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Capital IconMinnesota Legislature

HF 1760

3rd Engrossment - 86th Legislature (2009 - 2010) Posted on 02/09/2010 01:54am

KEY: stricken = removed, old language.
underscored = added, new language.
Line numbers 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 1.30 1.31 1.32 1.33
1.34 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9
2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25
2.26 2.27 2.28 2.29 2.30 2.31 2.32 2.33 2.34 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10
3.11 3.12 3.13 3.14
3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32 3.33 3.34 4.1 4.2
4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 4.33 4.34 4.35 5.1 5.2 5.3
5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15
5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 5.32 5.33 5.34 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19 6.20
6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30 6.31 6.32 6.33 6.34 6.35 7.1 7.2
7.3 7.4 7.5 7.6
7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14
7.15 7.16 7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29 7.30
7.31 7.32 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28 8.29 8.30 8.31 8.32 8.33 8.34 8.35 8.36 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22
9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 9.32 9.33 9.34 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 10.31 10.32 10.33 10.34 10.35 10.36 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25 11.26 11.27 11.28 11.29 11.30 11.31 11.32 11.33 11.34 11.35 11.36 12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26 12.27 12.28 12.29 12.30 12.31 12.32 12.33 12.34 12.35 12.36 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 13.30 13.31
13.32 13.33 13.34 13.35 14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8 14.9 14.10 14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18
14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 14.29 14.30 14.31 14.32 14.33 14.34 15.1 15.2
15.3 15.4 15.5 15.6 15.7 15.8 15.9 15.10
15.11 15.12 15.13 15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23
15.24 15.25 15.26 15.27 15.28 15.29 15.30 15.31 15.32
16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9
16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25
16.26 16.27 16.28 16.29 16.30 16.31 16.32 16.33 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31 17.32 17.33 17.34 17.35 17.36 18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16 18.17 18.18 18.19 18.20
18.21 18.22 18.23 18.24
18.25 18.26 18.27 18.28 18.29 18.30 18.31 18.32 18.33 19.1 19.2 19.3 19.4 19.5 19.6 19.7 19.8 19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 19.30 19.31 19.32 19.33 19.34 19.35 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26 20.27 20.28 20.29 20.30 20.31 20.32 20.33 20.34 20.35 20.36 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25 21.26 21.27 21.28 21.29 21.30 21.31 21.32 21.33 21.34 21.35 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 22.31 22.32 22.33 22.34 22.35 22.36 23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 23.32 23.33 23.34 23.35 23.36 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11 24.12 24.13 24.14
24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28 24.29 24.30 24.31 24.32 24.33 24.34 24.35
25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15 25.16 25.17 25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29 25.30 25.31 25.32 25.33 25.34 25.35 26.1 26.2 26.3 26.4 26.5 26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 26.30 26.31 26.32 26.33 26.34 26.35 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 27.32 27.33 27.34 27.35 28.1 28.2
28.3 28.4 28.5 28.6 28.7 28.8
28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 28.31 28.32 28.33 28.34 29.1 29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11 29.12 29.13 29.14 29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25
29.26 29.27 29.28 29.29 29.30 29.31 29.32 29.33
30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10 30.11 30.12 30.13 30.14 30.15 30.16 30.17 30.18 30.19 30.20 30.21 30.22 30.23
30.24 30.25 30.26 30.27 30.28 30.29 30.30 30.31 30.32 30.33 30.34 30.35 31.1 31.2 31.3 31.4
31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12
31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24 31.25 31.26 31.27 31.28 31.29 31.30 31.31 31.32 31.33 31.34 32.1 32.2 32.3 32.4 32.5 32.6
32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30 32.31 32.32 32.33 32.34 33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15
33.16 33.17 33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 33.31 33.32 33.33 33.34 34.1 34.2 34.3 34.4 34.5 34.6
34.7 34.8 34.9 34.10 34.11 34.12 34.13 34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26
34.27 34.28 34.29 34.30 34.31 34.32 34.33 35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20
35.21 35.22 35.23 35.24 35.25 35.26 35.27
35.28 35.29 35.30 35.31
35.32 36.1 36.2
36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31 36.32 36.33 36.34 36.35 37.1 37.2
37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17 37.18 37.19 37.20 37.21 37.22 37.23 37.24 37.25 37.26 37.27 37.28 37.29 37.30 37.31 37.32 37.33 37.34 38.1 38.2
38.3 38.4 38.5 38.6 38.7 38.8 38.9 38.10 38.11 38.12 38.13 38.14 38.15 38.16 38.17
38.18 38.19 38.20 38.21 38.22 38.23
38.24 38.25 38.26 38.27 38.28 38.29 38.30 38.31 38.32 38.33 39.1 39.2 39.3 39.4 39.5 39.6 39.7 39.8 39.9 39.10 39.11 39.12 39.13 39.14 39.15 39.16 39.17 39.18
39.19 39.20 39.21 39.22 39.23 39.24 39.25 39.26 39.27 39.28 39.29 39.30 39.31 39.32 39.33 39.34 39.35 40.1 40.2 40.3 40.4
40.5 40.6 40.7 40.8 40.9
40.10 40.11 40.12 40.13 40.14
40.15 40.16 40.17 40.18 40.19
40.20 40.21 40.22 40.23 40.24 40.25 40.26 40.27 40.28 40.29 40.30 40.31 40.32 41.1 41.2 41.3 41.4 41.5 41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14 41.15 41.16 41.17 41.18 41.19
41.20 41.21 41.22 41.23 41.24 41.25 41.26 41.27 41.28 41.29 41.30 41.31 41.32 41.33 42.1 42.2 42.3 42.4 42.5 42.6 42.7 42.8 42.9 42.10 42.11 42.12 42.13 42.14 42.15 42.16 42.17 42.18 42.19 42.20 42.21 42.22 42.23 42.24 42.25 42.26 42.27 42.28 42.29 42.30 42.31 42.32 42.33 42.34 42.35 42.36 43.1 43.2 43.3 43.4 43.5 43.6 43.7 43.8 43.9
43.10 43.11 43.12 43.13
43.14 43.15 43.16 43.17 43.18 43.19 43.20 43.21 43.22 43.23 43.24 43.25 43.26 43.27 43.28 43.29 43.30
43.31 43.32 43.33 44.1 44.2 44.3 44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14 44.15 44.16 44.17 44.18 44.19 44.20 44.21
44.22 44.23 44.24 44.25 44.26 44.27 44.28 44.29 44.30 44.31 44.32 44.33 44.34 45.1 45.2
45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25
45.26 45.27 45.28 45.29 45.30 45.31 45.32 45.33 45.34 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13
46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21
46.22 46.23 46.24 46.25 46.26 46.27 46.28
46.29 46.30 46.31 46.32 46.33 47.1 47.2 47.3 47.4 47.5 47.6
47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16 47.17 47.18 47.19
47.20 47.21 47.22 47.23 47.24 47.25 47.26 47.27 47.28
47.29 47.30 47.31 47.32
48.1 48.2 48.3 48.4 48.5 48.6 48.7 48.8
48.9 48.10 48.11 48.12 48.13 48.14 48.15 48.16 48.17
48.18 48.19 48.20 48.21 48.22 48.23
48.24 48.25 48.26 48.27 48.28 48.29 48.30 48.31 48.32
49.1 49.2 49.3 49.4 49.5 49.6 49.7 49.8 49.9
49.10 49.11 49.12 49.13 49.14 49.15 49.16 49.17 49.18 49.19 49.20
49.21 49.22 49.23 49.24 49.25 49.26 49.27
49.28 49.29 49.30 49.31 49.32 49.33
50.1 50.2 50.3 50.4 50.5 50.6
50.7 50.8 50.9 50.10
50.11 50.12 50.13 50.14 50.15
50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27 50.28 50.29 50.30 50.31 50.32 50.33 51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24 51.25 51.26 51.27 51.28 51.29 51.30 51.31 51.32 51.33 51.34 51.35 51.36 52.1 52.2 52.3 52.4 52.5 52.6 52.7 52.8 52.9 52.10 52.11 52.12 52.13 52.14 52.15 52.16 52.17 52.18 52.19 52.20 52.21 52.22 52.23 52.24 52.25 52.26 52.27
52.28 52.29 52.30 52.31 52.32 52.33 52.34 52.35 53.1 53.2 53.3 53.4 53.5 53.6 53.7 53.8
53.9 53.10 53.11 53.12 53.13 53.14 53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22 53.23 53.24 53.25 53.26 53.27 53.28
53.29 53.30 53.31 53.32 53.33 53.34 54.1 54.2 54.3 54.4
54.5 54.6 54.7 54.8 54.9 54.10 54.11 54.12 54.13 54.14 54.15 54.16 54.17 54.18 54.19 54.20 54.21 54.22 54.23 54.24 54.25 54.26 54.27 54.28 54.29 54.30 54.31 54.32 54.33 54.34 55.1 55.2 55.3 55.4 55.5 55.6 55.7 55.8 55.9 55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22 55.23 55.24 55.25 55.26 55.27 55.28 55.29 55.30 55.31 55.32 55.33 55.34 55.35 56.1 56.2 56.3 56.4
56.5 56.6 56.7 56.8 56.9 56.10 56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30 56.31 56.32 56.33 56.34 57.1 57.2
57.3 57.4 57.5 57.6
57.7 57.8 57.9 57.10 57.11 57.12
57.13 57.14 57.15 57.16 57.17 57.18 57.19 57.20 57.21 57.22 57.23 57.24 57.25 57.26 57.27 57.28 57.29 57.30 57.31 57.32 57.33 58.1 58.2 58.3 58.4 58.5 58.6 58.7 58.8 58.9 58.10
58.11 58.12 58.13 58.14 58.15 58.16 58.17 58.18 58.19 58.20 58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28 58.29 58.30 58.31
58.32 58.33 58.34 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12
59.13 59.14 59.15 59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26
59.27 59.28 59.29 59.30 59.31 59.32 59.33 60.1 60.2 60.3 60.4 60.5 60.6
60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14 60.15 60.16 60.17 60.18 60.19 60.20 60.21 60.22 60.23 60.24 60.25 60.26 60.27 60.28 60.29 60.30 60.31 60.32 60.33 60.34 60.35 61.1 61.2 61.3 61.4 61.5
61.6 61.7 61.8 61.9 61.10 61.11
61.12 61.13 61.14 61.15 61.16 61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27 61.28 61.29 61.30 61.31 61.32 61.33 61.34 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8
62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21 62.22
62.23 62.24 62.25 62.26 62.27 62.28 62.29 62.30 62.31 62.32 62.33 63.1 63.2 63.3 63.4 63.5 63.6 63.7 63.8 63.9 63.10 63.11 63.12 63.13 63.14 63.15 63.16 63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 63.31 63.32 63.33 63.34 63.35 63.36 64.1 64.2 64.3 64.4 64.5 64.6 64.7 64.8 64.9 64.10 64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19
64.20 64.21 64.22 64.23 64.24 64.25 64.26 64.27 64.28 64.29 64.30 64.31 64.32 64.33 64.34 64.35 65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15 65.16 65.17
65.18 65.19 65.20 65.21 65.22 65.23 65.24 65.25 65.26 65.27 65.28 65.29 65.30 65.31 65.32 65.33 65.34 66.1 66.2 66.3 66.4 66.5 66.6 66.7 66.8 66.9 66.10 66.11 66.12 66.13 66.14 66.15 66.16 66.17 66.18 66.19 66.20 66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 66.29 66.30 66.31 66.32 66.33 66.34 66.35 67.1 67.2 67.3 67.4 67.5 67.6 67.7 67.8
67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20
67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28 67.29 67.30 67.31 67.32 67.33 67.34 68.1 68.2 68.3 68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11 68.12
68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23 68.24 68.25 68.26 68.27 68.28 68.29 68.30 68.31 68.32 68.33 68.34 68.35 69.1 69.2 69.3 69.4 69.5 69.6 69.7 69.8 69.9 69.10
69.11 69.12 69.13 69.14 69.15 69.16 69.17 69.18 69.19 69.20 69.21 69.22 69.23 69.24
69.25 69.26 69.27 69.28 69.29 69.30 69.31 69.32 69.33 69.34 70.1 70.2 70.3 70.4 70.5 70.6
70.7 70.8 70.9 70.10 70.11 70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29
70.30 70.31 70.32 70.33 71.1 71.2 71.3 71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26 71.27 71.28 71.29 71.30 71.31 71.32 71.33 71.34 71.35 71.36 72.1 72.2
72.3 72.4 72.5 72.6 72.7 72.8 72.9 72.10 72.11 72.12 72.13 72.14 72.15 72.16 72.17 72.18 72.19 72.20 72.21 72.22 72.23 72.24 72.25 72.26 72.27 72.28 72.29 72.30 72.31 72.32 72.33 72.34 72.35 73.1 73.2 73.3 73.4 73.5 73.6 73.7 73.8 73.9 73.10 73.11 73.12 73.13 73.14 73.15 73.16 73.17 73.18 73.19 73.20 73.21 73.22 73.23 73.24 73.25 73.26 73.27 73.28 73.29 73.30 73.31 73.32 73.33 73.34 73.35 73.36 74.1 74.2 74.3 74.4 74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12 74.13 74.14 74.15 74.16 74.17 74.18 74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26 74.27 74.28
74.29 74.30 74.31 74.32 74.33 74.34 74.35 75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8 75.9 75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21 75.22 75.23 75.24 75.25 75.26 75.27 75.28 75.29 75.30 75.31 75.32 75.33
75.34 75.35 76.1 76.2 76.3 76.4 76.5 76.6 76.7 76.8 76.9 76.10 76.11 76.12 76.13
76.14 76.15 76.16 76.17 76.18 76.19 76.20 76.21 76.22 76.23 76.24 76.25 76.26 76.27 76.28 76.29 76.30 76.31 76.32 76.33 76.34 77.1 77.2 77.3 77.4 77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17
77.18 77.19 77.20 77.21 77.22 77.23 77.24
77.25 77.26 77.27 77.28 77.29 77.30 77.31 77.32 77.33 78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12 78.13 78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23 78.24 78.25 78.26 78.27 78.28 78.29 78.30 78.31 78.32 78.33 78.34 78.35 79.1 79.2 79.3 79.4 79.5 79.6 79.7 79.8 79.9 79.10 79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18 79.19 79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28 79.29 79.30 79.31 79.32 79.33 79.34 79.35 79.36 80.1 80.2 80.3 80.4 80.5 80.6 80.7 80.8 80.9 80.10 80.11 80.12 80.13 80.14
80.15 80.16 80.17 80.18 80.19 80.20 80.21 80.22 80.23 80.24 80.25 80.26 80.27 80.28
80.29 80.30 80.31 80.32 80.33 80.34
81.1 81.2 81.3 81.4 81.5 81.6 81.7 81.8 81.9 81.10 81.11 81.12 81.13 81.14 81.15 81.16 81.17 81.18 81.19 81.20 81.21 81.22 81.23 81.24 81.25 81.26 81.27 81.28 81.29 81.30 81.31 81.32 81.33 81.34 81.35 81.36 82.1 82.2 82.3 82.4 82.5 82.6 82.7 82.8 82.9 82.10 82.11 82.12 82.13 82.14 82.15 82.16 82.17 82.18 82.19 82.20 82.21 82.22 82.23 82.24 82.25 82.26 82.27 82.28
82.29 82.30 82.31 82.32 82.33 82.34 82.35
83.1 83.2 83.3

A bill for an act
relating to state government; modifying health and human services policy
provisions; changing health plan requirements; modifying nursing facility
provisions; requiring licensure of physician assistants; requiring patient record
keeping; changing the definition of doula services; requiring licensure of dental
assistants; changing health occupation fees; imposing late fees; establishing safe
patient handling in clinical settings; changing medical assistant reimbursement
provisions; requiring annual payment reports from manage care plans and
county-based purchasing plans; requiring a study of long-term care insurance and
local government employees; creating workgroups; requiring reports; amending
Minnesota Statutes 2008, sections 62A.65, subdivision 4; 62M.09, subdivision
3a; 62Q.525, subdivision 2; 62U.01, subdivision 8; 62U.09, subdivision 2;
144.1501, subdivision 1; 144.7065, subdivisions 8, 10; 144E.001, subdivisions
3a, 9c; 145.56, subdivisions 1, 2; 147.09; 147A.01; 147A.02; 147A.03; 147A.04;
147A.05; 147A.06; 147A.07; 147A.08; 147A.09; 147A.11; 147A.13; 147A.16;
147A.18; 147A.19; 147A.20; 147A.21; 147A.23; 147A.24; 147A.26; 147A.27;
148.06, subdivision 1; 148.624, subdivision 2; 148.89, subdivision 5; 148.995,
subdivisions 2, 4; 150A.01, subdivision 8; 150A.02, subdivision 1; 150A.05,
subdivision 2; 150A.06, subdivisions 2a, 2b, 2c, 2d, 4a, 5, 7, 8; 150A.08,
subdivisions 1, 3, 3a, 5, 6, 8; 150A.081; 150A.09, subdivisions 1, 3; 150A.091,
subdivisions 2, 3, 5, 7, 8, 9, 10, 11, 12, 14, 15, by adding subdivisions; 150A.10,
subdivisions 1a, 2, 4; 150A.12; 150A.13; 169.345, subdivision 2; 182.6551;
182.6552, by adding a subdivision; 252.27, subdivision 1a; 252.282, subdivisions
3, 5; 253B.02, subdivision 7; 253B.05, subdivision 2; 256B.0625, subdivision
28a; 256B.0657, subdivision 5; 256B.0751, subdivision 1; 256B.0913,
subdivisions 4, 5a, 12; 256B.0915, subdivision 2; 256B.431, subdivision 10;
256B.433, subdivision 1; 256B.441, subdivisions 5, 11; 256B.5011, subdivision
2; 256B.5012, subdivisions 6, 7; 256B.5013, subdivisions 1, 6; 256B.69,
subdivision 9b; 403.03; 626.557, subdivision 12b; proposing coding for new law
in Minnesota Statutes, chapters 148; 182; repealing Minnesota Statutes 2008,
sections 147A.22; 148.627; 150A.09, subdivision 6; 256B.5013, subdivisions 2,
3, 5.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2008, section 62A.65, subdivision 4, is amended to read:


Subd. 4.

Gender rating prohibited.

new text begin(a) new text endNo individual health plan offered, sold,
issued, or renewed to a Minnesota resident may determine the premium rate or any other
underwriting decision, including initial issuance, through a method that is in any way
based upon the gender of any person covered or to be covered under the health plan. This
subdivision prohibits the use of marital status or generalized differences in expected costs
between principal insureds and their spouses.

new text begin (b) No health carrier may refuse to initially offer, sell, or issue an individual health
plan to a Minnesota resident solely on the basis that the individual had a previous cesarean
delivery.
new text end

Sec. 2.

Minnesota Statutes 2008, section 62M.09, subdivision 3a, is amended to read:


Subd. 3a.

Mental health and substance abuse reviews.

new text begin(a) new text endA peer of the treating
mental health or substance abuse provider or a physician must review requests for
outpatient services in which the utilization review organization has concluded that a
determination not to certify a mental health or substance abuse service for clinical reasons
is appropriate, provided that any final determination not to certify treatment is made
by a psychiatrist certified by the American Board of Psychiatry and Neurology and
appropriately licensed in this statenew text begin or by a doctoral-level psychologist licensed in this state
if the treating provider is a psychologist
new text end.

new text begin (b) new text endNotwithstanding the notification requirements of section 62M.05, a utilization
review organization that has made an initial decision to certify in accordance with the
requirements of section 62M.05 may elect to provide notification of a determination to
continue coverage through facsimile or mail.

new text begin (c) new text endThis subdivision does not apply to determinations made in connection with
policies issued by a health plan company that is assessed less than three percent of the
total amount assessed by the Minnesota Comprehensive Health Association.

Sec. 3.

Minnesota Statutes 2008, section 62Q.525, subdivision 2, is amended to read:


Subd. 2.

Definitions.

(a) For purposes of this section, the terms defined in this
subdivision have the meanings given them.

(b) "Medical literature" means articles from major peer reviewed medical journals
that have recognized the drug or combination of drugs' safety and effectiveness for
treatment of the indication for which it has been prescribed. Each article shall meet the
uniform requirements for manuscripts submitted to biomedical journals established by
the International Committee of Medical Journal Editors or be published in a journal
specified by the United States Secretary of Health and Human Services pursuant to United
States Code, title 42, section 1395x, paragraph (t), clause (2), item (B), as amended, as
acceptable peer review medical literature. Each article must use generally acceptable
scientific standards and must not use case reports to satisfy this criterion.

(c) "Off-label use of drugs" means when drugs are prescribed for treatments other
than those stated in the labeling approved by the federal Food and Drug Administration.

(d) "Standard reference compendia" meansdeleted text begin:
deleted text end

deleted text begin (1) the United States Pharmacopeia Drug Information; or
deleted text end

deleted text begin (2) the American Hospital Formulary Service Drug Informationdeleted text endnew text begin any authoritative
compendia as identified by the Medicare program for use in the determination of a
medically accepted indication of drugs and biologicals used off-label
new text end.

Sec. 4.

Minnesota Statutes 2008, section 62U.01, subdivision 8, is amended to read:


Subd. 8.

Health plan company.

"Health plan company" has the meaning provided
in section 62Q.01, subdivision 4.new text begin For the purposes of this chapter, health plan company
shall include county-based purchasing arrangements authorized under section 256B.692.
new text end

Sec. 5.

Minnesota Statutes 2008, section 62U.09, subdivision 2, is amended to read:


Subd. 2.

Members.

(a) The Health Care Reform Review Council shall consist of deleted text begin14deleted text end
new text begin 16 new text endmembers who are appointed as follows:

(1) two members appointed by the Minnesota Medical Association, at least one
of whom must represent rural physicians;

(2) one member appointed by the Minnesota Nurses Association;

(3) two members appointed by the Minnesota Hospital Association, at least one of
whom must be a rural hospital administrator;

(4) one member appointed by the Minnesota Academy of Physician Assistants;

(5) one member appointed by the Minnesota Business Partnership;

(6) one member appointed by the Minnesota Chamber of Commerce;

(7) one member appointed by the SEIU Minnesota State Council;

(8) one member appointed by the AFL-CIO;

(9) one member appointed by the Minnesota Council of Health Plans;

(10) one member appointed by the Smart Buy Alliance;

(11) one member appointed by the Minnesota Medical Group Management
Association; deleted text beginand
deleted text end

(12) one consumer member appointed by AARP Minnesotanew text begin;
new text end

new text begin (13) one member appointed by the Minnesota Psychological Association; and
new text end

new text begin (14) one member appointed by the Minnesota Chiropractic Associationnew text end.

(b) If a member is no longer able or eligible to participate, a new member shall be
appointed by the entity that appointed the outgoing member.

Sec. 6.

Minnesota Statutes 2008, section 144.1501, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

(a) For purposes of this section, the following definitions
apply.

(b) "Dentist" means an individual who is licensed to practice dentistry.

(c) "Designated rural area" means:

(1) an area in Minnesota outside the counties of Anoka, Carver, Dakota, Hennepin,
Ramsey, Scott, and Washington, excluding the cities of Duluth, Mankato, Moorhead,
Rochester, and St. Cloud; or

(2) a municipal corporation, as defined under section 471.634, that is physically
located, in whole or in part, in an area defined as a designated rural area under clause (1).

(d) "Emergency circumstances" means those conditions that make it impossible for
the participant to fulfill the service commitment, including death, total and permanent
disability, or temporary disability lasting more than two years.

(e) "Medical resident" means an individual participating in a medical residency in
family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.

(f) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse
anesthetist, advanced clinical nurse specialist, or physician assistant.

(g) "Nurse" means an individual who has completed training and received all
licensing or certification necessary to perform duties as a licensed practical nurse or
registered nurse.

(h) "Nurse-midwife" means a registered nurse who has graduated from a program of
study designed to prepare registered nurses for advanced practice as nurse-midwives.

(i) "Nurse practitioner" means a registered nurse who has graduated from a program
of study designed to prepare registered nurses for advanced practice as nurse practitioners.

(j) "Pharmacist" means an individual with a valid license issued under chapter 151.

(k) "Physician" means an individual who is licensed to practice medicine in the areas
of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.

(l) "Physician assistant" means a person deleted text beginregistereddeleted text endnew text begin licensednew text end under chapter 147A.

(m) "Qualified educational loan" means a government, commercial, or foundation
loan for actual costs paid for tuition, reasonable education expenses, and reasonable living
expenses related to the graduate or undergraduate education of a health care professional.

(n) "Underserved urban community" means a Minnesota urban area or population
included in the list of designated primary medical care health professional shortage areas
(HPSAs), medically underserved areas (MUAs), or medically underserved populations
(MUPs) maintained and updated by the United States Department of Health and Human
Services.

Sec. 7.

Minnesota Statutes 2008, section 144.7065, subdivision 8, is amended to read:


Subd. 8.

Root cause analysis; corrective action plan.

Following the occurrence of
an adverse health care event, the facility must conduct a root cause analysis of the event.
new text begin In conducting the root cause analysis, the facility must consider as one of the factors
staffing levels and the impact of staffing levels on the event.
new text endFollowing the analysis, the
facility must: (1) implement a corrective action plan to implement the findings of the
analysis or (2) report to the commissioner any reasons for not taking corrective action. If
the root cause analysis and the implementation of a corrective action plan are complete at
the time an event must be reported, the findings of the analysis and the corrective action
plan must be included in the report of the event. The findings of the root cause analysis
and a copy of the corrective action plan must otherwise be filed with the commissioner
within 60 days of the event.

