SF 4198

1st Engrossment - 92nd Legislature (2021 - 2022) Posted on 04/05/2022 09:12am

A bill for an act
relating to health and human services; modifying health provisions related to closed
loop health exchangers, spa pools, hospital construction moratoriums, and
recommendations to the J-1 visa waiver program; exempting certain licensed
individuals from background checks; modifying human services provisions related
to dental provider reporting and medical assistance coverage and reimbursement;
modifying scope of practice for pharmacists in performing certain lab tests and
administering vaccines; modifying collaborative practice authorization for dental
hygienists; temporarily modifying the authority of the Emergency Medical Services
Regulatory Board; establishing interstate compacts for nurses, audiologists and
speech pathologists, and licensed professional counselors; modifying criteria for
the treatment of intractable pain; reducing the license fees for medical gas
manufacturers and wholesalers; modifying the expiration dates and repealing
certain mandated reports from the commissioner of health; expanding and renaming
the higher education facilities authority to include nonprofit health care
organizations; making human services forecast adjustments; appropriating money;
amending Minnesota Statutes 2020, sections 3.732, subdivision 1; 62J.692,
subdivision 5; 103I.005, subdivisions 17a, 20a, by adding a subdivision; 136A.25;
136A.26; 136A.27; 136A.28; 136A.29, subdivisions 1, 3, 6, 9, 10, 14, 19, 20, 21,
22, by adding a subdivision; 136A.32, subdivision 4; 136A.33; 136A.34,
subdivisions 3, 4; 136A.36; 136A.38; 136A.41; 136A.42; 136F.67, subdivision
1; 144.051, subdivision 6; 144.057, subdivision 1; 144.1222, subdivision 2d;
144.193; 144.4199, subdivision 8; 144.497; 144A.10, subdivision 17; 144A.483,
subdivision 1; 145.4134; 145.928, subdivision 13; 147.01, subdivision 7; 147.03,
subdivisions 1, 2; 147.037; 147A.28; 147C.15, subdivision 3; 147C.40, subdivision
5; 148.212, subdivision 1; 150A.10, subdivision 1a; 150A.105, subdivision 8;
151.01, subdivision 27; 151.065, subdivisions 1, 3, 7; 152.125; 245C.31,
subdivisions 1, 2, by adding a subdivision; 256B.0625, by adding a subdivision;
354B.20, subdivision 7; Minnesota Statutes 2021 Supplement, sections 10A.01,
subdivision 35; 144.551, subdivision 1; 245C.03, subdivision 5a; 256B.0371,
subdivision 4; Laws 2021, First Special Session chapter 7, article 16, sections 2,
subdivisions 29, 31, 33; 5; article 17, sections 3; 6; 10; 11; 12; 17, subdivision 3;
proposing coding for new law in Minnesota Statutes, chapters 103I; 145; 147A;
148; 148B; 151; repealing Minnesota Statutes 2020, sections 62U.10, subdivision
3; 136A.29, subdivision 4; 144.1911, subdivision 10; 144.564, subdivision 3;
144A.483, subdivision 2; 147.02, subdivision 2a; 254A.21.

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

ARTICLE 1

HEALTH DEPARTMENT

Section 1.

Minnesota Statutes 2020, section 103I.005, subdivision 17a, is amended to
read:

Subd. 17a.

deleted text begin Temporary boring deleted text end new text begin Submerged closed loop heat exchanger new text end .

deleted text begin "Temporary
boring" deleted text end new text begin "Submerged closed loop heat exchanger" new text end means deleted text begin an excavation that is 15 feet or
more in depth, is sealed within 72 hours of the time of construction, and is drilled, cored,
washed, driven, dug, jetted, or otherwise constructed to deleted text end new text begin a heating and cooling system that new text end :

(1) deleted text begin conduct physical, chemical, or biological testing of groundwater, including
groundwater quality monitoring deleted text end new text begin is installed in a water supply well new text end ;

(2) deleted text begin monitor or measure physical, chemical, radiological, or biological parameters of
earth materials or earth fluids, including hydraulic conductivity, bearing capacity, or
resistance deleted text end new text begin utilizes the convective flow of groundwater as the primary medium of heat
exchange new text end ;

(3) deleted text begin measure groundwater levels, including use of a piezometer deleted text end new text begin contains potable water
as the heat transfer fluid new text end ; and

(4) deleted text begin determine groundwater flow direction or velocity deleted text end new text begin operates using nonconsumptive
recirculation new text end .

new text begin A submerged closed loop heat exchanger also includes submersible pumps, a heat exchanger
device, piping, and other necessary appurtenances.
new text end

Sec. 2.

Minnesota Statutes 2020, section 103I.005, is amended by adding a subdivision
to read:

new text begin Subd. 17b. new text end

new text begin Temporary boring. new text end

new text begin "Temporary boring" means an excavation that is 15
feet or more in depth, is sealed within 72 hours of the time of construction, and is drilled,
cored, washed, driven, dug, jetted, or otherwise constructed to:
new text end

new text begin (1) conduct physical, chemical, or biological testing of groundwater, including
groundwater quality monitoring;
new text end

new text begin (2) monitor or measure physical, chemical, radiological, or biological parameters of
earth materials or earth fluids, including hydraulic conductivity, bearing capacity, or
resistance;
new text end

new text begin (3) measure groundwater levels, including use of a piezometer; and
new text end

new text begin (4) determine groundwater flow direction or velocity.
new text end

Sec. 3.

Minnesota Statutes 2020, section 103I.005, subdivision 20a, is amended to read:

Subd. 20a.

Water supply well.

"Water supply well" means a well that is not a dewatering
well or environmental well and includes wells used:

(1) for potable water supply;

(2) for irrigation;

(3) for agricultural, commercial, or industrial water supply;

(4) for heating or cooling; deleted text begin and
deleted text end

(5) new text begin for containing a submerged closed loop heat exchanger; and
new text end

new text begin (6) new text end for testing water yield for irrigation, commercial or industrial uses, residential supply,
or public water supply.

Sec. 4.

new text begin [103I.631] INSTALLATION OF A SUBMERGED CLOSED LOOP HEAT
EXCHANGER.
new text end

new text begin Subdivision 1. new text end

new text begin Installation. new text end

new text begin Notwithstanding any other provision of law, the
commissioner must allow the installation of a submerged closed loop heat exchanger in a
water supply well. A project may consist of more than one water supply well on a particular
site.
new text end

new text begin Subd. 2. new text end

new text begin Setbacks. new text end

new text begin Water supply wells used only for the nonpotable purpose of providing
heating and cooling using a submerged closed loop heat exchanger are exempt from isolation
distance requirements greater than ten feet.
new text end

new text begin Subd. 3. new text end

new text begin Construction. new text end

new text begin The screened interval of a water supply well constructed to
contain a submerged closed loop heat exchanger completed within a single aquifer may be
designed and constructed using any combination of screen, casing, leader, riser, sump, or
other piping combinations, so long as the screen configuration does not interconnect aquifers.
new text end

new text begin Subd. 4. new text end

new text begin Permits. new text end

new text begin A submerged closed loop heat exchanger is not subject to the permit
requirements in this chapter.
new text end

new text begin Subd. 5. new text end

new text begin Variances. new text end

new text begin A variance is not required to install or operate a submerged closed
loop heat exchanger.
new text end

Sec. 5.

Minnesota Statutes 2020, section 144.057, subdivision 1, is amended to read:

Subdivision 1.

Background studies required.

new text begin (a) Except as specified in paragraph (b),
new text end the commissioner of health shall contract with the commissioner of human services to
conduct background studies of:

(1) individuals providing services that have direct contact, as defined under section
245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes,
outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and
home care agencies licensed under chapter 144A; assisted living facilities and assisted living
facilities with dementia care licensed under chapter 144G; and board and lodging
establishments that are registered to provide supportive or health supervision services under
section 157.17;

(2) individuals specified in section 245C.03, subdivision 1, who perform direct contact
services in a nursing home or a home care agency licensed under chapter 144A; an assisted
living facility or assisted living facility with dementia care licensed under chapter 144G;
or a boarding care home licensed under sections 144.50 to 144.58. If the individual under
study resides outside Minnesota, the study must include a check for substantiated findings
of maltreatment of adults and children in the individual's state of residence when the
information is made available by that state, and must include a check of the National Crime
Information Center database;

(3) all other employees in assisted living facilities or assisted living facilities with
dementia care licensed under chapter 144G, nursing homes licensed under chapter 144A,
and boarding care homes licensed under sections 144.50 to 144.58. A disqualification of
an individual in this section shall disqualify the individual from positions allowing direct
contact or access to patients or residents receiving services. "Access" means physical access
to a client or the client's personal property without continuous, direct supervision as defined
in section 245C.02, subdivision 8, when the employee's employment responsibilities do not
include providing direct contact services;

(4) individuals employed by a supplemental nursing services agency, as defined under
section 144A.70, who are providing services in health care facilities; and

(5) controlling persons of a supplemental nursing services agency, as defined under
section 144A.70.

new text begin (b) The commissioner of human services is not required to conduct a background study
on any individual identified in paragraph (a) if the individual has a valid license issued by
a health-related licensing board as defined in section 214.01, subdivision 2, and has completed
the criminal background check as required in section 214.075. An entity that employs
individuals who meet the requirements of this paragraph must separate those individuals
from the entity's roster for NETStudy 2.0.
new text end

new text begin (c) new text end If a facility or program is licensed by the Department of Human Services and subject
to the background study provisions of chapter 245C and is also licensed by the Department
of Health, the Department of Human Services is solely responsible for the background
studies of individuals in the jointly licensed programs.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 6.

Minnesota Statutes 2020, section 144.1222, subdivision 2d, is amended to read:

Subd. 2d.

Hot tubs on rental deleted text begin houseboats deleted text end new text begin property new text end .

(a) A deleted text begin hot water deleted text end new text begin spa new text end pool intended
for seated recreational use, including a hot tub or whirlpool, that is located on a houseboat
that is rented to the public is not a public pool and is exempt from the requirements for
public pools under new text begin this section and new text end Minnesota Rules, chapter 4717.

(b) new text begin A spa pool intended for seated recreational use, including a hot tub or whirlpool,
that is located on the property of a stand-alone single-unit rental property that is rented to
the public by the property owner or through a resort and the spa pool is only intended to be
used by the occupants of the rental property, is not a public pool and is exempt from the
requirements for public pools under this section and Minnesota Rules, chapter 4717.
new text end

new text begin (c) new text end A deleted text begin hot water deleted text end new text begin spa new text end pool under this subdivision must be conspicuously posted with the
following notice to renters:

"NOTICE

This spa is exempt from state and local sanitary requirements that prevent disease
transmission.

USE AT YOUR OWN RISK

This notice is required under Minnesota Statutes, section 144.1222, subdivision 2d."

Sec. 7.

Minnesota Statutes 2021 Supplement, section 144.551, subdivision 1, is amended
to read:

Subdivision 1.

Restricted construction or modification.

(a) The following construction
or modification may not be commenced:

(1) any erection, building, alteration, reconstruction, modernization, improvement,
extension, lease, or other acquisition by or on behalf of a hospital that increases the bed
capacity of a hospital, relocates hospital beds from one physical facility, complex, or site
to another, or otherwise results in an increase or redistribution of hospital beds within the
state; and

(2) the establishment of a new hospital.

(b) This section does not apply to:

(1) construction or relocation within a county by a hospital, clinic, or other health care
facility that is a national referral center engaged in substantial programs of patient care,
medical research, and medical education meeting state and national needs that receives more
than 40 percent of its patients from outside the state of Minnesota;

(2) a project for construction or modification for which a health care facility held an
approved certificate of need on May 1, 1984, regardless of the date of expiration of the
certificate;

(3) a project for which a certificate of need was denied before July 1, 1990, if a timely
appeal results in an order reversing the denial;

(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200,
section 2;

(5) a project involving consolidation of pediatric specialty hospital services within the
Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number
of pediatric specialty hospital beds among the hospitals being consolidated;

(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to
an existing licensed hospital that will allow for the reconstruction of a new philanthropic,
pediatric-orthopedic hospital on an existing site and that will not result in a net increase in
the number of hospital beds. Upon completion of the reconstruction, the licenses of both
hospitals must be reinstated at the capacity that existed on each site before the relocation;

(7) the relocation or redistribution of hospital beds within a hospital building or
identifiable complex of buildings provided the relocation or redistribution does not result
in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from
one physical site or complex to another; or (iii) redistribution of hospital beds within the
state or a region of the state;

(8) relocation or redistribution of hospital beds within a hospital corporate system that
involves the transfer of beds from a closed facility site or complex to an existing site or
complex provided that: (i) no more than 50 percent of the capacity of the closed facility is
transferred; (ii) the capacity of the site or complex to which the beds are transferred does
not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal
health systems agency boundary in place on July 1, 1983; (iv) the relocation or redistribution
does not involve the construction of a new hospital building; and (v) the transferred beds
are used first to replace within the hospital corporate system the total number of beds
previously used in the closed facility site or complex for mental health services and substance
use disorder services. Only after the hospital corporate system has fulfilled the requirements
of this item may the remainder of the available capacity of the closed facility site or complex
be transferred for any other purpose;

(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice
County that primarily serves adolescents and that receives more than 70 percent of its
patients from outside the state of Minnesota;

(10) a project to replace a hospital or hospitals with a combined licensed capacity of
130 beds or less if: (i) the new hospital site is located within five miles of the current site;
and (ii) the total licensed capacity of the replacement hospital, either at the time of
construction of the initial building or as the result of future expansion, will not exceed 70
licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;

(11) the relocation of licensed hospital beds from an existing state facility operated by
the commissioner of human services to a new or existing facility, building, or complex
operated by the commissioner of human services; from one regional treatment center site
to another; or from one building or site to a new or existing building or site on the same
campus;

(12) the construction or relocation of hospital beds operated by a hospital having a
statutory obligation to provide hospital and medical services for the indigent that does not
result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27
beds, of which 12 serve mental health needs, may be transferred from Hennepin County
Medical Center to Regions Hospital under this clause;

(13) a construction project involving the addition of up to 31 new beds in an existing
nonfederal hospital in Beltrami County;

(14) a construction project involving the addition of up to eight new beds in an existing
nonfederal hospital in Otter Tail County with 100 licensed acute care beds;

(15) a construction project involving the addition of 20 new hospital beds in an existing
hospital in Carver County serving the southwest suburban metropolitan area;

(16) a project for the construction or relocation of up to 20 hospital beds for the operation
of up to two psychiatric facilities or units for children provided that the operation of the
facilities or units have received the approval of the commissioner of human services;

(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation
services in an existing hospital in Itasca County;

(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County
that closed 20 rehabilitation beds in 2002, provided that the beds are used only for
rehabilitation in the hospital's current rehabilitation building. If the beds are used for another
purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;

(19) a critical access hospital established under section 144.1483, clause (9), and section
1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that
delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33,
to the extent that the critical access hospital does not seek to exceed the maximum number
of beds permitted such hospital under federal law;

(20) notwithstanding section 144.552, a project for the construction of a new hospital
in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:

(i) the project, including each hospital or health system that will own or control the entity
that will hold the new hospital license, is approved by a resolution of the Maple Grove City
Council as of March 1, 2006;

(ii) the entity that will hold the new hospital license will be owned or controlled by one
or more not-for-profit hospitals or health systems that have previously submitted a plan or
plans for a project in Maple Grove as required under section 144.552, and the plan or plans
have been found to be in the public interest by the commissioner of health as of April 1,
2005;

(iii) the new hospital's initial inpatient services must include, but are not limited to,
medical and surgical services, obstetrical and gynecological services, intensive care services,
orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health
services, and emergency room services;

(iv) the new hospital:

(A) will have the ability to provide and staff sufficient new beds to meet the growing
needs of the Maple Grove service area and the surrounding communities currently being
served by the hospital or health system that will own or control the entity that will hold the
new hospital license;

(B) will provide uncompensated care;

(C) will provide mental health services, including inpatient beds;

(D) will be a site for workforce development for a broad spectrum of health-care-related
occupations and have a commitment to providing clinical training programs for physicians
and other health care providers;

(E) will demonstrate a commitment to quality care and patient safety;

(F) will have an electronic medical records system, including physician order entry;

(G) will provide a broad range of senior services;

(H) will provide emergency medical services that will coordinate care with regional
providers of trauma services and licensed emergency ambulance services in order to enhance
the continuity of care for emergency medical patients; and

(I) will be completed by December 31, 2009, unless delayed by circumstances beyond
the control of the entity holding the new hospital license; and

(v) as of 30 days following submission of a written plan, the commissioner of health
has not determined that the hospitals or health systems that will own or control the entity
that will hold the new hospital license are unable to meet the criteria of this clause;

(21) a project approved under section 144.553;

(22) a project for the construction of a hospital with up to 25 beds in Cass County within
a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder
is approved by the Cass County Board;

(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity
from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing
a separately licensed 13-bed skilled nursing facility;

(24) notwithstanding section 144.552, a project for the construction and expansion of a
specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients
who are under 21 years of age on the date of admission. The commissioner conducted a
public interest review of the mental health needs of Minnesota and the Twin Cities
metropolitan area in 2008. No further public interest review shall be conducted for the
construction or expansion project under this clause;

(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the
commissioner finds the project is in the public interest after the public interest review
conducted under section 144.552 is complete;

(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city
of Maple Grove, exclusively for patients who are under 21 years of age on the date of
admission, if the commissioner finds the project is in the public interest after the public
interest review conducted under section 144.552 is complete;

(ii) this project shall serve patients in the continuing care benefit program under section
256.9693. The project may also serve patients not in the continuing care benefit program;
and

(iii) if the project ceases to participate in the continuing care benefit program, the
commissioner must complete a subsequent public interest review under section 144.552. If
the project is found not to be in the public interest, the license must be terminated six months
from the date of that finding. If the commissioner of human services terminates the contract
without cause or reduces per diem payment rates for patients under the continuing care
benefit program below the rates in effect for services provided on December 31, 2015, the
project may cease to participate in the continuing care benefit program and continue to
operate without a subsequent public interest review;

(27) a project involving the addition of 21 new beds in an existing psychiatric hospital
in Hennepin County that is exclusively for patients who are under 21 years of age on the
date of admission;

(28) a project to add 55 licensed beds in an existing safety net, level I trauma center
hospital in Ramsey County as designated under section 383A.91, subdivision 5, of which
15 beds are to be used for inpatient mental health and 40 are to be used for other services.
In addition, five unlicensed observation mental health beds shall be added;

(29) upon submission of a plan to the commissioner for public interest review under
section 144.552 and the addition of the 15 inpatient mental health beds specified in clause
(28), to its bed capacity, a project to add 45 licensed beds in an existing safety net, level I
trauma center hospital in Ramsey County as designated under section 383A.91, subdivision
5. Five of the 45 additional beds authorized under this clause must be designated for use
for inpatient mental health and must be added to the hospital's bed capacity before the
remaining 40 beds are added. Notwithstanding section 144.552, the hospital may add licensed
beds under this clause prior to completion of the public interest review, provided the hospital
submits its plan by the 2021 deadline and adheres to the timelines for the public interest
review described in section 144.552; deleted text begin or
deleted text end

(30) upon submission of a plan to the commissioner for public interest review under
section 144.552, a project to add up to 30 licensed beds in an existing psychiatric hospital
in Hennepin County that exclusively provides care to patients who are under 21 years of
age on the date of admission. Notwithstanding section 144.552, the psychiatric hospital
may add licensed beds under this clause prior to completion of the public interest review,
provided the hospital submits its plan by the 2021 deadline and adheres to the timelines for
the public interest review described in section 144.552 deleted text begin . deleted text end new text begin ;
new text end

new text begin (31) a project to add licensed beds in a hospital that: (i) is designated as a critical access
hospital under section 144.1483, clause (9), and United States Code, title 42, section 1395i-4;
(ii) has a licensed bed capacity of fewer than 25 beds; and (iii) has an attached nursing home,
so long as the total number of licensed beds in the hospital after the bed addition does not
exceed 25 beds. Notwithstanding section 144.552, a public interest review is not required
for a project authorized under this clause; or
new text end

new text begin (32) upon submission of a plan to the commissioner for public interest review under
section 144.552, a project to add 22 licensed beds at a Minnesota freestanding children's
hospital in St. Paul that is part of an independent pediatric health system with freestanding
inpatient hospitals located in Minneapolis and St. Paul. The beds shall be utilized for pediatric
inpatient behavioral health services. Notwithstanding section 144.552, the hospital may add
licensed beds under this clause prior to completion of the public interest review, provided
the hospital submits its plan by the 2022 deadline and adheres to the timelines for the public
interest review described in section 144.552.
new text end

Sec. 8.

new text begin [145.267] FETAL ALCOHOL SPECTRUM DISORDERS PREVENTION
GRANTS.
new text end

new text begin (a) The commissioner of health shall award a grant to a statewide organization that
focuses solely on prevention of and intervention with fetal alcohol spectrum disorders. The
grant recipient must make subgrants to eligible regional collaboratives in rural and urban
areas of the state for the purposes specified in paragraph (c).
new text end

new text begin (b) "Eligible regional collaboratives" means a partnership between at least one local
government or Tribal government and at least one community-based organization and,
where available, a family home visiting program. For purposes of this paragraph, a local
government includes a county or a multicounty organization, a county-based purchasing
entity, or a community health board.
new text end

new text begin (c) Eligible regional collaboratives must use subgrant funds to reduce the incidence of
fetal alcohol spectrum disorders and other prenatal drug-related effects in children in
Minnesota by identifying and serving pregnant women suspected of or known to use or
abuse alcohol or other drugs. Eligible regional collaboratives must provide intensive services
to chemically dependent women to increase positive birth outcomes.
new text end

new text begin (d) An eligible regional collaborative that receives a subgrant under this section must
report to the grant recipient by January 15 of each year on the services and programs funded
by the subgrant. The report must include measurable outcomes for the previous year,
including the number of pregnant women served and the number of toxin-free babies born.
The grant recipient must compile the information in the subgrant reports and submit a
summary report to the commissioner of health by February 15 of each year.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2023.
new text end

Sec. 9.

Minnesota Statutes 2020, section 151.01, subdivision 27, is amended to read:

Subd. 27.

Practice of pharmacy.

"Practice of pharmacy" means:

(1) interpretation and evaluation of prescription drug orders;

(2) compounding, labeling, and dispensing drugs and devices (except labeling by a
manufacturer or packager of nonprescription drugs or commercially packaged legend drugs
and devices);

(3) participation in clinical interpretations and monitoring of drug therapy for assurance
of safe and effective use of drugs, including deleted text begin the performance of deleted text end new text begin ordering and performing new text end
laboratory tests that are waived under the federal Clinical Laboratory Improvement Act of
1988, United States Code, title 42, section 263a et seq. deleted text begin , provided that a pharmacist may
interpret the results of laboratory tests but may modify deleted text end new text begin A pharmacist may collect specimens,
interpret results, notify the patient of results, and refer patients to other health care providers
for follow-up care and may initiate, modify, or discontinue new text end drug therapy deleted text begin only deleted text end pursuant to
a protocol or collaborative practice agreement new text begin . A pharmacy technician or pharmacist intern
may perform tests authorized under this clause if the technician or intern is working under
the direct supervision of a pharmacist new text end ;

(4) participation in drug and therapeutic device selection; drug administration for first
dosage and medical emergencies; intramuscular and subcutaneous administration used for
the treatment of alcohol or opioid dependence; drug regimen reviews; and drug or
drug-related research;

(5) drug administration, through intramuscular and subcutaneous administration used
to treat mental illnesses as permitted under the following conditions:

(i) upon the order of a prescriber and the prescriber is notified after administration is
complete; or

(ii) pursuant to a protocol or collaborative practice agreement as defined by section
151.01, subdivisions 27b and 27c, and participation in the initiation, management,
modification, administration, and discontinuation of drug therapy is according to the protocol
or collaborative practice agreement between the pharmacist and a dentist, optometrist,
physician, podiatrist, or veterinarian, or an advanced practice registered nurse authorized
to prescribe, dispense, and administer under section 148.235. Any changes in drug therapy
or medication administration made pursuant to a protocol or collaborative practice agreement
must be documented by the pharmacist in the patient's medical record or reported by the
pharmacist to a practitioner responsible for the patient's care;

(6) participation in administration of influenza vaccines and vaccines approved by the
United States Food and Drug Administration related to COVID-19 or SARS-CoV-2 to all
eligible individuals six years of age and older and all other vaccines to patients 13 years of
age and older by written protocol with a physician licensed under chapter 147, a physician
assistant authorized to prescribe drugs under chapter 147A, or an advanced practice registered
nurse authorized to prescribe drugs under section 148.235, provided that new text begin the pharmacist new text end :

deleted text begin (i) the protocol includes, at a minimum:
deleted text end

deleted text begin (A) the name, dose, and route of each vaccine that may be given;
deleted text end

deleted text begin (B) the patient population for whom the vaccine may be given;
deleted text end

deleted text begin (C) contraindications and precautions to the vaccine;
deleted text end

deleted text begin (D) the procedure for handling an adverse reaction;
deleted text end

deleted text begin (E) the name, signature, and address of the physician, physician assistant, or advanced
practice registered nurse;
deleted text end

deleted text begin (F) a telephone number at which the physician, physician assistant, or advanced practice
registered nurse can be contacted; and
deleted text end

deleted text begin (G) the date and time period for which the protocol is valid;
deleted text end

deleted text begin (ii) the pharmacist deleted text end new text begin (i) new text end has successfully completed a program approved by the Accreditation
Council for Pharmacy Education specifically for the administration of immunizations or a
program approved by the board;

deleted text begin (iii) the pharmacist deleted text end new text begin (ii) new text end utilizes the Minnesota Immunization Information Connection to
assess the immunization status of individuals prior to the administration of vaccines, except
when administering influenza vaccines to individuals age nine and older;

deleted text begin (iv) the pharmacist deleted text end new text begin (iii) new text end reports the administration of the immunization to the Minnesota
Immunization Information Connection; deleted text begin and
deleted text end

deleted text begin (v) the pharmacist deleted text end new text begin (iv) new text end complies with guidelines for vaccines and immunizations
established by the federal Advisory Committee on Immunization Practices, except that a
pharmacist does not need to comply with those portions of the guidelines that establish
immunization schedules deleted text begin when deleted text end new text begin if the pharmacist is new text end administering a vaccine pursuant to a
valid, patient-specific order issued by a physician licensed under chapter 147, a physician
assistant authorized to prescribe drugs under chapter 147A, or an advanced practice registered
nurse authorized to prescribe drugs under section 148.235, provided that the order is
consistent with the United States Food and Drug Administration approved labeling of the
vaccine; new text begin and
new text end

new text begin (v) if the patient is 18 years of age or younger, informs the patient and any adult caregiver
accompanying the patient of the importance of a well-child visit with a pediatrician or other
licensed primary care provider;
new text end

(7) participation in the initiation, management, modification, and discontinuation of
drug therapy according to a written protocol or collaborative practice agreement between:
(i) one or more pharmacists and one or more dentists, optometrists, physicians, podiatrists,
or veterinarians; or (ii) one or more pharmacists and one or more physician assistants
authorized to prescribe, dispense, and administer under chapter 147A, or advanced practice
registered nurses authorized to prescribe, dispense, and administer under section 148.235.
Any changes in drug therapy made pursuant to a protocol or collaborative practice agreement
must be documented by the pharmacist in the patient's medical record or reported by the
pharmacist to a practitioner responsible for the patient's care;

(8) participation in the storage of drugs and the maintenance of records;

(9) patient counseling on therapeutic values, content, hazards, and uses of drugs and
devices;

(10) offering or performing those acts, services, operations, or transactions necessary
in the conduct, operation, management, and control of a pharmacy;

(11) participation in the initiation, management, modification, and discontinuation of
therapy with opiate antagonists, as defined in section 604A.04, subdivision 1, pursuant to:

(i) a written protocol as allowed under clause (7); or

(ii) a written protocol with a community health board medical consultant or a practitioner
designated by the commissioner of health, as allowed under section 151.37, subdivision 13;
and

(12) prescribing self-administered hormonal contraceptives; nicotine replacement
medications; and opiate antagonists for the treatment of an acute opiate overdose pursuant
to section 151.37, subdivision 14, 15, or 16.

Sec. 10.

new text begin [151.103] DELEGATION OF VACCINE ADMINISTRATION.
new text end

new text begin (a) A pharmacy technician or pharmacist intern may administer vaccines under section
151.01, subdivision 27, clause (6), if the technician or intern:
new text end

new text begin (1) is under the direct supervision of a pharmacist while administering the vaccine;
new text end

new text begin (2) has successfully completed a program approved by the Accreditation Council for
Pharmacy Education (ACPE) specifically for the administration of immunizations or a
program approved by the board;
new text end

new text begin (3) has a current certificate in basic cardiopulmonary resuscitation; and
new text end

new text begin (4) if delegated to a pharmacy technician, the technician has completed:
new text end

new text begin (i) one of the training programs listed under Minnesota Rules, part 6800.3850, subpart
1h, item B; and
new text end

new text begin (ii) a minimum of two hours of ACPE-approved, immunization-related continuing
pharmacy education as part of the pharmacy technician's two-year continuing education
schedule.
new text end

new text begin (b) Direct supervision under this section must be in-person and must not be done through
telehealth as defined under section 62A.673, subdivision 2.
new text end

Sec. 11.

Minnesota Statutes 2021 Supplement, section 245C.03, subdivision 5a, is amended
to read:

Subd. 5a.

Facilities serving children or adults licensed or regulated by the
Department of Health.

(a) new text begin Except as specified in paragraph (b), new text end the commissioner shall
conduct background studies of:

(1) individuals providing services who have direct contact, as defined under section
245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes,
outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and
home care agencies licensed under chapter 144A; assisted living facilities and assisted living
facilities with dementia care licensed under chapter 144G; and board and lodging
establishments that are registered to provide supportive or health supervision services under
section 157.17;

(2) individuals specified in subdivision 2 who provide direct contact services in a nursing
home or a home care agency licensed under chapter 144A; an assisted living facility or
assisted living facility with dementia care licensed under chapter 144G; or a boarding care
home licensed under sections 144.50 to 144.58. If the individual undergoing a study resides
outside of Minnesota, the study must include a check for substantiated findings of
maltreatment of adults and children in the individual's state of residence when the state
makes the information available;

(3) all other employees in assisted living facilities or assisted living facilities with
dementia care licensed under chapter 144G, nursing homes licensed under chapter 144A,
and boarding care homes licensed under sections 144.50 to 144.58. A disqualification of
an individual in this section shall disqualify the individual from positions allowing direct
contact with or access to patients or residents receiving services. "Access" means physical
access to a client or the client's personal property without continuous, direct supervision as
defined in section 245C.02, subdivision 8, when the employee's employment responsibilities
do not include providing direct contact services;

(4) individuals employed by a supplemental nursing services agency, as defined under
section 144A.70, who are providing services in health care facilities; and

(5) controlling persons of a supplemental nursing services agency, as defined by section
144A.70.

(b) new text begin The commissioner of human services is not required to conduct a background study
on any individual identified in paragraph (a) if the individual has a valid license issued by
a health-related licensing board as defined in section 214.01, subdivision 2, and has completed
the criminal background check as required in section 214.075. An entity that employs
individuals who meet the requirements of this paragraph must separate those individuals
from the entity's roster for NETStudy 2.0.
new text end

new text begin (c) new text end If a facility or program is licensed by the Department of Human Services and the
Department of Health and is subject to the background study provisions of this chapter, the
Department of Human Services is solely responsible for the background studies of individuals
in the jointly licensed program.

deleted text begin (c) deleted text end new text begin (d) new text end The commissioner of health shall review and make decisions regarding
reconsideration requests, including whether to grant variances, according to the procedures
and criteria in this chapter. The commissioner of health shall inform the requesting individual
and the Department of Human Services of the commissioner of health's decision regarding
the reconsideration. The commissioner of health's decision to grant or deny a reconsideration
of a disqualification is a final administrative agency action.

Sec. 12.

Minnesota Statutes 2020, section 245C.31, subdivision 1, is amended to read:

Subdivision 1.

Board determines disciplinary or corrective action.

(a) deleted text begin When the
subject of a background study is regulated by a health-related licensing board as defined in
chapter deleted text end deleted text begin 214 deleted text end deleted text begin , and the commissioner determines that the regulated individual is responsible
for substantiated maltreatment under section 626.557 or chapter deleted text end deleted text begin 260E deleted text end deleted text begin , instead of the
commissioner making a decision regarding disqualification, the board shall make a
determination whether to impose disciplinary or corrective action under chapter deleted text end deleted text begin 214 deleted text end new text begin The
commissioner shall notify a health-related licensing board as defined in section 214.01,
subdivision 2, if the commissioner determines that an individual who is licensed by the
health-related licensing board and who is included on the board's roster list provided in
accordance with subdivision 3a is responsible for substantiated maltreatment under section
626.557 or chapter 260E, in accordance with subdivision 2. Upon receiving notification,
the health-related licensing board shall make a determination as to whether to impose
disciplinary or corrective action under chapter 214 new text end .

