As Reported by the House State Government Committee

126th General Assembly Regular Session 2005-2006

Sub. H. B. No. 375

Representatives Flowers, McGregor, J., Evans, D., Brown, Willamowski, Allen, Setzer, Patton, T., Stewart, D. 

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A BILL

To amend sections 4765.05, 4765.11, 4765.16, 4766.01,

1

4766.02, 4766.03, 4766.04, 4766.06, 4766.07,

2

4766.17, and 4766.20 and to enact sections

3

4765.101, 4765.102, 4765.111, 4765.112, 4765.113,

4

4765.114, 4765.115, and 4765.116 of the Revised

5

Code concerning the authority of the State Board

6

of Emergency Medical Services to suspend

7

certificates to practice emergency medical

8

services and revisions to the law governing air

9

medical transportation.

10

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1. That sections 4765.05, 4765.11, 4765.16, 4766.01,	11
4766.02, 4766.03, 4766.04, 4766.06, 4766.07, 4766.17, and 4766.20	12
be amended and sections 4765.101, 4765.102, 4765.111, 4765.112,	13
4765.113, 4765.114, 4765.115, and 4765.116 of the Revised Code be	14
enacted to read as follows:	15

Sec. 4765.05. (A) As used in this section, "prehospital	16
emergency medical services" means an emergency medical services	17
system that provides medical services to patients who require	18
immediate assistance, because of illness or injury, prior to their	19
arrival at an emergency medical facility.	20

(B) The state board of emergency medical services shall	21
divide the state geographically into prehospital emergency medical	22
services regions for purposes of overseeing the delivery of adult	23
and pediatric prehospital emergency medical services. These	24
regions shall consist of the same geographic regions as the health	25
service areas designated by the director of health under section	26
3702.58 of the Revised Code. For each prehospital emergency	27
medical services region, the state board of emergency medical	28
services shall appoint either a physician to serve as the regional	29
director or a physician advisory board to serve as the regional	30
advisory board. The state board of emergency medical services	31
shall specify the duties of each regional director and regional	32
advisory board. Regional directors and members of regional	33
advisory boards shall serve without compensation, but shall be	34
reimbursed for actual and necessary expenses incurred in carrying	35
out duties as regional directors and members of regional advisory	36
boards.	37

(C) Nothing in this section shall be construed to limit in	38
any way the ability of a hospital to determine the market area of	39
that hospital.	40

Sec. 4765.101. (A) The state board of emergency medical	41
services shall investigate any allegation that a person has	42
violated this chapter or a rule adopted under it.	43

Any person may submit to the board a written complaint	44
regarding an alleged violation of this chapter or a rule adopted	45
under it. In the absence of fraud or bad faith, no person	46
submitting a complaint to the board or testifying in an	47
adjudication hearing conducted in accordance with Chapter 119. of	48
the Revised Code with regard to such an alleged violation shall be	49
liable to any person in damages in a civil action as a result of	50
submitting the complaint or providing testimony.	51

(B) In investigating an allegation, the board may do any of	52
the following:	53

(1) Administer oaths;

54

(2) Order the taking of depositions;

55

(3) Issue subpoenas;

56

(4) Compel the attendance of witnesses and production of	57
books, accounts, papers, records, documents, and testimony.	58

(C) A subpoena for patient record information shall not be	59
issued without consultation with the attorney general's office and	60
approval of the executive director of the board. Before issuance	61
of a subpoena for patient record information, the executive	62
director shall determine whether there is probable cause to	63
believe that the complaint filed alleges a violation of this	64
chapter or any rule adopted under it and that the records sought	65
are relevant to the alleged violation and material to the	66
investigation. The subpoena may apply only to records that cover a	67
reasonable period of time surrounding the alleged violation.	68

(D) On failure to comply with any subpoena issued by the	69
board and after reasonable notice to the person being subpoenaed,	70
the board may move, pursuant to the Rules of Civil Procedure, for	71
an order compelling the production of persons or records.	72

(E) A subpoena issued by the board may be served by a	73
sheriff, the sheriff's deputy, or an investigator for the division	74
of emergency medical services of the department of public safety.	75
Service of a subpoena issued by the board may be made by	76
delivering a copy of the subpoena to the person named in it,	77
reading it to the person, or leaving it at the person's usual	78
place of residence. When the person being served is an individual	79
authorized by this chapter to practice emergency medical services,	80
service of the subpoena may be made by certified mail, restricted	81
delivery, return receipt requested, and the subpoena shall be	82
deemed served on the date delivery is made or on the date that the	83
person refuses to accept delivery.	84

Sec. 4765.102. (A) As used in this section, "licensing	85
agency" means any entity that has the authority pursuant to Title	86
XLVII of the Revised Code to issue a license, and any other agency	87
of this or another state, other than the Ohio supreme court, that	88
has the authority to issue a license that authorizes an individual	89
to engage in an occupation or profession. "Licensing agency"	90
includes an administrative officer that has authority to issue a	91
license that authorizes an individual to engage in an occupation	92
or profession.	93

(B) Except as provided in divisions (C) and (D) of this	94
section and section 4765.111 of the Revised Code, all information	95
the state board of emergency medical services receives pursuant to	96
an investigation, including information regarding an alleged	97
violation of this chapter or rules adopted under it or a complaint	98
submitted under division (A) of section 4765.101 of the Revised	99
Code, is confidential, and is not subject to discovery in any	100
civil action, during the course of the investigation and any	101
adjudication proceedings that result from the investigation. Upon	102
completion of the investigation and any resulting adjudication	103
proceedings, the information is a matter of public record for	104
purposes of section 149.43 of the Revised Code.	105

(C) The board may release information otherwise made	106
confidential by division (B) of this section to law enforcement	107
officers or licensing agencies of this or another state that are	108
prosecuting, adjudicating, or investigating the holder of a	109
certificate issued under this chapter or a person who allegedly	110
engaged in the unauthorized provision of emergency medical	111
services.	112

A law enforcement officer or licensing agency with	113
information disclosed by the board under this division shall not	114
divulge the information other than for the purpose of an	115
adjudication by a court or licensing agency to which the subject	116
of the adjudication is a party.	117

