 
         626.557 are not affected by this section.  5.25(d) Notwithstanding section 
         626.556, 
         626.557, or any other provision of Minnesota 5.26statute or rule to the contrary, neither a lead agency under section 
         626.556, subdivision 3c, 5.27or 
         626.5572, subdivision 13, the commissioner of health, nor the director of the Office of 5.28Health Facility Complaints is required to conduct an investigation of or obtain or create 5.29investigative data or reports regarding an event described in subdivisions 2 to 6. If the 5.30facility satisfies the requirements described in paragraph (a), the review or investigation 5.31shall be conducted and data or reports shall be obtained or created only under sections 5.32144.706
          to 
         144.7069, except as permitted or required under sections 
         144.50 to 
         144.564, 5.33or as necessary to carry out the state's certification responsibility under the provisions of 5.34sections 1864 and 1867 of the Social Security Act.   If a licensed health care provider 5.35reports an event to the facility required to be reported under subdivisions 2 to 6, in a 5.36timely manner, the provider's licensing board is not required to conduct an investigation of 6.1or obtain or create investigative data or reports regarding the individual reporting of the 6.2events described in subdivisions 2 to 6.6.3(e) Data contained in the following records are nonpublic and, to the extent they 6.4contain data on individuals, confidential data on individuals, as defined in section 
         13.02:  6.5(1) reports provided to the commissioner under sections 
         147.155, 
         147A.155, 6.6148.267
         , 
         151.301, and 
         153.255;  6.7(2) event reports, findings of root cause analyses, and corrective action plans filed by 6.8a facility under this section; and6.9(3) records created or obtained by the commissioner in reviewing or investigating 6.10the reports, findings, and plans described in clause (2).6.11For purposes of the nonpublic data classification contained in this paragraph, the 6.12reporting facility shall be deemed the subject of the data.6.13    Sec. 9. Minnesota Statutes 2008, section 144E.001, subdivision 3a, is amended to read:6.14    Subd. 3a. Ambulance service personnel. "Ambulance service personnel" means 6.15individuals who are authorized by a licensed ambulance service to provide emergency 6.16care for the ambulance service and are:6.17(1) EMTs, EMT-Is, or EMT-Ps;6.18(2) Minnesota registered nurses who are: (i) EMTs, are currently practicing 6.19nursing, and have passed a paramedic practical skills test, as approved by the board 6.20and administered by a training program approved by the board; (ii) on the roster of an 6.21ambulance service on or before January 1, 2000; or (iii) after petitioning the board, 6.22deemed by the board to have training and skills equivalent to an EMT, as determined on 6.23a case-by-case basis; or6.24(3) Minnesota registered licensed physician assistants who are: (i) EMTs, are 6.25currently practicing as physician assistants, and have passed a paramedic practical skills 6.26test, as approved by the board and administered by a training program approved by the 6.27board; (ii) on the roster of an ambulance service on or before January 1, 2000; or (iii) after 6.28petitioning the board, deemed by the board to have training and skills equivalent to an 6.29EMT, as determined on a case-by-case basis.6.30    Sec. 10. Minnesota Statutes 2008, section 144E.001, subdivision 9c, is amended to 6.31read:6.32    Subd. 9c. Physician assistant. "Physician assistant" means a person registered6.33licensed to practice as a physician assistant under chapter 147A.6.34    Sec. 11. Minnesota Statutes 2008, section 145.56, subdivision 1, is amended to read:7.1    Subdivision 1. Suicide prevention plan. The commissioner of health shall refine, 7.2coordinate, and implement the state's suicide prevention plan using an evidence-based, 7.3public health approach for a life span plan focused on awareness and prevention, in 7.4collaboration with the commissioner of human services; the commissioner of public 7.5safety; the commissioner of education; the chancellor of Minnesota State Colleges and 7.6Universities; the president of the University of Minnesota; and appropriate agencies, 7.7organizations, and institutions in the community.7.8    Sec. 12. Minnesota Statutes 2008, section 145.56, subdivision 2, is amended to read:7.9    Subd. 2. Community-based programs. To the extent funds are appropriated for the 7.10purposes of this subdivision, the commissioner shall establish a grant program to fund:7.11(1) community-based programs to provide education, outreach, and advocacy 7.12services to populations who may be at risk for suicide;7.13(2) community-based programs that educate community helpers and gatekeepers, 7.14such as family members, spiritual leaders, coaches, and business owners, employers, and 7.15coworkers on how to prevent suicide by encouraging help-seeking behaviors;7.16(3) community-based programs that educate populations at risk for suicide and 7.17community helpers and gatekeepers that must include information on the symptoms 7.18of depression and other psychiatric illnesses, the warning signs of suicide, skills for 7.19preventing suicides, and making or seeking effective referrals to intervention and 7.20community resources; and7.21(4) community-based programs to provide evidence-based suicide prevention and 7.22intervention education to school staff, parents, and students in grades kindergarten through 7.2312, and for students attending Minnesota colleges and universities.7.24    Sec. 13. Minnesota Statutes 2008, section 147.09, is amended to read:7.25147.09 EXEMPTIONS.7.26Section 147.081 does not apply to, control, prevent or restrict the practice, service, 7.27or activities of:7.28(1) A person who is a commissioned medical officer of, a member of, or employed 7.29by, the armed forces of the United States, the United States Public Health Service, the 7.30Veterans Administration, any federal institution or any federal agency while engaged in 7.31the performance of official duties within this state, if the person is licensed elsewhere.7.32(2) A licensed physician from a state or country who is in actual consultation here.7.33(3) A licensed or registered physician who treats the physician's home state patients 7.34or other participating patients while the physicians and those patients are participating 7.35together in outdoor recreation in this state as defined by section 
         86A.03, subdivision 3. 8.1A physician shall first register with the board on a form developed by the board for that 8.2purpose. The board shall not be required to promulgate the contents of that form by rule. 8.3No fee shall be charged for this registration.8.4(4) A student practicing under the direct supervision of a preceptor while the student 8.5is enrolled in and regularly attending a recognized medical school.8.6(5) A student who is in continuing training and performing the duties of an intern or 8.7resident or engaged in postgraduate work considered by the board to be the equivalent of 8.8an internship or residency in any hospital or institution approved for training by the board, 8.9provided the student has a residency permit issued by the board under section 
         147.0391.8.10(6) A person employed in a scientific, sanitary, or teaching capacity by the state 8.11university, the Department of Education, a public or private school, college, or other 8.12bona fide educational institution, a nonprofit organization, which has tax-exempt status 8.13in accordance with the Internal Revenue Code, section 501(c)(3), and is organized and 8.14operated primarily for the purpose of conducting scientific research directed towards 8.15discovering the causes of and cures for human diseases, or the state Department of Health, 8.16whose duties are entirely of a research, public health, or educational character, while 8.17engaged in such duties; provided that if the research includes the study of humans, such 8.18research shall be conducted under the supervision of one or more physicians licensed 8.19under this chapter.8.20(7) Physician'sPhysician  assistants registered licensed in this state.8.21(8) A doctor of osteopathy duly licensed by the state Board of Osteopathy under 8.22Minnesota Statutes 1961, sections 
         148.11 to 
         148.16, prior to May 1, 1963, who has not 8.23been granted a license to practice medicine in accordance with this chapter provided that 8.24the doctor confines activities within the scope of the license.8.25(9) Any person licensed by a health-related licensing board, as defined in section 8.26214.01, subdivision 2
         , or registered by the commissioner of health pursuant to section 8.27214.13
         , including psychological practitioners with respect to the use of hypnosis; provided 8.28that the person confines activities within the scope of the license.8.29(10) A person who practices ritual circumcision pursuant to the requirements or 8.30tenets of any established religion.8.31(11) A Christian Scientist or other person who endeavors to prevent or cure disease 8.32or suffering exclusively by mental or spiritual means or by prayer.8.33(12) A physician licensed to practice medicine in another state who is in this state 8.34for the sole purpose of providing medical services at a competitive athletic event. The 8.35physician may practice medicine only on participants in the athletic event. A physician 8.36shall first register with the board on a form developed by the board for that purpose. The 9.1board shall not be required to adopt the contents of the form by rule. The physician shall 9.2provide evidence satisfactory to the board of a current unrestricted license in another state. 9.3The board shall charge a fee of $50 for the registration.9.4(13) A psychologist licensed under section 
         148.907 or a social worker licensed 9.5under chapter 148D who uses or supervises the use of a penile or vaginal plethysmograph 9.6in assessing and treating individuals suspected of engaging in aberrant sexual behavior 9.7and sex offenders.9.8(14) Any person issued a training course certificate or credentialed by the Emergency 9.9Medical Services Regulatory Board established in chapter 144E, provided the person 9.10confines activities within the scope of training at the certified or credentialed level.9.11(15) An unlicensed complementary and alternative health care practitioner practicing 9.12according to chapter 146A.9.13    Sec. 14. Minnesota Statutes 2008, section 147A.01, is amended to read:9.14147A.01 DEFINITIONS.9.15    Subdivision 1. Scope. For the purpose of this chapter the terms defined in this 9.16section have the meanings given them.9.17    Subd. 2.Active status."Active status" means the status of a person who has met all 9.18the qualifications of a physician assistant, has a physician-physician assistant agreement in 9.19force, and is registered.9.20    Subd. 3. Administer. "Administer" means the delivery by a physician assistant 9.21authorized to prescribe legend drugs, a single dose of a legend drug, including controlled 9.22substances, to a patient by injection, inhalation, ingestion, or by any other immediate 9.23means, and the delivery by a physician assistant ordered by a physician a single dose of a 9.24legend drug by injection, inhalation, ingestion, or by any other immediate means.9.25    Subd. 4. Agreement. "Agreement" means the document described in section 9.26147A.20
         .  9.27    Subd. 5. Alternate supervising physician. "Alternate supervising physician" 9.28means a Minnesota licensed physician listed in the physician-physician assistant 9.29delegation agreement, or supplemental listing, who is responsible for supervising 9.30the physician assistant when the main primary supervising physician is unavailable. 9.31The alternate supervising physician shall accept full medical responsibility for the 9.32performance, practice, and activities of the physician assistant while under the supervision 9.33of the alternate supervising physician.9.34    Subd. 6. Board. "Board" means the Board of Medical Practice or its designee.10.1    Subd. 7. Controlled substances. "Controlled substances" has the meaning given it 10.2in section 
         152.01, subdivision 4.  10.3    Subd. 8.Delegation form."Delegation form" means the form used to indicate the 10.4categories of drugs for which the authority to prescribe, administer, and dispense has been 10.5delegated to the physician assistant and signed by the supervising physician, any alternate 10.6supervising physicians, and the physician assistant. This form is part of the agreement 10.7described in section 147A.20, and shall be maintained by the supervising physician and 10.8physician assistant at the address of record. Copies shall be provided to the board upon 10.9request. "Addendum to the delegation form" means a separate listing of the schedules 10.10and categories of controlled substances, if any, for which the physician assistant has been 10.11delegated the authority to prescribe, administer, and dispense. The addendum shall be 10.12maintained as a separate document as described above.  10.13    Subd. 9. Diagnostic order. "Diagnostic order" means a directive to perform 10.14a procedure or test, the purpose of which is to determine the cause and nature of a 10.15pathological condition or disease.10.16    Subd. 10. Drug. "Drug" has the meaning given it in section 
         151.01, subdivision 5, 10.17including controlled substances as defined in section 
         152.01, subdivision 4.  10.18    Subd. 11. Drug category. "Drug category" means one of the categories listed on the 10.19physician-physician assistant delegation form agreement.10.20    Subd. 12. Inactive status. "Inactive status" means the status of a person who has 10.21met all the qualifications of a physician assistant, and is registered, but does not have a 10.22physician-physician assistant agreement in force a licensed physician assistant whose 10.23license has been placed on inactive status under section 147A.05.10.24    Subd. 13.Internal protocol."Internal protocol" means a document written by 10.25the supervising physician and the physician assistant which specifies the policies and 10.26procedures which will apply to the physician assistant's prescribing, administering, 10.27and dispensing of legend drugs and medical devices, including controlled substances 10.28as defined in section 152.01, subdivision 4, and lists the specific categories of drugs 10.29and medical devices, with any exceptions or conditions, that the physician assistant 10.30is authorized to prescribe, administer, and dispense. The supervising physician and 10.31physician assistant shall maintain the protocol at the address of record. Copies shall be 10.32provided to the board upon request.  10.33    Subd. 14. Legend drug. "Legend drug" has the meaning given it in section 
         151.01, 10.34subdivision 17
         .  11.1    Subd. 14a.Licensed."Licensed" means meeting the qualifications in section 11.2147A.02 and being issued a license by the board.11.3    Subd. 14b.Licensure."Licensure" means the process by which the board 11.4determines that an applicant has met the standards and qualifications in this chapter.11.5    Subd. 15.Locum tenens permit."Locum tenens permit" means time specific 11.6temporary permission for a physician assistant to practice as a physician assistant in 11.7a setting other than the practice setting established in the physician-physician assistant 11.8agreement.11.9    Subd. 16. Medical device. "Medical device" means durable medical equipment and 11.10assistive or rehabilitative appliances, objects, or products that are required to implement 11.11the overall plan of care for the patient and that are restricted by federal law to use upon 11.12prescription by a licensed practitioner.11.13    Subd. 16a.Notice of intent to practice."Notice of intent to practice" means 11.14a document sent to the board by a licensed physician assistant that documents the 11.15adoption of a physician-physician assistant delegation agreement and provides the names, 11.16addresses, and information required by section 147A.20.11.17    Subd. 17. Physician. "Physician" means a person currently licensed in good 11.18standing as a physician or osteopath under chapter 147.11.19    Subd. 17a.Physician-physician assistant delegation agreement.11.20"Physician-physician assistant delegation agreement" means the document prepared and 11.21signed by the physician and physician assistant affirming the supervisory relationship and 11.22defining the physician assistant scope of practice. Alternate supervising physicians must be 11.23identified on the delegation agreement or a supplemental listing with signed attestation that 11.24each shall accept full medical responsibility for the performance, practice, and activities of 11.25the physician assistant while under the supervision of the alternate supervising physician. 11.26The physician-physician assistant delegation agreement outlines the role of the physician 11.27assistant in the practice, describes the means of supervision, and specifies the categories of 11.28drugs, controlled substances, and medical devices that the supervising physician delegates 11.29to the physician assistant to prescribe. The physician-physician assistant delegation 11.30agreement must comply with the requirements of section 147A.20, be kept on file at the 11.31address of record, and be made available to the board or its representative upon request.11.32    Subd. 18. Physician assistant or registered licensed physician assistant.11.33"Physician assistant" or "registered licensed physician assistant" means a person registered11.34licensed pursuant to this chapter who is qualified by academic or practical training or 12.1both to provide patient services as specified in this chapter, under the supervision of a 12.2supervising physician meets the qualifications in section 147A.02.12.3    Subd. 19.Practice setting description."Practice setting description" means a 12.4signed record submitted to the board on forms provided by the board, on which:12.5(1) the supervising physician assumes full medical responsibility for the medical 12.6care rendered by a physician assistant;12.7(2) is recorded the address and phone number of record of each supervising 12.8physician and alternate, and the physicians' medical license numbers and DEA number;12.9(3) is recorded the address and phone number of record of the physician assistant 12.10and the physician assistant's registration number and DEA number;12.11(4) is recorded whether the physician assistant has been delegated prescribing, 12.12administering, and dispensing authority;12.13(5) is recorded the practice setting, address or addresses and phone number or 12.14numbers of the physician assistant; and12.15(6) is recorded a statement of the type, amount, and frequency of supervision.12.16    Subd. 20. Prescribe. "Prescribe" means to direct, order, or designate by means of a 12.17prescription the preparation, use of, or manner of using a drug or medical device.12.18    Subd. 21. Prescription. "Prescription" means a signed written order, or an oral 12.19order reduced to writing, or an electronic order meeting current and prevailing standards12.20given by a physician assistant authorized to prescribe drugs for patients in the course 12.21of the physician assistant's practice, issued for an individual patient and containing the 12.22information required in the physician-physician assistant delegation form agreement.12.23    Subd. 22.Registration."Registration" is the process by which the board determines 12.24that an applicant has been found to meet the standards and qualifications found in this 12.25chapter.12.26    Subd. 23. Supervising physician. "Supervising physician" means a Minnesota 12.27licensed physician who accepts full medical responsibility for the performance, practice, 12.28and activities of a physician assistant under an agreement as described in section 
         147A.20. 12.29The supervising physician who completes and signs the delegation agreement may be 12.30referred to as the primary supervising physician. A supervising physician shall not 12.31supervise more than two five full-time equivalent physician assistants simultaneously.  12.32With the approval of the board, or in a disaster or emergency situation pursuant to section 12.33147A.23, a supervising physician may supervise more than five full-time equivalent 12.34physician assistants simultaneously.13.1    Subd. 24. Supervision. "Supervision" means overseeing the activities of, and 13.2accepting responsibility for, the medical services rendered by a physician assistant. The 13.3constant physical presence of the supervising physician is not required so long as the 13.4supervising physician and physician assistant are or can be easily in contact with one 13.5another by radio, telephone, or other telecommunication device. The scope and nature of 13.6the supervision shall be defined by the individual physician-physician assistant delegation13.7agreement.13.8    Subd. 25. Temporary registration license."Temporary registration" means the 13.9status of a person who has satisfied the education requirement specified in this chapter; 13.10is enrolled in the next examination required in this chapter; or is awaiting examination 13.11results; has a physician-physician assistant agreement in force as required by this chapter, 13.12and has submitted a practice setting description to the board. Such provisional registration 13.13shall expire 90 days after completion of the next examination sequence, or after one year, 13.14whichever is sooner, for those enrolled in the next examination; and upon receipt of the 13.15examination results for those awaiting examination results. The registration shall be 13.16granted by the board or its designee. "Temporary license" means a license granted to a 13.17physician assistant who meets all of the qualifications for licensure but has not yet been 13.18approved for licensure at a meeting of the board.13.19    Subd. 26. Therapeutic order. "Therapeutic order" means an order given to another 13.20for the purpose of treating or curing a patient in the course of a physician assistant's 13.21practice. Therapeutic orders may be written or verbal, but do not include the prescribing 13.22of legend drugs or medical devices unless prescribing authority has been delegated within 13.23the physician-physician assistant delegation agreement.13.24    Subd. 27. Verbal order. "Verbal order" means an oral order given to another for 13.25the purpose of treating or curing a patient in the course of a physician assistant's practice. 13.26Verbal orders do not include the prescribing of legend drugs unless prescribing authority 13.27has been delegated within the physician-physician assistant delegation agreement.13.28    Sec. 15. Minnesota Statutes 2008, section 147A.02, is amended to read:13.29147A.02 QUALIFICATIONS FOR REGISTRATION LICENSURE.13.30Except as otherwise provided in this chapter, an individual shall be registered13.31licensed by the board before the individual may practice as a physician assistant.13.32The board may grant registration a license as a physician assistant to an applicant 13.33who:13.34(1) submits an application on forms approved by the board;13.35(2) pays the appropriate fee as determined by the board;14.1(3) has current certification from the National Commission on Certification of 14.2Physician Assistants, or its successor agency as approved by the board;14.3(4) certifies that the applicant is mentally and physically able to engage safely in 14.4practice as a physician assistant;14.5(5) has no licensure, certification, or registration as a physician assistant under 14.6current discipline, revocation, suspension, or probation for cause resulting from the 14.7applicant's practice as a physician assistant, unless the board considers the condition 14.8and agrees to licensure;14.9(6) submits any other information the board deems necessary to evaluate the 14.10applicant's qualifications; and14.11(7) has been approved by the board.14.12All persons registered as physician assistants as of June 30, 1995, are eligible for 14.13continuing registration license  renewal. All persons applying for registration licensure14.14after that date shall be registered licensed according to this chapter.14.15    Sec. 16. Minnesota Statutes 2008, section 147A.03, is amended to read:14.16147A.03 PROTECTED TITLES AND RESTRICTIONS ON USE.14.17    Subdivision 1. Protected titles. No individual may use the titles "Minnesota 14.18Registered Licensed Physician Assistant," "Registered Licensed Physician Assistant," 14.19"Physician Assistant," or "PA" in connection with the individual's name, or any other 14.20words, letters, abbreviations, or insignia indicating or implying that the individual is 14.21registered with licensed by the state unless they have been registered licensed according 14.22to this chapter.14.23    Subd. 2. Health care practitioners. Individuals practicing in a health care 14.24occupation are not restricted in the provision of services included in this chapter as long as 14.25they do not hold themselves out as physician assistants by or through the titles provided in 14.26subdivision 1 in association with provision of these services.14.27    Subd. 3.Identification of registered practitioners.Physician assistants in 14.28Minnesota shall wear name tags which identify them as physician assistants.14.29    Subd. 4. Sanctions. Individuals who hold themselves out as physician assistants by 14.30or through any of the titles provided in subdivision 1 without prior registration licensure14.31shall be subject to sanctions or actions against continuing the activity according to section 14.32214.11
         , or other authority.  14.33    Sec. 17. Minnesota Statutes 2008, section 147A.04, is amended to read:14.34147A.04 TEMPORARY PERMIT LICENSE.15.1The board may issue a temporary permit license to practice to a physician assistant 15.2eligible for registration licensure under this chapter only if the application for registration15.3licensure is complete, all requirements have been met, and a nonrefundable fee set by 15.4the board has been paid. The permit temporary license remains valid only until the 15.5next meeting of the board at which a decision is made on the application for registration15.6licensure.15.7    Sec. 18. Minnesota Statutes 2008, section 147A.05, is amended to read:15.8147A.05 INACTIVE REGISTRATION LICENSE.15.9Physician assistants who notify the board in writing on forms prescribed by the board 15.10may elect to place their registrations license on an inactive status. Physician assistants 15.11with an inactive registration license shall be excused from payment of renewal fees and 15.12shall not practice as physician assistants. Persons who engage in practice while their 15.13registrations are license is lapsed or on inactive status shall be considered to be practicing 15.14without registration a license, which shall be grounds for discipline under section 
