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To amend sections 4765.11, 4765.37, and 4765.38 and | 1 |
to enact sections 2305.331, 2925.61, and 2925.611 | 2 |
of the Revised Code to provide that a licensed | 3 |
health professional authorized to prescribe | 4 |
naloxone, if acting with reasonable care, may | 5 |
prescribe, administer, dispense, or furnish | 6 |
naloxone to a person who is, or a person who is in | 7 |
a position to assist a person who is, apparently | 8 |
experiencing or who is likely to experience an | 9 |
opioid-related overdose without being subject to | 10 |
administrative action or criminal prosecution, to | 11 |
provide that a person who is in a position to | 12 |
assist a person who is apparently experiencing or | 13 |
who is likely to experience an opioid-related | 14 |
overdose is not subject to actions of professional | 15 |
licensing boards, administrative action, or | 16 |
criminal prosecution for a drug offense or | 17 |
practicing medicine without a license if the | 18 |
person, acting in good faith, obtains naloxone or | 19 |
a naloxone prescription from a licensed health | 20 |
professional and administers it to a person for an | 21 |
opioid-related overdose, and to provide that peace | 22 |
officers and licensed emergency responders who are | 23 |
acting in good faith are not subject to | 24 |
administrative action or criminal prosecution for | 25 |
a drug offense or practicing medicine without a | 26 |
license for administering naloxone to a person who | 27 |
is apparently experiencing an opioid-related | 28 |
overdose. | 29 |
Section 1. That sections 4765.11, 4765.37, and 4765.38 be | 30 |
amended and sections 2305.331, 2925.61, and 2925.611 of the | 31 |
Revised Code be enacted to read as follows: | 32 |
Sec. 2305.331. (A) As used in this section: | 33 |
(1) "Administer" means the direct application of a drug to a | 34 |
person by inhalation. | 35 |
(2) "Dispense" has the same meaning as in section 3719.01 of | 36 |
the Revised Code. | 37 |
(3) "Licensed health professional" means all of the | 38 |
following: | 39 |
(a) A physician who is authorized under Chapter 4731. of the | 40 |
Revised Code to practice medicine and surgery, osteopathic | 41 |
medicine and surgery, or podiatric medicine and surgery; | 42 |
(b) A physician assistant who holds a certificate to | 43 |
prescribe issued under Chapter 4730. of the Revised Code; | 44 |
(c) A clinical nurse specialist, certified nurse-midwife, or | 45 |
certified nurse practitioner who holds a certificate to prescribe | 46 |
issued under section 4723.48 of the Revised Code. | 47 |
(4) "Naloxone" means naloxone hydrochloride. | 48 |
(B) A licensed health professional who is authorized to | 49 |
prescribe naloxone, if acting with reasonable care, may prescribe, | 50 |
administer, dispense, or personally furnish naloxone to any of the | 51 |
following persons without being subject to administrative action | 52 |
or criminal prosecution: | 53 |
(1) A person who is apparently experiencing or who is likely | 54 |
to experience an opioid-related overdose; | 55 |
(2) A family member, friend, or other person in a position to | 56 |
assist a person who is apparently experiencing or who is likely to | 57 |
experience an opioid-related overdose. | 58 |
Sec. 2925.61. (A) As used in sections 2925.61 and 2925.611 of | 59 |
the Revised Code: | 60 |
(1) "Administer" means the direct application of naloxone to | 61 |
a person by inhalation. | 62 |
(2) "Dispense" means to personally furnish, leave with, give | 63 |
away, or deliver. | 64 |
(3) "Emergency medical technician-basic," "emergency medical | 65 |
technician-intermediate," and "emergency medical | 66 |
technician-paramedic" have the same meanings as in section 4765.01 | 67 |
of the Revised Code. | 68 |
(4) "Law enforcement agency" means an organization or entity | 69 |
made up of peace officers. | 70 |
(5) "Licensed emergency responder" means an emergency medical | 71 |
technician-basic, emergency medical technician-intermediate, or | 72 |
emergency medical technician-paramedic. | 73 |
(6) "Licensed health professional" means all of the | 74 |
following: | 75 |
(a) A physician who is authorized under Chapter 4731. of the | 76 |
Revised Code to practice medicine and surgery, osteopathic | 77 |
medicine and surgery, or podiatric medicine and surgery; | 78 |
