Minnesota Legislature
Office of the Revisor of Statutes
Minnesota Session Laws - 1997, Regular Session
Key: (1) language to be deleted (2) new language
CHAPTER 120-S.F.No. 741
An act relating to health; regulating the practice of
respiratory care; establishing the requirements for
registration and regulation of respiratory care
practitioners; providing for continuing education,
fees, reporting obligations, disciplinary actions, and
for an advisory council; providing criminal penalties;
creating a physician assistant advisory council;
proposing coding for new law in Minnesota Statutes,
chapter 147A; proposing coding for new law as
Minnesota Statutes, chapter 147C; repealing Minnesota
Rules, parts 4762.0010; 4762.0020; 4762.0030;
4762.0040; 4762.0050; 4762.0060; 4762.0065; 4762.0070;
4762.0080; 4762.0090; 4762.0100; 4762.0200; and
4762.0300.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1. [147A.27] [PHYSICIAN ASSISTANT ADVISORY
COUNCIL.]
Subdivision 1. [MEMBERSHIP.] The physician assistant
advisory council is created and is composed of seven persons
appointed by the board. The seven persons must include:
(1) two public members, as defined in section 214.02;
(2) three physician assistants registered under this
chapter; and
(3) two licensed physicians with experience supervising
physician assistants.
Subd. 2. [ORGANIZATION.] The council shall be organized
and administered under section 15.059, except that the advisory
council shall expire on June 30, 2007.
Subd. 3. [DUTIES.] The council shall advise the board
regarding:
(1) physician assistant registration standards;
(2) enforcement of grounds for discipline;
(3) distribution of information regarding physician
assistant registration standards;
(4) applications and recommendations of applicants for
registration or registration renewal; and
(5) complaints and recommendations to the board regarding
disciplinary matters and proceedings concerning applicants and
registrants according to sections 214.10; 214.103; and 214.13,
subdivisions 6 and 7.
The council shall perform other duties authorized for the
council by chapter 214 as directed by the board.
Sec. 2. [147C.01] [DEFINITIONS.]
Subdivision 1. [APPLICABILITY.] The definitions in this
section apply to this chapter.
Subd. 2. [ADVISORY COUNCIL.] "Advisory council" means the
respiratory care practitioner advisory council established under
section 147C.35.
Subd. 3. [APPROVED EDUCATION PROGRAM.] "Approved education
program" means a university, college, or other post-secondary
education program leading to eligibility for registry or
certification in respiratory care, that, at the time the student
completes the program, is accredited by a national accrediting
organization approved by the board.
Subd. 4. [BOARD.] "Board" means the board of medical
practice or its designee.
Subd. 5. [CONTACT HOUR.] "Contact hour" means an
instructional session of 50 consecutive minutes, excluding
coffee breaks, registration, meals without a speaker, and social
activities.
Subd. 6. [CREDENTIAL.] "Credential" means a license,
permit, certification, registration, or other evidence of
qualification or authorization to engage in respiratory care
practice in this state or any other state.
Subd. 7. [CREDENTIALING EXAMINATION.] "Credentialing
examination" means an examination administered by the National
Board for Respiratory Care or other national testing
organization approved by the board for credentialing as a
certified respiratory therapy technician, registered respiratory
therapist, or other title indicating an entry or advanced level
respiratory care practitioner.
Subd. 8. [HEALTH CARE FACILITY.] "Health care facility"
means a hospital as defined in section 144.50, subdivision 2, a
medical facility as defined in section 144.561, subdivision 1,
paragraph (b), or a nursing home as defined in section l44A.01,
subdivision 5, a long-term acute care facility, a subacute care
facility, an outpatient clinic, a physician's office, or a
hospice.
Subd. 9. [QUALIFIED MEDICAL DIRECTION.] "Qualified medical
direction" means direction from a licensed physician who is on
the staff or is a consultant of a health care facility or home
care agency or home medical equipment provider and who has a
special interest in and knowledge of the diagnosis and treatment
of deficiencies, abnormalities, and diseases of the
cardiopulmonary system.
