Sub. H. B. No. 412 As Reported by the Senate Medicaid, Health and Human Services Committee

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

130th General Assembly

Regular Session

2013-2014

Sub. H. B. No. 412

Representative Gonzales

Cosponsors: Representatives Bishoff, Terhar, Young, Wachtmann, Schuring, Brown, Anielski, Baker, Blessing, Carney, Green, Grossman, Hackett, Huffman, Landis, Perales, Pillich, Rogers, Scherer Speaker Batchelder

A BILL

To amend sections 1.64, 2133.211, 2151.3515,

2305.113, 2925.61, 3701.92, 3727.06, 3729.05,

4503.44, 4723.01, 4723.06, 4723.07, 4723.18,

4723.181, 4723.48, 4723.482, 4723.50, 4729.01,

4730.01, 4730.02, 4730.03, 4730.04, 4730.06,

4730.08, 4730.091, 4730.10, 4730.101, 4730.11,

4730.12, 4730.13, 4730.14, 4730.19, 4730.21,

4730.22, 4730.25, 4730.251, 4730.27, 4730.28,

4730.31, 4730.32, 4730.33, 4730.38, 4730.39,

4730.41, 4730.42, 4730.43, 4730.431, 4730.49,

4730.51, 4730.53, 4731.07, 4761.01, 4761.17,

4765.01, 4765.51, 5122.11, 5122.111, and 5123.47;

to amend, for the purpose of adopting new section

numbers as indicated in parentheses, section

4730.091 (4730.201) and 4730.092 (4730.202); to

enact new section 4730.20 and sections 4723.489,

4730.111, and 4730.203; and to repeal sections

4730.081, 4730.09, 4730.15, 4730.16, 4730.17,

4730.18, 4730.20, 4730.44, 4730.45, 4730.46,

4730.47, 4730.48, 4730.50, and 4730.52 of the

Revised Code to revise the law governing the

practice of physician assistants, the practice of

advanced practice registered nurses, the

proceedings for court-ordered treatment of a

mentally ill person, and the licensure of

recreational vehicle parks and recreation camps,

and to amend the versions of sections 4730.25 and

4730.53 of the Revised Code that are scheduled to

take effect April 1, 2015, to continue the

provisions of this act on and after that effective

date.

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

Section 1. That sections 1.64, 2133.211, 2151.3515, 2305.113,	32
2925.61, 3701.92, 3727.06, 3729.05, 4503.44, 4723.01, 4723.06,	33
4723.07, 4723.18, 4723.181, 4723.48, 4723.482, 4723.50, 4729.01,	34
4730.01, 4730.02, 4730.03, 4730.04, 4730.06, 4730.08, 4730.091,	35
4730.10, 4730.101, 4730.11, 4730.12, 4730.13, 4730.14, 4730.19,	36
4730.21, 4730.22, 4730.25, 4730.251, 4730.27, 4730.28, 4730.31,	37
4730.32, 4730.33, 4730.38, 4730.39, 4730.41, 4730.42, 4730.43,	38
4730.431, 4730.49, 4730.51, 4730.53, 4731.07, 4761.01, 4761.17,	39
4765.01, 4765.51, 5122.11, 5122.111, and 5123.47 be amended,	40
sections 4730.091 (4730.201) and 4730.092 (4730.202) be amended	41
for the purpose of adopting new section numbers as indicated in	42
parentheses, and new section 4730.20 and sections 4723.489,	43
4730.111, and 4730.203 of the Revised Code be enacted to read as	44
follows:	45

Sec. 1.64. As used in the Revised Code:

(A) "Certified nurse-midwife" means a registered nurse who	47
holds a valid certificate of authority issued under Chapter 4723.	48
of the Revised Code that authorizes the practice of nursing as a	49
certified nurse-midwife in accordance with section 4723.43 of the	50
Revised Code and rules adopted by the board of nursing.	51

(B) "Certified nurse practitioner" means a registered nurse	52
who holds a valid certificate of authority issued under Chapter	53
4723. of the Revised Code that authorizes the practice of nursing	54
as a certified nurse practitioner in accordance with section	55
4723.43 of the Revised Code and rules adopted by the board of	56
nursing.	57

(C) "Clinical nurse specialist" means a registered nurse who	58
holds a valid certificate of authority issued under Chapter 4723.	59
of the Revised Code that authorizes the practice of nursing as a	60
clinical nurse specialist in accordance with section 4723.43 of	61
the Revised Code and rules adopted by the board of nursing.	62

(D) "Physician assistant" means an individual who ~~holds a~~	63
~~valid certificate to practice issued~~is licensed under Chapter	64
4730. of the Revised Code ~~authorizing the individual~~ to provide	65
services as a physician assistant to patients under the	66
supervision, control, and direction of one or more physicians.	67

Sec. 2133.211. A person who holds a certificate of authority	68
~~to practice~~ as a certified nurse practitioner or clinical nurse	69
specialist issued under ~~section 4723.42~~Chapter 4723. of the	70
Revised Code may take any action that may be taken by an attending	71
physician under sections 2133.21 to 2133.26 of the Revised Code	72
and has the immunity provided by section 2133.22 of the Revised	73
Code if the action is taken pursuant to a standard care	74
arrangement with a collaborating physician.	75

A person who holds a ~~certificate~~license to practice as a	76
physician assistant issued under Chapter 4730. of the Revised Code	77
may take any action that may be taken by an attending physician	78
under sections 2133.21 to 2133.26 of the Revised Code and has the	79
immunity provided by section 2133.22 of the Revised Code if the	80
action is taken pursuant to a ~~physician supervisory plan approved~~	81
~~pursuant to~~supervision agreement entered into under section	82
~~4730.17~~4730.19 of the Revised Code or, including, if applicable	83
the policies of a health care facility in which the physician	84
assistant is practicing.	85

Sec. 2151.3515. As used in sections 2151.3515 to 2151.3530	86
of the Revised Code:	87

(A) "Deserted child" means a child whose parent has	88
voluntarily delivered the child to an emergency medical service	89
worker, peace officer, or hospital employee without expressing an	90
intent to return for the child.	91

(B) "Emergency medical service organization," "emergency	92
medical technician-basic," "emergency medical	93
technician-intermediate," "first responder," and "paramedic" have	94
the same meanings as in section 4765.01 of the Revised Code.	95

(C) "Emergency medical service worker" means a first	96
responder, emergency medical technician-basic, emergency medical	97
technician-intermediate, or paramedic.	98

(D) "Hospital" has the same meaning as in section 3727.01 of	99
the Revised Code.	100

(E) "Hospital employee" means any of the following persons:

101

(1) A physician who has been granted privileges to practice	102
at the hospital;	103

(2) A nurse, physician assistant, or nursing assistant	104
employed by the hospital;	105

(3) An authorized person employed by the hospital who is	106
acting under the direction of a physician described in division	107
(E)(1) of this section.	108

(F) "Law enforcement agency" means an organization or entity	109
made up of peace officers.	110

(G) "Nurse" means a person who is licensed under Chapter	111
4723. of the Revised Code to practice as a registered nurse or	112
licensed practical nurse.	113

(H) "Nursing assistant" means a person designated by a	114
hospital as a nurse aide or nursing assistant whose job is to aid	115
nurses, physicians, and physician assistants in the performance of	116
their duties.	117

(I) "Peace officer" means a sheriff, deputy sheriff,	118
constable, police officer of a township or joint police district,	119
marshal, deputy marshal, municipal police officer, or a state	120
highway patrol trooper.	121

(J) "Physician" ~~and "physician assistant" have the same~~	122
~~meanings as in section 4730.01~~means an individual authorized	123
under Chapter 4731. of the Revised Code to practice medicine and	124
surgery, osteopathic medicine and surgery, or podiatric medicine	125
and surgery.	126

(K) "Physician assistant" means an individual who holds a	127
current, valid license to practice as a physician assistant issued	128
under Chapter 4730. of the Revised Code.	129

Sec. 2305.113. (A) Except as otherwise provided in this	130
section, an action upon a medical, dental, optometric, or	131
chiropractic claim shall be commenced within one year after the	132
cause of action accrued.	133

(B)(1) If prior to the expiration of the one-year period	134
specified in division (A) of this section, a claimant who	135
allegedly possesses a medical, dental, optometric, or chiropractic	136
claim gives to the person who is the subject of that claim written	137
notice that the claimant is considering bringing an action upon	138
that claim, that action may be commenced against the person	139
notified at any time within one hundred eighty days after the	140
notice is so given.	141

(2) An insurance company shall not consider the existence or	142
nonexistence of a written notice described in division (B)(1) of	143
this section in setting the liability insurance premium rates that	144
the company may charge the company's insured person who is	145
notified by that written notice.	146

(C) Except as to persons within the age of minority or of	147
unsound mind as provided by section 2305.16 of the Revised Code,	148
and except as provided in division (D) of this section, both of	149
the following apply:	150

(1) No action upon a medical, dental, optometric, or	151
chiropractic claim shall be commenced more than four years after	152
the occurrence of the act or omission constituting the alleged	153
basis of the medical, dental, optometric, or chiropractic claim.	154

(2) If an action upon a medical, dental, optometric, or	155
chiropractic claim is not commenced within four years after the	156
occurrence of the act or omission constituting the alleged basis	157
of the medical, dental, optometric, or chiropractic claim, then,	158
any action upon that claim is barred.	159

(D)(1) If a person making a medical claim, dental claim,	160
optometric claim, or chiropractic claim, in the exercise of	161
reasonable care and diligence, could not have discovered the	162
injury resulting from the act or omission constituting the alleged	163
basis of the claim within three years after the occurrence of the	164
act or omission, but, in the exercise of reasonable care and	165
diligence, discovers the injury resulting from that act or	166
omission before the expiration of the four-year period specified	167
in division (C)(1) of this section, the person may commence an	168
action upon the claim not later than one year after the person	169
discovers the injury resulting from that act or omission.	170

(2) If the alleged basis of a medical claim, dental claim,	171
optometric claim, or chiropractic claim is the occurrence of an	172
act or omission that involves a foreign object that is left in the	173
body of the person making the claim, the person may commence an	174
action upon the claim not later than one year after the person	175
discovered the foreign object or not later than one year after the	176
person, with reasonable care and diligence, should have discovered	177
the foreign object.	178

(3) A person who commences an action upon a medical claim,	179
dental claim, optometric claim, or chiropractic claim under the	180
circumstances described in division (D)(1) or (2) of this section	181
has the affirmative burden of proving, by clear and convincing	182
evidence, that the person, with reasonable care and diligence,	183
could not have discovered the injury resulting from the act or	184
omission constituting the alleged basis of the claim within the	185
three-year period described in division (D)(1) of this section or	186
within the one-year period described in division (D)(2) of this	187
section, whichever is applicable.	188

(E) As used in this section:

189

(1) "Hospital" includes any person, corporation, association,	190
board, or authority that is responsible for the operation of any	191
hospital licensed or registered in the state, including, but not	192
limited to, those that are owned or operated by the state,	193
political subdivisions, any person, any corporation, or any	194
combination of the state, political subdivisions, persons, and	195
corporations. "Hospital" also includes any person, corporation,	196
association, board, entity, or authority that is responsible for	197
the operation of any clinic that employs a full-time staff of	198
physicians practicing in more than one recognized medical	199
specialty and rendering advice, diagnosis, care, and treatment to	200
individuals. "Hospital" does not include any hospital operated by	201
the government of the United States or any of its branches.	202

(2) "Physician" means a person who is licensed to practice	203
medicine and surgery or osteopathic medicine and surgery by the	204
state medical board or a person who otherwise is authorized to	205
practice medicine and surgery or osteopathic medicine and surgery	206
in this state.	207

(3) "Medical claim" means any claim that is asserted in any	208
civil action against a physician, podiatrist, hospital, home, or	209
residential facility, against any employee or agent of a	210
physician, podiatrist, hospital, home, or residential facility, or	211
against a licensed practical nurse, registered nurse, advanced	212
practice registered nurse, physical therapist, physician	213
assistant, emergency medical technician-basic, emergency medical	214
technician-intermediate, or emergency medical	215
technician-paramedic, and that arises out of the medical	216
diagnosis, care, or treatment of any person. "Medical claim"	217
includes the following:	218

(a) Derivative claims for relief that arise from the medical	219
diagnosis, care, or treatment of a person;	220

(b) Claims that arise out of the medical diagnosis, care, or	221
treatment of any person and to which either of the following	222
applies:	223

(i) The claim results from acts or omissions in providing	224
medical care.	225

(ii) The claim results from the hiring, training,	226
supervision, retention, or termination of caregivers providing	227
medical diagnosis, care, or treatment.	228

(c) Claims that arise out of the medical diagnosis, care, or	229
treatment of any person and that are brought under section 3721.17	230
of the Revised Code.	231

(4) "Podiatrist" means any person who is licensed to practice	232
podiatric medicine and surgery by the state medical board.	233

(5) "Dentist" means any person who is licensed to practice	234
dentistry by the state dental board.	235

(6) "Dental claim" means any claim that is asserted in any	236
civil action against a dentist, or against any employee or agent	237
of a dentist, and that arises out of a dental operation or the	238
dental diagnosis, care, or treatment of any person. "Dental claim"	239
includes derivative claims for relief that arise from a dental	240
operation or the dental diagnosis, care, or treatment of a person.	241

(7) "Derivative claims for relief" include, but are not	242
limited to, claims of a parent, guardian, custodian, or spouse of	243
an individual who was the subject of any medical diagnosis, care,	244
or treatment, dental diagnosis, care, or treatment, dental	245
operation, optometric diagnosis, care, or treatment, or	246
chiropractic diagnosis, care, or treatment, that arise from that	247
diagnosis, care, treatment, or operation, and that seek the	248
recovery of damages for any of the following:	249

(a) Loss of society, consortium, companionship, care,	250
assistance, attention, protection, advice, guidance, counsel,	251
instruction, training, or education, or any other intangible loss	252
that was sustained by the parent, guardian, custodian, or spouse;	253

(b) Expenditures of the parent, guardian, custodian, or	254
spouse for medical, dental, optometric, or chiropractic care or	255
treatment, for rehabilitation services, or for other care,	256
treatment, services, products, or accommodations provided to the	257
individual who was the subject of the medical diagnosis, care, or	258
treatment, the dental diagnosis, care, or treatment, the dental	259
operation, the optometric diagnosis, care, or treatment, or the	260
chiropractic diagnosis, care, or treatment.	261

(8) "Registered nurse" means any person who is licensed to	262
practice nursing as a registered nurse by the board of nursing.	263

(9) "Chiropractic claim" means any claim that is asserted in	264
any civil action against a chiropractor, or against any employee	265
or agent of a chiropractor, and that arises out of the	266
chiropractic diagnosis, care, or treatment of any person.	267
"Chiropractic claim" includes derivative claims for relief that	268
arise from the chiropractic diagnosis, care, or treatment of a	269
person.	270

(10) "Chiropractor" means any person who is licensed to	271
practice chiropractic by the state chiropractic board.	272

(11) "Optometric claim" means any claim that is asserted in	273
any civil action against an optometrist, or against any employee	274
or agent of an optometrist, and that arises out of the optometric	275
diagnosis, care, or treatment of any person. "Optometric claim"	276
includes derivative claims for relief that arise from the	277
optometric diagnosis, care, or treatment of a person.	278

(12) "Optometrist" means any person licensed to practice	279
optometry by the state board of optometry.	280

(13) "Physical therapist" means any person who is licensed to	281
practice physical therapy under Chapter 4755. of the Revised Code.	282

(14) "Home" has the same meaning as in section 3721.10 of the	283
Revised Code.	284

(15) "Residential facility" means a facility licensed under	285
section 5123.19 of the Revised Code.	286

(16) "Advanced practice registered nurse" means any certified	287
nurse practitioner, clinical nurse specialist, certified	288
registered nurse anesthetist, or certified nurse-midwife who holds	289
a certificate of authority issued by the board of nursing under	290
Chapter 4723. of the Revised Code.	291

(17) "Licensed practical nurse" means any person who is	292
licensed to practice nursing as a licensed practical nurse by the	293
board of nursing pursuant to Chapter 4723. of the Revised Code.	294

(18) "Physician assistant" means any person who ~~holds a valid~~	295
~~certificate to practice issued pursuant to~~is licensed as a	296
physician assistant under Chapter 4730. of the Revised Code.	297

(19) "Emergency medical technician-basic," "emergency medical	298
technician-intermediate," and "emergency medical	299
technician-paramedic" means any person who is certified under	300
Chapter 4765. of the Revised Code as an emergency medical	301
technician-basic, emergency medical technician-intermediate, or	302
emergency medical technician-paramedic, whichever is applicable.	303

Sec. 2925.61. (A) As used in this section:

304

(1) "Administer naloxone" means to give naloxone to a person	305
by either of the following routes:	306

(a) Using a device manufactured for the intranasal	307
administration of liquid drugs;	308

(b) Using an autoinjector in a manufactured dosage form.

309

(2) "Law enforcement agency" means a government entity that	310
employs peace officers to perform law enforcement duties.	311

(3) "Licensed health professional" means all of the	312
following:	313

(a) A physician who is authorized under Chapter 4731. of the	314
Revised Code to practice medicine and surgery, osteopathic	315
medicine and surgery, or podiatric medicine and surgery;	316

(b) A physician assistant who is licensed under Chapter 4730.	317
of the Revised Code, holds a ~~certificate to prescribe~~valid	318
prescriber number issued ~~under Chapter 4730. of the Revised Code~~	319
by the state medical board, and has been granted	320
physician-delegated prescriptive authority;	321

(c) A clinical nurse specialist, certified nurse-midwife, or	322
certified nurse practitioner who holds a certificate to prescribe	323
issued under section 4723.48 of the Revised Code.	324

(4) "Peace officer" has the same meaning as in section	325
2921.51 of the Revised Code.	326

(B) A family member, friend, or other individual who is in a	327
position to assist an individual who is apparently experiencing or	328
at risk of experiencing an opioid-related overdose, is not subject	329
to criminal prosecution for a violation of section 4731.41 of the	330
Revised Code or criminal prosecution under this chapter if the	331
individual, acting in good faith, does all of the following:	332

(1) Obtains naloxone from a licensed health professional or a	333
prescription for naloxone from a licensed health professional;	334

(2) Administers that naloxone to an individual who is	335
apparently experiencing an opioid-related overdose;	336

(3) Attempts to summon emergency services either immediately	337
before or immediately after administering the naloxone.	338

(C) Division (B) of this section does not apply to a peace	339
officer or to an emergency medical technician-basic, emergency	340
medical technician-intermediate, or emergency medical	341
technician-paramedic, as defined in section 4765.01 of the Revised	342
Code.	343

(D) A peace officer employed by a law enforcement agency is	344
not subject to administrative action, criminal prosecution for a	345
violation of section 4731.41 of the Revised Code, or criminal	346
prosecution under this chapter if the peace officer, acting in	347
good faith, obtains naloxone from the peace officer's law	348
enforcement agency and administers the naloxone to an individual	349
who is apparently experiencing an opioid-related overdose.	350

Sec. 3701.92. As used in sections 3701.921 to 3701.929 of	351
the Revised Code:	352

(A) "Advanced practice registered nurse" has the same meaning	353
as in section 4723.01 of the Revised Code.	354

(B) "Patient centered medical home education advisory group"	355
means the entity established under section 3701.924 of the Revised	356
Code.	357

(C) "Patient centered medical home education program" means	358
the program established under section 3701.921 of the Revised Code	359
and any pilot projects operated pursuant to that section.	360

(D) "Patient centered medical home education pilot project"	361
means the pilot project established under section 3701.923 of the	362
Revised Code.	363

(E) "Physician assistant" ~~has the same meaning as in section~~	364
~~4730.01~~means any person who is licensed as a physician assistant	365
under Chapter 4730. of the Revised Code.	366

Sec. 3727.06. (A) As used in this section:

367

(1) "Doctor" means an individual authorized to practice	368
medicine and surgery or osteopathic medicine and surgery.	369

(2) "Podiatrist" means an individual authorized to practice	370
podiatric medicine and surgery.	371

(B)(1) Only the following may admit a patient to a hospital:

372

(a) A doctor who is a member of the hospital's medical staff;

373

(b) A dentist who is a member of the hospital's medical	374
staff;	375

(c) A podiatrist who is a member of the hospital's medical	376
staff;	377

(d) A clinical nurse specialist, certified nurse-midwife, or	378
certified nurse practitioner if all of the following conditions	379
are met:	380

(i) The clinical nurse specialist, certified nurse-midwife,	381
or certified nurse practitioner has a standard care arrangement	382
entered into pursuant to section 4723.431 of the Revised Code with	383
a collaborating doctor or podiatrist who is a member of the	384
medical staff;	385

(ii) The patient will be under the medical supervision of the	386
collaborating doctor or podiatrist;	387

(iii) The hospital has granted the clinical nurse specialist,	388
certified nurse-midwife, or certified nurse practitioner admitting	389
privileges and appropriate credentials.	390

(e) A physician assistant if all of the following conditions	391
are met:	392

(i) The physician assistant is listed on a supervision	393
agreement ~~approved~~entered into under section 4730.19 of the	394
Revised Code for a doctor or podiatrist who is a member of the	395
hospital's medical staff.	396

(ii) The patient will be under the medical supervision of the	397
supervising doctor or podiatrist.	398

(iii) The hospital has granted the physician assistant	399
admitting privileges and appropriate credentials.	400

(2) Prior to admitting a patient, a clinical nurse	401
specialist, certified nurse-midwife, certified nurse practitioner,	402
or physician assistant shall notify the collaborating or	403
supervising doctor or podiatrist of the planned admission.	404

(C) All hospital patients shall be under the medical	405
supervision of a doctor, except that services that may be rendered	406
by a licensed dentist pursuant to Chapter 4715. of the Revised	407
Code provided to patients admitted solely for the purpose of	408
receiving such services shall be under the supervision of the	409
admitting dentist and that services that may be rendered by a	410
podiatrist pursuant to section 4731.51 of the Revised Code	411
provided to patients admitted solely for the purpose of receiving	412
such services shall be under the supervision of the admitting	413
podiatrist. If treatment not within the scope of Chapter 4715. or	414
section 4731.51 of the Revised Code is required at the time of	415
admission by a dentist or podiatrist, or becomes necessary during	416
the course of hospital treatment by a dentist or podiatrist, such	417
treatment shall be under the supervision of a doctor who is a	418
member of the medical staff. It shall be the responsibility of the	419
admitting dentist or podiatrist to make arrangements with a doctor	420
who is a member of the medical staff to be responsible for the	421
patient's treatment outside the scope of Chapter 4715. or section	422
4731.51 of the Revised Code when necessary during the patient's	423
stay in the hospital.	424

Sec. 3729.05. (A)(1) OnExcept as otherwise provided in this	425
section, on or after the first day of April, but before the first	426
day of May of each year, every person who intends to operate a	427
recreational vehicle park, recreation camp, or combined park-camp	428
shall procure a license to operate the park or camp from the	429
licensor. If the applicable license fee prescribed under section	430
3729.07 of the Revised Code is not received by the licensor by the	431
close of business on the last day of April, the applicant for the	432
license shall pay a penalty equal to twenty-five per cent of the	433
applicable license fee. The penalty shall accompany the license	434
fee. If the last day of April is not a business day, the penalty	435
attaches upon the close of business on the next business day.	436

(2) Every person who intends to operate a temporary park-camp	437
shall obtain a license to operate the temporary park-camp from the	438
licensor at any time before the person begins operation of the	439
temporary park-camp during the calendar year.	440

(3) No recreational vehicle park, recreation camp, combined	441
park-camp, or temporary park-camp shall be maintained or operated	442
in this state without a license. However, no person who neither	443
intends to receive nor receives anything of value arising from the	444
use of, or the sale of goods or services in connection with the	445
use of, a recreational vehicle park, recreation camp, combined	446
park-camp, or temporary park-camp is required to procure a license	447
under this division. If any health hazard exists at such an	448
unlicensed park, camp, or park-camp, the health hazard shall be	449
corrected in a manner consistent with the appropriate rule adopted	450
under division (A) or (B) of section 3729.02 of the Revised Code.	451

(4) No person who has received a license under division	452
(A)(1) of this section, upon the sale or disposition of the	453
recreational vehicle park, recreation camp, or combined park-camp,	454
may have the license transferred to the new operator. A person	455
shall obtain a separate license to operate each recreational	456
vehicle park, recreation camp, or combined park-camp. No license	457
to operate a temporary park-camp shall be transferred. A person	458
shall obtain a separate license for each temporary park-camp that	459
the person intends to operate, and the license shall be valid for	460
a period of not longer than seven consecutive days. A person who	461
operates a temporary park-camp on a tract of land for more than	462
twenty-one days or parts thereof in a calendar year shall obtain a	463
license to operate a recreational vehicle park, recreation camp,	464
or combined park-camp.	465

(B)(1) Before a license is initially issued under division	466
(A)(1) of this section and annually thereafter, or more often if	467
necessary, the licensor shall cause each recreational vehicle	468
park, recreation camp, or combined park-camp to be inspected to	469
determine compliance with this chapter and rules adopted under it.	470
A record shall be made of each inspection on a form prescribed by	471
the director of health.	472

(2) When a license is initially issued under division (A)(2)	473
of this section, and more often if necessary, the licensor shall	474
cause each temporary park-camp to be inspected to determine	475
compliance with this chapter and rules adopted under it during the	476
period that the temporary park-camp is in operation. A record	477
shall be made of each inspection on a form prescribed by the	478
director.	479

(C) Each person applying for an initial license to operate a	480
recreational vehicle park, recreation camp, combined park-camp, or	481
temporary park-camp shall provide acceptable proof to the	482
director, or to the licensor in the case of a temporary park-camp,	483
that adequate fire protection will be provided and that applicable	484
fire codes will be adhered to in the construction and operation of	485
the park, camp, or park-camp.	486

(D) Any person that operates a county or state fair or any	487
independent agricultural society organized pursuant to section	488
1711.02 of the Revised Code that operates a fair shall not be	489
required to obtain a license under this chapter if recreational	490
vehicles, portable camping units, or any combination of them are	491
parked at the site of the fair only during the time of preparation	492
for, operation of, and dismantling of the fair and if the	493
recreational vehicles, portable camping units, or any combination	494
of them belong to participants in the fair.	495

(E) The following entities that operate a fair and that hold	496
a license issued under this chapter are not required to comply	497
with the requirements normally imposed on a licensee under this	498
chapter and rules adopted under it during the time of preparation	499
for, operation of, and dismantling of the fair:	500

(1) A county agricultural society organized pursuant to	501
section 1711.01 of the Revised Code;	502

(2) An independent agricultural society organized pursuant to	503
section 1711.02 of the Revised Code;	504

(3) The Ohio expositions commission.

505

(F) A motorsports park is exempt from the license	506
requirements established in divisions (A)(1) and (2) of this	507
section if the motorsports park does both of the following:	508

(1) Holds at least one annual event sanctioned by the	509
national association for stock car auto racing or the national hot	510
rod association during a motor sports racing event;	511

(2) Provides parking for recreational vehicles, dependent	512
recreational vehicles, and portable camping units that belong to	513
participants in that event.	514

The exemption established in this division applies to	515
participant-only areas during the time of preparation for and	516
operation of the event.	517

(G) A person subject to this chapter or rules adopted under	518
it may apply to the director for a waiver of or variance from a	519
provision of this chapter or rules adopted under it. The director	520
may grant a waiver or variance if the person demonstrates, to the	521
satisfaction of the director, that the waiver or variance will not	522
result in any adverse effect on the public health and safety. The	523
director shall adopt rules in accordance with Chapter 119. of the	524
Revised Code establishing requirements and procedures governing	525
the application for and granting of a waiver or variance under	526
this division.	527

Sec. 4503.44. (A) As used in this section and in section	528
4511.69 of the Revised Code:	529

(1) "Person with a disability that limits or impairs the	530
ability to walk" means any person who, as determined by a health	531
care provider, meets any of the following criteria:	532

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

533

(b) Cannot walk without the use of, or assistance from, a	534
brace, cane, crutch, another person, prosthetic device,	535
wheelchair, or other assistive device;	536

(c) Is restricted by a lung disease to such an extent that	537
the person's forced (respiratory) expiratory volume for one	538
second, when measured by spirometry, is less than one liter, or	539
the arterial oxygen tension is less than sixty millimeters of	540
mercury on room air at rest;	541

(d) Uses portable oxygen;

542

(e) Has a cardiac condition to the extent that the person's	543
functional limitations are classified in severity as class III or	544
class IV according to standards set by the American heart	545
association;	546

(f) Is severely limited in the ability to walk due to an	547
arthritic, neurological, or orthopedic condition;	548

(g) Is blind, legally blind, or severely visually impaired.

