As Passed by the House

130th General Assembly Regular Session 2013-2014

Sub. H. B. No. 314

Representatives Baker, Kunze 

Cosponsors: Representatives Hagan, C., Landis, Antonio, Sprague, Boose, Smith, Stebelton, Hood, Green, Sears, Driehaus, Patterson, O'Brien, Becker, Wachtmann, Hill, Schuring, Amstutz, Beck, Blair, Brown, Buchy, Burkley, Derickson, Dovilla, Hayes, Henne, Lynch, McClain, Pelanda, Perales, Pillich, Rosenberger, Ruhl, Sheehy, Slaby, Strahorn, Terhar, Thompson, Young Speaker Batchelder 

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A BILL

To amend sections 4715.30, 4723.481, and 4730.41 and

1

to enact sections 3719.061, 4723.283, 4725.191,

2

4730.252, and 4731.229 of the Revised Code to

3

require a prescriber to obtain written informed

4

consent from a minor's parent, guardian, or other

5

person responsible for the minor before issuing a

6

prescription for a controlled substance that

7

contains an opioid to the minor and to establish

8

sanctions for a prescriber's violation of this

9

requirement.

10

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

Section 1. That sections 4715.30, 4723.481, and 4730.41 be	11
amended and sections 3719.061, 4723.283, 4725.191, 4730.252, and	12
4731.229 of the Revised Code be enacted to read as follows:	13

Sec. 3719.061.  (A)(1) As used in this section:

14

(a) "Medical emergency" means a situation that in a	15
prescriber's good faith medical judgment creates an immediate	16
threat of serious risk to the life or physical health of a minor.	17

(b) "Minor" means a person under eighteen years of age who is	18
not emancipated.	19

(2) For the purposes of this section, a person under eighteen	20
years of age is emancipated only if the person has married,	21
entered the armed services of the United States, became employed	22
and self-sustaining, or has otherwise become independent from the	23
care and control of the person's parent, guardian, or custodian.	24

(B) Except as provided in division (C) of this section,	25
before issuing for a minor the first prescription in a single	26
course of treatment for a particular compound that is a controlled	27
substance that contains an opioid, regardless of whether the	28
dosage is modified during that course of treatment, a prescriber	29
shall do all of the following:	30

(1) As part of the prescriber's examination of the minor,	31
assess whether the minor has ever suffered, or is currently	32
suffering, from mental health or substance abuse disorders and	33
whether the minor has taken or is currently taking prescription	34
drugs for treatment of those disorders;	35

(2) Discuss with the minor and the minor's parent, guardian,	36
or other person responsible for the minor all of the following:	37

(a) The risks of addiction and overdose associated with the	38
compound;	39

(b) The increased risk of addiction to controlled substances	40
of individuals suffering from both mental and substance abuse	41
disorders;	42

(c) The dangers of taking controlled substances containing	43
opioids with benzodiazepines, alcohol, or other central nervous	44
system depressants;	45

(d) Any other information in the patient counseling	46
information section of labeling for the compound required under 21	47
C.F.R. 201.57(c)(18).	48

(3) Obtain written consent for the prescription from the	49
minor's parent, guardian, or other person responsible for the	50
minor.	51

The prescriber shall record the consent on a form, separate	52
from any other document the prescriber uses to obtain informed	53
consent for other treatment provided to the minor, that contains	54
all of the following:	55

(a) The name and quantity of the compound being prescribed	56
and the amount of the initial dose;	57

(b) A statement indicating that a controlled substance is a	58
drug or other substance that the United States drug enforcement	59
agency has identified as having a potential for abuse;	60

(c) A statement certifying that the prescriber discussed with	61
the minor and the minor's parent, guardian, or other person	62
responsible for the minor the matters described in division (B)(2)	63
of this section;	64

(d) The number of refills authorized by the prescription;

65

(e) The signature of the minor's parent, guardian, or other	66
person responsible for the minor and the date of signing.	67

(C)(1) The requirements in division (B) of this section do	68
not apply if the minor's treatment with a controlled substance	69
that contains an opioid meets any of the following criteria:	70

(a) The treatment is associated with or incident to a medical	71
emergency.	72

(b) The treatment is associated with or incident to surgery,	73
regardless of whether the surgery is performed on an inpatient or	74
outpatient basis.	75

