As Introduced

127th General Assembly Regular Session 2007-2008

H. B. No. 580

Representative Adams 

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A BILL

To amend section 4759.02 and to enact sections

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4783.01 to 4783.06 of the Revised Code regarding

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the provision of complementary or alternative

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health care services.

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

Section 1. That section 4759.02 be amended and sections	5
4783.01, 4783.02, 4783.03, 4783.04, 4783.05, and 4783.06 of the	6
Revised Code be enacted to read as follows:	7

Sec. 4759.02.  (A) Except as otherwise provided in this	8
section or in section 4759.10 of the Revised Code, no person shall	9
practice, offer to practice, or hold himselfthe person's self	10
forth to practice dietetics unless hethe person has been licensed	11
under section 4759.06 of the Revised Code.	12

(B) Except for a licensed dietitian holding an inactive	13
license who does not practice or offer to practice dietetics, or a	14
person licensed under section 4759.06 of the Revised Code, or as	15
otherwise provided in this section or in section 4759.10 of the	16
Revised Code:	17

(1) No, no person shall use the title "dietitian"; and

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(2) No person except for a person licensed under Chapters	19
4701. to 4755. of the Revised Code, when acting within the scope	20
of their practice, shall use any other title, designation, words,	21
letters, abbreviation, or insignia or combination of any title,	22
designation, words, letters, abbreviation, or insignia tending to	23
indicate that the person is practicing dietetics."	24

(C) Notwithstanding division (B) of this section, a person	25
who is a dietitian registered by the commission on dietetic	26
registration and who does not violate division (A) of this section	27
may use the designation "registered dietitian" and the	28
abbreviation "R.D."	29

(D) Division (A) of this section does not apply to:

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(1) A student enrolled in an academic program that is in	31
compliance with division (A)(5) of section 4759.06 of the Revised	32
Code who is engaging in the practice of dietetics under the	33
supervision of a dietitian licensed under section 4759.06 of the	34
Revised Code or a dietitian registered by the commission on	35
dietetic registration, as part of the academic program;	36

(2) A person participating in the pre-professional experience	37
required by division (A)(6) of section 4759.06 of the Revised	38
Code;	39

(3) A person holding a limited permit under division (F) of	40
section 4759.06 of the Revised Code.	41

(E) Divisions (A) and (B) of this section do not apply to a	42
person who performs no more than fifteen days of dietetic practice	43
in the state and who meets at least one of the following	44
requirements:	45

(1) The Ohio board of dietetics determines that hethe person	46
is licensed in another state with licensure requirements	47
equivalent to or more stringent than those set forth in this	48
chapter;	49

(2) HeThe person is a dietitian registered by the commission	50
on dietetic registration and resides in another state that either	51
has no dietitian licensure requirements or has licensure	52
requirements less stringent than those set forth in this chapter.	53

Sec. 4783.01.  As used in this chapter:

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(A) "Complementary or alternative health care practitioner"	55
means an individual who provides complementary or alternative	56
health care services to a client and who either is not a	57
licensed health care professional or, if an individual is a	58
licensed health care professional, the individual is not holding	59
the individual's self out as a licensed health care professional	60
when providing services.	61

(B) "Complementary or alternative health care services"	62
means the broad domain of health care and healing practices that	63
does not include any of the prohibited activities described in	64
division (A) of section 4783.03 of the Revised Code and that may	65
or may not be provided in addition to or in place of prevailing	66
or conventional treatment options.	67

(C) "Dangerous drug," "drug," and "licensed health	68
professional authorized to prescribe drugs" have the same	69
meanings as in section 4729.01 of the Revised Code.	70

(D) "Homeopathic remedy" means any substance that is labeled	71
as being homeopathic and to which either of the following applies:	72

(1) The substance is listed in the homeopathic pharmacopoeia	73
of the United States or an addendum or supplement to it.	74

(2) The substance is defined as a drug under the federal	75
"Food and Drug Cosmetic Act," 21 U.S.C. 321(g)(1)(A), and is	76
regulated pursuant to that federal act.	77