(b) This section does not apply to a background study of an individual regulated by a
health-related licensing board if the individual's study is related to child foster care, adult
foster care, or family child care licensure.

Sec. 13.

Minnesota Statutes 2020, section 245C.31, subdivision 2, is amended to read:

Subd. 2.

Commissioner's notice to board.

(a) The commissioner shall notify deleted text begin the deleted text end new text begin a new text end
health-related licensing board:

(1) deleted text begin upon completion of a background study that produces deleted text end new text begin of new text end a record showing that the
individual new text begin licensed by the board new text end was determined to have been responsible for substantiated
maltreatment;

(2) upon the commissioner's completion of an investigation that determined deleted text begin the deleted text end new text begin an new text end
individual new text begin licensed by the board new text end was responsible for substantiated maltreatment; or

(3) upon receipt from another agency of a finding of substantiated maltreatment for
which deleted text begin the deleted text end new text begin an new text end individual new text begin licensed by the board new text end was responsible.

(b) The commissioner's notice to the health-related licensing board shall indicate whether
the commissioner would have disqualified the individual for the substantiated maltreatment
if the individual were not regulated by the board.

(c) The commissioner shall concurrently send the notice under this subdivision to the
individual who is the subject of the deleted text begin background study deleted text end new text begin notification new text end .

Sec. 14.

Minnesota Statutes 2020, section 245C.31, is amended by adding a subdivision
to read:

new text begin Subd. 3a. new text end

new text begin Agreements with health-related licensing boards. new text end

new text begin The commissioner and
each health-related licensing board shall enter into an agreement in order for each board to
provide the commissioner with a quarterly roster list of individuals who have a license
issued by the board in active status. The list must include for each licensed individual the
individual's name, date of birth, and license number; the date the license was issued; and
the status of the license.
new text end

Sec. 15.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 33,
is amended to read:

Subd. 33. Grant Programs; Chemical Dependency Treatment Support Grants

Appropriations by Fund
General	4,273,000	4,274,000
Lottery Prize	1,733,000	1,733,000
Opiate Epidemic Response	500,000	500,000

(a) Problem Gambling. $225,000 in fiscal
year 2022 and $225,000 in fiscal year 2023
are from the lottery prize fund for a grant to
the state affiliate recognized by the National
Council on Problem Gambling. The affiliate
must provide services to increase public
awareness of problem gambling, education,
training for individuals and organizations
providing effective treatment services to
problem gamblers and their families, and
research related to problem gambling.

(b) Recovery Community Organization
Grants. $2,000,000 in fiscal year 2022 and
$2,000,000 in fiscal year 2023 are from the
general fund for grants to recovery community
organizations, as defined in Minnesota
Statutes, section 254B.01, subdivision 8, to
provide for costs and community-based peer
recovery support services that are not
otherwise eligible for reimbursement under
Minnesota Statutes, section 254B.05, as part
of the continuum of care for substance use
disorders. The general fund base for this
appropriation is $2,000,000 in fiscal year 2024
and $0 in fiscal year 2025

(c) Base Level Adjustment. The general fund
base is deleted text begin $4,636,000 deleted text end new text begin $3,886,000 new text end in fiscal year
2024 and deleted text begin $2,636,000 deleted text end new text begin $1,886,000 new text end in fiscal year
2025. The opiate epidemic response fund base
is $500,000 in fiscal year 2024 and $0 in fiscal
year 2025.

Sec. 16.

Laws 2021, First Special Session chapter 7, article 16, section 5, is amended to
read:

Sec. 5. EMERGENCY MEDICAL SERVICES REGULATORY BOARD

$

4,780,000

$

4,576,000

(a) Cooper/Sams Volunteer Ambulance
Program. $950,000 in fiscal year 2022 and
$950,000 in fiscal year 2023 are for the
Cooper/Sams volunteer ambulance program
under Minnesota Statutes, section 144E.40.

(1) Of this amount, $861,000 in fiscal year
2022 and $861,000 in fiscal year 2023 are for
the ambulance service personnel longevity
award and incentive program under Minnesota
Statutes, section 144E.40.

(2) Of this amount, $89,000 in fiscal year 2022
and $89,000 in fiscal year 2023 are for the
operations of the ambulance service personnel
longevity award and incentive program under
Minnesota Statutes, section 144E.40.

(b) EMSRB Operations. $1,880,000 in fiscal
year 2022 and $1,880,000 in fiscal year 2023
are for board operations.

(c) deleted text begin Regional Grants for Continuing
Education deleted text end new text begin Emergency Medical Services
Fund new text end . $585,000 in fiscal year 2022 and
$585,000 in fiscal year 2023 are for deleted text begin regional
emergency medical services programs, to be
distributed equally to the eight emergency
medical service regions under Minnesota
Statutes, section 144E.52 deleted text end new text begin the purposes under
Minnesota Statutes, section 144E.50.
Notwithstanding Minnesota Statutes, section
144E.50, subdivision 5, in each year the board
shall distribute the appropriation equally
among the eight emergency medical services
systems new text end .

(d) deleted text begin Regional Grants for Local and Regional
Emergency Medical Services deleted text end new text begin Regional
Grants for Continuing Education new text end . $800,000
in fiscal year 2022 and $800,000 in fiscal year
2023 are for distribution to emergency medical
services regions for regional emergency
medical services programs specified in
Minnesota Statutes, section deleted text begin 144E.50 deleted text end new text begin 144E.52 new text end .
deleted text begin Notwithstanding Minnesota Statutes, section
144E.50, subdivision 5, in each year the board
shall distribute the appropriation equally
among the eight emergency medical services
regions. deleted text end This is a onetime appropriation.

(e) Ambulance Training Grants. $565,000
in fiscal year 2022 and $361,000 in fiscal year
2023 are for training grants under Minnesota
Statutes, section 144E.35.

(f) Base Level Adjustment. The general fund
base is $3,776,000 in fiscal year 2024 and
$3,776,000 in fiscal year 2025.

Sec. 17. new text begin TEMPORARY REQUIREMENTS GOVERNING AMBULANCE SERVICE
OPERATIONS AND THE PROVISION OF EMERGENCY MEDICAL SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Application. new text end

new text begin Notwithstanding any law to the contrary in Minnesota
Statutes, chapter 144E, an ambulance service may operate according to this section, and
emergency medical technicians, advanced emergency medical technicians, and paramedics
may provide emergency medical services according to this section.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) The terms defined in this subdivision apply to this section.
new text end

new text begin (b) "Advanced emergency medical technician" has the meaning given in Minnesota
Statutes, section 144E.001, subdivision 5d.
new text end

new text begin (c) "Advanced life support" has the meaning given in Minnesota Statutes, section
144E.001, subdivision 1b.
new text end

new text begin (d) "Ambulance" has the meaning given in Minnesota Statutes, section 144E.001,
subdivision 2.
new text end

new text begin (e) "Ambulance service personnel" has the meaning given in Minnesota Statutes, section
144E.001, subdivision 3a.
new text end

new text begin (f) "Basic life support" has the meaning given in Minnesota Statutes, section 144E.001,
subdivision 4b.
new text end

new text begin (g) "Board" means the Emergency Medical Services Regulatory Board.
new text end

new text begin (h) "Emergency medical technician" has the meaning given in Minnesota Statutes, section
144E.001, subdivision 5c.
new text end

new text begin (i) "Paramedic" has the meaning given in Minnesota Statutes, section 144E.001,
subdivision 5e.
new text end

new text begin (j) "Primary service area" means the area designated by the board according to Minnesota
Statutes, section 144E.06, to be served by an ambulance service.
new text end

new text begin Subd. 3. new text end

new text begin Staffing. new text end

new text begin (a) For emergency ambulance calls in an ambulance service's primary
service area, an ambulance service must staff an ambulance that provides basic life support
with at least:
new text end

new text begin (1) one emergency medical technician, who must be in the patient compartment when
a patient is being transported; and
new text end

new text begin (2) one individual to drive the ambulance. The driver must hold a valid driver's license
from any state, must have attended an emergency vehicle driving course approved by the
ambulance service, and must have completed a course on cardiopulmonary resuscitation
approved by the ambulance service.
new text end

new text begin (b) For emergency ambulance calls in an ambulance service's primary service area, an
ambulance service must staff an ambulance that provides advanced life support with at least:
new text end

new text begin (1) one paramedic; one registered nurse who meets the requirements in Minnesota
Statutes, section 144E.001, subdivision 3a, clause (2); or one physician assistant who meets
the requirements in Minnesota Statutes, section 144E.001, subdivision 3a, clause (3), and
who must be in the patient compartment when a patient is being transported; and
new text end

new text begin (2) one individual to drive the ambulance. The driver must hold a valid driver's license
from any state, must have attended an emergency vehicle driving course approved by the
ambulance service, and must have completed a course on cardiopulmonary resuscitation
approved by the ambulance service.
new text end

new text begin (c) The ambulance service director and medical director must approve the staffing of
an ambulance according to this subdivision.
new text end

new text begin (d) An ambulance service staffing an ambulance according to this subdivision must
immediately notify the board in writing and in a manner prescribed by the board. The notice
must specify how the ambulance service is staffing its basic life support or advanced life
support ambulances and the time period the ambulance service plans to staff the ambulances
according to this subdivision. If an ambulance service continues to staff an ambulance
according to this subdivision after the date provided to the board in its initial notice, the
ambulance service must provide a new notice to the board in a manner that complies with
this paragraph.
new text end

new text begin (e) If an individual serving as a driver under this subdivision commits an act listed in
Minnesota Statutes, section 144E.27, subdivision 5, paragraph (a), the board may temporarily
suspend or prohibit the individual from driving an ambulance or place conditions on the
individual's ability to drive an ambulance using the procedures and authority in Minnesota
Statutes, section 144E.27, subdivisions 5 and 6.
new text end

new text begin Subd. 4. new text end

new text begin Use of expired emergency medications and medical supplies. new text end

new text begin (a) If an
ambulance service experiences a shortage of an emergency medication or medical supply,
ambulance service personnel may use an emergency medication or medical supply for up
to six months after the emergency medication's or medical supply's specified expiration
date, provided:
new text end

new text begin (1) the ambulance service director and medical director approve the use of the expired
emergency medication or medical supply;
new text end

new text begin (2) ambulance service personnel use an expired emergency medication or medical supply
only after depleting the ambulance service's supply of that emergency medication or medical
supply that is unexpired;
new text end

new text begin (3) the ambulance service has stored and maintained the expired emergency medication
or medical supply according to the manufacturer's instructions;
new text end

new text begin (4) if possible, ambulance service personnel obtain consent from the patient to use the
expired emergency medication or medical supply prior to its use; and
new text end

new text begin (5) when the ambulance service obtains a supply of that emergency medication or medical
supply that is unexpired, ambulance service personnel cease use of the expired emergency
medication or medical supply and instead use the unexpired emergency medication or
medical supply.
new text end

new text begin (b) Before approving the use of an expired emergency medication, an ambulance service
director and medical director must consult with the Board of Pharmacy regarding the safety
and efficacy of using the expired emergency medication.
new text end

new text begin (c) An ambulance service must keep a record of all expired emergency medications and
all expired medical supplies used and must submit that record in writing to the board in a
time and manner specified by the board. The record must list the specific expired emergency
medications and medical supplies used and the time period during which ambulance service
personnel used the expired emergency medication or medical supply.
new text end

new text begin Subd. 5. new text end

new text begin Provision of emergency medical services after certification expires. new text end

new text begin (a) At
the request of an emergency medical technician, advanced emergency medical technician,
or paramedic, and with the approval of the ambulance service director, an ambulance service
medical director may authorize the emergency medical technician, advanced emergency
medical technician, or paramedic to provide emergency medical services for the ambulance
service for up to three months after the certification of the emergency medical technician,
advanced emergency medical technician, or paramedic expires.
new text end

new text begin (b) An ambulance service must immediately notify the board each time its medical
director issues an authorization under paragraph (a). The notice must be provided in writing
and in a manner prescribed by the board and must include information on the time period
each emergency medical technician, advanced emergency medical technician, or paramedic
will provide emergency medical services according to an authorization under this subdivision;
information on why the emergency medical technician, advanced emergency medical
technician, or paramedic needs the authorization; and an attestation from the medical director
that the authorization is necessary to help the ambulance service adequately staff its
ambulances.
new text end

new text begin Subd. 6. new text end

new text begin Reports. new text end

new text begin The board must provide quarterly reports to the chairs and ranking
minority members of the legislative committees with jurisdiction over the board regarding
actions taken by ambulance services according to subdivisions 3, 4, and 5. The board must
submit reports by June 30, September 30, and December 31 of 2022; and by March 31, June
30, September 30, and December 31 of 2023. Each report must include the following
information:
new text end

new text begin (1) for each ambulance service staffing basic life support or advanced life support
ambulances according to subdivision 3, the primary service area served by the ambulance
service, the number of ambulances staffed according to subdivision 3, and the time period
the ambulance service has staffed and plans to staff the ambulances according to subdivision
3;
new text end

new text begin (2) for each ambulance service that authorized the use of an expired emergency
medication or medical supply according to subdivision 4, the expired emergency medications
and medical supplies authorized for use and the time period the ambulance service used
each expired emergency medication or medical supply; and
new text end

new text begin (3) for each ambulance service that authorized the provision of emergency medical
services according to subdivision 5, the number of emergency medical technicians, advanced
emergency medical technicians, and paramedics providing emergency medical services
under an expired certification and the time period each emergency medical technician,
advanced emergency medical technician, or paramedic provided and will provide emergency
medical services under an expired certification.
new text end

new text begin Subd. 7. new text end

new text begin Expiration. new text end

new text begin This section expires January 1, 2024.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 18. new text begin DIRECTION TO COMMISSIONER OF HEALTH; J-1 VISA WAIVER
PROGRAM RECOMMENDATION.
new text end

new text begin (a) For purposes of this section:
new text end

new text begin (1) "Department of Health recommendation" means a recommendation from the state
Department of Health that a foreign medical graduate should be considered for a J-1 visa
waiver under the J-1 visa waiver program; and
new text end

new text begin (2) "J-1 visa waiver program" means a program administered by the United States
Department of State under United States Code, title 8, section 1184(l), in which a waiver
is sought for the requirement that a foreign medical graduate with a J-1 visa must return to
the graduate's home country for two years at the conclusion of the graduate's medical study
before applying for employment authorization in the United States.
new text end

new text begin (b) In administering the program to issue Department of Health recommendations for
purposes of the J-1 visa waiver program, the commissioner of health shall allow an applicant
to submit to the commissioner evidence that the foreign medical graduate for whom the
waiver is sought is licensed to practice medicine in Minnesota in place of evidence that the
foreign medical graduate has passed steps 1, 2, and 3 of the United States Medical Licensing
Examination.
new text end

Sec. 19. new text begin BASE LEVEL ADJUSTMENT; FETAL ALCOHOL SPECTRUM
DISORDERS PREVENTION GRANTS.
new text end

new text begin The general fund base for the commissioner of health for health improvement is increased
by $750,000 in fiscal year 2024 and increased by $750,000 in fiscal year 2025 for fetal
alcohol spectrum disorders prevention grants under Minnesota Statutes, section 145.267.
new text end

Sec. 20. new text begin APPROPRIATION.
new text end

new text begin $103,000 in fiscal year 2023 is appropriated from the state government special revenue
fund to the commissioner of health to implement requirements for the submerged closed
loop heat exchanger. The base for this appropriation is $86,000 in fiscal year 2024 and
$86,000 in fiscal year 2025.
new text end

Sec. 21. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2020, section 254A.21, new text end new text begin is repealed, effective July 1, 2023.
new text end

ARTICLE 2

DEPARTMENT OF HUMAN SERVICES AND HEALTH CARE

Section 1.

Minnesota Statutes 2021 Supplement, section 256B.0371, subdivision 4, is
amended to read:

Subd. 4.

Dental utilization report.

(a) The commissioner shall submit an annual report
beginning March 15, 2022, and ending March 15, 2026, to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance that includes the percentage for adults and children one through 20 years
of age for the most recent complete calendar year receiving at least one dental visit for both
fee-for-service and the prepaid medical assistance program. The report must include:

(1) statewide utilization for both fee-for-service and for the prepaid medical assistance
program;

(2) utilization by county;

(3) utilization by children receiving dental services through fee-for-service and through
a managed care plan or county-based purchasing plan;

(4) utilization by adults receiving dental services through fee-for-service and through a
managed care plan or county-based purchasing plan.

(b) The report must also include a description of any corrective action plans required to
be submitted under subdivision 2.

(c) The initial report due on March 15, 2022, must include the utilization metrics described
in paragraph (a) for each of the following calendar years: 2017, 2018, 2019, and 2020.

new text begin (d) In the annual report due on March 15, 2023, and in each report due thereafter, the
commissioner shall include the following:
new text end

new text begin (1) the number of dentists enrolled with the commissioner as a medical assistance dental
provider and the congressional district or districts in which the dentist provides services;
new text end

new text begin (2) the number of enrolled dentists who provided fee-for-service dental services to
medical assistance or MinnesotaCare patients within the previous calendar year in the
following increments: one to nine patients, ten to 100 patients, and over 100 patients;
new text end

new text begin (3) the number of enrolled dentists who provided dental services to medical assistance
or MinnesotaCare patients through a managed care plan or county-based purchasing plan
within the previous calendar year in the following increments: one to nine patients, ten to
100 patients, and over 100 patients; and
new text end

new text begin (4) the number of dentists who provided dental services to a new patient who was enrolled
in medical assistance or MinnesotaCare within the previous calendar year.
new text end

new text begin (e) The report due on March 15, 2023, must include the metrics described in paragraph
(d) for each of the following years: 2017, 2018, 2019, 2020, and 2021.
new text end

Sec. 2.

Minnesota Statutes 2020, section 256B.0625, is amended by adding a subdivision
to read:

new text begin Subd. 13k. new text end

new text begin Vaccines and laboratory tests provided by pharmacists. new text end

new text begin (a) Medical
assistance covers vaccines initiated, ordered, or administered by a licensed pharmacist,
according to the requirements of section 151.01, subdivision 27, clause (6), at no less than
the rate for which the same services are covered when provided by any other licensed
practitioner.
new text end

new text begin (b) Medical assistance covers laboratory tests ordered and performed by a licensed
pharmacist, according to the requirements of section 151.01, subdivision 27, clause (3), at
no less than the rate for which the same services are covered when provided by any other
licensed practitioner.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 3. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
ENTERAL NUTRITION AND SUPPLIES.
new text end

new text begin Notwithstanding Minnesota Statutes, section 256B.766, paragraph (i), but subject to
Minnesota Statutes, section 256B.766, paragraph (l), effective for dates of service on or
after July 1, 2022, through June 30, 2023, the commissioner of human services shall not
adjust rates paid for enteral nutrition and supplies.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

ARTICLE 3

HEALTH-RELATED LICENSING BOARDS AND SCOPE OF PRACTICE

Section 1.

Minnesota Statutes 2020, section 144.051, subdivision 6, is amended to read:

Subd. 6.

Release of private or confidential data.

For providers regulated pursuant to
sections 144A.43 to 144A.482 new text begin , 148.5185, new text end and chapter 144G, the department may release
private or confidential data, except Social Security numbers, to the appropriate state, federal,
or local agency and law enforcement office to enhance investigative or enforcement efforts
or further a public health protective process. Types of offices include Adult Protective
Services, Office of the Ombudsman for Long-Term Care and Office of the Ombudsman for
Mental Health and Developmental Disabilities, the health licensing boards, Department of
Human Services, county or city attorney's offices, police, and local or county public health
offices.

Sec. 2.

Minnesota Statutes 2020, section 147.01, subdivision 7, is amended to read:

Subd. 7.

Physician application and license fees.

(a) The board may charge the following
nonrefundable application and license fees processed pursuant to sections 147.02, 147.03,
147.037, 147.0375, and 147.38:

(1) physician application fee, $200;

(2) physician annual registration renewal fee, $192;

(3) physician endorsement to other states, $40;

(4) physician emeritus license, $50;

deleted text begin (5) physician temporary license, $60;
deleted text end

deleted text begin (6) deleted text end new text begin (5) new text end physician late fee, $60;

deleted text begin (7) deleted text end new text begin (6) new text end duplicate license fee, $20;

deleted text begin (8) deleted text end new text begin (7) new text end certification letter fee, $25;

deleted text begin (9) deleted text end new text begin (8) new text end education or training program approval fee, $100;

deleted text begin (10) deleted text end new text begin (9) new text end report creation and generation fee, $60 per hour;

deleted text begin (11) deleted text end new text begin (10) new text end examination administration fee (half day), $50;

deleted text begin (12) deleted text end new text begin (11) new text end examination administration fee (full day), $80;

deleted text begin (13) deleted text end new text begin (12) new text end fees developed by the Interstate Commission for determining physician
qualification to register and participate in the interstate medical licensure compact, as
established in rules authorized in and pursuant to section 147.38, not to exceed $1,000; and

deleted text begin (14) deleted text end new text begin (13) new text end verification fee, $25.

(b) The board may prorate the initial annual license fee. All licensees are required to
pay the full fee upon license renewal. The revenue generated from the fee must be deposited
in an account in the state government special revenue fund.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 3.

Minnesota Statutes 2020, section 147.03, subdivision 1, is amended to read:

Subdivision 1.

Endorsement; reciprocity.

(a) The board may issue a license to practice
medicine to any person who satisfies the requirements in paragraphs (b) to (e).

(b) The applicant shall satisfy all the requirements established in section 147.02,
subdivision 1, paragraphs (a), (b), (d), (e), and (f) new text begin , or section 147.037, subdivision 1,
paragraphs (a) to (e) new text end .

(c) The applicant shall:

(1) have passed an examination prepared and graded by the Federation of State Medical
Boards, the National Board of Medical Examiners, or the United States Medical Licensing
Examination (USMLE) program in accordance with section 147.02, subdivision 1, paragraph
(c), clause (2); the National Board of Osteopathic Medical Examiners; or the Medical Council
of Canada; and

(2) have a current license from the equivalent licensing agency in another state or Canada
and, if the examination in clause (1) was passed more than ten years ago, either:

(i) pass the Special Purpose Examination of the Federation of State Medical Boards with
a score of 75 or better within three attempts; or

(ii) have a current certification by a specialty board of the American Board of Medical
Specialties, of the American Osteopathic Association, the Royal College of Physicians and
Surgeons of Canada, or of the College of Family Physicians of Canada; or

(3) if the applicant fails to meet the requirement established in section 147.02, subdivision
1, paragraph (c), clause (2), because the applicant failed to pass each of steps one, two, and
three of the USMLE within the required three attempts, the applicant may be granted a
license provided the applicant:

(i) has passed each of steps one, two, and three with passing scores as recommended by
the USMLE program within no more than four attempts for any of the three steps;

(ii) is currently licensed in another state; and

(iii) has current certification by a specialty board of the American Board of Medical
Specialties, the American Osteopathic Association Bureau of Professional Education, the
Royal College of Physicians and Surgeons of Canada, or the College of Family Physicians
of Canada.

(d) The applicant must not be under license suspension or revocation by the licensing
board of the state or jurisdiction in which the conduct that caused the suspension or revocation
occurred.

(e) The applicant must not have engaged in conduct warranting disciplinary action against
a licensee, or have been subject to disciplinary action other than as specified in paragraph
(d). If an applicant does not satisfy the requirements stated in this paragraph, the board may
issue a license only on the applicant's showing that the public will be protected through
issuance of a license with conditions or limitations the board considers appropriate.

(f) Upon the request of an applicant, the board may conduct the final interview of the
applicant by teleconference.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 4.

Minnesota Statutes 2020, section 147.03, subdivision 2, is amended to read:

Subd. 2.

Temporary permit.

new text begin (a) An applicant for licensure under this section may
request the board issue a temporary permit in accordance with this subdivision. Upon receipt
of the application for licensure, a request for a temporary permit, and a nonrefundable
physician application fee specified under section 147.01, subdivision 7, new text end the board may issue
a temporary permit to practice medicine deleted text begin to deleted text end new text begin as new text end a physician deleted text begin eligible for licensure under this
section only if the application for licensure is complete, all requirements in subdivision 1
have been met, and a nonrefundable fee set by the board has been paid deleted text end new text begin if the applicant is:
new text end

new text begin (1) currently licensed in good standing to practice medicine as a physician in another
state, territory, or Canadian province; and
new text end

new text begin (2) not the subject of a pending investigation or disciplinary action in any state, territory,
or Canadian province new text end .

deleted text begin The permit remains deleted text end new text begin (b) A temporary permit issued under this subdivision is nonrenewable
and new text end valid deleted text begin only deleted text end until deleted text begin the meeting of the board at which deleted text end a decision is made on the physician's
application for licensure new text begin or for 90 days, whichever occurs first new text end .

new text begin (c) The board may revoke a temporary permit issued under this subdivision if the
physician is the subject of an investigation or disciplinary action or is disqualified for
licensure for any other reason.
new text end

new text begin (d) Notwithstanding section 13.41, subdivision 2, the board may release information
regarding action taken by the board pursuant to this subdivision.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 5.

Minnesota Statutes 2020, section 147.037, is amended to read:

147.037 LICENSING OF FOREIGN MEDICAL SCHOOL GRADUATES deleted text begin ;
TEMPORARY PERMIT deleted text end .

Subdivision 1.

Requirements.

The board shall issue a license to practice medicine to
any person who satisfies the requirements in paragraphs (a) to (g).

(a) The applicant shall satisfy all the requirements established in section 147.02,
subdivision 1, paragraphs (a), (e), (f), (g), and (h).

(b) The applicant shall present evidence satisfactory to the board that the applicant is a
graduate of a medical or osteopathic school approved by the board as equivalent to accredited
United States or Canadian schools based upon its faculty, curriculum, facilities, accreditation,
or other relevant data. If the applicant is a graduate of a medical or osteopathic program
that is not accredited by the Liaison Committee for Medical Education or the American
Osteopathic Association, the applicant may use the Federation of State Medical Boards'
Federation Credentials Verification Service (FCVS) or its successor. If the applicant uses
this service as allowed under this paragraph, the physician application fee may be less than
$200 but must not exceed the cost of administering this paragraph.

(c) The applicant shall present evidence satisfactory to the board that the applicant has
been awarded a certificate by the Educational Council for Foreign Medical Graduates, and
the applicant has a working ability in the English language sufficient to communicate with
patients and physicians and to engage in the practice of medicine.

(d) The applicant shall present evidence satisfactory to the board of the completion of
one year of graduate, clinical medical training in a program accredited by a national
accrediting organization approved by the board or other graduate training approved in
advance by the board as meeting standards similar to those of a national accrediting
organization. This requirement does not apply:

(1) to an applicant who is admitted as a permanent immigrant to the United States on or
before October 1, 1991, as a person of exceptional ability in the sciences according to Code
of Federal Regulations, title 20, section 656.22(d); or

(2) to an applicant holding a valid license to practice medicine in another country and
issued a permanent immigrant visa after October 1, 1991, as a person of extraordinary ability
in the field of science or as an outstanding professor or researcher according to Code of
Federal Regulations, title 8, section 204.5(h) and (i), or a temporary nonimmigrant visa as
a person of extraordinary ability in the field of science according to Code of Federal
Regulations, title 8, section 214.2(o),

provided that a person under clause (1) or (2) is admitted pursuant to rules of the United
States Department of Labor.

(e) The applicant must:

(1) have passed an examination prepared and graded by the Federation of State Medical
Boards, the United States Medical Licensing Examination program in accordance with
section 147.02, subdivision 1, paragraph (c), clause (2), or the Medical Council of Canada;
and

(2) if the examination in clause (1) was passed more than ten years ago, either:

(i) pass the Special Purpose Examination of the Federation of State Medical Boards with
a score of 75 or better within three attempts; or

(ii) have a current certification by a specialty board of the American Board of Medical
Specialties, of the American Osteopathic Association, of the Royal College of Physicians
and Surgeons of Canada, or of the College of Family Physicians of Canada; or

(3) if the applicant fails to meet the requirement established in section 147.02, subdivision
1, paragraph (c), clause (2), because the applicant failed to pass each of steps one, two, and
three of the USMLE within the required three attempts, the applicant may be granted a
license provided the applicant:

(i) has passed each of steps one, two, and three with passing scores as recommended by
the USMLE program within no more than four attempts for any of the three steps;

(ii) is currently licensed in another state; and

(iii) has current certification by a specialty board of the American Board of Medical
Specialties, the American Osteopathic Association, the Royal College of Physicians and
Surgeons of Canada, or the College of Family Physicians of Canada.

(f) The applicant must not be under license suspension or revocation by the licensing
board of the state or jurisdiction in which the conduct that caused the suspension or revocation
occurred.

(g) The applicant must not have engaged in conduct warranting disciplinary action
against a licensee, or have been subject to disciplinary action other than as specified in
paragraph (f). If an applicant does not satisfy the requirements stated in this paragraph, the
board may issue a license only on the applicant's showing that the public will be protected
through issuance of a license with conditions or limitations the board considers appropriate.

deleted text begin Subd. 1a. deleted text end

deleted text begin Temporary permit. deleted text end

deleted text begin The board may issue a temporary permit to practice
medicine to a physician eligible for licensure under this section only if the application for
licensure is complete, all requirements in subdivision 1 have been met, and a nonrefundable
fee set by the board has been paid. The permit remains valid only until the meeting of the
board at which a decision is made on the physician's application for licensure.
deleted text end

Subd. 2.

Medical school review.

The board may contract with any qualified person or
organization for the performance of a review or investigation, including site visits if
necessary, of any medical or osteopathic school prior to approving the school under section
147.02, subdivision 1, paragraph (b), or subdivision 1, paragraph (b), of this section. To the
extent possible, the board shall require the school being reviewed to pay the costs of the
review or investigation.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 6.

new text begin [147A.025] TEMPORARY PERMIT.
new text end

new text begin (a) An applicant for licensure under section 147A.02 may request the board issue a
temporary permit in accordance with this section. Upon receipt of the application for
licensure, a request for a temporary permit, and a nonrefundable physician assistant
application fee as specified under section 147A.28, the board may issue a temporary permit
to practice as a physician assistant if the applicant is:
new text end

new text begin (1) currently licensed in good standing to practice as a physician assistant in another
state, territory, or Canadian province; and
new text end

new text begin (2) not subject to a pending investigation or disciplinary action in any state, territory, or
Canadian province.
new text end

new text begin (b) A temporary permit issued under this section is nonrenewable and valid until a
decision is made on the physician assistant's application for licensure or for 90 days,
whichever occurs first.
new text end

new text begin (c) The board may revoke the temporary permit that has been issued under this section
if the applicant is the subject of an investigation or disciplinary action or is disqualified for
licensure for any other reason.
new text end

new text begin (d) Notwithstanding section 13.41, subdivision 2, the board may release information
regarding any action taken by the board pursuant to this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 7.

Minnesota Statutes 2020, section 147A.28, is amended to read:

147A.28 PHYSICIAN ASSISTANT APPLICATION AND LICENSE FEES.

(a) The board may charge the following nonrefundable fees:

(1) physician assistant application fee, $120;

deleted text begin (2) physician assistant annual registration renewal fee (prescribing authority), $135;
deleted text end

deleted text begin (3) deleted text end new text begin (2) new text end physician assistant annual deleted text begin registration deleted text end new text begin license new text end renewal fee deleted text begin (no prescribing
authority) deleted text end , $115;

deleted text begin (4) physician assistant temporary registration, $115;
deleted text end

deleted text begin (5) physician assistant temporary permit, $60;
deleted text end

deleted text begin (6) deleted text end new text begin (3) new text end physician assistant locum tenens permit, $25;

deleted text begin (7) deleted text end new text begin (4) new text end physician assistant late fee, $50;

deleted text begin (8) deleted text end new text begin (5) new text end duplicate license fee, $20;

deleted text begin (9) deleted text end new text begin (6) new text end certification letter fee, $25;

deleted text begin (10) deleted text end new text begin (7) new text end education or training program approval fee, $100;

deleted text begin (11) deleted text end new text begin (8) new text end report creation and generation fee, $60 per hour; and

deleted text begin (12) deleted text end new text begin (9) new text end verification fee, $25.