(D) If an investigation conducted under section 4765.101 of	118
the Revised Code requires a review of patient records, the	119
investigation and proceedings related to it shall be conducted in	120
such a manner as to protect patient confidentiality. The board	121
shall not make public the name or any other identifying	122
information about a patient unless proper consent is given in	123
accordance with rules adopted by the board. If the patient is less	124
than eighteen years of age, the board shall obtain consent from	125
the patient's parent, guardian, or custodian.	126

Sec. 4765.11.  (A) The state board of emergency medical	127
services shall adopt, and may amend and rescind, rules in	128
accordance with Chapter 119. of the Revised Code and division (C)	129
of this section that establish all of the following:	130

(1) Procedures for its governance and the control of its	131
actions and business affairs;	132

(2) Standards for the performance of emergency medical	133
services by first responders, emergency medical technicians-basic,	134
emergency medical technicians-intermediate, and emergency medical	135
technicians-paramedic;	136

(3) Application fees for certificates of accreditation,	137
certificates of approval, certificates to teach, and certificates	138
to practice, which shall be deposited into the trauma and	139
emergency medical services fund created in section 4513.263 of the	140
Revised Code;	141

(4) Criteria for determining when the application or renewal	142
fee for a certificate to practice may be waived because an	143
applicant cannot afford to pay the fee;	144

(5) Procedures for issuance and renewal of certificates of	145
accreditation, certificates of approval, certificates to teach,	146
and certificates to practice, including any procedures necessary	147
to ensure that adequate notice of renewal is provided in	148
accordance with division (D) of section 4765.30 of the Revised	149
Code;	150

(6) Procedures for suspending or revoking certificates of	151
accreditation, certificates of approval, certificates to teach,	152
and certificates to practice;	153

(7) Grounds for suspension or revocation of a certificate to	154
practice issued under section 4765.30 of the Revised Code and for	155
taking any other disciplinary action against a first responder,	156
EMT-basic, EMT-I, or paramedic;	157

(8) Procedures for taking disciplinary action against a first	158
responder, EMT-basic, EMT-I, or paramedic;	159

(9) Standards for certificates of accreditation and	160
certificates of approval;	161

(10) Qualifications for certificates to teach;

162

(11) Requirements for a certificate to practice;

163

(12) The curricula, number of hours of instruction and	164
training, and instructional materials to be used in adult and	165
pediatric emergency medical services training programs and adult	166
and pediatric emergency medical services continuing education	167
programs;	168

(13) Procedures for conducting courses in recognizing	169
symptoms of life-threatening allergic reactions and in calculating	170
proper dosage levels and administering injections of epinephrine	171
to adult and pediatric patients who suffer life-threatening	172
allergic reactions;	173

(14) Examinations for certificates to practice;

174

(15) Procedures for administering examinations for	175
certificates to practice;	176

(16) Procedures for approving examinations that demonstrate	177
competence to have a certificate to practice renewed without	178
completing an emergency medical services continuing education	179
program;	180

(17) Procedures for granting extensions and exemptions of	181
emergency medical services continuing education requirements;	182

(18) Procedures for approving the additional emergency	183
medical services first responders are authorized by division (C)	184
of section 4765.35 of the Revised Code to perform, EMTs-basic are	185
authorized by division (C) of section 4765.37 of the Revised Code	186
to perform, EMTs-I are authorized by division (B)(5) of section	187
4765.38 of the Revised Code to perform, and paramedics are	188
authorized by division (B)(6) of section 4765.39 of the Revised	189
Code to perform;	190

(19) Standards and procedures for implementing the	191
requirements of section 4765.06 of the Revised Code, including	192
designations of the persons who are required to report information	193
to the board and the types of information to be reported;	194

(20) Procedures for administering the emergency medical	195
services grant program established under section 4765.07 of the	196
Revised Code;	197

(21) Procedures consistent with Chapter 119. of the Revised	198
Code for appealing decisions of the board;	199

(22) Minimum qualifications and peer review and quality	200
improvement requirements for persons who provide medical direction	201
to emergency medical service personnel;	202

(23) The manner in which a patient, or a patient's parent,	203
guardian, or custodian may consent to the board releasing	204
identifying information about the patient under division (D) of	205
section 4765.102 of the Revised Code;	206

(24) Circumstances under which a training program or	207
continuing education program, or portion of either type of	208
program, may be taught by a person who does not hold a certificate	209
to teach issued under section 4765.23 of the Revised Code.	210

(B) The board may adopt, and may amend and rescind, rules in	211
accordance with Chapter 119. of the Revised Code and division (C)	212
of this section that establish the following:	213

(1) Specifications of information that may be collected under	214
the trauma system registry and incidence reporting system created	215
under section 4765.06 of the Revised Code;	216

(2) Standards and procedures for implementing any of the	217
recommendations made by any committees of the board or under	218
section 4765.57 of the Revised Code;	219

(3) Requirements that a person must meet to receive a	220
certificate to practice as a first responder pursuant to division	221
(A)(2) of section 4765.30 of the Revised Code;	222

(4) Any other rules necessary to implement this chapter.

223

(C) In developing and administering rules adopted under this	224
chapter, the state board of emergency medical services shall	225
consult with regional directors and regional physician advisory	226
boards created by section 4765.05 of the Revised Code and	227
emphasize the special needs of pediatric and geriatric patients.	228

(D) Except as otherwise provided in this division, before	229
adopting, amending, or rescinding any rule under this chapter, the	230
board shall submit the proposed rule to the director of public	231
safety for review. The director may review the proposed rule for	232
not more than sixty days after the date it is submitted. If,	233
within this sixty-day period, the director approves the proposed	234
rule or does not notify the board that the rule is disapproved,	235
the board may adopt, amend, or rescind the rule as proposed. If,	236
within this sixty-day period, the director notifies the board that	237
the proposed rule is disapproved, the board shall not adopt,	238
amend, or rescind the rule as proposed unless at least twelve	239
members of the board vote to adopt, amend, or rescind it.	240

This division does not apply to an emergency rule adopted in	241
accordance with section 119.03 of the Revised Code.	242