         147A.13. 15.15Physician assistants who provide care under the provisions of section 147A.23 shall not 15.16be considered practicing without a license or subject to disciplinary action. Physician 15.17assistants requesting restoration from inactive status who notify the board of their intent to 15.18resume active practice shall be required to pay the current renewal fees and all unpaid back 15.19fees and shall be required to meet the criteria for renewal specified in section 
         147A.07.  15.20    Sec. 19. Minnesota Statutes 2008, section 147A.06, is amended to read:15.21147A.06 CANCELLATION OF REGISTRATION LICENSE FOR 15.22NONRENEWAL.15.23The board shall not renew, reissue, reinstate, or restore a registration license that 15.24has lapsed on or after July 1, 1996, and has not been renewed within two annual renewal 15.25cycles starting July 1, 1997. A registrant licensee whose registration license is canceled 15.26for nonrenewal must obtain a new registration license by applying for registration15.27licensure and fulfilling all requirements then in existence for an initial registration license15.28to practice as a physician assistant.15.29    Sec. 20. Minnesota Statutes 2008, section 147A.07, is amended to read:15.30147A.07 RENEWAL.15.31A person who holds a registration license as a physician assistant shall annually, 15.32upon notification from the board, renew the registration license by:15.33(1) submitting the appropriate fee as determined by the board;15.34(2) completing the appropriate forms; and16.1(3) meeting any other requirements of the board;16.2(4) submitting a revised and updated practice setting description showing evidence 16.3of annual review of the physician-physician assistant supervisory agreement.16.4    Sec. 21. Minnesota Statutes 2008, section 147A.08, is amended to read:16.5147A.08 EXEMPTIONS.16.6(a) This chapter does not apply to, control, prevent, or restrict the practice, service, 16.7or activities of persons listed in section 
         147.09, clauses (1) to (6) and (8) to (13), persons 16.8regulated under section 
         214.01, subdivision 2, or persons defined in section 
         144.1501, 16.9subdivision 1
         , paragraphs (f), (h), and (i).16.10(b) Nothing in this chapter shall be construed to require registration licensure of:16.11(1) a physician assistant student enrolled in a physician assistant or surgeon assistant 16.12educational program accredited by the Committee on Allied Health Education and 16.13Accreditation Review Commission on Education for the Physician Assistant or by its 16.14successor agency approved by the board;16.15(2) a physician assistant employed in the service of the federal government while 16.16performing duties incident to that employment; or16.17(3) technicians, other assistants, or employees of physicians who perform delegated 16.18tasks in the office of a physician but who do not identify themselves as a physician 16.19assistant.16.20    Sec. 22. Minnesota Statutes 2008, section 147A.09, is amended to read:16.21147A.09 SCOPE OF PRACTICE, DELEGATION.16.22    Subdivision 1. Scope of practice. Physician assistants shall practice medicine 16.23only with physician supervision. Physician assistants may perform those duties and 16.24responsibilities as delegated in the physician-physician assistant delegation agreement 16.25and delegation forms maintained at the address of record by the supervising physician 16.26and physician assistant, including the prescribing, administering, and dispensing of drugs, 16.27controlled substances, and medical devices and drugs, excluding anesthetics, other than 16.28local anesthetics, injected in connection with an operating room procedure, inhaled 16.29anesthesia and spinal anesthesia.16.30Patient service must be limited to:16.31(1) services within the training and experience of the physician assistant;16.32(2) services customary to the practice of the supervising physician or alternate 16.33supervising physician;16.34(3) services delegated by the supervising physician or alternate supervising physician 16.35under the physician-physician assistant delegation agreement; and17.1(4) services within the parameters of the laws, rules, and standards of the facilities 17.2in which the physician assistant practices.17.3Nothing in this chapter authorizes physician assistants to perform duties regulated 17.4by the boards listed in section 
         214.01, subdivision 2, other than the Board of Medical 17.5Practice, and except as provided in this section.  17.6    Subd. 2. Delegation. Patient services may include, but are not limited to, the 17.7following, as delegated by the supervising physician and authorized in the delegation17.8agreement:17.9(1) taking patient histories and developing medical status reports;17.10(2) performing physical examinations;17.11(3) interpreting and evaluating patient data;17.12(4) ordering or performing diagnostic procedures, including radiography the use of 17.13radiographic imaging systems in compliance with Minnesota Rules 2007, chapter 4732;17.14(5) ordering or performing therapeutic procedures including the use of ionizing 17.15radiation in compliance with Minnesota Rules 2007, chapter 4732;17.16(6) providing instructions regarding patient care, disease prevention, and health 17.17promotion;17.18(7) assisting the supervising physician in patient care in the home and in health 17.19care facilities;17.20(8) creating and maintaining appropriate patient records;17.21(9) transmitting or executing specific orders at the direction of the supervising 17.22physician;17.23(10) prescribing, administering, and dispensing legend drugs, controlled substances,17.24and medical devices if this function has been delegated by the supervising physician 17.25pursuant to and subject to the limitations of section 
         147A.18 and chapter 151. For 17.26physician assistants who have been delegated the authority to prescribe controlled 17.27substances shall maintain a separate addendum to the delegation form which lists all 17.28schedules and categories such delegation shall be included in the physician-physician 17.29assistant delegation agreement, and all schedules of controlled substances which the 17.30physician assistant has the authority to prescribe. This addendum shall be maintained with 17.31the physician-physician assistant agreement, and the delegation form at the address of 17.32record shall be specified;  17.33(11) for physician assistants not delegated prescribing authority, administering 17.34legend drugs and medical devices following prospective review for each patient by and 17.35upon direction of the supervising physician;18.1(12) functioning as an emergency medical technician with permission of the 18.2ambulance service and in compliance with section 
         144E.127, and ambulance service rules 18.3adopted by the commissioner of health;  18.4(13) initiating evaluation and treatment procedures essential to providing an 18.5appropriate response to emergency situations; and18.6(14) certifying a physical disability patient's eligibility for a disability parking 18.7certificate under section 
         169.345, subdivision 2a 2;18.8(15) assisting at surgery; and18.9(16) providing medical authorization for admission for emergency care and 18.10treatment of a patient under section 253B.05, subdivision 2.  18.11Orders of physician assistants shall be considered the orders of their supervising 18.12physicians in all practice-related activities, including, but not limited to, the ordering of 18.13diagnostic, therapeutic, and other medical services.18.14    Sec. 23. Minnesota Statutes 2008, section 147A.11, is amended to read:18.15147A.11 EXCLUSIONS OF LIMITATIONS ON EMPLOYMENT.18.16Nothing in this chapter shall be construed to limit the employment arrangement of a 18.17physician assistant registered licensed under this chapter.18.18    Sec. 24. Minnesota Statutes 2008, section 147A.13, is amended to read:18.19147A.13 GROUNDS FOR DISCIPLINARY ACTION.18.20    Subdivision 1. Grounds listed. The board may refuse to grant registration licensure18.21or may impose disciplinary action as described in this subdivision against any physician 18.22assistant. The following conduct is prohibited and is grounds for disciplinary action:18.23(1) failure to demonstrate the qualifications or satisfy the requirements for 18.24registration licensure contained in this chapter or rules of the board. The burden of proof 18.25shall be upon the applicant to demonstrate such qualifications or satisfaction of such 18.26requirements;18.27(2) obtaining registration a license by fraud or cheating, or attempting to subvert 18.28the examination process. Conduct which subverts or attempts to subvert the examination 18.29process includes, but is not limited to:18.30(i) conduct which violates the security of the examination materials, such as 18.31removing examination materials from the examination room or having unauthorized 18.32possession of any portion of a future, current, or previously administered licensing 18.33examination;18.34(ii) conduct which violates the standard of test administration, such as 18.35communicating with another examinee during administration of the examination, copying 19.1another examinee's answers, permitting another examinee to copy one's answers, or 19.2possessing unauthorized materials; and19.3(iii) impersonating an examinee or permitting an impersonator to take the 19.4examination on one's own behalf;19.5(3) conviction, during the previous five years, of a felony reasonably related to the 19.6practice of physician assistant. Conviction as used in this subdivision includes a conviction 19.7of an offense which if committed in this state would be deemed a felony without regard to 19.8its designation elsewhere, or a criminal proceeding where a finding or verdict of guilt is 19.9made or returned but the adjudication of guilt is either withheld or not entered;19.10(4) revocation, suspension, restriction, limitation, or other disciplinary action against 19.11the person's physician assistant credentials in another state or jurisdiction, failure to 19.12report to the board that charges regarding the person's credentials have been brought in 19.13another state or jurisdiction, or having been refused registration licensure by any other 19.14state or jurisdiction;19.15(5) advertising which is false or misleading, violates any rule of the board, or claims 19.16without substantiation the positive cure of any disease or professional superiority to or 19.17greater skill than that possessed by another physician assistant;19.18(6) violating a rule adopted by the board or an order of the board, a state, or federal 19.19law which relates to the practice of a physician assistant, or in part regulates the practice 19.20of a physician assistant, including without limitation sections 
         148A.02, 
         609.344, and 19.21609.345
         , or a state or federal narcotics or controlled substance law; 19.22(7) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm 19.23the public, or demonstrating a willful or careless disregard for the health, welfare, or 19.24safety of a patient; or practice which is professionally incompetent, in that it may create 19.25unnecessary danger to any patient's life, health, or safety, in any of which cases, proof 19.26of actual injury need not be established;19.27(8) failure to adhere to the provisions of the physician-physician assistant delegation19.28agreement;19.29(9) engaging in the practice of medicine beyond that allowed by the 19.30physician-physician assistant delegation agreement, including the delegation form or 19.31the addendum to the delegation form, or aiding or abetting an unlicensed person in the 19.32practice of medicine;19.33(10) adjudication as mentally incompetent, mentally ill or developmentally disabled, 19.34or as a chemically dependent person, a person dangerous to the public, a sexually 19.35dangerous person, or a person who has a sexual psychopathic personality by a court of 20.1competent jurisdiction, within or without this state. Such adjudication shall automatically 20.2suspend a registration license for its duration unless the board orders otherwise;20.3(11) engaging in unprofessional conduct. Unprofessional conduct includes any 20.4departure from or the failure to conform to the minimal standards of acceptable and 20.5prevailing practice in which proceeding actual injury to a patient need not be established;20.6(12) inability to practice with reasonable skill and safety to patients by reason of 20.7illness, drunkenness, use of drugs, narcotics, chemicals, or any other type of material, or 20.8as a result of any mental or physical condition, including deterioration through the aging 20.9process or loss of motor skills;20.10(13) revealing a privileged communication from or relating to a patient except when 20.11otherwise required or permitted by law;20.12(14) any use of identification of a physician assistant by the title "Physician," 20.13"Doctor," or "Dr." in a patient care setting or in a communication directed to the general 20.14public;20.15(15) improper management of medical records, including failure to maintain 20.16adequate medical records, to comply with a patient's request made pursuant to sections 20.17144.291
          to 144.298, or to furnish a medical record or report required by law; 20.18(16) engaging in abusive or fraudulent billing practices, including violations of the 20.19federal Medicare and Medicaid laws or state medical assistance laws;20.20(17) becoming addicted or habituated to a drug or intoxicant;20.21(18) prescribing a drug or device for other than medically accepted therapeutic, 20.22experimental, or investigative purposes authorized by a state or federal agency or referring 20.23a patient to any health care provider as defined in sections 
         144.291 to 144.298 for services 20.24or tests not medically indicated at the time of referral; 20.25(19) engaging in conduct with a patient which is sexual or may reasonably be 20.26interpreted by the patient as sexual, or in any verbal behavior which is seductive or 20.27sexually demeaning to a patient;20.28(20) failure to make reports as required by section 
         147A.14 or to cooperate with an 20.29investigation of the board as required by section 
         147A.15, subdivision 3; 20.30(21) knowingly providing false or misleading information that is directly related 20.31to the care of that patient unless done for an accepted therapeutic purpose such as the 20.32administration of a placebo;20.33(22) aiding suicide or aiding attempted suicide in violation of section 
         609.215 as 20.34established by any of the following: 20.35(i) a copy of the record of criminal conviction or plea of guilty for a felony in 20.36violation of section 
         609.215, subdivision 1 or 2; 21.1(ii) a copy of the record of a judgment of contempt of court for violating an 21.2injunction issued under section 
         609.215, subdivision 4; 21.3(iii) a copy of the record of a judgment assessing damages under section 
         609.215, 21.4subdivision 5
         ; or 21.5(iv) a finding by the board that the person violated section 
         609.215, subdivision 1 or 21.62. The board shall investigate any complaint of a violation of section 
         609.215, subdivision 21.71
          or 2; or 21.8(23) failure to maintain annually reviewed and updated physician-physician 21.9assistant delegation agreements, internal protocols, or prescribing delegation forms for 21.10each physician-physician assistant practice relationship, or failure to provide copies of 21.11such documents upon request by the board.21.12    Subd. 2. Effective dates, automatic suspension. A suspension, revocation, 21.13condition, limitation, qualification, or restriction of a registration license shall be in effect 21.14pending determination of an appeal unless the court, upon petition and for good cause 21.15shown, orders otherwise.21.16A physician assistant registration license is automatically suspended if:21.17(1) a guardian of a registrant licensee is appointed by order of a court pursuant to 21.18sections 
         524.5-101 to 
         524.5-502, for reasons other than the minority of the registrant21.19licensee; or 21.20(2) the registrant licensee is committed by order of a court pursuant to chapter 21.21253B. The registration license remains suspended until the registrant licensee is restored 21.22to capacity by a court and, upon petition by the registrant licensee, the suspension is 21.23terminated by the board after a hearing.21.24    Subd. 3. Conditions on reissued registration license. In its discretion, the board 21.25may restore and reissue a physician assistant registration license, but may impose as a 21.26condition any disciplinary or corrective measure which it might originally have imposed.21.27    Subd. 4. Temporary suspension of registration license. In addition to any other 21.28remedy provided by law, the board may, without a hearing, temporarily suspend the 21.29registration license of a physician assistant if the board finds that the physician assistant has 21.30violated a statute or rule which the board is empowered to enforce and continued practice 21.31by the physician assistant would create a serious risk of harm to the public. The suspension 21.32shall take effect upon written notice to the physician assistant, specifying the statute or 21.33rule violated. The suspension shall remain in effect until the board issues a final order 21.34in the matter after a hearing. At the time it issues the suspension notice, the board shall 21.35schedule a disciplinary hearing to be held pursuant to the Administrative Procedure Act.22.1The physician assistant shall be provided with at least 20 days' notice of any hearing 22.2held pursuant to this subdivision. The hearing shall be scheduled to begin no later than 30 22.3days after the issuance of the suspension order.22.4    Subd. 5. Evidence. In disciplinary actions alleging a violation of subdivision 22.51, clause (3) or (4), a copy of the judgment or proceeding under the seal of the court 22.6administrator or of the administrative agency which entered it shall be admissible into 22.7evidence without further authentication and shall constitute prima facie evidence of the 22.8contents thereof.22.9    Subd. 6. Mental examination; access to medical data. (a) If the board has 22.10probable cause to believe that a physician assistant comes under subdivision 1, clause 22.11(1), it may direct the physician assistant to submit to a mental or physical examination. 22.12For the purpose of this subdivision, every physician assistant registered licensed under 22.13this chapter is deemed to have consented to submit to a mental or physical examination 22.14when directed in writing by the board and further to have waived all objections to the 22.15admissibility of the examining physicians' testimony or examination reports on the ground 22.16that the same constitute a privileged communication. Failure of a physician assistant to 22.17submit to an examination when directed constitutes an admission of the allegations against 22.18the physician assistant, unless the failure was due to circumstance beyond the physician 22.19assistant's control, in which case a default and final order may be entered without the 22.20taking of testimony or presentation of evidence. A physician assistant affected under this 22.21subdivision shall at reasonable intervals be given an opportunity to demonstrate that 22.22the physician assistant can resume competent practice with reasonable skill and safety 22.23to patients. In any proceeding under this subdivision, neither the record of proceedings 22.24nor the orders entered by the board shall be used against a physician assistant in any 22.25other proceeding.22.26(b) In addition to ordering a physical or mental examination, the board may, 22.27notwithstanding sections 
         13.384, 
         144.651, or any other law limiting access to medical or 22.28other health data, obtain medical data and health records relating to a registrant licensee or 22.29applicant without the registrant's licensee's or applicant's consent if the board has probable 22.30cause to believe that a physician assistant comes under subdivision 1, clause (1). 22.31The medical data may be requested from a provider, as defined in section 
         144.291, 22.32subdivision 2
         , paragraph (h), an insurance company, or a government agency, including 22.33the Department of Human Services. A provider, insurance company, or government 22.34agency shall comply with any written request of the board under this subdivision and is not 22.35liable in any action for damages for releasing the data requested by the board if the data 22.36are released pursuant to a written request under this subdivision, unless the information 23.1is false and the provider giving the information knew, or had reason to believe, the 23.2information was false. Information obtained under this subdivision is classified as private 23.3under chapter 13. 23.4    Subd. 7. Tax clearance certificate. (a) In addition to the provisions of subdivision 23.51, the board may not issue or renew a registration license if the commissioner of revenue 23.6notifies the board and the registrant licensee or applicant for registration licensure that the 23.7registrant licensee or applicant owes the state delinquent taxes in the amount of $500 or 23.8more. The board may issue or renew the registration license only if:23.9(1) the commissioner of revenue issues a tax clearance certificate; and23.10(2) the commissioner of revenue, the registrant licensee, or the applicant forwards a 23.11copy of the clearance to the board.23.12The commissioner of revenue may issue a clearance certificate only if the registrant23.13licensee or applicant does not owe the state any uncontested delinquent taxes.23.14(b) For purposes of this subdivision, the following terms have the meanings given:23.15(1) "Taxes" are all taxes payable to the commissioner of revenue, including penalties 23.16and interest due on those taxes, and23.17(2) "Delinquent taxes" do not include a tax liability if:23.18(i) an administrative or court action that contests the amount or validity of the 23.19liability has been filed or served;23.20(ii) the appeal period to contest the tax liability has not expired; or23.21(iii) the licensee or applicant has entered into a payment agreement to pay the 23.22liability and is current with the payments.23.23(c) When a registrant licensee or applicant is required to obtain a clearance certificate 23.24under this subdivision, a contested case hearing must be held if the registrant licensee or 23.25applicant requests a hearing in writing to the commissioner of revenue within 30 days of 23.26the date of the notice provided in paragraph (a). The hearing must be held within 45 days 23.27of the date the commissioner of revenue refers the case to the Office of Administrative 23.28Hearings. Notwithstanding any law to the contrary, the licensee or applicant must be 23.29served with 20 days' notice in writing specifying the time and place of the hearing and 23.30the allegations against the registrant or applicant. The notice may be served personally or 23.31by mail.23.32(d) The board shall require all registrants licensees or applicants to provide their 23.33Social Security number and Minnesota business identification number on all registration23.34license applications. Upon request of the commissioner of revenue, the board must 23.35provide to the commissioner of revenue a list of all registrants licensees and applicants, 23.36including their names and addresses, Social Security numbers, and business identification 24.1numbers. The commissioner of revenue may request a list of the registrants licensees and 24.2applicants no more than once each calendar year.24.3    Subd. 8.Limitation.No board proceeding against a licensee shall be instituted 24.4unless commenced within seven years from the date of commission of some portion of the 24.5offense except for alleged violations of subdivision 1, paragraph (19), or subdivision 7.24.6    Sec. 25. Minnesota Statutes 2008, section 147A.16, is amended to read:24.7147A.16 FORMS OF DISCIPLINARY ACTION.24.8When the board finds that a registered licensed physician assistant has violated a 24.9provision of this chapter, it may do one or more of the following:24.10(1) revoke the registration license;24.11(2) suspend the registration license;24.12(3) impose limitations or conditions on the physician assistant's practice, including 24.13limiting the scope of practice to designated field specialties; impose retraining or 24.14rehabilitation requirements; require practice under additional supervision; or condition 24.15continued practice on demonstration of knowledge or skills by appropriate examination 24.16or other review of skill and competence;24.17(4) impose a civil penalty not exceeding $10,000 for each separate violation, the 24.18amount of the civil penalty to be fixed so as to deprive the physician assistant of any 24.19economic advantage gained by reason of the violation charged or to reimburse the board 24.20for the cost of the investigation and proceeding;24.21(5) order the physician assistant to provide unremunerated professional service 24.22under supervision at a designated public hospital, clinic, or other health care institution; or24.23(6) censure or reprimand the registered licensed physician assistant.24.24Upon judicial review of any board disciplinary action taken under this chapter, the 24.25reviewing court shall seal the administrative record, except for the board's final decision, 24.26and shall not make the administrative record available to the public.24.27    Sec. 26. Minnesota Statutes 2008, section 147A.18, is amended to read:24.28147A.18 DELEGATED AUTHORITY TO PRESCRIBE, DISPENSE, AND 24.29ADMINISTER DRUGS AND MEDICAL DEVICES.24.30    Subdivision 1. Delegation. (a) A supervising physician may delegate to a 24.31physician assistant who is registered with licensed by the board, certified by the National 24.32Commission on Certification of Physician Assistants or successor agency approved by the 24.33board, and who is under the supervising physician's supervision, the authority to prescribe, 24.34dispense, and administer legend drugs, medical devices, and controlled substances, and 24.35medical devices subject to the requirements in this section. The authority to dispense 25.1includes, but is not limited to, the authority to request, receive, and dispense sample drugs. 