(b) The board may prorate the initial annual license fee. All licensees are required to
pay the full fee upon license renewal. The revenue generated from the fees must be deposited
in an account in the state government special revenue fund.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 8.

Minnesota Statutes 2020, section 147C.15, subdivision 3, is amended to read:

Subd. 3.

Temporary permit.

new text begin (a) An applicant for licensure under this section may
request the board issue a temporary permit in accordance with this subdivision. Upon receipt
of the application for licensure, a request for a temporary permit, and a nonrefundable
respiratory therapist application fee as specified under section 147C.40, subdivision 5, new text end the
board may issue a temporary permit to practice as a respiratory therapist deleted text begin to an applicant
eligible for licensure under this section deleted text end if the deleted text begin application for licensure is complete, all
applicable requirements in this section have been met, and a nonrefundable fee set by the
board has been paid deleted text end new text begin applicant is:
new text end

new text begin (1) currently licensed to practice as a respiratory therapist in another state, territory, or
Canadian province; and
new text end

new text begin (2) not subject to a pending investigation or disciplinary action in any state, territory, or
Canadian province new text end .

deleted text begin The deleted text end new text begin (b) A temporary new text end permit deleted text begin remains deleted text end new text begin issued under this subdivision is nonrenewable and new text end
valid deleted text begin only deleted text end until deleted text begin the meeting of the board at which deleted text end a decision is made on the respiratory
therapist's application for licensure new text begin or for 90 days, whichever occurs first new text end .

new text begin (c) The board may revoke a temporary permit that has been issued under this subdivision
if the applicant is the subject of an investigation or disciplinary action or is disqualified for
licensure for any other reason.
new text end

new text begin (d) Notwithstanding section 13.41, subdivision 2, the board may release information
regarding any action taken by a board pursuant to this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 9.

Minnesota Statutes 2020, section 147C.40, subdivision 5, is amended to read:

Subd. 5.

Respiratory therapist application and license fees.

(a) The board may charge
the following nonrefundable fees:

(1) respiratory therapist application fee, $100;

(2) respiratory therapist annual registration renewal fee, $90;

(3) respiratory therapist inactive status fee, $50;

(4) respiratory therapist temporary registration fee, $90;

deleted text begin (5) respiratory therapist temporary permit, $60;
deleted text end

deleted text begin (6) deleted text end new text begin (5) new text end respiratory therapist late fee, $50;

deleted text begin (7) deleted text end new text begin (6) new text end duplicate license fee, $20;

deleted text begin (8) deleted text end new text begin (7) new text end certification letter fee, $25;

deleted text begin (9) deleted text end new text begin (8) new text end education or training program approval fee, $100;

deleted text begin (10) deleted text end new text begin (9) new text end report creation and generation fee, $60 per hour; and

deleted text begin (11) deleted text end new text begin (10) new text end verification fee, $25.

(b) The board may prorate the initial annual license fee. All licensees are required to
pay the full fee upon license renewal. The revenue generated from the fees must be deposited
in an account in the state government special revenue fund.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 10.

Minnesota Statutes 2020, section 148.212, subdivision 1, is amended to read:

Subdivision 1.

Issuance.

Upon receipt of the applicable licensure or reregistration fee
and permit fee, and in accordance with rules of the board, the board may issue a nonrenewable
temporary permit to practice professional or practical nursing to an applicant for licensure
or reregistration who is not the subject of a pending investigation or disciplinary action, nor
disqualified for any other reason, under the following circumstances:

(a) The applicant for licensure by endorsement under section 148.211, subdivision 2, is
currently licensed to practice professional or practical nursing in another state, territory, or
Canadian province. The permit is valid until the date of board action on the application or
for deleted text begin 60 deleted text end new text begin 90 new text end days, whichever comes first.

(b) The applicant for licensure by endorsement under section 148.211, subdivision 2,
or for reregistration under section 148.231, subdivision 5, is currently registered in a formal,
structured refresher course or its equivalent for nurses that includes clinical practice.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 11.

new text begin [148.2855] NURSE LICENSURE COMPACT.
new text end

new text begin The Nurse Licensure Compact is enacted into law and entered into with all other
jurisdictions legally joining in it, in the form substantially as follows:
new text end

new text begin ARTICLE 1
new text end

new text begin DEFINITIONS
new text end

new text begin As used in this compact:
new text end

new text begin (a) "Adverse action" means any administrative, civil, equitable, or criminal action
permitted by a state's law that is imposed by a licensing board or other authority against a
nurse, including actions against an individual's license or multistate licensure privilege such
as revocation, suspension, probation, monitoring of the licensee, limitation on the licensee's
practice, or any other encumbrance on licensure affecting a nurse's authorization to practice,
including issuance of a cease and desist action.
new text end

new text begin (b) "Alternative program" means a nondisciplinary monitoring program approved by a
licensing board.
new text end

new text begin (c) "Coordinated licensure information system" means an integrated process for collecting,
storing, and sharing information on nurse licensure and enforcement activities related to
nurse licensure laws that is administered by a nonprofit organization composed of and
controlled by licensing boards.
new text end

new text begin (d) "Current significant investigative information" means:
new text end

new text begin (1) investigative information that a licensing board, after a preliminary inquiry that
includes notification and an opportunity for the nurse to respond, if required by state law,
has reason to believe is not groundless and, if proved true, would indicate more than a minor
infraction; or
new text end

new text begin (2) investigative information that indicates that the nurse represents an immediate threat
to public health and safety, regardless of whether the nurse has been notified and had an
opportunity to respond.
new text end

new text begin (e) "Encumbrance" means a revocation or suspension of, or any limitation on, the full
and unrestricted practice of nursing imposed by a licensing board.
new text end

new text begin (f) "Home state" means the party state that is the nurse's primary state of residence.
new text end

new text begin (g) "Licensing board" means a party state's regulatory body responsible for issuing nurse
licenses.
new text end

new text begin (h) "Multistate license" means a license to practice as a registered or a licensed
practical/vocational nurse (LPN/VN) issued by a home state licensing board that authorizes
the licensed nurse to practice in all party states under a multistate licensure privilege.
new text end

new text begin (i) "Multistate licensure privilege" means a legal authorization associated with a multistate
license permitting the practice of nursing as either a registered nurse (RN) or LPN/VN in
a remote state.
new text end

new text begin (j) "Nurse" means an RN or LPN/VN, as those terms are defined by each party state's
practice laws.
new text end

new text begin (k) "Party state" means any state that has adopted this compact.
new text end

new text begin (l) "Remote state" means a party state other than the home state.
new text end

new text begin (m) "Single-state license" means a nurse license issued by a party state that authorizes
practice only within the issuing state and does not include a multistate licensure privilege
to practice in any other party state.
new text end

new text begin (n) "State" means a state, territory, or possession of the United States and the District
of Columbia.
new text end

new text begin (o) "State practice laws" means a party state's laws, rules, and regulations that govern
the practice of nursing, define the scope of nursing practice, and create the methods and
grounds for imposing discipline. State practice laws do not include requirements necessary
to obtain and retain a license, except for qualifications or requirements of the home state.
new text end

new text begin ARTICLE 2
new text end

new text begin GENERAL PROVISIONS AND JURISDICTION
new text end

new text begin (a) A multistate license to practice registered or licensed practical/vocational nursing
issued by a home state to a resident in that state will be recognized by each party state as
authorizing a nurse to practice as an RN or LPN/VN under a multistate licensure privilege
in each party state.
new text end

new text begin (b) A state must implement procedures for considering the criminal history records of
applicants for initial multistate license or licensure by endorsement. The procedures shall
include the submission of fingerprints or other biometric-based information by applicants
for the purpose of obtaining an applicant's criminal history record information from the
Federal Bureau of Investigation and the agency responsible for retaining that state's criminal
records.
new text end

new text begin (c) Each party state shall require the following for an applicant to obtain or retain a
multistate license in the home state:
new text end

new text begin (1) meets the home state's qualifications for licensure or renewal of licensure, as well
as all other applicable state laws;
new text end

new text begin (2)(i) has graduated or is eligible to graduate from a licensing board-approved RN or
LPN/VN prelicensure education program; or
new text end

new text begin (ii) has graduated from a foreign RN or LPN/VN prelicensure education program that:
new text end

new text begin (A) has been approved by the authorized accrediting body in the applicable country; and
new text end

new text begin (B) has been verified by an independent credentials review agency to be comparable to
a licensing board-approved prelicensure education program;
new text end

new text begin (3) has, if a graduate of a foreign prelicensure education program not taught in English
or if English is not the individual's native language, successfully passed an English
proficiency examination that includes the components of reading, speaking, writing, and
listening;
new text end

new text begin (4) has successfully passed an NCLEX-RN or NCLEX-PN Examination or recognized
predecessor, as applicable;
new text end

new text begin (5) is eligible for or holds an active, unencumbered license;
new text end

new text begin (6) has submitted, in connection with an application for initial licensure or licensure by
endorsement, fingerprints or other biometric data for the purpose of obtaining criminal
history record information from the Federal Bureau of Investigation and the agency
responsible for retaining that state's criminal records;
new text end

new text begin (7) has not been convicted or found guilty, or has entered into an agreed disposition, of
a felony offense under applicable state or federal criminal law;
new text end

new text begin (8) has not been convicted or found guilty, or has entered into an agreed disposition, of
a misdemeanor offense related to the practice of nursing as determined on a case-by-case
basis;
new text end

new text begin (9) is not currently enrolled in an alternative program;
new text end

new text begin (10) is subject to self-disclosure requirements regarding current participation in an
alternative program; and
new text end

new text begin (11) has a valid United States Social Security number.
new text end

new text begin (d) All party states shall be authorized, in accordance with existing state due process
law, to take adverse action against a nurse's multistate licensure privilege such as revocation,
suspension, probation, or any other action that affects a nurse's authorization to practice
under a multistate licensure privilege, including cease and desist actions. If a party state
takes such action, it shall promptly notify the administrator of the coordinated licensure
information system. The administrator of the coordinated licensure information system shall
promptly notify the home state of any such actions by remote states.
new text end

new text begin (e) A nurse practicing in a party state must comply with the state practice laws of the
state in which the client is located at the time service is provided. The practice of nursing
is not limited to patient care, but shall include all nursing practice as defined by the state
practice laws of the party state in which the client is located. The practice of nursing in a
party state under a multistate licensure privilege shall subject a nurse to the jurisdiction of
the licensing board, the courts, and the laws of the party state in which the client is located
at the time service is provided.
new text end

new text begin (f) Individuals not residing in a party state shall continue to be able to apply for a party
state's single-state license as provided under the laws of each party state. However, the
single-state license granted to these individuals will not be recognized as granting the
privilege to practice nursing in any other party state. Nothing in this compact shall affect
the requirements established by a party state for the issuance of a single-state license.
new text end

new text begin (g) Any nurse holding a home state multistate license, on the effective date of this
compact, may retain and renew the multistate license issued by the nurse's then-current
home state, provided that:
new text end

new text begin (1) a nurse, who changes primary state of residence after this compact's effective date,
must meet all applicable paragraph (c) requirements to obtain a multistate license from a
new home state; or
new text end

new text begin (2) a nurse who fails to satisfy the multistate licensure requirements in paragraph (c)
due to a disqualifying event occurring after this compact's effective date shall be ineligible
to retain or renew a multistate license, and the nurse's multistate license shall be revoked
or deactivated in accordance with applicable rules adopted by the Interstate Commission
of Nurse Licensure Compact Administrators ("Commission").
new text end

new text begin ARTICLE 3
new text end

new text begin APPLICATIONS FOR LICENSURE IN A PARTY STATE
new text end

new text begin (a) Upon application for a multistate license, the licensing board in the issuing party
state shall ascertain, through the coordinated licensure information system, whether the
applicant has ever held or is the holder of a license issued by any other state, whether there
are any encumbrances on any license or multistate licensure privilege held by the applicant,
whether any adverse action has been taken against any license or multistate licensure privilege
held by the applicant, and whether the applicant is currently participating in an alternative
program.
new text end

new text begin (b) A nurse may hold a multistate license issued by the home state in only one party
state at a time.
new text end

new text begin (c) If a nurse changes primary state of residence by moving between two party states,
the nurse must apply for licensure in the new home state, and the multistate license issued
by the prior home state will be deactivated in accordance with applicable rules adopted by
the commission:
new text end

new text begin (1) the nurse may apply for licensure in advance of a change in primary state of residence;
and
new text end

new text begin (2) a multistate license shall not be issued by the new home state until the nurse provides
satisfactory evidence of a change in primary state of residence to the new home state and
satisfies all applicable requirements to obtain a multistate license from the new home state.
new text end

new text begin (d) If a nurse changes primary state of residence by moving from a party state to a
nonparty state, the multistate license issued by the prior home state will convert to a
single-state license, valid only in the former home state.
new text end

new text begin ARTICLE 4
new text end

new text begin ADDITIONAL AUTHORITIES INVESTED IN PARTY STATE LICENSING BOARDS
new text end

new text begin (a) In addition to the other powers conferred by state law, a licensing board shall have
the authority to:
new text end

new text begin (1) take adverse action against a nurse's multistate licensure privilege to practice within
that party state:
new text end

new text begin (i) only the home state shall have the power to take adverse action against a nurse's
license issued by the home state; and
new text end

new text begin (ii) for purposes of taking adverse action, the home state licensing board shall give the
same priority and effect to reported conduct received from a remote state as it would if the
conduct occurred within the home state. In so doing, the home state shall apply its own state
laws to determine appropriate action;
new text end

new text begin (2) issue cease and desist orders or impose an encumbrance on a nurse's authority to
practice within that party state;
new text end

new text begin (3) complete any pending investigations of a nurse who changes primary state of residence
during the course of the investigations. The licensing board shall also have the authority to
take appropriate action and shall promptly report the conclusions of the investigations to
the administrator of the coordinated licensure information system. The administrator of the
coordinated licensure information system shall promptly notify the new home state of any
such actions;
new text end

new text begin (4) issue subpoenas for hearings and investigations that require the attendance and
testimony of witnesses, as well as the production of evidence. Subpoenas issued by a licensing
board in a party state for the attendance and testimony of witnesses or the production of
evidence from another party state shall be enforced in the latter state by any court of
competent jurisdiction according to the practice and procedure of that court applicable to
subpoenas issued in proceedings pending before it. The issuing authority shall pay any
witness fees, travel expenses, mileage, and other fees required by the service statutes of the
state in which the witnesses or evidence are located;
new text end

new text begin (5) obtain and submit, for each nurse licensure applicant, fingerprint or other
biometric-based information to the Federal Bureau of Investigation for criminal background
checks, receive the results of the Federal Bureau of Investigation record search on criminal
background checks, and use the results in making licensure decisions;
new text end

new text begin (6) if otherwise permitted by state law, recover from the affected nurse the costs of
investigations and disposition of cases resulting from any adverse action taken against that
nurse; and
new text end

new text begin (7) take adverse action based on the factual findings of the remote state, provided that
the licensing board follows its own procedures for taking such adverse action.
new text end

new text begin (b) If adverse action is taken by the home state against a nurse's multistate license, the
nurse's multistate licensure privilege to practice in all other party states shall be deactivated
until all encumbrances have been removed from the multistate license. All home state
disciplinary orders that impose adverse action against a nurse's multistate license shall
include a statement that the nurse's multistate licensure privilege is deactivated in all party
states during the pendency of the order.
new text end

new text begin (c) Nothing in this compact shall override a party state's decision that participation in
an alternative program may be used in lieu of adverse action. The home state licensing board
shall deactivate the multistate licensure privilege under the multistate license of any nurse
for the duration of the nurse's participation in an alternative program.
new text end

new text begin ARTICLE 5
new text end

new text begin COORDINATED LICENSURE INFORMATION SYSTEM AND EXCHANGE OF
INFORMATION
new text end

new text begin (a) All party states shall participate in a coordinated licensure information system of
RNs and LPNs. The system will include information on the licensure and disciplinary history
of each nurse, as submitted by party states, to assist in the coordination of nurse licensure
and enforcement efforts.
new text end

new text begin (b) The commission, in consultation with the administrator of the coordinated licensure
information system, shall formulate necessary and proper procedures for the identification,
collection, and exchange of information under this compact.
new text end

new text begin (c) All licensing boards shall promptly report to the coordinated licensure information
system any adverse action, any current significant investigative information, denials of
applications, including the reasons for the denials, and nurse participation in alternative
programs known to the licensing board, regardless of whether the participation is deemed
nonpublic or confidential under state law.
new text end

new text begin (d) Current significant investigative information and participation in nonpublic or
confidential alternative programs shall be transmitted through the coordinated licensure
information system only to party state licensing boards.
new text end

new text begin (e) Notwithstanding any other provision of law, all party state licensing boards
contributing information to the coordinated licensure information system may designate
information that shall not be shared with nonparty states or disclosed to other entities or
individuals without the express permission of the contributing state.
new text end

new text begin (f) Any personally identifiable information obtained from the coordinated licensure
information system by a party state licensing board shall not be shared with nonparty states
or disclosed to other entities or individuals except to the extent permitted by the laws of the
party state contributing the information.
new text end

new text begin (g) Any information contributed to the coordinated licensure information system that is
subsequently required to be expunged by the laws of the party state contributing that
information shall also be expunged from the coordinated licensure information system.
new text end

new text begin (h) The compact administrator of each party state shall furnish a uniform data set to the
compact administrator of each other party state, which shall include, at a minimum:
new text end

new text begin (1) identifying information;
new text end

new text begin (2) licensure data;
new text end

new text begin (3) information related to alternative program participation; and
new text end

new text begin (4) other information that may facilitate the administration of this compact, as determined
by commission rules.
new text end

new text begin (i) The compact administrator of a party state shall provide all investigative documents
and information requested by another party state.
new text end

new text begin ARTICLE 6
new text end

new text begin ESTABLISHMENT OF THE INTERSTATE COMMISSION OF NURSE LICENSURE
COMPACT ADMINISTRATORS
new text end

new text begin (a) The party states hereby create and establish a joint public entity known as the Interstate
Commission of Nurse Licensure Compact Administrators:
new text end

new text begin (1) the commission is an instrumentality of the party states;
new text end

new text begin (2) venue is proper, and judicial proceedings by or against the commission shall be
brought solely and exclusively in a court of competent jurisdiction where the principal office
of the commission is located. The commission may waive venue and jurisdictional defenses
to the extent it adopts or consents to participate in alternative dispute resolution proceedings;
and
new text end

new text begin (3) nothing in this compact shall be construed to be a waiver of sovereign immunity.
new text end

new text begin (b) Membership, voting, and meetings:
new text end

new text begin (1) each party state shall have and be limited to one administrator. The head of the state
licensing board or designee shall be the administrator of this compact for each party state.
Any administrator may be removed or suspended from office as provided by the laws of
the state from which the administrator is appointed. Any vacancy occurring in the commission
shall be filled in accordance with the laws of the party state in which the vacancy exists;
new text end

new text begin (2) each administrator shall be entitled to one vote with regard to the promulgation of
rules and creation of bylaws and shall otherwise have an opportunity to participate in the
business and affairs of the commission. An administrator shall vote in person or by such
other means as provided in the bylaws. The bylaws may provide for an administrator's
participation in meetings by telephone or other means of communication;
new text end

new text begin (3) the commission shall meet at least once during each calendar year. Additional
meetings shall be held as set forth in the bylaws or rules of the commission;
new text end

new text begin (4) all meetings shall be open to the public, and public notice of meetings shall be given
in the same manner as required under the rulemaking provisions in article 7;
new text end

new text begin (5) the commission may convene in a closed, nonpublic meeting if the commission must
discuss:
new text end

new text begin (i) noncompliance of a party state with its obligations under this compact;
new text end

new text begin (ii) the employment, compensation, discipline, or other personnel matters, practices, or
procedures related to specific employees or other matters related to the commission's internal
personnel practices and procedures;
new text end

new text begin (iii) current, threatened, or reasonably anticipated litigation;
new text end

new text begin (iv) negotiation of contracts for the purchase or sale of goods, services, or real estate;
new text end

new text begin (v) accusing any person of a crime or formally censuring any person;
new text end

new text begin (vi) disclosure of trade secrets or commercial or financial information that is privileged
or confidential;
new text end

new text begin (vii) disclosure of information of a personal nature where disclosure would constitute a
clearly unwarranted invasion of personal privacy;
new text end

new text begin (viii) disclosure of investigatory records compiled for law enforcement purposes;
new text end

new text begin (ix) disclosure of information related to any reports prepared by or on behalf of the
commission for the purpose of investigation of compliance with this compact; or
new text end

new text begin (x) matters specifically exempted from disclosure by federal or state statute; and
new text end

new text begin (6) if a meeting or portion of a meeting is closed pursuant to this provision, the
commission's legal counsel or designee shall certify that the meeting may be closed and
shall reference each relevant exempting provision. The commission shall keep minutes that
fully and clearly describe all matters discussed in a meeting and shall provide a full and
accurate summary of actions taken and the reasons therefore, including a description of the
views expressed. All documents considered in connection with an action shall be identified
in the minutes. All minutes and documents of a closed meeting shall remain under seal,
subject to release by a majority vote of the commission or order of a court of competent
jurisdiction.
new text end

new text begin (c) The commission shall, by a majority vote of the administrators, prescribe bylaws or
rules to govern its conduct as may be necessary or appropriate to carry out the purposes and
exercise the powers of this compact, including but not limited to:
new text end

new text begin (1) establishing the fiscal year of the commission;
new text end

new text begin (2) providing reasonable standards and procedures:
new text end

new text begin (i) for the establishment and meetings of other committees; and
new text end

new text begin (ii) governing any general or specific delegation of any authority or function of the
commission;
new text end

new text begin (3) providing reasonable procedures for calling and conducting meetings of the
commission, ensuring reasonable advance notice of all meetings and providing an opportunity
for attendance of the meetings by interested parties, with enumerated exceptions designed
to protect the public's interest, the privacy of individuals, and proprietary information,
including trade secrets. The commission may meet in closed session only after a majority
of the administrators vote to close a meeting in whole or in part. As soon as practicable, the
commission must make public a copy of the vote to close the meeting revealing the vote of
each administrator, with no proxy votes allowed;
new text end

new text begin (4) establishing the titles, duties, and authority and reasonable procedures for the election
of the officers of the commission;
new text end

new text begin (5) providing reasonable standards and procedures for the establishment of the personnel
policies and programs of the commission. Notwithstanding any civil service or other similar
laws of any party state, the bylaws shall exclusively govern the personnel policies and
programs of the commission; and
new text end

new text begin (6) providing a mechanism for winding up the operations of the commission and the
equitable disposition of any surplus funds that may exist after the termination of this compact
after the payment or reserving of all of its debts and obligations.
new text end

new text begin (d) The commission shall publish its bylaws, rules, and any amendments in a convenient
form on the website of the commission.
new text end

new text begin (e) The commission shall maintain its financial records in accordance with the bylaws.
new text end

new text begin (f) The commission shall meet and take actions consistent with the provisions of this
compact and the bylaws.
new text end

new text begin (g) The commission shall have the following powers:
new text end

new text begin (1) to promulgate uniform rules to facilitate and coordinate implementation and
administration of this compact. The rules shall have the force and effect of law and shall
be binding in all party states;
new text end

new text begin (2) to bring and prosecute legal proceedings or actions in the name of the commission,
provided that the standing of any licensing board to sue or be sued under applicable law
shall not be affected;
new text end

new text begin (3) to purchase and maintain insurance and bonds;
new text end

new text begin (4) to borrow, accept, or contract for services of personnel, including but not limited to
employees of a party state or nonprofit organizations;
new text end

new text begin (5) to cooperate with other organizations that administer state compacts related to the
regulation of nursing, including but not limited to sharing administrative or staff expenses,
office space, or other resources;
new text end

new text begin (6) to hire employees, elect or appoint officers, fix compensation, define duties, grant
such individuals appropriate authority to carry out the purposes of this compact, and establish
the commission's personnel policies and programs relating to conflicts of interest,
qualifications of personnel, and other related personnel matters;
new text end

new text begin (7) to accept any and all appropriate donations, grants, and gifts of money, equipment,
supplies, materials, and services, and to receive, utilize, and dispose of the same; provided
that at all times the commission shall avoid any appearance of impropriety or conflict of
interest;
new text end

new text begin (8) to lease, purchase, accept appropriate gifts or donations of, or otherwise to own,
hold, improve, or use any property, whether real, personal, or mixed; provided that at all
times the commission shall avoid any appearance of impropriety;
new text end

new text begin (9) to sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose
of any property, whether real, personal, or mixed;
new text end

new text begin (10) to establish a budget and make expenditures;
new text end

new text begin (11) to borrow money;
new text end

new text begin (12) to appoint committees, including advisory committees comprised of administrators,
state nursing regulators, state legislators or their representatives, and consumer
representatives, and other such interested persons;
new text end

new text begin (13) to provide and receive information from, and to cooperate with, law enforcement
agencies;
new text end

new text begin (14) to adopt and use an official seal; and
new text end

new text begin (15) to perform other functions as may be necessary or appropriate to achieve the purposes
of this compact consistent with the state regulation of nurse licensure and practice.
new text end

new text begin (h) Financing of the commission:
new text end

new text begin (1) the commission shall pay or provide for the payment of the reasonable expenses of
its establishment, organization, and ongoing activities;
new text end

new text begin (2) the commission may also levy on and collect an annual assessment from each party
state to cover the cost of its operations, activities, and staff in its annual budget as approved
each year. The aggregate annual assessment amount, if any, shall be allocated based on a
formula to be determined by the commission, which shall promulgate a rule that is binding
upon all party states;
new text end

new text begin (3) the commission shall not incur obligations of any kind prior to securing the funds
adequate to meet the same; nor shall the commission pledge the credit of any of the party
states, except by and with the authority of the party state; and
new text end

new text begin (4) the commission shall keep accurate accounts of all receipts and disbursements. The
receipts and disbursements of the commission shall be subject to the audit and accounting
procedures established under its bylaws. However, all receipts and disbursements of funds
handled by the commission shall be audited yearly by a certified or licensed public
accountant, and the report of the audit shall be included in and become part of the annual
report of the commission.
new text end

new text begin (i) Qualified immunity, defense, and indemnification:
new text end

new text begin (1) the administrators, officers, executive director, employees, and representatives of
the commission shall be immune from suit and liability, either personally or in their official
capacity, for any claim for damage to or loss of property or personal injury or other civil
liability caused by or arising out of any actual or alleged act, error, or omission that occurred,
or that the person against whom the claim is made had a reasonable basis for believing
occurred, within the scope of commission employment, duties, or responsibilities; provided
that nothing in this paragraph shall be construed to protect any such person from suit or
liability for any damage, loss, injury, or liability caused by the intentional, willful, or wanton
misconduct of that person;
new text end

new text begin (2) the commission shall defend any administrator, officer, executive director, employee,
or representative of the commission in any civil action seeking to impose liability arising
out of any actual or alleged act, error, or omission that occurred within the scope of
commission employment, duties, or responsibilities, or that the person against whom the
claim is made had a reasonable basis for believing occurred within the scope of commission
employment, duties, or responsibilities; provided that nothing herein shall be construed to
prohibit that person from retaining the person's counsel; and provided further that the actual
or alleged act, error, or omission did not result from that person's intentional, willful, or
wanton misconduct; and
new text end

new text begin (3) the commission shall indemnify and hold harmless any administrator, officer,
executive director, employee, or representative of the commission for the amount of any
settlement or judgment obtained against that person arising out of any actual or alleged act,
error, or omission that occurred within the scope of commission employment, duties, or
responsibilities, or that the person had a reasonable basis for believing occurred within the
scope of commission employment, duties, or responsibilities, provided that the actual or
alleged act, error, or omission did not result from the intentional, willful, or wanton
misconduct of that person.
new text end

new text begin ARTICLE 7
new text end

new text begin RULEMAKING
new text end

new text begin (a) The commission shall exercise its rulemaking powers pursuant to this article and the
rules adopted thereunder. Rules and amendments shall become binding as of the date
specified in each rule or amendment and shall have the same force and effect as provisions
of this compact.
new text end

new text begin (b) Rules or amendments to the rules shall be adopted at a regular or special meeting of
the commission.
new text end

new text begin (c) Prior to promulgation and adoption of a final rule or rules by the commission, and
at least 60 days in advance of the meeting at which the rule will be considered and voted
on, the commission shall file a notice of proposed rulemaking:
new text end

new text begin (1) on the website of the commission; and
new text end

new text begin (2) on the website of each licensing board or the publication in which the state would
otherwise publish proposed rules.
new text end

new text begin (d) The notice of proposed rulemaking shall include:
new text end

new text begin (1) the proposed time, date, and location of the meeting in which the rule will be
considered and voted on;
new text end

new text begin (2) the text of the proposed rule or amendment, and the reason for the proposed rule;
new text end

new text begin (3) a request for comments on the proposed rule from any interested person; and
new text end

new text begin (4) the manner in which interested persons may submit notice to the commission of their
intention to attend the public hearing and any written comments.
new text end

new text begin (e) Prior to adoption of a proposed rule, the commission shall allow persons to submit
written data, facts, opinions, and arguments that shall be made available to the public.
new text end

new text begin (f) The commission shall grant an opportunity for a public hearing before it adopts a
rule or amendment.
new text end

new text begin (g) The commission shall publish the place, time, and date of the scheduled public
hearing:
new text end

new text begin (1) hearings shall be conducted in a manner providing each person who wishes to
comment a fair and reasonable opportunity to comment orally or in writing. All hearings
will be recorded and a copy will be made available upon request; and
new text end

new text begin (2) nothing in this section shall be construed as requiring a separate hearing on each
rule. Rules may be grouped for the convenience of the commission at hearings required by
this section.
new text end

new text begin (h) If no person appears at the public hearing, the commission may proceed with
promulgation of the proposed rule.
new text end

new text begin (i) Following the scheduled hearing date or by the close of business on the scheduled
hearing date if the hearing was not held, the commission shall consider all written and oral
comments received.
new text end

new text begin (j) The commission shall, by majority vote of all administrators, take final action on the
proposed rule and shall determine the effective date of the rule, if any, based on the
rulemaking record and the full text of the rule.
new text end

new text begin (k) Upon determination that an emergency exists, the commission may consider and
adopt an emergency rule without prior notice or opportunity for comment or hearing,
provided that the usual rulemaking procedures provided in this compact and in this section
shall be retroactively applied to the rule as soon as reasonably possible, in no event later
than 90 days after the effective date of the rule. For the purposes of this provision, an
emergency rule is one that must be adopted immediately in order to:
new text end

new text begin (1) meet an imminent threat to public health, safety, or welfare;
new text end

new text begin (2) prevent a loss of commission or party state funds; or
new text end

new text begin (3) meet a deadline for the promulgation of an administrative rule that is required by
federal law or rule.
new text end

new text begin (l) The commission may direct revisions to a previously adopted rule or amendment for
purposes of correcting typographical errors, errors in format, errors in consistency, or
grammatical errors. Public notice of any revisions shall be posted on the website of the
commission. The revision shall be subject to challenge by any person for a period of 30
days after posting. The revision may be challenged only on grounds that the revision results
in a material change to a rule. A challenge shall be made in writing and delivered to the
commission before the end of the notice period. If no challenge is made, the revision will
take effect without further action. If the revision is challenged, the revision shall not take
effect without the approval of the commission.
new text end

new text begin ARTICLE 8
new text end

new text begin OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT
new text end

new text begin (a) Oversight:
new text end

new text begin (1) each party state shall enforce this compact and take all actions necessary and
appropriate to effectuate this compact's purposes and intent; and
new text end

new text begin (2) the commission shall be entitled to receive service of process in any proceeding that
may affect the powers, responsibilities, or actions of the commission and shall have standing
to intervene in such a proceeding for all purposes. Failure to provide service of process in
the proceeding to the commission shall render a judgment or order void as to the commission,
this compact, or promulgated rules.
new text end

new text begin (b) Default, technical assistance, and termination:
new text end

new text begin (1) if the commission determines that a party state has defaulted in the performance of
its obligations or responsibilities under this compact or the promulgated rules, the commission
shall:
new text end

new text begin (i) provide written notice to the defaulting state and other party states of the nature of
the default, the proposed means of curing the default, or any other action to be taken by the
commission; and
new text end

new text begin (ii) provide remedial training and specific technical assistance regarding the default;
new text end

new text begin (2) if a state in default fails to cure the default, the defaulting state's membership in this
compact may be terminated upon an affirmative vote of a majority of the administrators,
and all rights, privileges, and benefits conferred by this compact may be terminated on the
effective date of termination. A cure of the default does not relieve the offending state of
obligations or liabilities incurred during the period of default;
new text end

new text begin (3) termination of membership in this compact shall be imposed only after all other
means of securing compliance have been exhausted. Notice of intent to suspend or terminate
shall be given by the commission to the governor of the defaulting state and to the executive
officer of the defaulting state's licensing board and each of the party states;
new text end

new text begin (4) a state whose membership in this compact has been terminated is responsible for all
assessments, obligations, and liabilities incurred through the effective date of termination,
including obligations that extend beyond the effective date of termination;
new text end

new text begin (5) the commission shall not bear any costs related to a state that is found to be in default
or whose membership in this compact has been terminated, unless agreed upon in writing
between the commission and the defaulting state; and
new text end

new text begin (6) the defaulting state may appeal the action of the commission by petitioning the U.S.
District Court for the District of Columbia or the federal district in which the commission
has its principal offices. The prevailing party shall be awarded all costs of the litigation,
including reasonable attorney fees.
new text end

new text begin (c) Dispute resolution:
new text end

new text begin (1) upon request by a party state, the commission shall attempt to resolve disputes related
to the compact that arise among party states and between party and nonparty states;
new text end

new text begin (2) the commission shall promulgate a rule providing for both mediation and binding
dispute resolution for disputes, as appropriate; and
new text end

new text begin (3) in the event the commission cannot resolve disputes among party states arising under
this compact:
new text end

new text begin (i) the party states may submit the issues in dispute to an arbitration panel, that will be
comprised of individuals appointed by the compact administrator in each of the affected
party states and an individual mutually agreed upon by the compact administrators of all
the party states involved in the dispute; and
new text end

new text begin (ii) the decision of a majority of the arbitrators shall be final and binding.
new text end

new text begin (d) Enforcement:
new text end

new text begin (1) the commission, in the reasonable exercise of its discretion, shall enforce the
provisions and rules of this compact;
new text end

new text begin (2) by majority vote, the commission may initiate legal action in the U.S. District Court
for the District of Columbia or the federal district in which the commission has its principal
offices against a party state that is in default to enforce compliance with this compact and
its promulgated rules and bylaws. The relief sought may include both injunctive relief and
damages. In the event judicial enforcement is necessary, the prevailing party shall be awarded
all costs of the litigation, including reasonable attorney fees; and
new text end

new text begin (3) the remedies herein shall not be the exclusive remedies of the commission. The
commission may pursue any other remedies available under federal or state law.
new text end

new text begin ARTICLE 9
new text end

new text begin EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENT
new text end

new text begin (a) This compact shall become effective and binding on July 1, 2022. All party states to
this compact that also were parties to the prior Nurse Licensure Compact that was superseded
by this compact shall be deemed to have withdrawn from the prior compact within six
months after the effective date of this compact.
new text end

new text begin (b) Each party state to this compact shall continue to recognize a nurse's multistate
licensure privilege to practice in that party state issued under the prior compact until the
party state has withdrawn from the prior compact.
new text end

new text begin (c) Any party state may withdraw from this compact by legislative enactment. A party
state's withdrawal shall not take effect until six months after enactment of the repealing
statute.
new text end

new text begin (d) A party state's withdrawal or termination shall not affect the continuing requirement
of the withdrawing or terminated state's licensing board to report adverse actions and
significant investigations occurring prior to the effective date of the withdrawal or
termination.
new text end

new text begin (e) Nothing in this compact shall be construed to invalidate or prevent any nurse licensure
agreement or other cooperative arrangement between a party state and a nonparty state that
is made in accordance with the other provisions of this compact.
new text end

new text begin (f) This compact may be amended by the party states. No amendment to this compact
shall become effective and binding upon the party states unless and until it is enacted into
the laws of all party states.
new text end

new text begin (g) Representatives of nonparty states to this compact shall be invited to participate in
the activities of the commission on a nonvoting basis prior to the adoption of this compact
by all states.
new text end

new text begin ARTICLE 10
new text end

new text begin CONSTRUCTION AND SEVERABILITY
new text end

new text begin This compact shall be liberally construed so as to effectuate the purposes thereof. This
compact shall be severable, and if any phrase, clause, sentence, or provision of this compact
is declared to be contrary to the constitution of any party state or of the United States, or if
the applicability thereof to any government, agency, person, or circumstance is held invalid,
the validity of the remainder of this compact and the applicability thereof to any government,
agency, person, or circumstance shall not be affected thereby. If this compact is held to be
contrary to the constitution of any party state, this compact shall remain in full force and
effect for the remaining party states and in full force and effect for the party state affected
as to all severable matters.
new text end

