Bill Text: MN SF511 | 2013-2014 | 88th Legislature | Engrossed
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Advanced practice registered nurses licensure and regulations; advisory council creation and appropriation
Spectrum: Slight Partisan Bill (Democrat 22-8)
Status: (Passed) 2014-05-14 - Secretary of State Chapter 235 05/13/14 [SF511 Detail]
Download: Minnesota-2013-SF511-Engrossed.html
Bill Title: Advanced practice registered nurses licensure and regulations; advisory council creation and appropriation
Spectrum: Slight Partisan Bill (Democrat 22-8)
Status: (Passed) 2014-05-14 - Secretary of State Chapter 235 05/13/14 [SF511 Detail]
Download: Minnesota-2013-SF511-Engrossed.html
1.2relating to health; improving access to health care delivered by advanced practice
1.3registered nurses; providing penalties; providing for an advisory committee;
1.4appropriating money;amending Minnesota Statutes 2012, sections 148.171,
1.5subdivisions 3, 5, 9, 10, 11, 13, 16, 17, 21, by adding subdivisions; 148.181,
1.6subdivision 1; 148.191, subdivision 2; 148.211, subdivision 2, by adding
1.7subdivisions; 148.231, subdivisions 1, 4, 5; 148.233, subdivision 2; 148.234;
1.8148.235, by adding subdivisions; 148.251, subdivision 1; 148.261, subdivision 1;
1.9148.262, subdivisions 1, 2, 4; 148.281, subdivision 1, by adding a subdivision;
1.10148.283; 151.01, subdivision 23; 152.12; Minnesota Statutes 2013 Supplement,
1.11section 148.271; proposing coding for new law in Minnesota Statutes, chapter
1.12148; repealing Minnesota Statutes 2012, sections 148.171, subdivision 6;
1.13148.235, subdivisions 1, 2, 2a, 4, 4a, 4b, 6, 7; 148.284.
1.14BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.15 Section 1. Minnesota Statutes 2012, section 148.171, subdivision 3, is amended to read:
1.16 Subd. 3. Advanced practice registered nurse. "Advanced practice registered
1.17nurse," abbreviated APRN, means an individual licensed asa an advanced practice
1.18 registered nurse by the board and certified by a national nurse certification organization
1.19acceptable to the board to practice as a clinical nurse specialist, nurse anesthetist,
1.20nurse-midwife, or nurse practitioner. The national nursing certification organization must:
1.21(1) be endorsed by a national professional nursing organization that describes
1.22scope and standards statements specific to the practice as a clinical nurse specialist,
1.23nurse-midwife, nurse practitioner, or registered nurse anesthetist for the population focus
1.24for which the individual will be certified;
1.25(2) be independent from the national professional nursing organization in
1.26decision-making for all matters pertaining to certification or recertification;
2.1(3) administer a professional nursing certification program that is psychometrically
2.2sound and legally defensible, and meets nationally recognized accreditation standards
2.3for certification programs; and
2.4(4) require periodic recertification or be affiliated with an organization that provides
2.5recertification.
2.6 Sec. 2. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
2.7to read:
2.8 Subd. 4a. Certification. "Certification" means the formal recognition of knowledge,
2.9skills, and experience demonstrated by the achievement of standards identified by the
2.10National Professional Nursing Organization acceptable to the Minnesota Board of Nursing.
2.11 Sec. 3. Minnesota Statutes 2012, section 148.171, subdivision 5, is amended to read:
2.12 Subd. 5. Clinical nurse specialist practice. "Clinical nurse specialist practice"
2.13meansthe provision of patient care in a particular specialty or subspecialty of advanced
2.14practice registered nursing within the context of collaborative management, and includes:
2.15(1) diagnosing illness and disease; (2) providing nonpharmacologic treatment, including
2.16psychotherapy; (3) promoting wellness; and (4) preventing illness and disease. The
2.17certified clinical nurse specialist is certified for advanced practice registered nursing in a
2.18specific field of clinical nurse specialist practice.:
2.19(1) the diagnosis and treatment of health and illness states;
2.20(2) disease management;
2.21(3) prescribing pharmacologic and nonpharmacologic therapies;
2.22(4) ordering, performing, supervising, and interpreting diagnostic studies, excluding
2.23interpreting computed tomography scans, magnetic resonance imaging scans, positron
2.24emission tomography scans, nuclear scans, and mammography;
2.25(5) prevention of illness and risk behaviors;
2.26(6) nursing care for individuals, families, and communities;
2.27(7) consulting with, collaborating with, or referring to other health care providers as
2.28warranted by the needs of the patient; and
2.29(8) integration of care across the continuum to improve patient outcomes.
2.30 Sec. 4. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
2.31to read:
3.1 Subd. 6a. Collaboration. "Collaboration" means the process in which two or more
3.2health care professionals work together to meet the health care needs of a patient, as
3.3warranted by the patient.
3.4 Sec. 5. Minnesota Statutes 2012, section 148.171, subdivision 9, is amended to read:
3.5 Subd. 9. Nurse. "Nurse" means advanced practice registered nurse, registered
3.6nurse,advanced practice registered nurse, and licensed practical nurse unless the context
3.7clearly refers to only one category.
3.8 Sec. 6. Minnesota Statutes 2012, section 148.171, subdivision 10, is amended to read:
3.9 Subd. 10. Nurse-midwife practice. "Nurse-midwife practice" meansthe
3.10management of women's primary health care, focusing on pregnancy, childbirth, the
3.11postpartum period, care of the newborn, and the family planning and gynecological needs
3.12of women and includes diagnosing and providing nonpharmacologic treatment within a
3.13system that provides for consultation, collaborative management, and referral as indicated
3.14by the health status of patients.:
3.15(1) the management, diagnosis, and treatment of women's primary health care
3.16including pregnancy, childbirth, postpartum period, care of the newborn, family planning,
3.17partner care management relating to sexual health, and gynecological care of women
3.18across the life span;
3.19(2) ordering, performing, supervising, and interpreting diagnostic studies, excluding
3.20interpreting computed tomography scans, magnetic resonance imaging scans, positron
3.21emission tomography scans, nuclear scans, and mammography;
3.22(3) prescribing pharmacologic and nonpharmacologic therapies; and
3.23(4) consulting with, collaborating with, or referring to other health care providers
3.24as warranted by the needs of the patient.
3.25 Sec. 7. Minnesota Statutes 2012, section 148.171, subdivision 11, is amended to read:
3.26 Subd. 11. Nurse practitioner practice. "Nurse practitioner practice" means,
3.27within the context of collaborative management: (1) diagnosing, directly managing, and
3.28preventing acute and chronic illness and disease; and (2) promoting wellness, including
3.29providing nonpharmacologic treatment. The certified nurse practitioner is certified for
3.30advanced registered nurse practice in a specific field of nurse practitioner practice. the
3.31provision of care including:
3.32(1) health promotion, disease prevention, health education, and counseling;
3.33(2) providing health assessment and screening activities;
4.1(3) diagnosing, treating, and facilitating patients' management of their acute and
4.2chronic illnesses and diseases;
4.3(4) ordering, performing, supervising, and interpreting diagnostic studies, excluding
4.4interpreting computed tomography scans, magnetic resonance imaging scans, positron
4.5emission tomography scans, nuclear scans, and mammography;
4.6(5) prescribing pharmacologic and nonpharmacologic therapies; and
4.7(6) consulting with, collaborating with, or referring to other health care providers
4.8as warranted by the needs of the patient.
4.9 Sec. 8. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
4.10to read:
4.11 Subd. 12a. Population focus. "Population focus" means the categories of patients
4.12for which the advanced practice registered nurse has the educational preparation to
4.13provide care and services. The categories of population foci are:
4.14(1) family and individual across the life span;
4.15(2) adult gerontology;
4.16(3) neonatal;
4.17(4) pediatrics;
4.18(5) women's and gender-related health; and
4.19(6) psychiatric and mental health.
4.20 Sec. 9. Minnesota Statutes 2012, section 148.171, subdivision 13, is amended to read:
4.21 Subd. 13. Practice of advanced practice registered nursing. (a) The "practice
4.22of advanced practice registered nursing" means the performance ofclinical nurse
4.23specialist practice, nurse-midwife practice, nurse practitioner practice, or registered
4.24nurse anesthetist practice as defined in subdivisions 5, 10, 11, and 21 an expanded scope
4.25of nursing in at least one of the recognized advanced practice registered nurse roles
4.26for at least one population focus. The scope and practice standards of an advanced
4.27practice registered nurse are defined by the national professional nursing organizations
4.28specific to the practice as a clinical nurse specialist, nurse-midwife, nurse practitioner,
4.29or registered nurse anesthetist in the population focus. The scope of advanced practice
4.30registered nursing includes, but is not limited to, performing acts of advanced assessment,
4.31diagnosing, prescribing, and ordering. The practice includes functioning as a primary care
4.32provider, direct care provider, case manager, consultant, educator, and researcher.The
4.33practice of advanced practice registered nursing also includes accepting referrals from,
4.34consulting with, cooperating with, or referring to all other types of health care providers,
5.1including but not limited to physicians, chiropractors, podiatrists, and dentists, provided
5.2that the advanced practice registered nurse and the other provider are practicing within
5.3their scopes of practice as defined in state law. The advanced practice registered nurse
5.4must practice within a health care system that provides for consultation, collaborative
5.5management, and referral as indicated by the health status of the patient.
5.6(b) The practice of advanced practice registered nursing requires the advanced
5.7practice registered nurse to be accountable: (1) to patients for the quality of advanced
5.8nursing care rendered; (2) for recognizing limits of knowledge and experience; and (3)
5.9for planning for the management of situations beyond the advanced practice registered
5.10nurse's expertise. The practice of advanced practice registered nursing includes accepting
5.11referrals from, consulting with, collaborating with, or referring to other health care
5.12providers as warranted by the needs of the patient.
5.13 Sec. 10. Minnesota Statutes 2012, section 148.171, subdivision 16, is amended to read:
5.14 Subd. 16. Prescribing. "Prescribing" means the act of generating a prescription for
5.15the preparation of, use of, or manner of using a drug or therapeutic device in accordance
5.16with the provisions of section148.235 . Prescribing does not include recommending the
5.17use of a drug or therapeutic device which is not required by the federal Food and Drug
5.18Administration to meet the labeling requirements for prescription drugs and devices.
5.19Prescribing also does not include recommending or administering a drug or therapeutic
5.20deviceperioperatively for anesthesia care and related services by a certified registered
5.21nurse anesthetist.
5.22 Sec. 11. Minnesota Statutes 2012, section 148.171, subdivision 17, is amended to read:
5.23 Subd. 17. Prescription. "Prescription" means a written direction or an oral direction
5.24reduced to writing provided to or for an individual patient for the preparation or use of a
5.25drug or therapeutic device. In the case of a prescription for a drug, the requirements of
5.26section 151.01, subdivisions 16, 16a, and 16b, shall apply.
5.27 Sec. 12. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
5.28to read:
5.29 Subd. 17a. Primary care provider. "Primary care provider" means a licensed health
5.30care provider who acts as the first point of care for comprehensive health maintenance and
5.31promotion, preventive care, and undiagnosed health concerns and who provides continuing
5.32care of varied health conditions not limited by cause, organ systems, or diagnosis.
6.1 Sec. 13. Minnesota Statutes 2012, section 148.171, subdivision 21, is amended to read:
6.2 Subd. 21. Registered nurse anesthetist practice. (a) "Registered nurse anesthetist
6.3practice" means the provision of anesthesia care and related serviceswithin the context
6.4of collaborative management, including:
6.5(1) selecting, obtaining, and administering drugs and therapeutic devices to facilitate
6.6diagnostic, therapeutic, and surgical proceduresupon request, assignment, or referral by a
6.7patient's physician, dentist, or podiatrist.;
6.8(2) ordering, performing, supervising, and interpreting diagnostic studies, excluding
6.9interpreting computed tomography scans, magnetic resonance imaging scans, positron
6.10emission tomography scans, nuclear scans, and mammography;
6.11(3) prescribing pharmacologic and nonpharmacologic therapies;
6.12(4) providing anesthesia and analgesia for acute and chronic pain symptoms through
6.13noninvasive and interventional therapies, including the use of image-guided technology as
6.14needed for a selected therapy; and
6.15(5) consulting with, collaborating with, or referring to other health care providers
6.16as warranted by the needs of the patient.
