1.1 	A bill for an act
1.2 	relating to health; improving access to health care delivered by advanced practice 
1.3 	registered nurses; providing penalties;amending Minnesota Statutes 2012, 
1.4 	sections 148.171, subdivisions 3, 5, 9, 10, 11, 13, 16, 21, by adding subdivisions; 
1.5 	148.181, subdivision 1; 148.191, subdivision 2; 148.211, subdivision 2, by 
1.6 	adding subdivisions; 148.231, subdivisions 1, 4, 5; 148.233, subdivision 2; 
1.7 	148.234; 148.235, by adding subdivisions; 148.251, subdivision 1; 148.261, 
1.8 	subdivision 1; 148.262, subdivisions 1, 2, 4; 148.281, subdivision 1, by adding a 
1.9 	subdivision; Minnesota Statutes 2013 Supplement, section 148.271; repealing 
1.10 	Minnesota Statutes 2012, sections 148.171, subdivision 6; 148.235, subdivisions 
1.11 	1, 2, 2a, 4, 4a, 4b, 6, 7; 148.284.
1.12 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.13 	Section 1. Minnesota Statutes 2012, section 148.171, subdivision 3, is amended to read:
1.14 		Subd. 3.Advanced practice registered nurse. "Advanced practice registered 
1.15 	nurse," abbreviated APRN, means an individual licensed as a an advanced practice
1.16 	 registered nurse by the board and certified by a national nurse certification organization 
1.17 	acceptable to the board to practice as a clinical nurse specialist, nurse anesthetist, 
1.18 	nurse-midwife, or nurse practitioner.

1.19 	Sec. 2. Minnesota Statutes 2012, section 148.171, subdivision 5, is amended to read:
1.20 		Subd. 5.Clinical nurse specialist practice. "Clinical nurse specialist practice" 
1.21 	means the provision of patient care in a particular specialty or subspecialty of advanced 
1.22 	practice registered nursing within the context of collaborative management, and includes: 
1.23 	(1) diagnosing illness and disease; (2) providing nonpharmacologic treatment, including 
1.24 	psychotherapy; (3) promoting wellness; and (4) preventing illness and disease. The 
1.25 	certified clinical nurse specialist is certified for advanced practice registered nursing in a 
1.26 	specific field of clinical nurse specialist practice.:
2.1 	(1) the diagnosis and treatment of health and illness states;
2.2 	(2) disease management;
2.3 	(3) prescribing pharmacologic and nonpharmacologic therapies;
2.4 	(4) ordering, performing, supervising, and interpreting diagnostic studies;
2.5 	(5) prevention of illness and risk behaviors;
2.6 	(6) nursing care for individuals, families, and communities;
2.7 	(7) when necessary, consulting with other health care providers or making 
2.8 	appropriate referrals for patients and families; and
2.9 	(8) integration of care across the continuum to improve patient outcomes.

2.10 	Sec. 3. Minnesota Statutes 2012, section 148.171, subdivision 9, is amended to read:
2.11 		Subd. 9.Nurse. "Nurse" means advanced practice registered nurse,  registered 
2.12 	nurse, advanced practice registered nurse, and licensed practical nurse unless the context 
2.13 	clearly refers to only one category.

2.14 	Sec. 4. Minnesota Statutes 2012, section 148.171, subdivision 10, is amended to read:
2.15 		Subd. 10.Nurse-midwife practice. "Nurse-midwife practice" means the 
2.16 	management of women's primary health care, focusing on pregnancy, childbirth, the 
2.17 	postpartum period, care of the newborn, and the family planning and gynecological needs 
2.18 	of women and includes diagnosing and providing nonpharmacologic treatment within a 
2.19 	system that provides for consultation, collaborative management, and referral as indicated 
2.20 	by the health status of patients.:
2.21 	(1) the management, diagnosis, and treatment of women's primary health care 
2.22 	including pregnancy, childbirth, postpartum period, care of the newborn, family planning, 
2.23 	partner care management relating to sexual health, and gynecological care of women 
2.24 	across the life span;
2.25 	(2) ordering, performing, supervising, and interpreting diagnostic studies;
2.26 	(3) prescribing pharmacologic and nonpharmacologic therapies; and
2.27 	(4) when necessary, consulting with other health care providers or making 
2.28 	appropriate referrals for patients and families.

2.29 	Sec. 5. Minnesota Statutes 2012, section 148.171, subdivision 11, is amended to read:
2.30 		Subd. 11.Nurse practitioner practice. "Nurse practitioner practice" means, 
2.31 	within the context of collaborative management: (1) diagnosing, directly managing, and 
2.32 	preventing acute and chronic illness and disease; and (2) promoting wellness, including 
2.33 	providing nonpharmacologic treatment. The certified nurse practitioner is certified for 
3.1 	advanced registered nurse practice in a specific field of nurse practitioner practice. the 
3.2 	provision of care including:
3.3 	(1) health promotion, disease prevention, health education, and counseling;
3.4 	(2) providing health assessment and screening activities;
3.5 	(3) diagnosing, treating, and facilitating patients' management of their acute and 
3.6 	chronic illnesses and diseases;
3.7 	(4) ordering, performing, supervising, and interpreting diagnostic studies;
3.8 	(5) prescribing pharmacologic and nonpharmacologic therapies; and
3.9 	(6) when necessary, consulting with other health care providers or making 
3.10 	appropriate referrals for patients and families.