549

(2) "Organization" means any private organization or	550
corporation, or any governmental board, agency, department,	551
division, or office, that, as part of its business or program,	552
transports persons with disabilities that limit or impair the	553
ability to walk on a regular basis in a motor vehicle that has not	554
been altered for the purpose of providing it with special	555
equipment for use by persons with disabilities. This definition	556
does not apply to division (I) of this section.	557

(3) "Health care provider" means a physician, physician	558
assistant, advanced practice registered nurse, optometrist, or	559
chiropractor as defined in this section except that an optometrist	560
shall only make determinations as to division (A)(1)(g) of this	561
section.	562

(4) "Physician" means a person licensed to practice medicine	563
or surgery or osteopathic medicine and surgery under Chapter 4731.	564
of the Revised Code.	565

(5) "Chiropractor" means a person licensed to practice	566
chiropractic under Chapter 4734. of the Revised Code.	567

(6) "Advanced practice registered nurse" means a certified	568
nurse practitioner, clinical nurse specialist, certified	569
registered nurse anesthetist, or certified nurse-midwife who holds	570
a certificate of authority issued by the board of nursing under	571
Chapter 4723. of the Revised Code.	572

(7) "Physician assistant" means a person who ~~holds a~~	573
~~certificate to practice as a physician assistant issued~~is	574
licensed as a physician assistant under Chapter 4730. of the	575
Revised Code.	576

(8) "Optometrist" means a person licensed to engage in the	577
practice of optometry under Chapter 4725. of the Revised Code.	578

(B)(1) An organization, or a person with a disability that	579
limits or impairs the ability to walk, may apply for the	580
registration of any motor vehicle the organization or person owns	581
or leases. When a motor vehicle has been altered for the purpose	582
of providing it with special equipment for a person with a	583
disability that limits or impairs the ability to walk, but is	584
owned or leased by someone other than such a person, the owner or	585
lessee may apply to the registrar or a deputy registrar for	586
registration under this section. The application for registration	587
of a motor vehicle owned or leased by a person with a disability	588
that limits or impairs the ability to walk shall be accompanied by	589
a signed statement from the applicant's health care provider	590
certifying that the applicant meets at least one of the criteria	591
contained in division (A)(1) of this section and that the	592
disability is expected to continue for more than six consecutive	593
months. The application for registration of a motor vehicle that	594
has been altered for the purpose of providing it with special	595
equipment for a person with a disability that limits or impairs	596
the ability to walk but is owned by someone other than such a	597
person shall be accompanied by such documentary evidence of	598
vehicle alterations as the registrar may require by rule.	599

(2) When an organization, a person with a disability that	600
limits or impairs the ability to walk, or a person who does not	601
have a disability that limits or impairs the ability to walk but	602
owns a motor vehicle that has been altered for the purpose of	603
providing it with special equipment for a person with a disability	604
that limits or impairs the ability to walk first submits an	605
application for registration of a motor vehicle under this section	606
and every fifth year thereafter, the organization or person shall	607
submit a signed statement from the applicant's health care	608
provider, a completed application, and any required documentary	609
evidence of vehicle alterations as provided in division (B)(1) of	610
this section, and also a power of attorney from the owner of the	611
motor vehicle if the applicant leases the vehicle. Upon submission	612
of these items, the registrar or deputy registrar shall issue to	613
the applicant appropriate vehicle registration and a set of	614
license plates and validation stickers, or validation stickers	615
alone when required by section 4503.191 of the Revised Code. In	616
addition to the letters and numbers ordinarily inscribed thereon,	617
the license plates shall be imprinted with the international	618
symbol of access. The license plates and validation stickers shall	619
be issued upon payment of the regular license fee as prescribed	620
under section 4503.04 of the Revised Code and any motor vehicle	621
tax levied under Chapter 4504. of the Revised Code, and the	622
payment of a service fee equal to the amount specified in division	623
(D) or (G) of section 4503.10 of the Revised Code.	624

(C)(1) A person with a disability that limits or impairs the	625
ability to walk may apply to the registrar of motor vehicles for a	626
removable windshield placard by completing and signing an	627
application provided by the registrar. The person shall include	628
with the application a prescription from the person's health care	629
provider prescribing such a placard for the person based upon a	630
determination that the person meets at least one of the criteria	631
contained in division (A)(1) of this section. The health care	632
provider shall state on the prescription the length of time the	633
health care provider expects the applicant to have the disability	634
that limits or impairs the person's ability to walk.	635

In addition to one placard or one or more sets of license	636
plates, a person with a disability that limits or impairs the	637
ability to walk is entitled to one additional placard, but only if	638
the person applies separately for the additional placard, states	639
the reasons why the additional placard is needed, and the	640
registrar, in the registrar's discretion determines that good and	641
justifiable cause exists to approve the request for the additional	642
placard.	643

(2) An organization may apply to the registrar of motor	644
vehicles for a removable windshield placard by completing and	645
signing an application provided by the registrar. The organization	646
shall comply with any procedures the registrar establishes by	647
rule. The organization shall include with the application	648
documentary evidence that the registrar requires by rule showing	649
that the organization regularly transports persons with	650
disabilities that limit or impair the ability to walk.	651

(3) Upon receipt of a completed and signed application for a	652
removable windshield placard, the accompanying documents required	653
under division (C)(1) or (2) of this section, and payment of a	654
service fee equal to the amount specified in division (D) or (G)	655
of section 4503.10 of the Revised Code, the registrar or deputy	656
registrar shall issue to the applicant a removable windshield	657
placard, which shall bear the date of expiration on both sides of	658
the placard and shall be valid until expired, revoked, or	659
surrendered. Every removable windshield placard expires as	660
described in division (C)(4) of this section, but in no case shall	661
a removable windshield placard be valid for a period of less than	662
sixty days. Removable windshield placards shall be renewable upon	663
application as provided in division (C)(1) or (2) of this section	664
and upon payment of a service fee equal to the amount specified in	665
division (D) or (G) of section 4503.10 of the Revised Code for the	666
renewal of a removable windshield placard. The registrar shall	667
provide the application form and shall determine the information	668
to be included thereon. The registrar also shall determine the	669
form and size of the removable windshield placard, the material of	670
which it is to be made, and any other information to be included	671
thereon, and shall adopt rules relating to the issuance,	672
expiration, revocation, surrender, and proper display of such	673
placards. Any placard issued after October 14, 1999, shall be	674
manufactured in a manner that allows the expiration date of the	675
placard to be indicated on it through the punching, drilling,	676
boring, or creation by any other means of holes in the placard.	677

(4) At the time a removable windshield placard is issued to a	678
person with a disability that limits or impairs the ability to	679
walk, the registrar or deputy registrar shall enter into the	680
records of the bureau of motor vehicles the last date on which the	681
person will have that disability, as indicated on the accompanying	682
prescription. Not less than thirty days prior to that date and all	683
removable windshield placard renewal dates, the bureau shall send	684
a renewal notice to that person at the person's last known address	685
as shown in the records of the bureau, informing the person that	686
the person's removable windshield placard will expire on the	687
indicated date not to exceed five years from the date of issuance,	688
and that the person is required to renew the placard by submitting	689
to the registrar or a deputy registrar another prescription, as	690
described in division (C)(1) or (2) of this section, and by	691
complying with the renewal provisions prescribed in division	692
(C)(3) of this section. If such a prescription is not received by	693
the registrar or a deputy registrar by that date, the placard	694
issued to that person expires and no longer is valid, and this	695
fact shall be recorded in the records of the bureau.	696

(5) At least once every year, on a date determined by the	697
registrar, the bureau shall examine the records of the office of	698
vital statistics, located within the department of health, that	699
pertain to deceased persons, and also the bureau's records of all	700
persons who have been issued removable windshield placards and	701
temporary removable windshield placards. If the records of the	702
office of vital statistics indicate that a person to whom a	703
removable windshield placard or temporary removable windshield	704
placard has been issued is deceased, the bureau shall cancel that	705
placard, and note the cancellation in its records.	706

The office of vital statistics shall make available to the	707
bureau all information necessary to enable the bureau to comply	708
with division (C)(5) of this section.	709

(6) Nothing in this section shall be construed to require a	710
person or organization to apply for a removable windshield placard	711
or special license plates if the special license plates issued to	712
the person or organization under prior law have not expired or	713
been surrendered or revoked.	714

(D)(1)(a) A person with a disability that limits or impairs	715
the ability to walk may apply to the registrar or a deputy	716
registrar for a temporary removable windshield placard. The	717
application for a temporary removable windshield placard shall be	718
accompanied by a prescription from the applicant's health care	719
provider prescribing such a placard for the applicant, provided	720
that the applicant meets at least one of the criteria contained in	721
division (A)(1) of this section and that the disability is	722
expected to continue for six consecutive months or less. The	723
health care provider shall state on the prescription the length of	724
time the health care provider expects the applicant to have the	725
disability that limits or impairs the applicant's ability to walk,	726
which cannot exceed six months from the date of the prescription.	727
Upon receipt of an application for a temporary removable	728
windshield placard, presentation of the prescription from the	729
applicant's health care provider, and payment of a service fee	730
equal to the amount specified in division (D) or (G) of section	731
4503.10 of the Revised Code, the registrar or deputy registrar	732
shall issue to the applicant a temporary removable windshield	733
placard.	734

(b) Any active-duty member of the armed forces of the United	735
States, including the reserve components of the armed forces and	736
the national guard, who has an illness or injury that limits or	737
impairs the ability to walk may apply to the registrar or a deputy	738
registrar for a temporary removable windshield placard. With the	739
application, the person shall present evidence of the person's	740
active-duty status and the illness or injury. Evidence of the	741
illness or injury may include a current department of defense	742
convalescent leave statement, any department of defense document	743
indicating that the person currently has an ill or injured	744
casualty status or has limited duties, or a prescription from any	745
health care provider prescribing the placard for the applicant.	746
Upon receipt of the application and the necessary evidence, the	747
registrar or deputy registrar shall issue the applicant the	748
temporary removable windshield placard without the payment of any	749
service fee.	750

(2) The temporary removable windshield placard shall be of	751
the same size and form as the removable windshield placard, shall	752
be printed in white on a red-colored background, and shall bear	753
the word "temporary" in letters of such size as the registrar	754
shall prescribe. A temporary removable windshield placard also	755
shall bear the date of expiration on the front and back of the	756
placard, and shall be valid until expired, surrendered, or	757
revoked, but in no case shall such a placard be valid for a period	758
of less than sixty days. The registrar shall provide the	759
application form and shall determine the information to be	760
included on it, provided that the registrar shall not require a	761
health care provider's prescription or certification for a person	762
applying under division (D)(1)(b) of this section. The registrar	763
also shall determine the material of which the temporary removable	764
windshield placard is to be made and any other information to be	765
included on the placard and shall adopt rules relating to the	766
issuance, expiration, surrender, revocation, and proper display of	767
those placards. Any temporary removable windshield placard issued	768
after October 14, 1999, shall be manufactured in a manner that	769
allows for the expiration date of the placard to be indicated on	770
it through the punching, drilling, boring, or creation by any	771
other means of holes in the placard.	772

(E) If an applicant for a removable windshield placard is a	773
veteran of the armed forces of the United States whose disability,	774
as defined in division (A)(1) of this section, is	775
service-connected, the registrar or deputy registrar, upon receipt	776
of the application, presentation of a signed statement from the	777
applicant's health care provider certifying the applicant's	778
disability, and presentation of such documentary evidence from the	779
department of veterans affairs that the disability of the	780
applicant meets at least one of the criteria identified in	781
division (A)(1) of this section and is service-connected as the	782
registrar may require by rule, but without the payment of any	783
service fee, shall issue the applicant a removable windshield	784
placard that is valid until expired, surrendered, or revoked.	785

(F) Upon a conviction of a violation of division (H) or (I)	786
of this section, the court shall report the conviction, and send	787
the placard, if available, to the registrar, who thereupon shall	788
revoke the privilege of using the placard and send notice in	789
writing to the placardholder at that holder's last known address	790
as shown in the records of the bureau, and the placardholder shall	791
return the placard if not previously surrendered to the court, to	792
the registrar within ten days following mailing of the notice.	793

Whenever a person to whom a removable windshield placard has	794
been issued moves to another state, the person shall surrender the	795
placard to the registrar; and whenever an organization to which a	796
placard has been issued changes its place of operation to another	797
state, the organization shall surrender the placard to the	798
registrar.	799

(G) Subject to division (F) of section 4511.69 of the Revised	800
Code, the operator of a motor vehicle displaying a removable	801
windshield placard, temporary removable windshield placard, or the	802
special license plates authorized by this section is entitled to	803
park the motor vehicle in any special parking location reserved	804
for persons with disabilities that limit or impair the ability to	805
walk, also known as handicapped parking spaces or disability	806
parking spaces.	807

(H) No person or organization that is not eligible for the	808
issuance of license plates or any placard under this section shall	809
willfully and falsely represent that the person or organization is	810
so eligible.	811

No person or organization shall display license plates issued	812
under this section unless the license plates have been issued for	813
the vehicle on which they are displayed and are valid.	814

(I) No person or organization to which a removable windshield	815
placard or temporary removable windshield placard is issued shall	816
do either of the following:	817

(1) Display or permit the display of the placard on any motor	818
vehicle when having reasonable cause to believe the motor vehicle	819
is being used in connection with an activity that does not include	820
providing transportation for persons with disabilities that limit	821
or impair the ability to walk;	822

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

823

(J) If a removable windshield placard, temporary removable	824
windshield placard, or parking card is lost, destroyed, or	825
mutilated, the placardholder or cardholder may obtain a duplicate	826
by doing both of the following:	827

(1) Furnishing suitable proof of the loss, destruction, or	828
mutilation to the registrar;	829

(2) Paying a service fee equal to the amount specified in	830
division (D) or (G) of section 4503.10 of the Revised Code.	831

Any placardholder or cardholder who loses a placard or card	832
and, after obtaining a duplicate, finds the original, immediately	833
shall surrender the original placard or card to the registrar.	834

(K)(1) The registrar shall pay all fees received under this	835
section for the issuance of removable windshield placards or	836
temporary removable windshield placards or duplicate removable	837
windshield placards or cards into the state treasury to the credit	838
of the state bureau of motor vehicles fund created in section	839
4501.25 of the Revised Code.	840

(2) In addition to the fees collected under this section, the	841
registrar or deputy registrar shall ask each person applying for a	842
removable windshield placard or temporary removable windshield	843
placard or duplicate removable windshield placard or license plate	844
issued under this section, whether the person wishes to make a	845
two-dollar voluntary contribution to support rehabilitation	846
employment services. The registrar shall transmit the	847
contributions received under this division to the treasurer of	848
state for deposit into the rehabilitation employment fund, which	849
is hereby created in the state treasury. A deputy registrar shall	850
transmit the contributions received under this division to the	851
registrar in the time and manner prescribed by the registrar. The	852
contributions in the fund shall be used by the opportunities for	853
Ohioans with disabilities agency to purchase services related to	854
vocational evaluation, work adjustment, personal adjustment, job	855
placement, job coaching, and community-based assessment from	856
accredited community rehabilitation program facilities.	857

(L) For purposes of enforcing this section, every peace	858
officer is deemed to be an agent of the registrar. Any peace	859
officer or any authorized employee of the bureau of motor vehicles	860
who, in the performance of duties authorized by law, becomes aware	861
of a person whose placard or parking card has been revoked	862
pursuant to this section, may confiscate that placard or parking	863
card and return it to the registrar. The registrar shall prescribe	864
any forms used by law enforcement agencies in administering this	865
section.	866

No peace officer, law enforcement agency employing a peace	867
officer, or political subdivision or governmental agency employing	868
a peace officer, and no employee of the bureau is liable in a	869
civil action for damages or loss to persons arising out of the	870
performance of any duty required or authorized by this section. As	871
used in this division, "peace officer" has the same meaning as in	872
division (B) of section 2935.01 of the Revised Code.	873

(M) All applications for registration of motor vehicles,	874
removable windshield placards, and temporary removable windshield	875
placards issued under this section, all renewal notices for such	876
items, and all other publications issued by the bureau that relate	877
to this section shall set forth the criminal penalties that may be	878
imposed upon a person who violates any provision relating to	879
special license plates issued under this section, the parking of	880
vehicles displaying such license plates, and the issuance,	881
procurement, use, and display of removable windshield placards and	882
temporary removable windshield placards issued under this section.	883

(N) Whoever violates this section is guilty of a misdemeanor	884
of the fourth degree.	885

Sec. 4723.01. As used in this chapter:

886

(A) "Registered nurse" means an individual who holds a	887
current, valid license issued under this chapter that authorizes	888
the practice of nursing as a registered nurse.	889

(B) "Practice of nursing as a registered nurse" means	890
providing to individuals and groups nursing care requiring	891
specialized knowledge, judgment, and skill derived from the	892
principles of biological, physical, behavioral, social, and	893
nursing sciences. Such nursing care includes:	894

(1) Identifying patterns of human responses to actual or	895
potential health problems amenable to a nursing regimen;	896

(2) Executing a nursing regimen through the selection,	897
performance, management, and evaluation of nursing actions;	898

(3) Assessing health status for the purpose of providing	899
nursing care;	900

(4) Providing health counseling and health teaching;

901

(5) Administering medications, treatments, and executing	902
regimens authorized by an individual who is authorized to practice	903
in this state and is acting within the course of the individual's	904
professional practice;	905

(6) Teaching, administering, supervising, delegating, and	906
evaluating nursing practice.	907

(C) "Nursing regimen" may include preventative, restorative,	908
and health-promotion activities.	909

(D) "Assessing health status" means the collection of data	910
through nursing assessment techniques, which may include	911
interviews, observation, and physical evaluations for the purpose	912
of providing nursing care.	913

(E) "Licensed practical nurse" means an individual who holds	914
a current, valid license issued under this chapter that authorizes	915
the practice of nursing as a licensed practical nurse.	916

(F) "The practice of nursing as a licensed practical nurse"	917
means providing to individuals and groups nursing care requiring	918
the application of basic knowledge of the biological, physical,	919
behavioral, social, and nursing sciences at the direction of any	920
of the following who is authorized to practice in this state: a	921
~~licensed~~ physician, physician assistant, dentist, podiatrist,	922
optometrist, chiropractor, or registered nurse. Such nursing care	923
includes:	924

(1) Observation, patient teaching, and care in a diversity of	925
health care settings;	926

(2) Contributions to the planning, implementation, and	927
evaluation of nursing;	928

(3) Administration of medications and treatments authorized	929
by an individual who is authorized to practice in this state and	930
is acting within the course of the individual's professional	931
practice on the condition that the licensed practical nurse is	932
authorized under section 4723.17 of the Revised Code to administer	933
medications;	934

(4) Administration to an adult of intravenous therapy	935
authorized by an individual who is authorized to practice in this	936
state and is acting within the course of the individual's	937
professional practice, on the condition that the licensed	938
practical nurse is authorized under section 4723.18 or 4723.181 of	939
the Revised Code to perform intravenous therapy and performs	940
intravenous therapy only in accordance with those sections;	941

(5) Delegation of nursing tasks as directed by a registered	942
nurse;	943

(6) Teaching nursing tasks to licensed practical nurses and	944
individuals to whom the licensed practical nurse is authorized to	945
delegate nursing tasks as directed by a registered nurse.	946

(G) "Certified registered nurse anesthetist" means a	947
registered nurse who holds a valid certificate of authority issued	948
under this chapter that authorizes the practice of nursing as a	949
certified registered nurse anesthetist in accordance with section	950
4723.43 of the Revised Code and rules adopted by the board of	951
nursing.	952

(H) "Clinical nurse specialist" means a registered nurse who	953
holds a valid certificate of authority issued under this chapter	954
that authorizes the practice of nursing as a clinical nurse	955
specialist in accordance with section 4723.43 of the Revised Code	956
and rules adopted by the board of nursing.	957

(I) "Certified nurse-midwife" means a registered nurse who	958
holds a valid certificate of authority issued under this chapter	959
that authorizes the practice of nursing as a certified	960
nurse-midwife in accordance with section 4723.43 of the Revised	961
Code and rules adopted by the board of nursing.	962

(J) "Certified nurse practitioner" means a registered nurse	963
who holds a valid certificate of authority issued under this	964
chapter that authorizes the practice of nursing as a certified	965
nurse practitioner in accordance with section 4723.43 of the	966
Revised Code and rules adopted by the board of nursing.	967

(K) "Physician" means an individual authorized under Chapter	968
4731. of the Revised Code to practice medicine and surgery or	969
osteopathic medicine and surgery.	970

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

971

(1) In the case of a clinical nurse specialist, except as	972
provided in division (L)(3) of this section, or a certified nurse	973
practitioner, that one or more podiatrists acting within the scope	974
of practice of podiatry in accordance with section 4731.51 of the	975
Revised Code and with whom the nurse has entered into a standard	976
care arrangement or one or more physicians with whom the nurse has	977
entered into a standard care arrangement are continuously	978
available to communicate with the clinical nurse specialist or	979
certified nurse practitioner either in person or by radio,	980
telephone, or other form of telecommunication;	981

(2) In the case of a certified nurse-midwife, that one or	982
more physicians with whom the certified nurse-midwife has entered	983
into a standard care arrangement are continuously available to	984
communicate with the certified nurse-midwife either in person or	985
by radio, telephone, or other form of telecommunication;	986

(3) In the case of a clinical nurse specialist who practices	987
the nursing specialty of mental health or psychiatric mental	988
health without being authorized to prescribe drugs and therapeutic	989
devices, that one or more physicians are continuously available to	990
communicate with the nurse either in person or by radio,	991
telephone, or other form of telecommunication.	992

(M) "Supervision," as it pertains to a certified registered	993
nurse anesthetist, means that the certified registered nurse	994
anesthetist is under the direction of a podiatrist acting within	995
the podiatrist's scope of practice in accordance with section	996
4731.51 of the Revised Code, a dentist acting within the dentist's	997
scope of practice in accordance with Chapter 4715. of the Revised	998
Code, or a physician, and, when administering anesthesia, the	999
certified registered nurse anesthetist is in the immediate	1000
presence of the podiatrist, dentist, or physician.	1001

(N) "Standard care arrangement" means a written, formal guide	1002
for planning and evaluating a patient's health care that is	1003
developed by one or more collaborating physicians or podiatrists	1004
and a clinical nurse specialist, certified nurse-midwife, or	1005
certified nurse practitioner and meets the requirements of section	1006
4723.431 of the Revised Code.	1007

(O) "Advanced practice registered nurse" means a certified	1008
registered nurse anesthetist, clinical nurse specialist, certified	1009
nurse-midwife, or certified nurse practitioner.	1010

(P) "Dialysis care" means the care and procedures that a	1011
dialysis technician or dialysis technician intern is authorized to	1012
provide and perform, as specified in section 4723.72 of the	1013
Revised Code.	1014

(Q) "Dialysis technician" means an individual who holds a	1015
current, valid certificate to practice as a dialysis technician	1016
issued under section 4723.75 of the Revised Code.	1017

(R) "Dialysis technician intern" means an individual who	1018
holds a current, valid certificate to practice as a dialysis	1019
technician intern issued under section 4723.75 of the Revised	1020
Code.	1021

(S) "Certified community health worker" means an individual	1022
who holds a current, valid certificate as a community health	1023
worker issued under section 4723.85 of the Revised Code.	1024

(T) "Medication aide" means an individual who holds a	1025
current, valid certificate issued under this chapter that	1026
authorizes the individual to administer medication in accordance	1027
with section 4723.67 of the Revised Code.	1028

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

1029

(1) Administer and enforce the provisions of this chapter,	1030
including the taking of disciplinary action for violations of	1031
section 4723.28 of the Revised Code, any other provisions of this	1032
chapter, or rules adopted under this chapter;	1033

(2) Develop criteria that an applicant must meet to be	1034
eligible to sit for the examination for licensure to practice as a	1035
registered nurse or as a licensed practical nurse;	1036

(3) Issue and renew nursing licenses, dialysis technician	1037
certificates, and community health worker certificates, as	1038
provided in this chapter;	1039

(4) Define the minimum standards for educational programs of	1040
the schools of registered nursing and schools of practical nursing	1041
in this state;	1042

(5) Survey, inspect, and grant full approval to prelicensure	1043
nursing education programs in this state that meet the standards	1044
established by rules adopted under section 4723.07 of the Revised	1045
Code. Prelicensure nursing education programs include, but are not	1046
limited to, diploma, associate degree, baccalaureate degree,	1047
master's degree, and doctor of nursing programs leading to initial	1048
licensure to practice nursing as a registered nurse and practical	1049
nurse programs leading to initial licensure to practice nursing as	1050
a licensed practical nurse.	1051

(6) Grant conditional approval, by a vote of a quorum of the	1052
board, to a new prelicensure nursing education program or a	1053
program that is being reestablished after having ceased to	1054
operate, if the program meets and maintains the minimum standards	1055
of the board established by rules adopted under section 4723.07 of	1056
the Revised Code. If the board does not grant conditional	1057
approval, it shall hold an adjudication under Chapter 119. of the	1058
Revised Code to consider conditional approval of the program. If	1059
the board grants conditional approval, at the first meeting	1060
following completion of the survey process required by division	1061
(A)(5) of this section, the board shall determine whether to grant	1062
full approval to the program. If the board does not grant full	1063
approval or if it appears that the program has failed to meet and	1064
maintain standards established by rules adopted under section	1065
4723.07 of the Revised Code, the board shall hold an adjudication	1066
under Chapter 119. of the Revised Code to consider the program.	1067
Based on results of the adjudication, the board may continue or	1068
withdraw conditional approval, or grant full approval.	1069

(7) Place on provisional approval, for a period of time	1070
specified by the board, a program that has ceased to meet and	1071
maintain the minimum standards of the board established by rules	1072
adopted under section 4723.07 of the Revised Code. Prior to or at	1073
the end of the period, the board shall reconsider whether the	1074
program meets the standards and shall grant full approval if it	1075
does. If it does not, the board may withdraw approval, pursuant to	1076
an adjudication under Chapter 119. of the Revised Code.	1077

(8) Approve continuing education programs and courses under	1078
standards established in rules adopted under sections 4723.07,	1079
4723.69, 4723.79, and 4723.88 of the Revised Code;	1080

(9) Establish a program for monitoring chemical dependency in	1081
accordance with section 4723.35 of the Revised Code;	1082

(10) Establish the practice intervention and improvement	1083
program in accordance with section 4723.282 of the Revised Code;	1084

(11) Issue and renew certificates of authority to practice	1085
nursing as a certified registered nurse anesthetist, clinical	1086
nurse specialist, certified nurse-midwife, or certified nurse	1087
practitioner;	1088

(12) Approve under section 4723.46 of the Revised Code	1089
national certifying organizations for examination and	1090
certification of certified registered nurse anesthetists, clinical	1091
nurse specialists, certified nurse-midwives, or certified nurse	1092
practitioners;	1093

(13) Issue and renew certificates to prescribe in accordance	1094
with sections 4723.48 and 4723.486 of the Revised Code;	1095

(14) Grant approval to the ~~planned classroom and clinical~~	1096
course of study in advanced pharmacology and related topics	1097
required by section 4723.482 of the Revised Code to be eligible	1098
for a certificate to prescribe;	1099

(15) Make an annual edition of the formulary established in	1100
rules adopted under section 4723.50 of the Revised Code available	1101
to the public either in printed form or by electronic means and,	1102
as soon as possible after any revision of the formulary becomes	1103
effective, make the revision available to the public in printed	1104
form or by electronic means;	1105

(16) Provide guidance and make recommendations to the general	1106
assembly, the governor, state agencies, and the federal government	1107
with respect to the regulation of the practice of nursing and the	1108
enforcement of this chapter;	1109

(17) Make an annual report to the governor, which shall be	1110
open for public inspection;	1111

(18) Maintain and have open for public inspection the	1112
following records:	1113

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

1114

(b) A record of all applicants for, and holders of, licenses	1115
and certificates issued by the board under this chapter or in	1116
accordance with rules adopted under this chapter. The record shall	1117
be maintained in a format determined by the board.	1118

(c) A list of education and training programs approved by the	1119
board.	1120

(19) Deny approval to a person who submits or causes to be	1121
submitted false, misleading, or deceptive statements, information,	1122
or documentation to the board in the process of applying for	1123
approval of a new education or training program. If the board	1124
proposes to deny approval of a new education or training program,	1125
it shall do so pursuant to an adjudication conducted under Chapter	1126
119. of the Revised Code.	1127

(B) The board may fulfill the requirement of division (A)(8)	1128
of this section by authorizing persons who meet the standards	1129
established in rules adopted under section 4723.07 of the Revised	1130
Code to approve continuing education programs and courses. Persons	1131
so authorized shall approve continuing education programs and	1132
courses in accordance with standards established in rules adopted	1133
under section 4723.07 of the Revised Code.	1134

Persons seeking authorization to approve continuing education	1135
programs and courses shall apply to the board and pay the	1136
appropriate fee established under section 4723.08 of the Revised	1137
Code. Authorizations to approve continuing education programs and	1138
courses shall expire, and may be renewed according to the schedule	1139
established in rules adopted under section 4723.07 of the Revised	1140
Code.	1141

In addition to approving continuing education programs under	1142
division (A)(8) of this section, the board may sponsor continuing	1143
education activities that are directly related to the statutes and	1144
rules the board enforces.	1145

Sec. 4723.07. In accordance with Chapter 119. of the Revised	1146
Code, the board of nursing shall adopt and may amend and rescind	1147
rules that establish all of the following:	1148

(A) Provisions for the board's government and control of its	1149
actions and business affairs;	1150

(B) Minimum standards for nursing education programs that	1151
prepare graduates to be licensed under this chapter and procedures	1152
for granting, renewing, and withdrawing approval of those	1153
programs;	1154

(C) Criteria that applicants for licensure must meet to be	1155
eligible to take examinations for licensure;	1156

(D) Standards and procedures for renewal of the licenses and	1157
certificates issued by the board;	1158

(E) Standards for approval of continuing nursing education	1159
programs and courses for registered nurses, licensed practical	1160
nurses, certified registered nurse anesthetists, clinical nurse	1161
specialists, certified nurse-midwives, and certified nurse	1162
practitioners. The standards may provide for approval of	1163
continuing nursing education programs and courses that have been	1164
approved by other state boards of nursing or by national	1165
accreditation systems for nursing, including, but not limited to,	1166
the American nurses' credentialing center and the national	1167
association for practical nurse education and service.	1168

