Office of the Revisor of Statutes
Minnesota Session Laws - 1995, Regular Session
Key: (1) language to be deleted (2) new language
CHAPTER 205-S.F.No. 258
An act relating to occupations and professions; board
of medical practice; providing for the registration of
physician assistants by the board of medical practice;
providing for rulemaking; providing penalties;
amending Minnesota Statutes 1994, sections 116J.70,
subdivision 2a; 136A.1356, subdivision 1; 144.335,
subdivision 1; 148B.60, subdivision 3; 151.01,
subdivision 23; 151.37, subdivision 2a; 214.23,
subdivision 1; and 604A.01, subdivision 2; proposing
coding for new law as Minnesota Statutes, chapter
147A; repealing Minnesota Statutes 1994, sections
147.34; 147.35; and 147.36; Minnesota Rules, parts
5600.2600; 5600.2605; 5600.2610; 5600.2615; 5600.2620;
5600.2625; 5600.2630; 5600.2635; 5600.2640; 5600.2645;
5600.2650; 5600.2655; 5600.2660; 5600.2665; and
5600.2670.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
Section 1. [147A.01] [DEFINITIONS.]
Subdivision 1. [SCOPE.] For the purpose of this chapter
the terms defined in this section have the meanings given them.
Subd. 2. [ACTIVE STATUS.] "Active status" means the status
of a person who has met all the qualifications of a physician
assistant, has a physician-physician assistant agreement in
force, and is registered.
Subd. 3. [ADMINISTER.] "Administer" means the delivery by
a physician assistant authorized to prescribe legend drugs, a
single dose of a legend drug, including controlled substances,
to a patient by injection, inhalation, ingestion, or by any
other immediate means, and the delivery by a physician assistant
ordered by a physician a single dose of a legend drug by
injection, inhalation, ingestion, or by any other immediate
means.
Subd. 4. [AGREEMENT.] "Agreement" means the document
described in section 147A.20.
Subd. 5. [ALTERNATE SUPERVISING PHYSICIAN.] "Alternate
supervising physician" means a Minnesota licensed physician
listed in the physician-physician assistant agreement who is
responsible for supervising the physician assistant when the
main supervising physician is unavailable. The alternate
supervising physician shall accept full medical responsibility
for the performance, practice, and activities of the physician
assistant while under the supervision of the alternate
supervising physician.
Subd. 6. [BOARD.] "Board" means the board of medical
practice or its designee.
Subd. 7. [CONTROLLED SUBSTANCES.] "Controlled substances"
has the meaning given it in section 152.01, subdivision 4.
Subd. 8. [DELEGATION FORM.] "Delegation form" means the
form used to indicate the categories of drugs for which the
authority to prescribe, administer, and dispense has been
delegated to the physician assistant and signed by the
supervising physician, any alternate supervising physicians, and
the physician assistant. This form is part of the agreement
described in section 147A.20, and shall be maintained by the
supervising physician and physician assistant at the address of
record. Copies shall be provided to the board upon request.
"Addendum to the delegation form" means a separate listing of
the schedules and categories of controlled substances, if any,
for which the physician assistant has been delegated the
authority to prescribe, administer, and dispense. The addendum
shall be maintained as a separate document as described above.
Subd. 9. [DIAGNOSTIC ORDER.] "Diagnostic order" means a
directive to perform a procedure or test, the purpose of which
is to determine the cause and nature of a pathological condition
or disease.
Subd. 10. [DRUG.] "Drug" has the meaning given it in
section 151.01, subdivision 5, including controlled substances
as defined in section 152.01, subdivision 4.
Subd. 11. [DRUG CATEGORY.] "Drug category" means one of
the categories listed on the delegation form.
Subd. 12. [INACTIVE STATUS.] "Inactive status" means the
status of a person who has met all the qualifications of a
physician assistant, and is registered, but does not have a
physician-physician assistant agreement in force.
Subd. 13. [INTERNAL PROTOCOL.] "Internal protocol" means a
document written by the supervising physician and the physician
assistant which specifies the policies and procedures which will
apply to the physician assistant's prescribing, administering,
and dispensing of legend drugs and medical devices, including
controlled substances as defined in section 152.01, subdivision
4, and lists the specific categories of drugs and medical
devices, with any exceptions or conditions, that the physician
assistant is authorized to prescribe, administer, and dispense.
The supervising physician and physician assistant shall maintain
the protocol at the address of record. Copies shall be provided
to the board upon request.
Subd. 14. [LEGEND DRUG.] "Legend drug" has the meaning
given it in section 151.01, subdivision 17.
Subd. 15. [LOCUM TENENS PERMIT.] "Locum tenens permit"
means time specific temporary permission for a physician
assistant to practice as a physician assistant in a setting
other than the practice setting established in the
physician-physician assistant agreement.
Subd. 16. [MEDICAL DEVICE.] "Medical device" means durable
medical equipment and assistive or rehabilitative appliances,
objects, or products that are required to implement the overall
plan of care for the patient and that are restricted by federal
law to use upon prescription by a licensed practitioner.
Subd. 17. [PHYSICIAN.] "Physician" means a person
currently licensed in good standing as a physician or osteopath
under chapter 147.
Subd. 18. [PHYSICIAN ASSISTANT OR REGISTERED PHYSICIAN
ASSISTANT.] "Physician assistant" or "registered physician
assistant" means a person registered pursuant to this section
who is qualified by academic or practical training or both to
provide patient services as specified in this chapter, under the
supervision of a supervising physician.
Subd. 19. [PRACTICE SETTING DESCRIPTION.] "Practice
setting description" means a signed record submitted to the
board on forms provided by the board, on which:
(1) the supervising physician assumes full medical
responsibility for the medical care rendered by a physician
assistant;
(2) is recorded the address and phone number of record of
each supervising physician and alternate, and the physicians'
medical license numbers and DEA number;
(3) is recorded the address and phone number of record of
the physician assistant and the physician assistant's
registration number and DEA number;
(4) is recorded whether the physician assistant has been
delegated prescribing, administering, and dispensing authority;
(5) is recorded the practice setting, address or addresses
and phone number or numbers of the physician assistant; and
(6) is recorded a statement of the type, amount, and
frequency of supervision.
Subd. 20. [PRESCRIBE.] "Prescribe" means to direct, order,
or designate by means of a prescription the preparation, use of,
or manner of using a drug or medical device.
Subd. 21. [PRESCRIPTION.] "Prescription" means a signed
written order, or an oral order reduced to writing, given by a
physician assistant authorized to prescribe drugs for patients
in the course of the physician assistant's practice, issued for
an individual patient and containing the information required in
the delegation form.
Subd. 22. [REGISTRATION.] "Registration" is the process by
which the board determines that an applicant has been found to
meet the standards and qualifications found in this section.
Subd. 23. [SUPERVISING PHYSICIAN.] "Supervising physician"
means a Minnesota licensed physician who accepts full medical
responsibility for the performance, practice, and activities of
a physician assistant under an agreement as described in section
147A.20. A supervising physician shall not supervise more than
two full-time equivalent physician assistants simultaneously.
Subd. 24. [SUPERVISION.] "Supervision" means overseeing
the activities of, and accepting responsibility for, the medical
services rendered by a physician assistant. The constant
physical presence of the supervising physician is not required
so long as the supervising physician and physician assistant are
or can be easily in contact with one another by radio,
telephone, or other telecommunication device. The scope and
nature of the supervision shall be defined by the individual
physician-physician assistant agreement.
