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Sub. S. B. No. 124As Passed by the HouseAs Passed by the House
124th General Assembly | Regular Session | 2001-2002 |
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SENATORS Jordan, Amstutz, Austria, DiDonato, Randy Gardner, Harris, Hottinger, Jacobson, Spada, Wachtmann, Ryan
REPRESENTATIVES Jolivette, Gilb, Schuring, Kearns, Roman, McGregor, Raga, Patton, Seitz, Kilbane, Beatty, Hartnett, Schmidt, Faber, Brinkman, Trakas, Setzer, D. Miller, Seaver, Coates, Schneider, Niehaus, Flowers, Distel, Carano, Allen, Sferra, Clancy, Young, Buehrer, Reidelbach, Schaffer, Hughes, Hoops, Rhine, G. Smith
A BILL
To amend sections 2317.54, 3702.30, 3702.31, 3727.09,
3727.10, 4765.01, and 4765.50 and to enact
sections
3702.32, 3727.101, and 3727.102 of the Revised Code
relative to
sanctions for a health care facility's
violations
of licensing requirements and quality
standards,
injunctions to enjoin such violations,
informed consent compliance
requirements for
ambulatory
surgical facility physicians,
expanded
health
care facility rule making
authority
of the
Director of Health, and implementation of
requirements applicable to trauma centers.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 2317.54, 3702.30, 3702.31, 3727.09,
3727.10, 4765.01, and 4765.50 be amended and
sections 3702.32,
3727.101, and 3727.102 of the Revised Code be enacted to read as
follows:
Sec. 2317.54. No hospital, home health agency,
ambulatory
surgical facility, or provider
of a hospice care program shall be
held liable for a physician's
failure to obtain an informed
consent from
his
the physician's
patient prior to a
surgical or
medical procedure or course of procedures, unless the
physician is
an employee of the hospital, home health agency,
ambulatory
surgical facility or
provider of a hospice care program. Written consent to a surgical or medical procedure or
course
of procedures shall, to the extent that it fulfills all
the
requirements in divisions (A), (B), and (C) of this section,
be
presumed to be valid and effective, in the absence of proof by
a
preponderance of the evidence that the person who sought such
consent was not acting in good faith, or that the execution of
the
consent was induced by fraudulent misrepresentation of
material
facts, or that the person executing the consent was not
able to
communicate effectively in spoken and written English or
any other
language in which the consent is written. Except as
herein
provided, no evidence shall be admissible to impeach,
modify, or
limit the authorization for performance of the
procedure or
procedures set forth in such written consent. (A) The consent sets forth in general terms the nature and
purpose of the procedure or procedures, and what the procedures
are expected to accomplish, together with the reasonably known
risks, and, except in emergency situations, sets forth the names
of the physicians who shall perform the intended surgical
procedures. (B) The person making the consent acknowledges that such
disclosure of information has been made and that all questions
asked about the procedure or procedures have been answered in a
satisfactory manner. (C) The consent is signed by the patient for whom the
procedure is to be performed, or, if the patient for any reason
including, but not limited to, competence, infancy, or the fact
that, at the latest time that the consent is needed, the patient
is under the influence of alcohol, hallucinogens, or drugs, lacks
legal capacity to consent, by a person who has legal authority to
consent on behalf of such patient in such circumstances. Any use of a consent form that fulfills the requirements
stated in divisions (A), (B), and (C) of this section has no
effect on the common law rights and liabilities, including the
right of a physician to obtain the oral or implied consent of a
patient to a medical procedure, that may exist as between
physicians and patients on July 28, 1975. As used in this section the term "hospital" has the meaning
set forth in division (D) of section 2305.11 of the Revised Code;
"home health agency" has the meaning set forth in division (A) of
former
section 3701.88 of the Revised Code;
"ambulatory surgical
facility" has the meaning as in division (A) of section 3702.30 of
the Revised Code; and "hospice care program"
has the meaning set
forth in division (A) of section 3712.01 of
the Revised Code. The
provisions of this division apply to
hospitals, doctors of
medicine, doctors of osteopathic medicine,
and doctors of
podiatric medicine.