(b) A physician assistant who holds a certificate to | 79 |
prescribe issued under Chapter 4730. of the Revised Code; | 80 |
(c) A clinical nurse specialist, certified nurse-midwife, or | 81 |
certified nurse practitioner who holds a certificate to prescribe | 82 |
issued under section 4723.48 of the Revised Code. | 83 |
(7) "Naloxone" means naloxone hydrochloride. | 84 |
(8) "Peace officer" has the same meaning as in section | 85 |
2921.51 of the Revised Code. | 86 |
(B) A family member, friend, or other person who is in a | 87 |
position to assist a person who is apparently experiencing or who | 88 |
is likely to experience an opioid-related overdose, other than a | 89 |
licensed emergency responder or peace officer who is subject to | 90 |
section 2925.611 of the Revised Code, is not subject to actions by | 91 |
professional licensing boards, administrative action, criminal | 92 |
prosecution for a violation of section 4731.41 of the Revised | 93 |
Code, or criminal prosecution under Chapter 2925. of the Revised | 94 |
Code if the person, acting in good faith, obtains naloxone from a | 95 |
licensed health professional or a prescription for naloxone from a | 96 |
licensed health professional and administers the naloxone obtained | 97 |
from the licensed health professional or acquired pursuant to the | 98 |
prescription to a person who is apparently experiencing an | 99 |
opioid-related overdose. | 100 |
Sec. 2925.611. (A) A licensed emergency responder is not | 101 |
subject to administrative action, criminal prosecution for a | 102 |
violation of section 4731.41 of the Revised Code, or criminal | 103 |
prosecution under Chapter 2925. of the Revised Code if the | 104 |
licensed emergency responder, acting in good faith, obtains | 105 |
naloxone from the licensed emergency responder's emergency medical | 106 |
service organization and administers the naloxone to a person who | 107 |
is apparently experiencing an opioid-related overdose if the | 108 |
emergency medical service organization is licensed under Chapter | 109 |
4729. of the Revised Code as a terminal distributor of dangerous | 110 |
drugs. | 111 |
(B) A peace officer is not subject to administrative action, | 112 |
criminal prosecution for a violation of section 4731.41 of the | 113 |
Revised Code, or criminal prosecution under Chapter 2925. of the | 114 |
Revised Code if the peace officer, acting in good faith, obtains | 115 |
naloxone from the peace officer's law enforcement agency and | 116 |
administers the naloxone to a person who is apparently | 117 |
experiencing an opioid-related overdose, contingent on the law | 118 |
enforcement agency being licensed under Chapter 4729. of the | 119 |
Revised Code as a limited category II terminal distributor of | 120 |
dangerous drugs. | 121 |
Sec. 4765.11. (A) The state board of emergency medical, | 122 |
fire, and transportation services shall adopt, and may amend and | 123 |
rescind, rules in accordance with Chapter 119. of the Revised Code | 124 |
and division (C) of this section that establish all of the | 125 |
following: | 126 |
(1) Procedures for its governance and the control of its | 127 |
actions and business affairs; | 128 |
(2) Standards for the performance of emergency medical | 129 |
services by first responders, emergency medical technicians-basic, | 130 |
emergency medical technicians-intermediate, and emergency medical | 131 |
technicians-paramedic; | 132 |
(3) Application fees for certificates of accreditation, | 133 |
certificates of approval, certificates to teach, and certificates | 134 |
to practice, which shall be deposited into the trauma and | 135 |
emergency medical services fund created in section 4513.263 of the | 136 |
Revised Code; | 137 |
(4) Criteria for determining when the application or renewal | 138 |
fee for a certificate to practice may be waived because an | 139 |
applicant cannot afford to pay the fee; | 140 |
(5) Procedures for issuance and renewal of certificates of | 141 |
accreditation, certificates of approval, certificates to teach, | 142 |
and certificates to practice, including any procedures necessary | 143 |
to ensure that adequate notice of renewal is provided in | 144 |
accordance with division (D) of section 4765.30 of the Revised | 145 |
Code; | 146 |
