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Key: (1) language to be deleted (2) new language

                            CHAPTER 120-S.F.No. 741 
                  An act relating to health; regulating the practice of 
                  respiratory care; establishing the requirements for 
                  registration and regulation of respiratory care 
                  practitioners; providing for continuing education, 
                  fees, reporting obligations, disciplinary actions, and 
                  for an advisory council; providing criminal penalties; 
                  creating a physician assistant advisory council; 
                  proposing coding for new law in Minnesota Statutes, 
                  chapter 147A; proposing coding for new law as 
                  Minnesota Statutes, chapter 147C; repealing Minnesota 
                  Rules, parts 4762.0010; 4762.0020; 4762.0030; 
                  4762.0040; 4762.0050; 4762.0060; 4762.0065; 4762.0070; 
                  4762.0080; 4762.0090; 4762.0100; 4762.0200; and 
           Section 1.  [147A.27] [PHYSICIAN ASSISTANT ADVISORY 
           Subdivision 1.  [MEMBERSHIP.] The physician assistant 
        advisory council is created and is composed of seven persons 
        appointed by the board.  The seven persons must include: 
           (1) two public members, as defined in section 214.02; 
           (2) three physician assistants registered under this 
        chapter; and 
           (3) two licensed physicians with experience supervising 
        physician assistants. 
           Subd. 2.  [ORGANIZATION.] The council shall be organized 
        and administered under section 15.059, except that the advisory 
        council shall expire on June 30, 2007. 
           Subd. 3.  [DUTIES.] The council shall advise the board 
           (1) physician assistant registration standards; 
           (2) enforcement of grounds for discipline; 
           (3) distribution of information regarding physician 
        assistant registration standards; 
           (4) applications and recommendations of applicants for 
        registration or registration renewal; and 
           (5) complaints and recommendations to the board regarding 
        disciplinary matters and proceedings concerning applicants and 
        registrants according to sections 214.10; 214.103; and 214.13, 
        subdivisions 6 and 7. 
           The council shall perform other duties authorized for the 
        council by chapter 214 as directed by the board. 
           Sec. 2.  [147C.01] [DEFINITIONS.] 
           Subdivision 1.  [APPLICABILITY.] The definitions in this 
        section apply to this chapter. 
           Subd. 2.  [ADVISORY COUNCIL.] "Advisory council" means the 
        respiratory care practitioner advisory council established under 
        section 147C.35. 
           Subd. 3.  [APPROVED EDUCATION PROGRAM.] "Approved education 
        program" means a university, college, or other post-secondary 
        education program leading to eligibility for registry or 
        certification in respiratory care, that, at the time the student 
        completes the program, is accredited by a national accrediting 
        organization approved by the board.  
           Subd. 4.  [BOARD.] "Board" means the board of medical 
        practice or its designee. 
           Subd. 5.  [CONTACT HOUR.] "Contact hour" means an 
        instructional session of 50 consecutive minutes, excluding 
        coffee breaks, registration, meals without a speaker, and social 
           Subd. 6.  [CREDENTIAL.] "Credential" means a license, 
        permit, certification, registration, or other evidence of 
        qualification or authorization to engage in respiratory care 
        practice in this state or any other state. 
           Subd. 7.  [CREDENTIALING EXAMINATION.] "Credentialing 
        examination" means an examination administered by the National 
        Board for Respiratory Care or other national testing 
        organization approved by the board for credentialing as a 
        certified respiratory therapy technician, registered respiratory 
        therapist, or other title indicating an entry or advanced level 
        respiratory care practitioner.  
           Subd. 8.  [HEALTH CARE FACILITY.] "Health care facility" 
        means a hospital as defined in section 144.50, subdivision 2, a 
        medical facility as defined in section 144.561, subdivision 1, 
        paragraph (b), or a nursing home as defined in section l44A.01, 
        subdivision 5, a long-term acute care facility, a subacute care 
        facility, an outpatient clinic, a physician's office, or a 
           Subd. 9.  [QUALIFIED MEDICAL DIRECTION.] "Qualified medical 
        direction" means direction from a licensed physician who is on 
        the staff or is a consultant of a health care facility or home 
        care agency or home medical equipment provider and who has a 
        special interest in and knowledge of the diagnosis and treatment 
        of deficiencies, abnormalities, and diseases of the 
        cardiopulmonary system.  
