1.1                          A bill for an act 
  1.2             relating to professions; modifying certain protocols 
  1.3             for nurses; amending Minnesota Statutes 2000, sections 
  1.4             148.235, by adding subdivisions; 148.281, subdivision 
  1.5             1; 151.37, subdivision 2. 
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  Minnesota Statutes 2000, section 148.235, is 
  1.8   amended by adding a subdivision to read: 
  1.9      Subd. 8.  [PRESCRIPTION BY PROTOCOL.] A registered nurse 
  1.10  may implement a protocol that does not reference a specific 
  1.11  patient and results in a prescription of a legend drug that has 
  1.12  been predetermined and delegated by a licensed practitioner as 
  1.13  defined under section 151.01, subdivision 23, when caring for a 
  1.14  patient whose condition falls within the protocol and when the 
  1.15  protocol specifies the circumstances under which the drug is to 
  1.16  be prescribed or administered. 
  1.17     Sec. 2.  Minnesota Statutes 2000, section 148.235, is 
  1.18  amended by adding a subdivision to read: 
  1.19     Subd. 9.  [VACCINE BY PROTOCOL.] A nurse may implement a 
  1.20  protocol that does not reference a specific patient and results 
  1.21  in the administration of a vaccine that has been predetermined 
  1.22  and delegated by a licensed practitioner as defined in section 
  1.23  151.01, subdivision 23, when caring for a patient whose 
  1.24  characteristics fall within the protocol and when the protocol 
  1.25  specifies the contraindications for implementation, including 
  2.1   patients or populations of patients for whom the vaccine must 
  2.2   not be administered and the conditions under which the vaccine 
  2.3   must not be administered. 
  2.4      Sec. 3.  Minnesota Statutes 2000, section 148.281, 
  2.5   subdivision 1, is amended to read: 
  2.6      Subdivision 1.  [VIOLATIONS DESCRIBED.] It shall be 
  2.7   unlawful for any person, corporation, firm, or association, to: 
  2.8      (1) sell or fraudulently obtain or furnish any nursing 
  2.9   diploma, license or record, or aid or abet therein; 
  2.10     (2) practice professional or practical nursing, practice as 
  2.11  a public health nurse, or practice as a certified clinical nurse 
  2.12  specialist, certified nurse-midwife, certified nurse 
  2.13  practitioner, or certified registered nurse anesthetist under 
  2.14  cover of any diploma, permit, license, registration certificate, 
  2.15  advanced practice credential, or record illegally or 
  2.16  fraudulently obtained or signed or issued unlawfully or under 
  2.17  fraudulent representation; 
  2.18     (3) practice professional or practical nursing unless the 
  2.19  person has been issued a temporary permit under the provisions 
  2.20  of section 148.212 or is duly licensed and currently registered 
  2.21  to do so under the provisions of sections 148.171 to 148.285; 
  2.22     (4) use the title nurse unless duly licensed and currently 
  2.23  registered to practice professional or practical nursing under 
  2.24  the provisions of sections 148.171 to 148.285, except as 
  2.25  authorized by the board by rule; 
  2.26     (5) use any abbreviation or other designation tending to 
  2.27  imply licensure as a registered nurse or licensed practical 
  2.28  nurse unless duly licensed and currently registered so to 
  2.29  practice professional or practical nursing under the provisions 
  2.30  of sections 148.171 to 148.285 except as authorized by the board 
  2.31  by rule; 
  2.32     ~~(5)~~ (6) use any title, abbreviation, or other designation 
  2.33  tending to imply certification as a certified registered nurse 
  2.34  as defined in section 148.171, subdivision 22, unless duly 
  2.35  certified by a national nurse certification organization; 
  2.36     ~~(6)~~ (7) use any abbreviation or other designation tending 
  3.1   to imply registration as a public health nurse unless duly 
  3.2   registered by the board; 
  3.3      ~~(7)~~ (8) practice professional, advanced practice 
  3.4   registered, or practical nursing in a manner prohibited by the 
  3.5   board in any limitation of a license or registration issued 
  3.6   under the provisions of sections 148.171 to 148.285; 
  3.7      ~~(8)~~ (9) practice professional, advanced practice 
  3.8   registered, or practical nursing during the time a license or 
  3.9   current registration issued under the provisions of sections 
  3.10  148.171 to 148.285 shall be suspended or revoked; 
  3.11     ~~(9)~~ (10) conduct a nursing program for the education of 
  3.12  persons to become registered nurses or licensed practical nurses 
  3.13  unless the program has been approved by the board; 
  3.14     ~~(10)~~ (11) knowingly employ persons in the practice of 
  3.15  professional or practical nursing who have not been issued a 
  3.16  current permit, license, or registration certificate to practice 
  3.17  as a nurse in this state; and 
  3.18     ~~(11)~~ (12) knowingly employ a person in advanced practice 
  3.19  registered nursing unless the person meets the standards and 
  3.20  practices of sections 148.171 to 148.285. 
