1.1                          A bill for an act 
  1.2             relating to health; modifying provisions relating to 
  1.3             nursing; amending Minnesota Statutes 1996, sections 
  1.4             148.181, subdivision 1; 148.212; 148.231, subdivision 
  1.5             5; 148.235, by adding subdivisions; 148.261, 
  1.6             subdivision 1; 148.262, subdivision 2; 148.281, 
  1.7             subdivision 1; and 364.09; proposing coding for new 
  1.8             law in Minnesota Statutes, chapter 148. 
  1.9   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.10     Section 1.  Minnesota Statutes 1996, section 148.181, 
  1.11  subdivision 1, is amended to read: 
  1.12     Subdivision 1.  [MEMBERSHIP.] The board of nursing consists 
  1.13  of 16 members appointed by the governor, each of whom must be a 
  1.14  resident of this state.  Eight members must be registered 
  1.15  nurses, each of whom must have graduated from an approved school 
  1.16  of nursing, must be licensed and currently registered as a 
  1.17  registered nurse in this state, and must have had at least five 
  1.18  years experience in nursing practice, nursing administration, or 
  1.19  nursing education immediately preceding appointment.  One of the 
  1.20  eight must have had at least two years executive or teaching 
  1.21  experience in a baccalaureate degree nursing program approved by 
  1.22  the board under section 148.251 during the five years 
  1.23  immediately preceding appointment, one of the eight must have 
  1.24  had at least two years executive or teaching experience in an 
  1.25  associate degree nursing program approved by the board under 
  1.26  section 148.251 during the five years immediately preceding 
  1.27  appointment, one of the eight must be practicing professional 
  2.1   nursing in a nursing home at the time of appointment, one of the 
  2.2   eight must have had at least two years executive or teaching 
  2.3   experience in a practical nursing program approved by the board 
  2.4   under section 148.251 during the five years immediately 
  2.5   preceding appointment, and one of the eight must have national 
  2.6   certification as a registered nurse anesthetist, nurse 
  2.7   practitioner, nurse midwife, or clinical nurse specialist.  ~~Four~~ 
  2.8   The remaining three of the eight must have had at least five 
  2.9   years of experience in nursing practice or nursing 
  2.10  administration immediately preceding appointment.  Four members 
  2.11  must be licensed practical nurses, each of whom must have 
  2.12  graduated from an approved school of nursing, must be licensed 
  2.13  and currently registered as a licensed practical nurse in this 
  2.14  state, and must have had at least five years experience in 
  2.15  nursing practice immediately preceding appointment.  The 
  2.16  remaining four members must be public members as defined by 
  2.17  section 214.02. 
  2.18     A member may be reappointed but may not serve more than two 
  2.19  full terms consecutively.  The governor shall attempt to make 
  2.20  appointments to the board that reflect the geography of the 
  2.21  state.  The board members who are nurses should as a whole 
  2.22  reflect the broad mix of practice types and sites of nurses 
  2.23  practicing in Minnesota. 
  2.24     Membership terms, compensation of members, removal of 
  2.25  members, the filling of membership vacancies, and fiscal year 
  2.26  and reporting requirements are as provided in sections 214.07 to 
  2.27  214.09.  Any nurse on the board who during incumbency 
  2.28  permanently ceases to be actively engaged in the practice of 
  2.29  nursing or otherwise becomes disqualified for board membership 
  2.30  is automatically removed, and the governor shall fill the 
  2.31  vacancy.  The provision of staff, administrative services, and 
  2.32  office space; the review and processing of complaints; the 
  2.33  setting of board fees; and other provisions relating to board 
  2.34  operations are as provided in sections 148.171 to 148.285 and 
  2.35  chapter 214.  Each member of the board shall file with the 
  2.36  secretary of state the constitutional oath of office before 
  3.1   beginning the term of office. 
  3.2      Sec. 2.  Minnesota Statutes 1996, section 148.212, is 
  3.3   amended to read: 
  3.4      148.212 [TEMPORARY PERMIT.] 
