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Minnesota Legislature

Office of the Revisor of Statutes

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

                            CHAPTER 361-S.F.No. 1038 
                  An act relating to health occupations; establishing 
                  licensing requirements for occupational therapists and 
                  occupational therapy assistants; proposing coding for 
                  new law in Minnesota Statutes, chapter 148; repealing 
                  Minnesota Rules, parts 4666.0010; 4666.0020; 
                  4666.0030; 4666.0040; 4666.0050; 4666.0060; 4666.0070; 
                  4666.0080; 4666.0090; 4666.0100; 4666.0200; 4666.0300; 
                  4666.0400; 4666.0500; 4666.0600; 4666.0700; 4666.0800; 
                  4666.0900; 4666.1000; 4666.1100; 4666.1200; 4666.1300; 
                  and 4666.1400. 
        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
           Section 1.  [148.6401] [SCOPE.] 
           Sections 148.6401 to 148.6450 apply to persons who are 
        applicants for licensure, who are licensed, who use protected 
        titles, or who represent that they are licensed as occupational 
        therapists or occupational therapy assistants. 
           Sec. 2.  [148.6402] [DEFINITIONS.] 
           Subdivision 1.  [SCOPE.] For the purpose of sections 
        148.6401 to 148.6450, the following terms have the meaning given 
        them. 
           Subd. 2.  [ADVISORY COUNCIL.] "Advisory council" means the 
        occupational therapy practitioners advisory council in section 
        148.6450. 
           Subd. 3.  [BIENNIAL LICENSURE PERIOD.] "Biennial licensure 
        period" means the two-year period for which licensure is 
        effective. 
           Subd. 4.  [COMMISSIONER.] "Commissioner" means the 
        commissioner of health or a designee. 
           Subd. 5.  [CONTACT HOUR.] "Contact hour" means an 
        instructional session of 60 consecutive minutes, excluding 
        coffee breaks, registration, meals without a speaker, and social 
        activities. 
           Subd. 6.  [CREDENTIAL.] "Credential" means a license, 
        permit, certification, registration, or other evidence of 
        qualification or authorization to engage in the practice of 
        occupational therapy issued by any authority. 
           Subd. 7.  [CREDENTIALING EXAMINATION FOR OCCUPATIONAL 
        THERAPIST.] "Credentialing examination for occupational 
        therapist" means the examination sponsored by the National Board 
        for Certification in Occupational Therapy for credentialing as 
        an occupational therapist, registered. 
           Subd. 8.  [CREDENTIALING EXAMINATION FOR OCCUPATIONAL 
        THERAPY ASSISTANT.] "Credentialing examination for occupational 
        therapy assistant" means the examination sponsored by the 
        National Board for Certification in Occupational Therapy for 
        credentialing as a certified occupational therapy assistant. 
           Subd. 9.  [DELEGATE.] "Delegate" means to transfer to an 
        occupational therapy assistant the authority to perform selected 
        portions of an occupational therapy evaluation or treatment plan 
        for a specific patient. 
           Subd. 10.  [DIRECT SUPERVISION.] "Direct supervision" of an 
        occupational therapy assistant using physical agent modalities 
        means that the occupational therapist has evaluated the patient 
        and determined a need for use of a particular physical agent 
        modality in the occupational therapy treatment plan, has 
        determined the appropriate physical agent modality application 
        procedure, and is available for in-person intervention while 
        treatment is provided. 
           Subd. 11.  [ELECTRICAL STIMULATION DEVICE.] "Electrical 
        stimulation device" means any device which generates pulsed, 
        direct, or alternating electrical current for the purposes of 
        rehabilitation of neuromusculoskeletal dysfunction. 
           Subd. 12.  [ELECTROTHERAPY.] "Electrotherapy" means the use 
        of electrical stimulation devices for a therapeutic purpose. 
           Subd. 13.  [LICENSED HEALTH CARE PROFESSIONAL.] "Licensed 
        health care professional" means a person licensed in good 
        standing in Minnesota to practice medicine, osteopathy, 
        chiropractic, podiatry, or dentistry. 
           Subd. 14.  [OCCUPATIONAL THERAPIST.] Except as provided in 
        section 148.6408, subdivision 3, paragraph (b), "occupational 
        therapist" means an individual who meets the qualifications in 
        sections 148.6401 to 148.6450 and is licensed by the 
        commissioner.  For purposes of section 148.6408, subdivision 3, 
        paragraph (b), occupational therapist means the employment title 
        of a natural person before June 17, 1996. 
           Subd. 15.  [OCCUPATIONAL THERAPY.] "Occupational therapy" 
        means the use of purposeful activity to maximize the 
        independence and the maintenance of health of an individual who 
        is limited by a physical injury or illness, a cognitive 
        impairment, a psychosocial dysfunction, a mental illness, a 
        developmental or learning disability, or an adverse 
        environmental condition.  The practice encompasses evaluation, 
        assessment, treatment, and consultation.  Occupational therapy 
        services may be provided individually, in groups, or through 
        social systems.  Occupational therapy includes those services 
        described in section 148.6404. 
           Subd. 16.  [OCCUPATIONAL THERAPY ASSISTANT.] Except as 
        provided in section 148.6410, subdivision 3, "occupational 
        therapy assistant" means an individual who meets the 
        qualifications for an occupational therapy assistant in sections 
        148.6401 to 148.6450 and is licensed by the commissioner.  For 
        purposes of section 148.6410, subdivision 3, occupational 
        therapy assistant means the employment title of a natural person 
        before June 17, 1996. 
           Subd. 17.  [PHYSICAL AGENT MODALITIES.] "Physical agent 
        modalities" mean modalities that use the properties of light, 
        water, temperature, sound, or electricity to produce a response 
        in soft tissue.  The physical agent modalities referred to in 
        sections 148.6404 and 148.6440 are superficial physical agent 
        modalities, electrical stimulation devices, and ultrasound. 
           Subd. 18.  [PROVISIONAL LICENSURE.] "Provisional licensure" 
        means a method of licensure described in section 148.6408, 
        subdivision 3, for occupational therapists and section 148.6410, 
        subdivision 3, for occupational therapy assistants, in effect 
        for a limited time, by which an individual who has not completed 
        an accredited or approved education program but who meets the 
        employment requirements specified in those subdivisions may 
        qualify for licensure pending successful completion of the 
        credentialing examination. 
           Subd. 19.  [LICENSE OR LICENSED.] "License" or "licensed" 
        means the act or status of a natural person who meets the 
        requirements of sections 148.6401 to 148.6450.  
           Subd. 20.  [LICENSEE.] "Licensee" means a person who meets 
        the requirements of sections 148.6401 to 148.6450.  
           Subd. 21.  [LICENSURE BY EQUIVALENCY.] "Licensure by 
        equivalency" means a method of licensure described in section 
        148.6412 by which an individual who possesses a credential from 
        the National Board for Certification in Occupational Therapy may 
        qualify for licensure. 
           Subd. 22.  [LICENSURE BY RECIPROCITY.] "Licensure by 
        reciprocity" means a method of licensure described in section 
        148.6415 by which an individual who possesses a credential from 
        another jurisdiction may qualify for Minnesota licensure. 
           Subd. 23.  [SERVICE COMPETENCY.] "Service competency" of an 
        occupational therapy assistant in performing evaluation tasks 
        means the ability of an occupational therapy assistant to obtain 
        the same information as the supervising occupational therapist 
        when evaluating a client's function. 
           Service competency of an occupational therapy assistant in 
        performing treatment procedures means the ability of an 
        occupational therapy assistant to perform treatment procedures 
        in a manner such that the outcome, documentation, and follow-up 
        are equivalent to that which would have been achieved had the 
        supervising occupational therapist performed the treatment 
        procedure. 
           Service competency of an occupational therapist means the 
        ability of an occupational therapist to consistently perform an 
        assessment task or intervention procedure with the level of 
        skill recognized as satisfactory within the appropriate 
        acceptable prevailing practice of occupational therapy. 
           Subd. 24.  [SUPERFICIAL PHYSICAL AGENT MODALITY.] 
        "Superficial physical agent modality" means a therapeutic medium 
        which produces temperature changes in skin and underlying 
        subcutaneous tissues within a depth of zero to three centimeters 
        for the purposes of rehabilitation of neuromusculoskeletal 
        dysfunction.  Superficial physical agent modalities may include, 
        but are not limited to:  paraffin baths, hot packs, cold packs, 
        fluidotherapy, contrast baths, and whirlpool baths.  Superficial 
        physical agent modalities do not include the use of electrical 
        stimulation devices, ultrasound, or quick icing. 
           Subd. 25.  [TEMPORARY LICENSURE.] "Temporary licensure" 
        means a method of licensure described in section 148.6418, by 
        which an individual who (1) has completed an approved or 
        accredited education program but has not met the examination 
        requirement; or (2) possesses a credential from another 
        jurisdiction or the National Board for Certification in 
        Occupational Therapy but who has not submitted the documentation 
        required by section 148.6420, subdivisions 3 and 4, may qualify 
        for Minnesota licensure for a limited time period. 
           Subd. 26.  [ULTRASOUND DEVICE.] "Ultrasound device" means a 
        device intended to generate and emit high frequency acoustic 
        vibrational energy for the purposes of rehabilitation of 
        neuromusculoskeletal dysfunction. 