(F) Standards that persons must meet to be authorized by the	1169
board to approve continuing education programs and courses and a	1170
schedule by which that authorization expires and may be renewed;	1171

(G) Requirements, including continuing education	1172
requirements, for reactivating inactive licenses or certificates,	1173
and for reinstating licenses or certificates that have lapsed;	1174

(H) Conditions that may be imposed for reinstatement of a	1175
license or certificate following action taken under section	1176
3123.47, 4723.28, 4723.281, 4723.652, or 4723.86 of the Revised	1177
Code resulting in a license or certificate suspension;	1178

(I) Requirements for board approval of courses in medication	1179
administration by licensed practical nurses;	1180

(J) Criteria for evaluating the qualifications of an	1181
applicant for a license to practice nursing as a registered nurse,	1182
a license to practice nursing as a licensed practical nurse, or a	1183
certificate of authority issued under division (B) of section	1184
4723.41 of the Revised Code for the purpose of issuing the license	1185
or certificate by the board's endorsement of the applicant's	1186
authority to practice issued by the licensing agency of another	1187
state;	1188

(K) Universal and standard precautions that shall be used by	1189
each licensee or certificate holder. The rules shall define and	1190
establish requirements for universal and standard precautions that	1191
include the following:	1192

(1) Appropriate use of hand washing;

1193

(2) Disinfection and sterilization of equipment;

1194

(3) Handling and disposal of needles and other sharp	1195
instruments;	1196

(4) Wearing and disposal of gloves and other protective	1197
garments and devices.	1198

(L) Standards and procedures for approving certificates of	1199
authority to practice nursing as a certified registered nurse	1200
anesthetist, clinical nurse specialist, certified nurse-midwife,	1201
or certified nurse practitioner, and for renewal of those	1202
certificates;	1203

(M) Quality assurance standards for certified registered	1204
nurse anesthetists, clinical nurse specialists, certified	1205
nurse-midwives, or certified nurse practitioners;	1206

(N) Additional criteria for the standard care arrangement	1207
required by section 4723.431 of the Revised Code entered into by a	1208
clinical nurse specialist, certified nurse-midwife, or certified	1209
nurse practitioner and the nurse's collaborating physician or	1210
podiatrist;	1211

(O) Continuing education standards for clinical nurse	1212
specialists who were issued a certificate of authority to practice	1213
as a clinical nurse specialist under division (C) of section	1214
4723.41 of the Revised Code as that division existed at any time	1215
before ~~the effective date of this amendment~~March 20, 2013;	1216

(P) For purposes of division (B)(31) of section 4723.28 of	1217
the Revised Code, the actions, omissions, or other circumstances	1218
that constitute failure to establish and maintain professional	1219
boundaries with a patient;	1220

(Q) Standards and procedures for delegation under division	1221
(C) of section 4723.48 of the Revised Code of the authority to	1222
administer drugs.	1223

The board may adopt other rules necessary to carry out the	1224
provisions of this chapter. The rules shall be adopted in	1225
accordance with Chapter 119. of the Revised Code.	1226

Sec. 4723.18. (A) The board of nursing shall authorize a	1227
licensed practical nurse to administer to an adult intravenous	1228
therapy if the nurse supplies evidence satisfactory to the board	1229
that all of the following are the case:	1230

(1) The nurse holds a current, valid license issued under	1231
this chapter to practice nursing as a licensed practical nurse.	1232

(2) The nurse has been authorized under section ~~4723.18~~	1233
4723.17 of the Revised Code to administer medications.	1234

(3) The nurse successfully completed a course of study in the	1235
safe performance of intravenous therapy approved by the board	1236
pursuant to section 4723.19 of the Revised Code or by an agency in	1237
another jurisdiction that regulates the practice of nursing and	1238
has requirements for intravenous therapy course approval that are	1239
substantially similar to the requirements in division (B) of	1240
section 4723.19 of the Revised Code, as determined by the board.	1241

(4) The nurse has successfully completed a minimum of forty	1242
hours of training that includes all of the following:	1243

(a) The curriculum established by rules adopted by the board;

1244

(b) Training in the anatomy and physiology of the	1245
cardiovascular system, signs and symptoms of local and systemic	1246
complications in the administration of fluids and antibiotic	1247
additives, and guidelines for management of these complications;	1248

(c) Any other training or instruction the board considers	1249
appropriate;	1250

(d) A testing component that requires the nurse to perform a	1251
successful demonstration of the intravenous procedures, including	1252
all skills needed to perform them safely.	1253

(B) Except as provided in section 4723.181 of the Revised	1254
Code and subject to the restrictions in division (D) of this	1255
section, a licensed practical nurse may perform intravenous	1256
therapy on an adult patient only if authorized by the board	1257
pursuant to division (A) of this section and only at the direction	1258
of one of the following:	1259

(1) A ~~licensed~~ physician, physician assistant, dentist,	1260
optometrist, or podiatrist who is authorized to practice in this	1261
state and, except as provided in division (C)(2) of this section,	1262
is present and readily available at the facility where the	1263
intravenous therapy procedure is performed;	1264

(2) A registered nurse in accordance with division (C) of	1265
this section.	1266

(C)(1) Except as provided in division (C)(2) of this section	1267
and section 4723.181 of the Revised Code, when a licensed	1268
practical nurse authorized by the board to perform intravenous	1269
therapy performs an intravenous therapy procedure at the direction	1270
of a registered nurse, the registered nurse or another registered	1271
nurse shall be readily available at the site where the intravenous	1272
therapy is performed, and before the licensed practical nurse	1273
initiates the intravenous therapy, the registered nurse shall	1274
personally perform an on-site assessment of the adult patient who	1275
is to receive the intravenous therapy.	1276

(2) When a licensed practical nurse authorized by the board	1277
to perform intravenous therapy performs an intravenous therapy	1278
procedure in a home as defined in section 3721.10 of the Revised	1279
Code, or in an intermediate care facility for individuals with	1280
intellectual disabilities as defined in section 5124.01 of the	1281
Revised Code, at the direction of a registered nurse or ~~licensed~~	1282
physician, physician assistant, dentist, optometrist, or	1283
podiatrist who is authorized to practice in this state, a	1284
registered nurse shall be on the premises of the home or facility	1285
or accessible by some form of telecommunication.	1286

(D) No licensed practical nurse shall perform any of the	1287
following intravenous therapy procedures:	1288

(1) Initiating or maintaining any of the following:

1289

(a) Blood or blood components;

1290

(b) Solutions for total parenteral nutrition;

1291

(c) Any cancer therapeutic medication including, but not	1292
limited to, cancer chemotherapy or an anti-neoplastic agent;	1293

(d) Solutions administered through any central venous line or	1294
arterial line or any other line that does not terminate in a	1295
peripheral vein, except that a licensed practical nurse authorized	1296
by the board to perform intravenous therapy may maintain the	1297
solutions specified in division (D)(6)(a) of this section that are	1298
being administered through a central venous line or peripherally	1299
inserted central catheter;	1300

(e) Any investigational or experimental medication.

1301

(2) Initiating intravenous therapy in any vein, except that a	1302
licensed practical nurse authorized by the board to perform	1303
intravenous therapy may initiate intravenous therapy in accordance	1304
with this section in a vein of the hand, forearm, or antecubital	1305
fossa;	1306

(3) Discontinuing a central venous, arterial, or any other	1307
line that does not terminate in a peripheral vein;	1308

(4) Initiating or discontinuing a peripherally inserted	1309
central catheter;	1310

(5) Mixing, preparing, or reconstituting any medication for	1311
intravenous therapy, except that a licensed practical nurse	1312
authorized by the board to perform intravenous therapy may prepare	1313
or reconstitute an antibiotic additive;	1314

(6) Administering medication via the intravenous route,	1315
including all of the following activities:	1316

(a) Adding medication to an intravenous solution or to an	1317
existing infusion, except that a licensed practical nurse	1318
authorized by the board to perform intravenous therapy may do any	1319
of the following:	1320

(i) Initiate an intravenous infusion containing one or more	1321
of the following elements: dextrose 5%, normal saline, lactated	1322
ringers, sodium chloride .45%, sodium chloride 0.2%, sterile	1323
water;	1324

(ii) Hang subsequent containers of the intravenous solutions	1325
specified in division (D)(6)(a)(i) of this section that contain	1326
vitamins or electrolytes, if a registered nurse initiated the	1327
infusion of that same intravenous solution;	1328

(iii) Initiate or maintain an intravenous infusion containing	1329
an antibiotic additive.	1330

(b) Injecting medication via a direct intravenous route,	1331
except that a licensed practical nurse authorized by the board to	1332
perform intravenous therapy may inject heparin or normal saline to	1333
flush an intermittent infusion device or heparin lock including,	1334
but not limited to, bolus or push.	1335

(7) Changing tubing on any line including, but not limited	1336
to, an arterial line or a central venous line, except that a	1337
licensed practical nurse authorized by the board to perform	1338
intravenous therapy may change tubing on an intravenous line that	1339
terminates in a peripheral vein;	1340

(8) Programming or setting any function of a patient	1341
controlled infusion pump.	1342

(E) Notwithstanding divisions (A) and (D) of this section, at	1343
the direction of a physician or a registered nurse, a licensed	1344
practical nurse authorized by the board to perform intravenous	1345
therapy may perform the following activities for the purpose of	1346
performing dialysis:	1347

(1) The routine administration and regulation of saline	1348
solution for the purpose of maintaining an established fluid plan;	1349

(2) The administration of a heparin dose intravenously;

1350

(3) The administration of a heparin dose peripherally via a	1351
fistula needle;	1352

(4) The loading and activation of a constant infusion pump;

1353

(5) The intermittent injection of a dose of medication that	1354
is administered via the hemodialysis blood circuit and through the	1355
patient's venous access.	1356

(F) No person shall employ or direct a licensed practical	1357
nurse to perform an intravenous therapy procedure without first	1358
verifying that the licensed practical nurse is authorized by the	1359
board to perform intravenous therapy.	1360

Sec. 4723.181. (A) A licensed practical nurse may perform on	1361
any person any of the intravenous therapy procedures specified in	1362
division (B) of this section without receiving authorization to	1363
perform intravenous therapy from the board of nursing under	1364
section 4723.18 of the Revised Code, if both of the following	1365
apply:	1366

(1) The licensed practical nurse acts at the direction of a	1367
registered nurse or a ~~licensed~~ physician, physician assistant,	1368
dentist, optometrist, or podiatrist who is authorized to practice	1369
in this state and the registered nurse, physician, physician	1370
assistant, dentist, optometrist, or podiatrist is on the premises	1371
where the procedure is to be performed or accessible by some form	1372
of telecommunication.	1373

(2) The licensed practical nurse can demonstrate the	1374
knowledge, skills, and ability to perform the procedure safely.	1375

(B) The intravenous therapy procedures that a licensed	1376
practical nurse may perform pursuant to division (A) of this	1377
section are limited to the following:	1378

(1) Verification of the type of peripheral intravenous	1379
solution being administered;	1380

(2) Examination of a peripheral infusion site and the	1381
extremity for possible infiltration;	1382

(3) Regulation of a peripheral intravenous infusion according	1383
to the prescribed flow rate;	1384

(4) Discontinuation of a peripheral intravenous device at the	1385
appropriate time;	1386

(5) Performance of routine dressing changes at the insertion	1387
site of a peripheral venous or arterial infusion, peripherally	1388
inserted central catheter infusion, or central venous pressure	1389
subclavian infusion.	1390

Sec. 4723.48. (A) A clinical nurse specialist, certified	1391
nurse-midwife, or certified nurse practitioner seeking authority	1392
to prescribe drugs and therapeutic devices shall file with the	1393
board of nursing a written application for a certificate to	1394
prescribe. The board of nursing shall issue a certificate to	1395
prescribe to each applicant who meets the requirements specified	1396
in section 4723.482 or 4723.485 of the Revised Code.	1397

Except as provided in division (B) of this section, the	1398
initial certificate to prescribe that the board issues to an	1399
applicant shall be issued as an externship certificate. Under an	1400
externship certificate, the nurse may obtain experience in	1401
prescribing drugs and therapeutic devices by participating in an	1402
externship that evaluates the nurse's competence, knowledge, and	1403
skill in pharmacokinetic principles and their clinical application	1404
to the specialty being practiced. During the externship, the nurse	1405
may prescribe drugs and therapeutic devices only when one or more	1406
physicians are providing supervision in accordance with rules	1407
adopted under section 4723.50 of the Revised Code.	1408

After completing the externship, the holder of an externship	1409
certificate may apply for a new certificate to prescribe. On	1410
receipt of the new certificate, the nurse may prescribe drugs and	1411
therapeutic devices in collaboration with one or more physicians	1412
or podiatrists.	1413

(B) In the case of an applicant who meets the requirements of	1414
division (C) of section 4723.482 of the Revised Code, the initial	1415
certificate to prescribe that the board issues to the applicant	1416
under this section shall not be an externship certificate. The	1417
applicant shall be issued a certificate to prescribe that permits	1418
the recipient to prescribe drugs and therapeutic devices in	1419
collaboration with one or more physicians or podiatrists.	1420

(C)(1) The holder of a certificate issued under this section	1421
may delegate to a person not otherwise authorized to administer	1422
drugs the authority to administer a drug, other than a controlled	1423
substance, listed in the formulary established under division	1424
(B)(1) of section 4723.50 of the Revised Code to a specified	1425
patient. The delegation shall be in accordance with division	1426
(C)(2) of this section and standards and procedures established in	1427
rules adopted under division (O) of section 4723.07 of the Revised	1428
Code.	1429

(2) Prior to delegating authority, the certificate holder	1430
shall do both of the following:	1431

(a) Assess the patient and determine that the drug is	1432
appropriate for the patient;	1433

(b) Determine that the person to whom the authority will be	1434
delegated has met the conditions specified in division (D) of	1435
section 4723.489 of the Revised Code.	1436

Sec. 4723.482. (A) Except as provided in divisions (C) and	1437
(D) of this section, an applicant shall include with the	1438
application submitted under section 4723.48 of the Revised Code	1439
all of the following:	1440

(1) Evidence of holding a current, valid certificate of	1441
authority to practice as a clinical nurse specialist, certified	1442
nurse-midwife, or certified nurse practitioner that was issued by	1443
meeting the requirements of division (A) of section 4723.41 of the	1444
Revised Code;	1445

(2) Evidence of successfully completing the course of study	1446
in advanced pharmacology and related topics in accordance with the	1447
requirements specified in division (B) of this section;	1448

(3) The fee required by section 4723.08 of the Revised Code	1449
for a certificate to prescribe;	1450

(4) Any additional information the board of nursing requires	1451
pursuant to rules adopted under section 4723.50 of the Revised	1452
Code.	1453

(B) With respect to the course of study in advanced	1454
pharmacology and related topics that must be successfully	1455
completed to obtain a certificate to prescribe, all of the	1456
following requirements apply:	1457

(1) The course of study shall be completed not longer than	1458
three years before the application for the certificate to	1459
prescribe is filed.	1460

(2) ~~Except as provided in division (E) of this section, the~~	1461
~~course of study shall consist of planned classroom and clinical~~	1462
~~instruction.~~ The ~~total length of the~~ course of study shall be not	1463
less than forty-five contact hours.	1464

(3) The course of study shall meet the requirements to be	1465
approved by the board in accordance with standards established in	1466
rules adopted under section 4723.50 of the Revised Code.	1467

(4) The content of the course of study shall be specific to	1468
the applicant's nursing specialty.	1469

(5) The instruction provided in the course of study shall	1470
include all of the following:	1471

(a) A minimum of thirty-six contact hours of instruction in	1472
advanced pharmacology that includes pharmacokinetic principles and	1473
clinical application and the use of drugs and therapeutic devices	1474
in the prevention of illness and maintenance of health;	1475

(b) Instruction in the fiscal and ethical implications of	1476
prescribing drugs and therapeutic devices;	1477

(c) Instruction in the state and federal laws that apply to	1478
the authority to prescribe;	1479

(d) Instruction that is specific to schedule II controlled	1480
substances, including instruction in all of the following:	1481

(i) Indications for the use of schedule II controlled	1482
substances in drug therapies;	1483

(ii) The most recent guidelines for pain management	1484
therapies, as established by state and national organizations such	1485
as the Ohio pain initiative and the American pain society;	1486

(iii) Fiscal and ethical implications of prescribing schedule	1487
II controlled substances;	1488

(iv) State and federal laws that apply to the authority to	1489
prescribe schedule II controlled substances;	1490

(v) Prevention of abuse and diversion of schedule II	1491
controlled substances, including identification of the risk of	1492
abuse and diversion, recognition of abuse and diversion, types of	1493
assistance available for prevention of abuse and diversion, and	1494
methods of establishing safeguards against abuse and diversion.	1495

(e) Any additional instruction required pursuant to rules	1496
adopted under section 4723.50 of the Revised Code.	1497

(C) An applicant who practiced or is practicing as a clinical	1498
nurse specialist, certified nurse-midwife, or certified nurse	1499
practitioner in another jurisdiction or as an employee of the	1500
United States government, and is not seeking authority to	1501
prescribe drugs and therapeutic devices by meeting the	1502
requirements of division (A) or (D) of this section, shall include	1503
with the application submitted under section 4723.48 of the	1504
Revised Code all of the following:	1505

(1) Evidence of holding a current, valid certificate of	1506
authority issued under this chapter to practice as a clinical	1507
nurse specialist, certified nurse-midwife, or certified nurse	1508
practitioner;	1509

(2) The fee required by section 4723.08 of the Revised Code	1510
for a certificate to prescribe;	1511

(3) Either of the following:

1512

(a) Evidence of having held, for a continuous period of at	1513
least one year during the three years immediately preceding the	1514
date of application, valid authority issued by another	1515
jurisdiction to prescribe therapeutic devices and drugs, including	1516
at least some controlled substances;	1517

(b) Evidence of having been employed by the United States	1518
government and authorized, for a continuous period of at least one	1519
year during the three years immediately preceding the date of	1520
application, to prescribe therapeutic devices and drugs, including	1521
at least some controlled substances, in conjunction with that	1522
employment.	1523

(4) Evidence of having completed a two-hour course of	1524
instruction approved by the board in the laws of this state that	1525
govern drugs and prescriptive authority;	1526

(5) Any additional information the board requires pursuant to	1527
rules adopted under section 4723.50 of the Revised Code.	1528

(D) An applicant who practiced or is practicing as a clinical	1529
nurse specialist, certified nurse-midwife, or certified nurse	1530
practitioner in another jurisdiction or as an employee of the	1531
United States government, and is not seeking authority to	1532
prescribe drugs and therapeutic devices by meeting the	1533
requirements of division (A) or (C) of this section, shall include	1534
with the application submitted under section 4723.48 of the	1535
Revised Code all of the following:	1536

(1) Evidence of holding a current, valid certificate of	1537
authority issued under this chapter to practice as a clinical	1538
nurse specialist, certified nurse-midwife, or certified nurse	1539
practitioner;	1540

(2) The fee required by section 4723.08 of the Revised Code	1541
for a certificate to prescribe;	1542

(3) Either of the following:

1543

(a) Evidence of having held, for a continuous period of at	1544
least one year during the three years immediately preceding the	1545
date of application, valid authority issued by another	1546
jurisdiction to prescribe therapeutic devices and drugs, excluding	1547
controlled substances;	1548

(b) Evidence of having been employed by the United States	1549
government and authorized, for a continuous period of at least one	1550
year during the three years immediately preceding the date of	1551
application, to prescribe therapeutic devices and drugs, excluding	1552
controlled substances, in conjunction with that employment.	1553

(4) Any additional information the board requires pursuant to	1554
rules adopted under section 4723.50 of the Revised Code.	1555

~~(E) In the case of an applicant who meets the requirements of~~	1556
~~division (C) or (D) of this section other than the requirements of~~	1557
~~division (C)(3) or (D)(3) of this section and is seeking authority~~	1558
~~to prescribe drugs and therapeutic devices by meeting the~~	1559
~~requirements of division (A) of this section, the applicant may~~	1560
~~complete the instruction that is specific to schedule II~~	1561
~~controlled substances, as required by division (B)(5)(d) of this~~	1562
~~section, through an internet-based course of study in lieu of~~	1563
~~completing the instruction through a course of study consisting of~~	1564
~~planned classroom and clinical instruction.~~	1565

Sec. 4723.489. A person not otherwise authorized to	1566
administer drugs may administer a drug to a specified patient if	1567
all of the following conditions are met:	1568

(A) The authority to administer the drug is delegated to the	1569
person by an advanced practice registered nurse who is a clinical	1570
nurse specialist, certified nurse-midwife, or certified nurse	1571
practitioner and holds a certificate to prescribe issued under	1572
section 4723.48 of the Revised Code.	1573

(B) The drug is listed in the formulary established under	1574
division (B) of section 4723.50 of the Revised Code but is not a	1575
controlled substance and is not to be administered intravenously.	1576

(C) The drug is to be administered at a location other than a	1577
hospital inpatient care unit, as defined in section 3727.50 of the	1578
Revised Code; a hospital emergency department or a freestanding	1579
emergency department; or an ambulatory surgical facility, as	1580
defined in section 3702.30 of the Revised Code.	1581

(D) The person has successfully completed education based on	1582
a recognized body of knowledge concerning drug administration and	1583
demonstrates to the person's employer the knowledge, skills, and	1584
ability to administer the drug safely.	1585

(E) The person's employer has given the advanced practice	1586
registered nurse access to documentation, in written or electronic	1587
form, showing that the person has met the conditions specified in	1588
division (D) of this section.	1589

(F) The advanced practice registered nurse is physically	1590
present at the location where the drug is administered.	1591

Sec. 4723.50. (A) In accordance with Chapter 119. of the	1592
Revised Code, the board of nursing shall adopt rules as necessary	1593
to implement the provisions of this chapter pertaining to the	1594
authority of clinical nurse specialists, certified nurse-midwives,	1595
and certified nurse practitioners to prescribe drugs and	1596
therapeutic devices and the issuance and renewal of certificates	1597
to prescribe.	1598

The board shall adopt rules that are consistent with the	1599
recommendations the board receives from the committee on	1600
prescriptive governance pursuant to section 4723.492 of the	1601
Revised Code. After reviewing a recommendation submitted by the	1602
committee, the board may either adopt the recommendation as a rule	1603
or ask the committee to reconsider and resubmit the	1604
recommendation. The board shall not adopt any rule that does not	1605
conform to a recommendation made by the committee.	1606

(B) The board shall adopt rules under this section that do	1607
all of the following:	1608

(1) Establish a formulary listing the types of drugs and	1609
therapeutic devices that may be prescribed by a clinical nurse	1610
specialist, certified nurse-midwife, or certified nurse	1611
practitioner. The formulary may include controlled substances, as	1612
defined in section 3719.01 of the Revised Code. The formulary	1613
shall not permit the prescribing of any drug or device to perform	1614
or induce an abortion.	1615

(2) Establish safety standards to be followed by a clinical	1616
nurse specialist, certified nurse-midwife, or certified nurse	1617
practitioner when personally furnishing to patients complete or	1618
partial supplies of antibiotics, antifungals, scabicides,	1619
contraceptives, prenatal vitamins, antihypertensives, drugs and	1620
devices used in the treatment of diabetes, drugs and devices used	1621
in the treatment of asthma, and drugs used in the treatment of	1622
dyslipidemia;	1623

(3) Establish criteria for the components of the standard	1624
care arrangements described in section 4723.431 of the Revised	1625
Code that apply to the authority to prescribe, including the	1626
components that apply to the authority to prescribe schedule II	1627
controlled substances. The rules shall be consistent with that	1628
section and include all of the following:	1629

(a) Quality assurance standards;

1630

(b) Standards for periodic review by a collaborating	1631
physician or podiatrist of the records of patients treated by the	1632
clinical nurse specialist, certified nurse-midwife, or certified	1633
nurse practitioner;	1634

(c) Acceptable travel time between the location at which the	1635
clinical nurse specialist, certified nurse-midwife, or certified	1636
nurse practitioner is engaging in the prescribing components of	1637
the nurse's practice and the location of the nurse's collaborating	1638
physician or podiatrist;	1639

(d) Any other criteria recommended by the committee on	1640
prescriptive governance.	1641

(4) Establish standards and procedures for issuance and	1642
renewal of a certificate to prescribe, including specification of	1643
any additional information the board may require under division	1644
(A)(4), (C)(5), or (D)~~(5)~~(4) of section 4723.482 or, division	1645
(B)(3) of section 4723.485, or division (B)(3) of section 4723.486	1646
of the Revised Code;	1647

(5) Establish standards for board approval of the course of	1648
study in advanced pharmacology and related topics required by	1649
section 4723.482 of the Revised Code;	1650

(6) Establish requirements for board approval of the two-hour	1651
course of instruction in the laws of this state as required under	1652
division (C)(4) of section 4723.482 of the Revised Code and	1653
division (B)(2) of section 4723.484 of the Revised Code;	1654

(7) Establish standards and procedures for the appropriate	1655
conduct of an externship as described in section 4723.484 of the	1656
Revised Code, including the following:	1657

(a) Standards and procedures to be used in evaluating an	1658
individual's participation in an externship;	1659

(b) Standards and procedures for the supervision that a	1660
physician must provide during an externship, including supervision	1661
provided by working with the participant and supervision provided	1662
by making timely reviews of the records of patients treated by the	1663
participant. The manner in which supervision must be provided may	1664
vary according to the location where the participant is practicing	1665
and with the participant's level of experience.	1666

Sec. 4729.01. As used in this chapter:

1667

(A) "Pharmacy," except when used in a context that refers to	1668
the practice of pharmacy, means any area, room, rooms, place of	1669
business, department, or portion of any of the foregoing where the	1670
practice of pharmacy is conducted.	1671

(B) "Practice of pharmacy" means providing pharmacist care	1672
requiring specialized knowledge, judgment, and skill derived from	1673
the principles of biological, chemical, behavioral, social,	1674
pharmaceutical, and clinical sciences. As used in this division,	1675
"pharmacist care" includes the following:	1676

(1) Interpreting prescriptions;

1677

(2) Dispensing drugs and drug therapy related devices;

1678

(3) Compounding drugs;

1679

(4) Counseling individuals with regard to their drug therapy,	1680
recommending drug therapy related devices, and assisting in the	1681
selection of drugs and appliances for treatment of common diseases	1682
and injuries and providing instruction in the proper use of the	1683
drugs and appliances;	1684

(5) Performing drug regimen reviews with individuals by	1685
discussing all of the drugs that the individual is taking and	1686
explaining the interactions of the drugs;	1687

(6) Performing drug utilization reviews with licensed health	1688
professionals authorized to prescribe drugs when the pharmacist	1689
determines that an individual with a prescription has a drug	1690
regimen that warrants additional discussion with the prescriber;	1691

(7) Advising an individual and the health care professionals	1692
treating an individual with regard to the individual's drug	1693
therapy;	1694

(8) Acting pursuant to a consult agreement with a physician	1695
authorized under Chapter 4731. of the Revised Code to practice	1696
medicine and surgery or osteopathic medicine and surgery, if an	1697
agreement has been established with the physician;	1698

(9) Engaging in the administration of immunizations to the	1699
extent authorized by section 4729.41 of the Revised Code.	1700

(C) "Compounding" means the preparation, mixing, assembling,	1701
packaging, and labeling of one or more drugs in any of the	1702
following circumstances:	1703

(1) Pursuant to a prescription issued by a licensed health	1704
professional authorized to prescribe drugs;	1705

(2) Pursuant to the modification of a prescription made in	1706
accordance with a consult agreement;	1707

(3) As an incident to research, teaching activities, or	1708
chemical analysis;	1709

(4) In anticipation of orders for drugs pursuant to	1710
prescriptions, based on routine, regularly observed dispensing	1711
patterns;	1712

(5) Pursuant to a request made by a licensed health	1713
professional authorized to prescribe drugs for a drug that is to	1714
be used by the professional for the purpose of direct	1715
administration to patients in the course of the professional's	1716
practice, if all of the following apply:	1717

(a) At the time the request is made, the drug is not	1718
commercially available regardless of the reason that the drug is	1719
not available, including the absence of a manufacturer for the	1720
drug or the lack of a readily available supply of the drug from a	1721
manufacturer.	1722

(b) A limited quantity of the drug is compounded and provided	1723
to the professional.	1724

(c) The drug is compounded and provided to the professional	1725
as an occasional exception to the normal practice of dispensing	1726
drugs pursuant to patient-specific prescriptions.	1727

(D) "Consult agreement" means an agreement to manage an	1728
individual's drug therapy that has been entered into by a	1729
pharmacist and a physician authorized under Chapter 4731. of the	1730
Revised Code to practice medicine and surgery or osteopathic	1731
medicine and surgery.	1732

(E) "Drug" means:

1733

(1) Any article recognized in the United States pharmacopoeia	1734
and national formulary, or any supplement to them, intended for	1735
use in the diagnosis, cure, mitigation, treatment, or prevention	1736
of disease in humans or animals;	1737

(2) Any other article intended for use in the diagnosis,	1738
cure, mitigation, treatment, or prevention of disease in humans or	1739
animals;	1740

(3) Any article, other than food, intended to affect the	1741
structure or any function of the body of humans or animals;	1742

(4) Any article intended for use as a component of any	1743
article specified in division (E)(1), (2), or (3) of this section;	1744
but does not include devices or their components, parts, or	1745
accessories.	1746

(F) "Dangerous drug" means any of the following:

1747

(1) Any drug to which either of the following applies:

1748

(a) Under the "Federal Food, Drug, and Cosmetic Act," 52	1749
Stat. 1040 (1938), 21 U.S.C.A. 301, as amended, the drug is	1750
required to bear a label containing the legend "Caution: Federal	1751
law prohibits dispensing without prescription" or "Caution:	1752
Federal law restricts this drug to use by or on the order of a	1753
licensed veterinarian" or any similar restrictive statement, or	1754
the drug may be dispensed only upon a prescription;	1755

(b) Under Chapter 3715. or 3719. of the Revised Code, the	1756
drug may be dispensed only upon a prescription.	1757

(2) Any drug that contains a schedule V controlled substance	1758
and that is exempt from Chapter 3719. of the Revised Code or to	1759
which that chapter does not apply;	1760

(3) Any drug intended for administration by injection into	1761
the human body other than through a natural orifice of the human	1762
body.	1763

(G) "Federal drug abuse control laws" has the same meaning as	1764
in section 3719.01 of the Revised Code.	1765

(H) "Prescription" means a written, electronic, or oral order	1766
for drugs or combinations or mixtures of drugs to be used by a	1767
particular individual or for treating a particular animal, issued	1768
by a licensed health professional authorized to prescribe drugs.	1769

(I) "Licensed health professional authorized to prescribe	1770
drugs" or "prescriber" means an individual who is authorized by	1771
law to prescribe drugs or dangerous drugs or drug therapy related	1772
devices in the course of the individual's professional practice,	1773
including only the following:	1774

(1) A dentist licensed under Chapter 4715. of the Revised	1775
Code;	1776

(2) A clinical nurse specialist, certified nurse-midwife, or	1777
certified nurse practitioner who holds a certificate to prescribe	1778
issued under section 4723.48 of the Revised Code;	1779

(3) An optometrist licensed under Chapter 4725. of the	1780
Revised Code to practice optometry under a therapeutic	1781
pharmaceutical agents certificate;	1782

(4) A physician authorized under Chapter 4731. of the Revised	1783
Code to practice medicine and surgery, osteopathic medicine and	1784
surgery, or podiatric medicine and surgery;	1785

(5) A physician assistant who holds a ~~certificate to~~	1786
~~prescribe~~valid prescriber number issued ~~under Chapter 4730. of~~	1787
~~the Revised Code~~by the state medical board and has been granted	1788
physician-delegated prescriptive authority;	1789

(6) A veterinarian licensed under Chapter 4741. of the	1790
Revised Code.	1791

(J) "Sale" and "sell" include delivery, transfer, barter,	1792
exchange, or gift, or offer therefor, and each such transaction	1793
made by any person, whether as principal proprietor, agent, or	1794
employee.	1795

(K) "Wholesale sale" and "sale at wholesale" mean any sale in	1796
which the purpose of the purchaser is to resell the article	1797
purchased or received by the purchaser.	1798

(L) "Retail sale" and "sale at retail" mean any sale other	1799
than a wholesale sale or sale at wholesale.	1800

(M) "Retail seller" means any person that sells any dangerous	1801
drug to consumers without assuming control over and responsibility	1802
for its administration. Mere advice or instructions regarding	1803
administration do not constitute control or establish	1804
responsibility.	1805

(N) "Price information" means the price charged for a	1806
prescription for a particular drug product and, in an easily	1807
understandable manner, all of the following:	1808

(1) The proprietary name of the drug product;

1809

(2) The established (generic) name of the drug product;

1810

(3) The strength of the drug product if the product contains	1811
a single active ingredient or if the drug product contains more	1812
than one active ingredient and a relevant strength can be	1813
associated with the product without indicating each active	1814
ingredient. The established name and quantity of each active	1815
ingredient are required if such a relevant strength cannot be so	1816
associated with a drug product containing more than one	1817
ingredient.	1818

(4) The dosage form;

1819

(5) The price charged for a specific quantity of the drug	1820
product. The stated price shall include all charges to the	1821
consumer, including, but not limited to, the cost of the drug	1822
product, professional fees, handling fees, if any, and a statement	1823
identifying professional services routinely furnished by the	1824
pharmacy. Any mailing fees and delivery fees may be stated	1825
separately without repetition. The information shall not be false	1826
or misleading.	1827

(O) "Wholesale distributor of dangerous drugs" means a person	1828
engaged in the sale of dangerous drugs at wholesale and includes	1829
any agent or employee of such a person authorized by the person to	1830
engage in the sale of dangerous drugs at wholesale.	1831

(P) "Manufacturer of dangerous drugs" means a person, other	1832
than a pharmacist, who manufactures dangerous drugs and who is	1833
engaged in the sale of those dangerous drugs within this state.	1834

(Q) "Terminal distributor of dangerous drugs" means a person	1835
who is engaged in the sale of dangerous drugs at retail, or any	1836
person, other than a wholesale distributor or a pharmacist, who	1837
has possession, custody, or control of dangerous drugs for any	1838
purpose other than for that person's own use and consumption, and	1839
includes pharmacies, hospitals, nursing homes, and laboratories	1840
and all other persons who procure dangerous drugs for sale or	1841
other distribution by or under the supervision of a pharmacist or	1842
licensed health professional authorized to prescribe drugs.	1843

(R) "Promote to the public" means disseminating a	1844
representation to the public in any manner or by any means, other	1845
than by labeling, for the purpose of inducing, or that is likely	1846
to induce, directly or indirectly, the purchase of a dangerous	1847
drug at retail.	1848

(S) "Person" includes any individual, partnership,	1849
association, limited liability company, or corporation, the state,	1850
any political subdivision of the state, and any district,	1851
department, or agency of the state or its political subdivisions.	1852

(T) "Finished dosage form" has the same meaning as in section	1853
3715.01 of the Revised Code.	1854

(U) "Generically equivalent drug" has the same meaning as in	1855
section 3715.01 of the Revised Code.	1856

(V) "Animal shelter" means a facility operated by a humane	1857
society or any society organized under Chapter 1717. of the	1858
Revised Code or a dog pound operated pursuant to Chapter 955. of	1859
the Revised Code.	1860

(W) "Food" has the same meaning as in section 3715.01 of the	1861
Revised Code.	1862

(X) "Pain management clinic" has the same meaning as in	1863
section 4731.054 of the Revised Code.	1864

Sec. 4730.01. As used in this chapter:

1865

(A) ~~"Physician assistant" means a skilled person qualified by~~	1866
~~academic and clinical training to provide services to patients as~~	1867
~~a physician assistant under the supervision, control, and~~	1868
~~direction of one or more physicians who are responsible for the~~	1869
~~physician assistant's performance.~~	1870

~~(B)~~ "Physician" means an individual who is authorized under	1871
Chapter 4731. of the Revised Code to practice medicine and	1872
surgery, osteopathic medicine and surgery, or podiatric medicine	1873
and surgery.	1874

~~(C)~~(B) "Health care facility" means any of the following:

1875

(1) A hospital registered with the department of health under	1876
section 3701.07 of the Revised Code;	1877

(2) A health care facility licensed by the department of	1878
health under section 3702.30 of the Revised Code;	1879

(3) Any other facility designated by the state medical board	1880
in rules adopted pursuant to division (B)~~(2)~~ of section 4730.08 of	1881
the Revised Code.	1882

~~(D) "Special services" means the health care services that a~~	1883
~~physician assistant may be authorized to provide under the special~~	1884
~~services portion of a physician supervisory plan approved under~~	1885
~~section 4730.17 of the Revised Code~~(C) "Service" means a medical	1886
activity that requires training in the diagnosis, treatment, or	1887
prevention of disease.	1888

Sec. 4730.02. (A) No person shall hold that person out as	1889
being able to function as a physician assistant, or use any words	1890
or letters indicating or implying that the person is a physician	1891
assistant, without a current, valid ~~certificate~~license to	1892
practice as a physician assistant issued pursuant to this chapter.	1893

(B) No person shall practice as a physician assistant without	1894
the supervision, control, and direction of a physician.	1895

(C) ~~No person shall act as the supervising physician of a~~	1896
~~physician assistant without having received the state medical~~	1897
~~board's approval of a supervision agreement entered into with the~~	1898
~~physician assistant.~~	1899

~~(D)~~ No person shall practice as a physician assistant without	1900
having entered into a supervision agreement ~~that has been approved~~	1901
~~by the state medical board~~with a supervising physician under	1902
section 4730.19 of the Revised Code.	1903

~~(E)~~(D) No person acting as the supervising physician of a	1904
physician assistant shall authorize the physician assistant to	1905
perform services if either of the following is the case:	1906

(1) The services are not within the physician's normal course	1907
of practice and expertise;	1908

(2) The services are inconsistent with the ~~physician~~	1909
~~supervisory plan approved by the state medical board for the~~	1910
~~supervising physician or~~supervision agreement under which the	1911
physician assistant is being supervised, including, if applicable,	1912
the policies of the health care facility in which the physician	1913
and physician assistant are practicing.	1914

~~(F) No person shall practice as a physician assistant in a~~	1915
~~manner that is inconsistent with the physician supervisory plan~~	1916
~~approved for the physician who is responsible for supervising the~~	1917
~~physician assistant or the policies of the health care facility in~~	1918
~~which the physician assistant is practicing.~~	1919

~~(G)~~(E) No person practicing as a physician assistant shall	1920
prescribe any drug or device to perform or induce an abortion, or	1921
otherwise perform or induce an abortion.	1922

~~(H)~~(F) No person shall advertise to provide services as a	1923
physician assistant, except for the purpose of seeking employment.	1924

~~(I)~~(G) No person practicing as a physician assistant shall	1925
fail to wear at all times when on duty a placard, plate, or other	1926
device identifying that person as a "physician assistant."	1927

Sec. 4730.03. Nothing in this chapter shall:

1928

(A) Be construed to affect or interfere with the performance	1929
of duties of any medical personnel who are either of the	1930
following:	1931

(1) In active service in the army, navy, coast guard, marine	1932
corps, air force, public health service, or marine hospital	1933
service of the United States while so serving;	1934

(2) Employed by the veterans administration of the United	1935
States while so employed;.	1936

(B) Prevent any person from performing any of the services a	1937
physician assistant may be authorized to perform, if the person's	1938
professional scope of practice established under any other chapter	1939
of the Revised Code authorizes the person to perform the services;	1940

(C) Prohibit a physician from delegating responsibilities to	1941
any nurse or other qualified person who does not hold a	1942
~~certificate~~license to practice as a physician assistant, provided	1943
that the individual does not hold the individual out to be a	1944
physician assistant;	1945

(D) Be construed as authorizing a physician assistant	1946
independently to order or direct the execution of procedures or	1947
techniques by a registered nurse or licensed practical nurse in	1948
the care and treatment of a person in any setting, except to the	1949
extent that the physician assistant is authorized to do so by ~~the~~	1950
~~physician supervisory plan approved under section 4730.17 of the~~	1951
~~Revised Code for the~~a physician who is responsible for	1952
supervising the physician assistant orand, if applicable, the	1953
policies of the health care facility in which the physician	1954
assistant is practicing;	1955

(E) Authorize a physician assistant to engage in the practice	1956
of optometry, except to the extent that the physician assistant is	1957
authorized by a supervising physician acting in accordance with	1958
this chapter to perform routine visual screening, provide medical	1959
care prior to or following eye surgery, or assist in the care of	1960
diseases of the eye;	1961

(F) Be construed as authorizing a physician assistant to	1962
prescribe any drug or device to perform or induce an abortion, or	1963
as otherwise authorizing a physician assistant to perform or	1964
induce an abortion.	1965

Sec. 4730.04. (A) As used in this section:

1966

(1) "Disaster" means any imminent threat or actual occurrence	1967
of widespread or severe damage to or loss of property, personal	1968
hardship or injury, or loss of life that results from any natural	1969
phenomenon or act of a human.	1970

(2) "Emergency" means an occurrence or event that poses an	1971
imminent threat to the health or life of a human.	1972

(B) Nothing in this chapter prohibits any of the following	1973
individuals from providing medical care, to the extent the	1974
individual is able, in response to a need for medical care	1975
precipitated by a disaster or emergency:	1976

(1) An individual who holds a ~~certificate~~license to practice	1977
as a physician assistant issued under this chapter;	1978

(2) An individual licensed or authorized to practice as a	1979
physician assistant in another state;	1980

(3) An individual credentialed or employed as a physician	1981
assistant by an agency, office, or other instrumentality of the	1982
federal government.	1983

(C) For purposes of the medical care provided by a physician	1984
assistant pursuant to division (B)(1) of this section, both of the	1985
following apply notwithstanding any supervision requirement of	1986
this chapter to the contrary:	1987

(1) The physician who supervises the physician assistant	1988
pursuant to a ~~physician supervisory plan approved by the state~~	1989
~~medical board under section 4730.17 of the Revised Code~~	1990
supervision agreement entered into under section 4730.19 of the	1991
Revised Code is not required to meet the supervision requirements	1992
established under this chapter.	1993

(2) The physician designated as the medical director of the	1994
disaster or emergency may supervise the medical care provided by	1995
the physician assistant.	1996

Sec. 4730.06. (A) The physician assistant policy committee	1997
of the state medical board shall review, and shall submit to the	1998
board recommendations concerning, all of the following:	1999

(1) Requirements for ~~issuance of certificates~~issuing a	2000
license to practice as a physician assistant, including the	2001
educational requirements that must be met to receive a ~~certificate~~	2002
license to practice;	2003

(2) Existing and proposed rules pertaining to the practice of	2004
physician assistants, the supervisory relationship between	2005
physician assistants and supervising physicians, and the	2006
administration and enforcement of this chapter;	2007

(3) In accordance with section 4730.38 of the Revised Code,	2008
physician-delegated prescriptive authority for physician	2009
assistants and proposed changes to the physician assistant	2010
formulary the board adopts pursuant to division (A)(1) of section	2011
4730.39 of the Revised Code;	2012

(4) Application procedures and forms for ~~certificates~~a	2013
license to practice as a physician assistant~~, physician~~	2014
~~supervisory plans, and supervision agreements~~;	2015

(5) Fees required by this chapter for issuance and renewal of	2016
~~certificates~~a license to practice as a physician assistant;	2017

(6) ~~Criteria to be included in applications submitted to the~~	2018
~~board for approval of physician supervisory plans, including~~	2019
~~criteria to be included in applications for approval to delegate~~	2020
~~to physician assistants the performance of special services;~~	2021

~~(7) Criteria to be included in supervision agreements~~	2022
~~submitted to the board for approval and renewal of the board's~~	2023
~~approval;~~	2024

~~(8)~~ Any issue the board asks the committee to consider.

2025

(B) In addition to the matters that are required to be	2026
reviewed under division (A) of this section, the committee may	2027
review, and may submit to the board recommendations concerning,	2028
~~either or both of the following:~~	2029

~~(1) Quality~~quality assurance activities to be performed by a	2030
supervising physician and physician assistant under a quality	2031
assurance system established pursuant to division (F) of section	2032
4730.21 of the Revised Code;	2033

~~(2) The development and approval of one or more model~~	2034
~~physician supervisory plans and one or more models for a special~~	2035
~~services portion of the one or more model physician supervisory~~	2036
~~plans. The committee may submit recommendations for model plans~~	2037
~~that reflect various medical specialties~~.	2038

(C) The board shall take into consideration all	2039
recommendations submitted by the committee. Not later than ninety	2040
days after receiving a recommendation from the committee, the	2041
board shall approve or disapprove the recommendation and notify	2042
the committee of its decision. If a recommendation is disapproved,	2043
the board shall inform the committee of its reasons for making	2044
that decision. The committee may resubmit the recommendation after	2045
addressing the concerns expressed by the board and modifying the	2046
disapproved recommendation accordingly. Not later than ninety days	2047
after receiving a resubmitted recommendation, the board shall	2048
approve or disapprove the recommendation. There is no limit on the	2049
number of times the committee may resubmit a recommendation for	2050
consideration by the board.	2051

(D)(1) Except as provided in division (D)(2) of this section,	2052
the board may not take action regarding a matter that is subject	2053
to the committee's review under division (A) or (B) of this	2054
section unless the committee has made a recommendation to the	2055
board concerning the matter.	2056

(2) If the board submits to the committee a request for a	2057
recommendation regarding a matter that is subject to the	2058
committee's review under division (A) or (B) of this section, and	2059
the committee does not provide a recommendation before the	2060
sixty-first day after the request is submitted, the board may take	2061
action regarding the matter without a recommendation.	2062

Sec. 4730.08. (A) A ~~certificate~~license to practice as a	2063
physician assistant issued under this chapter authorizes the	2064
holder to practice as a physician assistant~~, subject to all of the~~	2065
~~following~~as follows:	2066

(1) The physician assistant shall practice only under the	2067
supervision, control, and direction of a physician with whom the	2068
physician assistant has entered into a supervision agreement	2069
~~approved by the state medical board~~ under section ~~4730.17~~4730.19	2070
of the Revised Code.	2071

(2) ~~When the physician assistant practices outside a health~~	2072
~~care facility, the~~The physician assistant shall practice in	2073
accordance with the ~~physician supervisory plan approved under~~	2074
~~section 4730.17 of the Revised Code for~~supervision agreement	2075
entered into with the physician who is responsible for supervising	2076
the physician assistant.	2077

~~(3) When the physician assistant practices within a health~~	2078
~~care facility, the physician assistant shall practice in~~	2079
~~accordance with~~, including, if applicable, the policies of the	2080
health care facility in which the physician assistant is	2081
practicing.	2082

(B) ~~For purposes of division (A) of this section and all~~	2083
~~other provisions of this chapter pertaining to the practice of a~~	2084
~~physician assistant under the policies of a health care facility,~~	2085
~~both of the following apply:~~	2086

~~(1) A physician who is supervising a physician assistant~~	2087
~~within a health care facility may impose limitations on the~~	2088
~~physician assistant's practice that are in addition to any~~	2089
~~limitations applicable under the policies of the facility.~~	2090

~~(2)~~ The state medical board may, subject to division (D) of	2091
section 4730.06 of the Revised Code, adopt rules designating	2092
facilities to be included as health care facilities that are in	2093
addition to the facilities specified in divisions ~~(C)~~(B)(1) and	2094
(2) of section 4730.01 of the Revised Code. ~~The~~Any rules adopted	2095
shall be adopted in accordance with Chapter 119. of the Revised	2096
Code.	2097

Sec. 4730.10. (A) An individual seeking a ~~certificate~~	2098
license to practice as a physician assistant shall file with the	2099
state medical board a written application on a form prescribed and	2100
supplied by the board. The application shall include all of the	2101
following:	2102

(1) The applicant's name, residential address, business	2103
address, if any, and social security number;	2104

(2) Satisfactory proof that the applicant meets the age and	2105
moral character requirements specified in divisions (A)(1) and (2)	2106
of section 4730.11 of the Revised Code;	2107

(3) Satisfactory proof that the applicant meets either the	2108
educational requirements specified in division (B)(1) or (2) of	2109
section 4730.11 of the Revised Code or the educational or other	2110
applicable requirements specified in division (C)(1), (2), or (3)	2111
of that section;	2112

(4) Any other information the board requires.

2113

(B) At the time of making application for a ~~certificate~~	2114
license to practice, the applicant shall pay the board a fee of	2115
~~two~~five hundred dollars, no part of which shall be returned. The	2116
fees shall be deposited in accordance with section 4731.24 of the	2117
Revised Code.	2118

Sec. 4730.101. In addition to any other eligibility	2119
requirement set forth in this chapter, each applicant for a	2120
~~certificate~~license to practice as a physician assistant shall	2121
comply with sections 4776.01 to 4776.04 of the Revised Code. The	2122
state medical board shall not grant to an applicant a ~~certificate~~	2123
license to practice as a physician assistant unless the board, in	2124
its discretion, decides that the results of the criminal records	2125
check do not make the applicant ineligible for a ~~certificate~~	2126
license issued pursuant to section 4730.12 of the Revised Code.	2127

Sec. 4730.11. (A) To be eligible to receive a ~~certificate~~	2128
license to practice as a physician assistant, all of the following	2129
apply to an applicant:	2130

(1) The applicant shall be at least eighteen years of age.

2131

(2) The applicant shall be of good moral character.

2132

(3) The applicant shall hold current certification by the	2133
national commission on certification of physician assistants or a	2134
successor organization that is recognized by the state medical	2135
board.	2136

(4) The applicant shall meet either of the following	2137
requirements:	2138

(a) The educational requirements specified in division (B)(1)	2139
or (2) of this section;	2140

(b) The educational or other applicable requirements	2141
specified in division (C)(1), (2), or (3) of this section.	2142

(B) Effective January 1, 2008, for purposes of division	2143
(A)(4)(a) of this section, an applicant shall meet either of the	2144
following educational requirements:	2145

(1) The applicant shall hold a master's or higher degree	2146
obtained from a program accredited by the accreditation review	2147
commission on education for the physician assistant or a	2148
predecessor or successor organization recognized by the board.	2149

(2) The applicant shall hold both of the following degrees:

2150

(a) A degree other than a master's or higher degree obtained	2151
from a program accredited by the accreditation review commission	2152
on education for the physician assistant or a predecessor or	2153
successor organization recognized by the board;	2154

(b) A master's or higher degree in a course of study with	2155
clinical relevance to the practice of physician assistants and	2156
obtained from a program accredited by a regional or specialized	2157
and professional accrediting agency recognized by the council for	2158
higher education accreditation.	2159

(C) For purposes of division (A)(4)(b) of this section, an	2160
applicant shall present evidence satisfactory to the board of	2161
meeting one of the following requirements in lieu of meeting the	2162
educational requirements specified in division (B)(1) or (2) of	2163
this section:	2164

(1) The applicant shall hold a current, valid license or	2165
other form of authority to practice as a physician assistant	2166
issued by another jurisdiction ~~prior to January 1, 2008~~and have	2167
been in active practice in any jurisdiction throughout the	2168
three-year period immediately preceding the date of application.	2169

(2) The applicant shall hold a degree obtained as a result of	2170
being enrolled on January 1, 2008, in a program in this state that	2171
was accredited by the accreditation review commission on education	2172
for the physician assistant but did not grant a master's or higher	2173
degree to individuals enrolled in the program on that date, and	2174
completing the program on or before December 31, 2009.	2175

(3) The applicant shall ~~meet both of the following~~	2176
~~educational and military experience requirements:~~	2177

~~(a) Hold~~hold a degree obtained from a program accredited by	2178
the accreditation review commission on education for the physician	2179
assistant;and meet either of the following experience	2180
requirements:	2181

~~(b)~~(a) Have experience practicing as a physician assistant	2182
for at least three consecutive years while on active duty, with	2183
evidence of service under honorable conditions, in any of the	2184
armed forces of the United States or the national guard of any	2185
state, including any experience attained while practicing as a	2186
physician assistant at a health care facility or clinic operated	2187
by the United States department of veterans affairs.	2188

(b) Have experience practicing as a physician assistant for	2189
at least three consecutive years while on active duty in the	2190
United States public health service commissioned corps.	2191

(D) Unless the applicant had prescriptive authority while	2192
practicing as a physician assistant in another jurisdiction, in	2193
the military, or in the public health service, the license issued	2194
to an applicant who does not hold a master's or higher degree	2195
described in division (B) of this section does not authorize the	2196
holder to exercise physician-delegated prescriptive authority and	2197
the state medical board shall not issue a prescriber number.	2198

(E)(1) This section does not require an individual to obtain	2199
a master's or higher degree as a condition of retaining or	2200
renewing a ~~certificate~~license to practice as a physician	2201
assistant if the individual received the ~~certificate~~license	2202
without holding a master's or higher degree as provided in either	2203
of the following:	2204

~~(1)~~(a) Before the educational requirements specified in	2205
division (B)(1) or (2) of this section became effective January 1,	2206
2008;	2207

~~(2)~~(b) By meeting the educational or other applicable	2208
requirements specified in division (C)(1), (2), or (3) of this	2209
section.	2210

(2) A license described in division (E)(1) of this section	2211
authorizes the license holder to exercise physician-delegated	2212
prescriptive authority if, on the effective date of this	2213
amendment, the license holder held a valid certificate to	2214
prescribe issued under former section 4730.44 of the Revised Code,	2215
as it existed immediately prior to the effective date of this	2216
amendment.	2217

(3) On application of an individual who received a license	2218
without having first obtained a master's or higher degree and is	2219
not authorized under division (E)(2) of this section to exercise	2220
physician-delegated prescriptive authority, the board shall grant	2221
the individual the authority to exercise physician-delegated	2222
prescriptive authority if the individual provides evidence	2223
satisfactory to the board of having obtained a master's or higher	2224
degree from either of the following:	2225

(a) A program accredited by the accreditation review	2226
commission on education for the physician assistant or a	2227
predecessor or successor organization recognized by the board;	2228

(b) A program accredited by a regional or specialized and	2229
professional accrediting agency recognized by the council for	2230
higher education accreditation, if the degree is in a course of	2231
study with clinical relevance to the practice of physician	2232
assistants.	2233

Sec. 4730.111. A physician assistant whose certification by	2234
the national commission on certification of physician assistants	2235
or a successor organization recognized by the state medical board	2236
is suspended or revoked shall give notice of that occurrence to	2237
the board not later than fourteen days after the physician	2238
assistant receives notice of the change in certification status. A	2239
physician assistant who fails to renew the certification shall	2240
notify the board not later than fourteen days after the	2241
certification expires.	2242

Sec. 4730.12. (A) The state medical board shall review ~~all~~	2243
~~applications~~each application received under section 4730.10 of	2244
the Revised Code for ~~certificates~~a license to practice as a	2245
physician assistant. Not later than sixty days after receiving a	2246
complete application, the board shall determine whether an	2247
applicant meets the requirements to receive a ~~certificate~~license	2248
to practice, as specified in section 4730.11 of the Revised Code.	2249
An affirmative vote of not fewer than six members of the board is	2250
required to determine that an applicant meets the requirements to	2251
receive a ~~certificate~~license to practice as a physician	2252
assistant.	2253

(B) If the board determines that an applicant meets the	2254
requirements to receive the ~~certificate~~license, the secretary of	2255
the board shall register the applicant as a physician assistant	2256
and issue to the applicant a ~~certificate~~license to practice as a	2257
physician assistant.	2258

(C)(1) During the first five hundred hours of the first one	2259
thousand hours of a physician assistant's exercise of	2260
physician-delegated prescriptive authority, the physician	2261
assistant shall exercise that authority only under the on-site	2262
supervision of a supervising physician.	2263

(2) A physician assistant shall be excused from the	2264
requirement established in division (C)(1) of this section if	2265
prior to application the physician assistant held a prescriber	2266
number, or the equivalent, from another jurisdiction and practiced	2267
with prescriptive authority in that jurisdiction for not less than	2268
one thousand hours.	2269

(3) A record of a physician assistant's completion of the	2270
hours required by division (C)(1) of this section or issuance of a	2271
prescriber number or equivalent by another jurisdiction shall be	2272
kept on file by a supervising physician of the physician	2273
assistant. The record shall be made available for inspection by	2274
the board.	2275

Sec. 4730.13. Upon application by the holder of a	2276
~~certificate~~license to practice as a physician assistant, the	2277
state medical board shall issue a duplicate ~~certificate~~license to	2278
replace one that is missing or damaged, to reflect a name change,	2279
or for any other reasonable cause. The fee for a duplicate	2280
~~certificate~~license shall be thirty-five dollars. All fees	2281
collected under this section shall be deposited in accordance with	2282
section 4731.24 of the Revised Code.	2283

Sec. 4730.14. (A) A ~~certificate~~license to practice as a	2284
physician assistant shall expire biennially and may be renewed in	2285
accordance with this section. A person seeking to renew a	2286
~~certificate~~license to practice as a physician assistant shall, on	2287
or before the thirty-first day of January of each even-numbered	2288
year, apply for renewal of the certificate. The state medical	2289
board shall send renewal notices at least one month prior to the	2290
expiration date.	2291

Applications shall be submitted to the board on forms the	2292
board shall prescribe and furnish. Each application shall be	2293
accompanied by a biennial renewal fee of ~~one~~two hundred dollars.	2294
The board shall deposit the fees in accordance with section	2295
4731.24 of the Revised Code.	2296

The applicant shall report any criminal offense that	2297
constitutes grounds for refusing to issue a ~~certificate~~license to	2298
practice under section 4730.25 of the Revised Code to which the	2299
applicant has pleaded guilty, of which the applicant has been	2300
found guilty, or for which the applicant has been found eligible	2301
for intervention in lieu of conviction, since last signing an	2302
application for a ~~certificate~~license to practice as a physician	2303
assistant.	2304

(B) To be eligible for renewal of a license, ~~a physician~~	2305
~~assistant shall certify to the board both~~an applicant is subject	2306
to all of the following:	2307

(1) ~~That the physician assistant~~The applicant shall certify	2308
to the board that the applicant has maintained certification by	2309
the national commission on certification of physician assistants	2310
or a successor organization that is recognized by the board by	2311
meeting the standards to hold current certification from the	2312
commission or its successor, including completion of continuing	2313
medical education requirements and passing periodic	2314
recertification examinations;.	2315

(2) Except as provided in division (F) of this section and	2316
section 5903.12 of the Revised Code, the applicant shall certify	2317
to the board that the ~~physician assistant~~applicant has completed	2318
during the current ~~certification~~licensure period not less than	2319
one hundred hours of continuing medical education acceptable to	2320
the board.	2321

(3) The applicant shall comply with the renewal eligibility	2322
requirements established under section 4730.49 of the Revised Code	2323
that pertain to the applicant.	2324