Sec. 12.

new text begin [148.2856] APPLICATION OF NURSE LICENSURE COMPACT TO
EXISTING LAWS.
new text end

new text begin (a) Section 148.2855 does not supersede existing state labor laws.
new text end

new text begin (b) If the board takes action against an individual's multistate privilege, the action must
be adjudicated following the procedures in sections 14.50 to 14.62 and must be subject to
the judicial review provided for in sections 14.63 to 14.69.
new text end

new text begin (c) The board may take action against an individual's multistate privilege based on the
grounds listed in section 148.261, subdivision 1, and any other statute authorizing or requiring
the board to take corrective or disciplinary action.
new text end

new text begin (d) The board may take all forms of disciplinary action provided in section 148.262,
subdivision 1, and corrective action provided in section 214.103, subdivision 6, against an
individual's multistate privilege.
new text end

new text begin (e) The cooperation requirements of section 148.265 apply to individuals who practice
professional or practical nursing in Minnesota under section 148.2855.
new text end

new text begin (f) Complaints against individuals who practice professional or practical nursing in
Minnesota under section 148.2855 must be addressed according to sections 214.10 and
214.103.
new text end

Sec. 13.

new text begin [148.5185] AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY
INTERSTATE COMPACT.
new text end

new text begin Section 1. Definitions
new text end

new text begin As used in this Compact, and except as otherwise provided, the following definitions
shall apply:
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new text begin A. "Active duty military" means full-time duty status in the active uniformed service of
the United States, including members of the National Guard and Reserve on active duty
orders pursuant to 10 U.S.C. sections 1209 and 1211.
new text end

new text begin B. "Adverse action" means any administrative, civil, equitable, or criminal action
permitted by a state's laws which is imposed by a licensing board or other authority against
an audiologist or speech-language pathologist, including actions against an individual's
license or privilege to practice such as revocation, suspension, probation, monitoring of the
licensee, or restriction on the licensee's practice.
new text end

new text begin C. "Alternative program" means a non-disciplinary monitoring process approved by an
audiology or speech-language pathology licensing board to address impaired practitioners.
new text end

new text begin D. "Audiologist" means an individual who is licensed by a state to practice audiology.
new text end

new text begin E. "Audiology" means the care and services provided by a licensed audiologist as set
forth in the member state's statutes and rules.
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new text begin F. "Audiology and Speech-Language Pathology Compact Commission" or "Commission"
means the national administrative body whose membership consists of all states that have
enacted the Compact.
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new text begin G. "Audiology and speech-language pathology licensing board," "audiology licensing
board," "speech-language pathology licensing board," or "licensing board" means the agency
of a state that is responsible for the licensing and regulation of audiologists or
speech-language pathologists or both.
new text end

new text begin H. "Compact privilege" means the authorization granted by a remote state to allow a
licensee from another member state to practice as an audiologist or speech-language
pathologist in the remote state under its laws and rules. The practice of audiology or
speech-language pathology occurs in the member state where the patient, client, or student
is located at the time of the patient, client, or student encounter.
new text end

new text begin I. "Current significant investigative information" means investigative information that
a licensing board, after an inquiry or investigation that includes notification and an
opportunity for the audiologist or speech-language pathologist to respond, if required by
state law, has reason to believe is not groundless and, if proved true, would indicate more
than a minor infraction.
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new text begin J. "Data system" means a repository of information about licensees, including, but not
limited to, continuing education, examination, licensure, investigation, compact privilege,
and adverse action.
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new text begin K. "Encumbered license" means a license in which an adverse action restricts the practice
of audiology or speech-language pathology by the licensee and said adverse action has been
reported to the National Practitioners Data Bank (NPDB).
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new text begin L. "Executive Committee" means a group of directors elected or appointed to act on
behalf of, and within the powers granted to them by, the Commission.
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new text begin M. "Home state" means the member state that is the licensee's primary state of residence.
new text end

new text begin N. "Impaired practitioner" means individuals whose professional practice is adversely
affected by substance abuse, addiction, or other health-related conditions.
new text end

new text begin O. "Licensee" means an individual who currently holds an authorization from the state
licensing board to practice as an audiologist or speech-language pathologist.
new text end

new text begin P. "Member state" means a state that has enacted the Compact.
new text end

new text begin Q. "Privilege to practice" means a legal authorization permitting the practice of audiology
or speech-language pathology in a remote state.
new text end

new text begin R. "Remote state" means a member state other than the home state where a licensee is
exercising or seeking to exercise the compact privilege.
new text end

new text begin S. "Rule" means a regulation, principle, or directive promulgated by the Commission
that has the force of law.
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new text begin T. "Single-state license" means an audiology or speech-language pathology license
issued by a member state that authorizes practice only within the issuing state and does not
include a privilege to practice in any other member state.
new text end

new text begin U. "Speech-language pathologist" means an individual who is licensed by a state to
practice speech-language pathology.
new text end

new text begin V. "Speech-language pathology" means the care and services provided by a licensed
speech-language pathologist as set forth in the member state's statutes and rules.
new text end

new text begin W. "State" means any state, commonwealth, district, or territory of the United States of
America that regulates the practice of audiology and speech-language pathology.
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new text begin X. "State practice laws" means a member state's laws, rules, and regulations that govern
the practice of audiology or speech-language pathology, define the scope of audiology or
speech-language pathology practice, and create the methods and grounds for imposing
discipline.
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new text begin Y. "Telehealth" means the application of telecommunication technology to deliver
audiology or speech-language pathology services at a distance for assessment, intervention,
or consultation.
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new text begin Section 2. State Participation in the Compact
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new text begin A. A license issued to an audiologist or speech-language pathologist by a home state to
a resident in that state shall be recognized by each member state as authorizing an audiologist
or speech-language pathologist to practice audiology or speech-language pathology, under
a privilege to practice, in each member state.
new text end

new text begin B. A state must implement or utilize procedures for considering the criminal history
records of applicants for initial privilege to practice. These procedures shall include the
submission of fingerprints or other biometric-based information by applicants for the purpose
of obtaining an applicant's criminal history record information from the Federal Bureau of
Investigation and the agency responsible for retaining that state's criminal records.
new text end

new text begin 1. A member state must fully implement a criminal background check requirement,
within a time frame established by rule, by receiving the results of the Federal Bureau of
Investigation record search on criminal background checks and use the results in making
licensure decisions.
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new text begin 2. Communication between a member state and the Commission and among member
states regarding the verification of eligibility for licensure through the Compact shall not
include any information received from the Federal Bureau of Investigation relating to a
federal criminal records check performed by a member state under Public Law 92-544.
new text end

new text begin C. Upon application for a privilege to practice, the licensing board in the issuing remote
state shall ascertain, through the data system, whether the applicant has ever held, or is the
holder of, a license issued by any other state, whether there are any encumbrances on any
license or privilege to practice held by the applicant, and whether any adverse action has
been taken against any license or privilege to practice held by the applicant.
new text end

new text begin D. Each member state shall require an applicant to obtain or retain a license in the home
state and meet the home state's qualifications for licensure or renewal of licensure, as well
as all other applicable state laws.
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new text begin E. For an audiologist:
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new text begin 1. Must meet one of the following educational requirements:
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new text begin a. On or before December 31, 2007, has graduated with a master's degree or doctoral
degree in audiology, or equivalent degree regardless of degree name, from a program that
is accredited by an accrediting agency recognized by the Council for Higher Education
Accreditation, or its successor, or by the United States Department of Education and operated
by a college or university accredited by a regional or national accrediting organization
recognized by the board; or
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new text begin b. On or after January 1, 2008, has graduated with a doctoral degree in audiology, or
equivalent degree regardless of degree name, from a program that is accredited by an
accrediting agency recognized by the Council for Higher Education Accreditation, or its
successor, or by the United States Department of Education and operated by a college or
university accredited by a regional or national accrediting organization recognized by the
board; or
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new text begin c. Has graduated from an audiology program that is housed in an institution of higher
education outside of the United States (a) for which the program and institution have been
approved by the authorized accrediting body in the applicable country and (b) the degree
program has been verified by an independent credentials review agency to be comparable
to a state licensing board-approved program;
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new text begin 2. Has completed a supervised clinical practicum experience from an accredited
educational institution or its cooperating programs as required by the board;
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new text begin 3. Has successfully passed a national examination approved by the Commission;
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new text begin 4. Holds an active, unencumbered license;
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new text begin 5. Has not been convicted or found guilty, and has not entered into an agreed disposition,
of a felony related to the practice of audiology, under applicable state or federal criminal
law; and
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new text begin 6. Has a valid United States Social Security or National Practitioner Identification
number.
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new text begin F. For a speech-language pathologist:
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new text begin 1. Must meet one of the following educational requirements:
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new text begin a. Has graduated with a master's degree from a speech-language pathology program that
is accredited by an organization recognized by the United States Department of Education
and operated by a college or university accredited by a regional or national accrediting
organization recognized by the board; or
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new text begin b. Has graduated from a speech-language pathology program that is housed in an
institution of higher education outside of the United States (a) for which the program and
institution have been approved by the authorized accrediting body in the applicable country
and (b) the degree program has been verified by an independent credentials review agency
to be comparable to a state licensing board-approved program;
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new text begin 2. Has completed a supervised clinical practicum experience from an educational
institution or its cooperating programs as required by the Commission;
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new text begin 3. Has completed a supervised postgraduate professional experience as required by the
Commission;
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new text begin 4. Has successfully passed a national examination approved by the Commission;
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new text begin 5. Holds an active, unencumbered license;
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new text begin 6. Has not been convicted or found guilty, and has not entered into an agreed disposition,
of a felony related to the practice of speech-language pathology, under applicable state or
federal criminal law; and
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new text begin 7. Has a valid United States Social Security or National Practitioner Identification
number.
new text end

new text begin G. The privilege to practice is derived from the home state license.
new text end

new text begin H. An audiologist or speech-language pathologist practicing in a member state must
comply with the state practice laws of the state in which the client is located at the time
service is provided. The practice of audiology and speech-language pathology shall include
all audiology and speech-language pathology practice as defined by the state practice laws
of the member state in which the client is located. The practice of audiology and
speech-language pathology in a member state under a privilege to practice shall subject an
audiologist or speech-language pathologist to the jurisdiction of the licensing board, the
courts and the laws of the member state in which the client is located at the time service is
provided.
new text end

new text begin I. Individuals not residing in a member state shall continue to be able to apply for a
member state's single-state license as provided under the laws of each member state.
However, the single-state license granted to these individuals shall not be recognized as
granting the privilege to practice audiology or speech-language pathology in any other
member state. Nothing in this Compact shall affect the requirements established by a member
state for the issuance of a single-state license.
new text end

new text begin J. Member states may charge a fee for granting a compact privilege.
new text end

new text begin K. Member states must comply with the bylaws and rules and regulations of the
Commission.
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new text begin Section 3. Compact Privilege
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new text begin A. To exercise the compact privilege under the terms and provisions of the Compact,
the audiologist or speech-language pathologist shall:
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new text begin 1. Hold an active license in the home state;
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new text begin 2. Have no encumbrance on any state license;
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new text begin 3. Be eligible for a compact privilege in any member state in accordance with Section
2;
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new text begin 4. Have not had any adverse action against any license or compact privilege within the
previous two years from date of application;
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new text begin 5. Notify the Commission that the licensee is seeking the compact privilege within a
remote state(s);
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new text begin 6. Pay any applicable fees, including any state fee, for the compact privilege; and
new text end

new text begin 7. Report to the Commission adverse action taken by any non-member state within 30
days from the date the adverse action is taken.
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new text begin B. For the purposes of the compact privilege, an audiologist or speech-language
pathologist shall only hold one home state license at a time.
new text end

new text begin C. Except as provided in Section 5, if an audiologist or speech-language pathologist
changes primary state of residence by moving between two member states, the audiologist
or speech-language pathologist must apply for licensure in the new home state, and the
license issued by the prior home state shall be deactivated in accordance with applicable
rules adopted by the Commission.
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new text begin D. The audiologist or speech-language pathologist may apply for licensure in advance
of a change in primary state of residence.
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new text begin E. A license shall not be issued by the new home state until the audiologist or
speech-language pathologist provides satisfactory evidence of a change in primary state of
residence to the new home state and satisfies all applicable requirements to obtain a license
from the new home state.
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new text begin F. If an audiologist or speech-language pathologist changes primary state of residence
by moving from a member state to a non-member state, the license issued by the prior home
state shall convert to a single-state license, valid only in the former home state.
new text end

new text begin G. The compact privilege is valid until the expiration date of the home state license. The
licensee must comply with the requirements of Section 3A to maintain the compact privilege
in the remote state.
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new text begin H. A licensee providing audiology or speech-language pathology services in a remote
state under the compact privilege shall function within the laws and regulations of the remote
state.
new text end

new text begin I. A licensee providing audiology or speech-language pathology services in a remote
state is subject to that state's regulatory authority. A remote state may, in accordance with
due process and that state's laws, remove a licensee's compact privilege in the remote state
for a specific period of time, impose fines, or take any other necessary actions to protect
the health and safety of its citizens.
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new text begin J. If a home state license is encumbered, the licensee shall lose the compact privilege in
any remote state until the following occur:
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new text begin 1. The home state license is no longer encumbered; and
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new text begin 2. Two years have elapsed from the date of the adverse action.
new text end

new text begin K. Once an encumbered license in the home state is restored to good standing, the licensee
must meet the requirements of Section 3A to obtain a compact privilege in any remote state.
new text end

new text begin L. Once the requirements of Section 3J have been met, the licensee must meet the
requirements in Section 3A to obtain a compact privilege in a remote state.
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new text begin Section 4. Compact Privilege to Practice Telehealth
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new text begin Member states shall recognize the right of an audiologist or speech-language pathologist,
licensed by a home state in accordance with Section 2 and under rules promulgated by the
Commission, to practice audiology or speech-language pathology in a member state via
telehealth under a privilege to practice as provided in the Compact and rules promulgated
by the Commission.
new text end

new text begin Section 5. Active Duty Military Personnel or Their Spouses
new text end

new text begin Active duty military personnel, or their spouse, shall designate a home state where the
individual has a current license in good standing. The individual may retain the home state
designation during the period the service member is on active duty. Subsequent to designating
a home state, the individual shall only change their home state through application for
licensure in the new state.
new text end

new text begin Section 6. Adverse Actions
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new text begin A. In addition to the other powers conferred by state law, a remote state shall have the
authority, in accordance with existing state due process law, to:
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new text begin 1. Take adverse action against an audiologist's or speech-language pathologist's privilege
to practice within that member state.
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new text begin 2. Issue subpoenas for both hearings and investigations that require the attendance and
testimony of witnesses as well as the production of evidence. Subpoenas issued by a licensing
board in a member state for the attendance and testimony of witnesses or the production of
evidence from another member state shall be enforced in the latter state by any court of
competent jurisdiction, according to the practice and procedure of that court applicable to
subpoenas issued in proceedings pending before it. The issuing authority shall pay any
witness fees, travel expenses, mileage and other fees required by the service statutes of the
state in which the witnesses or evidence are located.
new text end

new text begin B. Only the home state shall have the power to take adverse action against an audiologist's
or speech-language pathologist's license issued by the home state.
new text end

new text begin C. For purposes of taking adverse action, the home state shall give the same priority and
effect to reported conduct received from a member state as it would if the conduct had
occurred within the home state. In so doing, the home state shall apply its own state laws
to determine appropriate action.
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new text begin D. The home state shall complete any pending investigations of an audiologist or
speech-language pathologist who changes primary state of residence during the course of
the investigations. The home state shall also have the authority to take appropriate action(s)
and shall promptly report the conclusions of the investigations to the administrator of the
data system. The administrator of the data system shall promptly notify the new home state
of any adverse actions.
new text end

new text begin E. If otherwise permitted by state law, the member state may recover from the affected
audiologist or speech-language pathologist the costs of investigations and disposition of
cases resulting from any adverse action taken against that audiologist or speech-language
pathologist.
new text end

new text begin F. The member state may take adverse action based on the factual findings of the remote
state, provided that the home state follows its own procedures for taking the adverse action.
new text end

new text begin G. Joint Investigations
new text end

new text begin 1. In addition to the authority granted to a member state by its respective audiology or
speech-language pathology practice act or other applicable state law, any member state may
participate with other member states in joint investigations of licensees.
new text end

new text begin 2. Member states shall share any investigative, litigation, or compliance materials in
furtherance of any joint or individual investigation initiated under the Compact.
new text end

new text begin H. If adverse action is taken by the home state against an audiologist's or speech-language
pathologist's license, the audiologist's or speech-language pathologist's privilege to practice
in all other member states shall be deactivated until all encumbrances have been removed
from the state license. All home state disciplinary orders that impose adverse action against
an audiologist's or speech-language pathologist's license shall include a statement that the
audiologist's or speech-language pathologist's privilege to practice is deactivated in all
member states during the pendency of the order.
new text end

new text begin I. If a member state takes adverse action, it shall promptly notify the administrator of
the data system. The administrator of the data system shall promptly notify the home state
of any adverse actions by remote states.
new text end

new text begin J. Nothing in this Compact shall override a member state's decision that participation in
an alternative program may be used in lieu of adverse action.
new text end

new text begin Section 7. Establishment of the Audiology and Speech-Language Pathology Compact
Commission
new text end

new text begin A. The Compact member states hereby create and establish a joint public agency known
as the Audiology and Speech-Language Pathology Compact Commission:
new text end

new text begin 1. The Commission is an instrumentality of the Compact states.
new text end

new text begin 2. Venue is proper and judicial proceedings by or against the Commission shall be
brought solely and exclusively in a court of competent jurisdiction where the principal office
of the Commission is located. The Commission may waive venue and jurisdictional defenses
to the extent it adopts or consents to participate in alternative dispute resolution proceedings.
new text end

new text begin 3. Nothing in this Compact shall be construed to be a waiver of sovereign immunity.
new text end

new text begin B. Membership, Voting, and Meetings
new text end

new text begin 1. Each member state shall have two delegates selected by that member state's licensing
board. The delegates shall be current members of the licensing board. One shall be an
audiologist and one shall be a speech-language pathologist.
new text end

new text begin 2. An additional five delegates, who are either a public member or board administrator
from a state licensing board, shall be chosen by the Executive Committee from a pool of
nominees provided by the Commission at Large.
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new text begin 3. Any delegate may be removed or suspended from office as provided by the law of
the state from which the delegate is appointed.
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new text begin 4. The member state board shall fill any vacancy occurring on the Commission, within
90 days.
new text end

new text begin 5. Each delegate shall be entitled to one vote with regard to the promulgation of rules
and creation of bylaws and shall otherwise have an opportunity to participate in the business
and affairs of the Commission.
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new text begin 6. A delegate shall vote in person or by other means as provided in the bylaws. The
bylaws may provide for delegates' participation in meetings by telephone or other means
of communication.
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new text begin 7. The Commission shall meet at least once during each calendar year. Additional
meetings shall be held as set forth in the bylaws.
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new text begin C. The Commission shall have the following powers and duties:
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new text begin 1. Establish the fiscal year of the Commission;
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new text begin 2. Establish bylaws;
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new text begin 3. Establish a Code of Ethics;
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new text begin 4. Maintain its financial records in accordance with the bylaws;
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new text begin 5. Meet and take actions as are consistent with the provisions of this Compact and the
bylaws;
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new text begin 6. Promulgate uniform rules to facilitate and coordinate implementation and
administration of this Compact. The rules shall have the force and effect of law and shall
be binding in all member states;
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new text begin 7. Bring and prosecute legal proceedings or actions in the name of the Commission,
provided that the standing of any state audiology or speech-language pathology licensing
board to sue or be sued under applicable law shall not be affected;
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new text begin 8. Purchase and maintain insurance and bonds;
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new text begin 9. Borrow, accept, or contract for services of personnel, including, but not limited to,
employees of a member state;
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new text begin 10. Hire employees, elect or appoint officers, fix compensation, define duties, grant
individuals appropriate authority to carry out the purposes of the Compact, and establish
the Commission's personnel policies and programs relating to conflicts of interest,
qualifications of personnel, and other related personnel matters;
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new text begin 11. Accept any and all appropriate donations and grants of money, equipment, supplies,
materials and services, and to receive, utilize and dispose of the same; provided that at all
times the Commission shall avoid any appearance of impropriety and/or conflict of interest;
new text end

new text begin 12. Lease, purchase, accept appropriate gifts or donations of, or otherwise own, hold,
improve or use, any property, real, personal, or mixed; provided that at all times the
Commission shall avoid any appearance of impropriety;
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new text begin 13. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of
any property real, personal, or mixed;
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new text begin 14. Establish a budget and make expenditures;
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new text begin 15. Borrow money;
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new text begin 16. Appoint committees, including standing committees composed of members, and
other interested persons as may be designated in this Compact and the bylaws;
new text end

new text begin 17. Provide and receive information from, and cooperate with, law enforcement agencies;
new text end

new text begin 18. Establish and elect an Executive Committee; and
new text end

new text begin 19. Perform other functions as may be necessary or appropriate to achieve the purposes
of this Compact consistent with the state regulation of audiology and speech-language
pathology licensure and practice.
new text end

new text begin D. The Executive Committee
new text end

new text begin The Executive Committee shall have the power to act on behalf of the Commission
according to the terms of this Compact.
new text end

new text begin 1. The Executive Committee shall be composed of ten members:
new text end

new text begin a. Seven voting members who are elected by the Commission from the current
membership of the Commission;
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new text begin b. Two ex-officios, consisting of one nonvoting member from a recognized national
audiology professional association and one nonvoting member from a recognized national
speech-language pathology association; and
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new text begin c. One ex-officio, nonvoting member from the recognized membership organization of
the audiology and speech-language pathology licensing boards.
new text end

new text begin E. The ex-officio members shall be selected by their respective organizations.
new text end

new text begin 1. The Commission may remove any member of the Executive Committee as provided
in bylaws.
new text end

new text begin 2. The Executive Committee shall meet at least annually.
new text end

new text begin 3. The Executive Committee shall have the following duties and responsibilities:
new text end

new text begin a. Recommend to the entire Commission changes to the rules or bylaws, changes to this
Compact legislation, fees paid by Compact member states such as annual dues, and any
commission Compact fee charged to licensees for the compact privilege;
new text end

new text begin b. Ensure Compact administration services are appropriately provided, contractual or
otherwise;
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new text begin c. Prepare and recommend the budget;
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new text begin d. Maintain financial records on behalf of the Commission;
new text end

new text begin e. Monitor Compact compliance of member states and provide compliance reports to
the Commission;
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new text begin f. Establish additional committees as necessary; and
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new text begin g. Other duties as provided in rules or bylaws.
new text end

new text begin 4. Meetings of the Commission
new text end

new text begin All meetings shall be open to the public, and public notice of meetings shall be given
in the same manner as required under the rulemaking provisions in Section 9.
new text end

new text begin 5. The Commission or the Executive Committee or other committees of the Commission
may convene in a closed, non-public meeting if the Commission or Executive Committee
or other committees of the Commission must discuss:
new text end

new text begin a. Non-compliance of a member state with its obligations under the Compact;
new text end

new text begin b. The employment, compensation, discipline, or other matters, practices, or procedures
related to specific employees or other matters related to the Commission's internal personnel
practices and procedures;
new text end

new text begin c. Current, threatened, or reasonably anticipated litigation;
new text end

new text begin d. Negotiation of contracts for the purchase, lease, or sale of goods, services, or real
estate;
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new text begin e. Accusing any person of a crime or formally censuring any person;
new text end

new text begin f. Disclosure of trade secrets or commercial or financial information that is privileged
or confidential;
new text end

new text begin g. Disclosure of information of a personal nature where disclosure would constitute a
clearly unwarranted invasion of personal privacy;
new text end

new text begin h. Disclosure of investigative records compiled for law enforcement purposes;
new text end

new text begin i. Disclosure of information related to any investigative reports prepared by or on behalf
of or for use of the Commission or other committee charged with responsibility of
investigation or determination of compliance issues pursuant to the Compact; or
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new text begin j. Matters specifically exempted from disclosure by federal or member state statute.
new text end

new text begin 6. If a meeting, or portion of a meeting, is closed pursuant to this provision, the
Commission's legal counsel or designee shall certify that the meeting may be closed and
shall reference each relevant exempting provision.
new text end

new text begin 7. The Commission shall keep minutes that fully and clearly describe all matters discussed
in a meeting and shall provide a full and accurate summary of actions taken, and the reasons
therefore, including a description of the views expressed. All documents considered in
connection with an action shall be identified in minutes. All minutes and documents of a
closed meeting shall remain under seal, subject to release by a majority vote of the
Commission or order of a court of competent jurisdiction.
new text end

new text begin 8. Financing of the Commission
new text end

new text begin a. The Commission shall pay, or provide for the payment of, the reasonable expenses
of its establishment, organization, and ongoing activities.
new text end

new text begin b. The Commission may accept any and all appropriate revenue sources, donations, and
grants of money, equipment, supplies, materials, and services.
new text end

new text begin c. The Commission may levy on and collect an annual assessment from each member
state or impose fees on other parties to cover the cost of the operations and activities of the
Commission and its staff, which must be in a total amount sufficient to cover its annual
budget as approved each year for which revenue is not provided by other sources. The
aggregate annual assessment amount shall be allocated based upon a formula to be determined
by the Commission, which shall promulgate a rule binding upon all member states.
new text end

new text begin 9. The Commission shall not incur obligations of any kind prior to securing the funds
adequate to meet the same; nor shall the Commission pledge the credit of any of the member
states, except by and with the authority of the member state.
new text end

new text begin 10. The Commission shall keep accurate accounts of all receipts and disbursements. The
receipts and disbursements of the Commission shall be subject to the audit and accounting
procedures established under its bylaws. However, all receipts and disbursements of funds
handled by the Commission shall be audited yearly by a certified or licensed public
accountant, and the report of the audit shall be included in and become part of the annual
report of the Commission.
new text end

new text begin F. Qualified Immunity, Defense, and Indemnification
new text end

new text begin 1. The members, officers, executive director, employees and representatives of the
Commission shall be immune from suit and liability, either personally or in their official
capacity, for any claim for damage to or loss of property or personal injury or other civil
liability caused by or arising out of any actual or alleged act, error, or omission that occurred,
or that the person against whom the claim is made had a reasonable basis for believing
occurred within the scope of Commission employment, duties, or responsibilities; provided
that nothing in this paragraph shall be construed to protect any person from suit or liability
for any damage, loss, injury, or liability caused by the intentional or willful or wanton
misconduct of that person.
new text end

new text begin 2. The Commission shall defend any member, officer, executive director, employee, or
representative of the Commission in any civil action seeking to impose liability arising out
of any actual or alleged act, error, or omission that occurred within the scope of Commission
employment, duties, or responsibilities, or that the person against whom the claim is made
had a reasonable basis for believing occurred within the scope of Commission employment,
duties, or responsibilities; provided that nothing herein shall be construed to prohibit that
person from retaining his or her own counsel; and provided further, that the actual or alleged
act, error, or omission did not result from that person's intentional or willful or wanton
misconduct.
new text end

new text begin 3. The Commission shall indemnify and hold harmless any member, officer, executive
director, employee, or representative of the Commission for the amount of any settlement
or judgment obtained against that person arising out of any actual or alleged act, error or
omission that occurred within the scope of Commission employment, duties, or
responsibilities, or that person had a reasonable basis for believing occurred within the scope
of Commission employment, duties, or responsibilities, provided that the actual or alleged
act, error, or omission did not result from the intentional or willful or wanton misconduct
of that person.
new text end

new text begin Section 8. Data System
new text end

new text begin A. The Commission shall provide for the development, maintenance, and utilization of
a coordinated database and reporting system containing licensure, adverse action, and
investigative information on all licensed individuals in member states.
new text end

new text begin B. Notwithstanding any other provision of state law to the contrary, a member state shall
submit a uniform data set to the data system on all individuals to whom this Compact is
applicable as required by the rules of the Commission, including:
new text end

new text begin 1. Identifying information;
new text end

new text begin 2. Licensure data;
new text end

new text begin 3. Adverse actions against a license or compact privilege;
new text end

new text begin 4. Non-confidential information related to alternative program participation;
new text end

new text begin 5. Any denial of application for licensure, and the reason(s) for denial; and
new text end

new text begin 6. Other information that may facilitate the administration of this Compact, as determined
by the rules of the Commission.
new text end

new text begin C. Investigative information pertaining to a licensee in any member state shall only be
available to other member states.
new text end