25.2This authority to dispense extends only to those drugs described in the written agreement 25.3developed under paragraph (b).25.4(b) The delegation agreement between the physician assistant and supervising 25.5physician and any alternate supervising physicians must include a statement by the 25.6supervising physician regarding delegation or nondelegation of the functions of 25.7prescribing, dispensing, and administering of legend drugs, controlled substances,  and 25.8medical devices to the physician assistant. The statement must include a protocol 25.9indicating categories of drugs for which the supervising physician delegates prescriptive 25.10and dispensing authority including controlled substances when applicable. The delegation 25.11must be appropriate to the physician assistant's practice and within the scope of the 25.12physician assistant's training. Physician assistants who have been delegated the authority 25.13to prescribe, dispense, and administer legend drugs, controlled substances, and medical 25.14devices shall provide evidence of current certification by the National Commission 25.15on Certification of Physician Assistants or its successor agency when registering or 25.16reregistering applying for licensure or license renewal as physician assistants. Physician 25.17assistants who have been delegated the authority to prescribe controlled substances must 25.18present evidence of the certification andalso hold a valid DEA certificate registration. 25.19Supervising physicians shall retrospectively review the prescribing, dispensing, and 25.20administering of legend and controlled drugs, controlled substances, and medical devices 25.21by physician assistants, when this authority has been delegated to the physician assistant as 25.22part of the physician-physician assistant delegation agreement between the physician and 25.23the physician assistant. This review must take place as outlined in the internal protocol. 25.24The process and schedule for the review must be outlined in the physician-physician 25.25assistant delegation agreement.25.26(c) The board may establish by rule:25.27(1) a system of identifying physician assistants eligible to prescribe, administer, and 25.28dispense legend drugs and medical devices;25.29(2) a system of identifying physician assistants eligible to prescribe, administer, and 25.30dispense controlled substances;25.31(3) a method of determining the categories of legend and controlled drugs, controlled 25.32substances, and medical devices that each physician assistant is allowed to prescribe, 25.33administer, and dispense; and25.34(4) a system of transmitting to pharmacies a listing of physician assistants eligible to 25.35prescribe legend and controlled drugs, controlled substances, and medical devices.26.1    Subd. 2. Termination and reinstatement of prescribing authority.(a) The 26.2authority of a physician assistant to prescribe, dispense, and administer legend drugs, 26.3controlled substances, and medical devices shall end immediately when:26.4(1) the physician-physician assistant delegation agreement is terminated;26.5(2) the authority to prescribe, dispense, and administer is terminated or withdrawn 26.6by the supervising physician; or26.7(3) the physician assistant reverts toassistant's license is placed on  inactive status, 26.8loses National Commission on Certification of Physician Assistants or successor agency 26.9certification, or loses or terminates registration status;26.10(4) the physician assistant loses National Commission on Certification of Physician 26.11Assistants or successor agency certification; or26.12(5) the physician assistant loses or terminates licensure status.26.13(b) The physician assistant must notify the board in writing within ten days of the 26.14occurrence of any of the circumstances listed in paragraph (a).26.15(c) Physician assistants whose authority to prescribe, dispense, and administer 26.16has been terminated shall reapply for reinstatement of prescribing authority under this 26.17section and meet any requirements established by the board prior to reinstatement of the 26.18prescribing, dispensing, and administering authority.26.19    Subd. 3. Other requirements and restrictions.(a) The supervising physician and 26.20the physician assistant must complete, sign, and date an internal protocol which lists each 26.21category of drug or medical device, or controlled substance the physician assistant may 26.22prescribe, dispense, and administer. The supervising physician and physician assistant 26.23shall submit the internal protocol to the board upon request. The supervising physician 26.24may amend the internal protocol as necessary, within the limits of the completed delegation 26.25form in subdivision 5. The supervising physician and physician assistant must sign and 26.26date any amendments to the internal protocol. Any amendments resulting in a change to 26.27an addition or deletion to categories delegated in the delegation form in subdivision 5 must 26.28be submitted to the board according to this chapter, along with the fee required.26.29(b) The supervising physician and physician assistant shall review delegation of 26.30prescribing, dispensing, and administering authority on an annual basis at the time of 26.31reregistration. The internal protocol must be signed and dated by the supervising physician 26.32and physician assistant after review. Any amendments to the internal protocol resulting in 26.33changes to the delegation form in subdivision 5 must be submitted to the board according 26.34to this chapter, along with the fee required.26.35(c)(a) Each prescription initiated by a physician assistant shall indicate the 26.36following:27.1(1) the date of issue;27.2(2) the name and address of the patient;27.3(3) the name and quantity of the drug prescribed;27.4(4) directions for use; and27.5(5) the name and address of the prescribing physician assistant.27.6(d) (b) In prescribing, dispensing, and administering legend drugs, controlled 27.7substances, and medical devices, including controlled substances as defined in section 27.8152.01, subdivision 4, a physician assistant must conform with the agreement, chapter 27.9151, and this chapter.27.10    Subd. 4.Notification of pharmacies.(a) The board shall annually provide to the 27.11Board of Pharmacy and to registered pharmacies within the state a list of those physician 27.12assistants who are authorized to prescribe, administer, and dispense legend drugs and 27.13medical devices, or controlled substances.27.14(b) The board shall provide to the Board of Pharmacy a list of physician assistants 27.15authorized to prescribe legend drugs and medical devices every two months if additional 27.16physician assistants are authorized to prescribe or if physician assistants have authorization 27.17to prescribe withdrawn.27.18(c) The list must include the name, address, telephone number, and Minnesota 27.19registration number of the physician assistant, and the name, address, telephone number, 27.20and Minnesota license number of the supervising physician.27.21(d) The board shall provide the form in subdivision 5 to pharmacies upon request.27.22(e) The board shall make available prototype forms of the physician-physician 27.23assistant agreement, the internal protocol, the delegation form, and the addendum form.27.24    Subd. 5.Delegation form for physician assistant prescribing.The delegation 27.25form for physician assistant prescribing must contain a listing by drug category of the 27.26legend drugs and controlled substances for which prescribing authority has been delegated 27.27to the physician assistant.27.28    Sec. 27. Minnesota Statutes 2008, section 147A.19, is amended to read:27.29147A.19 IDENTIFICATION REQUIREMENTS.27.30Physician assistants registered licensed under this chapter shall keep their 27.31registration license available for inspection at their primary place of business and shall, 27.32when engaged in their professional activities, wear a name tag identifying themselves as 27.33a "physician assistant."27.34    Sec. 28. Minnesota Statutes 2008, section 147A.20, is amended to read:28.1147A.20 PHYSICIAN AND PHYSICIAN PHYSICIAN-PHYSICIAN28.2ASSISTANT AGREEMENT DOCUMENTS.28.3    Subdivision 1.Physician-physician assistant delegation agreement. (a) A 28.4physician assistant and supervising physician must sign an a physician-physician assistant 28.5delegation agreement which specifies scope of practice and amount and manner of 28.6supervision as required by the board. The agreement must contain:28.7(1) a description of the practice setting;28.8(2) a statement of practice type/specialty;28.9(3) a listing of categories of delegated duties;28.10(4) (3) a description of supervision type, amount, and frequency; and28.11(5) (4) a description of the process and schedule for review of prescribing, 28.12dispensing, and administering legend and controlled drugs and medical devices by the 28.13physician assistant authorized to prescribe.28.14(b) The agreement must be maintained by the supervising physician and physician 28.15assistant and made available to the board upon request. If there is a delegation of 28.16prescribing, administering, and dispensing of legend drugs, controlled substances, and 28.17medical devices, the agreement shall include an internal protocol and delegation form a 28.18description of the prescriptive authority delegated to the physician assistant. Physician 28.19assistants shall have a separate agreement for each place of employment. Agreements 28.20must be reviewed and updated on an annual basis. The supervising physician and 28.21physician assistant must maintain the physician-physician assistant delegation agreement, 28.22delegation form, and internal protocol at the address of record. Copies shall be provided to 28.23the board upon request.28.24(c) Physician assistants must provide written notification to the board within 30 28.25days of the following:28.26(1) name change;28.27(2) address of record change; and28.28(3) telephone number of record change; and28.29(4) addition or deletion of alternate supervising physician provided that the 28.30information submitted includes, for an additional alternate physician, an affidavit of 28.31consent to act as an alternate supervising physician signed by the alternate supervising 28.32physician.28.33(d) Modifications requiring submission prior to the effective date are changes to the 28.34practice setting description which include:28.35(1) supervising physician change, excluding alternate supervising physicians; or29.1(2) delegation of prescribing, administering, or dispensing of legend drugs, 29.2controlled substances, or medical devices.29.3(e) The agreement must be completed and the practice setting description submitted 29.4to the board before providing medical care as a physician assistant.29.5(d) Any alternate supervising physicians must be identified in the physician-physician 29.6assistant delegation agreement, or a supplemental listing, and must sign the agreement 29.7attesting that they shall provide the physician assistant with supervision in compliance 29.8with this chapter, the delegation agreement, and board rules.29.9    Subd. 2.Notification of intent to practice.A licensed physician assistant shall 29.10submit a notification of intent to practice to the board prior to beginning practice. The 29.11notification shall include the name, business address, and telephone number of the 29.12supervising physician and the physician assistant. Individuals who practice without 29.13submitting a notification of intent to practice shall be subject to disciplinary action under 29.14section 147A.13 for practicing without a license, unless the care is provided in response to 29.15a disaster or emergency situation pursuant to section 147A.23.29.16    Sec. 29. Minnesota Statutes 2008, section 147A.21, is amended to read:29.17147A.21 RULEMAKING AUTHORITY.29.18The board shall adopt rules:29.19(1) setting registration license fees;29.20(2) setting renewal fees;29.21(3) setting fees for locum tenens permits;29.22(4) setting fees for temporary registration licenses; and29.23(5) (4) establishing renewal dates.29.24    Sec. 30. Minnesota Statutes 2008, section 147A.23, is amended to read:29.25147A.23 RESPONDING TO DISASTER SITUATIONS.29.26(a) A registered physician assistant or a physician assistant duly licensed or 29.27credentialed in a United States jurisdiction or by a federal employer who is responding 29.28to a need for medical care created by an emergency according to section 604A.01, or a 29.29state or local disaster may render such care as the physician assistant is able trained to 29.30provide, under the physician assistant's license, registration, or credential, without the 29.31need of a physician and physician physician-physician assistant delegation agreement or 29.32a notice of intent to practice as required under section 
         147A.20. Physician supervision, 29.33as required under section 147A.09, must be provided under the direction of a physician 29.34licensed under chapter 147 who is involved with the disaster response. The physician 29.35assistant must establish a temporary supervisory agreement with the physician providing 30.1supervision before rendering care.A physician assistant may provide emergency care 30.2without physician supervision or under the supervision that is available.30.3(b) The physician who provides supervision to a physician assistant while the 30.4physician assistant is rendering care in a disaster in accordance with this section may do 30.5so without meeting the requirements of section 
         147A.20.  30.6(c) The supervising physician who otherwise provides supervision to a physician 30.7assistant under a physician and physician physician-physician assistant delegation30.8agreement described in section 
         147A.20 shall not be held medically responsible for the 30.9care rendered by a physician assistant pursuant to paragraph (a). Services provided by 30.10a physician assistant under paragraph (a) shall be considered outside the scope of the 30.11relationship between the supervising physician and the physician assistant.  30.12    Sec. 31. Minnesota Statutes 2008, section 147A.24, is amended to read:30.13147A.24 CONTINUING EDUCATION REQUIREMENTS.30.14    Subdivision 1. Amount of education required. Applicants for registration license30.15renewal or reregistration must either meet standards for continuing education through 30.16current certification by the National Commission on Certification of Physician Assistants, 30.17or its successor agency as approved by the board, orattest to and documentprovide 30.18evidence of successful completion of at least 50 contact hours of continuing education 30.19within the two years immediately preceding registration license renewal, reregistration, 30.20or attest to and document taking the national certifying examination required by this 30.21chapter within the past two years.30.22    Subd. 2. Type of education required.Approved Continuing education is approved 30.23if it is equivalent to category 1 credit hours as defined by the American Osteopathic 30.24Association Bureau of Professional Education, the Royal College of Physicians and 30.25Surgeons of Canada, the American Academy of Physician Assistants, or by organizations 30.26that have reciprocal arrangements with the physician recognition award program of the 30.27American Medical Association.30.28    Sec. 32. Minnesota Statutes 2008, section 147A.26, is amended to read:30.29147A.26 PROCEDURES.30.30The board shall establish, in writing, internal operating procedures for receiving and 30.31investigating complaints, accepting and processing applications, granting registrations30.32licenses, and imposing enforcement actions. The written internal operating procedures 30.33may include procedures for sharing complaint information with government agencies in 30.34this and other states. Procedures for sharing complaint information must be consistent 30.35with the requirements for handling government data under chapter 13.31.1    Sec. 33. Minnesota Statutes 2008, section 147A.27, is amended to read:31.2147A.27 PHYSICIAN ASSISTANT ADVISORY COUNCIL.31.3    Subdivision 1. Membership. (a) The Physician Assistant Advisory Council is 31.4created and is composed of seven persons appointed by the board. The seven persons 31.5must include:31.6(1) two public members, as defined in section 
         214.02;  31.7(2) three physician assistants registered licensed under this chapter who meet the 31.8criteria for a new applicant under section 147A.02; and31.9(3) two licensed physicians with experience supervising physician assistants.31.10(b) No member shall serve more than a total of two consecutive  terms. If a member 31.11is appointed for a partial term and serves more than half of that term it shall be considered 31.12a full term. Members serving on the council as of July 1, 2000, shall be allowed to 31.13complete their current terms.31.14    Subd. 2. Organization. The council shall be organized and administered under 31.15section 
         15.059.31.16    Subd. 3. Duties. The council shall advise the board regarding:31.17(1) physician assistant registration licensure standards;31.18(2) enforcement of grounds for discipline;31.19(3) distribution of information regarding physician assistant registration licensure31.20standards;31.21(4) applications and recommendations of applicants for registration licensure or 31.22registration license renewal; and31.23(5) complaints and recommendations to the board regarding disciplinary matters and 31.24proceedings concerning applicants and registrants licensees according to sections 
         214.10; 31.25214.103
         ; and 
         214.13, subdivisions 6 and 7; and31.26(6) issues related to physician assistant practice and regulation.  31.27The council shall perform other duties authorized for the council by chapter 214 31.28as directed by the board.31.29    Sec. 34. Minnesota Statutes 2008, section 148.06, subdivision 1, is amended to read:31.30    Subdivision 1. License required; qualifications. No person shall practice 31.31chiropractic in this state without first being licensed by the state Board of Chiropractic 31.32Examiners. The applicant shall have earned at least one-half of all academic credits 31.33required for awarding of a baccalaureate degree from the University of Minnesota, or 31.34other university, college, or community college of equal standing, in subject matter 31.35determined by the board, and taken a four-year resident course of at least eight months 32.1each in a school or college of chiropractic or in a chiropractic program that is accredited 32.2by the Council on Chiropractic Education, holds a recognition agreement with the 32.3Council on Chiropractic Education, or is accredited by an agency approved by the United 32.4States Office of Education or their successors as of January 1, 1988, or is approved by a 32.5Council on Chiropractic Education member organization of the Council on Chiropractic 32.6International. The board may issue licenses to practice chiropractic without compliance 32.7with prechiropractic or academic requirements listed above if in the opinion of the board 32.8the applicant has the qualifications equivalent to those required of other applicants, the 32.9applicant satisfactorily passes written and practical examinations as required by the Board 32.10of Chiropractic Examiners, and the applicant is a graduate of a college of chiropractic 32.11with a recognition agreement with the Council on Chiropractic Education approved by a 32.12Council on Chiropractic Education member organization of the Council on Chiropractic 32.13International. The board may recommend a two-year prechiropractic course of instruction 32.14to any university, college, or community college which in its judgment would satisfy the 32.15academic prerequisite for licensure as established by this section.32.16An examination for a license shall be in writing and shall include testing in:32.17(a) The basic sciences including but not limited to anatomy, physiology, bacteriology, 32.18pathology, hygiene, and chemistry as related to the human body or mind;32.19(b) The clinical sciences including but not limited to the science and art of 32.20chiropractic, chiropractic physiotherapy, diagnosis, roentgenology, and nutrition; and32.21(c) Professional ethics and any other subjects that the board may deem advisable.32.22The board may consider a valid certificate of examination from the National Board 32.23of Chiropractic Examiners as evidence of compliance with the examination requirements 32.24of this subdivision. The applicant shall be required to give practical demonstration in 32.25vertebral palpation, neurology, adjusting and any other subject that the board may deem 32.26advisable. A license, countersigned by the members of the board and authenticated by the 32.27seal thereof, shall be granted to each applicant who correctly answers 75 percent of the 32.28questions propounded in each of the subjects required by this subdivision and meets the 32.29standards of practical demonstration established by the board. Each application shall be 32.30accompanied by a fee set by the board. The fee shall not be returned but the applicant 32.31may, within one year, apply for examination without the payment of an additional fee. The 32.32board may grant a license to an applicant who holds a valid license to practice chiropractic 32.33issued by the appropriate licensing board of another state, provided the applicant meets 32.34the other requirements of this section and satisfactorily passes a practical examination 32.35approved by the board. The burden of proof is on the applicant to demonstrate these 32.36qualifications or satisfaction of these requirements.33.1    Sec. 35. [148.107] RECORD KEEPING.33.2All items in this section should be contained in the patient record, including, but not 33.3limited to, paragraphs (a), (b), (c), (e), (g), and (i).33.4(a) A description of past conditions and trauma, past treatment received, current 33.5treatment being received from other health care providers, and a description of the patient's 33.6current condition including onset and description of trauma if trauma occurred.33.7(b) Examinations performed to determine a preliminary or final diagnosis based on 33.8indicated diagnostic tests, with a record of findings of each test performed.33.9(c) A diagnosis supported by documented subjective and objective findings, or 33.10clearly qualified as an opinion.33.11(d) A treatment plan that describes the procedures and treatment used for the 33.12conditions identified, including approximate frequency of care.33.13(e) Daily notes documenting current subjective complaints as described by the 33.14patient, any change in objective findings if noted during that visit, a listing of all 33.15procedures provided during that visit, and all information that is exchanged and will affect 33.16that patient's treatment.33.17(f) A description by the chiropractor or written by the patient each time an incident 33.18occurs that results in an aggravation of the patient's condition or a new developing 33.19condition.33.20(g) Results of reexaminations that are performed to evaluate significant changes in 33.21a patient's condition, including tests that were positive or deviated from results used to 33.22indicate normal findings.33.23(h) When symbols or abbreviations are used, a key that explains their meanings must 33.24accompany each file when requested in writing by the patient or a third party.33.25(i) Documentation that family history has been evaluated.33.26    Sec. 36. Minnesota Statutes 2008, section 148.624, subdivision 2, is amended to read:33.27    Subd. 2. Nutrition. The board shall issue a license as a nutritionist to a person who 33.28files a completed application, pays all required fees, and certifies and furnishes evidence 33.29satisfactory to the board that the applicant:33.30(1) meets the following qualifications:33.31(i) has received a master's or doctoral degree from an accredited or approved college 33.32or university with a major in human nutrition, public health nutrition, clinical nutrition, 33.33nutrition education, community nutrition, or food and nutrition; and33.34(ii) has completed a documented supervised preprofessional practice experience 33.35component in dietetic practice of not less than 900 hours under the supervision of a 33.36registered dietitian, a state licensed nutrition professional, or an individual with a doctoral 34.1degree conferred by a United States regionally accredited college or university with a 34.2major course of study in human nutrition, nutrition education, food and nutrition, dietetics, 34.3or food systems management. Supervised practice experience must be completed in the 34.4United States or its territories. Supervisors who obtain their doctoral degree outside the 34.5United States and its territories must have their degrees validated as equivalent to the 34.6doctoral degree conferred by a United States regionally accredited college or university; or34.7(2) has qualified as a diplomate of the American Board of Nutrition, Springfield, 34.8Virginia received certification as a Certified Nutrition Specialist by the Certification Board 34.9for Nutrition Specialists.34.10    Sec. 37. Minnesota Statutes 2008, section 148.89, subdivision 5, is amended to read:34.11    Subd. 5. Practice of psychology. "Practice of psychology" means the observation, 34.12description, evaluation, interpretation, or modification of human behavior by the 34.13application of psychological principles, methods, or procedures for any reason, including 34.14to prevent, eliminate, or manage symptomatic, maladaptive, or undesired behavior and to 34.15enhance interpersonal relationships, work, life and developmental adjustment, personal 34.16and organizational effectiveness, behavioral health, and mental health. The practice of 34.17psychology includes, but is not limited to, the following services, regardless of whether 34.18the provider receives payment for the services:34.19(1) psychological research and teaching of psychology;34.20(2) assessment, including psychological testing and other means of evaluating 34.21personal characteristics such as intelligence, personality, abilities, interests, aptitudes, and 34.22neuropsychological functioning;34.23(3) a psychological report, whether written or oral, including testimony of a provider 34.24as an expert witness, concerning the characteristics of an individual or entity;34.25(4) psychotherapy, including but not limited to, categories such as behavioral, 34.26cognitive, emotive, systems, psychophysiological, or insight-oriented therapies; 34.27counseling; hypnosis; and diagnosis and treatment of:34.28(i) mental and emotional disorder or disability;34.29(ii) alcohol and substance dependence or abuse;34.30(iii) disorders of habit or conduct;34.31(iv) the psychological aspects of physical illness or condition, accident, injury, or 34.32disability, including the psychological impact of medications;34.33(v) life adjustment issues, including work-related and bereavement issues; and34.34(vi) child, family, or relationship issues;34.35(5) psychoeducational services and treatment; and34.36(6) consultation and supervision.35.1    Sec. 38. Minnesota Statutes 2008, section 148.995, subdivision 2, is amended to read:35.2    Subd. 2. Certified doula. "Certified doula" means an individual who has received 35.3a certification to perform doula services from the International Childbirth Education 35.4Association, the Doulas of North America (DONA), the Association of Labor Assistants 35.5and Childbirth Educators (ALACE), Birthworks, Childbirth and Postpartum Professional 35.6Association (CAPPA), or Childbirth International, or International Center for Traditional 35.7Childbearing.35.8    Sec. 39. Minnesota Statutes 2008, section 148.995, subdivision 4, is amended to read:35.9    Subd. 4. Doula services. "Doula services" means continuous emotional and 35.10physical support during pregnancy, labor, birth, and postpartum throughout labor and 35.11birth, and intermittently during the prenatal and postpartum periods.35.12    Sec. 40. Minnesota Statutes 2008, section 150A.01, subdivision 8, is amended to read:35.13    Subd. 8. Registered Licensed dental assistant. "Registered Licensed dental 35.14assistant" means a person registered licensed pursuant to section 