6.17(b) A registered nurse anesthetist may only provide services described under
6.18paragraph (a), clause (4), within the context of a collaborative agreement. For purposes of
6.19this section, a collaborative agreement means a mutually agreed upon plan between the
6.20registered nurse anesthetist and one or more physicians licensed under chapter 147 that
6.21designates the scope of collaboration necessary to manage the care for patients with acute
6.22and chronic pain. The registered nurse anesthetist must provide anesthesia services at the
6.23same hospital, clinic, or health care setting as the physician.
6.24 Sec. 14. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
6.25to read:
6.26 Subd. 23. Roles of advanced practice registered nurses. "Role" means one of four
6.27recognized advanced practice registered nurse roles: certified registered nurse anesthetist
6.28(CRNA); certified nurse-midwife (CNM); certified clinical nurse specialist (CNS); or
6.29certified nurse practitioner (CNP).
6.30 Sec. 15. Minnesota Statutes 2012, section 148.181, subdivision 1, is amended to read:
6.31 Subdivision 1. Membership. The Board of Nursing consists of 16 members
6.32appointed by the governor, each of whom must be a resident of this state. Eight members
6.33must be registered nurses, each of whom must have graduated from an approved school of
6.34nursing, must be licensed and currently registered as a registered nurse in this state, and
7.1must have had at least five years experience in nursing practice, nursing administration, or
7.2nursing education immediately preceding appointment. One of the eight must have had
7.3at least two years executive or teaching experience in a baccalaureate degree nursing
7.4program approved by the board under section148.251 during the five years immediately
7.5preceding appointment, one of the eight must have had at least two years executive or
7.6teaching experience in an associate degree nursing program approved by the board under
7.7section148.251 during the five years immediately preceding appointment, one of the eight
7.8must be practicing professional nursing in a nursing home at the time of appointment,
7.9one of the eight must have had at least two years executive or teaching experience in a
7.10practical nursing program approved by the board under section148.251 during the five
7.11years immediately preceding appointment, and one of the eight must be licensed and have
7.12national certification or recertification as a registered nurse anesthetist, nurse practitioner,
7.13nurse midwife, or clinical nurse specialist. Four of the eight must have had at least five
7.14years of experience in nursing practice or nursing administration immediately preceding
7.15appointment. Four members must be licensed practical nurses, each of whom must have
7.16graduated from an approved school of nursing, must be licensed and currently registered
7.17as a licensed practical nurse in this state, and must have had at least five years experience
7.18in nursing practice immediately preceding appointment. The remaining four members
7.19must be public members as defined by section214.02 .
7.20A member may be reappointed but may not serve more than two full terms
7.21consecutively. The governor shall attempt to make appointments to the board that reflect
7.22the geography of the state. The board members who are nurses should as a whole reflect
7.23the broad mix of practice types and sites of nurses practicing in Minnesota.
7.24Membership terms, compensation of members, removal of members, the filling of
7.25membership vacancies, and fiscal year and reporting requirements are as provided in
7.26sections214.07 to
214.09 . Any nurse on the board who during incumbency permanently
7.27ceases to be actively engaged in the practice of nursing or otherwise becomes disqualified
7.28for board membership is automatically removed, and the governor shall fill the vacancy.
7.29The provision of staff, administrative services, and office space; the review and processing
7.30of complaints; the setting of board fees; and other provisions relating to board operations
7.31are as provided in sections148.171 to
148.285 and chapter 214. Each member of the
7.32board shall file with the secretary of state the constitutional oath of office before beginning
7.33the term of office.
7.34 Sec. 16. Minnesota Statutes 2012, section 148.191, subdivision 2, is amended to read:
8.1 Subd. 2. Powers. (a) The board is authorized to adopt and, from time to time, revise
8.2rules not inconsistent with the law, as may be necessary to enable it to carry into effect the
8.3provisions of sections148.171 to
148.285 . The board shall prescribe by rule curricula and
8.4standards for schools and courses preparing persons for licensure under sections148.171
8.5to148.285 . It shall conduct or provide for surveys of such schools and courses at such
8.6times as it may deem necessary. It shall approve such schools and courses as meet the
8.7requirements of sections148.171 to
148.285 and board rules. It shall examine, license,
8.8and renew the license of duly qualified applicants. It shall hold examinations at least once
8.9in each year at such time and place as it may determine. It shall by rule adopt, evaluate,
8.10and periodically revise, as necessary, requirements for licensure and for registration and
8.11renewal of registration as defined in section148.231 . It shall maintain a record of all
8.12persons licensed by the board to practice advanced practice, professional, or practical
8.13nursingand all registered nurses who hold Minnesota licensure and registration and are
8.14certified as advanced practice registered nurses. It shall cause the prosecution of all persons
8.15violating sections148.171 to
148.285 and have power to incur such necessary expense
8.16therefor. It shall register public health nurses who meet educational and other requirements
8.17established by the board by rule, including payment of a fee. It shall have power to issue
8.18subpoenas, and to compel the attendance of witnesses and the production of all necessary
8.19documents and other evidentiary material. Any board member may administer oaths to
8.20witnesses, or take their affirmation. It shall keep a record of all its proceedings.
8.21(b) The board shall have access to hospital, nursing home, and other medical records
8.22of a patient cared for by a nurse under review. If the board does not have a written consent
8.23from a patient permitting access to the patient's records, the nurse or facility shall delete
8.24any data in the record that identifies the patient before providing it to the board. The board
8.25shall have access to such other records as reasonably requested by the board to assist the
8.26board in its investigation. Nothing herein may be construed to allow access to any records
8.27protected by section145.64 . The board shall maintain any records obtained pursuant to
8.28this paragraph as investigative data under chapter 13.
8.29(c) The board may accept and expend grants or gifts of money or in-kind services
8.30from a person, a public or private entity, or any other source for purposes consistent with
8.31the board's role and within the scope of its statutory authority.
8.32(d) The board may accept registration fees for meetings and conferences conducted
8.33for the purposes of board activities that are within the scope of its authority.
8.34 Sec. 17. Minnesota Statutes 2012, section 148.211, is amended by adding a subdivision
8.35to read:
9.1 Subd. 1a. Advanced practice registered nurse licensure. (a) Effective January 1,
9.22015, no advanced practice nurse shall practice as an advanced practice registered nurse
9.3unless the advanced practice nurse is licensed by the board under this section.
9.4(b) An applicant for a license to practice as an advanced practice registered nurse
9.5(APRN) shall apply to the board in a format prescribed by the board and pay a fee in an
9.6amount determined under section 148.243.
9.7(c) To be eligible for licensure an applicant:
9.8(1) must hold a current Minnesota professional nursing license or demonstrate
9.9eligibility for licensure as a registered nurse in this state;
9.10(2) must not hold an encumbered license as a registered nurse in any state or territory;
9.11(3) must have completed a graduate level APRN program accredited by a nursing
9.12or nursing-related accrediting body that is recognized by the United States Secretary of
9.13Education or the Council for Higher Education Accreditation as acceptable to the board.
9.14The education must be in one of the four APRN roles for at least one population focus;
9.15(4) must be currently certified by a national certifying body recognized by the board
9.16in the APRN role and population foci appropriate to educational preparation;
9.17(5) must report any criminal conviction, nolo contendere plea, Alford plea, or other
9.18plea arrangement in lieu of conviction; and
9.19(6) must not have committed any acts or omissions which are grounds for
9.20disciplinary action in another jurisdiction or, if these acts have been committed and would
9.21be grounds for disciplinary action as set forth in section 148.261, the board has found,
9.22after investigation, that sufficient restitution has been made.
9.23 Sec. 18. Minnesota Statutes 2012, section 148.211, is amended by adding a subdivision
9.24to read:
9.25 Subd. 1b. Advanced practice registered nurse grandfather provision. (a) The
9.26board shall issue a license to an applicant who does not meet the education requirements
9.27in subdivision 1a, paragraph (c), clause (3), if the applicant:
9.28(1) is recognized by the board to practice as an advanced practice registered nurse in
9.29this state on July 1, 2014;
9.30(2) submits an application to the board in a format prescribed by the board and the
9.31applicable fee as determined under section 148.243 by January 1, 2015; and
9.32(3) meets the requirements under subdivision 1a, paragraph (c), clauses (1), (2),
9.33(4), (5), and (6).
10.1(b) An advanced practice registered nurse licensed under this subdivision shall
10.2maintain all practice privileges provided to licensed advanced practice registered nurses
10.3under this chapter.
10.4 Sec. 19. Minnesota Statutes 2012, section 148.211, is amended by adding a subdivision
10.5to read:
10.6 Subd. 1c. Postgraduate practice. A nurse practitioner or clinical nurse specialist
10.7who qualifies for licensure as an advanced practice registered nurse must practice for
10.8at least 2,080 hours, within the context of a collaborative agreement, within a hospital
10.9or integrated clinical setting where advanced practice registered nurses and physicians
10.10work together to provide patient care. The nurse practitioner or clinical nurse specialist
10.11shall submit written evidence to the board with the application, or upon completion
10.12of the required collaborative practice experience. For purposes of this subdivision,
10.13a collaborative agreement is a mutually agreed upon plan for the overall working
10.14relationship between a nurse practitioner or clinical nurse specialist, and one or more
10.15physicians licensed under chapter 147, or one or more advanced practice registered nurses
10.16licensed under this section that designates the scope of collaboration necessary to manage
10.17the care of patients. The nurse practitioner or clinical nurse specialist, and one of the
10.18collaborating physicians or advanced practice registered nurses, must have experience in
10.19providing care to patients with the same or similar medical problems.
10.20 Sec. 20. Minnesota Statutes 2012, section 148.211, subdivision 2, is amended to read:
10.21 Subd. 2. Licensure by endorsement. (a) The board shall issue a license to practice
10.22professional nursing or practical nursing without examination to an applicant who has
10.23been duly licensed or registered as a nurse under the laws of another state, territory, or
10.24country, if in the opinion of the board the applicant has the qualifications equivalent
10.25to the qualifications required in this state as stated in subdivision 1, all other laws not
10.26inconsistent with this section, and rules promulgated by the board.
10.27(b) Effective January 1, 2015, an applicant for advanced practice registered nurse
10.28licensure by endorsement is eligible for licensure if the applicant meets the requirements
10.29in paragraph (a) and demonstrates:
10.30(1) current national certification or recertification in the advanced role and
10.31population focus area; and
10.32(2) compliance with the advanced practice nursing educational requirements that
10.33were in effect in Minnesota at the time the advanced practice registered nurse completed
10.34the advanced practice nursing education program.
11.1 Sec. 21. Minnesota Statutes 2012, section 148.231, subdivision 1, is amended to read:
11.2 Subdivision 1. Registration. (a) Every person licensed to practice advanced
11.3practice, professional, or practical nursing must maintain with the board a current
11.4registration for practice asa an advanced practice registered nurse, registered nurse, or
11.5licensed practical nurse which must be renewed at regular intervals established by the
11.6board by rule. No registration shall be issued by the board to a nurse until the nurse
11.7has submitted satisfactory evidence of compliance with the procedures and minimum
11.8requirements established by the board.
11.9The fee for periodic registration for practice as a nurse shall be determined by the
11.10board by law. (b) Upon receipt of the application and the required fees, as determined
11.11under section 148.243, the board shall verify the application and the evidence of
11.12completion of continuing education requirements in effect, andthereupon issue to the
11.13nurse registration for the next renewal period.
11.14(c) An applicant for advanced practice registered nursing (APRN) renewal must
11.15provide evidence of current certification or recertification in the appropriate APRN role
11.16in at least one population focus by a nationally accredited certifying body recognized
11.17by the board.
11.18 Sec. 22. Minnesota Statutes 2012, section 148.231, subdivision 4, is amended to read:
11.19 Subd. 4. Failure to register. Any person licensed under the provisions of sections
11.20148.171
to
148.285 who fails to register within the required period shall not be entitled
11.21to practice nursing in this state as an advanced practice registered nurse, a registered
11.22nurse, or a licensed practical nurse.
11.23 Sec. 23. Minnesota Statutes 2012, section 148.231, subdivision 5, is amended to read:
11.24 Subd. 5. Reregistration. A person whose registration has lapsed desiring to
11.25resume practice shall make application for reregistration, submit satisfactory evidence
11.26of compliance with the procedures and requirements established by the board, and pay
11.27the reregistration fee for the current period to the board. A penalty fee shall be required
11.28from a person who practiced nursing without current registration. Thereupon, registration
11.29shall be issued to the person who shall immediately be placed on the practicing list as an
11.30advanced practice registered nurse, a registered nurse, or a licensed practical nurse.