Subd. 25. [TEMPORARY REGISTRATION.] "Temporary
registration" means the status of a person who has satisfied the
education requirement specified in this chapter; is enrolled in
the next examination required in this chapter; or is awaiting
examination results; has a physician-physician assistant
agreement in force as required by this chapter, and has
submitted a practice setting description to the board. Such
provisional registration shall expire 90 days after completion
of the next examination sequence, or after one year, whichever
is sooner, for those enrolled in the next examination; and upon
receipt of the examination results for those awaiting
examination results. The registration shall be granted by the
board or its designee.
Subd. 26. [THERAPEUTIC ORDER.] "Therapeutic order" means
an order given to another for the purpose of treating or curing
a patient in the course of a physician assistant's practice.
Therapeutic orders may be written or verbal, but do not include
the prescribing of legend drugs or medical devices unless
prescribing authority has been delegated within the
physician-physician assistant agreement.
Subd. 27. [VERBAL ORDER.] "Verbal order" means an oral
order given to another for the purpose of treating or curing a
patient in the course of a physician assistant's practice.
Verbal orders do not include the prescribing of legend drugs
unless prescribing authority has been delegated within the
physician-physician assistant agreement.
Sec. 2. [147A.02] [QUALIFICATIONS FOR REGISTRATION.]
Except as otherwise provided in this chapter, an individual
shall be registered by the board before the individual may
practice as a physician assistant.
The board may grant registration as a physician assistant
to an applicant who:
(1) submits an application on forms approved by the board;
(2) pays the appropriate fee as determined by the board;
(3) has current certification from the National Commission
on Certification of Physician Assistants, or its successor
agency as approved by the board;
(4) certifies that the applicant is mentally and physically
able to engage safely in practice as a physician assistant;
(5) has no licensure, certification, or registration as a
physician assistant under current discipline, revocation,
suspension, or probation for cause resulting from the
applicant's practice as a physician assistant, unless the board
considers the condition and agrees to licensure;
(6) has a physician-physician assistant agreement, and
internal protocol and prescribing delegation form, if the
physician assistant has been delegated prescribing authority, as
described in section 147A.18 in place at the address of record;
(7) submits to the board a practice setting description and
any other information the board deems necessary to evaluate the
applicant's qualifications; and
(8) has been approved by the board.
All persons registered as physician assistants as of June
30, 1995, are eligible for continuing registration renewal. All
persons applying for registration after that date shall be
registered according to this chapter.
Sec. 3. [147A.03] [PROTECTED TITLES AND RESTRICTIONS ON
USE.]
Subdivision 1. [PROTECTED TITLES.] No individual may use
the titles "Minnesota Registered Physician Assistant,"
"Registered Physician Assistant," "Physician Assistant," or "PA"
in connection with the individual's name, or any other words,
letters, abbreviations, or insignia indicating or implying that
the individual is registered with the state unless they have
been registered according to this chapter.
Subd. 2. [HEALTH CARE PRACTITIONERS.] Individuals
practicing in a health care occupation are not restricted in the
provision of services included in this chapter as long as they
do not hold themselves out as physician assistants by or through
the titles provided in subdivision 1 in association with
provision of these services.
Subd. 3. [IDENTIFICATION OF REGISTERED PRACTITIONERS.]
Physician assistants in Minnesota shall wear name tags which
identify them as physician assistants.
Subd. 4. [SANCTIONS.] Individuals who hold themselves out
as physician assistants by or through any of the titles provided
in subdivision 1 without prior registration shall be subject to
sanctions or actions against continuing the activity according
to section 214.11, or other authority.
Sec. 4. [147A.04] [TEMPORARY PERMIT.]
The board may issue a temporary permit to practice to a
physician assistant eligible for registration under this chapter
only if the application for registration is complete, all
requirements 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
application for registration.
Sec. 5. [147A.05] [INACTIVE REGISTRATION.]
Physician assistants who notify the board in writing on
forms prescribed by the board may elect to place their
registrations on an inactive status. Physician assistants with
an inactive registration shall be excused from payment of
renewal fees and shall not practice as physician assistants.
Persons who engage in practice while their registrations are
lapsed or on inactive status shall be considered to be
practicing without registration, which shall be grounds for
discipline under section 147A.13. Physician assistants
requesting restoration from inactive status shall be required to
pay the current renewal fees and all unpaid back-fees and shall
be required to meet the criteria for renewal specified in
section 147A.07.
Sec. 6. [147A.06] [CANCELLATION OF REGISTRATION FOR
NONRENEWAL.]
The board shall not renew, reissue, reinstate, or restore a
registration that has lapsed on or after July 1, 1996, and has
not been renewed within two annual renewal cycles starting July
1, 1997. A registrant whose registration is canceled for
nonrenewal must obtain a new registration by applying for
registration and fulfilling all requirements then in existence
for an initial registration to practice as a physician assistant.
Sec. 7. [147A.07] [RENEWAL.]
A person who holds a registration as a physician assistant
shall, upon notification from the board, renew the registration
by:
(1) submitting the appropriate fee as determined by the
board;
(2) completing the appropriate forms;
(3) meeting any other requirements of the board;
(4) submitting a revised and updated practice setting
description showing evidence of annual review of the
physician-physician assistant supervisory agreement.
Sec. 8. [147A.08] [EXEMPTIONS.]
(a) This chapter does not apply to, control, prevent, or
restrict the practice, service, or activities of persons listed
in section 147.09, clauses (1) to (6) and (8) to (13), persons
regulated under section 214.01, subdivision 2, or persons
defined in section 136A.1356, subdivision 1, paragraphs (a) to
(d).
(b) Nothing in this chapter shall be construed to require
registration of:
(1) a physician assistant student enrolled in a physician
assistant or surgeon assistant educational program accredited by
the Committee on Allied Health Education and Accreditation or by
its successor agency approved by the board;
(2) a physician assistant employed in the service of the
federal government while performing duties incident to that
employment; or
(3) technicians, other assistants, or employees of
physicians who perform delegated tasks in the office of a
physician but who do not identify themselves as a physician
assistant.
Sec. 9. [147A.09] [SCOPE OF PRACTICE, DELEGATION.]
Subdivision 1. [SCOPE OF PRACTICE.] Physician assistants
shall practice medicine only with physician supervision.
Physician assistants may perform those duties and
responsibilities as delegated in the physician-physician
assistant agreement and delegation forms maintained at the
address of record by the supervising physician and physician
assistant, including the prescribing, administering, and
dispensing of medical devices and drugs, excluding anesthetics,
other than local anesthetics, injected in connection with an
operating room procedure, inhaled anesthesia and spinal
anesthesia.
Patient service must be limited to:
(1) services within the training and experience of the
physician assistant;
(2) services customary to the practice of the supervising
physician;
(3) services delegated by the supervising physician; and
(4) services within the parameters of the laws, rules, and
standards of the facilities in which the physician assistant
practices.
Nothing in this chapter authorizes physician assistants to
perform duties regulated by the boards listed in section 214.01,
subdivision 2, other than the board of medical practice, and
except as provided in this section.