         150A.06.35.15    Sec. 41. Minnesota Statutes 2008, section 150A.02, subdivision 1, is amended to read:35.16    Subdivision 1. Generally. There is hereby created a Board of Dentistry whose duty 35.17it shall be to carry out the purposes and enforce the provisions of sections 
         150A.01 to 35.18150A.12
         . The board shall consist of two public members as defined by section 
         214.02, 35.19five qualified resident dentists, one qualified resident registered licensed dental assistant, 35.20and one qualified resident dental hygienist appointed by the governor. Membership terms, 35.21compensation of members, removal of members, the filling of membership vacancies, and 35.22fiscal year and reporting requirements shall be as provided in sections 
         214.07 to 
         214.09. 35.23The provision of staff, administrative services and office space; the review and processing 35.24of board complaints; the setting of board fees; and other provisions relating to board 35.25operations shall be as provided in chapter 214. Each board member who is a dentist, 35.26registered licensed dental assistant, or dental hygienist shall have been lawfully in active 35.27practice in this state for five years immediately preceding appointment; and no board 35.28member shall be eligible for appointment to more than two consecutive four-year terms, 35.29and members serving on the board at the time of the enactment hereof shall be eligible 35.30to reappointment provided they shall not have served more than nine consecutive years 35.31at the expiration of the term to which they are to be appointed. At least 90 days prior to 35.32the expiration of the terms of dentists, registered licensed dental assistants, or dental 35.33hygienists, the Minnesota Dental Association, Minnesota Dental Assistants Association, 35.34or the Minnesota State Dental Hygiene Association shall recommend to the governor for 36.1each term expiring not less than two dentists, two registered licensed dental assistants, 36.2or two dental hygienists, respectively, who are qualified to serve on the board, and from 36.3the list so recommended the governor may appoint members to the board for the term of 36.4four years, the appointments to be made within 30 days after the expiration of the terms. 36.5Within 60 days after the occurrence of a dentist, registered licensed dental assistant or 36.6dental hygienist vacancy, prior to the expiration of the term, in the board, the Minnesota 36.7Dental Association, the Minnesota Dental Assistants Association, or the Minnesota State 36.8Dental Hygiene Association shall recommend to the governor not less than two dentists, 36.9two registered licensed dental assistants, or two dental hygienists, who are qualified to 36.10serve on the board and from the list so recommended the governor, within 30 days after 36.11receiving such list of dentists, may appoint one member to the board for the unexpired 36.12term occasioned by such vacancy. Any appointment to fill a vacancy shall be made 36.13within 90 days after the occurrence of such vacancy. The first four-year term of the 36.14dental hygienist and of the registered licensed dental assistant shall commence on the 36.15first Monday in January, 1977.36.16    Sec. 42. Minnesota Statutes 2008, section 150A.05, subdivision 2, is amended to read:36.17    Subd. 2. Exemptions and exceptions of certain practices and operations.36.18Sections 
         150A.01 to 
         150A.12 do not apply to:36.19(1) the practice of dentistry or dental hygiene in any branch of the armed services of 36.20the United States, the United States Public Health Service, or the United States Veterans 36.21Administration;36.22(2) the practice of dentistry, dental hygiene, or dental assisting by undergraduate 36.23dental students, dental hygiene students, and dental assisting students of the University 36.24of Minnesota, schools of dental hygiene, or schools of dental assisting approved by the 36.25board, when acting under the direction and indirect supervision of a Minnesota licensed 36.26dentist or a and under the instruction of a licensed dentist, licensed dental hygienist acting 36.27as an instructor, or licensed dental assistant;36.28(3) the practice of dentistry by licensed dentists of other states or countries while 36.29appearing as clinicians under the auspices of a duly approved dental school or college, or a 36.30reputable dental society, or a reputable dental study club composed of dentists;36.31(4) the actions of persons while they are taking examinations for licensure 36.32or registration administered or approved by the board pursuant to sections 
         150A.03, 36.33subdivision 1
         , and 
         150A.06, subdivisions 1, 2, and 2a;36.34(5) the practice of dentistry by dentists and dental hygienists licensed by other states 36.35during their functioning as examiners responsible for conducting licensure or registration36.36examinations administered by regional and national testing agencies with whom the 37.1board is authorized to affiliate and participate under section 
         150A.03, subdivision 1, 37.2and the practice of dentistry by the regional and national testing agencies during their 37.3administering examinations pursuant to section 
         150A.03, subdivision 1;37.4(6) the use of X-rays or other diagnostic imaging modalities for making radiographs 37.5or other similar records in a hospital under the supervision of a physician or dentist or 37.6by a person who is credentialed to use diagnostic imaging modalities or X-ray machines 37.7for dental treatment, roentgenograms, or dental diagnostic purposes by a credentialing 37.8agency other than the Board of Dentistry; or37.9(7) the service, other than service performed directly upon the person of a patient, of 37.10constructing, altering, repairing, or duplicating any denture, partial denture, crown, bridge, 37.11splint, orthodontic, prosthetic, or other dental appliance, when performed according 37.12to a written work order from a licensed dentist in accordance with section 
         150A.10, 37.13subdivision 3
         .37.14    Sec. 43. Minnesota Statutes 2008, section 150A.06, subdivision 2a, is amended to read:37.15    Subd. 2a. Registered Licensed dental assistant. A person of good moral character, 37.16who has graduated from a dental assisting program accredited by the Commission on 37.17Dental Accreditation of the American Dental Association, may apply for registration37.18licensure. The applicant must submit an application and fee as prescribed by the board 37.19and the diploma or certificate of dental assisting. In the case of examinations conducted 37.20pursuant to section 
         150A.03, subdivision 1, applicants shall take the examination before 37.21applying to the board for registration licensure. The examination shall include an 37.22examination of the applicant's knowledge of the laws of Minnesota relating to dentistry 37.23and the rules of the board. An applicant is ineligible to retake the registration licensure37.24examination required by the board after failing it twice until further education and training 37.25are obtained as specified by board rule. A separate, nonrefundable fee may be charged for 37.26each time a person applies. An applicant who passes the examination in compliance with 37.27subdivision 2b, abides by professional ethical conduct requirements, and meets all the 37.28other requirements of the board shall be registered licensed as a dental assistant.37.29    Sec. 44. Minnesota Statutes 2008, section 150A.06, subdivision 2b, is amended to read:37.30    Subd. 2b. Examination. When the Board of Dentistry administers the examination 37.31for licensure or registration, only those board members or board-appointed deputy 37.32examiners qualified for the particular examination may administer it. An examination 37.33which the board requires as a condition of licensure or registration must have been taken 37.34within the five years before the board receives the application for licensure or registration.37.35    Sec. 45. Minnesota Statutes 2008, section 150A.06, subdivision 2c, is amended to read:38.1    Subd. 2c. Guest license or registration. (a) The board shall grant a guest license to 38.2practice as a dentist or, dental hygienist, or a guest registration to practice as alicensed 38.3dental assistant if the following conditions are met:38.4(1) the dentist, dental hygienist, or dental assistant is currently licensed or registered38.5in good standing in North Dakota, South Dakota, Iowa, or Wisconsin;38.6(2) the dentist, dental hygienist, or dental assistant is currently engaged in the practice 38.7of that person's respective profession in North Dakota, South Dakota, Iowa, or Wisconsin;38.8(3) the dentist, dental hygienist, or dental assistant will limit that person's practice to 38.9a public health setting in Minnesota that (i) is approved by the board; (ii) was established 38.10by a nonprofit organization that is tax exempt under chapter 501(c)(3) of the Internal 38.11Revenue Code of 1986; and (iii) provides dental care to patients who have difficulty 38.12accessing dental care;38.13(4) the dentist, dental hygienist, or dental assistant agrees to treat indigent patients 38.14who meet the eligibility criteria established by the clinic; and38.15(5) the dentist, dental hygienist, or dental assistant has applied to the board for a 38.16guest license or registration and has paid a nonrefundable license fee to the board not 38.17to exceed $75.38.18(b) A guest license or registration must be renewed annually with the board and an 38.19annual renewal fee not to exceed $75 must be paid to the board.38.20(c) A dentist, dental hygienist, or dental assistant practicing under a guest license 38.21or registration under this subdivision shall have the same obligations as a dentist, dental 38.22hygienist, or dental assistant who is licensed in Minnesota and shall be subject to the laws 38.23and rules of Minnesota and the regulatory authority of the board. If the board suspends 38.24or revokes the guest license or registration of, or otherwise disciplines, a dentist, dental 38.25hygienist, or dental assistant practicing under this subdivision, the board shall promptly 38.26report such disciplinary action to the dentist's, dental hygienist's, or dental assistant's 38.27regulatory board in the border state.38.28    Sec. 46. Minnesota Statutes 2008, section 150A.06, subdivision 2d, is amended to read:38.29    Subd. 2d. Continuing education and professional development waiver. (a) The 38.30board shall grant a waiver to the continuing education requirements under this chapter 38.31for a licensed dentist, licensed dental hygienist, or registered licensed dental assistant 38.32who documents to the satisfaction of the board that the dentist, dental hygienist, or 38.33registered licensed dental assistant has retired from active practice in the state and limits 38.34the provision of dental care services to those offered without compensation in a public 38.35health, community, or tribal clinic or a nonprofit organization that provides services to 39.1the indigent or to recipients of medical assistance, general assistance medical care, or 39.2MinnesotaCare programs.39.3(b) The board may require written documentation from the volunteer and retired 39.4dentist, dental hygienist, or registered licensed dental assistant prior to granting this waiver.39.5(c) The board shall require the volunteer and retired dentist, dental hygienist, or 39.6registered licensed dental assistant to meet the following requirements:39.7(1) a licensee or registrant seeking a waiver under this subdivision must complete 39.8and document at least five hours of approved courses in infection control, medical 39.9emergencies, and medical management for the continuing education cycle; and39.10(2) provide documentation of certification in advanced or basic cardiac life 39.11support recognized bycurrent CPR certification from completion of the American Heart 39.12Association healthcare provider course, the American Red Cross professional rescuer 39.13course, or an equivalent entity.39.14    Sec. 47. Minnesota Statutes 2008, section 150A.06, subdivision 4a, is amended to read:39.15    Subd. 4a. Appeal of denial of application. A person whose application for 39.16licensure or registration by credentials has been denied may appeal the decision to the 39.17board. The board shall establish an appeals process and inform a denied candidate of the 39.18right to appeal and the process for filing the appeal.39.19    Sec. 48. Minnesota Statutes 2008, section 150A.06, subdivision 5, is amended to read:39.20    Subd. 5. Fraud in securing licenses or registrations. Every person implicated 39.21in employing fraud or deception in applying for or securing a license or registration to 39.22practice dentistry, dental hygiene, or dental assisting or in annually renewing a license 39.23or registration under sections 
         150A.01 to 
         150A.12 is guilty of a gross misdemeanor.39.24    Sec. 49. Minnesota Statutes 2008, section 150A.06, subdivision 7, is amended to read:39.25    Subd. 7. Additional remedies for licensure and registration. On a case-by-case 39.26basis, for initial or renewal of licensure or registration, the board may add additional 39.27remedies for deficiencies found based on the applicant's performance, character, and 39.28education.39.29    Sec. 50. Minnesota Statutes 2008, section 150A.06, subdivision 8, is amended to read:39.30    Subd. 8. Registration Licensure by credentials. (a) Any dental assistant may, upon 39.31application and payment of a fee established by the board, apply for registration licensure39.32based on an evaluation of the applicant's education, experience, and performance record in 39.33lieu of completing a board-approved dental assisting program for expanded functions as 39.34defined in rule, and may be interviewed by the board to determine if the applicant:40.1(1) has graduated from an accredited dental assisting program accredited by the 40.2Commission of Dental Accreditation of the American Dental Association, or is currently 40.3certified by the Dental Assisting National Board;40.4(2) is not subject to any pending or final disciplinary action in another state or 40.5Canadian province, or if not currently certified or registered, previously had a certification 40.6or registration in another state or Canadian province in good standing that was not subject 40.7to any final or pending disciplinary action at the time of surrender;40.8(3) is of good moral character and abides by professional ethical conduct 40.9requirements;40.10(4) at board discretion, has passed a board-approved English proficiency test if 40.11English is not the applicant's primary language; and40.12(5) has met all expanded functions curriculum equivalency requirements of a 40.13Minnesota board-approved dental assisting program.40.14(b) The board, at its discretion, may waive specific registration licensure40.15requirements in paragraph (a).40.16(c) An applicant who fulfills the conditions of this subdivision and demonstrates 40.17the minimum knowledge in dental subjects required for registration licensure under 40.18subdivision 2a must be registered licensed to practice the applicant's profession.40.19(d) If the applicant does not demonstrate the minimum knowledge in dental subjects 40.20required for registration licensure under subdivision 2a, the application must be denied. 40.21If registration licensure is denied, the board may notify the applicant of any specific 40.22remedy that the applicant could take which, when passed, would qualify the applicant 40.23for registration licensure. A denial does not prohibit the applicant from applying for 40.24registration licensure under subdivision 2a.40.25(e) A candidate whose application has been denied may appeal the decision to the 40.26board according to subdivision 4a.40.27    Sec. 51. Minnesota Statutes 2008, section 150A.08, subdivision 1, is amended to read:40.28    Subdivision 1. Grounds. The board may refuse or by order suspend or revoke, limit 40.29or modify by imposing conditions it deems necessary, any license to practice dentistry 40.30or, dental hygiene, or the registration of any dental assistant assisting upon any of the 40.31following grounds:40.32(1) fraud or deception in connection with the practice of dentistry or the securing of 40.33a license or registration certificate;40.34(2) conviction, including a finding or verdict of guilt, an admission of guilt, or a no 40.35contest plea, in any court of a felony or gross misdemeanor reasonably related to the 40.36practice of dentistry as evidenced by a certified copy of the conviction;41.1(3) conviction, including a finding or verdict of guilt, an admission of guilt, or a 41.2no contest plea, in any court of an offense involving moral turpitude as evidenced by a 41.3certified copy of the conviction;41.4(4) habitual overindulgence in the use of intoxicating liquors;41.5(5) improper or unauthorized prescription, dispensing, administering, or personal 41.6or other use of any legend drug as defined in chapter 151, of any chemical as defined in 41.7chapter 151, or of any controlled substance as defined in chapter 152;41.8(6) conduct unbecoming a person licensed to practice dentistry or, dental hygiene,41.9or registered as a dental assistant assisting, or conduct contrary to the best interest of the 41.10public, as such conduct is defined by the rules of the board;41.11(7) gross immorality;41.12(8) any physical, mental, emotional, or other disability which adversely affects a 41.13dentist's, dental hygienist's, or registered dental assistant's ability to perform the service 41.14for which the person is licensed or registered;41.15(9) revocation or suspension of a license, registration, or equivalent authority to 41.16practice, or other disciplinary action or denial of a license or registration application taken 41.17by a licensing, registering, or credentialing authority of another state, territory, or country 41.18as evidenced by a certified copy of the licensing authority's order, if the disciplinary action 41.19or application denial was based on facts that would provide a basis for disciplinary action 41.20under this chapter and if the action was taken only after affording the credentialed person 41.21or applicant notice and opportunity to refute the allegations or pursuant to stipulation 41.22or other agreement;41.23(10) failure to maintain adequate safety and sanitary conditions for a dental office in 41.24accordance with the standards established by the rules of the board;41.25(11) employing, assisting, or enabling in any manner an unlicensed person to 41.26practice dentistry;41.27(12) failure or refusal to attend, testify, and produce records as directed by the board 41.28under subdivision 7;41.29(13) violation of, or failure to comply with, any other provisions of sections 
         150A.0141.30to 
         150A.12, the rules of the Board of Dentistry, or any disciplinary order issued by the 41.31board, sections 
         144.291 to 144.298 or 
         595.02, subdivision 1, paragraph (d), or for any 41.32other just cause related to the practice of dentistry. Suspension, revocation, modification 41.33or limitation of any license shall not be based upon any judgment as to therapeutic or 41.34monetary value of any individual drug prescribed or any individual treatment rendered, 41.35but only upon a repeated pattern of conduct;42.1(14) knowingly providing false or misleading information that is directly related 42.2to the care of that patient unless done for an accepted therapeutic purpose such as the 42.3administration of a placebo; or42.4(15) aiding suicide or aiding attempted suicide in violation of section 
         609.215 as 42.5established by any of the following:42.6(i) a copy of the record of criminal conviction or plea of guilty for a felony in 42.7violation of section 
         609.215, subdivision 1 or 2;42.8(ii) a copy of the record of a judgment of contempt of court for violating an 42.9injunction issued under section 
         609.215, subdivision 4;42.10(iii) a copy of the record of a judgment assessing damages under section 
         609.215, 42.11subdivision 5
         ; or42.12(iv) a finding by the board that the person violated section 
         609.215, subdivision 42.131
          or 2. The board shall investigate any complaint of a violation of section 
         609.215, 42.14subdivision 1
          or 2.42.15    Sec. 52. Minnesota Statutes 2008, section 150A.08, subdivision 3, is amended to read:42.16    Subd. 3. Reinstatement. Any licensee or registrant whose license or registration has 42.17been suspended or revoked may have the license or registration reinstated or a new license 42.18or registration issued, as the case may be, when the board deems the action is warranted.42.19    Sec. 53. Minnesota Statutes 2008, section 150A.08, subdivision 3a, is amended to read:42.20    Subd. 3a. Costs; additional penalties. (a) The board may impose a civil penalty 42.21not exceeding $10,000 for each separate violation, the amount of the civil penalty to 42.22be fixed so as to deprive a licensee or registrant of any economic advantage gained by 42.23reason of the violation, to discourage similar violations by the licensee or registrant or any 42.24other licensee or registrant, or to reimburse the board for the cost of the investigation and 42.25proceeding, including, but not limited to, fees paid for services provided by the Office of 42.26Administrative Hearings, legal and investigative services provided by the Office of the 42.27Attorney General, court reporters, witnesses, reproduction of records, board members' 42.28per diem compensation, board staff time, and travel costs and expenses incurred by board 42.29staff and board members.42.30(b) In addition to costs and penalties imposed under paragraph (a), the board may 42.31also:42.32(1) order the dentist, dental hygienist, or dental assistant to provide unremunerated 42.33service;42.34(2) censure or reprimand the dentist, dental hygienist, or dental assistant; or42.35(3) any other action as allowed by law and justified by the facts of the case.43.1    Sec. 54. Minnesota Statutes 2008, section 150A.08, subdivision 5, is amended to read:43.2    Subd. 5. Medical examinations. If the board has probable cause to believe that a 43.3dentist, dental hygienist, registered dental assistant, or applicant engages in acts described 43.4in subdivision 1, clause (4) or (5), or has a condition described in subdivision 1, clause (8), 43.5it shall direct the dentist, dental hygienist, assistant, or applicant to submit to a mental 43.6or physical examination or a chemical dependency assessment. For the purpose of this 43.7subdivision, every dentist, hygienist, or dental assistant licensed or registered under 43.8this chapter or person submitting an application for a license or registration is deemed 43.9to have given consent to submit to a mental or physical examination when directed 43.10in writing by the board and to have waived all objections in any proceeding under this 43.11section to the admissibility of the examining physician's testimony or examination reports 43.12on the ground that they constitute a privileged communication. Failure to submit to an 43.13examination without just cause may result in an application being denied or a default and 43.14final order being entered without the taking of testimony or presentation of evidence, 43.15other than evidence which may be submitted by affidavit, that the licensee, registrant, or 43.16applicant did not submit to the examination. A dentist, dental hygienist, registered dental 43.17assistant, or applicant affected under this section shall at reasonable intervals be afforded 43.18an opportunity to demonstrate ability to start or resume the competent practice of dentistry 43.19or perform the duties of a dental hygienist or registered dental assistant with reasonable 43.20skill and safety to patients. In any proceeding under this subdivision, neither the record of 43.21proceedings nor the orders entered by the board is admissible, is subject to subpoena, or 43.22may be used against the dentist, dental hygienist, registered dental assistant, or applicant in 43.23any proceeding not commenced by the board. Information obtained under this subdivision 43.24shall be classified as private pursuant to the Minnesota Government Data Practices Act.43.25    Sec. 55. Minnesota Statutes 2008, section 150A.08, subdivision 6, is amended to read:43.26    Subd. 6. Medical records. Notwithstanding contrary provisions of sections 
         13.38443.27and 
