As Passed by the Senate

130th General Assembly
Regular Session
2013-2014
Sub. H. B. No. 165


Representative Roegner 

Cosponsors: Representatives Thompson, Wachtmann, Beck, Hood, Huffman, Scherer, Schuring, Sears Speaker Batchelder 

Senators Bacon, Eklund, LaRose, Seitz 



A BILL
To amend sections 4761.01, 4761.03, 4761.07, and 1
4761.11 of the Revised Code to exempt certified 2
hyperbaric technologists from the laws governing 3
the practice of respiratory care.4


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

       Section 1.  That sections 4761.01, 4761.03, 4761.07, and 5
4761.11 of the Revised Code be amended to read as follows:6

       Sec. 4761.01.  As used in this chapter:7

       (A) "Respiratory care" means rendering or offering to render 8
to individuals, groups, organizations, or the public any service 9
involving the evaluation of cardiopulmonary function, the 10
treatment of cardiopulmonary impairment, the assessment of 11
treatment effectiveness, and the care of patients with 12
deficiencies and abnormalities associated with the cardiopulmonary 13
system. The practice of respiratory care includes:14

       (1) Obtaining, analyzing, testing, measuring, and monitoring 15
blood and gas samples in the determination of cardiopulmonary 16
parameters and related physiologic data, including flows, 17
pressures, and volumes, and the use of equipment employed for this 18
purpose;19

       (2) Administering, monitoring, recording the results of, and 20
instructing in the use of medical gases, aerosols, and 21
bronchopulmonary hygiene techniques, including drainage, 22
aspiration, and sampling, and applying, maintaining, and 23
instructing in the use of artificial airways, ventilators, and 24
other life support equipment employed in the treatment of 25
cardiopulmonary impairment and provided in collaboration with 26
other licensed health care professionals responsible for providing 27
care;28

       (3) Performing cardiopulmonary resuscitation and respiratory 29
rehabilitation techniques;30

       (4) Administering medications for the testing or treatment of 31
cardiopulmonary impairment.32

       (B) "Respiratory care professional" means a person who is 33
licensed under this chapter to practice the full range of 34
respiratory care services as defined in division (A) of this 35
section.36

       (C) "Physician" means an individual authorized under Chapter 37
4731. of the Revised Code to practice medicine and surgery or 38
osteopathic medicine and surgery.39

       (D) "Registered nurse" means an individual licensed under 40
Chapter 4723. of the Revised Code to engage in the practice of 41
nursing as a registered nurse.42

       (E) "Hospital" means a facility that meets the operating 43
standards of section 3727.02 of the Revised Code.44

       (F) "Nursing facility" has the same meaning as in section 45
5165.01 of the Revised Code.46

       (G) "Certified hyperbaric technologist" means a person who 47
administers hyperbaric oxygen therapy and is certified as a 48
hyperbaric technologist by the national board of diving and 49
hyperbaric medical technology or its successor organization.50

       (H) "Hyperbaric oxygen therapy" means the administration of 51
pure oxygen in a pressurized room or chamber, except that it does 52
not include ventilator management.53

       (I) "Advanced practice registered nurse" has the same meaning 54
as in section 4723.01 of the Revised Code.55

       (J) "Physician assistant" means an individual who holds a 56
valid certificate to practice issued under Chapter 4730. of the 57
Revised Code authorizing the individual to provide services as a 58
physician assistant to patients under the supervision, control, 59
and direction of one or more physicians.60

       Sec. 4761.03.  The Ohio respiratory care board shall regulate 61
the practice of respiratory care in this state and the persons to 62
whom the board issues licenses and limited permits under this 63
chapter and shall license and register home medical equipment 64
services providers under Chapter 4752. of the Revised Code. Rules 65
adopted under this chapter that deal with the provision of 66
respiratory care in a hospital, other than rules regulating the 67
issuance of licenses or limited permits, shall be consistent with 68
the conditions for participation under medicare, Title XVIII of 69
the "Social Security Act," 79 Stat. 286 (1965), 42 U.S.C.A. 1395, 70
as amended, and with the respiratory care accreditation standards 71
of the joint commission on accreditation of healthcare 72
organizations or the American osteopathic association.73

       The board shall:74

       (A) Adopt, and may rescind or amend, rules in accordance with 75
Chapter 119. of the Revised Code to carry out the purposes of this 76
chapter, including rules prescribing:77

       (1) The form and manner for filing applications for licensure 78
and renewal, limited permits, and limited permit extensions under 79
sections 4761.05 and 4761.06 of the Revised Code;80

       (2) The form, scoring, and scheduling of examinations and 81
reexaminations for licensure and license renewal;82

       (3) Standards for the approval of educational programs 83
required to qualify for licensure and continuing education 84
programs required for license renewal;85

       (4) Continuing education courses and the number of hour 86
requirements necessary for license renewal, in accordance with 87
section 4761.06 of the Revised Code;88

