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H. B. No. 105 As Introduced
As Introduced
125th General Assembly | Regular Session | 2003-2004 |
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Representatives Collier, D. Evans, Hollister, McGregor, Raga, Schaffer, Redfern, Widener, Jerse, Webster, Allen, G. Smith
A BILL
To amend sections 4745.01, 4761.02, and 4761.03 and
to
enact sections 4752.01
to 4752.09 and 4752.99
of
the Revised
Code to require licensure of home
medical equipment services
providers by the Ohio
Respiratory Care Board.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 4745.01, 4761.02, and 4761.03 be
amended and sections
4752.01,
4752.02, 4752.03, 4752.04,
4752.05,
4752.06, 4752.07, 4752.08, 4752.09, and 4752.99 of the Revised
Code
be enacted to read as follows:
Sec. 4745.01. (A) "Standard renewal procedure," as used in
Chapters 905.,
907., 909., 911., 913., 915., 918., 921., 923.,
927., 942., 943.,
953., 1321., 3710., 3713., 3719., 3731., 3742.,
3748., 3769.,
3783., 3921., 3951., 4104., 4105., 4143., 4169.,
4561.,
4703., 4707., 4709., 4713., 4715., 4717., 4723., 4725.,
4727.,
4728., 4729., 4731., 4733., 4734., 4735., 4739., 4741.,
4747.,
4749., 4752., 4753., 4755., 4757.,
4758., 4759., 4761., 4766.,
4773., and 4775. of the
Revised Code, means the license renewal
procedures specified in
this chapter. (B) "Licensing agency," as used in this chapter, means any
department, division, board, section of a board, or other state
governmental unit subject to the standard renewal procedure, as
defined in this section, and authorized by the Revised Code to
issue a license to engage in a specific profession, occupation,
or
occupational activity, or to have charge of and operate
certain
specified equipment, machinery, or premises. (C) "License," as used in this chapter, means a license,
certificate, permit, card, or other authority issued or conferred
by a licensing agency by authority of which the licensee has or
claims the privilege to engage in the profession, occupation, or
occupational activity, or to have control of and operate certain
specific equipment, machinery, or premises, over which the
licensing agency has jurisdiction. (D) "Licensee," as used in this chapter, means either the
person to whom the license is issued or renewed by a licensing
agency, or the person, partnership, or corporation at whose
request the license is issued or renewed. (E) "Renewal" and "renewed," as used in this chapter and
in
the chapters of the Revised Code specified in division (A) of
this
section, includes the continuing licensing procedure
provided in
Chapter 3748. of the Revised Code and
rules adopted under it and
in sections 1321.05
and 3921.33 of the Revised Code, and as
applied to those
continuing
licenses any reference in this chapter
to the date of expiration
of any license shall be construed to
mean the due date of the
annual or other fee for the continuing
license.
Sec. 4752.01. As used in this chapter: (A) "Authorized health care professional" means a person
authorized under Chapter 4731. of the Revised Code to practice
medicine and surgery or osteopathic medicine and surgery or
otherwise authorized under Ohio law to prescribe the use of home
medical equipment by a patient.
(B)
"Home medical equipment" means equipment that can stand
repeated use, is primarily and customarily used to serve a medical
purpose, is not useful to a person in the absence of illness or
injury, and is appropriate for use in the home. "Home medical
equipment" includes all of the following: (1) Life-sustaining equipment prescribed by an authorized
health care professional that mechanically sustains, restores, or
supplants a vital bodily function, such as breathing;
(2) Technologically sophisticated medical equipment
prescribed by an authorized health care professional that requires
individualized adjustment or regular maintenance by a home medical
equipment services provider to maintain a patient's health care
condition or the effectiveness of the equipment;
(3) Any item specified by the board in rules adopted under
division (C) of section 4752.06 of the Revised Code. (C) "Home medical equipment services" means the sale,
delivery, installation, maintenance, replacement, or instruction
in the use of home medical equipment. (D) "Home medical equipment services provider" means a
person engaged in providing home medical equipment services. (E) "Hospital" has the same meaning as in section 3727.01
of
the Revised
Code. (F) "Sell or rent" means to transfer ownership or the right
to
use property, whether in person or through an agent, employee,
or other
person, in return for compensation.