(c) In the prescriber's professional judgment, fulfilling the	76
requirements of division (B) of this section with respect to the	77
minor's treatment would be a detriment to the minor's health or	78
safety.	79

(d) Except as provided in division (C)(2) of this section,	80
the treatment is rendered in a hospital, ambulatory surgical	81
facility, nursing home, pediatric respite care program,	82
residential care facility, freestanding rehabilitation facility,	83
or similar institutional facility.	84

(2) The exemption in division (C)(1)(d) of this section does	85
not apply to treatment rendered in a prescriber's office that is	86
located on the premises of or adjacent to a facility or other	87
location described in that division.	88

(D) If the exemption in division (C)(1)(c) of this section	89
applies, the prescriber shall notify the appropriate public	90
children services agency of the circumstances precipitating the	91
prescriber's professional judgment to invoke this exemption.	92

(E) The signed consent form shall be maintained in the	93
minor's medical record.	94

Sec. 4715.30.  (A) An applicant for or holder of a	95
certificate or license issued under this chapter is subject to	96
disciplinary action by the state dental board for any of the	97
following reasons:	98

(1) Employing or cooperating in fraud or material deception	99
in applying for or obtaining a license or certificate;	100

(2) Obtaining or attempting to obtain money or anything of	101
value by intentional misrepresentation or material deception in	102
the course of practice;	103

(3) Advertising services in a false or misleading manner or	104
violating the board's rules governing time, place, and manner of	105
advertising;	106

(4) Commission of an act that constitutes a felony in this	107
state, regardless of the jurisdiction in which the act was	108
committed;	109

(5) Commission of an act in the course of practice that	110
constitutes a misdemeanor in this state, regardless of the	111
jurisdiction in which the act was committed;	112

(6) Conviction of, a plea of guilty to, a judicial finding of	113
guilt of, a judicial finding of guilt resulting from a plea of no	114
contest to, or a judicial finding of eligibility for intervention	115
in lieu of conviction for, any felony or of a misdemeanor	116
committed in the course of practice;	117

(7) Engaging in lewd or immoral conduct in connection with	118
the provision of dental services;	119

(8) Selling, prescribing, giving away, or administering drugs	120
for other than legal and legitimate therapeutic purposes, or	121
conviction of, a plea of guilty to, a judicial finding of guilt	122
of, a judicial finding of guilt resulting from a plea of no	123
contest to, or a judicial finding of eligibility for intervention	124
in lieu of conviction for, a violation of any federal or state law	125
regulating the possession, distribution, or use of any drug;	126

(9) Providing or allowing dental hygienists, expanded	127
function dental auxiliaries, or other practitioners of auxiliary	128
dental occupations working under the certificate or license	129
holder's supervision, or a dentist holding a temporary limited	130
continuing education license under division (C) of section 4715.16	131
of the Revised Code working under the certificate or license	132
holder's direct supervision, to provide dental care that departs	133
from or fails to conform to accepted standards for the profession,	134
whether or not injury to a patient results;	135

(10) Inability to practice under accepted standards of the	136
profession because of physical or mental disability, dependence on	137
alcohol or other drugs, or excessive use of alcohol or other	138
drugs;	139

(11) Violation of any provision of this chapter or any rule	140
adopted thereunder;	141

(12) Failure to use universal blood and body fluid	142
precautions established by rules adopted under section 4715.03 of	143
the Revised Code;	144

(13) Except as provided in division (H) of this section,	145
either of the following:	146

(a) Waiving the payment of all or any part of a deductible or	147
copayment that a patient, pursuant to a health insurance or health	148
care policy, contract, or plan that covers dental services, would	149
otherwise be required to pay if the waiver is used as an	150
enticement to a patient or group of patients to receive health	151
care services from that certificate or license holder;	152

(b) Advertising that the certificate or license holder will	153
waive the payment of all or any part of a deductible or copayment	154
that a patient, pursuant to a health insurance or health care	155
policy, contract, or plan that covers dental services, would	156
otherwise be required to pay.	157

(14) Failure to comply with section 4729.79 of the Revised	158
Code, unless the state board of pharmacy no longer maintains a	159
drug database pursuant to section 4729.75 of the Revised Code;	160