Sec. 4765.111. Except as provided in this section or sections	243
4765.112 to 4765.116 of the Revised Code, the state board of	244
emergency medical services shall conduct disciplinary proceedings	245
regarding the holder of a certificate issued under this chapter in	246
accordance with rules adopted by the board under section 4765.11	247
of the Revised Code.	248

The board and a holder of a certificate are the parties to a	249
hearing conducted under this chapter. Either party may submit a	250
written request to the other party for a list of witnesses and	251
copies of documents intended to be introduced at the hearing. The	252
request shall be in writing and shall be served not less than	253
thirty-seven days prior to the commencement of the hearing, unless	254
the hearing officer or presiding board member grants an extension	255
of time to make the request. Not later than thirty days before the	256
hearing, the responding party shall provide the requested list of	257
witnesses and copies of documents to the requesting party, unless	258
the hearing officer or presiding board member grants an extension	259
of time to provide the list and copies.	260

Failure to timely provide a list or copies requested in	261
accordance with this section shall result in exclusion from the	262
hearing of the witnesses, testimony, or documents.	263

Sec.  4765.112.  (A) The state board of emergency medical	264
services, by an affirmative vote of the majority of its members,	265
may suspend without a prior hearing a certificate to practice	266
issued under this chapter if the board determines that there is	267
clear and convincing evidence that continued practice by the	268
certificate holder presents a danger of immediate and serious harm	269
to the public and that the certificate holder has done any of the	270
following:	271

(1) Furnished false, fraudulent, or misleading information to	272
the board;	273

(2) Engaged in activities that exceed those permitted by the	274
individual's certificate;	275

(3) In a court of this or any other state or federal court	276
been convicted of, pleaded guilty to, or been the subject of a	277
judicial finding of guilt of, a judicial finding of guilt	278
resulting from a plea of no contest to, or a judicial finding of	279
eligibility for intervention in lieu of conviction for, a felony	280
or for a misdemeanor committed in the course of practice or	281
involving gross immorality or moral turpitude.	282

(B) Immediately following the decision to impose a summary	283
suspension, the board, in accordance with section 119.07 of the	284
Revised Code, shall issue a written order of suspension, cause it	285
to be delivered to the certificate holder, and notify the	286
certificate holder of the opportunity for a hearing. If timely	287
requested by the certificate holder, a hearing shall be conducted	288
in accordance with section 4765.115 of the Revised Code.	289

Sec.  4765.113.  If the state board of emergency medical	290
services imposes a suspension on the basis of a conviction,	291
judicial finding, or plea as described in division (A)(3) of	292
section 4765.112 of the Revised Code that is overturned on appeal,	293
the certificate holder, on exhaustion of the criminal appeal	294
process, may file with the board a petition for reconsideration of	295
the suspension along with appropriate court documents. On receipt	296
of the petition and documents, the board shall reinstate the	297
certificate holder's certificate to practice.	298

Sec. 4765.114.  (A) A certificate to practice emergency	299
medical services issued under this chapter is automatically	300
suspended on the certificate holder's conviction of, plea of	301
guilty to, or judicial finding of guilt of any of the following:	302
aggravated murder, murder, voluntary manslaughter, felonious	303
assault, kidnapping, rape, sexual battery, gross sexual	304
imposition, aggravated arson, aggravated burglary, aggravated	305
robbery, or a substantially equivalent offense committed in this	306
or another jurisdiction. Continued practice after the suspension	307
is practicing without a certificate.	308

(B) If the state board of emergency medical services has	309
knowledge that an automatic suspension has occurred, it shall	310
notify, in accordance with section 119.07 of the Revised Code, the	311
certificate holder of the suspension and of the opportunity for a	312
hearing. If timely requested by the certificate holder, a hearing	313
shall be conducted in accordance with section 4765.115 of the	314
Revised Code.	315

Sec. 4765.115.  (A) A suspension order issued under section	316
4765.112 or automatic suspension under section 4765.114 of the	317
Revised Code is not subject to suspension by a court prior to a	318
hearing under this section or during the pendency of any appeal	319
filed under section 119.12 of the Revised Code.	320

(B) A suspension order issued under section 4765.112 or	321
automatic suspension under section 4765.114 of the Revised Code	322
remains in effect, unless reversed by the state board of emergency	323
medical services, until a final adjudication order issued by the	324
board pursuant to this section becomes effective.	325

(C) Hearings requested pursuant to section 4765.112 or	326
4765.114 of the Revised Code shall be conducted under this section	327
in accordance with Chapter 119. of the Revised Code.	328

(D) A hearing under this section shall be held not later than	329
forty-five days but not earlier than forty days after the	330
certificate holder requests it, unless another date is agreed to	331
by the certificate holder and the board.	332

(E) After completion of an adjudication hearing, the board	333
may adopt, by an affirmative vote of the majority of its members,	334
a final adjudication order that imposes any of the following	335
sanctions:	336

(1) Suspension of the holder's certificate to practice;

337

(2) Revocation of the holder's certificate to practice;

338

(3) Issuance of a written reprimand;

339

(4) A refusal to renew or a limitation on the holder's	340
certificate to practice.	341

The board shall issue its final adjudication order not later	342
than forty-five days after completion of an adjudication hearing.	343
If the board does not issue a final order within that time period,	344
the suspension order is void, but any final adjudication order	345
subsequently issued is not affected.	346

(F) Any action taken by the board under this section	347
resulting in a suspension from practice shall be accompanied by a	348
written statement of the conditions under which the certificate to	349
practice may be reinstated. Reinstatement of a certificate	350
suspended under this section requires an affirmative vote by the	351
majority of the members of the board.	352

(G) When the board revokes or refuses to reinstate a	353
certificate to practice, the board may specify that its action is	354
permanent. An individual subject to permanent action taken by the	355
board is forever ineligible to hold a certificate of the type	356
revoked or refused, and the board shall not accept from the	357
individual an application for reinstatement of the certificate or	358
for a new certificate.	359

Sec. 4765.116.  If a certificate holder subject to a	360
suspension order issued by the state board of emergency medical	361
services under section 4765.112 or an automatic suspension order	362
under section 4765.114 of the Revised Code fails to make a timely	363
request for a hearing, the following apply:	364