           Sec. 3.  [148.6403] [LICENSURE; PROTECTED TITLES AND 
        RESTRICTIONS ON USE; EXEMPT PERSONS; SANCTIONS.] 
           Subdivision 1.  [UNLICENSED PRACTICE PROHIBITED.] No person 
        shall engage in the practice of occupational therapy unless the 
        person is licensed as an occupational therapist or an 
        occupational therapist assistant in accordance with sections 
        148.6401 to 148.6450. 
           Subd. 2.  [PROTECTED TITLES AND RESTRICTIONS ON USE.] Use 
        of the phrase "occupational therapy" or "occupational 
        therapist," or the initials "O.T." alone or in combination with 
        any other words or initials to form an occupational title, or to 
        indicate or imply that the person is licensed by the state as an 
        occupational therapist or occupational therapy assistant, is 
        prohibited unless that person is licensed under sections 
        148.6401 to 148.6450. 
           Subd. 3.  [USE OF "MINNESOTA LICENSED."] Use of the term 
        "Minnesota licensed" in conjunction with titles protected under 
        this section by any person is prohibited unless that person is 
        licensed under sections 148.6401 to 148.6450. 
           Subd. 4.  [PERSONS LICENSED OR CERTIFIED IN OTHER STATES.] 
        A person who is licensed in Minnesota and licensed or certified 
        in another state may use the designation "licensed" or 
        "certified" with a protected title only if the state of 
        licensure or certification is clearly indicated. 
           Subd. 5.  [EXEMPT PERSONS.] This section does not apply to: 
           (1) a person employed as an occupational therapist or 
        occupational therapy assistant by the government of the United 
        States or any agency of it.  However, use of the protected 
        titles under those circumstances is allowed only in connection 
        with performance of official duties for the federal government; 
           (2) a student participating in supervised fieldwork or 
        supervised coursework that is necessary to meet the requirements 
        of section 148.6408, subdivision 1, or 148.6410, subdivision 1, 
        if the person is designated by a title which clearly indicates 
        the person's status as a student trainee.  Any use of the 
        protected titles under these circumstances is allowed only while 
        the person is performing the duties of the supervised fieldwork 
        or supervised coursework; or 
           (3) a person performing occupational therapy services in 
        the state, if the services are performed no more than 30 days in 
        a calendar year in association with an occupational therapist 
        licensed under sections 148.6401 to 148.6450, and 
           (i) the person is credentialed under the law of another 
        state which has credentialing requirements at least as stringent 
        as the requirements of sections 148.6401 to 148.6450; or 
           (ii) the person meets the requirements for certification as 
        an occupational therapist registered (OTR) or a certified 
        occupational therapy assistant (COTA), established by the 
        National Board for Certification in Occupational Therapy. 
           Subd. 6.  [SANCTIONS.] A person who practices occupational 
        therapy or holds out as an occupational therapist or 
        occupational therapy assistant by or through the use of any 
        title described in subdivision 2 without prior licensure 
        according to sections 148.6401 to 148.6450 is subject to 
        sanctions or action against continuing the activity according to 
        section 148.6448, chapter 214, or other statutory authority. 
           Subd. 7.  [EXEMPTION.] Nothing in sections 148.6401 to 
        148.6450 shall prohibit the practice of any profession or 
        occupation licensed or registered by the state by any person 
        duly licensed or registered to practice the profession or 
        occupation or to perform any act that falls within the scope of 
        practice of the profession or occupation. 
           Sec. 4.  [148.6404] [SCOPE OF PRACTICE.] 
           The practice of occupational therapy by an occupational 
        therapist or occupational therapy assistant includes, but is not 
        limited to, intervention directed toward: 
           (1) assessment and evaluation, including the use of skilled 
        observation or the administration and interpretation of 
        standardized or nonstandardized tests and measurements, to 
        identify areas for occupational therapy services; 
           (2) providing for the development of sensory integrative, 
        neuromuscular, or motor components of performance; 
           (3) providing for the development of emotional, 
        motivational, cognitive, or psychosocial components of 
        performance; 
           (4) developing daily living skills; 
           (5) developing feeding and swallowing skills; 
           (6) developing play skills and leisure capacities; 
           (7) enhancing educational performance skills; 
           (8) enhancing functional performance and work readiness 
        through exercise, range of motion, and use of ergonomic 
        principles; 
           (9) designing, fabricating, or applying rehabilitative 
        technology, such as selected orthotic and prosthetic devices, 
        and providing training in the functional use of these devices; 
           (10) designing, fabricating, or adapting assistive 
        technology and providing training in the functional use of 
        assistive devices; 
           (11) adapting environments using assistive technology such 
        as environmental controls, wheelchair modifications, and 
        positioning; 
           (12) employing physical agent modalities, in preparation 
        for or as an adjunct to purposeful activity, within the same 
        treatment session or to meet established functional occupational 
        therapy goals, consistent with the requirements of section 
        148.6440; and 
           (13) promoting health and wellness. 
           Sec. 5.  [148.6405] [LICENSURE REQUIREMENTS; PROCEDURES AND 
        QUALIFICATIONS.] 
           (a) An applicant for licensure must comply with the general 
        licensure procedures in section 148.6420.  To qualify for 
        licensure, an applicant must satisfy one of the requirements in 
        paragraphs (b) to (f) and not be subject to denial of licensure 
        under section 148.6448. 
           (b) A person who applies for licensure as an occupational 
        therapist and who has not been credentialed by the National 
        Board for Certification in Occupational Therapy or another 
        jurisdiction must meet the requirements in section 148.6408. 
           (c) A person who applies for licensure as an occupational 
        therapy assistant and who has not been credentialed by the 
        National Board for Certification in Occupational Therapy or 
        another jurisdiction must meet the requirements in section 
        148.6410. 
           (d) A person who is certified by the National Board for 
        Certification in Occupational Therapy may apply for licensure by 
        equivalency and must meet the requirements in section 148.6412. 
           (e) A person who is credentialed in another jurisdiction 
        may apply for licensure by reciprocity and must meet the 
        requirements in section 148.6415. 
           (f) A person who applies for temporary licensure must meet 
        the requirements in section 148.6418. 
           Sec. 6.  [148.6408] [QUALIFICATIONS FOR OCCUPATIONAL 
        THERAPIST.] 
           Subdivision 1.  [EDUCATION REQUIRED.] (a) An applicant who 
        has received professional education in the United States or its 
        possessions or territories must successfully complete all 
        academic and fieldwork requirements of an educational program 
        for occupational therapists approved or accredited by the 
        Accreditation Council for Occupational Therapy Education. 
           (b) An applicant who has received professional education 
        outside the United States or its possessions or territories must 
        successfully complete all academic and fieldwork requirements of 
        an educational program for occupational therapists approved by a 
        member association of the World Federation of Occupational 
        Therapists. 
           Subd. 2.  [QUALIFYING EXAMINATION SCORE REQUIRED.] (a) An 
        applicant must achieve a qualifying score on the credentialing 
        examination for occupational therapist. 
           (b) The commissioner shall determine the qualifying score 
        for the credentialing examination for occupational therapist.  
        In determining the qualifying score, the commissioner shall 
        consider the cut score recommended by the National Board for 
        Certification in Occupational Therapy, or other national 
        credentialing organization approved by the commissioner, using 
        the modified Angoff method for determining cut score or another 
        method for determining cut score that is recognized as 
        appropriate and acceptable by industry standards. 
           (c) The applicant is responsible for: 
           (1) making arrangements to take the credentialing 
        examination for occupational therapist; 
           (2) bearing all expenses associated with taking the 
        examination; and 
           (3) having the examination scores sent directly to the 
        commissioner from the testing service that administers the 
        examination. 
           Sec. 7.  [148.6410] [QUALIFICATIONS FOR OCCUPATIONAL 
        THERAPY ASSISTANTS.] 
           Subdivision 1.  [EDUCATION REQUIRED.] An applicant must 
        successfully complete all academic and fieldwork requirements of 
        an occupational therapy assistant program approved or accredited 
        by the Accreditation Council for Occupational Therapy Education. 
           Subd. 2.  [QUALIFYING EXAMINATION SCORE REQUIRED.] (a) An 
        applicant for licensure must achieve a qualifying score on the 
        credentialing examination for occupational therapy assistants. 
           (b) The commissioner shall determine the qualifying score 
        for the credentialing examination for occupational therapy 
        assistants.  In determining the qualifying score, the 
        commissioner shall consider the cut score recommended by the 
        National Board for Certification in Occupational Therapy, or 
        other national credentialing organization approved by the 
        commissioner, using the modified Angoff method for determining 
        cut score or another method for determining cut score that is 
        recognized as appropriate and acceptable by industry standards. 
           (c) The applicant is responsible for: 
           (1) making all arrangements to take the credentialing 
        examination for occupational therapy assistants; 
           (2) bearing all expense associated with taking the 
        examination; and 
           (3) having the examination scores sent directly to the 
        commissioner from the testing service that administers the 
        examination. 
           Sec. 8.  [148.6412] [LICENSURE BY EQUIVALENCY.] 