  3.5      Subdivision 1.  [ISSUANCE.] Upon receipt of the applicable 
  3.6   licensure or reregistration fee and permit fee, and in 
  3.7   accordance with rules of the board, the board may issue a 
  3.8   nonrenewable temporary permit to practice professional or 
  3.9   practical nursing to an applicant for licensure or 
  3.10  reregistration who is not the subject of a pending investigation 
  3.11  or disciplinary action, nor disqualified for any other reason, 
  3.12  under the following circumstances: 
  3.13     (a) The applicant for licensure by examination under 
  3.14  section 148.211, subdivision 1, has graduated from an approved 
  3.15  nursing program within the 60 days preceding board receipt of an 
  3.16  affidavit of graduation or transcript and has been authorized by 
  3.17  the board to write the licensure examination for the first time 
  3.18  in the United States.  The permit holder must practice 
  3.19  professional or practical nursing under the direct supervision 
  3.20  of a registered nurse.  The permit is valid from the date of 
  3.21  issue until the date the board takes action on the application 
  3.22  or for 60 days whichever occurs first. 
  3.23     (b) The applicant for licensure by endorsement under 
  3.24  section 148.211, subdivision 2, is currently licensed to 
  3.25  practice professional or practical nursing in another state, 
  3.26  territory, or Canadian province.  The permit is valid from 
  3.27  submission of a proper request until the date of board action on 
  3.28  the application. 
  3.29     (c) The applicant for licensure by endorsement under 
  3.30  section 148.211, subdivision 2, or for reregistration under 
  3.31  section 148.231, subdivision 5, is currently registered in a 
  3.32  formal, structured refresher course or its equivalent for nurses 
  3.33  that includes clinical practice. 
  3.34     Subd. 2.  [REVOCATION.] The board may revoke a temporary 
  3.35  permit which has been issued pursuant to subdivision 1 if the 
  3.36  permit holder is the subject of a pending investigation or 
  4.1   disciplinary action or is disqualified for any other reason. 
  4.2      Subd. 3.  [RELEASE OF INFORMATION.] Notwithstanding section 
  4.3   13.41, subdivision 2, the board may release information 
  4.4   indicating whether a permit has been issued or revoked by the 
  4.5   board pursuant to subdivisions 1 and 2. 
  4.6      Sec. 3.  Minnesota Statutes 1996, section 148.231, 
  4.7   subdivision 5, is amended to read: 
  4.8      Subd. 5.  [REREGISTRATION.] A person whose registration has 
  4.9   lapsed desiring to resume practice shall make application for 
  4.10  reregistration, submit satisfactory evidence of compliance with 
  4.11  the procedures and requirements established by the board, and 
  4.12  pay the ~~registration~~ reregistration fee ~~for the current period~~ 
  4.13  to the board.  A penalty fee shall be required from a person who 
  4.14  practiced nursing without current registration.  Thereupon, the 
  4.15  registration certificate shall be issued to the person who shall 
  4.16  immediately be placed on the practicing list as a registered 
  4.17  nurse or licensed practical nurse. 
  4.18     Sec. 4.  [148.2341] [DETERMINATION AND PRONOUNCEMENT OF 
  4.19  DEATH.] 
  4.20     Subdivision 1.  [AUTHORIZATION.] A nurse may determine and 
  4.21  pronounce death but shall not certify the cause of death for an 
  4.22  individual patient provided: 
  4.23     (1) the decedent was under the care of a health care 
  4.24  practitioner authorized to certify cause of death; and 
  4.25     (2) the decedent was a patient of the organization with 
  4.26  which the nurse is associated as an employee, by contract, or by 
  4.27  privilege. 
  4.28     Subd. 2.  [REQUIREMENTS.] A nurse who assumes 
  4.29  responsibility for the determination and pronouncement of death 
  4.30  shall: 
  4.31     (1) be knowledgeable of the laws and regulations regarding 
  4.32  death and human remains; 
  4.33     (2) make the determination of death in accordance with 
  4.34  generally accepted standards for determining the irreversible 
  4.35  cessation of circulatory and respiratory functions; 
  4.36     (3) ensure that a relative or legal guardian, and the 
  5.1   decedent's physician, are notified of the death; and 
  5.2      (4) document the findings, determination, and notification 
  5.3   in all appropriate records. 