Subd. 2. [DELEGATION.] Patient services may include, but
are not limited to, the following, as delegated by the
supervising physician and authorized in the agreement:
(1) taking patient histories and developing medical status
reports;
(2) performing physical examinations;
(3) interpreting and evaluating patient data;
(4) ordering or performing diagnostic procedures;
(5) ordering or performing therapeutic procedures;
(6) providing instructions regarding patient care, disease
prevention, and health promotion;
(7) assisting the supervising physician in patient care in
the home and in health care facilities;
(8) creating and maintaining appropriate patient records;
(9) transmitting or executing specific orders at the
direction of the supervising physician;
(10) prescribing, administering, and dispensing legend
drugs and medical devices if this function has been delegated by
the supervising physician pursuant to and subject to the
limitations of section 147.34 and chapter 151. Physician
assistants who have been delegated the authority to prescribe
controlled substances shall maintain a separate addendum to the
delegation form which lists all schedules and categories of
controlled substances which the physician assistant has the
authority to prescribe. This addendum shall be maintained with
the physician-physician assistant agreement, and the delegation
form at the address of record;
(11) for physician assistants not delegated prescribing
authority, administering legend drugs and medical devices
following prospective review for each patient by and upon
direction of the supervising physician;
(12) functioning as an emergency medical technician with
permission of the ambulance service and in compliance with
section 144.804, subdivision 2, paragraph (c), and ambulance
service rules adopted by the commissioner of health; and
(13) initiating evaluation and treatment procedures
essential to providing an appropriate response to emergency
situations.
Orders of physician assistants shall be considered the
orders of their supervising physicians in all practice-related
activities, including, but not limited to, the ordering of
diagnostic, therapeutic, and other medical services.
Sec. 10. [147A.10] [SATELLITE SETTINGS.]
Physician assistants may render services in a setting
geographically remote from the supervising physician.
Sec. 11. [147A.11] [EXCLUSIONS OF LIMITATIONS ON
EMPLOYMENT.]
Nothing in this chapter shall be construed to limit the
employment arrangement of a physician assistant registered under
this chapter.
Sec. 12. [147A.13] [GROUNDS FOR DISCIPLINARY ACTION.]
Subdivision 1. [GROUNDS LISTED.] The board may refuse to
grant registration or may impose disciplinary action as
described in this subdivision against any physician assistant.
The following conduct is prohibited and is grounds for
disciplinary action:
(1) failure to demonstrate the qualifications or satisfy
the requirements for registration contained in this chapter or
rules of the board. The burden of proof shall be upon the
applicant to demonstrate such qualifications or satisfaction of
such requirements;
(2) obtaining registration by fraud or cheating, or
attempting to subvert the examination process. Conduct which
subverts or attempts to subvert the examination process
includes, but is not limited to:
(i) conduct which violates the security of the examination
materials, such as removing examination materials from the
examination room or having unauthorized possession of any
portion of a future, current, or previously administered
licensing examination;
(ii) conduct which violates the standard of test
administration, such as communicating with another examinee
during administration of the examination, copying another
examinee's answers, permitting another examinee to copy one's
answers, or possessing unauthorized materials; and
(iii) impersonating an examinee or permitting an
impersonator to take the examination on one's own behalf;
(3) conviction, during the previous five years, of a felony
reasonably related to the practice of physician assistant.
Conviction as used in this subdivision includes a conviction of
an offense which if committed in this state would be deemed a
felony without regard to its designation elsewhere, or a
criminal proceeding where a finding or verdict of guilt is made
or returned but the adjudication of guilt is either withheld or
not entered;
(4) revocation, suspension, restriction, limitation, or
other disciplinary action against the person's physician
assistant credentials in another state or jurisdiction, failure
to report to the board that charges regarding the person's
credentials have been brought in another state or jurisdiction,
or having been refused registration by any other state or
jurisdiction;
(5) advertising which is false or misleading, violates any
rule of the board, or claims without substantiation the positive
cure of any disease or professional superiority to or greater
skill than that possessed by another physician assistant;
(6) violating a rule adopted by the board or an order of
the board, a state, or federal law which relates to the practice
of a physician assistant, or in part regulates the practice of a
physician assistant, including without limitation sections
148A.02, 609.344, and 609.345, or a state or federal narcotics
or controlled substance law;
(7) engaging in any unethical conduct; conduct likely to
deceive, defraud, or harm the public, or demonstrating a willful
or careless disregard for the health, welfare, or safety of a
patient; or practice which is professionally incompetent, in
that it may create unnecessary danger to any patient's life,
health, or safety, in any of which cases, proof of actual injury
need not be established;
(8) failure to adhere to the provisions of the
physician-physician assistant agreement;
(9) engaging in the practice of medicine beyond that
allowed by the physician-physician assistant agreement,
including the delegation form or the addendum to the delegation
form, or aiding or abetting an unlicensed person in the practice
of medicine;
(10) adjudication as mentally incompetent, mentally ill or
mentally retarded, or as a chemically dependent person, a person
dangerous to the public, a sexually dangerous person, or a
person who has a sexual psychopathic personality by a court of
competent jurisdiction, within or without this state. Such
adjudication shall automatically suspend a registration for its
duration unless the board orders otherwise;
(11) engaging in unprofessional conduct. Unprofessional
conduct includes any departure from or the failure to conform to
the minimal standards of acceptable and prevailing practice in
which proceeding actual injury to a patient need not be
established;
(12) inability to practice with reasonable skill and safety
to patients by reason of illness, drunkenness, use of drugs,
narcotics, chemicals, or any other type of material, or as a
result of any mental or physical condition, including
deterioration through the aging process or loss of motor skills;
(13) revealing a privileged communication from or relating
to a patient except when otherwise required or permitted by law;
(14) any use of the title "Physician," "Doctor," or "Dr.";
(15) improper management of medical records, including
failure to maintain adequate medical records, to comply with a
patient's request made pursuant to section 144.335, or to
furnish a medical record or report required by law;
(16) engaging in abusive or fraudulent billing practices,
including violations of the federal Medicare and Medicaid laws
or state medical assistance laws;
(17) becoming addicted or habituated to a drug or
intoxicant;
(18) prescribing a drug or device for other than medically
accepted therapeutic, experimental, or investigative purposes
authorized by a state or federal agency or referring a patient
to any health care provider as defined in section 144.335 for
services or tests not medically indicated at the time of
referral;
(19) engaging in conduct with a patient which is sexual or
may reasonably be interpreted by the patient as sexual, or in
any verbal behavior which is seductive or sexually demeaning to
a patient;
(20) failure to make reports as required by section 609.215
or to cooperate with an investigation of the board as required
by section 609.215;
(21) knowingly providing false or misleading information
that is directly related to the care of that patient unless done
for an accepted therapeutic purpose such as the administration
of a placebo;
(22) aiding suicide or aiding attempted suicide in
violation of section 609.215 as established by any of the
following:
(i) a copy of the record of criminal conviction or plea of
guilty for a felony in violation of section 609.215, subdivision
1 or 2;
(ii) a copy of the record of a judgment of contempt of
court for violating an injunction issued under section 609.215,
subdivision 4;
(iii) a copy of the record of a judgment assessing damages
under section 609.215, subdivision 5; or
(iv) a finding by the board that the person violated
section 609.215, subdivision 1 or 2. The board shall
investigate any complaint of a violation of section 609.215,
subdivision 1 or 2; or
(23) failure to maintain annually reviewed and updated
physician-physician assistant agreements, internal protocols, or
prescribing delegation forms for each physician-physician
assistant practice relationship, or failure to provide copies of
such documents upon request by the board.
Subd. 2. [EFFECTIVE DATES, AUTOMATIC SUSPENSION.] A
suspension, revocation, condition, limitation, qualification, or
restriction of a registration shall be in effect pending
determination of an appeal unless the court, upon petition and
for good cause shown, orders otherwise.
A physician assistant registration is automatically
suspended if:
(1) a guardian of the person of a registrant is appointed
by order of a court pursuant to sections 525.54 to 525.61, for
reasons other than the minority of the registrant; or
(2) the registrant is committed by order of a court
pursuant to chapter 253B. The registration remains suspended
until the registrant is restored to capacity by a court and,
upon petition by the registrant, the suspension is terminated by
the board after a hearing.
