As Reported by the Senate Health, Human Services and Aging Committee

129th General Assembly
Regular Session
2011-2012
Sub. H. B. No. 303


Representative Schuring 

Cosponsors: Representatives Carney, Gonzales, Fende, Antonio, Barnes, Garland, Hackett, Yuko, Adams, R., Anielski, Bubp, Celeste, Damschroder, Gardner, Grossman, Hagan, R., Heard, Hill, Hottinger, Johnson, Letson, Lynch, Mallory, McClain, Milkovich, Newbold, O'Brien, Okey, Pillich, Ramos, Reece, Sears, Stebelton, Stinziano, Wachtmann Speaker Batchelder 



A BILL
To amend sections 2305.113, 2305.234, 2711.22, 1
3701.92, 3701.923, 3701.924, 3701.925, 3701.926, 2
3701.927, 3701.928, 3701.929, 3793.11, 3963.01, 3
4503.44, 4723.01, 4723.03, 4723.06, 4723.063, 4
4723.07, 4723.08, 4723.09, 4723.17, 4723.171, 5
4723.24, 4723.271, 4723.28, 4723.32, 4723.34, 6
4723.35, 4723.41, 4723.42, 4723.43, 4723.431, 7
4723.44, 4723.48, 4723.482, 4723.485, 4723.487, 8
4723.50, 4723.61, 4723.64, 4723.65, 4723.651, 9
4723.652, 4723.66, 4723.67, 4723.68, 4723.69, 10
4723.71, 4723.72, 4723.73, 4723.74, 4723.75, 11
4723.751, 4723.76, 4723.77, 4723.79, 4723.83, 12
4723.84, 4723.87, 4723.88, 4723.99, 4759.01, 13
4759.03, 4759.05, 4759.06, 4759.10, 5111.222, 14
5111.231, 5111.24, 5111.242, 5111.246, 5111.25, 15
5111.88, 5111.981, and 5120.55; to amend, for the 16
purpose of adopting new section numbers as 17
indicated in parentheses, sections 4723.17 18
(4723.18) and 4723.171 (4723.181); to enact new 19
section 4723.17 and sections 4723.091, 4723.092, 20
4723.19, 4723.653, and 5111.982; to repeal 21
sections 4723.483, 4723.62, 4723.621, 4723.63, and 22
4723.78 of the Revised Code; and to amend Section 23
3.19 of Am. Sub. H.B. 95 of the 125th General 24
Assembly to revise the laws administered by the 25
Board of Nursing and the professionals regulated 26
by the Board, to update statutory references to 27
professional organizations of dietitians, to 28
extend qualified immunity from civil liability for 29
volunteer services provided by certain behavioral 30
health professionals, to modify the requirements 31
for licensure of methadone treatment programs, to 32
make changes in the laws governing certain 33
Medicaid payments for nursing facility services, 34
to authorize certain assessments of persons with 35
intellectual disabilities residing in intermediate 36
care facilities, and to declare an emergency.37


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

       Section 1. That sections 2305.113, 2305.234, 2711.22, 38
3701.92, 3701.923, 3701.924, 3701.925, 3701.926, 3701.927, 39
3701.928, 3701.929, 3793.11, 3963.01, 4503.44, 4723.01, 4723.03, 40
4723.06, 4723.063, 4723.07, 4723.08, 4723.09, 4723.17, 4723.171, 41
4723.24, 4723.271, 4723.28, 4723.32, 4723.34, 4723.35, 4723.41, 42
4723.42, 4723.43, 4723.431, 4723.44, 4723.48, 4723.482, 4723.485, 43
4723.487, 4723.50, 4723.61, 4723.64, 4723.65, 4723.651, 4723.652, 44
4723.66, 4723.67, 4723.68, 4723.69, 4723.71, 4723.72, 4723.73, 45
4723.74, 4723.75, 4723.751, 4723.76, 4723.77, 4723.79, 4723.83, 46
4723.84, 4723.87, 4723.88, 4723.99, 4759.01, 4759.03, 4759.05, 47
4759.06, 4759.10, 5111.222, 5111.231, 5111.24, 5111.242, 5111.246, 48
5111.25, 5111.88, 5111.981, and 5120.55 be amended; sections 49
4723.17 (4723.18) and 4723.171 (4723.181) be amended for the 50
purpose of adopting new section numbers as indicated in 51
parentheses; and new section 4723.17 and sections 4723.091, 52
4723.092, 4723.19, 4723.653, and 5111.982 of the Revised Code be 53
enacted to read as follows:54

       Sec. 2305.113. (A) Except as otherwise provided in this 55
section, an action upon a medical, dental, optometric, or 56
chiropractic claim shall be commenced within one year after the 57
cause of action accrued.58

       (B)(1) If prior to the expiration of the one-year period 59
specified in division (A) of this section, a claimant who 60
allegedly possesses a medical, dental, optometric, or chiropractic 61
claim gives to the person who is the subject of that claim written 62
notice that the claimant is considering bringing an action upon 63
that claim, that action may be commenced against the person 64
notified at any time within one hundred eighty days after the 65
notice is so given.66

       (2) An insurance company shall not consider the existence or 67
nonexistence of a written notice described in division (B)(1) of 68
this section in setting the liability insurance premium rates that 69
the company may charge the company's insured person who is 70
notified by that written notice.71

        (C) Except as to persons within the age of minority or of 72
unsound mind as provided by section 2305.16 of the Revised Code, 73
and except as provided in division (D) of this section, both of 74
the following apply:75

        (1) No action upon a medical, dental, optometric, or 76
chiropractic claim shall be commenced more than four years after 77
the occurrence of the act or omission constituting the alleged 78
basis of the medical, dental, optometric, or chiropractic claim.79

       (2) If an action upon a medical, dental, optometric, or 80
chiropractic claim is not commenced within four years after the 81
occurrence of the act or omission constituting the alleged basis 82
of the medical, dental, optometric, or chiropractic claim, then, 83
any action upon that claim is barred.84

       (D)(1) If a person making a medical claim, dental claim, 85
optometric claim, or chiropractic claim, in the exercise of 86
reasonable care and diligence, could not have discovered the 87
injury resulting from the act or omission constituting the alleged 88
basis of the claim within three years after the occurrence of the 89
act or omission, but, in the exercise of reasonable care and 90
diligence, discovers the injury resulting from that act or 91
omission before the expiration of the four-year period specified 92
in division (C)(1) of this section, the person may commence an 93
action upon the claim not later than one year after the person 94
discovers the injury resulting from that act or omission.95

       (2) If the alleged basis of a medical claim, dental claim, 96
optometric claim, or chiropractic claim is the occurrence of an 97
act or omission that involves a foreign object that is left in the 98
body of the person making the claim, the person may commence an 99
action upon the claim not later than one year after the person 100
discovered the foreign object or not later than one year after the 101
person, with reasonable care and diligence, should have discovered 102
the foreign object.103

       (3) A person who commences an action upon a medical claim, 104
dental claim, optometric claim, or chiropractic claim under the 105
circumstances described in division (D)(1) or (2) of this section 106
has the affirmative burden of proving, by clear and convincing 107
evidence, that the person, with reasonable care and diligence, 108
could not have discovered the injury resulting from the act or 109
omission constituting the alleged basis of the claim within the 110
three-year period described in division (D)(1) of this section or 111
within the one-year period described in division (D)(2) of this 112
section, whichever is applicable.113

        (E) As used in this section:114

        (1) "Hospital" includes any person, corporation, association, 115
board, or authority that is responsible for the operation of any 116
hospital licensed or registered in the state, including, but not 117
limited to, those that are owned or operated by the state, 118
political subdivisions, any person, any corporation, or any 119
combination of the state, political subdivisions, persons, and 120
corporations. "Hospital" also includes any person, corporation, 121
association, board, entity, or authority that is responsible for 122
the operation of any clinic that employs a full-time staff of 123
physicians practicing in more than one recognized medical 124
specialty and rendering advice, diagnosis, care, and treatment to 125
individuals. "Hospital" does not include any hospital operated by 126
the government of the United States or any of its branches.127

       (2) "Physician" means a person who is licensed to practice 128
medicine and surgery or osteopathic medicine and surgery by the 129
state medical board or a person who otherwise is authorized to 130
practice medicine and surgery or osteopathic medicine and surgery 131
in this state.132

        (3) "Medical claim" means any claim that is asserted in any 133
civil action against a physician, podiatrist, hospital, home, or 134
residential facility, against any employee or agent of a 135
physician, podiatrist, hospital, home, or residential facility, or 136
against a licensed practical nurse, registered nurse, advanced 137
practice registered nurse, physical therapist, physician 138
assistant, emergency medical technician-basic, emergency medical 139
technician-intermediate, or emergency medical 140
technician-paramedic, and that arises out of the medical 141
diagnosis, care, or treatment of any person. "Medical claim" 142
includes the following:143

       (a) Derivative claims for relief that arise from the medical 144
diagnosis, care, or treatment of a person;145

       (b) Claims that arise out of the medical diagnosis, care, or 146
treatment of any person and to which either of the following 147
applies:148

        (i) The claim results from acts or omissions in providing 149
medical care.150

        (ii) The claim results from the hiring, training, 151
supervision, retention, or termination of caregivers providing 152
medical diagnosis, care, or treatment.153

        (c) Claims that arise out of the medical diagnosis, care, or 154
treatment of any person and that are brought under section 3721.17 155
of the Revised Code.156

       (4) "Podiatrist" means any person who is licensed to practice 157
podiatric medicine and surgery by the state medical board.158

        (5) "Dentist" means any person who is licensed to practice 159
dentistry by the state dental board.160

        (6) "Dental claim" means any claim that is asserted in any 161
civil action against a dentist, or against any employee or agent 162
of a dentist, and that arises out of a dental operation or the 163
dental diagnosis, care, or treatment of any person. "Dental claim" 164
includes derivative claims for relief that arise from a dental 165
operation or the dental diagnosis, care, or treatment of a person.166

       (7) "Derivative claims for relief" include, but are not 167
limited to, claims of a parent, guardian, custodian, or spouse of 168
an individual who was the subject of any medical diagnosis, care, 169
or treatment, dental diagnosis, care, or treatment, dental 170
operation, optometric diagnosis, care, or treatment, or 171
chiropractic diagnosis, care, or treatment, that arise from that 172
diagnosis, care, treatment, or operation, and that seek the 173
recovery of damages for any of the following:174

       (a) Loss of society, consortium, companionship, care, 175
assistance, attention, protection, advice, guidance, counsel, 176
instruction, training, or education, or any other intangible loss 177
that was sustained by the parent, guardian, custodian, or spouse;178

        (b) Expenditures of the parent, guardian, custodian, or 179
spouse for medical, dental, optometric, or chiropractic care or 180
treatment, for rehabilitation services, or for other care, 181
treatment, services, products, or accommodations provided to the 182
individual who was the subject of the medical diagnosis, care, or 183
treatment, the dental diagnosis, care, or treatment, the dental 184
operation, the optometric diagnosis, care, or treatment, or the 185
chiropractic diagnosis, care, or treatment.186

        (8) "Registered nurse" means any person who is licensed to 187
practice nursing as a registered nurse by the board of nursing.188

       (9) "Chiropractic claim" means any claim that is asserted in 189
any civil action against a chiropractor, or against any employee 190
or agent of a chiropractor, and that arises out of the 191
chiropractic diagnosis, care, or treatment of any person. 192
"Chiropractic claim" includes derivative claims for relief that 193
arise from the chiropractic diagnosis, care, or treatment of a 194
person.195

        (10) "Chiropractor" means any person who is licensed to 196
practice chiropractic by the state chiropractic board.197

        (11) "Optometric claim" means any claim that is asserted in 198
any civil action against an optometrist, or against any employee 199
or agent of an optometrist, and that arises out of the optometric 200
diagnosis, care, or treatment of any person. "Optometric claim" 201
includes derivative claims for relief that arise from the 202
optometric diagnosis, care, or treatment of a person.203

       (12) "Optometrist" means any person licensed to practice 204
optometry by the state board of optometry.205

       (13) "Physical therapist" means any person who is licensed to 206
practice physical therapy under Chapter 4755. of the Revised Code.207

       (14) "Home" has the same meaning as in section 3721.10 of the 208
Revised Code.209

        (15) "Residential facility" means a facility licensed under 210
section 5123.19 of the Revised Code.211

       (16) "Advanced practice registered nurse" means any certified 212
nurse practitioner, clinical nurse specialist, certified 213
registered nurse anesthetist, or certified nurse-midwife who holds 214
a certificate of authority issued by the board of nursing under 215
Chapter 4723. of the Revised Code.216

       (17) "Licensed practical nurse" means any person who is 217
licensed to practice nursing as a licensed practical nurse by the 218
board of nursing pursuant to Chapter 4723. of the Revised Code.219

       (18) "Physician assistant" means any person who holds a valid 220
certificate to practice issued pursuant to Chapter 4730. of the 221
Revised Code.222

       (19) "Emergency medical technician-basic," "emergency medical 223
technician-intermediate," and "emergency medical 224
technician-paramedic" means any person who is certified under 225
Chapter 4765. of the Revised Code as an emergency medical 226
technician-basic, emergency medical technician-intermediate, or 227
emergency medical technician-paramedic, whichever is applicable.228

       Sec. 2305.234.  (A) As used in this section:229

       (1) "Chiropractic claim," "medical claim," and "optometric 230
claim" have the same meanings as in section 2305.113 of the 231
Revised Code.232

       (2) "Dental claim" has the same meaning as in section 233
2305.113 of the Revised Code, except that it does not include any 234
claim arising out of a dental operation or any derivative claim 235
for relief that arises out of a dental operation.236

       (3) "Governmental health care program" has the same meaning 237
as in section 4731.65 of the Revised Code.238

       (4) "Health care facility or location" means a hospital, 239
clinic, ambulatory surgical facility, office of a health care 240
professional or associated group of health care professionals, 241
training institution for health care professionals, or any other 242
place where medical, dental, or other health-related diagnosis, 243
care, or treatment is provided to a person.244

       (5) "Health care professional" means any of the following who 245
provide medical, dental, or other health-related diagnosis, care, 246
or treatment:247

       (a) Physicians authorized under Chapter 4731. of the Revised 248
Code to practice medicine and surgery or osteopathic medicine and 249
surgery;250

       (b) Registered nurses and licensed practical nurses licensed 251
under Chapter 4723. of the Revised Code and individuals who hold a 252
certificate of authority issued under that chapter that authorizes 253
the practice of nursing as a certified registered nurse 254
anesthetist, clinical nurse specialist, certified nurse-midwife, 255
or certified nurse practitioner;256

       (c) Physician assistants authorized to practice under Chapter 257
4730. of the Revised Code;258

       (d) Dentists and dental hygienists licensed under Chapter 259
4715. of the Revised Code;260

       (e) Physical therapists, physical therapist assistants, 261
occupational therapists, and occupational therapy assistants 262
licensed under Chapter 4755. of the Revised Code;263

       (f) Chiropractors licensed under Chapter 4734. of the Revised 264
Code;265

       (g) Optometrists licensed under Chapter 4725. of the Revised 266
Code;267

       (h) Podiatrists authorized under Chapter 4731. of the Revised 268
Code to practice podiatry;269

       (i) Dietitians licensed under Chapter 4759. of the Revised 270
Code;271

       (j) Pharmacists licensed under Chapter 4729. of the Revised 272
Code;273

       (k) Emergency medical technicians-basic, emergency medical 274
technicians-intermediate, and emergency medical 275
technicians-paramedic, certified under Chapter 4765. of the 276
Revised Code;277

       (l) Respiratory care professionals licensed under Chapter 278
4761. of the Revised Code;279

       (m) Speech-language pathologists and audiologists licensed 280
under Chapter 4753. of the Revised Code;281

       (n) Professional clinical counselors, professional 282
counselors, independent social workers, social workers, 283
independent marriage and family therapists, and marriage and 284
family therapists, licensed under Chapter 4757. of the Revised 285
Code;286

       (o) Psychologists licensed under Chapter 4732. of the Revised 287
Code;288

       (p) Independent chemical dependency counselors, chemical 289
dependency counselors III, chemical dependency counselors II, and 290
chemical dependency counselors I, licensed under Chapter 4758. of 291
the Revised Code.292

       (6) "Health care worker" means a person other than a health 293
care professional who provides medical, dental, or other 294
health-related care or treatment under the direction of a health 295
care professional with the authority to direct that individual's 296
activities, including medical technicians, medical assistants, 297
dental assistants, orderlies, aides, and individuals acting in 298
similar capacities.299

       (7) "Indigent and uninsured person" means a person who meets 300
all of the following requirements:301

       (a) The person's income is not greater than two hundred per 302
cent of the current poverty line as defined by the United States 303
office of management and budget and revised in accordance with 304
section 673(2) of the "Omnibus Budget Reconciliation Act of 1981," 305
95 Stat. 511, 42 U.S.C. 9902, as amended.306

       (b) The person is not eligible to receive medical assistance 307
under Chapter 5111. of the Revised Code or assistance under any 308
other governmental health care program.309

       (c) Either of the following applies:310

       (i) The person is not a policyholder, certificate holder, 311
insured, contract holder, subscriber, enrollee, member, 312
beneficiary, or other covered individual under a health insurance 313
or health care policy, contract, or plan.314

       (ii) The person is a policyholder, certificate holder, 315
insured, contract holder, subscriber, enrollee, member, 316
beneficiary, or other covered individual under a health insurance 317
or health care policy, contract, or plan, but the insurer, policy, 318
contract, or plan denies coverage or is the subject of insolvency 319
or bankruptcy proceedings in any jurisdiction.320

       (8) "Nonprofit health care referral organization" means an 321
entity that is not operated for profit and refers patients to, or 322
arranges for the provision of, health-related diagnosis, care, or 323
treatment by a health care professional or health care worker.324

       (9) "Operation" means any procedure that involves cutting or 325
otherwise infiltrating human tissue by mechanical means, including 326
surgery, laser surgery, ionizing radiation, therapeutic 327
ultrasound, or the removal of intraocular foreign bodies. 328
"Operation" does not include the administration of medication by 329
injection, unless the injection is administered in conjunction 330
with a procedure infiltrating human tissue by mechanical means 331
other than the administration of medicine by injection. 332
"Operation" does not include routine dental restorative 333
procedures, the scaling of teeth, or extractions of teeth that are 334
not impacted.335

       (10) "Tort action" means a civil action for damages for 336
injury, death, or loss to person or property other than a civil 337
action for damages for a breach of contract or another agreement 338
between persons or government entities.339

       (11) "Volunteer" means an individual who provides any 340
medical, dental, or other health-care related diagnosis, care, or 341
treatment without the expectation of receiving and without receipt 342
of any compensation or other form of remuneration from an indigent 343
and uninsured person, another person on behalf of an indigent and 344
uninsured person, any health care facility or location, any 345
nonprofit health care referral organization, or any other person 346
or government entity.347

       (12) "Community control sanction" has the same meaning as in 348
section 2929.01 of the Revised Code.349

       (13) "Deep sedation" means a drug-induced depression of 350
consciousness during which a patient cannot be easily aroused but 351
responds purposefully following repeated or painful stimulation, a 352
patient's ability to independently maintain ventilatory function 353
may be impaired, a patient may require assistance in maintaining a 354
patent airway and spontaneous ventilation may be inadequate, and 355
cardiovascular function is usually maintained.356

       (14) "General anesthesia" means a drug-induced loss of 357
consciousness during which a patient is not arousable, even by 358
painful stimulation, the ability to independently maintain 359
ventilatory function is often impaired, a patient often requires 360
assistance in maintaining a patent airway, positive pressure 361
ventilation may be required because of depressed spontaneous 362
ventilation or drug-induced depression of neuromuscular function, 363
and cardiovascular function may be impaired.364

       (B)(1) Subject to divisions (F) and (G)(3) of this section, a 365
health care professional who is a volunteer and complies with 366
division (B)(2) of this section is not liable in damages to any 367
person or government entity in a tort or other civil action, 368
including an action on a medical, dental, chiropractic, 369
optometric, or other health-related claim, for injury, death, or 370
loss to person or property that allegedly arises from an action or 371
omission of the volunteer in the provision to an indigent and 372
uninsured person of medical, dental, or other health-related 373
diagnosis, care, or treatment, including the provision of samples 374
of medicine and other medical products, unless the action or 375
omission constitutes willful or wanton misconduct.376

       (2) To qualify for the immunity described in division (B)(1) 377
of this section, a health care professional shall do all of the 378
following prior to providing diagnosis, care, or treatment:379

       (a) Determine, in good faith, that the indigent and uninsured 380
person is mentally capable of giving informed consent to the 381
provision of the diagnosis, care, or treatment and is not subject 382
to duress or under undue influence;383

       (b) Inform the person of the provisions of this section, 384
including notifying the person that, by giving informed consent to 385
the provision of the diagnosis, care, or treatment, the person 386
cannot hold the health care professional liable for damages in a 387
tort or other civil action, including an action on a medical, 388
dental, chiropractic, optometric, or other health-related claim, 389
unless the action or omission of the health care professional 390
constitutes willful or wanton misconduct;391

       (c) Obtain the informed consent of the person and a written 392
waiver, signed by the person or by another individual on behalf of 393
and in the presence of the person, that states that the person is 394
mentally competent to give informed consent and, without being 395
subject to duress or under undue influence, gives informed consent 396
to the provision of the diagnosis, care, or treatment subject to 397
the provisions of this section. A written waiver under division 398
(B)(2)(c) of this section shall state clearly and in conspicuous 399
type that the person or other individual who signs the waiver is 400
signing it with full knowledge that, by giving informed consent to 401
the provision of the diagnosis, care, or treatment, the person 402
cannot bring a tort or other civil action, including an action on 403
a medical, dental, chiropractic, optometric, or other 404
health-related claim, against the health care professional unless 405
the action or omission of the health care professional constitutes 406
willful or wanton misconduct.407

       (3) A physician or podiatrist who is not covered by medical 408
malpractice insurance, but complies with division (B)(2) of this 409
section, is not required to comply with division (A) of section 410
4731.143 of the Revised Code.411

       (C) Subject to divisions (F) and (G)(3) of this section, 412
health care workers who are volunteers are not liable in damages 413
to any person or government entity in a tort or other civil 414
action, including an action upon a medical, dental, chiropractic, 415
optometric, or other health-related claim, for injury, death, or 416
loss to person or property that allegedly arises from an action or 417
omission of the health care worker in the provision to an indigent 418
and uninsured person of medical, dental, or other health-related 419
diagnosis, care, or treatment, unless the action or omission 420
constitutes willful or wanton misconduct.421

       (D) Subject to divisions (F) and (G)(3) of this section, a 422
nonprofit health care referral organization is not liable in 423
damages to any person or government entity in a tort or other 424
civil action, including an action on a medical, dental, 425
chiropractic, optometric, or other health-related claim, for 426
injury, death, or loss to person or property that allegedly arises 427
from an action or omission of the nonprofit health care referral 428
organization in referring indigent and uninsured persons to, or 429
arranging for the provision of, medical, dental, or other 430
health-related diagnosis, care, or treatment by a health care 431
professional described in division (B)(1) of this section or a 432
health care worker described in division (C) of this section, 433
unless the action or omission constitutes willful or wanton 434
misconduct.435

       (E) Subject to divisions (F) and (G)(3) of this section and 436
to the extent that the registration requirements of section 437
3701.071 of the Revised Code apply, a health care facility or 438
location associated with a health care professional described in 439
division (B)(1) of this section, a health care worker described in 440
division (C) of this section, or a nonprofit health care referral 441
organization described in division (D) of this section is not 442
liable in damages to any person or government entity in a tort or 443
other civil action, including an action on a medical, dental, 444
chiropractic, optometric, or other health-related claim, for 445
injury, death, or loss to person or property that allegedly arises 446
from an action or omission of the health care professional or 447
worker or nonprofit health care referral organization relative to 448
the medical, dental, or other health-related diagnosis, care, or 449
treatment provided to an indigent and uninsured person on behalf 450
of or at the health care facility or location, unless the action 451
or omission constitutes willful or wanton misconduct.452

       (F)(1) Except as provided in division (F)(2) of this section, 453
the immunities provided by divisions (B), (C), (D), and (E) of 454
this section are not available to a health care professional, 455
health care worker, nonprofit health care referral organization, 456
or health care facility or location if, at the time of an alleged 457
injury, death, or loss to person or property, the health care 458
professionals or health care workers involved are providing one of 459
the following:460

       (a) Any medical, dental, or other health-related diagnosis, 461
care, or treatment pursuant to a community service work order 462
entered by a court under division (B) of section 2951.02 of the 463
Revised Code or imposed by a court as a community control 464
sanction;465

       (b) Performance of an operation to which any one of the 466
following applies:467

        (i) The operation requires the administration of deep 468
sedation or general anesthesia.469

        (ii) The operation is a procedure that is not typically 470
performed in an office.471

       (iii) The individual involved is a health care professional, 472
and the operation is beyond the scope of practice or the 473
education, training, and competence, as applicable, of the health 474
care professional.475

       (c) Delivery of a baby or any other purposeful termination of 476
a human pregnancy.477

       (2) Division (F)(1) of this section does not apply when a 478
health care professional or health care worker provides medical, 479
dental, or other health-related diagnosis, care, or treatment that 480
is necessary to preserve the life of a person in a medical 481
emergency.482

       (G)(1) This section does not create a new cause of action or 483
substantive legal right against a health care professional, health 484
care worker, nonprofit health care referral organization, or 485
health care facility or location.486

       (2) This section does not affect any immunities from civil 487
liability or defenses established by another section of the 488
Revised Code or available at common law to which a health care 489
professional, health care worker, nonprofit health care referral 490
organization, or health care facility or location may be entitled 491
in connection with the provision of emergency or other medical, 492
dental, or other health-related diagnosis, care, or treatment.493

       (3) This section does not grant an immunity from tort or 494
other civil liability to a health care professional, health care 495
worker, nonprofit health care referral organization, or health 496
care facility or location for actions that are outside the scope 497
of authority of health care professionals or health care workers.498

       (4) This section does not affect any legal responsibility of 499
a health care professional, health care worker, or nonprofit 500
health care referral organization to comply with any applicable 501
law of this state or rule of an agency of this state.502

       (5) This section does not affect any legal responsibility of 503
a health care facility or location to comply with any applicable 504
law of this state, rule of an agency of this state, or local code, 505
ordinance, or regulation that pertains to or regulates building, 506
housing, air pollution, water pollution, sanitation, health, fire, 507
zoning, or safety.508

       Sec. 2711.22.  (A) Except as otherwise provided in this 509
section, a written contract between a patient and a hospital or 510
healthcare provider to settle by binding arbitration any dispute 511
or controversy arising out of the diagnosis, treatment, or care of 512
the patient rendered by a hospital or healthcare provider, that is 513
entered into prior to the diagnosis, treatment, or care of the 514
patient is valid, irrevocable, and enforceable once the contract 515
is signed by all parties. The contract remains valid, irrevocable, 516
and enforceable until or unless the patient or the patient's legal 517
representative rescinds the contract by written notice within 518
thirty days of the signing of the contract. A guardian or other 519
legal representative of the patient may give written notice of the 520
rescission of the contract if the patient is incapacitated or a 521
minor.522

       (B) As used in this section and in sections 2711.23 and 523
2711.24 of the Revised Code:524

       (1) "Healthcare provider" means a physician, podiatrist, 525
dentist, licensed practical nurse, registered nurse, advanced 526
practice registered nurse, chiropractor, optometrist, physician 527
assistant, emergency medical technician-basic, emergency medical 528
technician-intermediate, emergency medical technician-paramedic, 529
or physical therapist.530

       (2) "Hospital," "physician," "podiatrist," "dentist," 531
"licensed practical nurse," "registered nurse," "advanced practice 532
registered nurse," "chiropractor," "optometrist," "physician 533
assistant," "emergency medical technician-basic," "emergency 534
medical technician-intermediate," "emergency medical 535
technician-paramedic," "physical therapist," "medical claim," 536
"dental claim," "optometric claim," and "chiropractic claim" have 537
the same meanings as in section 2305.113 of the Revised Code.538

       Sec. 3701.92.  As used in sections 3701.921 to 3701.929 of 539
the Revised Code:540

       (A) "Advanced practice registered nurse" has the same meaning 541
as in section 4723.01 of the Revised Code.542

       (B) "Patient centered medical home education advisory group" 543
means the entity established under section 3701.924 of the Revised 544
Code. 545

       (D)(C) "Patient centered medical home education program" 546
means the program established under section 3701.921 of the 547
Revised Code and any pilot projects operated pursuant to that 548
section.549

       (E)(D) "Patient centered medical home education pilot 550
project" means the pilot project established under section 551
3701.923 of the Revised Code.552

       (F)(E) "Physician assistant" has the same meaning as in 553
section 4730.01 of the Revised Code.554

       Sec. 3701.923. (A) To the extent that funds are available, 555
the director of health shall establish the patient centered 556
medical home education pilot project. If the director establishes 557
the project, all of the following apply:558

       (1) The director shall select practices led by physicians and 559
primary care practices led by advanced practice registered nurses 560
to participate in the project. The director may consider the 561
recommendations of the advisory group made in accordance with 562
section 3701.925 of the Revised Code, but may not select a 563
practice unless the practice complies with any applicable 564
requirements under section 3701.926 of the Revised Code.565

       (2) The director shall conduct the project in a manner that 566
advances education in the patient centered medical home model of 567
care.568

       (3) The director shall evaluate all of the following:569

       (a) Learning opportunities generated by the project;570

        (b) Training of physicians and advanced practice registered571
nurses under the project;572

       (c) Costs of the project;573

       (d) The extent to which the project met the expected outcomes 574
developed under division (A) of section 3701.924 of the Revised 575
Code.576

       (4) The director shall assess and review results of the 577
project.578

       (5) The director shall recommend best practices and 579
opportunities for improving technology, education, comprehensive 580
training, consultation, and technical assistance for health care 581
service providers in the patient centered medical home model of 582
care.583

       (B) The director may contract with an entity that has 584
significant experience in assisting physician-led practices led by 585
physicians and advanced practice nurse-led primary care practices 586
led by advanced practice registered nurses in transitioning to the 587
patient centered medical home model of care. The contract shall 588
require the entity to do both of the following:589

       (1) Provide, to each practice that enters into a contract 590
with the director pursuant to section 3701.927 of the Revised 591
Code, comprehensive training, consultation, and technical 592
assistance in the operation of a patient centered medical home, 593
including assistance with leadership training, scheduling changes, 594
staff support, and care management for chronic health conditions;595

       (2) Assist the director in identifying necessary financial 596
and operational requirements and any barriers or challenges 597
associated with transitioning to a patient centered medical home 598
model of care.599

       (C) The project established under this section shall begin 600
not later than the date the first practice enters into a contract 601
with the director pursuant to section 3701.927 of the Revised Code 602
and shall cease not later than the date the final report is 603
submitted pursuant to division (B)(3) of section 3701.929 of the 604
Revised Code.605

       (D) The project shall not be operated in a manner that 606
requires a patient, unless otherwise required by the Revised Code, 607
to receive a referral from a physician in a practice selected for 608
inclusion in the pilot project under division (A)(1) of this 609
section as a condition of being authorized to receive specialized 610
health care services from an individual licensed or certified 611
under Title XLVII of the Revised Code to provide those services.612

       Sec. 3701.924. (A) The patient centered medical home 613
education advisory group is hereby created for the purpose of 614
advising the director of health on the implementation and 615
administration of the patient centered medical home education 616
program. The advisory group shall develop and provide to the 617
director a set of expected outcomes for the pilot project. The 618
advisory group shall consider and provide other recommendations to 619
the director and complete other duties as the director considers 620
appropriate. 621

       (B) The advisory group shall consist of the following 622
members:623

       (1) The following members appointed by the director of 624
health:625

       (a) One individual with expertise in the training and 626
education of primary care physicians recommended by the dean of 627
the university of Toledo college of medicine;628

       (b) One individual with expertise in the training and 629
education of primary care physicians recommended by the dean of 630
the Boonshoft school of medicine at Wright state university;631

       (c) One individual with expertise in the training and 632
education of primary care physicians recommended by the president 633
and dean of the northeast Ohio medical university;634

       (d) One individual with expertise in the training and 635
education of primary care physicians recommended by the dean of 636
the Ohio university college of osteopathic medicine;637

       (e) Two individuals recommended by the governing board of the 638
Ohio academy of family physicians;639

       (f) One individual recommended by the governing board of the 640
Ohio chapter of the American college of physicians;641

       (g) One individual recommended by the governing board of the 642
Ohio chapter of the American academy of pediatrics;643

       (h) One individual recommended by the governing board of the 644
Ohio osteopathic association;645

       (i) One individual with expertise in the training and 646
education of advanced practice registered nurses, recommended by 647
the governing board of the Ohio council of deans and directors of 648
baccalaureate and higher degree programs in nursing;649

       (j) One individual recommended by the governing board of the 650
Ohio nurses association;651

        (k) One individual recommended by the governing board of the 652
Ohio association of advanced practice nurses;653

       (l) One individual recommended by the governing board of the 654
Ohio council for home care and hospice;655

       (m) One individual recommended by the superintendent of 656
insurance;657

       (n) An employee of the department of health;658

       (o) Not more than five additional members who have relevant 659
expertise that the director considers appropriate.660

       (2) The following members:661

       (a) The executive director of the state medical board or the 662
director's designee;663

       (b) The executive director of the board of nursing or the 664
director's designee;665

       (c) The chancellor of the Ohio board of regents or the 666
chancellor's designee;667

       (d) The medical assistance director, or the director's 668
designee.669

       (C)(1) In making the original appointments of the members 670
specified in divisions (B)(1)(a) to (m) of this section, the 671
director shall appoint the member who served in that capacity in 672
the patient centered medical home advisory group, as it existed 673
immediately prior to the effective date of this sectionSeptember 674
10, 2012. If for any reason the member who served immediately 675
prior to the effective date of this sectionSeptember 10, 2012, is 676
unable to serve on the advisory group, the director shall request 677
from the specified recommending authority a list of not less than 678
two persons qualified to serve as members of the advisory group. 679
The director shall appoint as a member one person from the list 680
submitted by the recommending authority.681

        (2) The advisory group members specified in divisions 682
(B)(1)(a) to (m) of this section shall serve at the pleasure of 683
the director, in consultation with their respective recommending 684
authorities. 685

       (3) Vacancies shall be filled in the manner provided for 686
original appointments.687

       (D) Members shall serve without compensation, except to the 688
extent that serving on the advisory group is considered part of 689
their regular employment duties.690

       (E) The director may appoint from the members of the advisory 691
group a chairperson and vice-chairperson. 692

       A majority of the members of the advisory group constitutes a 693
quorum. A majority of a quorum is necessary for the advisory group 694
to make any recommendations to the director.695

       The advisory group shall meet at the call of the director. 696
The director shall call the advisory group to meet not less than 697
annually to discuss or consider recommendations to the director on 698
the administration of the patient centered medical home education 699
program.700

       (F) Sections 101.82 to 101.87 of the Revised Code do not 701
apply to the advisory group.702

       Sec. 3701.925. (A) The patient centered medical home 703
education advisory group shall accept applications for inclusion 704
in the patient centered medical home education pilot project from 705
primary care practices with educational affiliations, as 706
determined by the advisory group, with one or more of the 707
following:708

       (1) The Boonshoft school of medicine at Wright state 709
university;710

       (2) The university of Toledo college of medicine;711

       (3) The northeast Ohio medical university;712

       (4) The Ohio university college of osteopathic medicine;713

       (5) The college of nursing at the university of Toledo;714

        (6) The Wright state university college of nursing and 715
health;716

       (7) The college of nursing at Kent state university;717

        (8) The university of Akron college of nursing;718

       (9) The school of nursing at Ohio university.719

       (B)(1) Subject to division (C)(1) of this section, the 720
advisory group shall recommend to the director of health for 721
inclusion in the pilot project not less than the following number 722
of primary care practices led by physicians:723

       (a) Ten practices affiliated with the Boonshoft school of 724
medicine at Wright state university;725

       (b) Ten practices affiliated with the university of Toledo 726
college of medicine;727

       (c) Ten practices affiliated with the northeast Ohio medical 728
university;729

       (d) Ten practices affiliated with the centers for osteopathic 730
research and education of the Ohio university college of 731
osteopathic medicine.732

       (2) Subject to division (C)(2) of this section, the advisory 733
group shall recommend to the director of health for inclusion in 734
the pilot project not less than the following number of primary 735
care practices led by advanced practice registered nurses:736

        (a) One practice affiliated with the college of nursing at 737
the university of Toledo;738

        (b) One practice affiliated with the Wright state university 739
college of nursing and health;740

        (c) One practice affiliated with the college of nursing at 741
Kent state university or the university of Akron college of 742
nursing;743

        (d) One practice affiliated with the school of nursing at 744
Ohio university. 745

       (C)(1) All of the following apply with respect to the 746
recommendation of physician-led practices under division (B)(1) of 747
this section of practices led by physicians:748

       (a) The advisory group shall strive to recommend 749
physician-led practices in such a manner that the pilot project 750
includes a diverse range of primary care specialties, including 751
practices specializing in pediatrics, geriatrics, general internal 752
medicine, or family medicine.753

       (b) When evaluating an application, the advisory group shall 754
consider the percentage of patients in the physician-led practice 755
who are part of a medically underserved population, including 756
medicaid recipients and individuals without health insurance.757

       (c) The advisory group shall recommend not fewer than six 758
practices that serve rural areas of this state, as those areas are 759
determined by the advisory group.760

       (d) A member of the advisory group shall abstain from 761
participating in any vote taken regarding the recommendation of a 762
physician-led practice if the member would receive any financial 763
benefit from having the practice included in the pilot project.764

       (2) All of the following apply with respect to the 765
recommendation of advanced practice nurse-led primary care 766
practices under division (B)(2) of this section of practices led 767
by advanced practice registered nurses:768

       (a) When evaluating an application, the advisory group shall 769
consider the percentage of patients in the advanced practice 770
nurse-led primary care practice who are part of a medically 771
underserved population, including medicaid recipients and 772
individuals without health insurance.773

       (b) If the advisory group determines that it has not received 774
an application from a sufficiently qualified advanced practice 775
nurse-led primary care practice affiliated with a particular 776
institution specified in division (B)(2) of this section, the 777
advisory group shall make the recommendations required under that 778
division in such a manner that the greatest possible number of 779
those institutions are recommended to be included in the pilot 780
project. To be recommended in this manner, a practice remains 781
subject to the eligibility requirements specified in division (B) 782
of section 3701.926 of the Revised Code. As specified in division 783
(B)(2) of this section, the number of practices recommended for 784
inclusion in the pilot project shall be at least four.785

       (c) A member of the advisory group shall abstain from 786
participating in any vote taken regarding the recommendation of an 787
advanced practice nurse-led primary carea practice if the member 788
would receive any financial benefit from having the practice 789
included in the pilot project. 790

       (D) The advisory group shall provide a copyto the director 791
of health copies of all applications received under this section 792
to the director of health after making recommendations under 793
division (B)(1) of this section.794

       Sec. 3701.926. (A) To be eligible for inclusion in the 795
patient centered medical home education pilot project, a 796
physician-ledprimary care practice led by physicians shall meet 797
all of the following requirements: 798

       (1) Consist of physicians who are board-certified in family 799
medicine, general pediatrics, or internal medicine, as those 800
designations are issued by a medical specialty certifying board 801
recognized by the American board of medical specialties or 802
American osteopathic association; 803

       (2) Be capable of adapting the practice during the period in 804
which the practice participates in the patient centered medical 805
home education pilot project in such a manner that the practice is 806
fully compliant with the minimum standards for operation of a 807
patient centered medical home, as those standards are established 808
by the director of health; 809

        (3) Have submitted an application to participate in the 810
project established under former section 185.05 of the Revised 811
Code not later than April 15, 2011.812

       (4) Meet any other criteria established by the director as 813
part of the selection process.814

       (B) To be eligible for inclusion in the pilot project, an 815
advanced practice nurse-leda primary care practice led by 816
advanced practice registered nurses shall meet all of the 817
following requirements:818

        (1) Consist of advanced practice registered nurses, each of 819
whom meets all of the following requirements:820

        (a) Holds a certificate to prescribe issued under section 821
4723.48 of the Revised Code;822

       (b) Is board-certified as a family nurse practitioner or 823
adult nurse practitioner by the American academy of nurse 824
practitioners or American nurses credentialing center, 825
board-certified as a geriatric nurse practitioner or women's 826
health nurse practitioner by the American nurses credentialing 827
center, or is board-certified as a pediatric nurse practitioner by 828
the American nurses credentialing center or pediatric nursing 829
certification board;830

        (c) Collaborates under a standard care arrangement with a 831
physician with board certification as specified in division (A)(1) 832
of this section and who is an active participant on the health 833
care team. 834

       (2) Be capable of adapting the primary care practice during 835
the period in which the practice participates in the project in 836
such a manner that the practice is fully compliant with the 837
minimum standards for operation of a patient centered medical 838
home, as those standards are established by the director;839

        (3) Have submitted an application to participate in the 840
project established under former section 185.05 of the Revised 841
Code not later than April 15, 2011.842

       (4) Meet any other criteria established by the director as 843
part of the selection process. 844

       Sec. 3701.927. The director of health shall enter into a 845
contract with each primary care practice selected by the director 846
for inclusion in the patient centered medical home education pilot 847
project. The contract shall specify the terms and conditions for 848
inclusion in the pilot project, including a requirement that the 849
practice provide comprehensive, coordinated primary care services 850
to patients and serve as the patients' medical home. The contract 851
shall also require the practice to participate in the training of 852
medical students, advanced practice registered nursing students, 853
physician assistant students, and primary care medical residents.854