Sec. 8.

Minnesota Statutes 2008, section 144.7065, subdivision 10, is amended to read:


Subd. 10.

Relation to other law; data classification.

(a) Adverse health events
described in subdivisions 2 to 6 do not constitute "maltreatment," "neglect," or "a physical
injury that is not reasonably explained" under section 626.556 or 626.557 and are excluded
from the reporting requirements of sections 626.556 and 626.557, provided the facility
makes a determination within 24 hours of the discovery of the event that this section is
applicable and the facility files the reports required under this section in a timely fashion.

(b) A facility that has determined that an event described in subdivisions 2 to 6
has occurred must inform persons who are mandated reporters under section 626.556,
subdivision 3
, or 626.5572, subdivision 16, of that determination. A mandated reporter
otherwise required to report under section 626.556, subdivision 3, or 626.557, subdivision
3
, paragraph (e), is relieved of the duty to report an event that the facility determines under
paragraph (a) to be reportable under subdivisions 2 to 6.

(c) The protections and immunities applicable to voluntary reports under sections
626.556 and 626.557 are not affected by this section.

(d) Notwithstanding section 626.556, 626.557, or any other provision of Minnesota
statute or rule to the contrary, neither a lead agency under section 626.556, subdivision 3c,
or 626.5572, subdivision 13, the commissioner of health, nor the director of the Office of
Health Facility Complaints is required to conduct an investigation of or obtain or create
investigative data or reports regarding an event described in subdivisions 2 to 6. If the
facility satisfies the requirements described in paragraph (a), the review or investigation
shall be conducted and data or reports shall be obtained or created only under sections
144.706 to 144.7069, except as permitted or required under sections 144.50 to 144.564,
or as necessary to carry out the state's certification responsibility under the provisions of
sections 1864 and 1867 of the Social Security Act. new text begin If a licensed health care provider
reports an event to the facility required to be reported under subdivisions 2 to 6, in a
timely manner, the provider's licensing board is not required to conduct an investigation of
or obtain or create investigative data or reports regarding the individual reporting of the
events described in subdivisions 2 to 6.
new text end

(e) Data contained in the following records are nonpublic and, to the extent they
contain data on individuals, confidential data on individuals, as defined in section 13.02:

(1) reports provided to the commissioner under sections 147.155, 147A.155,
148.267, 151.301, and 153.255;

(2) event reports, findings of root cause analyses, and corrective action plans filed by
a facility under this section; and

(3) records created or obtained by the commissioner in reviewing or investigating
the reports, findings, and plans described in clause (2).

For purposes of the nonpublic data classification contained in this paragraph, the
reporting facility shall be deemed the subject of the data.

Sec. 9.

Minnesota Statutes 2008, section 144E.001, subdivision 3a, is amended to read:


Subd. 3a.

Ambulance service personnel.

"Ambulance service personnel" means
individuals who are authorized by a licensed ambulance service to provide emergency
care for the ambulance service and are:

(1) EMTs, EMT-Is, or EMT-Ps;

(2) Minnesota registered nurses who are: (i) EMTs, are currently practicing
nursing, and have passed a paramedic practical skills test, as approved by the board
and administered by a training program approved by the board; (ii) on the roster of an
ambulance service on or before January 1, 2000; or (iii) after petitioning the board,
deemed by the board to have training and skills equivalent to an EMT, as determined on
a case-by-case basis; or

(3) Minnesota deleted text beginregistereddeleted text endnew text begin licensednew text end physician assistants who are: (i) EMTs, are
currently practicing as physician assistants, and have passed a paramedic practical skills
test, as approved by the board and administered by a training program approved by the
board; (ii) on the roster of an ambulance service on or before January 1, 2000; or (iii) after
petitioning the board, deemed by the board to have training and skills equivalent to an
EMT, as determined on a case-by-case basis.

Sec. 10.

Minnesota Statutes 2008, section 144E.001, subdivision 9c, is amended to
read:


Subd. 9c.

Physician assistant.

"Physician assistant" means a person deleted text beginregistereddeleted text endnew text begin
licensed
new text end to practice as a physician assistant under chapter 147A.

Sec. 11.

Minnesota Statutes 2008, section 145.56, subdivision 1, is amended to read:


Subdivision 1.

Suicide prevention plan.

The commissioner of health shall refine,
coordinate, and implement the state's suicide prevention plan using an evidence-based,
public health approachnew text begin for a life span plannew text end focused onnew text begin awareness andnew text end prevention, in
collaboration with the commissioner of human services; the commissioner of public
safety; the commissioner of education; new text beginthe chancellor of Minnesota State Colleges and
Universities; the president of the University of Minnesota;
new text endand appropriate agencies,
organizations, and institutions in the community.

Sec. 12.

Minnesota Statutes 2008, section 145.56, subdivision 2, is amended to read:


Subd. 2.

Community-based programs.

To the extent funds are appropriated for the
purposes of this subdivision, the commissioner shall establish a grant program to fund:

(1) community-based programs to provide education, outreach, and advocacy
services to populations who may be at risk for suicide;

(2) community-based programs that educate community helpers and gatekeepers,
such as family members, spiritual leaders, coaches, and business owners, employers, and
coworkers on how to prevent suicide by encouraging help-seeking behaviors;

(3) community-based programs that educate populations at risk for suicide and
community helpers and gatekeepers that must include information on the symptoms
of depression and other psychiatric illnesses, the warning signs of suicide, skills for
preventing suicides, and making or seeking effective referrals to intervention and
community resources; and

(4) community-based programs to provide evidence-based suicide prevention and
intervention education to school staff, parents, and students in grades kindergarten through
12new text begin, and for students attending Minnesota colleges and universitiesnew text end.

Sec. 13.

Minnesota Statutes 2008, section 147.09, is amended to read:


147.09 EXEMPTIONS.

Section 147.081 does not apply to, control, prevent or restrict the practice, service,
or activities of:

(1) A person who is a commissioned medical officer of, a member of, or employed
by, the armed forces of the United States, the United States Public Health Service, the
Veterans Administration, any federal institution or any federal agency while engaged in
the performance of official duties within this state, if the person is licensed elsewhere.

(2) A licensed physician from a state or country who is in actual consultation here.

(3) A licensed or registered physician who treats the physician's home state patients
or other participating patients while the physicians and those patients are participating
together in outdoor recreation in this state as defined by section 86A.03, subdivision 3.
A physician shall first register with the board on a form developed by the board for that
purpose. The board shall not be required to promulgate the contents of that form by rule.
No fee shall be charged for this registration.

(4) A student practicing under the direct supervision of a preceptor while the student
is enrolled in and regularly attending a recognized medical school.

(5) A student who is in continuing training and performing the duties of an intern or
resident or engaged in postgraduate work considered by the board to be the equivalent of
an internship or residency in any hospital or institution approved for training by the board,
provided the student has a residency permit issued by the board under section 147.0391.

(6) A person employed in a scientific, sanitary, or teaching capacity by the state
university, the Department of Education, a public or private school, college, or other
bona fide educational institution, a nonprofit organization, which has tax-exempt status
in accordance with the Internal Revenue Code, section 501(c)(3), and is organized and
operated primarily for the purpose of conducting scientific research directed towards
discovering the causes of and cures for human diseases, or the state Department of Health,
whose duties are entirely of a research, public health, or educational character, while
engaged in such duties; provided that if the research includes the study of humans, such
research shall be conducted under the supervision of one or more physicians licensed
under this chapter.

(7) deleted text beginPhysician'sdeleted text end new text beginPhysiciannew text end assistants deleted text beginregistereddeleted text endnew text begin licensednew text end in this state.

(8) A doctor of osteopathy duly licensed by the state Board of Osteopathy under
Minnesota Statutes 1961, sections 148.11 to 148.16, prior to May 1, 1963, who has not
been granted a license to practice medicine in accordance with this chapter provided that
the doctor confines activities within the scope of the license.

(9) Any person licensed by a health-related licensing board, as defined in section
214.01, subdivision 2, or registered by the commissioner of health pursuant to section
214.13, including psychological practitioners with respect to the use of hypnosis; provided
that the person confines activities within the scope of the license.

(10) A person who practices ritual circumcision pursuant to the requirements or
tenets of any established religion.

(11) A Christian Scientist or other person who endeavors to prevent or cure disease
or suffering exclusively by mental or spiritual means or by prayer.

(12) A physician licensed to practice medicine in another state who is in this state
for the sole purpose of providing medical services at a competitive athletic event. The
physician may practice medicine only on participants in the athletic event. A physician
shall first register with the board on a form developed by the board for that purpose. The
board shall not be required to adopt the contents of the form by rule. The physician shall
provide evidence satisfactory to the board of a current unrestricted license in another state.
The board shall charge a fee of $50 for the registration.

(13) A psychologist licensed under section 148.907 or a social worker licensed
under chapter 148D who uses or supervises the use of a penile or vaginal plethysmograph
in assessing and treating individuals suspected of engaging in aberrant sexual behavior
and sex offenders.

(14) Any person issued a training course certificate or credentialed by the Emergency
Medical Services Regulatory Board established in chapter 144E, provided the person
confines activities within the scope of training at the certified or credentialed level.

(15) An unlicensed complementary and alternative health care practitioner practicing
according to chapter 146A.

Sec. 14.

Minnesota Statutes 2008, section 147A.01, is amended to read:


147A.01 DEFINITIONS.

Subdivision 1.

Scope.

For the purpose of this chapter the terms defined in this
section have the meanings given them.

deleted text begin Subd. 2. deleted text end

deleted text begin Active status. deleted text end

deleted text begin "Active status" means the status of a person who has met all
the qualifications of a physician assistant, has a physician-physician assistant agreement in
force, and is registered.
deleted text end

Subd. 3.

Administer.

"Administer" means the delivery by a physician assistant
authorized to prescribe legend drugs, a single dose of a legend drug, including controlled
substances, to a patient by injection, inhalation, ingestion, or by any other immediate
means, and the delivery by a physician assistant ordered by a physician a single dose of a
legend drug by injection, inhalation, ingestion, or by any other immediate means.

Subd. 4.

Agreement.

"Agreement" means the document described in section
147A.20.

Subd. 5.

Alternate supervising physician.

"Alternate supervising physician"
means a Minnesota licensed physician listed in the physician-physician assistant
new text begin delegation new text endagreementnew text begin, or supplemental listing,new text end who is responsible for supervising
the physician assistant when the deleted text beginmaindeleted text endnew text begin primarynew text end supervising physician is unavailable.
The alternate supervising physician shall accept full medical responsibility for the
performance, practice, and activities of the physician assistant while under the supervision
of the alternate supervising physician.

Subd. 6.

Board.

"Board" means the Board of Medical Practice or its designee.

Subd. 7.

Controlled substances.

"Controlled substances" has the meaning given it
in section 152.01, subdivision 4.

deleted text begin Subd. 8. deleted text end

deleted text begin Delegation form. deleted text end

deleted text begin "Delegation form" means the form used to indicate the
categories of drugs for which the authority to prescribe, administer, and dispense has been
delegated to the physician assistant and signed by the supervising physician, any alternate
supervising physicians, and the physician assistant. This form is part of the agreement
described in section 147A.20, and shall be maintained by the supervising physician and
physician assistant at the address of record. Copies shall be provided to the board upon
request. "Addendum to the delegation form" means a separate listing of the schedules
and categories of controlled substances, if any, for which the physician assistant has been
delegated the authority to prescribe, administer, and dispense. The addendum shall be
maintained as a separate document as described above.
deleted text end

Subd. 9.

Diagnostic order.

"Diagnostic order" means a directive to perform
a procedure or test, the purpose of which is to determine the cause and nature of a
pathological condition or disease.

Subd. 10.

Drug.

"Drug" has the meaning given it in section 151.01, subdivision 5,
including controlled substances as defined in section 152.01, subdivision 4.

Subd. 11.

Drug category.

"Drug category" means one of the categories listed on the
new text begin physician-physician assistant new text enddelegation deleted text beginformdeleted text endnew text begin agreementnew text end.

Subd. 12.

Inactive deleted text beginstatusdeleted text end.

"Inactive deleted text beginstatusdeleted text end" means deleted text beginthe status of a person who has
met all the qualifications of a physician assistant, and is registered, but does not have a
physician-physician assistant agreement in force
deleted text endnew text begin a licensed physician assistant whose
license has been placed on inactive status under section 147A.05
new text end.

deleted text begin Subd. 13. deleted text end

deleted text begin Internal protocol. deleted text end

deleted text begin "Internal protocol" means a document written by
the supervising physician and the physician assistant which specifies the policies and
procedures which will apply to the physician assistant's prescribing, administering,
and dispensing of legend drugs and medical devices, including controlled substances
as defined in section 152.01, subdivision 4, and lists the specific categories of drugs
and medical devices, with any exceptions or conditions, that the physician assistant
is authorized to prescribe, administer, and dispense. The supervising physician and
physician assistant shall maintain the protocol at the address of record. Copies shall be
provided to the board upon request.
deleted text end

Subd. 14.

Legend drug.

"Legend drug" has the meaning given it in section 151.01,
subdivision 17
.

new text begin Subd. 14a. new text end

new text begin Licensed. new text end

new text begin "Licensed" means meeting the qualifications in section
147A.02 and being issued a license by the board.
new text end

new text begin Subd. 14b. new text end

new text begin Licensure. new text end

new text begin "Licensure" means the process by which the board
determines that an applicant has met the standards and qualifications in this chapter.
new text end

deleted text begin Subd. 15. deleted text end

deleted text begin Locum tenens permit. deleted text end

deleted text begin "Locum tenens permit" means time specific
temporary permission for a physician assistant to practice as a physician assistant in
a setting other than the practice setting established in the physician-physician assistant
agreement.
deleted text end

Subd. 16.

Medical device.

"Medical device" means durable medical equipment and
assistive or rehabilitative appliances, objects, or products that are required to implement
the overall plan of care for the patient and that are restricted by federal law to use upon
prescription by a licensed practitioner.

new text begin Subd. 16a. new text end

new text begin Notice of intent to practice. new text end

new text begin "Notice of intent to practice" means
a document sent to the board by a licensed physician assistant that documents the
adoption of a physician-physician assistant delegation agreement and provides the names,
addresses, and information required by section 147A.20.
new text end

Subd. 17.

Physician.

"Physician" means a person currently licensed in good
standing as a physician or osteopath under chapter 147.

new text begin Subd. 17a. new text end

new text begin Physician-physician assistant delegation agreement.
new text end

new text begin "Physician-physician assistant delegation agreement" means the document prepared and
signed by the physician and physician assistant affirming the supervisory relationship and
defining the physician assistant scope of practice. Alternate supervising physicians must be
identified on the delegation agreement or a supplemental listing with signed attestation that
each shall accept full medical responsibility for the performance, practice, and activities of
the physician assistant while under the supervision of the alternate supervising physician.
The physician-physician assistant delegation agreement outlines the role of the physician
assistant in the practice, describes the means of supervision, and specifies the categories of
drugs, controlled substances, and medical devices that the supervising physician delegates
to the physician assistant to prescribe. The physician-physician assistant delegation
agreement must comply with the requirements of section 147A.20, be kept on file at the
address of record, and be made available to the board or its representative upon request.
new text end

Subd. 18.

Physician assistant or deleted text beginregistereddeleted text endnew text begin licensednew text end physician assistant.

"Physician assistant" or "deleted text beginregistereddeleted text endnew text begin licensednew text end physician assistant" means a person deleted text beginregistereddeleted text endnew text begin
licensed
new text end pursuant to this chapter who deleted text beginis qualified by academic or practical training or
both to provide patient services as specified in this chapter, under the supervision of a
supervising physician
deleted text endnew text begin meets the qualifications in section 147A.02new text end.

deleted text begin Subd. 19. deleted text end

deleted text begin Practice setting description. deleted text end

deleted text begin "Practice setting description" means a
signed record submitted to the board on forms provided by the board, on which:
deleted text end

deleted text begin (1) the supervising physician assumes full medical responsibility for the medical
care rendered by a physician assistant;
deleted text end

deleted text begin (2) is recorded the address and phone number of record of each supervising
physician and alternate, and the physicians' medical license numbers and DEA number;
deleted text end

deleted text begin (3) is recorded the address and phone number of record of the physician assistant
and the physician assistant's registration number and DEA number;
deleted text end

deleted text begin (4) is recorded whether the physician assistant has been delegated prescribing,
administering, and dispensing authority;
deleted text end

deleted text begin (5) is recorded the practice setting, address or addresses and phone number or
numbers of the physician assistant; and
deleted text end

deleted text begin (6) is recorded a statement of the type, amount, and frequency of supervision.
deleted text end

Subd. 20.

Prescribe.

"Prescribe" means to direct, order, or designate by means of a
prescription the preparation, use of, or manner of using a drug or medical device.

Subd. 21.

Prescription.

"Prescription" means a signed written order, deleted text beginordeleted text end an oral
order reduced to writing,new text begin or an electronic order meeting current and prevailing standardsnew text end
given by a physician assistant authorized to prescribe drugs for patients in the course
of the physician assistant's practice, issued for an individual patient and containing the
information required in the new text beginphysician-physician assistant new text enddelegation deleted text beginformdeleted text endnew text begin agreementnew text end.

deleted text begin Subd. 22. deleted text end

deleted text begin Registration. deleted text end

deleted text begin "Registration" is the process by which the board determines
that an applicant has been found to meet the standards and qualifications found in this
chapter.
deleted text end

Subd. 23.

Supervising physician.

"Supervising physician" means a Minnesota
licensed physician who accepts full medical responsibility for the performance, practice,
and activities of a physician assistant under an agreement as described in section 147A.20.
new text begin The supervising physician who completes and signs the delegation agreement may be
referred to as the primary supervising physician.
new text endA supervising physician shall not
supervise more than deleted text begintwodeleted text endnew text begin fivenew text end full-time equivalent physician assistants simultaneously.
new text begin With the approval of the board, or in a disaster or emergency situation pursuant to section
147A.23, a supervising physician may supervise more than five full-time equivalent
physician assistants simultaneously.
new text end

Subd. 24.

Supervision.

"Supervision" means overseeing the activities of, and
accepting responsibility for, the medical services rendered by a physician assistant. The
constant physical presence of the supervising physician is not required so long as the
supervising physician and physician assistant are or can be easily in contact with one
another by radio, telephone, or other telecommunication device. The scope and nature of
the supervision shall be defined by the individual physician-physician assistantnew text begin delegationnew text end
agreement.

Subd. 25.

Temporary deleted text beginregistrationdeleted text endnew text begin licensenew text end.

deleted text begin "Temporary registration" means the
status of a person who has satisfied the education requirement specified in this chapter;
is enrolled in the next examination required in this chapter; or is awaiting examination
results; has a physician-physician assistant agreement in force as required by this chapter,
and has submitted a practice setting description to the board. Such provisional registration
shall expire 90 days after completion of the next examination sequence, or after one year,
whichever is sooner, for those enrolled in the next examination; and upon receipt of the
examination results for those awaiting examination results. The registration shall be
granted by the board or its designee.
deleted text end new text begin "Temporary license" means a license granted to a
physician assistant who meets all of the qualifications for licensure but has not yet been
approved for licensure at a meeting of the board.
new text end

Subd. 26.

Therapeutic order.

"Therapeutic order" means an order given to another
for the purpose of treating or curing a patient in the course of a physician assistant's
practice. Therapeutic orders may be written or verbal, but do not include the prescribing
of legend drugs or medical devices unless prescribing authority has been delegated within
the physician-physician assistant new text begindelegation new text endagreement.

Subd. 27.

Verbal order.

"Verbal order" means an oral order given to another for
the purpose of treating or curing a patient in the course of a physician assistant's practice.
Verbal orders do not include the prescribing of legend drugs unless prescribing authority
has been delegated within the physician-physician assistant new text begindelegation new text endagreement.

Sec. 15.

Minnesota Statutes 2008, section 147A.02, is amended to read:


147A.02 QUALIFICATIONS FOR deleted text beginREGISTRATIONdeleted text endnew text begin LICENSUREnew text end.

Except as otherwise provided in this chapter, an individual shall be deleted text beginregistereddeleted text endnew text begin
licensed
new text end by the board before the individual may practice as a physician assistant.

The board may grant deleted text beginregistrationdeleted text endnew text begin a licensenew text end as a physician assistant to an applicant
who:

(1) submits an application on forms approved by the board;

(2) pays the appropriate fee as determined by the board;

(3) has current certification from the National Commission on Certification of
Physician Assistants, or its successor agency as approved by the board;

(4) certifies that the applicant is mentally and physically able to engage safely in
practice as a physician assistant;

(5) has no licensure, certification, or registration as a physician assistant under
current discipline, revocation, suspension, or probation for cause resulting from the
applicant's practice as a physician assistant, unless the board considers the condition
and agrees to licensure;

(6) submits any other information the board deems necessary to evaluate the
applicant's qualifications; and

(7) has been approved by the board.

All persons registered as physician assistants as of June 30, 1995, are eligible for
continuing deleted text beginregistrationdeleted text endnew text begin license new text end renewal. All persons applying for deleted text beginregistrationdeleted text endnew text begin licensurenew text end
after that date shall be deleted text beginregistereddeleted text endnew text begin licensednew text end according to this chapter.

Sec. 16.

Minnesota Statutes 2008, section 147A.03, is amended to read:


147A.03 PROTECTED TITLES AND RESTRICTIONS ON USE.

Subdivision 1.

Protected titles.

No individual may use the titles "Minnesota
deleted text begin Registereddeleted text endnew text begin Licensednew text end Physician Assistant," "deleted text beginRegistereddeleted text endnew text begin Licensednew text end Physician Assistant,"
"Physician Assistant," or "PA" in connection with the individual's name, or any other
words, letters, abbreviations, or insignia indicating or implying that the individual is
deleted text begin registered withdeleted text endnew text begin licensed bynew text end the state unless they have been deleted text beginregistereddeleted text endnew text begin licensednew text end according
to this chapter.

Subd. 2.

Health care practitioners.

Individuals practicing in a health care
occupation are not restricted in the provision of services included in this chapter as long as
they do not hold themselves out as physician assistants by or through the titles provided in
subdivision 1 in association with provision of these services.

deleted text begin Subd. 3. deleted text end

deleted text begin Identification of registered practitioners. deleted text end

deleted text begin Physician assistants in
Minnesota shall wear name tags which identify them as physician assistants.
deleted text end

Subd. 4.

Sanctions.

Individuals who hold themselves out as physician assistants by
or through any of the titles provided in subdivision 1 without prior deleted text beginregistrationdeleted text endnew text begin licensurenew text end
shall be subject to sanctions or actions against continuing the activity according to section
214.11, or other authority.

Sec. 17.

Minnesota Statutes 2008, section 147A.04, is amended to read:


147A.04 TEMPORARY deleted text beginPERMITdeleted text endnew text begin LICENSEnew text end.

The board may issue a temporary deleted text beginpermitdeleted text endnew text begin licensenew text end to practice to a physician assistant
eligible for deleted text beginregistrationdeleted text endnew text begin licensurenew text end under this chapter only if the application for deleted text beginregistrationdeleted text endnew text begin
licensure
new text end is complete, all requirements have been met, and a nonrefundable fee set by
the board has been paid. The deleted text beginpermitdeleted text endnew text begin temporary licensenew text end remains valid only until the
new text begin next new text endmeeting of the board at which a decision is made on the application for deleted text beginregistrationdeleted text endnew text begin
licensure
new text end.

Sec. 18.

Minnesota Statutes 2008, section 147A.05, is amended to read:


147A.05 INACTIVE deleted text beginREGISTRATIONdeleted text endnew text begin LICENSEnew text end.

Physician assistants who notify the board in writing deleted text beginon forms prescribed by the board
deleted text endmay elect to place their deleted text beginregistrationsdeleted text endnew text begin licensenew text end on an inactive status. Physician assistants
with an inactive deleted text beginregistrationdeleted text endnew text begin licensenew text end shall be excused from payment of renewal fees and
shall not practice as physician assistants. Persons who engage in practice while their
deleted text begin registrations aredeleted text endnew text begin license isnew text end lapsed or on inactive status shall be considered to be practicing
without deleted text beginregistrationdeleted text endnew text begin a licensenew text end, which shall be grounds for discipline under section 147A.13.
new text begin Physician assistants who provide care under the provisions of section 147A.23 shall not
be considered practicing without a license or subject to disciplinary action.
new text endPhysician
assistants deleted text beginrequesting restoration from inactive statusdeleted text endnew text begin who notify the board of their intent to
resume active practice
new text end shall be required to pay the current renewal fees and all unpaid back
fees and shall be required to meet the criteria for renewal specified in section 147A.07.

Sec. 19.

Minnesota Statutes 2008, section 147A.06, is amended to read:


147A.06 CANCELLATION OF deleted text beginREGISTRATIONdeleted text endnew text begin LICENSEnew text end FOR
NONRENEWAL.

The board shall not renew, reissue, reinstate, or restore a deleted text beginregistrationdeleted text endnew text begin licensenew text end that
has lapsed on or after July 1, 1996, and has not been renewed within two annual renewal
cycles starting July 1, 1997. A deleted text beginregistrantdeleted text endnew text begin licenseenew text end whose deleted text beginregistrationdeleted text endnew text begin licensenew text end is canceled
for nonrenewal must obtain a new deleted text beginregistrationdeleted text endnew text begin licensenew text end by applying for deleted text beginregistrationdeleted text endnew text begin
licensure
new text end and fulfilling all requirements then in existence for an initial deleted text beginregistrationdeleted text endnew text begin licensenew text end
to practice as a physician assistant.