new text begin D. The Commission shall promptly notify all member states of any adverse action taken
against a licensee or an individual applying for a license. Adverse action information
pertaining to a licensee in any member state shall be available to any other member state.
new text end

new text begin E. Member states contributing information to the data system may designate information
that may not be shared with the public without the express permission of the contributing
state.
new text end

new text begin F. Any information submitted to the data system that is subsequently required to be
expunged by the laws of the member state contributing the information shall be removed
from the data system.
new text end

new text begin Section 9. Rulemaking
new text end

new text begin A. The Commission shall exercise its rulemaking powers pursuant to the criteria set
forth in this Section and the rules adopted thereunder. Rules and amendments shall become
binding as of the date specified in each rule or amendment.
new text end

new text begin B. If a majority of the legislatures of the member states rejects a rule, by enactment of
a statute or resolution in the same manner used to adopt the Compact within four years of
the date of adoption of the rule, the rule shall have no further force and effect in any member
state.
new text end

new text begin C. Rules or amendments to the rules shall be adopted at a regular or special meeting of
the Commission.
new text end

new text begin D. Prior to promulgation and adoption of a final rule or rules by the Commission, and
at least 30 days in advance of the meeting at which the rule shall be considered and voted
upon, the Commission shall file a Notice of Proposed Rulemaking:
new text end

new text begin 1. On the website of the Commission or other publicly accessible platform; and
new text end

new text begin 2. On the website of each member state audiology or speech-language pathology licensing
board or other publicly accessible platform or the publication in which each state would
otherwise publish proposed rules.
new text end

new text begin E. The Notice of Proposed Rulemaking shall include:
new text end

new text begin 1. The proposed time, date, and location of the meeting in which the rule shall be
considered and voted upon;
new text end

new text begin 2. The text of the proposed rule or amendment and the reason for the proposed rule;
new text end

new text begin 3. A request for comments on the proposed rule from any interested person; and
new text end

new text begin 4. The manner in which interested persons may submit notice to the Commission of
their intention to attend the public hearing and any written comments.
new text end

new text begin F. Prior to the adoption of a proposed rule, the Commission shall allow persons to submit
written data, facts, opinions, and arguments, which shall be made available to the public.
new text end

new text begin G. The Commission shall grant an opportunity for a public hearing before it adopts a
rule or amendment if a hearing is requested by:
new text end

new text begin 1. At least 25 persons;
new text end

new text begin 2. A state or federal governmental subdivision or agency; or
new text end

new text begin 3. An association having at least 25 members.
new text end

new text begin H. If a hearing is held on the proposed rule or amendment, the Commission shall publish
the place, time, and date of the scheduled public hearing. If the hearing is held via electronic
means, the Commission shall publish the mechanism for access to the electronic hearing.
new text end

new text begin 1. All persons wishing to be heard at the hearing shall notify the executive director of
the Commission or other designated member in writing of their desire to appear and testify
at the hearing not less than five business days before the scheduled date of the hearing.
new text end

new text begin 2. Hearings shall be conducted in a manner providing each person who wishes to comment
a fair and reasonable opportunity to comment orally or in writing.
new text end

new text begin 3. All hearings shall be recorded. A copy of the recording shall be made available on
request.
new text end

new text begin 4. Nothing in this section shall be construed as requiring a separate hearing on each rule.
Rules may be grouped for the convenience of the Commission at hearings required by this
section.
new text end

new text begin I. Following the scheduled hearing date, or by the close of business on the scheduled
hearing date if the hearing was not held, the Commission shall consider all written and oral
comments received.
new text end

new text begin J. If no written notice of intent to attend the public hearing by interested parties is
received, the Commission may proceed with promulgation of the proposed rule without a
public hearing.
new text end

new text begin K. The Commission shall, by majority vote of all members, take final action on the
proposed rule and shall determine the effective date of the rule, if any, based on the
rulemaking record and the full text of the rule.
new text end

new text begin L. Upon determination that an emergency exists, the Commission may consider and
adopt an emergency rule without prior notice, opportunity for comment, or hearing, provided
that the usual rulemaking procedures provided in the Compact and in this section shall be
retroactively applied to the rule as soon as reasonably possible, in no event later than 90
days after the effective date of the rule. For the purposes of this provision, an emergency
rule is one that must be adopted immediately in order to:
new text end

new text begin 1. Meet an imminent threat to public health, safety, or welfare;
new text end

new text begin 2. Prevent a loss of Commission or member state funds; or
new text end

new text begin 3. Meet a deadline for the promulgation of an administrative rule that is established by
federal law or rule.
new text end

new text begin M. The Commission or an authorized committee of the Commission may direct revisions
to a previously adopted rule or amendment for purposes of correcting typographical errors,
errors in format, errors in consistency, or grammatical errors. Public notice of any revisions
shall be posted on the website of the Commission. The revision shall be subject to challenge
by any person for a period of 30 days after posting. The revision may be challenged only
on grounds that the revision results in a material change to a rule. A challenge shall be made
in writing and delivered to the chair of the Commission prior to the end of the notice period.
If no challenge is made, the revision shall take effect without further action. If the revision
is challenged, the revision may not take effect without the approval of the Commission.
new text end

new text begin Section 10. Oversight, Dispute Resolution, and Enforcement
new text end

new text begin A. Dispute Resolution
new text end

new text begin 1. Upon request by a member state, the Commission shall attempt to resolve disputes
related to the Compact that arise among member states and between member and non-member
states.
new text end

new text begin 2. The Commission shall promulgate a rule providing for both mediation and binding
dispute resolution for disputes as appropriate.
new text end

new text begin B. Enforcement
new text end

new text begin 1. The Commission, in the reasonable exercise of its discretion, shall enforce the
provisions and rules of this Compact.
new text end

new text begin 2. By majority vote, the Commission may initiate legal action in the United States District
Court for the District of Columbia or the federal district where the Commission has its
principal offices against a member state in default to enforce compliance with the provisions
of the Compact and its promulgated rules and bylaws. The relief sought may include both
injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing
member shall be awarded all costs of litigation, including reasonable attorney's fees.
new text end

new text begin 3. The remedies herein shall not be the exclusive remedies of the Commission. The
Commission may pursue any other remedies available under federal or state law.
new text end

new text begin Section 11. Date of Implementation of the Interstate Commission for Audiology and
Speech-Language Pathology Practice and Associated Rules, Withdrawal, and Amendment
new text end

new text begin A. The Compact shall come into effect on the date on which the Compact statute is
enacted into law in the tenth member state. The provisions, which become effective at that
time, shall be limited to the powers granted to the Commission relating to assembly and the
promulgation of rules. Thereafter, the Commission shall meet and exercise rulemaking
powers necessary to the implementation and administration of the Compact.
new text end

new text begin B. Any state that joins the Compact subsequent to the Commission's initial adoption of
the rules shall be subject to the rules as they exist on the date on which the Compact becomes
law in that state. Any rule that has been previously adopted by the Commission shall have
the full force and effect of law on the day the Compact becomes law in that state.
new text end

new text begin C. Any member state may withdraw from this Compact by enacting a statute repealing
the same.
new text end

new text begin 1. A member state's withdrawal shall not take effect until six months after enactment of
the repealing statute.
new text end

new text begin 2. Withdrawal shall not affect the continuing requirement of the withdrawing state's
audiology or speech-language pathology licensing board to comply with the investigative
and adverse action reporting requirements of this act prior to the effective date of withdrawal.
new text end

new text begin D. Nothing contained in this Compact shall be construed to invalidate or prevent any
audiology or speech-language pathology licensure agreement or other cooperative
arrangement between a member state and a non-member state that does not conflict with
the provisions of this Compact.
new text end

new text begin E. This Compact may be amended by the member states. No amendment to this Compact
shall become effective and binding upon any member state until it is enacted into the laws
of all member states.
new text end

new text begin Section 12. Construction and Severability
new text end

new text begin This Compact shall be liberally construed so as to effectuate the purposes thereof. The
provisions of this Compact shall be severable and if any phrase, clause, sentence, or provision
of this Compact is declared to be contrary to the constitution of any member state or of the
United States or the applicability thereof to any government, agency, person, or circumstance
is held invalid, the validity of the remainder of this Compact and the applicability thereof
to any government, agency, person, or circumstance shall not be affected thereby. If this
Compact shall be held contrary to the constitution of any member state, the Compact shall
remain in full force and effect as to the remaining member states and in full force and effect
as to the member state affected as to all severable matters.
new text end

new text begin Section 13. Binding Effect of Compact and Other Laws
new text end

new text begin A. Nothing herein prevents the enforcement of any other law of a member state that is
not inconsistent with the Compact.
new text end

new text begin B. All laws in a member state in conflict with the Compact are superseded to the extent
of the conflict.
new text end

new text begin C. All lawful actions of the Commission, including all rules and bylaws promulgated
by the Commission, are binding upon the member states.
new text end

new text begin D. All agreements between the Commission and the member states are binding in
accordance with their terms.
new text end

new text begin E. In the event any provision of the Compact exceeds the constitutional limits imposed
on the legislature of any member state, the provision shall be ineffective to the extent of the
conflict with the constitutional provision in question in that member state.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective on the date on which the compact statute
is enacted into law in the tenth member state in accordance with section 11 of this Compact.
new text end

Sec. 14.

new text begin [148.5186] APPLICATION OF AUDIOLOGY AND SPEECH-LANGUAGE
PATHOLOGY INTERSTATE COMPACT TO EXISTING LAWS.
new text end

new text begin Subdivision 1. new text end

new text begin Rulemaking. new text end

new text begin Rules developed by the Audiology and Speech-Language
Pathology Compact Commission under section 148.5185 are not subject to sections 14.05
to 14.389.
new text end

new text begin Subd. 2. new text end

new text begin Background studies. new text end

new text begin The commissioner of health is authorized to require an
audiologist or speech-language pathologist licensed in Minnesota as the home state to submit
to a criminal history background check under section 144.0572.
new text end

new text begin Subd. 3. new text end

new text begin Provision of data. new text end

new text begin All provisions of section 148.5185 authorizing or requiring
the commissioner to provide data to the Audiology and Speech-Language Pathology Compact
Commission are authorized by section 144.051, subdivision 6.
new text end

Sec. 15.

new text begin [148B.75] LICENSED PROFESSIONAL COUNSELOR INTERSTATE
COMPACT.
new text end

new text begin The licensed professional counselor interstate compact is enacted into law and entered
into with all other jurisdictions legally joining in it, in the form substantially specified in
this section.
new text end

new text begin ARTICLE I
new text end

new text begin DEFINITIONS
new text end

new text begin (a) As used in this compact, and except as otherwise provided, the following definitions
shall apply.
new text end

new text begin (b) "Active duty military" means full-time duty status in the active uniformed service
of the United States, including members of the national guard and reserve on active duty
orders pursuant to United States Code, title 10, chapters 1209 and 1211.
new text end

new text begin (c) "Adverse action" means any administrative, civil, equitable, or criminal action
permitted by a state's laws which is imposed by a licensing board or other authority against
a licensed professional counselor, including actions against an individual's license or privilege
to practice such as revocation, suspension, probation, monitoring of the licensee, limitation
on the licensee's practice, or any other encumbrance on licensure affecting a licensed
professional counselor's authorization to practice, including issuance of a cease and desist
action.
new text end

new text begin (d) "Alternative program" means a non-disciplinary monitoring or practice remediation
process approved by a professional counseling licensing board to address impaired
practitioners.
new text end

new text begin (e) "Continuing competence" and "continuing education" means a requirement, as a
condition of license renewal, to provide evidence of participation in, and completion of,
educational and professional activities relevant to practice or area of work.
new text end

new text begin (f) "Counseling compact commission" or "commission" means the national administrative
body whose membership consists of all states that have enacted the compact.
new text end

new text begin (g) "Current significant investigative information" means:
new text end

new text begin (1) investigative information that a licensing board, after a preliminary inquiry that
includes notification and an opportunity for the licensed professional counselor to respond,
if required by state law, has reason to believe is not groundless and, if proved true, would
indicate more than a minor infraction; or
new text end

new text begin (2) investigative information that indicates that the licensed professional counselor
represents an immediate threat to public health and safety regardless of whether the licensed
professional counselor has been notified and had an opportunity to respond.
new text end

new text begin (h) "Data system" means a repository of information about licensees, including but not
limited to continuing education, examination, licensure, investigative, privilege to practice,
and adverse action information.
new text end

new text begin (i) "Encumbered license" means a license in which an adverse action restricts the practice
of licensed professional counseling by the licensee and said adverse action has been reported
to the National Practitioners Data Bank (NPDB).
new text end

new text begin (j) "Encumbrance" means a revocation or suspension of, or any limitation on, the full
and unrestricted practice of licensed professional counseling by a licensing board.
new text end

new text begin (k) "Executive committee" means a group of directors elected or appointed to act on
behalf of, and within the powers granted to them by, the commission.
new text end

new text begin (l) "Home state" means the member state that is the licensee's primary state of residence.
new text end

new text begin (m) "Impaired practitioner" means an individual who has a condition that may impair
their ability to practice as a licensed professional counselor without some type of intervention
and may include but is not limited to alcohol and drug dependence, mental health impairment,
and neurological or physical impairment.
new text end

new text begin (n) "Investigative information" means information, records, and documents received or
generated by a professional counseling licensing board pursuant to an investigation.
new text end

new text begin (o) "Jurisprudence requirement," if required by a member state, means the assessment
of an individual's knowledge of the laws and rules governing the practice of professional
counseling in a state.
new text end

new text begin (p) "Licensed professional counselor" means a counselor licensed by a member state,
regardless of the title used by that state, to independently assess, diagnose, and treat
behavioral health conditions.
new text end

new text begin (q) "Licensee" means an individual who currently holds an authorization from the state
to practice as a licensed professional counselor.
new text end

new text begin (r) "Licensing board" means the agency of a state, or equivalent, that is responsible for
the licensing and regulation of licensed professional counselors.
new text end

new text begin (s) "Member state" means a state that has enacted the compact.
new text end

new text begin (t) "Privilege to practice" means a legal authorization, which is equivalent to a license,
permitting the practice of professional counseling in a remote state.
new text end

new text begin (u) "Professional counseling" means the assessment, diagnosis, and treatment of
behavioral health conditions by a licensed professional counselor.
new text end

new text begin (v) "Remote state" means a member state other than the home state, where a licensee is
exercising or seeking to exercise the privilege to practice.
new text end

new text begin (w) "Rule" means a regulation promulgated by the commission that has the force of law.
new text end

new text begin (x) "Single state license" means a licensed professional counselor license issued by a
member state that authorizes practice only within the issuing state and does not include a
privilege to practice in any other member state.
new text end

new text begin (y) "State" means any state, commonwealth, district, or territory of the United States
that regulates the practice of professional counseling.
new text end

new text begin (z) "Telehealth" means the application of telecommunication technology to deliver
professional counseling services remotely to assess, diagnose, and treat behavioral health
conditions.
new text end

new text begin (aa) "Unencumbered license" means a license that authorizes a licensed professional
counselor to engage in the full and unrestricted practice of professional counseling.
new text end

new text begin ARTICLE II
new text end

new text begin STATE PARTICIPATION IN THE COMPACT
new text end

new text begin (a) To participate in the compact, a state must currently:
new text end

new text begin (1) license and regulate licensed professional counselors;
new text end

new text begin (2) require licensees to pass a nationally recognized exam approved by the commission;
new text end

new text begin (3) require licensees to have a 60 semester-hour or 90 quarter-hour master's degree in
counseling or 60 semester-hours or 90 quarter-hours of graduate coursework including the
following topic areas:
new text end

new text begin (i) professional counseling orientation and ethical practice;
new text end

new text begin (ii) social and cultural diversity;
new text end

new text begin (iii) human growth and development;
new text end

new text begin (iv) career development;
new text end

new text begin (v) counseling and helping relationships;
new text end

new text begin (vi) group counseling and group work;
new text end

new text begin (vii) diagnosis and treatment; assessment and testing;
new text end

new text begin (viii) research and program evaluation; and
new text end

new text begin (ix) other areas as determined by the commission;
new text end

new text begin (4) require licensees to complete a supervised postgraduate professional experience as
defined by the commission; and
new text end

new text begin (5) have a mechanism in place for receiving and investigating complaints about licensees.
new text end

new text begin (b) A member state shall:
new text end

new text begin (1) participate fully in the commission's data system, including using the commission's
unique identifier as defined in rules;
new text end

new text begin (2) notify the commission, in compliance with the terms of the compact and rules, of
any adverse action or the availability of investigative information regarding a licensee;
new text end

new text begin (3) implement or utilize procedures for considering the criminal history records of
applicants for an initial privilege to practice. These procedures shall include the submission
of fingerprints or other biometric-based information by applicants for the purpose of obtaining
an applicant's criminal history record information from the Federal Bureau of Investigation
and the agency responsible for retaining that state's criminal records;
new text end

new text begin (i) a member state must fully implement a criminal background check requirement,
within a timeframe established by rule, by receiving the results of the Federal Bureau of
Investigation record search and shall use the results in making licensure decisions; and
new text end

new text begin (ii) communication between a member state, the commission, and among member states
regarding the verification of eligibility for licensure through the compact shall not include
any information received from the Federal Bureau of Investigation relating to a federal
criminal records check performed by a member state under Public Law 92-544;
new text end

new text begin (4) comply with the rules of the commission;
new text end

new text begin (5) require an applicant to obtain or retain a license in the home state and meet the home
state's qualifications for licensure or renewal of licensure, as well as all other applicable
state laws;
new text end

new text begin (6) grant the privilege to practice to a licensee holding a valid unencumbered license in
another member state in accordance with the terms of the compact and rules; and
new text end

new text begin (7) provide for the attendance of the state's commissioner to the counseling compact
commission meetings.
new text end

new text begin (c) Member states may charge a fee for granting the privilege to practice.
new text end

new text begin (d) Individuals not residing in a member state shall continue to be able to apply for a
member state's single state license as provided under the laws of each member state. However,
the single state license granted to these individuals shall not be recognized as granting a
privilege to practice professional counseling in any other member state.
new text end

new text begin (e) Nothing in this compact shall affect the requirements established by a member state
for the issuance of a single state license.
new text end

new text begin (f) A license issued to a licensed professional counselor by a home state to a resident in
that state shall be recognized by each member state as authorizing a licensed professional
counselor to practice professional counseling, under a privilege to practice, in each member
state.
new text end

new text begin ARTICLE III
new text end

new text begin PRIVILEGE TO PRACTICE
new text end

new text begin (a) To exercise the privilege to practice under the terms and provisions of the compact,
the licensee shall:
new text end

new text begin (1) hold a license in the home state;
new text end

new text begin (2) have a valid United States Social Security number or national practitioner identifier;
new text end

new text begin (3) be eligible for a privilege to practice in any member state in accordance with this
article, paragraphs (d), (g), and (h);
new text end

new text begin (4) have not had any encumbrance or restriction against any license or privilege to
practice within the previous two years;
new text end

new text begin (5) notify the commission that the licensee is seeking the privilege to practice within a
remote state(s);
new text end

new text begin (6) pay any applicable fees, including any state fee, for the privilege to practice;
new text end

new text begin (7) meet any continuing competence or education requirements established by the home
state;
new text end

new text begin (8) meet any jurisprudence requirements established by the remote state in which the
licensee is seeking a privilege to practice; and
new text end

new text begin (9) report to the commission any adverse action, encumbrance, or restriction on license
taken by any nonmember state within 30 days from the date the action is taken.
new text end

new text begin (b) The privilege to practice is valid until the expiration date of the home state license.
The licensee must comply with the requirements of this article, paragraph (a), to maintain
the privilege to practice in the remote state.
new text end

new text begin (c) A licensee providing professional counseling in a remote state under the privilege
to practice shall adhere to the laws and regulations of the remote state.
new text end

new text begin (d) A licensee providing professional counseling services in a remote state is subject to
that state's regulatory authority. A remote state may, in accordance with due process and
that state's laws, remove a licensee's privilege to practice in the remote state for a specific
period of time, impose fines, or take any other necessary actions to protect the health and
safety of its citizens. The licensee may be ineligible for a privilege to practice in any member
state until the specific time for removal has passed and all fines are paid.
new text end

new text begin (e) If a home state license is encumbered, the licensee shall lose the privilege to practice
in any remote state until the following occur:
new text end

new text begin (1) the home state license is no longer encumbered; and
new text end

new text begin (2) have not had any encumbrance or restriction against any license or privilege to
practice within the previous two years.
new text end

new text begin (f) Once an encumbered license in the home state is restored to good standing, the
licensee must meet the requirements of this article, paragraph (a), to obtain a privilege to
practice in any remote state.
new text end

new text begin (g) If a licensee's privilege to practice in any remote state is removed, the individual
may lose the privilege to practice in all other remote states until the following occur:
new text end

new text begin (1) the specific period of time for which the privilege to practice was removed has ended;
new text end

new text begin (2) all fines have been paid; and
new text end

new text begin (3) have not had any encumbrance or restriction against any license or privilege to
practice within the previous two years.
new text end

new text begin (h) Once the requirements of this article, paragraph (g), have been met, the licensee must
meet the requirements in this article, paragraph (g), to obtain a privilege to practice in a
remote state.
new text end

new text begin ARTICLE IV
new text end

new text begin OBTAINING A NEW HOME STATE LICENSE BASED ON A PRIVILEGE TO
PRACTICE
new text end

new text begin (a) A licensed professional counselor may hold a home state license, which allows for
a privilege to practice in other member states, in only one member state at a time.
new text end

new text begin (b) If a licensed professional counselor changes primary state of residence by moving
between two member states:
new text end

new text begin (1) the licensed professional counselor shall file an application for obtaining a new home
state license based on a privilege to practice, pay all applicable fees, and notify the current
and new home state in accordance with applicable rules adopted by the commission;
new text end

new text begin (2) upon receipt of an application for obtaining a new home state license by virtue of a
privilege to practice, the new home state shall verify that the licensed professional counselor
meets the pertinent criteria outlined in article III via the data system, without need for
primary source verification, except for:
new text end

new text begin (i) a Federal Bureau of Investigation fingerprint-based criminal background check if not
previously performed or updated pursuant to applicable rules adopted by the commission
in accordance with Public Law 92-544;
new text end

new text begin (ii) other criminal background checks as required by the new home state; and
new text end

new text begin (iii) completion of any requisite jurisprudence requirements of the new home state;
new text end

new text begin (3) the former home state shall convert the former home state license into a privilege to
practice once the new home state has activated the new home state license in accordance
with applicable rules adopted by the commission;
new text end

new text begin (4) notwithstanding any other provision of this compact, if the licensed professional
counselor cannot meet the criteria in article V, the new home state may apply its requirements
for issuing a new single state license; and
new text end

new text begin (5) the licensed professional counselor shall pay all applicable fees to the new home
state in order to be issued a new home state license.
new text end

new text begin (c) If a licensed professional counselor changes primary state of residence by moving
from a member state to a nonmember state, or from a nonmember state to a member state,
the state criteria shall apply for issuance of a single state license in the new state.
new text end

new text begin (d) Nothing in this compact shall interfere with a licensee's ability to hold a single state
license in multiple states, however, for the purposes of this compact, a licensee shall have
only one home state license.
new text end

new text begin (e) Nothing in this compact shall affect the requirements established by a member state
for the issuance of a single state license.
new text end

new text begin ARTICLE V
new text end

new text begin ACTIVE DUTY MILITARY PERSONNEL OR THEIR SPOUSES
new text end

new text begin Active duty military personnel, or their spouse, shall designate a home state where the
individual has a current license in good standing. The individual may retain the home state
designation during the period the service member is on active duty. Subsequent to designating
a home state, the individual shall only change their home state through application for
licensure in the new state or through the process outlined in article IV.
new text end

new text begin ARTICLE VI
new text end

new text begin COMPACT PRIVILEGE TO PRACTICE TELEHEALTH
new text end

new text begin (a) Member states shall recognize the right of a licensed professional counselor, licensed
by a home state in accordance with article II and under rules promulgated by the commission,
to practice professional counseling in any member state via telehealth under a privilege to
practice as provided in the compact and rules promulgated by the commission.
new text end

new text begin (b) A licensee providing professional counseling services in a remote state under the
privilege to practice shall adhere to the laws and regulations of the remote state.
new text end

new text begin ARTICLE VII
new text end

new text begin ADVERSE ACTIONS
new text end

new text begin (a) In addition to the other powers conferred by state law, a remote state shall have the
authority, in accordance with existing state due process law, to:
new text end

new text begin (1) take adverse action against a licensed professional counselor's privilege to practice
within that member state; and
new text end

new text begin (2) issue subpoenas for both hearings and investigations that require the attendance and
testimony of witnesses as well as the production of evidence. Subpoenas issued by a licensing
board in a member state for the attendance and testimony of witnesses or the production of
evidence from another member state shall be enforced in the latter state by any court of
competent jurisdiction according to the practice and procedure of that court applicable to
subpoenas issued in proceedings pending before it. The issuing authority shall pay any
witness fees, travel expenses, mileage, and other fees required by the service statutes of the
state in which the witnesses or evidence are located.
new text end

new text begin (b) Only the home state shall have the power to take adverse action against a licensed
professional counselor's license issued by the home state.
new text end

new text begin (c) For purposes of taking adverse action, the home state shall give the same priority
and effect to reported conduct received from a member state as it would if the conduct had
occurred within the home state. In so doing, the home state shall apply its own state laws
to determine appropriate action.
new text end

new text begin (d) The home state shall complete any pending investigations of a licensed professional
counselor who changes primary state of residence during the course of the investigations.
The home state shall also have the authority to take appropriate action and shall promptly
report the conclusions of the investigations to the administrator of the data system. The
administrator of the coordinated licensure information system shall promptly notify the new
home state of any adverse actions.
new text end

new text begin (e) A member state, if otherwise permitted by state law, may recover from the affected
licensed professional counselor the costs of investigations and dispositions of cases resulting
from any adverse action taken against that licensed professional counselor.
new text end

new text begin (f) A member state may take adverse action based on the factual findings of the remote
state, provided that the member state follows its own procedures for taking the adverse
action.
new text end

new text begin (g) Joint investigations:
new text end

new text begin (1) in addition to the authority granted to a member state by its respective professional
counseling practice act or other applicable state law, any member state may participate with
other member states in joint investigations of licensees; and
new text end

new text begin (2) member states shall share any investigative, litigation, or compliance materials in
furtherance of any joint or individual investigation initiated under the compact.
new text end

new text begin (h) If adverse action is taken by the home state against the license of a licensed
professional counselor, the licensed professional counselor's privilege to practice in all other
member states shall be deactivated until all encumbrances have been removed from the
state license. All home state disciplinary orders that impose adverse action against the license
of a licensed professional counselor shall include a statement that the licensed professional
counselor's privilege to practice is deactivated in all member states during the pendency of
the order.
new text end

new text begin (i) If a member state takes adverse action, it shall promptly notify the administrator of
the data system. The administrator of the data system shall promptly notify the home state
of any adverse actions by remote states.
new text end

new text begin (j) Nothing in this compact shall override a member state's decision that participation
in an alternative program may be used in lieu of adverse action.
new text end

new text begin ARTICLE VIII
new text end

new text begin ESTABLISHMENT OF COUNSELING COMPACT COMMISSION
new text end

new text begin (a) The compact member states hereby create and establish a joint public agency known
as the counseling compact commission:
new text end

new text begin (1) the commission is an instrumentality of the compact states;
new text end

new text begin (2) venue is proper and judicial proceedings by or against the commission shall be
brought solely and exclusively in a court of competent jurisdiction where the principal office
of the commission is located. The commission may waive venue and jurisdictional defenses
to the extent it adopts or consents to participate in alternative dispute resolution proceedings;
and
new text end

new text begin (3) nothing in this compact shall be construed to be a waiver of sovereign immunity.
new text end

new text begin (b) Membership, voting, and meetings:
new text end

new text begin (1) each member state shall have and be limited to one delegate selected by that member
state's licensing board;
new text end

new text begin (2) the delegate shall be either:
new text end

new text begin (i) a current member of the licensing board at the time of appointment who is a licensed
professional counselor or public member; or
new text end

new text begin (ii) an administrator of the licensing board;
new text end

new text begin (3) any delegate may be removed or suspended from office as provided by the law of
the state from which the delegate is appointed;
new text end

new text begin (4) the member state licensing board shall fill any vacancy occurring on the commission
within 60 days;
new text end

new text begin (5) each delegate shall be entitled to one vote with regard to the promulgation of rules
and creation of bylaws and shall otherwise have an opportunity to participate in the business
and affairs of the commission;
new text end

new text begin (6) a delegate shall vote in person or by such other means as provided in the bylaws.
The bylaws may provide for delegates' participation in meetings by telephone or other means
of communication;
new text end

new text begin (7) the commission shall meet at least once during each calendar year. Additional
meetings shall be held as set forth in the bylaws; and
new text end

new text begin (8) the commission shall by rule establish a term of office for delegates and may by rule
establish term limits.
new text end

new text begin (c) The commission shall have the following powers and duties:
new text end

new text begin (1) establish the fiscal year of the commission;
new text end

new text begin (2) establish bylaws;
new text end

new text begin (3) maintain its financial records in accordance with the bylaws;
new text end

new text begin (4) meet and take such actions as are consistent with the provisions of this compact and
the bylaws;
new text end

new text begin (5) promulgate rules which shall be binding to the extent and in the manner provided
for in the compact;
new text end

new text begin (6) bring and prosecute legal proceedings or actions in the name of the commission,
provided that the standing of any state licensing board to sue or be sued under applicable
law shall not be affected;
new text end

new text begin (7) purchase and maintain insurance and bonds;
new text end

new text begin (8) borrow, accept, or contract for services of personnel, including but not limited to
employees of a member state;
new text end

new text begin (9) hire employees, elect or appoint officers, fix compensation, define duties, grant such
individuals appropriate authority to carry out the purposes of the compact, and establish the
commission's personnel policies and programs relating to conflicts of interest, qualifications
of personnel, and other related personnel matters;
new text end

new text begin (10) accept any and all appropriate donations and grants of money, equipment, supplies,
materials, and services and to receive, utilize, and dispose of the same; provided that at all
times the commission shall avoid any appearance of impropriety and conflict of interest;
new text end

new text begin (11) lease, purchase, accept appropriate gifts or donations of, or otherwise to own, hold,
improve, or use any property, real, personal, or mixed; provided that at all times the
commission shall avoid any appearance of impropriety;
new text end

new text begin (12) sell convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of
any property real, personal, or mixed;
new text end

new text begin (13) establish a budget and make expenditures;
new text end

new text begin (14) borrow money;
new text end

new text begin (15) appoint committees, including standing committees composed of members, state
regulators, state legislators or their representatives, and consumer representatives, and such
other interested persons as may be designated in this compact and the bylaws;
new text end

new text begin (16) provide and receive information from, and cooperate with, law enforcement agencies;
new text end

new text begin (17) establish and elect an executive committee; and
new text end

new text begin (18) perform such other functions as may be necessary or appropriate to achieve the
purposes of this compact consistent with the state regulation of professional counseling
licensure and practice.
new text end

new text begin (d) The executive committee:
new text end

new text begin (1) The executive committee shall have the power to act on behalf of the commission
according to the terms of this compact;
new text end

new text begin (2) The executive committee shall be composed of up to eleven members:
new text end

new text begin (i) seven voting members who are elected by the commission from the current
membership of the commission;
new text end

new text begin (ii) up to four ex-officio, nonvoting members from four recognized national professional
counselor organizations; and
new text end

new text begin (iii) the ex-officio members will be selected by their respective organizations;
new text end

new text begin (3) The commission may remove any member of the executive committee as provided
in bylaws;
new text end

new text begin (4) The executive committee shall meet at least annually; and
new text end

new text begin (5) The executive committee shall have the following duties and responsibilities:
new text end

new text begin (i) recommend to the entire commission changes to the rules or bylaws, changes to this
compact legislation, fees paid by compact member states such as annual dues, and any
commission compact fee charged to licensees for the privilege to practice;
new text end

new text begin (ii) ensure compact administration services are appropriately provided, contractual or
otherwise;
new text end

new text begin (iii) prepare and recommend the budget;
new text end

new text begin (iv) maintain financial records on behalf of the commission;
new text end

new text begin (v) monitor compact compliance of member states and provide compliance reports to
the commission;
new text end

new text begin (vi) establish additional committees as necessary; and
new text end

new text begin (vii) other duties as provided in rules or bylaws.
new text end

new text begin (e) Meetings of the commission:
new text end

new text begin (1) all meetings shall be open to the public, and public notice of meetings shall be given
in the same manner as required under the rulemaking provisions in article X;
new text end