(A) In the case of a certificate holder subject to a summary	365
suspension order, the board is not required to hold a hearing, but	366
may adopt, by an affirmative vote of a majority of its members, a	367
final order that contains the board's findings. In the final	368
order, the board may order any of the sanctions listed in division	369
(E) of section 4765.115 of the Revised Code.	370

(B) In the case of a certificate holder subject to an	371
automatic suspension order, the board may adopt, by an affirmative	372
vote of a majority of its members, a final order that permanently	373
revokes the holder's certificate to practice.	374

Sec. 4765.16.  (A) All courses offered through an emergency	375
medical services training program or an emergency medical services	376
continuing education program, other than ambulance driving, shall	377
be developed under the direction of a physician who specializes in	378
emergency medicine. Each course that deals with trauma care shall	379
be developed in consultation with a physician who specializes in	380
trauma surgery. EachExcept as specified by the state board of	381
emergency medical services pursuant to rules adopted under section	382
4765.11 of the Revised Code, each course offered through a	383
training program or continuing education program shall be taught	384
by a person who holds the appropriate certificate to teach issued	385
under section 4765.23 of the Revised Code.	386

(B) A training program for first responders shall meet the	387
standards established in rules adopted by the state board of	388
emergency medical services under section 4765.11 of the Revised	389
Code. The program shall include courses in both of the following	390
areas for at least the number of hours established by the board's	391
rules:	392

(1) Emergency victim care;

393

(2) Reading and interpreting a trauma victim's vital signs.

394

(C) A training program for emergency medical	395
technicians-basic shall meet the standards established in rules	396
adopted by the board under section 4765.11 of the Revised Code.	397
The program shall include courses in each of the following areas	398
for at least the number of hours established by the board's rules:	399

(1) Emergency victim care;

400

(2) Reading and interpreting a trauma victim's vital signs;

401

(3) Triage protocols for adult and pediatric trauma victims;

402

(4) In-hospital training;

403

(5) Clinical training;

404

(6) Training as an ambulance driver.

405

Each operator of a training program for emergency medical	406
technicians-basic shall allow any pupil in the twelfth grade in a	407
secondary school who is at least seventeen years old and who	408
otherwise meets the requirements for admission into such a	409
training program to be admitted to and complete the program and,	410
as part of the training, to ride in an ambulance with emergency	411
medical technicians-basic, emergency medical	412
technicians-intermediate, and emergency medical	413
technicians-paramedic. Each emergency medical service organization	414
shall allow pupils participating in training programs to ride in	415
an ambulance with emergency medical technicians-basic, advanced	416
emergency medical technicians-intermediate, and emergency medical	417
technicians-paramedic.	418

(D) A training program for emergency medical	419
technicians-intermediate shall meet the standards established in	420
rules adopted by the board under section 4765.11 of the Revised	421
Code. The program shall include, or require as a prerequisite, the	422
training specified in division (C) of this section and courses in	423
each of the following areas for at least the number of hours	424
established by the board's rules:	425

(1) Recognizing symptoms of life-threatening allergic	426
reactions and in calculating proper dosage levels and	427
administering injections of epinephrine to persons who suffer	428
life-threatening allergic reactions, conducted in accordance with	429
rules adopted by the board under section 4765.11 of the Revised	430
Code;	431

(2) Venous access procedures;

432

(3) Cardiac monitoring and electrical interventions to	433
support or correct the cardiac function.	434

(E) A training program for emergency medical	435
technicians-paramedic shall meet the standards established in	436
rules adopted by the board under section 4765.11 of the Revised	437
Code. The program shall include, or require as a prerequisite, the	438
training specified in divisions (C) and (D) of this section and	439
courses in each of the following areas for at least the number of	440
hours established by the board's rules:	441

(1) Medical terminology;

442

(2) Venous access procedures;

443

(3) Airway procedures;

444

(4) Patient assessment and triage;

445

(5) Acute cardiac care, including administration of	446
parenteral injections, electrical interventions, and other	447
emergency medical services;	448

(6) Emergency and trauma victim care beyond that required	449
under division (C) of this section;	450

(7) Clinical training beyond that required under division (C)	451
of this section.	452

(F) A continuing education program for first responders,	453
EMTs-basic, EMTs-I, or paramedics shall meet the standards	454
established in rules adopted by the board under section 4765.11 of	455
the Revised Code. A continuing education program shall include	456
instruction and training in subjects established by the board's	457
rules for at least the number of hours established by the board's	458
rules.	459

Sec. 4766.01.  As used in this chapter:

460

(A) "Advanced life support" means treatment described in	461
section 4765.39 of the Revised Code that a paramedic is certified	462
to perform.	463

(B) "Air medical service organizationprogram" means a	464
program operated by a person that provides air medical	465
transportation to the publicwhich furnishes, conducts, maintains,	466
advertises, promotes, or otherwise engages in providing emergency	467
medical services with a rotorcraft air ambulance or fixed wing air	468
ambulance.	469

(C) "Air medical transportation" is the use of a rotorcraft	470
air ambulance or fixed wing air ambulance to provide	471
transportation and advanced life support to seriously ill,	472
injured, wounded, or otherwise incapacitated or helpless	473
individuals who require use of a stretcher from airport to airport	474
or from an emergency scene to a hospital or other medical care	475
settingmeans the transporting of a patient by rotorcraft air	476
ambulance or fixed wing air ambulance with appropriately licensed	477
and certified medical personnel.	478

(D) "Ambulance" means any motor vehicle that is specifically	479
designed, constructed, or modified and equipped and is intended to	480
be used to provide basic life support, intermediate life support,	481
advanced life support, or mobile intensive care unit services and	482
transportation upon the streets or highways of this state of	483
persons who are seriously ill, injured, wounded, or otherwise	484
incapacitated or helpless. "Ambulance" does not include air	485
medical transportation or a vehicle designed and used solely for	486
the transportation of nonstretcher-bound persons, whether	487
hospitalized or handicapped or whether ambulatory or confined to a	488
wheelchair.	489

(E) "Ambulette" means a motor vehicle that is specifically	490
designed, constructed, or modified and equipped and is intended to	491
be used for transportation upon the streets or highways of this	492
state of persons who require use of a wheelchair.	493