3.11 	Sec. 6. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision 
3.12 	to read:
3.13 		Subd. 12b.Population focus. "Population focus" means the categories of patients 
3.14 	for which the advanced practice registered nurse has the educational preparation to 
3.15 	provide care and services. The categories of population foci are:
3.16 	(1) family and individual across the life-span;
3.17 	(2) adult-gerontology;
3.18 	(3) neonatal;
3.19 	(4) pediatrics;
3.20 	(5) women's and gender-related health; and
3.21 	(6) psychiatric and mental health.

3.22 	Sec. 7. Minnesota Statutes 2012, section 148.171, subdivision 13, is amended to read:
3.23 		Subd. 13.Practice of advanced practice registered nursing. (a) The "practice of 
3.24 	advanced practice registered nursing" means the performance of clinical nurse specialist 
3.25 	practice, nurse-midwife practice, nurse practitioner practice, or registered nurse anesthetist 
3.26 	practice as defined in subdivisions 5, 10, 11, and 21 an expanded scope of nursing in a role 
3.27 	and for at least one population focus. The scope of advanced practice registered nursing 
3.28 	includes, but is not limited to, performing acts of advanced assessment, diagnosing, 
3.29 	prescribing, and ordering. The practice includes functioning as a primary care provider,
3.30 	 direct care provider, case manager, consultant, educator, and researcher. The practice of 
3.31 	advanced practice registered nursing also includes accepting referrals from, consulting 
3.32 	with, cooperating with, or referring to all other types of health care providers, including 
3.33 	but not limited to physicians, chiropractors, podiatrists, and dentists, provided that the 
3.34 	advanced practice registered nurse and the other provider are practicing within their scopes 
4.1 	of practice as defined in state law. The advanced practice registered nurse must practice 
4.2 	within a health care system that provides for consultation, collaborative management, and 
4.3 	referral as indicated by the health status of the patient. An advanced practice registered 
4.4 	nursing practice requires the advanced practice registered nurse to be accountable: (1) to 
4.5 	patients for the quality of advanced nursing care rendered; (2) for recognizing limits of 
4.6 	knowledge and experience; and (3) for planning for the management of situations beyond 
4.7 	the advanced practice registered nurse's expertise. (b) The practice of advanced practice 
4.8 	registered nursing includes accepting referrals from, consulting with, cooperating with, 
4.9 	or referring to other health care providers as appropriate.

4.10 	Sec. 8. Minnesota Statutes 2012, section 148.171, subdivision 16, is amended to read:
4.11 		Subd. 16.Prescribing. "Prescribing" means the act of generating a prescription for 
4.12 	the preparation of, use of, or manner of using a drug or therapeutic device in accordance 
4.13 	with the provisions of section 148.235. Prescribing does not include recommending the 
4.14 	use of a drug or therapeutic device which is not required by the federal Food and Drug 
4.15 	Administration to meet the labeling requirements for prescription drugs and devices. 
4.16 	Prescribing also does not include recommending or administering a drug or therapeutic 
4.17 	device perioperatively for anesthesia care and related services by a certified registered 
4.18 	nurse anesthetist.

4.19 	Sec. 9. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision 
4.20 	to read:
4.21 		Subd. 17a.Primary care provider. "Primary care provider" means a licensed 
4.22 	health care provider who acts as the first point of care for comprehensive health 
4.23 	maintenance and promotion, preventative care, and undiagnosed health concerns and 
4.24 	who provides continuing care of varied health conditions not limited by cause, organ 
4.25 	systems, or diagnosis.

4.26 	Sec. 10. Minnesota Statutes 2012, section 148.171, subdivision 21, is amended to read:
4.27 		Subd. 21.Registered nurse anesthetist practice. "Registered nurse anesthetist 
4.28 	practice" means the provision of anesthesia care and related services within the context 
4.29 	of collaborative management, including:
4.30 	(1) selecting, obtaining, and administering drugs and therapeutic devices to facilitate 
4.31 	diagnostic, therapeutic, and surgical procedures upon request, assignment, or referral by a 
4.32 	patient's physician, dentist, or podiatrist.;
4.33 	(2) ordering, performing, supervising, and interpreting diagnostic studies;
5.1 	(3) prescribing pharmacologic and nonpharmacologic therapies; and
5.2 	(4) when necessary, consulting with other health care providers or making 
5.3 	appropriate referrals for patients and families.

5.4 	Sec. 11. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision 
5.5 	to read:
5.6 		Subd. 22a.Roles of advanced practice registered nurses. "Role" means one 
5.7 	of four recognized advanced practice registered nurse roles: certified registered nurse 
5.8 	anesthetist (CRNA); certified nurse-midwife (CNM); certified clinical nurse specialist 
5.9 	(CNS); or certified nurse practitioner (CNP).