11.31 Sec. 24. Minnesota Statutes 2012, section 148.233, subdivision 2, is amended to read:
11.32 Subd. 2. Advanced practice registered nurse.An advanced practice registered
11.33nurse certified as a certified clinical nurse specialist, certified nurse-midwife, certified
12.1nurse practitioner, or certified registered nurse anesthetist shall use the appropriate
12.2designation: RN,CNS; RN,CNM; RN,CNP; or RN,CRNA for personal identification and
12.3in documentation of services provided. Identification of educational degrees and specialty
12.4fields may be added. (a) Only those persons who hold a current license to practice
12.5advanced practice registered nursing in this state may use the title advanced practice
12.6registered nurse with the role designation of certified registered nurse anesthetist, certified
12.7nurse-midwife, certified clinical nurse specialist, or certified nurse practitioner.
12.8(b) An advanced practice registered nurse shall use the appropriate designation:
12.9APRN, CNS; APRN, CNM; APRN, CNP; or APRN, CRNA for personal identification
12.10and in documentation of services provided. Identification of educational degrees and
12.11specialty fields may be added.
12.12(c) When providing nursing care, an advanced practice registered nurse shall provide
12.13clear identification of the appropriate advanced practice registered nurse designation.
12.14 Sec. 25. Minnesota Statutes 2012, section 148.234, is amended to read:
12.15148.234 STATE BOUNDARIES CONSIDERATION.
12.16A nurse may performmedical patient care procedures and techniques at the direction
12.17of a physician, a podiatrist,or a dentist, or an advanced practice registered nurse licensed
12.18in another state, United States territory, or Canadian province if the physician, podiatrist,
12.19or dentist, or advanced practice registered nurse gave the direction after examining the
12.20patient and issued the direction in that state, United States territory, or Canadian province.
12.21Nothing in this section allows a nurse to perform amedical procedure patient care
12.22procedure or technique at the direction of a physician, a podiatrist,or a dentist, or an
12.23advanced practice registered nurse that is illegal in this state.
12.24 Sec. 26. Minnesota Statutes 2012, section 148.235, is amended by adding a subdivision
12.25to read:
12.26 Subd. 7a. Diagnosis, prescribing, and ordering. Advanced practice registered
12.27nurses are authorized to:
12.28(1) diagnose, prescribe, and institute therapy or referrals of patients to health care
12.29agencies and providers;
12.30(2) prescribe, procure, sign for, record, administer, and dispense over-the-counter,
12.31legend, and controlled substances, including sample drugs; and
12.32(3) plan and initiate a therapeutic regimen that includes ordering and prescribing
12.33durable medical devices and equipment, nutrition, diagnostic, and supportive services
12.34including, but not limited to, home health care, hospice, physical, and occupational therapy.
13.1 Sec. 27. Minnesota Statutes 2012, section 148.235, is amended by adding a subdivision
13.2to read:
13.3 Subd. 7b. Drug Enforcement Administration requirements. (a) Advanced
13.4practice registered nurses must:
13.5(1) comply with federal Drug Enforcement Administration (DEA) requirements
13.6related to controlled substances; and
13.7(2) file any and all of the nurse's DEA registrations and numbers with the board.
13.8(b) The board shall maintain current records of all advanced practice registered
13.9nurses with DEA registration and numbers.
13.10 Sec. 28. Minnesota Statutes 2012, section 148.251, subdivision 1, is amended to read:
13.11 Subdivision 1. Initial approval. An institution desiring to conduct a nursing
13.12program shall apply to the board and submit evidence that:
13.13(1) It is prepared to provide a program of theory and practice in advanced practice,
13.14 professional, or practical nursing that meets the program approval standards adopted by
13.15the board. Instruction and required experience may be obtained in one or more institutions
13.16or agencies outside the applying institution as long as the nursing program retains
13.17accountability for all clinical and nonclinical teaching.
13.18(2) It is prepared to meet other standards established by law and by the board.
13.19 Sec. 29. Minnesota Statutes 2012, section 148.261, subdivision 1, is amended to read:
13.20 Subdivision 1. Grounds listed. The board may deny, revoke, suspend, limit,
13.21or condition the license and registration of any person to practice advanced practice,
13.22 professional,advanced practice registered, or practical nursing under sections
148.171 to
13.23148.285
, or to otherwise discipline a licensee or applicant as described in section
148.262 .
13.24The following are grounds for disciplinary action:
13.25(1) Failure to demonstrate the qualifications or satisfy the requirements for a license
13.26contained in sections148.171 to
148.285 or rules of the board. In the case of a person
13.27applying for a license, the burden of proof is upon the applicant to demonstrate the
13.28qualifications or satisfaction of the requirements.
13.29(2) Employing fraud or deceit in procuring or attempting to procure a permit,
13.30license, or registration certificate to practice advanced practice, professional, or practical
13.31nursing or attempting to subvert the licensing examination process. Conduct that subverts
13.32or attempts to subvert the licensing examination process includes, but is not limited to:
14.1(i) conduct that violates the security of the examination materials, such as removing
14.2examination materials from the examination room or having unauthorized possession of
14.3any portion of a future, current, or previously administered licensing examination;
14.4(ii) conduct that violates the standard of test administration, such as communicating
14.5with another examinee during administration of the examination, copying another
14.6examinee's answers, permitting another examinee to copy one's answers, or possessing
14.7unauthorized materials; or
14.8(iii) impersonating an examinee or permitting an impersonator to take the
14.9examination on one's own behalf.
14.10(3) Conviction of a felony or gross misdemeanor reasonably related to the practice
14.11of professional, advanced practice registered, or practical nursing. Conviction as used in
14.12this subdivision includes a conviction of an offense that if committed in this state would
14.13be considered a felony or gross misdemeanor without regard to its designation elsewhere,
14.14or a criminal proceeding where a finding or verdict of guilt is made or returned but the
14.15adjudication of guilt is either withheld or not entered.
14.16(4) Revocation, suspension, limitation, conditioning, or other disciplinary action
14.17against the person's professional or practical nursing license or advanced practice
14.18registered nursing credential, in another state, territory, or country; failure to report to the
14.19board that charges regarding the person's nursing license or other credential are pending in
14.20another state, territory, or country; or having been refused a license or other credential by
14.21another state, territory, or country.
14.22(5) Failure to or inability to perform professional or practical nursing as defined in
14.23section148.171, subdivision 14 or 15, with reasonable skill and safety, including failure
14.24of a registered nurse to supervise or a licensed practical nurse to monitor adequately the
14.25performance of acts by any person working at the nurse's direction.
14.26(6) Engaging in unprofessional conduct, including, but not limited to, a departure
14.27from or failure to conform to board rules of professional or practical nursing practice that
14.28interpret the statutory definition of professional or practical nursing as well as provide
14.29criteria for violations of the statutes, or, if no rule exists, to the minimal standards of
14.30acceptable and prevailing professional or practical nursing practice, or any nursing
14.31practice that may create unnecessary danger to a patient's life, health, or safety. Actual
14.32injury to a patient need not be established under this clause.
14.33(7) Failure of an advanced practice registered nurse to practice with reasonable
14.34skill and safety or departure from or failure to conform to standards of acceptable and
14.35prevailing advanced practice registered nursing.
15.1(8) Delegating or accepting the delegation of a nursing function or a prescribed
15.2health care function when the delegation or acceptance could reasonably be expected to
15.3result in unsafe or ineffective patient care.
15.4(9) Actual or potential inability to practice nursing with reasonable skill and safety
15.5to patients by reason of illness, use of alcohol, drugs, chemicals, or any other material, or
15.6as a result of any mental or physical condition.
15.7(10) Adjudication as mentally incompetent, mentally ill, a chemically dependent
15.8person, or a person dangerous to the public by a court of competent jurisdiction, within or
15.9without this state.
15.10(11) Engaging in any unethical conduct, including, but not limited to, conduct likely
15.11to deceive, defraud, or harm the public, or demonstrating a willful or careless disregard
15.12for the health, welfare, or safety of a patient. Actual injury need not be established under
15.13this clause.
15.14(12) Engaging in conduct with a patient that is sexual or may reasonably be
15.15interpreted by the patient as sexual, or in any verbal behavior that is seductive or sexually
15.16demeaning to a patient, or engaging in sexual exploitation of a patient or former patient.
15.17(13) Obtaining money, property, or services from a patient, other than reasonable
15.18fees for services provided to the patient, through the use of undue influence, harassment,
15.19duress, deception, or fraud.
15.20(14) Revealing a privileged communication from or relating to a patient except when
15.21otherwise required or permitted by law.
15.22(15) Engaging in abusive or fraudulent billing practices, including violations of
15.23federal Medicare and Medicaid laws or state medical assistance laws.
15.24(16) Improper management of patient records, including failure to maintain adequate
15.25patient records, to comply with a patient's request made pursuant to sections144.291 to
15.26144.298, or to furnish a patient record or report required by law.
15.27(17) Knowingly aiding, assisting, advising, or allowing an unlicensed person to
15.28engage in the unlawful practice of advanced practice, professional,advanced practice
15.29registered, or practical nursing.
15.30(18) Violating a rule adopted by the board, an order of the board, or a state or
15.31federal law relating to the practice of advanced practice, professional,advanced practice
15.32registered, or practical nursing, or a state or federal narcotics or controlled substance law.
15.33(19) Knowingly providing false or misleading information that is directly related
15.34to the care of that patient unless done for an accepted therapeutic purpose such as the
15.35administration of a placebo.
16.1(20) Aiding suicide or aiding attempted suicide in violation of section609.215 as
16.2established by any of the following:
16.3(i) a copy of the record of criminal conviction or plea of guilty for a felony in
16.4violation of section609.215, subdivision 1 or 2;
16.5(ii) a copy of the record of a judgment of contempt of court for violating an
16.6injunction issued under section609.215, subdivision 4 ;
16.7(iii) a copy of the record of a judgment assessing damages under section609.215,
16.8subdivision 5 ; or
16.9(iv) a finding by the board that the person violated section609.215, subdivision
16.101 or 2. The board shall investigate any complaint of a violation of section
609.215,
16.11subdivision 1 or 2.
16.12(21) Practicing outside the scope of practice authorized by section148.171,
16.13subdivision 5 , 10, 11, 13, 14, 15, or 21.
16.14(22) Practicing outside the specific field of nursing practice for which an advanced
16.15practice registered nurse is certified unless the practice is authorized under section
148.284.
16.16(23) (22) Making a false statement or knowingly providing false information to the
16.17board, failing to make reports as required by section148.263 , or failing to cooperate with
16.18an investigation of the board as required by section148.265 .
16.19(24) (23) Engaging in false, fraudulent, deceptive, or misleading advertising.
16.20(25) (24) Failure to inform the board of the person's certification or recertification
16.21 status as a certified registered nurse anesthetist, certified nurse-midwife, certified nurse
16.22practitioner, or certified clinical nurse specialist.
16.23(26) (25) Engaging in clinical nurse specialist practice, nurse-midwife practice,
16.24nurse practitioner practice, or registered nurse anesthetist practice without a license
16.25and current certification or recertification by a national nurse certification organization
16.26acceptable to the board, except during the period between completion of an advanced
16.27practice registered nurse course of study and certification, not to exceed six months or as
16.28authorized by the board.
16.29(27) (26) Engaging in conduct that is prohibited under section
145.412 .
16.30(28) (27) Failing to report employment to the board as required by section
148.211,
16.31subdivision 2a , or knowingly aiding, assisting, advising, or allowing a person to fail to
16.32report as required by section148.211, subdivision 2a .
16.33 Sec. 30. Minnesota Statutes 2012, section 148.262, subdivision 1, is amended to read:
17.1 Subdivision 1. Forms of disciplinary action. When the board finds that grounds for
17.2disciplinary action exist under section148.261, subdivision 1 , it may take one or more
17.3of the following actions:
17.4(1) deny the license, registration, or registration renewal;
17.5(2) revoke the license;
17.6(3) suspend the license;
17.7(4) impose limitations on the nurse's practice of advanced practice, professional,
17.8advanced practice registered, or practical nursing including, but not limited to, limitation
17.9of scope of practice or the requirement of practice under supervision;
17.10(5) impose conditions on the retention of the license including, but not limited to, the
17.11imposition of retraining or rehabilitation requirements or the conditioning of continued
17.12practice on demonstration of knowledge or skills by appropriate examination, monitoring,
17.13or other review;
17.14(6) impose a civil penalty not exceeding $10,000 for each separate violation, the
17.15amount of the civil penalty to be fixed as to deprive the nurse of any economic advantage
17.16gained by reason of the violation charged, to reimburse the board for the cost of counsel,
17.17investigation, and proceeding, and to discourage repeated violations;
17.18(7) order the nurse to provide unremunerated service;
17.19(8) censure or reprimand the nurse; or
17.20(9) any other action justified by the facts in the case.