       The director may include as part of the contract any other 855
requirements necessary for a practice to be included in the 856
project, including requirements regarding the number of patients 857
served who are medicaid recipients and individuals without health 858
insurance.859

       Sec. 3701.928. (A) The director of health or, at the 860
director's request, the patient centered medical home education 861
advisory group may work with medical, nursing, and physician 862
assistant schools or programs in this state to develop appropriate 863
curricula designed to prepare primary care physicians, advanced 864
practice registered nurses, and physician assistants to practice 865
within the patient centered medical home model of care. In 866
developing the curricula, the director or advisory group and the 867
schools or programs shall include all of the following:868

       (1) Components for use at the medical student, advanced 869
practice registered nursing student, physician assistant student, 870
and primary care resident training levels;871

       (2) Components that reflect, as appropriate, the special 872
needs of patients who are part of a medically underserved 873
population, including medicaid recipients, individuals without 874
health insurance, individuals with disabilities, individuals with 875
chronic health conditions, and individuals within racial or ethnic 876
minority groups;877

       (3) Components that include training in interdisciplinary 878
cooperation between physicians, advanced practice registered879
nurses, and physician assistants in the patient centered medical 880
home model of care, including curricula ensuring that a common 881
conception of a patient centered medical home model of care is 882
provided to medical students, advanced practice registered nurses, 883
physician assistants, and primary care residents.884

       (B) The director or advisory group may work in association 885
with the medical, nursing, and physician assistant schools or 886
programs to identify funding sources to ensure that the curricula 887
developed under division (A) of this section are accessible to 888
medical students, advanced practice registered nursing students, 889
physician assistant students, and primary care residents. The 890
director or advisory group shall consider scholarship options or 891
incentives provided to students in addition to those provided 892
under the choose Ohio first scholarship program operated under 893
section 3333.61 of the Revised Code.894

       Sec. 3701.929. (A) If the director of health establishes the 895
patient centered medical home education pilot project, the 896
director shall prepare reports of its findings and recommendations 897
from the pilot project. Each report shall include an evaluation of 898
the learning opportunities generated by the pilot project, the 899
physicians and advanced practice registered nurses trained in the 900
pilot project, the costs of the pilot project, and the extent to 901
which the pilot project has met the set of expected outcomes 902
developed under division (A) of section 3701.924 of the Revised 903
Code.904

       (B) The reports shall be completed in accordance with the 905
following schedule:906

       (1) An interim report not later than six months after the 907
date on which the last primary care practice selected to 908
participate in the project enters into a contract with the 909
department of health pursuant to section 3701.927 of the Revised 910
Code;911

       (2) An update of the interim report not later than one year 912
after the date specified under division (B)(1) of this section;913

       (3) A final report not later than two years after the date 914
specified under division (B)(1) of this section.915

       (C) The director shall submit each of the reports to the 916
governor and, in accordance with section 101.68 of the Revised 917
Code, to the general assembly.918

       Sec. 3793.11.  (A) No alcohol and drug addiction program 919
shall employ methadone treatment or prescribe, dispense, or 920
administer methadone unless the program is licensed under this 921
section. No alcohol and drug addiction program licensed under this 922
section shall maintain methadone treatment in a manner 923
inconsistent with this section and the rules adopted under it.924

       (B) An alcohol and drug addiction program may apply to the 925
department of alcohol and drug addiction services for a license to 926
maintain methadone treatment. The department shall review all 927
applications received.928

       (C) The department may issue a license to maintain methadone 929
treatment to an alcohol and drug addiction program only if all of 930
the following apply:931

       (1) The program is operated by a private, nonprofit 932
organization or by a government entity;933

       (2) For at least two years immediately preceding the date of 934
application, the program has been fully certified under section 935
3793.06 of the Revised Code;936

       (3) The program has not been denied a license to maintain 937
methadone treatment or had its license withdrawn or revoked within 938
the five-year period immediately preceding the date of 939
application;940

       (4) It affirmatively appears to the department that the 941
program is adequately staffed and equipped to maintain methadone 942
treatment;943

       (5) It affirmatively appears to the department that the 944
program will conductmaintain methadone treatment in strict 945
compliance with section 3719.61 of the Revised Code, all other 946
laws relating to drug abuse, and the rules adopted by the 947
department;948

       (6) Except as provided in division (D) of this section, there 949
is no public or private school, licensed child day-care center, or 950
other child-serving agency within a radius of five hundred feet of 951
the location where the program is to maintain methadone treatment.952

        (D) The department may waive the requirement of division 953
(C)(6) of this section if it receives, from each public or private 954
school, licensed child day-care center, or other child-serving 955
agency that is within the applicable radius of the location where 956
the program is to maintain methadone treatment, a letter of 957
support for the location. The department shall determine whether a 958
letter of support is satisfactory for purposes of waiving the 959
requirement.960

       (D)(E) A license to maintain methadone treatment shall expire 961
one year from the date of issuance. Licenses may be renewed.962

       (E)(F) The department shall establish procedures and adopt 963
rules for licensing, inspection, and supervision of alcohol and 964
drug addiction programs that maintain methadone treatment. The 965
rules shall establish standards for the control, storage, 966
furnishing, use, and dispensing of methadone, prescribe minimum 967
standards for the operation of the methadone treatment component 968
of the program, and comply with federal laws and regulations.969

       All rules adopted under this division shall be adopted in 970
accordance with Chapter 119. of the Revised Code. All actions 971
taken by the department regarding the licensing of programs to 972
maintain methadone treatment shall be conducted in accordance with 973
Chapter 119. of the Revised Code, except as provided in division 974
(K)(L) of this section.975

       (F)(G) The department of alcohol and drug addiction services 976
shall inspect all alcohol and drug addiction programs licensed to 977
maintain methadone treatment. Inspections shall be conducted at 978
least annually and may be conducted more frequently. No person or 979
government entity shall interfere with a state or local government 980
official acting on behalf of the department while conducting an 981
inspection.982

       (G)(H) An alcohol and drug addiction program shall not 983
administer or dispense methadone in a tablet, powder, or 984
intravenous form. Methadone shall be administered or dispensed 985
only in a liquid form intended for ingestion. A program shall not 986
administer or dispense methadone to an individual for pain or 987
other medical reasons.988

       (H)(1)(I) As used in this division, "program sponsor" means a 989
person who assumes responsibility for the operation and employees 990
of the methadone treatment component of an alcohol and drug 991
addiction program.992

       (2) An alcohol and drug addiction program shall not employ an 993
individual who receives methadone treatment from that program. A 994
program shall not permit an individual to act as a program 995
sponsor, medical director, or director of the program if the 996
individual is receiving methadone treatment from any alcohol and 997
drug addiction program.998

       (I)(J) The department may issue orders to assure compliance 999
with section 3719.61 of the Revised Code, all other laws relating 1000
to drug abuse, and the rules adopted under this section. Subject 1001
to section 3793.13 of the Revised Code, the department may hold 1002
hearings, require the production of relevant matter, compel 1003
testimony, issue subpoenas, and make adjudications. Upon failure 1004
of a person without lawful excuse to obey a subpoena or to produce 1005
relevant matter, the department may apply to a court of common 1006
pleas for an order compelling compliance.1007

       (J)(K) The department may refuse to issue, or may withdraw or 1008
revoke, a license to maintain methadone treatment. A license may 1009
be refused if an alcohol and drug addiction program does not meet 1010
the requirements of division (C) of this section. A license may be 1011
withdrawn at any time the department determines that the program 1012
no longer meets the requirements for receiving the license. A 1013
license may be revoked in accordance with division (K)(L) of this 1014
section.1015

       (K)In the case of a license issued prior to the effective 1016
date of this amendment, the department shall not consider the 1017
requirement of division (C)(6) of this section in determining 1018
whether to renew, withdraw, or revoke the license.1019

        (L) If the department of alcohol and drug addiction services 1020
finds reasonable cause to believe that an alcohol and drug 1021
addiction program licensed under this section is in violation of 1022
any provision of section 3719.61 of the Revised Code, or of any 1023
other state or federal law or rule relating to drug abuse, the 1024
department may issue an order immediately revoking the license, 1025
subject to division (L)(M) of this section. The department shall 1026
set a date not more than fifteen days later than the date of the 1027
order of revocation for a hearing on the continuation or 1028
cancellation of the revocation. For good cause, the department may 1029
continue the hearing on application of any interested party. In 1030
conducting hearings, the department has all the authority and 1031
power set forth in division (I)(J) of this section. Following the 1032
hearing, the department shall either confirm or cancel the 1033
revocation. The hearing shall be conducted in accordance with 1034
Chapter 119. of the Revised Code, except that the program shall 1035
not be permitted to maintain methadone treatment pending the 1036
hearing or pending any appeal from an adjudication made as a 1037
result of the hearing. Notwithstanding any provision of Chapter 1038
119. of the Revised Code to the contrary, a court shall not stay 1039
or suspend any order of revocation issued by the director under 1040
this division pending judicial appeal.1041

       (L)(M) The department shall not revoke a license to maintain 1042
methadone treatment unless all clients receiving methadone 1043
treatment from the alcohol and drug addiction program are provided 1044
adequate substitute treatment. For purposes of this division, the 1045
department may transfer the clients to other programs licensed to 1046
maintain methadone treatment or replace any or all of the 1047
administrators and staff of the program with representatives of 1048
the department who shall continue on a provisional basis the 1049
methadone treatment component of the program.1050

       (M)(N) Each time the department receives an application from 1051
an alcohol and drug addiction program for a license to maintain 1052
methadone treatment, issues or refuses to issue a license, or 1053
withdraws or revokes a license, the department shall notify the 1054
board of alcohol, drug addiction, and mental health services of 1055
each alcohol, drug addiction, and mental health service district 1056
in which the program is operated.1057

       (N)(O) Whenever it appears to the department from files, upon 1058
complaint, or otherwise, that an alcohol and drug addiction 1059
program has engaged in any practice declared to be illegal or 1060
prohibited by section 3719.61 of the Revised Code, or any other 1061
state or federal laws or regulations relating to drug abuse, or 1062
when the department believes it to be in the best interest of the 1063
public and necessary for the protection of the citizens of the 1064
state, the department may request criminal proceedings by laying 1065
before the prosecuting attorney of the proper county any evidence 1066
of criminality which may come to its knowledge.1067

       (O)(P) The department shall maintain a current list of 1068
alcohol and drug addiction programs licensed by the department 1069
under division (C) of this section and shall provide a copy of the 1070
current list to a judge of a court of common pleas who requests a 1071
copy for the use of the judge under division (H) of section 1072
2925.03 of the Revised Code. The list of licensed alcohol and drug 1073
addiction programs shall identify each licensed program by its 1074
name, its address, and the county in which it is located.1075

       Sec. 3963.01. As used in this chapter:1076

       (A) "Affiliate" means any person or entity that has ownership 1077
or control of a contracting entity, is owned or controlled by a 1078
contracting entity, or is under common ownership or control with a 1079
contracting entity.1080

       (B) "Basic health care services" has the same meaning as in 1081
division (A) of section 1751.01 of the Revised Code, except that 1082
it does not include any services listed in that division that are 1083
provided by a pharmacist or nursing home.1084

       (C) "Contracting entity" means any person that has a primary 1085
business purpose of contracting with participating providers for 1086
the delivery of health care services.1087

       (D) "Credentialing" means the process of assessing and 1088
validating the qualifications of a provider applying to be 1089
approved by a contracting entity to provide basic health care 1090
services, specialty health care services, or supplemental health 1091
care services to enrollees.1092

       (E) "Edit" means adjusting one or more procedure codes billed 1093
by a participating provider on a claim for payment or a practice 1094
that results in any of the following:1095

       (1) Payment for some, but not all of the procedure codes 1096
originally billed by a participating provider;1097

       (2) Payment for a different procedure code than the procedure 1098
code originally billed by a participating provider;1099

       (3) A reduced payment as a result of services provided to an 1100
enrollee that are claimed under more than one procedure code on 1101
the same service date.1102

       (F) "Electronic claims transport" means to accept and 1103
digitize claims or to accept claims already digitized, to place 1104
those claims into a format that complies with the electronic 1105
transaction standards issued by the United States department of 1106
health and human services pursuant to the "Health Insurance 1107
Portability and Accountability Act of 1996," 110 Stat. 1955, 42 1108
U.S.C. 1320d, et seq., as those electronic standards are 1109
applicable to the parties and as those electronic standards are 1110
updated from time to time, and to electronically transmit those 1111
claims to the appropriate contracting entity, payer, or 1112
third-party administrator.1113

       (G) "Enrollee" means any person eligible for health care 1114
benefits under a health benefit plan, including an eligible 1115
recipient of medicaid under Chapter 5111. of the Revised Code, and 1116
includes all of the following terms:1117

       (1) "Enrollee" and "subscriber" as defined by section 1751.01 1118
of the Revised Code;1119

       (2) "Member" as defined by section 1739.01 of the Revised 1120
Code;1121

       (3) "Insured" and "plan member" pursuant to Chapter 3923. of 1122
the Revised Code;1123

       (4) "Beneficiary" as defined by section 3901.38 of the 1124
Revised Code.1125

       (H) "Health care contract" means a contract entered into, 1126
materially amended, or renewed between a contracting entity and a 1127
participating provider for the delivery of basic health care 1128
services, specialty health care services, or supplemental health 1129
care services to enrollees.1130

       (I) "Health care services" means basic health care services, 1131
specialty health care services, and supplemental health care 1132
services.1133

       (J) "Material amendment" means an amendment to a health care 1134
contract that decreases the participating provider's payment or 1135
compensation, changes the administrative procedures in a way that 1136
may reasonably be expected to significantly increase the 1137
provider's administrative expenses, or adds a new product. A 1138
material amendment does not include any of the following:1139

       (1) A decrease in payment or compensation resulting solely 1140
from a change in a published fee schedule upon which the payment 1141
or compensation is based and the date of applicability is clearly 1142
identified in the contract;1143

       (2) A decrease in payment or compensation that was 1144
anticipated under the terms of the contract, if the amount and 1145
date of applicability of the decrease is clearly identified in the 1146
contract;1147

       (3) An administrative change that may significantly increase 1148
the provider's administrative expense, the specific applicability 1149
of which is clearly identified in the contract;1150

       (4) Changes to an existing prior authorization, 1151
precertification, notification, or referral program that do not 1152
substantially increase the provider's administrative expense;1153

       (5) Changes to an edit program or to specific edits if the 1154
participating provider is provided notice of the changes pursuant 1155
to division (A)(1) of section 3963.04 of the Revised Code and the 1156
notice includes information sufficient for the provider to 1157
determine the effect of the change;1158

       (6) Changes to a health care contract described in division 1159
(B) of section 3963.04 of the Revised Code.1160

       (K) "Participating provider" means a provider that has a 1161
health care contract with a contracting entity and is entitled to 1162
reimbursement for health care services rendered to an enrollee 1163
under the health care contract.1164

       (L) "Payer" means any person that assumes the financial risk 1165
for the payment of claims under a health care contract or the 1166
reimbursement for health care services provided to enrollees by 1167
participating providers pursuant to a health care contract.1168

       (M) "Primary enrollee" means a person who is responsible for 1169
making payments for participation in a health care plan or an 1170
enrollee whose employment or other status is the basis of 1171
eligibility for enrollment in a health care plan.1172

       (N) "Procedure codes" includes the American medical 1173
association's current procedural terminology code, the American 1174
dental association's current dental terminology, and the centers 1175
for medicare and medicaid services health care common procedure 1176
coding system.1177

       (O) "Product" means one of the following types of categories 1178
of coverage for which a participating provider may be obligated to 1179
provide health care services pursuant to a health care contract:1180

       (1) A health maintenance organization or other product 1181
provided by a health insuring corporation;1182

       (2) A preferred provider organization;1183

       (3) Medicare;1184

       (4) Medicaid;1185

       (5) Workers' compensation.1186

       (P) "Provider" means a physician, podiatrist, dentist, 1187
chiropractor, optometrist, psychologist, physician assistant, 1188
advanced practice registered nurse, occupational therapist, 1189
massage therapist, physical therapist, professional counselor, 1190
professional clinical counselor, hearing aid dealer, orthotist, 1191
prosthetist, home health agency, hospice care program, or 1192
hospital, or a provider organization or physician-hospital 1193
organization that is acting exclusively as an administrator on 1194
behalf of a provider to facilitate the provider's participation in 1195
health care contracts. "Provider" does not mean a pharmacist, 1196
pharmacy, nursing home, or a provider organization or 1197
physician-hospital organization that leases the provider 1198
organization's or physician-hospital organization's network to a 1199
third party or contracts directly with employers or health and 1200
welfare funds.1201

       (Q) "Specialty health care services" has the same meaning as 1202
in section 1751.01 of the Revised Code, except that it does not 1203
include any services listed in division (B) of section 1751.01 of 1204
the Revised Code that are provided by a pharmacist or a nursing 1205
home.1206

       (R) "Supplemental health care services" has the same meaning 1207
as in division (B) of section 1751.01 of the Revised Code, except 1208
that it does not include any services listed in that division that 1209
are provided by a pharmacist or nursing home.1210

       Sec. 4503.44.  (A) As used in this section and in section 1211
4511.69 of the Revised Code:1212

       (1) "Person with a disability that limits or impairs the 1213
ability to walk" means any person who, as determined by a health 1214
care provider, meets any of the following criteria:1215

       (a) Cannot walk two hundred feet without stopping to rest;1216

       (b) Cannot walk without the use of, or assistance from, a 1217
brace, cane, crutch, another person, prosthetic device, 1218
wheelchair, or other assistive device;1219

       (c) Is restricted by a lung disease to such an extent that 1220
the person's forced (respiratory) expiratory volume for one 1221
second, when measured by spirometry, is less than one liter, or 1222
the arterial oxygen tension is less than sixty millimeters of 1223
mercury on room air at rest;1224

       (d) Uses portable oxygen;1225

       (e) Has a cardiac condition to the extent that the person's 1226
functional limitations are classified in severity as class III or 1227
class IV according to standards set by the American heart 1228
association;1229

       (f) Is severely limited in the ability to walk due to an 1230
arthritic, neurological, or orthopedic condition;1231

       (g) Is blind.1232

       (2) "Organization" means any private organization or 1233
corporation, or any governmental board, agency, department, 1234
division, or office, that, as part of its business or program, 1235
transports persons with disabilities that limit or impair the 1236
ability to walk on a regular basis in a motor vehicle that has not 1237
been altered for the purpose of providing it with special 1238
equipment for use by handicapped persons. This definition does not 1239
apply to division (J) of this section.1240

       (3) "Health care provider" means a physician, physician 1241
assistant, advanced practice registered nurse, or chiropractor as 1242
defined in this section.1243

       (4) "Physician" means a person licensed to practice medicine 1244
or surgery or osteopathic medicine and surgery under Chapter 4731. 1245
of the Revised Code.1246

       (5) "Chiropractor" means a person licensed to practice 1247
chiropractic under Chapter 4734. of the Revised Code.1248

       (6) "Advanced practice registered nurse" means anya1249
certified nurse practitioner, clinical nurse specialist, certified 1250
registered nurse anesthetist, or certified nurse-midwife who holds 1251
a certificate of authority issued by the board of nursing under 1252
Chapter 4723. of the Revised Code.1253

       (7) "Physician assistant" means a person who holds a 1254
certificate to practice as a physician assistant issued under 1255
Chapter 4730. of the Revised Code.1256

       (B) Any organization or person with a disability that limits 1257
or impairs the ability to walk may apply to the registrar of motor 1258
vehicles for a removable windshield placard or, if the person owns 1259
or leases a motor vehicle, the person may apply for the 1260
registration of any motor vehicle the person owns or leases. In 1261
addition to one or more sets of license plates or one placard, a 1262
person with a disability that limits or impairs the ability to 1263
walk is entitled to one additional placard, but only if the person 1264
applies separately for the additional placard, states the reasons 1265
why the additional placard is needed, and the registrar, in the 1266
registrar's discretion, determines that good and justifiable cause 1267
exists to approve the request for the additional placard. When a 1268
motor vehicle has been altered for the purpose of providing it 1269
with special equipment for a person with a disability that limits 1270
or impairs the ability to walk, but is owned or leased by someone 1271
other than such a person, the owner or lessee may apply to the 1272
registrar or a deputy registrar for registration under this 1273
section. The application for registration of a motor vehicle owned 1274
or leased by a person with a disability that limits or impairs the 1275
ability to walk shall be accompanied by a signed statement from 1276
the applicant's health care provider certifying that the applicant 1277
meets at least one of the criteria contained in division (A)(1) of 1278
this section and that the disability is expected to continue for 1279
more than six consecutive months. The application for a removable 1280
windshield placard made by a person with a disability that limits 1281
or impairs the ability to walk shall be accompanied by a 1282
prescription from the applicant's health care provider prescribing 1283
such a placard for the applicant, provided that the applicant 1284
meets at least one of the criteria contained in division (A)(1) of 1285
this section. The health care provider shall state on the 1286
prescription the length of time the health care provider expects 1287
the applicant to have the disability that limits or impairs the 1288
applicant's ability to walk. The application for a removable 1289
windshield placard made by an organization shall be accompanied by 1290
such documentary evidence of regular transport of persons with 1291
disabilities that limit or impair the ability to walk by the 1292
organization as the registrar may require by rule and shall be 1293
completed in accordance with procedures that the registrar may 1294
require by rule. The application for registration of a motor 1295
vehicle that has been altered for the purpose of providing it with 1296
special equipment for a person with a disability that limits or 1297
impairs the ability to walk but is owned by someone other than 1298
such a person shall be accompanied by such documentary evidence of 1299
vehicle alterations as the registrar may require by rule.1300

       (C) When an organization, a person with a disability that 1301
limits or impairs the ability to walk, or a person who does not 1302
have a disability that limits or impairs the ability to walk but 1303
owns a motor vehicle that has been altered for the purpose of 1304
providing it with special equipment for a person with a disability 1305
that limits or impairs the ability to walk first submits an 1306
application for registration of a motor vehicle under this section 1307
and every fifth year thereafter, the organization or person shall 1308
submit a signed statement from the applicant's health care 1309
provider, a completed application, and any required documentary 1310
evidence of vehicle alterations as provided in division (B) of 1311
this section, and also a power of attorney from the owner of the 1312
motor vehicle if the applicant leases the vehicle. Upon submission 1313
of these items, the registrar or deputy registrar shall issue to 1314
the applicant appropriate vehicle registration and a set of 1315
license plates and validation stickers, or validation stickers 1316
alone when required by section 4503.191 of the Revised Code. In 1317
addition to the letters and numbers ordinarily inscribed thereon, 1318
the license plates shall be imprinted with the international 1319
symbol of access. The license plates and validation stickers shall 1320
be issued upon payment of the regular license fee as prescribed 1321
under section 4503.04 of the Revised Code and any motor vehicle 1322
tax levied under Chapter 4504. of the Revised Code, and the 1323
payment of a service fee equal to the amount specified in division 1324
(D) or (G) of section 4503.10 of the Revised Code.1325

       (D)(1) Upon receipt of a completed and signed application for 1326
a removable windshield placard, a prescription as described in 1327
division (B) of this section, documentary evidence of regular 1328
transport of persons with disabilities that limit or impair the 1329
ability to walk, if required, and payment of a service fee equal 1330
to the amount specified in division (D) or (G) of section 4503.10 1331
of the Revised Code, the registrar or deputy registrar shall issue 1332
to the applicant a removable windshield placard, which shall bear 1333
the date of expiration on both sides of the placard and shall be 1334
valid until expired, revoked, or surrendered. Every removable 1335
windshield placard expires as described in division (D)(2) of this 1336
section, but in no case shall a removable windshield placard be 1337
valid for a period of less than sixty days. Removable windshield 1338
placards shall be renewable upon application as provided in 1339
division (B) of this section, and a service fee equal to the 1340
amount specified in division (D) or (G) of section 4503.10 of the 1341
Revised Code shall be charged for the renewal of a removable 1342
windshield placard. The registrar shall provide the application 1343
form and shall determine the information to be included thereon. 1344
The registrar also shall determine the form and size of the 1345
removable windshield placard, the material of which it is to be 1346
made, and any other information to be included thereon, and shall 1347
adopt rules relating to the issuance, expiration, revocation, 1348
surrender, and proper display of such placards. Any placard issued 1349
after October 14, 1999, shall be manufactured in a manner that 1350
allows the expiration date of the placard to be indicated on it 1351
through the punching, drilling, boring, or creation by any other 1352
means of holes in the placard.1353

       (2) At the time a removable windshield placard is issued to a 1354
person with a disability that limits or impairs the ability to 1355
walk, the registrar or deputy registrar shall enter into the 1356
records of the bureau of motor vehicles the last date on which the 1357
person will have that disability, as indicated on the accompanying 1358
prescription. Not less than thirty days prior to that date and all 1359
removable windshield placard renewal dates, the bureau shall send 1360
a renewal notice to that person at the person's last known address 1361
as shown in the records of the bureau, informing the person that 1362
the person's removable windshield placard will expire on the 1363
indicated date not to exceed five years from the date of issuance, 1364
and that the person is required to renew the placard by submitting 1365
to the registrar or a deputy registrar another prescription, as 1366
described in division (B) of this section, and by complying with 1367
the renewal provisions prescribed in division (D)(1) of this 1368
section. If such a prescription is not received by the registrar 1369
or a deputy registrar by that date, the placard issued to that 1370
person expires and no longer is valid, and this fact shall be 1371
recorded in the records of the bureau.1372

       (3) At least once every year, on a date determined by the 1373
registrar, the bureau shall examine the records of the office of 1374
vital statistics, located within the department of health, that 1375
pertain to deceased persons, and also the bureau's records of all 1376
persons who have been issued removable windshield placards and 1377
temporary removable windshield placards. If the records of the 1378
office of vital statistics indicate that a person to whom a 1379
removable windshield placard or temporary removable windshield 1380
placard has been issued is deceased, the bureau shall cancel that 1381
placard, and note the cancellation in its records.1382

       The office of vital statistics shall make available to the 1383
bureau all information necessary to enable the bureau to comply 1384
with division (D)(3) of this section.1385

       (4) Nothing in this section shall be construed to require a 1386
person or organization to apply for a removable windshield placard 1387
or special license plates if the parking card or special license 1388
plates issued to the person or organization under prior law have 1389
not expired or been surrendered or revoked.1390

       (E)(1)(a) Any person with a disability that limits or impairs 1391
the ability to walk may apply to the registrar or a deputy 1392
registrar for a temporary removable windshield placard. The 1393
application for a temporary removable windshield placard shall be 1394
accompanied by a prescription from the applicant's health care 1395
provider prescribing such a placard for the applicant, provided 1396
that the applicant meets at least one of the criteria contained in 1397
division (A)(1) of this section and that the disability is 1398
expected to continue for six consecutive months or less. The 1399
health care provider shall state on the prescription the length of 1400
time the health care provider expects the applicant to have the 1401
disability that limits or impairs the applicant's ability to walk, 1402
which cannot exceed six months from the date of the prescription. 1403
Upon receipt of an application for a temporary removable 1404
windshield placard, presentation of the prescription from the 1405
applicant's health care provider, and payment of a service fee 1406
equal to the amount specified in division (D) or (G) of section 1407
4503.10 of the Revised Code, the registrar or deputy registrar 1408
shall issue to the applicant a temporary removable windshield 1409
placard.1410

       (b) Any active-duty member of the armed forces of the United 1411
States, including the reserve components of the armed forces and 1412
the national guard, who has an illness or injury that limits or 1413
impairs the ability to walk may apply to the registrar or a deputy 1414
registrar for a temporary removable windshield placard. With the 1415
application, the person shall present evidence of the person's 1416
active-duty status and the illness or injury. Evidence of the 1417
illness or injury may include a current department of defense 1418
convalescent leave statement, any department of defense document 1419
indicating that the person currently has an ill or injured 1420
casualty status or has limited duties, or a prescription from any 1421
health care provider prescribing the placard for the applicant. 1422
Upon receipt of the application and the necessary evidence, the 1423
registrar or deputy registrar shall issue the applicant the 1424
temporary removable windshield placard without the payment of any 1425
service fee.1426

       (2) The temporary removable windshield placard shall be of 1427
the same size and form as the removable windshield placard, shall 1428
be printed in white on a red-colored background, and shall bear 1429
the word "temporary" in letters of such size as the registrar 1430
shall prescribe. A temporary removable windshield placard also 1431
shall bear the date of expiration on the front and back of the 1432
placard, and shall be valid until expired, surrendered, or 1433
revoked, but in no case shall such a placard be valid for a period 1434
of less than sixty days. The registrar shall provide the 1435
application form and shall determine the information to be 1436
included on it, provided that the registrar shall not require a 1437
health care provider's prescription or certification for a person 1438
applying under division (E)(1)(b) of this section. The registrar 1439
also shall determine the material of which the temporary removable 1440
windshield placard is to be made and any other information to be 1441
included on the placard and shall adopt rules relating to the 1442
issuance, expiration, surrender, revocation, and proper display of 1443
those placards. Any temporary removable windshield placard issued 1444
after October 14, 1999, shall be manufactured in a manner that 1445
allows for the expiration date of the placard to be indicated on 1446
it through the punching, drilling, boring, or creation by any 1447
other means of holes in the placard.1448

       (F) If an applicant for a removable windshield placard is a 1449
veteran of the armed forces of the United States whose disability, 1450
as defined in division (A)(1) of this section, is 1451
service-connected, the registrar or deputy registrar, upon receipt 1452
of the application, presentation of a signed statement from the 1453
applicant's health care provider certifying the applicant's 1454
disability, and presentation of such documentary evidence from the 1455
department of veterans affairs that the disability of the 1456
applicant meets at least one of the criteria identified in 1457
division (A)(1) of this section and is service-connected as the 1458
registrar may require by rule, but without the payment of any 1459
service fee, shall issue the applicant a removable windshield 1460
placard that is valid until expired, surrendered, or revoked.1461

       (G) Upon a conviction of a violation of division (I), (J), or 1462
(K) of this section, the court shall report the conviction, and 1463
send the placard or parking card, if available, to the registrar, 1464
who thereupon shall revoke the privilege of using the placard or 1465
parking card and send notice in writing to the placardholder or 1466
cardholder at that holder's last known address as shown in the 1467
records of the bureau, and the placardholder or cardholder shall 1468
return the placard or card if not previously surrendered to the 1469
court, to the registrar within ten days following mailing of the 1470
notice.1471

       Whenever a person to whom a removable windshield placard or 1472
parking card has been issued moves to another state, the person 1473
shall surrender the placard or card to the registrar; and whenever 1474
an organization to which a placard or card has been issued changes 1475
its place of operation to another state, the organization shall 1476
surrender the placard or card to the registrar.1477

       (H) Subject to division (F) of section 4511.69 of the Revised 1478
Code, the operator of a motor vehicle displaying a removable 1479
windshield placard, temporary removable windshield placard, 1480
parking card, or the special license plates authorized by this 1481
section is entitled to park the motor vehicle in any special 1482
parking location reserved for persons with disabilities that limit 1483
or impair the ability to walk, also known as handicapped parking 1484
spaces or disability parking spaces.1485

       (I) No person or organization that is not eligible under 1486
division (B) or (E) of this section shall willfully and falsely 1487
represent that the person or organization is so eligible.1488

       No person or organization shall display license plates issued 1489
under this section unless the license plates have been issued for 1490
the vehicle on which they are displayed and are valid.1491

       (J) No person or organization to which a removable windshield 1492
placard or temporary removable windshield placard is issued shall 1493
do either of the following:1494

       (1) Display or permit the display of the placard on any motor 1495
vehicle when having reasonable cause to believe the motor vehicle 1496
is being used in connection with an activity that does not include 1497
providing transportation for persons with disabilities that limit 1498
or impair the ability to walk;1499

       (2) Refuse to return or surrender the placard, when required.1500

       (K)(1) No person or organization to which a parking card is 1501
issued shall do either of the following:1502

       (a) Display or permit the display of the parking card on any 1503
motor vehicle when having reasonable cause to believe the motor 1504
vehicle is being used in connection with an activity that does not 1505
include providing transportation for a handicapped person;1506

       (b) Refuse to return or surrender the parking card, when 1507
required.1508

       (2) As used in division (K) of this section:1509

       (a) "Handicapped person" means any person who has lost the 1510
use of one or both legs or one or both arms, who is blind, deaf, 1511
or so severely handicapped as to be unable to move about without 1512
the aid of crutches or a wheelchair, or whose mobility is 1513
restricted by a permanent cardiovascular, pulmonary, or other 1514
handicapping condition.1515

       (b) "Organization" means any private organization or 1516
corporation, or any governmental board, agency, department, 1517
division, or office, that, as part of its business or program, 1518
transports handicapped persons on a regular basis in a motor 1519
vehicle that has not been altered for the purposes of providing it 1520
with special equipment for use by handicapped persons.1521

       (L) If a removable windshield placard, temporary removable 1522
windshield placard, or parking card is lost, destroyed, or 1523
mutilated, the placardholder or cardholder may obtain a duplicate 1524
by doing both of the following:1525

       (1) Furnishing suitable proof of the loss, destruction, or 1526
mutilation to the registrar;1527

       (2) Paying a service fee equal to the amount specified in 1528
division (D) or (G) of section 4503.10 of the Revised Code.1529

       Any placardholder or cardholder who loses a placard or card 1530
and, after obtaining a duplicate, finds the original, immediately 1531
shall surrender the original placard or card to the registrar.1532

       (M) The registrar shall pay all fees received under this 1533
section for the issuance of removable windshield placards or 1534
temporary removable windshield placards or duplicate removable 1535
windshield placards or cards into the state treasury to the credit 1536
of the state bureau of motor vehicles fund created in section 1537
4501.25 of the Revised Code.1538

       (N) In addition to the fees collected under this section, the 1539
registrar or deputy registrar shall ask each person applying for a 1540
removable windshield placard or temporary removable windshield 1541
placard or duplicate removable windshield placard or license plate 1542
issued under this section, whether the person wishes to make a 1543
two-dollar voluntary contribution to support rehabilitation 1544
employment services. The registrar shall transmit the 1545
contributions received under this division to the treasurer of 1546
state for deposit into the rehabilitation employment fund, which 1547
is hereby created in the state treasury. A deputy registrar shall 1548
transmit the contributions received under this division to the 1549
registrar in the time and manner prescribed by the registrar. The 1550
contributions in the fund shall be used by the rehabilitation 1551
services commission to purchase services related to vocational 1552
evaluation, work adjustment, personal adjustment, job placement, 1553
job coaching, and community-based assessment from accredited 1554
community rehabilitation program facilities.1555

       (O) For purposes of enforcing this section, every peace 1556
officer is deemed to be an agent of the registrar. Any peace 1557
officer or any authorized employee of the bureau of motor vehicles 1558
who, in the performance of duties authorized by law, becomes aware 1559
of a person whose placard or parking card has been revoked 1560
pursuant to this section, may confiscate that placard or parking 1561
card and return it to the registrar. The registrar shall prescribe 1562
any forms used by law enforcement agencies in administering this 1563
section.1564

       No peace officer, law enforcement agency employing a peace 1565
officer, or political subdivision or governmental agency employing 1566
a peace officer, and no employee of the bureau is liable in a 1567
civil action for damages or loss to persons arising out of the 1568
performance of any duty required or authorized by this section. As 1569
used in this division, "peace officer" has the same meaning as in 1570
division (B) of section 2935.01 of the Revised Code.1571

       (P) All applications for registration of motor vehicles, 1572
removable windshield placards, and temporary removable windshield 1573
placards issued under this section, all renewal notices for such 1574
items, and all other publications issued by the bureau that relate 1575
to this section shall set forth the criminal penalties that may be 1576
imposed upon a person who violates any provision relating to 1577
special license plates issued under this section, the parking of 1578
vehicles displaying such license plates, and the issuance, 1579
procurement, use, and display of removable windshield placards and 1580
temporary removable windshield placards issued under this section.1581

       (Q) Whoever violates this section is guilty of a misdemeanor 1582
of the fourth degree.1583

       Sec. 4723.01.  As used in this chapter:1584

       (A) "Registered nurse" means an individual who holds a 1585
current, valid license issued under this chapter that authorizes 1586
the practice of nursing as a registered nurse.1587

       (B) "Practice of nursing as a registered nurse" means 1588
providing to individuals and groups nursing care requiring 1589
specialized knowledge, judgment, and skill derived from the 1590
principles of biological, physical, behavioral, social, and 1591
nursing sciences. Such nursing care includes:1592

       (1) Identifying patterns of human responses to actual or 1593
potential health problems amenable to a nursing regimen;1594

       (2) Executing a nursing regimen through the selection, 1595
performance, management, and evaluation of nursing actions;1596

       (3) Assessing health status for the purpose of providing 1597
nursing care;1598

       (4) Providing health counseling and health teaching;1599

       (5) Administering medications, treatments, and executing 1600
regimens authorized by an individual who is authorized to practice 1601
in this state and is acting within the course of the individual's 1602
professional practice;1603

       (6) Teaching, administering, supervising, delegating, and 1604
evaluating nursing practice.1605

       (C) "Nursing regimen" may include preventative, restorative, 1606
and health-promotion activities.1607

       (D) "Assessing health status" means the collection of data 1608
through nursing assessment techniques, which may include 1609
interviews, observation, and physical evaluations for the purpose 1610
of providing nursing care.1611

       (E) "Licensed practical nurse" means an individual who holds 1612
a current, valid license issued under this chapter that authorizes 1613
the practice of nursing as a licensed practical nurse.1614

       (F) "The practice of nursing as a licensed practical nurse" 1615
means providing to individuals and groups nursing care requiring 1616
the application of basic knowledge of the biological, physical, 1617
behavioral, social, and nursing sciences at the direction of a 1618
licensed physician, dentist, podiatrist, optometrist, 1619
chiropractor, or registered nurse. Such nursing care includes:1620

       (1) Observation, patient teaching, and care in a diversity of 1621
health care settings;1622

       (2) Contributions to the planning, implementation, and 1623
evaluation of nursing;1624

       (3) Administration of medications and treatments authorized 1625
by an individual who is authorized to practice in this state and 1626
is acting within the course of the individual's professional 1627
practice, except that administration of intravenous therapy shall 1628
be performed only in accordance with section 4723.17 or 4723.171 1629
of the Revised Code. Medications may be administered by aon the 1630
condition that the licensed practical nurse upon proof of 1631
completion of a course in medication administration approved by 1632
the board of nursing.is authorized under section 4723.17 of the 1633
Revised Code to administer medications;1634

       (4) Administration to an adult of intravenous therapy 1635
authorized by an individual who is authorized to practice in this 1636
state and is acting within the course of the individual's 1637
professional practice, on the condition that the licensed 1638
practical nurse is authorized under section 4723.174723.18 or 1639
4723.1714723.181 of the Revised Code to perform intravenous 1640
therapy and performs intravenous therapy only in accordance with 1641
those sections;1642

       (5) Delegation of nursing tasks as directed by a registered 1643
nurse;1644

       (6) Teaching nursing tasks to licensed practical nurses and 1645
individuals to whom the licensed practical nurse is authorized to 1646
delegate nursing tasks as directed by a registered nurse.1647

       (G) "Certified registered nurse anesthetist" means a 1648
registered nurse who holds a valid certificate of authority issued 1649
under this chapter that authorizes the practice of nursing as a 1650
certified registered nurse anesthetist in accordance with section 1651
4723.43 of the Revised Code and rules adopted by the board of 1652
nursing.1653

       (H) "Clinical nurse specialist" means a registered nurse who 1654
holds a valid certificate of authority issued under this chapter 1655
that authorizes the practice of nursing as a clinical nurse 1656
specialist in accordance with section 4723.43 of the Revised Code 1657
and rules adopted by the board of nursing.1658

       (I) "Certified nurse-midwife" means a registered nurse who 1659
holds a valid certificate of authority issued under this chapter 1660
that authorizes the practice of nursing as a certified 1661
nurse-midwife in accordance with section 4723.43 of the Revised 1662
Code and rules adopted by the board of nursing.1663

       (J) "Certified nurse practitioner" means a registered nurse 1664
who holds a valid certificate of authority issued under this 1665
chapter that authorizes the practice of nursing as a certified 1666
nurse practitioner in accordance with section 4723.43 of the 1667
Revised Code and rules adopted by the board of nursing.1668

       (K) "Physician" means an individual authorized under Chapter 1669
4731. of the Revised Code to practice medicine and surgery or 1670
osteopathic medicine and surgery, except as used in divisions (C) 1671
and (D) of section 4723.482 of the Revised Code.1672

       (L) "Collaboration" or "collaborating" means the following:1673

       (1) In the case of a clinical nurse specialist, except as 1674
provided in division (L)(3) of this section, or a certified nurse 1675
practitioner, that one or more podiatrists acting within the scope 1676
of practice of podiatry in accordance with section 4731.51 of the 1677
Revised Code and with whom the nurse has entered into a standard 1678
care arrangement or one or more physicians with whom the nurse has 1679
entered into a standard care arrangement are continuously 1680
available to communicate with the clinical nurse specialist or 1681
certified nurse practitioner either in person or by radio, 1682
telephone, or other form of telecommunication;1683

       (2) In the case of a certified nurse-midwife, that one or 1684
more physicians with whom the certified nurse-midwife has entered 1685
into a standard care arrangement are continuously available to 1686
communicate with the certified nurse-midwife either in person or 1687
by radio, telephone, or other form of telecommunication;1688

       (3) In the case of a clinical nurse specialist who practices 1689
the nursing specialty of mental health or psychiatric mental 1690
health without being authorized to prescribe drugs and therapeutic 1691
devices, that one or more physicians are continuously available to 1692
communicate with the nurse either in person or by radio, 1693
telephone, or other form of telecommunication.1694