5.10 	Sec. 12. Minnesota Statutes 2012, section 148.181, subdivision 1, is amended to read:
5.11 		Subdivision 1.Membership. The Board of Nursing consists of 16 members 
5.12 	appointed by the governor, each of whom must be a resident of this state. Eight members 
5.13 	must be registered nurses, each of whom must have graduated from an approved school of 
5.14 	nursing, must be licensed and currently registered as a registered nurse in this state, and 
5.15 	must have had at least five years experience in nursing practice, nursing administration, or 
5.16 	nursing education immediately preceding appointment. One of the eight must have had 
5.17 	at least two years executive or teaching experience in a baccalaureate degree nursing 
5.18 	program approved by the board under section 148.251 during the five years immediately 
5.19 	preceding appointment, one of the eight must have had at least two years executive or 
5.20 	teaching experience in an associate degree nursing program approved by the board under 
5.21 	section 148.251 during the five years immediately preceding appointment, one of the eight 
5.22 	must be practicing professional nursing in a nursing home at the time of appointment, 
5.23 	one of the eight must have had at least two years executive or teaching experience in 
5.24 	a practical nursing program approved by the board under section 148.251 during the 
5.25 	five years immediately preceding appointment, and one of the eight must be licensed 
5.26 	and have national certification and recertification as a registered nurse anesthetist, nurse 
5.27 	practitioner, nurse midwife, or clinical nurse specialist. Four of the eight must have had at 
5.28 	least five years of experience in nursing practice or nursing administration immediately 
5.29 	preceding appointment. Four members must be licensed practical nurses, each of whom 
5.30 	must have graduated from an approved school of nursing, must be licensed and currently 
5.31 	registered as a licensed practical nurse in this state, and must have had at least five years 
5.32 	experience in nursing practice immediately preceding appointment. The remaining four 
5.33 	members must be public members as defined by section 214.02.
6.1 	A member may be reappointed but may not serve more than two full terms 
6.2 	consecutively. The governor shall attempt to make appointments to the board that reflect 
6.3 	the geography of the state. The board members who are nurses should as a whole reflect 
6.4 	the broad mix of practice types and sites of nurses practicing in Minnesota.
6.5 	Membership terms, compensation of members, removal of members, the filling of 
6.6 	membership vacancies, and fiscal year and reporting requirements are as provided in 
6.7 	sections 214.07 to 214.09. Any nurse on the board who during incumbency permanently 
6.8 	ceases to be actively engaged in the practice of nursing or otherwise becomes disqualified 
6.9 	for board membership is automatically removed, and the governor shall fill the vacancy. 
6.10 	The provision of staff, administrative services, and office space; the review and processing 
6.11 	of complaints; the setting of board fees; and other provisions relating to board operations 
6.12 	are as provided in sections 148.171 to 148.285 and chapter 214. Each member of the 
6.13 	board shall file with the secretary of state the constitutional oath of office before beginning 
6.14 	the term of office.

6.15 	Sec. 13. Minnesota Statutes 2012, section 148.191, subdivision 2, is amended to read:
6.16 		Subd. 2.Powers. (a) The board is authorized to adopt and, from time to time, revise 
6.17 	rules not inconsistent with the law, as may be necessary to enable it to carry into effect the 
6.18 	provisions of sections 148.171 to 148.285. The board shall prescribe by rule curricula and 
6.19 	standards for schools and courses preparing persons for licensure under sections 148.171
6.20 	to 148.285. It shall conduct or provide for surveys of such schools and courses at such 
6.21 	times as it may deem necessary. It shall approve such schools and courses as meet the 
6.22 	requirements of sections 148.171 to 148.285 and board rules. It shall examine, license, 
6.23 	and renew the license of duly qualified applicants. It shall hold examinations at least once 
6.24 	in each year at such time and place as it may determine. It shall by rule adopt, evaluate, 
6.25 	and periodically revise, as necessary, requirements for licensure and for registration and 
6.26 	renewal of registration as defined in section 148.231. It shall maintain a record of all 
6.27 	persons licensed by the board to practice advanced practice, professional, or practical 
6.28 	nursing and all registered nurses who hold Minnesota licensure and registration and are 
6.29 	certified as advanced practice registered nurses. It shall cause the prosecution of all persons 
6.30 	violating sections 148.171 to 148.285 and have power to incur such necessary expense 
6.31 	therefor. It shall register public health nurses who meet educational and other requirements 
6.32 	established by the board by rule, including payment of a fee. It shall have power to issue 
6.33 	subpoenas, and to compel the attendance of witnesses and the production of all necessary 
6.34 	documents and other evidentiary material. Any board member may administer oaths to 
6.35 	witnesses, or take their affirmation. It shall keep a record of all its proceedings.
7.1 	(b) The board shall have access to hospital, nursing home, and other medical records 
7.2 	of a patient cared for by a nurse under review. If the board does not have a written consent 
7.3 	from a patient permitting access to the patient's records, the nurse or facility shall delete 
7.4 	any data in the record that identifies the patient before providing it to the board. The board 
7.5 	shall have access to such other records as reasonably requested by the board to assist the 
7.6 	board in its investigation. Nothing herein may be construed to allow access to any records 
7.7 	protected by section 145.64. The board shall maintain any records obtained pursuant to 
7.8 	this paragraph as investigative data under chapter 13.
7.9 	(c) The board may accept and expend grants or gifts of money or in-kind services 
7.10 	from a person, a public or private entity, or any other source for purposes consistent with 
7.11 	the board's role and within the scope of its statutory authority.
7.12 	(d) The board may accept registration fees for meetings and conferences conducted 
7.13 	for the purposes of board activities that are within the scope of its authority.