           Subdivision 1.  [PERSONS CERTIFIED BY NATIONAL BOARD FOR 
        CERTIFICATION IN OCCUPATIONAL THERAPY BEFORE JUNE 17, 1996.] 
        Persons certified by the National Board for Certification in 
        Occupational Therapy as an occupational therapist before June 
        17, 1996, may apply for licensure by equivalency for 
        occupational therapist.  Persons certified by the National Board 
        for Certification in Occupational Therapy as an occupational 
        therapy assistant before June 17, 1996, may apply for licensure 
        by equivalency for occupational therapy assistant. 
           Subd. 2.  [PERSONS CERTIFIED BY NATIONAL BOARD FOR 
        CERTIFICATION IN OCCUPATIONAL THERAPY AFTER JUNE 17, 1996.] The 
        commissioner may license any person certified by the National 
        Board for Certification in Occupational Therapy as an 
        occupational therapist after June 17, 1996, if the commissioner 
        determines the requirements for certification are equivalent to 
        or exceed the requirements for licensure as an occupational 
        therapist under section 148.6408.  The commissioner may license 
        any person certified by the National Board for Certification in 
        Occupational Therapy as an occupational therapy assistant after 
        June 17, 1996, if the commissioner determines the requirements 
        for certification are equivalent to or exceed the requirements 
        for licensure as an occupational therapy assistant under section 
        148.6410.  Nothing in this section limits the commissioner's 
        authority to deny licensure based upon the grounds for 
        discipline in sections 148.6401 to 148.6450. 
           Subd. 3.  [APPLICATION PROCEDURES.] Applicants for 
        licensure by equivalency must provide: 
           (1) the application materials as required by section 
        148.6420, subdivisions 1, 3, and 4; and 
           (2) the fees required by section 148.6445. 
           Sec. 9.  [148.6415] [LICENSURE BY RECIPROCITY.] 
           A person who holds a current credential as an occupational 
        therapist in the District of Columbia or a state or territory of 
        the United States whose standards for credentialing are 
        determined by the commissioner to be equivalent to or exceed the 
        requirements for licensure under section 148.6408 may be 
        eligible for licensure by reciprocity as an occupational 
        therapist.  A person who holds a current credential as an 
        occupational therapy assistant in the District of Columbia or a 
        state or territory of the United States whose standards for 
        credentialing are determined by the commissioner to be 
        equivalent to or exceed the requirements for licensure under 
        section 148.6410 may be eligible for licensure by reciprocity as 
        an occupational therapy assistant.  Nothing in this section 
        limits the commissioner's authority to deny licensure based upon 
        the grounds for discipline in sections 148.6401 to 148.6450.  An 
        applicant must provide: 
           (1) the application materials as required by section 
        148.6420, subdivisions 1, 3, and 4; 
           (2) the fees required by section 148.6445; 
           (3) a copy of a current and unrestricted credential for the 
        practice of occupational therapy as either an occupational 
        therapist or occupational therapy assistant; 
           (4) a letter from the jurisdiction that issued the 
        credential describing the applicant's qualifications that 
        entitled the applicant to receive the credential; and 
           (5) other information necessary to determine whether the 
        credentialing standards of the jurisdiction that issued the 
        credential are equivalent to or exceed the requirements for 
        licensure under sections 148.6401 to 148.6450. 
           Sec. 10.  [148.6418] [TEMPORARY LICENSURE.] 
           Subdivision 1.  [APPLICATION.] The commissioner shall issue 
        temporary licensure as an occupational therapist or occupational 
        therapy assistant to applicants who have applied for licensure 
        under section 148.6408, subdivisions 1 and 2; 148.6410, 
        subdivisions 1 and 2; 148.6412; or 148.6415 and who are not the 
        subject of a disciplinary action or past disciplinary action, 
        nor disqualified on the basis of items listed in section 
        148.6448, subdivision 1. 
           Subd. 2.  [PROCEDURES.] To be eligible for temporary 
        licensure, an applicant must submit the application materials 
        required by section 148.6420, subdivision 1, the fees required 
        by section 148.6445, and one of the following: 
           (1) evidence of successful completion of the requirements 
        in section 148.6408, subdivision 1, or 148.6410, subdivision 1; 
           (2) a copy of a current and unrestricted credential for the 
        practice of occupational therapy as either an occupational 
        therapist or occupational therapy assistant in another 
        jurisdiction; or 
           (3) a copy of a current and unrestricted certificate from 
        the National Board for Certification in Occupational Therapy 
        stating that the applicant is certified as an occupational 
        therapist or occupational therapy assistant. 
           Subd. 3.  [ADDITIONAL DOCUMENTATION.] Persons who are 
        credentialed by the National Board for Certification in 
        Occupational Therapy or another jurisdiction must provide an 
        affidavit with the application for temporary licensure stating 
        that they are not the subject of a pending investigation or 
        disciplinary action and have not been the subject of a 
        disciplinary action in the past. 
           Subd. 4.  [SUPERVISION REQUIRED.] An applicant who has 
        graduated from an accredited occupational therapy program, as 
        required by section 148.6408, subdivision 1, or 148.6410, 
        subdivision 1, and who has not passed the examination required 
        by section 148.6408, subdivision 2, or 148.6410, subdivision 2, 
        must practice under the supervision of a licensed occupational 
        therapist.  The supervising therapist must, at a minimum, 
        supervise the person working under temporary licensure in the 
        performance of the initial evaluation, determination of the 
        appropriate treatment plan, and periodic review and modification 
        of the treatment plan.  The supervising therapist must observe 
        the person working under temporary licensure in order to assure 
        service competency in carrying out evaluation, treatment 
        planning, and treatment implementation.  The frequency of 
        face-to-face collaboration between the person working under 
        temporary licensure and the supervising therapist must be based 
        on the condition of each patient or client, the complexity of 
        treatment and evaluation procedures, and the proficiencies of 
        the person practicing under temporary licensure.  The 
        occupational therapist or occupational therapy assistant working 
        under temporary licensure must provide verification of 
        supervision on the application form provided by the commissioner.
           Subd. 5.  [EXPIRATION OF TEMPORARY LICENSURE.] A temporary 
        license issued to a person pursuant to subdivision 2, clause 
        (1), expires ten weeks after the next credentialing examination 
        for occupational therapists and occupational therapy assistants 
        or on the date the commissioner grants or denies licensure, 
        whichever occurs first.  A temporary license issued to a person 
        pursuant to subdivision 2, clause (2) or (3), expires 90 days 
        after it is issued.  Upon application for renewal, a temporary 
        license shall be renewed once to persons who have not met the 
        examination requirement under section 148.6408, subdivision 2, 
        or 148.6410, subdivision 2, within the initial temporary 
        licensure period and who are not the subject of a disciplinary 
        action nor disqualified on the basis of items in section 
        148.6448, subdivision 1.  Upon application for renewal, a 
        temporary license shall be renewed once to persons who are able 
        to demonstrate good cause for failure to meet the requirements 
        for licensure under section 148.6412 or 148.6415 within the 
        initial temporary licensure period and who are not the subject 
        of a disciplinary action nor disqualified on the basis of items 
        in section 148.6448, subdivision 1. 
           Sec. 11.  [148.6420] [GENERAL LICENSURE PROCEDURES.] 
           Subdivision 1.  [APPLICATIONS FOR LICENSURE.] An applicant 
        for licensure must: 
           (1) submit a completed application for licensure on forms 
        provided by the commissioner and must supply the information 
        requested on the application, including: 
           (i) the applicant's name, business address and business 
        telephone number, business setting, and daytime telephone 
        number; 
           (ii) the name and location of the occupational therapy 
        program the applicant completed; 
           (iii) a description of the applicant's education and 
        training, including a list of degrees received from educational 
        institutions; 
           (iv) the applicant's work history for the six years 
        preceding the application, including the number of hours worked; 
           (v) a list of all credentials currently and previously held 
        in Minnesota and other jurisdictions; 
           (vi) a description of any jurisdiction's refusal to 
        credential the applicant; 
           (vii) a description of all professional disciplinary 
        actions initiated against the applicant in any jurisdiction; 
           (viii) information on any physical or mental condition or 
        chemical dependency that impairs the person's ability to engage 
        in the practice of occupational therapy with reasonable judgment 
        or safety; 
           (ix) a description of any misdemeanor or felony conviction 
        that relates to honesty or to the practice of occupational 
        therapy; 
           (x) a description of any state or federal court order, 
        including a conciliation court judgment or a disciplinary order, 
        related to the individual's occupational therapy practice; and 
           (xi) a statement indicating the physical agent modalities 
        the applicant will use and whether the applicant will use the 
        modalities as an occupational therapist or an occupational 
        therapy assistant under direct supervision; 
           (2) submit with the application all fees required by 
        section 148.6445; 
           (3) sign a statement that the information in the 
        application is true and correct to the best of the applicant's 
        knowledge and belief; 
           (4) sign a waiver authorizing the commissioner to obtain 
        access to the applicant's records in this or any other state in 
        which the applicant holds or previously held a credential for 
        the practice of an occupation, has completed an accredited 
        occupational therapy education program, or engaged in the 
        practice of occupational therapy; 
           (5) submit additional information as requested by the 
        commissioner; and 
           (6) submit the additional information required for 
        licensure by equivalency, licensure by reciprocity, and 
        temporary licensure as specified in sections 148.6408 to 
        148.6418. 