           Subd. 10.  [RESPIRATORY CARE.] "Respiratory care" means the 
        provision of services described under section 147C.05 for the 
        assessment, treatment, education, management, evaluation, and 
        care of patients with deficiencies, abnormalities, and diseases 
        of the cardiopulmonary system, under the guidance of qualified 
        medical direction and pursuant to a referral from a physician 
        who has medical responsibility for the patient.  It includes 
        education pertaining to health promotion and disease prevention, 
        patient care, and treatment. 
           Sec. 3.  [147C.05] [SCOPE OF PRACTICE.] 
           (a) The practice of respiratory care by a registered 
        respiratory care practitioner includes, but is not limited to, 
        the following services: 
           (1) providing and monitoring therapeutic administration of 
        medical gases, aerosols, humidification, and pharmacological 
        agents related to respiratory care procedures, but not including 
        administration of general anesthesia; 
           (2) carrying out therapeutic application and monitoring of 
        mechanical ventilatory support; 
           (3) providing cardiopulmonary resuscitation and maintenance 
        of natural airways and insertion and maintenance of artificial 
           (4) assessing and monitoring signs, symptoms, and general 
        behavior relating to, and general physical response to, 
        respiratory care treatment or evaluation for treatment and 
        diagnostic testing, including determination of whether the 
        signs, symptoms, reactions, behavior, or general response 
        exhibit abnormal characteristics; 
           (5) obtaining physiological specimens and interpreting 
        physiological data including: 
           (i) analyzing arterial and venous blood gases; 
           (ii) assessing respiratory secretions; 
           (iii) measuring ventilatory volumes, pressures, and flows; 
           (iv) testing pulmonary function; 
           (v) testing and studying the cardiopulmonary system; and 
           (vi) diagnostic testing of breathing patterns related to 
        sleep disorders; 
           (6) assisting hemodynamic monitoring and support of the 
        cardiopulmonary system; 
           (7) assessing and making suggestions for modifications in 
        the treatment regimen based on abnormalities, protocols, or 
        changes in patient response to respiratory care treatment; 
           (8) providing cardiopulmonary rehabilitation including 
        respiratory-care related educational components, postural 
        drainage, chest physiotherapy, breathing exercises, aerosolized 
        administration of medications, and equipment use and 
           (9) instructing patients and their families in techniques 
        for the prevention, alleviation, and rehabilitation of 
        deficiencies, abnormalities, and diseases of the cardiopulmonary 
        system; and 
           (10) transcribing and implementing physician orders for 
        respiratory care services. 
           (b) Patient service by a practitioner must be limited to: 
           (1) services within the training and experience of the 
        practitioner; and 
           (2) services within the parameters of the laws, rules, and 
        standards of the facilities in which the respiratory care 
        practitioner practices.  
           (c) Respiratory care services provided by a registered 
        respiratory care practitioner, whether delivered in a health 
        care facility or the patient's residence, must not be provided 
        except upon referral from a physician. 
           Sec. 4.  [147C.10] [PROTECTED TITLES AND RESTRICTIONS ON 
           Subdivision 1.  [PROTECTED TITLES.] No individual may use 
        the title "Minnesota registered respiratory care practitioner," 
        "registered respiratory care practitioner," "respiratory care 
        practitioner," "respiratory therapist," "respiratory therapy (or 
        care) technician," "inhalation therapist," or "inhalation 
        therapy technician," or use, in connection with the individual's 
        name, the letters "RCP," or any other titles, words, letters, 
        abbreviations, or insignia indicating or implying that the 
        individual is eligible for registration by the state as a 
        respiratory care practitioner unless the individual has been 
        registered as a respiratory care practitioner according to this 
           Subd. 2.  [OTHER HEALTH CARE PRACTITIONERS.] (a) 
        Nonphysician individuals practicing in a health care occupation 
        or profession are not restricted in the provision of services 
        included in section 147C.05, as long as they do not hold 
        themselves out as respiratory care practitioners by or through 
        the use of the titles provided in subdivision 1 in association 
        with provision of these services. 