Sec. 4752.02. (A) Except as provided in division (B) of
this section, no person who does not hold a valid license issued
under this chapter shall provide home medical equipment or
services or claim to the public to be a home medical equipment
services provider. (B) Division (A) of this section does not apply to any
of
the following: (1) A health care practitioner, as defined in section
4769.01 of the Revised Code, who does not sell or rent home
medical equipment; (2) A hospital that provides home medical equipment
services
only as an integral part of patient care and does not
provide the
services through a separate
entity that has its own medicare or
medicaid provider number; (3) A manufacturer or wholesale distributor of home
medical
equipment that does not sell directly to the
public; (4) A hospice care program, as defined by section 3712.01
of
the Revised Code, that does not sell or
rent home medical
equipment; (5) A home, as defined by section 3721.01 of the
Revised
Code; (6) A home health agency that is certified under Title XVIII
of the "Social Security Act," 79 Stat. 286 (1965), 42 U.S.C.A.
1395, as a provider of home health services and does
not
sell or
rent home medical
equipment; (7) An individual who holds a current, valid license issued
under Chapter 4741. of the Revised Code to practice veterinary
medicine;
(8) An individual who holds a current, valid license issued
under Chapter 4779. of the Revised Code to practice orthotics,
prosthetics, or pedorthics;
(9) A pharmacy licensed under Chapter 4729. of the Revised
Code that either does not sell or rent home medical equipment or
receives total payments of less than ten thousand dollars per year
from selling or renting home medical equipment;
(10) A home dialysis equipment provider regulated by federal
law.
Sec. 4752.03. A person seeking a license to provide
home
medical equipment services shall apply to the Ohio respiratory
care board on a form the board shall prescribe and provide. The
application must be accompanied by the license application fee
established in rules adopted under section 4752.06 of the
Revised
Code and specify the location
of the facility from which services
will be provided. Sec. 4752.04. (A) The respiratory care board
shall issue a
license to provide home medical equipment
services to each
applicant that meets one of the following requirements: (1) Meets the standards established by the board in rules
adopted under section 4752.06 of the Revised Code; (2)
Is a hospital that provides home medical equipment
services through a separate entity that has its own medicare or
medicaid provider number; (3) Is a pharmacy licensed under Chapter 4729. of the
Revised Code that receives total payments of ten thousand dollars
or more per year from selling or renting home medical equipment; (4)
Is an entity accredited by the joint commission on
accreditation of healthcare organizations; (5) Is accredited based on home health care standards by
an
accrediting body recognized by the board in rules adopted
under
section 4752.06 of the Revised Code and provides
documentation of
its accreditation to the board. (B) During the period ending two years after the effective
date of this section, an applicant that does not meet any of the
requirements of division (A) of this section shall be granted an
initial license if for at least twelve months prior to the
effective date of this section the applicant was engaged in the
business of providing home medical equipment services. (C) The board may conduct a personal interview of an
applicant, or an applicant's representative, to determine the
applicant's qualifications for licensure. (D) A license issued under this section is valid from the
day it is issued and expires annually on the thirtieth day of
June. A license may be renewed in accordance with section
4752.05
of the Revised Code. (E) A license issued under this section is valid only for
the facility named in the application. A person that intends to
provide home medical equipment services from more than one
facility must obtain a separate license for each
facility.
Sec. 4752.05. A license issued under this chapter shall be
renewed by the Ohio respiratory care board if the license holder
is
in compliance with the applicable requirements of this
chapter. An application for license renewal shall be accompanied by
the renewal fee established in rules adopted under section
4752.06
of the Revised Code and documentation satisfactory to the board
that the continuing education requirements of section 4752.07 of
the Revised Code have been met. Renewals shall be made in
accordance with
the standard renewal procedure established under
Chapter 4745. of
the Revised Code. Sec. 4752.06. (A) The Ohio respiratory care board shall
adopt
rules to implement and administer this chapter. The rules
shall
establish all of the following: (1) Standards an applicant must meet to be eligible to be
granted a license under section 4752.04 of
the
Revised Code; (2) Standards for personnel policies, equipment
storage,
equipment maintenance, and record keeping; (3) Standards for continuing education programs in home
medical equipment services for individuals who provide home
medical
equipment services while employed by or under the
control of a
home medical equipment services provider; (4) Standards and procedures for inspection of home
medical
equipment providers and facilities from which home
medical
equipment services are provided and for appeal of
inspection
results; (5) Fees for initial license, license, license renewal, and
inspections; (6) Any other standards, requirements, or procedures the
board considers necessary for the implementation or
administration
of this chapter. (B) The board shall adopt rules that specify the following: (1)
The accrediting bodies it recognizes for the purposes of
division
(A)(5) of section 4752.04 of the Revised Code; (2)
Items considered home medical equipment for purposes of
divisions
(B)(1) and (2) of section 4752.01 of the Revised Code. (C) The board may adopt rules specifying additional items
that are considered home medical equipment for purposes of
division (B) of section 4752.01 of the Revised Code. (D) Rules shall be adopted under this chapter in
accordance
with Chapter 119. of the Revised
Code. Prior to adopting any
rule, the board shall consult with
representatives of any
association of home medical equipment services
providers that do
business in this state.
