|
|
To amend sections 185.01, 185.03, 185.05, 2105.35, | 1 |
2108.40, 2133.211, 3719.06, 4730.06, 4730.09, | 2 |
4730.38, 4730.39, 4730.40, 4730.41, 4730.42, | 3 |
4730.44, 4730.45, 4755.48, 4755.481, 4765.01, | 4 |
4765.35, 4765.36, 4765.37, 4765.38, 4765.39, | 5 |
4765.49, and 4765.51, to enact sections 4730.411, | 6 |
5111.0212, and 5111.051, and to repeal section | 7 |
4730.401 of the Revised Code to modify the laws | 8 |
governing physician assistants. | 9 |
Section 1. That sections 185.01, 185.03, 185.05, 2105.35, | 10 |
2108.40, 2133.211, 3719.06, 4730.06, 4730.09, 4730.38, 4730.39, | 11 |
4730.40, 4730.41, 4730.42, 4730.44, 4730.45, 4755.48, 4755.481, | 12 |
4765.01, 4765.35, 4765.36, 4765.37, 4765.38, 4765.39, 4765.49, and | 13 |
4765.51 be amended and sections 4730.411, 5111.0212, and 5111.051 | 14 |
of the Revised Code be enacted to read as follows: | 15 |
Sec. 185.01. As used in this chapter: | 16 |
(A) "Advanced practice nurse" has the same meaning as in | 17 |
section 4723.01 of the Revised Code. | 18 |
(B) "Collaboration" has the same meaning as in section | 19 |
4723.01 of the Revised Code. | 20 |
(C) "Health care coverage and quality council" means the | 21 |
entity established under section 3923.90 of the Revised Code. | 22 |
(D) "Patient centered medical home education advisory group" | 23 |
means the entity established under section 185.03 of the Revised | 24 |
Code to implement and administer the patient centered medical home | 25 |
education pilot project. | 26 |
(E) "Patient centered medical home education pilot project" | 27 |
means the pilot project established under section 185.02 of the | 28 |
Revised Code. | 29 |
(F) "Physician assistant" means an individual who holds a | 30 |
valid certificate to practice as a physician assistant issued | 31 |
under Chapter 4730. of the Revised Code. | 32 |
Sec. 185.03. (A) The patient centered medical home education | 33 |
advisory group is hereby created for the purpose of implementing | 34 |
and administering the patient centered medical home pilot project. | 35 |
The advisory group shall develop a set of expected outcomes for | 36 |
the pilot project. | 37 |
(B) The advisory group shall consist of the following voting | 38 |
members: | 39 |
(1) One individual with expertise in the training and | 40 |
education of primary care physicians who is appointed by the dean | 41 |
of the university of Toledo college of medicine; | 42 |
(2) One individual with expertise in the training and | 43 |
education of primary care physicians who is appointed by the dean | 44 |
of the Boonshoft school of medicine at Wright state university; | 45 |
(3) One individual with expertise in the training and | 46 |
education of primary care physicians who is appointed by the | 47 |
president and dean of the northeast Ohio medical university; | 48 |
(4) One individual with expertise in the training and | 49 |
education of primary care physicians who is appointed by the dean | 50 |
of the Ohio university college of osteopathic medicine; | 51 |
(5) Two individuals appointed by the governing board of the | 52 |
Ohio academy of family physicians; | 53 |
(6) One individual appointed by the governing board of the | 54 |
Ohio chapter of the American college of physicians; | 55 |
(7) One individual appointed by the governing board of the | 56 |
American academy of pediatrics; | 57 |
(8) One individual appointed by the governing board of the | 58 |
Ohio osteopathic association; | 59 |
(9) One individual with expertise in the training and | 60 |
education of advanced practice nurses who is appointed by the | 61 |
governing board of the Ohio council of deans and directors of | 62 |
baccalaureate and higher degree programs in nursing; | 63 |
(10) One individual appointed by the governing board of the | 64 |
Ohio nurses association; | 65 |
(11) One individual appointed by the governing board of the | 66 |
Ohio association of advanced practice nurses; | 67 |
(12) One individual appointed by the governing board of the | 68 |
Ohio association of physician assistants; | 69 |
(13) A member of the health care coverage and quality | 70 |
council, other than the advisory group member specified in | 71 |
division (C)(2) of this section, appointed by the superintendent | 72 |
of insurance. | 73 |
(C) The advisory group shall consist of the following | 74 |
nonvoting, ex officio members: | 75 |
(1) The executive director of the state medical board, or the | 76 |
director's designee; | 77 |
(2) The executive director of the board of nursing or the | 78 |
director's designee; | 79 |
(3) The chancellor of the Ohio board of regents, or the | 80 |
chancellor's designee; | 81 |
(4) The individual within the department of job and family | 82 |
services who serves as the director of medicaid, or the director's | 83 |
designee; | 84 |
(5) The director of health or the director's designee. | 85 |
(D) Advisory group members who are appointed shall serve at | 86 |
the pleasure of their appointing authorities. Terms of office of | 87 |
appointed members shall be three years, except that a member's | 88 |
term ends if the pilot project ceases operation during the | 89 |
member's term. | 90 |
Vacancies shall be filled in the manner provided for original | 91 |
appointments. | 92 |
Members shall serve without compensation, except to the | 93 |
extent that serving on the advisory group is considered part of | 94 |
their regular employment duties. | 95 |
(E) The advisory group shall select from among its members a | 96 |
chairperson and vice-chairperson. The advisory group may select | 97 |
any other officers it considers necessary to conduct its business. | 98 |
A majority of the members of the advisory group constitutes a | 99 |
quorum for the transaction of official business. A majority of a | 100 |
quorum is necessary for the advisory group to take any action, | 101 |
except that when one or more members of a quorum are required to | 102 |
abstain from voting as provided in division (C)(1)(d) or (C)(2)(c) | 103 |
of section 185.05 of the Revised Code, the number of members | 104 |
necessary for a majority of a quorum shall be reduced accordingly. | 105 |
The advisory group shall meet as necessary to fulfill its | 106 |
duties. The times and places for the meetings shall be selected by | 107 |
the chairperson. | 108 |
(F) Sections 101.82 to 101.87 of the Revised Code do not | 109 |
apply to the advisory group. | 110 |
Sec. 185.05. (A) The patient centered medical home education | 111 |
advisory group shall accept applications for inclusion in the | 112 |
patient centered medical home education pilot project from primary | 113 |
care practices with educational affiliations, as determined by the | 114 |
advisory group, with one or more of the following: | 115 |
(1) The Boonshoft school of medicine at Wright state | 116 |
university; | 117 |
(2) The university of Toledo college of medicine; | 118 |
(3) The northeastern Ohio universities colleges of medicine | 119 |
and pharmacy; | 120 |
(4) The Ohio university college of osteopathic medicine; | 121 |
(5) The college of nursing at the university of Toledo; | 122 |
(6) The Wright state university college of nursing and | 123 |
health; | 124 |
(7) The college of nursing at Kent state university; | 125 |
(8) The university of Akron college of nursing; | 126 |
(9) The school of nursing at Ohio university. | 127 |
(B)(1) Subject to division (C)(1) of this section, the | 128 |
advisory group shall select for inclusion in the pilot project not | 129 |
more than the following number of physician practices: | 130 |
(a) Ten practices affiliated with the Boonshoft school of | 131 |
medicine at Wright state university; | 132 |
(b) Ten practices affiliated with the university of Toledo | 133 |
college of medicine; | 134 |
(c) Ten practices affiliated with the northeastern Ohio | 135 |
universities colleges of medicine and pharmacy; | 136 |
(d) Ten practices affiliated with the centers for osteopathic | 137 |
research and education of the Ohio university college of | 138 |
osteopathic medicine. | 139 |
(2) Subject to division (C)(2) of this section, the advisory | 140 |
group shall select for inclusion in the pilot project not less | 141 |
than the following number of advanced practice nurse primary care | 142 |
practices: | 143 |
(a) One practice affiliated with the college of nursing at | 144 |
the university of Toledo; | 145 |
(b) One practice affiliated with the Wright state university | 146 |
college of nursing and health; | 147 |
(c) One practice affiliated with the college of nursing at | 148 |
Kent state university or the university of Akron college of | 149 |
nursing; | 150 |
(d) One practice affiliated with the school of nursing at | 151 |
Ohio university. | 152 |
(C)(1) All of the following apply with respect to the | 153 |
selection of physician practices under division (B) of this | 154 |
section: | 155 |
(a) The advisory group shall strive to select physician | 156 |
practices in such a manner that the pilot project includes | 157 |
of the following: | 158 |
(i) A diverse range of primary care specialties, including | 159 |
practices specializing in pediatrics, geriatrics, general internal | 160 |
medicine, or family medicine; | 161 |
(ii) Practices that utilize physician assistants as part of | 162 |
the health care delivery system. | 163 |
(b) When evaluating an application, the advisory group shall | 164 |
consider the percentage of patients in the physician practice who | 165 |
are part of a medically underserved population, including medicaid | 166 |
recipients and individuals without health insurance. | 167 |
(c) The advisory group shall select not fewer than six | 168 |
practices that serve rural areas of this state, as those areas are | 169 |
determined by the advisory group. | 170 |
(d) A member of the advisory group shall abstain from | 171 |
participating in any vote taken regarding the selection of a | 172 |
physician practice if the member would receive any financial | 173 |
benefit from having the practice included in the pilot project. | 174 |
(2) All of the following apply with respect to the selection | 175 |
of advanced practice nurse primary care practices under division | 176 |
(B) of this section: | 177 |
(a) When evaluating an application, the advisory group shall | 178 |
consider the percentage of patients in the advanced practice nurse | 179 |
primary care practice who are part of a medically underserved | 180 |
population, including medicaid recipients and individuals without | 181 |
health insurance. | 182 |
(b) If the advisory group determines that it has not received | 183 |
an application from a sufficiently qualified advanced practice | 184 |
nurse primary care practice affiliated with a particular | 185 |
institution specified in division (B)(2) of this section, the | 186 |
advisory group shall make the selections required under that | 187 |
division in such a manner that the greatest possible number of | 188 |
those institutions are represented in the pilot project. To be | 189 |