(F) "Basic life support" means treatment described in section	494
4765.37 of the Revised Code that an EMT-basic is certified to	495
perform.	496

(G) "Disaster situation" means any condition or situation	497
described by rule of the Ohio medical transportation board as a	498
mass casualty, major emergency, natural disaster, or national	499
emergency.	500

(H) "Emergency medical service organization" means an	501
organization that uses EMTs-basic, EMTs-I, or paramedics, or a	502
combination thereofof EMTs-basic, EMTs-I, and paramedics, to	503
provide medical care to victims of illness or injury. An emergency	504
medical service organization includes, but is not limited to, a	505
commercial ambulance service organization, a hospital, and a	506
funeral home.	507

(I) "EMT-basic," "EMT-I," and "paramedic" have the same	508
meanings as in section 4765.01 of the Revised Code.	509

(J) "Fixed wing air ambulance" means a fixed wing aircraft	510
operatedthat is specifically designed, constructed, or modified	511
and equipped and is intended to be used as a means of air medical	512
transportation.	513

(K) "Intermediate life support" means treatment described in	514
section 4765.38 of the Revised Code that an EMT-I is certified to	515
perform.	516

(L) "Major emergency" means any emergency event that cannot	517
be resolved through the use of locally available emergency	518
resources.	519

(M) "Mass casualty" means an emergency event that results in	520
ten or more persons being injured, incapacitated, made ill, or	521
killed.	522

(N) "Medical emergency" means an unforeseen event affecting	523
an individual in such a manner that a need for immediate care is	524
created.	525

(O) "Mobile intensive care unit" means an ambulance used only	526
for maintaining specialized or intensive care treatment and used	527
primarily for interhospital transports of patients whose	528
conditions require care beyond the scope of a paramedic as	529
provided in section 4765.39 of the Revised Code.	530

(P)(1) "Nonemergency medical service organization" means a	531
person that does both of the following:	532

(a) Provides services to the public on a regular basis for	533
the purpose of transporting individuals who require the use of a	534
wheelchair or are confined to a wheelchair to receive health care	535
services at health care facilities or health care practitioners'	536
offices in nonemergency circumstances;	537

(b) Provides the services for a fee, regardless of whether	538
the fee is paid by the person being transported, a third party	539
payer, as defined in section 3702.51 of the Revised Code, or any	540
other person or government entity.	541

(2) "Nonemergency medical service organization" does not	542
include a health care facility, as defined in section 1751.01 of	543
the Revised Code, that provides ambulette services only to	544
patients of that facility.	545

(P) "Mobile intensive care unit" means an ambulance used only	546
for maintaining specialized or intensive care treatment and used	547
primarily for interhospital transports of patients whose	548
conditions require care beyond the scope of a paramedic as	549
provided in section 4765.39 of the Revised Code.	550

(Q) "Nontransport vehicle" means a motor vehicle operated by	551
a licensed emergency medical service organization not as an	552
ambulance, but as a vehicle for providing services in conjunction	553
with the ambulances operated by the organization or other	554
emergency medical service organizations.	555

(R) "Patient" means any individual who as a result of illness	556
or injury needs medical attention, whose physical or mental	557
condition is such that there is imminent danger of loss of life or	558
significant health impairment, who may be otherwise incapacitated	559
or helpless as a result of a physical or mental condition, or	560
whose physical condition requires the use of a wheelchair.	561

(S) "Rotorcraft air ambulance" means a helicopter or other	562
aircraft capable of vertical takeoffs, vertical landings, and	563
hovering that is specifically designed, constructed, or modified	564
and equipped and is intended to be used as a means of air medical	565
transportation.	566

Sec. 4766.02.  (A) There is hereby created the Ohio medical	567
transportation board, consisting of nine voting members and one	568
nonvoting member, who shall be residents of this state and	569
appointed by the governor with the advice and consent of the	570
senate. Except as provided in division (B) of this section,	571
members shall serve terms of two years. One voting member shall be	572
a member of the Ohio ambulance association; two voting members,	573
one of whom shall be a licensed funeral director, shall be owners	574
or operators of private emergency medical service organizations	575
operating in this state; one voting member shall be a consumer of	576
emergency medical services who is not associated with any public	577
or private emergency medical service organization; one voting	578
member shall be an official with a public emergency medical	579
service organization; two voting members shall be owners or	580
operators of nonemergency medical service organizations that	581
provide ambulette services only,; and two voting members shall be	582
members of the Ohio association of critical care transport, one	583
member representing air-based services and the other representing	584
a ground-based mobile intensive care unit organization. A	585
physician who holds a certificate to practice issued under Chapter	586
4731. of the Revised Code and who is a member of the American	587
college of emergency physicians shall serve as the nonvoting	588
member. The board shall annually select from its membership a	589
chair and a vice-chair to act as chair in the chair's absence.	590

(B) Any member appointed to fill a vacancy occurring prior to	591
the expiration date of the term for which the member's predecessor	592
was appointed shall hold office for the remainder of that term.	593
Every member shall continue in office subsequent to the expiration	594
date of the member's term until the member's successor takes	595
office, or until a period of sixty days has elapsed, whichever	596
occurs first.	597

(C) Five members shall constitute a quorum for the	598
transaction of business, and the affirmative vote of five members	599
is required for the board to take any official action. The board,	600
after notice and hearing, may remove a member by majority vote for	601
malfeasance, misfeasance, or nonfeasance.	602

Members of the board shall be reimbursed for actual and	603
necessary expenses incurred in attending meetings of the board and	604
in the performance of their official duties. The board may hire	605
such employees as are necessary to enable it to execute its	606
duties.	607

(D) The division of emergency medical services within the	608
department of public safety shall provide the board with office	609
space, but the board shall not be a part of the division or the	610
department.	611

(E) The board is the sole supervisory body regarding the	612
licensing of private ambulance service organizations in this	613
state.	614

(F) The board is the sole supervisory body regarding the	615
licensing of private nonemergency medical service organizations in	616
this state.	617

(G) The board is the sole supervisory body regarding the	618
licensing of private air medical service organizationsprograms in	619
this state.	620