7.14 	Sec. 14. Minnesota Statutes 2012, section 148.211, is amended by adding a subdivision 
7.15 	to read:
7.16 		Subd. 1a.Initial advanced practice registered nurse licensure. (a) An applicant 
7.17 	for a license to practice as an advanced practice registered nurse (APRN) shall apply to 
7.18 	the board for a license in a format prescribed by the board and pay a fee in an amount 
7.19 	determined by statute. In no case may fees be refunded.
7.20 	(b) To be eligible for licensure:
7.21 	(1) the applicant must hold a current Minnesota professional nursing license or 
7.22 	demonstrate eligibility for licensure as a registered nurse in this jurisdiction;
7.23 	(2) the applicant shall not hold an encumbered license as a registered nurse in any 
7.24 	state or territory;
7.25 	(3) the applicant must have completed a graduate level APRN program accredited 
7.26 	by a nursing or nursing-related accrediting body that is recognized by the United States 
7.27 	Secretary of Education or the Council for Higher Education Accreditation as acceptable 
7.28 	to the board. The education will be in one of the four APRN roles and at least one 
7.29 	population focus;
7.30 	(4) the applicant must be currently certified by a national certifying body recognized 
7.31 	by the board in the APRN role and population foci appropriate to educational preparation;
7.32 	(5) the applicant must report any criminal conviction, nolo contendere plea, Alford 
7.33 	Plea, or other plea arrangement in lieu of conviction; and
7.34 	(6) the applicant must have committed no acts or omissions which are grounds for 
7.35 	disciplinary action in another jurisdiction or, if such acts have been committed and would 
8.1 	be grounds for disciplinary action as set forth in section 148.261, the board has found, 
8.2 	after investigation, that sufficient restitution has been made.
8.3 	(c) After December 31, 2015, all new graduates applying for advanced practice 
8.4 	registered nurse licensure must meet the licensure requirements in this chapter.

8.5 	Sec. 15. Minnesota Statutes 2012, section 148.211, is amended by adding a subdivision 
8.6 	to read:
8.7 		Subd. 1b.Advanced practice registered nurse grandfather provision. Any 
8.8 	advanced practice registered nurse with authority to practice as an advanced practice 
8.9 	registered nurse in this state that is valid on December 31, 2015, shall be eligible to apply 
8.10 	for licensure as an advanced practice registered nurse under the provisions of this chapter 
8.11 	with current privileges and shall be eligible for license renewal under the conditions 
8.12 	and standards prescribed in this chapter.

8.13 	Sec. 16. Minnesota Statutes 2012, section 148.211, subdivision 2, is amended to read:
8.14 		Subd. 2.Licensure by endorsement. (a) The board shall issue a license to practice
8.15 	 advanced practice registered nursing, professional nursing or practical nursing without 
8.16 	examination to an applicant who has been duly licensed or registered as a nurse under the 
8.17 	laws of another state, territory, or country, if in the opinion of the board the applicant has the 
8.18 	qualifications equivalent to the qualifications required in this state as stated in subdivision 
8.19 	1, all other laws not inconsistent with this section, and rules promulgated by the board.
8.20 	(b) After December 31, 2015, an applicant for advanced practice registered nurse 
8.21 	licensure by endorsement will be eligible for licensure if the applicant demonstrates:
8.22 	(1) current national certification or recertification in the advanced role and 
8.23 	population focus area; and
8.24 	(2) compliance with the advanced practice nursing educational requirements that 
8.25 	were in effect in Minnesota at the time the advanced practice registered nurse completed 
8.26 	the advanced practice nursing education program.

8.27 	Sec. 17. Minnesota Statutes 2012, section 148.231, subdivision 1, is amended to read:
8.28 		Subdivision 1.Registration. Every person licensed to practice advanced practice,
8.29 	 professional, or practical nursing must maintain with the board a current registration 
8.30 	for practice as a an advanced practice registered nurse, registered nurse, or licensed 
8.31 	practical nurse which must be renewed at regular intervals established by the board by 
8.32 	rule. No registration shall be issued by the board to a nurse until the nurse has submitted 
9.1 	satisfactory evidence of compliance with the procedures and minimum requirements 
9.2 	established by the board.
9.3 	The fee for periodic registration for practice as a nurse shall be determined by the 
9.4 	board by law in statute. Upon receipt of the application and the required fees, the board shall 
9.5 	verify the application and the evidence of completion of continuing education requirements 
9.6 	in effect, and thereupon issue to the nurse registration for the next renewal period. An 
9.7 	applicant for advanced practice registered nursing (APRN) renewal shall provide evidence 
9.8 	of current certification or recertification in the appropriate APRN role and at least one 
9.9 	population focus by a nationally accredited certifying body recognized by the board.

9.10 	Sec. 18. Minnesota Statutes 2012, section 148.231, subdivision 4, is amended to read:
9.11 		Subd. 4.Failure to register. Any person licensed under the provisions of sections 
9.12 	148.171 to 148.285 who fails to register within the required period shall not be entitled 
9.13 	to practice nursing in this state as an advanced practice registered nurse, a registered 
9.14 	nurse, or  a licensed practical nurse. 

9.15 	Sec. 19. Minnesota Statutes 2012, section 148.231, subdivision 5, is amended to read:
9.16 		Subd. 5.Reregistration. A person whose registration has lapsed desiring to 
9.17 	resume practice shall make application for reregistration, submit satisfactory evidence 
9.18 	of compliance with the procedures and requirements established by the board, and pay 
9.19 	the reregistration fee for the current period to the board. A penalty fee shall be required 
9.20 	from a person who practiced nursing without current registration. Thereupon, registration 
9.21 	shall be issued to the person who shall immediately be placed on the practicing list as an 
9.22 	advanced practice registered nurse, a registered nurse, or a licensed practical nurse.