Subd. 10. [RESPIRATORY CARE.] "Respiratory care" means the
provision of services described under section 147C.05 for the
assessment, treatment, education, management, evaluation, and
care of patients with deficiencies, abnormalities, and diseases
of the cardiopulmonary system, under the guidance of qualified
medical direction and pursuant to a referral from a physician
who has medical responsibility for the patient. It includes
education pertaining to health promotion and disease prevention,
patient care, and treatment.
Sec. 3. [147C.05] [SCOPE OF PRACTICE.]
(a) The practice of respiratory care by a registered
respiratory care practitioner includes, but is not limited to,
the following services:
(1) providing and monitoring therapeutic administration of
medical gases, aerosols, humidification, and pharmacological
agents related to respiratory care procedures, but not including
administration of general anesthesia;
(2) carrying out therapeutic application and monitoring of
mechanical ventilatory support;
(3) providing cardiopulmonary resuscitation and maintenance
of natural airways and insertion and maintenance of artificial
airways;
(4) assessing and monitoring signs, symptoms, and general
behavior relating to, and general physical response to,
respiratory care treatment or evaluation for treatment and
diagnostic testing, including determination of whether the
signs, symptoms, reactions, behavior, or general response
exhibit abnormal characteristics;
(5) obtaining physiological specimens and interpreting
physiological data including:
(i) analyzing arterial and venous blood gases;
(ii) assessing respiratory secretions;
(iii) measuring ventilatory volumes, pressures, and flows;
(iv) testing pulmonary function;
(v) testing and studying the cardiopulmonary system; and
(vi) diagnostic testing of breathing patterns related to
sleep disorders;
(6) assisting hemodynamic monitoring and support of the
cardiopulmonary system;
(7) assessing and making suggestions for modifications in
the treatment regimen based on abnormalities, protocols, or
changes in patient response to respiratory care treatment;
(8) providing cardiopulmonary rehabilitation including
respiratory-care related educational components, postural
drainage, chest physiotherapy, breathing exercises, aerosolized
administration of medications, and equipment use and
maintenance;
(9) instructing patients and their families in techniques
for the prevention, alleviation, and rehabilitation of
deficiencies, abnormalities, and diseases of the cardiopulmonary
system; and
(10) transcribing and implementing physician orders for
respiratory care services.
(b) Patient service by a practitioner must be limited to:
(1) services within the training and experience of the
practitioner; and
(2) services within the parameters of the laws, rules, and
standards of the facilities in which the respiratory care
practitioner practices.
(c) Respiratory care services provided by a registered
respiratory care practitioner, whether delivered in a health
care facility or the patient's residence, must not be provided
except upon referral from a physician.
Sec. 4. [147C.10] [PROTECTED TITLES AND RESTRICTIONS ON
USE.]
Subdivision 1. [PROTECTED TITLES.] No individual may use
the title "Minnesota registered respiratory care practitioner,"
"registered respiratory care practitioner," "respiratory care
practitioner," "respiratory therapist," "respiratory therapy (or
care) technician," "inhalation therapist," or "inhalation
therapy technician," or use, in connection with the individual's
name, the letters "RCP," or any other titles, words, letters,
abbreviations, or insignia indicating or implying that the
individual is eligible for registration by the state as a
respiratory care practitioner unless the individual has been
registered as a respiratory care practitioner according to this
chapter.
Subd. 2. [OTHER HEALTH CARE PRACTITIONERS.] (a)
Nonphysician individuals practicing in a health care occupation
or profession are not restricted in the provision of services
included in section 147C.05, as long as they do not hold
themselves out as respiratory care practitioners by or through
the use of the titles provided in subdivision 1 in association
with provision of these services.
(b) Physician practitioners are exempt from this chapter.
(c) Nothing in this chapter shall be construed to require
registration of:
(1) a respiratory care practitioner student enrolled in a
respiratory therapy education program accredited by the
Commission on Accreditation of Allied Health Education Programs
or another accrediting organization approved by the board; and
(2) a respiratory care practitioner employed in the service
of the federal government while performing duties incident to
that employment.