Sec. 20.

Minnesota Statutes 2008, section 147A.07, is amended to read:


147A.07 RENEWAL.

A person who holds a deleted text beginregistrationdeleted text endnew text begin licensenew text end as a physician assistant shallnew text begin annuallynew text end,
upon notification from the board, renew the deleted text beginregistrationdeleted text endnew text begin licensenew text end by:

(1) submitting the appropriate fee as determined by the board;

(2) completing the appropriate forms;new text begin and
new text end

(3) meeting any other requirements of the boarddeleted text begin;
deleted text end

deleted text begin (4) submitting a revised and updated practice setting description showing evidence
of annual review of the physician-physician assistant supervisory agreement
deleted text end.

Sec. 21.

Minnesota Statutes 2008, section 147A.08, is amended to read:


147A.08 EXEMPTIONS.

(a) This chapter does not apply to, control, prevent, or restrict the practice, service,
or activities of persons listed in section 147.09, clauses (1) to (6) and (8) to (13), persons
regulated under section 214.01, subdivision 2, or persons defined in section 144.1501,
subdivision 1
, paragraphs (f), (h), and (i).

(b) Nothing in this chapter shall be construed to require deleted text beginregistrationdeleted text endnew text begin licensurenew text end of:

(1) a physician assistant student enrolled in a physician assistant deleted text beginor surgeon assistant
deleted text endeducational program accredited by the deleted text beginCommittee on Allied Health Education and
deleted text endAccreditationnew text begin Review Commission on Education for the Physician Assistantnew text end or by its
successor agency approved by the board;

(2) a physician assistant employed in the service of the federal government while
performing duties incident to that employment; or

(3) technicians, other assistants, or employees of physicians who perform delegated
tasks in the office of a physician but who do not identify themselves as a physician
assistant.

Sec. 22.

Minnesota Statutes 2008, section 147A.09, is amended to read:


147A.09 SCOPE OF PRACTICE, DELEGATION.

Subdivision 1.

Scope of practice.

Physician assistants shall practice medicine
only with physician supervision. Physician assistants may perform those duties and
responsibilities as delegated in the physician-physician assistantnew text begin delegationnew text end agreement
and delegation forms maintained at the address of record by the supervising physician
and physician assistant, including the prescribing, administering, and dispensing ofnew text begin drugs,
controlled substances, and
new text end medical devices deleted text beginand drugsdeleted text end, excluding anesthetics, other than
local anesthetics, injected in connection with an operating room procedure, inhaled
anesthesia and spinal anesthesia.

Patient service must be limited to:

(1) services within the training and experience of the physician assistant;

(2) services customary to the practice of the supervising physiciannew text begin or alternate
supervising physician
new text end;

(3) services delegated by the supervising physiciannew text begin or alternate supervising physician
under the physician-physician assistant delegation agreement
new text end; and

(4) services within the parameters of the laws, rules, and standards of the facilities
in which the physician assistant practices.

Nothing in this chapter authorizes physician assistants to perform duties regulated
by the boards listed in section 214.01, subdivision 2, other than the Board of Medical
Practice, and except as provided in this section.

Subd. 2.

Delegation.

Patient services may include, but are not limited to, the
following, as delegated by the supervising physician and authorized in thenew text begin delegationnew text end
agreement:

(1) taking patient histories and developing medical status reports;

(2) performing physical examinations;

(3) interpreting and evaluating patient data;

(4) ordering or performing diagnostic procedures, including deleted text beginradiographydeleted text endnew text begin the use of
radiographic imaging systems in compliance with Minnesota Rules 2007, chapter 4732
new text end;

(5) ordering or performing therapeutic proceduresnew text begin including the use of ionizing
radiation in compliance with Minnesota Rules 2007, chapter 4732
new text end;

(6) providing instructions regarding patient care, disease prevention, and health
promotion;

(7) assisting the supervising physician in patient care in the home and in health
care facilities;

(8) creating and maintaining appropriate patient records;

(9) transmitting or executing specific orders at the direction of the supervising
physician;

(10) prescribing, administering, and dispensing deleted text beginlegenddeleted text end drugsnew text begin, controlled substances,new text end
and medical devices if this function has been delegated by the supervising physician
pursuant to and subject to the limitations of section 147A.18 and chapter 151. new text beginFor
new text endphysician assistants who have been delegated the authority to prescribe controlled
substances deleted text beginshall maintain a separate addendum to the delegation form which lists all
schedules and categories
deleted text endnew text begin such delegation shall be included in the physician-physician
assistant delegation agreement, and all schedules
new text end of controlled substances deleted text beginwhichdeleted text end the
physician assistant has the authority to prescribedeleted text begin. This addendum shall be maintained with
the physician-physician assistant agreement, and the delegation form at the address of
record
deleted text endnew text begin shall be specifiednew text end;

(11) for physician assistants not delegated prescribing authority, administering
legend drugs and medical devices following prospective review for each patient by and
upon direction of the supervising physician;

(12) functioning as an emergency medical technician with permission of the
ambulance service and in compliance with section 144E.127, and ambulance service rules
adopted by the commissioner of health;

(13) initiating evaluation and treatment procedures essential to providing an
appropriate response to emergency situations; deleted text beginand
deleted text end

(14) certifying a deleted text beginphysical disabilitydeleted text endnew text begin patient's eligibility for a disability parking
certificate
new text end under section 169.345, subdivision deleted text begin2adeleted text endnew text begin 2;
new text end

new text begin (15) assisting at surgery; and
new text end

new text begin (16) providing medical authorization for admission for emergency care and
treatment of a patient under section 253B.05, subdivision 2
new text end.

Orders of physician assistants shall be considered the orders of their supervising
physicians in all practice-related activities, including, but not limited to, the ordering of
diagnostic, therapeutic, and other medical services.

Sec. 23.

Minnesota Statutes 2008, section 147A.11, is amended to read:


147A.11 EXCLUSIONS OF LIMITATIONS ON EMPLOYMENT.

Nothing in this chapter shall be construed to limit the employment arrangement of a
physician assistant deleted text beginregistereddeleted text endnew text begin licensednew text end under this chapter.

Sec. 24.

Minnesota Statutes 2008, section 147A.13, is amended to read:


147A.13 GROUNDS FOR DISCIPLINARY ACTION.

Subdivision 1.

Grounds listed.

The board may refuse to grant deleted text beginregistrationdeleted text endnew text begin licensurenew text end
or may impose disciplinary action as described in this subdivision against any physician
assistant. The following conduct is prohibited and is grounds for disciplinary action:

(1) failure to demonstrate the qualifications or satisfy the requirements for
deleted text begin registrationdeleted text endnew text begin licensurenew text end contained in this chapter or rules of the board. The burden of proof
shall be upon the applicant to demonstrate such qualifications or satisfaction of such
requirements;

(2) obtaining deleted text beginregistrationdeleted text endnew text begin a licensenew text end by fraud or cheating, or attempting to subvert
the examination process. Conduct which subverts or attempts to subvert the examination
process includes, but is not limited to:

(i) conduct which violates the security of the examination materials, such as
removing examination materials from the examination room or having unauthorized
possession of any portion of a future, current, or previously administered licensing
examination;

(ii) conduct which violates the standard of test administration, such as
communicating with another examinee during administration of the examination, copying
another examinee's answers, permitting another examinee to copy one's answers, or
possessing unauthorized materials; and

(iii) impersonating an examinee or permitting an impersonator to take the
examination on one's own behalf;

(3) conviction, during the previous five years, of a felony reasonably related to the
practice of physician assistant. Conviction as used in this subdivision includes a conviction
of an offense which if committed in this state would be deemed a felony without regard to
its designation elsewhere, or a criminal proceeding where a finding or verdict of guilt is
made or returned but the adjudication of guilt is either withheld or not entered;

(4) revocation, suspension, restriction, limitation, or other disciplinary action against
the person's physician assistant credentials in another state or jurisdiction, failure to
report to the board that charges regarding the person's credentials have been brought in
another state or jurisdiction, or having been refused deleted text beginregistrationdeleted text endnew text begin licensurenew text end by any other
state or jurisdiction;

(5) advertising which is false or misleading, violates any rule of the board, or claims
without substantiation the positive cure of any disease or professional superiority to or
greater skill than that possessed by another physician assistant;

(6) violating a rule adopted by the board or an order of the board, a state, or federal
law which relates to the practice of a physician assistant, or in part regulates the practice
of a physician assistant, including without limitation sections 148A.02, 609.344, and
609.345, or a state or federal narcotics or controlled substance law;

(7) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm
the public, or demonstrating a willful or careless disregard for the health, welfare, or
safety of a patient; or practice which is professionally incompetent, in that it may create
unnecessary danger to any patient's life, health, or safety, in any of which cases, proof
of actual injury need not be established;

(8) failure to adhere to the provisions of the physician-physician assistantnew text begin delegationnew text end
agreement;

(9) engaging in the practice of medicine beyond that allowed by the
physician-physician assistant new text begindelegation new text endagreement, deleted text beginincluding the delegation form or
the addendum to the delegation form,
deleted text end or aiding or abetting an unlicensed person in the
practice of medicine;

(10) adjudication as mentally incompetent, mentally ill or developmentally disabled,
or as a chemically dependent person, a person dangerous to the public, a sexually
dangerous person, or a person who has a sexual psychopathic personality by a court of
competent jurisdiction, within or without this state. Such adjudication shall automatically
suspend a deleted text beginregistrationdeleted text endnew text begin licensenew text end for its duration unless the board orders otherwise;

(11) engaging in unprofessional conduct. Unprofessional conduct includes any
departure from or the failure to conform to the minimal standards of acceptable and
prevailing practice in which proceeding actual injury to a patient need not be established;

(12) inability to practice with reasonable skill and safety to patients by reason of
illness, drunkenness, use of drugs, narcotics, chemicals, or any other type of material, or
as a result of any mental or physical condition, including deterioration through the aging
process or loss of motor skills;

(13) revealing a privileged communication from or relating to a patient except when
otherwise required or permitted by law;

(14) any deleted text beginuse ofdeleted text endnew text begin identification of a physician assistant bynew text end the title "Physician,"
"Doctor," or "Dr."new text begin in a patient care setting or in a communication directed to the general
public
new text end;

(15) improper management of medical records, including failure to maintain
adequate medical records, to comply with a patient's request made pursuant to sections
144.291 to 144.298, or to furnish a medical record or report required by law;

(16) engaging in abusive or fraudulent billing practices, including violations of the
federal Medicare and Medicaid laws or state medical assistance laws;

(17) becoming addicted or habituated to a drug or intoxicant;

(18) prescribing a drug or device for other than medically accepted therapeutic,
experimental, or investigative purposes authorized by a state or federal agency or referring
a patient to any health care provider as defined in sections 144.291 to 144.298 for services
or tests not medically indicated at the time of referral;

(19) engaging in conduct with a patient which is sexual or may reasonably be
interpreted by the patient as sexual, or in any verbal behavior which is seductive or
sexually demeaning to a patient;

(20) failure to make reports as required by section 147A.14 or to cooperate with an
investigation of the board as required by section 147A.15, subdivision 3;

(21) knowingly providing false or misleading information that is directly related
to the care of that patient unless done for an accepted therapeutic purpose such as the
administration of a placebo;

(22) aiding suicide or aiding attempted suicide in violation of section 609.215 as
established by any of the following:

(i) a copy of the record of criminal conviction or plea of guilty for a felony in
violation of section 609.215, subdivision 1 or 2;

(ii) a copy of the record of a judgment of contempt of court for violating an
injunction issued under section 609.215, subdivision 4;

(iii) a copy of the record of a judgment assessing damages under section 609.215,
subdivision 5
; or

(iv) a finding by the board that the person violated section 609.215, subdivision 1 or
2. The board shall investigate any complaint of a violation of section 609.215, subdivision
1
or 2; or

(23) failure to maintain annually reviewed and updated physician-physician
assistantnew text begin delegationnew text end agreementsdeleted text begin, internal protocols, or prescribing delegation formsdeleted text end for
each physician-physician assistant practice relationship, or failure to provide copies of
such documents upon request by the board.

Subd. 2.

Effective dates, automatic suspension.

A suspension, revocation,
condition, limitation, qualification, or restriction of a deleted text beginregistrationdeleted text endnew text begin licensenew text end shall be in effect
pending determination of an appeal unless the court, upon petition and for good cause
shown, orders otherwise.

A physician assistant deleted text beginregistrationdeleted text endnew text begin licensenew text end is automatically suspended if:

(1) a guardian of a deleted text beginregistrantdeleted text endnew text begin licenseenew text end is appointed by order of a court pursuant to
sections 524.5-101 to 524.5-502, for reasons other than the minority of the deleted text beginregistrantdeleted text endnew text begin
licensee
new text end; or

(2) the deleted text beginregistrantdeleted text endnew text begin licenseenew text end is committed by order of a court pursuant to chapter
253B. The deleted text beginregistrationdeleted text endnew text begin licensenew text end remains suspended until the deleted text beginregistrantdeleted text endnew text begin licenseenew text end is restored
to capacity by a court and, upon petition by the deleted text beginregistrantdeleted text endnew text begin licenseenew text end, the suspension is
terminated by the board after a hearing.

Subd. 3.

Conditions on reissued deleted text beginregistrationdeleted text endnew text begin licensenew text end.

In its discretion, the board
may restore and reissue a physician assistant deleted text beginregistrationdeleted text endnew text begin licensenew text end, but may impose as a
condition any disciplinary or corrective measure which it might originally have imposed.

Subd. 4.

Temporary suspension of deleted text beginregistrationdeleted text endnew text begin licensenew text end.

In addition to any other
remedy provided by law, the board may, without a hearing, temporarily suspend the
deleted text begin registrationdeleted text endnew text begin licensenew text end of a physician assistant if the board finds that the physician assistant has
violated a statute or rule which the board is empowered to enforce and continued practice
by the physician assistant would create a serious risk of harm to the public. The suspension
shall take effect upon written notice to the physician assistant, specifying the statute or
rule violated. The suspension shall remain in effect until the board issues a final order
in the matter after a hearing. At the time it issues the suspension notice, the board shall
schedule a disciplinary hearing to be held pursuant to the Administrative Procedure Act.

The physician assistant shall be provided with at least 20 days' notice of any hearing
held pursuant to this subdivision. The hearing shall be scheduled to begin no later than 30
days after the issuance of the suspension order.

Subd. 5.

Evidence.

In disciplinary actions alleging a violation of subdivision
1, clause (3) or (4), a copy of the judgment or proceeding under the seal of the court
administrator or of the administrative agency which entered it shall be admissible into
evidence without further authentication and shall constitute prima facie evidence of the
contents thereof.

Subd. 6.

Mental examination; access to medical data.

(a) If the board has
probable cause to believe that a physician assistant comes under subdivision 1, clause
(1), it may direct the physician assistant to submit to a mental or physical examination.
For the purpose of this subdivision, every physician assistant deleted text beginregistereddeleted text endnew text begin licensednew text end under
this chapter is deemed to have consented to submit to a mental or physical examination
when directed in writing by the board and further to have waived all objections to the
admissibility of the examining physicians' testimony or examination reports on the ground
that the same constitute a privileged communication. Failure of a physician assistant to
submit to an examination when directed constitutes an admission of the allegations against
the physician assistant, unless the failure was due to circumstance beyond the physician
assistant's control, in which case a default and final order may be entered without the
taking of testimony or presentation of evidence. A physician assistant affected under this
subdivision shall at reasonable intervals be given an opportunity to demonstrate that
the physician assistant can resume competent practice with reasonable skill and safety
to patients. In any proceeding under this subdivision, neither the record of proceedings
nor the orders entered by the board shall be used against a physician assistant in any
other proceeding.

(b) In addition to ordering a physical or mental examination, the board may,
notwithstanding sections 13.384, 144.651, or any other law limiting access to medical or
other health data, obtain medical data and health records relating to a deleted text beginregistrantdeleted text endnew text begin licenseenew text end or
applicant without the deleted text beginregistrant'sdeleted text endnew text begin licensee'snew text end or applicant's consent if the board has probable
cause to believe that a physician assistant comes under subdivision 1, clause (1).

The medical data may be requested from a provider, as defined in section 144.291,
subdivision 2
, paragraph (h), an insurance company, or a government agency, including
the Department of Human Services. A provider, insurance company, or government
agency shall comply with any written request of the board under this subdivision and is not
liable in any action for damages for releasing the data requested by the board if the data
are released pursuant to a written request under this subdivision, unless the information
is false and the provider giving the information knew, or had reason to believe, the
information was false. Information obtained under this subdivision is classified as private
under chapter 13.

Subd. 7.

Tax clearance certificate.

(a) In addition to the provisions of subdivision
1, the board may not issue or renew a deleted text beginregistrationdeleted text endnew text begin licensenew text end if the commissioner of revenue
notifies the board and the deleted text beginregistrantdeleted text endnew text begin licenseenew text end or applicant for deleted text beginregistrationdeleted text endnew text begin licensurenew text end that the
deleted text begin registrantdeleted text endnew text begin licenseenew text end or applicant owes the state delinquent taxes in the amount of $500 or
more. The board may issue or renew the deleted text beginregistrationdeleted text endnew text begin licensenew text end only if:

(1) the commissioner of revenue issues a tax clearance certificate; and

(2) the commissioner of revenue, the deleted text beginregistrantdeleted text endnew text begin licenseenew text end, or the applicant forwards a
copy of the clearance to the board.

The commissioner of revenue may issue a clearance certificate only if the deleted text beginregistrantdeleted text endnew text begin
licensee
new text end or applicant does not owe the state any uncontested delinquent taxes.

(b) For purposes of this subdivision, the following terms have the meanings given:

(1) "Taxes" are all taxes payable to the commissioner of revenue, including penalties
and interest due on those taxes, and

(2) "Delinquent taxes" do not include a tax liability if:

(i) an administrative or court action that contests the amount or validity of the
liability has been filed or served;

(ii) the appeal period to contest the tax liability has not expired; or

(iii) the licensee or applicant has entered into a payment agreement to pay the
liability and is current with the payments.

(c) When a deleted text beginregistrantdeleted text endnew text begin licenseenew text end or applicant is required to obtain a clearance certificate
under this subdivision, a contested case hearing must be held if the deleted text beginregistrantdeleted text endnew text begin licenseenew text end or
applicant requests a hearing in writing to the commissioner of revenue within 30 days of
the date of the notice provided in paragraph (a). The hearing must be held within 45 days
of the date the commissioner of revenue refers the case to the Office of Administrative
Hearings. Notwithstanding any law to the contrary, the licensee or applicant must be
served with 20 days' notice in writing specifying the time and place of the hearing and
the allegations against the registrant or applicant. The notice may be served personally or
by mail.

(d) The board shall require all deleted text beginregistrantsdeleted text endnew text begin licenseesnew text end or applicants to provide their
Social Security number and Minnesota business identification number on all deleted text beginregistrationdeleted text endnew text begin
license
new text end applications. Upon request of the commissioner of revenue, the board must
provide to the commissioner of revenue a list of all deleted text beginregistrantsdeleted text endnew text begin licenseesnew text end and applicants,
including their names and addresses, Social Security numbers, and business identification
numbers. The commissioner of revenue may request a list of the deleted text beginregistrantsdeleted text endnew text begin licenseesnew text end and
applicants no more than once each calendar year.

new text begin Subd. 8. new text end

new text begin Limitation. new text end

new text begin No board proceeding against a licensee shall be instituted
unless commenced within seven years from the date of commission of some portion of the
offense except for alleged violations of subdivision 1, paragraph (19), or subdivision 7.
new text end

Sec. 25.

Minnesota Statutes 2008, section 147A.16, is amended to read:


147A.16 FORMS OF DISCIPLINARY ACTION.

When the board finds that a deleted text beginregistereddeleted text endnew text begin licensednew text end physician assistant has violated a
provision of this chapter, it may do one or more of the following:

(1) revoke the deleted text beginregistrationdeleted text endnew text begin licensenew text end;

(2) suspend the deleted text beginregistrationdeleted text endnew text begin licensenew text end;

(3) impose limitations or conditions on the physician assistant's practice, including
limiting the scope of practice to designated field specialties; impose retraining or
rehabilitation requirements; require practice under additional supervision; or condition
continued practice on demonstration of knowledge or skills by appropriate examination
or other review of skill and competence;

(4) impose a civil penalty not exceeding $10,000 for each separate violation, the
amount of the civil penalty to be fixed so as to deprive the physician assistant of any
economic advantage gained by reason of the violation charged or to reimburse the board
for the cost of the investigation and proceeding;

(5) order the physician assistant to provide unremunerated professional service
under supervision at a designated public hospital, clinic, or other health care institution; or

(6) censure or reprimand the deleted text beginregistereddeleted text endnew text begin licensednew text end physician assistant.

Upon judicial review of any board disciplinary action taken under this chapter, the
reviewing court shall seal the administrative record, except for the board's final decision,
and shall not make the administrative record available to the public.

Sec. 26.

Minnesota Statutes 2008, section 147A.18, is amended to read:


147A.18 DELEGATED AUTHORITY TO PRESCRIBE, DISPENSE, AND
ADMINISTER DRUGS AND MEDICAL DEVICES.

Subdivision 1.

Delegation.

(a) A supervising physician may delegate to a
physician assistant who is deleted text beginregistered withdeleted text endnew text begin licensed bynew text end the board, certified by the National
Commission on Certification of Physician Assistants or successor agency approved by the
board, and who is under the supervising physician's supervision, the authority to prescribe,
dispense, and administer legend drugs, deleted text beginmedical devices, anddeleted text end controlled substancesnew text begin, and
medical devices
new text end subject to the requirements in this section. The authority to dispense
includes, but is not limited to, the authority to request, receive, and dispense sample drugs.
This authority to dispense extends only to those drugs described in the written agreement
developed under paragraph (b).

(b) The new text begindelegation new text endagreement between the physician assistant and supervising
physician deleted text beginand any alternate supervising physiciansdeleted text end must include a statement by the
supervising physician regarding delegation or nondelegation of the functions of
prescribing, dispensing, and administering deleted text beginofdeleted text end legend drugsnew text begin, controlled substances, new text end and
medical devices to the physician assistant. The statement must include deleted text begina protocol
indicating
deleted text end categories of drugs for which the supervising physician delegates prescriptive
and dispensing authoritynew text begin including controlled substances when applicablenew text end. The delegation
must be appropriate to the physician assistant's practice and within the scope of the
physician assistant's training. Physician assistants who have been delegated the authority
to prescribe, dispense, and administer legend drugsnew text begin, controlled substances,new text end and medical
devices shall provide evidence of current certification by the National Commission
on Certification of Physician Assistants or its successor agency when deleted text beginregistering or
reregistering
deleted text endnew text begin applying for licensure or license renewalnew text end as physician assistants. Physician
assistants who have been delegated the authority to prescribe controlled substances must
deleted text begin present evidence of the certification anddeleted text end new text beginalsonew text end hold a valid DEA deleted text begincertificatedeleted text endnew text begin registrationnew text end.
Supervising physicians shall retrospectively review the prescribing, dispensing, and
administering of legend deleted text beginand controlleddeleted text end drugsnew text begin, controlled substances,new text end and medical devices
by physician assistants, when this authority has been delegated to the physician assistant as
part of the new text beginphysician-physician assistant new text enddelegation agreement deleted text beginbetween the physician and
the physician assistant. This review must take place as outlined in the internal protocol
deleted text end.
The process and schedule for the review must be outlined in thenew text begin physician-physician
assistant
new text end delegation agreement.

(c) The board may establish by rule:

(1) a system of identifying physician assistants eligible to prescribe, administer, and
dispense legend drugs and medical devices;

(2) a system of identifying physician assistants eligible to prescribe, administer, and
dispense controlled substances;

(3) a method of determining the categories of legend deleted text beginand controlleddeleted text end drugsnew text begin, controlled
substances,
new text end and medical devices that each physician assistant is allowed to prescribe,
administer, and dispense; and

(4) a system of transmitting to pharmacies a listing of physician assistants eligible to
prescribe legend deleted text beginand controlleddeleted text end drugsnew text begin, controlled substances,new text end and medical devices.

Subd. 2.

Termination and reinstatement of prescribing authority.

deleted text begin(a)deleted text end The
authority of a physician assistant to prescribe, dispense, and administer legend drugsnew text begin,
controlled substances,
new text end and medical devices shall end immediately when:

(1) the new text beginphysician-physician assistant delegation new text endagreement is terminated;

(2) the authority to prescribe, dispense, and administer is terminated or withdrawn
by the supervising physician; deleted text beginor
deleted text end

(3) the physician deleted text beginassistant reverts todeleted text end new text beginassistant's license is placed onnew text end inactive statusdeleted text begin,
loses National Commission on Certification of Physician Assistants or successor agency
certification, or loses or terminates registration status
deleted text endnew text begin;
new text end

new text begin (4) the physician assistant loses National Commission on Certification of Physician
Assistants or successor agency certification; or
new text end

new text begin (5) the physician assistant loses or terminates licensure statusnew text end.

deleted text begin (b) The physician assistant must notify the board in writing within ten days of the
occurrence of any of the circumstances listed in paragraph (a).
deleted text end

deleted text begin (c) Physician assistants whose authority to prescribe, dispense, and administer
has been terminated shall reapply for reinstatement of prescribing authority under this
section and meet any requirements established by the board prior to reinstatement of the
prescribing, dispensing, and administering authority.
deleted text end

Subd. 3.