Sec. 4752.07. The holder of a license issued under this
chapter shall do all of the following: (A) Maintain a physical facility and a medical equipment
inventory; (B) Establish equipment management and personnel
policies; (C) Provide life-sustaining home medical equipment, as
described in division (B)(1) of section 4752.01 of the Revised
Code, and
related home medical equipment services twenty-four hours per day, seven days per week; (D) Require persons in its employ or under its control who
provide home medical equipment services to successfully complete
continuing education programs in home medical equipment services
that meet the standards established by rule adopted under
section
4752.06 of the Revised
Code and maintain records on
participation
in those programs; (E) Maintain records on all individuals to whom it provides
home medical equipment and services; (F)
Maintain liability insurance, including coverage for
professional and products liability; (G) Comply with all other requirements established by rule
adopted under section 4752.06 of the Revised Code.
Sec. 4752.08. (A) The Ohio respiratory care board may
inspect the operations and facility, subpoena the records, and
compel
testimony of employees of any home medical equipment
services provider.
Inspections shall be conducted as provided in
rules adopted by the board under
section 4752.06 of the Revised
Code. (B)
The board shall employ investigators who shall, under
the
direction of the executive director of the board, investigate
complaints and conduct inspections. Pursuant to an
investigation
or inspection, investigators may review and
audit records during
normal business hours at the place of
business of the person being
investigated. The board and its
employees shall not disclose
confidential information obtained
during an investigation, except
pursuant to a court order.
(C) The board shall send the provider a report of the
results of an inspection. If the board determines that the
provider is not in compliance with any requirement of this
chapter, the board may direct the provider to attain compliance.
Failure of the provider to comply with the directive is grounds
for action by the board under division (A)(1) of section 4752.09
of the Revised Code.
(D)
A provider that disputes the
results of an inspection
may file an appeal with the board not later
than ninety
days after
receiving the report. The board shall
review the
inspection
report and, at the request of the
provider, conduct a
new
inspection.
Sec. 4752.09. (A) The Ohio respiratory care board may,
in
accordance
with Chapter 119. of the Revised Code, suspend or
revoke a license issued under this chapter
or discipline a license
holder by imposing a fine of not more than five
thousand dollars
or taking
other disciplinary action on any of the following
grounds: (1)
Violation of any provision of this chapter or an order
or
rule
of the board or failure to meet the standards established
under division
(A) of section 4752.06 of the Revised Code; (2) A plea of guilty to or a judicial finding of guilt of a
felony or a misdemeanor that involves dishonesty or is directly
related to the provision of medical equipment; (3) Making a material misstatement in furnishing information
to
the board; (4) Professional incompetence; (5) Being guilty of negligence or gross misconduct in
providing
home medical equipment and services; (6) Aiding, assisting, or willfully permitting another
person to
violate any provision of this chapter or an order or
rule of
the board; (7) Failing, within sixty days, to provide information in
response
to a written request by the board; (8) Engaging in conduct likely to deceive, defraud, or harm
the
public; (9) Denial, revocation, suspension, or restriction of a
license
to provide home medical equipment services, for any reason
other
than failure to renew, in another state or jurisdiction; (10) Directly or indirectly giving to or receiving from any
person a fee, commission, rebate, or other form of compensation
for services not rendered; (11) Knowingly making or filing false records, reports, or
billings in the course of providing home medical equipment and
services, including false records, reports, or billings prepared
for or submitted to state and federal agencies or departments; (12) Failing to comply with federal rules issued pursuant to
the
medicare program established under Title
XVIII of the
"Social
Security
Act," 49
Stat. 620(1935), 42 U.S.C.A. 1395,
as
amended,
relating to operations, financial transactions, and general
business practices of home medical services providers. (B) The respiratory care board may suspend a license
without
a hearing if it
determines that there is evidence that the license
holder is
subject to actions under this section and
that there is
clear and convincing evidence that continued
operation by the
license holder presents an immediate and
serious harm to the
public. The president and executive
director of the board shall
make a preliminary determination and
describe the evidence on
which they made their determination to
the other members of the
board. The board may by resolution
designate another board member
to act in place of the president
of the board or another employee
to act in the place of the
executive director, in the event that
the board president or
executive director is unavailable or
unable
to act. On
consideration of the evidence, the board may by
an
affirmative
vote of four members, not including the president
of
the board
or the person named to act in place of the president,
impose the
summary suspension. Immediately following the decision to suspend a license under
this division,
the board shall issue a written
order of suspension
and cause it to be delivered in accordance with section
119.07 of
the
Revised
Code. The order shall not be subject to suspension
by
the
court during the pendency of any appeal filed under section
119.12 of the
Revised
Code. If the license holder requests
an
adjudication hearing, the date set for the hearing shall be
within
fifteen days but not earlier than seven days after the
license
holder requests the hearing, unless another date is
agreed to by
the license holder and the board. The
suspension shall remain in
effect, unless reversed by the board,
until a final adjudication
order issued by the board pursuant to
this section and
Chapter
119. of the
Revised
Code
becomes
effective. The board shall issue
its final adjudication order
not later than ninety days after
completion of the hearing. The
board's failure to issue the order
by that day shall cause
the summary suspension to end, but shall
not affect the validity of any
subsequent final adjudication
order.