  3.21     Sec. 4.  Minnesota Statutes 2000, section 151.37, 
  3.22  subdivision 2, is amended to read: 
  3.23     Subd. 2.  [PRESCRIBING AND FILING.] (a) A licensed 
  3.24  practitioner in the course of professional practice only, may 
  3.25  prescribe, administer, and dispense a legend drug, and may cause 
  3.26  the same to be administered by a nurse, a physician assistant, 
  3.27  or medical student or resident under the practitioner's 
  3.28  direction and supervision, and may cause a person who is an 
  3.29  appropriately certified, registered, or licensed health care 
  3.30  professional to prescribe, dispense, and administer the same 
  3.31  within the expressed legal scope of the person's practice as 
  3.32  defined in Minnesota Statutes.  A licensed practitioner may 
  3.33  prescribe a legend drug, without reference to a specific 
  3.34  patient, by directing a ~~registered~~ nurse, pursuant to section 
  3.35  148.235, subdivisions 8 and 9, physician assistant, or medical 
  3.36  student or resident to adhere to a particular practice guideline 
  4.1   or protocol when treating patients whose condition falls within 
  4.2   such guideline or protocol, and when such guideline or protocol 
  4.3   specifies the circumstances under which the legend drug is to be 
  4.4   prescribed and administered.  An individual who verbally, 
  4.5   electronically, or otherwise transmits a written, oral, or 
  4.6   electronic order, as an agent of a prescriber, shall not be 
  4.7   deemed to have prescribed the legend drug.  This paragraph 
  4.8   applies to a physician assistant only if the physician assistant 
  4.9   meets the requirements of section 147A.18. 
  4.10     (b) A licensed practitioner that dispenses for profit a 
  4.11  legend drug that is to be administered orally, is ordinarily 
  4.12  dispensed by a pharmacist, and is not a vaccine, must file with 
  4.13  the practitioner's licensing board a statement indicating that 
  4.14  the practitioner dispenses legend drugs for profit, the general 
  4.15  circumstances under which the practitioner dispenses for profit, 
  4.16  and the types of legend drugs generally dispensed.  It is 
  4.17  unlawful to dispense legend drugs for profit after July 31, 
  4.18  1990, unless the statement has been filed with the appropriate 
  4.19  licensing board.  For purposes of this paragraph, "profit" means 
  4.20  (1) any amount received by the practitioner in excess of the 
  4.21  acquisition cost of a legend drug for legend drugs that are 
  4.22  purchased in prepackaged form, or (2) any amount received by the 
  4.23  practitioner in excess of the acquisition cost of a legend drug 
  4.24  plus the cost of making the drug available if the legend drug 
  4.25  requires compounding, packaging, or other treatment.  The 
  4.26  statement filed under this paragraph is public data under 
  4.27  section 13.03.  This paragraph does not apply to a licensed 
  4.28  doctor of veterinary medicine or a registered pharmacist.  Any 
  4.29  person other than a licensed practitioner with the authority to 
  4.30  prescribe, dispense, and administer a legend drug under 
  4.31  paragraph (a) shall not dispense for profit.  To dispense for 
  4.32  profit does not include dispensing by a community health clinic 
  4.33  when the profit from dispensing is used to meet operating 
  4.34  expenses.