(E) "Licensed health care professional" means an individual	78
who holds a current, valid license or certificate issued under	79
Chapter 4715., 4723., 4725., 4729., 4730., 4731., 4732., 4734.,	80
4755., 4759., 4762., or 4779. of the Revised Code.	81

(F) "Board" means the state dental board; board of nursing;	82
state board of optometry; state board of pharmacy; state medical	83
board; state board of psychology; state chiropractic board; Ohio	84
occupational therapy, physical therapy, and athletic trainers	85
board; Ohio board of dietetics; or state board of orthotics,	86
prosthetics, and pedorthics.	87

Sec. 4783.02.  It is hereby declared to be the public policy	88
of the state that the provision of complementary or alternative	89
health care services enhances the health and welfare of the	90
residents of this state.	91

Sec. 4783.03.  (A) No complementary or alternative health	92
care practitioner shall do any of the following:	93

(1) Perform surgery or any other procedure that punctures	94
the skin, except for pricking a finger for screening purposes;	95

(2) Perform any adjustment of the articulation of the joints	96
or spine of any individual;	97

(3) Use or recommend any procedure involving ionizing	98
radiation as defined in section 4773.01 of the Revised Code;	99

(4) Knowingly provide a medical diagnosis of a disease;

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(5) Provide diagnosis or treatment of a physical or mental	101
health condition of an individual knowing that the diagnosis or	102
treatment directly poses to that individual a recognizable and	103
imminent risk of significant and discernible physical or mental	104
harm;	105

(6) Knowingly counsel any individual to disregard the	106
instruction or counsel of a licensed health care professional;	107

(7) Knowingly counsel any individual to discontinue use of	108
any dangerous drug, drug, or therapeutic device prescribed to the	109
individual by a licensed health professional authorized to	110
prescribe drugs;	111

(8) Administer or prescribe any dangerous drug except	112
homeopathic remedies, device that requires a prescription from a	113
licensed health professional authorized to prescribe drugs to	114
obtain, or medical oxygen;	115

(9) Hold out, state, indicate, advertise, or otherwise imply	116
to any person that the practitioner is licensed by this state to	117
practice as a licensed health care professional unless the	118
practitioner is licensed;	119

(10) Perform or provide enteral or parenteral nutrition;

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(11) Promise a cure;

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(12) Set a fracture of a bone;

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(13) Provide or perform an abortion;

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(14) Insert intrauterine devices;

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(15) Provide complementary or alternative health care	125
services to either of the following persons unless the	126
practitioner has the consent of the person's parent or legal	127
guardian:	128

(a) Any person who is less than eighteen years of age and who	129
is not emancipated;	130

(b) Any person that the practitioner knows to be mentally	131
incompetent.	132

(B) Notwithstanding any provision of the Revised Code to the	133
contrary, a complementary or alternative health care practitioner	134
may refer to the practitioner's self using a title or	135
qualification conferred on the practitioner by virtue of degrees,	136
training, experience, credentials, or other qualifications	137
attained by the practitioner.	138

Sec. 4783.04.  A complementary or alternative health care	139
practitioner shall do all of the following:	140

(A) Prior to providing complementary or alternative health	141
care services to an individual for the first time, provide a	142
plainly worded, written document to the recipient of the services	143
that discloses all of the following information:	144

(1) The nature of the treatment to be provided;

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(2) The degrees, training, experience, credentials, or other	146
qualifications held by the practitioner with regard to the	147
services to be provided;	148

(3) If the practitioner is not a licensed health care	149
professional, the following statement, printed clearly in not less	150
than eleven-point font, that reads verbatim:	151

"I AM NOT LICENSED BY THE STATE OF OHIO AS A HEALTH CARE	152
PROFESSIONAL. I AM NOT A DOCTOR OR PHYSICIAN. THE STATE HAS NOT	153
ADOPTED ANY EDUCATIONAL OR TRAINING REQUIREMENTS FOR UNLICENSED	154
COMPLEMENTARY OR ALTERNATIVE HEALTH CARE PRACTITIONERS."	155