(6) Procedures for suspending or revoking certificates of | 147 |
accreditation, certificates of approval, certificates to teach, | 148 |
and certificates to practice; | 149 |
(7) Grounds for suspension or revocation of a certificate to | 150 |
practice issued under section 4765.30 of the Revised Code and for | 151 |
taking any other disciplinary action against a first responder, | 152 |
EMT-basic, EMT-I, or paramedic; | 153 |
(8) Procedures for taking disciplinary action against a first | 154 |
responder, EMT-basic, EMT-I, or paramedic; | 155 |
(9) Standards for certificates of accreditation and | 156 |
certificates of approval; | 157 |
(10) Qualifications for certificates to teach; | 158 |
(11) Requirements for a certificate to practice; | 159 |
(12) The curricula, number of hours of instruction and | 160 |
training, and instructional materials to be used in adult and | 161 |
pediatric emergency medical services training programs and adult | 162 |
and pediatric emergency medical services continuing education | 163 |
programs; | 164 |
(13) Procedures for conducting courses in recognizing | 165 |
symptoms of life-threatening allergic reactions and in calculating | 166 |
proper dosage levels and administering injections of epinephrine | 167 |
to adult and pediatric patients who suffer life-threatening | 168 |
allergic reactions; | 169 |
(14) Examinations for certificates to practice; | 170 |
(15) Procedures for administering examinations for | 171 |
certificates to practice; | 172 |
(16) Procedures for approving examinations that demonstrate | 173 |
competence to have a certificate to practice renewed without | 174 |
completing an emergency medical services continuing education | 175 |
program; | 176 |
(17) Procedures for granting extensions and exemptions of | 177 |
emergency medical services continuing education requirements; | 178 |
(18) Procedures for approving the additional emergency | 179 |
medical services first responders are authorized by division (C) | 180 |
of section 4765.35 of the Revised Code to perform, EMTs-basic are | 181 |
authorized by division (C) of section 4765.37 of the Revised Code | 182 |
to perform, EMTs-I are authorized by division (B) | 183 |
4765.38 of the Revised Code to perform, and paramedics are | 184 |
authorized by division (B)(6) of section 4765.39 of the Revised | 185 |
Code to perform; | 186 |
(19) Standards and procedures for implementing the | 187 |
requirements of section 4765.06 of the Revised Code, including | 188 |
designations of the persons who are required to report information | 189 |
to the board and the types of information to be reported; | 190 |
(20) Procedures for administering the emergency medical | 191 |
services grant program established under section 4765.07 of the | 192 |
Revised Code; | 193 |
(21) Procedures consistent with Chapter 119. of the Revised | 194 |
Code for appealing decisions of the board; | 195 |
(22) Minimum qualifications and peer review and quality | 196 |
improvement requirements for persons who provide medical direction | 197 |
to emergency medical service personnel; | 198 |
(23) The manner in which a patient, or a patient's parent, | 199 |
guardian, or custodian may consent to the board releasing | 200 |
identifying information about the patient under division (D) of | 201 |
section 4765.102 of the Revised Code; | 202 |
(24) Circumstances under which a training program or | 203 |
continuing education program, or portion of either type of | 204 |
program, may be taught by a person who does not hold a certificate | 205 |
to teach issued under section 4765.23 of the Revised Code; | 206 |
(25) Certification cycles for certificates issued under | 207 |
sections 4765.23 and 4765.30 of the Revised Code and certificates | 208 |
issued by the executive director of the state board of emergency | 209 |
medical, fire, and transportation services under section 4765.55 | 210 |
of the Revised Code that establish a common expiration date for | 211 |
all certificates. | 212 |
(B) The board may adopt, and may amend and rescind, rules in | 213 |
accordance with Chapter 119. of the Revised Code and division (C) | 214 |
of this section that establish the following: | 215 |
(1) Specifications of information that may be collected under | 216 |
the trauma system registry and incidence reporting system created | 217 |