(C) The board shall adopt rules in accordance with Chapter	2325
119. of the Revised Code specifying the types of continuing	2326
medical education that must be completed to fulfill the board's	2327
requirements under division (B)(2) of this section. Except when	2328
additional continuing medical education is required to renew a	2329
certificate to prescribe, as specified in section 4730.49 of the	2330
Revised Code, the board shall not adopt rules that require a	2331
physician assistant to complete in any ~~certification~~licensure	2332
period more than one hundred hours of continuing medical education	2333
acceptable to the board. In fulfilling the board's requirements, a	2334
physician assistant may use continuing medical education courses	2335
or programs completed to maintain certification by the national	2336
commission on certification of physician assistants or a successor	2337
organization that is recognized by the board if the standards for	2338
acceptable courses and programs of the commission or its successor	2339
are at least equivalent to the standards established by the board.	2340

(D) If an applicant submits a complete renewal application	2341
and qualifies for renewal pursuant to division (B) of this	2342
section, the board shall issue to the applicant a renewed	2343
~~certificate~~license to practice as a physician assistant.	2344

(E) The board may require a random sample of physician	2345
assistants to submit materials documenting certification by the	2346
national commission on certification of physician assistants or a	2347
successor organization that is recognized by the board and	2348
completion of the required number of hours of continuing medical	2349
education.	2350

(F) The board shall provide for pro rata reductions by month	2351
of the number of hours of continuing education that must be	2352
completed for individuals who are in their first ~~certification~~	2353
licensure period, who have been disabled due to illness or	2354
accident, or who have been absent from the country. The board	2355
shall adopt rules, in accordance with Chapter 119. of the Revised	2356
Code, as necessary to implement this division.	2357

(G)(1) A ~~certificate~~license to practice that is not renewed	2358
on or before its expiration date is automatically suspended on its	2359
expiration date. Continued practice after suspension of the	2360
certificate shall be considered as practicing in violation of	2361
division (A) of section 4730.02 of the Revised Code.	2362

(2) If a ~~certificate~~license has been suspended pursuant to	2363
division (G)(1) of this section for two years or less, it may be	2364
reinstated. The board shall reinstate a ~~certificate~~license	2365
suspended for failure to renew upon an applicant's submission of a	2366
renewal application, the biennial renewal fee, and any applicable	2367
monetary penalty.	2368

If a ~~certificate~~license has been suspended pursuant to	2369
division (G)(1) of this ~~division~~section for more than two years,	2370
it may be restored. In accordance with section 4730.28 of the	2371
Revised Code, the board may restore a ~~certificate~~license	2372
suspended for failure to renew upon an applicant's submission of a	2373
restoration application, the biennial renewal fee, and any	2374
applicable monetary penalty and compliance with sections 4776.01	2375
to 4776.04 of the Revised Code. The board shall not restore to an	2376
applicant a ~~certificate~~license to practice as a physician	2377
assistant unless the board, in its discretion, decides that the	2378
results of the criminal records check do not make the applicant	2379
ineligible for a ~~certificate~~license issued pursuant to section	2380
4730.12 of the Revised Code.	2381

The penalty for reinstatement shall be fifty dollars and the	2382
penalty for restoration shall be one hundred dollars. The board	2383
shall deposit penalties in accordance with section 4731.24 of the	2384
Revised Code.	2385

(H) If an individual certifies that the individual has	2386
completed the number of hours and type of continuing medical	2387
education required for renewal or reinstatement of a ~~certificate~~	2388
license to practice as a physician assistant, and the board finds	2389
through a random sample conducted under division (E) of this	2390
section or through any other means that the individual did not	2391
complete the requisite continuing medical education, the board may	2392
impose a civil penalty of not more than five thousand dollars. The	2393
board's finding shall be made pursuant to an adjudication under	2394
Chapter 119. of the Revised Code and by an affirmative vote of not	2395
fewer than six members.	2396

A civil penalty imposed under this division may be in	2397
addition to or in lieu of any other action the board may take	2398
under section 4730.25 of the Revised Code. The board shall deposit	2399
civil penalties in accordance with section 4731.24 of the Revised	2400
Code.	2401

Sec. 4730.19. (A) ~~For a supervision agreement to be approved~~	2402
~~by the board, all of the following apply:~~	2403

~~(1)~~Before initiating supervision of one or more physician	2404
assistants licensed under this chapter, a physician shall enter	2405
into a supervision agreement with each physician assistant who	2406
will be supervised. A supervision agreement may apply to one or	2407
more physician assistants, but, except as provided in division	2408
(B)(2)(e) of this section, may apply to not more than one	2409
physician. The supervision agreement shall specify that the	2410
physician agrees to supervise the physician assistant and the	2411
physician assistant agrees to practice ~~in accordance with the~~	2412
~~conditions specified in the physician supervisory plan approved~~	2413
~~for that physician or the policies of the health care facility in~~	2414
~~which the supervising physician and physician assistant are~~	2415
~~practicing~~under that physician's supervision.	2416

~~(2)~~ The agreement shall clearly state that the supervising	2417
physician is legally responsible and assumes legal liability for	2418
the services provided by the physician assistant. The agreement	2419
shall be signed by the physician and the physician assistant.	2420

~~(3) The physician assistant shall hold a current certificate~~	2421
~~to practice as a physician assistant.~~	2422

~~(4) If a physician supervisory plan applies to the physician~~	2423
~~assistant's practice, the physician shall hold an approved~~	2424
~~physician supervisory plan.~~	2425

~~(5) If the physician intends to grant physician-delegated~~	2426
~~prescriptive authority to a physician assistant, the physician~~	2427
~~assistant shall hold a certificate to prescribe issued under this~~	2428
~~chapter.~~	2429

~~(6) If the physician holds approval of more than one~~	2430
~~physician supervisory plan, the agreement shall specify the plan~~	2431
~~under which the physician assistant will practice.~~	2432

(B) ~~The board shall review each application received. If the~~	2433
~~board finds that the requirements specified in division (A) of~~	2434
~~this section have been met and the applicant has paid the fee~~	2435
~~specified in section 4730.18 of the Revised Code, the board shall~~	2436
~~approve the supervision agreement and notify the supervising~~	2437
~~physician of the board's approval. If physician-delegated~~	2438
~~prescriptive authority will be granted to more than one physician~~	2439
~~assistant under the supervision agreement, the board shall specify~~	2440
~~in the notice that its approval is specific to each physician~~	2441
~~assistant. The board shall provide notice of its approval of a~~	2442
~~supervision agreement not later than thirty days after the board~~	2443
~~receives a complete application for approval.~~A supervision	2444
agreement shall include either or both of the following:	2445

(1) If a physician assistant will practice within a health	2446
care facility, the agreement shall include terms that require the	2447
physician assistant to practice in accordance with the policies of	2448
the health care facility.	2449

(2) If a physician assistant will practice outside a health	2450
care facility, the agreement shall include terms that specify all	2451
of the following:	2452

(a) The responsibilities to be fulfilled by the physician in	2453
supervising the physician assistant;	2454

(b) The responsibilities to be fulfilled by the physician	2455
assistant when performing services under the physician's	2456
supervision;	2457

(c) Any limitations on the responsibilities to be fulfilled	2458
by the physician assistant;	2459

(d) The circumstances under which the physician assistant is	2460
required to refer a patient to the supervising physician;	2461

(e) If the supervising physician chooses to designate	2462
physicians to act as alternate supervising physicians, the names,	2463
business addresses, and business telephone numbers of the	2464
physicians who have agreed to act in that capacity.	2465

(C) ~~After a supervision agreement is approved, a physician~~	2466
~~may apply to the board for approval to initiate supervision of a~~	2467
~~physician assistant who is not listed on the agreement. There is~~	2468
~~no fee for applying for the addition of a physician assistant to a~~	2469
~~supervision agreement.~~	2470

~~To receive the board's approval of the addition to the~~	2471
~~supervision agreement, the physician assistant shall hold a~~	2472
~~current certificate to practice as a physician assistant. If the~~	2473
~~physician intends to grant physician-delegated prescriptive~~	2474
~~authority to the physician assistant, the physician assistant~~	2475
~~shall hold a current certificate to prescribe. If these~~	2476
~~requirements are met, the board shall notify the physician of its~~	2477
~~approval of the addition to the supervision agreement. The board~~	2478
~~shall provide notice of its approval not later than thirty days~~	2479
~~after the board receives a complete application for approval~~(1)	2480
The supervising physician shall submit a copy of each supervision	2481
agreement to the board. The board may review the supervision	2482
agreement at any time for compliance with this section and for	2483
verification of licensure of the supervising physician and the	2484
physician assistant. All of the following apply to the submission	2485
and review process:	2486

(a) If the board reviews a supervision agreement, the board	2487
shall notify the supervising physician of any way that the	2488
agreement fails to comply with this section.	2489

(b) A supervision agreement becomes effective at the end of	2490
the fifth business day after the day the board receives the	2491
agreement unless the board notifies the supervising physician that	2492
the agreement fails to comply with this section.	2493

A supervision agreement expires two years after the day it	2494
takes effect. The agreement may be renewed by submitting a copy of	2495
it to the board.	2496

(c) If a physician receives a notice under division (C)(1)(a)	2497
of this section, the physician may revise the supervision	2498
agreement and resubmit the agreement to the board. The board may	2499
review the agreement as provided in division (C)(1) of this	2500
section.	2501

(d) Until July 1, 2015, each initial or renewed agreement	2502
submitted under division (C)(1) of this section shall be	2503
accompanied by a fee of twenty-five dollars. No fee is required	2504
for submitting a revised agreement under division (C)(1)(c) of	2505
this section or for submitting an amendment under division (C)(2)	2506
of this section. Fees shall be deposited in accordance with	2507
section 4731.24 of the Revised Code.	2508

(2) Before expiration, a supervision agreement may be amended	2509
by including one or more additional physician assistants. An	2510
amendment to a supervision agreement shall be submitted to the	2511
board for review in the manner provided for review of an initial	2512
agreement under division (C)(1) of this section. The amendment	2513
does not alter the agreement's expiration date.	2514

(D) A supervision agreement shall be kept in the records	2515
maintained by the supervising physician who entered into the	2516
agreement.	2517

(E) The board may impose a civil penalty of not more than one	2518
thousand dollars if it finds through a review conducted under this	2519
section or through any other means either of the following:	2520

(1) A physician assistant has practiced pursuant to a	2521
supervision agreement that fails to comply with this section;	2522

(2) That a physician has acted as the supervising physician	2523
of a physician assistant pursuant to a supervision agreement that	2524
fails to comply with this section.	2525

The board's finding shall be made pursuant to an adjudication	2526
conducted under Chapter 119. of the Revised Code. A civil penalty	2527
imposed under this division may be in addition to or in lieu of	2528
any other action the board may take under section 4730.25 of the	2529
Revised Code.	2530

Sec. 4730.20. (A) A physician assistant licensed under this	2531
chapter may perform any of the following services authorized by	2532
the supervising physician that are part of the supervising	2533
physician's normal course of practice and expertise:	2534

(1) Ordering diagnostic, therapeutic, and other medical	2535
services;	2536

(2) Prescribing physical therapy or referring a patient to a	2537
physical therapist for physical therapy;	2538

(3) Ordering occupational therapy or referring a patient to	2539
an occupational therapist for occupational therapy;	2540

(4) Taking any action that may be taken by an attending	2541
physician under sections 2133.21 to 2133.26 of the Revised Code,	2542
as specified in section 2133.211 of the Revised Code;	2543

(5) Determining and pronouncing death in accordance with	2544
section 4730.202 of the Revised Code;	2545

(6) Assisting in surgery;

2546

(7) If the physician assistant holds a valid prescriber	2547
number issued by the state medical board and has been granted	2548
physician-delegated prescriptive authority, ordering, prescribing,	2549
personally furnishing, and administering drugs and medical	2550
devices;	2551

(8) Any other services that are part of the supervising	2552
physician's normal course of practice and expertise.	2553

(B) The services a physician assistant may provide under the	2554
policies of a health care facility are limited to the services the	2555
facility authorizes the physician assistant to provide for the	2556
facility. A facility shall not authorize a physician assistant to	2557
perform a service that is prohibited under this chapter. A	2558
physician who is supervising a physician assistant within a health	2559
care facility may impose limitations on the physician assistant's	2560
practice that are in addition to any limitations applicable under	2561
the policies of the facility.	2562

~~Sec. 4730.091.~~ Sec. 4730.201. (A) As used in this section, "local	2563
anesthesia" means the injection of a drug or combination of drugs	2564
to stop or prevent a painful sensation in a circumscribed area of	2565
the body where a painful procedure is to be performed. "Local	2566
anesthesia" includes only local infiltration anesthesia, digital	2567
blocks, and pudendal blocks.	2568

(B) A physician assistant may administer, monitor, or	2569
maintain local anesthesia as a component of a procedure the	2570
physician assistant is performing or as a separate service when	2571
the procedure requiring local anesthesia is to be performed by the	2572
physician assistant's supervising physician or another person. A	2573
physician assistant shall not administer, monitor, or maintain any	2574
other form of anesthesia, including regional anesthesia or any	2575
systemic sedation~~, regardless of whether the physician assistant~~	2576
~~is practicing under a physician supervisory plan or the policies~~	2577
~~of a health care facility~~.	2578

~~Sec. 4730.092.~~ Sec. 4730.202. (A) A physician assistant may	2579
determine and pronounce an individual's death, but only if the	2580
individual's respiratory and circulatory functions are not being	2581
artificially sustained and, at the time the determination and	2582
pronouncement of death is made, either or both of the following	2583
apply:	2584

(1) The individual was receiving care in one of the	2585
following:	2586

(a) A nursing home licensed under section 3721.02 of the	2587
Revised Code or by a political subdivision under section 3721.09	2588
of the Revised Code;	2589

(b) A residential care facility or home for the aging	2590
licensed under Chapter 3721. of the Revised Code;	2591

(c) A county home or district home operated pursuant to	2592
Chapter 5155. of the Revised Code;	2593

(d) A residential facility licensed under section 5123.19 of	2594
the Revised Code.	2595

(2) The physician assistant is providing or supervising the	2596
individual's care through a hospice care program licensed under	2597
Chapter 3712. of the Revised Code or any other entity that	2598
provides palliative care.	2599

(B) If a physician assistant determines and pronounces an	2600
individual's death, the physician assistant shall comply with both	2601
of the following:	2602

(1) The physician assistant shall not complete any portion of	2603
the individual's death certificate.	2604

(2) The physician assistant shall notify the individual's	2605
attending physician of the determination and pronouncement of	2606
death in order for the physician to fulfill the physician's duties	2607
under section 3705.16 of the Revised Code. The physician assistant	2608
shall provide the notification within a period of time that is	2609
reasonable but not later than twenty-four hours following the	2610
determination and pronouncement of the individual's death.	2611

Sec. 4730.203. (A) Acting pursuant to a supervision	2612
agreement, a physician assistant may delegate performance of a	2613
task to implement a patient's plan of care or, if the conditions	2614
in division (C) of this section are met, may delegate	2615
administration of a drug. Delegation may be to a person who has	2616
successfully completed a training and competency evaluation	2617
program approved by the director of health under section 3721.31	2618
of the Revised Code or, subject to division (D) of section 4730.03	2619
of the Revised Code, any other person. The physician assistant	2620
must be physically present at the location where the task is	2621
performed or the drug administered.	2622

(B) Prior to delegating a task or administration of a drug, a	2623
physician assistant shall determine that the task or drug is	2624
appropriate for the patient and the person to whom the delegation	2625
is to be made may safely perform the task or administer the drug.	2626

(C) A physician assistant may delegate administration of a	2627
drug only if all of the following conditions are met:	2628

(1) The physician assistant has physician-delegated	2629
prescriptive authority.	2630

(2) The drug is included in the formulary established under	2631
division (A) of section 4730.39 of the Revised Code.	2632

(3) The drug is not a controlled substance.

2633

(4) The drug will not be administered intravenously.

2634

(5) The drug will not be administered in a hospital inpatient	2635
care unit, as defined in section 3727.50 of the Revised Code; a	2636
hospital emergency department; a freestanding emergency	2637
department; or an ambulatory surgical facility licensed under	2638
section 3702.30 of the Revised Code.	2639

(D) A person not otherwise authorized to administer a drug or	2640
perform a specific task may do so in accordance with a physician	2641
assistant's delegation under this section.	2642

Sec. 4730.21. (A) The supervising physician of a physician	2643
assistant exercises supervision, control, and direction of the	2644
physician assistant. InA physician assistant may practice in any	2645
setting within which the supervising physician has supervision,	2646
control, and direction of the physician assistant.	2647

In supervising a physician assistant, all of the following	2648
apply:	2649

(1) ~~Except when the on-site supervision requirements~~	2650
~~specified in section 4730.45 of the Revised Code are applicable,~~	2651
~~the~~The supervising physician shall be continuously available for	2652
direct communication with the physician assistant by either of the	2653
following means:	2654

(a) Being physically present at the location where the	2655
physician assistant is practicing;	2656

(b) Being readily available to the physician assistant	2657
through some means of telecommunication and being in a location	2658
that ~~under normal conditions~~ is ~~not more than sixty minutes travel~~	2659
~~time away~~a distance from the location where the physician	2660
assistant is practicing that reasonably allows the physician to	2661
assure proper care of patients.	2662

(2) The supervising physician shall personally and actively	2663
review the physician assistant's professional activities.	2664

(3) ~~The supervising physician shall regularly review the~~	2665
~~condition of the patients treated by the physician assistant.~~	2666

~~(4)~~ The supervising physician shall ensure that the quality	2667
assurance system established pursuant to division (F) of this	2668
section is implemented and maintained.	2669

~~(5)~~(4) The supervising physician shall regularly perform any	2670
other reviews of the physician assistant that the supervising	2671
physician considers necessary.	2672

(B) A physician may enter into supervision agreements with	2673
any number of physician assistants, but the physician may not	2674
supervise more than ~~two~~three physician assistants at any one	2675
time. A physician assistant may enter into supervision agreements	2676
with any number of supervising physicians~~, but when practicing~~	2677
~~under the supervision of a particular physician, the physician~~	2678
~~assistant's scope of practice is subject to the limitations of the~~	2679
~~physician supervisory plan that has been approved under section~~	2680
~~4730.17 of the Revised Code for that physician or the policies of~~	2681
~~the health care facility in which the physician and physician~~	2682
~~assistant are practicing~~.	2683

(C) ~~A supervising physician may authorize a physician~~	2684
~~assistant to perform a service only if the service is authorized~~	2685
~~under the physician supervisory plan approved for that physician~~	2686
~~or the policies of the health care facility in which the physician~~	2687
~~and physician assistant are practicing.~~ A supervising physician	2688
may authorize a physician assistant to perform a service only if	2689
the physician is satisfied that the physician assistant is capable	2690
of competently performing the service. A supervising physician	2691
shall not authorize a physician assistant to perform any service	2692
that is beyond the physician's or the physician assistant's normal	2693
course of practice and expertise.	2694

(D)~~(1) A supervising physician may authorize a physician~~	2695
~~assistant to practice in any setting within which the supervising~~	2696
~~physician routinely practices.~~	2697

~~(2)~~ In the case of a health care facility with an emergency	2698
department, if the supervising physician routinely practices in	2699
the facility's emergency department, the supervising physician	2700
shall provide on-site supervision of the physician assistant when	2701
the physician assistant practices in the emergency department. If	2702
the supervising physician does not routinely practice in the	2703
facility's emergency department, the supervising physician may, on	2704
occasion, send the physician assistant to the facility's emergency	2705
department to assess and manage a patient. In supervising the	2706
physician assistant's assessment and management of the patient,	2707
the supervising physician shall determine the appropriate level of	2708
supervision in compliance with the requirements of divisions (A)	2709
to (C) of this section, except that the supervising physician must	2710
be available to go to the emergency department to personally	2711
evaluate the patient and, at the request of an emergency	2712
department physician, the supervising physician shall go to the	2713
emergency department to personally evaluate the patient.	2714

(E) Each time a physician assistant writes a medical order,	2715
including prescriptions written in the exercise of	2716
physician-delegated prescriptive authority, the physician	2717
assistant shall sign the form on which the order is written and	2718
record on the form the time and date that the order is written.	2719
~~When writing a medical order, the physician assistant shall~~	2720
~~clearly identify the physician under whose supervision the~~	2721
~~physician assistant is authorized to write the order.~~	2722

(F)(1) The supervising physician of a physician assistant	2723
shall establish a quality assurance system to be used in	2724
supervising the physician assistant. All or part of the system may	2725
be applied to other physician assistants who are supervised by the	2726
supervising physician. The system shall be developed in	2727
consultation with each physician assistant to be supervised by the	2728
physician.	2729

(2) In establishing the quality assurance system, the	2730
supervising physician shall describe a process to be used for all	2731
of the following:	2732

(a) Routine review by the physician of selected patient	2733
record entries made by the physician assistant and selected	2734
medical orders issued by the physician assistant;	2735

(b) Discussion of complex cases;

2736

(c) Discussion of new medical developments relevant to the	2737
practice of the physician and physician assistant;	2738

(d) Performance of any quality assurance activities required	2739
in rules adopted by state medical board pursuant to any	2740
recommendations made by the physician assistant policy committee	2741
under section 4730.06 of the Revised Code;	2742

(e) Performance of any other quality assurance activities	2743
that the supervising physician considers to be appropriate.	2744

(3) The supervising physician and physician assistant shall	2745
keep records of their quality assurance activities. On request,	2746
the records shall be made available to the board ~~and any health~~	2747
~~care professional working with the supervising physician and~~	2748
~~physician assistant~~.	2749

Sec. 4730.22. (A) AWhen performing authorized services, a	2750
physician assistant acts as the agent of the physician assistant's	2751
supervising physician. The supervising physician is legally	2752
responsible and assumes legal liability for the services provided	2753
by the physician assistant.	2754

The physician is not responsible or liable for any services	2755
provided by the physician assistant after their supervision	2756
agreement expires or is terminated.	2757

(B) When a health care facility permits physician assistants	2758
to practice within that facility or any other health care facility	2759
under its control, the health care facility shall make reasonable	2760
efforts to explain to each individual who may work with a	2761
particular physician assistant the scope of that physician	2762
assistant's practice within the facility. The appropriate	2763
credentialing body within the health care facility shall provide,	2764
on request of an individual practicing in the facility with a	2765
physician assistant, a copy of the facility's policies on the	2766
practice of physician assistants within the facility and a copy of	2767
each ~~physician supervisory plan and~~ supervision agreement	2768
applicable to the physician assistant.	2769

An individual who follows the orders of a physician assistant	2770
practicing in a health care facility is not subject to	2771
disciplinary action by any administrative agency that governs that	2772
individual's conduct and is not liable in damages in a civil	2773
action for injury, death, or loss to person or property resulting	2774
from the individual's acts or omissions in the performance of any	2775
procedure, treatment, or other health care service if the	2776
individual reasonably believed that the physician assistant was	2777
acting within the proper scope of practice or was relaying medical	2778
orders from a supervising physician, unless the act or omission	2779
constitutes willful or wanton misconduct.	2780

Sec. 4730.25. (A) The state medical board, by an affirmative	2781
vote of not fewer than six members, may revoke or may refuse to	2782
grant a ~~certificate~~license to practice as a physician assistant	2783
~~or a certificate to prescribe~~ to a person found by the board to	2784
have committed fraud, misrepresentation, or deception in applying	2785
for or securing the ~~certificate~~license.	2786

(B) The board, by an affirmative vote of not fewer than six	2787
members, shall, to the extent permitted by law, limit, revoke, or	2788
suspend an individual's ~~certificate~~license to practice as a	2789
physician assistant or ~~certificate to prescribe~~prescriber number,	2790
refuse to issue a ~~certificate~~license to an applicant, refuse to	2791
reinstate a ~~certificate~~license, or reprimand or place on	2792
probation the holder of a ~~certificate~~license for any of the	2793
following reasons:	2794

(1) Failure to practice in accordance with the ~~conditions~~	2795
~~under which the~~ supervising physician's supervision agreement with	2796
the physician assistant ~~was approved, including the requirement~~	2797
~~that when practicing under a particular supervising physician, the~~	2798
~~physician assistant must practice only according to the physician~~	2799
~~supervisory plan the board approved for that physician or~~,	2800
including, if applicable, the policies of the health care facility	2801
in which the supervising physician and physician assistant are	2802
practicing;	2803

(2) Failure to comply with the requirements of this chapter,	2804
Chapter 4731. of the Revised Code, or any rules adopted by the	2805
board;	2806

(3) Violating or attempting to violate, directly or	2807
indirectly, or assisting in or abetting the violation of, or	2808
conspiring to violate, any provision of this chapter, Chapter	2809
4731. of the Revised Code, or the rules adopted by the board;	2810

(4) Inability to practice according to acceptable and	2811
prevailing standards of care by reason of mental illness or	2812
physical illness, including physical deterioration that adversely	2813
affects cognitive, motor, or perceptive skills;	2814

(5) Impairment of ability to practice according to acceptable	2815
and prevailing standards of care because of habitual or excessive	2816
use or abuse of drugs, alcohol, or other substances that impair	2817
ability to practice;	2818

(6) Administering drugs for purposes other than those	2819
authorized under this chapter;	2820

(7) Willfully betraying a professional confidence;

2821

(8) Making a false, fraudulent, deceptive, or misleading	2822
statement in soliciting or advertising for employment as a	2823
physician assistant; in connection with any solicitation or	2824
advertisement for patients; in relation to the practice of	2825
medicine as it pertains to physician assistants; or in securing or	2826
attempting to secure a ~~certificate~~license to practice as a	2827
physician assistant~~, a certificate to prescribe, or approval of a~~	2828
~~supervision agreement~~.	2829

As used in this division, "false, fraudulent, deceptive, or	2830
misleading statement" means a statement that includes a	2831
misrepresentation of fact, is likely to mislead or deceive because	2832
of a failure to disclose material facts, is intended or is likely	2833
to create false or unjustified expectations of favorable results,	2834
or includes representations or implications that in reasonable	2835
probability will cause an ordinarily prudent person to	2836
misunderstand or be deceived.	2837

(9) Representing, with the purpose of obtaining compensation	2838
or other advantage personally or for any other person, that an	2839
incurable disease or injury, or other incurable condition, can be	2840
permanently cured;	2841

(10) The obtaining of, or attempting to obtain, money or	2842
anything of value by fraudulent misrepresentations in the course	2843
of practice;	2844

(11) A plea of guilty to, a judicial finding of guilt of, or	2845
a judicial finding of eligibility for intervention in lieu of	2846
conviction for, a felony;	2847

(12) Commission of an act that constitutes a felony in this	2848
state, regardless of the jurisdiction in which the act was	2849
committed;	2850

(13) A plea of guilty to, a judicial finding of guilt of, or	2851
a judicial finding of eligibility for intervention in lieu of	2852
conviction for, a misdemeanor committed in the course of practice;	2853

(14) A plea of guilty to, a judicial finding of guilt of, or	2854
a judicial finding of eligibility for intervention in lieu of	2855
conviction for, a misdemeanor involving moral turpitude;	2856

(15) Commission of an act in the course of practice that	2857
constitutes a misdemeanor in this state, regardless of the	2858
jurisdiction in which the act was committed;	2859

(16) Commission of an act involving moral turpitude that	2860
constitutes a misdemeanor in this state, regardless of the	2861
jurisdiction in which the act was committed;	2862

(17) A plea of guilty to, a judicial finding of guilt of, or	2863
a judicial finding of eligibility for intervention in lieu of	2864
conviction for violating any state or federal law regulating the	2865
possession, distribution, or use of any drug, including	2866
trafficking in drugs;	2867

(18) Any of the following actions taken by the state agency	2868
responsible for regulating the practice of physician assistants in	2869
another state, for any reason other than the nonpayment of fees:	2870
the limitation, revocation, or suspension of an individual's	2871
license to practice; acceptance of an individual's license	2872
surrender; denial of a license; refusal to renew or reinstate a	2873
license; imposition of probation; or issuance of an order of	2874
censure or other reprimand;	2875

(19) A departure from, or failure to conform to, minimal	2876
standards of care of similar physician assistants under the same	2877
or similar circumstances, regardless of whether actual injury to a	2878
patient is established;	2879

(20) Violation of the conditions placed by the board on a	2880
~~certificate~~license to practice as a physician assistant~~, a~~	2881
~~certificate to prescribe, a physician supervisory plan, or~~	2882
~~supervision agreement~~;	2883

(21) Failure to use universal blood and body fluid	2884
precautions established by rules adopted under section 4731.051 of	2885
the Revised Code;	2886

(22) Failure to cooperate in an investigation conducted by	2887
the board under section 4730.26 of the Revised Code, including	2888
failure to comply with a subpoena or order issued by the board or	2889
failure to answer truthfully a question presented by the board at	2890
a deposition or in written interrogatories, except that failure to	2891
cooperate with an investigation shall not constitute grounds for	2892
discipline under this section if a court of competent jurisdiction	2893
has issued an order that either quashes a subpoena or permits the	2894
individual to withhold the testimony or evidence in issue;	2895

(23) Assisting suicide, as defined in section 3795.01 of the	2896
Revised Code;	2897

(24) Prescribing any drug or device to perform or induce an	2898
abortion, or otherwise performing or inducing an abortion;	2899

(25) Failure to comply with the requirements in section	2900
3719.061 of the Revised Code before issuing tofor a minor a	2901
prescription for a controlled substance containing an opioid;	2902