17.21 Sec. 31. Minnesota Statutes 2012, section 148.262, subdivision 2, is amended to read:
17.22 Subd. 2. Automatic suspension. Unless the board orders otherwise, a license to
17.23practice advanced practice, professional, or practical nursing is automatically suspended if:
17.24(1) a guardian of a nurse is appointed by order of a court under sections524.5-101
17.25to524.5-502 ;
17.26(2) the nurse is committed by order of a court under chapter 253B; or
17.27(3) the nurse is determined to be mentally incompetent, mentally ill, chemically
17.28dependent, or a person dangerous to the public by a court of competent jurisdiction within
17.29or without this state.
17.30The license remains suspended until the nurse is restored to capacity by a court and,
17.31upon petition by the nurse, the suspension is terminated by the board after a hearing or
17.32upon agreement between the board and the nurse.
17.33 Sec. 32. Minnesota Statutes 2012, section 148.262, subdivision 4, is amended to read:
18.1 Subd. 4. Reissuance. The board may reinstate and reissue a license or registration
18.2certificate to practice advanced practice, professional, or practical nursing, but as a
18.3condition may impose any disciplinary or corrective measure that it might originally have
18.4imposed. Any person whose license or registration has been revoked, suspended, or limited
18.5may have the license reinstated and a new registration issued when, in the discretion of the
18.6board, the action is warranted, provided that the person shall be required by the board to
18.7pay the costs of the proceedings resulting in the revocation, suspension, or limitation of the
18.8license or registration certificate and reinstatement of the license or registration certificate,
18.9and to pay the fee for the current registration period. The cost of proceedings shall
18.10include, but not be limited to, the cost paid by the board to the Office of Administrative
18.11Hearings and the Office of the Attorney General for legal and investigative services, the
18.12costs of a court reporter and witnesses, reproduction of records, board staff time, travel,
18.13and expenses, and board members' per diem reimbursements, travel costs, and expenses.
18.14 Sec. 33. Minnesota Statutes 2013 Supplement, section 148.271, is amended to read:
18.15148.271 EXEMPTIONS.
18.16The provisions of sections148.171 to
148.285 shall not prohibit:
18.17(1) The furnishing of nursing assistance in an emergency.
18.18(2) The practice of advanced practice, professional, or practical nursing by any
18.19legally qualified advanced practice, registered, or licensed practical nurse of another state
18.20who is employed by the United States government or any bureau, division, or agency
18.21thereof while in the discharge of official duties.
18.22(3) The practice of any profession or occupation licensed by the state, other than
18.23advanced practice, professional, or practical nursing, by any person duly licensed to
18.24practice the profession or occupation, or the performance by a person of any acts properly
18.25coming within the scope of the profession, occupation, or license.
18.26(4) The provision of a nursing or nursing-related service by an unlicensed assistive
18.27person who has been delegated or assigned the specific function and is supervised by a
18.28registered nurse or monitored by a licensed practical nurse.
18.29(5) The care of the sick with or without compensation when done in a nursing home
18.30covered by the provisions of section144A.09, subdivision 1 .
18.31(6) Professional nursing practice or advanced practice registered nursing practice by
18.32a registered nurse or practical nursing practice by a licensed practical nurse licensed in
18.33another state or territory who is in Minnesota as a student enrolled in a formal, structured
18.34course of study, such as a course leading to a higher degree, certification in a nursing
18.35specialty, or to enhance skills in a clinical field, while the student is practicing in the course.
19.1(7) Professional or practical nursing practice by a student practicing under the
19.2supervision of an instructor while the student is enrolled in a nursing program approved by
19.3the board under section148.251 .
19.4(8) Advanced practice registered nursing as defined in section148.171, subdivisions
19.55, 10, 11, 13, and 21 , by a registered nurse who is licensed and currently registered in
19.6Minnesota or another United States jurisdiction and who is enrolled as a student in a
19.7formal graduate education program leading to eligibility for certification and licensure
19.8as an advanced practice registered nurse; or by a registered nurse licensed and currently
19.9registered in Minnesota who has completed an advanced practice registered nurse course
19.10of study and is awaiting certification, the period not to exceed six months.
19.11 Sec. 34. Minnesota Statutes 2012, section 148.281, subdivision 1, is amended to read:
19.12 Subdivision 1. Violations described. It shall be unlawful for any person,
19.13corporation, firm, or association, to:
19.14(1) sell or fraudulently obtain or furnish any nursing diploma, license or record, or
19.15aid or abet therein;
19.16(2) practice advanced practice, professional, or practical nursing, or practice
19.17as a public health nurse, or practice as a certified clinical nurse specialist, certified
19.18nurse-midwife, certified nurse practitioner, or certified registered nurse anesthetist
19.19 under cover of any diploma, permit, license, registration certificate, advanced practice
19.20credential, or record illegally or fraudulently obtained or signed or issued unlawfully or
19.21under fraudulent representation;
19.22(3) practice advanced practice, professional, or practical nursing unless the person has
19.23been issued a temporary permit under the provisions of section148.212 or is duly licensed
19.24and currently registered to do so under the provisions of sections148.171 to
148.285 ;
19.25(4) use the professional title nurse unless duly licensed to practice advanced practice,
19.26 professional, or practical nursing under the provisions of sections148.171 to
148.285 ,
19.27except as authorized by the board by rule;
19.28(5) use any abbreviation or other designation tending to imply licensure asa an
19.29advanced practice registered nurse, a registered nurse, or a licensed practical nurse unless
19.30duly licensed and currently registered so to practice advanced practice, professional, or
19.31practical nursing under the provisions of sections148.171 to
148.285 except as authorized
19.32by the board by rule;
19.33(6) use any title, abbreviation, or other designation tending to imply certification
19.34as a certified registered nurse as defined in section148.171, subdivision 22 , unless duly
19.35certified by a national nurse certification organization;
20.1(7) use any abbreviation or other designation tending to imply registration as a
20.2public health nurse unless duly registered by the board;
20.3(8) practice advanced practice, professional,advanced practice registered, or
20.4practical nursing in a manner prohibited by the board in any limitation of a license or
20.5registration issued under the provisions of sections148.171 to
148.285 ;
20.6(9) practice advanced practice, professional,advanced practice registered, or
20.7practical nursing during the time a license or current registration issued under the
20.8provisions of sections148.171 to
148.285 shall be suspended or revoked;
20.9(10) conduct a nursing program for the education of persons to become advanced
20.10practice registered nurses, registered nurses, or licensed practical nurses unless the
20.11program has been approved by the board; and
20.12(11) knowingly employ persons in the practice of advanced practice, professional,
20.13 or practical nursing who have not been issued a current permit, license, or registration
20.14certificate to practice as a nurse in this state; and.
20.15(12) knowingly employ a person in advanced practice registered nursing unless the
20.16person meets the standards and practices of sections
148.171 to
148.285.
20.17 Sec. 35. Minnesota Statutes 2012, section 148.281, is amended by adding a subdivision
20.18to read:
20.19 Subd. 3. Penalty; advanced practice registered nurses. In addition to subdivision
20.202, an advanced practice registered nurse who practices advanced practice registered
20.21nursing without a current license and certification or recertification shall pay a penalty fee
20.22of $200 for the first month or part of a month and an additional $100 for each subsequent
20.23month or parts of months of practice. The amount of the penalty fee shall be calculated
20.24from the first day the advanced practice registered nurse practiced without a current
20.25advanced practice registered nurse license and certification to the last day of practice
20.26without a current license and certification, or from the first day the advanced practice
20.27registered nurse practiced without a current license and certification on file with the board
20.28until the day the current license and certification is filed with the board.
20.29 Sec. 36. Minnesota Statutes 2012, section 148.283, is amended to read:
20.30148.283 UNAUTHORIZED PRACTICE OF PROFESSIONAL, ADVANCED
20.31PRACTICE REGISTERED, AND PRACTICAL NURSING.
20.32The practice of advanced practice, professional,advanced practice registered, or
20.33practical nursing by any person who has not been licensed to practice advanced practice,
20.34professional, or practical nursing under the provisions of sections148.171 to
148.285 ,
21.1or whose license has been suspended or revoked, or whose registration or national
21.2credential has expired, is hereby declared to be inimical to the public health and welfare
21.3and to constitute a public nuisance. Upon a complaint being madethereof by the board,
21.4 or any prosecuting officer, and upon a proper showing of the facts, the district court
21.5of the county where such practice occurred may enjoin such acts and practice. Such
21.6injunction proceeding shall be in addition to, and not in lieu of, all other penalties and
21.7remedies provided by law.
21.8 Sec. 37. [148.2841] ADVANCED PRACTICE NURSING ADVISORY
21.9COMMITTEE.
21.10 (a) The Board of Nursing shall appoint an Advanced Practice Nursing Advisory
21.11Committee consisting of:
21.12 (1) four Minnesota licensed advanced practice registered nurses, consisting of
21.13one nurse practitioner, one nurse-midwife, one clinical nurse specialist, and one nurse
21.14anesthetist;
21.15 (2) two Minnesota licensed physicians who work with advanced practice registered
21.16nurses; and
21.17 (3) one public member.
21.18The committee shall meet at least two times per year. Each member appointment shall be
21.19for a two-year term, with no member serving more than two consecutive terms. The chair
21.20shall rotate among the four advanced practice registered nurse members.
21.21 (b) The advisory committee shall:
21.22 (1) review prescribing trends of advanced practice registered nurses at an aggregate
21.23level;
21.24 (2) review emerging practices and overlap of advanced practice nursing and
21.25specialty medical practices in the six population foci and four categories of advanced
21.26practice registered nurse practice;
21.27 (3) provide recommendations to the Board of Nursing regarding advanced practice
21.28nursing;
21.29 (4) advise the board on advanced practice registered nurse licensure and practice
21.30standards, including emerging practice trends, aggregate prescribing trends, and overlap
21.31of advanced practice registered nursing and medical practices;
21.32 (5) advise the board on distribution of information regarding advanced practice
21.33registered nurse licensure standards; and
21.34 (6) advise the board on issues related to advanced practice registered nurse practice
21.35and regulation.
22.1 Sec. 38. Minnesota Statutes 2012, section 151.01, subdivision 23, is amended to read:
22.2 Subd. 23. Practitioner. "Practitioner" means a licensed doctor of medicine, licensed
22.3doctor of osteopathy duly licensed to practice medicine, licensed doctor of dentistry,
22.4licensed doctor of optometry, licensed podiatrist,or licensed veterinarian, or a licensed
22.5advanced practice registered nurse. For purposes of sections151.15, subdivision 4 ;
22.6151.37, subdivision 2
, paragraphs (b), (e), and (f); and
151.461 , "practitioner" also means
22.7a physician assistant authorized to prescribe, dispense, and administer under chapter 147A,
22.8or an advanced practice nurse authorized to prescribe, dispense, and administer under
22.9section
148.235151.15, subdivision 4 ;
151.37, subdivision 2 ,
22.10paragraph (b); and151.461 , "practitioner" also means a dental therapist authorized to
22.11dispense and administer under chapter 150A.
22.12 Sec. 39. Minnesota Statutes 2012, section 152.12, is amended to read:
22.13152.12DOCTORS HEALTH CARE PROVIDERS MAY PRESCRIBE.
22.14 Subdivision 1. Prescribing, dispensing, administering controlled substances in
22.15Schedules II through V. A licensed doctor of medicine, a doctor of osteopathy, duly
22.16licensed to practice medicine, a doctor of dental surgery, a doctor of dental medicine, a
22.17licensed doctor of podiatry, a licensed advanced practice registered nurse, or a licensed
22.18doctor of optometry limited to Schedules IV and V, and in the course of professional
22.19practice only, may prescribe, administer, and dispense a controlled substance included
22.20in Schedules II through V of section152.02 , may cause the same to be administered by
22.21a nurse, an intern or an assistant under the direction and supervision of the doctor, and
22.22may cause a person who is an appropriately certified and licensed health care professional
22.23to prescribe and administer the same within the expressed legal scope of the person's
22.24practice as defined in Minnesota Statutes.