Sec. 3702.30. (A) As used in this section: (1) "Ambulatory surgical facility" means a facility,
whether
or not part of the same organization as a hospital, that
is
located in a building distinct from
another in which inpatient
care is provided, and to which any of the
following apply: (a) Outpatient surgery is routinely performed in the
facility, and
the facility functions separately from a
hospital's
inpatient surgical service and from the offices of private
physicians, podiatrists, and dentists;. (b) Anesthesia is administered in the facility by
an
anesthesiologist or certified registered nurse anesthetist,
and
the facility functions separately from a hospital's inpatient
surgical
service and from the offices of private physicians,
podiatrists, and
dentists;. (c) The facility applies to be certified by the
United
States health care financing
administration as an ambulatory
surgical center for purposes of
reimbursement under Part B of the
medicare
program, Part B of Title XVIII
of the "Social Security
Act," 49 Stat. 620 (1935),
42 U.S.C.A. 301, as amended;. (d) The facility applies to be certified by a
national
accrediting body approved by the health care financing
administration for purposes of deemed compliance with the
conditions for participating in the medicare program as an
ambulatory surgical center;. (e) The facility bills or receives from any
third-party
payer, governmental health care program, or other person or
government entity any ambulatory surgical
facility fee that is
billed or paid in addition to any fee for
professional services;. (f) The facility is held out to any person or government
entity as an ambulatory surgical facility or similar facility by
means of
signage, advertising, or other promotional efforts. "Ambulatory surgical facility" does not include
a hospital
emergency department. (2) "Ambulatory surgical facility
fee" means a fee for
certain overhead costs associated with
providing surgical services
in an outpatient setting. A fee is
an ambulatory surgical
facility fee only if it directly or
indirectly pays for costs
associated with any of the following: (a) Use of operating and recovery rooms,
preparation areas,
and waiting rooms and lounges for patients and
relatives; (b) Administrative functions, record keeping,
housekeeping,
utilities, and rent; (c) Services provided by nurses, orderlies,
technical
personnel, and others involved in patient care related
to
providing surgery. "Ambulatory surgical facility fee" does
not include any
additional payment in excess of a professional
fee that is
provided to encourage physicians, podiatrists, and
dentists to
perform certain surgical procedures in their office
or their group
practice's office rather than a health care
facility, if the
purpose of the additional fee is to compensate
for additional cost
incurred in performing office-based surgery. (3) "Governmental health care program" has the same
meaning
as in section 4731.65 of the Revised Code. (4) "Health care facility" means any of the following: (a) An ambulatory surgical facility; (b) A freestanding dialysis center; (c) A freestanding inpatient rehabilitation facility; (d) A freestanding birthing center; (e) A freestanding radiation therapy center; (f) A freestanding or mobile diagnostic imaging center. (5)
"Metropolitan statistical area"
has the same meaning as
in section 3702.51 of the Revised Code. (6) "Third-party payer" has the same meaning as in
section
3901.38 of the Revised Code.
(B) By rule adopted in accordance with sections
3702.12 and
3702.13 of the Revised Code, the
director of health shall
establish quality standards for health care
facilities. The
standards may incorporate accreditation standards or other
quality
standards established by any entity recognized by the director.
The
rules shall be adopted so as to cause the standards to take
effect on
March 31, 1996. (C)
Every ambulatory surgical facility shall require
that
each physician who practices at the facility comply with all
relevant provisions in the Revised Code that relate to the
obtaining of informed consent
from a patient.
(D) The director shall issue a license to each health care
facility that makes application for a license and demonstrates to
the director
that it meets the quality standards established
by
the rules adopted under division (B) of
this section, except that
if a health care facility located in a metropolitan
statistical
area applies for a license on or after
March
31, 1996, and at the
time the license is to take effect
the quality standards
are not
yet in effect, the director shall issue the license without a
demonstration that the health care facility meets quality
standards
and satisfies the informed consent
compliance
requirements specified in division (C) of this section. (D)(E)(1) No
health
care facility shall operate without a
license issued under this section.
(2) If the department of health finds that a physician who
practices at a health care facility is not complying with any
provision of the Revised Code related to the obtaining of informed
consent from a patient, the department shall report its finding to
the state medical board, the physician, and the health care
facility.