(26) Having certification by the national commission on	2903
certification of physician assistants or a successor organization	2904
expire, lapse, or be suspended or revoked.	2905

(C) Disciplinary actions taken by the board under divisions	2906
(A) and (B) of this section shall be taken pursuant to an	2907
adjudication under Chapter 119. of the Revised Code, except that	2908
in lieu of an adjudication, the board may enter into a consent	2909
agreement with a physician assistant or applicant to resolve an	2910
allegation of a violation of this chapter or any rule adopted	2911
under it. A consent agreement, when ratified by an affirmative	2912
vote of not fewer than six members of the board, shall constitute	2913
the findings and order of the board with respect to the matter	2914
addressed in the agreement. If the board refuses to ratify a	2915
consent agreement, the admissions and findings contained in the	2916
consent agreement shall be of no force or effect.	2917

(D) For purposes of divisions (B)(12), (15), and (16) of this	2918
section, the commission of the act may be established by a finding	2919
by the board, pursuant to an adjudication under Chapter 119. of	2920
the Revised Code, that the applicant or ~~certificate~~license holder	2921
committed the act in question. The board shall have no	2922
jurisdiction under these divisions in cases where the trial court	2923
renders a final judgment in the ~~certificate~~license holder's favor	2924
and that judgment is based upon an adjudication on the merits. The	2925
board shall have jurisdiction under these divisions in cases where	2926
the trial court issues an order of dismissal upon technical or	2927
procedural grounds.	2928

(E) The sealing of conviction records by any court shall have	2929
no effect upon a prior board order entered under the provisions of	2930
this section or upon the board's jurisdiction to take action under	2931
the provisions of this section if, based upon a plea of guilty, a	2932
judicial finding of guilt, or a judicial finding of eligibility	2933
for intervention in lieu of conviction, the board issued a notice	2934
of opportunity for a hearing prior to the court's order to seal	2935
the records. The board shall not be required to seal, destroy,	2936
redact, or otherwise modify its records to reflect the court's	2937
sealing of conviction records.	2938

(F) For purposes of this division, any individual who holds a	2939
~~certificate~~license issued under this chapter, or applies for a	2940
~~certificate~~license issued under this chapter, shall be deemed to	2941
have given consent to submit to a mental or physical examination	2942
when directed to do so in writing by the board and to have waived	2943
all objections to the admissibility of testimony or examination	2944
reports that constitute a privileged communication.	2945

(1) In enforcing division (B)(4) of this section, the board,	2946
upon a showing of a possible violation, may compel any individual	2947
who holds a ~~certificate~~license issued under this chapter or who	2948
has applied for a ~~certificate~~license pursuant to this chapter to	2949
submit to a mental examination, physical examination, including an	2950
HIV test, or both a mental and physical examination. The expense	2951
of the examination is the responsibility of the individual	2952
compelled to be examined. Failure to submit to a mental or	2953
physical examination or consent to an HIV test ordered by the	2954
board constitutes an admission of the allegations against the	2955
individual unless the failure is due to circumstances beyond the	2956
individual's control, and a default and final order may be entered	2957
without the taking of testimony or presentation of evidence. If	2958
the board finds a physician assistant unable to practice because	2959
of the reasons set forth in division (B)(4) of this section, the	2960
board shall require the physician assistant to submit to care,	2961
counseling, or treatment by physicians approved or designated by	2962
the board, as a condition for an initial, continued, reinstated,	2963
or renewed ~~certificate~~license. An individual affected under this	2964
division shall be afforded an opportunity to demonstrate to the	2965
board the ability to resume practicing in compliance with	2966
acceptable and prevailing standards of care.	2967

(2) For purposes of division (B)(5) of this section, if the	2968
board has reason to believe that any individual who holds a	2969
~~certificate~~license issued under this chapter or any applicant for	2970
a ~~certificate~~license suffers such impairment, the board may	2971
compel the individual to submit to a mental or physical	2972
examination, or both. The expense of the examination is the	2973
responsibility of the individual compelled to be examined. Any	2974
mental or physical examination required under this division shall	2975
be undertaken by a treatment provider or physician qualified to	2976
conduct such examination and chosen by the board.	2977

Failure to submit to a mental or physical examination ordered	2978
by the board constitutes an admission of the allegations against	2979
the individual unless the failure is due to circumstances beyond	2980
the individual's control, and a default and final order may be	2981
entered without the taking of testimony or presentation of	2982
evidence. If the board determines that the individual's ability to	2983
practice is impaired, the board shall suspend the individual's	2984
~~certificate~~license or deny the individual's application and shall	2985
require the individual, as a condition for initial, continued,	2986
reinstated, or renewed ~~certification~~licensure to practice or	2987
prescribe, to submit to treatment.	2988

Before being eligible to apply for reinstatement of a	2989
~~certificate~~license suspended under this division, the physician	2990
assistant shall demonstrate to the board the ability to resume	2991
practice or prescribing in compliance with acceptable and	2992
prevailing standards of care. The demonstration shall include the	2993
following:	2994

(a) Certification from a treatment provider approved under	2995
section 4731.25 of the Revised Code that the individual has	2996
successfully completed any required inpatient treatment;	2997

(b) Evidence of continuing full compliance with an aftercare	2998
contract or consent agreement;	2999

(c) Two written reports indicating that the individual's	3000
ability to practice has been assessed and that the individual has	3001
been found capable of practicing according to acceptable and	3002
prevailing standards of care. The reports shall be made by	3003
individuals or providers approved by the board for making such	3004
assessments and shall describe the basis for their determination.	3005

The board may reinstate a ~~certificate~~license suspended under	3006
this division after such demonstration and after the individual	3007
has entered into a written consent agreement.	3008

When the impaired physician assistant resumes practice or	3009
prescribing, the board shall require continued monitoring of the	3010
physician assistant. The monitoring shall include compliance with	3011
the written consent agreement entered into before reinstatement or	3012
with conditions imposed by board order after a hearing, and, upon	3013
termination of the consent agreement, submission to the board for	3014
at least two years of annual written progress reports made under	3015
penalty of falsification stating whether the physician assistant	3016
has maintained sobriety.	3017

(G) If the secretary and supervising member determine that	3018
there is clear and convincing evidence that a physician assistant	3019
has violated division (B) of this section and that the	3020
individual's continued practice or prescribing presents a danger	3021
of immediate and serious harm to the public, they may recommend	3022
that the board suspend the individual's ~~certificate~~license to	3023
practice or authority to prescribe without a prior hearing.	3024
Written allegations shall be prepared for consideration by the	3025
board.	3026

The board, upon review of those allegations and by an	3027
affirmative vote of not fewer than six of its members, excluding	3028
the secretary and supervising member, may suspend a ~~certificate~~	3029
license without a prior hearing. A telephone conference call may	3030
be utilized for reviewing the allegations and taking the vote on	3031
the summary suspension.	3032

The board shall issue a written order of suspension by	3033
certified mail or in person in accordance with section 119.07 of	3034
the Revised Code. The order shall not be subject to suspension by	3035
the court during pendency of any appeal filed under section 119.12	3036
of the Revised Code. If the physician assistant requests an	3037
adjudicatory hearing by the board, the date set for the hearing	3038
shall be within fifteen days, but not earlier than seven days,	3039
after the physician assistant requests the hearing, unless	3040
otherwise agreed to by both the board and the ~~certificate~~license	3041
holder.	3042

A summary suspension imposed under this division shall remain	3043
in effect, unless reversed on appeal, until a final adjudicative	3044
order issued by the board pursuant to this section and Chapter	3045
119. of the Revised Code becomes effective. The board shall issue	3046
its final adjudicative order within sixty days after completion of	3047
its hearing. Failure to issue the order within sixty days shall	3048
result in dissolution of the summary suspension order, but shall	3049
not invalidate any subsequent, final adjudicative order.	3050

(H) If the board takes action under division (B)(11), (13),	3051
or (14) of this section, and the judicial finding of guilt, guilty	3052
plea, or judicial finding of eligibility for intervention in lieu	3053
of conviction is overturned on appeal, upon exhaustion of the	3054
criminal appeal, a petition for reconsideration of the order may	3055
be filed with the board along with appropriate court documents.	3056
Upon receipt of a petition and supporting court documents, the	3057
board shall reinstate the ~~certificate~~license to practice or	3058
~~prescribe~~. The board may then hold an adjudication under Chapter	3059
119. of the Revised Code to determine whether the individual	3060
committed the act in question. Notice of opportunity for hearing	3061
shall be given in accordance with Chapter 119. of the Revised	3062
Code. If the board finds, pursuant to an adjudication held under	3063
this division, that the individual committed the act, or if no	3064
hearing is requested, it may order any of the sanctions identified	3065
under division (B) of this section.	3066

(I) The ~~certificate~~license to practice issued to a physician	3067
assistant and the physician assistant's practice in this state are	3068
automatically suspended as of the date the physician assistant	3069
pleads guilty to, is found by a judge or jury to be guilty of, or	3070
is subject to a judicial finding of eligibility for intervention	3071
in lieu of conviction in this state or treatment or intervention	3072
in lieu of conviction in another state for any of the following	3073
criminal offenses in this state or a substantially equivalent	3074
criminal offense in another jurisdiction: aggravated murder,	3075
murder, voluntary manslaughter, felonious assault, kidnapping,	3076
rape, sexual battery, gross sexual imposition, aggravated arson,	3077
aggravated robbery, or aggravated burglary. Continued practice	3078
after the suspension shall be considered practicing without a	3079
~~certificate~~license.	3080

The board shall notify the individual subject to the	3081
suspension by certified mail or in person in accordance with	3082
section 119.07 of the Revised Code. If an individual whose	3083
~~certificate~~license is suspended under this division fails to make	3084
a timely request for an adjudication under Chapter 119. of the	3085
Revised Code, the board shall enter a final order permanently	3086
revoking the individual's ~~certificate~~license to practice.	3087

(J) In any instance in which the board is required by Chapter	3088
119. of the Revised Code to give notice of opportunity for hearing	3089
and the individual subject to the notice does not timely request a	3090
hearing in accordance with section 119.07 of the Revised Code, the	3091
board is not required to hold a hearing, but may adopt, by an	3092
affirmative vote of not fewer than six of its members, a final	3093
order that contains the board's findings. In that final order, the	3094
board may order any of the sanctions identified under division (A)	3095
or (B) of this section.	3096

(K) Any action taken by the board under division (B) of this	3097
section resulting in a suspension shall be accompanied by a	3098
written statement of the conditions under which the physician	3099
assistant's ~~certificate~~license may be reinstated. The board shall	3100
adopt rules in accordance with Chapter 119. of the Revised Code	3101
governing conditions to be imposed for reinstatement.	3102
Reinstatement of a ~~certificate~~license suspended pursuant to	3103
division (B) of this section requires an affirmative vote of not	3104
fewer than six members of the board.	3105

(L) When the board refuses to grant to an applicant a	3106
~~certificate~~license to practice as a physician assistant ~~or a~~	3107
~~certificate to prescribe~~, revokes an individual's ~~certificate~~	3108
license, refuses to issue a ~~certificate~~license, or refuses to	3109
reinstate an individual's ~~certificate~~license, the board may	3110
specify that its action is permanent. An individual subject to a	3111
permanent action taken by the board is forever thereafter	3112
ineligible to hold the ~~certificate~~license and the board shall not	3113
accept an application for reinstatement of the ~~certificate~~	3114
license or for issuance of a new ~~certificate~~license.	3115

(M) Notwithstanding any other provision of the Revised Code,	3116
all of the following apply:	3117

(1) The surrender of a ~~certificate~~license issued under this	3118
chapter is not effective unless or until accepted by the board.	3119
Reinstatement of a ~~certificate~~license surrendered to the board	3120
requires an affirmative vote of not fewer than six members of the	3121
board.	3122

(2) An application made under this chapter for a ~~certificate,~~	3123
~~approval of a physician supervisory plan, or approval of a~~	3124
~~supervision agreement~~license may not be withdrawn without	3125
approval of the board.	3126

(3) Failure by an individual to renew a ~~certificate~~license	3127
in accordance with section 4730.14 ~~or section 4730.48~~ of the	3128
Revised Code shall not remove or limit the board's jurisdiction to	3129
take disciplinary action under this section against the	3130
individual.	3131

Sec. 4730.251. On receipt of a notice pursuant to section	3132
3123.43 of the Revised Code, the state medical board shall comply	3133
with sections 3123.41 to 3123.50 of the Revised Code and any	3134
applicable rules adopted under section 3123.63 of the Revised Code	3135
with respect to a ~~certificate~~license to practice as a physician	3136
assistant issued pursuant to this chapter.	3137

Sec. 4730.27. If the state medical board has reason to	3138
believe that any person who has been granted a ~~certificate~~license	3139
under this chapter to practice as a physician assistant is	3140
mentally ill or mentally incompetent, it may file in the probate	3141
court of the county in which such person has a legal residence an	3142
affidavit in the form prescribed in section 5122.11 of the Revised	3143
Code and signed by the board secretary or a member of the	3144
secretary's staff, whereupon the same proceedings shall be had as	3145
provided in Chapter 5122. of the Revised Code. The attorney	3146
general may represent the board in any proceeding commenced under	3147
this section.	3148

If a physician assistant is adjudged by a probate court to be	3149
mentally ill or mentally incompetent, the individual's ~~certificate~~	3150
license shall be automatically suspended until the individual has	3151
filed with the board a certified copy of an adjudication by a	3152
probate court of being restored to competency or has submitted to	3153
the board proof, satisfactory to the board, of having been	3154
discharged as being restored to competency in the manner and form	3155
provided in section 5122.38 of the Revised Code. The judge of the	3156
court shall immediately notify the board of an adjudication of	3157
incompetence and note any suspension of a ~~certificate~~license in	3158
the margin of the court's record of the ~~certificate~~license.	3159

Sec. 4730.28. (A) An individual whose ~~certificate~~license to	3160
practice as a physician assistant issued under this chapter has	3161
been suspended or is in an inactive state for any cause for more	3162
than two years may apply to the state medical board to have the	3163
~~certificate~~license restored.	3164

(B)(1) The board shall not restore a ~~certificate~~license	3165
under this section unless the applicant complies with sections	3166
4776.01 to 4776.04 of the Revised Code. The board shall determine	3167
the applicant's present fitness to resume practice. The board	3168
shall consider the moral background and the activities of the	3169
applicant during the period of suspension or inactivity.	3170

(2) When restoring a ~~certificate~~license, the board may	3171
impose terms and conditions, including the following:	3172

(a) Requiring the applicant to obtain additional training and	3173
pass an examination upon completion of the training;	3174

(b) Restricting or limiting the extent, scope, or type of	3175
practice as a physician assistant that the individual may resume.	3176

Sec. 4730.31. (A) As used in this section, "prosecutor" has	3177
the same meaning as in section 2935.01 of the Revised Code.	3178

(B) Whenever any person holding a valid ~~certificate~~license	3179
to practice as a physician assistant issued pursuant to this	3180
chapter pleads guilty to, is subject to a judicial finding of	3181
guilt of, or is subject to a judicial finding of eligibility for	3182
intervention in lieu of conviction for a violation of Chapter	3183
2907., 2925., or 3719. of the Revised Code or of any substantively	3184
comparable ordinance of a municipal corporation in connection with	3185
practicing as a physician assistant, the prosecutor in the case	3186
shall, on forms prescribed and provided by the state medical	3187
board, promptly notify the board of the conviction. Within thirty	3188
days of receipt of such information, the board shall initiate	3189
action in accordance with Chapter 119. of the Revised Code to	3190
determine whether to suspend or revoke the ~~certificate~~license	3191
under section 4730.25 of the Revised Code.	3192

(C) The prosecutor in any case against any person holding a	3193
valid ~~certificate~~license issued pursuant to this chapter shall,	3194
on forms prescribed and provided by the state medical board,	3195
notify the board of any of the following:	3196

(1) A plea of guilty to, a judicial finding of guilt of, or	3197
judicial finding of eligibility for intervention in lieu of	3198
conviction for a felony, or a case where the trial court issues an	3199
order of dismissal upon technical or procedural grounds of a	3200
felony charge;	3201

(2) A plea of guilty to, a judicial finding of guilt of, or	3202
judicial finding or eligibility for intervention in lieu of	3203
conviction for a misdemeanor committed in the course of practice,	3204
or a case where the trial court issues an order of dismissal upon	3205
technical or procedural grounds of a charge of a misdemeanor, if	3206
the alleged act was committed in the course of practice;	3207

(3) A plea of guilty to, a judicial finding of guilt of, or	3208
judicial finding of eligibility for intervention in lieu of	3209
conviction for a misdemeanor involving moral turpitude, or a case	3210
where the trial court issues an order of dismissal upon technical	3211
or procedural grounds of a charge of a misdemeanor involving moral	3212
turpitude.	3213

The report shall include the name and address of the	3214
~~certificate~~license holder, the nature of the offense for which	3215
the action was taken, and the certified court documents recording	3216
the action.	3217

Sec. 4730.32. (A) Within sixty days after the imposition of	3218
any formal disciplinary action taken by a health care facility	3219
against any individual holding a valid ~~certificate~~license to	3220
practice as a physician assistant issued under this chapter, the	3221
chief administrator or executive officer of the facility shall	3222
report to the state medical board the name of the individual, the	3223
action taken by the facility, and a summary of the underlying	3224
facts leading to the action taken. Upon request, the board shall	3225
be provided certified copies of the patient records that were the	3226
basis for the facility's action. Prior to release to the board,	3227
the summary shall be approved by the peer review committee that	3228
reviewed the case or by the governing board of the facility.	3229

The filing of a report with the board or decision not to file	3230
a report, investigation by the board, or any disciplinary action	3231
taken by the board, does not preclude a health care facility from	3232
taking disciplinary action against a physician assistant.	3233

In the absence of fraud or bad faith, no individual or entity	3234
that provides patient records to the board shall be liable in	3235
damages to any person as a result of providing the records.	3236

(B) A physician assistant, professional association or	3237
society of physician assistants, physician, or professional	3238
association or society of physicians that believes a violation of	3239
any provision of this chapter, Chapter 4731. of the Revised Code,	3240
or rule of the board has occurred shall report to the board the	3241
information upon which the belief is based. This division does not	3242
require any treatment provider approved by the board under section	3243
4731.25 of the Revised Code or any employee, agent, or	3244
representative of such a provider to make reports with respect to	3245
a physician assistant participating in treatment or aftercare for	3246
substance abuse as long as the physician assistant maintains	3247
participation in accordance with the requirements of section	3248
4731.25 of the Revised Code and the treatment provider or	3249
employee, agent, or representative of the provider has no reason	3250
to believe that the physician assistant has violated any provision	3251
of this chapter or rule adopted under it, other than being	3252
impaired by alcohol, drugs, or other substances. This division	3253
does not require reporting by any member of an impaired	3254
practitioner committee established by a health care facility or by	3255
any representative or agent of a committee or program sponsored by	3256
a professional association or society of physician assistants to	3257
provide peer assistance to physician assistants with substance	3258
abuse problems with respect to a physician assistant who has been	3259
referred for examination to a treatment program approved by the	3260
board under section 4731.25 of the Revised Code if the physician	3261
assistant cooperates with the referral for examination and with	3262
any determination that the physician assistant should enter	3263
treatment and as long as the committee member, representative, or	3264
agent has no reason to believe that the physician assistant has	3265
ceased to participate in the treatment program in accordance with	3266
section 4731.25 of the Revised Code or has violated any provision	3267
of this chapter or rule adopted under it, other than being	3268
impaired by alcohol, drugs, or other substances.	3269

(C) Any professional association or society composed	3270
primarily of physician assistants that suspends or revokes an	3271
individual's membership for violations of professional ethics, or	3272
for reasons of professional incompetence or professional	3273
malpractice, within sixty days after a final decision, shall	3274
report to the board, on forms prescribed and provided by the	3275
board, the name of the individual, the action taken by the	3276
professional organization, and a summary of the underlying facts	3277
leading to the action taken.	3278

The filing or nonfiling of a report with the board,	3279
investigation by the board, or any disciplinary action taken by	3280
the board, shall not preclude a professional organization from	3281
taking disciplinary action against a physician assistant.	3282

(D) Any insurer providing professional liability insurance to	3283
any person holding a valid ~~certificate~~license to practice as a	3284
physician assistant issued under this chapter or any other entity	3285
that seeks to indemnify the professional liability of a physician	3286
assistant shall notify the board within thirty days after the	3287
final disposition of any written claim for damages where such	3288
disposition results in a payment exceeding twenty-five thousand	3289
dollars. The notice shall contain the following information:	3290

(1) The name and address of the person submitting the	3291
notification;	3292

(2) The name and address of the insured who is the subject of	3293
the claim;	3294

(3) The name of the person filing the written claim;

3295

(4) The date of final disposition;

3296

(5) If applicable, the identity of the court in which the	3297
final disposition of the claim took place.	3298

(E) The board may investigate possible violations of this	3299
chapter or the rules adopted under it that are brought to its	3300
attention as a result of the reporting requirements of this	3301
section, except that the board shall conduct an investigation if a	3302
possible violation involves repeated malpractice. As used in this	3303
division, "repeated malpractice" means three or more claims for	3304
malpractice within the previous five-year period, each resulting	3305
in a judgment or settlement in excess of twenty-five thousand	3306
dollars in favor of the claimant, and each involving negligent	3307
conduct by the physician assistant.	3308

(F) All summaries, reports, and records received and	3309
maintained by the board pursuant to this section shall be held in	3310
confidence and shall not be subject to discovery or introduction	3311
in evidence in any federal or state civil action involving a	3312
physician assistant, supervising physician, or health care	3313
facility arising out of matters that are the subject of the	3314
reporting required by this section. The board may use the	3315
information obtained only as the basis for an investigation, as	3316
evidence in a disciplinary hearing against a physician assistant	3317
or supervising physician, or in any subsequent trial or appeal of	3318
a board action or order.	3319

The board may disclose the summaries and reports it receives	3320
under this section only to health care facility committees within	3321
or outside this state that are involved in credentialing or	3322
recredentialing a physician assistant or supervising physician or	3323
reviewing their privilege to practice within a particular	3324
facility. The board shall indicate whether or not the information	3325
has been verified. Information transmitted by the board shall be	3326
subject to the same confidentiality provisions as when maintained	3327
by the board.	3328

(G) Except for reports filed by an individual pursuant to	3329
division (B) of this section, the board shall send a copy of any	3330
reports or summaries it receives pursuant to this section to the	3331
physician assistant. The physician assistant shall have the right	3332
to file a statement with the board concerning the correctness or	3333
relevance of the information. The statement shall at all times	3334
accompany that part of the record in contention.	3335

(H) An individual or entity that reports to the board or	3336
refers an impaired physician assistant to a treatment provider	3337
approved by the board under section 4731.25 of the Revised Code	3338
shall not be subject to suit for civil damages as a result of the	3339
report, referral, or provision of the information.	3340

(I) In the absence of fraud or bad faith, a professional	3341
association or society of physician assistants that sponsors a	3342
committee or program to provide peer assistance to a physician	3343
assistant with substance abuse problems, a representative or agent	3344
of such a committee or program, and a member of the state medical	3345
board shall not be held liable in damages to any person by reason	3346
of actions taken to refer a physician assistant to a treatment	3347
provider approved under section 4731.25 of the Revised Code for	3348
examination or treatment.	3349

Sec. 4730.33. The secretary of the state medical board shall	3350
enforce the laws relating to the practice of physician assistants.	3351
If the secretary has knowledge or notice of a violation of this	3352
chapter or the rules adopted under it, the secretary shall	3353
investigate the matter, and, upon probable cause appearing, file a	3354
complaint and prosecute the offender. When requested by the	3355
secretary, the prosecuting attorney of the proper county shall	3356
take charge of and conduct such prosecution.	3357

In the prosecution of any person for violation of division	3358
(A) of section 4730.02 of the Revised Code it shall not be	3359
necessary to allege or prove want of a valid ~~certificate~~license	3360
to practice as a physician assistant, but such matters shall be a	3361
matter of defense to be established by the accused.	3362

Sec. 4730.38. (A) Except as provided in division (B) of this	3363
section, the physician assistant policy committee of the state	3364
medical board shall, at such times the committee determines to be	3365
necessary, submit to the board recommendations regarding	3366
physician-delegated prescriptive authority for physician	3367
assistants. The committee's recommendations shall address both of	3368
the following:	3369

(1) Policy and procedures regarding physician-delegated	3370
prescriptive authority~~, including the issuance of certificates to~~	3371
~~prescribe under this chapter~~;	3372

(2) Any issue the committee considers necessary to assist the	3373
board in fulfilling its duty to adopt rules governing	3374
physician-delegated prescriptive authority~~, including the issuance~~	3375
~~of certificates to prescribe~~.	3376

(B) Not less than every six months beginning on the first day	3377
of June following ~~the effective date of this amendment~~March 22,	3378
2013, the committee shall review the physician assistant formulary	3379
the board adopts pursuant to division (A)(1) of section 4730.39 of	3380
the Revised Code and, to the extent it determines to be necessary,	3381
submit recommendations proposing changes to the formulary.	3382

(C) Recommendations submitted under this section are subject	3383
to the procedures and time frames specified in division (C) of	3384
section 4730.06 of the Revised Code.	3385

Sec. 4730.39. (A) The state medical board shall do ~~both~~all	3386
of the following:	3387

(1) Adopt a formulary listing the drugs and therapeutic	3388
devices by class and specific generic nomenclature that a	3389
physician may include in the physician-delegated prescriptive	3390
authority granted to a physician assistant who holds a ~~certificate~~	3391
~~to prescribe under this chapter~~valid prescriber number issued by	3392
the state medical board;	3393

(2) Adopt rules governing physician-delegated prescriptive	3394
authority for physician assistants~~, including the issuance of~~	3395
~~certificates to prescribe under this chapter~~;	3396

(3) Establish standards and procedures for delegation under	3397
division (A) of section 4730.203 of the Revised Code of the	3398
authority to administer drugs.	3399

(B) The board's rules governing physician-delegated	3400
prescriptive authority adopted pursuant to division (A)(2) of this	3401
section shall be adopted in accordance with Chapter 119. of the	3402
Revised Code and shall establish all of the following:	3403

(1) Requirements regarding the pharmacology courses that a	3404
physician assistant is required to complete ~~to receive a~~	3405
~~certificate to prescribe~~;	3406

(2) ~~Standards and procedures for the issuance and renewal of~~	3407
~~certificates to prescribe to physician assistants;~~	3408

~~(3) Standards and procedures for the appropriate conduct of~~	3409
~~the provisional period that a physician assistant is required to~~	3410
~~complete pursuant to section 4730.45 of the Revised Code and for~~	3411
~~determining whether a physician assistant has successfully~~	3412
~~completed the provisional period;~~	3413

~~(4)~~ A specific prohibition against prescribing any drug or	3414
device to perform or induce an abortion;	3415

~~(5)~~(3) Standards and procedures to be followed by a physician	3416
assistant in personally furnishing samples of drugs or complete or	3417
partial supplies of drugs to patients under section 4730.43 of the	3418
Revised Code;	3419

~~(6)~~(4) Any other requirements the board considers necessary	3420
to implement the provisions of this chapter regarding	3421
physician-delegated prescriptive authority ~~and the issuance of~~	3422
~~certificates to prescribe~~.	3423

(C)(1) After considering recommendations submitted by the	3424
physician assistant policy committee pursuant to sections 4730.06	3425
and 4730.38 of the Revised Code, the board shall review either or	3426
both of the following, as appropriate according to the submitted	3427
recommendations:	3428

(a) The formulary the board adopts under division (A)(1) of	3429
this section;	3430

(b) The rules the board adopts under division (A)(2) of this	3431
section regarding physician-delegated prescriptive authority.	3432

(2) Based on its review, the board shall make any necessary	3433
modifications to the formulary or rules.	3434

Sec. 4730.41. (A) A ~~certificate to prescribe issued under~~	3435
~~this chapter authorizes a~~ physician assistant who holds a valid	3436
prescriber number issued by the state medical board is authorized	3437
to prescribe and personally furnish drugs and therapeutic devices	3438
in the exercise of physician-delegated prescriptive authority.	3439

(B) In exercising physician-delegated prescriptive authority,	3440
a physician assistant is subject to all of the following:	3441

(1) The physician assistant shall exercise	3442
physician-delegated prescriptive authority only to the extent that	3443
the physician supervising the physician assistant has granted that	3444
authority.	3445

(2) The physician assistant shall comply with all conditions	3446
placed on the physician-delegated prescriptive authority, as	3447
specified by the supervising physician who is supervising the	3448
physician assistant in the exercise of physician-delegated	3449
prescriptive authority.	3450

(3) If the physician assistant possesses physician-delegated	3451
prescriptive authority for controlled substances, the physician	3452
assistant shall register with the federal drug enforcement	3453
administration.	3454

(4) If the physician assistant possesses physician-delegated	3455
prescriptive authority for schedule II controlled substances, the	3456
physician assistant shall comply with section 4730.411 of the	3457
Revised Code.	3458

(5) If the physician assistant possesses physician-delegated	3459
prescriptive authority to prescribe for a minor, as defined in	3460
section 3719.061 of the Revised Code, a compound that is a	3461
controlled substance containing an opioid, the physician assistant	3462
shall comply with section 3719.061 of the Revised Code.	3463

Sec. 4730.42. (A) In granting physician-delegated	3464
prescriptive authority to a particular physician assistant who	3465
holds a ~~certificate to prescribe~~valid prescriber number issued	3466
~~under this chapter~~by the state medical board, the supervising	3467
physician is subject to all of the following:	3468

