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

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

700 State Office Building, 100 Rev. Dr. Martin Luther King Jr. Blvd., St. Paul, MN 55155 ♦ Phone: (651) 296-2868 ♦ TTY: 1-800-627-3529 ♦ Fax: (651) 296-0569