(3) This division does not create, and shall not be
construed as creating, a new cause of action or substantive legal
right against a health care facility and in favor of a patient who
allegedly sustains harm as a result of the failure of the
patient's physician to obtain informed consent from the patient
prior to performing a procedure on or otherwise caring for the
patient in the health care facility. (E)(F) The rules adopted under division
(B) of this section
shall include
provisions
all of the following:
(1) Provisions governing
application for, renewal,
suspension, and revocation of
licenses
a license under this
section; (2) Provisions governing orders issued pursuant to section
3702.32 of the Revised Code for a health care facility to cease
its operations or to prohibit certain types of services provided
by a health care facility;
(3) Provisions governing the imposition under section
3702.32 of the Revised Code of civil penalties for violations of
this section or the rules adopted under this section, including a
scale for determining the amount of the penalties.
Sec. 3702.31. (A) The quality monitoring and
inspection
fund is hereby created in the state treasury. The
director of
health shall use the fund to
administer and enforce this section
and sections
3702.11 to 3702.20
and, 3702.30, and 3702.32 of the
Revised
Code and rules adopted pursuant to those sections.
The
director shall deposit in the fund any moneys
collected pursuant
to this section
or section 3702.32 of the Revised Code. All
investment earnings of
the fund shall be credited to the fund. (B) The director of health shall adopt rules pursuant to
Chapter 119. of the Revised Code establishing fees
for both of the
following: (1) Initial and renewal license applications submitted under
section
3702.30 of the Revised Code. The fees established under
division (B)(1) of this section shall not
exceed the actual and
necessary costs of performing the
activities described in division
(A) of this section. (2) Inspections conducted
under section 3702.15 or 3702.30
of the
Revised
Code. The fees established
under division (B)(2)
of this
section shall not exceed the actual and necessary costs
incurred
during an inspection, including any indirect costs
incurred by
the department for staff, salary, or other
administrative
costs.
The director of health shall provide to
each health
care facility or provider inspected pursuant to
section 3702.15
or 3702.30 of the Revised
Code a written statement
of the
fee.
The statement shall itemize and total the costs
incurred.
Within fifteen days after receiving a
statement from
the director, the facility or provider shall
forward the total
amount of the fee to the director. (3) The fees described in divisions
(B)(1) and (2) of this
section
shall meet both of the following requirements: (a) For each service described in
section 3702.11 of the
Revised
Code, the fee shall not exceed
one thousand
dollars two
hundred fifty
dollars annually, except that the total fees
charged
to a
health care provider under this section shall not exceed five
thousand dollars
annually. (b) The fee shall exclude any costs
reimbursable by the
United
States health care financing
administration as part of the
certification process for the
medicare program established under
Title
XVIII of the
"Social
Security
Act," 49
Stat. 620 (1935), 42
U.S.C.A.
301, as amended, and the medicaid program established
under
Title
XIX of that act. (4) The director shall not establish a fee for any
service
for which a licensure or inspection fee is paid by the
health care
provider to a state agency for the same or similar
licensure or
inspection.
Sec. 3702.32. (A) If the director of health determines that
a health care facility is operating without a license in violation
of division (E)(1) of section 3702.30 of the Revised Code, the
director shall do one or more of the following: (1) Provide an opportunity for the health care facility to
apply for a license within a specified time, not exceeding thirty
days after the date of the facility's receipt of the order; (2) Issue an order that the health care facility cease its
operations;
(3) Issue an order that prohibits the health care facility
from performing certain types of services; (4) Impose a civil penalty of not less than one thousand
dollars and not more than two hundred fifty thousand dollars upon
the health care facility for operating without a license; (5) Impose an additional civil penalty of not less than one
thousand dollars and not more than ten thousand dollars for each
day that the health care facility operates without a license. (B)(1) If a health care facility subject to an order issued
under division (A)(1) of this section continues to operate, the
director of health may file a petition in the court of common
pleas of the county in which the health care facility is located
for an injunction enjoining the facility from operating. The
court shall grant an injunction upon a showing that the respondent
named in the petition is operating without a license. (2) If a health care facility subject to an order issued
under division (A)(2) of this section continues to provide the
types of services prohibited by the order, the director of health
may file a petition in the court of common pleas of the county in
which the health care facility is located for an injunction
enjoining the facility from performing those types of services.