Sec. 4752.99. Whoever violates division (A) of section
4752.02
of the Revised Code is guilty of a minor misdemeanor on
the first offense. On the second
offense, the person is guilty of
a misdemeanor of the fourth degree. On each
subsequent offense,
the person is guilty of a misdemeanor of the first degree.
Sec. 4761.02. The governor, with the advice and consent of
the senate, shall appoint the Ohio respiratory care board,
consisting of
five
seven residents of this state. Three members
of the
board shall be respiratory care professionals who were
engaged in
or actively associated with the practice of respiratory
care in
this state for at least five years immediately preceding
appointment.
Two members shall be home medical equipment services
providers with not less than five years of management experience
in home medical equipment services prior to appointment. One
member
shall be a physician who has clinical training and
experience in
the management of pulmonary disease. One member
shall represent
the public. After the term of a member of the board expires or becomes
vacant, the Ohio state medical association may submit to the
governor the names of nominees for the board position to be
filled
by a physician. The board of directors of the Ohio
society for
respiratory care, inc., may recommend to the governor
at least
three persons for each board position to be filled by a
respiratory care professional.
The American lung association
of
Ohio may submit to the governor the names of nominees for the
board position to be filled by a person representing the public.
The Ohio association of medical equipment services may submit to
the governor the names of nominees for the two board positions to
be filled by home medical equipment services providers. The governor
shall consider these nominees in making the
appointments. Terms
Of the initial two home medical equipment services providers
appointed to the board, one shall be appointed for a term ending
the fourteenth day of
March immediately following the date that is one
year after the effective date of this amendment and one for a term
ending the fourteenth day of March immediately following the date
that is two years after the effective date of this amendment.
Thereafter, terms of
office shall be for three years, each term
ending on the same day
of the same month of the year as did the
term which it succeeds.
A member shall serve subsequent to the
expiration of the member's term
until
a
the member's successor is
appointed and qualifies, or until a period
of sixty days has
elapsed, whichever occurs first. Each member,
before entering
upon the duties of office, shall subscribe to
and file with the
secretary of state the oath of office required
under Section 7 of
Article XV, Ohio Constitution. Vacancies
shall be filled in the
manner prescribed for the regular
appointments to the board and
shall be limited to the unexpired
terms. Members of the board may
be reappointed.
Annually, upon the qualification of the member or members
appointed in that year, the Ohio respiratory care board shall
organize and shall select from its members a president and
secretary. A majority of the members of the board shall
constitute a quorum to transact and vote on the business of the
board.
Each member of the board shall receive an amount fixed
pursuant to division (J) of section 124.15 of the Revised Code
for
each day actually employed in the discharge of the member's
duties. In addition, each member shall receive actual and
necessary
expenses incurred in the performance of the member's
official
duties. The board shall employ an executive director who shall
be in
the
unclassified service of the state. The executive
director
shall assist the board in
the administration and enforcement of
this chapter and shall employ
individuals as the board considers
necessary to
provide that assistance.
Sec. 4761.03. The Ohio respiratory care board shall
regulate
the practice of respiratory care in this state and the persons to
whom the board issues licenses and limited permits
and shall
license home medical equipment services providers under Chapter
4752. of the Revised Code under this
chapter.