  5.4      Sec. 5.  Minnesota Statutes 1996, section 148.235, is 
  5.5   amended by adding a subdivision to read: 
  5.6      Subd. 7.  [IMPLEMENTATION OF A PROTOCOL.] A registered 
  5.7   nurse may, based on an assessment by the nurse, implement a 
  5.8   protocol that does not reference a specific patient and results 
  5.9   in a prescription, treatment, or diagnostic intervention that 
  5.10  has been predetermined and delegated by a licensed practitioner 
  5.11  as defined under section 151.01, subdivision 23, when caring for 
  5.12  a patient whose condition falls within the protocol and when the 
  5.13  protocol specifies the circumstances under which the drug, 
  5.14  treatment, or intervention is to be prescribed or administered. 
  5.15     Sec. 6.  Minnesota Statutes 1996, section 148.235, is 
  5.16  amended by adding a subdivision to read: 
  5.17     Subd. 8.  [ADMINISTRATION OF A VACCINE BY PROTOCOL.] A 
  5.18  nurse may implement a protocol that does not reference a 
  5.19  specific patient and results in the administration of a vaccine 
  5.20  that has been predetermined and delegated by a licensed 
  5.21  practitioner as defined in section 151.01, subdivision 23, when 
  5.22  caring for a patient whose characteristics fall within the 
  5.23  protocol and when the protocol specifies the contraindications 
  5.24  for implementation, including patients or populations of 
  5.25  patients for whom the vaccine must not be administered and the 
  5.26  conditions under which the vaccine must not be administered. 
  5.27     Sec. 7.  Minnesota Statutes 1996, section 148.261, 
  5.28  subdivision 1, is amended to read: 
  5.29     Subdivision 1.  [GROUNDS LISTED.] The board may deny, 
  5.30  revoke, suspend, limit, or condition the license and 
  5.31  registration of any person to practice professional or practical 
  5.32  nursing under sections 148.171 to 148.285, or to otherwise 
  5.33  discipline a licensee or applicant as described in section 
  5.34  148.262.  The following are grounds for disciplinary action: 
  5.35     (1) Failure to demonstrate the qualifications or satisfy 
  5.36  the requirements for a license contained in sections 148.171 to 
  6.1   148.285 or rules of the board.  In the case of a person applying 
  6.2   for a license, the burden of proof is upon the applicant to 
  6.3   demonstrate the qualifications or satisfaction of the 
  6.4   requirements. 
  6.5      (2) Employing fraud or deceit in procuring or attempting to 
  6.6   procure a permit, license, or registration certificate to 
  6.7   practice professional or practical nursing or attempting to 
  6.8   subvert the licensing examination process.  Conduct that 
  6.9   subverts or attempts to subvert the licensing examination 
  6.10  process includes, but is not limited to:  
  6.11     (i) conduct that violates the security of the examination 
  6.12  materials, such as removing examination materials from the 
  6.13  examination room or having unauthorized possession of any 
  6.14  portion of a future, current, or previously administered 
  6.15  licensing examination; 
  6.16     (ii) conduct that violates the standard of test 
  6.17  administration, such as communicating with another examinee 
  6.18  during administration of the examination, copying another 
  6.19  examinee's answers, permitting another examinee to copy one's 
  6.20  answers, or possessing unauthorized materials; or 
  6.21     (iii) impersonating an examinee or permitting an 
  6.22  impersonator to take the examination on one's own behalf. 
  6.23     (3) Conviction ~~during the previous five years~~ of a felony 
  6.24  or gross misdemeanor reasonably related to the practice of 
  6.25  professional or practical nursing or conviction of a felony or 
  6.26  gross misdemeanor for which a nurse would be disqualified from 
  6.27  having direct contact with persons served by a facility, agency, 
  6.28  or program pursuant to section 144.05 or 245A.04.  Conviction as 
  6.29  used in this subdivision includes a conviction of an offense 
  6.30  that if committed in this state would be considered a felony or 
  6.31  gross misdemeanor without regard to its designation elsewhere, 
  6.32  or a criminal proceeding where a finding or verdict of guilt is 
  6.33  made or returned but the adjudication of guilt is either 
  6.34  withheld or not entered. 
