1.1 	A bill for an act
1.2 	relating to health; modifying provisions relating to
1.3 	physical therapists; providing penalties; amending
1.4 	Minnesota Statutes 2004, sections 148.65, by adding
1.5 	subdivisions; 148.706; 148.75; 148.7806; proposing
1.6 	coding for new law in Minnesota Statutes, chapter 148;
1.7 	repealing Minnesota Rules, part 5601.0100, subparts 3,
1.8 	4.
1.9 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.10 	Section 1. Minnesota Statutes 2004, section 148.65, is
1.11 	amended by adding a subdivision to read:
1.12 		Subd. 3.Physical therapist assistant. "Physical
1.13 	therapist assistant" means a graduate of a physical therapist
1.14 	assistant educational program accredited by the Commission on
1.15 	Accreditation in Physical Therapy Education (CAPTE) or a
1.16 	recognized comparable national accrediting agency approved by
1.17 	the board.  The physical therapist assistant, under the
1.18 	direction and supervision of the physical therapist, performs
1.19 	physical therapy interventions and assists with coordination,
1.20 	communication, and documentation; and patient-client-related
1.21 	instruction.  The physical therapist is not required to be
1.22 	on-site except as required under Minnesota Rules, part
1.23 	5601.1500, but must be easily available by telecommunications.

1.24 	Sec. 2. Minnesota Statutes 2004, section 148.65, is
1.25 	amended by adding a subdivision to read:
1.26 		Subd. 4.Physical therapy aide. "Physical therapy aide"
1.27 	means a person, working under the direct supervision of a
2.1 	physical therapist, who is not a physical therapist assistant as
2.2 	defined in subdivision 3, who performs tasks as provided under
2.3 	Minnesota Rules, part 5601.1400.

2.4 	Sec. 3. Minnesota Statutes 2004, section 148.65, is
2.5 	amended by adding a subdivision to read:
2.6 		Subd. 5.Student physical therapist. "Student physical
2.7 	therapist" means a person in a professional educational program,
2.8 	approved by the board under section 148.705, who is satisfying
2.9 	supervised clinical education requirements by performing
2.10 	physical therapy under the on-site supervision of a licensed
2.11 	physical therapist.  "On-site supervision" means the physical
2.12 	therapist is easily available for instruction to the student
2.13 	physical therapist.  The physical therapist shall have direct
2.14 	contact with the patient during at least every second treatment
2.15 	session by the student physical therapist.  Telecommunications,
2.16 	except within the facility, does not meet the requirement of
2.17 	on-site supervision.

2.18 	Sec. 4. Minnesota Statutes 2004, section 148.65, is
2.19 	amended by adding a subdivision to read:
2.20 		Subd. 6.Student physical therapist assistant. "Student
2.21 	physical therapist assistant" means a person in a physical
2.22 	therapist assistant educational program accredited by the
2.23 	Commission on Accreditation in Physical Therapy Education
2.24 	(CAPTE) or a recognized comparable national accrediting agency
2.25 	approved by the board.  The student physical therapist
2.26 	assistant, under the direct supervision of the physical
2.27 	therapist, or the direct supervision of the physical therapist
2.28 	and physical therapist assistant, performs physical therapy
2.29 	interventions and assists with coordination, communication,
2.30 	documentation, and patient-client-related instruction.  "Direct
2.31 	supervision" means the physical therapist is physically present
2.32 	and immediately available to provide instruction to the student
2.33 	physical therapist assistant.

2.34 	Sec. 5. Minnesota Statutes 2004, section 148.65, is
2.35 	amended by adding a subdivision to read:
2.36 		Subd. 7.Supportive personnel. "Supportive personnel"
3.1 	means a physical therapist assistant, a physical therapy aide,
3.2 	or an athletic trainer working under a physical
3.3 	therapist-athletic trainer supervisory agreement as provided in
3.4 	section 148.707.

3.5 	Sec. 6. Minnesota Statutes 2004, section 148.65, is
3.6 	amended by adding a subdivision to read:
3.7 		Subd. 8.Athletic trainer. "Athletic trainer" means a
3.8 	person currently registered in good standing in Minnesota under
3.9 	sections 148.7801 to 148.7815.