           (b) Physician practitioners are exempt from this chapter. 
           (c) Nothing in this chapter shall be construed to require 
        registration of: 
           (1) a respiratory care practitioner student enrolled in a 
        respiratory therapy education program accredited by the 
        Commission on Accreditation of Allied Health Education Programs 
        or another accrediting organization approved by the board; and 
           (2) a respiratory care practitioner employed in the service 
        of the federal government while performing duties incident to 
        that employment. 
           Subd. 3.  [PENALTY.] A person who violates subdivision 1 is 
        guilty of a gross misdemeanor. 
        Respiratory care practitioners registered in Minnesota shall 
        wear name tags that identify them as respiratory care 
        practitioners while in a professional setting.  If not written 
        in full, this must be designated as RCP.  A student attending a 
        respiratory therapy training program or a tutorial intern 
        program must be identified as a student respiratory care 
        practitioner.  This abbreviated designation is Student RCP.  
        Unregulated individuals who work in an assisting respiratory 
        role under the supervision of respiratory care practitioners 
        must be identified as respiratory care assistants or aides. 
           Sec. 5.  [147C.15] [REGISTRATION REQUIREMENTS.] 
        be eligible for registration, an applicant, with the exception 
        of those seeking registration by reciprocity under subdivision 
        2, must: 
           (1) submit a completed application on forms provided by the 
        board along with all fees required under section 147C.40 that 
           (i) the applicant's name, social security number, home 
        address and telephone number, and business address and telephone 
           (ii) the name and location of the respiratory care 
        education program the applicant completed; 
           (iii) a list of degrees received from educational 
           (iv) a description of the applicant's professional training 
        beyond the first degree received; 
           (v) the applicant's work history for the five years 
        preceding the application, including the average number of hours 
        worked per week; 
           (vi) a list of registrations, certifications, and licenses 
        held in other jurisdictions; 
           (vii) a description of any other jurisdiction's refusal to 
        credential the applicant; 
           (viii) a description of all professional disciplinary 
        actions initiated against the applicant in any jurisdiction; and 
           (ix) any history of drug or alcohol abuse, and any 
        misdemeanor or felony conviction; 
           (2) submit a certificate of completion from an approved 
        education program; 
           (3) achieve a qualifying score on a credentialing 
        examination within five years prior to application for 
           (4) submit a verified copy of a valid and current 
        credential, issued by the National Board for Respiratory Care or 
        other board-approved national organization, as a certified 
        respiratory therapy technician, registered respiratory 
        therapist, or other entry or advanced level respiratory care 
        practitioner designation; 
           (5) submit additional information as requested by the 
        board, including providing any additional information necessary 
        to ensure that the applicant is able to practice with reasonable 
        skill and safety to the public; 
           (6) sign a statement that the information in the 
        application is true and correct to the best of the applicant's 
        knowledge and belief; and 
           (7) sign a waiver authorizing the board to obtain access to 
        the applicant's records in this or any other state in which the 
        applicant has completed an approved education program or engaged 
        in the practice of respiratory care. 
           Subd. 2.  [REGISTRATION BY RECIPROCITY.] To be eligible for 
        registration by reciprocity, the applicant must be credentialed 
        by the National Board for Respiratory Care or other 
        board-approved organization and have worked at least eight weeks 
        of the previous five years as a respiratory care practitioner 
        and must: 
           (1) submit the application materials and fees as required 
        by subdivision 1, clauses (1), (4), (5), (6), and (7); 
           (2) provide a verified copy from the appropriate government 
        body of a current and unrestricted credential for the practice 
        of respiratory care in another jurisdiction that has initial 
        credentialing requirements equivalent to or higher than the 
        requirements in subdivision 1; and 
           (3) provide letters of verification from the appropriate 
        government body in each jurisdiction in which the applicant 
        holds a credential.  Each letter must state the applicant's 
        name, date of birth, credential number, date of issuance, a 
        statement regarding disciplinary actions, if any, taken against 
        the applicant, and the terms under which the credential was 
           Subd. 3.  [TEMPORARY PERMIT.] The board may issue a 
        temporary permit to practice as a respiratory care practitioner 
        to an applicant eligible for registration under this section if 
        the application for registration is complete, all applicable 
        requirements in this section 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 respiratory care practitioner's application for 
           Subd. 4.  [TEMPORARY REGISTRATION.] The board may issue 
        temporary registration as a respiratory care practitioner for a 
        period of one year to an applicant for registration under this 
        section if the application for registration is complete, all 
        applicable requirements have been met with exception of 
        completion of a credentialing examination, and a nonrefundable 
        fee set by the board has been paid.  A respiratory care 
        practitioner with temporary registration may qualify for full 
        registration status upon submission of verified documentation 
        that the respiratory care practitioner has achieved a qualifying 
        score on a credentialing examination within one year after 
        receiving temporary registration status.  Temporary registration 
        may not be renewed. 