Rules adopted under
this chapter that deal with the
provision of
respiratory care in a
hospital, other than rules
regulating the
issuance of licenses or
limited permits, shall be
consistent with the
conditions for
participation under medicare,
Title XVIII of the
"Social Security
Act," 79 Stat. 286
(1965), 42
U.S.C.A. 1395, as amended,
and with
the respiratory care
accreditation standards of the
joint
commission on accreditation
of healthcare
organizations or
the
American osteopathic
association. (A) Adopt, and may rescind or amend, rules in accordance
with Chapter 119. of the Revised Code to carry out the purposes
of
this chapter, including rules prescribing: (1) The form and manner for filing applications for
licensure and renewal, limited permits, and limited permit
extensions under sections 4761.05 and 4761.06 of the
Revised Code; (2) The form, scoring, and scheduling of examinations and
reexaminations for licensure and license renewal; (3) Standards for the approval of educational programs
required to qualify for licensure and continuing education
programs required for license renewal; (4) Continuing education courses and the number
of hour
requirements necessary for license renewal, in accordance with
section 4761.06 of the Revised Code; (5) Procedures for the issuance and renewal of licenses
and
limited permits; (6) Procedures for the denial, suspension, permanent
revocation,
refusal to renew, and reinstatement of licenses and
limited permits,
the
conduct of hearings, and the imposition of
fines for engaging in
conduct that is grounds for such action and
hearings under
section 4761.09 of the Revised Code; (7) Standards of ethical conduct for the practice of
respiratory care; (8) Conditions under which the license renewal fee and
continuing education requirements may be waived at the request of
a licensee who is not in active practice; (9) The respiratory care tasks that may be performed by an
individual practicing as a polysomnographic technologist pursuant
to division
(B)(3) of section 4761.10 of the Revised Code; (10) Procedures for registering out-of-state respiratory
care
providers authorized to practice in this state under division
(A)(4) of section 4761.11 of the
Revised Code. (B) Determine the sufficiency of an applicant's
qualifications for admission to the licensing examination or a
reexamination, and for the issuance or renewal of a license or
limited permit; (C) Determine the respiratory care educational programs
that
are acceptable for fulfilling the requirements of division
(A) of
section 4761.04 of the Revised Code; (D) Schedule, administer, and score the licensing
examination or any reexamination for license renewal or
reinstatement. The board shall administer the licensing
examinations
at
least twice a year and notify applicants of the
time and place of the examinations. (E) Investigate complaints concerning alleged violations
of
section 4761.10 of the Revised Code or grounds for the
suspension,
permanent revocation, or refusal to issue licenses or
limited
permits under section 3123.47 or 4761.09 of
the Revised Code.
The
board
shall employ investigators who shall, under the
direction of
the
executive director of the board, investigate
complaints and
make
inspections and other inquiries as, in the
judgment of the
board,
are appropriate to enforce sections
3123.41 to
3123.50,
4761.09, and 4761.10 of the
Revised Code.
Pursuant to an
investigation and inspection,
the investigators may
review and
audit records
during normal business hours at the place
of
business
of a licensee or person who is the subject of a
complaint
filed with the board
or at any place where the
records
are kept.
Except when required by court order, the board and its
employees shall
not disclose
confidential information obtained
during an investigation or identifying
information about any
person
who files a complaint with the board. The board may hear testimony in matters relating to the
duties imposed upon it and issue subpoenas
pursuant to an
investigation. The president and
secretary of the board may
administer oaths. (F) Conduct hearings, keep records of its proceedings, and
do all such other things as are necessary and proper to carry out
and enforce the provisions of this chapter; (G) Maintain, publish, and make available upon request,
for
a fee not to exceed the actual cost of printing and mailing: (1) The requirements for the issuance of licenses and
limited permits under this chapter and rules adopted by the board; (2) A current register of every person licensed to
practice
respiratory care in this state, to include the addresses
of the
person's last known place of business and residence, the
effective
date and identification number of the license, the name
and
location of the institution that granted the person's degree
or
certificate of completion of respiratory care educational
requirements, and the date the degree or certificate was issued; (3) A list of the names and locations of the institutions
that each year granted degrees or certificates of completion in
respiratory care; (4) After the administration of each examination, a list
of
persons who passed the examination. (H) Submit to the governor and to the general assembly
each
year a report of all of its official actions during the
preceding
year, together with any findings and recommendations
with regard
to the improvement of the profession of respiratory
care; (I) Administer and enforce Chapter 4752. of the Revised
Code.
Section 2. That existing sections 4745.01, 4761.02, and
4761.03 of the Revised
Code are hereby repealed.
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