22.25 Subd. 2. Doctor of veterinary medicine. A licensed doctor of veterinary medicine,
22.26in good faith, and in the course of professional practice only, and not for use by a human
22.27being, may prescribe, administer, and dispense a controlled substance included in
22.28Schedules II through V of section152.02 , and may cause the same to be administered by
22.29an assistant under the direction and supervision of the doctor.
22.30 Subd. 3. Research project use of controlled substances. Any qualified person
22.31may use controlled substances in the course of a bona fide research project but cannot
22.32administer or dispense such drugs to human beings unless such drugs are prescribed,
22.33dispensed and administered by a person lawfully authorized to do so. Every person
22.34who engages in research involving the use of such substances shall apply annually for
22.35registration by the state Board of Pharmacy and shall pay any applicable fee specified in
23.1section151.065 , provided that such registration shall not be required if the person is
23.2covered by and has complied with federal laws covering such research projects.
23.3 Subd. 4. Sale of controlled substances not prohibited for certain persons and
23.4entities. Nothing in this chapter shall prohibit the sale to, or the possession of, a controlled
23.5substance in Schedule II, III, IV or V by: Registered drug wholesalers, registered
23.6manufacturers, registered pharmacies, or any licensed hospital or other licensed institutions
23.7wherein sick and injured persons are cared for or treated, or bona fide hospitals wherein
23.8animals are treated; or by licensed pharmacists, licensed doctors of medicine, doctors of
23.9osteopathy duly licensed to practice medicine, licensed doctors of dental surgery, licensed
23.10doctors of dental medicine, licensed doctors of podiatry, licensed doctors of optometry
23.11limited to Schedules IV and V, or licensed doctors of veterinary medicine when such
23.12practitioners use controlled substances within the course of their professional practice only.
23.13Nothing in this chapter shall prohibit the possession of a controlled substance in
23.14Schedule II, III, IV or V by an employee or agent of a registered drug wholesaler, registered
23.15manufacturer, or registered pharmacy, while acting in the course of employment; by a
23.16patient of a licensed doctor of medicine, a doctor of osteopathy duly licensed to practice
23.17medicine, a licensed doctor of dental surgery, a licensed doctor of dental medicine, or a
23.18licensed doctor of optometry limited to Schedules IV and V; or by the owner of an animal
23.19for which a controlled substance has been prescribed by a licensed doctor of veterinary
23.20medicine, when such controlled substances are dispensed according to law.
23.21 Subd. 5. Analytical laboratory not prohibited from providing anonymous
23.22analysis service. Nothing in this chapter shall prohibit an analytical laboratory from
23.23conducting an anonymous analysis service when such laboratory is registered by the
23.24Federal Drug Enforcement Administration, nor prohibit the possession of a controlled
23.25substance by an employee or agent of such analytical laboratory while acting in the course
23.26of employment.
23.27 Sec. 40. APPROPRIATION.
23.28$378,000 in fiscal year 2015 is appropriated from the state government special
23.29revenue fund to the Board of Nursing to implement licensing requirements for Advanced
23.30Practice Registered Nurses. The base for this appropriation is $232,000 in fiscal years
23.312016 and 2017.
23.32 Sec. 41. REPEALER.
23.33Minnesota Statutes 2012, sections 148.171, subdivision 6; 148.235, subdivisions 1,
23.342, 2a, 4, 4a, 4b, 6, and 7; and 148.284, are repealed.
24.1 Sec. 42. EFFECTIVE DATE.
24.2Sections 1 to 39 are effective January 1, 2015.
1.3registered nurses; providing penalties; providing for an advisory committee;
1.4appropriating money;amending Minnesota Statutes 2012, sections 148.171,
1.5subdivisions 3, 5, 9, 10, 11, 13, 16, 17, 21, by adding subdivisions; 148.181,
1.6subdivision 1; 148.191, subdivision 2; 148.211, subdivision 2, by adding
1.7subdivisions; 148.231, subdivisions 1, 4, 5; 148.233, subdivision 2; 148.234;
1.8148.235, by adding subdivisions; 148.251, subdivision 1; 148.261, subdivision 1;
1.9148.262, subdivisions 1, 2, 4; 148.281, subdivision 1, by adding a subdivision;
1.10148.283; 151.01, subdivision 23; 152.12; Minnesota Statutes 2013 Supplement,
1.11section 148.271; proposing coding for new law in Minnesota Statutes, chapter
1.12148; repealing Minnesota Statutes 2012, sections 148.171, subdivision 6;
1.13148.235, subdivisions 1, 2, 2a, 4, 4a, 4b, 6, 7; 148.284.
1.14BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.15 Section 1. Minnesota Statutes 2012, section 148.171, subdivision 3, is amended to read:
1.16 Subd. 3. Advanced practice registered nurse. "Advanced practice registered
1.17nurse," abbreviated APRN, means an individual licensed as
1.18 registered nurse by the board and certified by a national nurse certification organization
1.19acceptable to the board to practice as a clinical nurse specialist, nurse anesthetist,
1.20nurse-midwife, or nurse practitioner. The national nursing certification organization must:
1.21(1) be endorsed by a national professional nursing organization that describes
1.22scope and standards statements specific to the practice as a clinical nurse specialist,
1.23nurse-midwife, nurse practitioner, or registered nurse anesthetist for the population focus
1.24for which the individual will be certified;
1.25(2) be independent from the national professional nursing organization in
1.26decision-making for all matters pertaining to certification or recertification;
2.1(3) administer a professional nursing certification program that is psychometrically
2.2sound and legally defensible, and meets nationally recognized accreditation standards
2.3for certification programs; and
2.4(4) require periodic recertification or be affiliated with an organization that provides
2.5recertification.
2.6 Sec. 2. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
2.7to read:
2.8 Subd. 4a. Certification. "Certification" means the formal recognition of knowledge,
2.9skills, and experience demonstrated by the achievement of standards identified by the
2.10National Professional Nursing Organization acceptable to the Minnesota Board of Nursing.
2.11 Sec. 3. Minnesota Statutes 2012, section 148.171, subdivision 5, is amended to read:
2.12 Subd. 5. Clinical nurse specialist practice. "Clinical nurse specialist practice"
2.13means
2.14
2.15
2.16
2.17
2.18
2.19(1) the diagnosis and treatment of health and illness states;
2.20(2) disease management;
2.21(3) prescribing pharmacologic and nonpharmacologic therapies;
2.22(4) ordering, performing, supervising, and interpreting diagnostic studies, excluding
2.23interpreting computed tomography scans, magnetic resonance imaging scans, positron
2.24emission tomography scans, nuclear scans, and mammography;
2.25(5) prevention of illness and risk behaviors;
2.26(6) nursing care for individuals, families, and communities;
2.27(7) consulting with, collaborating with, or referring to other health care providers as
2.28warranted by the needs of the patient; and
2.29(8) integration of care across the continuum to improve patient outcomes.
2.30 Sec. 4. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
2.31to read:
3.1 Subd. 6a. Collaboration. "Collaboration" means the process in which two or more
3.2health care professionals work together to meet the health care needs of a patient, as
3.3warranted by the patient.
3.4 Sec. 5. Minnesota Statutes 2012, section 148.171, subdivision 9, is amended to read:
3.5 Subd. 9. Nurse. "Nurse" means advanced practice registered nurse, registered
3.6nurse,
3.7clearly refers to only one category.
3.8 Sec. 6. Minnesota Statutes 2012, section 148.171, subdivision 10, is amended to read:
3.9 Subd. 10. Nurse-midwife practice. "Nurse-midwife practice" means
3.10
3.11
3.12
3.13
3.14
3.15(1) the management, diagnosis, and treatment of women's primary health care
3.16including pregnancy, childbirth, postpartum period, care of the newborn, family planning,
3.17partner care management relating to sexual health, and gynecological care of women
3.18across the life span;
3.19(2) ordering, performing, supervising, and interpreting diagnostic studies, excluding
3.20interpreting computed tomography scans, magnetic resonance imaging scans, positron
3.21emission tomography scans, nuclear scans, and mammography;
3.22(3) prescribing pharmacologic and nonpharmacologic therapies; and
3.23(4) consulting with, collaborating with, or referring to other health care providers
3.24as warranted by the needs of the patient.
3.25 Sec. 7. Minnesota Statutes 2012, section 148.171, subdivision 11, is amended to read:
3.26 Subd. 11. Nurse practitioner practice. "Nurse practitioner practice" means
3.27
3.28
3.29
3.30
3.31provision of care including:
3.32(1) health promotion, disease prevention, health education, and counseling;
3.33(2) providing health assessment and screening activities;
4.1(3) diagnosing, treating, and facilitating patients' management of their acute and
4.2chronic illnesses and diseases;
4.3(4) ordering, performing, supervising, and interpreting diagnostic studies, excluding
4.4interpreting computed tomography scans, magnetic resonance imaging scans, positron
4.5emission tomography scans, nuclear scans, and mammography;
4.6(5) prescribing pharmacologic and nonpharmacologic therapies; and
4.7(6) consulting with, collaborating with, or referring to other health care providers
4.8as warranted by the needs of the patient.
4.9 Sec. 8. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
4.10to read:
4.11 Subd. 12a. Population focus. "Population focus" means the categories of patients
4.12for which the advanced practice registered nurse has the educational preparation to
4.13provide care and services. The categories of population foci are:
4.14(1) family and individual across the life span;
4.15(2) adult gerontology;
4.16(3) neonatal;
4.17(4) pediatrics;
4.18(5) women's and gender-related health; and
4.19(6) psychiatric and mental health.
4.20 Sec. 9. Minnesota Statutes 2012, section 148.171, subdivision 13, is amended to read:
4.21 Subd. 13. Practice of advanced practice registered nursing. (a) The "practice
4.22of advanced practice registered nursing" means the performance of
4.23
4.24
4.25of nursing in at least one of the recognized advanced practice registered nurse roles
4.26for at least one population focus. The scope and practice standards of an advanced
4.27practice registered nurse are defined by the national professional nursing organizations
4.28specific to the practice as a clinical nurse specialist, nurse-midwife, nurse practitioner,
4.29or registered nurse anesthetist in the population focus. The scope of advanced practice
4.30registered nursing includes, but is not limited to, performing acts of advanced assessment,
4.31diagnosing, prescribing, and ordering. The practice includes functioning as a primary care
4.32provider, direct care provider, case manager, consultant, educator, and researcher.
4.33
4.34
5.1
5.2
5.3
5.4
5.5
5.6(b) The practice of advanced practice registered nursing requires the advanced
5.7practice registered nurse to be accountable: (1) to patients for the quality of advanced
5.8nursing care rendered; (2) for recognizing limits of knowledge and experience; and (3)
5.9for planning for the management of situations beyond the advanced practice registered
5.10nurse's expertise. The practice of advanced practice registered nursing includes accepting
5.11referrals from, consulting with, collaborating with, or referring to other health care
5.12providers as warranted by the needs of the patient.
5.13 Sec. 10. Minnesota Statutes 2012, section 148.171, subdivision 16, is amended to read:
5.14 Subd. 16. Prescribing. "Prescribing" means the act of generating a prescription for
5.15the preparation of, use of, or manner of using a drug or therapeutic device in accordance
5.16with the provisions of section
5.17use of a drug or therapeutic device which is not required by the federal Food and Drug
5.18Administration to meet the labeling requirements for prescription drugs and devices.
5.19Prescribing also does not include recommending or administering a drug or therapeutic
5.20device
5.21nurse anesthetist.
5.22 Sec. 11. Minnesota Statutes 2012, section 148.171, subdivision 17, is amended to read:
5.23 Subd. 17. Prescription. "Prescription" means a written direction or an oral direction
5.24reduced to writing provided to or for an individual patient for the preparation or use of a
5.25drug or therapeutic device. In the case of a prescription for a drug, the requirements of
5.26section 151.01, subdivisions 16, 16a, and 16b, shall apply.
5.27 Sec. 12. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
5.28to read:
5.29 Subd. 17a. Primary care provider. "Primary care provider" means a licensed health
5.30care provider who acts as the first point of care for comprehensive health maintenance and
5.31promotion, preventive care, and undiagnosed health concerns and who provides continuing
5.32care of varied health conditions not limited by cause, organ systems, or diagnosis.