  6.35     (4) Revocation, suspension, limitation, conditioning, or 
  6.36  other disciplinary action against the person's professional or 
  7.1   practical nursing license in another state, territory, or 
  7.2   country; failure to report to the board that charges regarding 
  7.3   the person's nursing license are pending in another state, 
  7.4   territory, or country; or having been refused a license by 
  7.5   another state, territory, or country. 
  7.6      (5) Failure to or inability to perform professional or 
  7.7   practical nursing as defined in section 148.171, paragraph (3) 
  7.8   or (5), with reasonable skill and safety, including failure of a 
  7.9   registered nurse to supervise or a licensed practical nurse to 
  7.10  monitor adequately the performance of acts by any person working 
  7.11  at the nurse's direction. 
  7.12     (6) Engaging in unprofessional conduct, including, but not 
  7.13  limited to, a departure from or failure to conform to board 
  7.14  rules of professional or practical nursing practice that 
  7.15  interpret the statutory definition of professional or practical 
  7.16  nursing as well as provide criteria for violations of the 
  7.17  statutes, or, if no rule exists, to the minimal standards of 
  7.18  acceptable and prevailing professional or practical nursing 
  7.19  practice, or any nursing practice that may create unnecessary 
  7.20  danger to a patient's life, health, or safety.  Actual injury to 
  7.21  a patient need not be established under this clause.  
  7.22     (7) Delegating or accepting the delegation of a nursing 
  7.23  function or a prescribed health care function when the 
  7.24  delegation or acceptance could reasonably be expected to result 
  7.25  in unsafe or ineffective patient care. 
  7.26     (8) Actual or potential inability to practice nursing with 
  7.27  reasonable skill and safety to patients by reason of illness, 
  7.28  use of alcohol, drugs, chemicals, or any other material, or as a 
  7.29  result of any mental or physical condition.  
  7.30     (9) Adjudication as mentally incompetent, mentally ill, a 
  7.31  chemically dependent person, or a person dangerous to the public 
  7.32  by a court of competent jurisdiction, within or without this 
  7.33  state.  
  7.34     (10) Engaging in any unethical conduct, including, but not 
  7.35  limited to, conduct likely to deceive, defraud, or harm the 
  7.36  public, or demonstrating a willful or careless disregard for the 
  8.1   health, welfare, or safety of a patient.  Actual injury need not 
  8.2   be established under this clause.  
  8.3      (11) Engaging in conduct with a patient that is sexual or 
  8.4   may reasonably be interpreted by the patient as sexual, or in 
  8.5   any verbal behavior that is seductive or sexually demeaning to a 
  8.6   patient, or engaging in sexual exploitation of a patient or 
  8.7   former patient.  
  8.8      (12) Obtaining money, property, or services from a patient, 
  8.9   other than reasonable fees for services provided to the patient, 
  8.10  through the use of undue influence, harassment, duress, 
  8.11  deception, or fraud. 
  8.12     (13) Revealing a privileged communication from or relating 
  8.13  to a patient except when otherwise required or permitted by law. 
  8.14     (14) Engaging in abusive or fraudulent billing practices, 
  8.15  including violations of federal Medicare and Medicaid laws or 
  8.16  state medical assistance laws. 
  8.17     (15) Improper management of patient records, including 
  8.18  failure to maintain adequate patient records, to comply with a 
  8.19  patient's request made pursuant to section 144.335, or to 
  8.20  furnish a patient record or report required by law.  
  8.21     (16) Knowingly aiding, assisting, advising, or allowing an 
  8.22  unlicensed person to engage in the unlawful practice of 
  8.23  professional or practical nursing.  
  8.24     (17) Violating a rule adopted by the board, an order of the 
  8.25  board, or a state or federal law relating to the practice of 
  8.26  professional or practical nursing, or a state or federal 
  8.27  narcotics or controlled substance law. 
  8.28     (18) Knowingly providing false or misleading information 
  8.29  that is directly related to the care of that patient unless done 
  8.30  for an accepted therapeutic purpose such as the administration 
  8.31  of a placebo. 