Subd. 3. [CONDITIONS ON REISSUED REGISTRATION.] In its
discretion, the board may restore and reissue a physician
assistant registration, but may impose as a condition any
disciplinary or corrective measure which it might originally
have imposed.
Subd. 4. [TEMPORARY SUSPENSION OF REGISTRATION.] In
addition to any other remedy provided by law, the board may,
without a hearing, temporarily suspend the registration of a
physician assistant if the board finds that the physician
assistant has violated a statute or rule which the board is
empowered to enforce and continued practice by the physician
assistant would create a serious risk of harm to the public.
The suspension shall take effect upon written notice to the
physician assistant, specifying the statute or rule violated.
The suspension shall remain in effect until the board issues a
final order in the matter after a hearing. At the time it
issues the suspension notice, the board shall schedule a
disciplinary hearing to be held pursuant to the administrative
procedure act.
The physician assistant shall be provided with at least 20
days notice of any hearing held pursuant to this subdivision.
The hearing shall be scheduled to begin no later than 30 days
after the issuance of the suspension order.
Subd. 5. [EVIDENCE.] In disciplinary actions alleging a
violation of subdivision 1, clause (3) or (4), a copy of the
judgment or proceeding under the seal of the court administrator
or of the administrative agency which entered it shall be
admissible into evidence without further authentication and
shall constitute prima facie evidence of the contents thereof.
Subd. 6. [MENTAL EXAMINATION; ACCESS TO MEDICAL DATA.] (a)
If the board has probable cause to believe that a physician
assistant comes under subdivision 1, clause (1), it may direct
the physician assistant to submit to a mental or physical
examination. For the purpose of this subdivision, every
physician assistant registered under this chapter is deemed to
have consented to submit to a mental or physical examination
when directed in writing by the board and further to have waived
all objections to the admissibility of the examining physicians'
testimony or examination reports on the ground that the same
constitute a privileged communication. Failure of a physician
assistant to submit to an examination when directed constitutes
an admission of the allegations against the physician assistant,
unless the failure was due to circumstance beyond the physician
assistant's control, in which case a default and final order may
be entered without the taking of testimony or presentation of
evidence. A physician assistant affected under this subdivision
shall at reasonable intervals be given an opportunity to
demonstrate that the physician assistant can resume competent
practice with reasonable skill and safety to patients. In any
proceeding under this subdivision, neither the record of
proceedings nor the orders entered by the board shall be used
against a physician assistant in any other proceeding.
(b) In addition to ordering a physical or mental
examination, the board may, notwithstanding sections 13.42,
144.651, or any other law limiting access to medical or other
health data, obtain medical data and health records relating to
a registrant or applicant without the registrant's or
applicant's consent if the board has probable cause to believe
that a physician assistant comes under subdivision 1, clause (1).
The medical data may be requested from a provider, as
defined in section 144.335, subdivision 1, paragraph (b), an
insurance company, or a government agency, including the
department of human services. A provider, insurance company, or
government agency shall comply with any written request of the
board under this subdivision and is not liable in any action for
damages for releasing the data requested by the board if the
data are released pursuant to a written request under this
subdivision, unless the information is false and the provider
giving the information knew, or had reason to believe, the
information was false. Information obtained under this
subdivision is classified as private under chapter 13.
Subd. 7. [TAX CLEARANCE CERTIFICATE.] (a) In addition to
the provisions of subdivision 1, the board may not issue or
renew a registration if the commissioner of revenue notifies the
board and the registrant or applicant for registration that the
registrant or applicant owes the state delinquent taxes in the
amount of $500 or more. The board may issue or renew the
registration only if:
(1) the commissioner of revenue issues a tax clearance
certificate; and
(2) the commissioner of revenue, the registrant, or the
applicant forwards a copy of the clearance to the board.
The commissioner of revenue may issue a clearance certificate
only if the registrant or applicant does not owe the state any
uncontested delinquent taxes.
(b) For purposes of this subdivision, the following terms
have the meanings given:
(1) "Taxes" are all taxes payable to the commissioner of
revenue, including penalties and interest due on those taxes,
and
(2) "Delinquent taxes" do not include a tax liability if:
(i) an administrative or court action that contests the
amount or validity of the liability has been filed or served;
(ii) the appeal period to contest the tax liability has not
expired; or
(iii) the licensee or applicant has entered into a payment
agreement to pay the liability and is current with the payments.
(c) When a registrant or applicant is required to obtain a
clearance certificate under this subdivision, a contested case
hearing must be held if the registrant or applicant requests a
hearing in writing to the commissioner of revenue within 30 days
of the date of the notice provided in paragraph (a). The
hearing must be held within 45 days of the date the commissioner
of revenue refers the case to the office of administrative
hearings. Notwithstanding any law to the contrary, the licensee
or applicant must be served with 20 days' notice in writing
specifying the time and place of the hearing and the allegations
against the registrant or applicant. The notice may be served
personally or by mail.
(d) The board shall require all registrants or applicants
to provide their social security number and Minnesota business
identification number on all registration applications. Upon
request of the commissioner of revenue, the board must provide
to the commissioner of revenue a list of all registrants and
applicants, including their names and addresses, social security
numbers, and business identification numbers. The commissioner
of revenue may request a list of the registrants and applicants
no more than once each calendar year.
Sec. 13. [147A.14] [REPORTING OBLIGATIONS.]
Subdivision 1. [PERMISSION TO REPORT.] A person who has
knowledge of any conduct constituting grounds for discipline
under this chapter may report the violation to the board.
Subd. 2. [INSTITUTIONS.] Any hospital, clinic, prepaid
medical plan, or other health care institution or organization
located in this state shall report to the board any action taken
by the institution or organization, any of its administrators,
or its medical or other committees to revoke, suspend, restrict,
or condition a physician assistant's privilege to practice or
treat patients in the institution or as part of the
organization, any denial of privileges, or any other
disciplinary action. The institution or organization shall also
report the resignation of any physician assistants prior to the
conclusion of any disciplinary proceeding, or prior to the
commencement of formal charges but after the physician assistant
had knowledge that formal charges were contemplated or in
preparation. Each report made under this subdivision must state
the nature of the action taken, state in detail the reasons for
the action, and identify the specific patient medical records
upon which the action was based. No report shall be required of
a physician assistant voluntarily limiting the practice of the
physician assistant at a hospital provided that the physician
assistant notifies all hospitals at which the physician
assistant has privileges of the voluntary limitation and the
reasons for it.
Subd. 3. [PHYSICIAN ASSISTANT ORGANIZATIONS.] A state or
local physician assistant organization shall report to the board
any termination, revocation, or suspension of membership or any
other disciplinary action taken against a physician assistant.
If the society has received a complaint which might be grounds
for discipline under this chapter against a member physician
assistant on which it has not taken any disciplinary action, the
society shall report the complaint and the reason why it has not
taken action on it or shall direct the complainant to the board
of medical practice. This subdivision does not apply to a
physician assistant organization when it performs peer review
functions as an agent of an outside entity, organization, or
system.
Subd. 4. [LICENSED PROFESSIONALS.] Licensed health
professionals and persons holding residency permits under
section 147.0391, shall report to the board personal knowledge
of any conduct which the person reasonably believes constitutes
grounds for disciplinary action under this chapter by a
physician assistant, including any conduct indicating that the
person may be incompetent, or may have engaged in unprofessional
conduct or may be medically or physically unable to engage
safely in practice as a physician assistant. No report shall be
required if the information was obtained in the course of a
physician-patient relationship if the patient is a physician
assistant, and the treating physician successfully counsels the
person to limit or withdraw from practice to the extent required
by the impairment.