        REGISTRATION.] A respiratory care practitioner with temporary 
        registration is limited to working under the direct supervision 
        of a registered respiratory care practitioner or physician able 
        to provide qualified medical direction.  The respiratory care 
        practitioner or physician must be present in the health care 
        facility or readily available by telecommunication at the time 
        the respiratory care services are being provided.  A registered 
        respiratory care practitioner may supervise no more than two 
        respiratory care practitioners with temporary registration 
           Subd. 6.  [REGISTRATION EXPIRATION.] Registrations issued 
        under this chapter expire annually. 
           Subd. 7.  [RENEWAL.] (a) To be eligible for registration 
        renewal a registrant must: 
           (1) annually, or as determined by the board, complete a 
        renewal application on a form provided by the board; 
           (2) submit the renewal fee; 
           (3) provide evidence every two years of a total of 24 hours 
        of continuing education approved by the board as described in 
        section 147C.25; and 
           (4) submit any additional information requested by the 
        board to clarify information presented in the renewal 
        application.  The information must be submitted within 30 days 
        after the board's request, or the renewal request is nullified. 
           (b) Applicants for renewal who have not practiced the 
        equivalent of eight full weeks during the past five years must 
        achieve a passing score on retaking the credentialing 
        examination, or complete no less than eight weeks of advisory 
        council-approved supervised clinical experience having a broad 
        base of treatment modalities and patient care.  
           Subd. 8.  [CHANGE OF ADDRESS.] A registrant who changes 
        addresses must inform the board within 30 days, in writing, of 
        the change of address.  All notices or other correspondence 
        mailed to or served on a registrant by the board at the 
        registrant's address on file with the board shall be considered 
        as having been received by the registrant. 
           Subd. 9.  [REGISTRATION RENEWAL NOTICE.] At least 30 days 
        before the registration renewal date, the board shall send out a 
        renewal notice to the last known address of the registrant on 
        file.  The notice must include a renewal application and a 
        notice of fees required for renewal.  It must also inform the 
        registrant that registration will expire without further action 
        by the board if an application for registration renewal is not 
        received before the deadline for renewal.  The registrant's 
        failure to receive this notice shall not relieve the registrant 
        of the obligation to meet the deadline and other requirements 
        for registration renewal.  Failure to receive this notice is not 
        grounds for challenging expiration of registered status. 
           Subd. 10.  [RENEWAL DEADLINE.] The renewal application and 
        fee must be postmarked on or before July 1 of the year of 
        renewal or as determined by the board.  If the postmark is 
        illegible, the application shall be considered timely if 
        received by the third working day after the deadline. 
        (a) A registration may be placed in inactive status upon 
        application to the board by the registrant and upon payment of 
        an inactive status fee.  
           (b) Registrants seeking restoration to active from inactive 
        status must pay the current renewal fees and all unpaid back 
        inactive fees.  They must meet the criteria for renewal 
        specified in subdivision 7, including continuing education hours 
        equivalent to one hour for each month of inactive status, prior 
        to submitting an application to regain registered status.  If 
        the inactive status extends beyond five years, a qualifying 
        score on a credentialing examination, or completion of an 
        advisory council-approved eight-week supervised clinical 
        training experience is required.  If the registrant intends to 
        regain active registration by means of eight weeks of advisory 
        council-approved clinical training experience, the registrant 
        shall be granted temporary registration for a period of no 
        longer than six months. 