3.10 	Sec. 7. Minnesota Statutes 2004, section 148.706, is
3.11 	amended to read:
3.12 	148.706 SUPERVISION OF ASSISTANTS AND ,AIDES, AND
3.13 	STUDENTS.
3.14 	Every physical therapist who uses the services of an a
3.15 	physical therapist assistant or physical therapy aide for the
3.16 	purpose of assisting in the practice of physical therapy is
3.17 	responsible for functions performed by the assistant or aide
3.18 	while engaged in such assistance.  The physical therapist shall
3.19 	permit the assistant or aide to perform only those functions
3.20 	which the therapist is authorized by rule to delegate to a
3.21 	physical therapist assistant or assign to a physical therapy
3.22 	aide and shall provide supervision as specified delegate duties
3.23 	to the physical therapist assistant and assign tasks to the
3.24 	physical therapy aide in accordance with Minnesota Rules, part
3.25 	5601.1400. Physical therapists who instruct student physical
3.26 	therapists and student physical therapist assistants are
3.27 	responsible for the functions performed by the students and
3.28 	shall supervise the students as provided under section 148.65,
3.29 	subdivisions 5 and 6.

3.30 	Sec. 8. [148.707] SUPERVISION OF ATHLETIC TRAINERS.
3.31 		Subdivision 1.Filing requirement. Physical therapists
3.32 	who use athletic trainers pursuant to section 148.7806,
3.33 	paragraph (e), shall file with the board a physical
3.34 	therapist-athletic trainer supervisory agreement, prior to
3.35 	provision of services by the athletic trainer.  The board shall
3.36 	notify the physical therapist, in writing, of receipt of the
4.1 	supervisory agreement.
4.2 		Subd. 2.Physical therapist-athletic trainer
4.3 	agreement. (a) The supervising physical therapist, each
4.4 	alternate supervising physical therapist, and the athletic
4.5 	trainer must sign a supervisory agreement that specifies the
4.6 	physical therapy tasks assigned to the athletic trainer and the
4.7 	direct supervision by the physical therapist.  The supervisory
4.8 	agreement must contain:
4.9 	(1) the name, address, telephone number, and license number
4.10 	of record of the supervising physical therapist and any
4.11 	alternate supervising physical therapist;
4.12 	(2) the name, address, telephone number, and registration
4.13 	number of record of the athletic trainer;
4.14 	(3) a statement that the supervising physical therapist and
4.15 	alternate supervising physical therapists assume full
4.16 	responsibility for the physical therapy tasks performed by the
4.17 	athletic trainer, and that the services provided by the athletic
4.18 	trainer are customary to the practice of the supervising
4.19 	physical therapist or alternate supervising physical therapist;
4.20 	(4) documentation of the academic preparation and clinical
4.21 	skills of the athletic trainer to perform the tasks assigned by
4.22 	the supervising physical therapist and each alternate
4.23 	supervising physical therapist, if the tasks assigned by the
4.24 	alternate supervising physical therapist are different from the
4.25 	tasks assigned by the supervising physical therapist.  Evidence
4.26 	of clinical skills must show activities by the athletic trainer
4.27 	which have occurred within the year preceding the filing of the
4.28 	supervisory agreement; and 
4.29 	(5) a description of each individual physical therapy task
4.30 	assigned by the supervising physical therapist or the alternate
4.31 	supervising physical therapist to the athletic trainer.
4.32 	Physical therapy task assignment does not include examination,
4.33 	evaluation, diagnosis, prognosis, initial treatment, change of
4.34 	treatment, and initial or final documentation.
4.35 	(b) The supervising physical therapist, alternate
4.36 	supervising physical therapists, and the athletic trainer shall
5.1 	review and update the supervisory agreement on an annual basis
5.2 	from the date the board acknowledges receipt of the completed
5.3 	supervisory agreement.
5.4 	(c) The supervising physical therapist shall provide
5.5 	written notification to the board within 30 days of a change of
5.6 	name, address, or telephone number of the physical therapist,
5.7 	alternate supervising physical therapists, or athletic trainer.
5.8 	(d) Modification of tasks assigned by the supervising
5.9 	physical therapist or alternate supervising physical therapist
5.10 	to the athletic trainer must be submitted in writing by the
5.11 	supervising physical therapist to the board at least 30 days
5.12 	prior to the effective date of the modification, and meet the
5.13 	requirements in paragraph (a).
5.14 		Subd. 3.Informed consent. The supervising physical
5.15 	therapist and alternate supervising physical therapist shall
5.16 	document in the physical therapy record that the patient has
5.17 	been informed by the physical therapist that an athletic trainer
5.18 	is providing physical therapy tasks under direct supervision of
5.19 	the physical therapist and alternate supervising physical
5.20 	therapist.
5.21 		Subd. 4.Documentation. The supervising physical
5.22 	therapist and alternate supervising physical therapist shall
5.23 	document in the physical therapy record for each treatment
5.24 	session the name of the athletic trainer and all of the physical
5.25 	therapy tasks performed by the athletic trainer.
5.26 		Subd. 5.Patient list. The supervising physical
5.27 	therapist and alternate supervising physical therapist shall
5.28 	maintain a list of all patients seen by the athletic trainer
5.29 	pursuant to section 148.7806, paragraph (e), for a period of two
5.30 	years.
5.31 		Subd. 6.Supervision. The supervising physical therapist
5.32 	and alternate supervising physical therapist shall not supervise
5.33 	more than one athletic trainer working under section 148.7806,
5.34 	paragraph (e), at any given time.  "Direct supervision" means
5.35 	the supervising physical therapist or alternate supervising
5.36 	physical therapist is physically present and immediately
6.1 	available for instruction and assistance to the athletic
6.2 	trainer.  The supervising physical therapist or alternate
6.3 	supervising physical therapist must observe the patient's status
6.4 	before and after physical therapy tasks performed by the
6.5 	athletic trainer.  Telecommunications do not meet the
6.6 	requirements of direct supervision.