6.1 Sec. 13. Minnesota Statutes 2012, section 148.171, subdivision 21, is amended to read:
6.2 Subd. 21. Registered nurse anesthetist practice. (a) "Registered nurse anesthetist
6.3practice" means the provision of anesthesia care and related services
6.4
6.5(1) selecting, obtaining, and administering drugs and therapeutic devices to facilitate
6.6diagnostic, therapeutic, and surgical procedures
6.7
6.8(2) ordering, performing, supervising, and interpreting diagnostic studies, excluding
6.9interpreting computed tomography scans, magnetic resonance imaging scans, positron
6.10emission tomography scans, nuclear scans, and mammography;
6.11(3) prescribing pharmacologic and nonpharmacologic therapies;
6.12(4) providing anesthesia and analgesia for acute and chronic pain symptoms through
6.13noninvasive and interventional therapies, including the use of image-guided technology as
6.14needed for a selected therapy; and
6.15(5) consulting with, collaborating with, or referring to other health care providers
6.16as warranted by the needs of the patient.
6.17(b) A registered nurse anesthetist may only provide services described under
6.18paragraph (a), clause (4), within the context of a collaborative agreement. For purposes of
6.19this section, a collaborative agreement means a mutually agreed upon plan between the
6.20registered nurse anesthetist and one or more physicians licensed under chapter 147 that
6.21designates the scope of collaboration necessary to manage the care for patients with acute
6.22and chronic pain. The registered nurse anesthetist must provide anesthesia services at the
6.23same hospital, clinic, or health care setting as the physician.
6.24 Sec. 14. Minnesota Statutes 2012, section 148.171, is amended by adding a subdivision
6.25to read:
6.26 Subd. 23. Roles of advanced practice registered nurses. "Role" means one of four
6.27recognized advanced practice registered nurse roles: certified registered nurse anesthetist
6.28(CRNA); certified nurse-midwife (CNM); certified clinical nurse specialist (CNS); or
6.29certified nurse practitioner (CNP).
6.30 Sec. 15. Minnesota Statutes 2012, section 148.181, subdivision 1, is amended to read:
6.31 Subdivision 1. Membership. The Board of Nursing consists of 16 members
6.32appointed by the governor, each of whom must be a resident of this state. Eight members
6.33must be registered nurses, each of whom must have graduated from an approved school of
6.34nursing, must be licensed and currently registered as a registered nurse in this state, and
7.1must have had at least five years experience in nursing practice, nursing administration, or
7.2nursing education immediately preceding appointment. One of the eight must have had
7.3at least two years executive or teaching experience in a baccalaureate degree nursing
7.4program approved by the board under section
7.5preceding appointment, one of the eight must have had at least two years executive or
7.6teaching experience in an associate degree nursing program approved by the board under
7.7section
7.8must be practicing professional nursing in a nursing home at the time of appointment,
7.9one of the eight must have had at least two years executive or teaching experience in a
7.10practical nursing program approved by the board under section
7.11years immediately preceding appointment, and one of the eight must be licensed and have
7.12national certification or recertification as a registered nurse anesthetist, nurse practitioner,
7.13nurse midwife, or clinical nurse specialist. Four of the eight must have had at least five
7.14years of experience in nursing practice or nursing administration immediately preceding
7.15appointment. Four members must be licensed practical nurses, each of whom must have
7.16graduated from an approved school of nursing, must be licensed and currently registered
7.17as a licensed practical nurse in this state, and must have had at least five years experience
7.18in nursing practice immediately preceding appointment. The remaining four members
7.19must be public members as defined by section
7.20A member may be reappointed but may not serve more than two full terms
7.21consecutively. The governor shall attempt to make appointments to the board that reflect
7.22the geography of the state. The board members who are nurses should as a whole reflect
7.23the broad mix of practice types and sites of nurses practicing in Minnesota.
7.24Membership terms, compensation of members, removal of members, the filling of
7.25membership vacancies, and fiscal year and reporting requirements are as provided in
7.26sections
7.27ceases to be actively engaged in the practice of nursing or otherwise becomes disqualified
7.28for board membership is automatically removed, and the governor shall fill the vacancy.
7.29The provision of staff, administrative services, and office space; the review and processing
7.30of complaints; the setting of board fees; and other provisions relating to board operations
7.31are as provided in sections
7.32board shall file with the secretary of state the constitutional oath of office before beginning
7.33the term of office.
7.34 Sec. 16. Minnesota Statutes 2012, section 148.191, subdivision 2, is amended to read:
8.1 Subd. 2. Powers. (a) The board is authorized to adopt and, from time to time, revise
8.2rules not inconsistent with the law, as may be necessary to enable it to carry into effect the
8.3provisions of sections
8.4standards for schools and courses preparing persons for licensure under sections
8.5to
8.6times as it may deem necessary. It shall approve such schools and courses as meet the
8.7requirements of sections
8.8and renew the license of duly qualified applicants. It shall hold examinations at least once
8.9in each year at such time and place as it may determine. It shall by rule adopt, evaluate,
8.10and periodically revise, as necessary, requirements for licensure and for registration and
8.11renewal of registration as defined in section
8.12persons licensed by the board to practice advanced practice, professional, or practical
8.13nursing
8.14
8.15violating sections
8.16therefor. It shall register public health nurses who meet educational and other requirements
8.17established by the board by rule, including payment of a fee. It shall have power to issue
8.18subpoenas, and to compel the attendance of witnesses and the production of all necessary
8.19documents and other evidentiary material. Any board member may administer oaths to
8.20witnesses, or take their affirmation. It shall keep a record of all its proceedings.
8.21(b) The board shall have access to hospital, nursing home, and other medical records
8.22of a patient cared for by a nurse under review. If the board does not have a written consent
8.23from a patient permitting access to the patient's records, the nurse or facility shall delete
8.24any data in the record that identifies the patient before providing it to the board. The board
8.25shall have access to such other records as reasonably requested by the board to assist the
8.26board in its investigation. Nothing herein may be construed to allow access to any records
8.27protected by section
8.28this paragraph as investigative data under chapter 13.
8.29(c) The board may accept and expend grants or gifts of money or in-kind services
8.30from a person, a public or private entity, or any other source for purposes consistent with
8.31the board's role and within the scope of its statutory authority.
8.32(d) The board may accept registration fees for meetings and conferences conducted
8.33for the purposes of board activities that are within the scope of its authority.
8.34 Sec. 17. Minnesota Statutes 2012, section 148.211, is amended by adding a subdivision
8.35to read:
9.1 Subd. 1a. Advanced practice registered nurse licensure. (a) Effective January 1,
9.22015, no advanced practice nurse shall practice as an advanced practice registered nurse
9.3unless the advanced practice nurse is licensed by the board under this section.
9.4(b) An applicant for a license to practice as an advanced practice registered nurse
9.5(APRN) shall apply to the board in a format prescribed by the board and pay a fee in an
9.6amount determined under section 148.243.
9.7(c) To be eligible for licensure an applicant:
9.8(1) must hold a current Minnesota professional nursing license or demonstrate
9.9eligibility for licensure as a registered nurse in this state;
9.10(2) must not hold an encumbered license as a registered nurse in any state or territory;
9.11(3) must have completed a graduate level APRN program accredited by a nursing
9.12or nursing-related accrediting body that is recognized by the United States Secretary of
9.13Education or the Council for Higher Education Accreditation as acceptable to the board.
9.14The education must be in one of the four APRN roles for at least one population focus;
9.15(4) must be currently certified by a national certifying body recognized by the board
9.16in the APRN role and population foci appropriate to educational preparation;
9.17(5) must report any criminal conviction, nolo contendere plea, Alford plea, or other
9.18plea arrangement in lieu of conviction; and
9.19(6) must not have committed any acts or omissions which are grounds for
9.20disciplinary action in another jurisdiction or, if these acts have been committed and would
9.21be grounds for disciplinary action as set forth in section 148.261, the board has found,
9.22after investigation, that sufficient restitution has been made.
9.23 Sec. 18. Minnesota Statutes 2012, section 148.211, is amended by adding a subdivision
9.24to read:
9.25 Subd. 1b. Advanced practice registered nurse grandfather provision. (a) The
9.26board shall issue a license to an applicant who does not meet the education requirements
9.27in subdivision 1a, paragraph (c), clause (3), if the applicant:
9.28(1) is recognized by the board to practice as an advanced practice registered nurse in
9.29this state on July 1, 2014;
9.30(2) submits an application to the board in a format prescribed by the board and the
9.31applicable fee as determined under section 148.243 by January 1, 2015; and
9.32(3) meets the requirements under subdivision 1a, paragraph (c), clauses (1), (2),
9.33(4), (5), and (6).
10.1(b) An advanced practice registered nurse licensed under this subdivision shall
10.2maintain all practice privileges provided to licensed advanced practice registered nurses
10.3under this chapter.
10.4 Sec. 19. Minnesota Statutes 2012, section 148.211, is amended by adding a subdivision
10.5to read:
10.6 Subd. 1c. Postgraduate practice. A nurse practitioner or clinical nurse specialist
10.7who qualifies for licensure as an advanced practice registered nurse must practice for
10.8at least 2,080 hours, within the context of a collaborative agreement, within a hospital
10.9or integrated clinical setting where advanced practice registered nurses and physicians
10.10work together to provide patient care. The nurse practitioner or clinical nurse specialist
10.11shall submit written evidence to the board with the application, or upon completion
10.12of the required collaborative practice experience. For purposes of this subdivision,
10.13a collaborative agreement is a mutually agreed upon plan for the overall working
10.14relationship between a nurse practitioner or clinical nurse specialist, and one or more
10.15physicians licensed under chapter 147, or one or more advanced practice registered nurses
10.16licensed under this section that designates the scope of collaboration necessary to manage
10.17the care of patients. The nurse practitioner or clinical nurse specialist, and one of the
10.18collaborating physicians or advanced practice registered nurses, must have experience in
10.19providing care to patients with the same or similar medical problems.
10.20 Sec. 20. Minnesota Statutes 2012, section 148.211, subdivision 2, is amended to read:
10.21 Subd. 2. Licensure by endorsement. (a) The board shall issue a license to practice
10.22professional nursing or practical nursing without examination to an applicant who has
10.23been duly licensed or registered as a nurse under the laws of another state, territory, or
10.24country, if in the opinion of the board the applicant has the qualifications equivalent
10.25to the qualifications required in this state as stated in subdivision 1, all other laws not
10.26inconsistent with this section, and rules promulgated by the board.
10.27(b) Effective January 1, 2015, an applicant for advanced practice registered nurse
10.28licensure by endorsement is eligible for licensure if the applicant meets the requirements
10.29in paragraph (a) and demonstrates:
10.30(1) current national certification or recertification in the advanced role and
10.31population focus area; and
10.32(2) compliance with the advanced practice nursing educational requirements that
10.33were in effect in Minnesota at the time the advanced practice registered nurse completed
10.34the advanced practice nursing education program.
11.1 Sec. 21. Minnesota Statutes 2012, section 148.231, subdivision 1, is amended to read:
11.2 Subdivision 1. Registration. (a) Every person licensed to practice advanced
11.3practice, professional, or practical nursing must maintain with the board a current
11.4registration for practice as
11.5licensed practical nurse which must be renewed at regular intervals established by the
11.6board by rule. No registration shall be issued by the board to a nurse until the nurse
11.7has submitted satisfactory evidence of compliance with the procedures and minimum
11.8requirements established by the board.
11.9
11.10
11.11under section 148.243, the board shall verify the application and the evidence of
11.12completion of continuing education requirements in effect, and
11.13nurse registration for the next renewal period.
11.14(c) An applicant for advanced practice registered nursing (APRN) renewal must
11.15provide evidence of current certification or recertification in the appropriate APRN role
11.16in at least one population focus by a nationally accredited certifying body recognized
11.17by the board.
11.18 Sec. 22. Minnesota Statutes 2012, section 148.231, subdivision 4, is amended to read:
11.19 Subd. 4. Failure to register. Any person licensed under the provisions of sections
11.21to practice nursing in this state as an advanced practice registered nurse, a registered
11.22nurse, or a licensed practical nurse.
11.23 Sec. 23. Minnesota Statutes 2012, section 148.231, subdivision 5, is amended to read:
11.24 Subd. 5. Reregistration. A person whose registration has lapsed desiring to
11.25resume practice shall make application for reregistration, submit satisfactory evidence
11.26of compliance with the procedures and requirements established by the board, and pay
11.27the reregistration fee for the current period to the board. A penalty fee shall be required
11.28from a person who practiced nursing without current registration. Thereupon, registration
11.29shall be issued to the person who shall immediately be placed on the practicing list as an
11.30advanced practice registered nurse, a registered nurse, or a licensed practical nurse.