under section 4765.06 of the Revised Code; | 218 |
(2) Standards and procedures for implementing any of the | 219 |
recommendations made by any committees of the board or under | 220 |
section 4765.04 of the Revised Code; | 221 |
(3) Requirements that a person must meet to receive a | 222 |
certificate to practice as a first responder pursuant to division | 223 |
(A)(2) of section 4765.30 of the Revised Code; | 224 |
(4) Any other rules necessary to implement this chapter. | 225 |
(C) In developing and administering rules adopted under this | 226 |
chapter, the state board of emergency medical, fire, and | 227 |
transportation services shall consult with regional directors and | 228 |
regional physician advisory boards created by section 4765.05 of | 229 |
the Revised Code and emphasize the special needs of pediatric and | 230 |
geriatric patients. | 231 |
(D) Except as otherwise provided in this division, before | 232 |
adopting, amending, or rescinding any rule under this chapter, the | 233 |
board shall submit the proposed rule to the director of public | 234 |
safety for review. The director may review the proposed rule for | 235 |
not more than sixty days after the date it is submitted. If, | 236 |
within this sixty-day period, the director approves the proposed | 237 |
rule or does not notify the board that the rule is disapproved, | 238 |
the board may adopt, amend, or rescind the rule as proposed. If, | 239 |
within this sixty-day period, the director notifies the board that | 240 |
the proposed rule is disapproved, the board shall not adopt, | 241 |
amend, or rescind the rule as proposed unless at least twelve | 242 |
members of the board vote to adopt, amend, or rescind it. | 243 |
This division does not apply to an emergency rule adopted in | 244 |
accordance with section 119.03 of the Revised Code. | 245 |
Sec. 4765.37. (A) An emergency medical technician-basic | 246 |
shall perform the emergency medical services described in this | 247 |
section in accordance with this chapter and any rules adopted | 248 |
under it by the state board of emergency medical, fire, and | 249 |
transportation services. | 250 |
(B)(1) An emergency medical technician-basic may operate, or | 251 |
be responsible for operation of, an ambulance and may provide | 252 |
emergency medical services to patients. In an emergency, an | 253 |
EMT-basic may determine the nature and extent of illness or injury | 254 |
and establish priority for required emergency medical services. An | 255 |
EMT-basic may render emergency medical services such as opening | 256 |
and maintaining an airway, giving positive pressure ventilation, | 257 |
cardiac resuscitation, electrical interventions with automated | 258 |
defibrillators to support or correct the cardiac function and | 259 |
other methods determined by the board, controlling of hemorrhage, | 260 |
treatment of shock, immobilization of fractures, bandaging, | 261 |
assisting in childbirth, management of mentally disturbed | 262 |
patients, initial care of poison and burn patients, and | 263 |
determining triage of adult and pediatric trauma victims. Where | 264 |
patients must in an emergency be extricated from entrapment, an | 265 |
EMT-basic may assess the extent of injury and render all possible | 266 |
emergency medical services and protection to the entrapped | 267 |
patient; provide light rescue services if an ambulance has not | 268 |
been accompanied by a specialized unit; and after extrication, | 269 |
provide additional care in sorting of the injured in accordance | 270 |
with standard emergency procedures. | 271 |
(2) An EMT-basic may administer naloxone hydrochloride to a | 272 |
person who is apparently experiencing an opioid-related overdose | 273 |
by direct application of the naloxone to the person by inhalation. | 274 |
(C) An EMT-basic may perform any other emergency medical | 275 |
services approved pursuant to rules adopted under section 4765.11 | 276 |
of the Revised Code. The board shall determine whether the nature | 277 |
of any such service requires that an EMT-basic receive | 278 |
authorization prior to performing the service. | 279 |
(D)(1) Except as provided in division (D) | 280 |
section, if the board determines under division (C) of this | 281 |
section that a service requires prior authorization, the service | 282 |