       (M) "Supervision," as it pertains to a certified registered 1695
nurse anesthetist, means that the certified registered nurse 1696
anesthetist is under the direction of a podiatrist acting within 1697
the podiatrist's scope of practice in accordance with section 1698
4731.51 of the Revised Code, a dentist acting within the dentist's 1699
scope of practice in accordance with Chapter 4715. of the Revised 1700
Code, or a physician, and, when administering anesthesia, the 1701
certified registered nurse anesthetist is in the immediate 1702
presence of the podiatrist, dentist, or physician.1703

       (N) "Standard care arrangement" means a written, formal guide 1704
for planning and evaluating a patient's health care that is 1705
developed by one or more collaborating physicians or podiatrists 1706
and a clinical nurse specialist, certified nurse-midwife, or 1707
certified nurse practitioner and meets the requirements of section 1708
4723.431 of the Revised Code.1709

       (O) "Advanced practice registered nurse" means a certified 1710
registered nurse anesthetist, clinical nurse specialist, certified 1711
nurse-midwife, or certified nurse practitioner.1712

       (P) "Dialysis care" means the care and procedures that a 1713
dialysis technician or dialysis technician intern is authorized to 1714
provide and perform, as specified in section 4723.72 of the 1715
Revised Code.1716

       (Q) "Dialysis technician" means an individual who holds a 1717
current, valid certificate or temporary certificate issued under 1718
this chapter that authorizes the individual to practice as a 1719
dialysis technician in accordance withissued under section 1720
4723.724723.75 of the Revised Code.1721

       (R) "Dialysis technician intern" means an individual who 1722
holds a current, valid certificate to practice as a dialysis 1723
technician intern issued under section 4723.75 of the Revised 1724
Code.1725

       (S) "Certified community health worker" means an individual 1726
who holds a current, valid certificate as a community health 1727
worker issued by the board of nursing under section 4723.85 of the 1728
Revised Code.1729

       (T) "Medication aide" means an individual who holds a 1730
current, valid certificate issued under this chapter that 1731
authorizes the individual to administer medication in accordance 1732
with section 4723.67 of the Revised Code.1733

       Sec. 4723.03.  (A) No person shall engage in the practice of 1734
nursing as a registered nurse, represent the person as being a 1735
registered nurse, or use the title "registered nurse," the 1736
initials "R.N.," or any other title implying that the person is a 1737
registered nurse, for a fee, salary, or other consideration, or as 1738
a volunteer, without holding a current, valid license as a 1739
registered nurse under this chapter.1740

       (B) No person shall engage in the practice of nursing as a 1741
licensed practical nurse, represent the person as being a licensed 1742
practical nurse, or use the title "licensed practical nurse," the 1743
initials "L.P.N.," or any other title implying that the person is 1744
a licensed practical nurse, for a fee, salary, or other 1745
consideration, or as a volunteer, without holding a current, valid 1746
license as a practical nurse under this chapter.1747

       (C) No person shall use the titles or initials "graduate 1748
nurse," "G.N.," "professional nurse," "P.N.," "graduate practical 1749
nurse," "G.P.N.," "practical nurse," "P.N.," "trained nurse," 1750
"T.N.," or any other statement, title, or initials that would 1751
imply or represent to the public that the person is authorized to 1752
practice nursing in this state, except as follows:1753

       (1) A person licensed under this chapter to practice nursing 1754
as a registered nurse may use that title and the initials "R.N.";1755

       (2) A person licensed under this chapter to practice nursing 1756
as a licensed practical nurse may use that title and the initials 1757
"L.P.N.";1758

       (3) A person authorized under this chapter to practice 1759
nursing as a certified registered nurse anesthetist may use that 1760
title, the initials "C.R.N.A." or "N.A.," and any other title or 1761
initials approved by the board of nursing;1762

       (4) A person authorized under this chapter to practice 1763
nursing as a clinical nurse specialist may use that title, the 1764
initials "C.N.S.," and any other title or initials approved by the 1765
board;1766

       (5) A person authorized under this chapter to practice 1767
nursing as a certified nurse-midwife may use that title, the 1768
initials "C.N.M.," and any other title or initials approved by the 1769
board;1770

       (6) A person authorized under this chapter to practice 1771
nursing as a certified nurse practitioner may use that title, the 1772
initials "C.N.P.," and any other title or initials approved by the 1773
board;1774

       (7) A person authorized under this chapter to practice as a 1775
certified registered nurse anesthetist, clinical nurse specialist, 1776
certified nurse-midwife, or certified nurse practitioner may use 1777
the title "advanced practice registered nurse" or the initials 1778
"A.P.R.N."1779

       (D) No person shall employ a person not licensed as a 1780
registered nurse under this chapter to engage in the practice of 1781
nursing as a registered nurse. No person shall employ a person not 1782
licensed as a practical nurse under this chapter to engage in the 1783
practice of nursing as a licensed practical nurse.1784

       (E) No person shall sell or fraudulently obtain or furnish 1785
any nursing diploma, license, certificate, renewal, or record, or 1786
aid or abet such acts.1787

       Sec. 4723.06.  (A) The board of nursing shall:1788

       (1) Administer and enforce the provisions of this chapter, 1789
including the taking of disciplinary action for violations of 1790
section 4723.28 of the Revised Code, any other provisions of this 1791
chapter, or rules adopted under this chapter;1792

       (2) Develop criteria that an applicant must meet to be 1793
eligible to sit for the examination for licensure to practice as a 1794
registered nurse or as a licensed practical nurse;1795

       (3) Issue and renew nursing licenses, dialysis technician 1796
certificates, and community health worker certificates, as 1797
provided in this chapter;1798

       (4) Define the minimum curricula and standards for 1799
educational programs of the schools of professionalregistered1800
nursing and schools of practical nursing in this state;1801

       (5) Survey, inspect, and grant full approval to prelicensure 1802
nursing education programs in this state that meet the standards 1803
established by rules adopted under section 4723.07 of the Revised 1804
Code. Prelicensure nursing education programs include, but are not 1805
limited to, diploma, associate degree, baccalaureate degree, 1806
diplomamaster's degree, and doctor of nursing programs leading to 1807
initial licensure to practice nursing as a registered nurse and 1808
practical nurse programs leading to initial licensure to practice 1809
nursing as a licensed practical nurse.1810

       (6) Grant conditional approval, by a vote of a quorum of the 1811
board, to a new prelicensure nursing education program or a 1812
program that is being reestablished after having ceased to 1813
operate, if the program meets and maintains the minimum standards 1814
of the board established by rules adopted under section 4723.07 of 1815
the Revised Code. If the board does not grant conditional 1816
approval, it shall hold an adjudication under Chapter 119. of the 1817
Revised Code to consider conditional approval of the program. If 1818
the board grants conditional approval, at itsthe first meeting 1819
after the first class has completed the programfollowing 1820
completion of the survey process required by division (A)(5) of 1821
this section, the board shall determine whether to grant full 1822
approval to the program. If the board does not grant full approval 1823
or if it appears that the program has failed to meet and maintain 1824
standards established by rules adopted under section 4723.07 of 1825
the Revised Code, the board shall hold an adjudication under 1826
Chapter 119. of the Revised Code to consider the program. Based on 1827
results of the adjudication, the board may continue or withdraw 1828
conditional approval, or grant full approval.1829

       (7) Place on provisional approval, for a period of time 1830
specified by the board, a program that has ceased to meet and 1831
maintain the minimum standards of the board established by rules 1832
adopted under section 4723.07 of the Revised Code. AtPrior to or 1833
at the end of the period, the board shall reconsider whether the 1834
program meets the standards and shall grant full approval if it 1835
does. If it does not, the board may withdraw approval, pursuant to 1836
an adjudication under Chapter 119. of the Revised Code.1837

       (8) Approve continuing nursing education programs and courses 1838
under standards established in rules adopted under section1839
sections 4723.07, 4723.69, 4723.79, and 4723.88 of the Revised 1840
Code;1841

       (9) Approve peer support programs, under rules adopted under 1842
section 4723.07 of the Revised Code, for nurses, for dialysis 1843
technicians, and for certified community health workers;1844

       (10) Establish a program for monitoring chemical dependency 1845
in accordance with section 4723.35 of the Revised Code;1846

       (11)(10) Establish the practice intervention and improvement 1847
program in accordance with section 4723.282 of the Revised Code;1848

       (12)(11) Issue and renew certificates of authority to 1849
practice nursing as a certified registered nurse anesthetist, 1850
clinical nurse specialist, certified nurse-midwife, or certified 1851
nurse practitioner;1852

       (13)(12) Approve under section 4723.46 of the Revised Code 1853
national certifying organizations for examination and 1854
certification of certified registered nurse anesthetists, clinical 1855
nurse specialists, certified nurse-midwives, or certified nurse 1856
practitioners;1857

       (14)(13) Issue and renew certificates to prescribe in 1858
accordance with sections 4723.48 and 4723.486 of the Revised Code;1859

       (15)(14) Grant approval to the planned classroom and clinical 1860
study required by section 4723.482 of the Revised Code to be 1861
eligible for a certificate to prescribe;1862

       (16)(15) Make an annual edition of the formulary established 1863
in rules adopted under section 4723.50 of the Revised Code 1864
available to the public either in printed form or by electronic 1865
means and, as soon as possible after any revision of the formulary 1866
becomes effective, make the revision available to the public in 1867
printed form or by electronic means;1868

       (17)(16) Provide guidance and make recommendations to the 1869
general assembly, the governor, state agencies, and the federal 1870
government with respect to the regulation of the practice of 1871
nursing and the enforcement of this chapter;1872

       (18)(17) Make an annual report to the governor, which shall 1873
be open for public inspection;1874

       (19)(18) Maintain and have open for public inspection the 1875
following records:1876

       (a) A record of all its meetings and proceedings;1877

       (b) A filerecord of all applicants for, and holders of 1878
nursing, licenses, registrations, and certificates granted under 1879
this chapter; dialysis technician certificates granted under this 1880
chapter; and community health worker certificates grantedissued 1881
by the board under this chapter. The file shall be maintained in 1882
the form prescribed by rule of the boardor in accordance with 1883
rules adopted under this chapter. The record shall be maintained 1884
in a format determined by the board.1885

       (c) A list of prelicensure nursing education and training1886
programs approved by the board;1887

       (d) A list of approved peer support programs for nurses, 1888
dialysis technicians, and certified community health workers.1889

       (19) Deny approval to a person who submits or causes to be 1890
submitted false, misleading, or deceptive statements, information, 1891
or documentation to the board in the process of applying for 1892
approval of a new education or training program. If the board 1893
proposes to deny approval of a new education or training program, 1894
it shall do so pursuant to an adjudication conducted under Chapter 1895
119. of the Revised Code.1896

       (B) The board may fulfill the requirement of division (A)(8) 1897
of this section by authorizing persons who meet the standards 1898
established in rules adopted under section 4723.07 of the Revised 1899
Code to approve continuing nursing education programs and courses. 1900
Persons so authorized shall approve continuing nursing education 1901
programs and courses in accordance with standards established in 1902
rules adopted under section 4723.07 of the Revised Code.1903

       Persons seeking authorization to approve continuing nursing1904
education programs and courses shall apply to the board and pay 1905
the appropriate fee established under section 4723.08 of the 1906
Revised Code. Authorizations to approve continuing nursing1907
education programs and courses shall expire, and may be renewed 1908
according to the schedule established in rules adopted under 1909
section 4723.07 of the Revised Code.1910

       In addition to approving continuing nursing education 1911
programs under division (A)(8) of this section, the board may 1912
sponsor continuing education activities that are directly related 1913
to the statutes and rules pertaining to the practice of nursing in 1914
this statethe board enforces.1915

       Sec. 4723.063.  (A) As used in this section: 1916

       (1) "Health care facility" means:1917

       (a) A hospital registered under section 3701.07 of the 1918
Revised Code;1919

       (b) A nursing home licensed under section 3721.02 of the 1920
Revised Code, or by a political subdivision certified under 1921
section 3721.09 of the Revised Code;1922

       (c) A county home or a county nursing home as defined in 1923
section 5155.31 of the Revised Code that is certified under Title 1924
XVIII or XIX of the "Social Security Act," 49 Stat. 620 (1935), 42 1925
U.S.C. 301, as amended;1926

       (d) A freestanding dialysis center;1927

       (e) A freestanding inpatient rehabilitation facility;1928

       (f) An ambulatory surgical facility;1929

       (g) A freestanding cardiac catheterization facility;1930

       (h) A freestanding birthing center;1931

       (i) A freestanding or mobile diagnostic imaging center;1932

       (j) A freestanding radiation therapy center.1933

       (2) "Nurse education program" means a prelicensure nurse 1934
education program approved by the board of nursing under section 1935
4723.06 of the Revised Code or a postlicensure nurse education 1936
program approved by the board of regents under section 3333.04 of 1937
the Revised Code.1938

       (B) The state board of nursing shall establish and administer 1939
the nurse education grant program. Under the program, the board 1940
shall award grants to nurse education programs that have 1941
partnerships with other education programs, community health 1942
agencies, or health care facilities, or patient centered medical 1943
homes. Grant recipients shall use the money to fund partnerships 1944
to increase the nurse education program's enrollment capacity. 1945
Methods of increasing a program's enrollment capacity may include 1946
hiring faculty and preceptors, purchasing educational equipment 1947
and materials, and other actions acceptable to the board. Grant 1948
money shall not be used to construct or renovate buildings. 1949
Partnerships may be developed between one or more nurse education 1950
programs and one or more health care facilities.1951

       In awarding grants, the board shall give preference to 1952
partnerships between nurse education programs and hospitals, 1953
nursing homes, and county homes or county nursing homes, but may 1954
also award grants to fund partnerships between nurse education 1955
programs and other health care facilities and between nurse 1956
education programs and patient centered medical homes.1957

       (C) The board shall adopt rules in accordance with Chapter 1958
119. of the Revised Code establishing the following:1959

       (1) Eligibility requirements for receipt of a grant;1960

       (2) Grant application forms and procedures;1961

       (3) The amounts in which grants may be made and the total 1962
amount that may be awarded to a nurse education program that has a 1963
partnership with other education programs, a community health 1964
agency, or a health care facility, or a patient centered medical 1965
home;1966

       (4) A method whereby the board may evaluate the effectiveness 1967
of a partnership between joint recipients in increasing the nurse 1968
education program's enrollment capacity;1969

       (5) The percentage of the money in the fund that must remain 1970
in the fund at all times to maintain a fiscally responsible fund 1971
balance;1972

       (6) The percentage of available grants to be awarded to 1973
licensed practical nurse education programs, registered nurse 1974
education programs, and graduate programs;1975

       (7) Any other matters incidental to the operation of the 1976
program. 1977

       (D) From January 1, 2004, untilUntil December 31, 20132023, 1978
the ten dollars of each biennial nursing license renewal fee 1979
collected under section 4723.08 of the Revised Code shall be 1980
dedicated to the nurse education grant program fund, which is 1981
hereby created in the state treasury. The board shall use money in 1982
the fund for grants awarded under division (A) of this section and 1983
for expenses of administering the grant program. The amount used 1984
for administrative expenses in any year shall not exceed ten per 1985
cent of the amount transferred to the fund in that year.1986

       (E) Each quarter, for the purposes of transferring funds to 1987
the nurse education grant program, the board of nursing shall 1988
certify to the director of budget and management the number of 1989
biennial licenses renewed under this chapter during the preceding 1990
quarter and the amount equal to that number times ten dollars.1991

       (F) Notwithstanding the requirements of section 4743.05 of 1992
the Revised Code, from January 1, 2004, until December 31, 20131993
2023, at the end of each quarter, the director of budget and 1994
management shall transfer from the occupational licensing and 1995
regulatory fund to the nurse education grant program fund the 1996
amount certified under division (E) of this section.1997

       Sec. 4723.07.  In accordance with Chapter 119. of the Revised 1998
Code, the board of nursing shall adopt and may amend and rescind 1999
rules that establish all of the following:2000

       (A) Provisions for the board's government and control of its 2001
actions and business affairs;2002

       (B) Minimum curricula and standards for nursing education 2003
programs that prepare graduates to be licensed under this chapter 2004
and procedures for granting, renewing, and withdrawing approval of 2005
those programs;2006

       (C) Criteria that applicants for licensure must meet to be 2007
eligible to take examinations for licensure;2008

       (D) Standards and procedures for renewal of the licenses and 2009
certificates issued by the board;2010

       (E) Standards for approval of continuing nursing education 2011
programs and courses for registered nurses, licensed practical 2012
nurses, certified registered nurse anesthetists, clinical nurse 2013
specialists, certified nurse-midwives, and certified nurse 2014
practitioners. The standards may provide for approval of 2015
continuing nursing education programs and courses that have been 2016
approved by other state boards of nursing or by national 2017
accreditation systems for nursing, including, but not limited to, 2018
the American nurses' credentialing center and the national 2019
association for practical nurse education and service.2020

       (F) Standards that persons must meet to be authorized by the 2021
board to approve continuing nursing education programs and courses 2022
and a schedule by which that authorization expires and may be 2023
renewed;2024

       (G) Requirements, including continuing education 2025
requirements, for restoringreactivating inactive nursing2026
licenses, dialysis technician certificates, and community health 2027
workeror certificates, and for restoring nursingreinstating2028
licenses, dialysis technician certificates, and community health 2029
workeror certificates that have lapsed through failure to renew;2030

       (H) Conditions that may be imposed for reinstatement of a 2031
nursing license, dialysis technician certificate, or community 2032
health workeror certificate following action taken under section 2033
3123.47, 4723.28, 4723.281, 4723.652, or 4723.86 of the Revised 2034
Code resulting in a license or certificate suspension;2035

       (I) Standards for approval of peer support programs for 2036
persons who hold a nursing license, dialysis technician 2037
certificate, or community health worker certificate;2038

       (J) Requirements for board approval of courses in medication 2039
administration by licensed practical nurses;2040

       (K)(J) Criteria for evaluating the qualifications of an 2041
applicant for a license to practice nursing as a registered nurse 2042
or, a license to practice nursing as a licensed practical nurse, 2043
or a certificate of authority issued under division (E)(B) of 2044
section 4723.41 of the Revised Code, a dialysis technician 2045
certificate, or a community health worker certificatefor the 2046
purpose of issuing the license or certificate by the board's 2047
endorsement of the applicant's authority to practice issued by the 2048
licensing agency of another state;2049

       (L)(K) Universal blood and body fluidstandard precautions 2050
that shall be used by each person holding a nursing license2051
licensee or dialysis technician certificate issued under this 2052
chapter who performs exposure-prone invasive proceduresholder. 2053
The rules shall define and establish requirements for universal 2054
blood and body fluidstandard precautions that include the 2055
following:2056

       (1) Appropriate use of hand washing;2057

       (2) Disinfection and sterilization of equipment;2058

       (3) Handling and disposal of needles and other sharp 2059
instruments;2060

       (4) Wearing and disposal of gloves and other protective 2061
garments and devices.2062

       (M)(L) Standards and procedures for approving certificates of 2063
authority to practice nursing as a certified registered nurse 2064
anesthetist, clinical nurse specialist, certified nurse-midwife, 2065
or certified nurse practitioner, and for renewal of those 2066
certificates;2067

       (N)(M) Quality assurance standards for certified registered 2068
nurse anesthetists, clinical nurse specialists, certified 2069
nurse-midwives, or certified nurse practitioners;2070

       (O)(N) Additional criteria for the standard care arrangement 2071
required by section 4723.431 of the Revised Code entered into by a 2072
clinical nurse specialist, certified nurse-midwife, or certified 2073
nurse practitioner and the nurse's collaborating physician or 2074
podiatrist;2075

       (P)(O) Continuing education standards for clinical nurse 2076
specialists who are exemptwere issued a certificate of authority 2077
to practice as a clinical nurse specialist under division (C) of 2078
section 4723.41 of the Revised Code from the requirement of having 2079
passed a certification examinationas that division existed at any 2080
time before the effective date of this amendment;2081

       (Q)(P) For purposes of division (B)(31) of section 4723.28 of 2082
the Revised Code, the actions, omissions, or other circumstances 2083
that constitute failure to establish and maintain professional 2084
boundaries with a patient.2085

       The board may adopt other rules necessary to carry out the 2086
provisions of this chapter. The rules shall be adopted in 2087
accordance with Chapter 119. of the Revised Code.2088

       Sec. 4723.08.  (A) The board of nursing may impose fees not 2089
to exceed the following limits:2090

       (1) For application for licensure by examination to practice 2091
nursing as a registered nurse or as a licensed practical nurse, 2092
seventy-five dollars;2093

       (2) For application for licensure by endorsement to practice 2094
nursing as a registered nurse or as a licensed practical nurse, 2095
seventy-five dollars;2096

       (3) For application for a certificate of authority to 2097
practice nursing as a certified registered nurse anesthetist, 2098
clinical nurse specialist, certified nurse-midwife, or certified 2099
nurse practitioner, one hundred dollars;2100

       (4) For application for a temporary dialysis technician 2101
certificate, the amount specified in rules adopted under section 2102
4723.79 of the Revised Code;2103

       (5) For application for a full dialysis technician 2104
certificate, the amount specified in rules adopted under section 2105
4723.79 of the Revised Code;2106

       (6) For application for a certificate to prescribe, fifty 2107
dollars;2108

       (7) For providing, pursuant to division (B) of section 2109
4723.271 of the Revised Code, written verification of a nursing 2110
license, certificate of authority, orcertificate to prescribe,2111
dialysis technician certificate, medication aide certificate, or 2112
community health worker certificate to another jurisdiction, 2113
fifteen dollars;2114

       (8) For providing, pursuant to division (A) of section 2115
4723.271 of the Revised Code, a replacement copy of a nursing 2116
license, certificate of authority, certificate to prescribe, 2117
dialysis technician certificate, intravenous therapy card, or 2118
frameablewall certificate suitable for framing as described in 2119
that division, twenty-five dollars;2120

       (9) For biennial renewal of a nursing license that expires on 2121
or after August 31, 2003, but before January 1, 2004, forty-five 2122
dollars;2123

       (10) For biennial renewal of a nursing license that expires 2124
on or after January 1, 2004, sixty-five dollars;2125

       (11) For biennial renewal of a certificate of authority to 2126
practice nursing as a certified registered nurse anesthetist, 2127
clinical nurse specialist, certified nurse mid-wife, or certified 2128
nurse practitioner that expires on or before August 31, 2005, one 2129
hundred dollars;2130

       (12)(10) For biennial renewal of a certificate of authority 2131
to practice nursing as a certified registered nurse anesthetist, 2132
clinical nurse specialist, certified nurse-midwife, or certified 2133
nurse practitioner that expires on or after September 1, 2005, 2134
eighty-five dollars;2135

       (13)(11) For renewal of a certificate to prescribe, fifty 2136
dollars;2137

       (14)(12) For biennial renewal of a dialysis technician 2138
certificate, the amount specified in rules adopted under section 2139
4723.79 of the Revised Code;2140

       (15)(13) For processing a late application for renewal of a 2141
nursing license, certificate of authority, or dialysis technician 2142
certificate, fifty dollars;2143

       (16)(14) For application for authorization to approve 2144
continuing nursing education programs and courses from an 2145
applicant accredited by a national accreditation system for 2146
nursing, five hundred dollars;2147

       (17)(15) For application for authorization to approve 2148
continuing nursing education programs and courses from an 2149
applicant not accredited by a national accreditation system for 2150
nursing, one thousand dollars;2151

       (18)(16) For each year for which authorization to approve 2152
continuing nursing education programs and courses is renewed, one 2153
hundred fifty dollars;2154

       (19)(17) For application for approval to operate a dialysis 2155
training program, the amount specified in rules adopted under 2156
section 4723.79 of the Revised Code;2157

       (20)(18) For reinstatement of a lapsed nursing license, 2158
certificate of authority, or dialysis technician certificate 2159
issued under this chapter, one hundred dollars except as provided 2160
in section 5903.10 of the Revised Code;2161

       (21)(19) For written verification of a nursing license, 2162
certificate of authority, or dialysis technician certificate, when 2163
the verification is performed for purposes other than providing 2164
verification to another jurisdiction, five dollars;2165

       (22)(20) For processing a check returned to the board by a 2166
financial institution as noncollectible, twenty-five dollars;2167

       (23) For issuance of an intravenous therapy card for which a 2168
fee may be charged under section 4723.17 of the Revised Code, 2169
twenty-five dollars;2170

       (24) For out-of-state survey visits of nursing education 2171
programs operating in Ohio, two thousand dollars;2172

       (25)(21) The amounts specified in rules adopted under section 2173
4723.88 of the Revised Code pertaining to the issuance of 2174
certificates to community health workers, including fees for 2175
application for a certificate, verification of a certificate to 2176
another jurisdiction, written verification of a certificate when 2177
the verification is performed for purposes other than verification 2178
to another jurisdiction, providing a replacement copy of a 2179
certificate, biennial renewal of a certificate, processing a late 2180
application for renewal of a certificate, reinstatement of a 2181
lapsed certificate, application for approval of a community health 2182
worker training program for community health workers, and biennial 2183
renewal of the approval of a training program for community health 2184
workers.2185

       (B) Each quarter, for purposes of transferring funds under 2186
section 4743.05 of the Revised Code to the nurse education 2187
assistance fund created in section 3333.28 of the Revised Code, 2188
the board of nursing shall certify to the director of budget and 2189
management the number of biennial licenses renewed under this 2190
chapter during the preceding quarter and the amount equal to that 2191
number times five dollars.2192

       (C) The board may charge a participant in a board-sponsored 2193
continuing education activity an amount not exceeding fifteen 2194
dollars for each activity.2195

       (D) The board may contract for services pertaining to the 2196
process of providing written verification of a nursing license, 2197
certificate of authority, dialysis technician certificate, or 2198
community health worker certificate when the verification is 2199
performed for purposes other than providing verification to 2200
another jurisdiction. The contract may include provisions 2201
pertaining to the collection of the fee charged for providing the 2202
written verification. As part of these provisions, the board may 2203
permit the contractor to retain a portion of the fees as 2204
compensation, before any amounts are deposited into the state 2205
treasury.2206

       Sec. 4723.09.  (A)(1) An application for licensure by 2207
examination to practice as a registered nurse or as a licensed 2208
practical nurse shall be submitted to the board of nursing in the 2209
form prescribed by rules of the board. The application shall 2210
include evidence that the applicant has completed requirements of2211
a nursing education program approved by the board or approved by 2212
another jurisdiction'sunder division (A) of section 4723.06 of 2213
the Revised Code or by a board that regulates nurse licensureof 2214
another jurisdiction that is a member of the national council of 2215
state boards of nursing. The application also shall include any 2216
other information required by rules of the board. The application 2217
shall be accompanied by the application fee required by section 2218
4723.08 of the Revised Code.2219

       (2) The board shall grant a license to practice nursing as a 2220
registered nurse or as a licensed practical nurse if all of the 2221
following apply:2222

       (a) For all applicants, the applicant passes the examination 2223
accepted by the board under section 4723.10 of the Revised Code.2224

       (b) For an applicant who entered a prelicensure nursing 2225
education program on or after June 1, 2003, the results of a2226
criminal records check of the applicant that is completed by the 2227
bureau of criminal identification and investigation and includes a 2228
check of federal bureau of investigation records and that the 2229
bureau submits to the board indicates that the applicant has not 2230
been convicted of, has not pleaded guilty to, and has not had a 2231
judicial finding of guilt for violating section 2903.01, 2903.02, 2232
2903.03, 2903.11, 2905.01, 2907.02, 2907.03, 2907.05, 2909.02, 2233
2911.01, or 2911.11 of the Revised Code or a substantially similar 2234
law of another state, the United States, or another country2235
conducted in accordance with section 4723.091 of the Revised Code 2236
demonstrate that the applicant is not ineligible for licensure as 2237
specified in section 4723.092 of the Revised Code.2238

       (c) For all applicants, the board determines that the 2239
applicant has not committed any act that is grounds for 2240
disciplinary action under section 3123.47 or 4723.28 of the 2241
Revised Code or determines that an applicant who has committed any 2242
act that is grounds for disciplinary action under either section 2243
has made restitution or has been rehabilitated, or both.2244

       (d) For all applicants, the applicant is not required to 2245
register under Chapter 2950. of the Revised Code or a 2246
substantially similar law of another state, the United States, or 2247
another country.2248

       (3) The board is not required to afford an adjudication to an 2249
individual to whom it has refused to grant a license because of 2250
that individual's failure to pass the examination.2251

       (B)(1) An application for license by endorsement to practice 2252
nursing as a registered nurse or as a licensed practical nurse 2253
shall be submitted to the board in the form prescribed by rules of 2254
the board and shall be accompanied by the application fee required 2255
by section 4723.08 of the Revised Code. The application shall 2256
include evidence that the applicant holds a current, valid, and 2257
unrestricted license in good standing in another jurisdiction 2258
granted after passing an examination approved by the board of that 2259
jurisdiction that is equivalent to the examination requirements 2260
under this chapter for a license to practice nursing as a 2261
registered nurse or licensed practical nurse and. The application2262
shall include any other information required by rules of the board 2263
of nursing. The application shall be accompanied by the 2264
application fee required by section 4723.08 of the Revised Code.2265

       (2) The board shall grant a license by endorsement to 2266
practice nursing as a registered nurse or as a licensed practical 2267
nurse if the applicant is licensed or certified by another 2268
jurisdiction and the board determines, pursuant to rules 2269
established under section 4723.07 of the Revised Code, that all of 2270
the following apply:2271

       (1)(a) For all applicants, the educational preparation of the2272
applicant is substantially similar to the minimum curricula and 2273
standards forprovides evidence satisfactory to the board that the 2274
applicant has successfully completed a nursing education programs 2275
established byprogram approved by the board under division (A) of2276
section 4723.074723.06 of the Revised Code or by a board of 2277
another jurisdiction that is a member of the national council of 2278
state boards of nursing.2279

       (2)(b) For all applicants, the examination, at the time it is 2280
successfully completed, is equivalent to the examination 2281
requirements in effect at that time for applicants who were 2282
licensed by examination in this state.2283

       (3)(c) For all applicants, the board determines there is 2284
sufficient evidence that the applicant completed two contact hours 2285
of continuing education directly related to this chapter or the 2286
rules adopted under it.2287

       (d) For all applicants, the results of a criminal records 2288
check of the applicant that is completed by the bureau of criminal 2289
identification and investigation and includes a check of federal 2290
bureau of investigation records and that the bureau submits to the 2291
board indicates that the applicant has not been convicted of, has 2292
not pleaded guilty to, and has not had a judicial finding of guilt 2293
for violating section 2903.01, 2903.02, 2903.03, 2903.11, 2905.01, 2294
2907.02, 2907.03, 2907.05, 2909.02, 2911.01, or 2911.11 of the 2295
Revised Code or a substantially similar law of another state, the 2296
United States, or another countryconducted in accordance with 2297
section 4723.091 of the Revised Code demonstrate that the 2298
applicant is not ineligible for licensure as specified in section 2299
4723.092 of the Revised Code.2300

       (4)(e) For all applicants, the applicant has not committed 2301
any act that is grounds for disciplinary action under section 2302
3123.47,or 4723.28, or 4723.281 of the Revised Code, or the board 2303
determines that an applicant who has committed any act that is 2304
grounds for disciplinary action under anyeither of those sections 2305
has made restitution or has been rehabilitated, or both.2306

       (f) For all applicants, the applicant is not required to 2307
register under Chapter 2950. of the Revised Code, or a 2308
substantially similar law of another state, the United States, or 2309
another country.2310

       (C) The board may grant a nonrenewable temporary permit to 2311
practice nursing as a registered nurse or as a licensed practical 2312
nurse to an applicant for license by endorsement if the board is 2313
satisfied by the evidence that the applicant holds a current,2314
activevalid, and unrestricted license in good standing in another 2315
jurisdiction. Subject to earlier automatic termination as 2316
described in this paragraph, the temporary permit shall expire at 2317
the earlier of one hundred eighty days after issuance or upon the 2318
issuance of a license by endorsement. The temporary permit shall 2319
terminate automatically if the criminal records check completed by 2320
the bureau of criminal identification and investigation as 2321
described in this section 4723.091 of the Revised Code regarding 2322
the applicant indicates that the applicant previously has been 2323
convicted of, pleaded guilty to, or had a judicial finding of 2324
guilt for a violation of section 2903.01, 2903.02, 2903.03, 2325
2903.11, 2905.01, 2907.02, 2907.03, 2907.05, 2909.02, 2911.01, or 2326
2911.11 of the Revised Code or a substantially similar law of 2327
another state, the United States, or another countryis ineligible 2328
for licensure as specified in section 4723.092 of the Revised 2329
Code. An applicant whose temporary permit is automatically 2330
terminated is permanently prohibited from obtaining a license to 2331
practice nursing in this state as a registered nurse or as a 2332
licensed practical nurse.2333

       (C) An applicant under this section shall submit a request to 2334
the bureau of criminal identification and investigation for a 2335
criminal records check of the applicant. The request shall be on 2336
the form prescribed pursuant to division (C)(1) of section 109.572 2337
of the Revised Code, accompanied by a standard impression sheet to 2338
obtain fingerprints prescribed pursuant to division (C)(2) of that 2339
section, and accompanied by the fee prescribed pursuant to 2340
division (C)(3) of that section. Upon receipt of the completed 2341
form, the completed impression sheet, and the fee, the bureau 2342
shall conduct a criminal records check of the applicant. Upon 2343
completion of the criminal records check, the bureau shall send 2344
the results of the check to the board. An applicant requesting a 2345
criminal records check under this division shall ask the 2346
superintendent of the bureau of criminal identification and 2347
investigation to also request the federal bureau of investigation 2348
to provide the superintendent with any information it has with 2349
respect to the applicant.2350

       The results of any criminal records check conducted pursuant 2351
to a request made under this section, and any report containing 2352
those results, are not public records for purposes of section 2353
149.43 of the Revised Code and shall not be made available to any 2354
person or for any purpose other than the following:2355

       (1) The results may be made available to any person for use 2356
in determining under this section and division (N) of section 2357
4723.28 of the Revised Code whether the individual who is the 2358
subject of the check should be granted a license to practice 2359
nursing as a registered nurse or as a licensed practical nurse or 2360
whether any temporary permit granted to the individual under this 2361
section has terminated automatically.2362

       (2) The results may be made available to the individual who 2363
is the subject of the check or that individual's representative.2364

       Sec. 4723.091. (A) An individual who applies for licensure 2365
under section 4723.09 of the Revised Code; issuance of a 2366
certificate under section 4723.651, 4723.75, 4723.76, or 4723.85 2367
of the Revised Code; reactivation of a license, under division (D) 2368
of section 4723.24 of the Revised Code, that has been inactive for 2369
at least five years; or reinstatement of a license, under division 2370
(D) of section 4723.24 of the Revised Code, that has been expired 2371
for at least five years shall submit a request to the bureau of 2372
criminal identification and investigation for a criminal records 2373
check of the applicant. The request shall be made in accordance 2374
with section 109.572 of the Revised Code.2375

       (B) An applicant requesting a criminal records check under 2376
division (A) of this section shall also ask the superintendent of 2377
the bureau of criminal identification and investigation to request 2378
that the federal bureau of investigation send to the 2379
superintendent any information the federal bureau of investigation 2380
has with respect to the applicant.2381

       (C) On receipt of all items required for the commencement of 2382
a criminal records check pursuant to division (A) of this section, 2383
the bureau of criminal identification and investigation shall 2384
conduct a criminal records check of the applicant. On the 2385
completion of the criminal records check, the bureau shall send 2386
the results to the board of nursing.2387

       (D) The results of a criminal records check conducted 2388
pursuant to a request made under division (A) of this section, and 2389
any report containing those results, are not public records for 2390
purposes of section 149.43 of the Revised Code and shall not be 2391
made available to any person or for any purpose other than the 2392
following:2393

       (1) The results may be made available to any person for use 2394
in determining under section 4723.09, 4723.651, 4723.75, 4723.76, 2395
or 4723.85 of the Revised Code whether the individual who is the 2396
subject of the check should be granted a license or certificate 2397
under this chapter or whether any temporary permit granted to the 2398
individual under either of the following has terminated 2399
automatically:2400

       (a) Section 4723.09 of the Revised Code;2401

       (b) Section 4723.76 of the Revised Code as that section 2402
existed at any time before the effective date of this section.2403

       (2) The results may be made available to any person for use 2404
in determining under division (D) of section 4723.24 of the 2405
Revised Code whether the individual who is the subject of the 2406
check should have the individual's license or certificate 2407
reactivated or reinstated.2408

       (3) The results may be made available to any person for use 2409
in determining under section 4723.28 of the Revised Code whether 2410
the individual who is the subject of the check should be subject 2411
to disciplinary action in accordance with that section.2412

       (4) The results may be made available to the individual who 2413
is the subject of the check or that individual's representative.2414

       Sec. 4723.092. An individual is ineligible for licensure 2415
under section 4723.09 of the Revised Code or issuance of a 2416
certificate under section 4723.651, 4723.75, 4723.76, or 4723.85 2417
of the Revised Code if a criminal records check conducted in 2418
accordance with section 4723.091 of the Revised Code indicates 2419
that the individual has been convicted of, pleaded guilty to, or 2420
had a judicial finding of guilt for either of the following:2421

       (A) Violating section 2903.01, 2903.02, 2903.03, 2903.11, 2422
2905.01, 2907.02, 2907.03, 2907.05, 2909.02, 2911.01, or 2911.11 2423
of the Revised Code;2424

       (B) Violating a law of another state, the United States, or 2425
another country that is substantially similar to a law described 2426
in division (A) of this section.2427

       Sec. 4723.17. The board of nursing shall authorize a licensed 2428
practical nurse to administer medications if the nurse supplies 2429
evidence satisfactory to the board that either of the following is 2430
the case:2431

       (A) The nurse successfully completed, within a practical 2432
nurse prelicensure education program approved by the board or by 2433
another jurisdiction's agency that regulates the practice of 2434
nursing, a course in basic pharmacology.2435

        (B) The nurse successfully completed a postlicensure course 2436
in basic pharmacology that is acceptable to the board.2437

       Sec. 4723.17.        Sec. 4723.18.  (A) The board of nursing mayshall2438
authorize a licensed practical nurse to administer to an adult 2439
intravenous therapy authorized by an individual who is authorized 2440
to practice in this state and is acting within the course of the 2441
individual's professional practice, if the licensed practical2442
nurse has a current, valid license issued under this chapter that 2443
includes authorization to administer medications and onesupplies 2444
evidence satisfactory to the board that all of the following is2445
are the case:2446

       (1) The nurse holds a current, valid license issued under 2447
this chapter to practice nursing as a licensed practical nurse.2448

       (2) The nurse has been authorized under section 4723.18 of 2449
the Revised Code to administer medications.2450

        (3) The nurse has successfully completed, within a practical 2451
nurse prelicensure education programa course of study in the safe 2452
performance of intravenous therapy approved by the board or by 2453
another jurisdiction's agency that regulates the practice of 2454
nursing, a course of study that prepares the nurse to safely 2455
perform the intravenous therapy procedures the board may authorize 2456
under this section. To meet this requirement, the course of study 2457
must include all of the following:2458

       (a) Both didactic and clinical components;2459

       (b) Curriculum requirements established in rules the board of 2460
nursing shall adopt in accordance with Chapter 119. of the Revised 2461
Code;2462

       (c) Standards that require the nurse to perform a successful 2463
demonstration of the intravenous procedures, including all skills 2464
needed to perform them safelypursuant to section 4723.19 of the 2465
Revised Code or by an agency in another jurisdiction that 2466
regulates the practice of nursing and has requirements for 2467
intravenous therapy course approval that are substantially similar 2468
to the requirements in division (B) of section 4723.19 of the 2469
Revised Code, as determined by the board.2470

       (2)(4) The nurse has successfully completed a minimum of 2471
forty hours of training that includes all of the following:2472

       (a) The curriculum established by rules adopted by the board2473
and in effect on January 1, 1999;2474

       (b) Training in the anatomy and physiology of the 2475
cardiovascular system, signs and symptoms of local and systemic 2476
complications in the administration of fluids and antibiotic 2477
additives, and guidelines for management of these complications;2478

       (c) Any other training or instruction the board considers 2479
appropriate.;2480

       (d) A testing component that requires the nurse to perform a 2481
successful demonstration of the intravenous procedures, including 2482
all skills needed to perform them safely.2483

       (B) Except as provided in section 4723.1714723.181 of the 2484
Revised Code and subject to the restrictions in division (D) of 2485
this section, a licensed practical nurse may perform intravenous 2486
therapy on an adult patient only if authorized by the board 2487
pursuant to division (A) of this section and only if it is 2488
performed in accordance with this section.2489

       A licensed practical nurse authorized by the board to perform 2490
intravenous therapy may perform an intravenous therapy procedure 2491
only at the direction of one of the following:2492

       (1) A licensed physician, dentist, optometrist, or podiatrist 2493
who, except as provided in division (C)(2) of this section, is 2494
present and readily available at the facility where the 2495
intravenous therapy procedure is performed;2496

       (2) A registered nurse in accordance with division (C) of 2497
this section.2498

       (C)(1) Except as provided in division (C)(2) of this section 2499
and section 4723.1714723.181 of the Revised Code, when a licensed 2500
practical nurse authorized by the board to perform intravenous 2501
therapy performs an intravenous therapy procedure at the direction 2502
of a registered nurse, the registered nurse or another registered 2503
nurse shall be readily available at the site where the intravenous 2504
therapy is performed, and before the licensed practical nurse 2505
initiates the intravenous therapy, the registered nurse shall 2506
personally perform an on-site assessment of the individualadult 2507
patient who is to receive the intravenous therapy.2508

