As Introduced

130th General Assembly Regular Session 2013-2014

H. B. No. 170

Representatives Johnson, Stinziano 

Cosponsors: Representatives Amstutz, Antonio, Gonzales, Grossman, Letson, Lynch, Maag, Milkovich, Phillips, Reece, Rogers, Sprague, Stebelton, Ramos 

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A BILL

To amend sections 4765.11, 4765.37, and 4765.38 and

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to enact sections 2305.331, 2925.61, and 2925.611

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of the Revised Code to provide that a licensed

3

health professional authorized to prescribe

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naloxone, if acting with reasonable care, may

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prescribe, administer, dispense, or furnish

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naloxone to a person who is, or a person who is in

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a position to assist a person who is, apparently

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experiencing or who is likely to experience an

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opioid-related overdose without being subject to

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administrative action or criminal prosecution, to

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provide that a person who is in a position to

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assist a person who is apparently experiencing or

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who is likely to experience an opioid-related

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overdose is not subject to actions of professional

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licensing boards, administrative action, or

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criminal prosecution for a drug offense or

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practicing medicine without a license if the

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person, acting in good faith, obtains naloxone or

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a naloxone prescription from a licensed health

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professional and administers it to a person for an

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opioid-related overdose, and to provide that peace

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officers and licensed emergency responders who are

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acting in good faith are not subject to

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administrative action or criminal prosecution for

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a drug offense or practicing medicine without a

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license for administering naloxone to a person who

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is apparently experiencing an opioid-related

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overdose.

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

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;

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(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)(5)(7) of section	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)(2)(3) of this	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

(6)(7) Perform any other emergency medical services approved	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