        STATUS FOR TWO YEARS OR LESS.] For any individual whose 
        registration status has lapsed for two years or less, to regain 
        registration status, the individual must: 
           (1) apply for registration renewal according to subdivision 
           (2) document compliance with the continuing education 
        requirements of section 147C.25 since the registrant's initial 
        registration or last renewal; and 
           (3) submit the fees required under section 147C.40 for the 
        period not registered, including the fee for late renewal. 
           Subd. 13.  [CANCELLATION DUE TO NONRENEWAL.] The board 
        shall not renew, reissue, reinstate, or restore a registration 
        that has lapsed and has not been renewed within two annual 
        registration renewal cycles starting July 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 initial registration as a 
        respiratory care practitioner.  
        (a) A registrant holding active registration as a respiratory 
        care practitioner in the state may, upon approval of the board, 
        be granted registration cancellation if the board is not 
        investigating the person as a result of a complaint or 
        information received or if the board has not begun disciplinary 
        proceedings against the registrant.  Such action by the board 
        shall be reported as a cancellation of registration in good 
           (b) A registrant who receives board approval for 
        registration cancellation is not entitled to a refund of any 
        registration fees paid for the registration year in which 
        cancellation of the registration occurred. 
           (c) To obtain registration after cancellation, a registrant 
        must obtain a new registration by applying for registration and 
        fulfilling the requirements then in existence for obtaining 
        initial registration as a respiratory care practitioner.  
           Sec. 6.  [147C.20] [BOARD ACTION ON APPLICATIONS FOR 
           (a) The board shall act on each application for 
        registration according to paragraphs (b) to (d). 
           (b) The board shall determine if the applicant meets the 
        requirements for registration under section 147C.15.  The board 
        or advisory council may investigate information provided by an 
        applicant to determine whether the information is accurate and 
           (c) The board shall notify each applicant in writing of 
        action taken on the application, the grounds for denying 
        registration if registration is denied, and the applicant's 
        right to review under paragraph (d).  
           (d) Applicants denied registration may make a written 
        request to the board, within 30 days of the board's notice, to 
        appear before the advisory council and for the advisory council 
        to review the board's decision to deny the applicant's 
        registration.  After reviewing the denial, the advisory council 
        shall make a recommendation to the board as to whether the 
        denial shall be affirmed.  Each applicant is allowed only one 
        request for review per yearly registration period.  
           Sec. 7.  [147C.25] [CONTINUING EDUCATION REQUIREMENTS.] 
           Subdivision 1.  [NUMBER OF REQUIRED CONTACT HOURS.] Two 
        years after the date of initial registration, and every two 
        years thereafter, a registrant applying for registration renewal 
        must complete a minimum of 24 contact hours of board-approved 
        continuing education in the two years preceding registration 
        renewal and attest to completion of continuing education 
        requirements by reporting to the board. 
           Subd. 2.  [APPROVED PROGRAMS.] The board shall approve 
        continuing education programs that have been approved for 
        continuing education credit by the American Association of 
        Respiratory Care or the Minnesota Society for Respiratory Care 
        or their successor organizations.  The board shall also approve 
        programs substantially related to respiratory care that are 
        sponsored by an accredited university or college, medical 
        school, state or national medical association, national medical 
        specialty society, or that are approved for continuing education 
        credit by the Minnesota board of nursing.  
        board shall also approve continuing education programs that do 
        not meet the requirements of subdivision 2 but that meet the 
        following criteria: 
           (1) the program content directly relates to the practice of 
        respiratory care; 
           (2) each member of the program faculty is knowledgeable in 
        the subject matter as demonstrated by a degree from an 
        accredited education program, verifiable experience in the field 
        of respiratory care, special training in the subject matter, or 
        experience teaching in the subject area; 
           (3) the program lasts at least one contact hour; 
           (4) there are specific, measurable, written objectives, 
        consistent with the program, describing the expected outcomes 
        for the participants; and 
           (5) the program sponsor has a mechanism to verify 
        participation and maintains attendance records for three years. 
        COMPANY IN-SERVICES.] Hospital, health care facility, or medical 
        company in-service programs may qualify for continuing education 
        credits provided they meet the requirements of this section. 