       (2) When a licensed practical nurse authorized by the board 2509
to perform intravenous therapy performs an intravenous therapy 2510
procedure in a home as defined in section 3721.10 of the Revised 2511
Code, or in an intermediate care facility for the mentally 2512
retarded as defined in section 5111.20 of the Revised Code, at the 2513
direction of a registered nurse or licensed physician, dentist, 2514
optometrist, or podiatrist, a registered nurse shall be on the 2515
premises of the home or facility or accessible by some form of 2516
telecommunication.2517

       (D) No licensed practical nurse shall perform any of the 2518
following intravenous therapy procedures:2519

       (1) Initiating or maintaining any of the following:2520

       (a) Blood or blood components;2521

       (b) Solutions for total parenteral nutrition;2522

       (c) Any cancer therapeutic medication including, but not 2523
limited to, cancer chemotherapy or an anti-neoplastic agent;2524

       (d) Solutions administered through any central venous line or 2525
arterial line or any other line that does not terminate in a 2526
peripheral vein, except that a licensed practical nurse authorized 2527
by the board to perform intravenous therapy may maintain the 2528
solutions specified in division (D)(6)(a) of this section that are 2529
being administered through a central venous line or peripherally 2530
inserted central catheter;2531

       (e) Any investigational or experimental medication.2532

       (2) Initiating intravenous therapy in any vein, except that a 2533
licensed practical nurse authorized by the board to perform 2534
intravenous therapy may initiate intravenous therapy in accordance 2535
with this section in a vein of the hand, forearm, or antecubital 2536
fossa;2537

       (3) Discontinuing a central venous, arterial, or any other 2538
line that does not terminate in a peripheral vein;2539

       (4) Initiating or discontinuing a peripherally inserted 2540
central catheter;2541

       (5) Mixing, preparing, or reconstituting any medication for 2542
intravenous therapy, except that a licensed practical nurse 2543
authorized by the board to perform intravenous therapy may prepare 2544
or reconstitute an antibiotic additive;2545

       (6) Administering medication via the intravenous route, 2546
including all of the following activities:2547

       (a) Adding medication to an intravenous solution or to an 2548
existing infusion, except that a licensed practical nurse 2549
authorized by the board to perform intravenous therapy may do 2550
eitherany of the following:2551

       (i) Initiate an intravenous infusion containing one or more 2552
of the following elements: dextrose 5%;, normal saline;, lactated 2553
ringers;, sodium chloride .45%;, sodium chloride 0.2%;, sterile 2554
water.;2555

       (ii) Hang subsequent containers of the intravenous solutions 2556
specified in division (D)(6)(a)(i) of this section that contain 2557
vitamins or electrolytes, if a registered nurse initiated the 2558
infusion of that same intravenous solution.2559

       (b) Initiating or maintaining an intravenous piggyback 2560
infusion, except that a licensed practical nurse authorized by the 2561
board to perform intravenous therapy may initiate;2562

       (iii) Initiate or maintain an intravenous piggyback infusion 2563
containing an antibiotic additive;.2564

       (c)(b) Injecting medication via a direct intravenous route, 2565
except that a licensed practical nurse authorized by the board to 2566
perform intravenous therapy may inject heparin or normal saline to 2567
flush an intermittent infusion device or heparin lock including, 2568
but not limited to, bolus or push.2569

       (7) Aspirating any intravenous line to maintain patency;2570

       (8) Changing tubing on any line including, but not limited 2571
to, an arterial line or a central venous line, except that a 2572
licensed practical nurse authorized by the board to perform 2573
intravenous therapy may change tubing on an intravenous line that 2574
terminates in a peripheral vein;2575

       (9)(8) Programming or setting any function of a patient 2576
controlled infusion pump.2577

       (E) Notwithstanding divisiondivisions (A) and (D) of this 2578
section, at the direction of a physician or a registered nurse, a 2579
licensed practical nurse authorized by the board to perform 2580
intravenous therapy may perform the following activities for the 2581
purpose of performing dialysis:2582

       (1) The routine administration and regulation of saline 2583
solution for the purpose of maintaining an established fluid plan;2584

       (2) The administration of a heparin dose intravenously;2585

       (3) The administration of a heparin dose peripherally via a 2586
fistula needle;2587

       (4) The loading and activation of a constant infusion pump or 2588
the;2589

       (5) The intermittent injection of a dose of medication 2590
prescribed by a licensed physician for dialysisthat is 2591
administered via the hemodialysis blood circuit and through the 2592
patient's venous access.2593

       (F) No person shall employ or direct a licensed practical 2594
nurse to perform an intravenous therapy procedure without first 2595
verifying that the licensed practical nurse is authorized by the 2596
board to perform intravenous therapy.2597

       (G) The board shall issue an intravenous therapy card to the 2598
licensed practical nurses authorized pursuant to division (A) of 2599
this section to perform intravenous therapy. A fee for issuing the 2600
card shall not be charged under section 4723.08 of the Revised 2601
Code if the licensed practical nurse receives the card by meeting 2602
the requirements of division (A)(1) of this section. The board 2603
shall maintain a registry of the names of licensed practical 2604
nurses who hold intravenous therapy cards.2605

       Sec. 4723.171.        Sec. 4723.181.  (A) A licensed practical nurse may 2606
perform on any person any of the intravenous therapy procedures 2607
specified in division (B) of this section without receiving 2608
authorization to perform intravenous therapy from the board of 2609
nursing under section 4723.174723.18 of the Revised Code, if both 2610
of the following apply:2611

       (1) The licensed practical nurse acts at the direction of a 2612
registered nurse or a licensed physician, dentist, optometrist, or 2613
podiatrist and the registered nurse, physician, dentist, 2614
optometrist, or podiatrist is on the premises where the procedure 2615
is to be performed or accessible by some form of 2616
telecommunication.2617

       (2) The licensed practical nurse can demonstrate the 2618
knowledge, skills, and ability to perform the procedure safely.2619

       (B) The intravenous therapy procedures that a licensed 2620
practical nurse may perform pursuant to division (A) of this 2621
section are limited to the following:2622

       (1) Verification of the type of peripheral intravenous 2623
solution being administered;2624

       (2) Examination of a peripheral infusion site and the 2625
extremity for possible infiltration;2626

       (3) Regulation of a peripheral intravenous infusion according 2627
to the prescribed flow rate;2628

       (4) Discontinuation of a peripheral intravenous device at the 2629
appropriate time;2630

       (5) Performance of routine dressing changes at the insertion 2631
site of a peripheral venous or arterial infusion, peripherally 2632
inserted central catheter infusion, or central venous pressure 2633
subclavian infusion.2634

       Sec. 4723.19. (A) A person or government entity seeking 2635
approval to provide a course of study in the safe performance of 2636
intravenous therapy shall apply to the board of nursing in a 2637
manner specified by the board.2638

       (B) The board shall approve the applicant to provide a course 2639
of study in the safe performance of intravenous therapy if the 2640
content of the course of study to be provided includes all of the 2641
following:2642

       (1) Didactic and clinical components;2643

       (2) Curriculum requirements established in rules the board 2644
shall adopt in accordance with Chapter 119. of the Revised Code;2645

       (3) Standards that require the nurse to perform a successful 2646
demonstration of the intravenous procedures, including all skills 2647
needed to perform them safely.2648

       Sec. 4723.24.  (A) AllExcept as otherwise specified in this 2649
chapter, all active licenses and certificates issued under this 2650
chapter shall be renewed biennially according to a schedule 2651
established by the board of nursing. The board shall provide an 2652
application for renewal to every holder of an active license or 2653
certificate, except when the board is aware that an individual is 2654
ineligible for license or certificate renewal for any reason, 2655
including pending criminal charges in this state or another 2656
jurisdiction, failure to comply with a disciplinary order from the 2657
board or the terms of a consent agreement entered into with the 2658
board, failure to pay fines or fees owed to the board, or failure 2659
to provide on the board's request documentation of having 2660
completed the continuing nursing education requirements specified 2661
in division (C) of this section.2662

       If the board provides a renewal application by mail, the 2663
application shall be addressed to the last known post-office 2664
address of the license or certificate holder and mailed before the 2665
date specified in the board's schedule. Failure of the license or 2666
certificate holder to receive an application for renewal from the 2667
board shall not excuse the holder from the requirements contained 2668
in this section, except as provided in section 5903.10 of the 2669
Revised Code.2670

       The license or certificate holder shall complete the renewal 2671
form and return it to the treasurer of stateboard with the 2672
renewal fee required by section 4723.08 of the Revised Code on or 2673
before the date specified by the board. The license or certificate2674
holder shall report any conviction, plea, or judicial finding 2675
regarding a criminal offense that constitutes grounds for the 2676
board to impose sanctions under section 4723.28 of the Revised 2677
Code since the holder last submitted an application to the board.2678

       The treasurer shall immediately forward the renewal 2679
application to the board. On receipt of the renewal application, 2680
the board shall verify thatwhether the applicant meets the 2681
renewal requirements and. If the applicant meets the requirements, 2682
the board shall renew the license or certificate for the following 2683
two-year period.2684

       If a renewal application that meets the renewal requirements 2685
is submitted after the date specified in the board's schedule, but 2686
before expiration of the license or certificate, the board shall 2687
grant a renewal upon payment of the late renewal fee authorized 2688
under section 4723.08 of the Revised Code.2689

       (B) Every license or certificate holder shall give written 2690
notice to the board of any change of name or address within thirty 2691
days of the change. The board shall require the holder to document 2692
a change of name in a manner acceptable to the board.2693

       (C)(1) Except in the case of a first renewal after licensure 2694
by examination, to be eligible for renewal of an active license to 2695
practice nursing as a registered nurse or licensed practical 2696
nurse, each individual who holds an active license shall, in each 2697
two-year period specified by the board, complete continuing 2698
nursing education as follows:2699

       (a) For renewal of a license that was issued for a two-year 2700
renewal period, twenty-four hours of continuing nursing education;2701

       (b) For renewal of a license that was issued for less than a 2702
two-year renewal period, the number of hours of continuing nursing 2703
education specified by the board in rules adopted in accordance 2704
with Chapter 119. of the Revised Code;2705

       (c) Of the hours of continuing nursing education completed in 2706
any renewal period, at least one hour of the education must be 2707
directly related to the statutes and rules pertaining to the 2708
practice of nursing in this state.2709

       (2) The board shall adopt rules establishing the procedure 2710
for a license holder to certify to the board completion of the 2711
required continuing nursing education. The board may conduct a 2712
random sample of license holders and require that the license 2713
holders included in the sample submit satisfactory documentation 2714
of having completed the requirements for continuing nursing 2715
education. On the board's request, a license holder included in 2716
the sample shall submit the required documentation.2717

       (3) An educational activity may be applied toward meeting the 2718
continuing nursing education requirement only if it is obtained 2719
through a program or course approved by the board or a person the 2720
board has authorized to approve continuing nursing education 2721
programs and courses.2722

       (4) The continuing education required of a certified 2723
registered nurse anesthetist, clinical nurse specialist, certified 2724
nurse-midwife, or certified nurse practitioner to obtain or2725
maintain certification by a national certifying organization shall 2726
be applied toward the continuing education requirements for 2727
renewal of a license to practice nursing as a registered nurse 2728
only if it is obtained through a program or course approved by the 2729
board or a person the board has authorized to approve continuing 2730
nursing education programs and courses.2731

       (D) Except as otherwise provided in section 4723.28 of the 2732
Revised Code, aan individual who holds an active license holder2733
to practice nursing as a registered nurse or licensed practical 2734
nurse and who does not intend to practice in Ohio may send to the 2735
board written notice to that effect on or before the renewal date, 2736
and the board shall classify the license as inactive. During the 2737
period that the license is classified as inactive, the holder may 2738
not engage in the practice of nursing in Ohio and is not required 2739
to pay the renewal fee.2740

       The holder of an inactive license or an individual who has 2741
failed to renew the individual's license may have the license2742
restored or renewedreactivated or reinstated upon meetingdoing 2743
the following, as applicable to the holder or individual:2744

       (1) Applying to the board for license reactivation or 2745
reinstatement on forms provided by the board;2746

       (2) Meeting the requirements for restoring and renewing2747
reactivating or reinstating licenses established in rules adopted 2748
under section 4723.07 of the Revised Code or, if the individual 2749
did not renew because of service in the armed forces of the United 2750
States, as provided in section 5903.10 of the Revised Code;2751

       (3) If the license has been inactive for at least five years 2752
from the date of application for reactivation or has lapsed for at 2753
least five years from the date of application for reinstatement, 2754
submitting a request to the bureau of criminal identification and 2755
investigation for a criminal records check and check of federal 2756
bureau of investigation records pursuant to section 4723.091 of 2757
the Revised Code.2758

       Sec. 4723.271. The(A) Upon request of the holder of a 2759
nursing license, certificate of authority, dialysis technician 2760
certificate, medication aide certificate, or community health 2761
worker certificate issued under this chapter, the presentment of 2762
proper identification as prescribed in rules adopted by the board 2763
of nursing, and payment of the fee authorized under section 2764
4723.08 of the Revised Code, the board of nursing shall provide to 2765
the requestor a replacement copy of a nursing license, certificate 2766
of authority, dialysis technicianwall certificate, or community 2767
health worker certificate issued under this chapter upon request 2768
of the holder accompanied by proper identification as prescribed 2769
in rules adopted by the board and payment of the fee authorized 2770
under section 4723.08 of the Revised Codesuitable for framing.2771

       (B) Upon request of the holder of a nursing license, 2772
certificate of authority, certificate to prescribe, dialysis 2773
technician certificate, medication aide certificate, or community 2774
health worker certificate issued under this chapter and payment of 2775
the fee authorized under section 4723.08 of the Revised Code, the 2776
board shall verify to an agency of another jurisdiction or foreign 2777
country the fact that the person holds such nursing license, 2778
certificate of authority, certificate to prescribe, dialysis 2779
technician certificate, medication aide certificate, or community 2780
health worker certificate.2781

       Sec. 4723.28.  (A) The board of nursing, by a vote of a 2782
quorum, may revoke or may refuse to grant a nursing license, 2783
certificate of authority, or dialysis technician certificate to a 2784
person found by the board to haveimpose one or more of the 2785
following sanctions if it finds that a person committed fraud in 2786
passing an examination required to obtain thea license, 2787
certificate of authority, or dialysis technician certificate 2788
issued by the board or to have committed fraud, misrepresentation, 2789
or deception in applying for or securing any nursing license, 2790
certificate of authority, or dialysis technician certificate 2791
issued by the board: deny, revoke, suspend, or place restrictions 2792
on any nursing license, certificate of authority, or dialysis 2793
technician certificate issued by the board; reprimand or otherwise 2794
discipline a holder of a nursing license, certificate of 2795
authority, or dialysis technician certificate; or impose a fine of 2796
not more than five hundred dollars per violation.2797

       (B) Subject to division (N) of this section, theThe board of 2798
nursing, by a vote of a quorum, may impose one or more of the 2799
following sanctions: deny, revoke, suspend, or place restrictions 2800
on any nursing license, certificate of authority, or dialysis 2801
technician certificate issued by the board; reprimand or otherwise 2802
discipline a holder of a nursing license, certificate of 2803
authority, or dialysis technician certificate; or impose a fine of 2804
not more than five hundred dollars per violation. The sanctions 2805
may be imposed for any of the following:2806

       (1) Denial, revocation, suspension, or restriction of 2807
authority to engage in a licensed profession or practice a health 2808
care occupation, including nursing or practice as a dialysis 2809
technician, for any reason other than a failure to renew, in Ohio 2810
or another state or jurisdiction;2811

       (2) Engaging in the practice of nursing or engaging in 2812
practice as a dialysis technician, having failed to renew a 2813
nursing license or dialysis technician certificate issued under 2814
this chapter, or while a nursing license or dialysis technician 2815
certificate is under suspension;2816

       (3) Conviction of, a plea of guilty to, a judicial finding of 2817
guilt of, a judicial finding of guilt resulting from a plea of no 2818
contest to, or a judicial finding of eligibility for a pretrial 2819
diversion or similar program or for intervention in lieu of 2820
conviction for, a misdemeanor committed in the course of practice;2821

       (4) Conviction of, a plea of guilty to, a judicial finding of 2822
guilt of, a judicial finding of guilt resulting from a plea of no 2823
contest to, or a judicial finding of eligibility for a pretrial 2824
diversion or similar program or for intervention in lieu of 2825
conviction for, any felony or of any crime involving gross 2826
immorality or moral turpitude;2827

       (5) Selling, giving away, or administering drugs or 2828
therapeutic devices for other than legal and legitimate 2829
therapeutic purposes; or conviction of, a plea of guilty to, a 2830
judicial finding of guilt of, a judicial finding of guilt 2831
resulting from a plea of no contest to, or a judicial finding of 2832
eligibility for a pretrial diversion or similar program or for 2833
intervention in lieu of conviction for, violating any municipal, 2834
state, county, or federal drug law;2835

       (6) Conviction of, a plea of guilty to, a judicial finding of 2836
guilt of, a judicial finding of guilt resulting from a plea of no 2837
contest to, or a judicial finding of eligibility for a pretrial 2838
diversion or similar program or for intervention in lieu of 2839
conviction for, an act in another jurisdiction that would 2840
constitute a felony or a crime of moral turpitude in Ohio;2841

       (7) Conviction of, a plea of guilty to, a judicial finding of 2842
guilt of, a judicial finding of guilt resulting from a plea of no 2843
contest to, or a judicial finding of eligibility for a pretrial 2844
diversion or similar program or for intervention in lieu of 2845
conviction for, an act in the course of practice in another 2846
jurisdiction that would constitute a misdemeanor in Ohio;2847

       (8) Self-administering or otherwise taking into the body any 2848
dangerous drug, as defined in section 4729.01 of the Revised Code, 2849
in any way that is not in accordance with a legal, valid 2850
prescription issued for that individual, or self-administering or 2851
otherwise taking into the body any drug that is a schedule I 2852
controlled substance;2853

       (9) Habitual indulgence in theor excessive use of controlled 2854
substances, other habit-forming drugs, or alcohol or other 2855
chemical substances to an extent that impairs ability to practice2856
the individual's ability to provide safe nursing care or safe 2857
dialysis care;2858

       (10) Impairment of the ability to practice according to 2859
acceptable and prevailing standards of safe nursing care or safe 2860
dialysis care because of habitual or excessivethe use of drugs, 2861
alcohol, or other chemical substances that impair the ability to 2862
practice;2863

       (11) Impairment of the ability to practice according to 2864
acceptable and prevailing standards of safe nursing care or safe 2865
dialysis care because of a physical or mental disability;2866

       (12) Assaulting or causing harm to a patient or depriving a 2867
patient of the means to summon assistance;2868

       (13) Obtaining or attempting to obtainMisappropriation or 2869
attempted misappropriation of money or anything of value by 2870
intentional misrepresentation or material deception in the course 2871
of practice;2872

       (14) Adjudication by a probate court of being mentally ill or 2873
mentally incompetent. The board may restorereinstate the person's 2874
nursing license or dialysis technician certificate upon 2875
adjudication by a probate court of the person's restoration to 2876
competency or upon submission to the board of other proof of 2877
competency.2878

       (15) The suspension or termination of employment by the 2879
department of defense or the veterans administration of the United 2880
States for any act that violates or would violate this chapter;2881

       (16) Violation of this chapter or any rules adopted under it;2882

       (17) Violation of any restrictions placed by the board on a 2883
nursing license or dialysis technician certificate by the board;2884

       (18) Failure to use universal blood and body fluidstandard2885
precautions established by rules adopted under section 4723.07 of 2886
the Revised Code;2887

       (19) Failure to practice in accordance with acceptable and 2888
prevailing standards of safe nursing care or safe dialysis care;2889

       (20) In the case of a registered nurse, engaging in 2890
activities that exceed the practice of nursing as a registered 2891
nurse;2892

       (21) In the case of a licensed practical nurse, engaging in 2893
activities that exceed the practice of nursing as a licensed 2894
practical nurse;2895

       (22) In the case of a dialysis technician, engaging in 2896
activities that exceed those permitted under section 4723.72 of 2897
the Revised Code;2898

       (23) Aiding and abetting a person in that person's practice 2899
of nursing without a license or practice as a dialysis technician 2900
without a certificate issued under this chapter;2901

       (24) In the case of a certified registered nurse anesthetist, 2902
clinical nurse specialist, certified nurse-midwife, or certified 2903
nurse practitioner, except as provided in division (M) of this 2904
section, either of the following:2905

       (a) Waiving the payment of all or any part of a deductible or 2906
copayment that a patient, pursuant to a health insurance or health 2907
care policy, contract, or plan that covers such nursing services, 2908
would otherwise be required to pay if the waiver is used as an 2909
enticement to a patient or group of patients to receive health 2910
care services from that provider;2911

       (b) Advertising that the nurse will waive the payment of all 2912
or any part of a deductible or copayment that a patient, pursuant 2913
to a health insurance or health care policy, contract, or plan 2914
that covers such nursing services, would otherwise be required to 2915
pay.2916

       (25) Failure to comply with the terms and conditions of 2917
participation in the chemical dependency monitoring program 2918
established under section 4723.35 of the Revised Code;2919

       (26) Failure to comply with the terms and conditions required 2920
under the practice intervention and improvement program 2921
established under section 4723.282 of the Revised Code;2922

       (27) In the case of a certified registered nurse anesthetist, 2923
clinical nurse specialist, certified nurse-midwife, or certified 2924
nurse practitioner:2925

       (a) Engaging in activities that exceed those permitted for 2926
the nurse's nursing specialty under section 4723.43 of the Revised 2927
Code;2928

       (b) Failure to meet the quality assurance standards 2929
established under section 4723.07 of the Revised Code.2930

       (28) In the case of a clinical nurse specialist, certified 2931
nurse-midwife, or certified nurse practitioner, failure to 2932
maintain a standard care arrangement in accordance with section 2933
4723.431 of the Revised Code or to practice in accordance with the 2934
standard care arrangement;2935

       (29) In the case of a clinical nurse specialist, certified 2936
nurse-midwife, or certified nurse practitioner who holds a 2937
certificate to prescribe issued under section 4723.48 of the 2938
Revised Code, failure to prescribe drugs and therapeutic devices 2939
in accordance with section 4723.481 of the Revised Code;2940

       (30) Prescribing any drug or device to perform or induce an 2941
abortion, or otherwise performing or inducing an abortion;2942

       (31) Failure to establish and maintain professional 2943
boundaries with a patient, as specified in rules adopted under 2944
section 4723.07 of the Revised Code;2945

       (32) Regardless of whether the contact or verbal behavior is 2946
consensual, engaging with a patient other than the spouse of the 2947
registered nurse, licensed practical nurse, or dialysis technician 2948
in any of the following:2949

       (a) Sexual contact, as defined in section 2907.01 of the 2950
Revised Code;2951

       (b) Verbal behavior that is sexually demeaning to the patient 2952
or may be reasonably interpreted by the patient as sexually 2953
demeaning.2954

       (33) Assisting suicide as defined in section 3795.01 of the 2955
Revised Code.2956

       (C) Disciplinary actions taken by the board under divisions 2957
(A) and (B) of this section shall be taken pursuant to an 2958
adjudication conducted under Chapter 119. of the Revised Code, 2959
except that in lieu of a hearing, the board may enter into a 2960
consent agreement with an individual to resolve an allegation of a 2961
violation of this chapter or any rule adopted under it. A consent 2962
agreement, when ratified by a vote of a quorum, shall constitute 2963
the findings and order of the board with respect to the matter 2964
addressed in the agreement. If the board refuses to ratify a 2965
consent agreement, the admissions and findings contained in the 2966
agreement shall be of no effect.2967

       (D) The hearings of the board shall be conducted in 2968
accordance with Chapter 119. of the Revised Code, the board may 2969
appoint a hearing examiner, as provided in section 119.09 of the 2970
Revised Code, to conduct any hearing the board is authorized to 2971
hold under Chapter 119. of the Revised Code.2972

       In any instance in which the board is required under Chapter 2973
119. of the Revised Code to give notice of an opportunity for a 2974
hearing and the applicant, licensee, or licensecertificate holder 2975
does not make a timely request for a hearing in accordance with 2976
section 119.07 of the Revised Code, the board is not required to 2977
hold a hearing, but may adopt, by a vote of a quorum, a final 2978
order that contains the board's findings. In the final order, the 2979
board may order any of the sanctions listed in division (A) or (B) 2980
of this section.2981

       (E) If a criminal action is brought against a registered 2982
nurse, licensed practical nurse, or dialysis technician for an act 2983
or crime described in divisions (B)(3) to (7) of this section and 2984
the action is dismissed by the trial court other than on the 2985
merits, the board shall conduct an adjudication to determine 2986
whether the registered nurse, licensed practical nurse, or 2987
dialysis technician committed the act on which the action was 2988
based. If the board determines on the basis of the adjudication 2989
that the registered nurse, licensed practical nurse, or dialysis 2990
technician committed the act, or if the registered nurse, licensed 2991
practical nurse, or dialysis technician fails to participate in 2992
the adjudication, the board may take action as though the 2993
registered nurse, licensed practical nurse, or dialysis technician 2994
had been convicted of the act.2995

       If the board takes action on the basis of a conviction, plea, 2996
or a judicial finding as described in divisions (B)(3) to (7) of 2997
this section that is overturned on appeal, the registered nurse, 2998
licensed practical nurse, or dialysis technician may, on 2999
exhaustion of the appeal process, petition the board for 3000
reconsideration of its action. On receipt of the petition and 3001
supporting court documents, the board shall temporarily rescind 3002
its action. If the board determines that the decision on appeal 3003
was a decision on the merits, it shall permanently rescind its 3004
action. If the board determines that the decision on appeal was 3005
not a decision on the merits, it shall conduct an adjudication to 3006
determine whether the registered nurse, licensed practical nurse, 3007
or dialysis technician committed the act on which the original 3008
conviction, plea, or judicial finding was based. If the board 3009
determines on the basis of the adjudication that the registered 3010
nurse, licensed practical nurse, or dialysis technician committed 3011
such act, or if the registered nurse, licensed practical nurse, or 3012
dialysis technician does not request an adjudication, the board 3013
shall reinstate its action; otherwise, the board shall permanently 3014
rescind its action.3015

       Notwithstanding the provision of division (C)(2) of section 3016
2953.32 of the Revised Code specifying that if records pertaining 3017
to a criminal case are sealed under that section the proceedings 3018
in the case shall be deemed not to have occurred, sealing of the 3019
following records of a conviction on which the board has based an 3020
action under this section shall have no effect on the board's 3021
action or any sanction imposed by the board under this section: 3022
records of any conviction, guilty plea, judicial finding of guilt 3023
resulting from a plea of no contest, or a judicial finding of 3024
eligibility for a pretrial diversion program or intervention in 3025
lieu of conviction.3026

       The board shall not be required to seal, destroy, redact, or 3027
otherwise modify its records to reflect the court's sealing of 3028
conviction records.3029

       (F) The board may investigate an individual's criminal 3030
background in performing its duties under this section. As part of 3031
such investigation, the board may order the individual to submit, 3032
at the individual's expense, a request to the bureau of criminal 3033
identification and investigation for a criminal records check and 3034
check of federal bureau of investigation records in accordance 3035
with the procedure described in section 4723.091 of the Revised 3036
Code.3037

       (G) During the course of an investigation conducted under 3038
this section, the board may compel any registered nurse, licensed 3039
practical nurse, or dialysis technician or applicant under this 3040
chapter to submit to a mental or physical examination, or both, as 3041
required by the board and at the expense of the individual, if the 3042
board finds reason to believe that the individual under 3043
investigation may have a physical or mental impairment that may 3044
affect the individual's ability to provide safe nursing care. 3045
Failure of any individual to submit to a mental or physical 3046
examination when directed constitutes an admission of the 3047
allegations, unless the failure is due to circumstances beyond the 3048
individual's control, and a default and final order may be entered 3049
without the taking of testimony or presentation of evidence.3050

       If the board finds that an individual is impaired, the board 3051
shall require the individual to submit to care, counseling, or 3052
treatment approved or designated by the board, as a condition for 3053
initial, continued, reinstated, or renewed authority to practice. 3054
The individual shall be afforded an opportunity to demonstrate to 3055
the board that the individual can begin or resume the individual's 3056
occupation in compliance with acceptable and prevailing standards 3057
of care under the provisions of the individual's authority to 3058
practice.3059

       For purposes of this division, any registered nurse, licensed 3060
practical nurse, or dialysis technician or applicant under this 3061
chapter shall be deemed to have given consent to submit to a 3062
mental or physical examination when directed to do so in writing 3063
by the board, and to have waived all objections to the 3064
admissibility of testimony or examination reports that constitute 3065
a privileged communication.3066

       (H) The board shall investigate evidence that appears to show 3067
that any person has violated any provision of this chapter or any 3068
rule of the board. Any person may report to the board any 3069
information the person may have that appears to show a violation 3070
of any provision of this chapter or rule of the board. In the 3071
absence of bad faith, any person who reports such information or 3072
who testifies before the board in any adjudication conducted under 3073
Chapter 119. of the Revised Code shall not be liable for civil 3074
damages as a result of the report or testimony.3075

       (I) All of the following apply under this chapter with 3076
respect to the confidentiality of information:3077

       (1) Information received by the board pursuant to a complaint 3078
or an investigation is confidential and not subject to discovery 3079
in any civil action, except that the board may disclose 3080
information to law enforcement officers and government entities 3081
investigatingfor purposes of an investigation of either a 3082
licensed health care professional, including a registered nurse, 3083
licensed practical nurse, or dialysis technician, or a person who 3084
may have engaged in the unauthorized practice of nursing or 3085
dialysis care. No law enforcement officer or government entity 3086
with knowledge of any information disclosed by the board pursuant 3087
to this division shall divulge the information to any other person 3088
or government entity except for the purpose of a government 3089
investigation, a prosecution, or an adjudication by a court or 3090
government entity.3091

       (2) If an investigation requires a review of patient records, 3092
the investigation and proceeding shall be conducted in such a 3093
manner as to protect patient confidentiality.3094

       (3) All adjudications and investigations of the board shall 3095
be considered civil actions for the purposes of section 2305.252 3096
of the Revised Code.3097

       (4) Any board activity that involves continued monitoring of 3098
an individual as part of or following any disciplinary action 3099
taken under this section shall be conducted in a manner that 3100
maintains the individual's confidentiality. Information received 3101
or maintained by the board with respect to the board's monitoring 3102
activities is confidential and not subject to discovery in any 3103
civil action and is confidential, except that the board may 3104
disclose information to law enforcement officers and government 3105
entities for purposes of an investigation of a licensee or 3106
certificate holder.3107

       (J) Any action taken by the board under this section 3108
resulting in a suspension from practice shall be accompanied by a 3109
written statement of the conditions under which the person may be 3110
reinstated to practice.3111

       (K) When the board refuses to grant a license or certificate 3112
to an applicant, revokes a license or certificate, or refuses to 3113
reinstate a license or certificate, the board may specify that its 3114
action is permanent. An individual subject to permanent action 3115
taken by the board is forever ineligible to hold a license or 3116
certificate of the type that was refused or revoked and the board 3117
shall not accept from the individual an application for 3118
reinstatement of the license or certificate or for a new license 3119
or certificate.3120

       (L) No unilateral surrender of a nursing license, certificate 3121
of authority, or dialysis technician certificate issued under this 3122
chapter shall be effective unless accepted by majority vote of the 3123
board. No application for a nursing license, certificate of 3124
authority, or dialysis technician certificate issued under this 3125
chapter may be withdrawn without a majority vote of the board. The 3126
board's jurisdiction to take disciplinary action under this 3127
section is not removed or limited when an individual has a license 3128
or certificate classified as inactive or fails to renew a license 3129
or certificate.3130

       (M) Sanctions shall not be imposed under division (B)(24) of 3131
this section against any licensee who waives deductibles and 3132
copayments as follows:3133

       (1) In compliance with the health benefit plan that expressly 3134
allows such a practice. Waiver of the deductibles or copayments 3135
shall be made only with the full knowledge and consent of the plan 3136
purchaser, payer, and third-party administrator. Documentation of 3137
the consent shall be made available to the board upon request.3138

       (2) For professional services rendered to any other person 3139
licensed pursuant to this chapter to the extent allowed by this 3140
chapter and the rules of the board.3141

       (N)(1) Any person who enters a prelicensure nursing education 3142
program on or after June 1, 2003, and who subsequently applies 3143
under division (A) of section 4723.09 of the Revised Code for 3144
licensure to practice as a registered nurse or as a licensed 3145
practical nurse and any person who applies under division (B) of 3146
that section for license by endorsement to practice nursing as a 3147
registered nurse or as a licensed practical nurse shall submit a 3148
request to the bureau of criminal identification and investigation 3149
for the bureau to conduct a criminal records check of the 3150
applicant and to send the results to the board, in accordance with 3151
section 4723.09 of the Revised Code.3152

       The board shall refuse to grant a license to practice nursing 3153
as a registered nurse or as a licensed practical nurse under 3154
section 4723.09 of the Revised Code to a person who entered a 3155
prelicensure nursing education program on or after June 1, 2003, 3156
and applied under division (A) of section 4723.09 of the Revised 3157
Code for the license or a person who applied under division (B) of 3158
that section for the license, if the criminal records check 3159
performed in accordance with division (C) of that section 3160
indicates that the person has pleaded guilty to, been convicted 3161
of, or has had a judicial finding of guilt for violating section 3162
2903.01, 2903.02, 2903.03, 2903.11, 2905.01, 2907.02, 2907.03, 3163
2907.05, 2909.02, 2911.01, or 2911.11 of the Revised Code or a 3164
substantially similar law of another state, the United States, or 3165
another country.3166

       (2) Any person who enters a dialysis training program on or 3167
after June 1, 2003, and who subsequently applies for a certificate 3168
to practice as a dialysis technician shall submit a request to the 3169
bureau of criminal identification and investigation for the bureau 3170
to conduct a criminal records check of the applicant and to send 3171
the results to the board, in accordance with section 4723.75 of 3172
the Revised Code. 3173

       The board shall refuse to issue a certificate to practice as 3174
a dialysis technician under section 4723.75 of the Revised Code to 3175
a person who entered a dialysis training program on or after June 3176
1, 2003, and whose criminal records check performed in accordance 3177
with division (C) of that section indicates that the person has 3178
pleaded guilty to, been convicted of, or has had a judicial 3179
finding of guilt for violating section 2903.01, 2903.02, 2903.03, 3180
2903.11, 2905.01, 2907.02, 2907.03, 2907.05, 2909.02, 2911.01, or 3181
2911.11 of the Revised Code or a substantially similar law of 3182
another state, the United States, or another country.3183

       Sec. 4723.32.  This chapter does not prohibit any of the 3184
following:3185

       (A) The practice of nursing by a student currently enrolled 3186
in and actively pursuing completion of a prelicensure nursing 3187
education program, if all of the following are the case:3188

        (1) The student is participating in a program located in this 3189
state and approved by the board of nursing or participating in 3190
this state in a component of a program located in another 3191
jurisdiction and approved by a board that is a member of the 3192
national council of state boards of nursing;3193

        (2) The student's practice is under the auspices of the 3194
program;3195

       (3) The student acts under the supervision of a registered 3196
nurse serving for the program as a faculty member or teaching 3197
assistant.3198

       (B) The rendering of medical assistance to a licensed 3199
physician, licensed dentist, or licensed podiatrist by a person 3200
under the direction, supervision, and control of such licensed 3201
physician, dentist, or podiatrist;3202

       (C) The activities of persons employed as nursing aides, 3203
attendants, orderlies, or other auxiliary workers in patient 3204
homes, nurseries, nursing homes, hospitals, home health agencies, 3205
or other similar institutions;3206

       (D) The provision of nursing services to family members or in 3207
emergency situations;3208

       (E) The care of the sick when done in connection with the 3209
practice of religious tenets of any church and by or for its 3210
members;3211

       (F) The practice of nursing as a certified registered nurse 3212
anesthetist, clinical nurse specialist, certified nurse-midwife, 3213
or certified nurse practitioner by a student currently enrolled in 3214
and actively pursuing completion of a program of study leading to 3215
initial authorization by the board of nursing to practice nursing 3216
in the specialty, if all of the following are the case:3217

       (1) The program qualifies the student to sit for the 3218
examination of a national certifying organization listed in 3219
division (A)(3) of section 4723.41 of the Revised Code or approved 3220
by the board under section 4723.46 of the Revised Code or the 3221
program prepares the student to receive a master's degree in 3222
accordance with division (A)(2) of section 4723.41 of the Revised 3223
Code;3224

       (2) The student's practice is under the auspices of the 3225
program;3226

       (3) The student acts under the supervision of a registered 3227
nurse serving for the program as a faculty member, teaching 3228
assistant, or preceptor.3229

       (G) The activities of an individual who currently holds a 3230
license to practice nursing in another jurisdiction, if the 3231
individual's license has not been revoked, the individual is not 3232
currently under suspension or on probation, the individual does 3233
not represent the individual as being licensed under this chapter, 3234
and one of the following is the case:3235

       (1) The individual is engaging in the practice of nursing by 3236
discharging official duties while employed by or under contract 3237
with the United States government or any agency thereof;3238

       (2) The individual is engaging in the practice of nursing as 3239
an employee of an individual, agency, or corporation located in 3240
the other jurisdiction in a position with employment 3241
responsibilities that include transporting patients into, out of, 3242
or through this state, as long as each trip in this state does not 3243
exceed seventy-two hours;3244

       (3) The individual is consulting with an individual licensed 3245
in this state to practice any health-related profession;3246

       (4) The individual is engaging in activities associated with 3247
teaching in this state as a guest lecturer at or for a nursing 3248
education program, continuing nursing education program, or 3249
in-service presentation;3250

       (5) The individual is conducting evaluations of nursing care 3251
that are undertaken on behalf of an accrediting organization, 3252
including the national league for nursing accrediting committee, 3253
the joint commission on accreditation of healthcare organizations, 3254
or any other nationally recognized accrediting organization;3255

       (6) The individual is providing nursing care to an individual 3256
who is in this state on a temporary basis, not to exceed six 3257
months in any one calendar year, if the nurse is directly employed 3258
by or under contract with the individual or a guardian or other 3259
person acting on the individual's behalf;3260

       (7) The individual is providing nursing care during any 3261
disaster, natural or otherwise, that has been officially declared 3262
to be a disaster by a public announcement issued by an appropriate 3263
federal, state, county, or municipal official.3264

       (H) The administration of medication by an individual who 3265
holds a valid medication aide certificate issued under this 3266
chapter, if the medication is administered to a resident of a 3267
nursing home or residential care facility authorized by section 3268
4723.63 or 4723.64 of the Revised Code to use a certified 3269
medication aide and the medication is administered in accordance 3270
with section 4723.67 of the Revised Code.3271

       Sec. 4723.34.  (A) Reports to the board of nursing shall be 3272
made as follows:3273

       (1) Every employer ofA person or governmental entity that 3274
employs, or contracts directly or through another person or 3275
governmental entity for the provision of services by, registered 3276
nurses, licensed practical nurses, or dialysis technicians, 3277
medication aides, or certified community health workers and that 3278
knows or has reason to believe that a current or former employee 3279
or person providing services under a contract who holds a license 3280
or certificate issued under this chapter engaged in conduct that 3281
would be grounds for disciplinary action by the board of nursing 3282
under this chapter or rules adopted under it shall report to the 3283
board of nursing the name of anysuch current or former employee 3284
who holds a nursing license or dialysis technician certificate 3285
issued under this chapter who has engaged in conduct that would be 3286
grounds for disciplinary action by the board under section 4723.28 3287
of the Revised Codeor person providing services under a contract. 3288
The report shall be made on the person's or governmental entity's 3289
behalf by an individual licensed by the board who the person or 3290
governmental entity has designated to make such reports.3291

       Every employer of certified community health workers shall 3292
report to the board the name of any current or former employee who 3293
holds a community health worker certificate issued under this 3294
chapter who has engaged in conduct that would be grounds for 3295
disciplinary action by the board under section 4723.86 of the 3296
Revised Code.3297

       Every employer of medication aides shall report to the board 3298
the name of any current or former employee who holds a medication 3299
aide certificate issued under this chapter who has engaged in 3300
conduct that would be grounds for disciplinary action by the board 3301
under section 4723.652 of the Revised Code.3302

       (2) Nursing associations shall report to the board the name 3303
of any registered nurse or licensed practical nurse and dialysis 3304
technician associations shall report to the board the name of any 3305
dialysis technician who has been investigated and found to 3306
constitute a danger to the public health, safety, and welfare 3307
because of conduct that would be grounds for disciplinary action 3308
by the board under section 4723.28 of the Revised Code, except 3309
that an association is not required to report the individual's 3310
name if the individual is maintaining satisfactory participation 3311
in a peer support program approved by the board under rules 3312
adopted under section 4723.07 of the Revised Code.3313

       Community health worker associations shall report to the 3314
board the name of any certified community health worker who has 3315
been investigated and found to constitute a danger to the public 3316
health, safety, and welfare because of conduct that would be 3317
grounds for disciplinary action by the board under section 4723.86 3318
of the Revised Code, except that an association is not required to 3319
report the individual's name if the individual is maintaining 3320
satisfactory participation in a peer support program approved by 3321
the board under rules adopted under section 4723.07 of the Revised 3322
Code.3323