The court shall grant an injunction upon a showing that the
respondent named in the petition is providing the types of
services prohibited by the director's order. (C) If, after making its reports
as provided in division
(E)(2) of section 3702.30 of the Revised
Code, the department of
health finds that a physician has
continued to engage at the same
health care facility in a pattern
of repeating the same violation
and that the health care facility
has failed to take reasonable
steps to ensure that the physician
does not continue the same
violation at the health care facility,
the department may, after
providing the health care facility an
opportunity for a hearing
pursuant to Chapter 119. of the Revised
Code, impose a civil
penalty on the health care facility. The
penalty shall be not
less than one thousand dollars and not more
than fifty thousand
dollars. (D) If the director of health determines that a health care
facility has violated any provision of section 3702.30 of the
Revised Code, other than a violation of division (E)(1) or (2) of
that
section, any provision of Chapter 3701-83 of the
Administrative
Code, or any other rule adopted by the director of
health under
section 3702.30 of the Revised Code, the director may
do any or
all of the following: (1) Provide an opportunity for the health care facility to
correct the violation within a specified period of time; (2) Revoke, suspend, or refuse to renew the health care
facility's license; (3) Prior to or during the pendency of an administrative
hearing under Chapter 119. of the Revised Code, issue an order
that prohibits the health care facility from performing certain
types of services; (4) Provide an opportunity for the health care facility to
correct the violation; (5) Impose a civil penalty of not less than one thousand
dollars and not more than two hundred fifty thousand dollars upon
the health care facility for the violation; (6) Impose an additional civil penalty of not less than five
hundred dollars and not more than ten thousand dollars for each
day that the health care facility fails to correct the violation. (E) If a health care facility subject to an order issued
under division (C)(2) of this section continues to provide the
types of services prohibited by the order, the director of health
may file a petition in the court of common pleas of the county in
which the facility is located for an injunction enjoining the
facility from performing those types of services. The court shall
grant an injunction upon a showing that the respondent named in
the petition is providing the types of services prohibited by the
director's order. (F) The director shall deposit all moneys collected as civil
penalties under this section into the quality monitoring and
inspection fund created under section 3702.31 of the Revised Code
for use in accordance with that section.
Sec. 3727.09. (A) As used in this section and
section
sections 3727.10
and 3727.101 of the Revised Code: (1) "Trauma," "trauma care,"
and "trauma center,"
"trauma
patient," "pediatric," and "adult" have the same meanings as
in
section 4765.01 of the Revised Code. (2) "Stabilize" and "transfer" have the same meanings as in
section
1753.28 of the Revised Code. (B)
Not later than two years
On and after
the effective
date
of this section
November 3, 2002, each
hospital in
this state that
is not a trauma center
shall adopt protocols for adult and
pediatric trauma care provided in or by
that hospital; each
hospital in this state that is an adult trauma center and
not a
level I or level II pediatric trauma center shall
adopt protocols
for pediatric trauma care provided in or by that hospital;
each
hospital in this state that is a pediatric trauma center and
not a
level
I and II adult trauma center shall adopt protocols for
adult
trauma care provided in or by that hospital. In developing
its
trauma care
protocols, each hospital shall consider the
guidelines
for trauma care
established by the American college of
surgeons,
the
American college of emergency physicians, and the
American
academy of pediatrics. Trauma care protocols shall be
written,
comply with
applicable federal and state laws, and
include
policies and
procedures with respect to all of the
following: (1) Evaluation of trauma patients, including criteria for
prompt
identification of trauma patients who require a level of
adult or pediatric
trauma care that exceeds the hospital's
capabilities; (2) Emergency treatment and stabilization of trauma patients
prior to
transfer to an appropriate adult or pediatric trauma
center; (3) Timely transfer of trauma patients to appropriate adult
or pediatric
trauma centers based on a patient's medical needs.