         144.651 or any other statute limiting access to medical or other health data, the 43.28board may obtain medical data and health records of a licensee, registrant, or applicant 43.29without the licensee's, registrant's, or applicant's consent if the information is requested 43.30by the board as part of the process specified in subdivision 5. The medical data may be 43.31requested from a provider, as defined in section 
         144.291, subdivision 2, paragraph (h), 43.32an insurance company, or a government agency, including the Department of Human 43.33Services. A provider, insurance company, or government agency shall comply with 43.34any written request of the board under this subdivision and shall not be liable in any 43.35action for damages for releasing the data requested by the board if the data are released 44.1pursuant to a written request under this subdivision, unless the information is false and 44.2the provider giving the information knew, or had reason to believe, the information was 44.3false. Information obtained under this subdivision shall be classified as private under the 44.4Minnesota Government Data Practices Act.44.5    Sec. 56. Minnesota Statutes 2008, section 150A.08, subdivision 8, is amended to read:44.6    Subd. 8. Suspension of license. In addition to any other remedy provided by 44.7law, the board may, through its designated board members pursuant to section 
         214.10, 44.8subdivision 2
         , temporarily suspend a license or registration without a hearing if the 44.9board finds that the licensee or registrant has violated a statute or rule which the board is 44.10empowered to enforce and continued practice by the licensee or registrant would create an 44.11imminent risk of harm to others. The suspension shall take effect upon written notice to 44.12the licensee or registrant served by first class mail specifying the statute or rule violated, 44.13and the time, date, and place of the hearing before the board. If the notice is returned by 44.14the post office, the notice shall be effective upon reasonable attempts to locate and serve 44.15the licensee or registrant. Within ten days of service of the notice, the board shall hold a 44.16hearing before its own members on the sole issue of whether there is a reasonable basis to 44.17continue, modify, or lift the suspension. Evidence presented by the board, or licensee, 44.18or registrant, shall be in affidavit form only. The licensee or registrant or counsel of the 44.19licensee or registrant may appear for oral argument. Within five working days after the 44.20hearing, the board shall issue its order and, if the suspension is continued, the board 44.21shall schedule a disciplinary hearing to be held pursuant to the Administrative Procedure 44.22Act within 45 days of issuance of the order. The administrative law judge shall issue a 44.23report within 30 days of the closing of the contested case hearing record. The board 44.24shall issue a final order within 30 days of receiving that report. The board may allow a 44.25person who was licensed by any state to practice dentistry and whose license has been 44.26suspended to practice dentistry under the supervision of a licensed dentist for the purpose 44.27of demonstrating competence and eligibility for reinstatement.44.28    Sec. 57. Minnesota Statutes 2008, section 150A.081, is amended to read:44.29150A.081 ACCESS TO MEDICAL DATA.44.30    Subdivision 1. Access to data on licensee or registrant. When the board has 44.31probable cause to believe that a licensee's or registrant's condition meets a ground listed in 44.32section 
         150A.08, subdivision 1, clause (4) or (8), it may, notwithstanding sections 
         13.384, 44.33144.651
         , or any other law limiting access to medical data, obtain medical or health records 44.34on the licensee or registrant without the licensee's or registrant's consent. The medical data 44.35may be requested from a provider, as defined in section 
         144.291, subdivision 2, paragraph 45.1(h), an insurance company, or a government agency. A provider, insurance company, or 45.2government agency shall comply with a written request of the board under this subdivision 45.3and is not liable in any action for damages for releasing the data requested by the board 45.4if the data are released under the written request, unless the information is false and the 45.5entity providing the information knew, or had reason to believe, the information was false. 45.6    Subd. 2. Access to data on patients. The board has access to medical records of 45.7a patient treated by a licensee or registrant under review if the patient signs a written 45.8consent permitting access. If the patient has not given consent, the licensee or registrant45.9must delete data from which a patient may be identified before releasing medical records 45.10to the board.45.11    Subd. 3. Data classification; release of certain health data not required.45.12Information obtained under this section is classified as private data on individuals under 45.13chapter 13. Under this section, the commissioner of health is not required to release health 45.14data collected and maintained under section 
         13.3805, subdivision 2.45.15    Sec. 58. Minnesota Statutes 2008, section 150A.09, subdivision 1, is amended to read:45.16    Subdivision 1. Registration information and procedure. On or before the license 45.17or registration certificate expiration date every licensed dentist, dental hygienist, and 45.18registered dental assistant shall transmit to the executive secretary of the board, pertinent 45.19information required by the board, together with the fee established by the board. At least 45.2030 days before a license or registration certificate expiration date, the board shall send 45.21a written notice stating the amount and due date of the fee and the information to be 45.22provided to every licensed dentist, dental hygienist, and registered dental assistant.45.23    Sec. 59. Minnesota Statutes 2008, section 150A.09, subdivision 3, is amended to read:45.24    Subd. 3. Current address, change of address. Every dentist, dental hygienist, and 45.25registered dental assistant shall maintain with the board a correct and current mailing 45.26address. For dentists engaged in the practice of dentistry, the address shall be that of the 45.27location of the primary dental practice. Within 30 days after changing addresses, every 45.28dentist, dental hygienist, and registered dental assistant shall provide the board written 45.29notice of the new address either personally or by first class mail.45.30    Sec. 60. Minnesota Statutes 2008, section 150A.091, subdivision 2, is amended to read:45.31    Subd. 2. Application fees. Each applicant for licensure or registration shall submit 45.32with a license or registration permit application a nonrefundable fee in the following 45.33amounts in order to administratively process an application:45.34(1) dentist, $140;46.1(2) limited faculty dentist, $140;46.2(3) resident dentist, $55;46.3(4) dental hygienist, $55;46.4(5) registered licensed dental assistant, $35 $55; and46.5(6) dental assistant with a limited registration permit as described in Minnesota 46.6Rules, part 3100.8500, subpart 3, $15.46.7    Sec. 61. Minnesota Statutes 2008, section 150A.091, subdivision 3, is amended to read:46.8    Subd. 3. Initial license or registration permit fees. Along with the application fee, 46.9each of the following licensees or registrants applicants shall submit a separate prorated 46.10initial license or registration permit fee. The prorated initial fee shall be established by the 46.11board based on the number of months of the licensee's or registrant's applicant's initial 46.12term as described in Minnesota Rules, part 3100.1700, subpart 1a, not to exceed the 46.13following monthly fee amounts:46.14(1) dentist, $14 times the number of months of the initial term;46.15(2) dental hygienist, $5 times the number of months of the initial term;46.16(3) registered licensed dental assistant, $3 times the number of months of initial 46.17term; and46.18(4) dental assistant with a limited registration permit as described in Minnesota 46.19Rules, part 3100.8500, subpart 3, $1 times the number of months of the initial term.46.20    Sec. 62. Minnesota Statutes 2008, section 150A.091, subdivision 5, is amended to read:46.21    Subd. 5. Biennial license or registration permit fees. Each of the following 46.22licensees or registrants applicants shall submit with a biennial license or registration permit46.23renewal application a fee as established by the board, not to exceed the following amounts:46.24(1) dentist, $336;46.25(2) dental hygienist, $118;46.26(3) registered licensed dental assistant, $80; and46.27(4) dental assistant with a limited registration permit as described in Minnesota 46.28Rules, part 3100.8500, subpart 3, $24.46.29    Sec. 63. Minnesota Statutes 2008, section 150A.091, subdivision 7, is amended to read:46.30    Subd. 7. Biennial license or registration permit late fee. Applications for renewal 46.31of any license or registration permit received after the time specified in Minnesota Rules, 46.32part 3100.1700, must be assessed a late fee equal to 25 percent of the biennial renewal fee.46.33    Sec. 64. Minnesota Statutes 2008, section 150A.091, subdivision 8, is amended to read:47.1    Subd. 8. Duplicate license or registration certificate fee. Each licensee or 47.2registrant applicant shall submit, with a request for issuance of a duplicate of the original 47.3license or registration, or of an annual or biennial renewal of it certificate for a license 47.4or permit, a fee in the following amounts:47.5(1) original dentist or, dental hygiene, or dental assistant license, $35; and47.6(2) initial and renewal registration certificates and license annual or biennial renewal 47.7certificates, $10.47.8    Sec. 65. Minnesota Statutes 2008, section 150A.091, subdivision 9, is amended to read:47.9    Subd. 9. Licensure and registration by credentials. Each applicant for licensure 47.10as a dentist or, dental hygienist, or for registration as a registered dental assistant by 47.11credentials pursuant to section 
         150A.06, subdivisions 4 and 8, and Minnesota Rules, part 47.123100.1400, shall submit with the license or registration application a fee in the following 47.13amounts:47.14(1) dentist, $725;47.15(2) dental hygienist, $175; and47.16(3) registered dental assistant, $35.47.17    Sec. 66. Minnesota Statutes 2008, section 150A.091, is amended by adding a 47.18subdivision to read:47.19    Subd. 9a.Credential review; nonaccredited dental institution.Applicants who 47.20have graduated from a nonaccredited dental college desiring licensure as a dentist pursuant 47.21to section 150A.06, subdivision 1, shall submit an application for credential review and an 47.22application fee not to exceed the amount of $200.47.23    Sec. 67. Minnesota Statutes 2008, section 150A.091, is amended by adding a 47.24subdivision to read:47.25    Subd. 9b.Limited general license.Each applicant for licensure as a limited general 47.26dentist pursuant to section 150A.06, subdivision 9, shall submit the applicable fees 47.27established by the board not to exceed the following amounts:47.28(1) initial limited general license application, $140;47.29(2) annual limited general license renewal application, $155; and47.30(3) late fee assessment for renewal application equal to 50 percent of the annual 47.31limited general license renewal fee.47.32    Sec. 68. Minnesota Statutes 2008, section 150A.091, subdivision 10, is amended to 47.33read:48.1    Subd. 10. Reinstatement fee. No dentist, dental hygienist, or registered dental 48.2assistant whose license or registration has been suspended or revoked may have the 48.3license or registration reinstated or a new license or registration issued until a fee has been 48.4submitted to the board in the following amounts:48.5(1) dentist, $140;48.6(2) dental hygienist, $55; and48.7(3) registered dental assistant, $35.48.8    Sec. 69. Minnesota Statutes 2008, section 150A.091, subdivision 11, is amended to 48.9read:48.10    Subd. 11. Certificate application fee for anesthesia/sedation. Each dentist 48.11shall submit with a general anesthesia or conscious moderate sedation application or a 48.12contracted sedation provider application a fee as established by the board not to exceed 48.13the following amounts:48.14(1) for both a general anesthesia and conscious moderate sedation application, $5048.15$250;48.16(2) for a general anesthesia application only, $50 $250; and48.17(3) for a conscious moderate sedation application only, $50. $250; and48.18(4) for a contracted sedation provider application, $250.48.19    Sec. 70. Minnesota Statutes 2008, section 150A.091, is amended by adding a 48.20subdivision to read:48.21    Subd. 11a.Certificate for anesthesia/sedation late fee.Applications for renewal 48.22of a general anesthesia or moderate sedation certificate or a contracted sedation provider 48.23certificate received after the time specified in Minnesota Rules, part 3100.3600, subparts 48.249 and 9b, must be assessed a late fee equal to 50 percent of the biennial renewal fee for 48.25an anesthesia/sedation certificate.48.26    Sec. 71. Minnesota Statutes 2008, section 150A.091, is amended by adding a 48.27subdivision to read:48.28    Subd. 11b.Recertification fee for anesthesia/sedation.No dentist whose general 48.29anesthesia or moderate sedation certificate has been terminated by the board or voluntarily 48.30terminated by the dentist may become recertified until a fee has been submitted to the 48.31board not to exceed the amount of $500.48.32    Sec. 72. Minnesota Statutes 2008, section 150A.091, subdivision 12, is amended to 48.33read:49.1    Subd. 12. Duplicate certificate fee for anesthesia/sedation. Each dentist shall 49.2submit with a request for issuance of a duplicate of the original general anesthesia or 49.3conscious moderate sedation certificate or contracted sedation provider certificate a fee in 49.4the amount of $10.49.5    Sec. 73. Minnesota Statutes 2008, section 150A.091, subdivision 14, is amended to 49.6read:49.7    Subd. 14. Affidavit of licensure. Each licensee or registrant shall submit with a 49.8request for an affidavit of licensure a fee in the amount of $10.49.9    Sec. 74. Minnesota Statutes 2008, section 150A.091, subdivision 15, is amended to 49.10read:49.11    Subd. 15. Verification of licensure. Each institution or corporation shall submit 49.12with a request for verification of a license or registration a fee in the amount of $5 for 49.13each license or registration to be verified.49.14    Sec. 75. Minnesota Statutes 2008, section 150A.10, subdivision 1a, is amended to read:49.15    Subd. 1a. Limited authorization for dental hygienists. (a) Notwithstanding 49.16subdivision 1, a dental hygienist licensed under this chapter may be employed or retained 49.17by a health care facility, program, or nonprofit organization to perform dental hygiene 49.18services described under paragraph (b) without the patient first being examined by a 49.19licensed dentist if the dental hygienist:49.20(1) has been engaged in the active practice of clinical dental hygiene for not less than 49.212,400 hours in the past 18 months or a career total of 3,000 hours, including a minimum of 49.22200 hours of clinical practice in two of the past three years;49.23(2) has entered into a collaborative agreement with a licensed dentist that designates 49.24authorization for the services provided by the dental hygienist;49.25(3) has documented participation in courses in infection control and medical 49.26emergencies within each continuing education cycle; and49.27(4) maintains current certification in advanced or basic cardiac life support as 49.28recognized by the American Heart Association, the American Red Cross, or another 49.29agency that is equivalent to the CPR certification from completion of the American Heart 49.30Association or healthcare provider course, the American Red Cross professional rescuer 49.31course, or an equivalent entity.49.32(b) The dental hygiene services authorized to be performed by a dental hygienist 49.33under this subdivision are limited to:49.34(1) oral health promotion and disease prevention education;50.1(2) removal of deposits and stains from the surfaces of the teeth;50.2(3) application of topical preventive or prophylactic agents, including fluoride 50.3varnishes and pit and fissure sealants;50.4(4) polishing and smoothing restorations;50.5(5) removal of marginal overhangs;50.6(6) performance of preliminary charting;50.7(7) taking of radiographs; and50.8(8) performance of scaling and root planing.50.9The dental hygienist may administer injections of local anesthetic agents or nitrous 50.10oxide inhalation analgesia as specifically delegated in the collaborative agreement with 50.11a licensed dentist. The dentist need not first examine the patient or be present. If the 50.12patient is considered medically compromised, the collaborative dentist shall review the 50.13patient record, including the medical history, prior to the provision of these services. 50.14Collaborating dental hygienists may work with unregistered unlicensed and registered50.15licensed dental assistants who may only perform duties for which registration licensure50.16is not required. The performance of dental hygiene services in a health care facility, 50.17program, or nonprofit organization as authorized under this subdivision is limited to 50.18patients, students, and residents of the facility, program, or organization.50.19(c) A collaborating dentist must be licensed under this chapter and may enter into 50.20a collaborative agreement with no more than four dental hygienists unless otherwise 50.21authorized by the board. The board shall develop parameters and a process for obtaining 50.22authorization to collaborate with more than four dental hygienists. The collaborative 50.23agreement must include:50.24(1) consideration for medically compromised patients and medical conditions for 50.25which a dental evaluation and treatment plan must occur prior to the provision of dental 50.26hygiene services;50.27(2) age- and procedure-specific standard collaborative practice protocols, including 50.28recommended intervals for the performance of dental hygiene services and a period of 50.29time in which an examination by a dentist should occur;50.30(3) copies of consent to treatment form provided to the patient by the dental 50.31hygienist;50.32(4) specific protocols for the placement of pit and fissure sealants and requirements 50.33for follow-up care to assure the efficacy of the sealants after application; and50.34(5) a procedure for creating and maintaining dental records for the patients that are 50.35treated by the dental hygienist. This procedure must specify where these records are 50.36to be located.51.1The collaborative agreement must be signed and maintained by the dentist, the dental 51.2hygienist, and the facility, program, or organization; must be reviewed annually by the 51.3collaborating dentist and dental hygienist; and must be made available to the board 51.4upon request.51.5(d) Before performing any services authorized under this subdivision, a dental 51.6hygienist must provide the patient with a consent to treatment form which must include a 51.7statement advising the patient that the dental hygiene services provided are not a substitute 51.8for a dental examination by a licensed dentist. If the dental hygienist makes any referrals 51.9to the patient for further dental procedures, the dental hygienist must fill out a referral form 51.10and provide a copy of the form to the collaborating dentist.51.11(e) For the purposes of this subdivision, a "health care facility, program, or 51.12nonprofit organization" is limited to a hospital; nursing home; home health agency; group 51.13home serving the elderly, disabled, or juveniles; state-operated facility licensed by the 51.14commissioner of human services or the commissioner of corrections; and federal, state, or 51.15local public health facility, community clinic, tribal clinic, school authority, Head Start 51.16program, or nonprofit organization that serves individuals who are uninsured or who are 51.17Minnesota health care public program recipients.51.18(f) For purposes of this subdivision, a "collaborative agreement" means a written 51.19agreement with a licensed dentist who authorizes and accepts responsibility for the 51.20services performed by the dental hygienist. The services authorized under this subdivision 51.21and the collaborative agreement may be performed without the presence of a licensed 51.22dentist and may be performed at a location other than the usual place of practice of the 51.23dentist or dental hygienist and without a dentist's diagnosis and treatment plan, unless 51.24specified in the collaborative agreement.51.25    Sec. 76. Minnesota Statutes 2008, section 150A.10, subdivision 2, is amended to read:51.26    Subd. 2. Dental assistants. Every licensed dentist who uses the services of any 51.27unlicensed person for the purpose of assistance in the practice of dentistry shall be 51.28responsible for the acts of such unlicensed person while engaged in such assistance. 51.29Such dentist shall permit such unlicensed assistant to perform only those acts which are 51.30authorized to be delegated to unlicensed assistants by the Board of Dentistry. Such acts 51.31shall be performed under supervision of a licensed dentist. The board may permit differing 51.32levels of dental assistance based upon recognized educational standards, approved by the 51.33board, for the training of dental assistants. The board may also define by rule the scope of 51.34practice of registered licensed and nonregistered unlicensed dental assistants. The board 51.35by rule may require continuing education for differing levels of dental assistants, as a 51.36condition to their registration license or authority to perform their authorized duties. Any 52.1licensed dentist who shall permit such unlicensed assistant to perform any dental service 52.2other than that authorized by the board shall be deemed to be enabling an unlicensed 52.3person to practice dentistry, and commission of such an act by such unlicensed assistant 52.4shall constitute a violation of sections 
         150A.01 to 
         150A.12.  52.5    Sec. 77. Minnesota Statutes 2008, section 150A.10, subdivision 4, is amended to read:52.6    Subd. 4. Restorative procedures. (a) Notwithstanding subdivisions 1, 1a, and 52.72, a licensed dental hygienist or a registered licensed dental assistant may perform the 52.8following restorative procedures:52.9(1) place, contour, and adjust amalgam restorations;52.10(2) place, contour, and adjust glass ionomer;52.11(3) adapt and cement stainless steel crowns; and52.12(4) place, contour, and adjust class I and class V supragingival composite restorations 52.13where the margins are entirely within the enamel.52.14(b) The restorative procedures described in paragraph (a) may be performed only if:52.15(1) the licensed dental hygienist or the registered licensed dental assistant has 52.16completed a board-approved course on the specific procedures;52.17(2) the board-approved course includes a component that sufficiently prepares the 52.18licensed dental hygienist or registered licensed dental assistant to adjust the occlusion 52.19on the newly placed restoration;52.20(3) a licensed dentist has authorized the procedure to be performed; and52.21(4) a licensed dentist is available in the clinic while the procedure is being performed.52.22(c) The dental faculty who teaches the educators of the board-approved courses 52.23specified in paragraph (b) must have prior experience teaching these procedures in an 52.24accredited dental education program.52.25    Sec. 78. Minnesota Statutes 2008, section 150A.12, is amended to read:52.26150A.12 VIOLATION AND DEFENSES.52.27Every person who violates any of the provisions of sections 
         150A.01 to 
         150A.1252.28for which no specific penalty is provided herein, shall be guilty of a gross misdemeanor; 52.29and, upon conviction, punished by a fine of not more than $3,000 or by imprisonment in 52.30the county jail for not more than one year or by both such fine and imprisonment. In the 52.31prosecution of any person for violation of sections 
         150A.01 to 
         150A.12, it shall not be 52.32necessary to allege or prove lack of a valid license to practice dentistry or, dental hygiene, 52.33or dental assisting, but such matter shall be a matter of defense to be established by the 52.34defendant.52.35    Sec. 79. Minnesota Statutes 2008, section 150A.13, is amended to read:53.1150A.13 REPORTING OBLIGATIONS.53.2    Subdivision 1. Permission to report. A person who has knowledge of a registrant 53.3or a licensee unable to practice with reasonable skill and safety by reason of illness, use of 53.4alcohol, drugs, chemicals, or any other materials, or as a result of any mental, physical, or 53.5psychological condition may report the registrant or licensee to the board.53.6    Subd. 2. Institutions. A hospital, clinic, or other health care institution or 53.7organization located in this state shall report to the board any action taken by the agency, 53.8institution, or organization or any of its administrators or dental or other committees to 53.9revoke, suspend, restrict, or condition a registrant's or licensee's privilege to practice 53.10or treat patients or clients in the institution, or as part of the organization, any denial 53.11of privileges, or any other disciplinary action against a registrant or licensee described 53.12under subdivision 1. The institution or organization shall also report the resignation of 53.13any registrants or licensees prior to the conclusion of any disciplinary action proceeding 53.14against a registrant or licensee described under subdivision 1.53.15    Subd. 3. Dental societies. A state or local dental society or professional dental 53.16association shall report to the board any termination, revocation, or suspension of 53.17membership or any other disciplinary action taken against a registrant or licensee. If the 53.18society or association has received a complaint against a registrant or licensee described 53.19under subdivision 1, on which it has not taken any disciplinary action, the society or 53.20association shall report the complaint and the reason why it has not taken action on it or 53.21shall direct the complainant to the board. This subdivision does not apply to a society 53.22or association when it performs peer review functions as an agent of an outside entity, 53.23organization, or system.53.24    Subd. 4. Licensed professionals. (a) A licensed or registered health professional 53.25shall report to the board personal knowledge of any conduct by any person who the 53.26licensed or registered health professional reasonably believes is a registrant or licensee 53.27described under subdivision 1.53.28(b) Notwithstanding paragraph (a), a licensed health professional shall report to the 53.29board knowledge of any actions which institutions must report under subdivision 2.53.30    Subd. 5. Insurers and other entities making liability payments. (a) Four times 53.31each year as prescribed by the board, each insurer authorized to sell insurance described in 53.32section 