       Medication aide associations shall report to the board the 3324
name of any medication aide who has been investigated and found to 3325
constitute a danger to the public health, safety, and welfare 3326
because of conduct that would be grounds for disciplinary action 3327
by the board under section 4723.652 of the Revised Code, except 3328
that an association is not required to report the individual's 3329
name if the individual is maintaining satisfactory participation 3330
in a peer support program approved by the board under rules 3331
adopted under section 4723.69 of the Revised Code.3332

       (3) If theA prosecutor in a case described in divisions 3333
(B)(3) to (5) of section 4723.28 of the Revised Code, or in a case 3334
where the trial court issued an order of dismissal upon technical 3335
or procedural grounds of a charge of a misdemeanor committed in 3336
the course of practice, a felony charge, or a charge of gross 3337
immorality or moral turpitude, who knows or has reason to believe 3338
that the person charged is licensed under this chapter to practice 3339
nursing as a registered nurse or as a licensed practical nurse or 3340
holds a certificate issued under this chapter to practice as a 3341
dialysis technician, the prosecutor shall notify the board of 3342
nursing of the charge. With regard to certified community health 3343
workers and medication aides, if the prosecutor in a case 3344
involving a charge of a misdemeanor committed in the course of 3345
employment, a felony charge, or a charge of gross immorality or 3346
moral turpitude, including a case dismissed on technical or 3347
procedural grounds, who knows or has reason to believe that the 3348
person charged holds a community health worker or medication aide 3349
certificate issued under this chapter, the prosecutor shall notify 3350
the board of the charge.3351

       Each notification required by this divisionfrom a prosecutor3352
shall be made on forms prescribed and provided by the board. The 3353
report shall include the name and address of the license or 3354
certificate holder, the charge, and the certified court documents 3355
recording the action.3356

       (B) If any person or governmental entity fails to provide a 3357
report required by this section, the board may seek an order from 3358
a court of competent jurisdiction compelling submission of the 3359
report.3360

       Sec. 4723.35.  (A) As used in this section, "chemical 3361
dependency" means either of the following:3362

       (1) The chronic and habitual use of alcoholic beverages to 3363
the extent that the user no longer can control the use of alcohol 3364
or endangers the user's health, safety, or welfare or that of 3365
others;3366

       (2) The use of a controlled substance as defined in section 3367
3719.01 of the Revised Code, a harmful intoxicant as defined in 3368
section 2925.01 of the Revised Code, or a dangerous drug as 3369
defined in section 4729.01 of the Revised Code, to the extent that 3370
the user becomes physically or psychologically dependent on the 3371
substance, intoxicant, or drug or endangers the user's health, 3372
safety, or welfare or that of others.3373

       (B) The board of nursing may abstain from taking disciplinary 3374
action under section 4723.28 or 4723.86 of the Revised Code 3375
against an individual with a chemical dependency if it finds that 3376
the individual can be treated effectively and there is no 3377
impairment of the individual's ability to practice according to 3378
acceptable and prevailing standards of safe care. The board shall 3379
establish a chemical dependency monitoring program to monitor the 3380
registered nurses, licensed practical nurses, dialysis 3381
technicians, and certified community health workers against whom 3382
the board has abstained from taking action. The board shall 3383
develop the program, select the program's name, and designate a 3384
coordinator to administer the program.3385

       (C) Determinations regarding an individual's eligibility for 3386
admission to, continued participation in, and successful 3387
completion of the monitoring program shall be made by the board's 3388
supervising member for disciplinary matters in accordance with 3389
rules adopted under division (D) of this section.3390

       (D) The board shall adopt rules in accordance with Chapter 3391
119. of the Revised Code that establish the following:3392

       (1) Eligibility requirements for admission to and continued 3393
participation in the monitoring program;3394

       (2) Terms and conditions that must be met to participate in 3395
and successfully complete the program;3396

       (3) Procedures for keeping confidential records regarding 3397
participants;3398

       (4) Any other requirements or procedures necessary to 3399
establish and administer the program.3400

       (D)(E)(1) As a condition of being admitted to the monitoring 3401
program, an individual shall surrender to the program coordinator 3402
the license or certificate that the individual holds. While the 3403
surrender is in effect, the individual is prohibited from engaging 3404
in the practice of nursing, engaging in the provision of dialysis 3405
care, or engaging in the provision of services that were being 3406
provided as a certified community health worker.3407

       If the program coordinatorboard's supervising member for 3408
disciplinary matters determines that a participant is capable of 3409
resuming practice according to acceptable and prevailing standards 3410
of safe care, the program coordinator shall return the 3411
participant's license or certificate. If the participant violates 3412
the terms and conditions of resumed practice, the program3413
coordinator shall require the participant to surrender the license 3414
or certificate as a condition of continued participation in the 3415
program. The coordinator may require the surrender only on the 3416
approval of the board's supervising member for disciplinary 3417
matters.3418

       The surrender of a license or certificate on admission to the 3419
monitoring program or while participating in the program does not 3420
constitute an action by the board under section 4723.28 or 4723.86 3421
of the Revised Code. The participant may rescind the surrender at 3422
any time and the board may proceed by taking action under section 3423
4723.28 or 4723.86 of the Revised Code.3424

       (2) If the program coordinator determines that a participant 3425
is significantly out of compliance with the terms and conditions 3426
for participation, the coordinator shall notify the board's 3427
supervising member for disciplinary matters and the supervising 3428
member shall determine whether to temporarily suspend the 3429
participant's license or certificate. The program coordinator3430
board shall notify the participant of the suspension by certified 3431
mail sent to the participant's last known address and shall refer 3432
the matter to the board for formal action under section 4723.28 or 3433
4723.86 of the Revised Code.3434

       (E)(F) All of the following apply with respect to the 3435
receipt, release, and maintenance of records and information by 3436
the monitoring program:3437

       (1) The program coordinator shall maintain all program3438
records in the board's office, and for each participant, shall 3439
retain the records for a period of fivetwo years following the 3440
participant's date of successful completion of the program.3441

       (2) When applying to participate in the monitoring program, 3442
the applicant shall sign a waiver permitting the program 3443
coordinatorboard to receive and release information necessary for 3444
the coordinator to determine whether the individual is eligible 3445
for admission. After being admitted, the participant shall sign a 3446
waiver permitting the program coordinatorboard to receive and 3447
release information necessary to determine whether the individual 3448
is eligible for continued participation in the program. 3449
Information that may be necessary for the program coordinator3450
board's supervising member for disciplinary matters to determine 3451
eligibility for admission or continued participation in the 3452
monitoring program includes, but is not limited to, information 3453
provided to and by employers, probation officers, law enforcement 3454
agencies, peer assistance programs, health professionals, and 3455
treatment providers. No entity with knowledge that the information 3456
has been provided to the monitoring program shall divulge that 3457
knowledge to any other person.3458

       (3) Except as provided in division (E)(F)(4) of this section, 3459
all records pertaining to an individual's application for or 3460
participation in the monitoring program, including medical 3461
records, treatment records, and mental health records, shall be 3462
confidential. The records are not public records for the purposes 3463
of section 149.43 of the Revised Code and are not subject to 3464
discovery by subpoena or admissible as evidence in any judicial 3465
proceeding.3466

       (4) The program coordinatorboard may disclose information 3467
regarding a participant's progress in the program to any person or 3468
government entity that the participant authorizes in writing to be 3469
given the information. In disclosing information under this 3470
division, the coordinatorboard shall not include any information 3471
that is protected under section 3793.13 of the Revised Code or any 3472
federal statute or regulation that provides for the 3473
confidentiality of medical, mental health, or substance abuse 3474
records.3475

       (F)(G) In the absence of fraud or bad faith, the program 3476
coordinator, the board of nursing, and the board's employees and 3477
representativesas a whole, its individual members, and its 3478
employees and representatives are not liable for damages in any 3479
civil action as a result of disclosing information in accordance 3480
with division (E)(F)(4) of this section. In the absence of fraud 3481
or bad faith, any person reporting to the program with regard to 3482
an individual's chemical dependence, or the progress or lack of 3483
progress of that individual with regard to treatment, is not 3484
liable for damages in any civil action as a result of the report.3485

       Sec. 4723.41.  (A) Each person who desires to practice 3486
nursing as a certified nurse-midwife and has not been authorized 3487
to practice midwifery prior to December 1, 1967, and each person 3488
who desires to practice nursing as a certified registered nurse 3489
anesthetist, clinical nurse specialist, or certified nurse 3490
practitioner shall file with the board of nursing a written 3491
application for authorization to practice nursing in the desired 3492
specialty, under oath, on a form prescribed by the board.3493

       Except as provided in divisionsdivision (B), (C), and (D) of 3494
this section, at the time of making application, the applicant 3495
shall meet all of the following requirements:3496

       (1) Be a registered nurse;3497

       (2) Submit documentation satisfactory to the board that the 3498
applicant has earned a graduate degree with a major in a nursing 3499
specialty or in a related field that qualifies the applicant to 3500
sit for the certification examination of a national certifying 3501
organization listed in division (A)(3) of this section or approved 3502
by the board under section 4723.46 of the Revised Code;3503

       (3) Submit documentation satisfactory to the board of having 3504
passed the certification examination of one of the following:3505

       (a) If the applicant is applying to practice nursing as a 3506
certified nurse-midwife, the American college of nurse-midwives or 3507
another national certifying organization approved by the board 3508
under section 4723.46 of the Revised Code to examine and certify 3509
nurse-midwives;3510

       (b) If the applicant is applying to practice nursing as a 3511
certified registered nurse anesthetist, the national council on 3512
certification of nurse anesthetists of the American association of 3513
nurse anesthetists, the national council on recertification of 3514
nurse anesthetists of the American association of nurse 3515
anesthetists, or another national certifying organization approved 3516
by the board under section 4723.46 of the Revised Code to examine 3517
and certify registered nurse anesthetists;3518

       (c) If the applicant is applying to practice nursing as a 3519
clinical nurse specialist, the American nurses credentialing 3520
center or another national certifying organization approved by the 3521
board under section 4723.46 of the Revised Code to examine and 3522
certify clinical nurse specialists;3523

       (d) If the applicant is applying to practice nursing as a 3524
certified nurse practitioner, the American nurses credentialing 3525
center, the national certification corporation, the national board 3526
of pediatric nurse practitioners and associates, or anothera3527
national certifying organization approved by the board under 3528
section 4723.46 of the Revised Code to examine and certify, as 3529
applicable, nurse-midwives, registered nurse anesthetists, 3530
clinical nurse specialists, or nurse practitioners.;3531

       (4) Submit an affidavit with the application that states all 3532
of the following:3533

       (a) That the applicant is the person named in the documents 3534
submitted under divisions (A)(2) and (3) of this section and is 3535
the lawful possessor thereof;3536

       (b) The applicant's age, residence, the school at which the 3537
applicant obtained education in the applicant's nursing specialty, 3538
and any other facts that the board requires;3539

       (c) If the applicant is already engaged in the practice of 3540
nursing as a certified registered nurse anesthetist, clinical 3541
nurse specialist, certified nurse-midwife, or certified nurse 3542
practitioner, the period during which and the place where the 3543
applicant is engaged;3544

       (d) If the applicant is already engaged in the practice of 3545
nursing as a clinical nurse specialist, certified nurse-midwife, 3546
or certified nurse practitioner, the names and business addresses 3547
of the applicant's current collaborating physicians and 3548
podiatrists. If the applicant is not yet engaged in the practice 3549
of nursing as a clinical nurse specialist, certified 3550
nurse-midwife, or certified nurse practitioner, the applicant 3551
shall submit the names and business addresses of the applicant's 3552
collaborating physicians or podiatrists not later than thirty days 3553
after first engaging in the practice. The applicant shall give 3554
written notice to the board of any additions or deletions to the 3555
affidavit of collaborating physicians or podiatrists not later 3556
than thirty days after the change takes effect.3557

       (B) On or before December 31, 2000, the board shall issue to 3558
an applicant a certificate of authority to practice nursing as a 3559
certified registered nurse anesthetist, certified nurse-midwife, 3560
or certified nurse practitioner if the applicant complies with all 3561
requirements of this section, other than the requirement that the 3562
applicant has earned a graduate degree with a major in a nursing 3563
specialty or in a related field that qualifies the applicant to 3564
sit for the certification examination of a national certifying 3565
organization listed in division (A)(3) of this section or approved 3566
by the board under section 4723.46 of the Revised Code.3567

       (C) On or before December 31, 2000, the board shall issue to 3568
an applicant a certificate of authority to practice nursing as a 3569
clinical nurse specialist if one of the following applies:3570

       (1) The applicant holds a graduate degree with a major in a 3571
clinical area of nursing from an educational institution 3572
accredited by a national or regional accrediting organization and 3573
complies with all requirements of this section, other than the 3574
requirement of having passed a certification examination.3575

       (2) The applicant holds a graduate degree in nursing or a 3576
related field and is certified as a clinical nurse specialist by 3577
the American nurses credentialing center or another national 3578
certifying organization approved by the board under section 3579
4723.46 of the Revised Code.3580

       (D) On or before December 31, 2008, the board shall issue to 3581
an applicant a certificate of authority to practice nursing as a 3582
certified nurse practitioner if the applicant has successfully 3583
completed a nurse practitioner certificate program that receives 3584
funding under and is employed by a public agency or a private, 3585
nonprofit entity that receives funding under Title X of the 3586
"Public Health Service Act," 42 U.S.C. 300 and 300a-1 (1991), and 3587
complies with all requirements of this section, other than the 3588
requirement that the applicant has earned a graduate degree with a 3589
major in a nursing specialty or a related field.3590

       (E)(B)(1) A certified registered nurse anesthetist, clinical 3591
nurse specialist, certified nurse-midwife, or certified nurse 3592
practitioner who is practicing as such in another jurisdiction may 3593
apply for a certificate of authority to practice nursing as a 3594
certified registered nurse anesthetist, clinical nurse specialist, 3595
certified nurse-midwife, or certified nurse practitioner in this 3596
state if the nurse meets the requirements for a certificate of 3597
authority set forth in division (A) of this section or division 3598
(B)(2) of this section. The3599

       (2) If an applicant practicing in another jurisdiction 3600
applies for a certificate of authority under division (B)(2) of 3601
this section, the application shall be submitted to the board in 3602
the form prescribed by rules of the board and be accompanied by 3603
the application fee required by section 4723.08 of the Revised 3604
Code. The application shall include evidence that the applicant 3605
meets the requirements of division (B)(2) of this section, holds a 3606
license or certificate to practice nursing as a certified 3607
registered nurse anesthetist, clinical nurse specialist, certified 3608
nurse-midwife, or certified nurse practitioner in good standing in 3609
another jurisdiction granted after meeting requirements approved 3610
by the entity of that jurisdiction that licenses nurses, and other 3611
information required by rules of the board of nursing.3612

       IfWith respect to the educational requirements and national 3613
certification requirements that an applicant under division (B)(2) 3614
of this section must meet, both of the following apply:3615

       (a) If the applicant is a certified registered nurse 3616
anesthetist, certified nurse-midwife, or certified nurse 3617
practitioner who, on or before December 31, 2000, met the 3618
requirements of this section to practice as such and has 3619
maintainedobtained certification in the applicant's nursing 3620
specialty with a national certifying organization listed in 3621
division (A)(3) of section 4723.41 of the Revised Code as that 3622
division existed prior to the effective date of this amendment or 3623
that was at that time approved by the board under section 4723.46 3624
of the Revised Code, division (B) of this section shall applythe 3625
applicant must have maintained the certification. The applicant is 3626
not required to have earned a graduate degree with a major in a 3627
nursing specialty or in a related field that qualifies the 3628
applicant to sit for the certification examination.3629

       (b) If the applicant is a clinical nurse specialist who, on 3630
or before December 31, 2000, met the requirements of this section 3631
to practice as such, division (C) of this section shall applyone 3632
of the following must apply to the applicant:3633

       (i) On or before December 31, 2000, the applicant obtained a 3634
graduate degree with a major in a clinical area of nursing from an 3635
educational institution accredited by a national or regional 3636
accrediting organization. The applicant is not required to have 3637
passed a certification examination.3638

       (ii) On or before December 31, 2000, the applicant obtained a 3639
graduate degree in nursing or a related field and was certified as 3640
a clinical nurse specialist by the American nurses credentialing 3641
center or another national certifying organization that was at 3642
that time approved by the board under section 4723.46 of the 3643
Revised Code.3644

       Sec. 4723.42.  (A) If the applicant for authorization to 3645
practice nursing as a certified registered nurse anesthetist, 3646
clinical nurse specialist, certified nurse-midwife, or certified 3647
nurse practitioner has met all the requirements of section 4723.41 3648
of the Revised Code and has paid the fee required by section 3649
4723.08 of the Revised Code, the board of nursing shall issue its 3650
certificate of authority to practice nursing as a certified 3651
registered nurse anesthetist, clinical nurse specialist, certified 3652
nurse-midwife, or certified nurse practitioner, which shall 3653
designate the nursing specialty the nurse is authorized to 3654
practice. The certificate entitles its holder to practice nursing 3655
in the specialty designated on the certificate.3656

       The board shall issue or deny its certificate not later than 3657
sixty days after receiving all of the documents required by 3658
section 4723.41 of the Revised Code.3659

       If an applicant is under investigation for a violation of 3660
this chapter, the board shall conclude the investigation not later 3661
than ninety days after receipt of all required documents, unless 3662
this ninety-day period is extended by written consent of the 3663
applicant, or unless the board determines that a substantial 3664
question of such a violation exists and the board has notified the 3665
applicant in writing of the reasons for the continuation of the 3666
investigation. If the board determines that the applicant has not 3667
violated this chapter, it shall issue a certificate not later than 3668
forty-five days after making that determination.3669

       (B) Authorization to practice nursing as a certified 3670
registered nurse anesthetist, clinical nurse specialist, certified 3671
nurse-midwife, or certified nurse practitioner shall be renewed 3672
biennially according to rules and a schedule adopted by the board. 3673
In providing renewal applications to certificate holders, the 3674
board shall follow the procedures it follows under section 4723.24 3675
of the Revised Code in providing renewal applications to license 3676
holders. Failure of the certificate holder to receive an 3677
application for renewal from the board does not excuse the holder 3678
from the requirements of section 4723.44 of the Revised Code.3679

       Not later than the date specified by the board, the holder 3680
shall complete the renewal form and return it to the board with 3681
all of the following:3682

       (1) The renewal fee required by section 4723.08 of the 3683
Revised Code;3684

       (2) Except as provided in division (C) of this section, 3685
documentationDocumentation satisfactory to the board that the 3686
holder has maintained certification in the nursing specialty with 3687
a national certifying organization listed in division (A)(3) of 3688
section 4723.41 of the Revised Code or approved by the board under 3689
section 4723.46 of the Revised Code;3690

       (3) A list of the names and business addresses of the 3691
holder's current collaborating physicians and podiatrists, if the 3692
holder is a clinical nurse specialist, certified nurse-midwife, or 3693
certified nurse practitioner;3694

       (4) If the holder's certificate was issued under division (C) 3695
of section 4723.41 of the Revised Code, as that division existed 3696
at any time before the effective date of this amendment,3697
documentation satisfactory to the board that the holder has 3698
completed continuing education for a clinical nurse specialist as 3699
required by rule of the board;3700

       (5) If the holder's certificate was issued under division (D) 3701
of section 4723.41 of the Revised Code, documentation satisfactory 3702
to the board that the holder has continued employment by a public 3703
agency or a private, nonprofit entity that receives funding under 3704
Title X of the "Public Health Service Act," 42 U.S.C. 300 and 3705
300a-1 (1991).3706

       On receipt of the renewal application, fees, and documents, 3707
the board shall verify that the applicant holds a current license 3708
to practice nursing as a registered nurse in this state, and, if 3709
it so verifies, shall renew the certificate. If an applicant 3710
submits the completed renewal application after the date specified 3711
in the board's schedule, but before the expiration of the 3712
certificate, the board shall grant a renewal when the late renewal 3713
fee required by section 4723.08 of the Revised Code is paid.3714

       An applicant for reinstatement of an expired certificate 3715
shall submit the reinstatement fee, renewal fee, and late renewal 3716
fee required by section 4723.08 of the Revised Code. Any holder of 3717
a certificate who desires inactive status shall give the board 3718
written notice to that effect.3719

       (C) The board shall renew a certificate of authority to 3720
practice nursing as a clinical nurse specialist issued pursuant to 3721
division (C) of section 4723.41 of the Revised Code, if the 3722
certificate holder complies with all renewal requirements of this 3723
section other than the requirement of having maintained 3724
certification in the holder's nursing specialty.3725

       Sec. 4723.43.  A certified registered nurse anesthetist, 3726
clinical nurse specialist, certified nurse-midwife, or certified 3727
nurse practitioner may provide to individuals and groups nursing 3728
care that requires knowledge and skill obtained from advanced 3729
formal education and clinical experience. In this capacity as an 3730
advanced practice registered nurse, a certified nurse-midwife is 3731
subject to division (A) of this section, a certified registered 3732
nurse anesthetist is subject to division (B) of this section, a 3733
certified nurse practitioner is subject to division (C) of this 3734
section, and a clinical nurse specialist is subject to division 3735
(D) of this section.3736

       (A) A nurse authorized to practice as a certified 3737
nurse-midwife, in collaboration with one or more physicians, may 3738
provide the management of preventive services and those primary 3739
care services necessary to provide health care to women 3740
antepartally, intrapartally, postpartally, and gynecologically, 3741
consistent with the nurse's education and certification, and in 3742
accordance with rules adopted by the board of nursing.3743

       No certified nurse-midwife may perform version, deliver 3744
breech or face presentation, use forceps, do any obstetric 3745
operation, or treat any other abnormal condition, except in 3746
emergencies. Division (A) of this section does not prohibit a 3747
certified nurse-midwife from performing episiotomies or normal 3748
vaginal deliveries, or repairing vaginal tears. A certified 3749
nurse-midwife who holds a certificate to prescribe issued under 3750
section 4723.48 of the Revised Code may, in collaboration with one 3751
or more physicians, prescribe drugs and therapeutic devices in 3752
accordance with section 4723.481 of the Revised Code.3753

       (B) A nurse authorized to practice as a certified registered 3754
nurse anesthetist, with the supervision and in the immediate 3755
presence of a physician, podiatrist, or dentist, may administer 3756
anesthesia and perform anesthesia induction, maintenance, and 3757
emergence, and may perform with supervision preanesthetic 3758
preparation and evaluation, postanesthesia care, and clinical 3759
support functions, consistent with the nurse's education and 3760
certification, and in accordance with rules adopted by the board. 3761
A certified registered nurse anesthetist is not required to obtain 3762
a certificate to prescribe in order to provide the anesthesia care 3763
described in this division.3764

       The physician, podiatrist, or dentist supervising a certified 3765
registered nurse anesthetist must be actively engaged in practice 3766
in this state. When a certified registered nurse anesthetist is 3767
supervised by a podiatrist, the nurse's scope of practice is 3768
limited to the anesthesia procedures that the podiatrist has the 3769
authority under section 4731.51 of the Revised Code to perform. A 3770
certified registered nurse anesthetist may not administer general 3771
anesthesia under the supervision of a podiatrist in a podiatrist's 3772
office. When a certified registered nurse anesthetist is 3773
supervised by a dentist, the nurse's scope of practice is limited 3774
to the anesthesia procedures that the dentist has the authority 3775
under Chapter 4715. of the Revised Code to perform.3776

       (C) A nurse authorized to practice as a certified nurse 3777
practitioner, in collaboration with one or more physicians or 3778
podiatrists, may provide preventive and primary care services, 3779
provide services for acute illnesses, and evaluate and promote 3780
patient wellness within the nurse's nursing specialty, consistent 3781
with the nurse's education and certification, and in accordance 3782
with rules adopted by the board. A certified nurse practitioner 3783
who holds a certificate to prescribe issued under section 4723.48 3784
of the Revised Code may, in collaboration with one or more 3785
physicians or podiatrists, prescribe drugs and therapeutic devices 3786
in accordance with section 4723.481 of the Revised Code.3787

       When a certified nurse practitioner is collaborating with a 3788
podiatrist, the nurse's scope of practice is limited to the 3789
procedures that the podiatrist has the authority under section 3790
4731.51 of the Revised Code to perform.3791

       (D) A nurse authorized to practice as a clinical nurse 3792
specialist, in collaboration with one or more physicians or 3793
podiatrists, may provide and manage the care of individuals and 3794
groups with complex health problems and provide health care 3795
services that promote, improve, and manage health care within the 3796
nurse's nursing specialty, consistent with the nurse's education 3797
and in accordance with rules adopted by the board. A clinical 3798
nurse specialist who holds a certificate to prescribe issued under 3799
section 4723.48 of the Revised Code may, in collaboration with one 3800
or more physicians or podiatrists, prescribe drugs and therapeutic 3801
devices in accordance with section 4723.481 of the Revised Code.3802

       When a clinical nurse specialist is collaborating with a 3803
podiatrist, the nurse's scope of practice is limited to the 3804
procedures that the podiatrist has the authority under section 3805
4731.51 of the Revised Code to perform.3806

       Sec. 4723.431.  (A) Except as provided in division (D)(1) of 3807
this section, a clinical nurse specialist, certified 3808
nurse-midwife, or certified nurse practitioner may practice only 3809
in accordance with a standard care arrangement entered into with 3810
each physician or podiatrist with whom the nurse collaborates. A 3811
copy of the standard care arrangement shall be retained on file at 3812
each site where the nurse practices. Prior approval of the 3813
standard care arrangement by the board of nursing is not required, 3814
but the board may periodically review it for compliance with this 3815
section.3816

       A clinical nurse specialist, certified nurse-midwife, or 3817
certified nurse practitioner may enter into a standard care 3818
arrangement with one or more collaborating physicians or 3819
podiatrists. EachNot later than thirty days after first engaging 3820
in the practice of nursing as a clinical nurse specialist, 3821
certified nurse-midwife, or certified nurse practitioner, the 3822
nurse shall submit to the board the name and business address of 3823
each collaborating physician or podiatrist. Thereafter, the nurse 3824
shall give to the board written notice of any additions or 3825
deletions to the nurse's collaborating physicians or podiatrists 3826
not later than thirty days after the change takes effect.3827

       Each collaborating physician or podiatrist must be actively 3828
engaged in direct clinical practice in this state and practicing 3829
in a specialty that is the same as or similar to the nurse's 3830
nursing specialty. If a collaborating physician or podiatrist 3831
enters into standard care arrangements with more than three nurses 3832
who hold certificates to prescribe issued under section 4723.48 of 3833
the Revised Code, the physician or podiatrist shall not 3834
collaborate at the same time with more than three of the nurses in 3835
the prescribing component of their practices.3836

       (B) A standard care arrangement shall be in writing and, 3837
except as provided in division (D)(2) of this section, shall 3838
contain all of the following:3839

       (1) Criteria for referral of a patient by the clinical nurse 3840
specialist, certified nurse-midwife, or certified nurse 3841
practitioner to a collaborating physician or podiatrist;3842

       (2) A process for the clinical nurse specialist, certified 3843
nurse-midwife, or certified nurse practitioner to obtain a 3844
consultation with a collaborating physician or podiatrist;3845

       (3) A plan for coverage in instances of emergency or planned 3846
absences of either the clinical nurse specialist, certified 3847
nurse-midwife, or certified nurse practitioner or a collaborating 3848
physician or podiatrist that provides the means whereby a 3849
physician or podiatrist is available for emergency care;3850

       (4) The process for resolution of disagreements regarding 3851
matters of patient management between the clinical nurse 3852
specialist, certified nurse-midwife, or certified nurse 3853
practitioner and a collaborating physician or podiatrist;3854

       (5) A procedure for a regular review of the referrals by the 3855
clinical nurse specialist, certified nurse-midwife, or certified 3856
nurse practitioner to other health care professionals and the care 3857
outcomes for a random sample of all patients seen by the nurse;3858

       (6) If the clinical nurse specialist or certified nurse 3859
practitioner regularly provides services to infants, a policy for 3860
care of infants up to age one and recommendations for 3861
collaborating physician visits for children from birth to age 3862
three;3863

       (7) Any other criteria required by rule of the board adopted 3864
pursuant to section 4723.07 or 4723.50 of the Revised Code.3865

       (C) A standard care arrangement entered into pursuant to this 3866
section may permit a clinical nurse specialist, certified 3867
nurse-midwife, or certified nurse practitioner to supervise 3868
services provided by a home health agency as defined in section 3869
3701.881 of the Revised Code.3870

       (D)(1) A clinical nurse specialist who does not hold a 3871
certificate to prescribe and whose nursing specialty is mental 3872
health or psychiatric mental health, as determined by the board, 3873
is not required to enter into a standard care arrangement, but 3874
shall practice in collaboration with one or more physicians.3875

       (2) If a clinical nurse specialist practicing in either of 3876
the specialties specified in division (D)(1) of this section holds 3877
a certificate to prescribe, the nurse shall enter into a standard 3878
care arrangement with one or more physicians. The standard care 3879
arrangement must meet the requirements of division (B) of this 3880
section, but only to the extent necessary to address the 3881
prescribing component of the nurse's practice.3882

       (E) Nothing in this section prohibits a hospital from hiring 3883
a clinical nurse specialist, certified nurse-midwife, or certified 3884
nurse practitioner as an employee and negotiating standard care 3885
arrangements on behalf of the employee as necessary to meet the 3886
requirements of this section. A standard care arrangement between 3887
the hospital's employee and the employee's collaborating physician 3888
is subject to approval by the medical staff and governing body of 3889
the hospital prior to implementation of the arrangement at the 3890
hospital.3891

       Sec. 4723.44.  (A) No person shall do any of the following 3892
unless the person holds a current, valid certificate of authority 3893
to practice nursing as a certified registered nurse anesthetist, 3894
clinical nurse specialist, certified nurse-midwife, or certified 3895
nurse practitioner issued by the board of nursing under this 3896
chapter:3897

       (1) Engage in the practice of nursing as a certified 3898
registered nurse anesthetist, clinical nurse specialist, certified 3899
nurse-midwife, or certified nurse practitioner for a fee, salary, 3900
or other consideration, or as a volunteer;3901

       (2) Represent the person as being a certified registered 3902
nurse anesthetist, clinical nurse specialist, certified 3903
nurse-midwife, or certified nurse practitioner;3904

       (3) Use any title or initials implying that the person is a 3905
certified registered nurse anesthetist, clinical nurse specialist, 3906
certified nurse-midwife, or certified nurse practitioner;3907

       (4) Represent the person as being an advanced practice 3908
registered nurse;3909

       (5) Use any title or initials implying that the person is an 3910
advanced practice registered nurse.3911

       (B) No person who is not certified by the national council on 3912
certification of nurse anesthetists of the American association of 3913
nurse anesthetists, the national council on recertification of 3914
nurse anesthetists of the American association of nurse 3915
anesthetists, or another national certifying organization approved 3916
by the board under section 4723.46 of the Revised Code shall use 3917
the title "certified registered nurse anesthetist" or the initials 3918
"C.R.N.A.," or any other title or initial implying that the person 3919
has been certified by the council or organization.3920

       (C) No certified registered nurse anesthetist, clinical nurse 3921
specialist, certified nurse-midwife, or certified nurse 3922
practitioner shall do any of the following:3923

       (1) Engage, for a fee, salary, or other consideration, or as 3924
a volunteer, in the practice of a nursing specialty other than the 3925
specialty designated on the nurse's current, valid certificate of 3926
authority issued by the board under this chapter;3927

       (2) Represent the person as being authorized to practice any 3928
nursing specialty other than the specialty designated on the 3929
current, valid certificate of authority;3930

       (3) Use the title "certified registered nurse anesthetist" or 3931
the initials "N.A." or "C.R.N.A.," the title "clinical nurse 3932
specialist" or the initials "C.N.S.," the title "certified 3933
nurse-midwife" or the initials "C.N.M.," the title "certified 3934
nurse practitioner" or the initials "C.N.P.," the title "advanced 3935
practice registered nurse" or the initials "A.P.R.N.," or any 3936
other title or initials implying that the nurse is authorized to 3937
practice any nursing specialty other than the specialty designated 3938
on the nurse's current, valid certificate of authority;3939

       (4) Enter into a standard care arrangement with a physician 3940
or podiatrist whose practice is not the same as or similar to the 3941
nurse's nursing specialty;3942

       (5) Prescribe drugs or therapeutic devices unless the nurse 3943
holds a current, valid certificate to prescribe issued under 3944
section 4723.48 of the Revised Code;3945

       (6) Prescribe drugs or therapeutic devices under a 3946
certificate to prescribe in a manner that does not comply with 3947
section 4723.481 of the Revised Code;3948

       (7) Prescribe any drug or device to perform or induce an 3949
abortion, or otherwise Performperform or induce an abortion.3950

       (D) No person shall knowingly employ a person to engage in 3951
the practice of nursing as a certified registered nurse 3952
anesthetist, clinical nurse specialist, certified nurse-midwife, 3953
or certified nurse practitioner unless the person so employed 3954
holds a current, valid certificate of authority to engage in that 3955
nursing specialty issued by the board under this chapter.3956

       (E) A certificate certified by the executive director of the 3957
board, under the official seal of the board, to the effect that it 3958
appears from the records that no certificate of authority to 3959
practice nursing as a certified registered nurse anesthetist, 3960
clinical nurse specialist, certified nurse-midwife, or certified 3961
nurse practitioner has been issued to any person specified 3962
therein, or that a certificate, if issued, has been revoked or 3963
suspended, shall be received as prima-facie evidence of the record 3964
in any court or before any officer of the state.3965

       Sec. 4723.48.  (A) A clinical nurse specialist, certified 3966
nurse-midwife, or certified nurse practitioner seeking authority 3967
to prescribe drugs and therapeutic devices shall file with the 3968
board of nursing a written application for a certificate to 3969
prescribe. The board of nursing shall issue a certificate to 3970
prescribe to each applicant who meets the requirements specified 3971
in section 4723.482 or 4723.485 of the Revised Code. 3972

       Except as provided in division (B) of this section, the 3973
initial certificate to prescribe that the board issues to an 3974
applicant shall be issued as an externship certificate. Under an 3975
externship certificate, the nurse may obtain experience in 3976
prescribing drugs and therapeutic devices by participating in an 3977
externship that evaluates the nurse's competence, knowledge, and 3978
skill in pharmacokinetic principles and their clinical application 3979
to the specialty being practiced. During the externship, the nurse 3980
may prescribe drugs and therapeutic devices only when one or more 3981
physicians are providing supervision in accordance with rules 3982
adopted under section 4723.50 of the Revised Code. 3983

       After completing the externship, the holder of an externship 3984
certificate may apply for a new certificate to prescribe. On 3985
receipt of the new certificate, the nurse may prescribe drugs and 3986
therapeutic devices in collaboration with one or more physicians 3987
or podiatrists. 3988

       (B) In the case of an applicant who on May 17, 2000, was 3989
approved to prescribe drugs and therapeutic devices under section 3990
4723.56 of the Revised Code, as that section existed on that date, 3991
the initial certificate to prescribe that the board issues to the 3992
applicant under this section shall not be an externship 3993
certificate. The applicant shall be issued a certificate to 3994
prescribe that permits the recipient to prescribe drugs and 3995
therapeutic devices in collaboration with one or more physicians 3996
or podiatrists.3997

       In the case of an applicant who meets the requirements of 3998
division (C) of section 4723.482 of the Revised Code, the initial 3999
certificate to prescribe that the board issues to the applicant 4000
under this section shall not be an externship certificate. The 4001
applicant shall be issued a certificate to prescribe that permits 4002
the recipient to prescribe drugs and therapeutic devices in 4003
collaboration with one or more physicians or podiatrists. 4004

       Sec. 4723.482.  (A) Except as provided in divisions (C) and 4005
(D) of this section, an applicant shall include with the 4006
application submitted under section 4723.48 of the Revised Code 4007
all of the following: 4008

       (1) Subject to section 4723.483 of the Revised Code, evidence4009
Evidence of holding a current, valid certificate of authority 4010
issued under this chapter to practice as a clinical nurse 4011
specialist, certified nurse-midwife, or certified nurse 4012
practitioner that was issued by meeting the requirements of 4013
division (A) of section 4723.41 of the Revised Code; 4014

       (2) Evidence of successfully completing the course of study 4015
in advanced pharmacology and related topics in accordance with the 4016
requirements specified in division (B) of this section; 4017

       (3) The fee required by section 4723.08 of the Revised Code 4018
for a certificate to prescribe; 4019

       (4) Any additional information the board of nursing requires 4020
pursuant to rules adopted under section 4723.50 of the Revised 4021
Code. 4022

       (B) With respect to the course of study in advanced 4023
pharmacology and related topics that must be successfully 4024
completed to obtain a certificate to prescribe, all of the 4025
following requirements apply: 4026

       (1) The course of study shall be completed not longer than 4027
three years before the application for the certificate to 4028
prescribe is filed. 4029

       (2) The course of study shall consist of planned classroom 4030
and clinical instruction for a total of not less than forty-five 4031
contact hours.4032

       (3) The course of study shall meet the requirements to be 4033
approved by the board in accordance with standards established in 4034
rules adopted under section 4723.50 of the Revised Code. 4035

       (4) The content of the course of study shall be specific to 4036
the applicant's nursing specialty.4037

       (5) The instruction provided in the course of study shall 4038
include all of the following: 4039

       (a) A minimum of thirty-six contact hours of instruction in 4040
advanced pharmacology that includes pharmacokinetic principles and 4041
clinical application and the use of drugs and therapeutic devices 4042
in the prevention of illness and maintenance of health; 4043

       (b) Instruction in the fiscal and ethical implications of 4044
prescribing drugs and therapeutic devices; 4045

       (c) Instruction in the state and federal laws that apply to 4046
the authority to prescribe; 4047

       (d) Instruction that is specific to schedule II controlled 4048
substances, including instruction in all of the following:4049

       (i) Indications for the use of schedule II controlled 4050
substances in drug therapies; 4051

        (ii) The most recent guidelines for pain management 4052
therapies, as established by state and national organizations such 4053
as the Ohio pain initiative and the American pain society; 4054

       (iii) Fiscal and ethical implications of prescribing schedule 4055
II controlled substances; 4056

       (iv) State and federal laws that apply to the authority to 4057
prescribe schedule II controlled substances; 4058

        (v) Prevention of abuse and diversion of schedule II 4059
controlled substances, including identification of the risk of 4060
abuse and diversion, recognition of abuse and diversion, types of 4061
assistance available for prevention of abuse and diversion, and 4062
methods of establishing safeguards against abuse and diversion. 4063

       (e) Any additional instruction required pursuant to rules 4064
adopted under section 4723.50 of the Revised Code. 4065

       (C) An applicant who practiced or is practicing as a clinical 4066
nurse specialist, certified nurse-midwife, or certified nurse 4067
practitioner in another jurisdiction or as an employee of the 4068
United States government, and is not seeking authority to 4069
prescribe drugs and therapeutic devices by meeting the 4070
requirements of division (A) or (D) of this section, shall include 4071
with the application submitted under section 4723.48 of the 4072
Revised Code all of the following: 4073

       (1) Subject to section 4723.483 of the Revised Code, evidence4074
Evidence of holding a current, valid certificate of authority 4075
issued under this chapter to practice as a clinical nurse 4076
specialist, certified nurse-midwife, or certified nurse 4077
practitioner; 4078

       (2) The fee required by section 4723.08 of the Revised Code 4079
for a certificate to prescribe; 4080

       (3) Either of the following: 4081

       (a) Evidence of having held, for a continuous period of at 4082
least one year during the three years immediately preceding the 4083
date of application, valid authority issued by another 4084
jurisdiction to prescribe therapeutic devices and drugs, including 4085
at least some controlled substances; 4086

       (b) Evidence of having been employed by the United States 4087
government and authorized, for a continuous period of at least one 4088
year during the three years immediately preceding the date of 4089
application, to prescribe therapeutic devices and drugs, including 4090
at least some controlled substances, in conjunction with that 4091
employment. 4092

       (4) If the applicant includes the evidence described in 4093
division (C)(3)(a) of this section, documentation from a licensed 4094
physician in a form acceptable to the board that the prescribing 4095
component of the nurse's practice was overseen or supervised by a 4096
licensed physician in the other jurisdiction;4097

       (5) If the applicant includes the evidence described in 4098
division (C)(3)(b) of this section, documentation from a licensed 4099
physician employed by the United States government in a form 4100
acceptable to the board that the prescribing component of the 4101
nurse's practice was overseen or supervised by a licensed 4102
physician employed by the United States government;4103

       (6) Evidence of having completed a two-hour course of 4104
instruction approved by the board in the laws of this state that 4105
govern drugs and prescriptive authority;4106

       (7)(5) Any additional information the board requires pursuant 4107
to rules adopted under section 4723.50 of the Revised Code. 4108

       (D) An applicant who practiced or is practicing as a clinical 4109
nurse specialist, certified nurse-midwife, or certified nurse 4110
practitioner in another jurisdiction or as an employee of the 4111
United States government, and is not seeking authority to 4112
prescribe drugs and therapeutic devices by meeting the 4113
requirements of division (A) or (C) of this section, shall include 4114
with the application submitted under section 4723.48 of the 4115
Revised Code all of the following: 4116

       (1) Subject to section 4723.483 of the Revised Code, evidence4117
Evidence of holding a current, valid certificate of authority 4118
issued under this chapter to practice as a clinical nurse 4119
specialist, certified nurse-midwife, or certified nurse 4120
practitioner; 4121

       (2) The fee required by section 4723.08 of the Revised Code 4122
for a certificate to prescribe; 4123

       (3) Either of the following: 4124

       (a) Evidence of having held, for a continuous period of at 4125
least one year during the three years immediately preceding the 4126
date of application, valid authority issued by another 4127
jurisdiction to prescribe therapeutic devices and drugs, excluding 4128
controlled substances; 4129