(15) Any of the following actions taken by an agency	161
responsible for authorizing, certifying, or regulating an	162
individual to practice a health care occupation or provide health	163
care services in this state or another jurisdiction, for any	164
reason other than the nonpayment of fees: the limitation,	165
revocation, or suspension of an individual's license to practice;	166
acceptance of an individual's license surrender; denial of a	167
license; refusal to renew or reinstate a license; imposition of	168
probation; or issuance of an order of censure or other reprimand;	169

(16) Failure to cooperate in an investigation conducted by	170
the board under division (D) of section 4715.03 of the Revised	171
Code, including failure to comply with a subpoena or order issued	172
by the board or failure to answer truthfully a question presented	173
by the board at a deposition or in written interrogatories, except	174
that failure to cooperate with an investigation shall not	175
constitute grounds for discipline under this section if a court of	176
competent jurisdiction has issued an order that either quashes a	177
subpoena or permits the individual to withhold the testimony or	178
evidence in issue;	179

(17) Violation of section 3719.061 of the Revised Code.

180

(B) A manager, proprietor, operator, or conductor of a dental	181
facility shall be subject to disciplinary action if any dentist,	182
dental hygienist, expanded function dental auxiliary, or qualified	183
personnel providing services in the facility is found to have	184
committed a violation listed in division (A) of this section and	185
the manager, proprietor, operator, or conductor knew of the	186
violation and permitted it to occur on a recurring basis.	187

(C)(1) Subject to Chapter 119. of the Revised Code, the board	188
may take one or more of the following disciplinary actions if one	189
or more of the grounds for discipline listed in divisions (A)(1)	190
to (16) and (B) of this section exist:	191

(1)(a) Censure the license or certificate holder;

192

(2)(b) Place the license or certificate on probationary	193
status for such period of time the board determines necessary and	194
require the holder to:	195

(a)(i) Report regularly to the board upon the matters which	196
are the basis of probation;	197

(b)(ii) Limit practice to those areas specified by the board;

198

(c)(iii) Continue or renew professional education until a	199
satisfactory degree of knowledge or clinical competency has been	200
attained in specified areas.	201

(3)(c) Suspend the certificate or license;

202

(4)(d) Revoke the certificate or license.

203

(2) For the initial violation of section 3719.061 of the	204
Revised Code by a dentist, the board may impose a fine not to	205
exceed twenty thousand dollars. For each subsequent violation of	206
that section, the board may impose an additional fine not to	207
exceed twenty thousand dollars, suspend for not less than six	208
months the license of the dentist, or both.	209

Disciplinary action under this section shall be taken	210
pursuant to an adjudication conducted under Chapter 119. of the	211
Revised Code.	212

Where the board places a holder of a license or certificate	213
on probationary status pursuant to division (C)(2)(1)(b) of this	214
section, the board may subsequently suspend or revoke the license	215
or certificate if it determines that the holder has not met the	216
requirements of the probation or continues to engage in activities	217
that constitute grounds for discipline pursuant to division (A) or	218
(B) of this section.	219

Any order suspending a license or certificate for grounds for	220
discipline listed in divisions (A)(1) to (16) of this section	221
shall state the conditions under which the license or certificate	222
will be restored, which may include a conditional restoration	223
during which time the holder is in a probationary status pursuant	224
to division (C)(2)(1)(b) of this section. The board shall restore	225
the license or certificate unconditionally when such conditions	226
are met.	227

(D) If the physical or mental condition of an applicant or a	228
license or certificate holder is at issue in a disciplinary	229
proceeding, the board may order the license or certificate holder	230
to submit to reasonable examinations by an individual designated	231
or approved by the board and at the board's expense. The physical	232
examination may be conducted by any individual authorized by the	233
Revised Code to do so, including a physician assistant, a clinical	234
nurse specialist, a certified nurse practitioner, or a certified	235
nurse-midwife. Any written documentation of the physical	236
examination shall be completed by the individual who conducted the	237
examination.	238

Failure to comply with an order for an examination shall be	239
grounds for refusal of a license or certificate or summary	240
suspension of a license or certificate under division (E) of this	241
section.	242