       (5) Procedures for the issuance and renewal of licenses and 89
limited permits, including the duties that may be fulfilled by the 90
board's executive director and other board employees;91

       (6) Procedures for the denial, suspension, permanent 92
revocation, refusal to renew, and reinstatement of licenses and 93
limited permits, the conduct of hearings, and the imposition of 94
fines for engaging in conduct that is grounds for such action and 95
hearings under section 4761.09 of the Revised Code;96

       (7) Standards of ethical conduct for the practice of 97
respiratory care;98

       (8) Conditions under which the license renewal fee and 99
continuing education requirements may be waived at the request of 100
a licensee who is not in active practice;101

       (9) The respiratory care tasks that may be performed by an 102
individual practicing as a polysomnographic technologist pursuant 103
to division (B)(3) of section 4761.10 of the Revised Code;104

       (10) Procedures for registering out-of-state respiratory care 105
providers authorized to practice in this state under division 106
(A)(4) of section 4761.11 of the Revised Code;107

       (11) Requirements for criminal records checks of applicants 108
under section 4776.03 of the Revised Code;109

       (12) Procedures for accepting and storing copies of 110
hyperbaric technologist certifications filed with the board 111
pursuant to division (A)(11) of section 4761.11 of the Revised 112
Code.113

       (B) Determine the sufficiency of an applicant's 114
qualifications for admission to the licensing examination or a 115
reexamination, and for the issuance or renewal of a license or 116
limited permit;117

       (C) Determine the respiratory care educational programs that 118
are acceptable for fulfilling the requirements of division (A) of 119
section 4761.04 of the Revised Code;120

       (D) Schedule, administer, and score the licensing examination 121
or any reexamination for license renewal or reinstatement. The 122
board shall administer the licensing examinations at least twice a 123
year and notify applicants of the time and place of the 124
examinations.125

       (E) Investigate complaints concerning alleged violations of 126
section 4761.10 of the Revised Code or grounds for the suspension, 127
permanent revocation, or refusal to issue licenses or limited 128
permits under section 3123.47 or 4761.09 of the Revised Code. The 129
board shall employ investigators who shall, under the direction of 130
the executive director of the board, investigate complaints and 131
make inspections and other inquiries as, in the judgment of the 132
board, are appropriate to enforce sections 3123.41 to 3123.50, 133
4761.09, and 4761.10 of the Revised Code. Pursuant to an 134
investigation and inspection, the investigators may review and 135
audit records during normal business hours at the place of 136
business of a licensee or person who is the subject of a complaint 137
filed with the board or at any place where the records are kept.138

       Except when required by court order, the board and its 139
employees shall not disclose confidential information obtained 140
during an investigation or identifying information about any 141
person who files a complaint with the board.142

       The board may hear testimony in matters relating to the 143
duties imposed upon it and issue subpoenas pursuant to an 144
investigation. The president and secretary of the board may 145
administer oaths.146

       (F) Conduct hearings, keep records of its proceedings, and do 147
other things as are necessary and proper to carry out and enforce 148
the provisions of this chapter;149

       (G) Maintain, publish, and make available upon request, for a 150
fee not to exceed the actual cost of printing and mailing:151

       (1) The requirements for the issuance of licenses and limited 152
permits under this chapter and rules adopted by the board;153

       (2) A current register of every person licensed to practice 154
respiratory care in this state, to include the addresses of the 155
person's last known place of business and residence, the effective 156
date and identification number of the license, the name and 157
location of the institution that granted the person's degree or 158
certificate of completion of respiratory care educational 159
requirements, and the date the degree or certificate was issued;160

       (3) A list of the names and locations of the institutions 161
that each year granted degrees or certificates of completion in 162
respiratory care;163

       (4) After the administration of each examination, a list of 164
persons who passed the examination.165

       (H) Submit to the governor and to the general assembly each 166
year a report of all of its official actions during the preceding 167
year, together with any findings and recommendations with regard 168
to the improvement of the profession of respiratory care;169

       (I) Administer and enforce Chapter 4752. of the Revised Code.170

       Sec. 4761.07.  (A) The Ohio respiratory care board shall 171
charge any license applicant or holder who is to take an 172
examination required under division (A)(3) of section 4761.04 or a 173
reexamination required under division (B) of section 4761.06 of 174
the Revised Code for license renewal or under section 4761.09 of 175
the Revised Code for license reinstatement, a nonrefundable 176
examination fee, not to exceed the amount necessary to cover the 177
expense of administering the examination. The license applicant or 178
holder shall pay the fee at the time of application for licensure 179
or renewal.180

       (B) The board shall establish the following additional 181
nonrefundable fees and penalty:182

       (1) An initial license fee, not to exceed seventy-five 183
dollars;184

       (2) A biennial license renewal fee, not to exceed one hundred 185
dollars;186

       (3) A limited permit fee, not to exceed twenty dollars;187

       (4) A limited permit renewal fee, not to exceed ten dollars;188

       (5) A late renewal penalty, not to exceed fifty per cent of 189
the renewal fee;190