9.23 	Sec. 20. Minnesota Statutes 2012, section 148.233, subdivision 2, is amended to read:
9.24 		Subd. 2.Advanced practice registered nurse. An advanced practice registered 
9.25 	nurse certified as a certified clinical nurse specialist, certified nurse-midwife, certified 
9.26 	nurse practitioner, or certified registered nurse anesthetist shall use the appropriate 
9.27 	designation: RN,CNS; RN,CNM; RN,CNP; or RN,CRNA for personal identification and 
9.28 	in documentation of services provided. Identification of educational degrees and specialty 
9.29 	fields may be added. (a) Only those persons who hold current licensure to practice 
9.30 	advanced practice registered nursing in this state may use the title advanced practice 
9.31 	registered nurse with the role designation of certified registered nurse anesthetist, certified 
9.32 	nurse-midwife, certified clinical nurse specialist, or certified nurse practitioner.
10.1 	(b) An advanced practice registered nurse shall use the appropriate designation: 
10.2 	APRN, CNS; APRN, CNM; APRN, CNP; or APRN, CRNA for personal identification 
10.3 	and in documentation of services provided. Identification of educational degrees and 
10.4 	specialty fields may be added.
10.5 	(c) The advanced practice registered nurse with an earned doctorate may use the 
10.6 	term "doctor" or abbreviation "Dr." When providing nursing care, APRNs shall provide 
10.7 	clear identification of advanced practice registered nurse designation.

10.8 	Sec. 21. Minnesota Statutes 2012, section 148.234, is amended to read:
10.9 	148.234 STATE BOUNDARIES CONSIDERATION.
10.10 	A nurse may perform medical patient care procedures and techniques at the direction 
10.11 	of a physician, a podiatrist, or a dentist, or an advanced practice registered nurse licensed 
10.12 	in another state, United States territory, or Canadian province if the physician, podiatrist, 
10.13 	or dentist, or advanced practice registered nurse gave the direction after examining the 
10.14 	patient and issued the direction in that state, United States territory, or Canadian province.
10.15 	Nothing in this section allows a nurse to perform a medical procedure patient care 
10.16 	procedure or technique at the direction of a physician, a podiatrist, or a dentist, or an 
10.17 	advanced practice registered nurse that is illegal in this state.

10.18 	Sec. 22. Minnesota Statutes 2012, section 148.235, is amended by adding a subdivision 
10.19 	to read:
10.20 		Subd. 7a.Diagnosis, prescribing, and ordering. Advanced practice registered 
10.21 	nurses are authorized to:
10.22 	(1) diagnose, prescribe, and institute therapy or referrals of patients to health care 
10.23 	agencies and providers;
10.24 	(2) prescribe, procure, sign for, record, administer, and dispense over-the-counter, 
10.25 	legend, and controlled substances, including sample drugs; and
10.26 	(3) plan and initiate a therapeutic regimen that includes ordering and prescribing 
10.27 	durable medical devices and equipment, nutrition, diagnostic, and supportive services 
10.28 	including, but not limited to, home health care, hospice, physical, and occupational therapy.

10.29 	Sec. 23. Minnesota Statutes 2012, section 148.235, is amended by adding a subdivision 
10.30 	to read:
10.31 		Subd. 7b.Drug Enforcement Administration requirements. (a) Advanced 
10.32 	practice registered nurses must:
11.1 	(1) comply with federal Drug Enforcement Administration (DEA) requirements 
11.2 	related to controlled substances; and
11.3 	(2) immediately file any and all of the nurse's DEA registrations and numbers with 
11.4 	the board.
11.5 	(b) The board shall maintain current records of all advanced practice registered 
11.6 	nurses with DEA registration and numbers.

11.7 	Sec. 24. Minnesota Statutes 2012, section 148.251, subdivision 1, is amended to read:
11.8 		Subdivision 1.Initial approval. An institution desiring to conduct a nursing 
11.9 	program shall apply to the board and submit evidence that:
11.10 	(1) It is prepared to provide a program of theory and practice in advanced practice,
11.11 	 professional, or practical nursing that meets the program approval standards adopted by 
11.12 	the board. Instruction and required experience may be obtained in one or more institutions 
11.13 	or agencies outside the applying institution as long as the nursing program retains 
11.14 	accountability for all clinical and nonclinical teaching.
11.15 	(2) It is prepared to meet other standards established by law and by the board.