6.7 	Sec. 9. [148.735] CANCELLATION OF LICENSE IN GOOD
6.8 	STANDING.
6.9 		Subdivision 1.Board approval; reporting. A physical
6.10 	therapist holding an active license to practice physical therapy
6.11 	in the state may, upon approval of the board, be granted license
6.12 	cancellation if the board is not investigating the person as a
6.13 	result of a complaint or information received or if the board
6.14 	has not begun disciplinary proceedings against the person.  Such
6.15 	action by the board shall be reported as a cancellation of a
6.16 	license in good standing.
6.17 		Subd. 2.Fees nonrefundable. A physical therapist who
6.18 	receives board approval for license cancellation is not entitled
6.19 	to a refund of any license fees paid for the licensure year in
6.20 	which cancellation of the license occurred.
6.21 		Subd. 3.New license after cancellation. If a physical
6.22 	therapist who has been granted board approval for license
6.23 	cancellation desires to resume the practice of physical therapy
6.24 	in Minnesota, that physical therapist must obtain a new license
6.25 	by applying for licensure and fulfilling the requirements then
6.26 	in existence for obtaining an initial license to practice
6.27 	physical therapy in Minnesota.

6.28 	Sec. 10. [148.736] CANCELLATION OF CREDENTIALS UNDER
6.29 	DISCIPLINARY ORDER.
6.30 		Subdivision 1.Board approval; reporting. A physical
6.31 	therapist, whose right to practice is under suspension,
6.32 	condition, limitation, qualification, or restriction by the
6.33 	board may be granted cancellation of credentials by approval of
6.34 	the board.  Such action by the board shall be reported as
6.35 	cancellation while under discipline.  Credentials, for purposes
6.36 	of this section, means board authorized documentation of the
7.1 	privilege to practice physical therapy.
7.2 		Subd. 2.Fees nonrefundable. A physical therapist who
7.3 	receives board approval for credential cancellation is not
7.4 	entitled to a refund of any fees paid for the credentialing year
7.5 	in which cancellation of the credential occurred.
7.6 		Subd. 3.New credential after cancellation. If a
7.7 	physical therapist who has been granted board approval for
7.8 	credential cancellation desires to resume the practice of
7.9 	physical therapy in Minnesota, that physical therapist must
7.10 	obtain a new credential by applying to the board and fulfilling
7.11 	the requirements then in existence for obtaining an initial
7.12 	credential to practice physical therapy in Minnesota.