       (6) A fee for accepting and storing hyperbaric technologist 191
certifications filed with the board under division (A)(11) of 192
section 4761.11 of the Revised Code, not to exceed twenty dollars.193

       (C) Notwithstanding division (B)(4) of this section, after 194
the third renewal of a limited permit that meets the exception in 195
division (B)(3) of section 4761.05 of the Revised Code, the 196
limited permit renewal fee shall be one-half the amount of the 197
biennial license renewal fee established under division (B)(2) of 198
this section and section 4761.08 of the Revised Code.199

       (D) The board shall adjust the fees biennially and within the 200
limits established by division (B) of this section to provide 201
sufficient revenues to meet its expenses.202

       (E) The board may, by rule, provide for the waiver of all or 203
part of a license fee when the license is issued less than 204
eighteen months before its expiration date.205

       (F) All fees received by the board shall be deposited into 206
the state treasury to the credit of the occupational licensing and 207
regulatory fund.208

       Sec. 4761.11.  (A) Nothing in this chapter shall be construed 209
to prevent or restrict the practice, services, or activities of 210
any person who:211

       (1) Is a health care professional licensed by this state 212
providing respiratory care services included in the scope of 213
practice established by the license held, as long as the person 214
does not represent that the person is engaged in the practice of 215
respiratory care;216

       (2) Is employed as a respiratory care professional by an 217
agency of the United States government and provides respiratory 218
care solely under the direction or control of the employing 219
agency;220

       (3) Is a student enrolled in a board-approved respiratory 221
care education program leading to a certificate of completion in 222
respiratory care and is performing duties that are part of a 223
supervised course of study;224

       (4) Is a nonresident of this state practicing or offering to 225
practice respiratory care, if the respiratory care services are 226
offered for not more than thirty days in a year, services are 227
provided under the supervision of a respiratory care professional 228
licensed under this chapter, and the nonresident registers with 229
the board in accordance with rules adopted by the board under 230
section 4761.03 of the Revised Code and meets either of the 231
following requirements:232

       (a) Qualifies for licensure under this chapter, except for 233
passage of the examination required under division (A)(3) of 234
section 4761.04 of the Revised Code;235

       (b) Holds a valid license issued by a state that has 236
licensure requirements considered by the board to be comparable to 237
those of this state and has not been issued a license in another 238
state that has been revoked or is currently under suspension or on 239
probation.240

       (5) Provides respiratory care only to relatives or in medical 241
emergencies;242

       (6) Provides gratuitous care to friends or personal family 243
members;244

       (7) Provides only self care;245

       (8) Is employed in the office of a physician and renders 246
medical assistance under the physician's direct supervision 247
without representing that the person is engaged in the practice of 248
respiratory care;249

       (9) Is employed in a clinical chemistry or arterial blood gas 250
laboratory and is supervised by a physician without representing 251
that the person is engaged in the practice of respiratory care;252

       (10) Is engaged in the practice of respiratory care as an 253
employee of a person or governmental entity located in another 254
state and provides respiratory care services for less than 255
seventy-two hours to patients being transported into, out of, or 256
through this state;257

       (11) Is employed as a certified hyperbaric technologist, has 258
filed with the board a copy of the person's current certification 259
as a hyperbaric technologist in accordance with the rules adopted 260
by the board under section 4761.03 of the Revised Code, has paid 261
the fee established pursuant to section 4761.07 of the Revised 262
Code, and administers hyperbaric oxygen therapy under the direct 263
supervision of a physician, a physician assistant, or an advanced 264
practice registered nurse and without representing that the person 265
is engaged in the practice of respiratory care.266

       (B) Nothing in this chapter shall be construed to prevent any 267
person from advertising, describing, or offering to provide 268
respiratory care or billing for respiratory care when the 269
respiratory care services are provided by a health care 270
professional licensed by this state practicing within the scope of 271
practice established by the license held. Nothing in this chapter 272
shall be construed to prevent a hospital or nursing facility from 273
advertising, describing, or offering to provide respiratory care, 274
or billing for respiratory care rendered by a person licensed 275
under this chapter or persons who may provide limited aspects of 276
respiratory care or respiratory care tasks pursuant to division 277
(B) of section 4761.10 of the Revised Code.278

       (C) Notwithstanding division (A) of section 4761.10 of the 279
Revised Code, in a life-threatening situation, in the absence of 280
licensed personnel, unlicensed persons shall not be prohibited 281
from taking life-saving measures.282

       (D) Nothing in this chapter shall be construed as authorizing 283
a respiratory care professional to practice medicine and surgery 284
or osteopathic medicine and surgery. This division does not 285
prohibit a respiratory care professional from administering 286
topical or intradermal medications for the purpose of producing 287
localized decreased sensation as part of a procedure or task that 288
is within the scope of practice of a respiratory care 289
professional.290

       Section 2.  That existing sections 4761.01, 4761.03, 4761.07, 291
and 4761.11 of the Revised Code are hereby repealed.292