           Subd. 2.  [PERSONS APPLYING FOR LICENSURE UNDER SECTION 
        148.6408 OR 148.6410.] Persons applying for licensure under 
        section 148.6408, subdivisions 1 and 2, or 148.6410, 
        subdivisions 1 and 2, must submit the materials required in 
        subdivision 1 and the following: 
           (1) a certificate of successful completion of the 
        requirements in section 148.6408, subdivision 1, or 148.6410, 
        subdivision 1; and 
           (2) the applicant's test results from the examining agency, 
        as evidence that the applicant received a qualifying score on a 
        credentialing examination meeting the requirements of section 
        148.6408, subdivision 2, or 148.6410, subdivision 2. 
           Subd. 3.  [APPLICANTS WHO ARE CERTIFIED BY NATIONAL BOARD 
        FOR CERTIFICATION IN OCCUPATIONAL THERAPY.] An applicant who is 
        certified by the National Board for Certification in 
        Occupational Therapy must provide the materials required in 
        subdivision 1 and the following: 
           (1) verified documentation from the National Board for 
        Certification in Occupational Therapy stating that the applicant 
        is certified as an occupational therapist, registered or 
        certified occupational therapy assistant, the date certification 
        was granted, and the applicant's certification number.  The 
        document must also include a statement regarding disciplinary 
        actions.  The applicant is responsible for obtaining this 
        documentation by sending a form provided by the commissioner to 
        the National Board for Certification in Occupational Therapy; 
        and 
           (2) a waiver authorizing the commissioner to obtain access 
        to the applicant's records maintained by the National Board for 
        Certification in Occupational Therapy. 
           Subd. 4.  [APPLICANTS CREDENTIALED IN ANOTHER 
        JURISDICTION.] In addition to providing the materials required 
        in subdivision 1, an applicant credentialed in another 
        jurisdiction must request that the appropriate government body 
        in each jurisdiction in which the applicant holds or held an 
        occupational therapy credential send a letter to the 
        commissioner that verifies the applicant's credentials.  Except 
        as provided in section 148.6418, a license shall not be issued 
        until the commissioner receives letters verifying each of the 
        applicant's credentials.  Each letter must include the 
        applicant's name, date of birth, credential number, date of 
        issuance, a statement regarding investigations pending and 
        disciplinary actions taken or pending against the applicant, 
        current status of the credential, and the terms under which the 
        credential was issued. 
           Subd. 5.  [ACTION ON APPLICATIONS FOR LICENSURE.] (a) The 
        commissioner shall approve, approve with conditions, or deny 
        licensure.  The commissioner shall act on an application for 
        licensure according to paragraphs (b) to (d). 
           (b) The commissioner shall determine if the applicant meets 
        the requirements for licensure.  The commissioner, or the 
        advisory council at the commissioner's request, may investigate 
        information provided by an applicant to determine whether the 
        information is accurate and complete. 
           (c) The commissioner shall notify an applicant of action 
        taken on the application and, if licensure is denied or approved 
        with conditions, the grounds for the commissioner's 
        determination. 
           (d) An applicant denied licensure or granted licensure with 
        conditions may make a written request to the commissioner, 
        within 30 days of the date of the commissioner's determination, 
        for reconsideration of the commissioner's determination.  
        Individuals requesting reconsideration may submit information 
        which the applicant wants considered in the reconsideration.  
        After reconsideration of the commissioner's determination to 
        deny licensure or grant licensure with conditions, the 
        commissioner shall determine whether the original determination 
        should be affirmed or modified.  An applicant is allowed no more 
        than one request in any one biennial licensure period for 
        reconsideration of the commissioner's determination to deny 
        licensure or approve licensure with conditions. 
           Sec. 12.  [148.6423] [LICENSURE RENEWAL.] 
           Subdivision 1.  [RENEWAL REQUIREMENTS.] To be eligible for 
        licensure renewal, a licensee must: 
           (1) submit a completed and signed application for licensure 
        renewal on forms provided by the commissioner; 
           (2) submit the renewal fee required under section 148.6445; 
           (3) submit proof of having met the continuing education 
        requirement of section 148.6443 on forms provided by the 
        commissioner; and 
           (4) submit additional information as requested by the 
        commissioner to clarify information presented in the renewal 
        application.  The information must be submitted within 30 days 
        after the commissioner's request. 
           Subd. 2.  [RENEWAL DEADLINE.] (a) Except as provided in 
        paragraph (c), licenses must be renewed every two years.  
        Licensees must comply with the following procedures in 
        paragraphs (b) to (e): 
           (b) Each license must state an expiration date.  An 
        application for licensure renewal must be received by the 
        department of health or postmarked at least 30 calendar days 
        before the expiration date.  If the postmark is illegible, the 
        application shall be considered timely if received at least 21 
        calendar days before the expiration date. 
           (c) If the commissioner changes the renewal schedule and 
        the expiration date is less than two years, the fee and the 
        continuing education contact hours to be reported at the next 
        renewal must be prorated. 
           (d) An application for licensure renewal not received 
        within the time required under paragraph (b), but received on or 
        before the expiration date, must be accompanied by a late fee in 
        addition to the renewal fee specified by section 148.6445. 
           (e) Licensure renewals received after the expiration date 
        shall not be accepted and persons seeking licensed status must 
        comply with the requirements of section 148.6425. 
           Subd. 3.  [LICENSURE RENEWAL NOTICE.] At least 60 calendar 
        days before the expiration date in subdivision 2, the 
        commissioner shall mail a renewal notice to the licensee's last 
        known address on file with the commissioner.  The notice must 
        include an application for licensure renewal and notice of fees 
        required for renewal.  The licensee's failure to receive notice 
        does not relieve the licensee of the obligation to meet the 
        renewal deadline and other requirements for licensure renewal. 
           Sec. 13.  [148.6425] [RENEWAL OF LICENSURE; AFTER 
        EXPIRATION DATE.] 
           Subdivision 1.  [REMOVAL OF NAME FROM LIST.] The names of 
        licensees who do not comply with the licensure renewal 
        requirements of section 148.6423 on or before the expiration 
        date shall be removed from the list of individuals authorized to 
        practice occupational therapy and to use the protected titles in 
        section 148.6403.  The licensees must comply with the 
        requirements of this section in order to regain licensed status. 
           Subd. 2.  [LICENSURE RENEWAL AFTER LICENSURE EXPIRATION 
        DATE.] Except as provided in subdivision 4, an individual whose 
        application for licensure renewal is received after the 
        licensure expiration date must submit the following: 
           (1) a completed and signed application for licensure 
        following lapse in licensed status on forms provided by the 
        commissioner; 
           (2) the renewal fee and the late fee required under section 
        148.6445; 
           (3) proof of having met the continuing education 
        requirements since the individual's initial licensure or last 
        licensure renewal; and 
           (4) additional information as requested by the commissioner 
        to clarify information in the application, including information 
        to determine whether the individual has engaged in conduct 
        warranting disciplinary action as set forth in section 
        148.6448.  The information must be submitted within 30 days 
        after the commissioner's request. 
           Subd. 3.  [LICENSURE RENEWAL FOUR YEARS OR MORE AFTER 
        LICENSURE EXPIRATION DATE.] (a) Except as provided in 
        subdivision 4, an individual who requests licensure renewal four 
        years or more after the licensure expiration date must submit 
        the following: 
           (1) a completed and signed application for licensure on 
        forms provided by the commissioner; 
           (2) the renewal fee and the late fee required under section 
        148.6445; 
           (3) proof of having met the continuing education 
        requirement for the most recently completed two-year continuing 
        education cycle; and 
           (4) at the time of the next licensure renewal, proof of 
        having met the continuing education requirement, which shall be 
        prorated based on the number of months licensed during the 
        biennial licensure period. 
           (b) In addition to the requirements in paragraph (a), the 
        applicant must submit proof of one of the following: 
           (1) verified documentation of successful completion of 160 
        hours of supervised practice approved by the commissioner as 
        described in paragraph (c); 
           (2) verified documentation of having achieved a qualifying 
        score on the credentialing examination for occupational 
        therapists or the credentialing examination for occupational 
        therapy assistants administered within the past year; or 
           (3) documentation of having completed a combination of 
        occupational therapy courses or an occupational therapy 
        refresher program that contains both a theoretical and clinical 
        component approved by the commissioner.  Only courses completed 
        within one year preceding the date of the application or one 
        year after the date of the application qualify for approval. 
           (c) To participate in a supervised practice as described in 
        paragraph (b), clause (1), the applicant shall obtain limited 
        licensure.  To apply for limited licensure, the applicant shall 
        submit the completed limited licensure application, fees, and 
        agreement for supervision of an occupational therapist or 
        occupational therapy assistant practicing under limited 
        licensure signed by the supervising therapist and the 
        applicant.  The supervising occupational therapist shall state 
        the proposed level of supervision on the supervision agreement 
        form provided by the commissioner.  The supervising therapist 
        shall determine the frequency and manner of supervision based on 
        the condition of the patient or client, the complexity of the 
        procedure, and the proficiencies of the supervised occupational 
        therapist.  At a minimum, a supervising occupational therapist 
        shall be on the premises at all times that the person practicing 
        under limited licensure is working; be in the room ten percent 
        of the hours worked each week by the person practicing under 
        provisional licensure; and provide daily face-to-face 
        collaboration for the purpose of observing service competency of 
        the occupational therapist or occupational therapy assistant, 
        discussing treatment procedures and each client's response to 
        treatment, and reviewing and modifying, as necessary, each 
        treatment plan.  The supervising therapist shall document the 
        supervision provided.  The occupational therapist participating 
        in a supervised practice is responsible for obtaining the 
        supervision required under this paragraph and must comply with 
        the commissioner's requirements for supervision during the 
        entire 160 hours of supervised practice.  The supervised 
        practice must be completed in two months and may be completed at 
        the applicant's place of work. 