shall be performed only pursuant to the written or verbal | 283 |
authorization of a physician or of the cooperating physician | 284 |
advisory board, or pursuant to an authorization transmitted | 285 |
through a direct communication device by a physician, physician | 286 |
assistant designated by a physician, or registered nurse | 287 |
designated by a physician. | 288 |
(2) Except as provided in division (D)(3) of this section, an | 289 |
EMT-basic shall administer naloxone hydrochloride only pursuant to | 290 |
the written or verbal authorization of a physician or of the | 291 |
cooperating physician advisory board or pursuant to an | 292 |
authorization transmitted through a direct communication device by | 293 |
a physician, physician assistant designated by a physician, or | 294 |
registered nurse designated by a physician. | 295 |
(3) If communications fail during an emergency situation or | 296 |
the required response time prohibits communication, an EMT-basic | 297 |
may perform services subject to this division, if, in the judgment | 298 |
of the EMT-basic, the life of the patient is in immediate danger. | 299 |
Services performed under these circumstances shall be performed in | 300 |
accordance with the protocols for triage of adult and pediatric | 301 |
trauma victims established in rules adopted under sections 4765.11 | 302 |
and 4765.40 of the Revised Code and any applicable protocols | 303 |
adopted by the emergency medical service organization with which | 304 |
the EMT-basic is affiliated. | 305 |
Sec. 4765.38. (A) An emergency medical | 306 |
technician-intermediate shall perform the emergency medical | 307 |
services described in this section in accordance with this chapter | 308 |
and any rules adopted under it. | 309 |
(B) An EMT-I may do any of the following: | 310 |
(1) Establish and maintain an intravenous lifeline that has | 311 |
been approved by a cooperating physician or physician advisory | 312 |
board; | 313 |
(2) Perform cardiac monitoring; | 314 |
(3) Perform electrical interventions to support or correct | 315 |
the cardiac function; | 316 |
(4) Administer epinephrine; | 317 |
(5) Administer naloxone hydrochloride to a person who is | 318 |
apparently experiencing an opioid-related overdose by direct | 319 |
application of the naloxone to the person by inhalation; | 320 |
(6) Determine triage of adult and pediatric trauma victims; | 321 |
| 322 |
pursuant to rules adopted under section 4765.11 of the Revised | 323 |
Code. | 324 |
(C)(1) Except as provided in division (C)(2) of this section, | 325 |
the services described in division (B) of this section shall be | 326 |
performed by an EMT-I only pursuant to the written or verbal | 327 |
authorization of a physician or of the cooperating physician | 328 |
advisory board, or pursuant to an authorization transmitted | 329 |
through a direct communication device by a physician, physician | 330 |
assistant designated by a physician, or registered nurse | 331 |
designated by a physician. | 332 |
(2) If communications fail during an emergency situation or | 333 |
the required response time prohibits communication, an EMT-I may | 334 |
perform any of the services described in division (B) of this | 335 |
section, if, in the judgment of the EMT-I, the life of the patient | 336 |
is in immediate danger. Services performed under these | 337 |
circumstances shall be performed in accordance with the protocols | 338 |
for triage of adult and pediatric trauma victims established in | 339 |
rules adopted under sections 4765.11 and 4765.40 of the Revised | 340 |
Code and any applicable protocols adopted by the emergency medical | 341 |
service organization with which the EMT-I is affiliated. | 342 |
(D) In addition to, and in the course of, providing emergency | 343 |
medical treatment, an emergency medical technician-intermediate | 344 |
may withdraw blood as provided under sections 1547.11, 4506.17, | 345 |
and 4511.19 of the Revised Code. An emergency medical | 346 |
technician-intermediate shall withdraw blood in accordance with | 347 |
this chapter and any rules adopted under it by the state board of | 348 |
emergency medical, fire, and transportation services. | 349 |
Section 2. That existing sections 4765.11, 4765.37, and | 350 |
4765.38 of the Revised Code are hereby repealed. | 351 |