Sec. 4766.03.  (A) The Ohio medical transportation board	621
shall adopt rules, in accordance with Chapter 119. of the Revised	622
Code, implementing the requirements of this chapter. The rules	623
shall include provisions relating to the following:	624

(1) Requirements for an emergency medical service	625
organization to receive a permit for an ambulance or nontransport	626
vehicle;	627

(2) Requirements for an emergency medical service	628
organization to receive a license as a basic life-support,	629
intermediate life-support, advanced life-support, or mobile	630
intensive care unit organization;	631

(3) Requirements for a nonemergency medical service	632
organization to receive a permit for an ambulette vehicle;	633

(4) Requirements for a nonemergency medical service	634
organization to receive a license for an ambulette service;	635

(5) Requirements for an air medical service organization	636
program to receive a permit for a rotorcraft air ambulance or	637
fixed wing air ambulance;	638

(6) Requirements for licensure of air medical service	639
organizationsprograms;	640

(7) Forms for applications and renewals of licenses and	641
permits;	642

(8) Requirements for record keeping of service responses made	643
by licensed emergency medical service organizations;	644

(9) Fee amounts for licenses and permits, and their renewals	645
thereof;	646

(10) Inspection requirements for licensees' vehicles or	647
aircraft, records, and physical facilities;	648

(11) Fee amounts for inspections of ambulances, ambulettes,	649
rotorcraft air ambulances, fixed wing air ambulances, and	650
nontransport vehicles;	651

(12) Requirements for ambulances and nontransport vehicles	652
used by licensed emergency medical service organizations, for	653
ambulette vehicles used by licensed nonemergency medical service	654
organizations, and for rotorcraft air ambulances or fixed wing air	655
ambulances used by licensed air medical service organizations	656
programs that specify for each type of vehicle or aircraft the	657
types of equipment that must be carried, the communication systems	658
that must be maintained, and the personnel who must staff the	659
vehicle or aircraft;	660

(13) The level of care each type of emergency medical service	661
organization, nonemergency medical service organization, and air	662
medical service organizationprogram is authorized to provide;	663

(14) Eligibility requirements for employment as an ambulette	664
driver, including grounds for disqualification due to the results	665
of a motor vehicle law violation check, chemical test, or criminal	666
records check. The rule may require that an applicant for	667
employment as an ambulette driver provide a set of fingerprints to	668
law enforcement authorities if the applicant comes under final	669
consideration for employment.	670

(15) Any other rules that the board determines necessary for	671
the implementation and enforcement of this chapter.	672

(B) In the rules for ambulances and nontransport vehicles	673
adopted under division (A)(12) of this section, the board may	674
establish requirements that vary according to whether the	675
emergency medical service organization using the vehicles is	676
licensed as a basic life-support, intermediate life-support,	677
advanced life-support, or mobile intensive care unit organization.	678

(C) A mobile intensive care unit that is not dually certified	679
to provide advanced life-support and meets the requirements of the	680
rules adopted under this section is not required to carry	681
immobilization equipment, including board splint kits, traction	682
splints, backboards, backboard straps, cervical immobilization	683
devices, cervical collars, stairchairsstair chairs, folding cots,	684
or other types of immobilization equipment determined by the board	685
to be unnecessary for mobile intensive care units.	686

A mobile intensive care unit is exempt from the emergency	687
medical technician staffing requirements of division (B) of	688
section 4765.43 of the Revised Code when it is staffed by at least	689
one physician or registered nurse and another person, designated	690
by a physician, who holds a valid license or certificate to	691
practice in a health care profession, and when at least one of the	692
persons staffing the mobile intensive care unit is a registered	693
nurse whose training meets or exceeds the training required for a	694
paramedic.	695

Sec. 4766.04.  (A) Except as otherwise provided in this	696
chapter, no person shall furnish, operate, conduct, maintain,	697
advertise, engage in, or propose or profess to engage in the	698
business or service in this state of transporting persons who are	699
seriously ill, injured, or otherwise incapacitated or who require	700
the use of a wheelchair or are confined to a wheelchair unless the	701
person is licensed pursuant to this section.	702

(B) To qualify for a license as a basic life-support,	703
intermediate life-support, advanced life-support, or mobile	704
intensive care unit organization, an emergency medical service	705
organization shall do all of the following:	706

(1) Apply for a permit for each ambulance and nontransport	707
vehicle owned or leased as provided in section 4766.07 of the	708
Revised Code;	709

(2) Meet all requirements established in rules adopted by the	710
Ohio medical transportation board regarding ambulances and	711
nontransport vehicles, including requirements pertaining to	712
equipment, communications systems, staffing, and level of care the	713
particular organization is permitted to render;	714

(3) Maintain the appropriate type and amount of insurance as	715
specified in section 4766.06 of the Revised Code;	716

(4) Meet all other requirements established under rules	717
adopted by the board for the particular license.	718

(C) To qualify for a license to provide ambulette service, a	719
nonemergency medical service organization shall do all of the	720
following:	721

(1) Apply for a permit for each ambulette owned or leased as	722
provided in section 4766.07 of the Revised Code;	723

(2) Meet all requirements established in rules adopted by the	724
Ohio medical transportation board regarding ambulettes, including	725
requirements pertaining to equipment, communication systems,	726
staffing, and level of care the organization is permitted to	727
render;	728

(3) Maintain the appropriate type and amount of insurance as	729
specified in section 4766.06 of the Revised Code;	730

(4) Meet all other requirements established under rules	731
adopted by the board for the license.	732

(D) To qualify for a license to provide air medical	733
transportation, anthe operator of an air medical service	734
organizationprogram shall do all of the following:	735

(1) Apply for a permit for each rotorcraft air ambulance and	736
fixed wing air ambulance owned or leased as provided in section	737
4766.07 of the Revised Code;	738

(2) Meet all requirements established in rules adopted by the	739
Ohio medical transportation board regarding rotorcraft air	740
ambulances and fixed wing air ambulances, including requirements	741
pertaining to equipment, communication systems, staffing, and	742
level of care the organizationprogram is permitted to render;	743

(3) Maintain the appropriate type and amount of insurance as	744
specified in section 4766.06 of the Revised Code;	745

(4) Meet all other requirements established under rules	746
adopted by the board for the license.	747