selected in this manner, a practice remains subject to the | 190 |
eligibility requirements specified in division (B) of section | 191 |
185.06 of the Revised Code. As specified in division (B)(2) of | 192 |
this section, the number of practices selected for inclusion in | 193 |
the pilot project shall be at least four. | 194 |
(c) A member of the advisory group shall abstain from | 195 |
participating in any vote taken regarding the selection of an | 196 |
advanced practice nurse primary care practice if the member would | 197 |
receive any financial benefit from having the practice included in | 198 |
the pilot project. | 199 |
Sec. 2105.35. (A)(1) A person is dead if the person has been | 200 |
determined to be and pronounced dead pursuant to standards | 201 |
established under section 2108.40 of the Revised Code. | 202 |
(2) A physician or physician assistant who makes a | 203 |
determination and pronouncement of death in accordance with | 204 |
section 2108.40 of the Revised Code and any person who acts in | 205 |
good faith in reliance on a determination and pronouncement of | 206 |
death made | 207 |
2108.40 of the Revised Code by a physician or physician assistant | 208 |
are each entitled to the immunity conveyed by
| 209 |
2108.40 of the Revised Code. | 210 |
(B) A certified or authenticated copy of a death certificate | 211 |
purporting to be issued by an official or agency of the place | 212 |
where the death of a person purportedly occurred is prima-facie | 213 |
evidence of the fact, place, date, and time of the person's death | 214 |
and the identity of the decedent. | 215 |
(C) A certified or authenticated copy of any record or report | 216 |
of a domestic or foreign governmental agency that a person is | 217 |
missing, detained, dead, or alive is prima-facie evidence of the | 218 |
status and of the dates, circumstances, and places disclosed by | 219 |
the record or report. | 220 |
(D) In the absence of prima-facie evidence of death under | 221 |
division (B) or (C) of this section, the fact of death may be | 222 |
established by clear and convincing evidence, including | 223 |
circumstantial evidence. | 224 |
(E) Except as provided in division (F) of this section, a | 225 |
presumption of the death of a person arises: | 226 |
(1) When the person has disappeared and been continuously | 227 |
absent from the person's place of last domicile for a five-year | 228 |
period without being heard from during the period; | 229 |
(2) When the person has disappeared and been continuously | 230 |
absent from the person's place of last domicile without being | 231 |
heard from and was at the beginning of the person's absence | 232 |
exposed to a specific peril of death, even though the absence has | 233 |
continued for less than a five-year period. | 234 |
(F) When a person who is on active duty in the armed services | 235 |
of the United States has been officially determined to be absent | 236 |
in a status of "missing" or "missing in action," a presumption of | 237 |
death arises when the head of the federal department concerned has | 238 |
made a finding of death pursuant to the "Federal Missing Persons | 239 |
Act," 80 Stat. 625 (1966), 37 U.S.C.A. 551, as amended. | 240 |
(G) In the absence of evidence disputing the time of death | 241 |
stipulated on a document described in division (B) or (C) of this | 242 |
section, a document described in either of those divisions that | 243 |
stipulates a time of death one hundred twenty hours or more after | 244 |
the time of death of another person, however the time of death of | 245 |
the other person is determined, establishes by clear and | 246 |
convincing evidence that the person survived the other person by | 247 |
one hundred twenty hours. | 248 |
(H) The provisions of divisions (A) to (G) of this section | 249 |
are in addition to any other provisions of the Revised Code, the | 250 |
Rules of Criminal Procedure, or the Rules of Evidence that pertain | 251 |
to the determination of death and status of a person. | 252 |
Sec. 2108.40. (A) An individual is dead if the individual has | 253 |
sustained either irreversible cessation of circulatory and | 254 |
respiratory functions or irreversible cessation of all functions | 255 |
of the brain, including the brain stem, as determined in | 256 |
accordance with accepted medical standards. If the respiratory and | 257 |
circulatory functions of a person are being artificially | 258 |
sustained, under accepted medical standards a determination that | 259 |
death has occurred is made by a physician by observing and | 260 |
conducting a test to determine that the irreversible cessation of | 261 |
all functions of the brain has occurred. | 262 |
(B) The determination and pronouncement of an individual's | 263 |
death may be made by a physician or, subject to divisions (C) and | 264 |
(D) of this section, a physician assistant. | 265 |
(C) A physician assistant may determine and pronounce an | 266 |
individual's death only if the individual's respiratory and | 267 |
circulatory functions are not being artificially sustained and, at | 268 |
the time the determination and pronouncement of death is made, | 269 |
either or both of the following conditions are met: | 270 |
(1) The individual was receiving care in one of the | 271 |
following: | 272 |
(a) A nursing home, residential care facility, or home for | 273 |
the aging licensed under Chapter 3721. of the Revised Code; | 274 |
(b) A county home or district home operated pursuant to | 275 |
Chapter 5155. of the Revised Code; | 276 |
(c) A residential facility licensed under section 5123.19 of | 277 |
the Revised Code. | 278 |
(2) The physician assistant is providing or supervising the | 279 |
individual's care through a hospice care program licensed under | 280 |
Chapter 3712. of the Revised Code or any other entity that | 281 |
provides palliative care. | 282 |
(D) If a physician assistant determines and pronounces an | 283 |
individual's death, both of the following conditions apply: | 284 |
(1) The physician assistant shall not complete any portion of | 285 |
the individual's death certificate. | 286 |
(2) The physician assistant shall notify the individual's | 287 |
attending physician of the determination and pronouncement in | 288 |
order for the physician to fulfill the physician's duties under | 289 |
section 3705.16 of the Revised Code. The physician assistant shall | 290 |
provide the notification within a reasonable period of time | 291 |
following the determination and pronouncement of the individual's | 292 |
death. | 293 |
(E)(1) A physician who makes a determination and | 294 |
pronouncement of death in accordance with this section and | 295 |
accepted medical standards is not liable for | 296 |
to, any of the following for the physician's acts, the acts of a | 297 |
physician assistant who makes a determination and pronouncement of | 298 |
death in accordance with this section and accepted medical | 299 |
standards, or the acts of others based on a determination and | 300 |
pronouncement of death in accordance with this section and | 301 |
accepted medical standards: | 302 |
(a) Damages in any civil action | 303 |
(b) Prosecution in any criminal proceeding | 304 |
305 | |
306 |
(c) Professional disciplinary action pursuant to Chapter | 307 |
4731. of the Revised Code. | 308 |
(2) A physician assistant who makes a determination and | 309 |
pronouncement of death in accordance with this section and | 310 |
accepted medical standards is not liable for, or subject to, any | 311 |
of the following for the physician assistant's acts or the acts of | 312 |
others based on that determination and pronouncement: | 313 |
(a) Damages in any civil action; | 314 |
(b) Prosecution in any criminal proceeding; | 315 |
(c) Professional disciplinary action pursuant to Chapter | 316 |
4730. of the Revised Code. | 317 |
(3) Any person who acts in good faith in reliance on a | 318 |
determination and pronouncement of death made by a physician or | 319 |
physician assistant in accordance with this section and accepted | 320 |
medical standards is not liable for damages in any civil action or | 321 |
subject to prosecution in any criminal proceeding for the person's | 322 |
actions. | 323 |
Sec. 2133.211. A person who holds a certificate of authority | 324 |
to practice as a certified nurse practitioner or clinical nurse | 325 |
specialist issued under section 4723.42 of the Revised Code may | 326 |
take any action that may be taken by an attending physician under | 327 |
sections 2133.21 to 2133.26 of the Revised Code and has the | 328 |
immunity provided by section 2133.22 of the Revised Code if the | 329 |
action is taken pursuant to a standard care arrangement with a | 330 |
collaborating physician. | 331 |
A person who holds a certificate to practice as a physician | 332 |
assistant issued under Chapter 4730. of the Revised Code may take | 333 |
any action that may be taken by an attending physician under | 334 |
sections 2133.21 to 2133.26 of the Revised Code and has the | 335 |
immunity provided by section 2133.22 of the Revised Code if the | 336 |
action is taken pursuant to a physician supervisory plan approved | 337 |
pursuant to section 4730.17 of the Revised Code or the policies of | 338 |
a health care facility in which the physician assistant is | 339 |
practicing. | 340 |
Sec. 3719.06. (A)(1) A licensed health professional | 341 |
authorized to prescribe drugs, if acting in the course of | 342 |
professional practice, in accordance with the laws regulating the | 343 |
professional's practice, and in accordance with rules adopted by | 344 |
the state board of pharmacy, may, except as provided in division | 345 |
(A)(2) or (3) of this section, do the following: | 346 |
(a) Prescribe schedule II, III, IV, and V controlled | 347 |
substances; | 348 |
(b) Administer or personally furnish to patients schedule II, | 349 |
III, IV, and V controlled substances; | 350 |
(c) Cause schedule II, III, IV, and V controlled substances | 351 |
to be administered under the prescriber's direction and | 352 |
supervision. | 353 |
(2) A licensed health professional authorized to prescribe | 354 |
drugs who is a clinical nurse specialist, certified nurse-midwife, | 355 |
or certified nurse practitioner is subject to both of the | 356 |
following: | 357 |
(a) A schedule II controlled substance may be prescribed only | 358 |
for a patient with a terminal condition, as defined in section | 359 |
2133.01 of the Revised Code, only if the nurse's collaborating | 360 |
physician initially prescribed the substance for the patient, and | 361 |
only in an amount that does not exceed the amount necessary for | 362 |
the patient's use in a single, twenty-four-hour period. | 363 |
(b) No schedule II controlled substance shall be personally | 364 |
furnished to any patient. | 365 |
(3) A licensed health professional authorized to prescribe | 366 |
drugs who is a physician assistant | 367 |
368 | |
following: | 369 |
(a) A controlled substance | 370 |