Other requirements and restrictions.

deleted text begin (a) The supervising physician and
the physician assistant must complete, sign, and date an internal protocol which lists each
category of drug or medical device, or controlled substance the physician assistant may
prescribe, dispense, and administer. The supervising physician and physician assistant
shall submit the internal protocol to the board upon request. The supervising physician
may amend the internal protocol as necessary, within the limits of the completed delegation
form in subdivision 5. The supervising physician and physician assistant must sign and
date any amendments to the internal protocol. Any amendments resulting in a change to
an addition or deletion to categories delegated in the delegation form in subdivision 5 must
be submitted to the board according to this chapter, along with the fee required.
deleted text end

deleted text begin (b) The supervising physician and physician assistant shall review delegation of
prescribing, dispensing, and administering authority on an annual basis at the time of
reregistration. The internal protocol must be signed and dated by the supervising physician
and physician assistant after review. Any amendments to the internal protocol resulting in
changes to the delegation form in subdivision 5 must be submitted to the board according
to this chapter, along with the fee required.
deleted text end

deleted text begin (c)deleted text end new text begin(a) new text endEach prescription initiated by a physician assistant shall indicate the
following:

(1) the date of issue;

(2) the name and address of the patient;

(3) the name and quantity of the drug prescribed;

(4) directions for use; and

(5) the name and address of the prescribing physician assistant.

deleted text begin (d)deleted text endnew text begin (b)new text end In prescribing, dispensing, and administering legend drugsnew text begin, controlled
substances,
new text end and medical devicesdeleted text begin, including controlled substances as defined in section
deleted text enddeleted text begin152.01, subdivision 4deleted text enddeleted text begin,deleted text end a physician assistant must conform with the agreement, chapter
151, and this chapter.

deleted text begin Subd. 4. deleted text end

deleted text begin Notification of pharmacies. deleted text end

deleted text begin (a) The board shall annually provide to the
Board of Pharmacy and to registered pharmacies within the state a list of those physician
assistants who are authorized to prescribe, administer, and dispense legend drugs and
medical devices, or controlled substances.
deleted text end

deleted text begin (b) The board shall provide to the Board of Pharmacy a list of physician assistants
authorized to prescribe legend drugs and medical devices every two months if additional
physician assistants are authorized to prescribe or if physician assistants have authorization
to prescribe withdrawn.
deleted text end

deleted text begin (c) The list must include the name, address, telephone number, and Minnesota
registration number of the physician assistant, and the name, address, telephone number,
and Minnesota license number of the supervising physician.
deleted text end

deleted text begin (d) The board shall provide the form in subdivision 5 to pharmacies upon request.
deleted text end

deleted text begin (e) The board shall make available prototype forms of the physician-physician
assistant agreement, the internal protocol, the delegation form, and the addendum form.
deleted text end

deleted text begin Subd. 5. deleted text end

deleted text begin Delegation form for physician assistant prescribing. deleted text end

deleted text begin The delegation
form for physician assistant prescribing must contain a listing by drug category of the
legend drugs and controlled substances for which prescribing authority has been delegated
to the physician assistant.
deleted text end

Sec. 27.

Minnesota Statutes 2008, section 147A.19, is amended to read:


147A.19 IDENTIFICATION REQUIREMENTS.

Physician assistants deleted text beginregistereddeleted text endnew text begin licensednew text end under this chapter shall keep their
deleted text begin registrationdeleted text endnew text begin licensenew text end available for inspection at their primary place of business and shall,
when engaged in their professional activities, wear a name tag identifying themselves as
a "physician assistant."

Sec. 28.

Minnesota Statutes 2008, section 147A.20, is amended to read:


147A.20 deleted text beginPHYSICIAN AND PHYSICIANdeleted text endnew text begin PHYSICIAN-PHYSICIANnew text end
ASSISTANT AGREEMENTnew text begin DOCUMENTSnew text end.

new text begin Subdivision 1. new text end

new text begin Physician-physician assistant delegation agreement. new text end

(a) A
physician assistant and supervising physician must sign deleted text beginandeleted text endnew text begin a physician-physician assistant
delegation
new text end agreement which specifies scope of practice deleted text beginand amountdeleted text end and manner of
supervision as required by the board. The agreement must contain:

(1) a description of the practice setting;

(2) deleted text begina statement of practice type/specialty;
deleted text end

deleted text begin (3)deleted text end a listing of categories of delegated duties;

deleted text begin (4)deleted text endnew text begin (3)new text end a description of supervision typedeleted text begin, amount, and frequencydeleted text end; and

deleted text begin (5)deleted text endnew text begin (4)new text end a description of the process and schedule for review of prescribing,
dispensing, and administering legend and controlled drugs and medical devices by the
physician assistant authorized to prescribe.

(b) The agreement must be maintained by the supervising physician and physician
assistant and made available to the board upon request. If there is a delegation of
prescribing, administering, and dispensing of legend drugs, controlled substances, and
medical devices, the agreement shall include deleted text beginan internal protocol and delegation formdeleted text endnew text begin a
description of the prescriptive authority delegated to the physician assistant
new text end. Physician
assistants shall have a separate agreement for each place of employment. Agreements
must be reviewed and updated on an annual basis. The supervising physician and
physician assistant must maintain thenew text begin physician-physician assistant delegationnew text end agreementdeleted text begin,
delegation form, and internal protocol
deleted text end at the address of record. deleted text beginCopies shall be provided to
the board upon request.
deleted text end

(c) Physician assistants must provide written notification to the board within 30
days of the following:

(1) name change;

(2) address of record change;new text begin and
new text end

(3) telephone number of record changedeleted text begin; and
deleted text end

deleted text begin (4) addition or deletion of alternate supervising physician provided that the
information submitted includes, for an additional alternate physician, an affidavit of
consent to act as an alternate supervising physician signed by the alternate supervising
physician
deleted text end.

deleted text begin (d) Modifications requiring submission prior to the effective date are changes to the
practice setting description which include:
deleted text end

deleted text begin (1) supervising physician change, excluding alternate supervising physicians; or
deleted text end

deleted text begin (2) delegation of prescribing, administering, or dispensing of legend drugs,
controlled substances, or medical devices.
deleted text end

deleted text begin (e) The agreement must be completed and the practice setting description submitted
to the board before providing medical care as a physician assistant.
deleted text end

new text begin (d) Any alternate supervising physicians must be identified in the physician-physician
assistant delegation agreement, or a supplemental listing, and must sign the agreement
attesting that they shall provide the physician assistant with supervision in compliance
with this chapter, the delegation agreement, and board rules.
new text end

new text begin Subd. 2. new text end

new text begin Notification of intent to practice. new text end

new text begin A licensed physician assistant shall
submit a notification of intent to practice to the board prior to beginning practice. The
notification shall include the name, business address, and telephone number of the
supervising physician and the physician assistant. Individuals who practice without
submitting a notification of intent to practice shall be subject to disciplinary action under
section 147A.13 for practicing without a license, unless the care is provided in response to
a disaster or emergency situation pursuant to section 147A.23.
new text end

Sec. 29.

Minnesota Statutes 2008, section 147A.21, is amended to read:


147A.21 RULEMAKING AUTHORITY.

The board shall adopt rules:

(1) setting deleted text beginregistrationdeleted text endnew text begin licensenew text end fees;

(2) setting renewal fees;

(3) deleted text beginsetting fees for locum tenens permits;
deleted text end

deleted text begin (4)deleted text end setting fees for temporary deleted text beginregistrationdeleted text endnew text begin licensesnew text end; and

deleted text begin (5)deleted text endnew text begin (4)new text end establishing renewal dates.

Sec. 30.

Minnesota Statutes 2008, section 147A.23, is amended to read:


147A.23 RESPONDING TO DISASTER SITUATIONS.

(a) A deleted text beginregistered physician assistant or adeleted text end physician assistant duly licensed or
credentialed in a United States jurisdictionnew text begin or by a federal employernew text end who is responding
to a need for medical care created by new text beginan emergency according to section 604A.01, or new text enda
state or local disaster may render such care as the physician assistant is deleted text beginabledeleted text endnew text begin trainednew text end to
provide, under the physician assistant's licensedeleted text begin, registration,deleted text end or credential, without the
need of a deleted text beginphysician and physiciandeleted text endnew text begin physician-physiciannew text end assistantnew text begin delegationnew text end agreementnew text begin or
a notice of intent to practice
new text end as required under section 147A.20. deleted text beginPhysician supervision,
as required under section 147A.09, must be provided under the direction of a physician
licensed under chapter 147 who is involved with the disaster response. The physician
assistant must establish a temporary supervisory agreement with the physician providing
supervision before rendering care.
deleted text end new text beginA physician assistant may provide emergency care
without physician supervision or under the supervision that is available.
new text end

(b) The physician who provides supervision to a physician assistant while the
physician assistant is rendering care deleted text beginin a disasterdeleted text end in accordance with this section may do
so without meeting the requirements of section 147A.20.

(c) The supervising physician who otherwise provides supervision to a physician
assistant under a deleted text beginphysician and physiciandeleted text endnew text begin physician-physiciannew text end assistantnew text begin delegationnew text end
agreement described in section 147A.20 shall not be held medically responsible for the
care rendered by a physician assistant pursuant to paragraph (a). Services provided by
a physician assistant under paragraph (a) shall be considered outside the scope of the
relationship between the supervising physician and the physician assistant.

Sec. 31.

Minnesota Statutes 2008, section 147A.24, is amended to read:


147A.24 CONTINUING EDUCATION REQUIREMENTS.

Subdivision 1.

Amount of education required.

Applicants for deleted text beginregistrationdeleted text endnew text begin licensenew text end
renewal deleted text beginor reregistrationdeleted text end must eithernew text begin meet standards for continuing education through
current certification by the National Commission on Certification of Physician Assistants,
or its successor agency as approved by the board, or
new text end deleted text beginattest to and documentdeleted text end new text beginprovide
evidence of
new text endsuccessful completion of at least 50 contact hours of continuing education
within the two years immediately preceding deleted text beginregistrationdeleted text endnew text begin licensenew text end renewaldeleted text begin, reregistration,
or attest to and document taking the national certifying examination required by this
chapter within the past two years
deleted text end.

Subd. 2.

Type of education required.

deleted text beginApproveddeleted text end Continuing education is approved
if it is equivalent to category 1 credit hours as defined by the American Osteopathic
Association Bureau of Professional Education, the Royal College of Physicians and
Surgeons of Canada, the American Academy of Physician Assistants, or by organizations
that have reciprocal arrangements with the physician recognition award program of the
American Medical Association.

Sec. 32.

Minnesota Statutes 2008, section 147A.26, is amended to read:


147A.26 PROCEDURES.

The board shall establish, in writing, internal operating procedures for receiving and
investigating complaints, accepting and processing applications, granting deleted text beginregistrationsdeleted text endnew text begin
licenses
new text end, and imposing enforcement actions. The written internal operating procedures
may include procedures for sharing complaint information with government agencies in
this and other states. Procedures for sharing complaint information must be consistent
with the requirements for handling government data under chapter 13.

Sec. 33.

Minnesota Statutes 2008, section 147A.27, is amended to read:


147A.27 PHYSICIAN ASSISTANT ADVISORY COUNCIL.

Subdivision 1.

Membership.

(a) The Physician Assistant Advisory Council is
created and is composed of seven persons appointed by the board. The seven persons
must include:

(1) two public members, as defined in section 214.02;

(2) three physician assistants deleted text beginregistereddeleted text endnew text begin licensednew text end under this chapternew text begin who meet the
criteria for a new applicant under section 147A.02
new text end; and

(3) two licensed physicians with experience supervising physician assistants.

(b) No member shall serve more than deleted text begina total ofdeleted text end twonew text begin consecutive new text end terms. If a member
is appointed for a partial term and serves more than half of that term it shall be considered
a full term. deleted text beginMembers serving on the council as of July 1, 2000, shall be allowed to
complete their current terms.
deleted text end

Subd. 2.

Organization.

The council shall be organized and administered under
section 15.059.

Subd. 3.

Duties.

The council shall advise the board regarding:

(1) physician assistant deleted text beginregistrationdeleted text endnew text begin licensurenew text end standards;

(2) enforcement of grounds for discipline;

(3) distribution of information regarding physician assistant deleted text beginregistrationdeleted text endnew text begin licensurenew text end
standards;

(4) applications and recommendations of applicants for deleted text beginregistrationdeleted text endnew text begin licensurenew text end or
deleted text begin registrationdeleted text endnew text begin licensenew text end renewal; deleted text beginand
deleted text end

(5) complaints and recommendations to the board regarding disciplinary matters and
proceedings concerning applicants and deleted text beginregistrantsdeleted text endnew text begin licenseesnew text end according to sections 214.10;
214.103; and 214.13, subdivisions 6 and 7new text begin; and
new text end

new text begin (6) issues related to physician assistant practice and regulationnew text end.

The council shall perform other duties authorized for the council by chapter 214
as directed by the board.

Sec. 34.

Minnesota Statutes 2008, section 148.06, subdivision 1, is amended to read:


Subdivision 1.

License required; qualifications.

No person shall practice
chiropractic in this state without first being licensed by the state Board of Chiropractic
Examiners. The applicant shall have earned at least one-half of all academic credits
required for awarding of a baccalaureate degree from the University of Minnesota, or
other university, college, or community college of equal standing, in subject matter
determined by the board, and taken a four-year resident course of at least eight months
each in a school or college of chiropractic or in a chiropractic program that is accredited
by the Council on Chiropractic Education, deleted text beginholds a recognition agreement with the
Council on Chiropractic Education, or
deleted text end is accredited by an agency approved by the United
States Office of Education or their successors as of January 1, 1988new text begin, or is approved by a
Council on Chiropractic Education member organization of the Council on Chiropractic
International
new text end. The board may issue licenses to practice chiropractic without compliance
with prechiropractic or academic requirements listed above if in the opinion of the board
the applicant has the qualifications equivalent to those required of other applicants, the
applicant satisfactorily passes written and practical examinations as required by the Board
of Chiropractic Examiners, and the applicant is a graduate of a college of chiropractic
deleted text begin with a recognition agreement with the Council on Chiropractic Educationdeleted text endnew text begin approved by a
Council on Chiropractic Education member organization of the Council on Chiropractic
International
new text end. The board may recommend a two-year prechiropractic course of instruction
to any university, college, or community college which in its judgment would satisfy the
academic prerequisite for licensure as established by this section.

An examination for a license shall be in writing and shall include testing in:

(a) The basic sciences including but not limited to anatomy, physiology, bacteriology,
pathology, hygiene, and chemistry as related to the human body or mind;

(b) The clinical sciences including but not limited to the science and art of
chiropractic, chiropractic physiotherapy, diagnosis, roentgenology, and nutrition; and

(c) Professional ethics and any other subjects that the board may deem advisable.

The board may consider a valid certificate of examination from the National Board
of Chiropractic Examiners as evidence of compliance with the examination requirements
of this subdivision. The applicant shall be required to give practical demonstration in
vertebral palpation, neurology, adjusting and any other subject that the board may deem
advisable. A license, countersigned by the members of the board and authenticated by the
seal thereof, shall be granted to each applicant who correctly answers 75 percent of the
questions propounded in each of the subjects required by this subdivision and meets the
standards of practical demonstration established by the board. Each application shall be
accompanied by a fee set by the board. The fee shall not be returned but the applicant
may, within one year, apply for examination without the payment of an additional fee. The
board may grant a license to an applicant who holds a valid license to practice chiropractic
issued by the appropriate licensing board of another state, provided the applicant meets
the other requirements of this section and satisfactorily passes a practical examination
approved by the board. The burden of proof is on the applicant to demonstrate these
qualifications or satisfaction of these requirements.

Sec. 35.

new text begin [148.107] RECORD KEEPING.
new text end

new text begin All items in this section should be contained in the patient record, including, but not
limited to, paragraphs (a), (b), (c), (e), (g), and (i).
new text end

new text begin (a) A description of past conditions and trauma, past treatment received, current
treatment being received from other health care providers, and a description of the patient's
current condition including onset and description of trauma if trauma occurred.
new text end

new text begin (b) Examinations performed to determine a preliminary or final diagnosis based on
indicated diagnostic tests, with a record of findings of each test performed.
new text end

new text begin (c) A diagnosis supported by documented subjective and objective findings, or
clearly qualified as an opinion.
new text end

new text begin (d) A treatment plan that describes the procedures and treatment used for the
conditions identified, including approximate frequency of care.
new text end

new text begin (e) Daily notes documenting current subjective complaints as described by the
patient, any change in objective findings if noted during that visit, a listing of all
procedures provided during that visit, and all information that is exchanged and will affect
that patient's treatment.
new text end

new text begin (f) A description by the chiropractor or written by the patient each time an incident
occurs that results in an aggravation of the patient's condition or a new developing
condition.
new text end

new text begin (g) Results of reexaminations that are performed to evaluate significant changes in
a patient's condition, including tests that were positive or deviated from results used to
indicate normal findings.
new text end

new text begin (h) When symbols or abbreviations are used, a key that explains their meanings must
accompany each file when requested in writing by the patient or a third party.
new text end

new text begin (i) Documentation that family history has been evaluated.
new text end

Sec. 36.

Minnesota Statutes 2008, section 148.624, subdivision 2, is amended to read:


Subd. 2.

Nutrition.

The board shall issue a license as a nutritionist to a person who
files a completed application, pays all required fees, and certifies and furnishes evidence
satisfactory to the board that the applicant:

(1) meets the following qualifications:

(i) has received a master's or doctoral degree from an accredited or approved college
or university with a major in human nutrition, public health nutrition, clinical nutrition,
nutrition education, community nutrition, or food and nutrition; and

(ii) has completed a documented supervised preprofessional practice experience
component in dietetic practice of not less than 900 hours under the supervision of a
registered dietitian, a state licensed nutrition professional, or an individual with a doctoral
degree conferred by a United States regionally accredited college or university with a
major course of study in human nutrition, nutrition education, food and nutrition, dietetics,
or food systems management. Supervised practice experience must be completed in the
United States or its territories. Supervisors who obtain their doctoral degree outside the
United States and its territories must have their degrees validated as equivalent to the
doctoral degree conferred by a United States regionally accredited college or university; or

(2) has deleted text beginqualified as a diplomate of the American Board of Nutrition, Springfield,
Virginia
deleted text endnew text begin received certification as a Certified Nutrition Specialist by the Certification Board
for Nutrition Specialists
new text end.

Sec. 37.

Minnesota Statutes 2008, section 148.89, subdivision 5, is amended to read:


Subd. 5.

Practice of psychology.

"Practice of psychology" means the observation,
description, evaluation, interpretation, or modification of human behavior by the
application of psychological principles, methods, or procedures for any reason, including
to prevent, eliminate, or manage symptomatic, maladaptive, or undesired behavior and to
enhance interpersonal relationships, work, life and developmental adjustment, personal
and organizational effectiveness, behavioral health, and mental health. The practice of
psychology includes, but is not limited to, the following services, regardless of whether
the provider receives payment for the services:

(1) psychological research and teaching of psychology;

(2) assessment, including psychological testing and other means of evaluating
personal characteristics such as intelligence, personality, abilities, interests, aptitudes, and
neuropsychological functioning;

(3) a psychological report, whether written or oral, including testimony of a provider
as an expert witness, concerning the characteristics of an individual or entity;

(4) psychotherapy, including but not limited to, categories such as behavioral,
cognitive, emotive, systems, psychophysiological, or insight-oriented therapies;
counseling; hypnosis; and diagnosis and treatment of:

(i) mental and emotional disorder or disability;

(ii) alcohol and substance dependence or abuse;

(iii) disorders of habit or conduct;

(iv) the psychological aspects of physical illness or condition, accident, injury, or
disabilitynew text begin, including the psychological impact of medicationsnew text end;

(v) life adjustment issues, including work-related and bereavement issues; and

(vi) child, family, or relationship issues;

(5) psychoeducational services and treatment; and

(6) consultation and supervision.

Sec. 38.

Minnesota Statutes 2008, section 148.995, subdivision 2, is amended to read:


Subd. 2.

Certified doula.

"Certified doula" means an individual who has received
a certification to perform doula services from the International Childbirth Education
Association, the Doulas of North America (DONA), the Association of Labor Assistants
and Childbirth Educators (ALACE), Birthworks, Childbirth and Postpartum Professional
Association (CAPPA), deleted text beginordeleted text end Childbirth Internationalnew text begin, or International Center for Traditional
Childbearing
new text end.

Sec. 39.

Minnesota Statutes 2008, section 148.995, subdivision 4, is amended to read:


Subd. 4.

Doula services.

"Doula services" means new text begincontinuous new text endemotional and
physical support deleted text beginduring pregnancy, labor, birth, and postpartumdeleted text endnew text begin throughout labor and
birth, and intermittently during the prenatal and postpartum periods
new text end.

Sec. 40.

Minnesota Statutes 2008, section 150A.01, subdivision 8, is amended to read:


Subd. 8.

deleted text beginRegistereddeleted text endnew text begin Licensednew text end dental assistant.

"deleted text beginRegistereddeleted text endnew text begin Licensednew text end dental
assistant" means a person deleted text beginregistereddeleted text endnew text begin licensednew text end pursuant to section 150A.06.

Sec. 41.

Minnesota Statutes 2008, section 150A.02, subdivision 1, is amended to read:


Subdivision 1.

Generally.

There is hereby created a Board of Dentistry whose duty
it shall be to carry out the purposes and enforce the provisions of sections 150A.01 to
150A.12. The board shall consist of two public members as defined by section 214.02,
five qualified resident dentists, one qualified resident deleted text beginregistereddeleted text endnew text begin licensednew text end dental assistant,
and one qualified resident dental hygienist appointed by the governor. Membership terms,
compensation of members, removal of members, the filling of membership vacancies, and
fiscal year and reporting requirements shall be as provided in sections 214.07 to 214.09.
The provision of staff, administrative services and office space; the review and processing
of board complaints; the setting of board fees; and other provisions relating to board
operations shall be as provided in chapter 214. Each board member who is a dentist,
deleted text begin registereddeleted text endnew text begin licensednew text end dental assistant, or dental hygienist shall have been lawfully in active
practice in this state for five years immediately preceding appointment; and no board
member shall be eligible for appointment to more than two consecutive four-year terms,
and members serving on the board at the time of the enactment hereof shall be eligible
to reappointment provided they shall not have served more than nine consecutive years
at the expiration of the term to which they are to be appointed. At least 90 days prior to
the expiration of the terms of dentists, deleted text beginregistereddeleted text endnew text begin licensednew text end dental assistants, or dental
hygienists, the Minnesota Dental Association, Minnesota Dental Assistants Association,
or the Minnesota State Dental Hygiene Association shall recommend to the governor for
each term expiring not less than two dentists, two deleted text beginregistereddeleted text endnew text begin licensednew text end dental assistants,
or two dental hygienists, respectively, who are qualified to serve on the board, and from
the list so recommended the governor may appoint members to the board for the term of
four years, the appointments to be made within 30 days after the expiration of the terms.
Within 60 days after the occurrence of a dentist, deleted text beginregistereddeleted text endnew text begin licensednew text end dental assistant or
dental hygienist vacancy, prior to the expiration of the term, in the board, the Minnesota
Dental Association, the Minnesota Dental Assistants Association, or the Minnesota State
Dental Hygiene Association shall recommend to the governor not less than two dentists,
two deleted text beginregistereddeleted text endnew text begin licensednew text end dental assistants, or two dental hygienists, who are qualified to
serve on the board and from the list so recommended the governor, within 30 days after
receiving such list of dentists, may appoint one member to the board for the unexpired
term occasioned by such vacancy. Any appointment to fill a vacancy shall be made
within 90 days after the occurrence of such vacancy. The first four-year term of the
dental hygienist and of the deleted text beginregistereddeleted text endnew text begin licensednew text end dental assistant shall commence on the
first Monday in January, 1977.

Sec. 42.

Minnesota Statutes 2008, section 150A.05, subdivision 2, is amended to read:


Subd. 2.

Exemptions and exceptions of certain practices and operations.

Sections 150A.01 to 150A.12 do not apply to:

(1) the practice of dentistry or dental hygiene in any branch of the armed services of
the United States, the United States Public Health Service, or the United States Veterans
Administration;

(2) the practice of dentistry, dental hygiene, or dental assisting by undergraduate
dental students, dental hygiene students, and dental assisting students of the University
of Minnesota, schools of dental hygiene, or schools of dental assisting approved by the
board, when acting under the deleted text begindirection anddeleted text endnew text begin indirectnew text end supervision of a new text beginMinnesota new text endlicensed
dentist deleted text beginor adeleted text endnew text begin and under the instruction of a licensed dentist,new text end licensed dental hygienist deleted text beginacting
as an instructor
deleted text endnew text begin, or licensed dental assistantnew text end;

(3) the practice of dentistry by licensed dentists of other states or countries while
appearing as clinicians under the auspices of a duly approved dental school or college, or a
reputable dental society, or a reputable dental study club composed of dentists;

(4) the actions of persons while they are taking examinations for licensure
deleted text begin or registrationdeleted text end administered or approved by the board pursuant to sections 150A.03,
subdivision 1
, and 150A.06, subdivisions 1, 2, and 2a;

(5) the practice of dentistry by dentists and dental hygienists licensed by other states
during their functioning as examiners responsible for conducting licensure deleted text beginor registrationdeleted text end
examinations administered by regional and national testing agencies with whom the
board is authorized to affiliate and participate under section 150A.03, subdivision 1,
and the practice of dentistry by the regional and national testing agencies during their
administering examinations pursuant to section 150A.03, subdivision 1;

(6) the use of X-rays or other diagnostic imaging modalities for making radiographs
or other similar records in a hospital under the supervision of a physician or dentist or
by a person who is credentialed to use diagnostic imaging modalities or X-ray machines
for dental treatment, roentgenograms, or dental diagnostic purposes by a credentialing
agency other than the Board of Dentistry; or

(7) the service, other than service performed directly upon the person of a patient, of
constructing, altering, repairing, or duplicating any denture, partial denture, crown, bridge,
splint, orthodontic, prosthetic, or other dental appliance, when performed according
to a written work order from a licensed dentist in accordance with section 150A.10,
subdivision 3
.