Subd. 5. [INSURERS.] Four times each year as prescribed by
the board, each insurer authorized to sell insurance described
in section 60A.06, subdivision 1, clause (13), and providing
professional liability insurance to physician assistants, and
any medical clinic, hospital, political subdivision, or other
entity that self-insures and provides professional liability
coverage to physician assistants, shall submit to the board a
report concerning the physician assistants against whom
professional malpractice settlements or awards have been made to
the plaintiff.
Any medical clinic, hospital, political subdivision, or
other entity which provides liability coverage on behalf of a
physician assistant shall submit to the board a report
concerning settlements or awards paid on behalf of a physician
assistant, and any settlements or awards paid by a clinic,
hospital, political subdivision, or other entity on its own
behalf because of care rendered by a physician assistant. The
report shall be made to the board within 30 days of any
settlement. The report must contain at least the following
information:
(1) the total number of medical malpractice settlements or
awards made to the plaintiff;
(2) the date the medical malpractice settlements or awards
to the plaintiff were made;
(3) the allegations contained in the claim or complaint
leading to the settlements or awards made to the plaintiff;
(4) the dollar amount of each medical malpractice
settlement or award;
(5) the regular address of the practice of the physician
assistant against whom an award was made or with whom a
settlement was made; and
(6) the name of the physician assistant against whom an
award was made or with whom a settlement was made.
The insurance company shall, in addition to the above
information, report to the board any information it possesses
which tends to substantiate a charge that a physician assistant
may have engaged in conduct violating this chapter.
Subd. 6. [COURTS.] The court administrator of district
court or any other court of competent jurisdiction shall report
to the board any judgment or other determination of the court
which adjudges or includes a finding that a physician assistant
is mentally ill, mentally incompetent, guilty of a felony, or
guilty of a violation of federal or state narcotics laws or
controlled substances act, guilty of an abuse or fraud under
Medicare or Medicaid, appoints a guardian of the physician
assistant pursuant to section 525.54 to 525.61 or commits a
physician assistant pursuant to chapter 253B.
Subd. 7. [SELF-REPORTING.] A physician assistant shall
report to the board any personal action which is a violation of
this chapter.
Subd. 8. [DEADLINES; FORMS.] Reports required by
subdivisions 2 to 7 must be submitted not later than 30 days
after the occurrence of the reportable event or transaction.
The board may provide forms for the submission of reports
required by this section, may require that reports be submitted
on the forms provided, and may adopt rules necessary to assure
prompt and accurate reporting.
Subd. 9. [SUBPOENAS.] The board may issue subpoenas for
the production of any reports required by subdivisions 2 to 7 or
any related documents.
Sec. 14. [147A.15] [IMMUNITY.]
Subdivision 1. [REPORTING.] Any person, health care
facility, business, or organization is immune from civil
liability or criminal prosecution for submitting a report to the
board pursuant to this chapter or for otherwise reporting to the
board violations or alleged violations of this chapter. All
such reports are confidential and absolutely privileged
communications.
Subd. 2. [INVESTIGATION; INDEMNIFICATION.] (a) Members of
the board, persons employed by the board, and consultants
retained by the board for the purpose of investigation of
violations or the preparation and management of charges of
violations of this chapter on behalf of the board are immune
from civil liability and criminal prosecution for any actions,
transactions, or publications in the execution of, or relating
to, their duties under this chapter.
(b) For purposes of this section, a member of the board or
a consultant described in paragraph (a) is considered a state
employee under section 3.736, subdivision 9.
Subd. 3. [PHYSICIAN ASSISTANT COOPERATION.] A physician
assistant who is the subject of an investigation by or on behalf
of the board shall cooperate fully with the investigation.
Cooperation includes responding fully and promptly to any
question raised by or on behalf of the board relating to the
subject of the investigation and providing copies of patient
medical records, as reasonably requested by the board, to assist
the board in its investigation. The board shall pay for copies
requested. If the board does not have a written consent from a
patient permitting access to the patient's records, the
physician assistant shall delete any data in the record which
identifies the patient before providing it to the board. The
board shall maintain any records obtained pursuant to this
section as investigative data pursuant to chapter 13.
Sec. 15. [147A.16] [FORMS OF DISCIPLINARY ACTION.]
When the board finds that a registered physician assistant
has violated a provision of this chapter, it may do one or more
of the following:
(1) revoke the registration;
(2) suspend the registration;
(3) impose limitations or conditions on the physician
assistant's practice, including limiting the scope of practice
to designated field specialties; impose retraining or
rehabilitation requirements; require practice under additional
supervision; or condition continued practice on demonstration of
knowledge or skills by appropriate examination or other review
of skill and competence;
(4) impose a civil penalty not exceeding $10,000 for each
separate violation, the amount of the civil penalty to be fixed
so as to deprive the physician assistant of any economic
advantage gained by reason of the violation charged or to
reimburse the board for the cost of the investigation and
proceeding;
(5) order the physician assistant to provide unremunerated
professional service under supervision at a designated public
hospital, clinic, or other health care institution; or
(6) censure or reprimand the registered physician assistant.
Upon judicial review of any board disciplinary action taken
under this chapter, the reviewing court shall seal the
administrative record, except for the board's final decision,
and shall not make the administrative record available to the
public.
Sec. 16. [147A.17] [PHYSICIAN ASSISTANT ACCOUNTABILITY.]
Subdivision 1. [INVESTIGATION.] The board shall maintain
and keep current a file containing the reports and complaints
filed against physician assistants in the state. Each complaint
filed with the board pursuant to section 214.10, subdivision 1,
shall be investigated according to section 214.10, subdivision 2.
Whenever the files maintained by the board show that a
medical malpractice settlement or award to the plaintiff has
been made against a physician assistant as reported by insurers
pursuant to this chapter, the executive director of the board
shall notify the board and the board may authorize a review of
the physician assistant's practice.
Subd. 2. [ATTORNEY GENERAL INVESTIGATION.] When the board
initiates a review of a physician assistant's practice, it shall
notify the attorney general who shall investigate the matter in
the same manner as provided in section 214.10. If an
investigation is to be made, the attorney general shall notify
the physician assistant, and, if the incident being investigated
occurred there, the administrator and chief of staff at the
medical care facilities in which the physician assistant serves.
Subd. 3. [ACCESS TO HOSPITAL RECORDS.] The board shall
have access to hospital and medical records of a patient treated
by the physician assistant under review if the patient signs a
written consent form permitting such access. If no consent form
has been signed, the hospital or physician assistant shall first
delete data in the record which identifies the patient before
providing it to the board.
Sec. 17. [147A.18] [DELEGATED AUTHORITY TO PRESCRIBE,
DISPENSE, AND ADMINISTER DRUGS AND MEDICAL DEVICES.]
Subdivision 1. [DELEGATION.] (a) A supervising physician
may delegate to a physician assistant who is registered with the
board, certified by the National Commission on Certification of
Physician Assistants or successor agency approved by the board,
and who is under the supervising physician's supervision, the
authority to prescribe, dispense, and administer legend drugs,
medical devices, and controlled substances subject to the
requirements in this section. The authority to dispense
includes, but is not limited to, the authority to request,
receive, and dispense sample drugs. This authority to dispense
extends only to those drugs described in the written agreement
developed under paragraph (b).