personally furnished only if it is included in the | 371 |
physician-delegated prescriptive authority granted to the | 372 |
physician assistant in accordance with Chapter 4730. of the | 373 |
Revised Code. | 374 |
(b) A schedule II controlled substance may be prescribed only | 375 |
in accordance with division (B)(4) of section 4730.41 and section | 376 |
4730.411 of the Revised Code. | 377 |
(c) No schedule II controlled substance shall be personally | 378 |
furnished to any patient. | 379 |
(B) No licensed health professional authorized to prescribe | 380 |
drugs shall prescribe, administer, or personally furnish a | 381 |
schedule III anabolic steroid for the purpose of human muscle | 382 |
building or enhancing human athletic performance and no pharmacist | 383 |
shall dispense a schedule III anabolic steroid for either purpose, | 384 |
unless it has been approved for that purpose under the "Federal | 385 |
Food, Drug, and Cosmetic Act," 52 Stat. 1040 (1938), 21 U.S.C.A. | 386 |
301, as amended. | 387 |
(C) Each written prescription shall be properly executed, | 388 |
dated, and signed by the prescriber on the day when issued and | 389 |
shall bear the full name and address of the person for whom, or | 390 |
the owner of the animal for which, the controlled substance is | 391 |
prescribed and the full name, address, and registry number under | 392 |
the federal drug abuse control laws of the prescriber. If the | 393 |
prescription is for an animal, it shall state the species of the | 394 |
animal for which the controlled substance is prescribed. | 395 |
Sec. 4730.06. (A) The physician assistant policy committee | 396 |
of the state medical board shall review, and shall submit to the | 397 |
board recommendations concerning, all of the following: | 398 |
(1) Requirements for issuance of certificates to practice as | 399 |
a physician assistant, including the educational requirements that | 400 |
must be met to receive a certificate to practice; | 401 |
(2) Existing and proposed rules pertaining to the practice of | 402 |
physician assistants, the supervisory relationship between | 403 |
physician assistants and supervising physicians, and the | 404 |
administration and enforcement of this chapter; | 405 |
(3) | 406 |
the Revised Code, physician-delegated prescriptive authority for | 407 |
physician assistants | 408 |
the physician assistant formulary the board adopts pursuant to | 409 |
division (A)(1) of section | 410 |
(4) Application procedures and forms for certificates to | 411 |
practice as a physician assistant, physician supervisory plans, | 412 |
and supervision agreements; | 413 |
(5) Fees required by this chapter for issuance and renewal of | 414 |
certificates to practice as a physician assistant; | 415 |
(6) Criteria to be included in applications submitted to the | 416 |
board for approval of physician supervisory plans, including | 417 |
criteria to be included in applications for approval to delegate | 418 |
to physician assistants the performance of special services; | 419 |
(7) Criteria to be included in supervision agreements | 420 |
submitted to the board for approval and renewal of the board's | 421 |
approval; | 422 |
(8) Any issue the board asks the committee to consider. | 423 |
(B) In addition to the matters that are required to be | 424 |
reviewed under division (A) of this section, the committee may | 425 |
review, and may submit to the board recommendations concerning, | 426 |
either or both of the following: | 427 |
(1) Quality assurance activities to be performed by a | 428 |
supervising physician and physician assistant under a quality | 429 |
assurance system established pursuant to division (F) of section | 430 |
4730.21 of the Revised Code; | 431 |
(2) The development and approval of one or more model | 432 |
physician supervisory plans and one or more models for a special | 433 |
services portion of the one or more model physician supervisory | 434 |
plans. The committee may submit recommendations for model plans | 435 |
that reflect various medical specialties. | 436 |
(C) The board shall take into consideration all | 437 |
recommendations submitted by the committee. Not later than ninety | 438 |
days after receiving a recommendation from the committee, the | 439 |
board shall approve or disapprove the recommendation and notify | 440 |
the committee of its decision. If a recommendation is disapproved, | 441 |
the board shall inform the committee of its reasons for making | 442 |
that decision. The committee may resubmit the recommendation after | 443 |
addressing the concerns expressed by the board and modifying the | 444 |
disapproved recommendation accordingly. Not later than ninety days | 445 |
after receiving a resubmitted recommendation, the board shall | 446 |
approve or disapprove the recommendation. There is no limit on the | 447 |
number of times the committee may resubmit a recommendation for | 448 |
consideration by the board. | 449 |
(D)(1) Except as provided in division (D)(2) of this section, | 450 |
the board may not take action regarding a matter that is subject | 451 |
to the committee's review under division (A) or (B) of this | 452 |
section unless the committee has made a recommendation to the | 453 |
board concerning the matter. | 454 |
(2) If the board submits to the committee a request for a | 455 |
recommendation regarding a matter that is subject to the | 456 |
committee's review under division (A) or (B) of this section, and | 457 |
the committee does not provide a recommendation before the | 458 |
sixty-first day after the request is submitted, the board may take | 459 |
action regarding the matter without a recommendation. | 460 |
Sec. 4730.09. (A) Under a physician supervisory plan approved | 461 |
under section 4730.17 of the Revised Code, a physician assistant | 462 |
may provide any or all of the following services without approval | 463 |
by the state medical board as special services: | 464 |
(1) Obtaining comprehensive patient histories; | 465 |
(2) Performing physical examinations, including audiometry | 466 |
screening, routine visual screening, and pelvic, rectal, and | 467 |
genital-urinary examinations, when indicated; | 468 |
(3) Ordering, performing, or ordering and performing routine | 469 |
diagnostic procedures, as indicated; | 470 |
(4) Identifying normal and abnormal findings on histories, | 471 |
physical examinations, and commonly performed diagnostic studies; | 472 |
(5) Assessing patients and developing and implementing | 473 |
treatment plans for patients; | 474 |
(6) Monitoring the effectiveness of therapeutic | 475 |
interventions; | 476 |
(7) Exercising physician-delegated prescriptive authority | 477 |
pursuant to a certificate to prescribe issued under this chapter; | 478 |
(8) Carrying out or relaying the supervising physician's | 479 |
orders for the administration of medication, to the extent | 480 |
permitted by law; | 481 |
(9) Providing patient education; | 482 |
(10) Instituting and changing orders on patient charts; | 483 |
(11) Performing developmental screening examinations on | 484 |
children with regard to neurological, motor, and mental functions; | 485 |
(12) Performing wound care management, suturing minor | 486 |
lacerations and removing the sutures, and incision and drainage of | 487 |
uncomplicated superficial abscesses; | 488 |
(13) Removing superficial foreign bodies; | 489 |
(14) Administering intravenous fluids; | 490 |
(15) Inserting a foley or cudae catheter into the urinary | 491 |
bladder and removing the catheter; | 492 |
(16) | 493 |
| 494 |
| 495 |
supervising physician; | 496 |
| 497 |
(18) Removing birth control devices; | 498 |
| 499 |
| 500 |
| 501 |
posterior iliac crest; | 502 |
| 503 |
iliac crest; | 504 |
| 505 |
| 506 |
of nephrostomy tubes; | 507 |
| 508 |
including intrauterine devices, diaphragms, and cervical caps; | 509 |
| 510 |
| 511 |
| 512 |
| 513 |
| 514 |
| 515 |
| 516 |
completion of an advanced cardiac life support course; | 517 |
| 518 |
| 519 |
light-based medical devices for the purpose of hair removal; | 520 |
| 521 |
anesthesia, as defined in section 4730.091 of the Revised Code; | 522 |
| 523 |
| 524 |
(38) Prescribing physical therapy or referring a patient to a | 525 |
physical therapist for the purpose of receiving physical therapy; | 526 |
(39) Ordering occupational therapy or referring a patient to | 527 |
an occupational therapist for the purpose of receiving | 528 |
occupational therapy; | 529 |
(40) Taking any action that may be taken by an attending | 530 |
physician under sections 2133.21 to 2133.26 of the Revised Code, | 531 |
as specified in section 2133.211 of the Revised Code; | 532 |
(41) Performing other services that are within the | 533 |
supervising physician's normal course of practice and expertise, | 534 |
if the services are included in any model physician supervisory | 535 |
plan approved under section 4730.06 of the Revised Code or the | 536 |
services are designated by the board by rule or other means as | 537 |
services that are not subject to approval as special services. | 538 |
(B) Under the policies of a health care facility, the | 539 |
services a physician assistant may provide are limited to the | 540 |
services the facility has authorized the physician assistant to | 541 |
provide for the facility. The services a health care facility may | 542 |
authorize a physician assistant to provide for the facility | 543 |
include the following: | 544 |
(1) Any or all of the services specified in division (A) of | 545 |
this section; | 546 |
(2) Assisting in surgery in the health care facility; | 547 |
(3) Any other services permitted by the policies of the | 548 |
health care facility, except that the facility may not authorize a | 549 |
physician assistant to perform a service that is prohibited by | 550 |
this chapter. | 551 |
Sec. 4730.38. (A) | 552 |
553 | |
the physician assistant policy committee of the state medical | 554 |
board shall, at such times the committee determines to be | 555 |
necessary, submit to the board | 556 |
regarding physician-delegated prescriptive authority for physician | 557 |
assistants. The committee's recommendations shall address | 558 |
of the following: | 559 |
(1) Policy and procedures regarding physician-delegated | 560 |
prescriptive authority, including the issuance of certificates to | 561 |
prescribe under this chapter; | 562 |
(2) | 563 |
564 | |
565 | |
566 | |
567 | |
568 |
| 569 |
board in fulfilling its duty to adopt rules governing | 570 |
physician-delegated prescriptive authority, including the issuance | 571 |
of certificates to prescribe. | 572 |
(B) | 573 |
574 | |
575 | |
576 | |
577 | |
578 | |
day of June following the effective date of this amendment, the | 579 |
committee shall review the physician assistant formulary the board | 580 |
adopts pursuant to division (A)(1) of section 4730.39 of the | 581 |
Revised Code and, to the extent it determines to be necessary, | 582 |
submit recommendations proposing changes to the formulary. | 583 |