           (d) In addition to the requirements in paragraphs (a) and 
        (b), the applicant must submit additional information as 
        requested by the commissioner to clarify information in the 
        application, including information to determine whether the 
        applicant has engaged in conduct warranting disciplinary action 
        as set forth in section 148.6448.  The information must be 
        submitted within 30 days after the commissioner's request. 
           Sec. 14.  [148.6428] [CHANGE OF ADDRESS.] 
           A licensee who changes addresses must inform the 
        commissioner, in writing, of the change of address within 30 
        days.  All notices or other correspondence mailed to or served 
        on a licensee by the commissioner at the licensee's address on 
        file with the commissioner shall be considered as having been 
        received by the licensee. 
           Sec. 15.  [148.6430] [DELEGATION OF DUTIES; ASSIGNMENT OF 
        TASKS.] 
           The occupational therapist is responsible for all duties 
        delegated to the occupational therapy assistant or tasks 
        assigned to direct service personnel.  The occupational 
        therapist may delegate to an occupational therapy assistant 
        those portions of a client's evaluation, reevaluation, and 
        treatment that, according to prevailing practice standards of 
        the American Occupational Therapy Association, can be performed 
        by an occupational therapy assistant.  The occupational 
        therapist may not delegate portions of an evaluation or 
        reevaluation of a person whose condition is changing rapidly.  
        Delegation of duties related to use of physical agent modalities 
        to occupational therapy assistants is governed by section 
        148.6440, subdivision 6. 
           Sec. 16.  [148.6432] [SUPERVISION OF OCCUPATIONAL THERAPY 
        ASSISTANTS.] 
           Subdivision 1.  [APPLICABILITY.] If the professional 
        standards identified in section 148.6430 permit an occupational 
        therapist to delegate an evaluation, reevaluation, or treatment 
        procedure, the occupational therapist must provide supervision 
        consistent with this section.  Supervision of occupational 
        therapy assistants using physical agent modalities is governed 
        by section 148.6440, subdivision 6. 
           Subd. 2.  [EVALUATIONS.] The occupational therapist shall 
        determine the frequency of evaluations and reevaluations for 
        each client.  The occupational therapy assistant shall inform 
        the occupational therapist of the need for more frequent 
        reevaluation if indicated by the client's condition or response 
        to treatment.  Before delegating a portion of a client's 
        evaluation pursuant to section 148.6430, the occupational 
        therapist shall ensure the service competency of the 
        occupational therapy assistant in performing the evaluation 
        procedure and shall provide supervision consistent with the 
        condition of the patient or client and the complexity of the 
        evaluation procedure. 
           Subd. 3.  [TREATMENT.] (a) The occupational therapist shall 
        determine the frequency and manner of supervision of an 
        occupational therapy assistant performing treatment procedures 
        delegated pursuant to section 148.6430, based on the condition 
        of the patient or client, the complexity of the treatment 
        procedure, and the proficiencies of the occupational therapy 
        assistant. 
           (b) Face-to-face collaboration between the occupational 
        therapist and the occupational therapy assistant shall occur, at 
        a minimum, every two weeks, during which time the occupational 
        therapist is responsible for: 
           (1) planning and documenting an initial treatment plan and 
        discharge from treatment; 
           (2) reviewing treatment goals, therapy programs, and client 
        progress; 
           (3) supervising changes in the treatment plan; 
           (4) conducting or observing treatment procedures for 
        selected clients and documenting appropriateness of treatment 
        procedures.  Clients shall be selected based on the occupational 
        therapy services provided to the client and the role of the 
        occupational therapist and the occupational therapy assistant in 
        those services; and 
           (5) ensuring the service competency of the occupational 
        therapy assistant in performing delegated treatment procedures. 
           (c) Face-to-face collaboration must occur more frequently 
        than every two weeks if necessary to meet the requirements of 
        paragraph (a) or (b). 
           (d) The occupational therapist shall document compliance 
        with this subdivision in the client's file or chart. 
           Subd. 4.  [EXCEPTION.] The supervision requirements of this 
        section do not apply to an occupational therapy assistant who: 
           (1) works in an activities program; and 
           (2) does not perform occupational therapy services. 
        The occupational therapy assistant must meet all other 
        applicable requirements of sections 148.6401 to 148.6450. 
           Sec. 17.  [148.6435] [COORDINATION OF SERVICES.] 
           An occupational therapist shall: 
           (1) collect information necessary to ensure that the 
        provision of occupational therapy services are consistent with 
        the client's physical and mental health status.  The information 
        required to make this determination may include, but is not 
        limited to, contacting the client's licensed health care 
        professional for health history, current health status, current 
        medications, and precautions; 
           (2) modify or terminate occupational therapy treatment of a 
        client that is not beneficial to the client, not tolerated by 
        the client, or refused by the client, and if treatment was 
        terminated for a medical reason, notify the client's licensed 
        health care professional by correspondence postmarked or 
        delivered to the licensed health care professional within seven 
        calendar days of the termination of treatment; 
           (3) refer a client to an appropriate health care, social 
        service, or education practitioner if the client's condition 
        requires services not within the occupational therapist's 
        service competency or not within the practice of occupational 
        therapy generally; 
           (4) participate and cooperate in the coordination of 
        occupational therapy services with other related services, as a 
        member of the professional community serving the client; and 
           (5) communicate, in writing, with the appropriate licensed 
        health care professional an occupational therapy plan of care, 
        postmarked or delivered to the licensed health care professional 
        within 14 calendar days of the initiation of treatment.  The 
        occupational therapist must provide this written communication 
        even if occupational therapy treatment is concluded in less than 
        14 consecutive days.  The occupational therapist shall document 
        modifications to the plan of care requested by the licensed 
        health care professional following consultation with the 
        licensed health care professional.  Occupational therapists 
        employed by a school system are exempt from the requirements of 
        this clause in the performance of their duties within the school 
        system. 
           Sec. 18.  [148.6438] [RECIPIENT NOTIFICATION.] 
           Subdivision 1.  [REQUIRED NOTIFICATION.] In the absence of 
        a physician referral or prior authorization, and before 
        providing occupational therapy services for remuneration or 
        expectation of payment from the client, an occupational 
        therapist must provide the following written notification in all 
        capital letters of 12-point or larger bold-face type, to the 
        client, parent, or guardian: 
           "Your health care provider, insurer, or plan may require a 
        physician referral or prior authorization and you may be 
        obligated for partial or full payment for occupational therapy 
        services rendered." 
           Information other than this notification may be included as 
        long as the notification remains conspicuous on the face of the 
        document.  A nonwritten disclosure format may be used to satisfy 
        the recipient notification requirement when necessary to 
        accommodate the physical condition of a client or client's 
        guardian. 
           Subd. 2.  [EVIDENCE OF RECIPIENT NOTIFICATION.] The 
        occupational therapist is responsible for providing evidence of 
        compliance with the recipient notification requirement of this 
        section. 
           Sec. 19.  [148.6440] [PHYSICAL AGENT MODALITIES.] 
           Subdivision 1.  [GENERAL CONSIDERATIONS.] (a) Occupational 
        therapists who use superficial physical agent modalities must 
        comply with the requirements in subdivision 3.  Occupational 
        therapists who use electrotherapy must comply with the 
        requirements in subdivision 4.  Occupational therapists who use 
        ultrasound devices must comply with the requirements in 
        subdivision 5.  Occupational therapy assistants who use physical 
        agent modalities must comply with subdivision 6. 
           (b) Use of superficial physical agent modalities, 
        electrical stimulation devices, and ultrasound devices must be 
        on the order of a physician. 
           (c) The commissioner shall maintain a roster of persons 
        licensed under sections 148.6401 to 148.6450 who use physical 
        agent modalities.  Prior to using a physical agent modality, 
        licensees must inform the commissioner of the physical agent 
        modality they will use.  Persons who use physical agent 
        modalities must indicate on their initial and renewal 
        applications the physical agent modalities that they use. 
           (d) Licensees are responsible for informing the 
        commissioner of any changes in the information required in this 
        section within 30 days of any change. 
           Subd. 2.  [WRITTEN DOCUMENTATION REQUIRED.] Prior to use of 
        physical agent modalities, an occupational therapist must 
        provide to the commissioner documentation verifying that the 
        occupational therapist has met the educational and clinical 
        requirements described in subdivisions 3 to 5, depending on the 
        modality or modalities used.  Both theoretical training and 
        clinical application objectives must be met for each modality 
        used.  Documentation must include the name and address of the 
        individual or organization sponsoring the activity; the name and 
        address of the facility at which the activity was presented; and 
        a copy of the course, workshop, or seminar description, 
        including learning objectives and standards for meeting the 
        objectives.  In the case of clinical application objectives, 
        teaching methods must be documented, including actual supervised 
        practice.  Documentation must include a transcript or 
        certificate showing successful completion of the coursework.  