7.13 	Sec. 11. [148.737] CANCELLATION OF LICENSE FOR
7.14 	NONRENEWAL.
7.15 	The Board of Physical Therapy shall not renew, reissue,
7.16 	reinstate, or restore a license that has lapsed on or after
7.17 	January 1, 2006, and has not been renewed within two annual
7.18 	license renewal cycles starting January 1, 2008.  A licensee
7.19 	whose license is canceled for nonrenewal must obtain a new
7.20 	license by applying for licensure and fulfilling all
7.21 	requirements then in existence for an initial license to
7.22 	practice physical therapy in Minnesota.

7.23 	Sec. 12. Minnesota Statutes 2004, section 148.75, is
7.24 	amended to read:
7.25 	148.75 LICENSES; DENIAL, SUSPENSION, REVOCATION.
7.26 	(a) The state Board of Physical Therapy may refuse to grant
7.27 	a license to any physical therapist, or may suspend or revoke
7.28 	the license of any physical therapist for any of the following
7.29 	grounds:
7.30 	(1) using drugs or intoxicating liquors to an extent which
7.31 	affects professional competence;
7.32 	(2) conviction of a felony;
7.33 	(3) conviction for violating any state or federal narcotic
7.34 	law;
7.35 	(4) obtaining a license or attempting to obtain a license
7.36 	by fraud or deception;
8.1 	(5) conduct unbecoming a person licensed as a physical
8.2 	therapist or conduct detrimental to the best interests of the
8.3 	public;
8.4 	(6) gross negligence in the practice of physical therapy as
8.5 	a physical therapist;
8.6 	(7) treating human ailments by physical therapy after an
8.7 	initial 30-day period of patient admittance to treatment has
8.8 	lapsed, except by the order or referral of a person licensed in
8.9 	this state in the practice of medicine as defined in section
8.10 	147.081, the practice of chiropractic as defined in section
8.11 	148.01, the practice of podiatry as defined in section 153.01,
8.12 	or the practice of dentistry as defined in section 150A.05 and
8.13 	whose license is in good standing; or when a previous diagnosis
8.14 	exists indicating an ongoing condition warranting physical
8.15 	therapy treatment, subject to periodic review defined by board
8.16 	of physical therapy rule;
8.17 	(8) treating human ailments, without referral, by physical
8.18 	therapy treatment without first having practiced one year under
8.19 	a physician's orders as verified by the board's records;
8.20 	(9) failing to consult with the patient's health care
8.21 	provider who prescribed the physical therapy treatment if the
8.22 	treatment is altered by the physical therapist from the original
8.23 	written order.  The provision does not include written orders to
8.24 	"evaluate and treat";
8.25 	(10) treating human ailments other than by physical therapy
8.26 	unless duly licensed or registered to do so under the laws of
8.27 	this state;
8.28 	(11) inappropriate delegation to a physical therapist
8.29 	assistant or inappropriate task assignment to an aide or
8.30 	inadequate supervision of either level of supportive personnel a
8.31 	student physical therapist, physical therapist assistant,
8.32 	student physical therapist assistant, or a physical therapy
8.33 	aide;
8.34 	(12) practicing as a physical therapist performing medical
8.35 	diagnosis, the practice of medicine as defined in section
8.36 	147.081, or the practice of chiropractic as defined in section
9.1 	148.01;
9.2 	(13) failing to comply with a reasonable request to obtain
9.3 	appropriate clearance for mental or physical conditions that
9.4 	would interfere with the ability to practice physical therapy,
9.5 	and that may be potentially harmful to patients;
9.6 	(14) dividing fees with, or paying or promising to pay a
9.7 	commission or part of the fee to, any person who contacts the
9.8 	physical therapist for consultation or sends patients to the
9.9 	physical therapist for treatment;
9.10 	(15) engaging in an incentive payment arrangement, other
9.11 	than that prohibited by clause (14), that tends to promote
9.12 	physical therapy overuse, that allows the referring person or
9.13 	person who controls the availability of physical therapy
9.14 	services to a client to profit unreasonably as a result of
9.15 	patient treatment;
9.16 	(16) practicing physical therapy and failing to refer to a
9.17 	licensed health care professional a patient whose medical
9.18 	condition at the time of evaluation has been determined by the
9.19 	physical therapist to be beyond the scope of practice of a
9.20 	physical therapist; and 
9.21 	(17) failing to report to the board other licensed physical
9.22 	therapists who violate this section;
9.23 	(18) practice of physical therapy under lapsed or
9.24 	nonrenewed credentials;
9.25 	(19) inappropriate task assignment or inadequate
9.26 	supervision of an athletic trainer under section 148.7806,
9.27 	paragraph (e);
9.28 	(20) failure by a physical therapist to file a physical
9.29 	therapist-athletic trainer supervisory agreement with the board
9.30 	as required under section 148.707, subdivision 1; and 
9.31 	(21) failure by a physical therapist to comply with the
9.32 	requirements under section 148.707, subdivisions 2 to 5.
9.33 	(b) A license to practice as a physical therapist is
9.34 	suspended if (1) a guardian of the physical therapist is
9.35 	appointed by order of a court pursuant to sections 524.5-101 to
9.36 	524.5-502, for reasons other than the minority of the physical
10.1 	therapist; or (2) the physical therapist is committed by order
10.2 	of a court pursuant to chapter 253B.  The license remains
10.3 	suspended until the physical therapist is restored to capacity
10.4 	by a court and, upon petition by the physical therapist, the
10.5 	suspension is terminated by the Board of Physical Therapy after
10.6 	a hearing.