(E) If a license or certificate holder has failed to comply	243
with an order under division (D) of this section, the board may	244
apply to the court of common pleas of the county in which the	245
holder resides for an order temporarily suspending the holder's	246
license or certificate, without a prior hearing being afforded by	247
the board, until the board conducts an adjudication hearing	248
pursuant to Chapter 119. of the Revised Code. If the court	249
temporarily suspends a holder's license or certificate, the board	250
shall give written notice of the suspension personally or by	251
certified mail to the license or certificate holder. Such notice	252
shall inform the license or certificate holder of the right to a	253
hearing pursuant to Chapter 119. of the Revised Code.	254

(F) Any holder of a certificate or license issued under this	255
chapter who has pleaded guilty to, has been convicted of, or has	256
had a judicial finding of eligibility for intervention in lieu of	257
conviction entered against the holder in this state for aggravated	258
murder, murder, voluntary manslaughter, felonious assault,	259
kidnapping, rape, sexual battery, gross sexual imposition,	260
aggravated arson, aggravated robbery, or aggravated burglary, or	261
who has pleaded guilty to, has been convicted of, or has had a	262
judicial finding of eligibility for treatment or intervention in	263
lieu of conviction entered against the holder in another	264
jurisdiction for any substantially equivalent criminal offense, is	265
automatically suspended from practice under this chapter in this	266
state and any certificate or license issued to the holder under	267
this chapter is automatically suspended, as of the date of the	268
guilty plea, conviction, or judicial finding, whether the	269
proceedings are brought in this state or another jurisdiction.	270
Continued practice by an individual after the suspension of the	271
individual's certificate or license under this division shall be	272
considered practicing without a certificate or license. The board	273
shall notify the suspended individual of the suspension of the	274
individual's certificate or license under this division by	275
certified mail or in person in accordance with section 119.07 of	276
the Revised Code. If an individual whose certificate or license is	277
suspended under this division fails to make a timely request for	278
an adjudicatory hearing, the board shall enter a final order	279
revoking the individual's certificate or license.	280

(G) If the supervisory investigative panel determines both of	281
the following, the panel may recommend that the board suspend an	282
individual's certificate or license without a prior hearing:	283

(1) That there is clear and convincing evidence that an	284
individual has violated divisiondivisions (A)(1) to (16) of this	285
section;	286

(2) That the individual's continued practice presents a	287
danger of immediate and serious harm to the public.	288

Written allegations shall be prepared for consideration by	289
the board. The board, upon review of those allegations and by an	290
affirmative vote of not fewer than four dentist members of the	291
board and seven of its members in total, excluding any member on	292
the supervisory investigative panel, may suspend a certificate or	293
license without a prior hearing. A telephone conference call may	294
be utilized for reviewing the allegations and taking the vote on	295
the summary suspension.	296

The board shall issue a written order of suspension by	297
certified mail or in person in accordance with section 119.07 of	298
the Revised Code. The order shall not be subject to suspension by	299
the court during pendency or any appeal filed under section 119.12	300
of the Revised Code. If the individual subject to the summary	301
suspension requests an adjudicatory hearing by the board, the date	302
set for the hearing shall be within fifteen days, but not earlier	303
than seven days, after the individual requests the hearing, unless	304
otherwise agreed to by both the board and the individual.	305

Any summary suspension imposed under this division shall	306
remain in effect, unless reversed on appeal, until a final	307
adjudicative order issued by the board pursuant to this section	308
and Chapter 119. of the Revised Code becomes effective. The board	309
shall issue its final adjudicative order within seventy-five days	310
after completion of its hearing. A failure to issue the order	311
within seventy-five days shall result in dissolution of the	312
summary suspension order but shall not invalidate any subsequent,	313
final adjudicative order.	314

(H) Sanctions shall not be imposed under division (A)(13) of	315
this section against any certificate or license holder who waives	316
deductibles and copayments as follows:	317

(1) In compliance with the health benefit plan that expressly	318
allows such a practice. Waiver of the deductibles or copayments	319
shall be made only with the full knowledge and consent of the plan	320
purchaser, payer, and third-party administrator. Documentation of	321
the consent shall be made available to the board upon request.	322

(2) For professional services rendered to any other person	323
who holds a certificate or license issued pursuant to this chapter	324
to the extent allowed by this chapter and the rules of the board.	325