Trauma patient transfer
protocols shall specify all of the
following: (a) Confirmation of the ability of the receiving trauma
center to
provide prompt adult or pediatric trauma care
appropriate to a patient's
medical needs; (b) Procedures for selecting an appropriate alternative
adult or
pediatric trauma center to receive a patient when it is
not feasible or safe
to transport the patient to a particular
trauma center; (c) Advance notification and appropriate medical
consultation
with the trauma center to which a trauma patient is
being, or will be,
transferred; (d) Procedures for selecting an appropriate method of
transportation and the hospital responsible for arranging or
providing the
transportation; (e) Confirmation of the ability of the persons and vehicle
that
will transport a trauma patient to provide appropriate adult
or pediatric
trauma care; (f) Assured communication with, and appropriate medical
direction
of, the persons transporting a trauma patient to a
trauma center; (g) Identification and timely transfer of appropriate
medical
records of the trauma patient being transferred; (h) The hospital responsible for care of a patient in
transit; (i) The responsibilities of the physician attending a
patient
and, if different, the physician who authorizes a transfer
of the patient; (j) Procedures for determining, in consultation with an
appropriate adult or pediatric trauma center and the persons who
will
transport a trauma patient, when transportation of the
patient to a trauma
center may be delayed for either of the
following reasons: (i) Immediate transfer of the patient is unsafe due to
adverse
weather or ground conditions. (ii) No trauma center is able
to provide appropriate adult
or pediatric trauma care to the patient without
undue delay. (4) Peer review and quality assurance procedures for adult
and pediatric
trauma care provided in or by the hospital. (C)(1)
Not later than two years
On and after
the effective
date of this
section
November 3, 2002, each hospital shall
enter
into all of the following written
agreements unless otherwise
provided in division (C)(2) of this
section: (a) An agreement with one or more adult trauma centers in
each
level of categorization as a trauma center higher than the
hospital that
governs the transfer of adult trauma patients from
the hospital to those
trauma centers; (b) An agreement with one or more pediatric trauma centers
in
each level of categorization as a trauma center higher than the
hospital that
governs the transfer of pediatric trauma patients
from the hospital to those
trauma centers. (2) A level I or level II adult trauma center is not
required to enter into an adult trauma patient transfer agreement
with another
hospital. A level I or level II pediatric trauma
center is
not required to enter into a pediatric trauma patient
transfer agreement with
another hospital. A hospital is not
required to enter into an adult trauma
patient transfer agreement
with a level III or level IV
adult trauma center, or enter into a
pediatric trauma patient transfer
agreement with a level III or
level IV pediatric trauma
center, if no trauma center of that type
is reasonably available to receive
trauma patients transferred
from the hospital. (3) A trauma patient transfer agreement entered into by a
hospital
under division (C)(1) of this section shall comply with
applicable
federal and state laws and contain provisions
conforming to the requirements
for trauma care protocols set forth
in division (B) of this section. (D) A hospital shall make trauma care protocols it adopts
under
division (B) of this section and trauma patient transfer
agreements
it adopts under division (C) of this section available
for public
inspection during normal working hours. A hospital
shall furnish a copy of
such documents upon request and may charge
a reasonable and necessary fee for
doing so, provided that upon
request it shall furnish a copy of such documents
to the director
of health free of charge.
(E) A hospital that ceases to operate as an adult or
pediatric trauma center under provisional status is not in
violation of divisions (B) and (C) of this section during the time
it develops different trauma care protocols and enters into
different patient transfer agreements pursuant to division
(D)(2)(c) of section 3727.101 of the Revised Code.
Sec. 3727.10.
Beginning two years
On and after
the effective
date of this
section
November 3, 2002, no hospital in this
state
shall knowingly do any of the following: (A) Represent that it is able to provide adult or pediatric
trauma care to a severely injured patient that is inconsistent
with its level
of categorization as an adult or
pediatric trauma
center, provided that a hospital that operates an emergency
facility may represent that it provides emergency care; (B) Provide adult or pediatric trauma care to a severely
injured
patient that is inconsistent with
applicable federal laws,
state laws, and trauma care protocols and patient
transfer
agreements the hospital has adopted under section 3727.09
of the
Revised Code; (C) Transfer a severely injured adult or pediatric trauma
patient
to a hospital
that is not a trauma center with an
appropriate level of adult or pediatric
categorization or
otherwise transfer a severely injured adult or pediatric
trauma
patient in a
manner inconsistent with any applicable trauma
patient transfer agreement
adopted by the hospital under section
3727.09 of the Revised Code.
Sec. 3727.101. (A) If a hospital is seeking initial
verification as an adult or pediatric trauma center, verification
at a different level, or reverification after having ceased to be
verified for one year or longer, the hospital shall submit an
application to the American college of surgeons for a consultation
visit. If a hospital is seeking reverification after having
ceased to be verified for less than one year, the hospital shall
submit an application for either a consultation visit or a
reverification visit, except when operating pursuant to division
(C)(1)(b) of this section.
The hospital shall undergo the visit and obtain a written
report of the results of the visit. If the report is not obtained
by the date that occurs one year after the application for the
visit is
submitted, the hospital shall submit a new application.