         60A.06, subdivision 1, clause (13), and providing professional liability insurance 53.33to registrants or licensees, shall submit to the board a report concerning the registrants and53.34licensees against whom malpractice settlements or awards have been made to the plaintiff. 53.35The report must contain at least the following information:  54.1(1) the total number of malpractice settlements or awards made;54.2(2) the date the malpractice settlements or awards were made;54.3(3) the allegations contained in the claim or complaint leading to the settlements or 54.4awards made;54.5(4) the dollar amount of each malpractice settlement or award;54.6(5) the regular address of the practice of the registrant or licensee against whom an 54.7award was made or with whom a settlement was made; and54.8(6) the name of the registrant or licensee against whom an award was made or 54.9with whom a settlement was made.54.10(b) A dental clinic, hospital, political subdivision, or other entity which makes 54.11professional liability insurance payments on behalf of registrants or licensees shall submit 54.12to the board a report concerning malpractice settlements or awards paid on behalf of 54.13registrants or licensees, and any settlements or awards paid by a clinic, hospital, political 54.14subdivision, or other entity on its own behalf because of care rendered by registrants or54.15licensees. This requirement excludes forgiveness of bills. The report shall be made to the 54.16board within 30 days of payment of all or part of any settlement or award.54.17    Subd. 6. Courts. The court administrator of district court or any other court of 54.18competent jurisdiction shall report to the board any judgment or other determination 54.19of the court that adjudges or includes a finding that a registrant or licensee is mentally 54.20ill, mentally incompetent, guilty of a felony, guilty of a violation of federal or state 54.21narcotics laws or controlled substances act, or guilty of an abuse or fraud under Medicare 54.22or Medicaid; or that appoints a guardian of the registrant or licensee pursuant to sections 54.23524.5-101
          to 
         524.5-502, or commits a registrant or licensee pursuant to chapter 253B.  54.24    Subd. 7. Self-reporting. A registrant or licensee shall report to the board any 54.25personal action that would require that a report be filed by any person, health care facility, 54.26business, or organization pursuant to subdivisions 2 to 6.54.27    Subd. 8. Deadlines; forms. Reports required by subdivisions 2 to 7 must be 54.28submitted not later than 30 days after the occurrence of the reportable event or transaction. 54.29The board may provide forms for the submission of reports required by this section, may 54.30require that reports be submitted on the forms provided, and may adopt rules necessary 54.31to assure prompt and accurate reporting.54.32    Subd. 9. Subpoenas. The board may issue subpoenas for the production of any 54.33reports required by subdivisions 2 to 7 or any related documents.54.34    Sec. 80. Minnesota Statutes 2008, section 169.345, subdivision 2, is amended to read:55.1    Subd. 2. Definitions. (a) For the purpose of section 
         168.021 and this section, the 55.2following terms have the meanings given them in this subdivision.55.3(b) "Health professional" means a licensed physician, registered licensed physician 55.4assistant, advanced practice registered nurse, or licensed chiropractor.55.5(c) "Long-term certificate" means a certificate issued for a period greater than 12 55.6months but not greater than 71 months.55.7(d) "Organization certificate" means a certificate issued to an entity other than a 55.8natural person for a period of three years.55.9(e) "Permit" refers to a permit that is issued for a period of 30 days, in lieu of the 55.10certificate referred to in subdivision 3, while the application is being processed.55.11(f) "Physically disabled person" means a person who:55.12(1) because of disability cannot walk without significant risk of falling;55.13(2) because of disability cannot walk 200 feet without stopping to rest;55.14(3) because of disability cannot walk without the aid of another person, a walker, a 55.15cane, crutches, braces, a prosthetic device, or a wheelchair;55.16(4) is restricted by a respiratory disease to such an extent that the person's forced 55.17(respiratory) expiratory volume for one second, when measured by spirometry, is less 55.18than one liter;55.19(5) has an arterial oxygen tension (PAO2) of less than 60 mm/Hg on room air at rest;55.20(6) uses portable oxygen;55.21(7) has a cardiac condition to the extent that the person's functional limitations are 55.22classified in severity as class III or class IV according to standards set by the American 55.23Heart Association;55.24(8) has lost an arm or a leg and does not have or cannot use an artificial limb; or55.25(9) has a disability that would be aggravated by walking 200 feet under normal 55.26environmental conditions to an extent that would be life threatening.55.27(g) "Short-term certificate" means a certificate issued for a period greater than six 55.28months but not greater than 12 months.55.29(h) "Six-year certificate" means a certificate issued for a period of six years.55.30(i) "Temporary certificate" means a certificate issued for a period not greater than 55.31six months.55.32    Sec. 81. Minnesota Statutes 2008, section 182.6551, is amended to read:55.33182.6551 CITATION; SAFE PATIENT HANDLING ACT.55.34    Sections 
         182.6551 to 
         182.6553 182.6554 may be cited as the "Safe Patient Handling 55.35Act."56.1    Sec. 82. Minnesota Statutes 2008, section 182.6552, is amended by adding a 56.2subdivision to read:56.3    Subd. 5.Clinical settings that move patients."Clinical settings that move 56.4patients" means physician, dental, and other outpatient care facilities, except for outpatient 56.5surgical settings, where service requires movement of patients from point to point as part 56.6of the scope of service.56.7    Sec. 83. [182.6554] SAFE PATIENT HANDLING IN CLINICAL SETTINGS.56.8    Subdivision 1.Safe patient handling plan required.(a) By July 1, 2010, every 56.9clinical setting that moves patients in the state shall develop a written safe patient handling 56.10plan to achieve by January 1, 2012, the goal of ensuring the safe handling of patients by 56.11minimizing manual lifting of patients by direct patient care workers and by utilizing 56.12safe patient handling equipment.56.13    (b) The plan shall address:56.14    (1) assessment of risks with regard to patient handling that considers the patient 56.15population and environment of care;56.16    (2) the acquisition of an adequate supply of appropriate safe patient handling 56.17equipment;56.18    (3) initial and ongoing training of direct patient care workers on the use of this 56.19equipment;56.20    (4) procedures to ensure that physical plant modifications and major construction 56.21projects are consistent with plan goals; and56.22    (5) periodic evaluations of the safe patient handling plan. 56.23(c) A health care organization with more than one covered clinical setting that 56.24moves patients may establish a plan at each clinical setting or establish one plan to serve 56.25this function for all the clinical settings.56.26    Subd. 2.Facilities with existing programs.A clinical setting that moves patients 56.27that has already adopted a safe patient handling plan that satisfies the requirements of 56.28subdivision 1, or a clinical setting that moves patients that is covered by a safe patient 56.29handling plan that is covered under and consistent with section 182.6553, is considered 56.30to be in compliance with the requirements of this section. 56.31    Subd. 3.Training materials.The commissioner shall make training materials on 56.32implementation of this section available at no cost to all clinical settings that move patients 56.33as part of the training and education duties of the commissioner under section 182.673.56.34    Subd. 4.Enforcement.This section shall be enforced by the commissioner under 56.35section 182.661. An initial violation of this section shall not be assessed a penalty. A 57.1subsequent violation of this section is subject to the penalties provided under section 57.2182.666.57.3    Sec. 84. Minnesota Statutes 2008, section 252.27, subdivision 1a, is amended to read:57.4    Subd. 1a. Definitions. A "related condition" is a condition (1) that is found to be 57.5closely related to developmental disability, including, but not limited to, cerebral palsy, 57.6epilepsy, autism, fetal alcohol spectrum disorder, and Prader-Willi syndrome, and (2) that 57.7meets all of the following criteria:57.8(1) (i) is severe and chronic;57.9(2) (ii) results in impairment of general intellectual functioning or adaptive behavior 57.10similar to that of persons with developmental disabilities;57.11(3) (iii) requires treatment or services similar to those required for persons with 57.12developmental disabilities;57.13(4) (iv) is manifested before the person reaches 22 years of age;57.14(5) (v) is likely to continue indefinitely;57.15(6) (vi) results in substantial functional limitations in three or more of the following 57.16areas of major life activity: (i) (A) self-care, (ii) (B) understanding and use of language, 57.17(iii) (C) learning, (iv) (D) mobility, (v) (E) self-direction, (vi) (F) capacity for independent 57.18living; and57.19(7) (vii) is not attributable to mental illness as defined in section 
         245.462, subdivision 57.2020
         , or an emotional disturbance as defined in section 
         245.4871, subdivision 15. 57.21For purposes of clause (7) item (vii), notwithstanding section 
         245.462, subdivision 20, 57.22or 
         245.4871, subdivision 15, "mental illness" does not include autism or other pervasive 57.23developmental disorders.57.24    Sec. 85. Minnesota Statutes 2008, section 252.282, subdivision 3, is amended to read:57.25    Subd. 3. Recommendations. (a) Upon completion of the local system needs 57.26planning assessment, the host county shall make recommendations by May 15, 2000, and 57.27by July 1 every two years thereafter beginning in 2001. If no change is recommended, a 57.28copy of the assessment along with corresponding documentation shall be provided to the 57.29commissioner by July 1 prior to the contract year.57.30(b) Except as provided in section 252.292, subdivision 4, recommendations 57.31regarding closures, relocations, or downsizings that include a rate increase shall be 57.32submitted to the statewide advisory committee for review, along with the assessment, plan, 57.33and corresponding documentation that supports the payment rate adjustment request.  57.34(c) (b) Recommendations for closures, relocations, and downsizings that do not 57.35include a rate increase and for modification of existing services for which a change in the 58.1framework of service delivery is necessary shall be provided to the commissioner by July 58.21 prior to the contract year or at least 90 days prior to the anticipated change, along with 58.3the assessment and corresponding documentation.58.4    Sec. 86. Minnesota Statutes 2008, section 252.282, subdivision 5, is amended to read:58.5    Subd. 5. Responsibilities of commissioner. (a) In collaboration with counties and 58.6providers, the commissioner shall ensure that services recognize the preferences and needs 58.7of persons with developmental disabilities and related conditions through a recurring 58.8systemic review and assessment of ICF/MR facilities within the state.58.9    (b) The commissioner shall publish a notice in the State Register no less than 58.10biannually to announce the opportunity for counties or providers to submit requests for 58.11payment rate adjustments associated with plans for downsizing, relocation, and closure of 58.12ICF/MR facilities.58.13    (c) The commissioner shall designate funding parameters to counties and to the 58.14statewide advisory committee for the overall implementation of system needs within the 58.15fiscal resources allocated by the legislature.58.16    (d) (b) The commissioner shall contract with ICF/MR providers. Contracts shall 58.17be for two-year periods.58.18    Sec. 87. Minnesota Statutes 2008, section 253B.02, subdivision 7, is amended to read:58.19    Subd. 7. Examiner. "Examiner" means a person who is knowledgeable, trained, and 58.20practicing in the diagnosis and assessment or in the treatment of the alleged impairment, 58.21and who is:58.22(1) a licensed physician;58.23(2) a licensed psychologist who has a doctoral degree in psychology or who became 58.24a licensed consulting psychologist before July 2, 1975; or58.25(3) an advanced practice registered nurse certified in mental health or a licensed 58.26physician assistant, except that only a physician or psychologist meeting these 58.27requirements may be appointed by the court as described by sections 
         253B.07, subdivision 58.283
         ; 
         253B.092, subdivision 8, paragraph (b); 
         253B.17, subdivision 3; 
         253B.18, subdivision 58.292
         ; and 
         253B.19, subdivisions 1 and 2, and only a physician or psychologist may conduct 58.30an assessment as described by Minnesota Rules of Criminal Procedure, rule 20.58.31    Sec. 88. Minnesota Statutes 2008, section 253B.05, subdivision 2, is amended to read:58.32    Subd. 2. Peace or health officer authority. (a) A peace or health officer may take a 58.33person into custody and transport the person to a licensed physician or treatment facility if 58.34the officer has reason to believe, either through direct observation of the person's behavior, 59.1or upon reliable information of the person's recent behavior and knowledge of the person's 59.2past behavior or psychiatric treatment, that the person is mentally ill or developmentally 59.3disabled and in danger of injuring self or others if not immediately detained. A peace or 59.4health officer or a person working under such officer's supervision, may take a person 59.5who is believed to be chemically dependent or is intoxicated in public into custody and 59.6transport the person to a treatment facility. If the person is intoxicated in public or is 59.7believed to be chemically dependent and is not in danger of causing self-harm or harm to 59.8any person or property, the peace or health officer may transport the person home. The 59.9peace or health officer shall make written application for admission of the person to the 59.10treatment facility. The application shall contain the peace or health officer's statement 59.11specifying the reasons for and circumstances under which the person was taken into 59.12custody. If danger to specific individuals is a basis for the emergency hold, the statement 59.13must include identifying information on those individuals, to the extent practicable. A 59.14copy of the statement shall be made available to the person taken into custody.59.15(b) As far as is practicable, a peace officer who provides transportation for a person 59.16placed in a facility under this subdivision may not be in uniform and may not use a vehicle 59.17visibly marked as a law enforcement vehicle.59.18(c) A person may be admitted to a treatment facility for emergency care and 59.19treatment under this subdivision with the consent of the head of the facility under the 59.20following circumstances: (1) a written statement shall only be made by the following 59.21individuals who are knowledgeable, trained, and practicing in the diagnosis and treatment 59.22of mental illness or developmental disability; the medical officer, or the officer's designee 59.23on duty at the facility, including a licensed physician, a registered licensed physician 59.24assistant, or an advanced practice registered nurse who after preliminary examination has 59.25determined that the person has symptoms of mental illness or developmental disability 59.26and appears to be in danger of harming self or others if not immediately detained; or (2) a 59.27written statement is made by the institution program director or the director's designee 59.28on duty at the facility after preliminary examination that the person has symptoms 59.29of chemical dependency and appears to be in danger of harming self or others if not 59.30immediately detained or is intoxicated in public.59.31    Sec. 89. Minnesota Statutes 2008, section 256B.0625, subdivision 28a, is amended to 59.32read:59.33    Subd. 28a. Registered Licensed physician assistant services. Medical assistance 59.34covers services performed by a registered licensed physician assistant if the service is 59.35otherwise covered under this chapter as a physician service and if the service is within the 59.36scope of practice of a registered licensed physician assistant as defined in section 
         147A.09. 60.1    Sec. 90. Minnesota Statutes 2008, section 256B.0657, subdivision 5, is amended to 60.2read:60.3    Subd. 5. Self-directed supports option plan requirements. (a) The plan for the 60.4self-directed supports option must meet the following requirements:60.5    (1) the plan must be completed using a person-centered process that:60.6    (i) builds upon the recipient's capacity to engage in activities that promote 60.7community life;60.8    (ii) respects the recipient's preferences, choices, and abilities;60.9    (iii) involves families, friends, and professionals in the planning or delivery of 60.10services or supports as desired or required by the recipient; and 60.11    (iv) addresses the need for personal care assistant services identified in the recipient's 60.12self-directed supports option assessment;60.13    (2) the plan shall be developed by the recipient or by the guardian of an adult 60.14recipient or by a parent or guardian of a minor child, with the assistance of an enrolled 60.15medical assistance home care targeted case manager and may be assisted by a provider 60.16who meets the requirements established for using a person-centered planning process and 60.17shall be reviewed at least annually upon reassessment or when there is a significant change 60.18in the recipient's condition; and 60.19    (3) the plan must include the total budget amount available divided into monthly 60.20amounts that cover the number of months of personal care assistant services authorization 60.21included in the budget. The amount used each month may vary, but additional funds shall 60.22not be provided above the annual personal care assistant services authorized amount 60.23unless a change in condition is documented.60.24    (b) The commissioner shall:60.25    (1) establish the format and criteria for the plan as well as the requirements for 60.26providers who assist with plan development;60.27    (2) review the assessment and plan and, within 30 days after receiving the 60.28assessment and plan, make a decision on approval of the plan;60.29    (3) notify the recipient, parent, or guardian of approval or denial of the plan and 60.30provide notice of the right to appeal under section 
         256.045; and 60.31    (4) provide a copy of the plan to the fiscal support entity selected by the recipient.60.32    Sec. 91. Minnesota Statutes 2008, section 256B.0751, subdivision 1, is amended to 60.33read:60.34    Subdivision 1. Definitions. (a) For purposes of sections 
         256B.0751 to 
         256B.0753, 60.35the following definitions apply.61.1    (b) "Commissioner" means the commissioner of human services.61.2    (c) "Commissioners" means the commissioner of humans services and the 61.3commissioner of health, acting jointly.61.4    (d) "Health plan company" has the meaning provided in section 
         62Q.01, subdivision 61.54.61.6    (e) "Personal clinician" means a physician licensed under chapter 147, a physician 61.7assistant registered licensed and practicing under chapter 147A, or an advanced practice 61.8nurse licensed and registered to practice under chapter 148.61.9    (f) "State health care program" means the medical assistance, MinnesotaCare, and 61.10general assistance medical care programs.61.11    Sec. 92. Minnesota Statutes 2008, section 256B.0913, subdivision 4, is amended to 61.12read:61.13    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.61.14    (a) Funding for services under the alternative care program is available to persons who 61.15meet the following criteria:61.16    (1) the person has been determined by a community assessment under section 61.17256B.0911
          to be a person who would require the level of care provided in a nursing 61.18facility, but for the provision of services under the alternative care program;61.19    (2) the person is age 65 or older;61.20    (3) the person would be eligible for medical assistance within 135 days of admission 61.21to a nursing facility;61.22    (4) the person is not ineligible for the payment of long-term care services by the 61.23medical assistance program due to an asset transfer penalty under section 
         256B.0595 or 61.24equity interest in the home exceeding $500,000 as stated in section 
         256B.056;61.25    (5) the person needs long-term care services that are not funded through other 61.26state or federal funding, or other health insurance or other third-party insurance such as 61.27long-term care insurance;61.28    (6) the monthly cost of the alternative care services funded by the program for 61.29this person does not exceed 75 percent of the monthly limit described under section 61.30256B.0915, subdivision 3a
         . This monthly limit does not prohibit the alternative care 61.31client from payment for additional services, but in no case may the cost of additional 61.32services purchased under this section exceed the difference between the client's monthly 61.33service limit defined under section 
         256B.0915, subdivision 3, and the alternative care 61.34program monthly service limit defined in this paragraph. If care-related supplies and 61.35equipment or environmental modifications and adaptations are or will be purchased for 61.36an alternative care services recipient, the costs may be prorated on a monthly basis for 62.1up to 12 consecutive months beginning with the month of purchase. If the monthly cost 62.2of a recipient's other alternative care services exceeds the monthly limit established in 62.3this paragraph, the annual cost of the alternative care services shall be determined. In this 62.4event, the annual cost of alternative care services shall not exceed 12 times the monthly 62.5limit described in this paragraph; and62.6    (7) the person is making timely payments of the assessed monthly fee.62.7A person is ineligible if payment of the fee is over 60 days past due, unless the person 62.8agrees to:62.9    (i) the appointment of a representative payee;62.10    (ii) automatic payment from a financial account;62.11    (iii) the establishment of greater family involvement in the financial management of 62.12payments; or62.13    (iv) another method acceptable to the lead agency to ensure prompt fee payments.62.14    The lead agency may extend the client's eligibility as necessary while making 62.15arrangements to facilitate payment of past-due amounts and future premium payments. 62.16Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be 62.17reinstated for a period of 30 days.62.18    (b) Alternative care funding under this subdivision is not available for a person 62.19who is a medical assistance recipient or who would be eligible for medical assistance 62.20without a spenddown or waiver obligation. A person whose initial application for medical 62.21assistance and the elderly waiver program is being processed may be served under the 62.22alternative care program for a period up to 60 days. If the individual is found to be eligible 62.23for medical assistance, medical assistance must be billed for services payable under the 62.24federally approved elderly waiver plan and delivered from the date the individual was 62.25found eligible for the federally approved elderly waiver plan. Notwithstanding this 62.26provision, alternative care funds may not be used to pay for any service the cost of which: 62.27(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; 62.28or (iii) is used to pay a medical assistance income spenddown for a person who is eligible 62.29to participate in the federally approved elderly waiver program under the special income 62.30standard provision.62.31    (c) Alternative care funding is not available for a person who resides in a licensed 62.32nursing home, certified boarding care home, hospital, or intermediate care facility, except 62.33for case management services which are provided in support of the discharge planning 62.34process for a nursing home resident or certified boarding care home resident to assist with 62.35a relocation process to a community-based setting.63.1    (d) Alternative care funding is not available for a person whose income is greater 63.2than the maintenance needs allowance under section 
         256B.0915, subdivision 1d, but equal 63.3to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal 63.4year for which alternative care eligibility is determined, who would be eligible for the 63.5elderly waiver with a waiver obligation.63.6    Sec. 93. Minnesota Statutes 2008, section 256B.0913, subdivision 5a, is amended to 63.7read:63.8    Subd. 5a. Services; service definitions; service standards. (a) Unless specified in 63.9statute, the services, service definitions, and standards for alternative care services shall 63.10be the same as the services, service definitions, and standards specified in the federally 63.11approved elderly waiver plan, except alternative care does not cover transitional support 63.12services, assisted living services, adult foster care services, and residential care and 63.13benefits defined under section 