Subd. 3. [PENALTY.] A person who violates subdivision 1 is
guilty of a gross misdemeanor.
Subd. 4. [IDENTIFICATION OF REGISTERED PRACTITIONERS.]
Respiratory care practitioners registered in Minnesota shall
wear name tags that identify them as respiratory care
practitioners while in a professional setting. If not written
in full, this must be designated as RCP. A student attending a
respiratory therapy training program or a tutorial intern
program must be identified as a student respiratory care
practitioner. This abbreviated designation is Student RCP.
Unregulated individuals who work in an assisting respiratory
role under the supervision of respiratory care practitioners
must be identified as respiratory care assistants or aides.
Sec. 5. [147C.15] [REGISTRATION REQUIREMENTS.]
Subdivision 1. [GENERAL REQUIREMENTS FOR REGISTRATION.] To
be eligible for registration, an applicant, with the exception
of those seeking registration by reciprocity under subdivision
2, must:
(1) submit a completed application on forms provided by the
board along with all fees required under section 147C.40 that
includes:
(i) the applicant's name, social security number, home
address and telephone number, and business address and telephone
number;
(ii) the name and location of the respiratory care
education program the applicant completed;
(iii) a list of degrees received from educational
institutions;
(iv) a description of the applicant's professional training
beyond the first degree received;
(v) the applicant's work history for the five years
preceding the application, including the average number of hours
worked per week;
(vi) a list of registrations, certifications, and licenses
held in other jurisdictions;
(vii) a description of any other jurisdiction's refusal to
credential the applicant;
(viii) a description of all professional disciplinary
actions initiated against the applicant in any jurisdiction; and
(ix) any history of drug or alcohol abuse, and any
misdemeanor or felony conviction;
(2) submit a certificate of completion from an approved
education program;
(3) achieve a qualifying score on a credentialing
examination within five years prior to application for
registration;
(4) submit a verified copy of a valid and current
credential, issued by the National Board for Respiratory Care or
other board-approved national organization, as a certified
respiratory therapy technician, registered respiratory
therapist, or other entry or advanced level respiratory care
practitioner designation;
(5) submit additional information as requested by the
board, including providing any additional information necessary
to ensure that the applicant is able to practice with reasonable
skill and safety to the public;
(6) sign a statement that the information in the
application is true and correct to the best of the applicant's
knowledge and belief; and
(7) sign a waiver authorizing the board to obtain access to
the applicant's records in this or any other state in which the
applicant has completed an approved education program or engaged
in the practice of respiratory care.
Subd. 2. [REGISTRATION BY RECIPROCITY.] To be eligible for
registration by reciprocity, the applicant must be credentialed
by the National Board for Respiratory Care or other
board-approved organization and have worked at least eight weeks
of the previous five years as a respiratory care practitioner
and must:
(1) submit the application materials and fees as required
by subdivision 1, clauses (1), (4), (5), (6), and (7);
(2) provide a verified copy from the appropriate government
body of a current and unrestricted credential for the practice
of respiratory care in another jurisdiction that has initial
credentialing requirements equivalent to or higher than the
requirements in subdivision 1; and
(3) provide letters of verification from the appropriate
government body in each jurisdiction in which the applicant
holds a credential. Each letter must state the applicant's
name, date of birth, credential number, date of issuance, a
statement regarding disciplinary actions, if any, taken against
the applicant, and the terms under which the credential was
issued.
Subd. 3. [TEMPORARY PERMIT.] The board may issue a
temporary permit to practice as a respiratory care practitioner
to an applicant eligible for registration under this section if
the application for registration is complete, all applicable
requirements in this section have been met, and a nonrefundable
fee set by the board has been paid. The permit remains valid
only until the meeting of the board at which a decision is made
on the respiratory care practitioner's application for
registration.