(E) An emergency medical service organization that applies	748
for a license as a basic life-support, intermediate life-support,	749
advanced life-support, or mobile intensive care unit organization;	750
a nonemergency medical service organization that applies for a	751
license to provide ambulette service; or an operator of an air	752
medical service organizationprogram that applies for a license to	753
provide air medical transportation shall submit a completed	754
application to the board, on a form provided by the board for each	755
particular license, together with the appropriate fees established	756
under section 4766.05 of the Revised Code. The application form	757
shall include all of the following:	758

(1) The name and business address of the operator of the	759
organization or program for which licensure is sought;	760

(2) The name under which the applicant will operate the	761
organization or program;	762

(3) A list of the names and addresses of all officers and	763
directors of the organization or program;	764

(4) For emergency medical service organizations and	765
nonemergency medical service organizations, a description of each	766
vehicle to be used, including the make, model, year of	767
manufacture, mileage, vehicle identification number, and the color	768
scheme, insignia, name, monogram, or other distinguishing	769
characteristics to be used to designate the applicant's vehicle;	770

(5) For air medical service organizationsprograms using	771
fixed wing air ambulances, a description of each aircraft to be	772
used, including the make, model, year of manufacture, and aircraft	773
Hobbs meter hour reading;	774

(6) For air medical service organizationsprograms using	775
rotorcraft air ambulances, a description of each aircraft to be	776
used, including the make, model, year of manufacture, aircraft	777
Hobbs meter hour reading, aircraft identification number, and the	778
color scheme, insignia, name, monogram, or other distinguishing	779
characteristics to be used to designate the applicant's rotorcraft	780
air ambulance;	781

(7) The location and description of each place from which the	782
organization or program will operate;	783

(8) A description of the geographic area to be served by the	784
applicant;	785

(9) Any other information the board, by rule, determines	786
necessary.	787

(F) Within sixty days after receiving a completed application	788
for licensure as a basic life-support, intermediate life-support,	789
advanced life-support, or mobile intensive care unit organization;	790
an ambulette service; or an air medical service organization	791
program, the board shall approve or deny the application. The	792
board shall deny an application if it determines that the	793
applicant does not meet the requirements of this chapter or any	794
rules adopted under it. The board shall send notice of the denial	795
of an application by certified mail to the applicant. The	796
applicant may request a hearing within ten days after receipt of	797
the notice. If the board receives a timely request, it shall hold	798
a hearing in accordance with Chapter 119. of the Revised Code.	799

(G) If an applicant or licensee operates or plans to operate	800
an organization in more than one location under the same or	801
different identities, the applicant or licensee shall apply for	802
and meet all requirements for licensure or renewal of a license,	803
other than payment of a license fee or renewal fee, for operating	804
the organization at each separate location. An applicant or	805
licensee that operates or plans to operate under the same	806
organization identity in separate locations shall pay only a	807
single license fee.	808

(H) An emergency medical service organization that wishes to	809
provide ambulette services to the public must apply for a separate	810
license under division (C) of this section.	811

(I) Each license issued under this section and each permit	812
issued under section 4766.07 of the Revised Code expires one year	813
after the date of issuance and may be renewed in accordance with	814
the standard renewal procedures of Chapter 4745. of the Revised	815
Code, except that a license or permit issued in 1998 or in 1999	816
prior to June 30, 1999, shall expire two years after the date of	817
issuance. An application for renewal shall include the license or	818
permit renewal fee established under section 4766.05 of the	819
Revised Code. An applicant for renewal of a permit also shall	820
submit to the board proof of an annual inspection of the vehicle	821
or aircraft for which permit renewal is sought. The board shall	822
renew a license if the applicant meets the requirements for	823
licensure and shall renew a permit if the applicant and vehicle or	824
aircraft meet the requirements to maintain a permit for that	825
vehicle or aircraft.	826

(J) Each licensee shall maintain accurate records of all	827
service responses conducted. The records shall be maintained on	828
forms prescribed by the board and shall contain information as	829
specified by rule by the board.	830

Sec. 4766.06.  (A)(1) Every emergency medical service	831
organization and nonemergency medical service organization	832
licensee under this chapter shall furnish adequate evidence of	833
liability insurance coverage, in an amount of not less than five	834
hundred thousand dollars per occurrence and not less than five	835
hundred thousand dollars in the aggregate, for any cause for which	836
the licensee would be liable.	837

(2) Every operator of an air medical service organization	838
licenseeprogram licensed under this chapter shall furnish	839
adequate evidence of liability insurance coverage, in an amount	840
not less than twenty million dollars per occurrence and not less	841
than twenty million dollars in the aggregate, for any cause for	842
which the licensee would be liable.	843

(B) In addition to the insurance requirements of division (A)	844
of this section, every licensee shall carry bodily injury and	845
property damage insurance with solvent and responsible insurers	846
licensed to do business in this state for any loss or damage	847
resulting from any occurrence arising out of or caused by the	848
operation or use of any ambulance, ambulette, rotorcraft air	849
ambulance, fixed wing air ambulance, or nontransport vehicle. The	850
insurance shall insure each vehicle or aircraft for the sum of not	851
less than one hundred thousand dollars for bodily injury to or	852
death of any one person arising out of any one accident and the	853
sum of not less than three hundred thousand dollars for bodily	854
injury to or death of more than one person in any one accident and	855
for the sum of fifty thousand dollars for damage to property	856
arising from any one accident.	857

(C) Each policy or contract of insurance issued shall provide	858
for the payment and satisfaction of any financial judgment entered	859
against the licensee and any person operating the vehicle or	860
aircraft and for a thirty-day cancellation notice to the board.	861

Sec. 4766.07.  (A) Each emergency medical service	862
organization, nonemergency medical service organization, and	863
operator of an air medical service organizationprogram subject to	864
licensure under this chapter shall possess a valid permit for each	865
ambulance, ambulette, rotorcraft air ambulance, fixed wing air	866
ambulance, and nontransport vehicle it owns or leases that is or	867
will be used by the licensee to perform the services permitted by	868
the license. Each licensee and license applicant shall submit the	869
appropriate fee and an application for a permit for each	870
ambulance, ambulette, rotorcraft air ambulance, fixed wing air	871
ambulance, and nontransport vehicle to the Ohio medical	872
transportation board on forms provided by the board. The	873
application shall include documentation that the vehicle or	874
aircraft meets the appropriate standards set by the board, that	875
the vehicle or aircraft has been inspected pursuant to division	876
(C) of this section, that the permit applicant maintains insurance	877
as provided in section 4766.06 of the Revised Code, and that the	878
vehicle or aircraft and permit applicant meet any other	879
requirements established under rules adopted by the board.	880