11.16 	Sec. 25. Minnesota Statutes 2012, section 148.261, subdivision 1, is amended to read:
11.17 		Subdivision 1.Grounds listed. The board may deny, revoke, suspend, limit, 
11.18 	or condition the license and registration of any person to practice advanced practice,
11.19 	 professional, advanced practice registered, or practical nursing under sections 148.171 to 
11.20 	148.285, or to otherwise discipline a licensee or applicant as described in section 148.262. 
11.21 	The following are grounds for disciplinary action:
11.22 	(1) Failure to demonstrate the qualifications or satisfy the requirements for a license 
11.23 	contained in sections 148.171 to 148.285 or rules of the board. In the case of a person 
11.24 	applying for a license, the burden of proof is upon the applicant to demonstrate the 
11.25 	qualifications or satisfaction of the requirements.
11.26 	(2) Employing fraud or deceit in procuring or attempting to procure a permit, 
11.27 	license, or registration certificate to practice advanced practice, professional, or practical 
11.28 	nursing or attempting to subvert the licensing examination process. Conduct that subverts 
11.29 	or attempts to subvert the licensing examination process includes, but is not limited to:
11.30 	(i) conduct that violates the security of the examination materials, such as removing 
11.31 	examination materials from the examination room or having unauthorized possession of 
11.32 	any portion of a future, current, or previously administered licensing examination;
11.33 	(ii) conduct that violates the standard of test administration, such as communicating 
11.34 	with another examinee during administration of the examination, copying another 
12.1 	examinee's answers, permitting another examinee to copy one's answers, or possessing 
12.2 	unauthorized materials; or
12.3 	(iii) impersonating an examinee or permitting an impersonator to take the 
12.4 	examination on one's own behalf.
12.5 	(3) Conviction of a felony or gross misdemeanor reasonably related to the practice 
12.6 	of professional, advanced practice registered, or practical nursing. Conviction as used in 
12.7 	this subdivision includes a conviction of an offense that if committed in this state would 
12.8 	be considered a felony or gross misdemeanor without regard to its designation elsewhere, 
12.9 	or a criminal proceeding where a finding or verdict of guilt is made or returned but the 
12.10 	adjudication of guilt is either withheld or not entered.
12.11 	(4) Revocation, suspension, limitation, conditioning, or other disciplinary action 
12.12 	against the person's professional or practical nursing license or advanced practice 
12.13 	registered nursing credential, in another state, territory, or country; failure to report to the 
12.14 	board that charges regarding the person's nursing license or other credential are pending in 
12.15 	another state, territory, or country; or having been refused a license or other credential by 
12.16 	another state, territory, or country.
12.17 	(5) Failure to or inability to perform professional or practical nursing as defined in 
12.18 	section 148.171, subdivision 14 or 15, with reasonable skill and safety, including failure 
12.19 	of a registered nurse to supervise or a licensed practical nurse to monitor adequately the 
12.20 	performance of acts by any person working at the nurse's direction.
12.21 	(6) Engaging in unprofessional conduct, including, but not limited to, a departure 
12.22 	from or failure to conform to board rules of professional or practical nursing practice that 
12.23 	interpret the statutory definition of professional or practical nursing as well as provide 
12.24 	criteria for violations of the statutes, or, if no rule exists, to the minimal standards of 
12.25 	acceptable and prevailing professional or practical nursing practice, or any nursing 
12.26 	practice that may create unnecessary danger to a patient's life, health, or safety. Actual 
12.27 	injury to a patient need not be established under this clause.
12.28 	(7) Failure of an advanced practice registered nurse to practice with reasonable 
12.29 	skill and safety or departure from or failure to conform to standards of acceptable and 
12.30 	prevailing advanced practice registered nursing.
12.31 	(8) Delegating or accepting the delegation of a nursing function or a prescribed 
12.32 	health care function when the delegation or acceptance could reasonably be expected to 
12.33 	result in unsafe or ineffective patient care.
12.34 	(9) Actual or potential inability to practice nursing with reasonable skill and safety 
12.35 	to patients by reason of illness, use of alcohol, drugs, chemicals, or any other material, or 
12.36 	as a result of any mental or physical condition.
13.1 	(10) Adjudication as mentally incompetent, mentally ill, a chemically dependent 
13.2 	person, or a person dangerous to the public by a court of competent jurisdiction, within or 
13.3 	without this state.
13.4 	(11) Engaging in any unethical conduct, including, but not limited to, conduct likely 
13.5 	to deceive, defraud, or harm the public, or demonstrating a willful or careless disregard 
13.6 	for the health, welfare, or safety of a patient. Actual injury need not be established under 
13.7 	this clause.
13.8 	(12) Engaging in conduct with a patient that is sexual or may reasonably be 
13.9 	interpreted by the patient as sexual, or in any verbal behavior that is seductive or sexually 
13.10 	demeaning to a patient, or engaging in sexual exploitation of a patient or former patient.
13.11 	(13) Obtaining money, property, or services from a patient, other than reasonable 
13.12 	fees for services provided to the patient, through the use of undue influence, harassment, 
13.13 	duress, deception, or fraud.
13.14 	(14) Revealing a privileged communication from or relating to a patient except when 
13.15 	otherwise required or permitted by law.
13.16 	(15) Engaging in abusive or fraudulent billing practices, including violations of 
13.17 	federal Medicare and Medicaid laws or state medical assistance laws.
13.18 	(16) Improper management of patient records, including failure to maintain adequate 
13.19 	patient records, to comply with a patient's request made pursuant to sections 144.291 to 
13.20 	144.298, or to furnish a patient record or report required by law.
13.21 	(17) Knowingly aiding, assisting, advising, or allowing an unlicensed person to 
13.22 	engage in the unlawful practice of professional, advanced practice registered, or practical 
13.23 	nursing.
13.24 	(18) Violating a rule adopted by the board, an order of the board, or a state or federal 
13.25 	law relating to the practice of professional, advanced practice registered, or practical 
13.26 	nursing, or a state or federal narcotics or controlled substance law.
13.27 	(19) Knowingly providing false or misleading information that is directly related 
13.28 	to the care of that patient unless done for an accepted therapeutic purpose such as the 
13.29 	administration of a placebo.
13.30 	(20) Aiding suicide or aiding attempted suicide in violation of section 609.215 as 
13.31 	established by any of the following:
13.32 	(i) a copy of the record of criminal conviction or plea of guilty for a felony in 
13.33 	violation of section 609.215, subdivision 1 or 2;
13.34 	(ii) a copy of the record of a judgment of contempt of court for violating an 
13.35 	injunction issued under section 609.215, subdivision 4;
14.1 	(iii) a copy of the record of a judgment assessing damages under section 609.215, 
14.2 	subdivision 5; or
14.3 	(iv) a finding by the board that the person violated section 609.215, subdivision 
14.4 	1 or 2. The board shall investigate any complaint of a violation of section 609.215, 
14.5 	subdivision 1 or 2.
14.6 	(21) Practicing outside the scope of practice authorized by section 148.171, 
14.7 	subdivision 5, 10, 11, 13, 14, 15, or 21.
14.8 	(22) Practicing outside the specific field of nursing practice for which an advanced 
14.9 	practice registered nurse is certified unless the practice is authorized under section 148.284.
14.10 	(23) (22) Making a false statement or knowingly providing false information to the 
14.11 	board, failing to make reports as required by section 148.263, or failing to cooperate with 
14.12 	an investigation of the board as required by section 148.265.
14.13 	(24) (23) Engaging in false, fraudulent, deceptive, or misleading advertising.
14.14 	(25) (24) Failure to inform the board of the person's certification or recertification
14.15 	 status as a certified registered nurse anesthetist, certified nurse-midwife, certified nurse 
14.16 	practitioner, or certified clinical nurse specialist.
14.17 	(26) (25) Engaging in clinical nurse specialist practice, nurse-midwife practice, nurse 
14.18 	practitioner practice, or registered nurse anesthetist practice without current certification 
14.19 	by a national nurse certification organization acceptable to the board, except during the 
14.20 	period between completion of an advanced practice registered nurse course of study and 
14.21 	certification, not to exceed six months or as authorized by the board.
14.22 	(27) (26) Engaging in conduct that is prohibited under section 145.412.
14.23 	(28) (27) Failing to report employment to the board as required by section 148.211, 
14.24 	subdivision 2a, or knowingly aiding, assisting, advising, or allowing a person to fail to 
14.25 	report as required by section 148.211, subdivision 2a.