        Practitioners are prohibited from using physical agent 
        modalities independently until granted approval as provided in 
        subdivision 7.  
           Subd. 3.  [EDUCATIONAL AND CLINICAL REQUIREMENTS FOR USE OF 
        SUPERFICIAL PHYSICAL AGENT MODALITIES.] (a) An occupational 
        therapist may use superficial physical agent modalities if the 
        occupational therapist has received theoretical training and 
        clinical application training in the use of superficial physical 
        agent modalities.  
           (b) Theoretical training in the use of superficial physical 
        agent modalities must:  
           (1) explain the rationale and clinical indications for use 
        of superficial physical agent modalities; 
           (2) explain the physical properties and principles of the 
        superficial physical agent modalities; 
           (3) describe the types of heat and cold transference; 
           (4) explain the factors affecting tissue response to 
        superficial heat and cold; 
           (5) describe the biophysical effects of superficial 
        physical agent modalities in normal and abnormal tissue; 
           (6) describe the thermal conductivity of tissue, matter, 
        and air; 
           (7) explain the advantages and disadvantages of superficial 
        physical agent modalities; and 
           (8) explain the precautions and contraindications of 
        superficial physical agent modalities. 
           (c) Clinical application training in the use of superficial 
        physical agent modalities must include activities requiring the 
        practitioner to: 
           (1) formulate and justify a plan for the use of superficial 
        physical agents for treatment appropriate to its use and 
        simulate the treatment; 
           (2) evaluate biophysical effects of the superficial 
        physical agents; 
           (3) identify when modifications to the treatment plan for 
        use of superficial physical agents are needed and propose the 
        modification plan; 
           (4) safely and appropriately administer superficial 
        physical agents under the supervision of a course instructor or 
        clinical trainer; 
           (5) document parameters of treatment, patient response, and 
        recommendations for progression of treatment for the superficial 
        physical agents; and 
           (6) demonstrate the ability to work competently with 
        superficial physical agents as determined by a course instructor 
        or clinical trainer. 
           Subd. 4.  [EDUCATIONAL AND CLINICAL REQUIREMENTS FOR USE OF 
        ELECTROTHERAPY.] (a) An occupational therapist may use 
        electrotherapy if the occupational therapist has received 
        theoretical training and clinical application training in the 
        use of electrotherapy.  
           (b) Theoretical training in the use of electrotherapy must: 
           (1) explain the rationale and clinical indications of 
        electrotherapy, including pain control, muscle dysfunction, and 
        tissue healing; 
           (2) demonstrate comprehension and understanding of 
        electrotherapeutic terminology and biophysical principles, 
        including current, voltage, amplitude, and resistance; 
           (3) describe the types of current used for electrical 
        stimulation, including the description, modulations, and 
        clinical relevance; 
           (4) describe the time-dependent parameters of pulsed and 
        alternating currents, including pulse and phase durations and 
        intervals; 
           (5) describe the amplitude-dependent characteristics of 
        pulsed and alternating currents; 
           (6) describe neurophysiology and the properties of 
        excitable tissue; 
           (7) describe nerve and muscle response from externally 
        applied electrical stimulation, including tissue healing; 
           (8) describe the electrotherapeutic effects and the 
        response of nerve, denervated and innervated muscle, and other 
        soft tissue; and 
           (9) explain the precautions and contraindications of 
        electrotherapy, including considerations regarding pathology of 
        nerve and muscle tissue.  
           (c) Clinical application training in the use of 
        electrotherapy must include activities requiring the 
        practitioner to: 
           (1) formulate and justify a plan for the use of electrical 
        stimulation devices for treatment appropriate to its use and 
        simulate the treatment; 
           (2) evaluate biophysical treatment effects of the 
        electrical stimulation; 
           (3) identify when modifications to the treatment plan using 
        electrical stimulation are needed and propose the modification 
        plan; 
           (4) safely and appropriately administer electrical 
        stimulation under supervision of a course instructor or clinical 
        trainer; 
           (5) document the parameters of treatment, case example 
        (patient) response, and recommendations for progression of 
        treatment for electrical stimulation; and 
           (6) demonstrate the ability to work competently with 
        electrical stimulation as determined by a course instructor or 
        clinical trainer. 
           Subd. 5.  [EDUCATIONAL AND CLINICAL REQUIREMENTS FOR USE OF 
        ULTRASOUND.] (a) An occupational therapist may use an ultrasound 
        device if the occupational therapist has received theoretical 
        training and clinical application training in the use of 
        ultrasound.  
           (b) The theoretical training in the use of ultrasound must: 
           (1) explain the rationale and clinical indications for the 
        use of ultrasound, including anticipated physiological responses 
        of the treated area; 
           (2) describe the biophysical thermal and nonthermal effects 
        of ultrasound on normal and abnormal tissue; 
           (3) explain the physical principles of ultrasound, 
        including wavelength, frequency, attenuation, velocity, and 
        intensity; 
           (4) explain the mechanism and generation of ultrasound and 
        energy transmission through physical matter; and 
           (5) explain the precautions and contraindications regarding 
        use of ultrasound devices. 
           (c) The clinical application training in the use of 
        ultrasound must include activities requiring the practitioner to:
           (1) formulate and justify a plan for the use of ultrasound 
        for treatment appropriate to its use and stimulate the 
        treatment; 
           (2) evaluate biophysical effects of ultrasound; 
           (3) identify when modifications to the treatment plan for 
        use of ultrasound are needed and propose the modification plan; 
           (4) safely and appropriately administer ultrasound under 
        supervision of a course instructor or clinical trainer; 
           (5) document parameters of treatment, patient response, and 
        recommendations for progression of treatment for ultrasound; and 
           (6) demonstrate the ability to work competently with 
        ultrasound as determined by a course instructor or clinical 
        trainer. 
           Subd. 6.  [OCCUPATIONAL THERAPY ASSISTANT USE OF PHYSICAL 
        AGENT MODALITIES.] An occupational therapy assistant may set up 
        and implement treatment using physical agent modalities if the 
        assistant meets the requirements of this section, has 
        demonstrated service competency for the particular modality 
        used, and works under the direct supervision of an occupational 
        therapist.  An occupational therapy assistant who uses 
        superficial physical agent modalities must meet the requirements 
        of subdivision 3.  An occupational therapy assistant who uses 
        electrotherapy must meet the requirements of subdivision 4.  An 
        occupational therapy assistant who uses ultrasound must meet the 
        requirements of subdivision 5.  An occupational therapist may 
        not delegate evaluation, reevaluation, treatment planning, and 
        treatment goals for physical agent modalities to an occupational 
        therapy assistant. 
           Subd. 7.  [APPROVAL.] (a) The advisory council shall 
        appoint a committee to review documentation under subdivisions 2 
        to 6 to determine if established educational and clinical 
        requirements are met. 
           (b) Occupational therapists shall be advised of the status 
        of their request for approval within 30 days.  Occupational 
        therapists must provide any additional information requested by 
        the committee that is necessary to make a determination 
        regarding approval or denial. 
           (c) A determination regarding a request for approval of 
        training under this subdivision shall be made in writing to the 
        occupational therapist.  If denied, the reason for denial shall 
        be provided. 
           (d) A licensee who was approved by the commissioner as a 
        level two provider prior to July 1, 1999, shall remain on the 
        roster maintained by the commissioner in accordance with 
        subdivision 1, paragraph (c). 
           (e) To remain on the roster maintained by the commissioner, 
        a licensee who was approved by the commissioner as a level one 
        provider prior to July 1, 1999, must submit to the commissioner 
        documentation of training and experience gained using physical 
        agent modalities since the licensee's approval as a level one 
        provider.  The committee appointed under paragraph (a) shall 
        review the documentation and make a recommendation to the 
        commissioner regarding approval. 
           (f) An occupational therapist who received training in the 
        use of physical agent modalities prior to July 1, 1999, but who 
        has not been placed on the roster of approved providers may 
        submit to the commissioner documentation of training and 
        experience gained using physical agent modalities.  The 
        committee appointed under paragraph (a) shall review 
        documentation and make a recommendation to the commissioner 
        regarding approval. 
           Sec. 20.  [148.6443] [CONTINUING EDUCATION REQUIREMENTS.] 
           Subdivision 1.  [GENERAL REQUIREMENTS.] An occupational 
        therapist applying for licensure renewal must have completed a 
        minimum of 24 contact hours of continuing education in the two 
        years preceding licensure renewal.  An occupational therapy 
        assistant applying for licensure renewal must have completed a 
        minimum of 18 contact hours of continuing education in the two 
        years preceding licensure renewal.  Licensees who are issued 
        licenses for a period of less than two years shall prorate the 
        number of contact hours required for licensure renewal based on 
        the number of months licensed during the biennial licensure 
        period.  Licensees shall receive contact hours for continuing 
        education activities only for the biennial licensure period in 
        which the continuing education activity was performed. 