(C) Recommendations submitted under this section are subject | 584 |
to the procedures and time frames specified in division (C) of | 585 |
section 4730.06 of the Revised Code. | 586 |
Sec. 4730.39. (A) | 587 |
588 | |
589 | |
590 | |
of the following: | 591 |
(1) Adopt a formulary listing the drugs and therapeutic | 592 |
devices by class and specific generic nomenclature that a | 593 |
physician may include in the physician-delegated prescriptive | 594 |
authority granted to a physician assistant who holds a certificate | 595 |
to prescribe under this chapter; | 596 |
(2) Adopt rules governing physician-delegated prescriptive | 597 |
authority for physician assistants, including the issuance of | 598 |
certificates to prescribe under this chapter. | 599 |
(B) The board's rules governing physician-delegated | 600 |
prescriptive authority adopted pursuant to division (A)(2) of this | 601 |
section shall be adopted in accordance with Chapter 119. of the | 602 |
Revised Code and shall establish all of the following: | 603 |
(1) | 604 |
605 | |
606 | |
607 | |
608 | |
609 |
| 610 |
physician assistant is required to complete to receive a | 611 |
certificate to prescribe; | 612 |
| 613 |
of certificates to prescribe to physician assistants; | 614 |
| 615 |
of the provisional period that a physician assistant is required | 616 |
to complete pursuant to section 4730.45 of the Revised Code and | 617 |
for determining whether a physician assistant has successfully | 618 |
completed the provisional period; | 619 |
| 620 |
device to perform or induce an abortion; | 621 |
| 622 |
assistant in personally furnishing samples of drugs or complete or | 623 |
partial supplies of drugs to patients under section 4730.43 of the | 624 |
Revised Code; | 625 |
| 626 |
to implement the provisions of this chapter regarding | 627 |
physician-delegated prescriptive authority and the issuance of | 628 |
certificates to prescribe. | 629 |
| 630 |
recommendations submitted by the physician assistant policy | 631 |
committee pursuant to sections 4730.06 and 4730.38 of the Revised | 632 |
Code, the board shall | 633 |
the | 634 |
submitted recommendations: | 635 |
(a) The formulary the board adopts under division (A)(1) of | 636 |
this section; | 637 |
(b) The rules the board adopts under division (A)(2) of this | 638 |
section regarding physician-delegated prescriptive authority. | 639 |
(2) Based on its review, the board shall make any necessary | 640 |
modifications to the formulary or rules. | 641 |
| 642 |
643 | |
644 | |
645 | |
646 | |
647 | |
648 | |
649 | |
650 |
Sec. 4730.40. (A) Subject to | 651 |
of this section, the physician assistant formulary | 652 |
adopted by the state medical board | 653 |
4730.39 of the Revised Code
| 654 |
655 | |
656 | |
657 | |
658 | |
the following drugs: | 659 |
(1) Schedule II, III, IV, and V controlled substances; | 660 |
(2) Drugs that under state or federal law may be dispensed | 661 |
only pursuant to a prescription by a licensed health professional | 662 |
authorized to prescribe drugs, as defined in section 4729.01 of | 663 |
the Revised Code; | 664 |
(3) Any drug that is not a dangerous drug, as defined in | 665 |
section 4729.01 of the Revised Code. | 666 |
(B) The formulary | 667 |
the board shall not include, and shall specify that it does not | 668 |
include, | 669 |
| 670 |
| 671 |
abortion. | 672 |
| 673 |
674 | |
675 | |
676 | |
677 | |
678 | |
679 | |
680 | |
681 | |
682 | |
683 |
Sec. 4730.41. (A) A certificate to prescribe issued under | 684 |
this chapter authorizes a physician assistant to prescribe and | 685 |
personally furnish drugs and therapeutic devices in the exercise | 686 |
of physician-delegated prescriptive authority. | 687 |
(B) In exercising physician-delegated prescriptive authority, | 688 |
a physician assistant is subject to all of the following: | 689 |
(1) The physician assistant shall exercise | 690 |
physician-delegated prescriptive authority only to the extent that | 691 |
the physician supervising the physician assistant has granted that | 692 |
authority. | 693 |
(2) The physician assistant shall comply with all conditions | 694 |
placed on the physician-delegated prescriptive authority, as | 695 |
specified by the supervising physician who is supervising the | 696 |
physician assistant in the exercise of physician-delegated | 697 |
prescriptive authority. | 698 |
(3) If the physician assistant possesses physician-delegated | 699 |
prescriptive authority for controlled substances, the physician | 700 |
assistant shall register with the federal drug enforcement | 701 |
administration. | 702 |
(4) If the physician assistant possesses physician-delegated | 703 |
prescriptive authority for schedule II controlled substances, the | 704 |
physician assistant shall comply with section 4730.411 of the | 705 |
Revised Code. | 706 |
Sec. 4730.411. (A) Except as provided in division (B) or (C) | 707 |
of this section, the physician assistant may prescribe to a | 708 |
patient a schedule II controlled substance only if all of the | 709 |
following are the case: | 710 |
(1) The patient is in a terminal condition, as defined in | 711 |
section 2133.01 of the Revised Code. | 712 |
(2) The physician assistant's supervising physician initially | 713 |
prescribed the substance for the patient. | 714 |
(3) The prescription is for an amount that does not exceed | 715 |
the amount necessary for the patient's use in a single, | 716 |
twenty-four-hour period. | 717 |
(B) The restrictions on prescriptive authority in division | 718 |
(A) of this section do not apply if a physician assistant issues | 719 |
the prescription to the patient from any of the following | 720 |
locations: | 721 |
(1) A hospital registered under section 3701.07 of the | 722 |
Revised Code; | 723 |
(2) A health care facility operated by the department of | 724 |
mental health or the department of developmental disabilities; | 725 |
(3) A nursing home licensed under section 3721.02 of the | 726 |
Revised Code or by a political subdivision certified under section | 727 |
3721.09 of the Revised Code; | 728 |
(4) A county home or district home operated under Chapter | 729 |
5155. of the Revised Code that is certified under Title XVIII or | 730 |
XIX of the Social Security Act of 1935; | 731 |
(5) A hospice care program, as defined in section 3712.01 of | 732 |
the Revised Code; | 733 |
(6) A community mental health facility, as defined in section | 734 |
5122.01 of the Revised Code; | 735 |
(7) An ambulatory surgical facility, as defined in section | 736 |
3702.30 of the Revised Code; | 737 |
(8) A freestanding birthing center, as defined in section | 738 |
3702.51 of the Revised Code; | 739 |
(9) A federally qualified health center, as defined in | 740 |
section 1905(l)(2)(B) of the "Social Security Act," 103 Stat. 2264 | 741 |
(1989), 42 U.S.C. 1396d(l)(2)(B); | 742 |
(10) A health care office or facility operated by the board | 743 |
of health of a city or general health district or the authority | 744 |
having the duties of a board of health under section 3709.05 of | 745 |
the Revised Code. | 746 |
(C) A physician assistant shall not issue to a patient a | 747 |
prescription for a schedule II controlled substance from a | 748 |
convenience care clinic even if the convenience care clinic is | 749 |
owned or operated by an entity specified in division (B) of this | 750 |
section. | 751 |
Sec. 4730.42. (A) In granting physician-delegated | 752 |
prescriptive authority to a particular physician assistant who | 753 |
holds a certificate to prescribe issued under this chapter, the | 754 |
supervising physician is subject to all of the following: | 755 |
(1) The supervising physician shall not grant | 756 |
physician-delegated prescriptive authority for any drug or | 757 |
therapeutic device that is not listed on the physician assistant | 758 |
formulary | 759 |
the Revised Code as a drug or therapeutic device that may be | 760 |
included in the physician-delegated prescriptive authority granted | 761 |
to a physician assistant. | 762 |
(2) The supervising physician shall not grant | 763 |
physician-delegated prescriptive authority for any drug or device | 764 |
that may be used to perform or induce an abortion. | 765 |
(3) The supervising physician shall not grant | 766 |
physician-delegated prescriptive authority in a manner that | 767 |
exceeds the supervising physician's prescriptive authority. | 768 |
(4) The supervising physician shall supervise the physician | 769 |
assistant in accordance with all of the following: | 770 |
(a) The supervision requirements specified in section 4730.21 | 771 |
of the Revised Code and, in the case of supervision provided | 772 |
during a provisional period of physician-delegated prescriptive | 773 |
authority, the supervision requirements specified in section | 774 |
4730.45 of the Revised Code; | 775 |
(b) The physician supervisory plan approved for the | 776 |
supervising physician or the policies of the health care facility | 777 |
in which the physician and physician assistant are practicing; | 778 |
(c) The supervision agreement approved under section 4730.19 | 779 |
of the Revised Code that applies to the supervising physician and | 780 |
the physician assistant. | 781 |
(B)(1) The supervising physician of a physician assistant may | 782 |
place conditions on the physician-delegated prescriptive authority | 783 |
granted to the physician assistant. If conditions are placed on | 784 |
that authority, the supervising physician shall maintain a written | 785 |
record of the conditions and make the record available to the | 786 |
state medical board on request. | 787 |
(2) The conditions that a supervising physician may place on | 788 |
the physician-delegated prescriptive authority granted to a | 789 |
physician assistant include the following: | 790 |
(a) Identification by class and specific generic nomenclature | 791 |
of drugs and therapeutic devices that the physician chooses not to | 792 |
permit the physician assistant to prescribe; | 793 |
(b) Limitations on the dosage units or refills that the | 794 |
physician assistant is authorized to prescribe; | 795 |
(c) Specification of circumstances under which the physician | 796 |
assistant is required to refer patients to the supervising | 797 |
physician or another physician when exercising physician-delegated | 798 |
prescriptive authority; | 799 |
(d) Responsibilities to be fulfilled by the physician in | 800 |
supervising the physician assistant that are not otherwise | 801 |
specified in the physician supervisory plan or otherwise required | 802 |
by this chapter. | 803 |
Sec. 4730.44. (A) A physician assistant seeking a certificate | 804 |
to prescribe shall submit to the state medical board a written | 805 |
application on a form prescribed and supplied by the board. The | 806 |
application shall include all of the following information: | 807 |
(1) The applicant's name, residential address, business | 808 |
address, if any, and social security number; | 809 |