Subd. 4. [TEMPORARY REGISTRATION.] The board may issue
temporary registration as a respiratory care practitioner for a
period of one year to an applicant for registration under this
section if the application for registration is complete, all
applicable requirements have been met with exception of
completion of a credentialing examination, and a nonrefundable
fee set by the board has been paid. A respiratory care
practitioner with temporary registration may qualify for full
registration status upon submission of verified documentation
that the respiratory care practitioner has achieved a qualifying
score on a credentialing examination within one year after
receiving temporary registration status. Temporary registration
may not be renewed.
Subd. 5. [PRACTICE LIMITATIONS WITH TEMPORARY
REGISTRATION.] A respiratory care practitioner with temporary
registration is limited to working under the direct supervision
of a registered respiratory care practitioner or physician able
to provide qualified medical direction. The respiratory care
practitioner or physician must be present in the health care
facility or readily available by telecommunication at the time
the respiratory care services are being provided. A registered
respiratory care practitioner may supervise no more than two
respiratory care practitioners with temporary registration
status.
Subd. 6. [REGISTRATION EXPIRATION.] Registrations issued
under this chapter expire annually.
Subd. 7. [RENEWAL.] (a) To be eligible for registration
renewal a registrant must:
(1) annually, or as determined by the board, complete a
renewal application on a form provided by the board;
(2) submit the renewal fee;
(3) provide evidence every two years of a total of 24 hours
of continuing education approved by the board as described in
section 147C.25; and
(4) submit any additional information requested by the
board to clarify information presented in the renewal
application. The information must be submitted within 30 days
after the board's request, or the renewal request is nullified.
(b) Applicants for renewal who have not practiced the
equivalent of eight full weeks during the past five years must
achieve a passing score on retaking the credentialing
examination, or complete no less than eight weeks of advisory
council-approved supervised clinical experience having a broad
base of treatment modalities and patient care.
Subd. 8. [CHANGE OF ADDRESS.] A registrant who changes
addresses must inform the board within 30 days, in writing, of
the change of address. All notices or other correspondence
mailed to or served on a registrant by the board at the
registrant's address on file with the board shall be considered
as having been received by the registrant.
Subd. 9. [REGISTRATION RENEWAL NOTICE.] At least 30 days
before the registration renewal date, the board shall send out a
renewal notice to the last known address of the registrant on
file. The notice must include a renewal application and a
notice of fees required for renewal. It must also inform the
registrant that registration will expire without further action
by the board if an application for registration renewal is not
received before the deadline for renewal. The registrant's
failure to receive this notice shall not relieve the registrant
of the obligation to meet the deadline and other requirements
for registration renewal. Failure to receive this notice is not
grounds for challenging expiration of registered status.
Subd. 10. [RENEWAL DEADLINE.] The renewal application and
fee must be postmarked on or before July 1 of the year of
renewal or as determined by the board. If the postmark is
illegible, the application shall be considered timely if
received by the third working day after the deadline.
Subd. 11. [INACTIVE STATUS AND RETURN TO ACTIVE STATUS.]
(a) A registration may be placed in inactive status upon
application to the board by the registrant and upon payment of
an inactive status fee.
(b) Registrants seeking restoration to active from inactive
status must pay the current renewal fees and all unpaid back
inactive fees. They must meet the criteria for renewal
specified in subdivision 7, including continuing education hours
equivalent to one hour for each month of inactive status, prior
to submitting an application to regain registered status. If
the inactive status extends beyond five years, a qualifying
score on a credentialing examination, or completion of an
advisory council-approved eight-week supervised clinical
training experience is required. If the registrant intends to
regain active registration by means of eight weeks of advisory
council-approved clinical training experience, the registrant
shall be granted temporary registration for a period of no
longer than six months.
Subd. 12. [REGISTRATION FOLLOWING LAPSE OF REGISTRATION
STATUS FOR TWO YEARS OR LESS.] For any individual whose
registration status has lapsed for two years or less, to regain
registration status, the individual must:
(1) apply for registration renewal according to subdivision
7;
(2) document compliance with the continuing education
requirements of section 147C.25 since the registrant's initial
registration or last renewal; and
(3) submit the fees required under section 147C.40 for the
period not registered, including the fee for late renewal.