14.26 	Sec. 26. Minnesota Statutes 2012, section 148.262, subdivision 1, is amended to read:
14.27 		Subdivision 1.Forms of disciplinary action. When the board finds that grounds for 
14.28 	disciplinary action exist under section 148.261, subdivision 1, it may take one or more 
14.29 	of the following actions: 
14.30 	(1) deny the license, registration, or registration renewal;
14.31 	(2) revoke the license;
14.32 	(3) suspend the license;
14.33 	(4) impose limitations on the nurse's practice of advanced practice, professional, 
14.34 	advanced practice registered, or practical nursing including, but not limited to, limitation 
14.35 	of scope of practice or the requirement of practice under supervision;
15.1 	(5) impose conditions on the retention of the license including, but not limited to, the 
15.2 	imposition of retraining or rehabilitation requirements or the conditioning of continued 
15.3 	practice on demonstration of knowledge or skills by appropriate examination, monitoring, 
15.4 	or other review;
15.5 	(6) impose a civil penalty not exceeding $10,000 for each separate violation, the 
15.6 	amount of the civil penalty to be fixed as to deprive the nurse of any economic advantage 
15.7 	gained by reason of the violation charged, to reimburse the board for the cost of counsel, 
15.8 	investigation, and proceeding, and to discourage repeated violations;
15.9 	(7) order the nurse to provide unremunerated service;
15.10 	(8) censure or reprimand the nurse; or
15.11 	(9) any other action justified by the facts in the case.

15.12 	Sec. 27. Minnesota Statutes 2012, section 148.262, subdivision 2, is amended to read:
15.13 		Subd. 2.Automatic suspension. Unless the board orders otherwise, a license to 
15.14 	practice advanced practice, professional, or practical nursing is automatically suspended if:
15.15 	(1) a guardian of a nurse is appointed by order of a court under sections 524.5-101
15.16 	to 524.5-502; 
15.17 	(2) the nurse is committed by order of a court under chapter 253B; or
15.18 	(3) the nurse is determined to be mentally incompetent, mentally ill, chemically 
15.19 	dependent, or a person dangerous to the public by a court of competent jurisdiction within 
15.20 	or without this state.
15.21 	The license remains suspended until the nurse is restored to capacity by a court and, 
15.22 	upon petition by the nurse, the suspension is terminated by the board after a hearing or 
15.23 	upon agreement between the board and the nurse.

15.24 	Sec. 28. Minnesota Statutes 2012, section 148.262, subdivision 4, is amended to read:
15.25 		Subd. 4.Reissuance. The board may reinstate and reissue a license or registration 
15.26 	certificate to practice advanced practice, professional, or practical nursing, but as a 
15.27 	condition may impose any disciplinary or corrective measure that it might originally have 
15.28 	imposed. Any person whose license or registration has been revoked, suspended, or limited 
15.29 	may have the license reinstated and a new registration issued when, in the discretion of the 
15.30 	board, the action is warranted, provided that the person shall be required by the board to 
15.31 	pay the costs of the proceedings resulting in the revocation, suspension, or limitation of the 
15.32 	license or registration certificate and reinstatement of the license or registration certificate, 
15.33 	and to pay the fee for the current registration period. The cost of proceedings shall 
15.34 	include, but not be limited to, the cost paid by the board to the Office of Administrative 
16.1 	Hearings and the Office of the Attorney General for legal and investigative services, the 
16.2 	costs of a court reporter and witnesses, reproduction of records, board staff time, travel, 
16.3 	and expenses, and board members' per diem reimbursements, travel costs, and expenses.