(2) Evidence of holding a valid certificate to practice as a | 810 |
physician assistant issued under this chapter; | 811 |
(3) One of the following: | 812 |
(a) Satisfactory proof that the applicant meets the | 813 |
requirements specified in section 4730.46 of the Revised Code to | 814 |
participate in a provisional period of physician-delegated | 815 |
prescriptive authority | 816 |
(b) Satisfactory proof of successful completion of the | 817 |
provisional period, evidenced by a letter or copy of a letter | 818 |
attesting to the successful completion written by a supervising | 819 |
physician of the physician assistant at the time of completion; | 820 |
(c) Satisfactory proof that the applicant has practiced as a | 821 |
physician assistant in another state or was credentialed or | 822 |
employed as a physician assistant by the United States government, | 823 |
holds a master's or higher degree that was obtained from a program | 824 |
accredited by the accreditation review commission on education for | 825 |
the physician assistant or a predecessor or successor organization | 826 |
recognized by the board, and held valid authority issued by the | 827 |
other state or the United States government to prescribe | 828 |
therapeutic devices and drugs, including at least some controlled | 829 |
substances, evidenced by an affidavit issued by an appropriate | 830 |
agency or office of the other state or the United States | 831 |
government attesting to the prescriptive authority described in | 832 |
division (A)(3)(c) of this section. | 833 |
(4) Any other information the board requires. | 834 |
(B) At the time of making application for a certificate to | 835 |
prescribe, the applicant shall pay the board a fee of one hundred | 836 |
dollars, no part of which shall be returned. The fees shall be | 837 |
deposited in accordance with section 4731.24 of the Revised Code. | 838 |
(C)(1) The board shall review all applications received. If | 839 |
an application is complete and the board determines that the | 840 |
applicant meets the requirements for a certificate to prescribe, | 841 |
the board shall, subject to division (C)(2) of this section, issue | 842 |
the certificate to the applicant. | 843 |
(2) The initial certificate to prescribe issued to an | 844 |
applicant who meets the requirements of division (A)(3)(a) of this | 845 |
section shall be issued as a provisional certificate to prescribe. | 846 |
Sec. 4730.45. (A) A provisional certificate to prescribe | 847 |
issued under division (C)(2) of section 4730.44 of the Revised | 848 |
Code authorizes the physician assistant holding the certificate to | 849 |
participate in a provisional period of physician-delegated | 850 |
prescriptive authority. The physician assistant shall successfully | 851 |
complete the provisional period as a condition of receiving a new | 852 |
certificate to prescribe. | 853 |
(B) The provisional period shall be conducted by one or more | 854 |
supervising physicians in accordance with rules adopted under | 855 |
section 4730.39 of the Revised Code. When supervising a physician | 856 |
assistant who is completing the first five hundred hours of a | 857 |
provisional period, the supervising physician shall provide | 858 |
on-site supervision of the physician assistant's exercise of | 859 |
physician-delegated prescriptive authority. | 860 |
The provisional period shall last not longer than one year, | 861 |
unless it is extended for not longer than one additional year at | 862 |
the direction of a supervising physician. The physician assistant | 863 |
shall not be required to participate in the provisional period for | 864 |
more than | 865 |
hours, except when a supervising physician has extended the | 866 |
physician assistant's provisional period. | 867 |
(C) If a physician assistant does not successfully complete | 868 |
the provisional period, each supervising physician shall cease | 869 |
granting physician-delegated prescriptive authority to the | 870 |
physician assistant. The supervising physician with primary | 871 |
responsibility for conducting the provisional period shall | 872 |
promptly notify the state medical board that the physician | 873 |
assistant did not successfully complete the provisional period and | 874 |
the board shall revoke the certificate. | 875 |
(D) A physician assistant who successfully completes a | 876 |
provisional period shall not be required to complete another | 877 |
provisional period as a condition of being eligible to be granted | 878 |
physician-delegated prescriptive authority by a supervising | 879 |
physician who was not involved in the conduct of the provisional | 880 |
period. | 881 |
Sec. 4755.48. (A) No person shall employ fraud or deception | 882 |
in applying for or securing a license to practice physical therapy | 883 |
or to be a physical therapist assistant. | 884 |
(B) No person shall practice or in any way imply or claim to | 885 |
the public by words, actions, or the use of letters as described | 886 |
in division (C) of this section to be able to practice physical | 887 |
therapy or to provide physical therapy services, including | 888 |
practice as a physical therapist assistant, unless the person | 889 |
holds a valid license under sections 4755.40 to 4755.56 of the | 890 |
Revised Code or except for submission of claims as provided in | 891 |
section 4755.56 of the Revised Code. | 892 |
(C) No person shall use the words or letters, physical | 893 |
therapist, physical therapy, physical therapy services, | 894 |
physiotherapist, physiotherapy, physiotherapy services, licensed | 895 |
physical therapist, P.T., Ph.T., P.T.T., R.P.T., L.P.T., M.P.T., | 896 |
D.P.T., M.S.P.T., P.T.A., physical therapy assistant, physical | 897 |
therapist assistant, physical therapy technician, licensed | 898 |
physical therapist assistant, L.P.T.A., R.P.T.A., or any other | 899 |
letters, words, abbreviations, or insignia, indicating or implying | 900 |
that the person is a physical therapist or physical therapist | 901 |
assistant without a valid license under sections 4755.40 to | 902 |
4755.56 of the Revised Code. | 903 |
(D) No person who practices physical therapy or assists in | 904 |
the provision of physical therapy treatments under the supervision | 905 |
of a physical therapist shall fail to display the person's current | 906 |
license granted under sections 4755.40 to 4755.56 of the Revised | 907 |
Code in a conspicuous location in the place where the person | 908 |
spends the major part of the person's time so engaged. | 909 |
(E) Nothing in sections 4755.40 to 4755.56 of the Revised | 910 |
Code shall affect or interfere with the performance of the duties | 911 |
of any physical therapist or physical therapist assistant in | 912 |
active service in the army, navy, coast guard, marine corps, air | 913 |
force, public health service, or marine hospital service of the | 914 |
United States, while so serving. | 915 |
(F) Nothing in sections 4755.40 to 4755.56 of the Revised | 916 |
Code shall prevent or restrict the activities or services of a | 917 |
person | 918 |
physical therapy in an accredited or approved educational program | 919 |
if the activities or services constitute a part of a supervised | 920 |
course of study and the person is designated by a title that | 921 |
clearly indicates the person's status as a student. | 922 |
(G) | 923 |
section and subject to division (H) of this section, no person | 924 |
shall practice physical therapy other than on the prescription of, | 925 |
or the referral of a patient by, a person who is licensed in this | 926 |
or another state to | 927 |
(a) Practice medicine and surgery, chiropractic, dentistry, | 928 |
osteopathic medicine and surgery, podiatric medicine and surgery | 929 |
930 |
(b) Practice as a physician assistant; | 931 |
(c) Practice nursing as a certified registered nurse | 932 |
anesthetist, clinical nurse specialist, certified nurse-midwife, | 933 |
or certified nurse practitioner | 934 |
935 | |
936 |
| 937 |
practicing physical therapy other than on the prescription of, or | 938 |
the referral of a patient by, any of the persons described in that | 939 |
division does not apply if either of the following applies to the | 940 |
person: | 941 |
(a) The person holds a master's or doctorate degree from a | 942 |
professional physical therapy program that is accredited by a | 943 |
national physical therapy accreditation agency recognized by the | 944 |
United States department of education. | 945 |
| 946 |
completed at least two years of practical experience as a licensed | 947 |
physical therapist. | 948 |
(H) To be authorized to prescribe physical therapy or refer | 949 |
a patient to a physical therapist for physical therapy, a person | 950 |
described in division (G)(1) of this section must be in good | 951 |
standing with the relevant licensing board in this state or the | 952 |
state in which the person is licensed and must act only within the | 953 |
person's scope of practice. | 954 |
(I) In the prosecution of any person for violation of | 955 |
division (B) or (C) of this section, it is not necessary to allege | 956 |
or prove want of a valid license to practice physical therapy or | 957 |
to practice as a physical therapist assistant, but such matters | 958 |
shall be a matter of defense to be established by the accused. | 959 |
Sec. 4755.481. (A) If a physical therapist evaluates and | 960 |
treats a patient without the prescription of, or the referral of | 961 |
the patient by, a person | 962 |
963 | |
964 | |
965 | |
966 | |
division (G)(1) of section 4755.48 of the Revised Code, all of the | 967 |
following apply: | 968 |
(1) The physical therapist shall, upon consent of the | 969 |
patient, inform the | 970 |
971 | |
972 | |
973 | |
section 4755.48 of the Revised Code of the evaluation not later | 974 |
than five business days after the evaluation is made. | 975 |
(2) If the physical therapist determines, based on reasonable | 976 |
evidence, that no substantial progress has been made with respect | 977 |
to that patient during the thirty-day period immediately following | 978 |
the date of the patient's initial visit with the physical | 979 |
therapist, the physical therapist shall consult with or refer the | 980 |
patient to a | 981 |
982 | |
983 | |
984 | |
4755.48 of the Revised Code, unless either of the following | 985 |
applies: | 986 |
(a) The evaluation, treatment, or services are being provided | 987 |
for fitness, wellness, or prevention purposes. | 988 |
(b) The patient previously was diagnosed with chronic, | 989 |
neuromuscular, or developmental conditions and the evaluation, | 990 |
treatment, or services are being provided for problems or symptoms | 991 |
associated with one or more of those previously diagnosed | 992 |
conditions. | 993 |
(3) If the physical therapist determines that orthotic | 994 |
devices are necessary to treat the patient, the physical therapist | 995 |
shall be limited to the application of the following orthotic | 996 |