Subd. 13. [CANCELLATION DUE TO NONRENEWAL.] The board
shall not renew, reissue, reinstate, or restore a registration
that has lapsed and has not been renewed within two annual
registration renewal cycles starting July 1997. A registrant
whose registration is canceled for nonrenewal must obtain a new
registration by applying for registration and fulfilling all
requirements then in existence for initial registration as a
respiratory care practitioner.
Subd. 14. [CANCELLATION OF REGISTRATION IN GOOD STANDING.]
(a) A registrant holding active registration as a respiratory
care practitioner in the state may, upon approval of the board,
be granted registration cancellation if the board is not
investigating the person as a result of a complaint or
information received or if the board has not begun disciplinary
proceedings against the registrant. Such action by the board
shall be reported as a cancellation of registration in good
standing.
(b) A registrant who receives board approval for
registration cancellation is not entitled to a refund of any
registration fees paid for the registration year in which
cancellation of the registration occurred.
(c) To obtain registration after cancellation, a registrant
must obtain a new registration by applying for registration and
fulfilling the requirements then in existence for obtaining
initial registration as a respiratory care practitioner.
Sec. 6. [147C.20] [BOARD ACTION ON APPLICATIONS FOR
REGISTRATION.]
(a) The board shall act on each application for
registration according to paragraphs (b) to (d).
(b) The board shall determine if the applicant meets the
requirements for registration under section 147C.15. The board
or advisory council may investigate information provided by an
applicant to determine whether the information is accurate and
complete.
(c) The board shall notify each applicant in writing of
action taken on the application, the grounds for denying
registration if registration is denied, and the applicant's
right to review under paragraph (d).
(d) Applicants denied registration may make a written
request to the board, within 30 days of the board's notice, to
appear before the advisory council and for the advisory council
to review the board's decision to deny the applicant's
registration. After reviewing the denial, the advisory council
shall make a recommendation to the board as to whether the
denial shall be affirmed. Each applicant is allowed only one
request for review per yearly registration period.
Sec. 7. [147C.25] [CONTINUING EDUCATION REQUIREMENTS.]
Subdivision 1. [NUMBER OF REQUIRED CONTACT HOURS.] Two
years after the date of initial registration, and every two
years thereafter, a registrant applying for registration renewal
must complete a minimum of 24 contact hours of board-approved
continuing education in the two years preceding registration
renewal and attest to completion of continuing education
requirements by reporting to the board.
Subd. 2. [APPROVED PROGRAMS.] The board shall approve
continuing education programs that have been approved for
continuing education credit by the American Association of
Respiratory Care or the Minnesota Society for Respiratory Care
or their successor organizations. The board shall also approve
programs substantially related to respiratory care that are
sponsored by an accredited university or college, medical
school, state or national medical association, national medical
specialty society, or that are approved for continuing education
credit by the Minnesota board of nursing.
Subd. 3. [APPROVAL OF CONTINUING EDUCATION PROGRAMS.] The
board shall also approve continuing education programs that do
not meet the requirements of subdivision 2 but that meet the
following criteria:
(1) the program content directly relates to the practice of
respiratory care;
(2) each member of the program faculty is knowledgeable in
the subject matter as demonstrated by a degree from an
accredited education program, verifiable experience in the field
of respiratory care, special training in the subject matter, or
experience teaching in the subject area;
(3) the program lasts at least one contact hour;
(4) there are specific, measurable, written objectives,
consistent with the program, describing the expected outcomes
for the participants; and
(5) the program sponsor has a mechanism to verify
participation and maintains attendance records for three years.
Subd. 4. [HOSPITAL, HEALTH CARE FACILITY, OR MEDICAL
COMPANY IN-SERVICES.] Hospital, health care facility, or medical
company in-service programs may qualify for continuing education
credits provided they meet the requirements of this section.
Subd. 5. [ACCUMULATION OF CONTACT HOURS.] A registrant may
not apply contact hours acquired in one two-year reporting
period to a future continuing education reporting period.
Subd. 6. [VERIFICATION OF CONTINUING EDUCATION CREDITS.]