(b) The agreement between the physician assistant and
supervising physician and any alternate supervising physicians
must include a statement by the supervising physician regarding
delegation or nondelegation of the functions of prescribing,
dispensing, and administering of legend drugs and medical
devices to the physician assistant. The statement must include
a protocol indicating categories of drugs for which the
supervising physician delegates prescriptive and dispensing
authority. The delegation must be appropriate to the physician
assistant's practice and within the scope of the physician
assistant's training. Physician assistants who have been
delegated the authority to prescribe, dispense, and administer
legend drugs and medical devices shall provide evidence of
current certification by the National Commission on
Certification of Physician Assistants or its successor agency
when registering or reregistering as physician assistants.
Physician assistants who have been delegated the authority to
prescribe controlled substances must present evidence of the
certification and hold a valid DEA certificate. Supervising
physicians shall retrospectively review, on a daily basis, the
prescribing, dispensing, and administering of legend and
controlled drugs and medical devices by physician assistants,
when this authority has been delegated to the physician
assistant as part of the delegation agreement between the
physician and the physician assistant. During each daily
review, the supervising physician shall document by signature
and date that the prescriptive, administering, and dispensing
practice of the physician assistant has been reviewed.
(c) The board may establish by rule:
(1) a system of identifying physician assistants eligible
to prescribe, administer, and dispense legend drugs and medical
devices;
(2) a system of identifying physician assistants eligible
to prescribe, administer, and dispense controlled substances;
(3) a method of determining the categories of legend and
controlled drugs and medical devices that each physician
assistant is allowed to prescribe, administer, and dispense; and
(4) a system of transmitting to pharmacies a listing of
physician assistants eligible to prescribe legend and controlled
drugs and medical devices.
Subd. 2. [TERMINATION AND REINSTATEMENT OF PRESCRIBING
AUTHORITY.] (a) The authority of a physician assistant to
prescribe, dispense, and administer legend drugs and medical
devices shall end immediately when:
(1) the agreement is terminated;
(2) the authority to prescribe, dispense, and administer is
terminated or withdrawn by the supervising physician; or
(3) the physician assistant reverts to inactive status,
loses National Commission on Certification of Physician
Assistants or successor agency certification, or loses or
terminates registration status.
(b) The physician assistant must notify the board in
writing within ten days of the occurrence of any of the
circumstances listed in paragraph (a).
(c) Physician assistants whose authority to prescribe,
dispense, and administer has been terminated shall reapply for
reinstatement of prescribing authority under this section and
meet any requirements established by the board prior to
reinstatement of the prescribing, dispensing, and administering
authority.
Subd. 3. [OTHER REQUIREMENTS AND RESTRICTIONS.] (a) The
supervising physician and the physician assistant must complete,
sign, and date an internal protocol which lists each category of
drug or medical device, or controlled substance the physician
assistant may prescribe, dispense, and administer. The
supervising physician and physician assistant shall submit the
internal protocol to the board upon request. The supervising
physician may amend the internal protocol as necessary, within
the limits of the completed delegation form in subdivision 5.
The supervising physician and physician assistant must sign and
date any amendments to the internal protocol. Any amendments
resulting in a change to an addition or deletion to categories
delegated in the delegation form in subdivision 5 must be
submitted to the board according to this chapter, along with the
fee required.
(b) The supervising physician and physician assistant shall
review delegation of prescribing, dispensing, and administering
authority on an annual basis at the time of reregistration. The
internal protocol must be signed and dated by the supervising
physician and physician assistant after review. Any amendments
to the internal protocol resulting in changes to the delegation
form in subdivision 5 must be submitted to the board according
to this chapter, along with the fee required.
(c) Each prescription initiated by a physician assistant
shall indicate the following:
(1) the date of issue;
(2) the name and address of the patient;
(3) the name and quantity of the drug prescribed;
(4) directions for use; and
(5) the name, address, and telephone number of the
prescribing physician assistant and of the physician serving as
supervisor.
(d) In prescribing, dispensing, and administering legend
drugs and medical devices, including controlled substances as
defined in section 152.01, subdivision 4, a physician assistant
must conform with the agreement, chapter 151, and this chapter.
Subd. 4. [NOTIFICATION OF PHARMACIES.] (a) The board shall
annually provide to the board of pharmacy and to registered
pharmacies within the state a list of those physician assistants
who are authorized to prescribe, administer, and dispense legend
drugs and medical devices, or controlled substances.
(b) The board shall provide to the board of pharmacy a list
of physician assistants authorized to prescribe legend drugs and
medical devices every two months if additional physician
assistants are authorized to prescribe or if physician
assistants have authorization to prescribe withdrawn.
(c) The list must include the name, address, telephone
number, and Minnesota registration number of the physician
assistant, and the name, address, telephone number, and
Minnesota license number of the supervising physician.
(d) The board shall provide the form in subdivision 5 to
pharmacies upon request.
(e) The board shall make available prototype forms of the
physician-physician assistant agreement, the internal protocol,
the delegation form, and the addendum form.
Subd. 5. [DELEGATION FORM FOR PHYSICIAN ASSISTANT
PRESCRIBING.] The delegation form for physician assistant
prescribing must contain a listing by drug category of the
legend drugs and controlled substances for which prescribing
authority has been delegated to the physician assistant.
Sec. 18. [147A.19] [IDENTIFICATION REQUIREMENTS.]
Physician assistants registered under this chapter shall
keep their registration available for inspection at their
primary place of business and shall, when engaged in their
professional activities, wear a name tag identifying themselves
as a "physician assistant."
Sec. 19. [147A.20] [PHYSICIAN AND PHYSICIAN ASSISTANT
AGREEMENT.]
(a) A physician assistant and supervising physician must
sign an agreement which specifies scope of practice and amount
and manner of supervision as required by the board. The
agreement must contain:
(1) a description of the practice setting;
(2) a statement of practice type/specialty;
(3) a listing of categories of delegated duties; and
(4) a description of supervision type, amount, and
frequency.
(b) The agreement must be maintained by the supervising
physician and physician assistant and made available to the
board upon request. If there is a delegation of prescribing,
administering, and dispensing of legend drugs, controlled
substances, and medical devices, the agreement shall include an
internal protocol and delegation form. Physician assistants
shall have a separate agreement for each place of employment.
Agreements must be reviewed and updated on an annual basis. The
supervising physician and physician assistant must maintain the
agreement, delegation form, and internal protocol at the address
of record. Copies shall be provided to the board upon request.
(c) Physician assistants must provide written notification
to the board within 30 days of the following:
(1) name change;
(2) address of record change;
(3) telephone number of record change; and
(4) addition or deletion of alternate supervising physician
provided that the information submitted includes, for an
additional alternate physician, an affidavit of consent to act
as an alternate supervising physician signed by the alternate
supervising physician.
(d) Modifications requiring submission prior to the
effective date are changes to the practice setting description
which include:
(1) supervising physician change, excluding alternate
supervising physicians; or
(2) delegation of prescribing, administering, or dispensing
of legend drugs, controlled substances, or medical devices.
Sec. 20. [147A.21] [RULEMAKING AUTHORITY.]
The board shall adopt rules:
(1) setting registration fees;
(2) setting renewal fees;
(3) setting fees for locum tenens permits;
(4) setting fees for temporary registration; and
(5) establishing renewal dates.
Sec. 21. [147A.22] [LOCUM TENENS PERMIT.]
The board may grant a locum tenens permit to any applicant
who is registered in the state. The applications for locum
tenens permits shall be reviewed at the next scheduled board
meeting. The application shall include a practice setting
description. The maximum duration of a locum tenens permit is
one year. The permit may be renewed annually on a date set by
the board.