new text begin (2) the commission or the executive committee or other committees of the commission
may convene in a closed, non-public meeting if the commission or executive committee or
other committees of the commission must discuss:
new text end

new text begin (i) non-compliance of a member state with its obligations under the compact;
new text end

new text begin (ii) the employment, compensation, discipline, or other matters, practices, or procedures
related to specific employees or other matters related to the commission's internal personnel
practices and procedures;
new text end

new text begin (iii) current, threatened, or reasonably anticipated litigation;
new text end

new text begin (iv) negotiation of contracts for the purchase, lease, or sale of goods, services, or real
estate;
new text end

new text begin (v) accusing any person of a crime or formally censuring any person;
new text end

new text begin (vi) disclosure of trade secrets or commercial or financial information that is privileged
or confidential;
new text end

new text begin (vii) disclosure of information of a personal nature where disclosure would constitute a
clearly unwarranted invasion of personal privacy;
new text end

new text begin (viii) disclosure of investigative records compiled for law enforcement purposes;
new text end

new text begin (ix) disclosure of information related to any investigative reports prepared by or on
behalf of or for use of the commission or other committee charged with responsibility of
investigation or determination of compliance issues pursuant to the compact; or
new text end

new text begin (x) matters specifically exempted from disclosure by federal or member state statute;
new text end

new text begin (3) if a meeting, or portion of a meeting, is closed pursuant to this provision, the
commission's legal counsel or designee shall certify that the meeting may be closed and
shall reference each relevant exempting provision; and
new text end

new text begin (4) the commission shall keep minutes that fully and clearly describe all matters discussed
in a meeting and shall provide a full and accurate summary of actions taken and the reasons
therefore, including a description of the views expressed. All documents considered in
connection with an action shall be identified in such minutes. All minutes and documents
of a closed meeting shall remain under seal, subject to release by a majority vote of the
commission or order of a court of competent jurisdiction.
new text end

new text begin (f) Financing of the commission:
new text end

new text begin (i) the commission shall pay, or provide for the payment of, the reasonable expenses of
its establishment, organization, and ongoing activities;
new text end

new text begin (ii) the commission may accept any and all appropriate revenue sources, donations, and
grants of money, equipment, supplies, materials, and services;
new text end

new text begin (iii) the commission may levy on and collect an annual assessment from each member
state or impose fees on other parties to cover the cost of the operations and activities of the
commission and its staff, which must be in a total amount sufficient to cover its annual
budget as approved each year for which revenue is not provided by other sources. The
aggregate annual assessment amount shall be allocated based upon a formula to be determined
by the commission, which shall promulgate a rule binding upon all member states;
new text end

new text begin (iv) the commission shall not incur obligations of any kind prior to securing the funds
adequate to meet the same; nor shall the commission pledge the credit of any of the member
states, except by and with the authority of the member state; and
new text end

new text begin (v) the commission shall keep accurate accounts of all receipts and disbursements. The
receipts and disbursements of the commission shall be subject to the audit and accounting
procedures established under its bylaws. However, all receipts and disbursements of funds
handled by the commission shall be audited yearly by a certified or licensed public
accountant, and the report of the audit shall be included in and become part of the annual
report of the commission.
new text end

new text begin (g) Qualified immunity, defense, and indemnification:
new text end

new text begin (1) the members, officers, executive director, employees, and representatives of the
commission shall be immune from suit and liability, either personally or in their official
capacity, for any claim for damage to or loss of property or personal injury or other civil
liability caused by or arising out of any actual or alleged act, error, or omission that occurred,
or that the person against whom the claim is made had a reasonable basis for believing
occurred within the scope of commission employment, duties or responsibilities; provided
that nothing in this paragraph shall be construed to protect any such person from suit or
liability for any damage, loss, injury, or liability caused by the intentional or willful or
wanton misconduct of that person;
new text end

new text begin (2) the commission shall defend any member, officer, executive director, employee or
representative of the commission in any civil action seeking to impose liability arising out
of any actual or alleged act, error, or omission that occurred within the scope of commission
employment, duties, or responsibilities, or that the person against whom the claim is made
had a reasonable basis for believing occurred within the scope of commission employment,
duties, or responsibilities; provided that nothing herein shall be construed to prohibit that
person from retaining his or her own counsel; and provided further, that the actual or alleged
act, error, or omission did not result from that person's intentional or willful or wanton
misconduct; and
new text end

new text begin (3) the commission shall indemnify and hold harmless any member, officer, executive
director, employee, or representative of the commission for the amount of any settlement
or judgment obtained against that person arising out of any actual or alleged act, error, or
omission that occurred within the scope of commission employment, duties, or
responsibilities, or that such person had a reasonable basis for believing occurred within
the scope of commission employment, duties, or responsibilities, provided that the actual
or alleged act, error, or omission did not result from the intentional or willful or wanton
misconduct of that person.
new text end

new text begin ARTICLE IX
new text end

new text begin DATA SYSTEM
new text end

new text begin (a) The commission shall provide for the development, maintenance, operation, and
utilization of a coordinated database and reporting system containing licensure, adverse
action, and investigative information on all licensed individuals in member states.
new text end

new text begin (b) Notwithstanding any other provision of state law to the contrary, a member state
shall submit a uniform data set to the data system on all individuals to whom this compact
is applicable as required by the rules of the commission, including:
new text end

new text begin (1) identifying information;
new text end

new text begin (2) licensure data;
new text end

new text begin (3) adverse actions against a license or privilege to practice;
new text end

new text begin (4) nonconfidential information related to alternative program participation;
new text end

new text begin (5) any denial of application for licensure and the reason for such denial;
new text end

new text begin (6) current significant investigative information; and
new text end

new text begin (7) other information that may facilitate the administration of this compact, as determined
by the rules of the commission.
new text end

new text begin (c) Investigative information pertaining to a licensee in any member state will only be
available to other member states.
new text end

new text begin (d) The commission shall promptly notify all member states of any adverse action taken
against a licensee or an individual applying for a license. Adverse action information
pertaining to a licensee in any member state will be available to any other member state.
new text end

new text begin (e) Member states contributing information to the data system may designate information
that may not be shared with the public without the express permission of the contributing
state.
new text end

new text begin (f) Any information submitted to the data system that is subsequently required to be
expunged by the laws of the member state contributing the information shall be removed
from the data system.
new text end

new text begin ARTICLE X
new text end

new text begin RULEMAKING
new text end

new text begin (a) The commission shall promulgate reasonable rules in order to effectively and
efficiently achieve the purpose of the compact. Notwithstanding the foregoing, in the event
the commission exercises its rulemaking authority in a manner that is beyond the scope of
the purposes of the compact, or the powers granted hereunder, then such an action by the
commission shall be invalid and have no force or effect.
new text end

new text begin (b) The commission shall exercise its rulemaking powers pursuant to the criteria set
forth in this article and the rules adopted thereunder. Rules and amendments shall become
binding as of the date specified in each rule or amendment.
new text end

new text begin (c) If a majority of the legislatures of the member states rejects a rule, by enactment of
a statute or resolution in the same manner used to adopt the compact within four years of
the date of adoption of the rule, then such rule shall have no further force and effect in any
member state.
new text end

new text begin (d) Rules or amendments to the rules shall be adopted at a regular or special meeting of
the commission.
new text end

new text begin (e) Prior to promulgation and adoption of a final rule or rules by the commission, and
at least thirty days in advance of the meeting at which the rule will be considered and voted
upon, the commission shall file a notice of proposed rulemaking:
new text end

new text begin (1) on the website of the commission or other publicly accessible platform; and
new text end

new text begin (2) on the website of each member state professional counseling licensing board or other
publicly accessible platform or the publication in which each state would otherwise publish
proposed rules.
new text end

new text begin (f) The notice of proposed rulemaking shall include:
new text end

new text begin (1) the proposed time, date, and location of the meeting in which the rule will be
considered and voted upon;
new text end

new text begin (2) the text of the proposed rule or amendment and the reason for the proposed rule;
new text end

new text begin (3) a request for comments on the proposed rule from any interested person; and
new text end

new text begin (4) the manner in which interested persons may submit notice to the commission of their
intention to attend the public hearing and any written comments.
new text end

new text begin (g) Prior to adoption of a proposed rule, the commission shall allow persons to submit
written data, facts, opinions, and arguments, which shall be made available to the public.
new text end

new text begin (h) The commission shall grant an opportunity for a public hearing before it adopts a
rule or amendment if a hearing is requested by:
new text end

new text begin (1) at least 25 persons;
new text end

new text begin (2) a state or federal governmental subdivision or agency; or
new text end

new text begin (3) an association having at least 25 members.
new text end

new text begin (i) If a hearing is held on the proposed rule or amendment, the commission shall publish
the place, time, and date of the scheduled public hearing. If the hearing is held via electronic
means, the commission shall publish the mechanism for access to the electronic hearing:
new text end

new text begin (1) all persons wishing to be heard at the hearing shall notify the executive director of
the commission or other designated member in writing of their desire to appear and testify
at the hearing not less than five business days before the scheduled date of the hearing;
new text end

new text begin (2) hearings shall be conducted in a manner providing each person who wishes to
comment a fair and reasonable opportunity to comment orally or in writing;
new text end

new text begin (3) all hearings will be recorded. A copy of the recording will be made available on
request; and
new text end

new text begin (4) nothing in this article shall be construed as requiring a separate hearing on each rule.
Rules may be grouped for the convenience of the commission at hearings required by this
article.
new text end

new text begin (j) Following the scheduled hearing date, or by the close of business on the scheduled
hearing date if the hearing was not held, the commission shall consider all written and oral
comments received.
new text end

new text begin (k) If no written notice of intent to attend the public hearing by interested parties is
received, the commission may proceed with promulgation of the proposed rule without a
public hearing.
new text end

new text begin (l) The commission shall, by majority vote of all members, take final action on the
proposed rule and shall determine the effective date of the rule, if any, based on the
rulemaking record and the full text of the rule.
new text end

new text begin (m) Upon determination that an emergency exists, the commission may consider and
adopt an emergency rule without prior notice, opportunity for comment, or hearing, provided
that the usual rulemaking procedures provided in the compact and in this article shall be
retroactively applied to the rule as soon as reasonably possible, in no event later than 90
days after the effective date of the rule. For the purposes of this provision, an emergency
rule is one that must be adopted immediately in order to:
new text end

new text begin (1) meet an imminent threat to public health, safety, or welfare;
new text end

new text begin (2) prevent a loss of commission or member state funds;
new text end

new text begin (3) meet a deadline for the promulgation of an administrative rule that is established by
federal law or rule; or
new text end

new text begin (4) protect public health and safety.
new text end

new text begin (n) The commission or an authorized committee of the commission may direct revisions
to a previously adopted rule or amendment for purposes of correcting typographical errors,
errors in format, errors in consistency, or grammatical errors. Public notice of any revisions
shall be posted on the website of the commission. The revision shall be subject to challenge
by any person for a period of thirty days after posting. The revision may be challenged only
on grounds that the revision results in a material change to a rule. A challenge shall be made
in writing and delivered to the chair of the commission prior to the end of the notice period.
If no challenge is made, the revision will take effect without further action. If the revision
is challenged, the revision may not take effect without the approval of the commission.
new text end

new text begin ARTICLE XI
new text end

new text begin OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT
new text end

new text begin (a) Oversight:
new text end

new text begin (1) the executive, legislative, and judicial branches of state government in each member
state shall enforce this compact and take all actions necessary and appropriate to effectuate
the compact's purposes and intent. The provisions of this compact and the rules promulgated
hereunder shall have standing as statutory law;
new text end

new text begin (2) all courts shall take judicial notice of the compact and the rules in any judicial or
administrative proceeding in a member state pertaining to the subject matter of this compact
which may affect the powers, responsibilities, or actions of the commission; and
new text end

new text begin (3) the commission shall be entitled to receive service of process in any such proceeding
and shall have standing to intervene in such a proceeding for all purposes. Failure to provide
service of process to the commission shall render a judgment or order void as to the
commission, this compact, or promulgated rules.
new text end

new text begin (b) Default, technical assistance, and termination:
new text end

new text begin (1) if the commission determines that a member state has defaulted in the performance
of its obligations or responsibilities under this compact or the promulgated rules, the
commission shall:
new text end

new text begin (i) provide written notice to the defaulting state and other member states of the nature
of the default, the proposed means of curing the default, or any other action to be taken by
the commission; and
new text end

new text begin (ii) provide remedial training and specific technical assistance regarding the default.
new text end

new text begin (c) If a state in default fails to cure the default, the defaulting state may be terminated
from the compact upon an affirmative vote of a majority of the member states, and all rights,
privileges, and benefits conferred by this compact may be terminated on the effective date
of termination. A cure of the default does not relieve the offending state of obligations or
liabilities incurred during the period of default.
new text end

new text begin (d) Termination of membership in the compact shall be imposed only after all other
means of securing compliance have been exhausted. Notice of intent to suspend or terminate
shall be given by the commission to the governor, the majority and minority leaders of the
defaulting state's legislature, and each of the member states.
new text end

new text begin (e) A state that has been terminated is responsible for all assessments, obligations, and
liabilities incurred through the effective date of termination, including obligations that
extend beyond the effective date of termination.
new text end

new text begin (f) The commission shall not bear any costs related to a state that is found to be in default
or that has been terminated from the compact, unless agreed upon in writing between the
commission and the defaulting state.
new text end

new text begin (g) The defaulting state may appeal the action of the commission by petitioning the
United States District Court for the District of Columbia or the federal district where the
commission has its principal offices. The prevailing member shall be awarded all costs of
such litigation, including reasonable attorney's fees.
new text end

new text begin (h) Dispute resolution:
new text end

new text begin (1) Upon request by a member state, the commission shall attempt to resolve disputes
related to the compact that arise among member states and between member and nonmember
states; and
new text end

new text begin (2) the commission shall promulgate a rule providing for both mediation and binding
dispute resolution for such disputes as appropriate.
new text end

new text begin (i) Enforcement:
new text end

new text begin (1) The commission, in the reasonable exercise of its discretion, shall enforce the
provisions and rules of this compact;
new text end

new text begin (2) by majority vote, the commission may initiate legal action in the United States District
Court for the District of Columbia or the federal district where the commission has its
principal offices against a member state in default to enforce compliance with the provisions
of the compact and its promulgated rules and bylaws. The relief sought may include both
injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing
member shall be awarded all costs of such litigation, including reasonable attorney's fees;
and
new text end

new text begin (3) the remedies herein shall not be the exclusive remedies of the commission. The
commission may pursue any other remedies available under federal or state law.
new text end

new text begin ARTICLE XII
new text end

new text begin DATE OF IMPLEMENTATION OF THE COUNSELING COMPACT COMMISSION
AND ASSOCIATED RULES, WITHDRAWAL, AND AMENDMENT
new text end

new text begin (a) The compact shall come into effect on the date on which the compact statute is
enacted into law in the tenth member state. The provisions, which become effective at that
time, shall be limited to the powers granted to the commission relating to assembly and the
promulgation of rules. Thereafter, the commission shall meet and exercise rulemaking
powers necessary to the implementation and administration of the compact.
new text end

new text begin (b) Any state that joins the compact subsequent to the commission's initial adoption of
the rules shall be subject to the rules as they exist on the date on which the compact becomes
law in that state. Any rule that has been previously adopted by the commission shall have
the full force and effect of law on the day the compact becomes law in that state.
new text end

new text begin (c) Any member state may withdraw from this compact by enacting a statute repealing
the same.
new text end

new text begin (1) a member state's withdrawal shall not take effect until six months after enactment
of the repealing statute; and
new text end

new text begin (2) withdrawal shall not affect the continuing requirement of the withdrawing state's
professional counseling licensing board to comply with the investigative and adverse action
reporting requirements of this act prior to the effective date of withdrawal.
new text end

new text begin (d) Nothing contained in this compact shall be construed to invalidate or prevent any
professional counseling licensure agreement or other cooperative arrangement between a
member state and a nonmember state that does not conflict with the provisions of this
compact.
new text end

new text begin (e) This compact may be amended by the member states. No amendment to this compact
shall become effective and binding upon any member state until it is enacted into the laws
of all member states.
new text end

new text begin ARTICLE XIII
new text end

new text begin CONSTRUCTION AND SEVERABILITY
new text end

new text begin This compact shall be liberally construed so as to effectuate the purposes thereof. The
provisions of this compact shall be severable and if any phrase, clause, sentence, or provision
of this compact is declared to be contrary to the constitution of any member state or of the
United States or the applicability thereof to any government, agency, person, or circumstance
is held invalid, the validity of the remainder of this compact and the applicability thereof
to any government, agency, person, or circumstance shall not be affected thereby. If this
compact shall be held contrary to the constitution of any member state, the compact shall
remain in full force and effect as to the remaining member states and in full force and effect
as to the member state affected as to all severable matters.
new text end

new text begin ARTICLE XIV
new text end

new text begin BINDING EFFECT OF COMPACT AND OTHER LAWS
new text end

new text begin (a) A licensee providing professional counseling services in a remote state under the
privilege to practice shall adhere to the laws and regulations, including scope of practice,
of the remote state.
new text end

new text begin (b) Nothing herein prevents the enforcement of any other law of a member state that is
not inconsistent with the compact.
new text end

new text begin (c) Any laws in a member state in conflict with the compact are superseded to the extent
of the conflict.
new text end

new text begin (d) Any lawful actions of the commission, including all rules and bylaws properly
promulgated by the commission, are binding upon the member states.
new text end

new text begin (e) All permissible agreements between the commission and the member states are
binding in accordance with their terms.
new text end

new text begin (f) In the event any provision of the compact exceeds the constitutional limits imposed
on the legislature of any member state, the provision shall be ineffective to the extent of the
conflict with the constitutional provision in question in that member state.
new text end

Sec. 16.

Minnesota Statutes 2020, section 150A.10, subdivision 1a, is amended to read:

Subd. 1a.

Collaborative practice authorization for dental hygienists in community
settings.

(a) Notwithstanding subdivision 1, a dental hygienist licensed under this chapter
may be employed or retained by a health care facility, program, deleted text begin or deleted text end nonprofit organization new text begin ,
or licensed dentist new text end to perform the dental hygiene services listed in Minnesota Rules, part
3100.8700, subpart 1, without the patient first being examined by a licensed dentist if the
dental hygienist:

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

(2) has documented completion of a course on medical emergencies within each
continuing education cycle.

(b) 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 deleted text begin assure the deleted text end new text begin ensure new text end efficacy deleted text begin of the sealants after application deleted text end ; and

(5) the procedure for creating and maintaining dental records for patients who are treated
by the dental hygienist under Minnesota Rules, part 3100.9600, including specifying where
records will be located.

deleted text begin 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.
deleted text end

new text begin (c) The collaborative agreement must be:
new text end

new text begin (1) signed and maintained by the dentist; the dental hygienist; and the facility, program,
or organization;
new text end

new text begin (2) reviewed annually by the collaborating dentist and the dental hygienist; and
new text end

new text begin (3) made available to the board upon request.
new text end

deleted text begin (c) deleted text end new text begin (d) new text end 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. When the patient requires a referral for
additional dental services, the dental hygienist shall complete a referral form and provide
a copy to the patient, the facility, if applicable, the dentist to whom the patient is being
referred, and the collaborating dentist, if specified in the collaborative agreement. A copy
of the referral form shall be maintained in the patient's health care record. The patient does
not become a new patient of record of the dentist to whom the patient was referred until the
dentist accepts the patient for follow-up services after referral from the dental hygienist.

deleted text begin (d) deleted text end new text begin (e) new text end For the purposes of this subdivision, a "health care facility, program, or nonprofit
organization" includes 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; new text begin a state agency administered public
health program or event; new text end 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.

deleted text begin (e) deleted text end new text begin (f) new text end 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.

new text begin (g) A collaborative practice dental hygienist must be reimbursed for all services performed
through a health care facility, program, nonprofit organization, or licensed dentist.
new text end

new text begin (h) The commissioner of human services shall report annually, beginning February 15,
2023, and each February 15 thereafter, to the Board of Dentistry on the services provided
by collaborative practice dental hygienists to medical assistance and MinnesotaCare enrollees
during the previous calendar year. The information reported must include, at a minimum,
the geographic location and type of setting at which care was delivered, the number of
medical assistance and MinnesotaCare patients served, and the characteristics of the patient
population.
new text end

Sec. 17.

Minnesota Statutes 2020, section 150A.105, subdivision 8, is amended to read:

Subd. 8.

Definitions.

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

(b) "Practice settings that serve the low-income and underserved" mean:

(1) critical access dental provider settings as designated by the commissioner of human
services under section 256B.76, subdivision 4;

(2) dental hygiene collaborative practice settings identified in section 150A.10,
subdivision 1a, paragraph deleted text begin (d) deleted text end new text begin (e) new text end , and including medical facilities, assisted living facilities,
federally qualified health centers, and organizations eligible to receive a community clinic
grant under section 145.9268, subdivision 1;

(3) military and veterans administration hospitals, clinics, and care settings;

(4) a patient's residence or home when the patient is home-bound or receiving or eligible
to receive home care services or home and community-based waivered services, regardless
of the patient's income;

(5) oral health educational institutions; or

(6) any other clinic or practice setting, including mobile dental units, in which at least
50 percent of the total patient base of the dental therapist or advanced dental therapist
consists of patients who:

(i) are enrolled in a Minnesota health care program;

(ii) have a medical disability or chronic condition that creates a significant barrier to
receiving dental care;

(iii) do not have dental health coverage, either through a public health care program or
private insurance, and have an annual gross family income equal to or less than 200 percent
of the federal poverty guidelines; or

(iv) do not have dental health coverage, either through a state public health care program
or private insurance, and whose family gross income is equal to or less than 200 percent of
the federal poverty guidelines.

(c) "Dental health professional shortage area" means an area that meets the criteria
established by the secretary of the United States Department of Health and Human Services
and is designated as such under United States Code, title 42, section 254e.

Sec. 18.

Minnesota Statutes 2020, section 151.065, subdivision 1, is amended to read:

Subdivision 1.

Application fees.

Application fees for licensure and registration are as
follows:

(1) pharmacist licensed by examination, $175;

(2) pharmacist licensed by reciprocity, $275;

(3) pharmacy intern, $50;

(4) pharmacy technician, $50;

(5) pharmacy, $260;

(6) drug wholesaler, legend drugs only, $5,260;

(7) drug wholesaler, legend and nonlegend drugs, $5,260;

(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $5,260;

(9) drug wholesaler, medical gases, deleted text begin $5,260 for the first facility and deleted text end $260 deleted text begin for each
additional facility deleted text end ;

(10) third-party logistics provider, $260;

(11) drug manufacturer, nonopiate legend drugs only, $5,260;

(12) drug manufacturer, nonopiate legend and nonlegend drugs, $5,260;

(13) drug manufacturer, nonlegend or veterinary legend drugs, $5,260;

(14) drug manufacturer, medical gases, deleted text begin $5,260 for the first facility and deleted text end $260 deleted text begin for each
additional facility deleted text end ;

(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $5,260;

(16) drug manufacturer of opiate-containing controlled substances listed in section
152.02, subdivisions 3 to 5, $55,260;

(17) medical gas dispenser, $260;

(18) controlled substance researcher, $75; and

(19) pharmacy professional corporation, $150.

Sec. 19.

Minnesota Statutes 2020, section 151.065, subdivision 3, is amended to read:

Subd. 3.

Annual renewal fees.

Annual licensure and registration renewal fees are as
follows:

(1) pharmacist, $175;

(2) pharmacy technician, $50;

(3) pharmacy, $260;

(4) drug wholesaler, legend drugs only, $5,260;

(5) drug wholesaler, legend and nonlegend drugs, $5,260;

(6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $5,260;

(7) drug wholesaler, medical gases, deleted text begin $5,260 for the first facility and deleted text end $260 deleted text begin for each
additional facility deleted text end ;

(8) third-party logistics provider, $260;

(9) drug manufacturer, nonopiate legend drugs only, $5,260;

(10) drug manufacturer, nonopiate legend and nonlegend drugs, $5,260;

(11) drug manufacturer, nonlegend, veterinary legend drugs, or both, $5,260;

(12) drug manufacturer, medical gases, deleted text begin $5,260 for the first facility and deleted text end $260 deleted text begin for each
additional facility deleted text end ;

(13) drug manufacturer, also licensed as a pharmacy in Minnesota, $5,260;

(14) drug manufacturer of opiate-containing controlled substances listed in section
152.02, subdivisions 3 to 5, $55,260;

(15) medical gas dispenser, $260;

(16) controlled substance researcher, $75; and

(17) pharmacy professional corporation, $100.

Sec. 20.

Minnesota Statutes 2020, section 151.065, subdivision 7, is amended to read:

Subd. 7.

Deposit of fees.

(a) The license fees collected under this section, with the
exception of the fees identified in paragraphs (b) and (c), shall be deposited in the state
government special revenue fund.

(b) $5,000 of each fee collected under subdivision 1, clauses (6) to deleted text begin (9) deleted text end new text begin (8) new text end , deleted text begin and deleted text end (11) to
new text begin (13), and new text end (15), and subdivision 3, clauses (4) to deleted text begin (7) deleted text end new text begin (6) new text end , deleted text begin and deleted text end (9) to new text begin (11), and new text end (13), and $55,000
of each fee collected under subdivision 1, clause (16), and subdivision 3, clause (14), shall
be deposited in the opiate epidemic response fund established in section 256.043.

(c) If the fees collected under subdivision 1, clause (16), or subdivision 3, clause (14),
are reduced under section 256.043, $5,000 of the reduced fee shall be deposited in the opiate
epidemic response fund in section 256.043.

Sec. 21.

Minnesota Statutes 2020, section 152.125, is amended to read:

152.125 INTRACTABLE PAIN.

Subdivision 1.

deleted text begin Definition deleted text end new text begin Definitions new text end .

new text begin (a) new text end For purposes of this section, new text begin the terms in this
subdivision have the meanings given.
new text end

new text begin (b) "Drug diversion" means the unlawful transfer of prescription drugs from their licit
medical purpose to the illicit marketplace.
new text end

new text begin (c) new text end "Intractable pain" means a pain state in which the cause of the pain cannot be removed
or otherwise treated with the consent of the patient and in which, in the generally accepted
course of medical practice, no relief or cure of the cause of the pain is possible, or none has
been found after reasonable efforts. new text begin Conditions associated with intractable pain include but
are not limited to cancer and the recovery period, sickle cell disease, noncancer pain, rare
diseases, orphan diseases, severe injuries, and health conditions requiring the provision of
palliative care or hospice care. new text end Reasonable efforts for relieving or curing the cause of the
pain may be determined on the basis of, but are not limited to, the following:

(1) when treating a nonterminally ill patient for intractable pain, new text begin an new text end evaluation new text begin conducted
new text end by the attending physician new text begin , advanced practice registered nurse, or physician assistant new text end and
one or more physicians new text begin , advanced practice registered nurses, or physician assistants new text end
specializing in pain medicine or the treatment of the area, system, or organ of the body
new text begin confirmed or new text end perceived as the source of the new text begin intractable new text end pain; or

(2) when treating a terminally ill patient, new text begin an new text end evaluation new text begin conducted new text end by the attending
physician new text begin , advanced practice registered nurse, or physician assistant new text end who does so in
accordance with new text begin the standard of care and new text end the level of care, skill, and treatment that would
be recognized by a reasonably prudent physician new text begin , advanced practice registered nurse, or
physician assistant new text end under similar conditions and circumstances.

new text begin (d) "Palliative care" has the meaning provided in section 144A.75, subdivision 12.
new text end

new text begin (e) "Rare disease" means a disease, disorder, or condition that affects fewer than 200,000
individuals in the United States and is chronic, serious, life altering, or life threatening.
new text end

new text begin Subd. 1a. new text end

new text begin Criteria for the evaluation and treatment of intractable pain. new text end

new text begin The evaluation
and treatment of intractable pain when treating a nonterminally ill patient is governed by
the following criteria:
new text end

new text begin (1) a diagnosis of intractable pain by the treating physician, advanced practice registered
nurse, or physician assistant and either by a physician, advanced practice registered nurse,
or physician assistant specializing in pain medicine or a physician, advanced practice
registered nurse, or physician assistant treating the area, system, or organ of the body that
is the source of the pain is sufficient to meet the definition of intractable pain; and
new text end

new text begin (2) the cause of the diagnosis of intractable pain must not interfere with medically
necessary treatment including but not limited to prescribing or administering a controlled
substance in Schedules II to V of section 152.02.
new text end

Subd. 2.

Prescription and administration of controlled substances for intractable
pain.

new text begin (a) new text end Notwithstanding any other provision of this chapter, a physician new text begin , advanced practice
registered nurse, or physician assistant new text end may prescribe or administer a controlled substance
in Schedules II to V of section 152.02 to deleted text begin an individual deleted text end new text begin a patient new text end in the course of the
physician's new text begin , advanced practice registered nurse's, or physician assistant's new text end treatment of the
deleted text begin individual deleted text end new text begin patient new text end for a diagnosed condition causing intractable pain. No physician new text begin , advanced
practice registered nurse, or physician assistant new text end shall be subject to disciplinary action by
the Board of Medical Practice new text begin or Board of Nursing new text end for appropriately prescribing or
administering a controlled substance in Schedules II to V of section 152.02 in the course
of treatment of deleted text begin an individual deleted text end new text begin a patient new text end for intractable pain, provided the physician new text begin , advanced
practice registered nurse, or physician assistant:
new text end

new text begin (1) new text end keeps accurate records of the purpose, use, prescription, and disposal of controlled
substances, writes accurate prescriptions, and prescribes medications in conformance with
chapter 147 deleted text begin . deleted text end new text begin or 148 or in accordance with the current standard of care; and
new text end

new text begin (2) enters into a patient-provider agreement that meets the criteria in subdivision 5.
new text end

new text begin (b) No physician, advanced practice registered nurse, or physician assistant, acting in
good faith and based on the needs of the patient, shall be subject to any civil or criminal
action or investigation, disenrollment, or termination by the commissioner of health or
human services solely for prescribing a dosage that equates to an upward deviation from
morphine milligram equivalent dosage recommendations or thresholds specified in state or
federal opioid prescribing guidelines or policies, including but not limited to the Guideline
for Prescribing Opioids for Chronic Pain issued by the Centers for Disease Control and
Prevention, Minnesota opioid prescribing guidelines, the Minnesota opioid prescribing
improvement program, and the Minnesota quality improvement program established under
section 256B.0638.
new text end

new text begin (c) A physician, advanced practice registered nurse, or physician assistant treating
intractable pain by prescribing, dispensing, or administering a controlled substance in
Schedules II to V of section 152.02 that includes but is not limited to opioid analgesics must
not taper a patient's medication dosage solely to meet a predetermined morphine milligram
equivalent dosage recommendation or threshold if the patient is stable and compliant with
the treatment plan, is experiencing no serious harm from the level of medication currently
being prescribed or previously prescribed, and is in compliance with the patient-provider
agreement as described in subdivision 5.
new text end

new text begin (d) A physician's, advanced practice registered nurse's, or physician assistant's decision
to taper a patient's medication dosage must be based on factors other than a morphine
milligram equivalent recommendation or threshold.
new text end

new text begin (e) No pharmacist, health plan company, or pharmacy benefit manager shall refuse to
fill a prescription for an opiate issued by a licensed practitioner with the authority to prescribe
opiates solely based on the prescription exceeding a predetermined morphine milligram
equivalent dosage recommendation or threshold.
new text end

Subd. 3.

Limits on applicability.

This section does not apply to:

(1) a physician's new text begin , advanced practice registered nurse's, or physician assistant's new text end treatment
of deleted text begin an individual deleted text end new text begin a patient new text end for chemical dependency resulting from the use of controlled
substances in Schedules II to V of section 152.02;

(2) the prescription or administration of controlled substances in Schedules II to V of
section 152.02 to deleted text begin an individual deleted text end new text begin a patient new text end whom the physician new text begin , advanced practice registered
nurse, or physician assistant new text end knows to be using the controlled substances for nontherapeutic
new text begin or drug diversion new text end purposes;

(3) the prescription or administration of controlled substances in Schedules II to V of
section 152.02 for the purpose of terminating the life of deleted text begin an individual deleted text end new text begin a patient new text end having
intractable pain; or

(4) the prescription or administration of a controlled substance in Schedules II to V of
section 152.02 that is not a controlled substance approved by the United States Food and
Drug Administration for pain relief.

Subd. 4.

Notice of risks.