(B) Not later than one year after obtaining a report under
division (A) of this section, a hospital may apply to the American
college of surgeons for verification or reverification as an adult
or pediatric trauma center if, based on the report, all of the
following occur:
(1) The hospital's chief medical officer and chief
executive officer certify in writing to the hospital's governing
board that the hospital is committed and able to provide adult or
pediatric trauma care consistent with the level of verification or
reverification being sought.
(2) The hospital's governing board adopts a resolution
stating that the hospital is committed and able to provide adult
or pediatric trauma care consistent with the level of verification
or reverification being sought.
(3) The hospital's governing board approves a written plan
and timetable for obtaining the level of verification or
reverification being sought, including provisions for correcting
at the earliest practicable date any deficiencies identified in
the report obtained pursuant to division (A) of this section.
(C)(1) A hospital may operate as an adult or pediatric
trauma center under provisional status, as follows: (a) On submission of an application under division (B) of
this section; (b) Until it receives the final result of its reverification
if the application was submitted within one year before it ceased
to be verified. (2) A hospital operating as an adult or pediatric trauma
care
center under provisional status is subject to both of the
following:
(a) The hospital shall limit its provisional status
activities to those activities authorized by the level of
verification or reverification being sought.
(b) The hospital shall make a reasonable, good faith effort
to comply with all requirements established by the American
college of surgeons that must be met for the level of verification
or reverification being sought.
(D)(1) A hospital shall cease to operate as an adult or
pediatric trauma center under provisional status if any of the
following applies:
(a) The application for verification or reverification is
denied, suspended, terminated, or withdrawn.
(b) In the case of a hospital seeking initial verification,
verification at a different level, or reverification after having
ceased to be verified for one year or longer, the hospital has not
obtained verification or reverification by the date that occurs
eighteen months after commencing to operate under provisional
status.
(c) In the case of a hospital seeking reverification after
having ceased to be verified for less than one year, the hospital
has not obtained reverification by the date that occurs one year
after commencing to operate under provisional status.
(2) A hospital that ceases to operate as an adult or
pediatric trauma center under provisional status pursuant to
division (D)(1) of this section shall do all of the following:
(a) Except as otherwise provided by federal law, at the
earliest practicable date transfer to one or more appropriate
trauma centers all trauma patients in the hospital to whom the
hospital is not permitted to provide trauma care.
(b) Promptly comply with section 3727.10 of the Revised
Code according to its current status.
(c) Not later than one hundred eighty days after ceasing to
operate under provisional status, comply with section 3727.09 of
the Revised Code according to its current status.
(3) A hospital that ceases to operate as an adult or
pediatric trauma center under provisional status may not operate
as an adult or pediatric trauma center under provisional status
until two years have elapsed since it ceased to operate under
that
status.
(E) With respect to the availability of documents and other
information prepared pursuant to this section, an adult or
pediatric trauma center operating under provisional status is
subject to both of the following:
(1) The trauma center shall make available for public
inspection during normal working hours a copy of the
certification, resolution, and application prepared pursuant to
division (B) of this section. On request, the trauma center shall
provide a copy of the documents. A reasonable fee may be charged
to cover the necessary expenses incurred in furnishing the copies,
except that no fee shall be charged if the copies are being
furnished to the director of health.
(2) On request, the trauma center shall furnish to the
director of health a copy of the report of the consultative or
reverification visit obtained from the American college of
surgeons pursuant to division (A) of this section and a copy of
the plan and timetable approved pursuant to division (B)(3) of
this section for obtaining verification or reverification. The
documents provided may omit patient-identifying information.
Submission of the documents to the director does not waive any
privilege or right of confidentiality that otherwise applies to
the documents and the information in them.
The documents and the information in them are not public
records and shall not be disclosed to any person except employees
of the department of health who are expressly authorized by the
director of health to examine the copies and information in them.
The documents and information in them are not subject to discovery
or introduction into evidence in a civil action, except an action
brought by the director against the trauma center or a person that
authorized, approved, or created the original documents and the
information in them.