(B)(1) Within sixty days after receiving a completed	881
application for a permit, the board shall issue or deny the	882
permit. The board shall deny an application if it determines that	883
the permit applicant, vehicle, or aircraft does not meet the	884
requirements of this chapter and the rules adopted under it that	885
apply to permits for ambulances, ambulettes, rotorcraft air	886
ambulances, fixed wing air ambulances, and nontransport vehicles.	887
The board shall send notice of the denial of an application by	888
certified mail to the permit applicant. The permit applicant may	889
request a hearing within ten days after receipt of the notice. If	890
the board receives a timely request, it shall hold a hearing in	891
accordance with Chapter 119. of the Revised Code.	892

(2) If the board issues the vehicle permit for an ambulance,	893
ambulette, or nontransport vehicle, it also shall issue a decal,	894
in a form prescribed by rule, to be displayed on the rear window	895
of the vehicle. The board shall not issue a decal until all of the	896
requirements for licensure and permit issuance have been met.	897

(3) If the board issues the aircraft permit for a rotorcraft	898
air ambulance or fixed wing air ambulance, it also shall issue a	899
decal, in a form prescribed by rule, to be displayed on the left	900
fuselage aircraft window in a manner that complies with all	901
applicable federal aviation regulations. The board shall not issue	902
a decal until all of the requirements for licensure and permit	903
issuance have been met.	904

(C) In addition to any other requirements that the board	905
establishes by rule, a licensee or license applicant applying for	906
an initial vehicle or aircraft permit under division (A) of this	907
section shall submit to the board the vehicle or aircraft for	908
which the permit is sought. Thereafter, a licensee shall annually	909
submit to the board each vehicle or aircraft for which a permit	910
has been issued.	911

(1) The board shall conduct a physical inspection of an	912
ambulance, ambulette, or nontransport vehicle to determine its	913
roadworthiness and compliance with standard motor vehicle	914
requirements.	915

(2) The board shall conduct a physical inspection of the	916
medical equipment, communication system, and interior of an	917
ambulance to determine the operational condition and safety of the	918
equipment and the ambulance's interior and to determine whether	919
the ambulance is in compliance with the federal requirements for	920
ambulance construction that were in effect at the time the	921
ambulance was manufactured, as specified by the general services	922
administration in the various versions of its publication titled	923
"federal specification for the star-of-life ambulance,	924
KKK-A-1822."	925

(3) The board shall conduct a physical inspection of the	926
equipment, communication system, and interior of an ambulette to	927
determine the operational condition and safety of the equipment	928
and the ambulette's interior and to determine whether the	929
ambulette is in compliance with state requirements for ambulette	930
construction. The board shall determine by rule requirements for	931
the equipment, communication system, interior, and construction of	932
an ambulette.	933

(4) The board shall conduct a physical inspection of the	934
medical equipment, communication system, and interior of a	935
rotorcraft air ambulance or fixed wing air ambulance to determine	936
the operational condition and safety of the equipment and the	937
aircraft's interior.	938

(5) The board shall issue a certificate to the applicant for	939
each vehicle or aircraft that passes the inspection and may assess	940
a fee for each inspection, as established by the board.	941

(6) The board shall adopt rules regarding the implementation	942
and coordination of inspections. The rules may permit the board to	943
contract with a third party to conduct the inspections required of	944
the board under this section.	945

Sec. 4766.17. (A) An air medical service organizationprogram	946
licensed under this chapter that uses a rotorcraft air ambulance	947
shall do both of the following:	948

(1) Use at a minimum both of the following to provide	949
advanced life support to seriously ill, injured, wounded, or	950
otherwise incapacitated or helpless individuals who require use of	951
a stretcher:	952

(a) A paramedica physician or registered nurse, both as	953
defined in section 4765.01 of the Revised Code;	954

(b) One, and one other person, designated by the medical	955
director of the air medical service organizationprogram, who	956
holds a current, valid certificate or license to practice a health	957
care profession in this state.;	958

(2) Employ as a medical director an individual who holds a	959
current, valid certificate issued under Chapter 4731. of the	960
Revised Code authorizing the practice of medicine and surgery or	961
osteopathic medicine and surgery.	962

(B) An air medical program licensed under this chapter that	963
uses a fixed wing air ambulance shall do both of the following:	964

(1) Use at a minimum a person, designated by the medical	965
director of the air medical program, who holds a current, valid	966
certificate or license to practice a health care profession in the	967
state;	968

(2) Employ as a medical director a person who holds a	969
current, valid certificate issued under Chapter 4731. of the	970
Revised Code.	971

(C) The medical director employed by a licensed air medical	972
service organizationprogram pursuant to division (A)(2) of this	973
section is ultimately responsible for the medical care provided to	974
each patient by the organizationprogram.	975

Sec. 4766.20. The Ohio medical transportation board may	976
create committees to review and make recommendations regarding	977
medical transportation services provided in this state. A	978
committee created under this section may receive information about	979
medical transportation services provided in this state from	980
emergency medical service organizations, nonemergency medical	981
service organizations, air medical service organizationsprograms,	982
experts in the field of medical transportation, and other entities	983
or individuals designated by the board.	984

A committee created under this section shall meet all of the	985
following requirements:	986

(A) Be composed of at least one member of the board and any	987
experts in the field of medical transportation designated by the	988
board;	989

(B) Not exceed a total of six members;

990

(C) Cease to exist at the pleasure of the board;

991

(D) Meet any other requirements established by the board.

992

Section 2. That existing sections 4765.05, 4765.11, 4765.16,	993
4766.01, 4766.02, 4766.03, 4766.04, 4766.06, 4766.07, 4766.17, and	994
4766.20 of the Revised Code are hereby repealed.	995