The board shall periodically select a random sample of
registrants and require those registrants to supply the board
with evidence of having completed the continuing education to
which they attested. Documentation may come directly from the
registrant or from state or national organizations that maintain
continuing education records.
Subd. 7. [RESTRICTION ON CONTINUING EDUCATION TOPICS.] A
registrant may apply no more than a combined total of eight
hours of continuing education in the areas of management, risk
management, personal growth, and educational techniques to a
two-year reporting period.
Subd. 8. [CREDIT FOR CREDENTIALING EXAMINATION.] A
registrant may fulfill the continuing education requirements for
a two-year reporting period by achieving a qualifying score on
one of the credentialing examinations or a specialty
credentialing examination of the National Board for Respiratory
Care or another board-approved testing organization. A
registrant may achieve 12 hours of continuing education credit
by completing a National Board for Respiratory Care or other
board-approved testing organization's specialty examination.
Sec. 8. [147C.30] [DISCIPLINE; REPORTING.]
For purposes of this chapter, registered respiratory care
practitioners and applicants are subject to the provisions of
sections 147.091 to 147.162.
Sec. 9. [147C.35] [RESPIRATORY CARE PRACTITIONER ADVISORY
COUNCIL.]
Subdivision 1. [MEMBERSHIP.] The board shall appoint a
seven-member respiratory care practitioner advisory council
consisting of two public members as defined in section 214.02,
three registered respiratory care practitioners, and two
licensed physicians with expertise in respiratory care.
Subd. 2. [ORGANIZATION.] The advisory council shall be
organized and administered under section 15.059. The council
expires June 30, 2001.
Subd. 3. [DUTIES.] The advisory council shall:
(1) advise the board regarding standards for respiratory
care practitioners;
(2) provide for distribution of information regarding
respiratory care practitioner standards;
(3) advise the board on enforcement of sections 147.091 to
147.162;
(4) review applications and recommend granting or denying
registration or registration renewal;
(5) advise the board on issues related to receiving and
investigating complaints, conducting hearings, and imposing
disciplinary action in relation to complaints against
respiratory care practitioners;
(6) advise the board regarding approval of continuing
education programs using the criteria in section 147C.25,
subdivision 3; and
(7) perform other duties authorized for advisory councils
by chapter 214, as directed by the board.
Sec. 10. [147C.40] [FEES.]
Subdivision 1. [FEES.] The board shall adopt rules setting:
(1) registration fees;
(2) renewal fees;
(3) late fees;
(4) inactive status fees;
(5) fees for temporary permits; and
(6) fees for temporary registration.
Subd. 2. [PRORATION OF FEES.] The board may prorate the
initial annual registration fee. All registrants are required
to pay the full fee upon registration renewal.
Subd. 3. [PENALTY FEE FOR LATE RENEWALS.] An application
for registration renewal submitted after the deadline must be
accompanied by a late fee in addition to the required fees.
Subd. 4. [NONREFUNDABLE FEES.] All of the fees in
subdivision 1 are nonrefundable.
Sec. 11. [PHYSICIAN ASSISTANT ADVISORY COUNCIL
MEMBERSHIP.]
The current members of the physician assistant advisory
council, appointed pursuant to Minnesota Rules, part 5600.2665,
shall continue to serve until their terms expire.
Sec. 12. [REPEALER.]
Minnesota Rules, parts 4762.0010; 4762.0020; 4762.0030;
4762.0040; 4762.0050; 4762.0060; 4762.0065; 4762.0070;
4762.0080; 4762.0090; 4762.0100; 4762.0200; and 4762.0300, are
repealed.
Sec. 13. [EFFECTIVE DATE.]
Sections 2 to 10 and 12 are effective August 1, 1997,
except that, until August 1, 1998, applicants for initial
registration need not meet the credentialing requirement within
five years prior to registration. Fees in effect on the day
before the effective date of section 12 remain in effect until
the board changes them by rule.
Presented to the governor May 7, 1997
Signed by the governor May 8, 1997, 11:30 a.m.
Official Publication of the State of Minnesota
Revisor of Statutes