  8.32     (19) Aiding suicide or aiding attempted suicide in 
  8.33  violation of section 609.215 as established by any of the 
  8.34  following: 
  8.35     (i) a copy of the record of criminal conviction or plea of 
  8.36  guilty for a felony in violation of section 609.215, subdivision 
  9.1   1 or 2; 
  9.2      (ii) a copy of the record of a judgment of contempt of 
  9.3   court for violating an injunction issued under section 609.215, 
  9.4   subdivision 4; 
  9.5      (iii) a copy of the record of a judgment assessing damages 
  9.6   under section 609.215, subdivision 5; or 
  9.7      (iv) a finding by the board that the person violated 
  9.8   section 609.215, subdivision 1 or 2.  The board shall 
  9.9   investigate any complaint of a violation of section 609.215, 
  9.10  subdivision 1 or 2. 
  9.11     (20) Practicing outside the scope of practice authorized by 
  9.12  section 148.171, paragraph (3) or (5). 
  9.13     (21) Making a false statement or knowingly providing false 
  9.14  information to the board, failing to make reports as required by 
  9.15  section 148.263, or failing to cooperate with an investigation 
  9.16  of the board as required by section 148.265. 
  9.17     (22) Engaging in false, fraudulent, deceptive, or 
  9.18  misleading advertising.  
  9.19     Sec. 8.  Minnesota Statutes 1996, section 148.262, 
  9.20  subdivision 2, is amended to read: 
  9.21     Subd. 2.  [AUTOMATIC SUSPENSION.] Unless the board orders 
  9.22  otherwise, a license to practice professional or practical 
  9.23  nursing is automatically suspended if:  
  9.24     (1) a guardian of a nurse is appointed by order of a court 
  9.25  under sections 525.54 to 525.61; 
  9.26     (2) the nurse is committed by order of a court under 
  9.27  chapter 253B; ~~or~~ 
  9.28     (3) the nurse is determined to be mentally incompetent, 
  9.29  mentally ill, chemically dependent, or a person dangerous to the 
  9.30  public by a court of competent jurisdiction within or without 
  9.31  this state~~.~~; or 
  9.32     (4) the nurse fails to maintain a current name and address 
  9.33  with the board while the nurse is:  (i) under board 
  9.34  investigation; (ii) party to a contested case with the board; 
  9.35  (iii) party to an agreement for corrective action with the 
  9.36  board; or (iv) under a board order for disciplinary action. 
 10.1      The license remains suspended under clauses (1), (2), or 
 10.2   (3) until the nurse is restored to capacity by a court and, upon 
 10.3   petition by the nurse, the suspension is terminated by the board 
 10.4   after a hearing or upon agreement between the board and the 
 10.5   nurse or under clause (4) until lifted by the board pursuant to 
 10.6   the board's receipt of a petition from the nurse, along with the 
 10.7   nurse's current name and address. 
 10.8      Sec. 9.  [148.267] [DISCLOSURE.] 
 10.9      Subdivision 1.  [WITHHOLDING OF CERTAIN ADDRESSES AND 
 10.10  TELEPHONE NUMBERS.] Notwithstanding section 13.41, subdivision 2 
 10.11  or 4, the board may withhold the residence address and telephone 
 10.12  number of an applicant or licensee if the applicant or licensee 
 10.13  so requests. 
 10.14     Subd. 2.  [RELEASE OF SOCIAL SECURITY 
 10.15  NUMBER.] Notwithstanding section 13.49, subdivision 1, the board 
 10.16  may release the social security number of a licensee or 
 10.17  applicant to the National Council of State Boards of Nursing or 
 10.18  a Minnesota state agency if the National Council of State Boards 
 10.19  of Nursing or a Minnesota state agency requests the social 
 10.20  security number for the purpose of establishing the 
 10.21  identification of a licensee or an applicant. 