Sec. 22. [147A.24] [CONTINUING EDUCATION REQUIREMENTS.]
Subdivision 1. [AMOUNT OF EDUCATION REQUIRED.] Applicants
for registration renewal or reregistration must either attest to
and document successful completion of at least 50 contact hours
of continuing education within the two years immediately
preceding registration renewal, reregistration, or attest to and
document taking the national certifying examination required by
this chapter within the past two years.
Subd. 2. [TYPE OF EDUCATION REQUIRED.] Approved continuing
education equivalent to category 1 credit hours as defined by
the American Osteopathic Association Bureau of Professional
Education, the Royal College of Physicians and Surgeons of
Canada, the American Academy of Physician Assistants, or by
organizations that have reciprocal arrangements with the
physician recognition award program of the American Medical
Association.
Sec. 23. [147A.25] [CONTINUING EDUCATION CYCLES.]
During each two-year cycle each physician assistant shall
obtain 50 hours of continuing medical education credit with at
least two hours in the subject of infection control, including
blood borne diseases. "Infection control" means programs,
procedures, and methods to reduce the transmission of agents of
infection for the purpose of preventing or decreasing the
incidence of infectious diseases. "Blood borne diseases" means
diseases that are spread through exposure to, inoculation of, or
injection of blood, or through exposure to blood contained in
body fluids, tissue, or organs. Blood borne diseases include
infection caused by such agents as the human immunodeficiency
virus (HIV) and hepatitis B virus (HBV). Infection control
continuing education credits must be obtained from the category
1 activities. Continuing education in infection control is
required for renewal periods beginning on or after October 1,
1995. For initial continuing education periods of less than two
years, one continuing education hour in infection control is
required for each remaining full year.
Sec. 24. [147A.26] [PROCEDURES.]
The board shall establish, in writing, internal operating
procedures for receiving and investigating complaints, accepting
and processing applications, granting registrations, and
imposing enforcement actions. The written internal operating
procedures may include procedures for sharing complaint
information with government agencies in this and other states.
Establishment of the operating procedures are not subject to
rulemaking procedures under chapter 14. Procedures for sharing
complaint information must be consistent with the requirements
for handling government data under chapter 13.
Sec. 25. [REPEALER.]
Minnesota Statutes 1994, sections 147.34; 147.35; and
147.36; Minnesota Rules, parts 5600.2600; 5600.2605; 5600.2610;
5600.2615; 5600.2620; 5600.2625; 5600.2630; 5600.2635;
5600.2640; 5600.2645; 5600.2650; 5600.2655; 5600.2660;
5600.2665; and 5600.2670, are repealed.
Sec. 26. [EFFECTIVE DATE.]
Sections 1 to 25 are effective on the day following final
enactment, except that sections 7; 12, subdivisions 1 and 7; and
21, are effective on July 1, 1996. All physician assistants
registered under this act shall be in compliance no later than
July 1, 1996.
ARTICLE 2
CONFORMING AMENDMENTS
Section 1. Minnesota Statutes 1994, section 116J.70,
subdivision 2a, is amended to read:
Subd. 2a. [LICENSE; EXCEPTIONS.] "Business license" or
"license" does not include the following:
(1) any occupational license or registration issued by a
licensing board listed in section 214.01 or any occupational
registration issued by the commissioner of health pursuant to
section 214.13;
(2) any license issued by a county, home rule charter city,
statutory city, township, or other political subdivision;
(3) any license required to practice the following
occupation regulated by the following sections:
(a) abstracters regulated pursuant to chapter 386;
(b) accountants regulated pursuant to chapter 326;
(c) adjusters regulated pursuant to chapter 72B;
(d) architects regulated pursuant to chapter 326;
(e) assessors regulated pursuant to chapter 270;
(f) athletic trainers regulated pursuant to chapter 148;
(g) attorneys regulated pursuant to chapter 481;
(h) auctioneers regulated pursuant to chapter 330;
(i) barbers regulated pursuant to chapter 154;
(j) beauticians regulated pursuant to chapter 155A;
(k) boiler operators regulated pursuant to chapter 183;
(l) chiropractors regulated pursuant to chapter 148;
(m) collection agencies regulated pursuant to chapter 332;
(n) cosmetologists regulated pursuant to chapter 155A;
(o) dentists, registered dental assistants, and dental
hygienists regulated pursuant to chapter 150A;
(p) detectives regulated pursuant to chapter 326;
(q) electricians regulated pursuant to chapter 326;
(r) embalmers regulated pursuant to chapter 149;
(s) engineers regulated pursuant to chapter 326;
(t) insurance brokers and salespersons regulated pursuant
to chapter 60A;
(u) certified interior designers regulated pursuant to
chapter 326;
(v) midwives regulated pursuant to chapter 148;
(w) morticians regulated pursuant to chapter 149;
(x) nursing home administrators regulated pursuant to
chapter 144A;
(y) optometrists regulated pursuant to chapter 148;
(z) osteopathic physicians regulated pursuant to chapter
147;
(aa) pharmacists regulated pursuant to chapter 151;
(bb) physical therapists regulated pursuant to chapter 148;
(cc) physician assistants regulated pursuant to chapter
147A;
(dd) physicians and surgeons regulated pursuant to chapter
147;
(dd) (ee) plumbers regulated pursuant to chapter 326;
(ee) (ff) podiatrists regulated pursuant to chapter 153;
(ff) (gg) practical nurses regulated pursuant to chapter
148;
(gg) (hh) professional fund raisers regulated pursuant to
chapter 309;
(hh) (ii) psychologists regulated pursuant to chapter 148;
(ii) (jj) real estate brokers, salespersons, and others
regulated pursuant to chapters 82 and 83;
(jj) (kk) registered nurses regulated pursuant to chapter
148;
(kk) (ll) securities brokers, dealers, agents, and
investment advisers regulated pursuant to chapter 80A;
(ll) (mm) steamfitters regulated pursuant to chapter 326;
(mm) (nn) teachers and supervisory and support personnel
regulated pursuant to chapter 125;
(nn) (oo) veterinarians regulated pursuant to chapter 156;
(oo) (pp) water conditioning contractors and installers
regulated pursuant to chapter 326;
(pp) (qq) water well contractors regulated pursuant to
chapter 156A;
(qq) (rr) water and waste treatment operators regulated
pursuant to chapter 115;
(rr) (ss) motor carriers regulated pursuant to chapter 221;
(ss) (tt) professional corporations regulated pursuant to
chapter 319A;
(tt) (uu) real estate appraisers regulated pursuant to
chapter 82B;
(uu) (vv) residential building contractors, residential
remodelers, residential roofers, manufactured home installers,
and specialty contractors regulated pursuant to chapter 326;
(4) any driver's license required pursuant to chapter 171;
(5) any aircraft license required pursuant to chapter 360;
(6) any watercraft license required pursuant to chapter
86B;
(7) any license, permit, registration, certification, or
other approval pertaining to a regulatory or management program
related to the protection, conservation, or use of or
interference with the resources of land, air, or water, which is
required to be obtained from a state agency or instrumentality;
and
(8) any pollution control rule or standard established by
the pollution control agency or any health rule or standard
established by the commissioner of health or any licensing rule
or standard established by the commissioner of human services.
Sec. 2. Minnesota Statutes 1994, section 136A.1356,
subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] For purposes of this
section, the following definitions apply:
(a) "Designated rural area" has the definition developed in
rule by the higher education coordinating board.