       (b) Evidence of having been employed by the United States 4130
government and authorized, for a continuous period of at least one 4131
year during the three years immediately preceding the date of 4132
application, to prescribe therapeutic devices and drugs, excluding 4133
controlled substances, in conjunction with that employment. 4134

       (4) If the applicant includes the evidence described in 4135
division (D)(3)(a) of this section, documentation from a licensed 4136
physician in a form acceptable to the board that the prescribing 4137
component of the nurse's practice was overseen or supervised by a 4138
licensed physician in the other jurisdiction;4139

       (5) If the applicant includes the evidence described in 4140
division (D)(3)(b) of this section, documentation from a licensed 4141
physician employed by the United States government in a form 4142
acceptable to the board that the prescribing component of the 4143
nurse's practice was overseen or supervised by a licensed 4144
physician employed by the United States government;4145

        (6) Any additional information the board requires pursuant to 4146
rules adopted under section 4723.50 of the Revised Code.4147

       Sec.  4723.485.  (A) A(1) Except as provided in division 4148
(A)(2) of this section, a certificate to prescribe issued under 4149
section 4723.48 of the Revised Code as an externship certificate 4150
is valid for not more than one year, unless earlier suspended or 4151
revoked by the board of nursing. The4152

       (2) An externship certificate may be extended beyond the 4153
period for an additional yearwhich it was issued if the holder 4154
submits to the board evidence of continued participation in an 4155
externship. The extension period shall not exceed two years.4156

       (3) If an externship is terminated for any reason, the nurse 4157
shall notify the board.4158

       (B) To be eligible for a certificate to prescribe after 4159
receiving an externship certificate, an applicant shall include 4160
with the application submitted under section 4723.48 of the 4161
Revised Code all of the following:4162

       (1) A statement from a supervising physician attesting to the 4163
applicant's successful completion of the externship;4164

       (2) The fee required by section 4723.08 of the Revised Code 4165
for a certificate to prescribe;4166

       (3) Any additional information the board requires pursuant to 4167
rules adopted under section 4723.50 of the Revised Code.4168

       Sec. 4723.487. (A) As used in this section, "drug database" 4169
means the database established and maintained by the state board 4170
of pharmacy pursuant to section 4729.75 of the Revised Code.4171

       (B) The board of nursing shall adopt rules in accordance with 4172
Chapter 119. of the Revised Code that establish standards and 4173
procedures to be followed by an advanced practice registered nurse 4174
with a certificate to prescribe issued under section 4723.48 of 4175
the Revised Code regarding the review of patient information 4176
available through the drug database.4177

       (C) This section and the rules adopted under it do not apply 4178
if the state board of pharmacy no longer maintains the drug 4179
database.4180

       Sec. 4723.50.  (A) In accordance with Chapter 119. of the 4181
Revised Code, the board of nursing shall adopt rules as necessary 4182
to implement the provisions of this chapter pertaining to the 4183
authority of clinical nurse specialists, certified nurse-midwives, 4184
and certified nurse practitioners to prescribe drugs and 4185
therapeutic devices and the issuance and renewal of certificates 4186
to prescribe. 4187

       The board shall adopt rules that are consistent with the 4188
recommendations the board receives from the committee on 4189
prescriptive governance pursuant to section 4723.492 of the 4190
Revised Code. After reviewing a recommendation submitted by the 4191
committee, the board may either adopt the recommendation as a rule 4192
or ask the committee to reconsider and resubmit the 4193
recommendation. The board shall not adopt any rule that does not 4194
conform to a recommendation made by the committee. 4195

       (B) The board shall adopt rules under this section that do 4196
all of the following: 4197

       (1) Establish a formulary listing the types of drugs and 4198
therapeutic devices that may be prescribed by a clinical nurse 4199
specialist, certified nurse-midwife, or certified nurse 4200
practitioner. The formulary may include controlled substances, as 4201
defined in section 3719.01 of the Revised Code. The formulary 4202
shall not permit the prescribing of any drug or device to perform 4203
or induce an abortion. 4204

       (2) Establish safety standards to be followed by a clinical 4205
nurse specialist, certified nurse-midwife, or certified nurse 4206
practitioner when personally furnishing to patients complete or 4207
partial supplies of antibiotics, antifungals, scabicides, 4208
contraceptives, prenatal vitamins, antihypertensives, drugs and 4209
devices used in the treatment of diabetes, drugs and devices used 4210
in the treatment of asthma, and drugs used in the treatment of 4211
dyslipidemia; 4212

       (3) Establish criteria for the components of the standard 4213
care arrangements described in section 4723.431 of the Revised 4214
Code that apply to the authority to prescribe, including the 4215
components that apply to the authority to prescribe schedule II 4216
controlled substances. The rules shall be consistent with that 4217
section and include all of the following: 4218

       (a) Quality assurance standards; 4219

       (b) Standards for periodic review by a collaborating 4220
physician or podiatrist of the records of patients treated by the 4221
clinical nurse specialist, certified nurse-midwife, or certified 4222
nurse practitioner; 4223

       (c) Acceptable travel time between the location at which the 4224
clinical nurse specialist, certified nurse-midwife, or certified 4225
nurse practitioner is engaging in the prescribing components of 4226
the nurse's practice and the location of the nurse's collaborating 4227
physician or podiatrist; 4228

       (d) Any other criteria recommended by the committee on 4229
prescriptive governance. 4230

       (4) Establish standards and procedures for issuance and 4231
renewal of a certificate to prescribe, including specification of 4232
any additional information the board may require under division 4233
(A)(4), (C)(7)(5), or (D)(6)(5) of section 4723.482 or division 4234
(B)(3) of section 4723.485 of the Revised Code; 4235

       (5) Establish standards for board approval of the course of 4236
study in advanced pharmacology and related topics required by 4237
section 4723.482 of the Revised Code; 4238

       (6) Establish requirements for board approval of the two-hour 4239
course of instruction in the laws of this state as required under 4240
division (C)(6)(4) of section 4723.482 of the Revised Code and 4241
division (B)(2) of section 4723.484 of the Revised Code;4242

       (7) Establish standards and procedures for the appropriate 4243
conduct of an externship as described in section 4723.484 of the 4244
Revised Code, including the following: 4245

       (a) Standards and procedures to be used in evaluating an 4246
individual's participation in an externship; 4247

       (b) Standards and procedures for the supervision that a 4248
physician must provide during an externship, including supervision 4249
provided by working with the participant and supervision provided 4250
by making timely reviews of the records of patients treated by the 4251
participant. The manner in which supervision must be provided may 4252
vary according to the location where the participant is practicing 4253
and with the participant's level of experience.4254

       Sec. 4723.61.  As used in this section and in sections 4255
4723.624723.64 to 4723.69 of the Revised Code:4256

       (A) "Medication" means a drug, as defined in section 4729.01 4257
of the Revised Code.4258

       (B) "Medication error" means a failure to follow the 4259
prescriber's instructions when administering a prescription 4260
medication.4261

       (C) "Nursing home" and "residential care facility" have the 4262
same meanings as in section 3721.01 of the Revised Code.4263

       (D) "Prescription medication" means a medication that may be 4264
dispensed only pursuant to a prescription.4265

       (E) "Prescriber" and "prescription" have the same meanings as 4266
in section 4729.01 of the Revised Code.4267

       Sec. 4723.64. On and after the thirty-first day following 4268
the board of nursing's submission of the report required by 4269
division (F)(2) of section 4723.63 of the Revised Code, anyA4270
nursing home or residential care facility may use one or more 4271
medication aides to administer prescription medications to its 4272
residents, subject to both of the following conditions:4273

        (A) Each individual used as a medication aide must hold a 4274
current, valid medication aide certificate issued by the board of 4275
nursing under this chapter.4276

        (B) The nursing home or residential care facility shall 4277
ensure that the requirements of section 4723.67 of the Revised 4278
Code are met.4279

       Sec. 4723.65. (A) An individual seeking certification as a 4280
medication aide shall apply to the board of nursing on a form 4281
prescribed and provided by the board. If theThe application is 4282
submitted on or after the day any nursing home or residential care 4283
facility may initially use medication aides as specified in 4284
section 4723.64 of the Revised Code, the application shall be 4285
accompanied by the certification fee established in rules adopted 4286
under section 4723.69 of the Revised Code.4287

       (B)(1) Except as provided in division (B)(2) of this section, 4288
an applicant for a medication aide certificate shall submit a 4289
request to the bureau of criminal identification and investigation 4290
for a criminal records check. The request shall be on the form 4291
prescribed pursuant to division (C)(1) of section 109.572 of the 4292
Revised Code and shall be accompanied by a standard impression 4293
sheet to obtain fingerprints prescribed pursuant to division 4294
(C)(2) of that section. The request shall also be accompanied by 4295
the fee prescribed pursuant to division (C)(3) of section 109.572 4296
of the Revised Code. On receipt of the completed form, the 4297
completed impression sheet, and the fee, the bureau shall conduct 4298
a criminal records check of the applicant. On completion of the 4299
criminal records check, the bureau shall send the results of the 4300
check to the board. An applicant requesting a criminal records 4301
check under this division who has not lived in this state for at 4302
least five years shall ask the superintendent of the bureau of 4303
criminal identification and investigation to also request that the 4304
federal bureau of investigation provide the superintendent with 4305
any information it has with respect to the applicant.4306

       (2) If a criminal records check of an applicant was completed 4307
pursuant to section 3721.121 of the Revised Code not more than 4308
five years prior to the date the application is submitted, the 4309
applicant may include a certified copy of the criminal records 4310
check completed pursuant to that section and is not required to 4311
comply with division (B)(1) of this section.4312

       (3) A criminal records check provided to the board in 4313
accordance with division (B)(1) or (B)(2) of this section shall 4314
not be made available to any person or for any purpose other than 4315
the following:4316

       (a) The results may be made available to any person for use 4317
in determining whether the individual who is the subject of the 4318
check should be issued a medication aide certificate.4319

       (b) The results may be made available to the person who is 4320
the subject of the check or a representative of that person.4321

       Sec. 4723.651. (A) To be eligible to receive a medication 4322
aide certificate, an applicant shall meet all of the following 4323
conditions:4324

       (1) Be at least eighteen years of age;4325

       (2) Have a high school diploma or a high school equivalence 4326
diploma as defined in section 5107.40 of the Revised Code;4327

       (3) If the applicant is to practice as a medication aide in a 4328
nursing home, be a nurse aide who satisfies the requirements of 4329
division (A)(1), (2), (3), (4), (5), (6), or (8) of section 4330
3721.32 of the Revised Code;4331

       (4) If the applicant is to practice as a medication aide in a 4332
residential care facility, be a nurse aide who satisfies the 4333
requirements of division (A)(1), (2), (3), (4), (5), (6), or (8) 4334
of section 3721.32 of the Revised Code or an individual who has at 4335
least one year of direct care experience in a residential care 4336
facility;4337

       (5) Successfully complete the course of instruction provided 4338
by a training program approved by the board under section 4723.66 4339
of the Revised Code;4340

       (6) Have results on the criminal records check provided to 4341
the board under division (B)(1) or (2) of section 4723.65 of the 4342
Revised Code indicating that the applicant has not been convicted 4343
of, has not pleaded guilty to, and has not had a judicial finding 4344
of guilt for violating section 2903.01, 2903.02, 2903.03, 2903.11, 4345
2905.01, 2907.02, 2907.03, 2907.05, 2909.02, 2911.01, or 2911.11 4346
of the Revised Code or a substantially similar law of another 4347
state, the United States, or another countryNot be ineligible for 4348
licensure or certification as specified in section 4723.092 of the 4349
Revised Code;4350

       (7) Have not committed any act that is grounds for 4351
disciplinary action under section 3123.47 or 4723.28 of the 4352
Revised Code or be determined by the board to have made 4353
restitution, been rehabilitated, or both;4354

       (8) Not be required to register under Chapter 2950. of the 4355
Revised Code or a substantially similar law of another state, the 4356
United States, or another country;4357

       (9) Meet all other requirements for a medication aide 4358
certificate established in rules adopted under section 4723.69 of 4359
the Revised Code.4360

       (B) If an applicant meets the requirement specified in 4361
division (A) of this section, the board shall issue a medication 4362
aide certificate to the applicant. If a medication aide 4363
certificate is issued to an individual on the basis of having at 4364
least one year of direct care experience working in a residential 4365
care facility, as provided in division (A)(4) of this section, the 4366
certificate is valid for use only in a residential care facility. 4367
The board shall state the limitation on the certificate issued to 4368
the individual.4369

       (C) A medication aide certificate is valid for two years, 4370
unless earlier suspended or revoked. The certificate may be 4371
renewed in accordance with procedures specified by the board in 4372
rules adopted under section 4723.69 of the Revised Code. To be 4373
eligible for renewal, an applicant shall pay the renewal fee 4374
established in the rules and meet all renewal qualifications 4375
specified in the rules.4376

       Sec. 4723.652.  (A) The board of nursing, by vote of a 4377
quorum, may impose one or more of the following sanctions against 4378
any individual who applies for, or holds, a medication aide 4379
certificate: deny, revoke, suspend, or place restrictions on the 4380
certificate; reprimand or otherwise discipline the holder of a 4381
medication aide certificate; or impose a fine of not more than 4382
five hundred dollars per violation. The sanctions may be imposed 4383
for any of the reasons specified in division (A) or (B) of section 4384
4723.28 of the Revised Code, to the extent that those reasons are 4385
applicable to medication aides or applicants as specified in rules 4386
adopted under section 4723.69 of the Revised Code.4387

       (B) Disciplinary actions taken by the board under this 4388
section shall be taken pursuant to an adjudication conducted under 4389
Chapter 119. of the Revised Code, except that in lieu of a 4390
hearing, the board may enter into a consent agreement with an 4391
individual to resolve an allegation of a violation of this chapter 4392
or any rule adopted under it. A consent agreement, when ratified 4393
by vote of a quorum, shall constitute the findings and order of 4394
the board with respect to the matter addressed in the agreement. 4395
If the board refuses to ratify a consent agreement, the admissions 4396
and findings contained in the agreement shall be of no effect.4397

       (C) In taking actions under this section, the board has the 4398
same powers and duties that it has when taking actions under 4399
section 4723.28 of the Revised Code. In addition, the board may 4400
issue an order to summarily suspend or automatically suspend a 4401
medication aide certificate in the same manner that the board is 4402
authorized to take those actions under section 4723.281 of the 4403
Revised Code.4404

       Sec. 4723.653. (A) No person shall engage in the 4405
administration of medication as a medication aide, represent the 4406
person as being a certified medication aide, or use the title, 4407
"medication aide," or any other title implying that the person is 4408
a certified medication aide, for a fee, salary, or other 4409
compensation, or as a volunteer, without holding a current, valid 4410
certificate as a medication aide under this chapter.4411

       (B) No person shall employ a person not certified as a 4412
medication aide under this chapter to engage in the administration 4413
of medication as a medication aide.4414

       Sec. 4723.66.  (A) A person or government entity seeking 4415
approval to provide a medication aide training program shall apply 4416
to the board of nursing on a form prescribed and provided by the 4417
board. If the application is submitted on or after the day any 4418
nursing home or residential care facility may initially use 4419
medication aides as specified in section 4723.64 of the Revised 4420
Code, theThe application shall be accompanied by the fee 4421
established in rules adopted under section 4723.69 of the Revised 4422
Code.4423

       (B) The board shall approve the applicant to provide a 4424
medication aide training program if the content of the course of 4425
instruction to be provided by the program meets the standards 4426
specified by the board in rules adopted under section 4723.69 of 4427
the Revised Code and includes all of the following:4428

       (1) At least seventy clock-hours of instruction, including 4429
both classroom instruction on medication administration and at 4430
least twenty clock-hours of supervised clinical practice in 4431
medication administration;4432

       (2) A mechanism for evaluating whether an individual's 4433
reading, writing, and mathematical skills are sufficient for the 4434
individual to be able to administer prescription medications 4435
safely;4436

       (3) An examination that tests the ability to administer 4437
prescription medications safely and that meets the requirements 4438
established by the board in rules adopted under section 4723.69 of 4439
the Revised Code.4440

       (C) The board may deny, suspend, or revoke the approval 4441
granted to the provider of a medication aide training program for 4442
reasons specified in rules adopted under section 4723.69 of the 4443
Revised Code. All actions taken by the board to deny, suspend, or 4444
revoke the approval of a training program shall be taken in 4445
accordance with Chapter 119. of the Revised Code.4446

       Sec. 4723.67.  (A) Except for the prescription medications 4447
specified in division (C) of this section and the methods of 4448
medication administration specified in division (D) of this 4449
section, a medication aide who holds a current, valid medication 4450
aide certificate issued under this chapter may administer 4451
prescription medications to the residents of nursing homes and 4452
residential care facilities that use medication aides pursuant to 4453
section 4723.63 or 4723.64 of the Revised Code. A medication aide 4454
shall administer prescription medications only pursuant to the 4455
delegation of a registered nurse or a licensed practical nurse 4456
acting at the direction of a registered nurse.4457

       Delegation of medication administration to a medication aide 4458
shall be carried out in accordance with the rules for nursing 4459
delegation adopted under this chapter by the board of nursing. A 4460
nurse who has delegated to a medication aide responsibility for 4461
the administration of prescription medications to the residents of 4462
a nursing home or residential care facility shall not withdraw the 4463
delegation on an arbitrary basis or for any purpose other than 4464
patient safety.4465

       (B) In exercising the authority to administer prescription 4466
medications pursuant to nursing delegation, a medication aide may 4467
administer prescription medications in any of the following 4468
categories:4469

       (1) Oral medications;4470

       (2) Topical medications;4471

       (3) Medications administered as drops to the eye, ear, or 4472
nose;4473

       (4) Rectal and vaginal medications;4474

       (5) Medications prescribed with a designation authorizing or 4475
requiring administration on an as-needed basis, but only if a 4476
nursing assessment of the patient is completed before the 4477
medication is administered.4478

       (C) A medication aide shall not administer prescription 4479
medications in either of the following categories:4480

       (1) Medications containing a schedule II controlled 4481
substance, as defined in section 3719.01 of the Revised Code;4482

       (2) Medications requiring dosage calculations.4483

       (D) A medication aide shall not administer prescription 4484
medications by any of the following methods:4485

       (1) Injection;4486

       (2) Intravenous therapy procedures;4487

       (3) Splitting pills for purposes of changing the dose being 4488
given.4489

       (E) A nursing home or residential care facility that uses 4490
medication aides shall ensure that medication aides do not have 4491
access to any schedule II controlled substances within the home or 4492
facility for use by its residents.4493

       Sec. 4723.68.  (A) A registered nurse, or licensed practical 4494
nurse acting at the direction of a registered nurse, who delegates 4495
medication administration to a medication aide who holds a 4496
current, valid medication aide certificate issued under this 4497
chapter is not liable in damages to any person or government 4498
entity in a civil action for injury, death, or loss to person or 4499
property that allegedly arises from an action or omission of the 4500
medication aide in performing the medication administration, if 4501
the delegating nurse delegates the medication administration in 4502
accordance with this chapter and the rules adopted under this 4503
chapter.4504

        (B) A person employed by a nursing home or residential care 4505
facility that uses medication aides pursuant to section 4723.63 or4506
4723.64 of the Revised Code who reports in good faith a medication 4507
error at the nursing home or residential care facility is not 4508
subject to disciplinary action by the board of nursing or any 4509
other government entity regulating that person's professional 4510
practice and is not liable in damages to any person or government 4511
entity in a civil action for injury, death, or loss to person or 4512
property that allegedly results from reporting the medication 4513
error.4514

       Sec. 4723.69.  (A) In consultation with the medication aide 4515
advisory council created under section 4723.62 of the Revised 4516
Code, theThe board of nursing shall adopt rules to implement 4517
sections 4723.61 to 4723.68 of the Revised Code. Initial rules 4518
shall be adopted not later than February 1, 2006. All rules 4519
adopted under this section shall be adopted in accordance with 4520
Chapter 119. of the Revised Code.4521

       (B) The rules adopted under this section shall establish or 4522
specify all of the following:4523

       (1) Fees, in an amount sufficient to cover the costs the 4524
board incurs in implementing sections 4723.61 to 4723.68 of the 4525
Revised Code, for participation in the medication aide pilot 4526
program, certification as a medication aide, and approval of a 4527
medication aide training program;4528

       (2) Requirements to obtain a medication aide certificate that 4529
are not otherwise specified in section 4723.651 of the Revised 4530
Code;4531

       (3) Procedures for renewal of medication aide certificates;4532

       (4) The extent to which the board determines that the reasons 4533
for taking disciplinary actions under section 4723.28 of the 4534
Revised Code are applicable reasons for taking disciplinary 4535
actions under section 4723.652 of the Revised Code against an 4536
applicant for or holder of a medication aide certificate;4537

       (5) Standards for approval of peer support programs for the 4538
holders of medication aide certificates;4539

       (6) Standards for medication aide training programs, 4540
including the examination to be administered by the training 4541
program to test an individual's ability to administer prescription 4542
medications safely;4543

       (6) Standards for approval of continuing education programs 4544
and courses for medication aides;4545

       (7) Reasons for denying, revoking, or suspending approval of 4546
a medication aide training program;4547

       (8) Other standards and procedures the board considers 4548
necessary to implement sections 4723.61 to 4723.68 of the Revised 4549
Code.4550

       Sec. 4723.71.  (A) There is hereby established, under the 4551
board of nursing, the advisory group on dialysis. The advisory 4552
group shall advise the board of nursing regarding the 4553
qualifications, standards for training, and competence of dialysis 4554
technicians and dialysis technician interns and all other related4555
matters related to dialysis technicians. The advisory group shall 4556
consist of the members appointed under divisions (B) and (C) of 4557
this section. A member of the board of nursing or a representative 4558
appointed by the board shall serve as chairperson of all meetings 4559
of the advisory group.4560

       (B) The board of nursing shall appoint the following as 4561
members of the advisory group:4562

       (1) Four dialysis technicians;4563

       (2) A registered nurse who regularly performs dialysis and 4564
cares for patients who receive dialysis;4565

       (3) A physician, recommended by the state medical board, who 4566
specializes in nephrology;4567

       (4) An administrator of a dialysis center;4568

       (5) A dialysis patient;4569

       (6) A representative of the association for hospitals and 4570
health systems (OHA)Ohio hospital association;4571

       (7) A representative from the end-stage renal disease 4572
network, as defined in 42 C.F.R. 405.2102.4573

       (C) The members of the advisory group appointed under 4574
division (B) of this section may recommend additional persons to 4575
serve as members of the advisory group. The board of nursing may 4576
appoint, as appropriate, any of the additional persons 4577
recommended.4578

       (D) The board of nursing shall specify the terms for the 4579
advisory group members. Members shall serve at the discretion of 4580
the board of nursing. Members shall receive their actual and 4581
necessary expenses incurred in the performance of their official 4582
duties.4583

       (E) Sections 101.82 to 101.87 of the Revised Code do not 4584
apply to the advisory group.4585

       Sec. 4723.72.  (A) A dialysis technician or dialysis 4586
technician intern may engage in dialysis care by doing the 4587
following:4588

       (1) Performing and monitoring dialysis procedures, including 4589
initiating, monitoring, and discontinuing dialysis;4590

       (2) Drawing blood;4591

       (3) Administering any of the medications as specified in 4592
division (C) of this section when the administration is essential 4593
to the dialysis process;4594

       (4) Responding to complications that arise during dialysis.4595

       (B) A(1) Subject to divisions (B)(2) and (3) of this 4596
section, a dialysis technician or dialysis technician intern may 4597
provide the dialysis care specified in division (A) of this 4598
section only if the care has been delegated to the technician or 4599
intern by a physician or registered nurse and the technician or 4600
intern is under the supervision of a physician or registered 4601
nurse. Supervision requires that the dialysis technician or 4602
dialysis technician intern be in the immediate presence of a 4603
physician or registered nurse, or, in.4604

       (2) In accordance with division (E) of section 4723.73 of the 4605
Revised Code, a dialysis technician intern shall not provide 4606
dialysis care in a patient's home.4607

       (3) In the case of dialysis care provided in a patient's home 4608
by a dialysis technician, that the dialysisboth of the following 4609
apply:4610

       (a) The technician shall be supervised in accordance with the 4611
rules adopted under section 4723.79 of the Revised Code for 4612
supervision of dialysis technicians who provide dialysis care in a 4613
patient's home. Division (E)4614

       (b) Division (D)(5) of section 4723.73 of the Revised Code 4615
does not allow a dialysis technician who provides dialysis care in 4616
a patient's home to provide dialysis care that is not authorized 4617
under this section.4618

       (C) A dialysis technician or dialysis technician intern may 4619
administer medication only the following medications as ordered by 4620
a licensed health professional authorized to prescribe drugs as 4621
defined in section 4729.01 of the Revised Code and in accordance 4622
with the standards for the delegation of dialysis care 4623
established in division (B) of this section and in rules adopted 4624
under section 4723.79 of the Revised Code. A dialysis technician 4625
may administer only the following medications:4626

       (1) Intradermal lidocaine or other single therapeutically 4627
equivalent local anesthetic for the purpose of initiating dialysis 4628
treatment;4629

       (2) Intravenous heparin or other single therapeutically 4630
equivalent anticoagulant for the purpose of initiating and 4631
maintaining dialysis treatment;4632

       (3) Intravenous normal saline;4633

       (4) Patient-specific dialysate, to which the person4634
technician or intern may add electrolytes but no other additives 4635
or medications;4636

       (5) Oxygen, when the administration of the oxygen has been 4637
delegated to the technician by a registered nurse.4638

       Sec. 4723.73.  (A) No person shall claim to the public to be 4639
a dialysis technician unless the person holdswho does not hold a 4640
current, valid certificate issued under section 4723.75 or renewed 4641
under section 4723.77 or a current, valid temporary certificate 4642
issued under section 4723.76 of the Revised Code.shall do either 4643
of the following:4644

       (1) Claim to the public to be a dialysis technician;4645

       (B) No person shall use(2) Use the title "Ohio certified 4646
dialysis technician," the initials "OCDT," or any other title or 4647
initials to represent that the person is authorized to perform 4648
dialysis care as a fully certified dialysis technician, unless the 4649
person holds a current, valid certificate issued under section 4650
4723.75 or renewed under section 4723.77 of the Revised Code.4651

       (C)(B) No person who does not hold a current, valid dialysis 4652
technician intern certificate issued under section 4723.76 of the 4653
Revised Code shall use anydo either of the following:4654

       (1) Claim to the public to be a dialysis technician intern;4655

       (2) Use the title or"dialysis technician intern," the4656
initials "DTI," or any other title or initials to represent that 4657
the person is authorized to perform dialysis care as a temporarily 4658
certified dialysis technician, unless the person holds a current, 4659
valid temporary certificate issued under section 4723.76 of the 4660
Revised Codeintern.4661

       (D)(C) No dialysis technician or dialysis technician intern4662
shall engage in dialysis care in a manner that is inconsistent 4663
with section 4723.72 of the Revised Code.4664

       (E)(D) No person other than a dialysis technician or dialysis 4665
technician intern shall engage in the dialysis care that is 4666
authorized by section 4723.72 of the Revised Code, unless the 4667
person is one or more of the following applies:4668

       (1) The person is aA registered nurse or licensed practical 4669
nurse.;4670

       (2) The person is aA physician.;4671

       (3) The person is aA student performing dialysis care under 4672
the supervision of an instructor as an integral part of a dialysis 4673
training program approved by the board of nursing under section 4674
4723.74 of the Revised Code.;4675

       (4) The person is aA dialysis patient who has been trained 4676
to engage in the dialysis care with little or no professional 4677
assistance by completing a medicare-approved self-dialysis or home 4678
dialysis training program.;4679

       (5) The person is aA family member or friend of a dialysis 4680
patient who engages in self-dialysis or home dialysis, and the 4681
person engages in the dialysis care by assisting the patient in 4682
performing the self-dialysis or home dialysis, after the person 4683
providing the assistance has completed a medicare-approved 4684
self-dialysis or home dialysis training program for the particular 4685
dialysis patient being assisted.4686

       (E) No dialysis technician intern shall do either of the 4687
following:4688

       (1) Serve as a trainer or preceptor in a dialysis training 4689
program;4690

       (2) Provide dialysis care in a patient's home.4691

       (F) No person shall operate a dialysis training program, 4692
unless the program is approved by the board of nursing under 4693
section 4723.74 of the Revised Code.4694

       Sec. 4723.74.  (A) A person who seeks to operate a dialysis 4695
training program shall apply to the board of nursing for approval 4696
of the program. Applications shall be submitted in accordance with 4697
rules adopted under section 4723.79 of the Revised Code. The 4698
person shall include with the application the fee prescribed in 4699
those rules. If the program meets the requirements for approval as 4700
specified in the rules, the board shall approve the program. A 4701
program shall apply for reapproval and may be reapproved in 4702
accordance with rules adopted under section 4723.79 of the Revised 4703
Code.4704

       (B) The board may place on provisional approval, for a period 4705
of time it specifies, a dialysis training program that has ceased 4706
to meet and maintain the minimum standards of the board 4707
established by rules adopted under section 4723.79 of the Revised 4708
Code. Prior to or at the end of the period, the board shall 4709
reconsider whether the program meets the standards. The board 4710
shall grant full approval if the program meets the standards. If 4711
the program does not meet the standards, the board may withdraw 4712
approval in accordance with division (C) of this section.4713

       (C) The board may withdraw the approval of a program that 4714
ceases to meet the requirements for approval. Any action to 4715
withdraw the approval shall be taken in accordance with Chapter 4716
119. of the Revised Code.4717

       (B) A person(D) An individual shall not be permitted to 4718
enroll, and shall not enroll, in a dialysis training program 4719
approved by the board under division (A) of this section unless 4720
the personindividual is eighteen years of age or older and 4721
possesses a high school diploma or high school equivalence 4722
diploma.4723

       Sec. 4723.75.  (A) The board of nursing shall issue a 4724
certificate to practice as a dialysis technician to a personan 4725
applicant who meets all of the following applicable requirements:4726

       (1) For all personsapplicants, the person applies4727
application is submitted to the board in accordance with rules 4728
adopted under section 4723.79 of the Revised Code and includes4729
with the application theboth of the following:4730

       (a) The fee established in those rules adopted under section 4731
4723.79 of the Revised Code;4732

       (b) The name and address of each approved dialysis training 4733
program in which the applicant has enrolled and the dates during 4734
which the applicant was enrolled in each program.4735

       (2) For all personsapplicants, the personapplicant meets 4736
the requirements established by the board's rules.4737

       (3) For all personsapplicants, the personapplicant4738
demonstrates competency to practice as a dialysis technician, as 4739
specified underin division (B) of this section.4740

       (4) For personsapplicants who entered a dialysis training 4741
program on or after June 1, 2003, the results of a criminal 4742
records check of the person that is completed by the bureau of 4743
criminal identification and investigation and includes a check of 4744
federal bureau of investigation records and that the bureau 4745
submits to the board indicates that the person has not been 4746
convicted of, has not pleaded guilty to, and has not had a 4747
judicial finding of guilt for violating section 2903.01, 2903.02, 4748
2903.03, 2903.11, 2905.01, 2907.02, 2907.03, 2907.05, 2909.02, 4749
2911.01, or 2911.11 of the Revised Code or a substantially similar 4750
law of another state, the United States, or another country4751
conducted in accordance with section 4723.091 of the Revised Code 4752
demonstrate that the applicant is not ineligible for certification 4753
as specified in section 4723.092 of the Revised Code.4754

       (B) For a personan applicant to demonstrate competence to 4755
practice as a dialysis technician, one of the following must 4756
apply:4757

       (1) The person meets all of the following requirements:4758

       (a) The personapplicant has successfully completed a 4759
dialysis training program approved by the board under section 4760
4723.74 of the Revised Code.4761

       (b) The person has been employed to performand meets both of 4762
the following requirements:4763

       (a) Has performed dialysis care byfor a dialysis provider 4764
for not less than twelve months immediately prior to the date of 4765
application.4766

       (c) The person passes;4767

       (b) Has passed a certification examination demonstrating 4768
competence to perform dialysis care. The person must pass the 4769
examination not later than eighteen months after entering4770
successfully completing a dialysis training program approved by 4771
the board under section 4723.74 of the Revised Code. A person who 4772
does not pass the examination within eighteen months after 4773
entering a dialysis training program must repeat and successfully 4774
complete the training program, or successfully complete another 4775
dialysis training program approved by the board, and pass the 4776
examination not less than six months after entering the new or 4777
repeated program. A person who does not pass the examination 4778
within six months after entering the new or repeated program must 4779
wait at least one year before entering or reentering any dialysis 4780
training program approved by the board, after which the person 4781
must successfully complete a dialysis training program approved by 4782
the board and pass the examination not later than six months after 4783
entering the program.4784

       (2) The person meets both of the following requirements:4785

       (a) The person holds, on December 24, 2000, a current, valid 4786
certificate from a qualifying testing organization specified by 4787
the board under division (B) of section 4723.751 of the Revised 4788
Code or provides evidence satisfactory to the board of having 4789
passed the examination of a qualifying testing organization not 4790
longer than five years prior to December 24, 2000.4791

       (b) The dialysis provider who employs the person provides the 4792
board with the information specified in rules adopted under 4793
section 4723.79 of the Revised Code attesting to the person's 4794
competence to perform dialysis care.4795

       (3) The person submits evidence satisfactory to the board 4796
that the person holds a current, valid license, certificate, or 4797
other authorization to perform dialysis care issued by another 4798
state that has standards for dialysis technicians that the board 4799
considers substantially similar to those established under 4800
sections 4723.71 to 4723.79 of the Revised Code applicant does 4801
all of the following:4802

       (a) Has a testing organization approved by the board submit 4803
evidence satisfactory to the board that the applicant passed an 4804
examination, in another jurisdiction, that demonstrates the 4805
applicant's competence to provide dialysis care;4806

       (b) Submits evidence satisfactory to the board that the 4807
applicant has been employed to perform dialysis care in another 4808
jurisdiction for not less than twelve months immediately prior to 4809
the date of application for certification under this section;4810

       (c) Submits evidence satisfactory to the board that the 4811
applicant completed at least two hours of education directly 4812
related to this chapter and the rules adopted under it.4813

       (C) A person who applies under this section to be certified 4814
to practice as a dialysis technician shall submit a request to the 4815
bureau of criminal identification and investigation for a criminal 4816
records check of the applicant. The request shall be on the form 4817
prescribed pursuant to division (C)(1) of section 109.572, 4818
accompanied by a standard impression sheet to obtain fingerprints 4819
prescribed pursuant to division (C)(2) of that section, and 4820
accompanied by the fee prescribed pursuant to division (C)(3) of 4821
that section. Upon receipt of the completed form, the completed 4822
impression sheet, and the fee, the bureau shall conduct a criminal 4823
records check of the applicant. Upon completion of the criminal 4824
records check, the bureau shall send the results of the check to 4825
the board. A person requesting a criminal records check under this 4826
division shall ask the superintendent of the bureau of criminal 4827
identification and investigation to also request the federal 4828
bureau of investigation to provide the superintendent with any 4829
information it has with respect to the person.4830

       The results of any criminal records check conducted pursuant 4831
to a request made under this section, and any report containing 4832
those results, are not public records for purposes of section 4833
149.43 of the Revised Code and shall not be made available to any 4834
person or for any purpose other than the following:4835

       (1) The results may be made available to any person for use 4836
in determining under this section and division (N) of section 4837
4723.28 of the Revised Code whether the individual who is the 4838
subject of the check should be issued a certificate to practice as 4839
a dialysis technician.4840

       (2) The results may be made available to the individual who 4841
is the subject of the check or that individual's representative.4842
An applicant who does not pass the certification examination 4843
described in division (B)(1)(b) of this section within the time 4844
period prescribed in that division may continue to pursue 4845
certification by repeating the entire training and application 4846
process, including doing all of the following:4847

       (1) Enrolling in and successfully completing a dialysis 4848
training program approved by the board;4849

       (2) Submitting a request to the bureau of criminal 4850
identification and investigation for a criminal records check and 4851
check of federal bureau of investigation records pursuant to 4852
section 4723.091 of the Revised Code;4853

       (3) Submitting an application for a dialysis technician 4854
intern certificate in accordance with section 4723.76 of the 4855
Revised Code;4856

       (4) Demonstrating competence to perform dialysis care in 4857
accordance with division (B) of this section.4858

       Sec. 4723.751. (A) The board of nursing shall either conduct 4859
dialysis technician certification examinations itself or, in 4860
accordance with rules adopted under section 4723.79 of the Revised 4861
Code, approve testing organizations to conduct the examinations. 4862
If it conducts the examinations, the board may use all or part of 4863
a standard examination created by a testing organization approved 4864
by the board. Regardless of who conducts it, the examination shall 4865
cover all of the subjects specified in rules adopted under section 4866
4723.79 of the Revised Code. 4867

       (B) The board shall specify the testing organizations that 4868
qualify a person to demonstrate competence to practice as a 4869
dialysis technician pursuant to division (B)(2) of section 4723.75 4870
of the Revised Code.4871

       Sec. 4723.76.  (A) The board of nursing shall issue a4872
temporary certificate to practice as a dialysis technician intern4873
to a personan applicant who has not passed the dialysis 4874
technician certification examination required by section 4723.751 4875
of the Revised Code, but who meetssatisfies all of the following 4876
requirements:4877

       (1) The person appliesApplies to the board in accordance 4878
with rules adopted under section 4723.79 of the Revised Code and 4879
includes with the application theboth of the following:4880

       (a) The fee established in those rules adopted under section 4881
4723.79 of the Revised Code;4882

       (b) The name and address of all dialysis training programs 4883
approved by the board in which the applicant has been enrolled and 4884
the dates of enrollment in each program.4885

       (2) The person providesProvides documentation from the 4886
person'sapplicant's employer that demonstratesattesting that the 4887
personapplicant is competent to perform dialysis care.;4888

       (3) One of the following applies:4889

       (a) The person hasHas successfully completed a dialysis 4890
training program approved by the board of nursing under section 4891
4723.74 of the Revised Code.4892

       (b) The person is, on December 24, 2000, employed as a 4893
dialysis technician but has been so employed for less than twelve 4894
months.4895

       (c) The person has experience as a dialysis technician in a 4896
jurisdiction that does not license or certify dialysis technicians 4897
and has successfully completed a training program that is 4898
substantially similar to a program approved by the board.4899

       (B) A temporarydialysis technician intern certificate issued 4900
to a personan applicant who meets the requirementrequirements in 4901
division (A)(3)(a) of this section is valid for a period of time 4902
that is eighteen months from the date on which the holder entered4903
applicant successfully completed a dialysis training program 4904
approved by the board under section 4723.74 of the Revised Code, 4905
minus the time the applicant was enrolled in one or more dialysis 4906
training programs approved by the board.4907

       A temporary certificate issued to a person who meets the 4908
requirement in division (A)(3)(b) of this section is valid for the 4909
number of months equal to eighteen months minus the number of 4910
months the person has been employed as a dialysis technician.4911

       A temporary certificate issued to a person who meets the 4912
requirement in division (A)(3)(c) of this section and has been 4913
working as a dialysis technician for twelve months or longer is 4914
valid for six months. A temporary certificate issued to a person 4915
who meets the requirement in division (A)(3)(c) of this section 4916
and has been employed as a dialysis technician for less than 4917
twelve months is valid for the number of months equal to eighteen 4918
months minus the number of months the person has been employed as 4919
a dialysis technician.4920

       (C) A temporarydialysis technician intern certificate issued 4921
under this section may not be renewed once if the holder enrolls 4922
or re-enrolls in a dialysis training program approved by the 4923
board. A temporary certificate that has been renewed is not 4924
renewable. A person holding a temporary certificate shall provide 4925
a copy of the temporary certificate to the dialysis provider who 4926
employs the person. The person shall not act as a trainer or 4927
preceptor in any dialysis training program.4928

       Sec. 4723.77.  A dialysis technician certificate issued under 4929
section 4723.75 of the Revised Code expires biennially and shall 4930
be renewed according to a schedule established by the board of 4931
nursing in rules adopted under section 4723.79 of the Revised 4932
Code. An application for renewal of a dialysis technician4933
certificate shall be accompanied by the renewal fee established in 4934
rules adopted by the board under section 4723.79 of the Revised 4935
Code. A certificate may be renewed only if, during the period for 4936
which the certificate was issued, the certificate holder satisfied 4937
the continuing education requirements established by the board's 4938
rules. Of the hours of continuing education completed during the 4939
period for which the dialysis technician certificate was issued, 4940
at least one hour of the education must be directly related to the 4941
statutes and rules pertaining to the practice of nursing in this 4942
state or the practice as a dialysis technician in this state.4943

       Sec. 4723.79.  The board of nursing shall adopt rules to 4944
administer and enforce sections 4723.71 to 4723.79 of the Revised 4945
Code. The board shall adopt the rules in accordance with Chapter 4946
119. of the Revised Code. The rules shall establish or specify all 4947
of the following:4948

       (A) The application process, fee, and requirements for 4949
approval, reapproval, and withdrawing the approval of a dialysis 4950
training program under section 4723.74 of the Revised Code. The 4951
requirements shall include standards that must be satisfied 4952
regarding curriculum, length of training, and instructions in 4953
patient care.4954

       (B) The application process, fee, and requirements for 4955
issuance of a dialysis technician certificate under section 4956
4723.75 of the Revised Code, except that the amount of the fee 4957
shall be no greater than the fee charged under division (A)(1) of 4958
section 4723.08 of the Revised Code;4959