devices: | 997 |
(a) Upper extremity adaptive equipment used to facilitate the | 998 |
activities of daily living; | 999 |
(b) Finger splints; | 1000 |
(c) Wrist splints; | 1001 |
(d) Prefabricated elastic or fabric abdominal supports with | 1002 |
or without metal or plastic reinforcing stays and other | 1003 |
prefabricated soft goods requiring minimal fitting; | 1004 |
(e) Nontherapeutic accommodative inlays; | 1005 |
(f) Shoes that are not manufactured or modified for a | 1006 |
particular individual; | 1007 |
(g) Prefabricated foot care products; | 1008 |
(h) Custom foot orthotics; | 1009 |
(i) Durable medical equipment. | 1010 |
(4) If, at any time, the physical therapist has reason to | 1011 |
believe that the patient has symptoms or conditions that require | 1012 |
treatment or services beyond the scope of practice of a physical | 1013 |
therapist, the physical therapist shall refer the patient to a | 1014 |
licensed health care practitioner acting within the practitioner's | 1015 |
scope of practice. | 1016 |
(B) Nothing in sections 4755.40 to 4755.56 of the Revised | 1017 |
Code shall be construed to require reimbursement under any health | 1018 |
insuring corporation policy, contract, or agreement, any sickness | 1019 |
and accident insurance policy, the medical assistance program as | 1020 |
defined in section 5111.01 of the Revised Code, or the health | 1021 |
partnership program or qualified health plans established pursuant | 1022 |
to sections 4121.44 to 4121.442 of the Revised Code, for any | 1023 |
physical therapy service rendered without the prescription of, or | 1024 |
the referral of the patient by, a | 1025 |
1026 | |
1027 | |
1028 | |
(G)(1) of section 4755.48 of the Revised Code. | 1029 |
(C) For purposes of this section, "business day" means any | 1030 |
calendar day that is not a Saturday, Sunday, or legal holiday. | 1031 |
"Legal holiday" has the same meaning as in section 1.14 of the | 1032 |
Revised Code. | 1033 |
Sec. 4765.01. As used in this chapter: | 1034 |
(A) "First responder" means an individual who holds a | 1035 |
current, valid certificate issued under section 4765.30 of the | 1036 |
Revised Code to practice as a first responder. | 1037 |
(B) "Emergency medical technician-basic" or "EMT-basic" means | 1038 |
an individual who holds a current, valid certificate issued under | 1039 |
section 4765.30 of the Revised Code to practice as an emergency | 1040 |
medical technician-basic. | 1041 |
(C) "Emergency medical technician-intermediate" or "EMT-I" | 1042 |
means an individual who holds a current, valid certificate issued | 1043 |
under section 4765.30 of the Revised Code to practice as an | 1044 |
emergency medical technician-intermediate. | 1045 |
(D) "Emergency medical technician-paramedic" or "paramedic" | 1046 |
means an individual who holds a current, valid certificate issued | 1047 |
under section 4765.30 of the Revised Code to practice as an | 1048 |
emergency medical technician-paramedic. | 1049 |
(E) "Ambulance" means any motor vehicle that is used, or is | 1050 |
intended to be used, for the purpose of responding to emergency | 1051 |
medical situations, transporting emergency patients, and | 1052 |
administering emergency medical service to patients before, | 1053 |
during, or after transportation. | 1054 |
(F) "Cardiac monitoring" means a procedure used for the | 1055 |
purpose of observing and documenting the rate and rhythm of a | 1056 |
patient's heart by attaching electrical leads from an | 1057 |
electrocardiograph monitor to certain points on the patient's body | 1058 |
surface. | 1059 |
(G) "Emergency medical service" means any of the services | 1060 |
described in sections 4765.35, 4765.37, 4765.38, and 4765.39 of | 1061 |
the Revised Code that are performed by first responders, emergency | 1062 |
medical technicians-basic, emergency medical | 1063 |
technicians-intermediate, and paramedics. "Emergency medical | 1064 |
service" includes such services performed before or during any | 1065 |
transport of a patient, including transports between hospitals and | 1066 |
transports to and from helicopters. | 1067 |
(H) "Emergency medical service organization" means a public | 1068 |
or private organization using first responders, EMTs-basic, | 1069 |
EMTs-I, or paramedics, or a combination of first responders, | 1070 |
EMTs-basic, EMTs-I, and paramedics, to provide emergency medical | 1071 |
services. | 1072 |
(I) "Physician" means an individual who holds a current, | 1073 |
valid certificate issued under Chapter 4731. of the Revised Code | 1074 |
authorizing the practice of medicine and surgery or osteopathic | 1075 |
medicine and surgery. | 1076 |
(J) "Registered nurse" means an individual who holds a | 1077 |
current, valid license issued under Chapter 4723. of the Revised | 1078 |
Code authorizing the practice of nursing as a registered nurse. | 1079 |
(K) "Volunteer" means a person who provides services either | 1080 |
for no compensation or for compensation that does not exceed the | 1081 |
actual expenses incurred in providing the services or in training | 1082 |
to provide the services. | 1083 |
(L) "Emergency medical service personnel" means first | 1084 |
responders, emergency medical service technicians-basic, emergency | 1085 |
medical service technicians-intermediate, emergency medical | 1086 |
service technicians-paramedic, and persons who provide medical | 1087 |
direction to such persons. | 1088 |
(M) "Hospital" has the same meaning as in section 3727.01 of | 1089 |
the Revised Code. | 1090 |
(N) "Trauma" or "traumatic injury" means severe damage to or | 1091 |
destruction of tissue that satisfies both of the following | 1092 |
conditions: | 1093 |
(1) It creates a significant risk of any of the following: | 1094 |
(a) Loss of life; | 1095 |
(b) Loss of a limb; | 1096 |
(c) Significant, permanent disfigurement; | 1097 |
(d) Significant, permanent disability. | 1098 |
(2) It is caused by any of the following: | 1099 |
(a) Blunt or penetrating injury; | 1100 |
(b) Exposure to electromagnetic, chemical, or radioactive | 1101 |
energy; | 1102 |
(c) Drowning, suffocation, or strangulation; | 1103 |
(d) A deficit or excess of heat. | 1104 |
(O) "Trauma victim" or "trauma patient" means a person who | 1105 |
has sustained a traumatic injury. | 1106 |
(P) "Trauma care" means the assessment, diagnosis, | 1107 |
transportation, treatment, or rehabilitation of a trauma victim by | 1108 |
emergency medical service personnel or by a physician, nurse, | 1109 |
physician assistant, respiratory therapist, physical therapist, | 1110 |
chiropractor, occupational therapist, speech-language pathologist, | 1111 |
audiologist, or psychologist licensed to practice as such in this | 1112 |
state or another jurisdiction. | 1113 |
(Q) "Trauma center" means all of the following: | 1114 |
(1) Any hospital that is verified by the American college of | 1115 |
surgeons as an adult or pediatric trauma center; | 1116 |
(2) Any hospital that is operating as an adult or pediatric | 1117 |
trauma center under provisional status pursuant to section | 1118 |
3727.101 of the Revised Code; | 1119 |
(3) Until December 31, 2004, any hospital in this state that | 1120 |
is designated by the director of health as a level II pediatric | 1121 |
trauma center under section 3727.081 of the Revised Code; | 1122 |
(4) Any hospital in another state that is licensed or | 1123 |
designated under the laws of that state as capable of providing | 1124 |
specialized trauma care appropriate to the medical needs of the | 1125 |
trauma patient. | 1126 |
(R) "Pediatric" means involving a patient who is less than | 1127 |
sixteen years of age. | 1128 |
(S) "Adult" means involving a patient who is not a pediatric | 1129 |
patient. | 1130 |
(T) "Geriatric" means involving a patient who is at least | 1131 |
seventy years old or exhibits significant anatomical or | 1132 |
physiological characteristics associated with advanced aging. | 1133 |
(U) "Air medical organization" means an organization that | 1134 |
provides emergency medical services, or transports emergency | 1135 |
victims, by means of fixed or rotary wing aircraft. | 1136 |
(V) "Emergency care" and "emergency facility" have the same | 1137 |
meanings as in section 3727.01 of the Revised Code. | 1138 |
(W) "Stabilize," except as it is used in division (B) of | 1139 |
section 4765.35 of the Revised Code with respect to the manual | 1140 |
stabilization of fractures, has the same meaning as in section | 1141 |
1753.28 of the Revised Code. | 1142 |
(X) "Transfer" has the same meaning as in section 1753.28 of | 1143 |
the Revised Code. | 1144 |
(Y) "Firefighter" means any member of a fire department as | 1145 |
defined in section 742.01 of the Revised Code. | 1146 |
(Z) "Volunteer firefighter" has the same meaning as in | 1147 |
section 146.01 of the Revised Code. | 1148 |
(AA) "Part-time paid firefighter" means a person who provides | 1149 |
firefighting services on less than a full-time basis, is routinely | 1150 |
scheduled to be present on site at a fire station or other | 1151 |
designated location for purposes of responding to a fire or other | 1152 |
emergency, and receives more than nominal compensation for the | 1153 |
provision of firefighting services. | 1154 |
(BB) "Physician assistant" means an individual who holds a | 1155 |
valid certificate to practice as a physician assistant issued | 1156 |
under Chapter 4730. of the Revised Code. | 1157 |
Sec. 4765.35. (A) A first responder shall perform the | 1158 |
emergency medical services described in this section in accordance | 1159 |
with this chapter and any rules adopted under it. | 1160 |
(B) A first responder may provide limited emergency medical | 1161 |
services to patients until the arrival of an emergency medical | 1162 |
technician-basic, emergency medical technician-intermediate, or | 1163 |
emergency medical technician-paramedic. In an emergency, a first | 1164 |
responder may render emergency medical services such as opening | 1165 |
and maintaining an airway, giving mouth to barrier ventilation, | 1166 |
chest compressions, electrical interventions with automated | 1167 |
defibrillators to support or correct the cardiac function and | 1168 |
other methods determined by the board, controlling of hemorrhage, | 1169 |
manual stabilization of fractures, bandaging, assisting in | 1170 |
childbirth, and determining triage of trauma victims. | 1171 |
(C) A first responder may perform any other emergency medical | 1172 |
services approved pursuant to rules adopted under section 4765.11 | 1173 |
of the Revised Code. The board shall determine whether the nature | 1174 |
of any such service requires that a first responder receive | 1175 |
authorization prior to performing the service. | 1176 |
(D)(1) Except as provided in division (D)(2) of this section, | 1177 |
if the board determines under division (C) of this section that a | 1178 |
service requires prior authorization, the service shall be | 1179 |
