HF 1760A

Conference Committee Report - 86th Legislature (2009 - 2010) Posted on 01/15/2013 08:25pm

1.1CONFERENCE COMMITTEE REPORT ON H. F. No. 1760

1.2A bill for an act

1.3relating 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, 2009
1.20The Honorable Margaret Anderson Kelliher
1.21Speaker of the House of Representatives
1.22The Honorable James P. Metzen
1.23President of the Senate
1.24We, 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; or
3.3(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 14
3.1216 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; and
3.27    (12) one consumer member appointed by AARP Minnesota;
3.28(13) one member appointed by the Minnesota Psychological Association; and
3.29(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; or
4.6(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; and
6.9(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; or
6.24(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 registered
6.33licensed 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; and
7.21(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's Physician 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 registered
11.34licensed 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; and
12.15(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 standards
12.20given 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 delegation
13.7agreement.
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 registered
13.31licensed 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; and
14.11(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 licensure
14.14after 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 licensure
14.31shall 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 registration
15.3licensure 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 registration
15.6licensure.

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 registration
15.27licensure and fulfilling all requirements then in existence for an initial registration license
15.28to 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; and
16.1(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; or
16.17(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; and
17.1(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 delegation
17.8agreement:
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; and
18.6(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; and
18.9(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 licensure
18.21or 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; and
19.3(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 delegation
19.28agreement;
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 registrant
21.19licensee; 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; and
23.10(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 registrant
23.13licensee 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, and
23.17(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; or
23.21(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 registration
23.34license 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; or
24.23(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 and also 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; and
25.34(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; or
26.7(3) the physician assistant reverts to assistant'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; or
26.12(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; and
27.5(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-PHYSICIAN
28.2ASSISTANT 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; and
28.11(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; and
28.28(3) telephone number of record change; and
28.29(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; or
29.1(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; and
29.23(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 delegation
30.8agreement 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 license
30.15renewal 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, or attest to and document provide
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 registrations
30.32licenses, 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; and
31.9(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 licensure
31.20standards;
31.21(4) applications and recommendations of applicants for registration licensure or
31.22registration license renewal; and
31.23(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; and
31.26(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; and
32.21(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; and
33.34(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; or
34.7(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; and
34.34(vi) child, family, or relationship issues;
34.35(5) psychoeducational services and treatment; and
34.36(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 registration
36.36examinations 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; or
37.9(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 registration
37.18licensure. 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 licensure
37.24examination 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 a licensed
38.3dental assistant if the following conditions are met:
38.4(1) the dentist, dental hygienist, or dental assistant is currently licensed or registered
38.5in 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; and
38.15(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; and
39.10(2) provide documentation of certification in advanced or basic cardiac life
39.11support recognized by current 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 licensure
39.32based 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; and
40.12(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 licensure
40.15requirements 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.01
41.30to 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; or
42.4(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 ; or
42.12(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; or
42.35(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 13.384
43.27and 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 registrant
45.9must 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; and
46.5(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; and
46.18(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 permit
46.23renewal 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; and
46.27(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; and
47.6(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; and
47.16(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; and
47.30(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; and
48.7(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, $50
48.15$250;
48.16(2) for a general anesthesia application only, $50 $250; and
48.17(3) for a conscious moderate sedation application only, $50. $250; and
48.18(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; and
49.27(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; and
50.8(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 registered
50.15licensed dental assistants who may only perform duties for which registration licensure
50.16is 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; and
50.34(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; and
52.12(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; and
52.21(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.12
52.28for 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 and
53.34licensees 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; and
54.8(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 or
54.15licensees. 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; or
55.25(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; and
56.22    (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; and
57.19(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; or
58.25(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; and
62.6    (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; or
62.13    (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; and
64.26    (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; or
65.6    (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; and
65.23    (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; and
66.1    (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 training
67.35except 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; and
69.1(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; and
71.22    (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; and
72.9    (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; or
73.34(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; and
74.19(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; and
74.25(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; and
75.13(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; and
76.33(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; and
77.9(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; and
77.28(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; and
78.2(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; and
79.26(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; and
80.4(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; and
80.17(viii) state support of Alzheimer's research through Minnesota universities and
80.18other resources; and
80.19(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 act

81.15relating 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

82.1	We request the adoption of this report and repassage of the bill.
82.2	House Conferees:(Signed)
82.3	.....		.....
82.4	Paul Thissen		Maria Ruud
82.5	.....		.....
82.6	Julie Bunn		Patti Fritz
82.7	.....
82.8	Tim Kelly
82.9	Senate Conferees:(Signed)
82.10	.....		.....
82.11	Tony Lourey		John Marty
82.12	.....		.....
82.13	Linda Higgins		Yvonne Prettner Solon
82.14	.....
82.15	Michelle Fischbach