(1) The supervising physician shall not grant	3469
physician-delegated prescriptive authority for any drug or	3470
therapeutic device that is not listed on the physician assistant	3471
formulary adopted under section 4730.39 of the Revised Code as a	3472
drug or therapeutic device that may be included in the	3473
physician-delegated prescriptive authority granted to a physician	3474
assistant.	3475

(2) The supervising physician shall not grant	3476
physician-delegated prescriptive authority for any drug or device	3477
that may be used to perform or induce an abortion.	3478

(3) The supervising physician shall not grant	3479
physician-delegated prescriptive authority in a manner that	3480
exceeds the supervising physician's prescriptive authority,	3481
including the physician's authority to treat chronic pain with	3482
controlled substances and products containing tramadol as	3483
described in section 4731.052 of the Revised Code.	3484

(4) The supervising physician shall supervise the physician	3485
assistant in accordance with ~~all~~both of the following:	3486

(a) The supervision requirements specified in section 4730.21	3487
of the Revised Code ~~and, in the case of supervision provided~~	3488
~~during a provisional period of physician-delegated prescriptive~~	3489
~~authority, the supervision requirements specified in section~~	3490
~~4730.45 of the Revised Code~~;	3491

(b) The ~~physician supervisory plan approved for the~~	3492
~~supervising physician or~~supervision agreement entered into with	3493
the physician assistant under section 4730.19 of the Revised Code,	3494
including, if applicable, the policies of the health care facility	3495
in which the physician and physician assistant are practicing;	3496

~~(c) The supervision agreement approved under section 4730.19~~	3497
~~of the Revised Code that applies to the supervising physician and~~	3498
~~the physician assistant~~.	3499

(B)(1) The supervising physician of a physician assistant may	3500
place conditions on the physician-delegated prescriptive authority	3501
granted to the physician assistant. If conditions are placed on	3502
that authority, the supervising physician shall maintain a written	3503
record of the conditions and make the record available to the	3504
state medical board on request.	3505

(2) The conditions that a supervising physician may place on	3506
the physician-delegated prescriptive authority granted to a	3507
physician assistant include the following:	3508

(a) Identification by class and specific generic nomenclature	3509
of drugs and therapeutic devices that the physician chooses not to	3510
permit the physician assistant to prescribe;	3511

(b) Limitations on the dosage units or refills that the	3512
physician assistant is authorized to prescribe;	3513

(c) Specification of circumstances under which the physician	3514
assistant is required to refer patients to the supervising	3515
physician or another physician when exercising physician-delegated	3516
prescriptive authority;	3517

(d) Responsibilities to be fulfilled by the physician in	3518
supervising the physician assistant that are not otherwise	3519
specified in the ~~physician supervisory plan~~supervision agreement	3520
or otherwise required by this chapter.	3521

Sec. 4730.43. (A) A physician assistant who holds a	3522
~~certificate to prescribe~~valid prescriber number issued ~~under this~~	3523
~~chapter~~by the state medical board and has been granted	3524
physician-delegated prescriptive authority ~~by a supervising~~	3525
~~physician~~ may personally furnish to a patient samples of drugs and	3526
therapeutic devices that are included in the physician assistant's	3527
physician-delegated prescriptive authority, subject to all of the	3528
following:	3529

(1) The amount of the sample furnished shall not exceed a	3530
seventy-two-hour supply, except when the minimum available	3531
quantity of the sample is packaged in an amount that is greater	3532
than a seventy-two-hour supply, in which case the physician	3533
assistant may furnish the sample in the package amount.	3534

(2) No charge may be imposed for the sample or for furnishing	3535
it.	3536

(3) Samples of controlled substances may not be personally	3537
furnished.	3538

(B) A physician assistant who holds a ~~certificate to~~	3539
~~prescribe~~valid prescriber number issued ~~under this chapter~~by the	3540
board and has been granted physician-delegated prescriptive	3541
authority ~~by a supervising physician~~ may personally furnish to a	3542
patient a complete or partial supply of the drugs and therapeutic	3543
devices that are included in the physician assistant's	3544
physician-delegated prescriptive authority, subject to all of the	3545
following:	3546

(1) The physician assistant shall personally furnish only	3547
antibiotics, antifungals, scabicides, contraceptives, prenatal	3548
vitamins, antihypertensives, drugs and devices used in the	3549
treatment of diabetes, drugs and devices used in the treatment of	3550
asthma, and drugs used in the treatment of dyslipidemia.	3551

(2) The physician assistant shall not furnish the drugs and	3552
devices in locations other than a health department operated by	3553
the board of health of a city or general health district or the	3554
authority having the duties of a board of health under section	3555
3709.05 of the Revised Code, a federally funded comprehensive	3556
primary care clinic, or a nonprofit health care clinic or program.	3557

(3) The physician assistant shall comply with all standards	3558
and procedures for personally furnishing supplies of drugs and	3559
devices, as established in rules adopted under section 4730.39 of	3560
the Revised Code.	3561

Sec. 4730.431. (A) Notwithstanding any provision of this	3562
chapter or rule adopted by the state medical board, a physician	3563
assistant who holds a ~~certificate to prescribe~~valid prescriber	3564
number issued ~~under this chapter~~by the board may personally	3565
furnish a supply of naloxone, or issue a prescription for	3566
naloxone, without having examined the individual to whom it may be	3567
administered if all of the following conditions are met:	3568

(1) The naloxone supply is furnished to, or the prescription	3569
is issued to and in the name of, a family member, friend, or other	3570
individual in a position to assist an individual who there is	3571
reason to believe is at risk of experiencing an opioid-related	3572
overdose.	3573

(2) The physician assistant instructs the individual	3574
receiving the naloxone supply or prescription to summon emergency	3575
services either immediately before or immediately after	3576
administering naloxone to an individual apparently experiencing an	3577
opioid-related overdose.	3578

(3) The naloxone is personally furnished or prescribed in	3579
such a manner that it may be administered by only either of the	3580
following routes:	3581

(a) Using a device manufactured for the intranasal	3582
administration of liquid drugs;	3583

(b) Using an autoinjector in a manufactured dosage form.

3584

(B) A physician assistant who under division (A) of this	3585
section in good faith furnishes a supply of naloxone or issues a	3586
prescription for naloxone is not liable for or subject to any of	3587
the following for any action or omission of the individual to whom	3588
the naloxone is furnished or the prescription is issued: damages	3589
in any civil action, prosecution in any criminal proceeding, or	3590
professional disciplinary action.	3591

Sec. 4730.49. (A) To be eligible for renewal of a	3592
~~certificate to prescribe~~license to practice as a physician	3593
assistant, an applicant who has been granted physician-delegated	3594
prescriptive authority is subject to both of the following:	3595

(1) The applicant shall complete every two years at least	3596
twelve hours of continuing education in pharmacology from an	3597
accredited institution recognized by the state medical board.	3598
Except as provided in division (B) of this section and in section	3599
5903.12 of the Revised Code, the continuing education shall be	3600
completed not later than the thirty-first day of January of each	3601
even-numbered year.	3602

(2)(a) Except as provided in division (A)(2)(b) of this	3603
section, in the case of an applicant who prescribes opioid	3604
analgesics or benzodiazepines, the applicant shall certify to the	3605
board whether the applicant has been granted access to the drug	3606
database established and maintained by the state board of pharmacy	3607
pursuant to section 4729.75 of the Revised Code.	3608

(b) The requirement in division (A)(2)(a) of this section	3609
does not apply if either of the following is the case:	3610

(i) The state board of pharmacy notifies the state medical	3611
board pursuant to section 4729.861 of the Revised Code that the	3612
applicant has been restricted from obtaining further information	3613
from the drug database.	3614

(ii) The state board of pharmacy no longer maintains the drug	3615
database.	3616

(c) If an applicant certifies to the state medical board that	3617
the applicant has been granted access to the drug database and the	3618
board finds through an audit or other means that the applicant has	3619
not been granted access, the board may take action under section	3620
4730.25 of the Revised Code.	3621

(B) The state medical board shall provide for pro rata	3622
reductions by month of the number of hours of continuing education	3623
in pharmacology that is required to be completed for physician	3624
assistants who are in their first ~~certification~~licensure period	3625
after completing the ~~provisional~~ period of supervision required	3626
under section ~~4730.45~~4730.12 of the Revised Code, who have been	3627
disabled due to illness or accident, or who have been absent from	3628
the country. The board shall adopt rules, in accordance with	3629
Chapter 119. of the Revised Code, as necessary to implement this	3630
division.	3631

(C) The continuing education required by this section is in	3632
addition to the continuing education required under section	3633
4730.14 of the Revised Code.	3634

Sec. 4730.51. In the information the board maintains on ~~the~~	3635
its internet web site, the state medical board shall include the	3636
following:	3637

(A) The name of each physician assistant who holds a	3638
~~certificate to prescribe~~license under this chapter;	3639

(B) For each physician assistant who holds a ~~certificate to~~	3640
~~prescribe~~valid prescriber number issued by the state medical	3641
board, the name of each supervising physician who has authority to	3642
grant physician-delegated prescriptive authority to the physician	3643
assistant.	3644

Sec. 4730.53. (A) As used in this section, "drug database"	3645
means the database established and maintained by the state board	3646
of pharmacy pursuant to section 4729.75 of the Revised Code.	3647

(B) The state medical board shall adopt rules in accordance	3648
with Chapter 119. of the Revised Code that establish standards and	3649
procedures to be followed by a physician assistant ~~who holds a~~	3650
~~certificate to prescribe issued~~licensed under this chapter who	3651
has been granted physician-delegated prescriptive authority	3652
regarding the review of patient information available through the	3653
drug database under division (A)(5) of section 4729.80 of the	3654
Revised Code.	3655

(C) This section and the rules adopted under it do not apply	3656
if the state board of pharmacy no longer maintains the drug	3657
database.	3658

Sec. 4731.07. (A) The state medical board shall keep a record	3659
of its proceedings. The minutes of a meeting of the board shall,	3660
on approval by the board, constitute an official record of its	3661
proceedings.	3662

(B) The board shall keep a register of applicants for	3663
certificates of registration and certificates to practice issued	3664
under this chapter and Chapters ~~4730.,~~ 4760., 4762., and 4774. of	3665
the Revised Code and licenses issued under ~~Chapter~~Chapters 4730.	3666
and 4778. of the Revised Code. The register shall show the name of	3667
the applicant and whether the applicant was granted or refused a	3668
certificate or license. With respect to applicants to practice	3669
medicine and surgery or osteopathic medicine and surgery, the	3670
register shall show the name of the institution that granted the	3671
applicant the degree of doctor of medicine or osteopathic	3672
medicine. The books and records of the board shall be prima-facie	3673
evidence of matters therein contained.	3674

Sec. 4761.01. As used in this chapter:

3675

(A) "Respiratory care" means rendering or offering to render	3676
to individuals, groups, organizations, or the public any service	3677
involving the evaluation of cardiopulmonary function, the	3678
treatment of cardiopulmonary impairment, the assessment of	3679
treatment effectiveness, and the care of patients with	3680
deficiencies and abnormalities associated with the cardiopulmonary	3681
system. The practice of respiratory care includes:	3682

(1) Obtaining, analyzing, testing, measuring, and monitoring	3683
blood and gas samples in the determination of cardiopulmonary	3684
parameters and related physiologic data, including flows,	3685
pressures, and volumes, and the use of equipment employed for this	3686
purpose;	3687

(2) Administering, monitoring, recording the results of, and	3688
instructing in the use of medical gases, aerosols, and	3689
bronchopulmonary hygiene techniques, including drainage,	3690
aspiration, and sampling, and applying, maintaining, and	3691
instructing in the use of artificial airways, ventilators, and	3692
other life support equipment employed in the treatment of	3693
cardiopulmonary impairment and provided in collaboration with	3694
other licensed health care professionals responsible for providing	3695
care;	3696

(3) Performing cardiopulmonary resuscitation and respiratory	3697
rehabilitation techniques;	3698

(4) Administering medications for the testing or treatment of	3699
cardiopulmonary impairment.	3700

(B) "Respiratory care professional" means a person who is	3701
licensed under this chapter to practice the full range of	3702
respiratory care services as defined in division (A) of this	3703
section.	3704

(C) "Physician" means an individual authorized under Chapter	3705
4731. of the Revised Code to practice medicine and surgery or	3706
osteopathic medicine and surgery.	3707

(D) "Registered nurse" means an individual licensed under	3708
Chapter 4723. of the Revised Code to engage in the practice of	3709
nursing as a registered nurse.	3710

(E) "Hospital" means a facility that meets the operating	3711
standards of section 3727.02 of the Revised Code.	3712

(F) "Nursing facility" has the same meaning as in section	3713
5165.01 of the Revised Code.	3714

(G) "Certified hyperbaric technologist" means a person who	3715
administers hyperbaric oxygen therapy and is certified as a	3716
hyperbaric technologist by the national board of diving and	3717
hyperbaric medical technology or its successor organization.	3718

(H) "Hyperbaric oxygen therapy" means the administration of	3719
pure oxygen in a pressurized room or chamber, except that it does	3720
not include ventilator management.	3721

(I) "Advanced practice registered nurse" has the same meaning	3722
as in section 4723.01 of the Revised Code.	3723

(J) "Physician assistant" means an individual who holds a	3724
valid ~~certificate~~license to practice issued under Chapter 4730.	3725
of the Revised Code authorizing the individual to provide services	3726
as a physician assistant to patients under the supervision,	3727
control, and direction of one or more physicians.	3728

Sec. 4761.17. All of the following apply to the practice of	3729
respiratory care by a person who holds a license or limited permit	3730
issued under this chapter:	3731

(A) The person shall practice only pursuant to a prescription	3732
or other order for respiratory care issued by aany of the	3733
following:	3734

(1) A physician ~~or by a~~;

3735

(2) A registered nurse who holds a certificate of authority	3736
issued under Chapter 4723. of the Revised Code to practice as a	3737
certified nurse practitioner or clinical nurse specialist and has	3738
entered into a standard care arrangement with a physician that	3739
allows the nurse to prescribe or order respiratory care services;	3740

(3) A physician assistant who has been granted	3741
physician-delegated prescriptive authority that allows the	3742
physician assistant to prescribe or order respiratory care	3743
services.	3744

(B) The person shall practice only under the supervision of a	3745
any of the following:	3746

(1) A physician ~~or under the supervision of a~~;

3747

(2) A certified nurse practitioner or clinical nurse	3748
specialist who is authorized to prescribe or order respiratory	3749
care services as provided in division (A)(2) of this section;	3750

(3) A physician assistant who is authorized to prescribe or	3751
order respiratory care services as provided in division (A)(3) of	3752
this section.	3753

(C) When practicing under the prescription or order of a	3754
certified nurse practitioner or clinical nurse specialist or under	3755
the supervision of such a nurse, the person's administration of	3756
medication that requires a prescription is limited to the drugs	3757
that the nurse is authorized to prescribe pursuant to the nurse's	3758
certificate to prescribe issued under section 4723.48 of the	3759
Revised Code.	3760

(D) When practicing under the prescription or order of a	3761
physician assistant or under the supervision of a physician	3762
assistant, the person's administration of medication that requires	3763
a prescription is limited to the drugs that the physician	3764
assistant is authorized to prescribe pursuant to the physician	3765
assistant's physician-delegated prescriptive authority.	3766

Sec. 4765.01. As used in this chapter:

3767

(A) "First responder" means an individual who holds a	3768
current, valid certificate issued under section 4765.30 of the	3769
Revised Code to practice as a first responder.	3770

(B) "Emergency medical technician-basic" or "EMT-basic" means	3771
an individual who holds a current, valid certificate issued under	3772
section 4765.30 of the Revised Code to practice as an emergency	3773
medical technician-basic.	3774

(C) "Emergency medical technician-intermediate" or "EMT-I"	3775
means an individual who holds a current, valid certificate issued	3776
under section 4765.30 of the Revised Code to practice as an	3777
emergency medical technician-intermediate.	3778

(D) "Emergency medical technician-paramedic" or "paramedic"	3779
means an individual who holds a current, valid certificate issued	3780
under section 4765.30 of the Revised Code to practice as an	3781
emergency medical technician-paramedic.	3782

(E) "Ambulance" means any motor vehicle that is used, or is	3783
intended to be used, for the purpose of responding to emergency	3784
medical situations, transporting emergency patients, and	3785
administering emergency medical service to patients before,	3786
during, or after transportation.	3787

(F) "Cardiac monitoring" means a procedure used for the	3788
purpose of observing and documenting the rate and rhythm of a	3789
patient's heart by attaching electrical leads from an	3790
electrocardiograph monitor to certain points on the patient's body	3791
surface.	3792

(G) "Emergency medical service" means any of the services	3793
described in sections 4765.35, 4765.37, 4765.38, and 4765.39 of	3794
the Revised Code that are performed by first responders, emergency	3795
medical technicians-basic, emergency medical	3796
technicians-intermediate, and paramedics. "Emergency medical	3797
service" includes such services performed before or during any	3798
transport of a patient, including transports between hospitals and	3799
transports to and from helicopters.	3800

(H) "Emergency medical service organization" means a public	3801
or private organization using first responders, EMTs-basic,	3802
EMTs-I, or paramedics, or a combination of first responders,	3803
EMTs-basic, EMTs-I, and paramedics, to provide emergency medical	3804
services.	3805

(I) "Physician" means an individual who holds a current,	3806
valid certificate issued under Chapter 4731. of the Revised Code	3807
authorizing the practice of medicine and surgery or osteopathic	3808
medicine and surgery.	3809

(J) "Registered nurse" means an individual who holds a	3810
current, valid license issued under Chapter 4723. of the Revised	3811
Code authorizing the practice of nursing as a registered nurse.	3812

(K) "Volunteer" means a person who provides services either	3813
for no compensation or for compensation that does not exceed the	3814
actual expenses incurred in providing the services or in training	3815
to provide the services.	3816

(L) "Emergency medical service personnel" means first	3817
responders, emergency medical service technicians-basic, emergency	3818
medical service technicians-intermediate, emergency medical	3819
service technicians-paramedic, and persons who provide medical	3820
direction to such persons.	3821

(M) "Hospital" has the same meaning as in section 3727.01 of	3822
the Revised Code.	3823

(N) "Trauma" or "traumatic injury" means severe damage to or	3824
destruction of tissue that satisfies both of the following	3825
conditions:	3826

(1) It creates a significant risk of any of the following:

3827

(a) Loss of life;

3828

(b) Loss of a limb;

3829

3830

(d) Significant, permanent disability.

3831

(2) It is caused by any of the following:

3832

(a) Blunt or penetrating injury;

3833

(b) Exposure to electromagnetic, chemical, or radioactive	3834
energy;	3835

3836

(d) A deficit or excess of heat.

3837

(O) "Trauma victim" or "trauma patient" means a person who	3838
has sustained a traumatic injury.	3839

(P) "Trauma care" means the assessment, diagnosis,	3840
transportation, treatment, or rehabilitation of a trauma victim by	3841
emergency medical service personnel or by a physician, nurse,	3842
physician assistant, respiratory therapist, physical therapist,	3843
chiropractor, occupational therapist, speech-language pathologist,	3844
audiologist, or psychologist licensed to practice as such in this	3845
state or another jurisdiction.	3846

(Q) "Trauma center" means all of the following:

3847

(1) Any hospital that is verified by the American college of	3848
surgeons as an adult or pediatric trauma center;	3849

(2) Any hospital that is operating as an adult or pediatric	3850
trauma center under provisional status pursuant to section	3851
3727.101 of the Revised Code;	3852

(3) Until December 31, 2004, any hospital in this state that	3853
is designated by the director of health as a level II pediatric	3854
trauma center under section 3727.081 of the Revised Code;	3855

(4) Any hospital in another state that is licensed or	3856
designated under the laws of that state as capable of providing	3857
specialized trauma care appropriate to the medical needs of the	3858
trauma patient.	3859

(R) "Pediatric" means involving a patient who is less than	3860
sixteen years of age.	3861

(S) "Adult" means involving a patient who is not a pediatric	3862
patient.	3863

(T) "Geriatric" means involving a patient who is at least	3864
seventy years old or exhibits significant anatomical or	3865
physiological characteristics associated with advanced aging.	3866

(U) "Air medical organization" means an organization that	3867
provides emergency medical services, or transports emergency	3868
victims, by means of fixed or rotary wing aircraft.	3869

(V) "Emergency care" and "emergency facility" have the same	3870
meanings as in section 3727.01 of the Revised Code.	3871

(W) "Stabilize," except as it is used in division (B) of	3872
section 4765.35 of the Revised Code with respect to the manual	3873
stabilization of fractures, has the same meaning as in section	3874
1753.28 of the Revised Code.	3875

(X) "Transfer" has the same meaning as in section 1753.28 of	3876
the Revised Code.	3877

(Y) "Firefighter" means any member of a fire department as	3878
defined in section 742.01 of the Revised Code.	3879

(Z) "Volunteer firefighter" has the same meaning as in	3880
section 146.01 of the Revised Code.	3881

(AA) "Part-time paid firefighter" means a person who provides	3882
firefighting services on less than a full-time basis, is routinely	3883
scheduled to be present on site at a fire station or other	3884
designated location for purposes of responding to a fire or other	3885
emergency, and receives more than nominal compensation for the	3886
provision of firefighting services.	3887

(BB) "Physician assistant" means an individual who holds a	3888
current, valid ~~certificate~~license to practice as a physician	3889
assistant issued under Chapter 4730. of the Revised Code.	3890

Sec. 4765.51. Nothing in this chapter prevents or restricts	3891
the practice, services, or activities of any registered nurse	3892
practicing within the scope of the registered nurse's practice.	3893

Nothing in this chapter prevents or restricts the practice,	3894
services, or activities of any physician assistant practicing in	3895
accordance with a ~~physician supervisory plan approved~~supervision	3896
agreement entered into under section ~~4730.17~~4730.19 of the	3897
Revised Code or, including, if applicable, the policies of the	3898
health care facility in which the physician assistant is	3899
practicing.	3900

Sec. 5122.11. Proceedings for a mentally ill person subject	3901
to court order pursuant to sections 5122.11 to 5122.15 of the	3902
Revised Code shall be commenced by the filing of an affidavit in	3903
the manner prescribed by the department of mental health and	3904
addiction services and in a form prescribed in section 5122.111 of	3905
the Revised Code, by any person or persons with the probate court	3906
~~in the county where the mentally ill person subject to court order~~	3907
~~resides~~, either on reliable information or actual knowledge,	3908
whichever is determined to be proper by the court. This section	3909
does not apply to the hospitalization of a person pursuant to	3910
section 2945.39, 2945.40, 2945.401, or 2945.402 of the Revised	3911
Code.	3912

The affidavit shall contain an allegation setting forth the	3913
specific category or categories under division (B) of section	3914
5122.01 of the Revised Code upon which the jurisdiction of the	3915
court is based and a statement of alleged facts sufficient to	3916
indicate probable cause to believe that the person is a mentally	3917
ill person subject to court order. The affidavit may be	3918
accompanied, or the court may require that the affidavit be	3919
accompanied, by a certificate of a psychiatrist, or a certificate	3920
signed by a licensed clinical psychologist and a certificate	3921
signed by a licensed physician stating that the person who issued	3922
the certificate has examined the person and is of the opinion that	3923
the person is a mentally ill person subject to court order, or	3924
shall be accompanied by a written statement by the applicant,	3925
under oath, that the person has refused to submit to an	3926
examination by a psychiatrist, or by a licensed clinical	3927
psychologist and licensed physician.	3928

Upon receipt of the affidavit, if a judge of the court or a	3929
referee who is an attorney at law appointed by the court has	3930
probable cause to believe that the person named in the affidavit	3931
is a mentally ill person subject to court order, the judge or	3932
referee may issue a temporary order of detention ordering any	3933
health or police officer or sheriff to take into custody and	3934
transport the person to a hospital or other place designated in	3935
section 5122.17 of the Revised Code, or may set the matter for	3936
further hearing. If a temporary order of detention is issued and	3937
the person is transported to a hospital or other designated place,	3938
the court that issued the order shall retain jurisdiction over the	3939
case as it relates to the person's outpatient treatment,	3940
notwithstanding that the hospital or other designated place to	3941
which the person is transported is outside the territorial	3942
jurisdiction of the court.	3943

The person may be observed and treated until the hearing	3944
provided for in section 5122.141 of the Revised Code. If no such	3945
hearing is held, the person may be observed and treated until the	3946
hearing provided for in section 5122.15 of the Revised Code.	3947

Sec. 5122.111. To initiate proceedings for court-ordered	3948
treatment of a person under section 5122.11 of the Revised Code, a	3949
person or persons shall file an affidavit with the probate court	3950
that is identical in form and content to the following:	3951

AFFIDAVIT OF MENTAL ILLNESS

3952

		3953
The State of Ohio		3954
..................... County,	ss.	3955
..................... Court		3956

.................................................................			3957
the undersigned, residing at			3958
.................................................................			3959
says, that he/she has information to believe or has actual knowledge that			3960
.................................................................			3961

(Please specify specific category(ies) below with an X.)	3962

[ ] Represents a substantial risk of physical harm to self as	3963
manifested by evidence of threats of, or attempts at, suicide or	3964
serious self-inflicted bodily harm;	3965

[ ] Represents a substantial risk of physical harm to others as	3966
manifested by evidence of recent homicidal or other violent	3967
behavior or evidence of recent threats that place another in	3968
reasonable fear of violent behavior and serious physical harm or	3969
other evidence of present dangerousness;	3970

[ ] Represents a substantial and immediate risk of serious	3971
physical impairment or injury to self as manifested by evidence of	3972
being unable to provide for and of not providing for basic	3973
physical needs because of mental illness and that appropriate	3974
provision for such needs cannot be made immediately available in	3975
the community;	3976

[ ] Would benefit from treatment for mental illness and is in need	3977
of such treatment as manifested by evidence of behavior that	3978
creates a grave and imminent risk to substantial rights of others	3979
or the person; or	3980

[ ] Would benefit from treatment as manifested by evidence of	3981
behavior that indicates all of the following:	3982

(a) The person is unlikely to survive safely in the community	3983
without supervision, based on a clinical determination.	3984

(b) The person has a history of lack of compliance with treatment	3985
for mental illness and one of the following applies:	3986

(i) At least twice within the thirty-six months prior to the	3987
filing of an affidavit seeking court-ordered treatment of the	3988
person under section 5122.111 of the Revised Code, the lack of	3989
compliance has been a significant factor in necessitating	3990
hospitalization in a hospital or receipt of services in a forensic	3991
or other mental health unit of a correctional facility, provided	3992
that the thirty-six-month period shall be extended by the length	3993
of any hospitalization or incarceration of the person that	3994
occurred within the thirty-six-month period.	3995

(ii) Within the forty-eight months prior to the filing of an	3996
affidavit seeking court-ordered treatment of the person under	3997
section 5122.111 of the Revised Code, the lack of compliance	3998
resulted in one or more acts of serious violent behavior toward	3999
self or others or threats of, or attempts at, serious physical	4000
harm to self or others, provided that the forty-eight-month period	4001
shall be extended by the length of any hospitalization or	4002
incarceration of the person that occurred within the	4003
forty-eight-month period.	4004

(c) The person, as a result of mental illness, is unlikely to	4005
voluntarily participate in necessary treatment.	4006

(d) In view of the person's treatment history and current	4007
behavior, the person is in need of treatment in order to prevent a	4008
relapse or deterioration that would be likely to result in	4009
substantial risk of serious harm to the person or others.	4010

.................................................................			4011
(Name of the party filing the affidavit) further says that the facts supporting this belief are as follows:			4012
.................................................................			4013
.................................................................			4014
.................................................................			4015
.................................................................			4016
.................................................................			4017
.................................................................			4018
These facts being sufficient to indicate probable cause that the			4019
above said person is a mentally ill person subject to			4020
court order.			4021

Name of Patient's Last Physician or Licensed Clinical Psychologist			4022
.................................................................			4023
Address of Patient's Last Physician or Licensed Clinical Psychologist			4024
.................................................................			4025
.................................................................			4026

The name and address of respondent's legal guardian, spouse, and	4027
adult next of kin are:	4028

Name	Kinship	Address	4029
			4030
	Legal Guardian		4031
			4032
			4033
	Spouse		4034
			4035
			4036
	Adult Next of Kin		4037
			4038
			4039
	Adult Next of Kin		4040
			4041

The following constitutes additional information that may be			4042
necessary for the purpose of determining residence:			4043
.................................................................			4044
.................................................................			4045
.................................................................			4046
.................................................................			4047
.................................................................			4048

Dated this ............. day of ..............., 20...	4049

			4050
	Signature of the party filing the affidavit		4051

Sworn to before me and signed in my presence on the day and year	4052
above dated.	4053

			4054
	Signature of Probate Judge		4055

			4056
	~~Signature of~~, Deputy Clerk, or Notary Public		4057

WAIVER	4058

I, the undersigned party filing the affidavit hereby waive the	4059
issuing and service of notice of the hearing on said affidavit,	4060
and voluntarily enter my appearance herein.	4061

Dated this ............. day of ..............., 20...	4062

			4063
	Signature of the party filing the affidavit		4064

Sec. 5123.47. (A) As used in this section:

4065

(1) "In-home care" means the supportive services provided	4066
within the home of an individual with mental retardation or a	4067
developmental disability who receives funding for the services	4068
through a county board of developmental disabilities, including	4069
any recipient of residential services funded as home and	4070
community-based services, family support services provided under	4071
section 5126.11 of the Revised Code, or supported living provided	4072
in accordance with sections 5126.41 to 5126.47 of the Revised	4073
Code. "In-home care" includes care that is provided outside an	4074
individual's home in places incidental to the home, and while	4075
traveling to places incidental to the home, except that "in-home	4076
care" does not include care provided in the facilities of a county	4077
board of developmental disabilities or care provided in schools.	4078

(2) "Parent" means either parent of a child, including an	4079
adoptive parent but not a foster parent.	4080

(3) "Unlicensed in-home care worker" means an individual who	4081
provides in-home care but is not a health care professional.	4082

(4) "Family member" means a parent, sibling, spouse, son,	4083
daughter, grandparent, aunt, uncle, cousin, or guardian of the	4084
individual with mental retardation or a developmental disability	4085
if the individual with mental retardation or developmental	4086
disabilities lives with the person and is dependent on the person	4087
to the extent that, if the supports were withdrawn, another living	4088
arrangement would have to be found.	4089

(5) "Health care professional" means any of the following:

4090

(a) A dentist who holds a valid license issued under Chapter	4091
4715. of the Revised Code;	4092

(b) A registered or licensed practical nurse who holds a	4093
valid license issued under Chapter 4723. of the Revised Code;	4094

(c) An optometrist who holds a valid license issued under	4095
Chapter 4725. of the Revised Code;	4096

(d) A pharmacist who holds a valid license issued under	4097
Chapter 4729. of the Revised Code;	4098

(e) A person who holds a valid certificate issued under	4099
Chapter 4731. of the Revised Code to practice medicine and	4100
surgery, osteopathic medicine and surgery, podiatric medicine and	4101
surgery, or a limited brand of medicine;	4102

(f) A physician assistant who holds a valid ~~certificate~~	4103
license issued under Chapter 4730. of the Revised Code;	4104

(g) An occupational therapist or occupational therapy	4105
assistant or a physical therapist or physical therapist assistant	4106
who holds a valid license issued under Chapter 4755. of the	4107
Revised Code;	4108

(h) A respiratory care professional who holds a valid license	4109
issued under Chapter 4761. of the Revised Code.	4110

(6) "Health care task" means a task that is prescribed,	4111
ordered, delegated, or otherwise directed by a health care	4112
professional acting within the scope of the professional's	4113
practice.	4114

(B) Except as provided in division (E) of this section, a	4115
family member of an individual with mental retardation or a	4116
developmental disability may authorize an unlicensed in-home care	4117
worker to administer oral and topical prescribed medications or	4118
perform other health care tasks as part of the in-home care the	4119
worker provides to the individual, if all of the following apply:	4120

(1) The family member is the primary supervisor of the care.