       (C) The application process, fee, and requirements for 4960
issuance of a temporarydialysis technician intern certificate 4961
under section 4723.76 of the Revised Code;4962

       (D) The process for approval of testing organizations under 4963
section 4723.751 of the Revised Code;4964

       (E) Subjects to be included in a certification examination4965
provided for in division (B)(1) ofpursuant to section 4723.754966
4723.751 of the Revised Code;4967

       (F) The schedule, fees, and continuing education requirements 4968
for renewal of a dialysis technician certificate under section 4969
4723.77 of the Revised Code, except that the amount of the fee for 4970
the renewal of a certificate shall be no greater than the fee 4971
charged under division (A)(9)(10) of section 4723.08 of the 4972
Revised Code or, effective September 1, 2003, division (A)(10) of 4973
that section;4974

       (G) Standards and procedures for establishing and maintaining 4975
the dialysis registry required by section 4723.78 of the Revised 4976
Code, including standards and procedures that persons must follow 4977
in providing the information to be included in the registryfor 4978
approval of continuing education programs and courses for dialysis 4979
technicians;4980

       (H) Standards for the administration of medication by 4981
dialysis technicians and dialysis technician interns under section 4982
4723.72 of the Revised Code;4983

       (I) The information a dialysis provider is to provide to the 4984
board when attesting to a person's competence to perform dialysis;4985

       (J) Standards and procedures for the supervision of dialysis 4986
technicians who provide dialysis care in a patient's home, 4987
including monthly home visits by a registered nurse to monitor the 4988
quality of the dialysis care;4989

       (K)(J) Any other procedures or requirements necessary for the 4990
administration and enforcement of sections 4723.71 to 4723.79 of 4991
the Revised Code.4992

       Sec. 4723.83. (A) An individual seeking a community health 4993
worker certificate shall submit an application to the board of 4994
nursing on forms the board shall prescribe and furnish. The 4995
applicant shall include all information the board requires to 4996
process the application. The application shall be accompanied by 4997
the fee established in rules adopted under section 4723.88 of the 4998
Revised Code.4999

       (B) An applicant for a community health worker certificate 5000
shall submit a request to the bureau of criminal identification 5001
and investigation for a criminal records check of the applicant. 5002
The request shall be on the form prescribed pursuant to division 5003
(C)(1) of section 109.572 of the Revised Code, accompanied by a 5004
standard impression sheet to obtain fingerprints prescribed 5005
pursuant to division (C)(2) of that section, and accompanied by 5006
the fee prescribed pursuant to division (C)(3) of that section. On 5007
receipt of the completed form, the completed impression sheet, and 5008
the fee, the bureau shall conduct a criminal records check of the 5009
applicant. On completion of the criminal records check, the bureau 5010
shall send the results of the check to the board. The applicant 5011
shall ask the superintendent of the bureau of criminal 5012
identification and investigation to request that the federal 5013
bureau of investigation provide the superintendent with any 5014
information it has with respect to the applicant.5015

       The results of any criminal records check conducted pursuant 5016
to a request made under this section, and any report containing 5017
those results, are not public records for purposes of section 5018
149.43 of the Revised Code and shall not be made available to any 5019
person or for any purpose other than the following:5020

       (1) The results may be made available to any person for use 5021
in determining whether the individual who is the subject of the 5022
check should be issued a community health worker certificate.5023

       (2) The results may be made available to the individual who 5024
is the subject of the check or that individual's representative.5025

       Sec. 4723.84. (A) To be eligible to receive a community 5026
health worker certificate, an applicant shall meet all of the 5027
following conditions:5028

       (1) Be eighteen years of age or older;5029

       (2) Possess a high school diploma or the equivalent of a high 5030
school diploma, as determined by the board;5031

       (3) Except as provided in division (B) of this section, 5032
successfully complete a community health worker training program 5033
approved by the board under section 4723.87 of the Revised Code;5034

       (4) Have results on the criminal records check requested 5035
under section 4723.83 of the Revised Code indicating that the 5036
individual has not been convicted of, has not pleaded guilty to, 5037
and has not had a judicial finding of guilt for violating section 5038
2903.01, 2903.02, 2903.03, 2903.11, 2905.01, 2907.02, 2907.03, 5039
2907.05, 2909.02, 2911.01, or 2911.11 of the Revised Code or a 5040
substantially similar law of another state, the United States, or 5041
another countryNot be ineligible for certification as specified 5042
in section 4723.092 of the Revised Code;5043

       (5) Not have committed any act that is grounds for 5044
disciplinary action under section 3123.47 of the Revised Code or 5045
rules adopted under division (F) of section 4723.88 of the Revised 5046
Code or, if such an act has been committed, be determined by the 5047
board to have made restitution, been rehabilitated, or both;5048

       (6) Not be required to register under Chapter 2950. of the 5049
Revised Code or a substantially similar law of another state, the 5050
United States, or another country;5051

       (7) Meet all other requirements the board specifies in rules 5052
adopted under section 4723.88 of the Revised Code.5053

       (B) In lieu of meeting the condition of completing a 5054
community health worker training program, an applicant may be 5055
issued a community health worker certificate if the individual was 5056
employed in a capacity substantially the same as a community 5057
health worker before the board implemented the certification 5058
programprior to February 1, 2005. To be eligible under this 5059
division, an applicant must meet the requirements specified in 5060
rules adopted by the board under section 4723.88 of the Revised 5061
Code and provide documentation from the employer attesting to the 5062
employer's belief that the applicant is competent to perform 5063
activities as a certified community health worker.5064

       Sec. 4723.87. (A) A person or government entity seeking to 5065
operate a training program that prepares individuals to become 5066
certified community health workers shall submit an application to 5067
the board of nursing on forms the board shall prescribe and 5068
furnish. The applicant shall include all information the board 5069
requires to process the application. The application shall be 5070
accompanied by the fee established in rules adopted under section 5071
4723.87 of the Revised Code.5072

       The board shall review all applications received. If an 5073
applicant meets the standards for approval established in the 5074
board's rules adopted under section 4723.88 of the Revised Code, 5075
the board shall approve the program.5076

       (B) The board's approval of a training program expires 5077
biennially and may be renewed in accordance with the schedule and 5078
procedures established by the board in rules adopted under section 5079
4723.88 of the Revised Code.5080

       (C) If an approved community health worker training program 5081
ceases to meet the standards for approval, the board shall 5082
withdraw its approval of the program, refuse to renew its approval 5083
of the program, or place the program on provisional approval. In 5084
withdrawing or refusing to renew its approval, the board shall act 5085
in accordance with Chapter 119. of the Revised Code. In placing a 5086
program on provisional approval, the board shall specify the 5087
period of time during which the provisional approval is valid. At5088
Prior to or at the end of the period, the board shall reconsider 5089
whether the program meets the standards for approval. If the 5090
program meets the standards for approval, the board shall 5091
reinstate its full approval of the program or renew its approval 5092
of the program. If the program does not meet the standards for 5093
approval, the board shall proceed by withdrawing or refusing to 5094
renew its approval of the program.5095

       Sec. 4723.88. The board of nursing, in accordance with 5096
Chapter 119. of the Revised Code, shall adopt rules to administer 5097
and enforce sections 4723.81 to 4723.87 of the Revised Code. The 5098
rules shall establish all of the following:5099

       (A) Standards and procedures for issuance of community health 5100
worker certificates;5101

       (B) Standards for evaluating the competency of an individual 5102
who applies to receive a certificate on the basis of having been 5103
employed in a capacity substantially the same as a community 5104
health worker before the board implemented the certification 5105
program;5106

       (C) Standards and procedures for renewal of community health 5107
worker certificates, including the continuing education 5108
requirements that must be met for renewal;5109

       (D) Standards governing the performance of activities related 5110
to nursing care that are delegated by a registered nurse to 5111
certified community health workers. In establishing the standards, 5112
the board shall specify limits on the number of certified 5113
community health workers a registered nurse may supervise at any 5114
one time.5115

       (E) Standards and procedures for assessing the quality of the 5116
services that are provided by certified community health workers;5117

       (F) Standards and procedures for denying, suspending, and 5118
revoking a community health worker certificate, including reasons 5119
for imposing the sanctions that are substantially similar to the 5120
reasons that sanctions are imposed under section 4723.28 of the 5121
Revised Code;5122

       (G) Standards and procedures for approving and renewing the 5123
board's approval of training programs that prepare individuals to 5124
become certified community health workers. In establishing the 5125
standards, the board shall specify the minimum components that 5126
must be included in a training program, shall require that all 5127
approved training programs offer the standardized curriculum, and 5128
shall ensure that the curriculum enables individuals to use the 5129
training as a basis for entering programs leading to other 5130
careers, including nursing education programs.5131

       (H) Standards for approval of continuing education programs 5132
and courses for certified community health workers;5133

       (I) Standards and procedures for withdrawing the board's 5134
approval of a training program, refusing to renew the approval of 5135
a training program, and placing a training program on provisional 5136
approval;5137

       (I)(J) Amounts for each fee that may be imposed under 5138
division (A)(25)(21) of section 4723.08 of the Revised Code;5139

       (J)(K) Any other standards or procedures the board considers 5140
necessary and appropriate for the administration and enforcement 5141
of sections 4723.81 to 4723.87 of the Revised Code.5142

       Sec. 4723.99.  (A) Except as provided in division (B) of this 5143
section, whoever violates section 4723.03, 4723.44, 4723.653, or 5144
4723.73 of the Revised Code is guilty of a felony of the fifth 5145
degree on a first offense and a felony of the fourth degree on 5146
each subsequent offense.5147

       (B) AEach of the following is guilty of a minor misdemeanor:5148

       (1) A registered nurse or licensed practical nurse who 5149
violates division (A) or (B) of section 4723.03 of the Revised 5150
Code by reason of a license to practice nursing that has lapsed 5151
for failure to renew or by practicing nursing after a license has 5152
been classified as inactive is guilty of a minor misdemeanor;5153

       (2) A medication aide who violates section 4723.653 of the 5154
Revised Code by reason of a medication aide certificate that has 5155
lapsed for failure to renew or by administering medication as a 5156
medication aide after a certificate has been classified as 5157
inactive.5158

       Sec. 4759.01.  As used in this chapter:5159

       (A) "The practicePractice of dietetics" means any of the 5160
following:5161

       (1) Nutritional assessment to determine nutritional needs and 5162
to recommend appropriate nutritional intake, including enteral and 5163
parenteral nutrition;5164

       (2) Nutritional counseling or education as components of 5165
preventive, curative, and restorative health care;5166

       (3) Development, administration, evaluation, and consultation 5167
regarding nutritional care standards.5168

       (B) "The American dietetic associationAcademy of nutrition 5169
and dietetics" means the national professional organization of 5170
dietitians that provides direction and leadership for quality 5171
dietetic practice, education, and researchknown by that name or a 5172
successor organization that serves in an equivalent capacity.5173

       (C) "Commission on dietetic registration" means the5174
commission on dietetic registration that is a member of the 5175
national commission on health certifying agenciesentity that 5176
serves as the credentialing agency for the academy of nutrition 5177
and dietetics.5178

       (D) "Ohio academy of nutrition and dietetics" means the state 5179
professional organization known by that name or a successor 5180
organization that serves in an equivalent capacity.5181

       Sec. 4759.03.  There is hereby created the Ohio board of 5182
dietetics consisting of five members appointed by the governor 5183
with the advice and consent of the senate. The Ohio dietetic 5184
associationacademy of nutrition and dietetics may submit a list 5185
of five names for each position or vacancy on the board to be 5186
filled by a dietitian, and the governor may make his appointment5187
appointments from the persons so recommended or from other 5188
persons. Within5189

       Within thirty days of the effective date of this sectionJuly 5190
1, 1987, the governor shall make initial appointments to the 5191
board. Of the initial appointments, one shall be for a term ending 5192
one year after the effective date of this sectionJuly 1, 1987, 5193
one shall be for a term ending two years after the effective date 5194
of this sectionJuly 1, 1987, one shall be for a term ending three 5195
years after the effective date of this sectionJuly 1, 1987, one 5196
shall be for a term ending four years after the effective date of 5197
this sectionJuly 1, 1987, and one shall be for a term ending five 5198
years after the effective date of this sectionJuly 1, 1987. 5199
Thereafter, terms of office shall be for five years, each term 5200
ending on the same day of the same month as did the term which it 5201
succeeds. Each member shall hold office from the date of his5202
appointment until the end of the term for which hethe member was 5203
appointed. The governor shall appoint a member to fill a vacancy 5204
in the manner prescribed for filling the position in which the 5205
vacancy occurs. Any member appointed to fill a vacancy occurring 5206
prior to the expiration of the term for which histhe member's5207
predecessor was appointed shall hold office for the remainder of 5208
the term. Any member shall continue in office subsequent to the 5209
expiration date of histhe member's term until hisa successor 5210
takes office, or until a period of sixty days has elapsed, 5211
whichever occurs first.5212

       Members of the board may be removed by the governor for 5213
malfeasance, misfeasance, or nonfeasance after an adjudication 5214
hearing pursuant to Chapter 119. of the Revised Code. Members may 5215
not be appointed to a second term unless a period of five years 5216
has passed since the expiration of the first term, except that 5217
members appointed for less than a five-year term or appointed to 5218
fill an unexpired term may be appointed for one full term of five 5219
years immediately following the end of the term for which hethe 5220
member was first appointed.5221

       Three members of the board shall be dietitians who have been 5222
actively engaged in the practice of dietetics in the state for at 5223
least five years immediately preceding their appointment; one 5224
member shall be an educator with a doctoral degree who holds a 5225
regular faculty appointment in a program that prepares students to 5226
meet the requirements of division (A)(5) of section 4759.06 of the 5227
Revised Code; and one member shall be a member of the general 5228
public who is not and never has been a dietitian, is not a member 5229
of the immediate family of a dietitian, does not have a financial 5230
interest in the provision of goods or services to dietitians, and 5231
is not engaged in any activity related to the practice of 5232
dietetics.5233

       Each member of the board shall receive an amount fixed 5234
pursuant to division (J) of section 124.15 of the Revised Code for 5235
each day, or portion thereof, he is actually engaged in the 5236
discharge of his official duties, and shall be reimbursed for 5237
actual and necessary expenses incurred in the performance of those 5238
duties.5239

       Sec. 4759.05.  The Ohio board of dietetics shall:5240

       (A) Adopt, amend, or rescind rules pursuant to Chapter 119. 5241
of the Revised Code to carry out the provisions of this chapter, 5242
including rules governing the following:5243

       (1) Selection and approval of a dietitian licensure 5244
examination offered by the commission on dietetic registration or 5245
any other examination;5246

       (2) The examination of applicants for licensure as a 5247
dietitian, to be held at least twice annually, as required under 5248
division (A) of section 4759.06 of the Revised Code;5249

       (3) Requirements for pre-professional dietetic experience of 5250
applicants for licensure as a dietitian that are at least 5251
equivalent to the requirements adopted by the commission on 5252
dietetic registration;5253

       (4) Requirements for a person holding a limited permit under 5254
division (F) of section 4759.06 of the Revised Code, including the 5255
duration of validity of a limited permit;5256

       (5) Requirements for a licensed dietitian who places a 5257
license in inactive status under division (G) of section 4759.06 5258
of the Revised Code, including a procedure for changing inactive 5259
status to active status;5260

       (6) Continuing education requirements for renewal of a 5261
license, except that the board may adopt rules to waive the 5262
requirements for a person who is unable to meet the requirements 5263
due to illness or other reasons. Rules adopted under this division 5264
shall be consistent with the continuing education requirements 5265
adopted by the commission on dietetic registration.5266

       (7) Any additional education requirements the board considers 5267
necessary, for applicants who have not practiced dietetics within 5268
five years of the initial date of application for licensure;5269

       (8) Standards of professional responsibility and practice for 5270
persons licensed under this chapter that are consistent with those 5271
standards of professional responsibility and practice adopted by 5272
the American dietetic associationacademy of nutrition and 5273
dietetics;5274

       (9) Formulation of a written application form for licensure 5275
or license renewal that includes the statement that any applicant 5276
who knowingly makes a false statement on the application is guilty 5277
of a misdemeanor of the first degree under section 2921.13 of the 5278
Revised Code;5279

       (10) Procedures for license renewal;5280

       (11) Establishing a time period after the notification of a 5281
violation of section 4759.02 of the Revised Code, by which the 5282
person notified must request a hearing by the board under section 5283
4759.09 of the Revised Code;5284

       (12) Requirements for criminal records checks of applicants 5285
under section 4776.03 of the Revised Code.5286

       (B) Investigate alleged violations of sections 4759.02 to 5287
4759.10 of the Revised Code. In making its investigations, the 5288
board may issue subpoenas, examine witnesses, and administer 5289
oaths.5290

       (C) Adopt a seal;5291

       (D) Conduct meetings and keep records as are necessary to 5292
carry out the provisions of this chapter;5293

       (E) Publish, and make available to the public, upon request 5294
and for a fee not to exceed the actual cost of printing and 5295
mailing, the board's rules and requirements for licensure adopted 5296
under division (A) of this section and a record of all persons 5297
licensed under section 4759.06 of the Revised Code.5298

       Sec. 4759.06.  (A) The Ohio board of dietetics shall issue or 5299
renew a license to practice dietetics to an applicant who:5300

       (1) Has satisfactorily completed an application for licensure 5301
in accordance with division (A) of section 4759.05 of the Revised 5302
Code;5303

       (2) Has paid the fee required under division (A) of section 5304
4759.08 of the Revised Code;5305

       (3) Is a resident of the state or performs or plans to 5306
perform dietetic services within the state;5307

       (4) Is of good moral character;5308

       (5) Has received a baccalaureate or higher degree from an 5309
institution of higher education that is approved by the board or a 5310
regional accreditation agency that is recognized by the council on 5311
postsecondary accreditation, and has completed a program 5312
consistent with the academic standards for dietitians established 5313
by the American dietetic associationacademy of nutrition and 5314
dietetics;5315

       (6) Has successfully completed a pre-professional dietetic 5316
experience approved by the American dietetic associationacademy 5317
of nutrition and dietetics, or experience approved by the board 5318
under division (A)(3) of section 4759.05 of the Revised Code;5319

       (7) Has passed the examination approved by the board under 5320
division (A)(1) of section 4759.05 of the Revised Code;5321

       (8) Is an applicant for renewal of a license, and has 5322
fulfilled the continuing education requirements adopted under 5323
division (A)(6) of section 4759.05 of the Revised Code.5324

       (B) The board shall waive the requirements of divisions 5325
(A)(5), (6), and (7) of this section and any rules adopted under 5326
division (A)(7) of section 4759.05 of the Revised Code if the 5327
applicant presents satisfactory evidence to the board of current 5328
registration as a registered dietitian with the commission on 5329
dietetic registration.5330

       (C) The board shall waive the requirements of division (A)(7) 5331
of this section if the application for renewal is made within two 5332
years after the date of license expiration.5333

       (D) The board may waive the requirements of division (A)(5), 5334
(6), or (7) of this section or any rules adopted under division 5335
(A)(7) of section 4759.05 of the Revised Code, if the applicant 5336
presents satisfactory evidence of education, experience, or 5337
passing an examination in another state or a foreign country, that 5338
the board considers the equivalent of the requirements stated in 5339
those divisions or rules.5340

       (E) The board shall issue an initial license to practice 5341
dietetics to an applicant who meets the requirements of division 5342
(A) of this section. An initial license shall be valid from the 5343
date of issuance through the thirtieth day of June following 5344
issuance of the license. Each subsequent license shall be valid 5345
from the first day of July through the thirtieth day of June. The 5346
board shall renew the license of an applicant who is licensed to 5347
practice dietetics and who meets the continuing education 5348
requirements of division (A)(6) of section 4759.05 of the Revised 5349
Code. The renewal shall be pursuant to the standard renewal 5350
procedure of sections 4745.01 to 4745.03 of the Revised Code.5351

       (F) The board may grant a limited permit to a person who has 5352
completed the education and pre-professional requirements of 5353
divisions (A)(5) and (6) of this section and who presents evidence 5354
to the board of having applied to take the examination approved by 5355
the board under division (A)(1) of section 4759.05 of the Revised 5356
Code. A person holding a limited permit who has failed the 5357
examination shall practice only under the direct supervision of a 5358
licensed dietitian.5359

       (G) A licensed dietitian may place the license in inactive 5360
status.5361

       Sec. 4759.10.  Sections 4759.01 to 4759.09 of the Revised 5362
Code do not apply to any of the following:5363

       (A) A person licensed under Chapters 4701. to 4755. of the 5364
Revised Code who is acting within the scope of the person's 5365
profession, provided that the person complies with division (B) of 5366
section 4759.02 of the Revised Code;5367

       (B) A person who is a graduate of an associate degree program 5368
approved by the American dietetic associationacademy of nutrition 5369
and dietetics or the Ohio board of dietetics who is working as a 5370
dietetic technician under the supervision of a dietitian licensed 5371
under section 4759.06 of the Revised Code or registered by the 5372
commission on dietetic registration, except that the person is 5373
subject to division (B) of section 4759.02 of the Revised Code if 5374
the person uses a title other than "dietetic technician";5375

       (C) A person who practices dietetics related to employment in 5376
the armed forces, veteran's administration, or the public health 5377
service of the United States;5378

       (D) Persons employed by a nonprofit agency approved by the 5379
board or by a federal, state, municipal or county government, or 5380
by any other political subdivision, elementary or secondary 5381
school, or an institution of higher education approved by the 5382
board or by a regional agency recognized by the council on 5383
postsecondary accreditation, who performs only nutritional 5384
education activities and such other nutritional activities as the 5385
board of dietetics, by rule, permits, provided the person does not 5386
violate division (B) of section 4759.02 of the Revised Code;5387

       (E) A person who has completed a program meeting the academic 5388
standards set by the American dietetic association for dietitians 5389
by the academy of nutrition and dietetics, received a 5390
baccalaureate or higher degree from a school, college, or 5391
university approved by a regional accreditation agency recognized 5392
by the council on postsecondary accreditation, works under the 5393
supervision of a licensed dietitian or registered dietitian, and 5394
does not violate division (B) of section 4759.02 of the Revised 5395
Code;5396

       (F) A person when acting, under the direction and supervision 5397
of a person licensed under Chapters 4701. to 4755. of the Revised 5398
Code, in the execution of a plan of treatment authorized by the 5399
licensed person, provided the person complies with division (B) of 5400
section 4759.02 of the Revised Code;5401

       (G) The free dissemination of literature in the state;5402

       (H) Provided that the persons involved in the sale, 5403
promotion, or explanation of the sale of food, food materials, or 5404
dietary supplements do not violate division (B) of section 4759.02 5405
of the Revised Code, the sale of food, food materials, or dietary 5406
supplements and the marketing and distribution of food, food 5407
materials, or dietary supplements and the promotion or explanation 5408
of the use of food, food materials, or dietary supplements 5409
provided that the promotion or explanation does not violate 5410
Chapter 1345. of the Revised Code;5411

       (I) A person who offers dietary supplements for sale and who 5412
makes the following statements about the product if the statements 5413
are consistent with the dietary supplement's label or labeling:5414

       (1) Claim a benefit related to a classical nutrient 5415
deficiency disease and disclose the prevalence of the disease in 5416
the United States;5417

       (2) Describe the role of a nutrient or dietary ingredient 5418
intended to affect the structure or function of the human body;5419

       (3) Characterize the documented mechanism by which a nutrient 5420
or dietary ingredient acts to maintain the structure or function 5421
of the human body;5422

       (4) Describe general well-being from the consumption of a 5423
nutrient or dietary ingredient.5424

       (J) Provided that the persons involved in presenting a 5425
general program of instruction for weight control do not violate 5426
division (B) of section 4759.02 of the Revised Code, a general 5427
program of instruction for weight control approved in writing by a 5428
licensed dietitian, a physician licensed under Chapter 4731. of 5429
the Revised Code to practice medicine or surgery or osteopathic 5430
medicine or surgery, a person licensed in another state that the 5431
board considers to have substantially equivalent licensure 5432
requirements as this state, or a registered dietitian;5433

       (K) The continued practice of dietetics at a hospital by a 5434
person employed at that same hospital to practice dietetics for 5435
the twenty years immediately prior to July 1, 1987, so long as the 5436
person works under the supervision of a dietitian licensed under 5437
section 4759.06 of the Revised Code and does not violate division 5438
(B) of section 4759.02 of the Revised Code. This division does not 5439
apply to any person who has held a license issued under this 5440
chapter to practice dietetics. As used in this division, 5441
"hospital" has the same meaning as in section 3727.01 of the 5442
Revised Code.5443

       Sec. 5111.222.  (A) As used in this section, "low resource 5444
utilization resident" means a medicaid recipient residing in a 5445
nursing facility who, for purposes of calculating the nursing 5446
facility's medicaid reimbursement rate for direct care costs, is 5447
placed in either of the two lowest resource utilization groups, 5448
excluding any resource utilization group that is a default group 5449
used for residents with incomplete assessment data.5450

       (B) Except as otherwise provided by sections 5111.20 to 5451
5111.331 of the Revised Code and by division (B)(C) of this 5452
section, the total rate that the department of job and family 5453
services shall agree to pay for a fiscal year to the provider of a 5454
nursing facility pursuant to a provider agreement shall equal the 5455
sum of all of the following:5456

        (1) The rate for direct care costs determined for the nursing 5457
facility under section 5111.231 of the Revised Code;5458

        (2) The rate for ancillary and support costs determined for 5459
the nursing facility's ancillary and support cost peer group under 5460
section 5111.24 of the Revised Code;5461

        (3) The rate for tax costs determined for the nursing 5462
facility under section 5111.242 of the Revised Code;5463

        (4) The quality incentive payment paid to the nursing 5464
facility under section 5111.244 of the Revised Code;5465

        (5) If the nursing facility qualifies as a critical access 5466
nursing facility, the critical access incentive payment paid to 5467
the nursing facility under section 5111.246 of the Revised Code;5468

       (6) The rate for capital costs determined for the nursing 5469
facility's capital costs peer group under section 5111.25 of the 5470
Revised Code.5471

        (B) The department shall adjust the rates otherwise 5472
determined under division (A) of this section as directed by the 5473
general assembly through the enactment of law governing medicaid 5474
payments to providers of nursing facilities, including any law 5475
that establishes factors by which the rates are to be adjusted.5476

       (C) The total rate determined under division (B) of this 5477
section shall not be paid for nursing facility services provided 5478
to low resource utilization residents. Instead, the total rate for 5479
nursing facility services that a nursing facility provides to low 5480
resource utilization residents shall be one hundred thirty dollars 5481
per medicaid day.5482

       (D) In addition to paying a nursing facility provider the 5483
nursing facility's total rate determined for the nursing facility5484
under division (A)(B) or (C) of this section for a fiscal year, 5485
the department shall pay the provider a quality bonus under 5486
section 5111.245 of the Revised Code for that fiscal year if the 5487
provider's nursing facility is a qualifying nursing facility, as 5488
defined in that section, for that fiscal year. The quality bonus 5489
shall not be part of the total rate.5490

       Sec. 5111.231. (A) As used in this section:5491

       (1) "Applicable calendar year" means the following:5492

       (a) For the purpose of the department of job and family 5493
services' initial determination under division (D) of this section 5494
of each peer group's cost per case-mix unit, calendar year 2003;5495

        (b) For the purpose of the department's rebasings, the 5496
calendar year the department selects.5497

       (2) "Rebasing" means a redetermination under division (D) of 5498
this section of each peer groups' cost per case-mix unit using 5499
information from cost reports for an applicable calendar year that 5500
is later than the applicable calendar year used for the previous 5501
determination of such costs.5502

        (B) The department of job and family services shall pay a 5503
provider for each of the provider's eligible nursing facilities a 5504
per resident per day rate for direct care costs determined 5505
semiannually by multiplying the cost per case-mix unit determined 5506
under division (D) of this section for the facility's peer group 5507
by the facility's semiannual case-mix score determined under 5508
section 5111.232 of the Revised Code.5509

        (C) For the purpose of determining nursing facilities' rate 5510
for direct care costs, the department shall establish three peer 5511
groups.5512

        Each nursing facility located in any of the following 5513
counties shall be placed in peer group one: Brown, Butler, 5514
Clermont, Clinton, Hamilton, and Warren.5515

        Each nursing facility located in any of the following 5516
counties shall be placed in peer group two: Ashtabula, Champaign, 5517
Clark, Cuyahoga, Darke, Delaware, Fairfield, Fayette, Franklin, 5518
Fulton, Geauga, Greene, Hancock, Knox, Lake, Licking, Lorain, 5519
Lucas, Madison, Marion, Medina, Miami, Montgomery, Morrow, Ottawa, 5520
Pickaway, Portage, Preble, Ross, Sandusky, Seneca, Summit, Union, 5521
and Wood.5522

        Each nursing facility located in any of the following 5523
counties shall be placed in peer group three: Adams, Allen, 5524
Ashland, Athens, Auglaize, Belmont, Carroll, Columbiana, 5525
Coshocton, Crawford, Defiance, Erie, Gallia, Guernsey, Hardin, 5526
Harrison, Henry, Highland, Hocking, Holmes, Huron, Jackson, 5527
Jefferson, Lawrence, Logan, Mahoning, Meigs, Mercer, Monroe, 5528
Morgan, Muskingum, Noble, Paulding, Perry, Pike, Putnam, Richland, 5529
Scioto, Shelby, Stark, Trumbull, Tuscarawas, Van Wert, Vinton, 5530
Washington, Wayne, Williams, and Wyandot.5531

        (D)(1) The department shall determine a cost per case-mix 5532
unit for each peer group established under division (C) of this 5533
section. The department is not required to conduct a rebasing more 5534
than once every ten years. Except as necessary to implement the 5535
amendments made by this act to this section by Am. Sub. H.B. 153 5536
and Sub. H.B. 303, both of the 129th general assembly, the cost 5537
per case-mix unit determined under this division for a peer group 5538
shall be used for subsequent years until the department conducts a 5539
rebasing. To determine a peer group's cost per case-mix unit, the 5540
department shall do all of the following:5541

        (a) Determine the cost per case-mix unit for each nursing 5542
facility in the peer group for the applicable calendar year by 5543
dividing each facility's desk-reviewed, actual, allowable, per 5544
diem direct care costs for the applicable calendar year by the 5545
facility's annual average case-mix score determined under section 5546
5111.232 of the Revised Code for the applicable calendar year;5547

        (b) Subject to division (D)(2) of this section, identify 5548
which nursing facility in the peer group is at the twenty-fifth 5549
percentile of the cost per case-mix units determined under 5550
division (D)(1)(a) of this section;5551

        (c) Calculate the amount that is two per cent above the cost 5552
per case-mix unit determined under division (D)(1)(a) of this 5553
section for the nursing facility identified under division 5554
(D)(1)(b) of this section;5555

        (d) Using the index specified in division (D)(3) of this 5556
section, multiply the rate of inflation for the eighteen-month 5557
period beginning on the first day of July of the applicable 5558
calendar year and ending the last day of December of the calendar 5559
year immediately following the applicable calendar year by the 5560
amount calculated under division (D)(1)(c) of this section;5561

       (e) Until the first rebasing occurs, add one dollar and 5562
eighty-eight cents to the amount calculated under division 5563
(D)(1)(d) of this section;5564

       (f) Until the first rebasing occurs, increase the amount 5565
calculated under division (D)(1)(e) of this section by five and 5566
eight hundredths per cent.5567

        (2) In making the identification under division (D)(1)(b) of 5568
this section, the department shall exclude both of the following:5569

        (a) Nursing facilities that participated in the medicaid 5570
program under the same provider for less than twelve months in the 5571
applicable calendar year;5572

        (b) Nursing facilities whose cost per case-mix unit is more 5573
than one standard deviation from the mean cost per case-mix unit 5574
for all nursing facilities in the nursing facility's peer group 5575
for the applicable calendar year.5576

        (3) The following index shall be used for the purpose of the 5577
calculation made under division (D)(1)(d) of this section:5578

       (a) Until the first rebasing occurs, the employment cost 5579
index for total compensation, health services component, published 5580
by the United States bureau of labor statistics, as the index 5581
existed on July 1, 2005;5582

       (b) Effective with the first rebasing and except as provided 5583
in division (D)(3)(c) of this section, the employment cost index 5584
for total compensation, nursing and residential care facilities 5585
occupational group, published by the United States bureau of labor 5586
statistics;5587

       (c) If the United States bureau of labor statistics ceases to 5588
publish the index specified in division (D)(3)(b) of this section, 5589
the index the bureau subsequently publishes that covers nursing 5590
facilities' staff costs.5591

        (4) The department shall not redetermine a peer group's cost 5592
per case-mix unit under this division based on additional 5593
information that it receives after the peer group's per case-mix 5594
unit is determined. The department shall redetermine a peer 5595
group's cost per case-mix unit only if it made an error in 5596
determining the peer group's cost per case-mix unit based on 5597
information available to the department at the time of the 5598
original determination.5599

       Sec. 5111.24. (A) As used in this section:5600

       (1) "Applicable calendar year" means the following:5601

       (a) For the purpose of the department of job and family 5602
services' initial determination under division (D) of this section 5603
of each peer group's rate for ancillary and support costs, 5604
calendar year 2003;5605

       (b) For the purpose of the department's rebasings, the 5606
calendar year the department selects.5607

       (2) "Rebasing" means a redetermination under division (D) of 5608
this section of each peer groups' rate for ancillary and support 5609
costs using information from cost reports for an applicable 5610
calendar year that is later than the applicable calendar year used 5611
for the previous determination of such rates.5612

        (B) The department of job and family services shall pay a 5613
provider for each of the provider's eligible nursing facilities a 5614
per resident per day rate for ancillary and support costs 5615
determined for the nursing facility's peer group under division 5616
(D) of this section.5617

        (C) For the purpose of determining nursing facilities' rate 5618
for ancillary and support costs, the department shall establish 5619
six peer groups.5620

        Each nursing facility located in any of the following 5621
counties shall be placed in peer group one or two: Brown, Butler, 5622
Clermont, Clinton, Hamilton, and Warren. Each nursing facility 5623
located in any of those counties that has fewer than one hundred 5624
beds shall be placed in peer group one. Each nursing facility 5625
located in any of those counties that has one hundred or more beds 5626
shall be placed in peer group two.5627

        Each nursing facility located in any of the following 5628
counties shall be placed in peer group three or four: Ashtabula, 5629
Champaign, Clark, Cuyahoga, Darke, Delaware, Fairfield, Fayette, 5630
Franklin, Fulton, Geauga, Greene, Hancock, Knox, Lake, Licking, 5631
Lorain, Lucas, Madison, Marion, Medina, Miami, Montgomery, Morrow, 5632
Ottawa, Pickaway, Portage, Preble, Ross, Sandusky, Seneca, Summit, 5633
Union, and Wood. Each nursing facility located in any of those 5634
counties that has fewer than one hundred beds shall be placed in 5635
peer group three. Each nursing facility located in any of those 5636
counties that has one hundred or more beds shall be placed in peer 5637
group four.5638

        Each nursing facility located in any of the following 5639
counties shall be placed in peer group five or six: Adams, Allen, 5640
Ashland, Athens, Auglaize, Belmont, Carroll, Columbiana, 5641
Coshocton, Crawford, Defiance, Erie, Gallia, Guernsey, Hardin, 5642
Harrison, Henry, Highland, Hocking, Holmes, Huron, Jackson, 5643
Jefferson, Lawrence, Logan, Mahoning, Meigs, Mercer, Monroe, 5644
Morgan, Muskingum, Noble, Paulding, Perry, Pike, Putnam, Richland, 5645
Scioto, Shelby, Stark, Trumbull, Tuscarawas, Van Wert, Vinton, 5646
Washington, Wayne, Williams, and Wyandot. Each nursing facility 5647
located in any of those counties that has fewer than one hundred 5648
beds shall be placed in peer group five. Each nursing facility 5649
located in any of those counties that has one hundred or more beds 5650
shall be placed in peer group six.5651

        (D)(1) The department shall determine the rate for ancillary 5652
and support costs for each peer group established under division 5653
(C) of this section. The department is not required to conduct a 5654
rebasing more than once every ten years. Except as necessary to 5655
implement the amendments made by this act to this section by Am. 5656
Sub. H.B. 153 and Sub. H.B. 303, both of the 129th general 5657
assembly, the rate for ancillary and support costs determined 5658
under this division for a peer group shall be used for subsequent 5659
years until the department conducts a rebasing. To determine a 5660
peer group's rate for ancillary and support costs, the department 5661
shall do all of the following:5662

        (a) Subject to division (D)(2) of this section, determine the 5663
rate for ancillary and support costs for each nursing facility in 5664
the peer group for the applicable calendar year by using the 5665
greater of the nursing facility's actual inpatient days for the 5666
applicable calendar year or the inpatient days the nursing 5667
facility would have had for the applicable calendar year if its 5668
occupancy rate had been ninety per cent;5669

        (b) Subject to division (D)(3) of this section, identify 5670
which nursing facility in the peer group is at the twenty-fifth 5671
percentile of the rate for ancillary and support costs for the 5672
applicable calendar year determined under division (D)(1)(a) of 5673
this section;5674

        (c) Multiply the rate for ancillary and support costs 5675
determined under division (D)(1)(a) of this section for the 5676
nursing facility identified under division (D)(1)(b) of this 5677
section by the rate of inflation for the eighteen-month period 5678
beginning on the first day of July of the applicable calendar year 5679
and ending the last day of December of the calendar year 5680
immediately following the applicable calendar year using the 5681
following:5682

       (i) Until the first rebasing occurs, the consumer price index 5683
for all items for all urban consumers for the north central 5684
region, published by the United States bureau of labor statistics, 5685
as that index existed on July 1, 2005;5686

       (ii) Effective with the first rebasing and except as provided 5687
in division (D)(1)(c)(iii) of this section, the consumer price 5688
index for all items for all urban consumers for the midwest 5689
region, published by the United States bureau of labor statistics;5690

       (iii) If the United States bureau of labor statistics ceases 5691
to publish the index specified in division (D)(1)(c)(ii) of this 5692
section, the index the bureau subsequently publishes that covers 5693
urban consumers' prices for items for the region that includes 5694
this state.5695

       (d) Until the first rebasing occurs, increase the amount 5696
calculated under division (D)(1)(c) of this section by five and 5697
eight hundredths per cent.5698

        (2) For the purpose of determining a nursing facility's 5699
occupancy rate under division (D)(1)(a) of this section, the 5700
department shall include any beds that the nursing facility 5701
removes from its medicaid-certified capacity unless the nursing 5702
facility also removes the beds from its licensed bed capacity.5703

       (3) In making the identification under division (D)(1)(b) of 5704
this section, the department shall exclude both of the following:5705

        (a) Nursing facilities that participated in the medicaid 5706
program under the same provider for less than twelve months in the 5707
applicable calendar year;5708

        (b) Nursing facilities whose ancillary and support costs are 5709
more than one standard deviation from the mean desk-reviewed, 5710
actual, allowable, per diem ancillary and support cost for all 5711
nursing facilities in the nursing facility's peer group for the 5712
applicable calendar year.5713

        (4) The department shall not redetermine a peer group's rate 5714
for ancillary and support costs under this division based on 5715
additional information that it receives after the rate is 5716
determined. The department shall redetermine a peer group's rate 5717
for ancillary and support costs only if the department made an 5718
error in determining the rate based on information available to 5719
the department at the time of the original determination.5720

       Sec. 5111.242. (A) As used in this section, "applicable:5721

       (1) "Applicable calendar year" means the following:5722

       (1)(a) For the purpose of the department of job and family 5723
services' initial determination under this section of nursing 5724
facilities' rate for tax costs, calendar year 2003;5725

        (2)(b) For the purpose of the department's subsequent 5726
determinations under division (C) of this section of nursing 5727
facilities' rate for tax costsrebasings, the calendar year the 5728
department selects.5729

       (2) "Rebasing" means a redetermination under division (C) of 5730
this section of each nursing facility's rate for tax costs using 5731
information from cost reports for an applicable calendar year that 5732
is later than the applicable calendar year used for the previous 5733
determination of such rates.5734

        (B) The department of job and family services shall pay a 5735
provider for each of the provider's eligible nursing facilities a 5736
per resident per day rate for tax costs determined under division 5737
(C) of this section.5738

        (C) At least once every ten years, theThe department shall 5739
determine the rate for tax costs for each nursing facility. The 5740
department is not required to conduct a rebasing more than once 5741
every ten years. Except as necessary to implement the amendments 5742
made to this section by Sub. H.B. 303 of the 129th general 5743
assembly, the rate for tax costs determined under this division 5744
for a nursing facility shall be used for subsequent years until 5745
the department redetermines itconducts a rebasing. To determine 5746
a nursing facility's rate for tax costs and except as provided in 5747
division (D) of this section, the department shall dividedo both 5748
of the following:5749

       (1) Divide the nursing facility's desk-reviewed, actual, 5750
allowable tax costs paid for the applicable calendar year by the 5751
number of inpatient days the nursing facility would have had if 5752
its occupancy rate had been one hundred per cent during the 5753
applicable calendar year;5754

       (2) Until the first rebasing occurs, increase the amount 5755
calculated under division (C)(1) of this section by five and eight 5756
hundredths per cent.5757

       (D) If a nursing facility had a credit regarding its real 5758
estate taxes reflected on its cost report for calendar year 2003, 5759
the department shall determine, as follows, its rate for tax costs 5760
for the period beginning on July 1, 2010, and ending on the first 5761
day of the fiscal year for which the department first redetermines 5762
all nursing facilities' rate for tax costs under division (C) of 5763
this section by dividingconducts a rebasing:5764