Sec. 43.

Minnesota Statutes 2008, section 150A.06, subdivision 2a, is amended to read:


Subd. 2a.

deleted text beginRegistereddeleted text endnew text begin Licensednew text end dental assistant.

A person of good moral character,
who has graduated from a dental assisting program accredited by the Commission on
Dental Accreditation of the American Dental Association, may apply for deleted text beginregistrationdeleted text endnew text begin
licensure
new text end. The applicant must submit an application and fee as prescribed by the board
and the diploma or certificate of dental assisting. In the case of examinations conducted
pursuant to section 150A.03, subdivision 1, applicants shall take the examination before
applying to the board for deleted text beginregistrationdeleted text endnew text begin licensurenew text end. The examination shall include an
examination of the applicant's knowledge of the laws of Minnesota relating to dentistry
and the rules of the board. An applicant is ineligible to retake the deleted text beginregistrationdeleted text endnew text begin licensurenew text end
examination required by the board after failing it twice until further education and training
are obtained as specified by board rule. A separate, nonrefundable fee may be charged for
each time a person applies. An applicant who passes the examination in compliance with
subdivision 2b, abides by professional ethical conduct requirements, and meets all the
other requirements of the board shall be deleted text beginregistereddeleted text endnew text begin licensednew text end as a dental assistant.

Sec. 44.

Minnesota Statutes 2008, section 150A.06, subdivision 2b, is amended to read:


Subd. 2b.

Examination.

When the Board of Dentistry administers the examination
for licensure deleted text beginor registrationdeleted text end, only those board members or board-appointed deputy
examiners qualified for the particular examination may administer it. An examination
which the board requires as a condition of licensure deleted text beginor registrationdeleted text end must have been taken
within the five years before the board receives the application for licensure deleted text beginor registrationdeleted text end.

Sec. 45.

Minnesota Statutes 2008, section 150A.06, subdivision 2c, is amended to read:


Subd. 2c.

Guest license deleted text beginor registrationdeleted text end.

(a) The board shall grant a guest license to
practice as a dentist deleted text beginordeleted text endnew text begin,new text end dental hygienistnew text begin,new text end or deleted text begina guest registration to practice as adeleted text end new text beginlicensed
new text enddental assistant if the following conditions are met:

(1) the dentist, dental hygienist, or dental assistant is currently licensed deleted text beginor registereddeleted text end
in good standing in North Dakota, South Dakota, Iowa, or Wisconsin;

(2) the dentist, dental hygienist, or dental assistant is currently engaged in the practice
of that person's respective profession in North Dakota, South Dakota, Iowa, or Wisconsin;

(3) the dentist, dental hygienist, or dental assistant will limit that person's practice to
a public health setting in Minnesota that (i) is approved by the board; (ii) was established
by a nonprofit organization that is tax exempt under chapter 501(c)(3) of the Internal
Revenue Code of 1986; and (iii) provides dental care to patients who have difficulty
accessing dental care;

(4) the dentist, dental hygienist, or dental assistant agrees to treat indigent patients
who meet the eligibility criteria established by the clinic; and

(5) the dentist, dental hygienist, or dental assistant has applied to the board for a
guest license deleted text beginor registrationdeleted text end and has paid a nonrefundable license fee to the board not
to exceed $75.

(b) A guest license deleted text beginor registrationdeleted text end must be renewed annually with the board and an
annual renewal fee not to exceed $75 must be paid to the board.

(c) A dentist, dental hygienist, or dental assistant practicing under a guest license
deleted text begin or registrationdeleted text end under this subdivision shall have the same obligations as a dentist, dental
hygienist, or dental assistant who is licensed in Minnesota and shall be subject to the laws
and rules of Minnesota and the regulatory authority of the board. If the board suspends
or revokes the guest license deleted text beginor registrationdeleted text end of, or otherwise disciplines, a dentist, dental
hygienist, or dental assistant practicing under this subdivision, the board shall promptly
report such disciplinary action to the dentist's, dental hygienist's, or dental assistant's
regulatory board in the border state.

Sec. 46.

Minnesota Statutes 2008, section 150A.06, subdivision 2d, is amended to read:


Subd. 2d.

Continuing education and professional development waiver.

(a) The
board shall grant a waiver to the continuing education requirements under this chapter
for a licensed dentist, licensed dental hygienist, or deleted text beginregistereddeleted text endnew text begin licensednew text end dental assistant
who documents to the satisfaction of the board that the dentist, dental hygienist, or
deleted text begin registereddeleted text endnew text begin licensednew text end dental assistant has retired from active practice in the state and limits
the provision of dental care services to those offered without compensation in a public
health, community, or tribal clinic or a nonprofit organization that provides services to
the indigent or to recipients of medical assistance, general assistance medical care, or
MinnesotaCare programs.

(b) The board may require written documentation from the volunteer and retired
dentist, dental hygienist, or deleted text beginregistereddeleted text endnew text begin licensednew text end dental assistant prior to granting this waiver.

(c) The board shall require the volunteer and retired dentist, dental hygienist, or
deleted text begin registereddeleted text endnew text begin licensednew text end dental assistant to meet the following requirements:

(1) a licensee deleted text beginor registrantdeleted text end seeking a waiver under this subdivision must complete
and document at least five hours of approved courses in infection control, medical
emergencies, and medical management for the continuing education cycle; and

(2) provide documentation of deleted text begincertification in advanced or basic cardiac life
support recognized by
deleted text end new text begincurrent CPR certification from completion of new text endthe American Heart
Associationnew text begin healthcare provider coursenew text end, the American Red Crossnew text begin professional rescuer
course
new text end, or an equivalent entity.

Sec. 47.

Minnesota Statutes 2008, section 150A.06, subdivision 4a, is amended to read:


Subd. 4a.

Appeal of denial of application.

A person whose application for
licensure deleted text beginor registrationdeleted text end by credentials has been denied may appeal the decision to the
board. The board shall establish an appeals process and inform a denied candidate of the
right to appeal and the process for filing the appeal.

Sec. 48.

Minnesota Statutes 2008, section 150A.06, subdivision 5, is amended to read:


Subd. 5.

Fraud in securing licenses deleted text beginor registrationsdeleted text end.

Every person implicated
in employing fraud or deception in applying for or securing a license deleted text beginor registrationdeleted text end to
practice dentistry, dental hygiene, or dental assisting or in annually renewing a license
deleted text begin or registrationdeleted text end under sections 150A.01 to 150A.12 is guilty of a gross misdemeanor.

Sec. 49.

Minnesota Statutes 2008, section 150A.06, subdivision 7, is amended to read:


Subd. 7.

Additional remedies for licensure deleted text beginand registrationdeleted text end.

On a case-by-case
basis, for initial or renewal of licensure deleted text beginor registrationdeleted text end, the board may add additional
remedies for deficiencies found based on the applicant's performance, character, and
education.

Sec. 50.

Minnesota Statutes 2008, section 150A.06, subdivision 8, is amended to read:


Subd. 8.

deleted text beginRegistrationdeleted text endnew text begin Licensurenew text end by credentials.

(a) Any dental assistant may, upon
application and payment of a fee established by the board, apply for deleted text beginregistrationdeleted text endnew text begin licensurenew text end
based on an evaluation of the applicant's education, experience, and performance record in
lieu of completing a board-approved dental assisting program for expanded functions as
defined in rule, and may be interviewed by the board to determine if the applicant:

(1) has graduated from an accredited dental assisting program accredited by the
Commission of Dental Accreditation of the American Dental Association, or is currently
certified by the Dental Assisting National Board;

(2) is not subject to any pending or final disciplinary action in another state or
Canadian province, or if not currently certified or registered, previously had a certification
or registration in another state or Canadian province in good standing that was not subject
to any final or pending disciplinary action at the time of surrender;

(3) is of good moral character and abides by professional ethical conduct
requirements;

(4) at board discretion, has passed a board-approved English proficiency test if
English is not the applicant's primary language; and

(5) has met all expanded functions curriculum equivalency requirements of a
Minnesota board-approved dental assisting program.

(b) The board, at its discretion, may waive specific deleted text beginregistrationdeleted text endnew text begin licensurenew text end
requirements in paragraph (a).

(c) An applicant who fulfills the conditions of this subdivision and demonstrates
the minimum knowledge in dental subjects required for deleted text beginregistrationdeleted text endnew text begin licensurenew text end under
subdivision 2a must be deleted text beginregistereddeleted text endnew text begin licensednew text end to practice the applicant's profession.

(d) If the applicant does not demonstrate the minimum knowledge in dental subjects
required for deleted text beginregistrationdeleted text endnew text begin licensurenew text end under subdivision 2a, the application must be denied.
If deleted text beginregistrationdeleted text endnew text begin licensurenew text end is denied, the board may notify the applicant of any specific
remedy that the applicant could take which, when passed, would qualify the applicant
for deleted text beginregistrationdeleted text endnew text begin licensurenew text end. A denial does not prohibit the applicant from applying for
deleted text begin registrationdeleted text endnew text begin licensurenew text end under subdivision 2a.

(e) A candidate whose application has been denied may appeal the decision to the
board according to subdivision 4a.

Sec. 51.

Minnesota Statutes 2008, section 150A.08, subdivision 1, is amended to read:


Subdivision 1.

Grounds.

The board may refuse or by order suspend or revoke, limit
or modify by imposing conditions it deems necessary, any license to practice dentistry
deleted text begin ordeleted text endnew text begin,new text end dental hygienenew text begin,new text end or deleted text beginthe registration of anydeleted text end dental deleted text beginassistantdeleted text endnew text begin assistingnew text end upon any of the
following grounds:

(1) fraud or deception in connection with the practice of dentistry or the securing of
a license deleted text beginor registrationdeleted text end certificate;

(2) conviction, including a finding or verdict of guilt, an admission of guilt, or a no
contest plea, in any court of a felony or gross misdemeanor reasonably related to the
practice of dentistry as evidenced by a certified copy of the conviction;

(3) conviction, including a finding or verdict of guilt, an admission of guilt, or a
no contest plea, in any court of an offense involving moral turpitude as evidenced by a
certified copy of the conviction;

(4) habitual overindulgence in the use of intoxicating liquors;

(5) improper or unauthorized prescription, dispensing, administering, or personal
or other use of any legend drug as defined in chapter 151, of any chemical as defined in
chapter 151, or of any controlled substance as defined in chapter 152;

(6) conduct unbecoming a person licensed to practice dentistry deleted text beginordeleted text endnew text begin,new text end dental hygienenew text begin,new text end
or deleted text beginregistered as adeleted text end dental deleted text beginassistantdeleted text endnew text begin assistingnew text end, or conduct contrary to the best interest of the
public, as such conduct is defined by the rules of the board;

(7) gross immorality;

(8) any physical, mental, emotional, or other disability which adversely affects a
dentist's, dental hygienist's, or deleted text beginregistereddeleted text end dental assistant's ability to perform the service
for which the person is licensed deleted text beginor registereddeleted text end;

(9) revocation or suspension of a licensedeleted text begin, registration,deleted text end or equivalent authority to
practice, or other disciplinary action or denial of a license deleted text beginor registrationdeleted text end application taken
by a licensingdeleted text begin, registering,deleted text end or credentialing authority of another state, territory, or country
as evidenced by a certified copy of the licensing authority's order, if the disciplinary action
or application denial was based on facts that would provide a basis for disciplinary action
under this chapter and if the action was taken only after affording the credentialed person
or applicant notice and opportunity to refute the allegations or pursuant to stipulation
or other agreement;

(10) failure to maintain adequate safety and sanitary conditions for a dental office in
accordance with the standards established by the rules of the board;

(11) employing, assisting, or enabling in any manner an unlicensed person to
practice dentistry;

(12) failure or refusal to attend, testify, and produce records as directed by the board
under subdivision 7;

(13) violation of, or failure to comply with, any other provisions of sections 150A.01
to 150A.12, the rules of the Board of Dentistry, or any disciplinary order issued by the
board, sections 144.291 to 144.298 or 595.02, subdivision 1, paragraph (d), or for any
other just cause related to the practice of dentistry. Suspension, revocation, modification
or limitation of any license shall not be based upon any judgment as to therapeutic or
monetary value of any individual drug prescribed or any individual treatment rendered,
but only upon a repeated pattern of conduct;

(14) knowingly providing false or misleading information that is directly related
to the care of that patient unless done for an accepted therapeutic purpose such as the
administration of a placebo; or

(15) aiding suicide or aiding attempted suicide in violation of section 609.215 as
established by any of the following:

(i) a copy of the record of criminal conviction or plea of guilty for a felony in
violation of section 609.215, subdivision 1 or 2;

(ii) a copy of the record of a judgment of contempt of court for violating an
injunction issued under section 609.215, subdivision 4;

(iii) a copy of the record of a judgment assessing damages under section 609.215,
subdivision 5
; or

(iv) a finding by the board that the person violated section 609.215, subdivision
1
or 2. The board shall investigate any complaint of a violation of section 609.215,
subdivision 1
or 2.

Sec. 52.

Minnesota Statutes 2008, section 150A.08, subdivision 3, is amended to read:


Subd. 3.

Reinstatement.

Any licensee deleted text beginor registrantdeleted text end whose license deleted text beginor registrationdeleted text end has
been suspended or revoked may have the license deleted text beginor registrationdeleted text end reinstated or a new license
deleted text begin or registrationdeleted text end issued, as the case may be, when the board deems the action is warranted.

Sec. 53.

Minnesota Statutes 2008, section 150A.08, subdivision 3a, is amended to read:


Subd. 3a.

Costs; additional penalties.

(a) The board may impose a civil penalty
not exceeding $10,000 for each separate violation, the amount of the civil penalty to
be fixed so as to deprive a licensee deleted text beginor registrantdeleted text end of any economic advantage gained by
reason of the violation, to discourage similar violations by the licensee deleted text beginor registrantdeleted text end or any
other licensee deleted text beginor registrantdeleted text end, or to reimburse the board for the cost of the investigation and
proceeding, including, but not limited to, fees paid for services provided by the Office of
Administrative Hearings, legal and investigative services provided by the Office of the
Attorney General, court reporters, witnesses, reproduction of records, board members'
per diem compensation, board staff time, and travel costs and expenses incurred by board
staff and board members.

(b) In addition to costs and penalties imposed under paragraph (a), the board may
also:

(1) order the dentist, dental hygienist, or dental assistant to provide unremunerated
service;

(2) censure or reprimand the dentist, dental hygienist, or dental assistant; or

(3) any other action as allowed by law and justified by the facts of the case.

Sec. 54.

Minnesota Statutes 2008, section 150A.08, subdivision 5, is amended to read:


Subd. 5.

Medical examinations.

If the board has probable cause to believe that a
dentist, dental hygienist, deleted text beginregistereddeleted text end dental assistant, or applicant engages in acts described
in subdivision 1, clause (4) or (5), or has a condition described in subdivision 1, clause (8),
it shall direct the dentist, dental hygienist, assistant, or applicant to submit to a mental
or physical examination or a chemical dependency assessment. For the purpose of this
subdivision, every dentist, hygienist, or new text begindental new text endassistant licensed deleted text beginor registereddeleted text end under
this chapter or person submitting an application for a license deleted text beginor registrationdeleted text end is deemed
to have given consent to submit to a mental or physical examination when directed
in writing by the board and to have waived all objections in any proceeding under this
section to the admissibility of the examining physician's testimony or examination reports
on the ground that they constitute a privileged communication. Failure to submit to an
examination without just cause may result in an application being denied or a default and
final order being entered without the taking of testimony or presentation of evidence,
other than evidence which may be submitted by affidavit, that the licenseedeleted text begin, registrant,deleted text end or
applicant did not submit to the examination. A dentist, dental hygienist, deleted text beginregistereddeleted text end dental
assistant, or applicant affected under this section shall at reasonable intervals be afforded
an opportunity to demonstrate ability to start or resume the competent practice of dentistry
or perform the duties of a dental hygienist or deleted text beginregistereddeleted text end dental assistant with reasonable
skill and safety to patients. In any proceeding under this subdivision, neither the record of
proceedings nor the orders entered by the board is admissible, is subject to subpoena, or
may be used against the dentist, dental hygienist, deleted text beginregistereddeleted text end dental assistant, or applicant in
any proceeding not commenced by the board. Information obtained under this subdivision
shall be classified as private pursuant to the Minnesota Government Data Practices Act.

Sec. 55.

Minnesota Statutes 2008, section 150A.08, subdivision 6, is amended to read:


Subd. 6.

Medical records.

Notwithstanding contrary provisions of sections 13.384
and 144.651 or any other statute limiting access to medical or other health data, the
board may obtain medical data and health records of a licenseedeleted text begin, registrant,deleted text end or applicant
without the licensee'sdeleted text begin, registrant's,deleted text end or applicant's consent if the information is requested
by the board as part of the process specified in subdivision 5. The medical data may be
requested from a provider, as defined in section 144.291, subdivision 2, paragraph (h),
an insurance company, or a government agency, including the Department of Human
Services. A provider, insurance company, or government agency shall comply with
any written request of the board under this subdivision and shall not be liable in any
action for damages for releasing the data requested by the board if the data are released
pursuant to a written request under this subdivision, unless the information is false and
the provider giving the information knew, or had reason to believe, the information was
false. Information obtained under this subdivision shall be classified as private under the
Minnesota Government Data Practices Act.

Sec. 56.

Minnesota Statutes 2008, section 150A.08, subdivision 8, is amended to read:


Subd. 8.

Suspension of license.

In addition to any other remedy provided by
law, the board may, through its designated board members pursuant to section 214.10,
subdivision 2
, temporarily suspend a license deleted text beginor registrationdeleted text end without a hearing if the
board finds that the licensee deleted text beginor registrantdeleted text end has violated a statute or rule which the board is
empowered to enforce and continued practice by the licensee deleted text beginor registrantdeleted text end would create an
imminent risk of harm to others. The suspension shall take effect upon written notice to
the licensee deleted text beginor registrantdeleted text end served by first class mail specifying the statute or rule violated,
and the time, date, and place of the hearing before the board. If the notice is returned by
the post office, the notice shall be effective upon reasonable attempts to locate and serve
the licensee deleted text beginor registrantdeleted text end. Within ten days of service of the notice, the board shall hold a
hearing before its own members on the sole issue of whether there is a reasonable basis to
continue, modify, or lift the suspension. Evidence presented by the boarddeleted text begin,deleted text endnew text begin ornew text end licenseedeleted text begin,
or registrant,
deleted text end shall be in affidavit form only. The licensee deleted text beginor registrantdeleted text end or counsel of the
licensee deleted text beginor registrantdeleted text end may appear for oral argument. Within five working days after the
hearing, the board shall issue its order and, if the suspension is continued, the board
shall schedule a disciplinary hearing to be held pursuant to the Administrative Procedure
Act within 45 days of issuance of the order. The administrative law judge shall issue a
report within 30 days of the closing of the contested case hearing record. The board
shall issue a final order within 30 days of receiving that report. The board may allow a
person who was licensed by any state to practice dentistry and whose license has been
suspended to practice dentistry under the supervision of a licensed dentist for the purpose
of demonstrating competence and eligibility for reinstatement.

Sec. 57.

Minnesota Statutes 2008, section 150A.081, is amended to read:


150A.081 ACCESS TO MEDICAL DATA.

Subdivision 1.

Access to data on licensee deleted text beginor registrantdeleted text end.

When the board has
probable cause to believe that a licensee's deleted text beginor registrant'sdeleted text end condition meets a ground listed in
section 150A.08, subdivision 1, clause (4) or (8), it may, notwithstanding sections 13.384,
144.651, or any other law limiting access to medical data, obtain medical or health records
on the licensee deleted text beginor registrantdeleted text end without the licensee's deleted text beginor registrant'sdeleted text end consent. The medical data
may be requested from a provider, as defined in section 144.291, subdivision 2, paragraph
(h), an insurance company, or a government agency. A provider, insurance company, or
government agency shall comply with a written request of the board under this subdivision
and is not liable in any action for damages for releasing the data requested by the board
if the data are released under the written request, unless the information is false and the
entity providing the information knew, or had reason to believe, the information was false.

Subd. 2.

Access to data on patients.

The board has access to medical records of
a patient treated by a licensee deleted text beginor registrantdeleted text end under review if the patient signs a written
consent permitting access. If the patient has not given consent, the licensee deleted text beginor registrantdeleted text end
must delete data from which a patient may be identified before releasing medical records
to the board.

Subd. 3.

Data classification; release of certain health data not required.

Information obtained under this section is classified as private data on individuals under
chapter 13. Under this section, the commissioner of health is not required to release health
data collected and maintained under section 13.3805, subdivision 2.

Sec. 58.

Minnesota Statutes 2008, section 150A.09, subdivision 1, is amended to read:


Subdivision 1.

Registration information and procedure.

On or before the license
deleted text begin or registrationdeleted text end certificate expiration date every licensed dentist, dental hygienist, and
deleted text begin registereddeleted text end dental assistant shall transmit to the executive secretary of the board, pertinent
information required by the board, together with the fee established by the board. At least
30 days before a license deleted text beginor registrationdeleted text end certificate expiration date, the board shall send
a written notice stating the amount and due date of the fee and the information to be
provided to every licensed dentist, dental hygienist, and deleted text beginregistereddeleted text end dental assistant.

Sec. 59.

Minnesota Statutes 2008, section 150A.09, subdivision 3, is amended to read:


Subd. 3.

Current address, change of address.

Every dentist, dental hygienist, and
deleted text begin registereddeleted text end dental assistant shall maintain with the board a correct and current mailing
address. For dentists engaged in the practice of dentistry, the address shall be that of the
location of the primary dental practice. Within 30 days after changing addresses, every
dentist, dental hygienist, and deleted text beginregistereddeleted text end dental assistant shall provide the board written
notice of the new address either personally or by first class mail.

Sec. 60.

Minnesota Statutes 2008, section 150A.091, subdivision 2, is amended to read:


Subd. 2.

Application fees.

Each applicant deleted text beginfor licensure or registrationdeleted text end shall submit
with a license or deleted text beginregistrationdeleted text endnew text begin permitnew text end application a nonrefundable fee in the following
amounts in order to administratively process an application:

(1) dentist, $140;

(2) limited faculty dentist, $140;

(3) resident dentist, $55;

(4) dental hygienist, $55;

(5) deleted text beginregistereddeleted text endnew text begin licensednew text end dental assistant, deleted text begin$35deleted text endnew text begin $55new text end; and

(6) dental assistant with a deleted text beginlimited registrationdeleted text endnew text begin permit as described in Minnesota
Rules, part 3100.8500, subpart 3
new text end, $15.

Sec. 61.

Minnesota Statutes 2008, section 150A.091, subdivision 3, is amended to read:


Subd. 3.

Initial license or deleted text beginregistrationdeleted text endnew text begin permitnew text end fees.

Along with the application fee,
each of the following deleted text beginlicensees or registrantsdeleted text endnew text begin applicantsnew text end shall submit a separate prorated
initial license or deleted text beginregistrationdeleted text endnew text begin permitnew text end fee. The prorated initial fee shall be established by the
board based on the number of months of the deleted text beginlicensee's or registrant'sdeleted text endnew text begin applicant'snew text end initial
term as described in Minnesota Rules, part 3100.1700, subpart 1a, not to exceed the
following monthly fee amounts:

(1) dentist, $14 times the number of months of the initial term;

(2) dental hygienist, $5 times the number of months of the initial term;

(3) deleted text beginregistereddeleted text endnew text begin licensednew text end dental assistant, $3 times the number of months of initial
term; and

(4) dental assistant with a deleted text beginlimited registrationdeleted text endnew text begin permit as described in Minnesota
Rules, part 3100.8500, subpart 3
new text end, $1 times the number of months of the initial term.

Sec. 62.

Minnesota Statutes 2008, section 150A.091, subdivision 5, is amended to read:


Subd. 5.

Biennial license or deleted text beginregistrationdeleted text endnew text begin permitnew text end fees.

Each of the following
deleted text begin licensees or registrantsdeleted text endnew text begin applicantsnew text end shall submit with a biennial license or deleted text beginregistrationdeleted text endnew text begin permitnew text end
renewal application a fee as established by the board, not to exceed the following amounts:

(1) dentist, $336;

(2) dental hygienist, $118;

(3) deleted text beginregistereddeleted text endnew text begin licensednew text end dental assistant, $80; and

(4) dental assistant with a deleted text beginlimited registrationdeleted text endnew text begin permit as described in Minnesota
Rules, part 3100.8500, subpart 3
new text end, $24.

Sec. 63.