(I) In no event shall the board consider or raise during a	326
hearing required by Chapter 119. of the Revised Code the	327
circumstances of, or the fact that the board has received, one or	328
more complaints about a person unless the one or more complaints	329
are the subject of the hearing or resulted in the board taking an	330
action authorized by this section against the person on a prior	331
occasion.	332

(J) The board may share any information it receives pursuant	333
to an investigation under division (D) of section 4715.03 of the	334
Revised Code, including patient records and patient record	335
information, with law enforcement agencies, other licensing	336
boards, and other governmental agencies that are prosecuting,	337
adjudicating, or investigating alleged violations of statutes or	338
administrative rules. An agency or board that receives the	339
information shall comply with the same requirements regarding	340
confidentiality as those with which the state dental board must	341
comply, notwithstanding any conflicting provision of the Revised	342
Code or procedure of the agency or board that applies when it is	343
dealing with other information in its possession. In a judicial	344
proceeding, the information may be admitted into evidence only in	345
accordance with the Rules of Evidence, but the court shall require	346
that appropriate measures are taken to ensure that confidentiality	347
is maintained with respect to any part of the information that	348
contains names or other identifying information about patients or	349
complainants whose confidentiality was protected by the state	350
dental board when the information was in the board's possession.	351
Measures to ensure confidentiality that may be taken by the court	352
include sealing its records or deleting specific information from	353
its records.	354

Sec. 4723.283. (A) For the initial violation of section	355
3719.061 of the Revised Code by a clinical nurse specialist,	356
certified nurse-midwife, or certified nurse practitioner, the	357
board of nursing, by a vote of a quorum, may impose a fine not to	358
exceed twenty thousand dollars. For each subsequent violation of	359
that section, the board, by a vote of a quorum, may impose an	360
additional fine not to exceed twenty thousand dollars; suspend for	361
not less than six months the nurse's license to practice as a	362
registered nurse, certificate of authority, and certificate to	363
prescribe; or both.	364

(B) Disciplinary action under this section shall be taken	365
pursuant to an adjudication conducted under Chapter 119. of the	366
Revised Code.	367

When investigating or conducting a hearing on an alleged	368
violation of section 3719.061 of the Revised Code, the board may	369
take any action it is authorized to take under division (D), (F),	370
or (G) of section 4723.28 of the Revised Code.	371

Sec. 4723.481.  This section establishes standards and	372
conditions regarding the authority of a clinical nurse specialist,	373
certified nurse-midwife, or certified nurse practitioner to	374
prescribe drugs and therapeutic devices under a certificate to	375
prescribe issued under section 4723.48 of the Revised Code.	376

(A) A clinical nurse specialist, certified nurse-midwife, or	377
certified nurse practitioner shall not prescribe any drug or	378
therapeutic device that is not included in the types of drugs and	379
devices listed on the formulary established in rules adopted under	380
section 4723.50 of the Revised Code.	381

(B) The prescriptive authority of a clinical nurse	382
specialist, certified nurse-midwife, or certified nurse	383
practitioner shall not exceed the prescriptive authority of the	384
collaborating physician or podiatrist, including the collaborating	385
physician's authority to treat chronic pain with controlled	386
substances and products containing tramadol as described in	387
section 4731.052 of the Revised Code.	388

(C)(1) Except as provided in division (C)(2) or (3) of this	389
section, a clinical nurse specialist, certified nurse-midwife, or	390
certified nurse practitioner may prescribe to a patient a schedule	391
II controlled substance only if all of the following are the case:	392

(a) The patient has a terminal condition, as defined in	393
section 2133.01 of the Revised Code.	394

(b) The collaborating physician of the clinical nurse	395
specialist, certified nurse-midwife, or certified nurse	396
practitioner initially prescribed the substance for the patient.	397

(c) The prescription is for an amount that does not exceed	398
the amount necessary for the patient's use in a single,	399
twenty-four-hour period.	400

(2) The restrictions on prescriptive authority in division	401
(C)(1) of this section do not apply if a clinical nurse	402
specialist, certified nurse-midwife, or certified nurse	403
practitioner issues the prescription to the patient from any of	404
the following locations:	405

(a) A hospital registered under section 3701.07 of the	406
Revised Code;	407

(b) An entity owned or controlled, in whole or in part, by a	408
hospital or by an entity that owns or controls, in whole or in	409
part, one or more hospitals;	410