performed only pursuant to the written or verbal authorization of | 1180 |
a physician or of the cooperating physician advisory board, or | 1181 |
pursuant to an authorization transmitted through a direct | 1182 |
communication device by a physician, physician assistant | 1183 |
designated by a physician, or registered nurse designated by a | 1184 |
physician. | 1185 |
(2) If communications fail during an emergency situation or | 1186 |
the required response time prohibits communication, a first | 1187 |
responder may perform services subject to this division, if, in | 1188 |
the judgment of the first responder, the life of the patient is in | 1189 |
immediate danger. Services performed under these circumstances | 1190 |
shall be performed in accordance with the written protocols for | 1191 |
triage of adult and pediatric trauma victims established in rules | 1192 |
adopted under sections 4765.11 and 4765.40 of the Revised Code and | 1193 |
any applicable protocols adopted by the emergency medical service | 1194 |
organization with which the first responder is affiliated. | 1195 |
Sec. 4765.36. In a hospital, an emergency medical | 1196 |
technician-basic, emergency medical technician-intermediate, or | 1197 |
emergency medical technician-paramedic may perform emergency | 1198 |
medical services | 1199 |
1200 | |
if the services are performed in accordance with both of the | 1201 |
following conditions: | 1202 |
(A) Only in the hospital's emergency department or while | 1203 |
moving a patient between the emergency department and another part | 1204 |
of the hospital; | 1205 |
(B) Only under the direction and supervision of one of the | 1206 |
following: | 1207 |
(1) A physician; | 1208 |
(2) A physician assistant designated by a physician; | 1209 |
(3) A registered nurse designated by a physician. | 1210 |
Sec. 4765.37. (A) An emergency medical technician-basic | 1211 |
shall perform the emergency medical services described in this | 1212 |
section in accordance with this chapter and any rules adopted | 1213 |
under it by the state board of emergency medical services. | 1214 |
(B) An emergency medical technician-basic may operate, or be | 1215 |
responsible for operation of, an ambulance and may provide | 1216 |
emergency medical services to patients. In an emergency, an | 1217 |
EMT-basic may determine the nature and extent of illness or injury | 1218 |
and establish priority for required emergency medical services. An | 1219 |
EMT-basic may render emergency medical services such as opening | 1220 |
and maintaining an airway, giving positive pressure ventilation, | 1221 |
cardiac resuscitation, electrical interventions with automated | 1222 |
defibrillators to support or correct the cardiac function and | 1223 |
other methods determined by the board, controlling of hemorrhage, | 1224 |
treatment of shock, immobilization of fractures, bandaging, | 1225 |
assisting in childbirth, management of mentally disturbed | 1226 |
patients, initial care of poison and burn patients, and | 1227 |
determining triage of adult and pediatric trauma victims. Where | 1228 |
patients must in an emergency be extricated from entrapment, an | 1229 |
EMT-basic may assess the extent of injury and render all possible | 1230 |
emergency medical services and protection to the entrapped | 1231 |
patient; provide light rescue services if an ambulance has not | 1232 |
been accompanied by a specialized unit; and after extrication, | 1233 |
provide additional care in sorting of the injured in accordance | 1234 |
with standard emergency procedures. | 1235 |
(C) An EMT-basic may perform any other emergency medical | 1236 |
services approved pursuant to rules adopted under section 4765.11 | 1237 |
of the Revised Code. The board shall determine whether the nature | 1238 |
of any such service requires that an EMT-basic receive | 1239 |
authorization prior to performing the service. | 1240 |
(D)(1) Except as provided in division (D)(2) of this section, | 1241 |
if the board determines under division (C) of this section that a | 1242 |
service requires prior authorization, the service shall be | 1243 |
performed only pursuant to the written or verbal authorization of | 1244 |
a physician or of the cooperating physician advisory board, or | 1245 |
pursuant to an authorization transmitted through a direct | 1246 |
communication device by a physician, physician assistant | 1247 |
designated by a physician, or registered nurse designated by a | 1248 |
physician. | 1249 |
(2) If communications fail during an emergency situation or | 1250 |
the required response time prohibits communication, an EMT-basic | 1251 |
may perform services subject to this division, if, in the judgment | 1252 |
of the EMT-basic, the life of the patient is in immediate danger. | 1253 |
Services performed under these circumstances shall be performed in | 1254 |
accordance with the protocols for triage of adult and pediatric | 1255 |
trauma victims established in rules adopted under sections 4765.11 | 1256 |
and 4765.40 of the Revised Code and any applicable protocols | 1257 |
adopted by the emergency medical service organization with which | 1258 |
the EMT-basic is affiliated. | 1259 |
Sec. 4765.38. (A) An emergency medical | 1260 |
technician-intermediate shall perform the emergency medical | 1261 |
services described in this section in accordance with this chapter | 1262 |
and any rules adopted under it. | 1263 |
(B) An EMT-I may do any of the following: | 1264 |
(1) Establish and maintain an intravenous lifeline that has | 1265 |
been approved by a cooperating physician or physician advisory | 1266 |
board; | 1267 |
(2) Perform cardiac monitoring; | 1268 |
(3) Perform electrical interventions to support or correct | 1269 |
the cardiac function; | 1270 |
(4) Administer epinephrine; | 1271 |
(5) Determine triage of adult and pediatric trauma victims; | 1272 |
(6) Perform any other emergency medical services approved | 1273 |
pursuant to rules adopted under section 4765.11 of the Revised | 1274 |
Code. | 1275 |
(C)(1) Except as provided in division (C)(2) of this section, | 1276 |
the services described in division (B) of this section shall be | 1277 |
performed by an EMT-I only pursuant to the written or verbal | 1278 |
authorization of a physician or of the cooperating physician | 1279 |
advisory board, or pursuant to an authorization transmitted | 1280 |
through a direct communication device by a physician, physician | 1281 |
assistant designated by a physician, or registered nurse | 1282 |
designated by a physician. | 1283 |
(2) If communications fail during an emergency situation or | 1284 |
the required response time prohibits communication, an EMT-I may | 1285 |
perform any of the services described in division (B) of this | 1286 |
section, if, in the judgment of the EMT-I, the life of the patient | 1287 |
is in immediate danger. Services performed under these | 1288 |
circumstances shall be performed in accordance with the protocols | 1289 |
for triage of adult and pediatric trauma victims established in | 1290 |
rules adopted under sections 4765.11 and 4765.40 of the Revised | 1291 |
Code and any applicable protocols adopted by the emergency medical | 1292 |
service organization with which the EMT-I is affiliated. | 1293 |
(D) In addition to, and in the course of, providing emergency | 1294 |
medical treatment, an emergency medical technician-intermediate | 1295 |
may withdraw blood as provided under sections 1547.11, 4506.17, | 1296 |
and 4511.19 of the Revised Code. An emergency medical | 1297 |
technician-intermediate shall withdraw blood in accordance with | 1298 |
this chapter and any rules adopted under it by the state board of | 1299 |
emergency medical services. | 1300 |
Sec. 4765.39. (A) An emergency medical technician-paramedic | 1301 |
shall perform the emergency medical services described in this | 1302 |
section in accordance with this chapter and any rules adopted | 1303 |
under it. | 1304 |
(B) A paramedic may do any of the following: | 1305 |
(1) Perform cardiac monitoring; | 1306 |
(2) Perform electrical interventions to support or correct | 1307 |
the cardiac function; | 1308 |
(3) Perform airway procedures; | 1309 |
(4) Perform relief of pneumothorax; | 1310 |
(5) Administer appropriate drugs and intravenous fluids; | 1311 |
(6) Determine triage of adult and pediatric trauma victims; | 1312 |
(7) Perform any other emergency medical services, including | 1313 |
life support or intensive care techniques, approved pursuant to | 1314 |
rules adopted under section 4765.11 of the Revised Code. | 1315 |
(C)(1) Except as provided in division (C)(2) of this section, | 1316 |
the services described in division (B) of this section shall be | 1317 |
performed by a paramedic only pursuant to the written or verbal | 1318 |
authorization of a physician or of the cooperating physician | 1319 |
advisory board, or pursuant to an authorization transmitted | 1320 |
through a direct communication device by a physician, physician | 1321 |
assistant designated by a physician, or registered nurse | 1322 |
designated by a physician. | 1323 |
(2) If communications fail during an emergency situation or | 1324 |
the required response time prohibits communication, a paramedic | 1325 |
may perform any of the services described in division (B) of this | 1326 |
section, if, in the paramedic's judgment, the life of the patient | 1327 |
is in immediate danger. Services performed under these | 1328 |
circumstances shall be performed in accordance with the protocols | 1329 |
for triage of adult and pediatric trauma victims established in | 1330 |
rules adopted under sections 4765.11 and 4765.40 of the Revised | 1331 |
Code and any applicable protocols adopted by the emergency medical | 1332 |
service organization with which the paramedic is affiliated. | 1333 |
(D) In addition to, and in the course of, providing emergency | 1334 |
medical treatment, an emergency medical technician-paramedic may | 1335 |
withdraw blood as provided under sections 1547.11, 4506.17, and | 1336 |
4511.19 of the Revised Code. An emergency medical | 1337 |
technician-paramedic shall withdraw blood in accordance with this | 1338 |
chapter and any rules adopted under it by the state board of | 1339 |
emergency medical services. | 1340 |
Sec. 4765.49. (A) A first responder, emergency medical | 1341 |
technician-basic, emergency medical technician-intermediate, or | 1342 |
emergency medical technician-paramedic is not liable in damages in | 1343 |
a civil action for injury, death, or loss to person or property | 1344 |
resulting from the individual's administration of emergency | 1345 |
medical services, unless the services are administered in a manner | 1346 |
that constitutes willful or wanton misconduct. A physician, | 1347 |
physician assistant designated by a physician, or registered nurse | 1348 |
designated by a physician, | 1349 |
assisting in the emergency medical services by means of any | 1350 |
communication device or telemetering system, is not liable in | 1351 |