10.7 	Sec. 13. [148.754] EXAMINATION; ACCESS TO MEDICAL DATA.
10.8 	(a) If the board has probable cause to believe that a
10.9 	physical therapist comes under section 148.75, paragraph (a), it
10.10 	may direct the physical therapist to submit to a mental or
10.11 	physical examination.  For the purpose of this paragraph, every
10.12 	physical therapist is deemed to have consented to submit to a
10.13 	mental or physical examination when directed in writing by the
10.14 	board and further to have waived all objections to the
10.15 	admissibility of the examining physicians' testimony or
10.16 	examination reports on the ground that they constitute a
10.17 	privileged communication.  Failure of the physical therapist to
10.18 	submit to an examination when directed constitutes an admission
10.19 	of the allegations against the person, unless the failure was
10.20 	due to circumstances beyond the person's control, in which case
10.21 	a default and final order may be entered without the taking of
10.22 	testimony or presentation of evidence.  A physical therapist
10.23 	affected under this paragraph shall, at reasonable intervals, be
10.24 	given an opportunity to demonstrate that the person can resume
10.25 	the competent practice of physical therapy with reasonable skill
10.26 	and safety to the public.
10.27 	(b) In any proceeding under paragraph (a), neither the
10.28 	record of proceedings nor the orders entered by the board shall
10.29 	be used against a physical therapist in any other proceeding.
10.30 	(c) In addition to ordering a physical or mental
10.31 	examination, the board may, notwithstanding section 13.384,
10.32 	144.651, or any other law limiting access to medical or other
10.33 	health data, obtain medical data and health records relating to
10.34 	a physical therapist or applicant without the person's or
10.35 	applicant's consent if the board has probable cause to believe
10.36 	that a physical therapist comes under paragraph (a).  The
11.1 	medical data may be requested from a provider, as defined in
11.2 	section 144.335, subdivision 1, paragraph (b), an insurance
11.3 	company, or a government agency, including the Department of
11.4 	Human Services.  A provider, insurance company, or government
11.5 	agency shall comply with any written request of the board under
11.6 	this paragraph and is not liable in any action for damages for
11.7 	releasing the data requested by the board if the data are
11.8 	released pursuant to a written request under this paragraph,
11.9 	unless the information is false and the provider giving the
11.10 	information knew, or had reason to believe, the information was
11.11 	false.  Information obtained under this paragraph is classified
11.12 	as private under sections 13.01 to 13.87.