(c) A health care facility operated by the department of	411
mental health and addiction services or the department of	412
developmental disabilities;	413

(d) A nursing home licensed under section 3721.02 of the	414
Revised Code or by a political subdivision certified under section	415
3721.09 of the Revised Code;	416

(e) A county home or district home operated under Chapter	417
5155. of the Revised Code that is certified under the medicare or	418
medicaid program;	419

(f) A hospice care program, as defined in section 3712.01 of	420
the Revised Code;	421

(g) A community mental health services provider, as defined	422
in section 5122.01 of the Revised Code;	423

(h) An ambulatory surgical facility, as defined in section	424
3702.30 of the Revised Code;	425

(i) A freestanding birthing center, as defined in section	426
3702.141 of the Revised Code;	427

(j) A federally qualified health center, as defined in	428
section 3701.047 of the Revised Code;	429

(k) A federally qualified health center look-alike, as	430
defined in section 3701.047 of the Revised Code;	431

(l) A health care office or facility operated by the board of	432
health of a city or general health district or the authority	433
having the duties of a board of health under section 3709.05 of	434
the Revised Code;	435

(m) A site where a medical practice is operated, but only if	436
the practice is comprised of one or more physicians who also are	437
owners of the practice; the practice is organized to provide	438
direct patient care; and the clinical nurse specialist, certified	439
nurse-midwife, or certified nurse practitioner providing services	440
at the site has a standard care arrangement and collaborates with	441
at least one of the physician owners who practices primarily at	442
that site.	443

(3) A clinical nurse specialist, certified nurse-midwife, or	444
certified nurse practitioner shall not issue to a patient a	445
prescription for a schedule II controlled substance from a	446
convenience care clinic even if the clinic is owned or operated by	447
an entity specified in division (C)(2) of this section.	448

(D) A pharmacist who acts in good faith reliance on a	449
prescription issued by a clinical nurse specialist, certified	450
nurse-midwife, or certified nurse practitioner under division	451
(C)(2) of this section is not liable for or subject to any of the	452
following for relying on the prescription: damages in any civil	453
action, prosecution in any criminal proceeding, or professional	454
disciplinary action by the state board of pharmacy under Chapter	455
4729. of the Revised Code.	456

(E) A clinical nurse specialist, certified nurse-midwife, or	457
certified nurse practitioner may personally furnish to a patient a	458
sample of any drug or therapeutic device included in the types of	459
drugs and devices listed on the formulary, except that all of the	460
following conditions apply:	461

(1) The amount of the sample furnished shall not exceed a	462
seventy-two-hour supply, except when the minimum available	463
quantity of the sample is packaged in an amount that is greater	464
than a seventy-two-hour supply, in which case the packaged amount	465
may be furnished.	466

(2) No charge may be imposed for the sample or for furnishing	467
it.	468

(3) Samples of controlled substances may not be personally	469
furnished.	470

(F) A clinical nurse specialist, certified nurse-midwife, or	471
certified nurse practitioner may personally furnish to a patient a	472
complete or partial supply of a drug or therapeutic device	473
included in the types of drugs and devices listed on the	474
formulary, except that all of the following conditions apply:	475

(1) The clinical nurse specialist, certified nurse-midwife,	476
or certified nurse practitioner shall personally furnish only	477
antibiotics, antifungals, scabicides, contraceptives, prenatal	478
vitamins, antihypertensives, drugs and devices used in the	479
treatment of diabetes, drugs and devices used in the treatment of	480
asthma, and drugs used in the treatment of dyslipidemia.	481

(2) The clinical nurse specialist, certified nurse-midwife,	482
or certified nurse practitioner shall not furnish the drugs and	483
devices in locations other than a health department operated by	484
the board of health of a city or general health district or the	485
authority having the duties of a board of health under section	486
3709.05 of the Revised Code, a federally funded comprehensive	487
primary care clinic, or a nonprofit health care clinic or program.	488

(3) The clinical nurse specialist, certified nurse-midwife,	489
or certified nurse practitioner shall comply with all safety	490
standards for personally furnishing supplies of drugs and devices,	491
as established in rules adopted under section 4723.50 of the	492
Revised Code.	493