damages in a civil action for injury, death, or loss to person or | 1352 |
property resulting from the individual's advisory communication or | 1353 |
assistance, unless the advisory communication or assistance is | 1354 |
provided in a manner that constitutes willful or wanton | 1355 |
misconduct. Medical directors and members of cooperating physician | 1356 |
advisory boards of emergency medical service organizations are not | 1357 |
liable in damages in a civil action for injury, death, or loss to | 1358 |
person or property resulting from their acts or omissions in the | 1359 |
performance of their duties, unless the act or omission | 1360 |
constitutes willful or wanton misconduct. | 1361 |
(B) A political subdivision, joint ambulance district, joint | 1362 |
emergency medical services district, or other public agency, and | 1363 |
any officer or employee of a public agency or of a private | 1364 |
organization operating under contract or in joint agreement with | 1365 |
one or more political subdivisions, that provides emergency | 1366 |
medical services, or that enters into a joint agreement or a | 1367 |
contract with the state, any political subdivision, joint | 1368 |
ambulance district, or joint emergency medical services district | 1369 |
for the provision of emergency medical services, is not liable in | 1370 |
damages in a civil action for injury, death, or loss to person or | 1371 |
property arising out of any actions taken by a first responder, | 1372 |
EMT-basic, EMT-I, or paramedic working under the officer's or | 1373 |
employee's jurisdiction, or for injury, death, or loss to person | 1374 |
or property arising out of any actions of licensed medical | 1375 |
personnel advising or assisting the first responder, EMT-basic, | 1376 |
EMT-I, or paramedic, unless the services are provided in a manner | 1377 |
that constitutes willful or wanton misconduct. | 1378 |
(C) A student who is enrolled in an emergency medical | 1379 |
services training program accredited under section 4765.17 of the | 1380 |
Revised Code or an emergency medical services continuing education | 1381 |
program approved under that section is not liable in damages in a | 1382 |
civil action for injury, death, or loss to person or property | 1383 |
resulting from either of the following: | 1384 |
(1) The student's administration of emergency medical | 1385 |
services or patient care or treatment, if the services, care, or | 1386 |
treatment is administered while the student is under the direct | 1387 |
supervision and in the immediate presence of an EMT-basic, EMT-I, | 1388 |
paramedic, registered nurse, physician assistant, or physician and | 1389 |
while the student is receiving clinical training that is required | 1390 |
by the program, unless the services, care, or treatment is | 1391 |
provided in a manner that constitutes willful or wanton | 1392 |
misconduct; | 1393 |
(2) The student's training as an ambulance driver, unless the | 1394 |
driving is done in a manner that constitutes willful or wanton | 1395 |
misconduct. | 1396 |
(D) An EMT-basic, EMT-I, paramedic, or other operator, who | 1397 |
holds a valid commercial driver's license issued pursuant to | 1398 |
Chapter 4506. of the Revised Code or driver's license issued | 1399 |
pursuant to Chapter 4507. of the Revised Code and who is employed | 1400 |
by an emergency medical service organization that is not owned or | 1401 |
operated by a political subdivision as defined in section 2744.01 | 1402 |
of the Revised Code, is not liable in damages in a civil action | 1403 |
for injury, death, or loss to person or property that is caused by | 1404 |
the operation of an ambulance by the EMT-basic, EMT-I, paramedic, | 1405 |
or other operator while responding to or completing a call for | 1406 |
emergency medical services, unless the operation constitutes | 1407 |
willful or wanton misconduct or does not comply with the | 1408 |
precautions of section 4511.03 of the Revised Code. An emergency | 1409 |
medical service organization is not liable in damages in a civil | 1410 |
action for any injury, death, or loss to person or property that | 1411 |
is caused by the operation of an ambulance by its employee or | 1412 |
agent, if this division grants the employee or agent immunity from | 1413 |
civil liability for the injury, death, or loss. | 1414 |
(E) An employee or agent of an emergency medical service | 1415 |
organization who receives requests for emergency medical services | 1416 |
that are directed to the organization, dispatches first | 1417 |
responders, EMTs-basic, EMTs-I, or paramedics in response to those | 1418 |
requests, communicates those requests to those employees or agents | 1419 |
of the organization who are authorized to dispatch first | 1420 |
responders, EMTs-basic, EMTs-I, or paramedics, or performs any | 1421 |
combination of these functions for the organization, is not liable | 1422 |
in damages in a civil action for injury, death, or loss to person | 1423 |
or property resulting from the individual's acts or omissions in | 1424 |
the performance of those duties for the organization, unless an | 1425 |
act or omission constitutes willful or wanton misconduct. | 1426 |
(F) A person who is performing the functions of a first | 1427 |
responder, EMT-basic, EMT-I, or paramedic under the authority of | 1428 |
the laws of a state that borders this state and who provides | 1429 |
emergency medical services to or transportation of a patient in | 1430 |
this state is not liable in damages in a civil action for injury, | 1431 |
death, or loss to person or property resulting from the person's | 1432 |
administration of emergency medical services, unless the services | 1433 |
are administered in a manner that constitutes willful or wanton | 1434 |
misconduct. A physician, physician assistant designated by a | 1435 |
physician, or registered nurse designated by a physician, | 1436 |
of whom is licensed to practice in the adjoining state and who is | 1437 |
advising or assisting in the emergency medical services by means | 1438 |
of any communication device or telemetering system, is not liable | 1439 |
in damages in a civil action for injury, death, or loss to person | 1440 |
or property resulting from the person's advisory communication or | 1441 |
assistance, unless the advisory communication or assistance is | 1442 |
provided in a manner that constitutes willful or wanton | 1443 |
misconduct. | 1444 |
(G) A person certified under section 4765.23 of the Revised | 1445 |
Code to teach in an emergency medical services training program or | 1446 |
emergency medical services continuing education program, and a | 1447 |
person who teaches at the Ohio fire academy established under | 1448 |
section 3737.33 of the Revised Code or in a fire service training | 1449 |
program described in division (A) of section 4765.55 of the | 1450 |
Revised Code, is not liable in damages in a civil action for | 1451 |
injury, death, or loss to person or property resulting from the | 1452 |
person's acts or omissions in the performance of the person's | 1453 |
duties, unless an act or omission constitutes willful or wanton | 1454 |
misconduct. | 1455 |
(H) In the accreditation of emergency medical services | 1456 |
training programs or approval of emergency medical services | 1457 |
continuing education programs, the state board of emergency | 1458 |
medical services and any person or entity authorized by the board | 1459 |
to evaluate applications for accreditation or approval are not | 1460 |
liable in damages in a civil action for injury, death, or loss to | 1461 |
person or property resulting from their acts or omissions in the | 1462 |
performance of their duties, unless an act or omission constitutes | 1463 |
willful or wanton misconduct. | 1464 |
(I) A person authorized by an emergency medical service | 1465 |
organization to review the performance of first responders, | 1466 |
EMTs-basic, EMTs-I, and paramedics or to administer quality | 1467 |
assurance programs is not liable in damages in a civil action for | 1468 |
injury, death, or loss to person or property resulting from the | 1469 |
person's acts or omissions in the performance of the person's | 1470 |
duties, unless an act or omission constitutes willful or wanton | 1471 |
misconduct. | 1472 |
Sec. 4765.51. Nothing in this chapter prevents or restricts | 1473 |
the practice, services, or activities of any registered nurse | 1474 |
practicing within the scope of
| 1475 |
practice. | 1476 |
Nothing in this chapter prevents or restricts the practice, | 1477 |
services, or activities of any physician assistant practicing in | 1478 |
accordance with a physician supervisory plan approved pursuant to | 1479 |
section 4730.17 of the Revised Code or the policies of the health | 1480 |
care facility in which the physician assistant is practicing. | 1481 |
Sec. 5111.0212. For any service a physician assistant | 1482 |
provides to a medicaid recipient in accordance with Chapter 4730. | 1483 |
of the Revised Code, the medicaid program shall reimburse the | 1484 |
physician assistant an amount that is one hundred per cent of the | 1485 |
amount, as contained in the medicaid fee schedule determined | 1486 |
pursuant to rules adopted under section 5111.02 of the Revised | 1487 |
Code, established as the medicaid maximum for the service. | 1488 |
Sec. 5111.051. (A) As used in this section, "group practice" | 1489 |
has the same meaning as in section 4731.65 of the Revised Code. | 1490 |
(B) The department of job and family services shall establish | 1491 |
a process by which a physician assistant may enter into a medicaid | 1492 |
provider agreement. | 1493 |
(C) Subject to division (D) of this section, a claim for | 1494 |
reimbursement for a service provided by a physician assistant to a | 1495 |
medicaid recipient may be submitted by either of the following: | 1496 |
(1) The physician assistant who provided the service or | 1497 |
another person the physician assistant designates to submit the | 1498 |
claim on the physician assistant's behalf; | 1499 |
(2) The physician, group practice, clinic, or other health | 1500 |
care facility that employs or contracts with the physician | 1501 |
assistant. | 1502 |
(D) A claim for reimbursement may be submitted as described | 1503 |
in division (C)(1) of this section only if the physician assistant | 1504 |
has a valid medicaid provider agreement. When submitting the | 1505 |
claim, the physician assistant or designated person shall use only | 1506 |
the medicaid provider number the department has assigned to the | 1507 |
physician assistant. | 1508 |
Section 2. That existing sections 185.01, 185.03, 185.05, | 1509 |
2105.35, 2108.40, 2133.211, 3719.06, 4730.06, 4730.09, 4730.38, | 1510 |
4730.39, 4730.40, 4730.41, 4730.42, 4730.44, 4730.45, 4755.48, | 1511 |
4755.481, 4765.01, 4765.35, 4765.36, 4765.37, 4765.38, 4765.39, | 1512 |
4765.49, and 4765.51 and section 4730.401 of the Revised Code are | 1513 |
hereby repealed. | 1514 |