Prior to treating deleted text begin an individual deleted text end new text begin a patient new text end for intractable pain in
accordance with subdivision 2, a physician new text begin , advanced practice registered nurse, or physician
assistant new text end shall discuss with the deleted text begin individual deleted text end new text begin patient or the patient's legal guardian, if applicable, new text end
the risks associated with the controlled substances in Schedules II to V of section 152.02
to be prescribed or administered in the course of the physician's new text begin , advanced practice registered
nurse's, or physician assistant's new text end treatment of deleted text begin an individual deleted text end new text begin a patient new text end , and document the
discussion in the deleted text begin individual's deleted text end new text begin patient's new text end record new text begin as required in the patient-provider agreement
described in subdivision 5 new text end .

new text begin Subd. 5. new text end

new text begin Patient-provider agreement. new text end

new text begin (a) Before treating a patient for intractable pain,
a physician, advanced practice registered nurse, or physician assistant and the patient or the
patient's legal guardian, if applicable, must mutually agree to the treatment and enter into
a provider-patient agreement. The agreement must include a description of the prescriber's
and the patient's expectations, responsibilities, and rights according to best practices and
current standards of care.
new text end

new text begin (b) The agreement must be signed by the patient or the patient's legal guardian, if
applicable, and the physician, advanced practice registered nurse, or physician assistant and
included in the patient's medical records. A copy of the signed agreement must be provided
to the patient.
new text end

new text begin (c) The agreement must be reviewed by the patient and the physician, advanced practice
registered nurse, or physician assistant annually. If there is a change in the patient's treatment
plan, the agreement must be updated and a revised agreement must be signed by the patient
or the patient's legal guardian. A copy of the revised agreement must be included in the
patient's medical record and a copy must be provided to the patient.
new text end

new text begin (d) A patient-provider agreement is not required in an emergency or inpatient hospital
setting.
new text end

Sec. 22. new text begin APPROPRIATION.
new text end

new text begin $157,000 in fiscal year 2023 is appropriated from the state government special revenue
fund to the Board of Nursing for the purposes of implementing Minnesota Statutes, section
148.2855. The base for this appropriation is $6,000 in fiscal year 2024 and $6,000 in fiscal
year 2025.
new text end

Sec. 23. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2020, section 147.02, subdivision 2a, new text end new text begin is repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

ARTICLE 4

MINNESOTA HEALTH AND EDUCATION FACILITIES AUTHORITY

Section 1.

Minnesota Statutes 2020, section 3.732, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

As used in this section and section 3.736 the terms defined
in this section have the meanings given them.

(1) "State" includes each of the departments, boards, agencies, commissions, courts, and
officers in the executive, legislative, and judicial branches of the state of Minnesota and
includes but is not limited to the Housing Finance Agency, the Minnesota Office of Higher
Education, the deleted text begin Higher deleted text end new text begin Health and new text end Education Facilities Authority, the Health Technology
Advisory Committee, the Armory Building Commission, the Zoological Board, the
Department of Iron Range Resources and Rehabilitation, the Minnesota Historical Society,
the State Agricultural Society, the University of Minnesota, the Minnesota State Colleges
and Universities, state hospitals, and state penal institutions. It does not include a city, town,
county, school district, or other local governmental body corporate and politic.

(2) "Employee of the state" means all present or former officers, members, directors, or
employees of the state, members of the Minnesota National Guard, members of a bomb
disposal unit approved by the commissioner of public safety and employed by a municipality
defined in section 466.01 when engaged in the disposal or neutralization of bombs or other
similar hazardous explosives, as defined in section 299C.063, outside the jurisdiction of the
municipality but within the state, or persons acting on behalf of the state in an official
capacity, temporarily or permanently, with or without compensation. It does not include
either an independent contractor except, for purposes of this section and section 3.736 only,
a guardian ad litem acting under court appointment, or members of the Minnesota National
Guard while engaged in training or duty under United States Code, title 10, or title 32,
section 316, 502, 503, 504, or 505, as amended through December 31, 1983. Notwithstanding
sections 43A.02 and 611.263, for purposes of this section and section 3.736 only, "employee
of the state" includes a district public defender or assistant district public defender in the
Second or Fourth Judicial District, a member of the Health Technology Advisory Committee,
and any officer, agent, or employee of the state of Wisconsin performing work for the state
of Minnesota pursuant to a joint state initiative.

(3) "Scope of office or employment" means that the employee was acting on behalf of
the state in the performance of duties or tasks lawfully assigned by competent authority.

(4) "Judicial branch" has the meaning given in section 43A.02, subdivision 25.

Sec. 2.

Minnesota Statutes 2021 Supplement, section 10A.01, subdivision 35, is amended
to read:

Subd. 35.

Public official.

"Public official" means any:

(1) member of the legislature;

(2) individual employed by the legislature as secretary of the senate, legislative auditor,
director of the Legislative Budget Office, chief clerk of the house of representatives, revisor
of statutes, or researcher, legislative analyst, fiscal analyst, or attorney in the Office of
Senate Counsel, Research and Fiscal Analysis, House Research, or the House Fiscal Analysis
Department;

(3) constitutional officer in the executive branch and the officer's chief administrative
deputy;

(4) solicitor general or deputy, assistant, or special assistant attorney general;

(5) commissioner, deputy commissioner, or assistant commissioner of any state
department or agency as listed in section 15.01 or 15.06, or the state chief information
officer;

(6) member, chief administrative officer, or deputy chief administrative officer of a state
board or commission that has either the power to adopt, amend, or repeal rules under chapter
14, or the power to adjudicate contested cases or appeals under chapter 14;

(7) individual employed in the executive branch who is authorized to adopt, amend, or
repeal rules under chapter 14 or adjudicate contested cases under chapter 14;

(8) executive director of the State Board of Investment;

(9) deputy of any official listed in clauses (7) and (8);

(10) judge of the Workers' Compensation Court of Appeals;

(11) administrative law judge or compensation judge in the State Office of Administrative
Hearings or unemployment law judge in the Department of Employment and Economic
Development;

(12) member, regional administrator, division director, general counsel, or operations
manager of the Metropolitan Council;

(13) member or chief administrator of a metropolitan agency;

(14) director of the Division of Alcohol and Gambling Enforcement in the Department
of Public Safety;

(15) member or executive director of the deleted text begin Higher deleted text end new text begin Health and new text end Education Facilities
Authority;

(16) member of the board of directors or president of Enterprise Minnesota, Inc.;

(17) member of the board of directors or executive director of the Minnesota State High
School League;

(18) member of the Minnesota Ballpark Authority established in section 473.755;

(19) citizen member of the Legislative-Citizen Commission on Minnesota Resources;

(20) manager of a watershed district, or member of a watershed management organization
as defined under section 103B.205, subdivision 13;

(21) supervisor of a soil and water conservation district;

(22) director of Explore Minnesota Tourism;

(23) citizen member of the Lessard-Sams Outdoor Heritage Council established in section
97A.056;

(24) citizen member of the Clean Water Council established in section 114D.30;

(25) member or chief executive of the Minnesota Sports Facilities Authority established
in section 473J.07;

(26) district court judge, appeals court judge, or supreme court justice;

(27) county commissioner;

(28) member of the Greater Minnesota Regional Parks and Trails Commission;

(29) member of the Destination Medical Center Corporation established in section
469.41; or

(30) chancellor or member of the Board of Trustees of the Minnesota State Colleges
and Universities.

Sec. 3.

Minnesota Statutes 2020, section 136A.25, is amended to read:

136A.25 CREATION.

A state agency known as the Minnesota deleted text begin Higher deleted text end new text begin Health and new text end Education Facilities Authority
is hereby created.

Sec. 4.

Minnesota Statutes 2020, section 136A.26, is amended to read:

136A.26 MEMBERSHIPS; OFFICERS; COMPENSATION; REMOVAL.

Subdivision 1.

Membership.

The Minnesota deleted text begin Higher deleted text end new text begin Health and new text end Education Facilities
Authority shall consist of deleted text begin eight deleted text end new text begin nine new text end members appointed by the governor with the advice
and consent of the senate, and a representative of the deleted text begin office deleted text end new text begin Office of Higher Education new text end .

All members to be appointed by the governor shall be residents of the state. At least two
members must reside outside the metropolitan area as defined in section 473.121, subdivision
2. At least one of the members shall be a person having a favorable reputation for skill,
knowledge, and experience in the field of state and municipal finance; deleted text begin and deleted text end at least one shall
be a person having a favorable reputation for skill, knowledge, and experience in the building
construction field; deleted text begin and deleted text end at least one of the members shall be a trustee, director, officer, or
employee of an institution of higher education new text begin ; and at least one of the members shall be a
trustee, director, officer, or employee of a health care organization new text end .

Subd. 1a.

Private College Council member.

The president of the Minnesota Private
College Council, or the president's designee, shall serve without compensation as an advisory,
nonvoting member of the authority.

new text begin Subd. 1b. new text end

new text begin Nonprofit health care association member. new text end

new text begin The chief executive officer of
a Minnesota nonprofit membership association whose members are primarily nonprofit
health care organizations, or the chief executive officer's designee, shall serve without
compensation as an advisory, nonvoting member of the authority. The identity of the
Minnesota nonprofit membership association shall be determined and may be changed from
time to time by the members of the authority in accordance with and as shall be provided
in the bylaws of the authority.
new text end

Subd. 2.

Term; compensation; removal.

The membership terms, compensation, removal
of members, and filling of vacancies for authority members other than the representative
of the office, deleted text begin and deleted text end the president of the Private College Council, new text begin or the chief executive officer
of the Minnesota nonprofit membership association described in subdivision 1b new text end shall be as
provided in section 15.0575.

Sec. 5.

Minnesota Statutes 2020, section 136A.27, is amended to read:

136A.27 POLICY.

It is hereby declared that for the benefit of the people of the state, the increase of their
commerce, welfare and prosperity and the improvement of their health and living conditions
it is essential that new text begin health care organizations within the state be provided with appropriate
additional means to establish, acquire, construct, improve, and expand health care facilities
in furtherance of their purposes; that new text end this and future generations of youth be given the fullest
opportunity to learn and to develop their intellectual and mental capacities; deleted text begin that it is essential deleted text end
that institutions of higher education within the state be provided with appropriate additional
means to assist such youth in achieving the required levels of learning and development of
their intellectual and mental capacities new text begin ; new text end and new text begin that health care organizations and institutions
of higher education new text end be enabled to refinance outstanding indebtedness incurred to provide
existing facilities used for such purposes in order to preserve and enhance the utilization of
facilities for purposes of new text begin health care and new text end higher education, to extend or adjust maturities in
relation to the resources available for their payment, and to save interest costs and thereby
reduce new text begin health care costs or higher education new text end tuition, fees new text begin , new text end and charges deleted text begin ; and deleted text end new text begin . It is hereby
further declared new text end that it is the purpose of sections 136A.25 to 136A.42 to provide a measure
of assistance and an alternative method to enable new text begin health care organizations and new text end institutions
of higher education in the state to provide the facilities and structures which are sorely
needed to accomplish the purposes of sections 136A.25 to 136A.42, all to the public benefit
and good, to the extent and manner provided herein.

Sec. 6.

Minnesota Statutes 2020, section 136A.28, is amended to read:

136A.28 DEFINITIONS.

Subdivision 1.

Scope.

In sections 136A.25 to 136A.42, the following words and terms
shall, unless the context otherwise requires, have the meanings ascribed to them.

new text begin Subd. 1a. new text end

new text begin Affiliate. new text end

new text begin "Affiliate" means an entity that directly or indirectly controls, is
controlled by, or is under common control with, another entity. For the purposes of this
subdivision, "control" means either the power to elect a majority of the members of the
governing body of an entity or the power, whether by contract or otherwise, to direct the
management and policies of the entity. Affiliate also means an entity whose business or
substantially all of whose property is operated under a lease, management agreement, or
operating agreement by another entity, or an entity who operates the business or substantially
all of the property of another entity under a lease, management agreement, or operating
agreement.
new text end

Subd. 2.

Authority.

"Authority" means the deleted text begin Higher deleted text end new text begin Health and new text end Education Facilities
Authority created by sections 136A.25 to 136A.42.

Subd. 3.

Project.

"Project" means deleted text begin a structure or structures available for use as a dormitory
or other student housing facility, a dining hall, student union, administration building,
academic building, library, laboratory, research facility, classroom, athletic facility, health
care facility, child care facility, and maintenance, storage, or utility facility and other
structures or facilities related thereto or required or useful for the instruction of students or
the conducting of research or the operation of an institution of higher education, whether
proposed, under construction, or completed, including parking and other facilities or
structures essential or convenient for the orderly conduct of such institution for higher
education, and shall also include landscaping, site preparation, furniture, equipment and
machinery, and other similar items necessary or convenient for the operation of a particular
facility or structure in the manner for which its use is intended but shall not include such
items as books, fuel, supplies, or other items the costs of which are customarily deemed to
result in a current operating charge, and shall deleted text end new text begin a health care facility or an education facility
whether proposed, under construction, or completed, and includes land or interests in land,
appurtenances, site preparation, landscaping, buildings and structures, systems, fixtures,
furniture, machinery, equipment, and parking. Project also includes other structures, facilities,
improvements, machinery, equipment, and means of transport of a capital nature that are
necessary or convenient for the operation of the facility. Project does new text end not include new text begin : (1) new text end any
facility used or to be used for sectarian instruction or as a place of religious worship deleted text begin nor deleted text end new text begin ;
(2) new text end any facility which is used or to be used primarily in connection with any part of the
program of a school or department of divinity for any religious denomination new text begin ; nor (3) any
books, supplies, medicine, medical supplies, fuel, or other items, the cost of which are
customarily deemed to result in a current operating charge new text end .

Subd. 4.

Cost.

"Cost," as applied to a project or any portion thereof financed under the
provisions of sections 136A.25 to 136A.42, means all or any part of the cost of construction,
acquisition, alteration, enlargement, reconstruction and remodeling of a project including
all lands, structures, real or personal property, rights, rights-of-way, franchises, easements
and interests acquired or used for or in connection with a project, the cost of demolishing
or removing any buildings or structures on land so acquired, including the cost of acquiring
any lands to which deleted text begin such deleted text end buildings or structures may be moved, the cost of all machinery
and equipment, financing charges, interest prior to, during and for a period after completion
of such construction and acquisition, provisions for reserves for principal and interest and
for extensions, enlargements, additions and improvements, the cost of architectural,
engineering, financial and legal services, plans, specifications, studies, surveys, estimates
of cost and of revenues, administrative expenses, expenses necessary or incident to
determining the feasibility or practicability of constructing the project and such other
expenses as may be necessary or incident to the construction and acquisition of the project,
the financing of such construction and acquisition and the placing of the project in operation.

Subd. 5.

Bonds.

"Bonds," or "revenue bonds" means revenue bonds of the authority
issued under the provisions of sections 136A.25 to 136A.42, including revenue refunding
bonds, notwithstanding that the same may be secured by mortgage or the full faith and credit
of a participating institution deleted text begin for higher education deleted text end or any other lawfully pledged security of
a participating institution deleted text begin for higher education deleted text end .

Subd. 6.

Institution of higher education.

"Institution of higher education" means a
nonprofit educational institution within the state authorized to provide a program of education
beyond the high school level.

new text begin Subd. 6a. new text end

new text begin Health care organization. new text end

new text begin (a) "Health care organization" means a nonprofit
organization located within the state and authorized by law to operate a nonprofit health
care facility in the state. Health care organization also means a nonprofit affiliate of a health
care organization as defined under this paragraph, provided the affiliate is located within
the state or within a state that is geographically contiguous to Minnesota.
new text end

new text begin (b) Health care organization also means a nonprofit organization located within another
state that is geographically contiguous to Minnesota and authorized by law to operate a
nonprofit health care facility in that state, provided that the nonprofit organization located
within the contiguous state is an affiliate of a health care organization located within the
state.
new text end

new text begin Subd. 6b. new text end

new text begin Education facility. new text end

new text begin "Education facility" means a structure or structures
available for use as a dormitory or other student housing facility, dining hall, student union,
administration building, academic building, library, laboratory, research facility, classroom,
athletic facility, student health care facility, or child care facility, and includes other facilities
or structures related thereto essential or convenient for the orderly conduct of an institution
of higher education.
new text end

new text begin Subd. 6c. new text end

new text begin Health care facility. new text end

new text begin (a) "Health care facility" means a structure or structures
available for use within this state as a hospital, clinic, psychiatric residential treatment
facility, birth center, outpatient surgical center, comprehensive outpatient rehabilitation
facility, outpatient physical therapy or speech pathology facility, end-stage renal dialysis
facility, medical laboratory, pharmacy, radiation therapy facility, diagnostic imaging facility,
medical office building, residence for nurses or interns, nursing home, boarding care home,
assisted living facility, residential hospice, intermediate care facility for persons with
developmental disabilities, supervised living facility, housing with services establishment,
board and lodging establishment with special services, adult day care center, day services
facility, prescribed pediatric extended care facility, community residential setting, adult
foster home, or other facility related to medical or health care research, or the delivery or
administration of health care services, and includes other structures or facilities related
thereto essential or convenient for the orderly conduct of a health care organization.
new text end

new text begin (b) Health care facility also means a facility in a state that is geographically contiguous
to Minnesota operated by a health care organization that corresponds by purpose, function,
or use with a facility listed in paragraph (a).
new text end

Subd. 7.

Participating institution deleted text begin of higher education deleted text end .

"Participating institution deleted text begin of
higher education deleted text end " means new text begin a health care organization or new text end an institution of higher education
that, under the provisions of sections 136A.25 to 136A.42, undertakes the financing and
construction or acquisition of a project or undertakes the refunding or refinancing of
obligations or of a mortgage or of advances as provided in sections 136A.25 to 136A.42.
Community colleges and technical colleges may be considered participating institutions deleted text begin of
higher education deleted text end for the purpose of financing and constructing child care facilities and
parking facilities.

Sec. 7.

Minnesota Statutes 2020, section 136A.29, subdivision 1, is amended to read:

Subdivision 1.

Purpose.

The purpose of the authority shall be to assist new text begin health care
organizations and new text end institutions of higher education in the construction, financing, and
refinancing of projects. The exercise by the authority of the powers conferred by sections
136A.25 to 136A.42, shall be deemed and held to be the performance of an essential public
function. For the purpose of sections 136A.25 to 136A.42, the authority shall have the
powers and duties set forth in subdivisions 2 to 23.

Sec. 8.

Minnesota Statutes 2020, section 136A.29, subdivision 3, is amended to read:

Subd. 3.

Employees.

The authority is authorized and empowered to appoint and employ
employees as it may deem necessary to carry out its duties, determine the title of the
employees so employed, and fix the salary of deleted text begin said deleted text end new text begin its new text end employees. Employees of the authority
shall participate in retirement and other benefits in the same manner that employees in the
deleted text begin unclassified service of the office deleted text end new text begin managerial plan under section 43A.18, subdivision 3, new text end
participate.

Sec. 9.

Minnesota Statutes 2020, section 136A.29, subdivision 6, is amended to read:

Subd. 6.

Projects; generally.

new text begin (a) new text end The authority is authorized and empowered to determine
the location and character of any project to be financed under the provisions of sections
136A.25 to 136A.42, and to construct, reconstruct, remodel, maintain, manage, enlarge,
alter, add to, repair, operate, lease, as lessee or lessor, and regulate the same, to enter into
contracts for any or all of such purposes, to enter into contracts for the management and
operation of a project, and to designate a participating institution deleted text begin of higher education deleted text end as its
agent to determine the location and character of a project undertaken by such participating
institution deleted text begin of higher education deleted text end under the provisions of sections 136A.25 to 136A.42 and as
the agent of the authority, to construct, reconstruct, remodel, maintain, manage, enlarge,
alter, add to, repair, operate, lease, as lessee or lessor, and regulate the same, and as the
agent of the authority, to enter into contracts for any or all of such purposes, including
contracts for the management and operation of such project.

new text begin (b) Notwithstanding paragraph (a), a project involving a health care facility within the
state financed under sections 136A.25 to 136A.42, must comply with all applicable
requirements in state law related to authorizing construction of or modifications to a health
care facility, including the requirements of sections 144.5509, 144.551, 144A.071, and
252.291.
new text end

new text begin (c) new text end Contracts of the authority or of a participating institution deleted text begin of higher education deleted text end to
acquire or to construct, reconstruct, remodel, maintain, enlarge, alter, add to, or repair
projects shall not be subject to the provisions of chapter 16C or section 574.26, or any other
public contract or competitive bid law.

Sec. 10.

Minnesota Statutes 2020, section 136A.29, subdivision 9, is amended to read:

Subd. 9.

Revenue bonds; limit.

new text begin (a) new text end The authority is authorized and empowered to issue
revenue bonds whose aggregate principal amount at any time shall not exceed deleted text begin $1,300,000,000 deleted text end new text begin
$4,000,000,000 new text end and to issue notes, bond anticipation notes, and revenue refunding bonds
of the authority under the provisions of sections 136A.25 to 136A.42, to provide funds for
acquiring, constructing, reconstructing, enlarging, remodeling, renovating, improving,
furnishing, or equipping one or more projects or parts thereof.

new text begin (b) Of the $4,000,000,000 limit in paragraph (a), the aggregate principal amount used
to fund education facilities may not exceed $1,750,000,000 at any time, and the aggregate
principal amount used to fund health care facilities may not exceed $2,250,000,000 at any
time.
new text end

Sec. 11.

Minnesota Statutes 2020, section 136A.29, subdivision 10, is amended to read:

Subd. 10.

Revenue bonds; issuance, purpose, conditions.

The authority is authorized
and empowered to issue revenue bonds to acquire projects from or to make loans to
participating institutions deleted text begin of higher education deleted text end and thereby refinance outstanding indebtedness
incurred by participating institutions deleted text begin of higher education deleted text end to provide funds for the acquisition,
construction or improvement of a facility before or after the enactment of sections 136A.25
to 136A.42, but otherwise eligible to be and being a project thereunder, whenever the
authority finds that such refinancing will enhance or preserve such participating institutions
and such facilities or utilization thereof for new text begin health care or new text end educational purposes or extend
or adjust maturities to correspond to the resources available for their payment, or reduce
new text begin charges or fees imposed on patients or occupants, or new text end the tuition, charges new text begin , new text end or fees imposed
on students for the use new text begin or occupancy new text end of the facilities of such participating institutions deleted text begin of
higher education deleted text end or costs met by federal or state public funds, or enhance or preserve new text begin health
care or new text end educational programs and research or the acquisition or improvement of other
facilities eligible to be a project or part thereof by the participating institution deleted text begin of higher
education deleted text end . The amount of revenue bonds to be issued to refinance outstanding indebtedness
of a participating institution deleted text begin of higher education deleted text end shall not exceed the lesser of (a) the fair
value of the project to be acquired by the authority from the institution or mortgaged to the
authority by the institution or (b) the amount of the outstanding indebtedness including any
premium thereon and any interest accrued or to accrue to the date of redemption and any
legal, fiscal and related costs in connection with such refinancing and reasonable reserves,
as determined by the authority. The provisions of this subdivision do not prohibit the authority
from issuing revenue bonds within and charged against the limitations provided in subdivision
9 to provide funds for improvements, alteration, renovation, or extension of the project
refinanced.

Sec. 12.

Minnesota Statutes 2020, section 136A.29, subdivision 14, is amended to read:

Subd. 14.

Rules for use of projects.

The authority is authorized and empowered to
establish rules for the use of a project or any portion thereof and to designate a participating
institution deleted text begin of higher education deleted text end as its agent to establish rules for the use of a project undertaken
for such participating institution deleted text begin of higher education deleted text end .

Sec. 13.

Minnesota Statutes 2020, section 136A.29, subdivision 19, is amended to read:

Subd. 19.

Surety.

Before the issuance of any revenue bonds under the provisions of
sections 136A.25 to 136A.42, any member or officer of the authority authorized by resolution
of the authority to handle funds or sign checks of the authority shall be covered under a
surety or fidelity bond in an amount to be determined by the authority. Each such bond shall
be conditioned upon the faithful performance of the duties of the office of the member or
officer, new text begin and new text end shall be executed by a surety company authorized to transact business in the
state of Minnesota as surety. The cost of each such bond shall be paid by the authority.

Sec. 14.

Minnesota Statutes 2020, section 136A.29, subdivision 20, is amended to read:

Subd. 20.

Sale, lease, and disposal of property.

The authority is authorized and
empowered to sell, lease, release new text begin , new text end or otherwise dispose of real and personal property or
interests therein, or a combination thereof, acquired by the authority under authority of
sections 136A.25 to 136A.42 and no longer needed for the purposes of deleted text begin such deleted text end new text begin this new text end chapter or
of the authority, and grant such easements and other rights in, over, under, or across a project
as will not interfere with its use of deleted text begin such deleted text end new text begin the new text end property. deleted text begin Such deleted text end new text begin The new text end sale, lease, release,
disposition, or grant may be made without competitive bidding and in deleted text begin such deleted text end new text begin the new text end manner new text begin and new text end
for such consideration as the authority in its judgment deems appropriate.

Sec. 15.

Minnesota Statutes 2020, section 136A.29, subdivision 21, is amended to read:

Subd. 21.

Loans.

The authority is authorized and empowered to make loans to any
participating institution deleted text begin of higher education deleted text end for the cost of a project in accordance with an
agreement between the authority and the participating institution deleted text begin of higher education deleted text end ;
provided that no deleted text begin such deleted text end loan shall exceed the total cost of the project as determined by the
participating institution deleted text begin of higher education deleted text end and approved by the authority.

Sec. 16.

Minnesota Statutes 2020, section 136A.29, subdivision 22, is amended to read:

Subd. 22.

Costs, expenses, and other charges.

The authority is authorized and
empowered to charge to and apportion among participating institutions deleted text begin of higher education deleted text end
its administrative costs and expenses incurred in the exercise of the powers and duties
conferred by sections 136A.25 to 136A.42 new text begin in the manner as the authority in its judgment
deems appropriate new text end .

Sec. 17.

Minnesota Statutes 2020, section 136A.29, is amended by adding a subdivision
to read:

new text begin Subd. 24. new text end

new text begin Determination of affiliate status. new text end

new text begin The authority is authorized and empowered
to determine whether an entity is an affiliate as defined in section 136A.28, subdivision 1a.
A determination by the authority of affiliate status shall be deemed conclusive for the
purposes of sections 136A.25 to 136A.42.
new text end

Sec. 18.

Minnesota Statutes 2020, section 136A.32, subdivision 4, is amended to read:

Subd. 4.

Provisions of resolution authorizing bonds.

Any resolution or resolutions
authorizing any revenue bonds or any issue of revenue bonds may contain provisions, which
shall be a part of the contract with the holders of the revenue bonds to be authorized, as to:

(1) pledging all or any part of the revenues of a project or projects, any revenue producing
contract or contracts made by the authority with deleted text begin any individual partnership, corporation or
association or other body deleted text end new text begin one or more partnerships, corporations or associations, or other
bodies new text end , public or private, to secure the payment of the revenue bonds or of any particular
issue of revenue bonds, subject to such agreements with bondholders as may then exist;

(2) the rentals, fees and other charges to be charged, and the amounts to be raised in
each year thereby, and the use and disposition of the revenues;

(3) the setting aside of reserves or sinking funds, and the regulation and disposition
thereof;

(4) limitations on the right of the authority or its agent to restrict and regulate the use of
the project;

(5) limitations on the purpose to which the proceeds of sale of any issue of revenue
bonds then or thereafter to be issued may be applied and pledging such proceeds to secure
the payment of the revenue bonds or any issue of the revenue bonds;

(6) limitations on the issuance of additional bonds, the terms upon which additional
bonds may be issued and secured and the refunding of outstanding bonds;

(7) the procedure, if any, by which the terms of any contract with bondholders may be
amended or abrogated, the amount of bonds the holders of which must consent thereto, and
the manner in which such consent may be given;

(8) limitations on the amount of moneys derived from the project to be expended for
operating, administrative or other expenses of the authority;

(9) defining the acts or omissions to act which shall constitute a default in the duties of
the authority to holders of its obligations and providing the rights and remedies of such
holders in the event of a default; new text begin or
new text end

(10) the mortgaging of a project and the site thereof for the purpose of securing the
bondholders.

Sec. 19.

Minnesota Statutes 2020, section 136A.33, is amended to read:

136A.33 TRUST AGREEMENT.

In the discretion of the authority any revenue bonds issued under the provisions of
sections 136A.25 to 136A.42, may be secured by a trust agreement by and between the
authority and a corporate trustee or trustees, which may be any trust company or bank having
the powers of a trust company within the state. deleted text begin Such deleted text end new text begin The new text end trust agreement or the resolution
providing for the issuance of deleted text begin such deleted text end revenue bonds may pledge or assign the revenues to be
received or proceeds of any contract or contracts pledged and may convey or mortgage the
project or any portion thereof. deleted text begin Such deleted text end new text begin The new text end trust agreement or resolution providing for the
issuance of deleted text begin such deleted text end revenue bonds may contain such provisions for protecting and enforcing
the rights and remedies of the bondholders as may be reasonable and proper and not in
violation of laws, including particularly such provisions as have hereinabove been specifically
authorized to be included in any resolution or resolutions of the authority authorizing revenue
bonds thereof. Any bank or trust company incorporated under the laws of the state deleted text begin which deleted text end new text begin
that new text end may act as depository of the proceeds of bonds or of revenues or other moneys may
furnish deleted text begin such deleted text end indemnifying bonds or deleted text begin pledges such deleted text end new text begin pledge new text end securities as may be required by
the authority. Any deleted text begin such deleted text end trust agreement may set forth the rights and remedies of the
bondholders and of the trustee or trustees and may restrict the individual right of action by
bondholders. In addition to the foregoing, any deleted text begin such deleted text end trust agreement or resolution may contain
deleted text begin such deleted text end other provisions as the authority may deem reasonable and proper for the security of
the bondholders. All expenses incurred in carrying out the provisions of deleted text begin such deleted text end new text begin the new text end trust
agreement or resolution may be treated as a part of the cost of the operation of a project.

Sec. 20.

Minnesota Statutes 2020, section 136A.34, subdivision 3, is amended to read:

Subd. 3.

Investment.

Any deleted text begin such deleted text end escrowed proceeds, pending such use, may be invested
and reinvested in direct obligations of the United States of America, or in certificates of
deposit or time deposits secured by direct obligations of the United States of America, new text begin or
in shares or units in any money market mutual fund whose investment portfolio consists
solely of direct obligations of the United States of America, new text end maturing at such time or times
as shall be appropriate to assure the prompt payment, as to principal, interest and redemption
premium, if any, of the outstanding revenue bonds to be so refunded. The interest, income
and profits, if any, earned or realized on any such investment may also be applied to the
payment of the outstanding revenue bonds to be so refunded. After the terms of the escrow
have been fully satisfied and carried out, any balance of such proceeds and interest, income
and profits, if any, earned or realized on the investments thereof may be returned to the
authority for use by it in any lawful manner.

Sec. 21.

Minnesota Statutes 2020, section 136A.34, subdivision 4, is amended to read:

Subd. 4.

Additional purpose; improvements.

The portion of the proceeds of any deleted text begin such deleted text end
revenue bonds issued for the additional purpose of paying all or any part of the cost of
constructing and acquiring additions, improvements, extensions or enlargements of a project
may be invested or deposited deleted text begin in time deposits deleted text end as provided in section 136A.32, subdivision
7.

Sec. 22.

Minnesota Statutes 2020, section 136A.36, is amended to read:

136A.36 REVENUES.