16.4 	Sec. 29. Minnesota Statutes 2013 Supplement, section 148.271, is amended to read:
16.5 	148.271 EXEMPTIONS.
16.6 	The provisions of sections 148.171 to 148.285 shall not prohibit:
16.7 	(1) The furnishing of nursing assistance in an emergency.
16.8 	(2) The practice of advanced practice, professional, or practical nursing by any 
16.9 	legally qualified advanced practice, registered, or licensed practical nurse of another state 
16.10 	who is employed by the United States government or any bureau, division, or agency 
16.11 	thereof while in the discharge of official duties.
16.12 	(3) The practice of any profession or occupation licensed by the state, other than 
16.13 	advanced practice, professional, or practical nursing, by any person duly licensed to 
16.14 	practice the profession or occupation, or the performance by a person of any acts properly 
16.15 	coming within the scope of the profession, occupation, or license.
16.16 	(4) The provision of a nursing or nursing-related service by an unlicensed assistive 
16.17 	person who has been delegated or assigned the specific function and is supervised by a 
16.18 	registered nurse or monitored by a licensed practical nurse.
16.19 	(5) The care of the sick with or without compensation when done in a nursing home 
16.20 	covered by the provisions of section 144A.09, subdivision 1.
16.21 	(6) Professional nursing practice or advanced practice registered nursing practice by 
16.22 	a registered nurse or practical nursing practice by a licensed practical nurse licensed in 
16.23 	another state or territory who is in Minnesota as a student enrolled in a formal, structured 
16.24 	course of study, such as a course leading to a higher degree, certification in a nursing 
16.25 	specialty, or to enhance skills in a clinical field, while the student is practicing in the course.
16.26 	(7) Professional or practical nursing practice by a student practicing under the 
16.27 	supervision of an instructor while the student is enrolled in a nursing program approved by 
16.28 	the board under section 148.251.
16.29 	(8) Advanced practice registered nursing as defined in section 148.171, subdivisions 
16.30 	5, 10, 11, 13, and 21, by a registered nurse who is licensed and currently registered in 
16.31 	Minnesota or another United States jurisdiction and who is enrolled as a student in a 
16.32 	formal graduate education program leading to eligibility for certification and licensure 
16.33 	as an advanced practice registered nurse; or by a registered nurse licensed and currently 
16.34 	registered in Minnesota who has completed an advanced practice registered nurse course 
16.35 	of study and is awaiting certification, the period not to exceed six months.

17.1 	Sec. 30. Minnesota Statutes 2012, section 148.281, subdivision 1, is amended to read:
17.2 		Subdivision 1.Violations described. It shall be unlawful for any person, 
17.3 	corporation, firm, or association, to:
17.4 	(1) sell or fraudulently obtain or furnish any nursing diploma, license or record, or 
17.5 	aid or abet therein;
17.6 	(2) practice advanced practice, professional, or practical nursing, or practice 
17.7 	as a public health nurse, or practice as a certified clinical nurse specialist, certified 
17.8 	nurse-midwife, certified nurse practitioner, or certified registered nurse anesthetist
17.9 	 under cover of any diploma, permit, license, registration certificate, advanced practice 
17.10 	credential, or record illegally or fraudulently obtained or signed or issued unlawfully or 
17.11 	under fraudulent representation;
17.12 	(3) practice advanced practice, professional, or practical nursing unless the person has 
17.13 	been issued a temporary permit under the provisions of section 148.212 or is duly licensed 
17.14 	and currently registered to do so under the provisions of sections 148.171 to 148.285; 
17.15 	(4) use the professional title nurse unless duly licensed to practice advanced practice,
17.16 	 professional,  or practical nursing under the provisions of sections 148.171 to 148.285, 
17.17 	except as authorized by the board by rule; 
17.18 	(5) use any abbreviation or other designation tending to imply licensure as a an 
17.19 	advanced practice registered nurse, a registered nurse,  or a licensed practical nurse unless 
17.20 	duly licensed and currently registered so to practice advanced practice, professional, or 
17.21 	practical nursing under the provisions of sections 148.171 to 148.285 except as authorized 
17.22 	by the board by rule; 
17.23 	(6) use any title, abbreviation, or other designation tending to imply certification 
17.24 	as a certified registered nurse as defined in section 148.171, subdivision 22, unless duly 
17.25 	certified by a national nurse certification organization; 
17.26 	(7) use any abbreviation or other designation tending to imply registration as a 
17.27 	public health nurse unless duly registered by the board;
17.28 	(8) practice advanced practice, professional, advanced practice registered, or 
17.29 	practical nursing in a manner prohibited by the board in any limitation of a license or 
17.30 	registration issued under the provisions of sections 148.171 to 148.285; 
17.31 	(9) practice advanced practice, professional, advanced practice registered, or 
17.32 	practical nursing during the time a license or current registration issued under the 
17.33 	provisions of sections 148.171 to 148.285 shall be suspended or revoked; 
17.34 	(10) conduct a nursing program for the education of persons to become advanced 
17.35 	practice registered nurses, registered nurses, or licensed practical nurses unless the 
17.36 	program has been approved by the board; and
18.1 	(11) knowingly employ persons in the practice of advanced practice, professional,
18.2 	 or practical nursing who have not been issued a current permit, license, or registration 
18.3 	certificate to practice as a nurse in this state; and.
18.4 	(12) knowingly employ a person in advanced practice registered nursing unless the 
18.5 	person meets the standards and practices of sections 148.171 to 148.285. 

18.6 	Sec. 31. Minnesota Statutes 2012, section 148.281, is amended by adding a subdivision 
18.7 	to read:
18.8 		Subd. 3.Penalty; advanced practice registered nurses. An advanced practice 
18.9 	registered nurse who practices advanced practice registered nursing without current 
18.10 	licensure and certification or recertification as an advanced practice registered nurse shall 
18.11 	pay a penalty fee of $200 for the first month or part of a month and an additional $100 for 
18.12 	each subsequent month or parts of months of practice. The amount of the penalty fee shall 
18.13 	be calculated from the first day the advanced practice registered nurse practiced without 
18.14 	current advanced practice registered nurse licensure and certification or recertification 
18.15 	to the date of last practice or from the first day the advanced practice registered nurse 
18.16 	practiced without the current licensure and certification or recertification.

18.17 	Sec. 32.  REPEALER.
 18.18 	Minnesota Statutes 2012, sections 148.171, subdivision 6; 148.235, subdivisions 1, 
18.19 	2, 2a, 4, 4a, 4b, 6, and 7; and 148.284, are repealed.