Minnesota Statutes 2008, section 150A.091, subdivision 7, is amended to read:


Subd. 7.

Biennial license or deleted text beginregistrationdeleted text endnew text begin permitnew text end late fee.

Applications for renewal
of any license or deleted text beginregistrationdeleted text endnew text begin permitnew text end received after the time specified in Minnesota Rules,
part 3100.1700, must be assessed a late fee equal to 25 percent of the biennial renewal fee.

Sec. 64.

Minnesota Statutes 2008, section 150A.091, subdivision 8, is amended to read:


Subd. 8.

Duplicate license or deleted text beginregistrationdeleted text endnew text begin certificatenew text end fee.

Each deleted text beginlicensee or
registrant
deleted text endnew text begin applicantnew text end shall submit, with a request for issuance of a duplicate of the original
license deleted text beginor registrationdeleted text end, or of an annual or biennial renewal deleted text beginof itdeleted text endnew text begin certificate for a license
or permit
new text end, a fee in the following amounts:

(1) original dentist deleted text beginordeleted text endnew text begin,new text end dental hygienenew text begin, or dental assistantnew text end license, $35; and

(2) deleted text begininitial and renewal registration certificates and licensedeleted text endnew text begin annual or biennialnew text end renewal
certificates, $10.

Sec. 65.

Minnesota Statutes 2008, section 150A.091, subdivision 9, is amended to read:


Subd. 9.

Licensure deleted text beginand registrationdeleted text end by credentials.

Each applicant for licensure
as a dentist deleted text beginordeleted text endnew text begin,new text end dental hygienistnew text begin,new text end or deleted text beginfor registration as a registereddeleted text end dental assistant by
credentials pursuant to section 150A.06, subdivisions 4 and 8, and Minnesota Rules, part
3100.1400, shall submit with the license deleted text beginor registrationdeleted text end application a fee in the following
amounts:

(1) dentist, $725;

(2) dental hygienist, $175; and

(3) deleted text beginregistereddeleted text end dental assistant, $35.

Sec. 66.

Minnesota Statutes 2008, section 150A.091, is amended by adding a
subdivision to read:


new text begin Subd. 9a. new text end

new text begin Credential review; nonaccredited dental institution. new text end

new text begin Applicants who
have graduated from a nonaccredited dental college desiring licensure as a dentist pursuant
to section 150A.06, subdivision 1, shall submit an application for credential review and an
application fee not to exceed the amount of $200.
new text end

Sec. 67.

Minnesota Statutes 2008, section 150A.091, is amended by adding a
subdivision to read:


new text begin Subd. 9b. new text end

new text begin Limited general license. new text end

new text begin Each applicant for licensure as a limited general
dentist pursuant to section 150A.06, subdivision 9, shall submit the applicable fees
established by the board not to exceed the following amounts:
new text end

new text begin (1) initial limited general license application, $140;
new text end

new text begin (2) annual limited general license renewal application, $155; and
new text end

new text begin (3) late fee assessment for renewal application equal to 50 percent of the annual
limited general license renewal fee.
new text end

Sec. 68.

Minnesota Statutes 2008, section 150A.091, subdivision 10, is amended to
read:


Subd. 10.

Reinstatement fee.

No dentist, dental hygienist, or deleted text beginregistereddeleted text end dental
assistant whose license deleted text beginor registrationdeleted text end has been suspended or revoked may have the
license deleted text beginor registrationdeleted text end reinstated or a new license deleted text beginor registrationdeleted text end issued until a fee has been
submitted to the board in the following amounts:

(1) dentist, $140;

(2) dental hygienist, $55; and

(3) deleted text beginregistereddeleted text end dental assistant, $35.

Sec. 69.

Minnesota Statutes 2008, section 150A.091, subdivision 11, is amended to
read:


Subd. 11.

Certificate application fee for anesthesia/sedation.

Each dentist
shall submit with a general anesthesia or deleted text beginconsciousdeleted text endnew text begin moderatenew text end sedation application new text beginor a
contracted sedation provider application
new text enda fee as established by the board not to exceed
the following amounts:

(1) for both a general anesthesia and deleted text beginconsciousdeleted text endnew text begin moderatenew text end sedation application, deleted text begin$50deleted text endnew text begin
$250
new text end;

(2) for a general anesthesia application only, deleted text begin$50deleted text endnew text begin $250new text end; deleted text beginand
deleted text end

(3) for a deleted text beginconsciousdeleted text endnew text begin moderatenew text end sedation application only, deleted text begin$50.deleted text endnew text begin $250; and
new text end

new text begin (4) for a contracted sedation provider application, $250.
new text end

Sec. 70.

Minnesota Statutes 2008, section 150A.091, is amended by adding a
subdivision to read:


new text begin Subd. 11a. new text end

new text begin Certificate for anesthesia/sedation late fee. new text end

new text begin Applications for renewal
of a general anesthesia or moderate sedation certificate or a contracted sedation provider
certificate received after the time specified in Minnesota Rules, part 3100.3600, subparts
9 and 9b, must be assessed a late fee equal to 50 percent of the biennial renewal fee for
an anesthesia/sedation certificate.
new text end

Sec. 71.

Minnesota Statutes 2008, section 150A.091, is amended by adding a
subdivision to read:


new text begin Subd. 11b. new text end

new text begin Recertification fee for anesthesia/sedation. new text end

new text begin No dentist whose general
anesthesia or moderate sedation certificate has been terminated by the board or voluntarily
terminated by the dentist may become recertified until a fee has been submitted to the
board not to exceed the amount of $500.
new text end

Sec. 72.

Minnesota Statutes 2008, section 150A.091, subdivision 12, is amended to
read:


Subd. 12.

Duplicate certificate fee for anesthesia/sedation.

Each dentist shall
submit with a request for issuance of a duplicate of the original general anesthesia or
deleted text begin consciousdeleted text endnew text begin moderatenew text end sedation certificate new text beginor contracted sedation provider certificate new text enda fee in
the amount of $10.

Sec. 73.

Minnesota Statutes 2008, section 150A.091, subdivision 14, is amended to
read:


Subd. 14.

Affidavit of licensure.

Each licensee deleted text beginor registrantdeleted text end shall submit with a
request for an affidavit of licensure a fee in the amount of $10.

Sec. 74.

Minnesota Statutes 2008, section 150A.091, subdivision 15, is amended to
read:


Subd. 15.

Verification of licensure.

Each institution or corporation shall submit
with a request for verification of a license deleted text beginor registrationdeleted text end a fee in the amount of $5 for
each license deleted text beginor registrationdeleted text end to be verified.

Sec. 75.

Minnesota Statutes 2008, section 150A.10, subdivision 1a, is amended to read:


Subd. 1a.

Limited authorization for dental hygienists.

(a) Notwithstanding
subdivision 1, a dental hygienist licensed under this chapter may be employed or retained
by a health care facility, program, or nonprofit organization to perform dental hygiene
services described under paragraph (b) without the patient first being examined by a
licensed dentist if the dental hygienist:

(1) has been engaged in the active practice of clinical dental hygiene for not less than
2,400 hours in the past 18 months or a career total of 3,000 hours, including a minimum of
200 hours of clinical practice in two of the past three years;

(2) has entered into a collaborative agreement with a licensed dentist that designates
authorization for the services provided by the dental hygienist;

(3) has documented participation in courses in infection control and medical
emergencies within each continuing education cycle; and

(4) maintains current deleted text begincertification in advanced or basic cardiac life support as
recognized by the American Heart Association, the American Red Cross, or another
agency that is equivalent to the
deleted text endnew text begin CPR certification from completion of thenew text end American Heart
Association deleted text beginordeleted text endnew text begin healthcare provider course,new text end the American Red Crossnew text begin professional rescuer
course, or an equivalent entity
new text end.

(b) The dental hygiene services authorized to be performed by a dental hygienist
under this subdivision are limited to:

(1) oral health promotion and disease prevention education;

(2) removal of deposits and stains from the surfaces of the teeth;

(3) application of topical preventive or prophylactic agents, including fluoride
varnishes and pit and fissure sealants;

(4) polishing and smoothing restorations;

(5) removal of marginal overhangs;

(6) performance of preliminary charting;

(7) taking of radiographs; and

(8) performance of scaling and root planing.

The dental hygienist may administer injections of local anesthetic agents or nitrous
oxide inhalation analgesia as specifically delegated in the collaborative agreement with
a licensed dentist. The dentist need not first examine the patient or be present. If the
patient is considered medically compromised, the collaborative dentist shall review the
patient record, including the medical history, prior to the provision of these services.
Collaborating dental hygienists may work with deleted text beginunregistereddeleted text endnew text begin unlicensednew text end and deleted text beginregistereddeleted text end
new text begin licensed new text enddental assistants who may only perform duties for which deleted text beginregistrationdeleted text endnew text begin licensurenew text end
is not required. The performance of dental hygiene services in a health care facility,
program, or nonprofit organization as authorized under this subdivision is limited to
patients, students, and residents of the facility, program, or organization.

(c) A collaborating dentist must be licensed under this chapter and may enter into
a collaborative agreement with no more than four dental hygienists unless otherwise
authorized by the board. The board shall develop parameters and a process for obtaining
authorization to collaborate with more than four dental hygienists. The collaborative
agreement must include:

(1) consideration for medically compromised patients and medical conditions for
which a dental evaluation and treatment plan must occur prior to the provision of dental
hygiene services;

(2) age- and procedure-specific standard collaborative practice protocols, including
recommended intervals for the performance of dental hygiene services and a period of
time in which an examination by a dentist should occur;

(3) copies of consent to treatment form provided to the patient by the dental
hygienist;

(4) specific protocols for the placement of pit and fissure sealants and requirements
for follow-up care to assure the efficacy of the sealants after application; and

(5) a procedure for creating and maintaining dental records for the patients that are
treated by the dental hygienist. This procedure must specify where these records are
to be located.

The collaborative agreement must be signed and maintained by the dentist, the dental
hygienist, and the facility, program, or organization; must be reviewed annually by the
collaborating dentist and dental hygienist; and must be made available to the board
upon request.

(d) Before performing any services authorized under this subdivision, a dental
hygienist must provide the patient with a consent to treatment form which must include a
statement advising the patient that the dental hygiene services provided are not a substitute
for a dental examination by a licensed dentist. If the dental hygienist makes any referrals
to the patient for further dental procedures, the dental hygienist must fill out a referral form
and provide a copy of the form to the collaborating dentist.

(e) For the purposes of this subdivision, a "health care facility, program, or
nonprofit organization" is limited to a hospital; nursing home; home health agency; group
home serving the elderly, disabled, or juveniles; state-operated facility licensed by the
commissioner of human services or the commissioner of corrections; and federal, state, or
local public health facility, community clinic, tribal clinic, school authority, Head Start
program, or nonprofit organization that serves individuals who are uninsured or who are
Minnesota health care public program recipients.

(f) For purposes of this subdivision, a "collaborative agreement" means a written
agreement with a licensed dentist who authorizes and accepts responsibility for the
services performed by the dental hygienist. The services authorized under this subdivision
and the collaborative agreement may be performed without the presence of a licensed
dentist and may be performed at a location other than the usual place of practice of the
dentist or dental hygienist and without a dentist's diagnosis and treatment plan, unless
specified in the collaborative agreement.

Sec. 76.

Minnesota Statutes 2008, section 150A.10, subdivision 2, is amended to read:


Subd. 2.

Dental assistants.

Every licensed dentist who uses the services of any
unlicensed person for the purpose of assistance in the practice of dentistry shall be
responsible for the acts of such unlicensed person while engaged in such assistance.
Such dentist shall permit such unlicensed assistant to perform only those acts which are
authorized to be delegated to unlicensed assistants by the Board of Dentistry. Such acts
shall be performed under supervision of a licensed dentist. The board may permit differing
levels of dental assistance based upon recognized educational standards, approved by the
board, for the training of dental assistants. The board may also define by rule the scope of
practice of deleted text beginregistereddeleted text endnew text begin licensednew text end and deleted text beginnonregistereddeleted text endnew text begin unlicensednew text end dental assistants. The board
by rule may require continuing education for differing levels of dental assistants, as a
condition to their deleted text beginregistrationdeleted text endnew text begin licensenew text end or authority to perform their authorized duties. Any
licensed dentist who shall permit such unlicensed assistant to perform any dental service
other than that authorized by the board shall be deemed to be enabling an unlicensed
person to practice dentistry, and commission of such an act by such unlicensed assistant
shall constitute a violation of sections 150A.01 to 150A.12.

Sec. 77.

Minnesota Statutes 2008, section 150A.10, subdivision 4, is amended to read:


Subd. 4.

Restorative procedures.

(a) Notwithstanding subdivisions 1, 1a, and
2, a licensed dental hygienist or deleted text begina registereddeleted text endnew text begin licensednew text end dental assistant may perform the
following restorative procedures:

(1) place, contour, and adjust amalgam restorations;

(2) place, contour, and adjust glass ionomer;

(3) adapt and cement stainless steel crowns; and

(4) place, contour, and adjust class I and class V supragingival composite restorations
where the margins are entirely within the enamel.

(b) The restorative procedures described in paragraph (a) may be performed only if:

(1) the licensed dental hygienist or deleted text beginthe registereddeleted text endnew text begin licensednew text end dental assistant has
completed a board-approved course on the specific procedures;

(2) the board-approved course includes a component that sufficiently prepares the
new text begin licensed new text enddental hygienist or deleted text beginregistereddeleted text endnew text begin licensednew text end dental assistant to adjust the occlusion
on the newly placed restoration;

(3) a licensed dentist has authorized the procedure to be performed; and

(4) a licensed dentist is available in the clinic while the procedure is being performed.

(c) The dental faculty who teaches the educators of the board-approved courses
specified in paragraph (b) must have prior experience teaching these procedures in an
accredited dental education program.

Sec. 78.

Minnesota Statutes 2008, section 150A.12, is amended to read:


150A.12 VIOLATION AND DEFENSES.

Every person who violates any of the provisions of sections 150A.01 to 150A.12
for which no specific penalty is provided herein, shall be guilty of a gross misdemeanor;
and, upon conviction, punished by a fine of not more than $3,000 or by imprisonment in
the county jail for not more than one year or by both such fine and imprisonment. In the
prosecution of any person for violation of sections 150A.01 to 150A.12, it shall not be
necessary to allege or prove lack of a valid license to practice dentistry deleted text beginordeleted text endnew text begin,new text end dental hygienenew text begin,
or dental assisting,
new text end but such matter shall be a matter of defense to be established by the
defendant.

Sec. 79.

Minnesota Statutes 2008, section 150A.13, is amended to read:


150A.13 REPORTING OBLIGATIONS.

Subdivision 1.

Permission to report.

A person who has knowledge of deleted text begina registrant
or
deleted text end a licensee unable to practice with reasonable skill and safety by reason of illness, use of
alcohol, drugs, chemicals, or any other materials, or as a result of any mental, physical, or
psychological condition may report the deleted text beginregistrant ordeleted text end licensee to the board.

Subd. 2.

Institutions.

A hospital, clinic, or other health care institution or
organization located in this state shall report to the board any action taken by the agency,
institution, or organization or any of its administrators or dental or other committees to
revoke, suspend, restrict, or condition a deleted text beginregistrant's ordeleted text end licensee's privilege to practice
or treat patients or clients in the institution, or as part of the organization, any denial
of privileges, or any other disciplinary action against a deleted text beginregistrant ordeleted text end licensee described
under subdivision 1. The institution or organization shall also report the resignation of
any deleted text beginregistrants ordeleted text end licensees prior to the conclusion of any disciplinary action proceeding
against a deleted text beginregistrant ordeleted text end licensee described under subdivision 1.

Subd. 3.

Dental societies.

A state or local dental society or professional dental
association shall report to the board any termination, revocation, or suspension of
membership or any other disciplinary action taken against a deleted text beginregistrant ordeleted text end licensee. If the
society or association has received a complaint against a deleted text beginregistrant ordeleted text end licensee described
under subdivision 1, on which it has not taken any disciplinary action, the society or
association shall report the complaint and the reason why it has not taken action on it or
shall direct the complainant to the board. This subdivision does not apply to a society
or association when it performs peer review functions as an agent of an outside entity,
organization, or system.

Subd. 4.

Licensed professionals.

(a) A licensed deleted text beginor registereddeleted text end health professional
shall report to the board personal knowledge of any conduct by any person who the
licensed deleted text beginor registereddeleted text end health professional reasonably believes is a deleted text beginregistrant ordeleted text end licensee
described under subdivision 1.

(b) Notwithstanding paragraph (a), a licensed health professional shall report to the
board knowledge of any actions which institutions must report under subdivision 2.

Subd. 5.

Insurers and other entities making liability payments.

(a) Four times
each year as prescribed by the board, each insurer authorized to sell insurance described in
section 60A.06, subdivision 1, clause (13), and providing professional liability insurance
to deleted text beginregistrants ordeleted text end licensees, shall submit to the board a report concerning the deleted text beginregistrants anddeleted text end
licensees against whom malpractice settlements or awards have been made to the plaintiff.
The report must contain at least the following information:

(1) the total number of malpractice settlements or awards made;

(2) the date the malpractice settlements or awards were made;

(3) the allegations contained in the claim or complaint leading to the settlements or
awards made;

(4) the dollar amount of each malpractice settlement or award;

(5) the regular address of the practice of the deleted text beginregistrant ordeleted text end licensee against whom an
award was made or with whom a settlement was made; and

(6) the name of the deleted text beginregistrant ordeleted text end licensee against whom an award was made or
with whom a settlement was made.

(b) A dental clinic, hospital, political subdivision, or other entity which makes
professional liability insurance payments on behalf of deleted text beginregistrants ordeleted text end licensees shall submit
to the board a report concerning malpractice settlements or awards paid on behalf of
deleted text begin registrants ordeleted text end licensees, and any settlements or awards paid by a clinic, hospital, political
subdivision, or other entity on its own behalf because of care rendered by deleted text beginregistrants ordeleted text end
licensees. This requirement excludes forgiveness of bills. The report shall be made to the
board within 30 days of payment of all or part of any settlement or award.

Subd. 6.

Courts.

The court administrator of district court or any other court of
competent jurisdiction shall report to the board any judgment or other determination
of the court that adjudges or includes a finding that a deleted text beginregistrant ordeleted text end licensee is mentally
ill, mentally incompetent, guilty of a felony, guilty of a violation of federal or state
narcotics laws or controlled substances act, or guilty of an abuse or fraud under Medicare
or Medicaid; or that appoints a guardian of the deleted text beginregistrant ordeleted text end licensee pursuant to sections
524.5-101 to 524.5-502, or commits a deleted text beginregistrant ordeleted text end licensee pursuant to chapter 253B.

Subd. 7.

Self-reporting.

A deleted text beginregistrant ordeleted text end licensee shall report to the board any
personal action that would require that a report be filed by any person, health care facility,
business, or organization pursuant to subdivisions 2 to 6.

Subd. 8.

Deadlines; forms.

Reports required by subdivisions 2 to 7 must be
submitted not later than 30 days after the occurrence of the reportable event or transaction.
The board may provide forms for the submission of reports required by this section, may
require that reports be submitted on the forms provided, and may adopt rules necessary
to assure prompt and accurate reporting.

Subd. 9.

Subpoenas.

The board may issue subpoenas for the production of any
reports required by subdivisions 2 to 7 or any related documents.

Sec. 80.

Minnesota Statutes 2008, section 169.345, subdivision 2, is amended to read:


Subd. 2.

Definitions.

(a) For the purpose of section 168.021 and this section, the
following terms have the meanings given them in this subdivision.

(b) "Health professional" means a licensed physician, deleted text beginregistereddeleted text endnew text begin licensednew text end physician
assistant, advanced practice registered nurse, or licensed chiropractor.

(c) "Long-term certificate" means a certificate issued for a period greater than 12
months but not greater than 71 months.

(d) "Organization certificate" means a certificate issued to an entity other than a
natural person for a period of three years.

(e) "Permit" refers to a permit that is issued for a period of 30 days, in lieu of the
certificate referred to in subdivision 3, while the application is being processed.

(f) "Physically disabled person" means a person who:

(1) because of disability cannot walk without significant risk of falling;

(2) because of disability cannot walk 200 feet without stopping to rest;

(3) because of disability cannot walk without the aid of another person, a walker, a
cane, crutches, braces, a prosthetic device, or a wheelchair;

(4) is restricted by a respiratory disease to such an extent that the person's forced
(respiratory) expiratory volume for one second, when measured by spirometry, is less
than one liter;

(5) has an arterial oxygen tension (PAO2) of less than 60 mm/Hg on room air at rest;

(6) uses portable oxygen;

(7) has a cardiac condition to the extent that the person's functional limitations are
classified in severity as class III or class IV according to standards set by the American
Heart Association;

(8) has lost an arm or a leg and does not have or cannot use an artificial limb; or

(9) has a disability that would be aggravated by walking 200 feet under normal
environmental conditions to an extent that would be life threatening.

(g) "Short-term certificate" means a certificate issued for a period greater than six
months but not greater than 12 months.

(h) "Six-year certificate" means a certificate issued for a period of six years.

(i) "Temporary certificate" means a certificate issued for a period not greater than
six months.

Sec. 81.

Minnesota Statutes 2008, section 182.6551, is amended to read:


182.6551 CITATION; SAFE PATIENT HANDLING ACT.

Sections 182.6551 to deleted text begin182.6553deleted text endnew text begin 182.6554new text end may be cited as the "Safe Patient Handling
Act."

Sec. 82.

Minnesota Statutes 2008, section 182.6552, is amended by adding a
subdivision to read:


new text begin Subd. 5. new text end

new text begin Clinical settings that move patients. new text end

new text begin "Clinical settings that move
patients" means physician, dental, and other outpatient care facilities, except for outpatient
surgical settings, where service requires movement of patients from point to point as part
of the scope of service.
new text end

Sec. 83.

new text begin [182.6554] SAFE PATIENT HANDLING IN CLINICAL SETTINGS.
new text end

new text begin Subdivision 1. new text end

new text begin Safe patient handling plan required. new text end

new text begin (a) By July 1, 2010, every
clinical setting that moves patients in the state shall develop a written safe patient handling
plan to achieve by January 1, 2012, the goal of ensuring the safe handling of patients by
minimizing manual lifting of patients by direct patient care workers and by utilizing
safe patient handling equipment.
new text end

new text begin (b) The plan shall address:
new text end

new text begin (1) assessment of risks with regard to patient handling that considers the patient
population and environment of care;
new text end

new text begin (2) the acquisition of an adequate supply of appropriate safe patient handling
equipment;
new text end

new text begin (3) initial and ongoing training of direct patient care workers on the use of this
equipment;
new text end

new text begin (4) procedures to ensure that physical plant modifications and major construction
projects are consistent with plan goals; and
new text end

new text begin (5) periodic evaluations of the safe patient handling plan.
new text end

new text begin (c) A health care organization with more than one covered clinical setting that
moves patients may establish a plan at each clinical setting or establish one plan to serve
this function for all the clinical settings.
new text end

new text begin Subd. 2. new text end

new text begin Facilities with existing programs. new text end

new text begin A clinical setting that moves patients
that has already adopted a safe patient handling plan that satisfies the requirements of
subdivision 1, or a clinical setting that moves patients that is covered by a safe patient
handling plan that is covered under and consistent with section 182.6553, is considered
to be in compliance with the requirements of this section.
new text end

new text begin Subd. 3. new text end

new text begin Training materials. new text end

new text begin The commissioner shall make training materials on
implementation of this section available at no cost to all clinical settings that move patients
as part of the training and education duties of the commissioner under section 182.673.
new text end

new text begin Subd. 4. new text end

new text begin Enforcement. new text end

new text begin This section shall be enforced by the commissioner under
section 182.661. An initial violation of this section shall not be assessed a penalty. A
subsequent violation of this section is subject to the penalties provided under section
182.666.
new text end

Sec. 84.

Minnesota Statutes 2008, section 252.27, subdivision 1a, is amended to read:


Subd. 1a.

Definitions.

A "related condition" is a conditionnew text begin (1)new text end that is found to be
closely related to developmental disability, including, but not limited to, cerebral palsy,
epilepsy, autism, new text beginfetal alcohol spectrum disorder, new text endand Prader-Willi syndromenew text begin,new text end and new text begin(2) new text endthat
meets all of the following criteria:

deleted text begin (1)deleted text endnew text begin (i)new text end is severe and chronic;

deleted text begin (2)deleted text endnew text begin (ii)new text end results in impairment of general intellectual functioning or adaptive behavior
similar to that of persons with developmental disabilities;

deleted text begin (3)deleted text endnew text begin (iii)new text end requires treatment or services similar to those required for persons with
developmental disabilities;

deleted text begin (4)deleted text endnew text begin (iv)new text end is manifested before the person reaches 22 years of age;

deleted text begin (5)deleted text endnew text begin (v)new text end is likely to continue indefinitely;

deleted text begin (6)deleted text endnew text begin (vi)new text end results in substantial functional limitations in three or more of the following
areas of major life activity: deleted text begin(i)deleted text endnew text begin (A)new text end self-care, deleted text begin(ii)deleted text endnew text begin (B)new text end understanding and use of language,
deleted text begin (iii)deleted text endnew text begin (C)new text end learning, deleted text begin(iv)deleted text endnew text begin (D)new text end mobility, deleted text begin(v)deleted text endnew text begin (E)new text end self-direction, deleted text begin(vi)deleted text endnew text begin (F)new text end capacity for independent
living; and

deleted text begin (7)deleted text endnew text begin (vii)new text end is not attributable to mental illness as defined in section 245.462, subdivision
20
, or an emotional disturbance as defined in section 245.4871, subdivision 15.

