1.1                          A bill for an act 
  1.2             relating to health; modifying certain protocols for 
  1.3             nurses; authorizing transfer of certain nursing 
  1.4             facility beds; providing for the administration of 
  1.5             epinephrine on emergency ambulance calls; amending 
  1.6             Minnesota Statutes 2000, sections 148.235, by adding 
  1.7             subdivisions; 151.37, subdivision 2; Minnesota 
  1.8             Statutes 2001 Supplement, sections 148.284; 256B.437, 
  1.9             by adding a subdivision. 
  1.10  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.11     Section 1.  Minnesota Statutes 2000, section 148.235, is 
  1.12  amended by adding a subdivision to read: 
  1.13     Subd. 8.  [PRESCRIPTION BY PROTOCOL.] A registered nurse 
  1.14  may implement a protocol that does not reference a specific 
  1.15  patient and results in a prescription of a legend drug that has 
  1.16  been predetermined and delegated by a licensed practitioner as 
  1.17  defined under section 151.01, subdivision 23, when caring for a 
  1.18  patient whose condition falls within the protocol and when the 
  1.19  protocol specifies the circumstances under which the drug is to 
  1.20  be prescribed or administered. 
  1.21     Sec. 2.  Minnesota Statutes 2000, section 148.235, is 
  1.22  amended by adding a subdivision to read: 
  1.23     Subd. 9.  [VACCINE BY PROTOCOL.] A nurse may implement a 
  1.24  protocol that does not reference a specific patient and results 
  1.25  in the administration of a vaccine that has been predetermined 
  1.26  and delegated by a licensed practitioner as defined in section 
  1.27  151.01, subdivision 23, when caring for a patient whose 
  2.1   characteristics fall within the protocol and when the protocol 
  2.2   specifies the contraindications for implementation, including 
  2.3   patients or populations of patients for whom the vaccine must 
  2.4   not be administered and the conditions under which the vaccine 
  2.5   must not be administered. 
  2.6      Sec. 3.  Minnesota Statutes 2001 Supplement, section 
  2.7   148.284, is amended to read: 
  2.8      148.284 [CERTIFICATION OF ADVANCED PRACTICE REGISTERED 
  2.9   NURSES.] 
  2.10     (a) No person shall practice advanced practice registered 
  2.11  nursing or use any title, abbreviation, or other designation 
  2.12  tending to imply that the person is an advanced practice 
  2.13  registered nurse, clinical nurse specialist, nurse anesthetist, 
  2.14  nurse-midwife, or nurse practitioner unless the person is 
  2.15  certified for such advanced practice registered nursing by a 
  2.16  national nurse certification organization. 
  2.17     (b) Paragraph (a) does not apply to an advanced practice 
  2.18  registered nurse who is within six months after completion of an 
  2.19  advanced practice registered nurse course of study and is 
  2.20  awaiting certification, provided that the person has not 
  2.21  previously failed the certification examination.  
  2.22     (c) An advanced practice registered nurse who has completed 
  2.23  a formal course of study as an advanced practice registered 
  2.24  nurse and has been certified by a national nurse certification 
  2.25  organization prior to January 1, 1999, may continue to practice 
  2.26  in the field of nursing in which the advanced practice 
  2.27  registered nurse is practicing as of July 1, 1999, regardless of 
  2.28  the type of certification held if the advanced practice 
  2.29  registered nurse is not eligible for the proper certification. 
  2.30     (d) Prior to July 1, 2007, a clinical nurse specialist may 
  2.31  petition the board for waiver from the certification requirement 
  2.32  in paragraph (a) if the clinical nurse specialist is 
  2.33  academically prepared as a clinical nurse specialist in a 
  2.34  specialty area for which there is no certification within the 
  2.35  clinical nurse specialist role and specialty or a related 
  2.36  specialty.  The board may determine that an available 
  3.1   certification as a clinical nurse specialist in a related 
  3.2   specialty must be obtained in lieu of the specific specialty or 
  3.3   subspecialty.  The petitioner must be academically prepared as a 
  3.4   clinical nurse specialist in a specific field of clinical nurse 
  3.5   specialist practice with a master's degree in nursing that 
  3.6   included clinical experience in the clinical specialty, and must 
  3.7   have 1,000 hours of supervised clinical experience in the 
  3.8   clinical specialty for which the individual was academically 
  3.9   prepared with a minimum of 500 hours of supervised clinical 
  3.10  practice after graduation.  The board may grant a nonrenewable 
  3.11  permit for no longer than 12 months for the supervised 
  3.12  postgraduate clinical experience.  The board may renew the 
  3.13  waiver for three-year periods provided the clinical nurse 
  3.14  specialist continues to be ineligible for certification as a 
  3.15  clinical nurse specialist by an organization acceptable to the 
  3.16  board. 