4121

(2) The unlicensed in-home care worker has been selected by	4122
the family member or the individual receiving care and is under	4123
the direct supervision of the family member.	4124

(3) The unlicensed in-home care worker is providing the care	4125
through an employment or other arrangement entered into directly	4126
with the family member and is not otherwise employed by or under	4127
contract with a person or government entity to provide services to	4128
individuals with mental retardation and developmental	4129
disabilities.	4130

(C) A family member shall obtain a prescription, if	4131
applicable, and written instructions from a health care	4132
professional for the care to be provided to the individual. The	4133
family member shall authorize the unlicensed in-home care worker	4134
to provide the care by preparing a written document granting the	4135
authority. The family member shall provide the unlicensed in-home	4136
care worker with appropriate training and written instructions in	4137
accordance with the instructions obtained from the health care	4138
professional.	4139

(D) A family member who authorizes an unlicensed in-home care	4140
worker to administer oral and topical prescribed medications or	4141
perform other health care tasks retains full responsibility for	4142
the health and safety of the individual receiving the care and for	4143
ensuring that the worker provides the care appropriately and	4144
safely. No entity that funds or monitors the provision of in-home	4145
care may be held liable for the results of the care provided under	4146
this section by an unlicensed in-home care worker, including such	4147
entities as the county board of developmental disabilities and the	4148
department of developmental disabilities.	4149

An unlicensed in-home care worker who is authorized under	4150
this section by a family member to provide care to an individual	4151
may not be held liable for any injury caused in providing the	4152
care, unless the worker provides the care in a manner that is not	4153
in accordance with the training and instructions received or the	4154
worker acts in a manner that constitutes wanton or reckless	4155
misconduct.	4156

(E) A county board of developmental disabilities may evaluate	4157
the authority granted by a family member under this section to an	4158
unlicensed in-home care worker at any time it considers necessary	4159
and shall evaluate the authority on receipt of a complaint. If the	4160
board determines that a family member has acted in a manner that	4161
is inappropriate for the health and safety of the individual	4162
receiving the care, the authorization granted by the family member	4163
to an unlicensed in-home care worker is void, and the family	4164
member may not authorize other unlicensed in-home care workers to	4165
provide the care. In making such a determination, the board shall	4166
use appropriately licensed health care professionals and shall	4167
provide the family member an opportunity to file a complaint under	4168
section 5126.06 of the Revised Code.	4169

Section 2. That existing sections 1.64, 2133.211, 2151.3515	4170
2305.113, 2925.61, 3701.92, 3727.06, 3729.05, 4503.44, 4723.01,	4171
4723.06, 4723.07, 4723.18, 4723.181, 4723.48, 4723.482, 4723.50,	4172
4729.01, 4730.01, 4730.02, 4730.03, 4730.04, 4730.06, 4730.08,	4173
4730.091, 4730.10, 4730.101, 4730.11, 4730.12, 4730.13, 4730.14,	4174
4730.19, 4730.21, 4730.22, 4730.25, 4730.251, 4730.27, 4730.28,	4175
4730.31, 4730.32, 4730.33, 4730.38, 4730.39, 4730.41, 4730.42,	4176
4730.43, 4730.431, 4730.49, 4730.51, 4730.53, 4731.07, 4761.01,	4177
4761.17, 4765.01, 4765.51, 5122.11, 5122.111, and 5123.47 and	4178
sections 4730.081, 4730.09, 4730.15, 4730.16, 4730.17,	4179
4730.18, 4730.20, 4730.44, 4730.45, 4730.46, 4730.47, 4730.48,	4180
4730.50, and 4730.52 of the Revised Code are hereby repealed.	4181

Section 3. That the versions of sections 4730.25 and 4730.53	4182
of the Revised Code that are scheduled to take effect April 1,	4183
2015, be amended to read as follows:	4184

Sec. 4730.25. (A) The state medical board, by an affirmative	4185
vote of not fewer than six members, may revoke or may refuse to	4186
grant a ~~certificate~~license to practice as a physician assistant	4187
~~or a certificate to prescribe~~ to a person found by the board to	4188
have committed fraud, misrepresentation, or deception in applying	4189
for or securing the ~~certificate~~license.	4190

(B) The board, by an affirmative vote of not fewer than six	4191
members, shall, to the extent permitted by law, limit, revoke, or	4192
suspend an individual's ~~certificate~~license to practice as a	4193
physician assistant or ~~certificate to prescribe~~prescriber number,	4194
refuse to issue a ~~certificate~~license to an applicant, refuse to	4195
reinstate a ~~certificate~~license, or reprimand or place on	4196
probation the holder of a ~~certificate~~license for any of the	4197
following reasons:	4198

(1) Failure to practice in accordance with the ~~conditions~~	4199
~~under which the~~ supervising physician's supervision agreement with	4200
the physician assistant ~~was approved, including the requirement~~	4201
~~that when practicing under a particular supervising physician, the~~	4202
~~physician assistant must practice only according to the physician~~	4203
~~supervisory plan the board approved for that physician or~~,	4204
including, if applicable, the policies of the health care facility	4205
in which the supervising physician and physician assistant are	4206
practicing;	4207

(2) Failure to comply with the requirements of this chapter,	4208
Chapter 4731. of the Revised Code, or any rules adopted by the	4209
board;	4210

(3) Violating or attempting to violate, directly or	4211
indirectly, or assisting in or abetting the violation of, or	4212
conspiring to violate, any provision of this chapter, Chapter	4213
4731. of the Revised Code, or the rules adopted by the board;	4214

(4) Inability to practice according to acceptable and	4215
prevailing standards of care by reason of mental illness or	4216
physical illness, including physical deterioration that adversely	4217
affects cognitive, motor, or perceptive skills;	4218

(5) Impairment of ability to practice according to acceptable	4219
and prevailing standards of care because of habitual or excessive	4220
use or abuse of drugs, alcohol, or other substances that impair	4221
ability to practice;	4222

(6) Administering drugs for purposes other than those	4223
authorized under this chapter;	4224

(7) Willfully betraying a professional confidence;

4225

(8) Making a false, fraudulent, deceptive, or misleading	4226
statement in soliciting or advertising for employment as a	4227
physician assistant; in connection with any solicitation or	4228
advertisement for patients; in relation to the practice of	4229
medicine as it pertains to physician assistants; or in securing or	4230
attempting to secure a ~~certificate~~license to practice as a	4231
physician assistant~~, a certificate to prescribe, or approval of a~~	4232
~~supervision agreement~~.	4233

As used in this division, "false, fraudulent, deceptive, or	4234
misleading statement" means a statement that includes a	4235
misrepresentation of fact, is likely to mislead or deceive because	4236
of a failure to disclose material facts, is intended or is likely	4237
to create false or unjustified expectations of favorable results,	4238
or includes representations or implications that in reasonable	4239
probability will cause an ordinarily prudent person to	4240
misunderstand or be deceived.	4241

(9) Representing, with the purpose of obtaining compensation	4242
or other advantage personally or for any other person, that an	4243
incurable disease or injury, or other incurable condition, can be	4244
permanently cured;	4245

(10) The obtaining of, or attempting to obtain, money or	4246
anything of value by fraudulent misrepresentations in the course	4247
of practice;	4248

(11) A plea of guilty to, a judicial finding of guilt of, or	4249
a judicial finding of eligibility for intervention in lieu of	4250
conviction for, a felony;	4251

(12) Commission of an act that constitutes a felony in this	4252
state, regardless of the jurisdiction in which the act was	4253
committed;	4254

(13) A plea of guilty to, a judicial finding of guilt of, or	4255
a judicial finding of eligibility for intervention in lieu of	4256
conviction for, a misdemeanor committed in the course of practice;	4257

(14) A plea of guilty to, a judicial finding of guilt of, or	4258
a judicial finding of eligibility for intervention in lieu of	4259
conviction for, a misdemeanor involving moral turpitude;	4260

(15) Commission of an act in the course of practice that	4261
constitutes a misdemeanor in this state, regardless of the	4262
jurisdiction in which the act was committed;	4263

(16) Commission of an act involving moral turpitude that	4264
constitutes a misdemeanor in this state, regardless of the	4265
jurisdiction in which the act was committed;	4266

(17) A plea of guilty to, a judicial finding of guilt of, or	4267
a judicial finding of eligibility for intervention in lieu of	4268
conviction for violating any state or federal law regulating the	4269
possession, distribution, or use of any drug, including	4270
trafficking in drugs;	4271

(18) Any of the following actions taken by the state agency	4272
responsible for regulating the practice of physician assistants in	4273
another state, for any reason other than the nonpayment of fees:	4274
the limitation, revocation, or suspension of an individual's	4275
license to practice; acceptance of an individual's license	4276
surrender; denial of a license; refusal to renew or reinstate a	4277
license; imposition of probation; or issuance of an order of	4278
censure or other reprimand;	4279

(19) A departure from, or failure to conform to, minimal	4280
standards of care of similar physician assistants under the same	4281
or similar circumstances, regardless of whether actual injury to a	4282
patient is established;	4283

(20) Violation of the conditions placed by the board on a	4284
~~certificate~~license to practice as a physician assistant~~, a~~	4285
~~certificate to prescribe, a physician supervisory plan, or~~	4286
~~supervision agreement~~;	4287

(21) Failure to use universal blood and body fluid	4288
precautions established by rules adopted under section 4731.051 of	4289
the Revised Code;	4290

(22) Failure to cooperate in an investigation conducted by	4291
the board under section 4730.26 of the Revised Code, including	4292
failure to comply with a subpoena or order issued by the board or	4293
failure to answer truthfully a question presented by the board at	4294
a deposition or in written interrogatories, except that failure to	4295
cooperate with an investigation shall not constitute grounds for	4296
discipline under this section if a court of competent jurisdiction	4297
has issued an order that either quashes a subpoena or permits the	4298
individual to withhold the testimony or evidence in issue;	4299

(23) Assisting suicide, as defined in section 3795.01 of the	4300
Revised Code;	4301

(24) Prescribing any drug or device to perform or induce an	4302
abortion, or otherwise performing or inducing an abortion;	4303

(25) Failure to comply with section 4730.53 of the Revised	4304
Code, unless the board no longer maintains a drug database	4305
pursuant to section 4729.75 of the Revised Code;	4306

~~(25)~~(26) Failure to comply with the requirements in section	4307
3719.061 of the Revised Code before issuing tofor a minor a	4308
prescription for a controlled substance containing an opioid;	4309

(27) Having certification by the national commission on	4310
certification of physician assistants or a successor organization	4311
expire, lapse, or be suspended or revoked.	4312

(C) Disciplinary actions taken by the board under divisions	4313
(A) and (B) of this section shall be taken pursuant to an	4314
adjudication under Chapter 119. of the Revised Code, except that	4315
in lieu of an adjudication, the board may enter into a consent	4316
agreement with a physician assistant or applicant to resolve an	4317
allegation of a violation of this chapter or any rule adopted	4318
under it. A consent agreement, when ratified by an affirmative	4319
vote of not fewer than six members of the board, shall constitute	4320
the findings and order of the board with respect to the matter	4321
addressed in the agreement. If the board refuses to ratify a	4322
consent agreement, the admissions and findings contained in the	4323
consent agreement shall be of no force or effect.	4324

(D) For purposes of divisions (B)(12), (15), and (16) of this	4325
section, the commission of the act may be established by a finding	4326
by the board, pursuant to an adjudication under Chapter 119. of	4327
the Revised Code, that the applicant or ~~certificate~~license holder	4328
committed the act in question. The board shall have no	4329
jurisdiction under these divisions in cases where the trial court	4330
renders a final judgment in the ~~certificate~~license holder's	4331
favor and that judgment is based upon an adjudication on the	4332
merits. The board shall have jurisdiction under these divisions in	4333
cases where the trial court issues an order of dismissal upon	4334
technical or procedural grounds.	4335

(E) The sealing of conviction records by any court shall have	4336
no effect upon a prior board order entered under the provisions of	4337
this section or upon the board's jurisdiction to take action under	4338
the provisions of this section if, based upon a plea of guilty, a	4339
judicial finding of guilt, or a judicial finding of eligibility	4340
for intervention in lieu of conviction, the board issued a notice	4341
of opportunity for a hearing prior to the court's order to seal	4342
the records. The board shall not be required to seal, destroy,	4343
redact, or otherwise modify its records to reflect the court's	4344
sealing of conviction records.	4345

(F) For purposes of this division, any individual who holds a	4346
~~certificate~~license issued under this chapter, or applies for a	4347
~~certificate~~license issued under this chapter, shall be deemed to	4348
have given consent to submit to a mental or physical examination	4349
when directed to do so in writing by the board and to have waived	4350
all objections to the admissibility of testimony or examination	4351
reports that constitute a privileged communication.	4352

(1) In enforcing division (B)(4) of this section, the board,	4353
upon a showing of a possible violation, may compel any individual	4354
who holds a ~~certificate~~license issued under this chapter or who	4355
has applied for a ~~certificate~~license pursuant to this chapter to	4356
submit to a mental examination, physical examination, including an	4357
HIV test, or both a mental and physical examination. The expense	4358
of the examination is the responsibility of the individual	4359
compelled to be examined. Failure to submit to a mental or	4360
physical examination or consent to an HIV test ordered by the	4361
board constitutes an admission of the allegations against the	4362
individual unless the failure is due to circumstances beyond the	4363
individual's control, and a default and final order may be entered	4364
without the taking of testimony or presentation of evidence. If	4365
the board finds a physician assistant unable to practice because	4366
of the reasons set forth in division (B)(4) of this section, the	4367
board shall require the physician assistant to submit to care,	4368
counseling, or treatment by physicians approved or designated by	4369
the board, as a condition for an initial, continued, reinstated,	4370
or renewed ~~certificate~~license. An individual affected under this	4371
division shall be afforded an opportunity to demonstrate to the	4372
board the ability to resume practicing in compliance with	4373
acceptable and prevailing standards of care.	4374

(2) For purposes of division (B)(5) of this section, if the	4375
board has reason to believe that any individual who holds a	4376
~~certificate~~license issued under this chapter or any applicant for	4377
a ~~certificate~~license suffers such impairment, the board may	4378
compel the individual to submit to a mental or physical	4379
examination, or both. The expense of the examination is the	4380
responsibility of the individual compelled to be examined. Any	4381
mental or physical examination required under this division shall	4382
be undertaken by a treatment provider or physician qualified to	4383
conduct such examination and chosen by the board.	4384

Failure to submit to a mental or physical examination ordered	4385
by the board constitutes an admission of the allegations against	4386
the individual unless the failure is due to circumstances beyond	4387
the individual's control, and a default and final order may be	4388
entered without the taking of testimony or presentation of	4389
evidence. If the board determines that the individual's ability to	4390
practice is impaired, the board shall suspend the individual's	4391
~~certificate~~license or deny the individual's application and shall	4392
require the individual, as a condition for initial, continued,	4393
reinstated, or renewed ~~certification~~licensure to practice or	4394
prescribe, to submit to treatment.	4395

Before being eligible to apply for reinstatement of a	4396
~~certificate~~license suspended under this division, the physician	4397
assistant shall demonstrate to the board the ability to resume	4398
practice or prescribing in compliance with acceptable and	4399
prevailing standards of care. The demonstration shall include the	4400
following:	4401

(a) Certification from a treatment provider approved under	4402
section 4731.25 of the Revised Code that the individual has	4403
successfully completed any required inpatient treatment;	4404

(b) Evidence of continuing full compliance with an aftercare	4405
contract or consent agreement;	4406

(c) Two written reports indicating that the individual's	4407
ability to practice has been assessed and that the individual has	4408
been found capable of practicing according to acceptable and	4409
prevailing standards of care. The reports shall be made by	4410
individuals or providers approved by the board for making such	4411
assessments and shall describe the basis for their determination.	4412

The board may reinstate a ~~certificate~~license suspended under	4413
this division after such demonstration and after the individual	4414
has entered into a written consent agreement.	4415

When the impaired physician assistant resumes practice or	4416
prescribing, the board shall require continued monitoring of the	4417
physician assistant. The monitoring shall include compliance with	4418
the written consent agreement entered into before reinstatement or	4419
with conditions imposed by board order after a hearing, and, upon	4420
termination of the consent agreement, submission to the board for	4421
at least two years of annual written progress reports made under	4422
penalty of falsification stating whether the physician assistant	4423
has maintained sobriety.	4424

(G) If the secretary and supervising member determine that	4425
there is clear and convincing evidence that a physician assistant	4426
has violated division (B) of this section and that the	4427
individual's continued practice or prescribing presents a danger	4428
of immediate and serious harm to the public, they may recommend	4429
that the board suspend the individual's ~~certificate~~license to	4430
practice or authority to prescribe without a prior hearing.	4431
Written allegations shall be prepared for consideration by the	4432
board.	4433

The board, upon review of those allegations and by an	4434
affirmative vote of not fewer than six of its members, excluding	4435
the secretary and supervising member, may suspend a ~~certificate~~	4436
license without a prior hearing. A telephone conference call may	4437
be utilized for reviewing the allegations and taking the vote on	4438
the summary suspension.	4439

The board shall issue a written order of suspension by	4440
certified mail or in person in accordance with section 119.07 of	4441
the Revised Code. The order shall not be subject to suspension by	4442
the court during pendency of any appeal filed under section 119.12	4443
of the Revised Code. If the physician assistant requests an	4444
adjudicatory hearing by the board, the date set for the hearing	4445
shall be within fifteen days, but not earlier than seven days,	4446
after the physician assistant requests the hearing, unless	4447
otherwise agreed to by both the board and the ~~certificate~~license	4448
holder.	4449

A summary suspension imposed under this division shall remain	4450
in effect, unless reversed on appeal, until a final adjudicative	4451
order issued by the board pursuant to this section and Chapter	4452
119. of the Revised Code becomes effective. The board shall issue	4453
its final adjudicative order within sixty days after completion of	4454
its hearing. Failure to issue the order within sixty days shall	4455
result in dissolution of the summary suspension order, but shall	4456
not invalidate any subsequent, final adjudicative order.	4457

(H) If the board takes action under division (B)(11), (13),	4458
or (14) of this section, and the judicial finding of guilt, guilty	4459
plea, or judicial finding of eligibility for intervention in lieu	4460
of conviction is overturned on appeal, upon exhaustion of the	4461
criminal appeal, a petition for reconsideration of the order may	4462
be filed with the board along with appropriate court documents.	4463
Upon receipt of a petition and supporting court documents, the	4464
board shall reinstate the ~~certificate~~license to practice or	4465
~~prescribe~~. The board may then hold an adjudication under Chapter	4466
119. of the Revised Code to determine whether the individual	4467
committed the act in question. Notice of opportunity for hearing	4468
shall be given in accordance with Chapter 119. of the Revised	4469
Code. If the board finds, pursuant to an adjudication held under	4470
this division, that the individual committed the act, or if no	4471
hearing is requested, it may order any of the sanctions identified	4472
under division (B) of this section.	4473

(I) The ~~certificate~~license to practice issued to a physician	4474
assistant and the physician assistant's practice in this state are	4475
automatically suspended as of the date the physician assistant	4476
pleads guilty to, is found by a judge or jury to be guilty of, or	4477
is subject to a judicial finding of eligibility for intervention	4478
in lieu of conviction in this state or treatment or intervention	4479
in lieu of conviction in another state for any of the following	4480
criminal offenses in this state or a substantially equivalent	4481
criminal offense in another jurisdiction: aggravated murder,	4482
murder, voluntary manslaughter, felonious assault, kidnapping,	4483
rape, sexual battery, gross sexual imposition, aggravated arson,	4484
aggravated robbery, or aggravated burglary. Continued practice	4485
after the suspension shall be considered practicing without a	4486
~~certificate~~license.	4487

The board shall notify the individual subject to the	4488
suspension by certified mail or in person in accordance with	4489
section 119.07 of the Revised Code. If an individual whose	4490
~~certificate~~license is suspended under this division fails to make	4491
a timely request for an adjudication under Chapter 119. of the	4492
Revised Code, the board shall enter a final order permanently	4493
revoking the individual's ~~certificate~~license to practice.	4494

(J) In any instance in which the board is required by Chapter	4495
119. of the Revised Code to give notice of opportunity for hearing	4496
and the individual subject to the notice does not timely request a	4497
hearing in accordance with section 119.07 of the Revised Code, the	4498
board is not required to hold a hearing, but may adopt, by an	4499
affirmative vote of not fewer than six of its members, a final	4500
order that contains the board's findings. In that final order, the	4501
board may order any of the sanctions identified under division (A)	4502
or (B) of this section.	4503

(K) Any action taken by the board under division (B) of this	4504
section resulting in a suspension shall be accompanied by a	4505
written statement of the conditions under which the physician	4506
assistant's ~~certificate~~license may be reinstated. The board shall	4507
adopt rules in accordance with Chapter 119. of the Revised Code	4508
governing conditions to be imposed for reinstatement.	4509
Reinstatement of a ~~certificate~~license suspended pursuant to	4510
division (B) of this section requires an affirmative vote of not	4511
fewer than six members of the board.	4512

(L) When the board refuses to grant to an applicant a	4513
~~certificate~~license to practice as a physician assistant ~~or a~~	4514
~~certificate to prescribe~~, revokes an individual's ~~certificate~~	4515
license, refuses to issue a ~~certificate~~license, or refuses to	4516
reinstate an individual's ~~certificate~~license, the board may	4517
specify that its action is permanent. An individual subject to a	4518
permanent action taken by the board is forever thereafter	4519
ineligible to hold the ~~certificate~~license and the board shall not	4520
accept an application for reinstatement of the ~~certificate~~	4521
license or for issuance of a new ~~certificate~~license.	4522

(M) Notwithstanding any other provision of the Revised Code,	4523
all of the following apply:	4524

(1) The surrender of a ~~certificate~~license issued under this	4525
chapter is not effective unless or until accepted by the board.	4526
Reinstatement of a ~~certificate~~license surrendered to the board	4527
requires an affirmative vote of not fewer than six members of the	4528
board.	4529

(2) An application made under this chapter for a ~~certificate,~~	4530
~~approval of a physician supervisory plan, or approval of a~~	4531
~~supervision agreement~~license may not be withdrawn without	4532
approval of the board.	4533

(3) Failure by an individual to renew a ~~certificate~~license	4534
in accordance with section 4730.14 ~~or section 4730.48~~ of the	4535
Revised Code shall not remove or limit the board's jurisdiction to	4536
take disciplinary action under this section against the	4537
individual.	4538

Sec. 4730.53. (A) As used in this section, "drug database"	4539
means the database established and maintained by the state board	4540
of pharmacy pursuant to section 4729.75 of the Revised Code.	4541

(B) Except as provided in divisions (C) and (E) of this	4542
section, a physician assistant ~~holding a certificate to prescribe~~	4543
~~issued~~licensed under this chapter who has been granted	4544
physician-delegated prescriptive authority shall comply with all	4545
of the following as conditions of prescribing a drug that is	4546
either an opioid analgesic or a benzodiazepine as part of a	4547
patient's course of treatment for a particular condition:	4548

(1) Before initially prescribing the drug, the physician	4549
assistant or the physician assistant's delegate shall request from	4550
the drug database a report of information related to the patient	4551
that covers at least the twelve months immediately preceding the	4552
date of the request. If the physician assistant practices	4553
primarily in a county of this state that adjoins another state,	4554
the physician assistant or delegate also shall request a report of	4555
any information available in the drug database that pertains to	4556
prescriptions issued or drugs furnished to the patient in the	4557
state adjoining that county.	4558

(2) If the patient's course of treatment for the condition	4559
continues for more than ninety days after the initial report is	4560
requested, the physician assistant or delegate shall make periodic	4561
requests for reports of information from the drug database until	4562
the course of treatment has ended. The requests shall be made at	4563
intervals not exceeding ninety days, determined according to the	4564
date the initial request was made. The request shall be made in	4565
the same manner provided in division (B)(1) of this section for	4566
requesting the initial report of information from the drug	4567
database.	4568

(3) On receipt of a report under division (B)(1) or (2) of	4569
this section, the physician assistant shall assess the information	4570
in the report. The physician assistant shall document in the	4571
patient's record that the report was received and the information	4572
was assessed.	4573

(C) Division (B) of this section does not apply in any of the	4574
following circumstances:	4575

(1) A drug database report regarding the patient is not	4576
available, in which case the physician assistant shall document in	4577
the patient's record the reason that the report is not available.	4578

(2) The drug is prescribed in an amount indicated for a	4579
period not to exceed seven days.	4580

(3) The drug is prescribed for the treatment of cancer or	4581
another condition associated with cancer.	4582

(4) The drug is prescribed to a hospice patient in a hospice	4583
care program, as those terms are defined in section 3712.01 of the	4584
Revised Code, or any other patient diagnosed as terminally ill.	4585

(5) The drug is prescribed for administration in a hospital,	4586
nursing home, or residential care facility.	4587

(D) With respect to prescribing any drug that is not an	4588
opioid analgesic or a benzodiazepine but is included in the drug	4589
database pursuant to rules adopted under section 4729.84 of the	4590
Revised Code, the state medical board shall adopt rules that	4591
establish standards and procedures to be followed by a physician	4592
assistant ~~who holds a certificate to prescribe issued~~licensed	4593
under this chapter who has been granted physician-delegated	4594
prescriptive authority regarding the review of patient information	4595
available through the drug database under division (A)(5) of	4596
section 4729.80 of the Revised Code. The rules shall be adopted in	4597
accordance with Chapter 119. of the Revised Code.	4598

(E) This section and the rules adopted under it do not apply	4599
if the state board of pharmacy no longer maintains the drug	4600
database.	4601

Section 4. That the existing versions of sections 4730.25 and	4602
4730.53 of the Revised Code that are scheduled to take effect	4603
April 1, 2015, are hereby repealed.	4604

Section 5. Sections 3 and 4 of this act shall take effect	4605
April 1, 2015.	4606

Section 6. (A) The State Medical Board may continue to issue	4607
certificates to practice and certificates to prescribe pursuant to	4608
Chapter 4730. of the Revised Code for not longer than ninety days	4609
after the effective date of this act. Thereafter, the Board shall	4610
issue physician assistant licenses in compliance with this act.	4611

(B) Certificates to practice and certificates to prescribe	4612
issued pursuant to division (A) of this section or Chapter 4730.	4613
of the Revised Code, as it existed immediately prior to the	4614
effective date of this act, shall satisfy the requirements for	4615
physician assistant licenses, as created by this act, until the	4616
thirty-first day of January of the first even-numbered year	4617
following the effective date of this act.	4618

Section 7. Section 4730.25 of the Revised Code is presented	4619
in Section 4 of this act as a composite of the section as amended	4620
by Sub. H.B. 314, Am. Sub. H.B. 341, and Am. Sub. H.B. 483, all of	4621
the 130th General Assembly. The General Assembly, applying the	4622
principle stated in division (B) of section 1.52 of the Revised	4623
Code that amendments are to be harmonized if reasonably capable of	4624
simultaneous operation, finds that the composite is the resulting	4625
version of the section in effect prior to the effective date of	4626
the section as presented in this act.	4627