11.13 	Sec. 14. [148.755] TEMPORARY SUSPENSION OF LICENSE.
11.14 	In addition to any other remedy provided by law, the board
11.15 	may, without a hearing, temporarily suspend the license of a
11.16 	physical therapist if the board finds that the physical
11.17 	therapist has violated a statute or rule which the board is
11.18 	empowered to enforce and continued practice by the physical
11.19 	therapist would create a serious risk of harm to the public.
11.20 	The suspension shall take effect upon written notice to the
11.21 	physical therapist, specifying the statute or rule violated.
11.22 	The suspension shall remain in effect until the board issues a
11.23 	final order in the matter after a hearing.  At the time it
11.24 	issues the suspension notice, the board shall schedule a
11.25 	disciplinary hearing to be held pursuant to the Administrative
11.26 	Procedure Act, chapter 14.  The physical therapist shall be
11.27 	provided with at least 20 days' notice of any hearing held
11.28 	pursuant to this section.  The hearing shall be scheduled to
11.29 	begin no later than 30 days after the issuance of the suspension
11.30 	order.

11.31 	Sec. 15. Minnesota Statutes 2004, section 148.7806, is
11.32 	amended to read:
11.33 	148.7806 ATHLETIC TRAINING.
11.34 	Athletic training by a registered athletic trainer under
11.35 	section 148.7808 includes the activities described in paragraphs
11.36 	(a) to (e).
12.1 	(a) An athletic trainer shall:
12.2 	(1) prevent, recognize, and evaluate athletic injuries;
12.3 	(2) give emergency care and first aid;
12.4 	(3) manage and treat athletic injuries; and
12.5 	(4) rehabilitate and physically recondition athletic
12.6 	injuries.
12.7 	The athletic trainer may use modalities such as cold, heat,
12.8 	light, sound, electricity, exercise, and mechanical devices for
12.9 	treatment and rehabilitation of athletic injuries to athletes in
12.10 	the primary employment site.
12.11 	(b) The primary physician shall establish evaluation and
12.12 	treatment protocols to be used by the athletic trainer.  The
12.13 	primary physician shall record the protocols on a form
12.14 	prescribed by the board.  The protocol form must be updated
12.15 	yearly at the athletic trainer's registration renewal time and
12.16 	kept on file by the athletic trainer.
12.17 	(c) At the primary employment site, except in a corporate
12.18 	setting, an athletic trainer may evaluate and treat an athlete
12.19 	for an athletic injury not previously diagnosed for not more
12.20 	than 30 days, or a period of time as designated by the primary
12.21 	physician on the protocol form, from the date of the initial
12.22 	evaluation and treatment.  Preventative care after resolution of
12.23 	the injury is not considered treatment.  This paragraph does not
12.24 	apply to a person who is referred for treatment by a person
12.25 	licensed in this state to practice medicine as defined in
12.26 	section 147.081, to practice chiropractic as defined in section
12.27 	148.01, to practice podiatry as defined in section 153.01, or to
12.28 	practice dentistry as defined in section 150A.05 and whose
12.29 	license is in good standing.
12.30 	(d) An athletic trainer may:
12.31 	(1) organize and administer an athletic training program
12.32 	including, but not limited to, educating and counseling
12.33 	athletes;
12.34 	(2) monitor the signs, symptoms, general behavior, and
12.35 	general physical response of an athlete to treatment and
12.36 	rehabilitation including, but not limited to, whether the signs,
13.1 	symptoms, reactions, behavior, or general response show abnormal
13.2 	characteristics; and
13.3 	(3) make suggestions to the primary physician or other
13.4 	treating provider for a modification in the treatment and
13.5 	rehabilitation of an injured athlete based on the indicators in
13.6 	clause (2).
13.7 	(e) In a clinical, corporate, and physical therapy setting,
13.8 	when the service provided is, or is represented as being,
13.9 	physical therapy, an athletic trainer may work only under the
13.10 	direct supervision as defined in section 148.707of a physical
13.11 	therapist as defined in section 148.65.

13.12 	Sec. 16. REPEALER.
 13.13 	Minnesota Rules, part 5601.0100, subparts 3 and 4, are
13.14 	repealed.