(F) Notwithstanding any provision of this section regarding
the
receipt of a report of the results of a consultation visit or
reverification visit from the American college of surgeons, if a
hospital submitted an application for a consultation visit or
reverification visit as an adult or pediatric trauma center on or
before May 20, 2002, the hospital may operate as an
adult or
pediatric trauma center under provisional status. The
hospital
shall do all of the following: (1) Comply with divisions (B)(1) and (2) of this section
as
though the report has been received; (2) Approve through its governing board a written plan and
timetable for obtaining the level of verification or
reverification being sought, including provisions for correcting
at the earliest practicable date any deficiencies identified in
the exit interview following the consultation or reverification
visit and any subsequent report received; (3) Comply with all
other provisions of this section
applicable to the operation of a
trauma center under provisional
status, including the requirements of division (D) of this section
regarding the ceasing of operation under provisional status.
Sec. 3727.102. A hospital shall promptly notify in writing
the director of health, the emergency medical services division of
the department of public safety, and the appropriate regional
directors and regional advisory boards appointed under section
4765.05 of the Revised Code if any of the following occurs:
(A) The hospital ceases to be an adult or pediatric trauma
center verified by the American college of surgeons.
(B) The hospital changes its level of verification as an
adult or pediatric trauma center verified by the American college
of surgeons.
(C) The hospital commences to operate as an adult or
pediatric trauma center under provisional status pursuant to
section 3727.101 of the Revised Code.
(D) The hospital changes the level of verification or
reverification it is seeking under its provisional status.
(E) The hospital ceases to operate under its provisional
status.
(F) The hospital receives verification or reverification in
place of its provisional status.
Sec. 4765.01. As used in this chapter: (A) "First responder" means an individual who holds a
current,
valid certificate issued under section 4765.30 of the
Revised Code to practice
as a first responder. (B) "Emergency medical
technician-basic" or "EMT-basic"
means an individual who holds a current, valid certificate issued
under section 4765.30 of the Revised Code to practice as an
emergency medical technician-basic. (C) "Emergency medical technician-intermediate" or
"EMT-I"
means an
individual who holds a current, valid
certificate issued
under section 4765.30 of the Revised Code to
practice as an
emergency medical technician-intermediate. (D) "Emergency medical technician-paramedic" or
"paramedic"
means an individual who holds a current, valid
certificate issued
under section 4765.30 of the Revised Code to
practice as an
emergency medical technician-paramedic. (E) "Ambulance" means any motor vehicle that is used, or
is
intended to be used, for the purpose of responding to
emergency
medical situations, transporting emergency patients,
and
administering emergency medical service to patients before,
during, or after transportation. (F) "Cardiac monitoring" means a procedure used for the
purpose of observing and documenting the rate and rhythm of a
patient's heart by attaching electrical leads from an
electrocardiograph monitor to certain points on the patient's
body
surface. (G) "Emergency medical service" means any of the services
described in sections 4765.35, 4765.37, 4765.38, and 4765.39 of
the
Revised Code that are performed by first responders, emergency
medical technicians-basic,
emergency medical
technicians-intermediate, and paramedics. "Emergency
medical
service" includes such services performed before or during any
transport of a patient, including transports between hospitals and
transports
to and from helicopters. (H) "Emergency medical service organization" means a
public
or private organization using first responders,
EMTs-basic,
EMTs-I, or paramedics, or a combination of
first responders,
EMTs-basic, EMTs-I, and
paramedics, to provide emergency medical
services. (I) "Physician" means an individual who holds a current,
valid certificate issued under Chapter 4731. of the Revised Code
authorizing the practice of medicine and surgery or osteopathic
medicine and surgery. (J) "Registered nurse" means an individual who holds a
current, valid license issued under Chapter 4723. of the Revised
Code authorizing the practice of nursing as a registered nurse. (K) "Volunteer" means a person who provides services either
for no compensation
or for compensation
that does not exceed the
actual expenses incurred in providing
the services or in training
to provide the services.
(l)(L) "Emergency medical service personnel" means
first
responders, emergency medical service technicians-basic,
emergency
medical service technicians-intermediate,
emergency medical
service technicians-paramedic, and persons who provide
medical
direction to such persons.
(M) "Hospital" has the same meaning as in section
3727.01 of
the Revised Code. (N) "Trauma" or "traumatic injury" means severe damage to or
destruction of tissue that satisfies both of the following
conditions: (1) It creates a significant risk of any of the following: (c) Significant, permanent disfigurement; (d) Significant, permanent disability. (2) It is caused by any of the following: (a) Blunt or penetrating injury; (b) Exposure to
electtomagnetic
electromagnetic, chemical,
or
rodioactive
radioactive energy; (c) Drowning, suffocation, or
stangulation
strangulation; (d) A
dificit
deficit or excess of heat. (o)(O) "Trauma victim" or "trauma patient" means a person
who
has sustained a traumatic injury.