(4) If the practitioner also is a licensed health care	156
professional, the following statement, printed clearly in not less	157
than eleven-point font, that reads:	158

"I HOLD THE FOLLOWING LICENSES AND CERTIFICATIONS ISSUED BY	159
THE STATE OF OHIO: (list of licenses and certificates). HOWEVER, I	160
AM PROVIDING MY SERVICES TO YOU AS A COMPLEMENTARY OR ALTERNATIVE	161
HEALTH CARE PRACTITIONER AND I AM NOT PROVIDING SERVICES AS A	162
LICENSED HEALTH CARE PROFESSIONAL. THE STATE HAS NOT ADOPTED ANY	163
EDUCATION OR TRAINING REQUIREMENTS FOR UNLICENSED COMPLEMENTARY	164
OR ALTERNATIVE HEALTH CARE PRACTITIONERS."	165

(5) A statement that describes the following:

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(a) Any agreement or other arrangement between the	167
practitioner and another complementary or alternative health care	168
practitioner or between the practitioner and a licensed health	169
care professional whereby that practitioner derives a financial	170
or other benefit;	171

(b) The nature of any benefit resulting from an agreement or	172
arrangement described in division (A)(5)(a) of this section.	173

(B) Obtain from the recipient of the services a written	174
acknowledgment that the recipient has been provided a document	175
disclosing all the information required to be disclosed pursuant	176
to division (A) of this section;	177

(C) Provide the recipient of the services with a copy of the	178
acknowledgment described in division (B) of this section;	179

(D) Maintain the acknowledgment described in division (B) of	180
this section from every recipient of the practitioner's services	181
for at least two years after the date that a recipient receives	182
services from the practitioner for the final time.	183

Sec. 4783.05. (A) Notwithstanding any provision of the	184
Revised Code to the contrary, a complementary or alternative	185
health care practitioner is not considered to have violated a	186
provision of this chapter or Chapter 4715., 4723., 4725., 4729.,	187
4730., 4731., 4732., 4734., 4755., 4759., 4762., or 4779. of the	188
Revised Code unless the individual commits an act described in	189
division (A) of section 4783.03 of the Revised Code or fails to	190
comply with section 4783.04 of the Revised Code.	191

(B) A board that receives a complaint against a practitioner	192
shall do both of the following:	193

(1) If the board determines that the subject matter of the	194
complaint falls under the jurisdiction of another board, refer the	195
complaint to the appropriate board.	196

(2) If the board determines that the subject matter of the	197
complaint falls under the board's jurisdiction, conduct a	198
preliminary investigation of the complaint to determine whether	199
the practitioner who is the subject of the complaint violated	200
division (A) of section 4783.03 or failed to comply with section	201
4783.04 of the Revised Code.	202

(C) If the preliminary investigation conducted by a board	203
pursuant to division (B) of this section reveals no significant	204
evidence that a violation or failure to comply occurred, the	205
board shall not pursue the matter further.	206

(D) If the preliminary investigation conducted by a board	207
pursuant to division (B) of this section regarding an alleged	208
violation of section 4783.04 of the Revised Code by a practitioner	209
reveals significant evidence that a practitioner has violated that	210
section, the board shall notify the practitioner of the finding of	211
the board and request the practitioner to comply with the	212
requirements specified in that section.	213

(E) If the preliminary investigation conducted by a board	214
pursuant to division (B) of this section regarding an alleged	215
violation of section 4783.03 of the Revised Code by a practitioner	216
reveals significant evidence that the practitioner has engaged in	217
an activity specified in that section, or if a practitioner fails	218
to comply with a board's request issued under division (D) of this	219
section, the board shall address the matter in the same manner the	220
board addresses a matter involving an individual who engages in an	221
activity for which the individual must have a license or	222
certificate, including referring the matter to the appropriate	223
prosecutorial authority.	224