           To qualify as a continuing education activity, the activity 
        must be a minimum of one contact hour.  Contact hours must be 
        earned and reported in increments of one contact hour or 
        one-half contact hour for each continuing education activity.  
        One-half contact hour means an instructional session of 30 
        consecutive minutes, excluding coffee breaks, registration, 
        meals without a speaker, and social activities. 
           Each licensee is responsible for financing the cost of the 
        licensee's continuing education activities. 
           Subd. 2.  [STANDARDS FOR DETERMINING QUALIFIED CONTINUING 
        EDUCATION ACTIVITIES.] Except as provided in subdivision 3, 
        paragraph (f), in order to qualify as a continuing education 
        activity, the activity must: 
           (1) constitute an organized program of learning; 
           (2) reasonably be expected to advance the knowledge and 
        skills of the occupational therapy practitioner; 
           (3) pertain to subjects that directly relate to the 
        practice of occupational therapy; 
           (4) be conducted by individuals who have education, 
        training, and experience by reason of which the individuals 
        should be considered experts on the subject matter of the 
        activity; and 
           (5) be presented by a sponsor who has a mechanism to verify 
        participation and maintains attendance records for three years. 
           Subd. 3.  [ACTIVITIES QUALIFYING FOR CONTINUING EDUCATION 
        CONTACT HOURS.] (a) The activities in this subdivision qualify 
        for continuing education contact hours if they meet all other 
        requirements of this section. 
           (b) A licensee may obtain an unlimited number of contact 
        hours in any two-year continuing education period through 
        participation in the following: 
           (1) attendance at educational programs of annual 
        conferences, lectures, panel discussions, workshops, in-service 
        training, seminars, and symposiums; 
           (2) successful completion of college or university 
        courses.  The licensee must obtain a grade of at least a "C" or 
        a pass in a pass or fail course in order to receive the 
        following continuing education credits: 
           (i) one semester credit equals 14 contact hours; 
           (ii) one trimester credit equals 12 contact hours; and 
           (iii) one quarter credit equals ten contact hours; and 
           (3) successful completion of home study courses that 
        require the participant to demonstrate the participant's 
        knowledge following completion of the course. 
           (c) A licensee may obtain a maximum of six contact hours in 
        any two-year continuing education period for teaching continuing 
        education courses that meet the requirements of this section.  A 
        licensee is entitled to earn a maximum of two contact hours as 
        preparation time for each contact hour of presentation time.  
        Contact hours may be claimed only once for teaching the same 
        course in any two-year continuing education period.  A course 
        schedule or brochure must be maintained for audit. 
           (d) A licensee may obtain a maximum of two contact hours in 
        any two-year continuing education period for continuing 
        education activities in the following areas: 
           (1) business-related topics:  marketing, time management, 
        administration, risk management, government regulations, 
        techniques for training professionals, computer skills, and 
        similar topics; 
           (2) personal skill topics:  career burnout, communication 
        skills, human relations, and similar topics; and 
           (3) training that is obtained in conjunction with a 
        licensee's employment, occurs during a licensee's normal 
        workday, and does not include subject matter specific to the 
        fundamentals of occupational therapy. 
           (e) An occupational therapy practitioner that utilizes 
        leisure activities, recreational activities, or hobbies as part 
        of occupational therapy services in the practitioner's current 
        work setting may obtain a maximum of six contact hours in any 
        two-year continuing education period for participation in 
        courses teaching these activities. 
           (f) A licensee may obtain a maximum of six contact hours in 
        any two-year continuing education period for supervision of 
        occupational therapist or occupational therapy assistant 
        students.  A licensee may earn one contact hour for every eight 
        hours of student supervision.  Licensees must maintain a log 
        indicating the name of each student supervised and the hours 
        each student was supervised.  Contact hours obtained by student 
        supervision must be obtained by supervising students from an 
        occupational therapy education program accredited by the 
        Accreditation Council for Occupational Therapy Education. 
           Subd. 4.  [ACTIVITIES NOT QUALIFYING FOR CONTINUING 
        EDUCATION CONTACT HOURS.] No credit shall be granted for the 
        following activities:  hospital rounds, entertainment or 
        recreational activities, employment orientation sessions, 
        holding an office or serving as an organizational delegate, 
        meetings for the purpose of making policy, noneducational 
        association meetings, training related to payment systems, 
        including covered services, coding, and billing. 
           Subd. 5.  [REPORTING CONTINUING EDUCATION CONTACT HOURS.] 
        At the time of licensure renewal, each licensee shall submit 
        verification that the licensee has met the continuing education 
        requirements of this section on the continuing education report 
        form provided by the commissioner.  The continuing education 
        report form may require the following information: 
           (1) title of continuing education activity; 
           (2) brief description of the continuing education activity; 
           (3) sponsor, presenter, or author; 
           (4) location and attendance dates; 
           (5) number of contact hours; and 
           (6) licensee's notarized affirmation that the information 
        is true and correct. 
           Subd. 6.  [AUDITING CONTINUING EDUCATION REPORTS.] (a) The 
        commissioner may audit a percentage of the continuing education 
        reports based on random selection.  A licensee shall maintain 
        all documentation required by this section for two years after 
        the last day of the biennial licensure period in which the 
        contact hours were earned. 
           (b) All renewal applications that are received after the 
        expiration date may be subject to a continuing education report 
        audit. 
           (c) Any licensee against whom a complaint is filed may be 
        subject to a continuing education report audit. 
           (d) The licensee shall make the following information 
        available to the commissioner for auditing purposes: 
           (1) a copy of the completed continuing education report 
        form for the continuing education reporting period that is the 
        subject of the audit including all supporting documentation 
        required by subdivision 5; 
           (2) a description of the continuing education activity 
        prepared by the presenter or sponsor that includes the course 
        title or subject matter, date, place, number of program contact 
        hours, presenters, and sponsors; 
           (3) documentation of self-study programs by materials 
        prepared by the presenter or sponsor that includes the course 
        title, course description, name of sponsor or author, and the 
        number of hours required to complete the program; 
           (4) documentation of university, college, or vocational 
        school courses by a course syllabus, listing in a course 
        bulletin, or equivalent documentation that includes the course 
        title, instructor's name, course dates, number of contact hours, 
        and course content, objectives, or goals; and 
           (5) verification of attendance by: 
           (i) a signature of the presenter or a designee at the 
        continuing education activity on the continuing education report 
        form or a certificate of attendance with the course name, course 
        date, and licensee's name; 
           (ii) a summary or outline of the educational content of an 
        audio or video educational activity to verify the licensee's 
        participation in the activity if a designee is not available to 
        sign the continuing education report form; 
           (iii) verification of self-study programs by a certificate 
        of completion or other documentation indicating that the 
        individual has demonstrated knowledge and has successfully 
        completed the program; or 
           (iv) verification of attendance at a university, college, 
        or vocational course by an official transcript. 
           Subd. 7.  [WAIVER OF CONTINUING EDUCATION REQUIREMENTS.] 
        The commissioner may grant a waiver of the requirements of this 
        section in cases where the requirements would impose an extreme 
        hardship on the licensee.  The request for a waiver must be in 
        writing, state the circumstances that constitute extreme 
        hardship, state the period of time the licensee wishes to have 
        the continuing education requirement waived, and state the 
        alternative measures that will be taken if a waiver is granted.  
        The commissioner shall set forth, in writing, the reasons for 
        granting or denying the waiver.  Waivers granted by the 
        commissioner shall specify, in writing, the time limitation and 
        required alternative measures to be taken by the licensee.  A 
        request for waiver shall be denied if the commissioner finds 
        that the circumstances stated by the licensee do not support a 
        claim of extreme hardship, the requested time period for waiver 
        is unreasonable, the alternative measures proposed by the 
        licensee are not equivalent to the continuing education activity 
        being waived, or the request for waiver is not submitted to the 
        commissioner within 60 days after the expiration date. 
           Subd. 8.  [PENALTIES FOR NONCOMPLIANCE.] The commissioner 
        shall refuse to renew or grant, or shall suspend, condition, 
        limit, or qualify the license of any person who the commissioner 
        determines has failed to comply with the continuing education 
        requirements of this section.  A licensee may request 
        reconsideration of the commissioner's determination of 
        noncompliance or the penalty imposed under this section by 
        making a written request to the commissioner within 30 days of 
        the date of notification to the applicant.  Individuals 
        requesting reconsideration may submit information that the 
        licensee wants considered in the reconsideration. 
           Sec. 21.  [148.6445] [FEES; SURCHARGE.] 
           Subdivision 1.  [INITIAL LICENSURE FEE.] The initial 
        licensure fee for occupational therapists is $180.  The initial 
        licensure fee for occupational therapy assistants is $100.  The 
        commissioner shall prorate fees based on the number of quarters 
        remaining in the biennial licensure period. 
           Subd. 2.  [LICENSURE RENEWAL FEE.] The biennial licensure 
        renewal fee for occupational therapists is $180.  The biennial 
        licensure renewal fee for occupational therapy assistants is 
        $100. 
           Subd. 3.  [LATE FEE.] The fee for late submission of a 
        renewal application is $25. 
           Subd. 4.  [TEMPORARY LICENSURE FEE.] The fee for temporary 
        licensure is $50. 
           Subd. 5.  [LIMITED LICENSURE FEE.] The fee for limited 
        licensure is $96. 