(p)(P) "Trauma care" means the assessment, diagnosis,
transportation, treatment, or rehabilitation of a trauma victim
by
emergency
medical service personnel or by a physician, nurse,
physician
assistant, respiratory therapist, physical therapist,
chiropractor, occupational therapist, speech-language
pathologist,
audiologist, or psychologist licensed to practice as such in
this
state or another jurisdiction.
(Q) "Trauma center" means all of the following: (1) Any hospital that is
verified by the American college of
surgeons as an adult or pediatric trauma center; (2)
Any hospital that is operating as an adult or pediatric
trauma center under provisional status pursuant to section
3727.101 of the Revised Code; (3) Until December 31, 2004, any hospital in this state
that
is designated by the director of health as a level II
pediatric
trauma center under section 3727.081 of the Revised Code; (3)(4) Any hospital in
another state that is licensed or
designated under the laws of that state
as capable of providing
specialized trauma care appropriate to the medical
needs of the
trauma patient.
(R) "Pediatric" means involving a patient who is less than
sixteen years of age. (S) "Adult" means involving a patient who is not a pediatric
patient. (T) "Geriatric" means involving a patient who is at least
seventy
years old or exhibits significant anatomical or
physiological
characteristics associated with advanced aging. (U) "Air medical organization" means an organization that
provides emergency medical services, or transports emergency
victims, by means
of fixed or rotary wing aircraft. (V) "Emergency care" and "emergency facility" have the same
meanings as in section 3727.01 of the Revised Code. (W) "Stabilize," except as it is used in division (B)
of
section
4765.35 of the Revised Code with respect to the manual
stabilization of fractures, has the same meaning as in section
1753.28 of
the Revised Code. (X) "Transfer" has the same meaning as in section 1753.28 of
the
Revised Code.
Sec. 4765.50. (A) Except as provided in division (D) of
this section, no person shall represent that the person
is a first
responder, an emergency medical technician-basic or
EMT-basic, an
emergency medical technician-intermediate or
EMT-I, or an
emergency medical technician-paramedic or paramedic
unless
appropriately certified under section 4765.30 of the Revised Code. (B)(1) No person shall operate an emergency medical
services
training program without a certificate of accreditation
issued
under section 4765.17 of the Revised Code. (2) No person shall operate an emergency medical services
continuing education program without a certificate of approval
issued under section 4765.17 of the Revised Code. (C) No public or private entity shall advertise or
disseminate information leading the public to believe that the
entity is an emergency medical service organization, unless that
entity actually provides emergency medical services. (D) A person who is performing the functions of a first
responder, EMT-basic, EMT-I, or paramedic under
the authority of
the
laws of a jurisdiction other than this state,
who is employed
by or serves as a
volunteer with an emergency medical service
organization based in
that state, and provides emergency medical
services to or
transportation of a patient in this state is not in
violation of
division (A) of this section. A person who is performing the functions of a first
responder, EMT-basic, EMT-I, or paramedic under a
reciprocal
agreement authorized by section 4765.10 of the Revised Code is not
in violation of division (A) of this section. (E)
Beginning two years
On and after
the effective date of
this
amendment
November 3, 2002, no physician shall
purposefully
do any of the following: (1) Admit an adult trauma patient to a hospital that is not
an
adult trauma center for the purpose of providing adult trauma
care; (2) Admit a pediatric trauma patient to a hospital that is
not a
pediatric trauma center for the purpose of providing
pediatric
trauma care; (3) Fail to transfer an adult or pediatric trauma patient to
an
adult or pediatric trauma center in accordance with applicable
federal law, state law, and adult or pediatric trauma protocols
and patient transfer agreements adopted under section 3727.09 of
the Revised Code.
Section 2. That existing sections 2317.54, 3702.30, 3702.31,
3727.09, 3727.10, 4765.01, and 4765.50 of the
Revised Code are
hereby repealed.
Section 3. Sections 3727.101 and 3727.102 of the Revised
Code, as enacted by this act, shall take effect on November 3,
2002, or the earliest time permitted by law, whichever is later.
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