         256B.0625 that meet primary and acute health care needs.63.14    (b) The lead agency must ensure that the funds are not used to supplant or 63.15supplement services available through other public assistance or services programs, 63.16including supplementation of client co-pays, deductibles, premiums, or other cost-sharing 63.17arrangements for health-related benefits and services or entitlement programs and 63.18services that are available to the person, but in which they have elected not to enroll. 63.19The lead agency must ensure that the benefit department recovery system in the Medicaid 63.20Management Information System (MMIS) has the necessary information on any other 63.21health insurance or third-party insurance policy to which the client may have access. For a 63.22provider of supplies and equipment when the monthly cost of the supplies and equipment 63.23is less than $250, persons or agencies must be employed by or under a contract with the 63.24lead agency or the public health nursing agency of the local board of health in order to 63.25receive funding under the alternative care program. Supplies and equipment may be 63.26purchased from a vendor not certified to participate in the Medicaid program if the cost for 63.27the item is less than that of a Medicaid vendor.63.28    (c) Personal care services must meet the service standards defined in the federally 63.29approved elderly waiver plan, except that a lead agency may contract with a client's 63.30relative who meets the relative hardship waiver requirements or a relative who meets the 63.31criteria and is also the responsible party under an individual service plan that ensures the 63.32client's health and safety and supervision of the personal care services by a qualified 63.33professional as defined in section 
         256B.0625, subdivision 19c. Relative hardship is 63.34established by the lead agency when the client's care causes a relative caregiver to do any 63.35of the following: resign from a paying job, reduce work hours resulting in lost wages, 63.36obtain a leave of absence resulting in lost wages, incur substantial client-related expenses, 64.1provide services to address authorized, unstaffed direct care time, or meet special needs of 64.2the client unmet in the formal service plan.64.3    Sec. 94. Minnesota Statutes 2008, section 256B.0913, subdivision 12, is amended to 64.4read:64.5    Subd. 12. Client fees. (a) A fee is required for all alternative care eligible clients 64.6to help pay for the cost of participating in the program. The amount of the fee for the 64.7alternative care client shall be determined as follows:64.8    (1) when the alternative care client's income less recurring and predictable medical 64.9expenses is less than 100 percent of the federal poverty guideline effective on July 1 of 64.10the state fiscal year in which the fee is being computed, and total assets are less than 64.11$10,000, the fee is zero;64.12    (2) when the alternative care client's income less recurring and predictable medical 64.13expenses is equal to or greater than 100 percent but less than 150 percent of the federal 64.14poverty guideline effective on July 1 of the state fiscal year in which the fee is being 64.15computed, and total assets are less than $10,000, the fee is five percent of the cost of 64.16alternative care services;64.17    (3) when the alternative care client's income less recurring and predictable medical 64.18expenses is equal to or greater than 150 percent but less than 200 percent of the federal 64.19poverty guidelines effective on July 1 of the state fiscal year in which the fee is being 64.20computed and assets are less than $10,000, the fee is 15 percent of the cost of alternative 64.21care services;64.22    (4) when the alternative care client's income less recurring and predictable medical 64.23expenses is equal to or greater than 200 percent of the federal poverty guidelines effective 64.24on July 1 of the state fiscal year in which the fee is being computed and assets are less than 64.25$10,000, the fee is 30 percent of the cost of alternative care services; and64.26    (5) when the alternative care client's assets are equal to or greater than $10,000, the 64.27fee is 30 percent of the cost of alternative care services.64.28    For married persons, total assets are defined as the total marital assets less the 64.29estimated community spouse asset allowance, under section 
         256B.059, if applicable. For 64.30married persons, total income is defined as the client's income less the monthly spousal 64.31allotment, under section 
         256B.058. 64.32    All alternative care services shall be included in the estimated costs for the purpose 64.33of determining the fee.64.34    Fees are due and payable each month alternative care services are received unless the 64.35actual cost of the services is less than the fee, in which case the fee is the lesser amount.64.36    (b) The fee shall be waived by the commissioner when:65.1    (1) a person is residing in a nursing facility;65.2    (2) a married couple is requesting an asset assessment under the spousal 65.3impoverishment provisions;65.4    (3) a person is found eligible for alternative care, but is not yet receiving alternative 65.5care services including case management services; or65.6    (4) a person has chosen to participate in a consumer-directed service plan for which 65.7the cost is no greater than the total cost of the person's alternative care service plan less 65.8the monthly fee amount that would otherwise be assessed.65.9    (c) The commissioner will bill and collect the fee from the client. Money collected 65.10must be deposited in the general fund and is appropriated to the commissioner for the 65.11alternative care program. The client must supply the lead agency with the client's Social 65.12Security number at the time of application. The lead agency shall supply the commissioner 65.13with the client's Social Security number and other information the commissioner requires 65.14to collect the fee from the client. The commissioner shall collect unpaid fees using the 65.15Revenue Recapture Act in chapter 270A and other methods available to the commissioner. 65.16The commissioner may require lead agencies to inform clients of the collection procedures 65.17that may be used by the state if a fee is not paid. This paragraph does not apply to 65.18alternative care pilot projects authorized in Laws 1993, First Special Session chapter 1, 65.19article 5, section 133, if a county operating under the pilot project reports the following 65.20dollar amounts to the commissioner quarterly:65.21    (1) total fees billed to clients;65.22    (2) total collections of fees billed; and65.23    (3) balance of fees owed by clients.65.24If a lead agency does not adhere to these reporting requirements, the commissioner may 65.25terminate the billing, collecting, and remitting portions of the pilot project and require the 65.26lead agency involved to operate under the procedures set forth in this paragraph.65.27    Sec. 95. Minnesota Statutes 2008, section 256B.0915, subdivision 2, is amended to 65.28read:65.29    Subd. 2. Spousal impoverishment policies. The commissioner shall apply:65.30    (1) the spousal impoverishment criteria as authorized under United States Code, title 65.3142, section 1396r-5, and as implemented in sections 
         256B.0575, 
         256B.058, and 
         256B.059;, 65.32except that individuals with income at or below the special income standard according 65.33to Code of Federal Regulations, title 42, section 435.236, receive the maintenance needs 65.34amount in subdivision 1d.65.35    (2) the personal needs allowance permitted in section 256B.0575; and66.1    (3) an amount equivalent to the group residential housing rate as set by section 66.2256I.03, subdivision 5, and according to the approved federal waiver and medical 66.3assistance state plan. 66.4    Sec. 96. Minnesota Statutes 2008, section 256B.431, subdivision 10, is amended to 66.5read:66.6    Subd. 10. Property rate adjustments and construction projects. A nursing 66.7facility's facility completing a construction project that is eligible for a rate adjustment 66.8under section 256B.434, subdivision 4f, and that was not approved through the moratorium 66.9exception process in section 144A.073 must request for from the commissioner a 66.10property-related payment rate adjustment and the related supporting documentation of 66.11project construction cost information must be submitted to the commissioner. If the 66.12request is made within 60 days after the construction project's completion date to be 66.13considered eligible for a property-related payment rate adjustment the effective date of 66.14the rate adjustment is the first of the month following the completion date. If the request 66.15is made more than 60 days after the completion date, the rate adjustment is effective on 66.16the first of the month following the request. The commissioner shall provide a rate notice 66.17reflecting the allowable costs within 60 days after receiving all the necessary information 66.18to compute the rate adjustment. No sooner than the effective date of the rate adjustment 66.19for the building construction project, a nursing facility may adjust its rates by the amount 66.20anticipated to be allowed. Any amounts collected from private pay residents in excess of 66.21the allowable rate must be repaid to private pay residents with interest at the rate used by 66.22the commissioner of revenue for the late payment of taxes and in effect on the date the 66.23rate increase is effective. Construction projects with completion dates within one year 66.24of the completion date associated with the property rate adjustment request and phased 66.25projects with project completion dates within three years of the last phase of the phased 66.26project must be aggregated for purposes of the minimum thresholds in subdivisions 16 66.27and 17, and the maximum threshold in section 
         144A.071, subdivision 2. "Construction 66.28project" and "project construction costs" have the meanings given them in Minnesota 66.29Statutes, section 
         144A.071, subdivision 1a. 66.30    Sec. 97. Minnesota Statutes 2008, section 256B.433, subdivision 1, is amended to read:66.31    Subdivision 1. Setting payment; monitoring use of therapy services. The 66.32commissioner shall promulgate adopt rules pursuant to under the Administrative 66.33Procedure Act to set the amount and method of payment for ancillary materials and 66.34services provided to recipients residing in nursing facilities. Payment for materials and 66.35services may be made to either the nursing facility in the operating cost per diem, to the 67.1vendor of ancillary services pursuant to Minnesota Rules, parts 9505.0170 to 9505.0475,67.2or to a nursing facility pursuant to Minnesota Rules, parts 9505.0170 to 9505.0475. 67.3Payment for the same or similar service to a recipient shall not be made to both the nursing 67.4facility and the vendor. The commissioner shall ensure the avoidance of double payments 67.5through audits and adjustments to the nursing facility's annual cost report as required by 67.6section 
         256B.47, and that charges and arrangements for ancillary materials and services 67.7are cost-effective and as would be incurred by a prudent and cost-conscious buyer. 67.8Therapy services provided to a recipient must be medically necessary and appropriate 67.9to the medical condition of the recipient. If the vendor, nursing facility, or ordering 67.10physician cannot provide adequate medical necessity justification, as determined by the 67.11commissioner, the commissioner may recover or disallow the payment for the services 67.12and may require prior authorization for therapy services as a condition of payment or 67.13may impose administrative sanctions to limit the vendor, nursing facility, or ordering 67.14physician's participation in the medical assistance program. If the provider number of a 67.15nursing facility is used to bill services provided by a vendor of therapy services that is 67.16not related to the nursing facility by ownership, control, affiliation, or employment status, 67.17no withholding of payment shall be imposed against the nursing facility for services not 67.18medically necessary except for funds due the unrelated vendor of therapy services as 67.19provided in subdivision 3, paragraph (c). For the purpose of this subdivision, no monetary 67.20recovery may be imposed against the nursing facility for funds paid to the unrelated 67.21vendor of therapy services as provided in subdivision 3, paragraph (c), for services not 67.22medically necessary. For purposes of this section and section 
         256B.47, therapy includes 67.23physical therapy, occupational therapy, speech therapy, audiology, and mental health 67.24services that are covered services according to Minnesota Rules, parts 9505.0170 to 67.259505.0475, and that could be reimbursed separately from the nursing facility per diem. 67.26For purposes of this subdivision, "ancillary services" include transportation defined as 67.27a covered service in section 256B.0625, subdivision 17.67.28    Sec. 98. Minnesota Statutes 2008, section 256B.441, subdivision 5, is amended to read:67.29    Subd. 5. Administrative costs. "Administrative costs" means the direct costs for 67.30administering the overall activities of the nursing home. These costs include salaries and 67.31wages of the administrator, assistant administrator, business office employees, security 67.32guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases 67.33related to business office functions, licenses, and permits except as provided in the external 67.34fixed costs category, employee recognition, travel including meals and lodging, all training67.35except as specified in subdivision 11, voice and data communication or transmission, 67.36office supplies, liability insurance and other forms of insurance not designated to other 68.1areas, personnel recruitment, legal services, accounting services, management or business 68.2consultants, data processing, information technology, Web site, central or home office 68.3costs, business meetings and seminars, postage, fees for professional organizations, 68.4subscriptions, security services, advertising, board of director's fees, working capital 68.5interest expense, and bad debts and bad debt collection fees.68.6    Sec. 99. Minnesota Statutes 2008, section 256B.441, subdivision 11, is amended to 68.7read:68.8    Subd. 11. Direct care costs. "Direct care costs" means costs for the wages of 68.9nursing administration, staff education, direct care registered nurses, licensed practical 68.10nurses, certified nursing assistants, trained medication aides, employees conducting 68.11training in resident care topics and associated fringe benefits and payroll taxes; services 68.12from a supplemental nursing services agency; supplies that are stocked at nursing stations 68.13or on the floor and distributed or used individually, including, but not limited to: alcohol, 68.14applicators, cotton balls, incontinence pads, disposable ice bags, dressings, bandages, 68.15water pitchers, tongue depressors, disposable gloves, enemas, enema equipment, soap, 68.16medication cups, diapers, plastic waste bags, sanitary products, thermometers, hypodermic 68.17needles and syringes, clinical reagents or similar diagnostic agents, drugs that are not paid 68.18on a separate fee schedule by the medical assistance program or any other payer, and 68.19technology related to the provision of nursing care to residents, such as electronic charting 68.20systems; costs of materials used for resident care training, and training courses outside of 68.21the facility attended by direct care staff on resident care topics.68.22    Sec. 100. Minnesota Statutes 2008, section 256B.5011, subdivision 2, is amended to 68.23read:68.24    Subd. 2. Contract provisions. (a) The service contract with each intermediate 68.25care facility must include provisions for:68.26(1) modifying payments when significant changes occur in the needs of the 68.27consumers;68.28(2) the establishment and use of a quality improvement plan. Using criteria and 68.29options for performance measures developed by the commissioner, each intermediate care 68.30facility must identify a minimum of one performance measure on which to focus its efforts 68.31for quality improvement during the contract period;68.32(3) (2) appropriate and necessary statistical information required by the 68.33commissioner;68.34(4) (3) annual aggregate facility financial information; and69.1(5) (4) additional requirements for intermediate care facilities not meeting the 69.2standards set forth in the service contract.69.3(b) The commissioner of human services and the commissioner of health, in 69.4consultation with representatives from counties, advocacy organizations, and the provider 69.5community, shall review the consolidated standards under chapter 245B and the supervised 69.6living facility rule under Minnesota Rules, chapter 4665, to determine what provisions 69.7in Minnesota Rules, chapter 4665, may be waived by the commissioner of health for 69.8intermediate care facilities in order to enable facilities to implement the performance 69.9measures in their contract and provide quality services to residents without a duplication 69.10of or increase in regulatory requirements.69.11    Sec. 101. Minnesota Statutes 2008, section 256B.5012, subdivision 6, is amended to 69.12read:69.13    Subd. 6. ICF/MR rate increases October 1, 2005, and October 1, 2006. (a) For 69.14the rate periods beginning October 1, 2005, and October 1, 2006, the commissioner shall 69.15make available to each facility reimbursed under this section an adjustment to the total 69.16operating payment rate of 
         2.2553 percent.69.17(b) 75 percent of the money resulting from the rate adjustment under paragraph (a) 69.18must be used to increase wages and benefits and pay associated costs for  employees, 69.19except for administrative and central office employees. 75 percent of the money received 69.20by a facility as a result of the rate adjustment provided in paragraph (a) must be used only 69.21for wage, benefit, and staff increases implemented on or after the effective date of the rate 69.22increase each year, and must not be used for increases implemented prior to that date. The 69.23wage adjustment eligible employees may receive may vary based on merit, seniority, or 69.24other factors determined by the provider.69.25(c) For each facility, the commissioner shall make available an adjustment, based 69.26on occupied beds,  using the percentage specified in paragraph (a) multiplied by the total 69.27payment rate, including variable rate but excluding the property-related payment rate, in 69.28effect on the preceding day. The total payment rate shall include the adjustment provided 69.29in section 
         256B.501, subdivision 12.69.30(d) A facility whose payment rates are governed by closure agreements,or 69.31receivership agreements, or Minnesota Rules, part 9553.0075, is not eligible for an 69.32adjustment otherwise granted under this subdivision.69.33(e) A facility may apply for the portion of the payment rate adjustment provided 69.34under paragraph (a) for employee wages and benefits and associated costs. The application 69.35must be made to the commissioner and contain a plan by which the facility will distribute 69.36the funds according to paragraph (b). For facilities in which the employees are represented 70.1by an exclusive bargaining representative, an agreement negotiated and agreed to by the 70.2employer and the exclusive bargaining representative constitutes the plan. A negotiated 70.3agreement may constitute the plan only if the agreement is finalized after the date of 70.4enactment of all rate increases for the rate year. The commissioner shall review the plan to 70.5ensure that the payment rate adjustment per diem is used as provided in this subdivision. 70.6To be eligible, a facility must submit its plan by March 31, 2006, and December 31, 70.72006, respectively. If a facility's plan is effective for its employees after the first day of 70.8the applicable rate period that the funds are available, the payment rate adjustment per 70.9diem is effective the same date as its plan.70.10(f) A copy of the approved distribution plan must be made available to all employees 70.11by giving each employee a copy or by posting it in an area of the facility to which all 70.12employees have access. If an employee does not receive the wage and benefit adjustment 70.13described in the facility's approved plan and is unable to resolve the problem with the 70.14facility's management or through the employee's union representative, the employee 70.15may contact the commissioner at an address or telephone number provided by the 70.16commissioner and included in the approved plan.70.17    Sec. 102. Minnesota Statutes 2008, section 256B.5012, subdivision 7, is amended to 70.18read:70.19    Subd. 7. ICF/MR rate increases effective October 1, 2007, and October 1, 2008.70.20    (a) For the rate year beginning October 1, 2007, the commissioner shall make available to 70.21each facility reimbursed under this section operating payment rate adjustments equal to 70.222.0 percent of the operating payment rates in effect on September 30, 2007. For the rate 70.23year beginning October 1, 2008, the commissioner shall make available to each facility 70.24reimbursed under this section operating payment rate adjustments equal to 2.0 percent 70.25of the operating payment rates in effect on September 30, 2008. For each facility, the 70.26commissioner shall make available an adjustment, based on occupied beds, using the 70.27percentage specified in this paragraph multiplied by the total payment rate, including the 70.28variable rate but excluding the property-related payment rate, in effect on the preceding 70.29day. The total payment rate shall include the adjustment provided in section 
         256B.501, 70.30subdivision 12
         . A facility whose payment rates are governed by closure agreements,70.31or receivership agreements, or Minnesota Rules, part 9553.0075, is not eligible for an 70.32adjustment otherwise granted under this subdivision.70.33    (b) Seventy-five percent of the money resulting from the rate adjustments under 70.34paragraph (a) must be used for increases in compensation-related costs for employees 70.35directly employed by the facility on or after the effective date of the rate adjustments, 70.36except:71.1    (1) the administrator;71.2    (2) persons employed in the central office of a corporation that has an ownership 71.3interest in the facility or exercises control over the facility; and 71.4    (3) persons paid by the facility under a management contract.71.5    (c) Two-thirds of the money available under paragraph (b) must be used for wage 71.6increases for all employees directly employed by the facility on or after the effective 71.7date of the rate adjustments, except those listed in paragraph (b), clauses (1) to (3). The 71.8wage adjustment that employees receive under this paragraph must be paid as an equal 71.9hourly percentage wage increase for all eligible employees. All wage increases under this 71.10paragraph must be effective on the same date. Only costs associated with the portion of 71.11the equal hourly percentage wage increase that goes to all employees shall qualify under 71.12this paragraph. Costs associated with wage increases in excess of the amount of the equal 71.13hourly percentage wage increase provided to all employees shall be allowed only for 71.14meeting the requirements in paragraph (b). This paragraph shall not apply to employees 71.15covered by a collective bargaining agreement.71.16    (d) The commissioner shall allow as compensation-related costs all costs for:71.17    (1) wages and salaries;71.18    (2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers' 71.19compensation;71.20    (3) the employer's share of health and dental insurance, life insurance, disability 71.21insurance, long-term care insurance, uniform allowance, and pensions; and71.22    (4) other benefits provided, subject to the approval of the commissioner.71.23    (e) The portion of the rate adjustments under paragraph (a) that is not subject to the 71.24requirements in paragraphs (b) and (c) shall be provided to facilities effective October 71.251 of each year.71.26    (f) Facilities may apply for the portion of the rate adjustments under paragraph 71.27(a) that is subject to the requirements in paragraphs (b) and (c). The application 71.28must be submitted to the commissioner within six months of the effective date of the 71.29rate adjustments, and the facility must provide additional information required by 71.30the commissioner within nine months of the effective date of the rate adjustments. 71.31The commissioner must respond to all applications within three weeks of receipt. 71.32The commissioner may waive the deadlines in this paragraph under extraordinary 71.33circumstances, to be determined at the sole discretion of the commissioner. The 71.34application must contain:71.35    (1) an estimate of the amounts of money that must be used as specified in paragraphs 71.36(b) and (c);72.1    (2) a detailed distribution plan specifying the allowable compensation-related and 72.2wage increases the facility will implement to use the funds available in clause (1);72.3    (3) a description of how the facility will notify eligible employees of the contents of 72.4the approved application, which must provide for giving each eligible employee a copy of 72.5the approved application, excluding the information required in clause (1), or posting a 72.6copy of the approved application, excluding the information required in clause (1), for 72.7a period of at least six weeks in an area of the facility to which all eligible employees 72.8have access; and72.9    (4) instructions for employees who believe they have not received the 72.10compensation-related or wage increases specified in clause (2), as approved by the 72.11commissioner, and which must include a mailing address, e-mail address, and the 72.12telephone number that may be used by the employee to contact the commissioner or the 72.13commissioner's representative.72.14    (g) The commissioner shall ensure that cost increases in distribution plans under 72.15paragraph (f), clause (2), that may be included in approved applications, comply with 72.16requirements in clauses (1) to (4):72.17    (1) costs to be incurred during the applicable rate year resulting from wage and 72.18salary increases effective after October 1, 2006, and prior to the first day of the facility's 72.19payroll period that includes October 1 of each year shall be allowed if they were not used 72.20in the prior year's application and they meet the requirements of paragraphs (b) and (c);72.21    (2) a portion of the costs resulting from tenure-related wage or salary increases 72.22may be considered to be allowable wage increases, according to formulas that the 72.23commissioner shall provide, where employee retention is above the average statewide 72.24rate of retention of direct care employees;72.25    (3) the annualized amount of increases in costs for the employer's share of health 72.26and dental insurance, life insurance, disability insurance, and workers' compensation shall 72.27be allowable compensation-related increases if they are effective on or after April 1 of 72.28the year in which the rate adjustments are effective and prior to April 1 of the following 72.29year; and 72.30    (4) for facilities in which employees are represented by an exclusive bargaining 72.31representative, the commissioner shall approve the application only upon receipt of a letter 72.32of acceptance of the distribution plan, as regards members of the bargaining unit, signed 72.33by the exclusive bargaining agent and dated after May 25, 2007. Upon receipt of the letter 72.34of acceptance, the commissioner shall deem all requirements of this section as having 72.35been met in regard to the members of the bargaining unit.73.1    (h) The commissioner shall review applications received under paragraph (f) and 73.2shall provide the portion of the rate adjustments under paragraphs (b) and (c) if the 73.3requirements of this subdivision have been met. The rate adjustments shall be effective 73.4October 1 of each year. Notwithstanding paragraph (a), if the approved application 73.5distributes less money than is available, the amount of the rate adjustment shall be reduced 73.6so that the amount of money made available is equal to the amount to be distributed.73.7    Sec. 103. Minnesota Statutes 2008, section 256B.5013, subdivision 1, is amended to 73.8read:73.9    Subdivision 1. Variable rate adjustments. (a) For rate years beginning on or after 73.10October 1, 2000, when there is a documented increase in the needs of a current ICF/MR 73.11recipient, the county of financial responsibility may recommend a variable rate to enable 73.12the facility to meet the individual's increased needs. Variable rate adjustments made under 73.13this subdivision replace payments for persons with special needs under section 