  3.17     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2002. 
  3.18     Sec. 4.  Minnesota Statutes 2000, section 151.37, 
  3.19  subdivision 2, is amended to read: 
  3.20     Subd. 2.  [PRESCRIBING AND FILING.] (a) A licensed 
  3.21  practitioner in the course of professional practice only, may 
  3.22  prescribe, administer, and dispense a legend drug, and may cause 
  3.23  the same to be administered by a nurse, a physician assistant, 
  3.24  or medical student or resident under the practitioner's 
  3.25  direction and supervision, and may cause a person who is an 
  3.26  appropriately certified, registered, or licensed health care 
  3.27  professional to prescribe, dispense, and administer the same 
  3.28  within the expressed legal scope of the person's practice as 
  3.29  defined in Minnesota Statutes.  A licensed practitioner may 
  3.30  prescribe a legend drug, without reference to a specific 
  3.31  patient, by directing a ~~registered~~ nurse, pursuant to section 
  3.32  148.235, subdivisions 8 and 9, physician assistant, or medical 
  3.33  student or resident to adhere to a particular practice guideline 
  3.34  or protocol when treating patients whose condition falls within 
  3.35  such guideline or protocol, and when such guideline or protocol 
  3.36  specifies the circumstances under which the legend drug is to be 
  4.1   prescribed and administered.  An individual who verbally, 
  4.2   electronically, or otherwise transmits a written, oral, or 
  4.3   electronic order, as an agent of a prescriber, shall not be 
  4.4   deemed to have prescribed the legend drug.  This paragraph 
  4.5   applies to a physician assistant only if the physician assistant 
  4.6   meets the requirements of section 147A.18. 
  4.7      (b) A licensed practitioner that dispenses for profit a 
  4.8   legend drug that is to be administered orally, is ordinarily 
  4.9   dispensed by a pharmacist, and is not a vaccine, must file with 
  4.10  the practitioner's licensing board a statement indicating that 
  4.11  the practitioner dispenses legend drugs for profit, the general 
  4.12  circumstances under which the practitioner dispenses for profit, 
  4.13  and the types of legend drugs generally dispensed.  It is 
  4.14  unlawful to dispense legend drugs for profit after July 31, 
  4.15  1990, unless the statement has been filed with the appropriate 
  4.16  licensing board.  For purposes of this paragraph, "profit" means 
  4.17  (1) any amount received by the practitioner in excess of the 
  4.18  acquisition cost of a legend drug for legend drugs that are 
  4.19  purchased in prepackaged form, or (2) any amount received by the 
  4.20  practitioner in excess of the acquisition cost of a legend drug 
  4.21  plus the cost of making the drug available if the legend drug 
  4.22  requires compounding, packaging, or other treatment.  The 
  4.23  statement filed under this paragraph is public data under 
  4.24  section 13.03.  This paragraph does not apply to a licensed 
  4.25  doctor of veterinary medicine or a registered pharmacist.  Any 
  4.26  person other than a licensed practitioner with the authority to 
  4.27  prescribe, dispense, and administer a legend drug under 
  4.28  paragraph (a) shall not dispense for profit.  To dispense for 
  4.29  profit does not include dispensing by a community health clinic 
  4.30  when the profit from dispensing is used to meet operating 
  4.31  expenses. 
  4.32     Sec. 5.  Minnesota Statutes 2001 Supplement, section 
  4.33  256B.437, is amended by adding a subdivision to read: 
  4.34     Subd. 9.  [TRANSFER OF BEDS.] The board of commissioners of 
  4.35  Saint Louis county may amend their planned closure rate 
  4.36  adjustment application to allow up to 50 beds of a 159-licensed 
  5.1   bed county-owned nursing facility that is in the process of 
  5.2   closing to be transferred to a hospital-attached nursing 
  5.3   facility in Aurora and up to 50 beds to a 235-bed nursing 
  5.4   facility in Duluth, and may also assign all or a portion of the 
  5.5   planned closure rate adjustment that would be received as a 
  5.6   result of closure to the Aurora facility or the Duluth facility. 
  5.7      Sec. 6.  [EPINEPHRINE ON EMERGENCY AMBULANCE CALLS.] 
  5.8      The emergency medical services regulatory board, in 
  5.9   cooperation with the Minnesota Nurses Association, the Minnesota 
  5.10  Medical Association, the American College of Emergency 
  5.11  Physicians, and the Minnesota Ambulance Association, shall 
  5.12  establish a plan under which epinephrine is available on 
  5.13  emergency ambulance calls made in Minnesota on or after 
  5.14  September 1, 2002.  The emergency medical services regulatory 
  5.15  board shall report to the legislature by January 15, 2003, on 
  5.16  the success of the policy of making epinephrine fully available. 
  5.17     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
  5.18  following final enactment.