Sec. 4783.06. Nothing in this chapter modifies or changes the	225
scope of practice of any licensee or certificate holder under	226
Chapter 4715., 4723., 4725., 4729., 4730., 4731., 4732., 4734.,	227
4755., 4759., 4762., or 4779. of the Revised Code, nor does it	228
alter in any way the provisions of those chapters that prohibit	229
fraud and the exploitation of patients and that require licensees	230
and certificate holders to practice within their respective	231
standards of care.	232

This chapter does not apply to a person who is exempt from	233
the requirement to obtain a license or certificate pursuant to	234
Chapter 4715., 4723., 4725., 4729., 4730., 4731., 4732., 4734.,	235
4755., 4759., 4762., or 4779. of the Revised Code and by that	236
exemption is permitted to engage in the activities in which the	237
person wishes to engage.	238

This chapter does not apply to an individual authorized to	239
practice medicine and surgery or osteopathic medicine and surgery	240
under Chapter 4731. of the Revised Code who is engaging in	241
activities specified in section 4731.227 of the Revised Code in	242
accordance with that section.	243

Section 2.  That existing section 4759.02 of the Revised Code	244
is hereby repealed.	245

Section 3. (A) This act shall be known as the "Ohio Consumer	246
Health Freedom Act."	247

(B) The General Assembly of the State of Ohio finds the	248
following:	249

(1) Based upon studies, research, and public policy	250
declarations by state governments, including a proclamation issued	251
by the Governor of Florida, and laws enacted by the states of	252
California, Idaho, Minnesota, and Rhode Island, it is evident that	253
millions of Americans and hundreds of thousands of Ohioans	254
presently receive a substantial amount of their health care from	255
providers of complementary or alternative health care services.	256

(2) Numerous studies –– including a comprehensive report by	257
the National Institutes of Medicine and a study published by the	258
New England Journal of Medicine –– demonstrate that individuals	259
who utilize complementary or alternative health care services	260
vary widely in age, ethnicity, socioeconomic status, and other	261
demographic categories.	262

(3) Notwithstanding the widespread use of complementary or	263
alternative health care services, for Ohioans, access to such	264
services has been hampered and the flow of information about such	265
services inhibited.	266

(4) Ohio has failed to openly acknowledge the existence of	267
health care therapies and methods that are not suitable for	268
regulation or licensure under the state's policing power. As a	269
result, the providers of such services, who are not licensed by	270
the state as health care professionals, cannot openly offer their	271
services for fear of fines, penalties, or the restriction of	272
their practice based on charges that such providers are in	273
violation of Ohio's professional licensing laws, notwithstanding	274
that the delivery of health care services by such providers has	275
not been shown to pose a recognizable and imminent risk of	276
significant and discernible harm to the public's health, safety,	277
or welfare.	278

(5) Ohio's failure to acknowledge complementary or	279
alternative health care services impedes the beneficial exchange	280
of health care information between a complementary or alternative	281
health care practitioner and the practitioner's clients and	282
between a complementary or alternative health care practitioner	283
and a licensed health care professional with regard to their	284
mutual patients and clients.	285

(6) The practice of complementary or alternative health care	286
services is suitable and desirable for the public health and	287
welfare.	288

(C) The General Assembly hereby acknowledges Ohioans' desire	289
for broader access to complementary or alternative health care	290
therapies. The General Assembly recognizes that the public health	291
and welfare will be enhanced by a public policy that declares that	292
a profession or occupation is not subject to regulation by the	293
state unless, and then only to the extent that, the profession or	294
occupation has been shown to pose a recognizable and imminent risk	295
of significant and discernible harm to the health, safety, or	296
welfare of the public.	297

(D) The General Assembly hereby declares, based on the	298
findings of this section, its intent to allow and protect the	299
performance and delivery of, and public access to, complementary	300
or alternative health care services in Ohio, subject only to the	301
limitations and restrictions provided in this act.	302