11.31 Sec. 24. Minnesota Statutes 2012, section 148.233, subdivision 2, is amended to read:
11.32 Subd. 2. Advanced practice registered nurse.
11.33
12.1
12.2
12.3
12.4
12.5advanced practice registered nursing in this state may use the title advanced practice
12.6registered nurse with the role designation of certified registered nurse anesthetist, certified
12.7nurse-midwife, certified clinical nurse specialist, or certified nurse practitioner.
12.8(b) An advanced practice registered nurse shall use the appropriate designation:
12.9APRN, CNS; APRN, CNM; APRN, CNP; or APRN, CRNA for personal identification
12.10and in documentation of services provided. Identification of educational degrees and
12.11specialty fields may be added.
12.12(c) When providing nursing care, an advanced practice registered nurse shall provide
12.13clear identification of the appropriate advanced practice registered nurse designation.
12.14 Sec. 25. Minnesota Statutes 2012, section 148.234, is amended to read:
12.15148.234 STATE BOUNDARIES CONSIDERATION.
12.16A nurse may perform
12.17of a physician, a podiatrist,
12.18in another state, United States territory, or Canadian province if the physician, podiatrist,
12.19
12.20patient and issued the direction in that state, United States territory, or Canadian province.
12.21Nothing in this section allows a nurse to perform a
12.22procedure or technique at the direction of a physician, a podiatrist,
12.23advanced practice registered nurse that is illegal in this state.
12.24 Sec. 26. Minnesota Statutes 2012, section 148.235, is amended by adding a subdivision
12.25to read:
12.26 Subd. 7a. Diagnosis, prescribing, and ordering. Advanced practice registered
12.27nurses are authorized to:
12.28(1) diagnose, prescribe, and institute therapy or referrals of patients to health care
12.29agencies and providers;
12.30(2) prescribe, procure, sign for, record, administer, and dispense over-the-counter,
12.31legend, and controlled substances, including sample drugs; and
12.32(3) plan and initiate a therapeutic regimen that includes ordering and prescribing
12.33durable medical devices and equipment, nutrition, diagnostic, and supportive services
12.34including, but not limited to, home health care, hospice, physical, and occupational therapy.
13.1 Sec. 27. Minnesota Statutes 2012, section 148.235, is amended by adding a subdivision
13.2to read:
13.3 Subd. 7b. Drug Enforcement Administration requirements. (a) Advanced
13.4practice registered nurses must:
13.5(1) comply with federal Drug Enforcement Administration (DEA) requirements
13.6related to controlled substances; and
13.7(2) file any and all of the nurse's DEA registrations and numbers with the board.
13.8(b) The board shall maintain current records of all advanced practice registered
13.9nurses with DEA registration and numbers.
13.10 Sec. 28. Minnesota Statutes 2012, section 148.251, subdivision 1, is amended to read:
13.11 Subdivision 1. Initial approval. An institution desiring to conduct a nursing
13.12program shall apply to the board and submit evidence that:
13.13(1) It is prepared to provide a program of theory and practice in advanced practice,
13.14 professional, or practical nursing that meets the program approval standards adopted by
13.15the board. Instruction and required experience may be obtained in one or more institutions
13.16or agencies outside the applying institution as long as the nursing program retains
13.17accountability for all clinical and nonclinical teaching.
13.18(2) It is prepared to meet other standards established by law and by the board.
13.19 Sec. 29. Minnesota Statutes 2012, section 148.261, subdivision 1, is amended to read:
13.20 Subdivision 1. Grounds listed. The board may deny, revoke, suspend, limit,
13.21or condition the license and registration of any person to practice advanced practice,
13.22 professional,
13.24The following are grounds for disciplinary action:
13.25(1) Failure to demonstrate the qualifications or satisfy the requirements for a license
13.26contained in sections
13.27applying for a license, the burden of proof is upon the applicant to demonstrate the
13.28qualifications or satisfaction of the requirements.
13.29(2) Employing fraud or deceit in procuring or attempting to procure a permit,
13.30license, or registration certificate to practice advanced practice, professional, or practical
13.31nursing or attempting to subvert the licensing examination process. Conduct that subverts
13.32or attempts to subvert the licensing examination process includes, but is not limited to:
14.1(i) conduct that violates the security of the examination materials, such as removing
14.2examination materials from the examination room or having unauthorized possession of
14.3any portion of a future, current, or previously administered licensing examination;
14.4(ii) conduct that violates the standard of test administration, such as communicating
14.5with another examinee during administration of the examination, copying another
14.6examinee's answers, permitting another examinee to copy one's answers, or possessing
14.7unauthorized materials; or
14.8(iii) impersonating an examinee or permitting an impersonator to take the
14.9examination on one's own behalf.
14.10(3) Conviction of a felony or gross misdemeanor reasonably related to the practice
14.11of professional, advanced practice registered, or practical nursing. Conviction as used in
14.12this subdivision includes a conviction of an offense that if committed in this state would
14.13be considered a felony or gross misdemeanor without regard to its designation elsewhere,
14.14or a criminal proceeding where a finding or verdict of guilt is made or returned but the
14.15adjudication of guilt is either withheld or not entered.
14.16(4) Revocation, suspension, limitation, conditioning, or other disciplinary action
14.17against the person's professional or practical nursing license or advanced practice
14.18registered nursing credential, in another state, territory, or country; failure to report to the
14.19board that charges regarding the person's nursing license or other credential are pending in
14.20another state, territory, or country; or having been refused a license or other credential by
14.21another state, territory, or country.
14.22(5) Failure to or inability to perform professional or practical nursing as defined in
14.23section
14.24of a registered nurse to supervise or a licensed practical nurse to monitor adequately the
14.25performance of acts by any person working at the nurse's direction.
14.26(6) Engaging in unprofessional conduct, including, but not limited to, a departure
14.27from or failure to conform to board rules of professional or practical nursing practice that
14.28interpret the statutory definition of professional or practical nursing as well as provide
14.29criteria for violations of the statutes, or, if no rule exists, to the minimal standards of
14.30acceptable and prevailing professional or practical nursing practice, or any nursing
14.31practice that may create unnecessary danger to a patient's life, health, or safety. Actual
14.32injury to a patient need not be established under this clause.
14.33(7) Failure of an advanced practice registered nurse to practice with reasonable
14.34skill and safety or departure from or failure to conform to standards of acceptable and
14.35prevailing advanced practice registered nursing.
15.1(8) Delegating or accepting the delegation of a nursing function or a prescribed
15.2health care function when the delegation or acceptance could reasonably be expected to
15.3result in unsafe or ineffective patient care.
15.4(9) Actual or potential inability to practice nursing with reasonable skill and safety
15.5to patients by reason of illness, use of alcohol, drugs, chemicals, or any other material, or
15.6as a result of any mental or physical condition.
15.7(10) Adjudication as mentally incompetent, mentally ill, a chemically dependent
15.8person, or a person dangerous to the public by a court of competent jurisdiction, within or
15.9without this state.
15.10(11) Engaging in any unethical conduct, including, but not limited to, conduct likely
15.11to deceive, defraud, or harm the public, or demonstrating a willful or careless disregard
15.12for the health, welfare, or safety of a patient. Actual injury need not be established under
15.13this clause.
15.14(12) Engaging in conduct with a patient that is sexual or may reasonably be
15.15interpreted by the patient as sexual, or in any verbal behavior that is seductive or sexually
15.16demeaning to a patient, or engaging in sexual exploitation of a patient or former patient.
15.17(13) Obtaining money, property, or services from a patient, other than reasonable
15.18fees for services provided to the patient, through the use of undue influence, harassment,
15.19duress, deception, or fraud.
15.20(14) Revealing a privileged communication from or relating to a patient except when
15.21otherwise required or permitted by law.
15.22(15) Engaging in abusive or fraudulent billing practices, including violations of
15.23federal Medicare and Medicaid laws or state medical assistance laws.
15.24(16) Improper management of patient records, including failure to maintain adequate
15.25patient records, to comply with a patient's request made pursuant to sections
15.26144.298, or to furnish a patient record or report required by law.
15.27(17) Knowingly aiding, assisting, advising, or allowing an unlicensed person to
15.28engage in the unlawful practice of advanced practice, professional,
15.29
15.30(18) Violating a rule adopted by the board, an order of the board, or a state or
15.31federal law relating to the practice of advanced practice, professional,
15.32
15.33(19) Knowingly providing false or misleading information that is directly related
15.34to the care of that patient unless done for an accepted therapeutic purpose such as the
15.35administration of a placebo.
16.1(20) Aiding suicide or aiding attempted suicide in violation of section
16.2established by any of the following:
16.3(i) a copy of the record of criminal conviction or plea of guilty for a felony in
16.4violation of section
16.5(ii) a copy of the record of a judgment of contempt of court for violating an
16.6injunction issued under section
16.7(iii) a copy of the record of a judgment assessing damages under section
16.8subdivision 5
16.9(iv) a finding by the board that the person violated section
16.101
16.11subdivision 1
16.12(21) Practicing outside the scope of practice authorized by section
16.13subdivision 5
16.14
16.15
16.16
16.17board, failing to make reports as required by section
16.18an investigation of the board as required by section
16.19
16.20
16.21 status as a certified registered nurse anesthetist, certified nurse-midwife, certified nurse
16.22practitioner, or certified clinical nurse specialist.
16.23
16.24nurse practitioner practice, or registered nurse anesthetist practice without a license
16.25and current certification or recertification by a national nurse certification organization
16.26acceptable to the board
16.27
16.28
16.29
16.30
16.31subdivision 2a
16.32report as required by section
16.33 Sec. 30. Minnesota Statutes 2012, section 148.262, subdivision 1, is amended to read:
17.1 Subdivision 1. Forms of disciplinary action. When the board finds that grounds for
17.2disciplinary action exist under section
17.3of the following actions:
17.4(1) deny the license, registration, or registration renewal;
17.5(2) revoke the license;
17.6(3) suspend the license;
17.7(4) impose limitations on the nurse's practice of advanced practice, professional,
17.8
17.9of scope of practice or the requirement of practice under supervision;
17.10(5) impose conditions on the retention of the license including, but not limited to, the
17.11imposition of retraining or rehabilitation requirements or the conditioning of continued
17.12practice on demonstration of knowledge or skills by appropriate examination, monitoring,
17.13or other review;
17.14(6) impose a civil penalty not exceeding $10,000 for each separate violation, the
17.15amount of the civil penalty to be fixed as to deprive the nurse of any economic advantage
17.16gained by reason of the violation charged, to reimburse the board for the cost of counsel,
17.17investigation, and proceeding, and to discourage repeated violations;
17.18(7) order the nurse to provide unremunerated service;
17.19(8) censure or reprimand the nurse; or
17.20(9) any other action justified by the facts in the case.
17.21 Sec. 31. Minnesota Statutes 2012, section 148.262, subdivision 2, is amended to read:
17.22 Subd. 2. Automatic suspension. Unless the board orders otherwise, a license to
17.23practice advanced practice, professional, or practical nursing is automatically suspended if:
17.24(1) a guardian of a nurse is appointed by order of a court under sections
17.25to
17.26(2) the nurse is committed by order of a court under chapter 253B; or
17.27(3) the nurse is determined to be mentally incompetent, mentally ill, chemically
17.28dependent, or a person dangerous to the public by a court of competent jurisdiction within
17.29or without this state.
17.30The license remains suspended until the nurse is restored to capacity by a court and,
17.31upon petition by the nurse, the suspension is terminated by the board after a hearing or
17.32upon agreement between the board and the nurse.
17.33 Sec. 32. Minnesota Statutes 2012, section 148.262, subdivision 4, is amended to read:
18.1 Subd. 4. Reissuance. The board may reinstate and reissue a license or registration
18.2certificate to practice advanced practice, professional, or practical nursing, but as a
18.3condition may impose any disciplinary or corrective measure that it might originally have
18.4imposed. Any person whose license or registration has been revoked, suspended, or limited
18.5may have the license reinstated and a new registration issued when, in the discretion of the
18.6board, the action is warranted, provided that the person shall be required by the board to
18.7pay the costs of the proceedings resulting in the revocation, suspension, or limitation of the
18.8license or registration certificate and reinstatement of the license or registration certificate,
18.9and to pay the fee for the current registration period. The cost of proceedings shall
18.10include, but not be limited to, the cost paid by the board to the Office of Administrative
18.11Hearings and the Office of the Attorney General for legal and investigative services, the
18.12costs of a court reporter and witnesses, reproduction of records, board staff time, travel,
18.13and expenses, and board members' per diem reimbursements, travel costs, and expenses.