           Subd. 6.  [FEE FOR COURSE APPROVAL AFTER LAPSE OF 
        LICENSURE.] The fee for course approval after lapse of licensure 
        is $96. 
           Subd. 7.  [CERTIFICATION TO OTHER STATES.] The fee for 
        certification of licensure to other states is $25. 
           Subd. 8.  [VERIFICATION TO INSTITUTIONS.] The fee for 
        verification of licensure to institutions is $10. 
           Subd. 9.  [SURCHARGE.] Until June 17, 2001, all licensees 
        must pay a surcharge fee in addition to other applicable fees.  
        Occupational therapists must pay a biennial surcharge fee of $62 
        upon application for licensure and licensure renewal.  
        Occupational therapy assistants must pay a biennial surcharge 
        fee of $36 upon application for licensure and licensure renewal. 
           Subd. 10.  [NONREFUNDABLE FEES.] All fees are nonrefundable.
           Sec. 22.  [148.6448] [GROUNDS FOR DENIAL OF LICENSURE OR 
        DISCIPLINE; INVESTIGATION PROCEDURES; DISCIPLINARY ACTIONS.] 
           Subdivision 1.  [GROUNDS FOR DENIAL OF LICENSURE OR 
        DISCIPLINE.] The commissioner may deny an application for 
        licensure, may approve licensure with conditions, or may 
        discipline a licensee using any disciplinary actions listed in 
        subdivision 3 on proof that the individual has: 
           (1) intentionally submitted false or misleading information 
        to the commissioner or the advisory council; 
           (2) failed, within 30 days, to provide information in 
        response to a written request by the commissioner or advisory 
        council; 
           (3) performed services of an occupational therapist or 
        occupational therapy assistant in an incompetent manner or in a 
        manner that falls below the community standard of care; 
           (4) failed to satisfactorily perform occupational therapy 
        services during a period of provisional licensure; 
           (5) violated sections 148.6401 to 148.6450; 
           (6) failed to perform services with reasonable judgment, 
        skill, or safety due to the use of alcohol or drugs, or other 
        physical or mental impairment; 
           (7) been convicted of violating any state or federal law, 
        rule, or regulation which directly relates to the practice of 
        occupational therapy; 
           (8) aided or abetted another person in violating any 
        provision of sections 148.6401 to 148.6450; 
           (9) been disciplined for conduct in the practice of an 
        occupation by the state of Minnesota, another jurisdiction, or a 
        national professional association, if any of the grounds for 
        discipline are the same or substantially equivalent to those in 
        sections 148.6401 to 148.6450; 
           (10) not cooperated with the commissioner or advisory 
        council in an investigation conducted according to subdivision 
        2; 
           (11) advertised in a manner that is false or misleading; 
           (12) engaged in dishonest, unethical, or unprofessional 
        conduct in connection with the practice of occupational therapy 
        that is likely to deceive, defraud, or harm the public; 
           (13) demonstrated a willful or careless disregard for the 
        health, welfare, or safety of a client; 
           (14) performed medical diagnosis or provided treatment, 
        other than occupational therapy, without being licensed to do so 
        under the laws of this state; 
           (15) paid or promised to pay a commission or part of a fee 
        to any person who contacts the occupational therapist for 
        consultation or sends patients to the occupational therapist for 
        treatment; 
           (16) engaged in an incentive payment arrangement, other 
        than that prohibited by clause (15), that promotes occupational 
        therapy overutilization, whereby the referring person or person 
        who controls the availability of occupational therapy services 
        to a client profits unreasonably as a result of client 
        treatment; 
           (17) engaged in abusive or fraudulent billing practices, 
        including violations of federal Medicare and Medicaid laws, Food 
        and Drug Administration regulations, or state medical assistance 
        laws; 
           (18) obtained money, property, or services from a consumer 
        through the use of undue influence, high pressure sales tactics, 
        harassment, duress, deception, or fraud; 
           (19) performed services for a client who had no possibility 
        of benefiting from the services; 
           (20) failed to refer a client for medical evaluation when 
        appropriate or when a client indicated symptoms associated with 
        diseases that could be medically or surgically treated; 
           (21) engaged in conduct with a client that is sexual or may 
        reasonably be interpreted by the client as sexual, or in any 
        verbal behavior that is seductive or sexually demeaning to a 
        patient; 
           (22) violated a federal or state court order, including a 
        conciliation court judgment, or a disciplinary order issued by 
        the commissioner, related to the person's occupational therapy 
        practice; or 
           (23) any other just cause related to the practice of 
        occupational therapy. 
           Subd. 2.  [INVESTIGATION OF COMPLAINTS.] The commissioner, 
        or the advisory council when authorized by the commissioner, may 
        initiate an investigation upon receiving a complaint or other 
        oral or written communication that alleges or implies that a 
        person has violated sections 148.6401 to 148.6450.  In the 
        receipt, investigation, and hearing of a complaint that alleges 
        or implies a person has violated sections 148.6401 to 148.6450, 
        the commissioner shall follow the procedures in section 214.10. 
           Subd. 3.  [DISCIPLINARY ACTIONS.] If the commissioner finds 
        that an occupational therapist or occupational therapy assistant 
        should be disciplined according to subdivision 1, the 
        commissioner may take any one or more of the following actions: 
           (1) refuse to grant or renew licensure; 
           (2) approve licensure with conditions; 
           (3) revoke licensure; 
           (4) suspend licensure; 
           (5) any reasonable lesser action including, but not limited 
        to, reprimand or restriction on licensure; or 
           (6) any action authorized by statute. 
           Subd. 4.  [EFFECT OF SPECIFIC DISCIPLINARY ACTION ON USE OF 
        TITLE.] Upon notice from the commissioner denying licensure 
        renewal or upon notice that disciplinary actions have been 
        imposed and the person is no longer entitled to practice 
        occupational therapy and use the occupational therapy and 
        licensed titles, the person shall cease to practice occupational 
        therapy, to use titles protected by sections 148.6401 to 
        148.6450, and to represent to the public that the person is 
        licensed by the commissioner. 
           Subd. 5.  [REINSTATEMENT REQUIREMENTS AFTER DISCIPLINARY 
        ACTION.] A person who has had licensure suspended may request 
        and provide justification for reinstatement following the period 
        of suspension specified by the commissioner.  The requirements 
        of sections 148.6423 and 148.6425 for renewing licensure and any 
        other conditions imposed with the suspension must be met before 
        licensure may be reinstated. 
           Sec. 23.  [148.6450] [OCCUPATIONAL THERAPY PRACTITIONERS 
        ADVISORY COUNCIL.] 
           Subdivision 1.  [MEMBERSHIP.] The commissioner shall 
        appoint seven persons to an occupational therapy practitioners 
        advisory council consisting of the following: 
           (1) two public members, as defined in section 214.02.  The 
        public members shall be either persons who have received 
        occupational therapy services or family members of or caregivers 
        to such persons; 
           (2) two members who are occupational therapists and two 
        occupational therapy assistants licensed under sections 148.6401 
        to 148.6450, each of whom is employed in a different practice 
        area including, but not limited to, long-term care, school 
        therapy, early intervention, administration, gerontology, 
        industrial rehabilitation, cardiac rehabilitation, physical 
        disability, pediatrics, mental health, home health, and hand 
        therapy.  Three of the four occupational therapy practitioners 
        who serve on the advisory council must be currently, and for the 
        three years preceding the appointment, engaged in the practice 
        of occupational therapy or employed as an administrator or an 
        instructor of an occupational therapy program.  At least one of 
        the four occupational therapy practitioners who serves on the 
        advisory council must be employed in a rural area; and 
           (3) one member who is a licensed or registered health care 
        practitioner, or other credentialed practitioner, who works 
        collaboratively with occupational therapy practitioners. 
           Subd. 2.  [DUTIES.] At the commissioner's request, the 
        advisory council shall: 
           (1) advise the commissioner regarding the occupational 
        therapy practitioner licensure standards; 
           (2) advise the commissioner on enforcement of sections 
        148.6401 to 148.6450; 
           (3) provide for distribution of information regarding 
        occupational therapy practitioners licensure standards; 
           (4) review applications and make recommendations to the 
        commissioner on granting or denying licensure or licensure 
        renewal; 
           (5) review reports of investigations relating to 
        individuals and make recommendations to the commissioner as to 
        whether licensure should be denied or disciplinary action taken 
        against the person; and 
           (6) perform other duties authorized for advisory councils 
        by chapter 214, as directed by the commissioner. 
           Sec. 24.  [REPEALER.] 
           Minnesota Rules, parts 4666.0010; 4666.0020; 4666.0030; 
        4666.0040; 4666.0050; 4666.0060; 4666.0070; 4666.0080; 
        4666.0090; 4666.0100; 4666.0200; 4666.0300; 4666.0400; 
        4666.0500; 4666.0600; 4666.0700; 4666.0800; 4666.0900; 
        4666.1000; 4666.1100; 4666.1200; 4666.1300; and 4666.1400, are 
        repealed. 
           Sec. 25.  [EFFECTIVE DATE.] 
           Sections 1 to 24 are effective the day following final 
        enactment. 
           Presented to the governor April 7, 2000 
           Signed by the governor April 11, 2000, 10:37 a.m.