The authority may fix, revise, charge and collect rates, rents, fees and charges for the
use of and for the services furnished or to be furnished by each project and deleted text begin to deleted text end new text begin may new text end contract
with any person, partnership, association or corporation, or other body, public or private,
in respect thereof. deleted text begin Such deleted text end new text begin The new text end rates, rents, fees new text begin , new text end and charges new text begin may vary between projects
involving an education facility and projects involving a health care facility and new text end shall be
fixed and adjusted in respect of the aggregate of rates, rents, fees new text begin , new text end and charges from deleted text begin such deleted text end new text begin
the new text end project so as to provide funds sufficient with other revenues, if any:

(1) to pay the cost of maintaining, repairing and operating the project and each and every
portion thereof, to the extent that the payment of such cost has not otherwise been adequately
provided for;

(2) to pay the principal of and the interest on outstanding revenue bonds of the authority
issued in respect of such project as the same shall become due and payable; and

(3) to create and maintain reserves required or provided for in any resolution authorizing,
or trust agreement securing, deleted text begin such deleted text end revenue bonds of the authority. deleted text begin Such deleted text end new text begin The new text end rates, rents, fees
and charges shall not be subject to supervision or regulation by any department, commission,
board, body, bureau or agency of this state other than the authority. A sufficient amount of
the revenues derived in respect of a project, except deleted text begin such deleted text end part of deleted text begin such deleted text end new text begin the new text end revenues as may
be necessary to pay the cost of maintenance, repair and operation and to provide reserves
and for renewals, replacements, extensions, enlargements and improvements as may be
provided for in the resolution authorizing the issuance of any revenue bonds of the authority
or in the trust agreement securing the same, shall be set aside at such regular intervals as
may be provided in deleted text begin such deleted text end new text begin the new text end resolution or trust agreement in a sinking or other similar fund
deleted text begin which deleted text end new text begin that new text end is hereby pledged to, and charged with, the payment of the principal of and the
interest on deleted text begin such deleted text end revenue bonds as the same shall become due, and the redemption price or
the purchase price of bonds retired by call or purchase as therein provided. deleted text begin Such deleted text end new text begin The new text end pledge
shall be valid and binding from the time when the pledge is made; the rates, rents, fees and
charges and other revenues or other moneys so pledged and thereafter received by the
authority shall immediately be subject to the lien of deleted text begin such deleted text end new text begin the new text end pledge without physical delivery
thereof or further act, and the lien of any such pledge shall be valid and binding as against
all parties having claims of any kind against the authority, irrespective of whether such
parties have notice thereof. Neither the resolution nor any trust agreement by which a pledge
is created need be filed or recorded except in the records of the authority. The use and
disposition of moneys to the credit of such sinking or other similar fund shall be subject to
the provisions of the resolution authorizing the issuance of such bonds or of such trust
agreement. Except as may otherwise be provided in deleted text begin such deleted text end new text begin the new text end resolution or deleted text begin such deleted text end trust
agreement, deleted text begin such deleted text end new text begin the new text end sinking or other similar fund shall be a fund for all deleted text begin such deleted text end revenue bonds
issued to finance a project or projects at one or more participating institutions deleted text begin of higher
education deleted text end without distinction or priority of one over another; provided the authority in any
such resolution or trust agreement may provide that such sinking or other similar fund shall
be the fund for a particular project at deleted text begin an deleted text end new text begin a participating new text end institution deleted text begin of higher education deleted text end and
for the revenue bonds issued to finance a particular project and may, additionally, permit
and provide for the issuance of revenue bonds having a subordinate lien in respect of the
security herein authorized to other revenue bonds of the authority and, in such case, the
authority may create separate or other similar funds in respect of deleted text begin such deleted text end new text begin the new text end subordinate lien
bonds.

Sec. 23.

Minnesota Statutes 2020, section 136A.38, is amended to read:

136A.38 BONDS ELIGIBLE FOR INVESTMENT.

Bonds issued by new text begin the new text end authority under the provisions of sections 136A.25 to 136A.42, are
hereby made securities in which all public officers and public bodies of the state and its
political subdivisions, all insurance companies, trust companies, banking associations,
investment companies, executors, administrators, trustees and other fiduciaries may properly
and legally invest funds, including capital in their control or belonging to them; it being the
purpose of this section to authorize the investment in such bonds of all sinking, insurance,
retirement, compensation, pension and trust funds, whether owned or controlled by private
or public persons or officers; provided, however, that nothing contained in this section may
be construed as relieving any person, firm, or corporation from any duty of exercising due
care in selecting securities for purchase or investment; and provide further, that in no event
shall assets of pension funds of public employees of the state of Minnesota or any of its
agencies, boards or subdivisions, whether publicly or privately administered, be invested
in bonds issued under the provisions of sections 136A.25 to 136A.42. Such bonds are hereby
constituted "authorized securities" within the meaning and for the purposes of Minnesota
Statutes 1969, section 50.14. deleted text begin Such deleted text end new text begin The new text end bonds are hereby made securities deleted text begin which deleted text end new text begin that new text end may
properly and legally be deposited with and received by any state or municipal officer or any
agency or political subdivision of the state for any purpose for which the deposit of bonds
or obligations of the state now or may hereafter be authorized by law.

Sec. 24.

Minnesota Statutes 2020, section 136A.41, is amended to read:

136A.41 CONFLICT OF INTEREST.

Notwithstanding any other law to the contrary it shall not be or constitute a conflict of
interest for a trustee, director, officer or employee of any participating institution deleted text begin of higher
education deleted text end , financial institution, investment banking firm, brokerage firm, commercial bank
or trust company, architecture firm, insurance company, construction company, or any other
firm, person or corporation to serve as a member of the authority, provided such trustee,
director, officer or employee shall abstain from deliberation, action and vote by the authority
in each instance where the business affiliation of any such trustee, director, officer or
employee is involved.

Sec. 25.

Minnesota Statutes 2020, section 136A.42, is amended to read:

136A.42 ANNUAL REPORT.

The authority shall keep an accurate account of all of its activities and all of its receipts
and expenditures deleted text begin and shall annually report to the office deleted text end . new text begin Each year, the authority shall submit
to the Minnesota Historical Society and the Legislative Reference Library a report of the
authority's activities in the previous year, including all financial activities.
new text end

Sec. 26.

Minnesota Statutes 2020, section 136F.67, subdivision 1, is amended to read:

Subdivision 1.

Authorization.

A technical college or a community college must not
seek financing for child care facilities or parking facilities through the deleted text begin Higher deleted text end new text begin Health and new text end
Education Facilities Authority, as provided in section 136A.28, subdivision 7, without the
explicit authorization of the board.

Sec. 27.

Minnesota Statutes 2020, section 354B.20, subdivision 7, is amended to read:

Subd. 7.

Employing unit.

"Employing unit," if the agency employs any persons covered
by the individual retirement account plan under section 354B.211, means:

(1) the board;

(2) the Minnesota Office of Higher Education; and

(3) the deleted text begin Higher deleted text end new text begin Health and new text end Education Facilities Authority.

Sec. 28. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall renumber the law establishing and governing the Minnesota
Higher Education Facilities Authority, renamed the Minnesota Health and Education
Facilities Authority in this act, as Minnesota Statutes, chapter 16F, coded in Minnesota
Statutes 2020, sections 136A.25 to 136A.42, as amended or repealed in this act. The revisor
of statutes shall also duplicate any required definitions from Minnesota Statutes, chapter
136A, revise any statutory cross-references consistent with the recoding, and report the
history in Minnesota Statutes, chapter 16F.
new text end

Sec. 29. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2020, section 136A.29, subdivision 4, new text end new text begin is repealed.
new text end

ARTICLE 5

HUMAN SERVICES FORECAST ADJUSTMENTS AND CARRY FORWARD
AUTHORITY

Section 1. new text begin HUMAN SERVICES APPROPRIATION. new text end

new text begin The dollar amounts shown in the columns marked "Appropriations" are added to or, if
shown in parentheses, are subtracted from the appropriations in Laws 2021, First Special
Session chapter 7, article 16, from the general fund or any fund named to the Department
of Human Services for the purposes specified in this article, to be available for the fiscal
year indicated for each purpose. The figures "2022" and "2023" used in this article mean
that the appropriations listed under them are available for the fiscal years ending June 30,
2022, or June 30, 2023, respectively. "The first year" is fiscal year 2022. "The second year"
is fiscal year 2023. "The biennium" is fiscal years 2022 and 2023.
new text end

			new text begin APPROPRIATIONS new text end
			new text begin Available for the Year new text end
			new text begin Ending June 30 new text end
				new text begin 2022 new text end		new text begin 2023 new text end

Sec. 2. new text begin COMMISSIONER OF HUMAN SERVICES new text end

new text begin Subdivision 1. new text end new text begin Total Appropriation new text end

new text begin $ new text end

new text begin (585,901,000) new text end

new text begin $ new text end

new text begin 182,791,000 new text end

new text begin Appropriations by Fund new text end
new text begin General Fund new text end	new text begin (406,629,000) new text end	new text begin 185,395,000 new text end
new text begin Health Care Access Fund new text end	new text begin (86,146,000) new text end	new text begin (11,799,000) new text end
new text begin Federal TANF new text end	new text begin (93,126,000) new text end	new text begin 9,195,000 new text end

new text begin Subd. 2. new text end new text begin Forecasted Programs new text end

new text begin (a) MFIP/DWP new text end

new text begin Appropriations by Fund new text end
new text begin General Fund new text end	new text begin 72,106,000 new text end	new text begin (14,397,000) new text end
new text begin Federal TANF new text end	new text begin (93,126,000) new text end	new text begin 9,195,000 new text end

new text begin (b) MFIP Child Care Assistance new text end

new text begin (103,347,000) new text end

new text begin (73,738,000) new text end

new text begin (c) General Assistance new text end

new text begin (4,175,000) new text end

new text begin (1,488,000) new text end

new text begin (d) Minnesota Supplemental Aid new text end

new text begin 318,000 new text end

new text begin 1,613,000 new text end

new text begin (e) Housing Support new text end

new text begin (1,994,000) new text end

new text begin 9,257,000 new text end

new text begin (f) Northstar Care for Children new text end

new text begin (9,613,000) new text end

new text begin (4,865,000) new text end

new text begin (g) MinnesotaCare new text end

new text begin (86,146,000) new text end

new text begin (11,799,000) new text end

new text begin These appropriations are from the health care
access fund.
new text end

new text begin (h) Medical Assistance new text end

new text begin Appropriations by Fund new text end
new text begin General Fund new text end	new text begin (348,364,000) new text end	new text begin 292,880,000 new text end
new text begin Health Care Access Fund new text end	new text begin 0 new text end	new text begin 0 new text end

new text begin (i) Alternative Care Program new text end

new text begin 0 new text end

new text begin 0 new text end

new text begin (j) Behavioral Health Fund new text end

new text begin (11,560,000) new text end

new text begin (23,867,000) new text end

new text begin Subd. 3. new text end new text begin Technical Activities new text end

new text begin 0 new text end

new text begin 0 new text end

new text begin These appropriations are from the federal
TANF fund.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 3.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 29,
is amended to read:

Subd. 29. Grant Programs; Disabilities Grants

31,398,000

31,010,000

(a) Training Stipends for Direct Support
Services Providers. $1,000,000 in fiscal year
2022 is from the general fund for stipends for
individual providers of direct support services
as defined in Minnesota Statutes, section
256B.0711, subdivision 1. deleted text begin These deleted text end new text begin The new text end stipends
are available to individual providers who have
completed designated voluntary trainings
made available through the State-Provider
Cooperation Committee formed by the State
of Minnesota and the Service Employees
International Union Healthcare Minnesota.
Any unspent appropriation in fiscal year 2022
is available in fiscal year 2023. This is a
onetime appropriation. This appropriation is
available only if the labor agreement between
the state of Minnesota and the Service
Employees International Union Healthcare
Minnesota under Minnesota Statutes, section
179A.54, is approved under Minnesota
Statutes, section 3.855.

(b) Parent-to-Parent Peer Support. $125,000
in fiscal year 2022 and $125,000 in fiscal year
2023 are from the general fund for a grant to
an alliance member of Parent to Parent USA
to support the alliance member's
parent-to-parent peer support program for
families of children with a disability or special
health care need.

(c) Self-Advocacy Grants. (1) $143,000 in
fiscal year 2022 and $143,000 in fiscal year
2023 are from the general fund for a grant
under Minnesota Statutes, section 256.477,
subdivision 1.

(2) $105,000 in fiscal year 2022 and $105,000
in fiscal year 2023 are from the general fund
for subgrants under Minnesota Statutes,
section 256.477, subdivision 2.

(d) Minnesota Inclusion Initiative Grants.
$150,000 in fiscal year 2022 and $150,000 in
fiscal year 2023 are from the general fund for
grants under Minnesota Statutes, section
256.4772.

(e) Grants to Expand Access to Child Care
for Children with Disabilities. $250,000 in
fiscal year 2022 and $250,000 in fiscal year
2023 are from the general fund for grants to
expand access to child care for children with
disabilities. new text begin Any unexpended amount in fiscal
year 2022 is available through June 30, 2023. new text end
This is a onetime appropriation.

(f) Parenting with a Disability Pilot Project.
The general fund base includes $1,000,000 in
fiscal year 2024 and $0 in fiscal year 2025 to
implement the parenting with a disability pilot
project.

(g) Base Level Adjustment. The general fund
base is $29,260,000 in fiscal year 2024 and
$22,260,000 in fiscal year 2025.

Sec. 4.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 31,
is amended to read:

Subd. 31. Grant Programs; Adult Mental Health Grants

Appropriations by Fund
General	98,772,000	98,703,000
Opiate Epidemic Response	2,000,000	2,000,000

(a) Culturally and Linguistically
Appropriate Services Implementation
Grants. $2,275,000 in fiscal year 2022 and
$2,206,000 in fiscal year 2023 are from the
general fund for grants to disability services,
mental health, and substance use disorder
treatment providers to implement culturally
and linguistically appropriate services
standards, according to the implementation
and transition plan developed by the
commissioner. new text begin Any unexpended amount in
fiscal year 2022 is available through June 30,
2023. new text end The general fund base for this
appropriation is $1,655,000 in fiscal year 2024
and $0 in fiscal year 2025.

(b) Base Level Adjustment. The general fund
base is $93,295,000 in fiscal year 2024 and
$83,324,000 in fiscal year 2025. The opiate
epidemic response fund base is $2,000,000 in
fiscal year 2024 and $0 in fiscal year 2025.

Sec. 5.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 33,
is amended to read:

Subd. 33. Grant Programs; Chemical Dependency Treatment Support Grants

Appropriations by Fund
General	4,273,000	4,274,000
Lottery Prize	1,733,000	1,733,000
Opiate Epidemic Response	500,000	500,000

(a) Problem Gambling. $225,000 in fiscal
year 2022 and $225,000 in fiscal year 2023
are from the lottery prize fund for a grant to
the state affiliate recognized by the National
Council on Problem Gambling. The affiliate
must provide services to increase public
awareness of problem gambling, education,
training for individuals and organizations
providing effective treatment services to
problem gamblers and their families, and
research related to problem gambling.

(b) Recovery Community Organization
Grants. $2,000,000 in fiscal year 2022 and
$2,000,000 in fiscal year 2023 are from the
general fund for grants to recovery community
organizations, as defined in Minnesota
Statutes, section 254B.01, subdivision 8, to
provide for costs and community-based peer
recovery support services that are not
otherwise eligible for reimbursement under
Minnesota Statutes, section 254B.05, as part
of the continuum of care for substance use
disorders. new text begin Any unexpended amount in fiscal
year 2022 is available through June 30, 2023. new text end
The general fund base for this appropriation
is $2,000,000 in fiscal year 2024 and $0 in
fiscal year 2025

(c) Base Level Adjustment. The general fund
base is $4,636,000 in fiscal year 2024 and
$2,636,000 in fiscal year 2025. The opiate
epidemic response fund base is $500,000 in
fiscal year 2024 and $0 in fiscal year 2025.

Sec. 6.

Laws 2021, First Special Session chapter 7, article 17, section 3, is amended to
read:

Sec. 3. GRANTS FOR TECHNOLOGY FOR HCBS RECIPIENTS.

(a) This act includes $500,000 in fiscal year 2022 and $2,000,000 in fiscal year 2023
for the commissioner of human services to issue competitive grants to home and
community-based service providers. Grants must be used to provide technology assistance,
including but not limited to Internet services, to older adults and people with disabilities
who do not have access to technology resources necessary to use remote service delivery
and telehealth. new text begin Any unexpended amount in fiscal year 2022 is available through June 30,
2023. new text end The general fund base included in this act for this purpose is $1,500,000 in fiscal year
2024 and $0 in fiscal year 2025.

(b) All grant activities must be completed by March 31, 2024.

(c) This section expires June 30, 2024.

Sec. 7.

Laws 2021, First Special Session chapter 7, article 17, section 6, is amended to
read:

Sec. 6. TRANSITION TO COMMUNITY INITIATIVE.

(a) This act includes $5,500,000 in fiscal year 2022 and $5,500,000 in fiscal year 2023
for additional funding for grants awarded under the transition to community initiative
described in Minnesota Statutes, section 256.478. new text begin Any unexpended amount in fiscal year
2022 is available through June 30, 2023. new text end The general fund base in this act for this purpose
is $4,125,000 in fiscal year 2024 and $0 in fiscal year 2025.

(b) All grant activities must be completed by March 31, 2024.

(c) This section expires June 30, 2024.

Sec. 8.

Laws 2021, First Special Session chapter 7, article 17, section 10, is amended to
read:

Sec. 10. PROVIDER CAPACITY GRANTS FOR RURAL AND UNDERSERVED
COMMUNITIES.

(a) This act includes $6,000,000 in fiscal year 2022 and $8,000,000 in fiscal year 2023
for the commissioner to establish a grant program for small provider organizations that
provide services to rural or underserved communities with limited home and
community-based services provider capacity. The grants are available to build organizational
capacity to provide home and community-based services in Minnesota and to build new or
expanded infrastructure to access medical assistance reimbursement. new text begin Any unexpended
amount in fiscal year 2022 is available through June 30, 2023. new text end The general fund base in this
act for this purpose is $8,000,000 in fiscal year 2024 and $0 in fiscal year 2025.

(b) The commissioner shall conduct community engagement, provide technical assistance,
and establish a collaborative learning community related to the grants available under this
section and work with the commissioner of management and budget and the commissioner
of the Department of Administration to mitigate barriers in accessing grant funds. Funding
awarded for the community engagement activities described in this paragraph is exempt
from state solicitation requirements under Minnesota Statutes, section 16B.97, for activities
that occur in fiscal year 2022.

(c) All grant activities must be completed by March 31, 2024.

(d) This section expires June 30, 2024.

Sec. 9.

Laws 2021, First Special Session chapter 7, article 17, section 11, is amended to
read:

Sec. 11. EXPAND MOBILE CRISIS.

(a) This act includes $8,000,000 in fiscal year 2022 and $8,000,000 in fiscal year 2023
for additional funding for grants for adult mobile crisis services under Minnesota Statutes,
section 245.4661, subdivision 9, paragraph (b), clause (15). new text begin Any unexpended amount in
fiscal year 2022 is available through June 30, 2023. new text end The general fund base in this act for
this purpose is $4,000,000 in fiscal year 2024 and $0 in fiscal year 2025.

(b) Beginning April 1, 2024, counties may fund and continue conducting activities
funded under this section.

(c) All grant activities must be completed by March 31, 2024.

(d) This section expires June 30, 2024.

Sec. 10.

Laws 2021, First Special Session chapter 7, article 17, section 12, is amended to
read:

Sec. 12. PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY AND CHILD
AND ADOLESCENT MOBILE TRANSITION UNIT.

(a) This act includes $2,500,000 in fiscal year 2022 and $2,500,000 in fiscal year 2023
for the commissioner of human services to create children's mental health transition and
support teams to facilitate transition back to the community of children from psychiatric
residential treatment facilities, and child and adolescent behavioral health hospitals. new text begin Any
unexpended amount in fiscal year 2022 is available through June 30, 2023. new text end The general
fund base included in this act for this purpose is $1,875,000 in fiscal year 2024 and $0 in
fiscal year 2025.

(b) Beginning April 1, 2024, counties may fund and continue conducting activities
funded under this section.

(c) This section expires March 31, 2024.

Sec. 11.

Laws 2021, First Special Session chapter 7, article 17, section 17, subdivision 3,
is amended to read:

Subd. 3.

Respite services for older adults grants.

(a) This act includes $2,000,000 in
fiscal year 2022 and $2,000,000 in fiscal year 2023 for the commissioner of human services
to establish a grant program for respite services for older adults. The commissioner must
award grants on a competitive basis to respite service providers. new text begin Any unexpended amount
in fiscal year 2022 is available through June 30, 2023. new text end The general fund base included in
this act for this purpose is $2,000,000 in fiscal year 2024 and $0 in fiscal year 2025.

(b) All grant activities must be completed by March 31, 2024.

(c) This subdivision expires June 30, 2024.

ARTICLE 6

MANDATED REPORTS

Section 1.

Minnesota Statutes 2020, section 62J.692, subdivision 5, is amended to read:

Subd. 5.

Report.

(a) Sponsoring institutions receiving funds under this section must
sign and submit a medical education grant verification report (GVR) to verify that the correct
grant amount was forwarded to each eligible training site. If the sponsoring institution fails
to submit the GVR by the stated deadline, or to request and meet the deadline for an
extension, the sponsoring institution is required to return the full amount of funds received
to the commissioner within 30 days of receiving notice from the commissioner. The
commissioner shall distribute returned funds to the appropriate training sites in accordance
with the commissioner's approval letter.

(b) The reports must provide verification of the distribution of the funds and must include:

(1) the total number of eligible trainee FTEs in each clinical medical education program;

(2) the name of each funded program and, for each program, the dollar amount distributed
to each training site and a training site expenditure report;

(3) documentation of any discrepancies between the initial grant distribution notice
included in the commissioner's approval letter and the actual distribution;

(4) a statement by the sponsoring institution stating that the completed grant verification
report is valid and accurate; and

(5) other information the commissioner deems appropriate to evaluate the effectiveness
of the use of funds for medical education.

(c) Each year, the commissioner shall provide an annual summary report to the legislature
on the implementation of this section. new text begin This report is exempt from section 144.05, subdivision
7.
new text end

Sec. 2.

Minnesota Statutes 2020, section 144.193, is amended to read:

144.193 INVENTORY OF BIOLOGICAL AND HEALTH DATA.

By February 1, 2014, and annually after that date, the commissioner shall prepare an
inventory of biological specimens, registries, and health data and databases collected or
maintained by the commissioner. In addition to the inventory, the commissioner shall provide
the schedules for storage of health data and biological specimens. The inventories must be
listed in reverse chronological order beginning with the year 2012. The commissioner shall
make the inventory and schedules available on the department's website deleted text begin and submit the
inventory and schedules to the chairs and ranking minority members of the committees of
the legislature with jurisdiction over health policy and data practices issues deleted text end .

Sec. 3.

Minnesota Statutes 2020, section 144.4199, subdivision 8, is amended to read:

Subd. 8.

Report.

By January 15 of each year, the commissioner shall submit a report to
the chairs and ranking minority members of the house of representatives Ways and Means
Committee, the senate Finance Committee, and the house of representatives and senate
committees with jurisdiction over health and human services finance, detailing expenditures
made in the previous calendar year from the public health response contingency account. new text begin
This report is exempt from section 144.05, subdivision 7.
new text end

Sec. 4.

Minnesota Statutes 2020, section 144.497, is amended to read:

144.497 ST ELEVATION MYOCARDIAL INFARCTION.

The commissioner of health shall assess and report on the quality of care provided in
the state for ST elevation myocardial infarction response and treatment. The commissioner
shall:

(1) utilize and analyze data provided by ST elevation myocardial infarction receiving
centers to the ACTION Registry-Get with the guidelines or an equivalent data platform that
does not identify individuals or associate specific ST elevation myocardial infarction heart
attack events with an identifiable individual;

(2) quarterly post a summary report of the data in aggregate form on the Department of
Health website; new text begin and
new text end

deleted text begin (3) annually inform the legislative committees with jurisdiction over public health of
progress toward improving the quality of care and patient outcomes for ST elevation
myocardial infarctions; and
deleted text end

deleted text begin (4) deleted text end new text begin (3) new text end coordinate to the extent possible with national voluntary health organizations
involved in ST elevation myocardial infarction heart attack quality improvement to encourage
ST elevation myocardial infarction receiving centers to report data consistent with nationally
recognized guidelines on the treatment of individuals with confirmed ST elevation myocardial
infarction heart attacks within the state and encourage sharing of information among health
care providers on ways to improve the quality of care of ST elevation myocardial infarction
patients in Minnesota.

Sec. 5.

Minnesota Statutes 2020, section 144A.10, subdivision 17, is amended to read:

Subd. 17.

Agency quality improvement program; annual report on survey
process.

(a) The commissioner shall establish a quality improvement program for the nursing
facility survey and complaint processes. The commissioner must regularly consult with
consumers, consumer advocates, and representatives of the nursing home industry and
representatives of nursing home employees in implementing the program. The commissioner,
through the quality improvement program, shall submit to the legislature an annual survey
and certification quality improvement report, beginning December 15, 2004, and each
December 15 thereafter. new text begin This report is exempt from section 144.05, subdivision 7.
new text end

(b) The report must include, but is not limited to, an analysis of:

(1) the number, scope, and severity of citations by region within the state;

(2) cross-referencing of citations by region within the state and between states within
the Centers for Medicare and Medicaid Services region in which Minnesota is located;

(3) the number and outcomes of independent dispute resolutions;

(4) the number and outcomes of appeals;

(5) compliance with timelines for survey revisits and complaint investigations;

(6) techniques of surveyors in investigations, communication, and documentation to
identify and support citations;

(7) compliance with timelines for providing facilities with completed statements of
deficiencies; and

(8) other survey statistics relevant to improving the survey process.

(c) The report must also identify and explain inconsistencies and patterns across regions
of the state; include analyses and recommendations for quality improvement areas identified
by the commissioner, consumers, consumer advocates, and representatives of the nursing
home industry and nursing home employees; and provide action plans to address problems
that are identified.

Sec. 6.

Minnesota Statutes 2020, section 144A.483, subdivision 1, is amended to read:

Subdivision 1.

Annual legislative report on home care licensing.

The commissioner
shall establish a quality improvement program for the home care survey and home care
complaint investigation processes. The commissioner shall submit to the legislature an
annual report, beginning October 1, 2015, and each October 1 thereafter new text begin , until October 1,
2027 new text end . Each report will review the previous state fiscal year of home care licensing and
regulatory activities. The report must include, but is not limited to, an analysis of:

(1) the number of FTEs in the Division of Compliance Monitoring, including the Office
of Health Facility Complaints units assigned to home care licensing, survey, investigation,
and enforcement process;

(2) numbers of and descriptive information about licenses issued, complaints received
and investigated, including allegations made and correction orders issued, surveys completed
and timelines, and correction order reconsiderations and results;

(3) descriptions of emerging trends in home care provision and areas of concern identified
by the department in its regulation of home care providers;

(4) information and data regarding performance improvement projects underway and
planned by the commissioner in the area of home care surveys; and

(5) work of the Department of Health Home Care Advisory Council.

Sec. 7.

Minnesota Statutes 2020, section 145.4134, is amended to read:

145.4134 COMMISSIONER'S PUBLIC REPORT.

(a) By July 1 of each year, except for 1998 and 1999 information, the commissioner
shall issue a public report providing statistics for the previous calendar year compiled from
the data submitted under sections 145.4131 to 145.4133 and sections 145.4241 to 145.4249.
For 1998 and 1999 information, the report shall be issued October 1, 2000. Each report
shall provide the statistics for all previous calendar years, adjusted to reflect any additional
information from late or corrected reports. The commissioner shall ensure that none of the
information included in the public reports can reasonably lead to identification of an
individual having performed or having had an abortion. All data included on the forms
under sections 145.4131 to 145.4133 and sections 145.4241 to 145.4249 must be included
in the public report, except that the commissioner shall maintain as confidential, data which
alone or in combination may constitute information from which an individual having
performed or having had an abortion may be identified using epidemiologic principles. deleted text begin The
commissioner shall submit the report to the senate Health and Family Security Committee
and the house of representatives Health and Human Services Committee.
deleted text end

(b) The commissioner may, by rules adopted under chapter 14, alter the submission
dates established under sections 145.4131 to 145.4133 for administrative convenience, fiscal
savings, or other valid reason, provided that physicians or facilities and the commissioner
of human services submit the required information once each year and the commissioner
issues a report once each year.

Sec. 8.

Minnesota Statutes 2020, section 145.928, subdivision 13, is amended to read:

Subd. 13.

Reports.

(a) The commissioner shall submit a biennial report to the legislature
on the local community projects, tribal government, and community health board prevention
activities funded under this section. These reports must include information on grant
recipients, activities that were conducted using grant funds, evaluation data, and outcome
measures, if available. These reports are due by January 15 of every other year, beginning
in the year 2003.

(b) The commissioner shall release an annual report to the public deleted text begin and submit the annual
report to the chairs and ranking minority members of the house of representatives and senate
committees with jurisdiction over public health deleted text end on grants made under subdivision 7 to
decrease racial and ethnic disparities in infant mortality rates. The report must provide
specific information on the amount of each grant awarded to each agency or organization,
an itemized list submitted to the commissioner by each agency or organization awarded a
grant specifying all uses of grant funds and the amount expended for each use, the population
served by each agency or organization, outcomes of the programs funded by each grant,
and the amount of the appropriation retained by the commissioner for administrative and
associated expenses. The commissioner shall issue a report each January 15 for the previous
fiscal year beginning January 15, 2016.

Sec. 9. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2020, sections 62U.10, subdivision 3; 144.1911, subdivision 10;
144.564, subdivision 3; and 144A.483, subdivision 2, new text end new text begin are repealed.
new text end

APPENDIX

Repealed Minnesota Statutes: S4198-1

62U.10 HEALTH CARE TRANSFER, SAVINGS, AND REPAYMENT.

Subd. 3.

Actual spending and savings determination.

By June 1, 2010, and each June 1 thereafter until June 1, 2020, the commissioner of health shall determine the actual total private and public health care spending for residents of this state for the calendar year two years before the current calendar year, based on data collected under chapter 62J, and shall determine the difference between the projected spending, as determined under subdivision 2, and the actual spending for that year. The actual spending must be certified by an independent actuarial consultant. If the actual spending is less than the projected spending, the commissioner shall determine, based on the proportion of spending for state-administered health care programs to total private and public health care spending for the calendar year two years before the current calendar year, the percentage of the calculated aggregate savings amount accruing to state-administered health care programs.

136A.29 POWERS; DUTIES.

Subd. 4.

Mutual agreement; staff, equipment, office space.

By mutual agreement between the authority and the office, authority staff employees may also be members of the office staff. By mutual agreement, authority employees may be provided office space in the office of the Office of Higher Education, and said employees may make use of equipment, supplies, and office space, provided that the authority fully reimburses the office for salaries and for space, equipment, supplies, and materials used. In the absence of such mutual agreement between the authority and the office, the authority may maintain an office at such place or places as it may designate.

144.1911 INTERNATIONAL MEDICAL GRADUATES ASSISTANCE PROGRAM.

Subd. 10.

Report.

The commissioner shall submit an annual report to the chairs and ranking minority members of the legislative committees with jurisdiction over health care and higher education on the progress of the integration of international medical graduates into the Minnesota health care delivery system. The report shall include recommendations on actions needed for continued progress integrating international medical graduates. The report shall be submitted by January 15 each year, beginning January 15, 2016.

144.564 MONITORING OF SUBACUTE OR TRANSITIONAL CARE SERVICES.

Subd. 3.

Annual report.

The commissioner shall monitor the provision of services described in this section and shall report annually to the legislature concerning these services, including recommendations on the need for legislation.

144A.483 AGENCY QUALITY IMPROVEMENT PROGRAM.

Subd. 2.

Study of correction order appeal process.

Starting July 1, 2015, the commissioner shall study whether to add a correction order appeal process conducted by an independent reviewer such as an administrative law judge or other office and submit a report to the legislature by February 1, 2016. The commissioner shall review home care regulatory systems in other states as part of that study. The commissioner shall consult with the home care providers and representatives.

147.02 EXAMINATION; LICENSING.

Subd. 2a.

Temporary permit.

The board may issue a temporary permit to practice medicine to a physician eligible for licensure under this section only if the application for licensure is complete, all requirements in subdivision 1 have been met, and a nonrefundable fee set by the board has been paid. The permit remains valid only until the meeting of the board at which a decision is made on the physician's application for licensure.

254A.21 FETAL ALCOHOL SPECTRUM DISORDERS PREVENTION GRANTS.

(a) The commissioner of human services shall award a grant to a statewide organization that focuses solely on prevention of and intervention with fetal alcohol spectrum disorders. The grant recipient must make subgrants to eligible regional collaboratives in rural and urban areas of the state for the purposes specified in paragraph (c).

(b) "Eligible regional collaboratives" means a partnership between at least one local government or tribal government and at least one community-based organization and, where available, a family home visiting program. For purposes of this paragraph, a local government includes a county or a multicounty organization, a county-based purchasing entity, or a community health board.

(c) Eligible regional collaboratives must use subgrant funds to reduce the incidence of fetal alcohol spectrum disorders and other prenatal drug-related effects in children in Minnesota by identifying and serving pregnant women suspected of or known to use or abuse alcohol or other drugs. Eligible regional collaboratives must provide intensive services to chemically dependent women to increase positive birth outcomes.

(d) An eligible regional collaborative that receives a subgrant under this section must report to the grant recipient by January 15 of each year on the services and programs funded by the subgrant. The report must include measurable outcomes for the previous year, including the number of pregnant women served and the number of toxic-free babies born. The grant recipient must compile the information in the subgrant reports and submit a summary report to the commissioner of human services by February 15 of each year.