 10.22     Sec. 10.  Minnesota Statutes 1996, section 148.281, 
 10.23  subdivision 1, is amended to read: 
 10.24     Subdivision 1.  [VIOLATIONS ~~DESCRIBED~~; PENALTY.] It shall 
 10.25  be unlawful for any person, corporation, or association, to: 
 10.26     (1) Sell or fraudulently obtain or furnish any nursing 
 10.27  diploma, license or record, or aid or abet therein; 
 10.28     (2) Practice professional or practical nursing or practice 
 10.29  as a public health nurse under cover of any diploma, permit, 
 10.30  license, registration certificate, or record illegally or 
 10.31  fraudulently obtained or signed or issued unlawfully or under 
 10.32  fraudulent representation; 
 10.33     (3) Practice professional or practical nursing unless the 
 10.34  person has been issued a temporary permit under the provisions 
 10.35  of section 148.212 or is duly licensed and currently registered 
 10.36  to do so under the provisions of sections 148.171 to 148.285; 
 11.1      (4) Use the title of nurse unless duly licensed and 
 11.2   currently registered to practice professional or practical 
 11.3   nursing under the provisions of sections 148.171 to 148.285 
 11.4   except as authorized by the board by rule; 
 11.5      (5) Use any abbreviation or other designation tending to 
 11.6   imply licensure as a registered nurse or licensed practical 
 11.7   nurse unless duly licensed and currently registered so to 
 11.8   practice professional or practical nursing under the provisions 
 11.9   of sections 148.171 to 148.285 except as authorized by the board 
 11.10  by rule; 
 11.11     ~~(5)~~ (6) Use any abbreviation or other designation tending 
 11.12  to imply registration as a public health nurse unless duly 
 11.13  registered by the board; 
 11.14     ~~(6)~~ (7) Practice professional or practical nursing in a 
 11.15  manner prohibited by the board in any limitation of a license or 
 11.16  registration issued under the provisions of sections 148.171 to 
 11.17  148.285; 
 11.18     ~~(7)~~ (8) Practice professional or practical nursing during 
 11.19  the time a license or current registration issued under the 
 11.20  provisions of sections 148.171 to 148.285 shall be suspended or 
 11.21  revoked; 
 11.22     ~~(8)~~ (9) Conduct a nursing program for the education of 
 11.23  persons to become registered nurses or licensed practical nurses 
 11.24  unless the program has been approved by the board; and 
 11.25     ~~(9)~~ (10) Knowingly employ persons in the practice of 
 11.26  professional or practical nursing who have not been issued a 
 11.27  current permit, license, or registration certificate to practice 
 11.28  as a nurse in this state.  
 11.29     Sec. 11.  Minnesota Statutes 1996, section 364.09, is 
 11.30  amended to read: 
 11.31     364.09 [EXCEPTIONS.] 
 11.32     (a) This chapter does not apply to the licensing process 
 11.33  for peace officers; to law enforcement agencies as defined in 
 11.34  section 626.84, subdivision 1, paragraph (h); to fire protection 
 11.35  agencies; to eligibility for a private detective or protective 
 11.36  agent license; to eligibility for a family day care license, a 
 12.1   family foster care license, or a home care provider license; to 
 12.2   eligibility for school bus driver endorsements; or to 
 12.3   eligibility for special transportation service endorsements.  
 12.4   This chapter also shall not apply to eligibility for juvenile 
 12.5   corrections employment, where the offense involved child 
 12.6   physical or sexual abuse or criminal sexual conduct.  
 12.7      (b) This chapter does not apply to a school district or to 
 12.8   eligibility for a license issued or renewed by the board of 
 12.9   teaching or the state board of education.  
 12.10     (c) Nothing in this section precludes the Minnesota police 
 12.11  and peace officers training board or the state fire marshal from 
 12.12  recommending policies set forth in this chapter to the attorney 
 12.13  general for adoption in the attorney general's discretion to 
 12.14  apply to law enforcement or fire protection agencies. 
 12.15     (d) This chapter does not apply to a license to practice 
 12.16  medicine that has been denied or revoked by the board of medical 
 12.17  practice pursuant to section 147.091, subdivision 1a. 
 12.18     (e) This chapter does not apply to a license to practice 
 12.19  nursing that has been denied or revoked by the board of nursing 
 12.20  pursuant to section 148.261, subdivision 1. 
 12.21     Sec. 12.  [INSTRUCTION TO REVISOR.] 
 12.22     The revisor shall insert the words "; IMPLEMENTATION OF 
 12.23  PROTOCOL" in the headnote to Minnesota Statutes, section 148.235.