18.14 Sec. 33. Minnesota Statutes 2013 Supplement, section 148.271, is amended to read:
18.15148.271 EXEMPTIONS.
18.16The provisions of sections
18.17(1) The furnishing of nursing assistance in an emergency.
18.18(2) The practice of advanced practice, professional, or practical nursing by any
18.19legally qualified advanced practice, registered, or licensed practical nurse of another state
18.20who is employed by the United States government or any bureau, division, or agency
18.21thereof while in the discharge of official duties.
18.22(3) The practice of any profession or occupation licensed by the state, other than
18.23advanced practice, professional, or practical nursing, by any person duly licensed to
18.24practice the profession or occupation, or the performance by a person of any acts properly
18.25coming within the scope of the profession, occupation, or license.
18.26(4) The provision of a nursing or nursing-related service by an unlicensed assistive
18.27person who has been delegated or assigned the specific function and is supervised by a
18.28registered nurse or monitored by a licensed practical nurse.
18.29(5) The care of the sick with or without compensation when done in a nursing home
18.30covered by the provisions of section
18.31(6) Professional nursing practice or advanced practice registered nursing practice by
18.32a registered nurse or practical nursing practice by a licensed practical nurse licensed in
18.33another state or territory who is in Minnesota as a student enrolled in a formal, structured
18.34course of study, such as a course leading to a higher degree, certification in a nursing
18.35specialty, or to enhance skills in a clinical field, while the student is practicing in the course.
19.1(7) Professional or practical nursing practice by a student practicing under the
19.2supervision of an instructor while the student is enrolled in a nursing program approved by
19.3the board under section
19.4(8) Advanced practice registered nursing as defined in section
19.55, 10, 11, 13, and 21
19.6Minnesota or another United States jurisdiction and who is enrolled as a student in a
19.7formal graduate education program leading to eligibility for certification and licensure
19.8as an advanced practice registered nurse
19.9
19.10
19.11 Sec. 34. Minnesota Statutes 2012, section 148.281, subdivision 1, is amended to read:
19.12 Subdivision 1. Violations described. It shall be unlawful for any person,
19.13corporation, firm, or association, to:
19.14(1) sell or fraudulently obtain or furnish any nursing diploma, license or record, or
19.15aid or abet therein;
19.16(2) practice advanced practice, professional, or practical nursing
19.17as a public health nurse
19.18
19.19 under cover of any diploma, permit, license, registration certificate, advanced practice
19.20credential, or record illegally or fraudulently obtained or signed or issued unlawfully or
19.21under fraudulent representation;
19.22(3) practice advanced practice, professional, or practical nursing unless the person has
19.23been issued a temporary permit under the provisions of section
19.24and currently registered to do so under the provisions of sections
19.25(4) use the professional title nurse unless duly licensed to practice advanced practice,
19.26 professional, or practical nursing under the provisions of sections
19.27except as authorized by the board by rule;
19.28(5) use any abbreviation or other designation tending to imply licensure as
19.29advanced practice registered nurse, a registered nurse, or a licensed practical nurse unless
19.30duly licensed and currently registered so to practice advanced practice, professional, or
19.31practical nursing under the provisions of sections
19.32by the board by rule;
19.33(6) use any title, abbreviation, or other designation tending to imply certification
19.34as a certified registered nurse as defined in section
19.35certified by a national nurse certification organization;
20.1(7) use any abbreviation or other designation tending to imply registration as a
20.2public health nurse unless duly registered by the board;
20.3(8) practice advanced practice, professional,
20.4practical nursing in a manner prohibited by the board in any limitation of a license or
20.5registration issued under the provisions of sections
20.6(9) practice advanced practice, professional,
20.7practical nursing during the time a license or current registration issued under the
20.8provisions of sections
20.9(10) conduct a nursing program for the education of persons to become advanced
20.10practice registered nurses, registered nurses, or licensed practical nurses unless the
20.11program has been approved by the board; and
20.12(11) knowingly employ persons in the practice of advanced practice, professional,
20.13 or practical nursing who have not been issued a current permit, license, or registration
20.14certificate to practice as a nurse in this state
20.15
20.16
20.17 Sec. 35. Minnesota Statutes 2012, section 148.281, is amended by adding a subdivision
20.18to read:
20.19 Subd. 3. Penalty; advanced practice registered nurses. In addition to subdivision
20.202, an advanced practice registered nurse who practices advanced practice registered
20.21nursing without a current license and certification or recertification shall pay a penalty fee
20.22of $200 for the first month or part of a month and an additional $100 for each subsequent
20.23month or parts of months of practice. The amount of the penalty fee shall be calculated
20.24from the first day the advanced practice registered nurse practiced without a current
20.25advanced practice registered nurse license and certification to the last day of practice
20.26without a current license and certification, or from the first day the advanced practice
20.27registered nurse practiced without a current license and certification on file with the board
20.28until the day the current license and certification is filed with the board.
20.29 Sec. 36. Minnesota Statutes 2012, section 148.283, is amended to read:
20.30148.283 UNAUTHORIZED PRACTICE OF PROFESSIONAL, ADVANCED
20.31PRACTICE REGISTERED, AND PRACTICAL NURSING.
20.32The practice of advanced practice, professional,
20.33practical nursing by any person who has not been licensed to practice advanced practice,
20.34professional, or practical nursing under the provisions of sections
21.1or whose license has been suspended or revoked, or whose registration or national
21.2credential has expired, is hereby declared to be inimical to the public health and welfare
21.3and to constitute a public nuisance. Upon a complaint being made
21.4 or any prosecuting officer, and upon a proper showing of the facts, the district court
21.5of the county where such practice occurred may enjoin such acts and practice. Such
21.6injunction proceeding shall be in addition to, and not in lieu of, all other penalties and
21.7remedies provided by law.
21.8 Sec. 37. [148.2841] ADVANCED PRACTICE NURSING ADVISORY
21.9COMMITTEE.
21.10 (a) The Board of Nursing shall appoint an Advanced Practice Nursing Advisory
21.11Committee consisting of:
21.12 (1) four Minnesota licensed advanced practice registered nurses, consisting of
21.13one nurse practitioner, one nurse-midwife, one clinical nurse specialist, and one nurse
21.14anesthetist;
21.15 (2) two Minnesota licensed physicians who work with advanced practice registered
21.16nurses; and
21.17 (3) one public member.
21.18The committee shall meet at least two times per year. Each member appointment shall be
21.19for a two-year term, with no member serving more than two consecutive terms. The chair
21.20shall rotate among the four advanced practice registered nurse members.
21.21 (b) The advisory committee shall:
21.22 (1) review prescribing trends of advanced practice registered nurses at an aggregate
21.23level;
21.24 (2) review emerging practices and overlap of advanced practice nursing and
21.25specialty medical practices in the six population foci and four categories of advanced
21.26practice registered nurse practice;
21.27 (3) provide recommendations to the Board of Nursing regarding advanced practice
21.28nursing;
21.29 (4) advise the board on advanced practice registered nurse licensure and practice
21.30standards, including emerging practice trends, aggregate prescribing trends, and overlap
21.31of advanced practice registered nursing and medical practices;
21.32 (5) advise the board on distribution of information regarding advanced practice
21.33registered nurse licensure standards; and
21.34 (6) advise the board on issues related to advanced practice registered nurse practice
21.35and regulation.
22.1 Sec. 38. Minnesota Statutes 2012, section 151.01, subdivision 23, is amended to read:
22.2 Subd. 23. Practitioner. "Practitioner" means a licensed doctor of medicine, licensed
22.3doctor of osteopathy duly licensed to practice medicine, licensed doctor of dentistry,
22.4licensed doctor of optometry, licensed podiatrist,
22.5advanced practice registered nurse. For purposes of sections
22.7a physician assistant authorized to prescribe, dispense, and administer under chapter 147A
22.8
22.9
22.10paragraph (b); and
22.11dispense and administer under chapter 150A.
22.12 Sec. 39. Minnesota Statutes 2012, section 152.12, is amended to read:
22.13152.12
22.14 Subdivision 1. Prescribing, dispensing, administering controlled substances in
22.15Schedules II through V. A licensed doctor of medicine, a doctor of osteopathy, duly
22.16licensed to practice medicine, a doctor of dental surgery, a doctor of dental medicine, a
22.17licensed doctor of podiatry, a licensed advanced practice registered nurse, or a licensed
22.18doctor of optometry limited to Schedules IV and V, and in the course of professional
22.19practice only, may prescribe, administer, and dispense a controlled substance included
22.20in Schedules II through V of section
22.21a nurse, an intern or an assistant under the direction and supervision of the doctor, and
22.22may cause a person who is an appropriately certified and licensed health care professional
22.23to prescribe and administer the same within the expressed legal scope of the person's
22.24practice as defined in Minnesota Statutes.
22.25 Subd. 2. Doctor of veterinary medicine. A licensed doctor of veterinary medicine,
22.26in good faith, and in the course of professional practice only, and not for use by a human
22.27being, may prescribe, administer, and dispense a controlled substance included in
22.28Schedules II through V of section
22.29an assistant under the direction and supervision of the doctor.
22.30 Subd. 3. Research project use of controlled substances. Any qualified person
22.31may use controlled substances in the course of a bona fide research project but cannot
22.32administer or dispense such drugs to human beings unless such drugs are prescribed,
22.33dispensed and administered by a person lawfully authorized to do so. Every person
22.34who engages in research involving the use of such substances shall apply annually for
22.35registration by the state Board of Pharmacy and shall pay any applicable fee specified in
23.1section
23.2covered by and has complied with federal laws covering such research projects.
23.3 Subd. 4. Sale of controlled substances not prohibited for certain persons and
23.4entities. Nothing in this chapter shall prohibit the sale to, or the possession of, a controlled
23.5substance in Schedule II, III, IV or V by: Registered drug wholesalers, registered
23.6manufacturers, registered pharmacies, or any licensed hospital or other licensed institutions
23.7wherein sick and injured persons are cared for or treated, or bona fide hospitals wherein
23.8animals are treated; or by licensed pharmacists, licensed doctors of medicine, doctors of
23.9osteopathy duly licensed to practice medicine, licensed doctors of dental surgery, licensed
23.10doctors of dental medicine, licensed doctors of podiatry, licensed doctors of optometry
23.11limited to Schedules IV and V, or licensed doctors of veterinary medicine when such
23.12practitioners use controlled substances within the course of their professional practice only.
23.13Nothing in this chapter shall prohibit the possession of a controlled substance in
23.14Schedule II, III, IV or V by an employee or agent of a registered drug wholesaler, registered
23.15manufacturer, or registered pharmacy, while acting in the course of employment; by a
23.16patient of a licensed doctor of medicine, a doctor of osteopathy duly licensed to practice
23.17medicine, a licensed doctor of dental surgery, a licensed doctor of dental medicine, or a
23.18licensed doctor of optometry limited to Schedules IV and V; or by the owner of an animal
23.19for which a controlled substance has been prescribed by a licensed doctor of veterinary
23.20medicine, when such controlled substances are dispensed according to law.
23.21 Subd. 5. Analytical laboratory not prohibited from providing anonymous
23.22analysis service. Nothing in this chapter shall prohibit an analytical laboratory from
23.23conducting an anonymous analysis service when such laboratory is registered by the
23.24Federal Drug Enforcement Administration, nor prohibit the possession of a controlled
23.25substance by an employee or agent of such analytical laboratory while acting in the course
23.26of employment.
23.27 Sec. 40. APPROPRIATION.
23.28$378,000 in fiscal year 2015 is appropriated from the state government special
23.29revenue fund to the Board of Nursing to implement licensing requirements for Advanced
23.30Practice Registered Nurses. The base for this appropriation is $232,000 in fiscal years
23.312016 and 2017.
23.32 Sec. 41. REPEALER.
23.33Minnesota Statutes 2012, sections 148.171, subdivision 6; 148.235, subdivisions 1,
23.342, 2a, 4, 4a, 4b, 6, and 7; and 148.284, are repealed.
24.1 Sec. 42. EFFECTIVE DATE.
24.2Sections 1 to 39 are effective January 1, 2015.