         256B.501, 73.14subdivision 8
         , and payments for persons with special needs for crisis intervention services 73.15under section 
         256B.501, subdivision 8a. Effective July 1, 2003, facilities with a base rate 73.16above the 50th percentile of the statewide average reimbursement rate for a Class A 73.17facility or Class B facility, whichever matches the facility licensure, are not eligible for a 73.18variable rate adjustment. Variable rate adjustments may not exceed a 12-month period, 73.19except when approved for purposes established in paragraph (b), clause (1). Variable rate 73.20adjustments approved solely on the basis of changes on a developmental disabilities 73.21screening document will end June 30, 2002. 73.22(b) A variable rate may be recommended by the county of financial responsibility 73.23for increased needs in the following situations:73.24(1) a need for resources due to an individual's full or partial retirement from 73.25participation in a day training and habilitation service when the individual: (i) has reached 73.26the age of 65 or has a change in health condition that makes it difficult for the person 73.27to participate in day training and habilitation services over an extended period of time 73.28because it is medically contraindicated; and (ii) has expressed a desire for change through 73.29the developmental disability screening process under section 
         256B.092; 73.30(2) a need for additional resources for intensive short-term programming which is 73.31necessary prior to an individual's discharge to a less restrictive, more integrated setting;73.32(3) a demonstrated medical need that significantly impacts the type or amount of 73.33services needed by the individual; or73.34(4) a demonstrated behavioral need that significantly impacts the type or amount of 73.35services needed by the individual.74.1(c) The county of financial responsibility must justify the purpose, the projected 74.2length of time, and the additional funding needed for the facility to meet the needs of 74.3the individual.74.4(d) The facility shall provide a quarterly an annual report to the county case manager 74.5on the use of the variable rate funds and the status of the individual on whose behalf the 74.6funds were approved. The county case manager will forward the facility's report with a 74.7recommendation to the commissioner to approve or disapprove a continuation of the 74.8variable rate.74.9(e) Funds made available through the variable rate process that are not used by 74.10the facility to meet the needs of the individual for whom they were approved shall be 74.11returned to the state.74.12    Sec. 104. Minnesota Statutes 2008, section 256B.5013, subdivision 6, is amended to 74.13read:74.14    Subd. 6. Commissioner's responsibilities. The commissioner shall:74.15(1) make a determination to approve, deny, or modify a request for a variable rate 74.16adjustment within 30 days of the receipt of the completed application;74.17(2) notify the ICF/MR facility and county case manager of the duration and 74.18conditions of variable rate adjustment approvals; and74.19(3) modify MMIS II service agreements to reimburse ICF/MR facilities for approved 74.20variable rates;.74.21(4) provide notification of legislatively appropriated funding for facility closures, 74.22downsizings, and relocations;74.23(5) assess the fiscal impacts of the proposals for closures, downsizings, and 74.24relocations forwarded for consideration through the state advisory committee; and74.25(6) review the payment rate process on a biannual basis and make recommendations 74.26to the legislature for necessary adjustments to the review and approval process.74.27    Sec. 105. Minnesota Statutes 2008, section 256B.69, subdivision 9b, is amended to 74.28read:74.29    Subd. 9b. Reporting provider payment rates. (a) According to guidelines 74.30developed by the commissioner, in consultation with health care providers, managed care 74.31plans, and county-based purchasing plans, each managed care plan and county-based 74.32purchasing plan must annually provide to the commissioner, at the commissioner's request, 74.33detailed or aggregate information on reimbursement rates paid by the managed care plan 74.34under this section or the county-based purchasing plan under section 
         256B.692 to provider 74.35types providers and vendors for administrative services under contract with the plan.75.1(b) Each managed care plan and county-based purchasing plan must annually 75.2provide to the commissioner, in the form and manner specified by the commissioner:75.3(1) the amount of the payment made to the plan under this section that is paid to 75.4health care providers for patient care;75.5(2) aggregate provider payment data, categorized by inpatient payments and 75.6outpatient payments, with the outpatient payments categorized by payments to primary 75.7care providers and nonprimary care providers;75.8(3) the process by which increases or decreases in payments made to the plan 75.9under this section, that are based on actuarial analysis related to provider cost increases 75.10or decreases, or that are required by legislative action, are passed through to health care 75.11providers, categorized by payments to primary care providers and nonprimary care 75.12providers; and75.13(4) specific information on the methodology used to establish provider 75.14reimbursement rates paid by the managed health care plan and county-based purchasing 75.15plan.75.16Data provided to the commissioner under this subdivision must allow the 75.17commissioner to conduct the analyses required under paragraph (d).75.18    (b) (c) Data provided to the commissioner under this subdivision are nonpublic 75.19data as defined in section 
         13.02.75.20(d) The commissioner shall analyze data provided under this subdivision to assist the 75.21legislature in providing oversight and accountability related to expenditures under this 75.22section. The analysis must include information on payments to physicians, physician 75.23extenders, and hospitals, and may include other provider types as determined by the 75.24commissioner. The commissioner shall also array aggregate provider reimbursement rates 75.25by health plan, by primary care, and nonprimary care categories. The commissioner shall 75.26report the analysis to the legislature annually, beginning December 15, 2010, and each 75.27December 15 thereafter. The commissioner shall also make this information available on 75.28the agency's Web site to managed care and county-based purchasing plans, health care 75.29providers, and the public.75.30    Sec. 106. Minnesota Statutes 2008, section 403.03, is amended to read:75.31403.03 911 SERVICES TO BE PROVIDED.75.32Services available through a 911 system shall must include police, firefighting, 75.33and emergency medical and ambulance services. Other emergency and civil defense 75.34services may be incorporated into the 911 system at the discretion of the public agency 75.35operating the public safety answering point. The 911 system may include a referral to 75.36mental health crisis teams, where available.76.1    Sec. 107. Minnesota Statutes 2008, section 626.557, subdivision 12b, is amended to 76.2read:76.3    Subd. 12b. Data management. (a) In performing any of the duties of this section as 76.4a lead agency, the county social service agency shall maintain appropriate records. Data 76.5collected by the county social service agency under this section are welfare data under 76.6section 
         13.46. Notwithstanding section 
         13.46, subdivision 1, paragraph (a), data under this 76.7paragraph that are inactive investigative data on an individual who is a vendor of services 76.8are private data on individuals, as defined in section 
         13.02. The identity of the reporter 76.9may only be disclosed as provided in paragraph (c).76.10Data maintained by the common entry point are confidential data on individuals or 76.11protected nonpublic data as defined in section 
         13.02. Notwithstanding section 
         138.163, 76.12the common entry point shall destroy data maintain data for  three calendar years after date 76.13of receipt and then destroy the data unless otherwise directed by federal requirements.76.14(b) The commissioners of health and human services shall prepare an investigation 76.15memorandum for each report alleging maltreatment investigated under this section. 76.16County social service agencies must maintain private data on individuals but are not 76.17required to prepare an investigation memorandum. During an investigation by the 76.18commissioner of health or the commissioner of human services, data collected under this 76.19section are confidential data on individuals or protected nonpublic data as defined in 76.20section 
         13.02. Upon completion of the investigation, the data are classified as provided in 76.21clauses (1) to (3) and paragraph (c).76.22(1) The investigation memorandum must contain the following data, which are 76.23public:76.24(i) the name of the facility investigated;76.25(ii) a statement of the nature of the alleged maltreatment;76.26(iii) pertinent information obtained from medical or other records reviewed;76.27(iv) the identity of the investigator;76.28(v) a summary of the investigation's findings;76.29(vi) statement of whether the report was found to be substantiated, inconclusive, 76.30false, or that no determination will be made;76.31(vii) a statement of any action taken by the facility;76.32(viii) a statement of any action taken by the lead agency; and76.33(ix) when a lead agency's determination has substantiated maltreatment, a statement 76.34of whether an individual, individuals, or a facility were responsible for the substantiated 76.35maltreatment, if known.77.1The investigation memorandum must be written in a manner which protects the 77.2identity of the reporter and of the vulnerable adult and may not contain the names or, to 77.3the extent possible, data on individuals or private data listed in clause (2).77.4(2) Data on individuals collected and maintained in the investigation memorandum 77.5are private data, including:77.6(i) the name of the vulnerable adult;77.7(ii) the identity of the individual alleged to be the perpetrator;77.8(iii) the identity of the individual substantiated as the perpetrator; and77.9(iv) the identity of all individuals interviewed as part of the investigation.77.10(3) Other data on individuals maintained as part of an investigation under this section 77.11are private data on individuals upon completion of the investigation.77.12(c) The subject of the report may compel disclosure of the name of the reporter only 77.13with the consent of the reporter or upon a written finding by a court that the report was 77.14false and there is evidence that the report was made in bad faith. This subdivision does 77.15not alter disclosure responsibilities or obligations under the Rules of Criminal Procedure, 77.16except that where the identity of the reporter is relevant to a criminal prosecution, the 77.17district court shall do an in-camera review prior to determining whether to order disclosure 77.18of the identity of the reporter.77.19(d) Notwithstanding section 
         138.163, data maintained under this section by the 77.20commissioners of health and human services must be destroyed maintained under the 77.21following schedule and then destroyed unless otherwise directed by federal requirements:77.22(1) data from reports determined to be false, two maintained for three years after the 77.23finding was made;77.24(2) data from reports determined to be inconclusive, maintained for four years after 77.25the finding was made;77.26(3) data from reports determined to be substantiated, maintained for seven years 77.27after the finding was made; and77.28(4) data from reports which were not investigated by a lead agency and for which 77.29there is no final disposition, two maintained for three years from the date of the report.77.30(e) The commissioners of health and human services shall each annually report to 77.31the legislature and the governor on the number and type of reports of alleged maltreatment 77.32involving licensed facilities reported under this section, the number of those requiring 77.33investigation under this section, and the resolution of those investigations. The report 77.34shall identify:77.35(1) whether and where backlogs of cases result in a failure to conform with statutory 77.36time frames;78.1(2) where adequate coverage requires additional appropriations and staffing; and78.2(3) any other trends that affect the safety of vulnerable adults.78.3(f) Each lead agency must have a record retention policy.78.4(g) Lead agencies, prosecuting authorities, and law enforcement agencies may 78.5exchange not public data, as defined in section 
         13.02, if the agency or authority requesting 78.6the data determines that the data are pertinent and necessary to the requesting agency in 78.7initiating, furthering, or completing an investigation under this section. Data collected 78.8under this section must be made available to prosecuting authorities and law enforcement 78.9officials, local county agencies, and licensing agencies investigating the alleged 78.10maltreatment under this section. The lead agency shall exchange not public data with the 78.11vulnerable adult maltreatment review panel established in section 
         256.021 if the data are 78.12pertinent and necessary for a review requested under that section. Upon completion of the 78.13review, not public data received by the review panel must be returned to the lead agency.78.14(h) Each lead agency shall keep records of the length of time it takes to complete its 78.15investigations.78.16(i) A lead agency may notify other affected parties and their authorized representative 78.17if the agency has reason to believe maltreatment has occurred and determines the 78.18information will safeguard the well-being of the affected parties or dispel widespread 78.19rumor or unrest in the affected facility.78.20(j) Under any notification provision of this section, where federal law specifically 78.21prohibits the disclosure of patient identifying information, a lead agency may not provide 78.22any notice unless the vulnerable adult has consented to disclosure in a manner which 78.23conforms to federal requirements.78.24    Sec. 108. STUDY OF ALLOWING LONG-TERM CARE INSURANCE TO BE 78.25PURCHASED BY LOCAL GOVERNMENT EMPLOYEES.78.26The commissioner of management and budget, in conjunction with two 78.27representatives of state government employees, with one each to be designated by the 78.28American Federation of State, County, and Municipal Employees and the Minnesota 78.29Association of Professional Employees; one representative of local government employees 78.30to be designated by the American Federation of State, County, and Municipal Employees; 78.31and one representative each designated by the League of Minnesota Cities and the 78.32Association of Minnesota Counties, shall study allowing local government employees to 78.33purchase long-term care insurance authorized under Minnesota Statutes, section 43A.318, 78.34subdivision 2. On or before February 15, 2010, the commissioner shall report on their 78.35findings and recommendations to the chairs of the house of representatives Health Care 79.1and Human Services Policy and Oversight Committee and the senate Health, Housing, 79.2and Family Security Committee.79.3    Sec. 109. HEALTH DEPARTMENT WORKGROUP.79.4The commissioner of health shall consult with hospitals, RN staff nurses, and 79.5quality assurance staff working in facilities that report under Minnesota Statutes, section 79.6144.7065, subdivision 8, and other stakeholders, taking into account geographic balance, 79.7to define and develop questions related to staffing for inclusion in the root cause analysis 79.8tool required under that subdivision.79.9    Sec. 110. ALZHEIMER'S DISEASE WORKING GROUP.79.10    Subdivision 1.Establishment; members.The Minnesota Board on Aging must 79.11appoint, unless otherwise provided, an Alzheimer's disease working group that consists of 79.12no more than 20 members including, but not limited to:79.13(1) at least one caregiver of a person who has been diagnosed with Alzheimer's 79.14disease;79.15(2) at least one person who has been diagnosed with Alzheimer's disease;79.16(3) a representative of the nursing facility industry;79.17(4) a representative of the assisted living industry;79.18(5) a representative of the adult day services industry;79.19(6) a representative of the medical care provider community;79.20(7) a psychologist who specializes in dementia care;79.21(8) an Alzheimer's researcher;79.22(9) a representative of the Alzheimer's Association;79.23(10) the commissioner of human services or a designee;79.24(11) the commissioner of health or a designee;79.25(12) the ombudsman for long-term care or a designee; and79.26(13) at least two public members named by the governor.79.27The appointing authorities under this subdivision must complete their appointments no 79.28later than September 1, 2009.79.29    Subd. 2.Duties; recommendations.The Alzheimer's disease working group must 79.30examine the array of needs of individuals diagnosed with Alzheimer's disease, services 79.31available to meet these needs, and the capacity of the state and current providers to meet 79.32these and future needs. The working group shall consider and make recommendations and 79.33findings on the following issues:79.34(1) trends in the state's Alzheimer's population and service needs including, but 79.35not limited to:80.1(i) the state's role in long-term care, family caregiver support, and assistance to 80.2persons with early-stage and early-onset of Alzheimer's disease;80.3(ii) state policy regarding persons with Alzheimer's disease and dementia; and80.4(iii) establishment of a surveillance system to provide proper estimates of the 80.5number of persons in the state with Alzheimer's disease, and the changing population 80.6with dementia;80.7(2) existing resources, services, and capacity including, but not limited to:80.8(i) type, cost, and availability of dementia services;80.9(ii) dementia-specific training requirements for long-term care staff;80.10(iii) quality care measures for residential care facilities;80.11(iv) availability of home and community-based resources for persons with 80.12Alzheimer's disease, including respite care;80.13(v) number and availability of long-term care dementia units;80.14(vi) adequacy and appropriateness of geriatric psychiatric units for persons with 80.15behavior disorders associated with Alzheimer's and related dementia;80.16(vii) assisted living residential options for persons with dementia; and80.17(viii) state support of Alzheimer's research through Minnesota universities and 80.18other resources; and80.19(3) needed policies or responses including, but not limited to, the provision of 80.20coordinated services and supports to persons and families living with Alzheimer's and 80.21related disorders, the capacity to meet these needs, and strategies to address identified 80.22gaps in services.80.23    Subd. 3.Meetings.The board must select a designee to convene the first meeting of 80.24the working group no later than September 1, 2009. Meetings of the working group must 80.25be open to the public, and to the extent practicable, technological means, such as Web casts, 80.26shall be used to reach the greatest number of people throughout the state. The members of 80.27the working group shall select a chair from their membership at the first meeting.80.28    Subd. 4.Report.The Board on Aging must submit a report providing the findings 80.29and recommendations of the working group, including any draft legislation necessary 80.30to implement the recommendations, to the governor and chairs and ranking minority 80.31members of the legislative committees with jurisdiction over health care no later than 80.32January 15, 2011.80.33    Subd. 5.Private funding.To the extent available, the Board on Aging may utilize 80.34funding provided by private foundations and other private funding sources to complete the 80.35duties of the Alzheimer's disease working group.81.1    Subd. 6.Expiration.This section expires when the report under subdivision 4 is 81.2submitted.81.3    Sec. 111. DEADLINE FOR APPOINTMENT.81.4(a) The Minnesota Psychological Association must complete the appointment 81.5required under Minnesota Statutes, section 62U.09, subdivision 2, paragraph (a), clause 81.6(13), no later than October 1, 2009.81.7(b) The Minnesota Chiropractic Association must complete the appointment 81.8required under Minnesota Statutes, section 62U.09, subdivision2, paragraph (a), clause 81.9(14), no later than October 1, 2009.81.10    Sec. 112.  REPEALER.81.11Minnesota Statutes 2008, sections 147A.22; 148.627; 150A.09, subdivision 6; and 81.12256B.5013, subdivisions 2, 3, and 5, are repealed."81.13Delete the title and insert:81.14"A bill for an act81.15relating to state government; modifying health and human services policy 81.16provisions; changing health plan requirements; modifying nursing facility 81.17provisions; requiring licensure of physician assistants; requiring patient record 81.18keeping; changing the definition of doula services; requiring licensure of dental 81.19assistants; changing health occupation fees; imposing late fees; establishing safe 81.20patient handling in clinical settings; changing medical assistant reimbursement 81.21provisions; requiring annual payment reports from manage care plans and 81.22county-based purchasing plans; requiring a study of long-term care insurance and 81.23local government employees; creating workgroups; requiring reports;amending 81.24Minnesota Statutes 2008, sections 62A.65, subdivision 4; 62M.09, subdivision 81.253a; 62Q.525, subdivision 2; 62U.01, subdivision 8; 62U.09, subdivision 2; 81.26144.1501, subdivision 1; 144.7065, subdivisions 8, 10; 144E.001, subdivisions 81.273a, 9c; 145.56, subdivisions 1, 2; 147.09; 147A.01; 147A.02; 147A.03; 147A.04; 81.28147A.05; 147A.06; 147A.07; 147A.08; 147A.09; 147A.11; 147A.13; 147A.16; 81.29147A.18; 147A.19; 147A.20; 147A.21; 147A.23; 147A.24; 147A.26; 147A.27; 81.30148.06, subdivision 1; 148.624, subdivision 2; 148.89, subdivision 5; 148.995, 81.31subdivisions 2, 4; 150A.01, subdivision 8; 150A.02, subdivision 1; 150A.05, 81.32subdivision 2; 150A.06, subdivisions 2a, 2b, 2c, 2d, 4a, 5, 7, 8; 150A.08, 81.33subdivisions 1, 3, 3a, 5, 6, 8; 150A.081; 150A.09, subdivisions 1, 3; 150A.091, 81.34subdivisions 2, 3, 5, 7, 8, 9, 10, 11, 12, 14, 15, by adding subdivisions; 150A.10, 81.35subdivisions 1a, 2, 4; 150A.12; 150A.13; 169.345, subdivision 2; 182.6551; 81.36182.6552, by adding a subdivision; 252.27, subdivision 1a; 252.282, subdivisions 81.373, 5; 253B.02, subdivision 7; 253B.05, subdivision 2; 256B.0625, subdivision 81.3828a; 256B.0657, subdivision 5; 256B.0751, subdivision 1; 256B.0913, 81.39subdivisions 4, 5a, 12; 256B.0915, subdivision 2; 256B.431, subdivision 10; 81.40256B.433, subdivision 1; 256B.441, subdivisions 5, 11; 256B.5011, subdivision 81.412; 256B.5012, subdivisions 6, 7; 256B.5013, subdivisions 1, 6; 256B.69, 81.42subdivision 9b; 403.03; 626.557, subdivision 12b; proposing coding for new law 81.43in Minnesota Statutes, chapters 148; 182; repealing Minnesota Statutes 2008, 81.44sections 147A.22; 148.627; 150A.09, subdivision 6; 256B.5013, subdivisions 81.452, 3, 5."
         		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

82.1We request the adoption of this report and repassage of the bill.82.2House Conferees:(Signed)82.3
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                     						82.4Paul ThissenMaria Ruud82.5
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                     						82.6Julie BunnPatti Fritz82.7
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                     						82.8Tim Kelly82.9Senate Conferees:(Signed)82.10
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                     						82.11Tony LoureyJohn Marty82.12
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                     						82.13Linda HigginsYvonne Prettner Solon82.14
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                     						82.15Michelle Fischbach