For purposes of deleted text beginclause (7)deleted text endnew text begin item (vii)new text end, notwithstanding section 245.462, subdivision 20,
or 245.4871, subdivision 15, "mental illness" does not include autism or other pervasive
developmental disorders.

Sec. 85.

Minnesota Statutes 2008, section 252.282, subdivision 3, is amended to read:


Subd. 3.

Recommendations.

(a) Upon completion of the local system needs
planning assessment, the host county shall make recommendations by May 15, 2000, and
by July 1 every two years thereafter beginning in 2001. If no change is recommended, a
copy of the assessment along with corresponding documentation shall be provided to the
commissioner by July 1 prior to the contract year.

deleted text begin (b) Except as provided in section 252.292, subdivision 4, recommendations
regarding closures, relocations, or downsizings that include a rate increase shall be
submitted to the statewide advisory committee for review, along with the assessment, plan,
and corresponding documentation that supports the payment rate adjustment request.
deleted text end

deleted text begin (c)deleted text endnew text begin (b)new text end Recommendations for closures, relocations, and downsizings that do not
include a rate increase and for modification of existing services for which a change in the
framework of service delivery is necessary shall be provided to the commissioner by July
1 prior to the contract year or at least 90 days prior to the anticipated change, along with
the assessment and corresponding documentation.

Sec. 86.

Minnesota Statutes 2008, section 252.282, subdivision 5, is amended to read:


Subd. 5.

Responsibilities of commissioner.

(a) In collaboration with counties and
providers, the commissioner shall ensure that services recognize the preferences and needs
of persons with developmental disabilities and related conditions through a recurring
systemic review and assessment of ICF/MR facilities within the state.

deleted text begin (b) The commissioner shall publish a notice in the State Register no less than
biannually to announce the opportunity for counties or providers to submit requests for
payment rate adjustments associated with plans for downsizing, relocation, and closure of
ICF/MR facilities.
deleted text end

deleted text begin (c) The commissioner shall designate funding parameters to counties and to the
statewide advisory committee for the overall implementation of system needs within the
fiscal resources allocated by the legislature.
deleted text end

deleted text begin (d)deleted text endnew text begin (b)new text end The commissioner shall contract with ICF/MR providers. Contracts shall
be for two-year periods.

Sec. 87.

Minnesota Statutes 2008, section 253B.02, subdivision 7, is amended to read:


Subd. 7.

Examiner.

"Examiner" means a person who is knowledgeable, trained, and
practicing in the diagnosis and assessment or in the treatment of the alleged impairment,
and who is:

(1) a licensed physician;

(2) a licensed psychologist who has a doctoral degree in psychology or who became
a licensed consulting psychologist before July 2, 1975; or

(3) an advanced practice registered nurse certified in mental health new text beginor a licensed
physician assistant
new text end, except that only a physician or psychologist meeting these
requirements may be appointed by the court as described by sections 253B.07, subdivision
3
; 253B.092, subdivision 8, paragraph (b); 253B.17, subdivision 3; 253B.18, subdivision
2
; and 253B.19, subdivisions 1 and 2, and only a physician or psychologist may conduct
an assessment as described by Minnesota Rules of Criminal Procedure, rule 20.

Sec. 88.

Minnesota Statutes 2008, section 253B.05, subdivision 2, is amended to read:


Subd. 2.

Peace or health officer authority.

(a) A peace or health officer may take a
person into custody and transport the person to a licensed physician or treatment facility if
the officer has reason to believe, either through direct observation of the person's behavior,
or upon reliable information of the person's recent behavior and knowledge of the person's
past behavior or psychiatric treatment, that the person is mentally ill or developmentally
disabled and in danger of injuring self or others if not immediately detained. A peace or
health officer or a person working under such officer's supervision, may take a person
who is believed to be chemically dependent or is intoxicated in public into custody and
transport the person to a treatment facility. If the person is intoxicated in public or is
believed to be chemically dependent and is not in danger of causing self-harm or harm to
any person or property, the peace or health officer may transport the person home. The
peace or health officer shall make written application for admission of the person to the
treatment facility. The application shall contain the peace or health officer's statement
specifying the reasons for and circumstances under which the person was taken into
custody. If danger to specific individuals is a basis for the emergency hold, the statement
must include identifying information on those individuals, to the extent practicable. A
copy of the statement shall be made available to the person taken into custody.

(b) As far as is practicable, a peace officer who provides transportation for a person
placed in a facility under this subdivision may not be in uniform and may not use a vehicle
visibly marked as a law enforcement vehicle.

(c) A person may be admitted to a treatment facility for emergency care and
treatment under this subdivision with the consent of the head of the facility under the
following circumstances: (1) a written statement shall only be made by the following
individuals who are knowledgeable, trained, and practicing in the diagnosis and treatment
of mental illness or developmental disability; the medical officer, or the officer's designee
on duty at the facility, including a licensed physician, a deleted text beginregistereddeleted text endnew text begin licensednew text end physician
assistant, or an advanced practice registered nurse who after preliminary examination has
determined that the person has symptoms of mental illness or developmental disability
and appears to be in danger of harming self or others if not immediately detained; or (2) a
written statement is made by the institution program director or the director's designee
on duty at the facility after preliminary examination that the person has symptoms
of chemical dependency and appears to be in danger of harming self or others if not
immediately detained or is intoxicated in public.

Sec. 89.

Minnesota Statutes 2008, section 256B.0625, subdivision 28a, is amended to
read:


Subd. 28a.

deleted text beginRegistereddeleted text endnew text begin Licensednew text end physician assistant services.

Medical assistance
covers services performed by a deleted text beginregistereddeleted text endnew text begin licensednew text end physician assistant if the service is
otherwise covered under this chapter as a physician service and if the service is within the
scope of practice of a deleted text beginregistereddeleted text endnew text begin licensednew text end physician assistant as defined in section 147A.09.

Sec. 90.

Minnesota Statutes 2008, section 256B.0657, subdivision 5, is amended to
read:


Subd. 5.

Self-directed supports option plan requirements.

(a) The plan for the
self-directed supports option must meet the following requirements:

(1) the plan must be completed using a person-centered process that:

(i) builds upon the recipient's capacity to engage in activities that promote
community life;

(ii) respects the recipient's preferences, choices, and abilities;

(iii) involves families, friends, and professionals in the planning or delivery of
services or supports as desired or required by the recipient; and

(iv) addresses the need for personal care assistant services identified in the recipient's
self-directed supports option assessment;

(2) the plan shall be developed by the recipient or by the guardian of an adult
recipient or by a parent or guardian of a minor child, deleted text beginwith the assistance of an enrolled
medical assistance home care targeted case manager
deleted text endnew text begin and may be assisted by anew text end provider
who meets the requirements established for using a person-centered planning process and
shall be reviewed at least annually upon reassessment or when there is a significant change
in the recipient's condition; and

(3) the plan must include the total budget amount available divided into monthly
amounts that cover the number of months of personal care assistant services authorization
included in the budget. The amount used each month may vary, but additional funds shall
not be provided above the annual personal care assistant services authorized amount
unless a change in condition is documented.

(b) The commissioner shall:

(1) establish the format and criteria for the plan as well as the requirements for
providers who assist with plan development;

(2) review the assessment and plan and, within 30 days after receiving the
assessment and plan, make a decision on approval of the plan;

(3) notify the recipient, parent, or guardian of approval or denial of the plan and
provide notice of the right to appeal under section 256.045; and

(4) provide a copy of the plan to the fiscal support entity selected by the recipient.

Sec. 91.

Minnesota Statutes 2008, section 256B.0751, subdivision 1, is amended to
read:


Subdivision 1.

Definitions.

(a) For purposes of sections 256B.0751 to 256B.0753,
the following definitions apply.

(b) "Commissioner" means the commissioner of human services.

(c) "Commissioners" means the commissioner of humans services and the
commissioner of health, acting jointly.

(d) "Health plan company" has the meaning provided in section 62Q.01, subdivision
4.

(e) "Personal clinician" means a physician licensed under chapter 147, a physician
assistant deleted text beginregistereddeleted text endnew text begin licensednew text end and practicing under chapter 147A, or an advanced practice
nurse licensed and registered to practice under chapter 148.

(f) "State health care program" means the medical assistance, MinnesotaCare, and
general assistance medical care programs.

Sec. 92.

Minnesota Statutes 2008, section 256B.0913, subdivision 4, is amended to
read:


Subd. 4.

Eligibility for funding for services for nonmedical assistance recipients.

(a) Funding for services under the alternative care program is available to persons who
meet the following criteria:

(1) the person has been determined by a community assessment under section
256B.0911 to be a person who would require the level of care provided in a nursing
facility, but for the provision of services under the alternative care program;

(2) the person is age 65 or older;

(3) the person would be eligible for medical assistance within 135 days of admission
to a nursing facility;

(4) the person is not ineligible for the payment of long-term care services by the
medical assistance program due to an asset transfer penalty under section 256B.0595 or
equity interest in the home exceeding $500,000 as stated in section 256B.056;

(5) the person needs long-term care services that are not funded through other
state or federal fundingnew text begin, or other health insurance or other third-party insurance such as
long-term care insurance
new text end;

(6) the monthly cost of the alternative care services funded by the program for
this person does not exceed 75 percent of the monthly limit described under section
256B.0915, subdivision 3a. This monthly limit does not prohibit the alternative care
client from payment for additional services, but in no case may the cost of additional
services purchased under this section exceed the difference between the client's monthly
service limit defined under section 256B.0915, subdivision 3, and the alternative care
program monthly service limit defined in this paragraph. If care-related supplies and
equipment or environmental modifications and adaptations are or will be purchased for
an alternative care services recipient, the costs may be prorated on a monthly basis for
up to 12 consecutive months beginning with the month of purchase. If the monthly cost
of a recipient's other alternative care services exceeds the monthly limit established in
this paragraph, the annual cost of the alternative care services shall be determined. In this
event, the annual cost of alternative care services shall not exceed 12 times the monthly
limit described in this paragraph; and

(7) the person is making timely payments of the assessed monthly fee.

A person is ineligible if payment of the fee is over 60 days past due, unless the person
agrees to:

(i) the appointment of a representative payee;

(ii) automatic payment from a financial account;

(iii) the establishment of greater family involvement in the financial management of
payments; or

(iv) another method acceptable to the lead agency to ensure prompt fee payments.

The lead agency may extend the client's eligibility as necessary while making
arrangements to facilitate payment of past-due amounts and future premium payments.
Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
reinstated for a period of 30 days.

(b) Alternative care funding under this subdivision is not available for a person
who is a medical assistance recipient or who would be eligible for medical assistance
without a spenddown or waiver obligation. A person whose initial application for medical
assistance and the elderly waiver program is being processed may be served under the
alternative care program for a period up to 60 days. If the individual is found to be eligible
for medical assistance, medical assistance must be billed for services payable under the
federally approved elderly waiver plan and delivered from the date the individual was
found eligible for the federally approved elderly waiver plan. Notwithstanding this
provision, alternative care funds may not be used to pay for any service the cost of which:
(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation;
or (iii) is used to pay a medical assistance income spenddown for a person who is eligible
to participate in the federally approved elderly waiver program under the special income
standard provision.

(c) Alternative care funding is not available for a person who resides in a licensed
nursing home, certified boarding care home, hospital, or intermediate care facility, except
for case management services which are provided in support of the discharge planning
process for a nursing home resident or certified boarding care home resident to assist with
a relocation process to a community-based setting.

(d) Alternative care funding is not available for a person whose income is greater
than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
year for which alternative care eligibility is determined, who would be eligible for the
elderly waiver with a waiver obligation.

Sec. 93.

Minnesota Statutes 2008, section 256B.0913, subdivision 5a, is amended to
read:


Subd. 5a.

Services; service definitions; service standards.

(a) Unless specified in
statute, the services, service definitions, and standards for alternative care services shall
be the same as the services, service definitions, and standards specified in the federally
approved elderly waiver plan, except alternative care does not cover transitional support
services, assisted living services, adult foster care services, and residential care and
benefits defined under section 256B.0625 that meet primary and acute health care needs.

(b) The lead agency must ensure that the funds are not used to supplant or
supplement services available through other public assistance or services programs,
including supplementation of client co-pays, deductibles, premiums, or other cost-sharing
arrangements for health-related benefits and services or entitlement programs and
services that are available to the person, but in which they have elected not to enroll.
new text begin The lead agency must ensure that the benefit department recovery system in the Medicaid
Management Information System (MMIS) has the necessary information on any other
health insurance or third-party insurance policy to which the client may have access.
new text endFor a
provider of supplies and equipment when the monthly cost of the supplies and equipment
is less than $250, persons or agencies must be employed by or under a contract with the
lead agency or the public health nursing agency of the local board of health in order to
receive funding under the alternative care program. Supplies and equipment may be
purchased from a vendor not certified to participate in the Medicaid program if the cost for
the item is less than that of a Medicaid vendor.

(c) Personal care services must meet the service standards defined in the federally
approved elderly waiver plan, except that a lead agency may contract with a client's
relative who meets the relative hardship waiver requirements or a relative who meets the
criteria and is also the responsible party under an individual service plan that ensures the
client's health and safety and supervision of the personal care services by a qualified
professional as defined in section 256B.0625, subdivision 19c. Relative hardship is
established by the lead agency when the client's care causes a relative caregiver to do any
of the following: resign from a paying job, reduce work hours resulting in lost wages,
obtain a leave of absence resulting in lost wages, incur substantial client-related expenses,
provide services to address authorized, unstaffed direct care time, or meet special needs of
the client unmet in the formal service plan.

Sec. 94.

Minnesota Statutes 2008, section 256B.0913, subdivision 12, is amended to
read:


Subd. 12.

Client fees.

(a) A fee is required for all alternative care eligible clients
to help pay for the cost of participating in the program. The amount of the fee for the
alternative care client shall be determined as follows:

(1) when the alternative care client's income less recurring and predictable medical
expenses is less than 100 percent of the federal poverty guideline effective on July 1 of
the state fiscal year in which the fee is being computed, and total assets are less than
$10,000, the fee is zero;

(2) when the alternative care client's income less recurring and predictable medical
expenses is equal to or greater than 100 percent but less than 150 percent of the federal
poverty guideline effective on July 1 of the state fiscal year in which the fee is being
computed, and total assets are less than $10,000, the fee is five percent of the cost of
alternative care services;

(3) when the alternative care client's income less recurring and predictable medical
expenses is equal to or greater than 150 percent but less than 200 percent of the federal
poverty guidelines effective on July 1 of the state fiscal year in which the fee is being
computed and assets are less than $10,000, the fee is 15 percent of the cost of alternative
care services;

(4) when the alternative care client's income less recurring and predictable medical
expenses is equal to or greater than 200 percent of the federal poverty guidelines effective
on July 1 of the state fiscal year in which the fee is being computed and assets are less than
$10,000, the fee is 30 percent of the cost of alternative care services; and

(5) when the alternative care client's assets are equal to or greater than $10,000, the
fee is 30 percent of the cost of alternative care services.

For married persons, total assets are defined as the total marital assets less the
estimated community spouse asset allowance, under section 256B.059, if applicable. For
married persons, total income is defined as the client's income less the monthly spousal
allotment, under section 256B.058.

All alternative care services shall be included in the estimated costs for the purpose
of determining the fee.

Fees are due and payable each month alternative care services are received unless the
actual cost of the services is less than the fee, in which case the fee is the lesser amount.

(b) The fee shall be waived by the commissioner when:

(1) a person is residing in a nursing facility;

(2) a married couple is requesting an asset assessment under the spousal
impoverishment provisions;

(3) a person is found eligible for alternative care, but is not yet receiving alternative
care services including case management services; or

(4) a person has chosen to participate in a consumer-directed service plan for which
the cost is no greater than the total cost of the person's alternative care service plan less
the monthly fee amount that would otherwise be assessed.

(c) The commissioner will bill and collect the fee from the client. Money collected
must be deposited in the general fund and is appropriated to the commissioner for the
alternative care program. The client must supply the lead agency with the client's Social
Security number at the time of application. The lead agency shall supply the commissioner
with the client's Social Security number and other information the commissioner requires
to collect the fee from the client. The commissioner shall collect unpaid fees using the
Revenue Recapture Act in chapter 270A and other methods available to the commissioner.
The commissioner may require lead agencies to inform clients of the collection procedures
that may be used by the state if a fee is not paid. deleted text beginThis paragraph does not apply to
alternative care pilot projects authorized in Laws 1993, First Special Session chapter 1,
article 5, section 133, if a county operating under the pilot project reports the following
dollar amounts to the commissioner quarterly:
deleted text end

deleted text begin (1) total fees billed to clients;
deleted text end

deleted text begin (2) total collections of fees billed; and
deleted text end

deleted text begin (3) balance of fees owed by clients.
deleted text end

deleted text begin If a lead agency does not adhere to these reporting requirements, the commissioner may
terminate the billing, collecting, and remitting portions of the pilot project and require the
lead agency involved to operate under the procedures set forth in this paragraph.
deleted text end

Sec. 95.

Minnesota Statutes 2008, section 256B.0915, subdivision 2, is amended to
read:


Subd. 2.

Spousal impoverishment policies.

The commissioner shall apply:

deleted text begin (1)deleted text end the spousal impoverishment criteria as authorized under United States Code, title
42, section 1396r-5, and as implemented in sections 256B.0575, 256B.058, and 256B.059deleted text begin;deleted text endnew text begin,
except that individuals with income at or below the special income standard according
to Code of Federal Regulations, title 42, section 435.236, receive the maintenance needs
amount in subdivision 1d.
new text end

deleted text begin (2) the personal needs allowance permitted in section 256B.0575; and
deleted text end

deleted text begin (3) an amount equivalent to the group residential housing rate as set by section
256I.03, subdivision 5, and according to the approved federal waiver and medical
assistance state plan.
deleted text end

Sec. 96.

Minnesota Statutes 2008, section 256B.431, subdivision 10, is amended to
read:


Subd. 10.

Property rate adjustments and construction projects.

A nursing
deleted text begin facility'sdeleted text endnew text begin facility completing a construction project that is eligible for a rate adjustment
under section 256B.434, subdivision 4f, and that was not approved through the moratorium
exception process in section 144A.073 must
new text end request deleted text beginfordeleted text endnew text begin from the commissionernew text end a
property-related payment rate adjustment deleted text beginand the related supporting documentation of
project construction cost information must be submitted to the commissioner
deleted text endnew text begin. If the
request is made
new text end within 60 days after the construction project's completion date deleted text beginto be
considered eligible for a property-related payment rate adjustment
deleted text endnew text begin the effective date of
the rate adjustment is the first of the month following the completion date. If the request
is made more than 60 days after the completion date, the rate adjustment is effective on
the first of the month following the request
new text end. The commissioner shall provide a rate notice
reflecting the allowable costs within 60 days after receiving all the necessary information
to compute the rate adjustment. No sooner than the effective date of the rate adjustment
for the deleted text beginbuildingdeleted text endnew text begin constructionnew text end project, a nursing facility may adjust its rates by the amount
anticipated to be allowed. Any amounts collected from private pay residents in excess of
the allowable rate must be repaid to private pay residents with interest at the rate used by
the commissioner of revenue for the late payment of taxes and in effect on the date the
rate increase is effective. Construction projects with completion dates within one year
of the completion date associated with the property rate adjustment request and phased
projects with project completion dates within three years of the last phase of the phased
project must be aggregated for purposes of the minimum thresholds in subdivisions 16
and 17, and the maximum threshold in section 144A.071, subdivision 2. "Construction
project" and "project construction costs" have the meanings given them in Minnesota
Statutes, section 144A.071, subdivision 1a.

Sec. 97.

Minnesota Statutes 2008, section 256B.433, subdivision 1, is amended to read:


Subdivision 1.

Setting payment; monitoring use of therapy services.

The
commissioner shall deleted text beginpromulgatedeleted text endnew text begin adoptnew text end rules deleted text beginpursuant todeleted text endnew text begin undernew text end the Administrative
Procedure Act to set the amount and method of payment for ancillary materials and
services provided to recipients residing in nursing facilities. Payment for materials and
services may be made to either deleted text beginthe nursing facility in the operating cost per diem, todeleted text end the
vendor of ancillary services pursuant to Minnesota Rules, parts 9505.0170 to 9505.0475new text begin,new text end
or to a nursing facility pursuant to Minnesota Rules, parts 9505.0170 to 9505.0475.
Payment for the same or similar service to a recipient shall not be made to both the nursing
facility and the vendor. The commissioner shall ensure the avoidance of double payments
through audits and adjustments to the nursing facility's annual cost report as required by
section 256B.47, and that charges and arrangements for ancillary materials and services
are cost-effective and as would be incurred by a prudent and cost-conscious buyer.
Therapy services provided to a recipient must be medically necessary and appropriate
to the medical condition of the recipient. If the vendor, nursing facility, or ordering
physician cannot provide adequate medical necessity justification, as determined by the
commissioner, the commissioner may recover or disallow the payment for the services
and may require prior authorization for therapy services as a condition of payment or
may impose administrative sanctions to limit the vendor, nursing facility, or ordering
physician's participation in the medical assistance program. If the provider number of a
nursing facility is used to bill services provided by a vendor of therapy services that is
not related to the nursing facility by ownership, control, affiliation, or employment status,
no withholding of payment shall be imposed against the nursing facility for services not
medically necessary except for funds due the unrelated vendor of therapy services as
provided in subdivision 3, paragraph (c). For the purpose of this subdivision, no monetary
recovery may be imposed against the nursing facility for funds paid to the unrelated
vendor of therapy services as provided in subdivision 3, paragraph (c), for services not
medically necessary. For purposes of this section and section 256B.47, therapy includes
physical therapy, occupational therapy, speech therapy, audiology, and mental health
services that are covered services according to Minnesota Rules, parts 9505.0170 to
9505.0475deleted text begin, and that could be reimbursed separately from the nursing facility per diemdeleted text end.
new text begin For purposes of this subdivision, "ancillary services" include transportation defined as
a covered service in section 256B.0625, subdivision 17.
new text end

Sec. 98.

Minnesota Statutes 2008, section 256B.441, subdivision 5, is amended to read:


Subd. 5.

Administrative costs.

"Administrative costs" means the direct costs for
administering the overall activities of the nursing home. These costs include salaries and
wages of the administrator, assistant administrator, business office employees, security
guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases
related to business office functions, licenses, and permits except as provided in the external
fixed costs category, employee recognition, travel including meals and lodging, new text beginall new text endtrainingnew text begin
except as specified in subdivision 11
new text end, voice and data communication or transmission,
office supplies, liability insurance and other forms of insurance not designated to other
areas, personnel recruitment, legal services, accounting services, management or business
consultants, data processing, information technology, Web site, central or home office
costs, business meetings and seminars, postage, fees for professional organizations,
subscriptions, security services, advertising, board of director's fees, working capital
interest expense, and bad debts and bad debt collection fees.

Sec. 99.

Minnesota Statutes 2008, section 256B.441, subdivision 11, is amended to
read:


Subd. 11.

Direct care costs.

"Direct care costs" means costs for the wages of
nursing administration, deleted text beginstaff education,deleted text end direct care registered nurses, licensed practical
nurses, certified nursing assistants, trained medication aides, new text beginemployees conducting
training in resident care topics
new text endand associated fringe benefits and payroll taxes; services
from a supplemental nursing services agency; supplies that are stocked at nursing stations
or on the floor and distributed or used individually, including, but not limited to: alcohol,
applicators, cotton balls, incontinence pads, disposable ice bags, dressings, bandages,
water pitchers, tongue depressors, disposable gloves, enemas, enema equipment, soap,
medication cups, diapers, plastic waste bags, sanitary products, thermometers, hypodermic
needles and syringes, clinical reagents or similar diagnostic agents, drugs that are not paid
on a separate fee schedule by the medical assistance program or any other payer, and
technology related to the provision of nursing care to residents, such as electronic charting
systemsnew text begin; costs of materials used for resident care training, and training courses outside of
the facility attended by direct care staff on resident care topics
new text end.

Sec. 100.

Minnesota Statutes 2008, section 256B.5011, subdivision 2, is amended to
read:


Subd. 2.

Contract provisions.

(a) The service contract with each intermediate
care facility must include provisions for:

(1) modifying payments when significant changes occur in the needs of the
consumers;

deleted text begin (2) the establishment and use of a quality improvement plan. Using criteria and
options for performance measures developed by the commissioner, each intermediate care
facility must identify a minimum of one performance measure on which to focus its efforts
for quality improvement during the contract period;
deleted text end

deleted text begin (3)deleted text endnew text begin (2)new text end appropriate and necessary statistical information required by the
commissioner;

deleted text begin (4)deleted text endnew text begin (3)new text end annual aggregate facility financial information; and

deleted text begin (5)deleted text endnew text begin (4)new text end additional requirements for intermediate care facilities not meeting the
standards set forth in the service contract.

(b) The commissioner of human services and the commissioner of health, in
consultation with representatives from counties, advocacy organizations, and the provider
community, shall review the consolidated standards under chapter 245B and the supervised
living facility rule under Minnesota Rules, chapter 4665, to determine what provisions
in Minnesota Rules, chapter 4665, may be waived by the commissioner of health for
intermediate care facilities in order to enable facilities to implement the performance
measures in their contract and provide quality services to residents without a duplication
of or increase in regulatory requirements.