(G) A clinical nurse specialist, certified nurse-midwife, or	494
certified nurse practitioner shall comply with section 3719.061 of	495
the Revised Code if the nurse prescribes a controlled substance	496
that contains an opioid to a minor, as defined in that section.	497

Sec. 4725.191. (A) For the initial violation of section	498
3719.061 of the Revised Code by an optometrist, the state board of	499
optometry, by an affirmative vote of not fewer than six members,	500
may impose a fine not to exceed twenty thousand dollars. For each	501
subsequent violation of that section, the board, by an affirmative	502
vote of not fewer than six members, may impose an additional fine	503
not to exceed twenty thousand dollars, suspend for not less than	504
six months the operation of the optometrist's certificate of	505
licensure and therapeutic pharmaceutical agents certificate, or	506
both.	507

(B) Disciplinary action under this section shall be taken	508
pursuant to an adjudication conducted under Chapter 119. of the	509
Revised Code.	510

Sec. 4730.252. (A) For the initial violation of section	511
3719.061 of the Revised Code by a physician assistant, the state	512
medical board, by an affirmative vote of not fewer than six	513
members, may impose a fine not to exceed twenty thousand dollars.	514
For each subsequent violation of that section, the board, by an	515
affirmative vote of not fewer than six members, may impose an	516
additional fine not to exceed twenty thousand dollars, suspend for	517
not less than six months the physician assistant's certificate to	518
practice and certificate to prescribe, or both.	519

(B) Except as specified in division (J) of section 4730.25 of	520
the Revised Code, disciplinary action under this section shall be	521
taken pursuant to an adjudication conducted under Chapter 119. of	522
the Revised Code.	523

Sec. 4730.41.  (A) A certificate to prescribe issued under	524
this chapter authorizes a physician assistant to prescribe and	525
personally furnish drugs and therapeutic devices in the exercise	526
of physician-delegated prescriptive authority.	527

(B) In exercising physician-delegated prescriptive authority,	528
a physician assistant is subject to all of the following:	529

(1) The physician assistant shall exercise	530
physician-delegated prescriptive authority only to the extent that	531
the physician supervising the physician assistant has granted that	532
authority.	533

(2) The physician assistant shall comply with all conditions	534
placed on the physician-delegated prescriptive authority, as	535
specified by the supervising physician who is supervising the	536
physician assistant in the exercise of physician-delegated	537
prescriptive authority.	538

(3) If the physician assistant possesses physician-delegated	539
prescriptive authority for controlled substances, the physician	540
assistant shall register with the federal drug enforcement	541
administration.	542

(4) If the physician assistant possesses physician-delegated	543
prescriptive authority for schedule II controlled substances, the	544
physician assistant shall comply with section 4730.411 of the	545
Revised Code.	546

(5) If the physician assistant prescribes a controlled	547
substance that contains an opioid to a minor, the physician	548
assistant shall comply with section 3719.061 of the Revised Code.	549
As used in this division, "minor" has the same meaning as in	550
section 3719.061 of the Revised Code.	551

Sec. 4731.229. (A) As used in this section, "physician" means	552
an individual authorized under this chapter to practice medicine	553
and surgery, osteopathic medicine and surgery, or podiatric	554
medicine and surgery.	555

(B) For the initial violation of section 3719.061 of the	556
Revised Code by a physician, the state medical board, by an	557
affirmative vote of not fewer than six members, may impose a fine	558
not to exceed twenty thousand dollars. For each subsequent	559
violation of that section, the board, by an affirmative vote of	560
not fewer than six members, may impose an additional fine not to	561
exceed twenty thousand dollars; suspend for not less than six	562
months the physician's certificate to practice medicine and	563
surgery, osteopathic medicine and surgery, or podiatric medicine	564
and surgery; or both.	565

(C) When investigating or conducting a hearing on an alleged	566
violation of section 3719.061 of the Revised Code, the board may	567
take any action it is authorized to take under division (F) of	568
section 4731.22 of the Revised Code.	569

(D) Except as specified in division (J) of section 4731.22 of	570
the Revised Code, disciplinary action under this section shall be	571
taken pursuant to an adjudication conducted under Chapter 119. of	572
the Revised Code.	573

Section 2.  That existing sections 4715.30, 4723.481, and	574
4730.41 of the Revised Code are hereby repealed.	575