       (1) Divide the nursing facility's desk-reviewed, actual, 5765
allowable tax costs paid for calendar year 2004 by the number of 5766
inpatient days the nursing facility would have had if its 5767
occupancy rate had been one hundred per cent during calendar year 5768
2004;5769

        (2) Until the first rebasing occurs, increase the amount 5770
calculated under division (D)(1) of this section by five and eight 5771
hundredths per cent.5772

       Sec. 5111.246.  (A) Each fiscal year, the department of job 5773
and family services shall pay a critical access incentive payment 5774
to the provider of each nursing facility that qualifies as a 5775
critical access nursing facility. To qualify as a critical access 5776
nursing facility for a fiscal year, a nursing facility must meet 5777
all of the following requirements:5778

       (1) The nursing facility must be located in an area that, on 5779
December 31, 2011, was designated an empowerment zone under 5780
section 1391 of the "Internal Revenue Code of 1986," 107 Stat. 5781
543, 26 U.S.C. 1391, as amended.5782

       (2) The nursing facility must have an occupancy rate of at 5783
least eighty-five per cent as of the last day of the calendar year 5784
preceding the fiscal year.5785

       (3) The nursing facility must have a medicaid utilization 5786
rate of at least sixty-five per cent as of the last day of the 5787
calendar year preceding the fiscal year.5788

       (B) A critical access nursing facility's critical access 5789
incentive payment for a fiscal year shall equal five per cent of 5790
the portion of the nursing facility's total rate for the fiscal 5791
year that is the sum of the rates and payment identified in 5792
divisions (A)(B)(1) to (4) and (6) of section 5111.222 of the 5793
Revised Code.5794

       Sec. 5111.25.  (A) As used in this section:5795

       (1) "Applicable calendar year" means the following:5796

       (a) For the purpose of the department of job and family 5797
services' initial determination under division (D) of this section 5798
of each peer group's rate for capital costs, calendar year 2003;5799

       (b) For the purpose of the department's rebasings, the 5800
calendar year the department selects.5801

       (2) "Rebasing" means a redetermination under division (D) of 5802
this section of each peer groups' rate for capital costs using 5803
information from cost reports for an applicable calendar year that 5804
is later than the applicable calendar year used for the previous 5805
determination of such rates.5806

        (B) The department of job and family services shall pay a 5807
provider for each of the provider's eligible nursing facilities a 5808
per resident per day rate for capital costs determined for the 5809
nursing facility's peer group under division (D) of this section.5810

        (C) For the purpose of determining nursing facilities' rate 5811
for capital costs, the department shall establish six peer groups.5812

        Each nursing facility located in any of the following 5813
counties shall be placed in peer group one or two: Brown, Butler, 5814
Clermont, Clinton, Hamilton, and Warren. Each nursing facility 5815
located in any of those counties that has fewer than one hundred 5816
beds shall be placed in peer group one. Each nursing facility 5817
located in any of those counties that has one hundred or more beds 5818
shall be placed in peer group two.5819

        Each nursing facility located in any of the following 5820
counties shall be placed in peer group three or four: Ashtabula, 5821
Champaign, Clark, Cuyahoga, Darke, Delaware, Fairfield, Fayette, 5822
Franklin, Fulton, Geauga, Greene, Hancock, Knox, Lake, Licking, 5823
Lorain, Lucas, Madison, Marion, Medina, Miami, Montgomery, Morrow, 5824
Ottawa, Pickaway, Portage, Preble, Ross, Sandusky, Seneca, Summit, 5825
Union, and Wood. Each nursing facility located in any of those 5826
counties that has fewer than one hundred beds shall be placed in 5827
peer group three. Each nursing facility located in any of those 5828
counties that has one hundred or more beds shall be placed in peer 5829
group four.5830

        Each nursing facility located in any of the following 5831
counties shall be placed in peer group five or six: Adams, Allen, 5832
Ashland, Athens, Auglaize, Belmont, Carroll, Columbiana, 5833
Coshocton, Crawford, Defiance, Erie, Gallia, Guernsey, Hardin, 5834
Harrison, Henry, Highland, Hocking, Holmes, Huron, Jackson, 5835
Jefferson, Lawrence, Logan, Mahoning, Meigs, Mercer, Monroe, 5836
Morgan, Muskingum, Noble, Paulding, Perry, Pike, Putnam, Richland, 5837
Scioto, Shelby, Stark, Trumbull, Tuscarawas, Van Wert, Vinton, 5838
Washington, Wayne, Williams, and Wyandot. Each nursing facility 5839
located in any of those counties that has fewer than one hundred 5840
beds shall be placed in peer group five. Each nursing facility 5841
located in any of those counties that has one hundred or more beds 5842
shall be placed in peer group six.5843

        (D)(1) The department shall determine the rate for capital 5844
costs for each peer group established under division (C) of this 5845
section. The department is not required to conduct a rebasing more 5846
than once every ten years. Except as necessary to implement the 5847
amendments made by this act to this section by Am. Sub. H.B. 153 5848
and Sub. H.B. 303, both of the 129th general assembly, the rate 5849
for capital costs determined under this division for a peer group 5850
shall be used for subsequent years until the department conducts a 5851
rebasing. ATo determine a peer group's rate for capital costs 5852
shall be, the department shall do both of the following:5853

       (a) Determine the rate for capital costs determined for the 5854
nursing facility in the peer group that is at the twenty-fifth 5855
percentile of the rate for capital costs for the applicable 5856
calendar year;5857

       (b) Until the first rebasing occurs, increase the amount 5858
calculated under division (D)(1)(a) of this section by five and 5859
eight hundredths per cent. In identifying that5860

       (2) To identify the nursing facility in a peer group that is 5861
at the twenty-fifth percentile of the rate for capital costs for 5862
the applicable calendar year, the department shall do both of the 5863
following:5864

        (a) Subject to division (D)(2)(3) of this section, use the 5865
greater of each nursing facility's actual inpatient days for the 5866
applicable calendar year or the inpatient days the nursing 5867
facility would have had for the applicable calendar year if its 5868
occupancy rate had been one hundred per cent;5869

        (b) Exclude both of the following:5870

        (i) Nursing facilities that participated in the medicaid 5871
program under the same provider for less than twelve months in the 5872
applicable calendar year;5873

        (ii) Nursing facilities whose capital costs are more than one 5874
standard deviation from the mean desk-reviewed, actual, allowable, 5875
per diem capital cost for all nursing facilities in the nursing 5876
facility's peer group for the applicable calendar year.5877

        (2)(3) For the purpose of determining a nursing facility's 5878
occupancy rate under division (D)(1)(2)(a) of this section, the 5879
department shall include any beds that the nursing facility 5880
removes from its medicaid-certified capacity after June 30, 2005, 5881
unless the nursing facility also removes the beds from its 5882
licensed bed capacity.5883

       (3)(4) The department shall not redetermine a peer group's 5884
rate for capital costs under this division based on additional 5885
information that it receives after the rate is determined. The 5886
department shall redetermine a peer group's rate for capital costs 5887
only if the department made an error in determining the rate based 5888
on information available to the department at the time of the 5889
original determination.5890

       (E) Buildings shall be depreciated using the straight line 5891
method over forty years or over a different period approved by the 5892
department. Components and equipment shall be depreciated using 5893
the straight-line method over a period designated in rules adopted 5894
under section 5111.02 of the Revised Code, consistent with the 5895
guidelines of the American hospital association, or over a 5896
different period approved by the department. Any rules authorized 5897
by this division that specify useful lives of buildings, 5898
components, or equipment apply only to assets acquired on or after 5899
July 1, 1993. Depreciation for costs paid or reimbursed by any 5900
government agency shall not be included in capital costs unless 5901
that part of the payment under sections 5111.20 to 5111.331 of the 5902
Revised Code is used to reimburse the government agency.5903

       (F) The capital cost basis of nursing facility assets shall 5904
be determined in the following manner:5905

        (1) Except as provided in division (F)(3) of this section, 5906
for purposes of calculating the rates to be paid for facilities 5907
with dates of licensure on or before June 30, 1993, the capital 5908
cost basis of each asset shall be equal to the desk-reviewed, 5909
actual, allowable, capital cost basis that is listed on the 5910
facility's cost report for the calendar year preceding the fiscal 5911
year during which the rate will be paid.5912

       (2) For facilities with dates of licensure after June 30, 5913
1993, the capital cost basis shall be determined in accordance 5914
with the principles of the medicare program established under 5915
Title XVIII, except as otherwise provided in sections 5111.20 to 5916
5111.331 of the Revised Code.5917

       (3) Except as provided in division (F)(4) of this section, if 5918
a provider transfers an interest in a facility to another provider 5919
after June 30, 1993, there shall be no increase in the capital 5920
cost basis of the asset if the providers are related parties or 5921
the provider to which the interest is transferred authorizes the 5922
provider that transferred the interest to continue to operate the 5923
facility under a lease, management agreement, or other 5924
arrangement. If the previous sentence does not prohibit the 5925
adjustment of the capital cost basis under this division, the 5926
basis of the asset shall be adjusted by one-half of the change in 5927
the consumer price index for all items for all urban consumers, as 5928
published by the United States bureau of labor statistics, during 5929
the time that the transferor held the asset.5930

       (4) If a provider transfers an interest in a facility to 5931
another provider who is a related party, the capital cost basis of 5932
the asset shall be adjusted as specified in division (F)(3) of 5933
this section if all of the following conditions are met:5934

       (a) The related party is a relative of owner;5935

       (b) Except as provided in division (F)(4)(c)(ii) of this 5936
section, the provider making the transfer retains no ownership 5937
interest in the facility;5938

       (c) The department of job and family services determines that 5939
the transfer is an arm's length transaction pursuant to rules 5940
adopted under section 5111.02 of the Revised Code. The rules shall 5941
provide that a transfer is an arm's length transaction if all of 5942
the following apply:5943

       (i) Once the transfer goes into effect, the provider that 5944
made the transfer has no direct or indirect interest in the 5945
provider that acquires the facility or the facility itself, 5946
including interest as an owner, officer, director, employee, 5947
independent contractor, or consultant, but excluding interest as a 5948
creditor.5949

       (ii) The provider that made the transfer does not reacquire 5950
an interest in the facility except through the exercise of a 5951
creditor's rights in the event of a default. If the provider 5952
reacquires an interest in the facility in this manner, the 5953
department shall treat the facility as if the transfer never 5954
occurred when the department calculates its reimbursement rates 5955
for capital costs.5956

       (iii) The transfer satisfies any other criteria specified in 5957
the rules.5958

       (d) Except in the case of hardship caused by a catastrophic 5959
event, as determined by the department, or in the case of a 5960
provider making the transfer who is at least sixty-five years of 5961
age, not less than twenty years have elapsed since, for the same 5962
facility, the capital cost basis was adjusted most recently under 5963
division (F)(4) of this section or actual, allowable cost of 5964
ownership was determined most recently under division (G)(9) of 5965
this section.5966

       (G) As used in this division:5967

       "Imputed interest" means the lesser of the prime rate plus 5968
two per cent or ten per cent.5969

       "Lease expense" means lease payments in the case of an 5970
operating lease and depreciation expense and interest expense in 5971
the case of a capital lease. 5972

       "New lease" means a lease, to a different lessee, of a 5973
nursing facility that previously was operated under a lease.5974

       (1) Subject to division (B) of this section, for a lease of a 5975
facility that was effective on May 27, 1992, the entire lease 5976
expense is an actual, allowable capital cost during the term of 5977
the existing lease. The entire lease expense also is an actual, 5978
allowable capital cost if a lease in existence on May 27, 1992, is 5979
renewed under either of the following circumstances:5980

       (a) The renewal is pursuant to a renewal option that was in 5981
existence on May 27, 1992;5982

       (b) The renewal is for the same lease payment amount and 5983
between the same parties as the lease in existence on May 27, 5984
1992.5985

       (2) Subject to division (B) of this section, for a lease of a 5986
facility that was in existence but not operated under a lease on 5987
May 27, 1992, actual, allowable capital costs shall include the 5988
lesser of the annual lease expense or the annual depreciation 5989
expense and imputed interest expense that would be calculated at 5990
the inception of the lease using the lessor's entire historical 5991
capital asset cost basis, adjusted by one-half of the change in 5992
the consumer price index for all items for all urban consumers, as 5993
published by the United States bureau of labor statistics, during 5994
the time the lessor held each asset until the beginning of the 5995
lease.5996

       (3) Subject to division (B) of this section, for a lease of a 5997
facility with a date of licensure on or after May 27, 1992, that 5998
is initially operated under a lease, actual, allowable capital 5999
costs shall include the annual lease expense if there was a 6000
substantial commitment of money for construction of the facility 6001
after December 22, 1992, and before July 1, 1993. If there was not 6002
a substantial commitment of money after December 22, 1992, and 6003
before July 1, 1993, actual, allowable capital costs shall include 6004
the lesser of the annual lease expense or the sum of the 6005
following:6006

       (a) The annual depreciation expense that would be calculated 6007
at the inception of the lease using the lessor's entire historical 6008
capital asset cost basis;6009

       (b) The greater of the lessor's actual annual amortization of 6010
financing costs and interest expense at the inception of the lease 6011
or the imputed interest expense calculated at the inception of the 6012
lease using seventy per cent of the lessor's historical capital 6013
asset cost basis.6014

       (4) Subject to division (B) of this section, for a lease of a 6015
facility with a date of licensure on or after May 27, 1992, that 6016
was not initially operated under a lease and has been in existence 6017
for ten years, actual, allowable capital costs shall include the 6018
lesser of the annual lease expense or the annual depreciation 6019
expense and imputed interest expense that would be calculated at 6020
the inception of the lease using the entire historical capital 6021
asset cost basis of one-half of the change in the consumer price 6022
index for all items for all urban consumers, as published by the 6023
United States bureau of labor statistics, during the time the 6024
lessor held each asset until the beginning of the lease.6025

       (5) Subject to division (B) of this section, for a new lease 6026
of a facility that was operated under a lease on May 27, 1992, 6027
actual, allowable capital costs shall include the lesser of the 6028
annual new lease expense or the annual old lease payment. If the 6029
old lease was in effect for ten years or longer, the old lease 6030
payment from the beginning of the old lease shall be adjusted by 6031
one-half of the change in the consumer price index for all items 6032
for all urban consumers, as published by the United States bureau 6033
of labor statistics, from the beginning of the old lease to the 6034
beginning of the new lease.6035

       (6) Subject to division (B) of this section, for a new lease 6036
of a facility that was not in existence or that was in existence 6037
but not operated under a lease on May 27, 1992, actual, allowable 6038
capital costs shall include the lesser of annual new lease expense 6039
or the annual amount calculated for the old lease under division 6040
(G)(2), (3), (4), or (6) of this section, as applicable. If the 6041
old lease was in effect for ten years or longer, the lessor's 6042
historical capital asset cost basis shall be, for purposes of 6043
calculating the annual amount under division (G)(2), (3), (4), or 6044
(6) of this section, adjusted by one-half of the change in the 6045
consumer price index for all items for all urban consumers, as 6046
published by the United States bureau of labor statistics, from 6047
the beginning of the old lease to the beginning of the new lease.6048

       In the case of a lease under division (G)(3) of this section 6049
of a facility for which a substantial commitment of money was made 6050
after December 22, 1992, and before July 1, 1993, the old lease 6051
payment shall be adjusted for the purpose of determining the 6052
annual amount.6053

       (7) For any revision of a lease described in division (G)(1), 6054
(2), (3), (4), (5), or (6) of this section, or for any subsequent 6055
lease of a facility operated under such a lease, other than 6056
execution of a new lease, the portion of actual, allowable capital 6057
costs attributable to the lease shall be the same as before the 6058
revision or subsequent lease.6059

       (8) Except as provided in division (G)(9) of this section, if 6060
a provider leases an interest in a facility to another provider 6061
who is a related party or previously operated the facility, the 6062
related party's or previous operator's actual, allowable capital 6063
costs shall include the lesser of the annual lease expense or the 6064
reasonable cost to the lessor.6065

       (9) If a provider leases an interest in a facility to another 6066
provider who is a related party, regardless of the date of the 6067
lease, the related party's actual, allowable capital costs shall 6068
include the annual lease expense, subject to the limitations 6069
specified in divisions (G)(1) to (7) of this section, if all of 6070
the following conditions are met:6071

       (a) The related party is a relative of owner;6072

       (b) If the lessor retains an ownership interest, it is, 6073
except as provided in division (G)(9)(c)(ii) of this section, in 6074
only the real property and any improvements on the real property;6075

       (c) The department of job and family services determines that 6076
the lease is an arm's length transaction pursuant to rules adopted 6077
under section 5111.02 of the Revised Code. The rules shall provide 6078
that a lease is an arm's length transaction if all of the 6079
following apply:6080

       (i) Once the lease goes into effect, the lessor has no direct 6081
or indirect interest in the lessee or, except as provided in 6082
division (G)(9)(b) of this section, the facility itself, including 6083
interest as an owner, officer, director, employee, independent 6084
contractor, or consultant, but excluding interest as a lessor.6085

       (ii) The lessor does not reacquire an interest in the 6086
facility except through the exercise of a lessor's rights in the 6087
event of a default. If the lessor reacquires an interest in the 6088
facility in this manner, the department shall treat the facility 6089
as if the lease never occurred when the department calculates its 6090
reimbursement rates for capital costs.6091

       (iii) The lease satisfies any other criteria specified in the 6092
rules.6093

       (d) Except in the case of hardship caused by a catastrophic 6094
event, as determined by the department, or in the case of a lessor 6095
who is at least sixty-five years of age, not less than twenty 6096
years have elapsed since, for the same facility, the capital cost 6097
basis was adjusted most recently under division (F)(4) of this 6098
section or actual, allowable capital costs were determined most 6099
recently under division (G)(9) of this section.6100

       (10) This division does not apply to leases of specific items 6101
of equipment.6102

       Sec. 5111.88.  (A) As used in sections 5111.88 to 5111.8811 6103
of the Revised Code:6104

       (1) "Adult" means an individual at least eighteen years of 6105
age.6106

       (2) "Authorized representative" means the following:6107

       (a) In the case of a consumer who is a minor, the consumer's 6108
parent, custodian, or guardian;6109

       (b) In the case of a consumer who is an adult, an individual 6110
selected by the consumer pursuant to section 5111.8810 of the 6111
Revised Code to act on the consumer's behalf for purposes 6112
regarding home care attendant services.6113

       (3) "Authorizing health care professional" means a health 6114
care professional who, pursuant to section 5111.887 of the Revised 6115
Code, authorizes a home care attendant to assist a consumer with 6116
self-administration of medication, nursing tasks, or both.6117

       (4) "Consumer" means an individual to whom all of the 6118
following apply:6119

       (a) The individual is enrolled in a participating medicaid 6120
waiver component.6121

       (b) The individual has a medically determinable physical 6122
impairment to which both of the following apply:6123

       (i) It is expected to last for a continuous period of not 6124
less than twelve months.6125

       (ii) It causes the individual to require assistance with 6126
activities of daily living, self-care, and mobility, including 6127
either assistance with self-administration of medication or the 6128
performance of nursing tasks, or both.6129

       (c) In the case of an individual who is an adult, the 6130
individual is mentally alert and is, or has an authorized 6131
representative who is, capable of selecting, directing the actions 6132
of, and dismissing a home care attendant.6133

       (d) In the case of an individual who is a minor, the 6134
individual has an authorized representative who is capable of 6135
selecting, directing the actions of, and dismissing a home care 6136
attendant.6137

       (5) "Controlled substance" has the same meaning as in section 6138
3719.01 of the Revised Code.6139

       (6) "Custodian" has the same meaning as in section 2151.011 6140
of the Revised Code.6141

       (7) "Gastrostomy tube" means a percutaneously inserted 6142
catheter that terminates in the stomach.6143

       (8) "Guardian" has the same meaning as in section 2111.01 of 6144
the Revised Code.6145

       (9) "Health care professional" means a physician or 6146
registered nurse.6147

       (10) "Home care attendant" means an individual holding a 6148
valid medicaid provider agreement in accordance with section 6149
5111.881 of the Revised Code that authorizes the individual to 6150
provide home care attendant services to consumers.6151

       (11) "Home care attendant services" means all of the 6152
following as provided by a home care attendant:6153

       (a) Personal care aide services;6154

       (b) Assistance with the self-administration of medication;6155

       (c) Assistance with nursing tasks.6156

       (12) "Jejunostomy tube" means a percutaneously inserted 6157
catheter that terminates in the jejunum.6158

       (13) "Medicaid waiver component" has the same meaning as in 6159
section 5111.85 of the Revised Code.6160

       (14) "Medication" means a drug as defined in section 4729.01 6161
of the Revised Code.6162

       (15) "Minor" means an individual under eighteen years of age.6163

       (16) "Participating medicaid waiver component" means both of 6164
the following:6165

       (a) The Ohio home care program created under section 5111.861 6166
of the Revised Code;6167

       (b) The Ohio transitions II aging carve-out program created 6168
under section 5111.863 of the Revised Code.6169

       (17) "Physician" means an individual authorized under Chapter 6170
4731. of the Revised Code to practice medicine and surgery or 6171
osteopathic medicine and surgery.6172

       (18) "Practice of nursing as a registered nurse," "practice 6173
of nursing as a licensed practical nurse," and "registered nurse" 6174
have the same meanings as in section 4723.01 of the Revised Code. 6175
"Registered nurse" includes an advanced practice registered nurse, 6176
as defined in section 4723.01 of the Revised Code.6177

       (19) "Schedule II," "schedule III," "schedule IV," and 6178
"schedule V" have the same meanings as in section 3719.01 of the 6179
Revised Code.6180

       (B) The director of job and family services may submit 6181
requests to the United States secretary of health and human 6182
services to amend the federal medicaid waivers authorizing the 6183
participating medicaid waiver components to have those components 6184
cover home care attendant services in accordance with sections 6185
5111.88 to 5111.8810 of the Revised Code and rules adopted under 6186
section 5111.8811 of the Revised Code. Notwithstanding sections 6187
5111.881 to 5111.8811 of the Revised Code, those sections shall be 6188
implemented regarding a participating medicaid waiver component 6189
only if the secretary approves a waiver amendment for the 6190
component.6191

       Sec. 5111.981.  (A) As used in this section and section 6192
5111.982 of the Revised Code:6193

       "Dual eligible individual" has the same meaning as in section 6194
1915(h)(2)(B) of the "Social Security Act," 124 Stat. 315 (2010)6195
section 1915(h)(2)(B), 42 U.S.C. 1396n(h)(2)(B).6196

       "Medicare program" means the program created under Title 6197
XVIII ofin the "Social Security Act," 79 Stat. 286 (1965)Title 6198
XVIII, 42 U.S.C. 1395 et seq., as amended.6199

       (B) Subject to division (C) of this section, the medical 6200
assistance director of job and family services may implement a 6201
demonstration project called the integrated care delivery system6202
to test and evaluate the integration of the care that dual 6203
eligible individuals receive under the medicare and medicaid 6204
programs. No provision of Title LI of the Revised Code applies to 6205
the demonstration projectintegrated care delivery system if that 6206
provision implements or incorporates a provision of federal law 6207
governing the medicaid program and that provision of federal law 6208
does not apply to the demonstration projectsystem.6209

       (C) Before implementing the demonstration projectintegrated 6210
care delivery system under division (B) of this section, the 6211
director shall obtain the approval of the United States secretary 6212
of health and human services in the form of a federal medicaid 6213
waiver, medicaid state plan amendment, or demonstration grant. The 6214
director is required to seek the federal approval only if the 6215
director seeks to implement the demonstration projectintegrated 6216
care delivery system. The director shall implement the 6217
demonstration projectintegrated care delivery system in 6218
accordance with the terms of the federal approval, including the 6219
terms regarding the duration of the demonstration projectsystem.6220

       Sec. 5111.982.  (A) As used in this section:6221

       "Covered skilled nursing facility services" has the same 6222
meaning as in the "Social Security Act," section 1888(e)(2)(A), 42 6223
U.S.C. 1395yy(e)(2)(A).6224

       "Current medicare fee-for-service rate" means the 6225
fee-for-service rate in effect for a covered skilled nursing 6226
facility service under medicare at the time the service is 6227
provided.6228

       "Skilled nursing facility" has the same meaning as in the 6229
"Social Security Act," section 1819(a), 42 U.S.C. 1395i-3(a).6230

       (B) Except as provided in division (C) of this section, a 6231
managed care organization shall pay a skilled nursing facility at 6232
least the current medicare fee-for-service rate, without deduction 6233
for any coinsurance, for covered skilled nursing facility services 6234
that the skilled nursing facility provides to a dual eligible 6235
individual if the managed care organization is responsible for the 6236
payment under the terms of a contract that the managed care 6237
organization, medical assistance director, and United States 6238
secretary of health and human services jointly enter into under 6239
the integrated care delivery system authorized by section 5111.981 6240
of the Revised Code.6241

       (C) A managed care organization is required to pay the rate 6242
specified in division (B) of this section for covered skilled 6243
nursing facility services only if all of the following apply:6244

       (1) The United States secretary agrees to the payment rate as 6245
part of the contract that the managed care organization, medical 6246
assistance director, and United States secretary jointly enter 6247
into under the integrated care delivery system;6248

       (2) The managed care organization receives a federal 6249
capitation payment that is an actuarially sufficient amount for 6250
the costs that the managed care organization incurs in paying the 6251
rate;6252

       (3) No state funds are used for any part of the costs that 6253
the managed care organization incurs in paying the rate;6254

       (4) The integrated care delivery system provides for dual 6255
eligible individuals to receive the covered skilled nursing 6256
facility services as part of the system.6257

       Sec. 5120.55.  (A) As used in this section, "licensed health 6258
professional" means any or all of the following:6259

        (1) A dentist who holds a current, valid license issued under 6260
Chapter 4715. of the Revised Code to practice dentistry;6261

        (2) A licensed practical nurse who holds a current, valid 6262
license issued under Chapter 4723. of the Revised Code that 6263
authorizes the practice of nursing as a licensed practical nurse;6264

        (3) An optometrist who holds a current, valid certificate of 6265
licensure issued under Chapter 4725. of the Revised Code that 6266
authorizes the holder to engage in the practice of optometry;6267

        (4) A physician who is authorized under Chapter 4731. of the 6268
Revised Code to practice medicine and surgery, osteopathic 6269
medicine and surgery, or podiatrypodiatric medicine and surgery;6270

       (5) A psychologist who holds a current, valid license issued 6271
under Chapter 4732. of the Revised Code that authorizes the 6272
practice of psychology as a licensed psychologist;6273

       (6) A registered nurse who holds a current, valid license 6274
issued under Chapter 4723. of the Revised Code that authorizes the 6275
practice of nursing as a registered nurse regardless of whether 6276
the, including such a nurse who is also authorized to practice as 6277
an advanced practice registered nurse as defined in section 6278
4723.01 of the Revised Code.6279

       (B)(1) The department of rehabilitation and correction may 6280
establish a recruitment program under which the department, by 6281
means of a contract entered into under division (C) of this 6282
section, agrees to repay all or part of the principal and interest 6283
of a government or other educational loan incurred by a licensed 6284
health professional who agrees to provide services to inmates of 6285
correctional institutions under the department's administration.6286

       (2)(a) For a physician to be eligible to participate in the 6287
program, the physician must have attended a school that was, 6288
during the time of attendance, a medical school or osteopathic 6289
medical school in this country accredited by the liaison committee 6290
on medical education or the American osteopathic association, a 6291
college of podiatry in this country recognized as being in good 6292
standing under section 4731.53 of the Revised Code, or a medical 6293
school, osteopathic medical school, or college of podiatry located 6294
outside this country that was acknowledged by the world health 6295
organization and verified by a member state of that organization 6296
as operating within that state's jurisdiction.6297

       (b) For a nurse to be eligible to participate in the program, 6298
the nurse must have attended a school that was, during the time of 6299
attendance, a nursing school in this country accredited by the 6300
commission on collegiate nursing education or the national league 6301
for nursing accrediting commission or a nursing school located 6302
outside this country that was acknowledged by the world health 6303
organization and verified by a member state of that organization 6304
as operating within that state's jurisdiction.6305

       (c) For a dentist to be eligible to participate in the 6306
program, the dentist must have attended a school that was, during 6307
the time of attendance, a dental college that enabled the dentist 6308
to meet the requirements specified in section 4715.10 of the 6309
Revised Code to be granted a license to practice dentistry.6310

       (d) For an optometrist to be eligible to participate in the 6311
program, the optometrist must have attended a school of optometry 6312
that was, during the time of attendance, approved by the state 6313
board of optometry.6314

        (e) For a psychologist to be eligible to participate in the 6315
program, the psychologist must have attended an educational 6316
institution that, during the time of attendance, maintained a 6317
specific degree program recognized by the state board of 6318
psychology as acceptable for fulfilling the requirement of 6319
division (B)(4) of section 4732.10 of the Revised Code.6320

       (C) The department shall enter into a contract with each 6321
licensed health professional it recruits under this section. Each 6322
contract shall include at least the following terms:6323

       (1) The licensed health professional agrees to provide a 6324
specified scope of medical, osteopathic medical, podiatric, 6325
optometric, psychological, nursing, or dental services to inmates 6326
of one or more specified state correctional institutions for a 6327
specified number of hours per week for a specified number of 6328
years.6329

       (2) The department agrees to repay all or a specified portion 6330
of the principal and interest of a government or other educational 6331
loan taken by the licensed health professional for the following 6332
expenses to attend, for up to a maximum of four years, a school 6333
that qualifies the licensed health professional to participate in 6334
the program:6335

       (a) Tuition;6336

       (b) Other educational expenses for specific purposes, 6337
including fees, books, and laboratory expenses, in amounts 6338
determined to be reasonable in accordance with rules adopted under 6339
division (D) of this section;6340

       (c) Room and board, in an amount determined to be reasonable 6341
in accordance with rules adopted under division (D) of this 6342
section.6343

       (3) The licensed health professional agrees to pay the 6344
department a specified amount, which shall be no less than the 6345
amount already paid by the department pursuant to its agreement, 6346
as damages if the licensed health professional fails to complete 6347
the service obligation agreed to or fails to comply with other 6348
specified terms of the contract. The contract may vary the amount 6349
of damages based on the portion of the service obligation that 6350
remains uncompleted.6351

       (4) Other terms agreed upon by the parties.6352

       The licensed health professional's lending institution or the 6353
Ohio board of regents, may be a party to the contract. The 6354
contract may include an assignment to the department of the 6355
licensed health professional's duty to repay the principal and 6356
interest of the loan.6357

       (D) If the department elects to implement the recruitment 6358
program, it shall adopt rules in accordance with Chapter 119. of 6359
the Revised Code that establish all of the following:6360

       (1) Criteria for designating institutions for which licensed 6361
health professionals will be recruited;6362

       (2) Criteria for selecting licensed health professionals for 6363
participation in the program;6364

       (3) Criteria for determining the portion of a loan which the 6365
department will agree to repay;6366

       (4) Criteria for determining reasonable amounts of the 6367
expenses described in divisions (C)(2)(b) and (c) of this section;6368

       (5) Procedures for monitoring compliance by a licensed health 6369
professional with the terms of the contract the licensed health 6370
professional enters into under this section;6371

       (6) Any other criteria or procedures necessary to implement 6372
the program.6373

       Section 2. That existing sections 2305.113, 2305.234, 6374
2711.22, 3701.92, 3701.923, 3701.924, 3701.925, 3701.926, 6375
3701.927, 3701.928, 3701.929, 3793.11, 3963.01, 4503.44, 4723.01, 6376
4723.03, 4723.06, 4723.063, 4723.07, 4723.08, 4723.09, 4723.17, 6377
4723.171, 4723.24, 4723.271, 4723.28, 4723.32, 4723.34, 4723.35, 6378
4723.41, 4723.42, 4723.43, 4723.431, 4723.44, 4723.48, 4723.482, 6379
4723.485, 4723.487, 4723.50, 4723.61, 4723.64, 4723.65, 4723.651, 6380
4723.652, 4723.66, 4723.67, 4723.68, 4723.69, 4723.71, 4723.72, 6381
4723.73, 4723.74, 4723.75, 4723.751, 4723.76, 4723.77, 4723.79, 6382
4723.83, 4723.84, 4723.87, 4723.88, 4723.99, 4759.01, 4759.03, 6383
4759.05, 4759.06, 4759.10, 5111.222, 5111.231, 5111.24, 5111.242, 6384
5111.246, 5111.25, 5111.88, 5111.981, and 5120.55 and sections 6385
4723.483, 4723.62, 4723.621, 4723.63, and 4723.78 of the 6386
Revised Code are hereby repealed.6387

       Section 3. That Section 3.19 of Am. Sub. H.B. 95 of the 125th 6388
General Assembly be amended to read as follows:6389

       Sec. 3.19. Section 4723.063 of the Revised Code is hereby 6390
repealed, effective December 31, 20132023.6391

       Section 4. That existing Section 3.19 of Am. Sub. H.B. 95 of 6392
the 125th General Assembly is hereby repealed.6393

       Section 5.  Sections 1 to 4 of this act take effect ninety 6394
days after the effective date of this act, except as follows:6395

       (A) Section 3793.11 of the Revised Code, as amended by this 6396
act, takes effect at the earliest time permitted by law;6397

       (B) Sections 5111.22, 5111.231, 5111.24, 5111.242, 5111.246, 6398
and 5111.25 of the Revised Code, as amended by this act, take 6399
effect July 1, 2013.6400

       Section 6. In the case of an application pending on the 6401
effective date of this section for a license to maintain methadone 6402
treatment, the requirement of division (C)(6) of section 3793.11 6403
of the Revised Code, as amended by this act, shall be applied by 6404
the Department of Alcohol and Drug Addiction Services in 6405
determining whether to issue the license. The Department may waive 6406
the requirement pursuant to division (D) of section 3793.11 of the 6407
Revised Code, as amended by this act.6408

       Section 7. (A) Notwithstanding the provisions of section 6409
4723.482 of the Revised Code specifying that the course of study 6410
in advanced pharmacology and related topics that must be completed 6411
as a condition of eligibility to receive a certificate to 6412
prescribe from the Board of Nursing is to consist of planned 6413
classroom and clinical instruction, the Board may accept 6414
instruction completed in another form, including instruction 6415
obtained through an internet-based program, as fulfillment of all 6416
or part of the requirement of division (B)(5)(d) of that section 6417
to complete instruction specific to schedule II controlled 6418
substances. To be accepted by the Board, the instruction obtained 6419
in another form shall meet all other standards established in 6420
rules adopted under section 4723.50 of the Revised Code regarding 6421
the required instruction specific to schedule II controlled 6422
substances.6423

       (B) Division (A) of this section applies only in the case of 6424
an applicant who completed the required course of study prior to 6425
the effective date of this section and does not alter the 6426
requirement of division (B)(1) of section 4723.482 of the Revised 6427
Code that the course of study be completed not longer than three 6428
years before an application for a certificate to prescribe is 6429
filed.6430

       Section 8. (A) As used in this section, "intermediate care 6431
facility for individuals with intellectual disabilities" and 6432
"ICF/IID" mean an intermediate care facility for the mentally 6433
retarded as defined in the "Social Security Act," section 1905(d), 6434
42 U.S.C. 1396d(d).6435

       (B) The Department of Developmental Disabilities may conduct 6436
or contract with another entity to conduct, for the first quarter 6437
of calendar year 2013, assessments of all residents of each 6438
ICF/IID, regardless of payment source, who are in the ICF/IID, or 6439
on hospital or therapeutic leave from the ICF/IID, on the day or 6440
days that the assessments are conducted at the ICF/IID.6441

       (C) If assessments are conducted under division (B) of this 6442
section, the Department shall do all of the following:6443

       (1) In conducting the assessments, provide for both of the 6444
following:6445

       (a) The resident assessment instrument prescribed in rules 6446
authorized by division (B) of section 5111.232 of the Revised Code 6447
to be used in accordance with an inter-rater reliable process;6448

       (b) The assessments to be performed by individuals who meet 6449
the requirements to be qualified intellectual disability 6450
professionals, as specified in 42 C.F.R. 483.430(a).6451

       (2) Use the data obtained from the assessments to determine 6452
each ICF/IID's case-mix score for the first quarter of calendar 6453
year 2013;6454

       (3) For the purpose of determining each ICF/IID's fiscal year 6455
2014 Medicaid rates for direct care costs and subject to divisions 6456
(C)(8) and (E) of this section, do both of the following:6457

       (a) In determining costs per case-mix units and maximum costs 6458
per case-mix units for the purpose of division (B) of section 6459
5111.23 of the Revised Code, use each ICF/IID's case-mix score 6460
determined under division (C)(2) of this section in place of the 6461
ICF/IID's average case-mix score for calendar year 2012;6462

       (b) Instead of determining quarterly Medicaid rates for the 6463
direct care costs of each ICF/IID pursuant to division (D) of 6464
section 5111.23 of the Revised Code, determine, as follows, one 6465
Medicaid rate for the direct care costs of each ICF/IID to be paid 6466
for all of fiscal year 2014:6467

       (i) Multiply the ICF/IID's case-mix score determined under 6468
division (C)(2) of this section by the lesser of the cost per 6469
case-mix unit determined for the ICF/IID pursuant to division 6470
(C)(3)(a) of this section or the maximum cost per case-mix unit 6471
determined for the ICF/IID's peer group pursuant to division 6472
(C)(3)(a) of this section;6473

       (ii) Adjust the product determined under division 6474
(C)(3)(b)(i) of this section by the inflation rate estimated in 6475
accordance with division (B)(3) of section 5111.23 of the Revised 6476
Code.6477

       (4) For the purpose of determining each ICF/IID's fiscal year 6478
2015 Medicaid rates for direct care costs and subject to division 6479
(C)(8) of this section, use the following when determining, 6480
pursuant to the second paragraph of division (C) of section 6481
5111.232 of the Revised Code, each ICF/IID's annual average 6482
case-mix score for calendar year 2013:6483

       (a) For the first quarter of calendar year 2013, the 6484
ICF/IID's case-mix score determined under division (C)(2) of this 6485
section;6486

       (b) For the last three quarters of calendar year 2013 and 6487
except as provided in division (D) of section 5111.232 of the 6488
Revised Code, the ICF/IID's case-mix scores determined by using 6489
the data the ICF/IID provider compiles in accordance with the 6490
first paragraph of division (C) of section 5111.232 of the Revised 6491
Code.6492

       (5) Notify each ICF/IID provider that the provider is 6493
permitted but not required to compile assessment data for the 6494
first quarter of calendar year 2013 pursuant to the first 6495
paragraph of division (C) of section 5111.232 of the Revised Code;6496

       (6) After the assessments of all of an ICF/IID's residents 6497
are completed but not later than April 30, 2013, provide, or have 6498
the entity (if any) with which the Department contracts pursuant 6499
to division (B) of this section provide, the results of the 6500
assessments to the ICF/IID provider;6501

       (7) Conduct, in accordance with division (C)(8) of this 6502
section, a reconsideration for any ICF/IID provider who does both 6503
of the following:6504

       (a) Submits a written request for the reconsideration to the 6505
Department not later than fifteen days after the provider receives 6506
the assessments' results pursuant to division (C)(6) of this 6507
section;6508

       (b) Includes in the request all of the following:6509

       (i) A detailed explanation of the items in the assessments' 6510
results that the provider disputes;6511

       (ii) Copies of relevant supporting documentation from 6512
specific resident records;6513

       (iii) The provider's proposed resolution of the disputes.6514

       (8) When conducting a reconsideration required by division 6515
(C)(7) of this section, do both of the following:6516

       (a) Consider all of the following:6517

       (i) The historic results of the resident assessments 6518
performed pursuant to the first paragraph of division (C) of 6519
section 5111.232 of the Revised Code by the ICF/IID provider who 6520
requested the reconsideration;6521

       (ii) All of the materials the provider includes in the 6522
reconsideration request;6523

       (iii) All other matters the Department determines necessary 6524
for consideration.6525

       (b) Issue a written decision regarding the reconsideration 6526
not later than the sooner of the following:6527

       (i) Thirty days after the Department receives the 6528
reconsideration request;6529

       (ii) June 1, 2013.6530

       (D) The Department's decision regarding a reconsideration 6531
required by division (C)(7) of this section is final and not 6532
subject to further appeal.6533

       (E) Regardless of what an ICF/IID's case-mix score is 6534
determined to be under division (C)(2) of this section or pursuant 6535
to a reconsideration required by division (C)(7) of this section, 6536
no such case-mix score shall cause an ICF/IID's fiscal year 2014 6537
Medicaid rate for direct care costs to be less than ninety per 6538
cent of its June 30, 2013, Medicaid rate for direct care costs.6539

       (F) No ICF/IID provider shall be treated as having failed, 6540
for the first quarter of calendar year 2013, to timely submit data 6541
necessary to determine the ICF/IID's case-mix score for that 6542
quarter if the assessment is to be conducted under division (B) of 6543
this section.6544

       (G) The Department may provide for assessments to be 6545
conducted under division (B) of this section and, if it so 6546
provides, shall comply with the other divisions of this section 6547
notwithstanding anything to the contrary in sections 5111.20, 6548
5111.23, and 5111.232 of the Revised Code.6549

       Section 9. This act is hereby declared to be an emergency 6550
measure necessary for the immediate preservation of the public 6551
peace, health, and safety. The reason for such necessity is that 6552
the certain reforms included in the provisions of this act are 6553
immediately needed to ensure the efficient regulation of nursing 6554
services in this state, to create a safe environment for the youth 6555
of this state while also fulfilling the need to deliver effective 6556
addiction services to others, and to establish appropriate systems 6557
for conducting assessments of residents of facilities providing 6558
needed care to individuals in this state with intellectual 6559
disabilities. Therefore, this act shall go into immediate effect. 6560