           Subd. 5.  [ACCUMULATION OF CONTACT HOURS.] A registrant may 
        not apply contact hours acquired in one two-year reporting 
        period to a future continuing education reporting period.  
        The board shall periodically select a random sample of 
        registrants and require those registrants to supply the board 
        with evidence of having completed the continuing education to 
        which they attested.  Documentation may come directly from the 
        registrant or from state or national organizations that maintain 
        continuing education records. 
        registrant may apply no more than a combined total of eight 
        hours of continuing education in the areas of management, risk 
        management, personal growth, and educational techniques to a 
        two-year reporting period. 
        registrant may fulfill the continuing education requirements for 
        a two-year reporting period by achieving a qualifying score on 
        one of the credentialing examinations or a specialty 
        credentialing examination of the National Board for Respiratory 
        Care or another board-approved testing organization.  A 
        registrant may achieve 12 hours of continuing education credit 
        by completing a National Board for Respiratory Care or other 
        board-approved testing organization's specialty examination.  
           Sec. 8.  [147C.30] [DISCIPLINE; REPORTING.] 
           For purposes of this chapter, registered respiratory care 
        practitioners and applicants are subject to the provisions of 
        sections 147.091 to 147.162.  
           Subdivision 1.  [MEMBERSHIP.] The board shall appoint a 
        seven-member respiratory care practitioner advisory council 
        consisting of two public members as defined in section 214.02, 
        three registered respiratory care practitioners, and two 
        licensed physicians with expertise in respiratory care. 
           Subd. 2.  [ORGANIZATION.] The advisory council shall be 
        organized and administered under section 15.059.  The council 
        expires June 30, 2001.  
           Subd. 3.  [DUTIES.] The advisory council shall: 
           (1) advise the board regarding standards for respiratory 
        care practitioners; 
           (2) provide for distribution of information regarding 
        respiratory care practitioner standards; 
           (3) advise the board on enforcement of sections 147.091 to 
           (4) review applications and recommend granting or denying 
        registration or registration renewal; 
           (5) advise the board on issues related to receiving and 
        investigating complaints, conducting hearings, and imposing 
        disciplinary action in relation to complaints against 
        respiratory care practitioners; 
           (6) advise the board regarding approval of continuing 
        education programs using the criteria in section 147C.25, 
        subdivision 3; and 
           (7) perform other duties authorized for advisory councils 
        by chapter 214, as directed by the board. 
           Sec. 10.  [147C.40] [FEES.] 
           Subdivision 1.  [FEES.] The board shall adopt rules setting:
           (1) registration fees; 
           (2) renewal fees; 
           (3) late fees; 
           (4) inactive status fees; 
           (5) fees for temporary permits; and 
           (6) fees for temporary registration. 
           Subd. 2.  [PRORATION OF FEES.] The board may prorate the 
        initial annual registration fee.  All registrants are required 
        to pay the full fee upon registration renewal. 
           Subd. 3.  [PENALTY FEE FOR LATE RENEWALS.] An application 
        for registration renewal submitted after the deadline must be 
        accompanied by a late fee in addition to the required fees. 
           Subd. 4.  [NONREFUNDABLE FEES.] All of the fees in 
        subdivision 1 are nonrefundable. 
           The current members of the physician assistant advisory 
        council, appointed pursuant to Minnesota Rules, part 5600.2665, 
        shall continue to serve until their terms expire. 
           Sec. 12.  [REPEALER.] 
           Minnesota Rules, parts 4762.0010; 4762.0020; 4762.0030; 
        4762.0040; 4762.0050; 4762.0060; 4762.0065; 4762.0070; 
        4762.0080; 4762.0090; 4762.0100; 4762.0200; and 4762.0300, are 
           Sec. 13.  [EFFECTIVE DATE.] 
           Sections 2 to 10 and 12 are effective August 1, 1997, 
        except that, until August 1, 1998, applicants for initial 
        registration need not meet the credentialing requirement within 
        five years prior to registration.  Fees in effect on the day 
        before the effective date of section 12 remain in effect until 
        the board changes them by rule. 
           Presented to the governor May 7, 1997 
           Signed by the governor May 8, 1997, 11:30 a.m.

Official Publication of the State of Minnesota
Revisor of Statutes