Sec. 101.

Minnesota Statutes 2008, section 256B.5012, subdivision 6, is amended to
read:


Subd. 6.

ICF/MR rate increases October 1, 2005, and October 1, 2006.

(a) For
the rate periods beginning October 1, 2005, and October 1, 2006, the commissioner shall
make available to each facility reimbursed under this section an adjustment to the total
operating payment rate of 2.2553 percent.

(b) 75 percent of the money resulting from the rate adjustment under paragraph (a)
must be used to increase wages and benefits and pay associated costs for employees,
except for administrative and central office employees. 75 percent of the money received
by a facility as a result of the rate adjustment provided in paragraph (a) must be used only
for wage, benefit, and staff increases implemented on or after the effective date of the rate
increase each year, and must not be used for increases implemented prior to that date. The
wage adjustment eligible employees may receive may vary based on merit, seniority, or
other factors determined by the provider.

(c) For each facility, the commissioner shall make available an adjustment, based
on occupied beds, using the percentage specified in paragraph (a) multiplied by the total
payment rate, including variable rate but excluding the property-related payment rate, in
effect on the preceding day. The total payment rate shall include the adjustment provided
in section 256B.501, subdivision 12.

(d) A facility whose payment rates are governed by closure agreementsdeleted text begin,deleted text end new text beginor
new text endreceivership agreementsdeleted text begin, or Minnesota Rules, part 9553.0075,deleted text end is not eligible for an
adjustment otherwise granted under this subdivision.

(e) A facility may apply for the portion of the payment rate adjustment provided
under paragraph (a) for employee wages and benefits and associated costs. The application
must be made to the commissioner and contain a plan by which the facility will distribute
the funds according to paragraph (b). For facilities in which the employees are represented
by an exclusive bargaining representative, an agreement negotiated and agreed to by the
employer and the exclusive bargaining representative constitutes the plan. A negotiated
agreement may constitute the plan only if the agreement is finalized after the date of
enactment of all rate increases for the rate year. The commissioner shall review the plan to
ensure that the payment rate adjustment per diem is used as provided in this subdivision.
To be eligible, a facility must submit its plan by March 31, 2006, and December 31,
2006, respectively. If a facility's plan is effective for its employees after the first day of
the applicable rate period that the funds are available, the payment rate adjustment per
diem is effective the same date as its plan.

(f) A copy of the approved distribution plan must be made available to all employees
by giving each employee a copy or by posting it in an area of the facility to which all
employees have access. If an employee does not receive the wage and benefit adjustment
described in the facility's approved plan and is unable to resolve the problem with the
facility's management or through the employee's union representative, the employee
may contact the commissioner at an address or telephone number provided by the
commissioner and included in the approved plan.

Sec. 102.

Minnesota Statutes 2008, section 256B.5012, subdivision 7, is amended to
read:


Subd. 7.

ICF/MR rate increases effective October 1, 2007, and October 1, 2008.

(a) For the rate year beginning October 1, 2007, the commissioner shall make available to
each facility reimbursed under this section operating payment rate adjustments equal to
2.0 percent of the operating payment rates in effect on September 30, 2007. For the rate
year beginning October 1, 2008, the commissioner shall make available to each facility
reimbursed under this section operating payment rate adjustments equal to 2.0 percent
of the operating payment rates in effect on September 30, 2008. For each facility, the
commissioner shall make available an adjustment, based on occupied beds, using the
percentage specified in this paragraph multiplied by the total payment rate, including the
variable rate but excluding the property-related payment rate, in effect on the preceding
day. The total payment rate shall include the adjustment provided in section 256B.501,
subdivision 12
. A facility whose payment rates are governed by closure agreementsdeleted text begin,deleted text end
new text begin or new text endreceivership agreementsdeleted text begin, or Minnesota Rules, part 9553.0075,deleted text end is not eligible for an
adjustment otherwise granted under this subdivision.

(b) Seventy-five percent of the money resulting from the rate adjustments under
paragraph (a) must be used for increases in compensation-related costs for employees
directly employed by the facility on or after the effective date of the rate adjustments,
except:

(1) the administrator;

(2) persons employed in the central office of a corporation that has an ownership
interest in the facility or exercises control over the facility; and

(3) persons paid by the facility under a management contract.

(c) Two-thirds of the money available under paragraph (b) must be used for wage
increases for all employees directly employed by the facility on or after the effective
date of the rate adjustments, except those listed in paragraph (b), clauses (1) to (3). The
wage adjustment that employees receive under this paragraph must be paid as an equal
hourly percentage wage increase for all eligible employees. All wage increases under this
paragraph must be effective on the same date. Only costs associated with the portion of
the equal hourly percentage wage increase that goes to all employees shall qualify under
this paragraph. Costs associated with wage increases in excess of the amount of the equal
hourly percentage wage increase provided to all employees shall be allowed only for
meeting the requirements in paragraph (b). This paragraph shall not apply to employees
covered by a collective bargaining agreement.

(d) The commissioner shall allow as compensation-related costs all costs for:

(1) wages and salaries;

(2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers'
compensation;

(3) the employer's share of health and dental insurance, life insurance, disability
insurance, long-term care insurance, uniform allowance, and pensions; and

(4) other benefits provided, subject to the approval of the commissioner.

(e) The portion of the rate adjustments under paragraph (a) that is not subject to the
requirements in paragraphs (b) and (c) shall be provided to facilities effective October
1 of each year.

(f) Facilities may apply for the portion of the rate adjustments under paragraph
(a) that is subject to the requirements in paragraphs (b) and (c). The application
must be submitted to the commissioner within six months of the effective date of the
rate adjustments, and the facility must provide additional information required by
the commissioner within nine months of the effective date of the rate adjustments.
The commissioner must respond to all applications within three weeks of receipt.
The commissioner may waive the deadlines in this paragraph under extraordinary
circumstances, to be determined at the sole discretion of the commissioner. The
application must contain:

(1) an estimate of the amounts of money that must be used as specified in paragraphs
(b) and (c);

(2) a detailed distribution plan specifying the allowable compensation-related and
wage increases the facility will implement to use the funds available in clause (1);

(3) a description of how the facility will notify eligible employees of the contents of
the approved application, which must provide for giving each eligible employee a copy of
the approved application, excluding the information required in clause (1), or posting a
copy of the approved application, excluding the information required in clause (1), for
a period of at least six weeks in an area of the facility to which all eligible employees
have access; and

(4) instructions for employees who believe they have not received the
compensation-related or wage increases specified in clause (2), as approved by the
commissioner, and which must include a mailing address, e-mail address, and the
telephone number that may be used by the employee to contact the commissioner or the
commissioner's representative.

(g) The commissioner shall ensure that cost increases in distribution plans under
paragraph (f), clause (2), that may be included in approved applications, comply with
requirements in clauses (1) to (4):

(1) costs to be incurred during the applicable rate year resulting from wage and
salary increases effective after October 1, 2006, and prior to the first day of the facility's
payroll period that includes October 1 of each year shall be allowed if they were not used
in the prior year's application and they meet the requirements of paragraphs (b) and (c);

(2) a portion of the costs resulting from tenure-related wage or salary increases
may be considered to be allowable wage increases, according to formulas that the
commissioner shall provide, where employee retention is above the average statewide
rate of retention of direct care employees;

(3) the annualized amount of increases in costs for the employer's share of health
and dental insurance, life insurance, disability insurance, and workers' compensation shall
be allowable compensation-related increases if they are effective on or after April 1 of
the year in which the rate adjustments are effective and prior to April 1 of the following
year; and

(4) for facilities in which employees are represented by an exclusive bargaining
representative, the commissioner shall approve the application only upon receipt of a letter
of acceptance of the distribution plan, as regards members of the bargaining unit, signed
by the exclusive bargaining agent and dated after May 25, 2007. Upon receipt of the letter
of acceptance, the commissioner shall deem all requirements of this section as having
been met in regard to the members of the bargaining unit.

(h) The commissioner shall review applications received under paragraph (f) and
shall provide the portion of the rate adjustments under paragraphs (b) and (c) if the
requirements of this subdivision have been met. The rate adjustments shall be effective
October 1 of each year. Notwithstanding paragraph (a), if the approved application
distributes less money than is available, the amount of the rate adjustment shall be reduced
so that the amount of money made available is equal to the amount to be distributed.

Sec. 103.

Minnesota Statutes 2008, section 256B.5013, subdivision 1, is amended to
read:


Subdivision 1.

Variable rate adjustments.

(a) For rate years beginning on or after
October 1, 2000, when there is a documented increase in the needs of a current ICF/MR
recipient, the county of financial responsibility may recommend a variable rate to enable
the facility to meet the individual's increased needs. Variable rate adjustments made under
this subdivision replace payments for persons with special needs under section 256B.501,
subdivision 8
, and payments for persons with special needs for crisis intervention services
under section 256B.501, subdivision 8a. Effective July 1, 2003, facilities with a base rate
above the 50th percentile of the statewide average reimbursement rate for a Class A
facility or Class B facility, whichever matches the facility licensure, are not eligible for a
variable rate adjustment. Variable rate adjustments may not exceed a 12-month period,
except when approved for purposes established in paragraph (b), clause (1). Variable rate
adjustments approved solely on the basis of changes on a developmental disabilities
screening document will end June 30, 2002.

(b) A variable rate may be recommended by the county of financial responsibility
for increased needs in the following situations:

(1) a need for resources due to an individual's full or partial retirement from
participation in a day training and habilitation service when the individual: (i) has reached
the age of 65 or has a change in health condition that makes it difficult for the person
to participate in day training and habilitation services over an extended period of time
because it is medically contraindicated; and (ii) has expressed a desire for change through
the developmental disability screening process under section 256B.092;

(2) a need for additional resources for intensive short-term programming which is
necessary prior to an individual's discharge to a less restrictive, more integrated setting;

(3) a demonstrated medical need that significantly impacts the type or amount of
services needed by the individual; or

(4) a demonstrated behavioral need that significantly impacts the type or amount of
services needed by the individual.

(c) The county of financial responsibility must justify the purpose, the projected
length of time, and the additional funding needed for the facility to meet the needs of
the individual.

(d) The facility shall provide deleted text begina quarterlydeleted text endnew text begin an annualnew text end report to the county case manager
on the use of the variable rate funds and the status of the individual on whose behalf the
funds were approved. The county case manager will forward the facility's report with a
recommendation to the commissioner to approve or disapprove a continuation of the
variable rate.

(e) Funds made available through the variable rate process that are not used by
the facility to meet the needs of the individual for whom they were approved shall be
returned to the state.

Sec. 104.

Minnesota Statutes 2008, section 256B.5013, subdivision 6, is amended to
read:


Subd. 6.

Commissioner's responsibilities.

The commissioner shall:

(1) make a determination to approve, deny, or modify a request for a variable rate
adjustment within 30 days of the receipt of the completed application;

(2) notify the ICF/MR facility and county case manager of the duration and
conditions of variable rate adjustment approvals;new text begin and
new text end

(3) modify MMIS II service agreements to reimburse ICF/MR facilities for approved
variable ratesdeleted text begin;deleted text endnew text begin.
new text end

deleted text begin (4) provide notification of legislatively appropriated funding for facility closures,
downsizings, and relocations;
deleted text end

deleted text begin (5) assess the fiscal impacts of the proposals for closures, downsizings, and
relocations forwarded for consideration through the state advisory committee; and
deleted text end

deleted text begin (6) review the payment rate process on a biannual basis and make recommendations
to the legislature for necessary adjustments to the review and approval process.
deleted text end

Sec. 105.

Minnesota Statutes 2008, section 256B.69, subdivision 9b, is amended to
read:


Subd. 9b.

Reporting provider payment rates.

(a) According to guidelines
developed by the commissioner, in consultation withnew text begin health care providers,new text end managed care
plansnew text begin,new text end and county-based purchasing plans, each managed care plan and county-based
purchasing plan mustnew text begin annuallynew text end provide to the commissionerdeleted text begin, at the commissioner's request,
detailed or aggregate
deleted text end information on reimbursement rates paid by the managed care plan
under this section or the county-based purchasing plan under section 256B.692 to deleted text beginprovider
types
deleted text endnew text begin providersnew text end and vendors for administrative services under contract with the plan.

new text begin (b) Each managed care plan and county-based purchasing plan must annually
provide to the commissioner, in the form and manner specified by the commissioner:
new text end

new text begin (1) the amount of the payment made to the plan under this section that is paid to
health care providers for patient care;
new text end

new text begin (2) aggregate provider payment data, categorized by inpatient payments and
outpatient payments, with the outpatient payments categorized by payments to primary
care providers and nonprimary care providers;
new text end

new text begin (3) the process by which increases or decreases in payments made to the plan
under this section, that are based on actuarial analysis related to provider cost increases
or decreases, or that are required by legislative action, are passed through to health care
providers, categorized by payments to primary care providers and nonprimary care
providers; and
new text end

new text begin (4) specific information on the methodology used to establish provider
reimbursement rates paid by the managed health care plan and county-based purchasing
plan.
new text end

new text begin Data provided to the commissioner under this subdivision must allow the
commissioner to conduct the analyses required under paragraph (d).
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end Data provided to the commissioner under this subdivision are nonpublic
data as defined in section 13.02.

new text begin (d) The commissioner shall analyze data provided under this subdivision to assist the
legislature in providing oversight and accountability related to expenditures under this
section. The analysis must include information on payments to physicians, physician
extenders, and hospitals, and may include other provider types as determined by the
commissioner. The commissioner shall also array aggregate provider reimbursement rates
by health plan, by primary care, and nonprimary care categories. The commissioner shall
report the analysis to the legislature annually, beginning December 15, 2010, and each
December 15 thereafter. The commissioner shall also make this information available on
the agency's Web site to managed care and county-based purchasing plans, health care
providers, and the public.
new text end

Sec. 106.

Minnesota Statutes 2008, section 403.03, is amended to read:


403.03 911 SERVICES TO BE PROVIDED.

Services available through a 911 system deleted text beginshalldeleted text endnew text begin mustnew text end include police, firefighting,
and emergency medical and ambulance services. Other emergency and civil defense
services may be incorporated into the 911 system at the discretion of the public agency
operating the public safety answering point.new text begin The 911 system may include a referral to
mental health crisis teams, where available.
new text end

Sec. 107.

Minnesota Statutes 2008, section 626.557, subdivision 12b, is amended to
read:


Subd. 12b.

Data management.

(a) In performing any of the duties of this section as
a lead agency, the county social service agency shall maintain appropriate records. Data
collected by the county social service agency under this section are welfare data under
section 13.46. Notwithstanding section 13.46, subdivision 1, paragraph (a), data under this
paragraph that are inactive investigative data on an individual who is a vendor of services
are private data on individuals, as defined in section 13.02. The identity of the reporter
may only be disclosed as provided in paragraph (c).

Data maintained by the common entry point are confidential data on individuals or
protected nonpublic data as defined in section 13.02. Notwithstanding section 138.163,
the common entry point shall deleted text begindestroy datadeleted text endnew text begin maintain data for new text end three calendar years after date
of receipt new text beginand then destroy the data unless otherwise directed by federal requirementsnew text end.

(b) The commissioners of health and human services shall prepare an investigation
memorandum for each report alleging maltreatment investigated under this section.
County social service agencies must maintain private data on individuals but are not
required to prepare an investigation memorandum. During an investigation by the
commissioner of health or the commissioner of human services, data collected under this
section are confidential data on individuals or protected nonpublic data as defined in
section 13.02. Upon completion of the investigation, the data are classified as provided in
clauses (1) to (3) and paragraph (c).

(1) The investigation memorandum must contain the following data, which are
public:

(i) the name of the facility investigated;

(ii) a statement of the nature of the alleged maltreatment;

(iii) pertinent information obtained from medical or other records reviewed;

(iv) the identity of the investigator;

(v) a summary of the investigation's findings;

(vi) statement of whether the report was found to be substantiated, inconclusive,
false, or that no determination will be made;

(vii) a statement of any action taken by the facility;

(viii) a statement of any action taken by the lead agency; and

(ix) when a lead agency's determination has substantiated maltreatment, a statement
of whether an individual, individuals, or a facility were responsible for the substantiated
maltreatment, if known.

The investigation memorandum must be written in a manner which protects the
identity of the reporter and of the vulnerable adult and may not contain the names or, to
the extent possible, data on individuals or private data listed in clause (2).

(2) Data on individuals collected and maintained in the investigation memorandum
are private data, including:

(i) the name of the vulnerable adult;

(ii) the identity of the individual alleged to be the perpetrator;

(iii) the identity of the individual substantiated as the perpetrator; and

(iv) the identity of all individuals interviewed as part of the investigation.

(3) Other data on individuals maintained as part of an investigation under this section
are private data on individuals upon completion of the investigation.

(c) The subject of the report may compel disclosure of the name of the reporter only
with the consent of the reporter or upon a written finding by a court that the report was
false and there is evidence that the report was made in bad faith. This subdivision does
not alter disclosure responsibilities or obligations under the Rules of Criminal Procedure,
except that where the identity of the reporter is relevant to a criminal prosecution, the
district court shall do an in-camera review prior to determining whether to order disclosure
of the identity of the reporter.

(d) Notwithstanding section 138.163, data maintained under this section by the
commissioners of health and human services must be deleted text begindestroyeddeleted text endnew text begin maintainednew text end under the
following schedule new text beginand then destroyed unless otherwise directed by federal requirementsnew text end:

(1) data from reports determined to be false, deleted text begintwodeleted text endnew text begin maintained for threenew text end years after the
finding was made;

(2) data from reports determined to be inconclusive, new text beginmaintained for new text endfour years after
the finding was made;

(3) data from reports determined to be substantiated, new text beginmaintained for new text endseven years
after the finding was made; and

(4) data from reports which were not investigated by a lead agency and for which
there is no final disposition, deleted text begintwodeleted text endnew text begin maintained for threenew text end years from the date of the report.

(e) The commissioners of health and human services shall each annually report to
the legislature and the governor on the number and type of reports of alleged maltreatment
involving licensed facilities reported under this section, the number of those requiring
investigation under this section, and the resolution of those investigations. The report
shall identify:

(1) whether and where backlogs of cases result in a failure to conform with statutory
time frames;

(2) where adequate coverage requires additional appropriations and staffing; and

(3) any other trends that affect the safety of vulnerable adults.

(f) Each lead agency must have a record retention policy.

(g) Lead agencies, prosecuting authorities, and law enforcement agencies may
exchange not public data, as defined in section 13.02, if the agency or authority requesting
the data determines that the data are pertinent and necessary to the requesting agency in
initiating, furthering, or completing an investigation under this section. Data collected
under this section must be made available to prosecuting authorities and law enforcement
officials, local county agencies, and licensing agencies investigating the alleged
maltreatment under this section. The lead agency shall exchange not public data with the
vulnerable adult maltreatment review panel established in section 256.021 if the data are
pertinent and necessary for a review requested under that section. Upon completion of the
review, not public data received by the review panel must be returned to the lead agency.

(h) Each lead agency shall keep records of the length of time it takes to complete its
investigations.

(i) A lead agency may notify other affected parties and their authorized representative
if the agency has reason to believe maltreatment has occurred and determines the
information will safeguard the well-being of the affected parties or dispel widespread
rumor or unrest in the affected facility.

(j) Under any notification provision of this section, where federal law specifically
prohibits the disclosure of patient identifying information, a lead agency may not provide
any notice unless the vulnerable adult has consented to disclosure in a manner which
conforms to federal requirements.

Sec. 108. new text beginSTUDY OF ALLOWING LONG-TERM CARE INSURANCE TO BE
PURCHASED BY LOCAL GOVERNMENT EMPLOYEES.
new text end

new text begin The commissioner of management and budget, in conjunction with two
representatives of state government employees, with one each to be designated by the
American Federation of State, County, and Municipal Employees and the Minnesota
Association of Professional Employees; one representative of local government employees
to be designated by the American Federation of State, County, and Municipal Employees;
and one representative each designated by the League of Minnesota Cities and the
Association of Minnesota Counties, shall study allowing local government employees to
purchase long-term care insurance authorized under Minnesota Statutes, section 43A.318,
subdivision 2. On or before February 15, 2010, the commissioner shall report on their
findings and recommendations to the chairs of the house of representatives Health Care
and Human Services Policy and Oversight Committee and the senate Health, Housing,
and Family Security Committee.
new text end

Sec. 109. new text beginHEALTH DEPARTMENT WORKGROUP.
new text end

new text begin The commissioner of health shall consult with hospitals, RN staff nurses, and
quality assurance staff working in facilities that report under Minnesota Statutes, section
144.7065, subdivision 8, and other stakeholders, taking into account geographic balance,
to define and develop questions related to staffing for inclusion in the root cause analysis
tool required under that subdivision.
new text end

Sec. 110. new text beginALZHEIMER'S DISEASE WORKING GROUP.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment; members. new text end

new text begin The Minnesota Board on Aging must
appoint, unless otherwise provided, an Alzheimer's disease working group that consists of
no more than 20 members including, but not limited to:
new text end

new text begin (1) at least one caregiver of a person who has been diagnosed with Alzheimer's
disease;
new text end

new text begin (2) at least one person who has been diagnosed with Alzheimer's disease;
new text end

new text begin (3) a representative of the nursing facility industry;
new text end

new text begin (4) a representative of the assisted living industry;
new text end

new text begin (5) a representative of the adult day services industry;
new text end

new text begin (6) a representative of the medical care provider community;
new text end

new text begin (7) a psychologist who specializes in dementia care;
new text end

new text begin (8) an Alzheimer's researcher;
new text end

new text begin (9) a representative of the Alzheimer's Association;
new text end

new text begin (10) the commissioner of human services or a designee;
new text end

new text begin (11) the commissioner of health or a designee;
new text end

new text begin (12) the ombudsman for long-term care or a designee; and
new text end

new text begin (13) at least two public members named by the governor.
new text end

new text begin The appointing authorities under this subdivision must complete their appointments no
later than September 1, 2009.
new text end

new text begin Subd. 2. new text end

new text begin Duties; recommendations. new text end

new text begin The Alzheimer's disease working group must
examine the array of needs of individuals diagnosed with Alzheimer's disease, services
available to meet these needs, and the capacity of the state and current providers to meet
these and future needs. The working group shall consider and make recommendations and
findings on the following issues:
new text end

new text begin (1) trends in the state's Alzheimer's population and service needs including, but
not limited to:
new text end

new text begin (i) the state's role in long-term care, family caregiver support, and assistance to
persons with early-stage and early-onset of Alzheimer's disease;
new text end

new text begin (ii) state policy regarding persons with Alzheimer's disease and dementia; and
new text end

new text begin (iii) establishment of a surveillance system to provide proper estimates of the
number of persons in the state with Alzheimer's disease, and the changing population
with dementia;
new text end

new text begin (2) existing resources, services, and capacity including, but not limited to:
new text end

new text begin (i) type, cost, and availability of dementia services;
new text end

new text begin (ii) dementia-specific training requirements for long-term care staff;
new text end

new text begin (iii) quality care measures for residential care facilities;
new text end

new text begin (iv) availability of home and community-based resources for persons with
Alzheimer's disease, including respite care;
new text end

new text begin (v) number and availability of long-term care dementia units;
new text end

new text begin (vi) adequacy and appropriateness of geriatric psychiatric units for persons with
behavior disorders associated with Alzheimer's and related dementia;
new text end

new text begin (vii) assisted living residential options for persons with dementia; and
new text end

new text begin (viii) state support of Alzheimer's research through Minnesota universities and
other resources; and
new text end

new text begin (3) needed policies or responses including, but not limited to, the provision of
coordinated services and supports to persons and families living with Alzheimer's and
related disorders, the capacity to meet these needs, and strategies to address identified
gaps in services.
new text end

new text begin Subd. 3. new text end

new text begin Meetings. new text end

new text begin The board must select a designee to convene the first meeting of
the working group no later than September 1, 2009. Meetings of the working group must
be open to the public, and to the extent practicable, technological means, such as Web casts,
shall be used to reach the greatest number of people throughout the state. The members of
the working group shall select a chair from their membership at the first meeting.
new text end

new text begin Subd. 4. new text end

new text begin Report. new text end

new text begin The Board on Aging must submit a report providing the findings
and recommendations of the working group, including any draft legislation necessary
to implement the recommendations, to the governor and chairs and ranking minority
members of the legislative committees with jurisdiction over health care no later than
January 15, 2011.
new text end

new text begin Subd. 5. new text end

new text begin Private funding. new text end

new text begin To the extent available, the Board on Aging may utilize
funding provided by private foundations and other private funding sources to complete the
duties of the Alzheimer's disease working group.
new text end

new text begin Subd. 6. new text end

new text begin Expiration. new text end

new text begin This section expires when the report under subdivision 4 is
submitted.
new text end

Sec. 111. new text beginDEADLINE FOR APPOINTMENT.
new text end

new text begin (a) The Minnesota Psychological Association must complete the appointment
required under Minnesota Statutes, section 62U.09, subdivision 2, paragraph (a), clause
(13), no later than October 1, 2009.
new text end

new text begin (b) The Minnesota Chiropractic Association must complete the appointment
required under Minnesota Statutes, section 62U.09, subdivision2, paragraph (a), clause
(14), no later than October 1, 2009.
new text end

Sec. 112. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2008, sections 147A.22; 148.627; 150A.09, subdivision 6; and
256B.5013, subdivisions 2, 3, and 5,
new text end new text begin are repealed.
new text end