(b) "Midlevel practitioner" means a nurse practitioner,
nurse-midwife, nurse anesthetist, advanced clinical nurse
specialist, or physician assistant.
(c) "Nurse-midwife" means a registered nurse who has
graduated from a program of study designed to prepare registered
nurses for advance practice as nurse-midwives.
(d) "Nurse practitioner" means a registered nurse who has
graduated from a program of study designed to prepare registered
nurses for advance practice as nurse practitioners.
(e) "Physician assistant" means a person meeting the
definition in Minnesota Rules, part 5600.2600, subpart
11 registered under chapter 147A.
Sec. 3. Minnesota Statutes 1994, section 144.335,
subdivision 1, is amended to read:
Subdivision 1. [DEFINITIONS.] For the purposes of this
section, the following terms have the meanings given them:
(a) "Patient" means a natural person who has received
health care services from a provider for treatment or
examination of a medical, psychiatric, or mental condition, the
surviving spouse and parents of a deceased patient, or a person
the patient designates in writing as a representative. Except
for minors who have received health care services pursuant to
sections 144.341 to 144.347, in the case of a minor, patient
includes a parent or guardian, or a person acting as a parent or
guardian in the absence of a parent or guardian.
(b) "Provider" means (1) any person who furnishes health
care services and is licensed to furnish the services pursuant
to chapter 147, 148, 148B, 150A, 151, or 153; (2) a home care
provider licensed under section 144A.46; (3) a health care
facility licensed pursuant to this chapter or chapter 144A; (4)
a physician assistant registered under chapter 147A; and (4) (5)
an unlicensed mental health practitioner regulated pursuant to
sections 148B.60 to 148B.71.
(c) "Individually identifiable form" means a form in which
the patient is or can be identified as the subject of the health
records.
Sec. 4. Minnesota Statutes 1994, section 148B.60,
subdivision 3, is amended to read:
Subd. 3. [UNLICENSED MENTAL HEALTH PRACTITIONER OR
PRACTITIONER.] "Unlicensed mental health practitioner" or
"practitioner" means a person who provides or purports to
provide, for remuneration, mental health services as defined in
subdivision 4. It does not include persons licensed by the
board of medical practice under chapter 147 or registered by the
board of medical practice under chapter 147A; the board of
nursing under sections 148.171 to 148.285; the board of
psychology under sections 148.88 to 148.98; the board of social
work under sections 148B.18 to 148B.28; the board of marriage
and family therapy under sections 148B.29 to 148B.39; or another
licensing board if the person is practicing within the scope of
the license; or members of the clergy who are providing pastoral
services in the context of performing and fulfilling the
salaried duties and obligations required of a member of the
clergy by a religious congregation. For the purposes of
complaint investigation or disciplinary action relating to an
individual practitioner, the term includes:
(1) hospital and nursing home social workers exempt from
licensure by the board of social work under section 148B.28,
subdivision 6, including hospital and nursing home social
workers acting within the scope of their employment by the
hospital or nursing home;
(2) persons employed by a program licensed by the
commissioner of human services who are acting as mental health
practitioners within the scope of their employment;
(3) persons employed by a program licensed by the
commissioner of human services who are providing chemical
dependency counseling services; persons who are providing
chemical dependency counseling services in private practice; and
(4) clergy who are providing mental health services that
are equivalent to those defined in subdivision 4.
Sec. 5. Minnesota Statutes 1994, section 151.01,
subdivision 23, is amended to read:
Subd. 23. [PRACTITIONER.] "Practitioner" means a licensed
doctor of medicine, licensed doctor of osteopathy duly licensed
to practice medicine, licensed doctor of dentistry, licensed
doctor of optometry, licensed podiatrist, or licensed
veterinarian. For purposes of sections 151.15, subdivision 4,
151.37, subdivision 2, paragraph (b), and 151.461,
"practitioner" also means a physician assistant authorized to
prescribe, dispense, and administer under section 147.34 chapter
147A, or an advanced practice nurse authorized to prescribe,
dispense, and administer under section 148.235.
Sec. 6. Minnesota Statutes 1994, section 151.37,
subdivision 2a, is amended to read:
Subd. 2a. A supervising physician may delegate to a
physician assistant who is registered with the board of medical
practice and certified by the National Commission on
Certification of Physician Assistants and who is under the
supervising physician's supervision, the authority to prescribe,
dispense, and administer legend drugs and medical devices,
subject to the requirements in section 147.34 chapter 147A and
other requirements established by the commissioner of health
board of medical practice in rules.
Sec. 7. Minnesota Statutes 1994, section 214.23,
subdivision 1, is amended to read:
Subdivision 1. [COMMISSIONER OF HEALTH.] The board shall
enter into a contract with the commissioner to perform the
functions in subdivisions 2 and 3. The contract shall provide
that:
(1) unless requested to do otherwise by a regulated person,
a board shall refer all regulated persons infected with HIV or
HBV to the commissioner;
(2) the commissioner may choose to refer any regulated
person who is infected with HIV or HBV as well as all
information related thereto to the person's board at any time
for any reason, including but not limited to: the degree of
cooperation and compliance by the regulated person; the
inability to secure information or the medical records of the
regulated person; or when the facts may present other possible
violations of the regulated persons practices act. Upon request
of the regulated person who is infected with HIV or HBV the
commissioner shall refer the regulated person and all
information related thereto to the person's board. Once the
commissioner has referred a regulated person to a board, the
board may not thereafter submit it to the commissioner to
establish a monitoring plan unless the commissioner of health
consents in writing;
(3) a board shall not take action on grounds relating
solely to the HIV or HBV status of a regulated person until
after referral by the commissioner; and
(4) notwithstanding sections 13.39 and 13.41 and chapters
147, 147A, 148, 150A, 153, and 214, a board shall forward to the
commissioner any information on a regulated person who is
infected with HIV or HBV that the department of health requests.
Sec. 8. Minnesota Statutes 1994, section 604A.01,
subdivision 2, is amended to read:
Subd. 2. [GENERAL IMMUNITY FROM LIABILITY.] (a) A person
who, without compensation or the expectation of compensation,
renders emergency care, advice, or assistance at the scene of an
emergency or during transit to a location where professional
medical care can be rendered, is not liable for any civil
damages as a result of acts or omissions by that person in
rendering the emergency care, advice, or assistance, unless the
person acts in a willful and wanton or reckless manner in
providing the care, advice, or assistance. This subdivision
does not apply to a person rendering emergency care, advice, or
assistance during the course of regular employment, and
receiving compensation or expecting to receive compensation for
rendering the care, advice, or assistance.
(b) For the purposes of this section, the scene of an
emergency is an area outside the confines of a hospital or other
institution that has hospital facilities, or an office of a
person licensed to practice one or more of the healing arts
under chapter 147, 147A, 148, 150A, or 153. The scene of an
emergency includes areas threatened by or exposed to spillage,
seepage, fire, explosion, or other release of hazardous
materials, and includes ski areas and trails.
(c) For the purposes of this section, "person" includes a
public or private nonprofit volunteer firefighter, volunteer
police officer, volunteer ambulance attendant, volunteer first
provider of emergency medical services, volunteer ski patroller,
and any partnership, corporation, association, or other entity.
(d) For the purposes of this section, "compensation" does
not include payments, reimbursement for expenses, or pension
benefits paid to members of volunteer organizations.
Sec. 9. [EFFECTIVE DATE.]
Sections 1 to 8 are effective on the day following final
enactment.
Presented to the governor May 22, 1995
Signed by the governor May 22, 1995, 7:38 p.m.
Official Publication of the State of Minnesota
Revisor of Statutes