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Sub. H. B. No. 375 As Passed by the HouseAs Passed by the House
126th General Assembly | Regular Session | 2005-2006 |
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Representatives Flowers, McGregor, J., Evans, D., Brown, Willamowski, Allen, Setzer, Patton, T., Stewart, D., Blessing, Cassell, Collier, Combs, Domenick, Fende, Hagan, Hughes, Mitchell, Otterman, Reidelbach, Smith, G., Widener, Williams, Wolpert, Yuko
A BILL
To amend sections 4765.05, 4765.11, 4765.16, 4766.01, 4766.02, 4766.03, 4766.04, 4766.06, 4766.07, 4766.17, and 4766.20 and to enact sections 4765.101, 4765.102, 4765.111, 4765.112, 4765.113, 4765.114, 4765.115, and 4765.116 of the Revised Code concerning the authority of the State Board of Emergency Medical Services to suspend certificates to practice emergency medical services and revisions to the law governing air medical transportation.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 4765.05, 4765.11, 4765.16, 4766.01, 4766.02, 4766.03, 4766.04, 4766.06, 4766.07, 4766.17, and 4766.20 be amended and sections 4765.101, 4765.102, 4765.111, 4765.112, 4765.113, 4765.114, 4765.115, and 4765.116 of the Revised Code be enacted to read as follows:
Sec. 4765.05. (A) As used in this section, "prehospital
emergency medical services" means an emergency medical services
system that provides medical services to patients who require
immediate assistance, because of illness or injury, prior to
their arrival at an emergency medical facility. (B) The state board of emergency medical services shall divide
the state geographically into prehospital emergency medical services regions for
purposes of overseeing the delivery of adult and pediatric prehospital
emergency medical services. These regions shall consist of the same
geographic regions as the health service areas designated by the
director of health under section 3702.58 of the Revised Code.
For each prehospital emergency medical services region, the state board of emergency medical services shall appoint either a physician to
serve as the regional director or a physician advisory board to
serve as the regional advisory board. The state board of emergency medical services shall specify
the duties of each regional director and regional advisory board.
Regional directors and members of regional advisory boards shall
serve without compensation, but shall be reimbursed for
actual and necessary expenses incurred in carrying out
duties as regional directors and members of regional advisory
boards.
(C) Nothing in this section shall be construed to limit in any way the ability of a hospital to determine the market area of that hospital.
Sec. 4765.101. (A) The state board of emergency medical services shall investigate any allegation that a person has violated this chapter or a rule adopted under it. Any person may submit to the board a written complaint regarding an alleged violation of this chapter or a rule adopted under it. In the absence of fraud or bad faith, no person submitting a complaint to the board or testifying in an adjudication hearing conducted in accordance with Chapter 119. of the Revised Code with regard to such an alleged violation shall be liable to any person in damages in a civil action as a result of submitting the complaint or providing testimony.
(B) In investigating an allegation, the board may do any of the following:
(2) Order the taking of depositions;
(4) Compel the attendance of witnesses and production of books, accounts, papers, records, documents, and testimony. (C) A subpoena for patient record information shall not be issued without consultation with the attorney general's office and approval of the executive director of the board. Before issuance of a subpoena for patient record information, the executive director shall determine whether there is probable cause to believe that the complaint filed alleges a violation of this chapter or any rule adopted under it and that the records sought are relevant to the alleged violation and material to the investigation. The subpoena may apply only to records that cover a reasonable period of time surrounding the alleged violation.
(D) On failure to comply with any subpoena issued by the board and after reasonable notice to the person being subpoenaed, the board may move, pursuant to the Rules of Civil Procedure, for an order compelling the production of persons or records.
(E) A subpoena issued by the board may be served by a sheriff, the sheriff's deputy, or an investigator for the division of emergency medical services of the department of public safety. Service of a subpoena issued by the board may be made by delivering a copy of the subpoena to the person named in it, reading it to the person, or leaving it at the person's usual place of residence. When the person being served is an individual authorized by this chapter to practice emergency medical services, service of the subpoena may be made by certified mail, restricted delivery, return receipt requested, and the subpoena shall be deemed served on the date delivery is made or on the date that the person refuses to accept delivery.
Sec. 4765.102. (A) As used in this section, "licensing agency" means any entity that has the authority pursuant to Title XLVII of the Revised Code to issue a license, and any other agency of this or another state, other than the Ohio supreme court, that has the authority to issue a license that authorizes an individual to engage in an occupation or profession. "Licensing agency" includes an administrative officer that has authority to issue a license that authorizes an individual to engage in an occupation or profession. (B) Except as provided in divisions (C) and (D) of this section and section 4765.111 of the Revised Code, all information the state board of emergency medical services receives pursuant to an investigation, including information regarding an alleged violation of this chapter or rules adopted under it or a complaint submitted under division (A) of section 4765.101 of the Revised Code, is confidential, and is not subject to discovery in any civil action, during the course of the investigation and any adjudication proceedings that result from the investigation. Upon completion of the investigation and any resulting adjudication proceedings, the information is a matter of public record for purposes of section 149.43 of the Revised Code.
(C) The board may release information otherwise made confidential by division (B) of this section to law enforcement officers or licensing agencies of this or another state that are prosecuting, adjudicating, or investigating the holder of a certificate issued under this chapter or a person who allegedly engaged in the unauthorized provision of emergency medical services.
A law enforcement officer or licensing agency with information disclosed by the board under this division shall not divulge the information other than for the purpose of an adjudication by a court or licensing agency to which the subject of the adjudication is a party.
(D) If an investigation conducted under section 4765.101 of the Revised Code requires a review of patient records, the investigation and proceedings related to it shall be conducted in such a manner as to protect patient confidentiality. The board shall not make public the name or any other identifying information about a patient unless proper consent is given in accordance with rules adopted by the board. If the patient is less than eighteen years of age, the board shall obtain consent from the patient's parent, guardian, or custodian.
Sec. 4765.11. (A) The state board of emergency medical
services shall adopt, and may amend and rescind, rules in
accordance with Chapter 119. of the Revised Code and division (C)
of this section that establish all of the following: (1) Procedures for its governance and the control of its
actions and business affairs; (2) Standards for the performance of emergency medical
services by first responders, emergency medical
technicians-basic, emergency medical technicians-intermediate, and emergency
medical technicians-paramedic; (3) Application fees for certificates of accreditation,
certificates of approval, certificates to teach, and certificates
to practice, which shall be deposited into the trauma and emergency
medical services fund
created in section 4513.263 of the Revised Code; (4) Criteria for determining when the application or
renewal fee for a certificate to practice may be waived because
an applicant cannot afford to pay the fee; (5) Procedures for issuance and renewal of certificates of
accreditation, certificates of approval, certificates to teach,
and certificates to practice, including any procedures necessary to
ensure that adequate notice of renewal is provided in accordance with division
(D) of section 4765.30 of the Revised Code; (6) Procedures for suspending or revoking certificates of
accreditation, certificates of approval, certificates to teach,
and certificates to practice; (7) Grounds for suspension or revocation of a certificate
to practice issued under section 4765.30 of the Revised Code and
for taking any other disciplinary action against a first
responder, EMT-basic, EMT-I, or paramedic; (8) Procedures for taking disciplinary action against a first
responder, EMT-basic, EMT-I, or paramedic; (9) Standards for certificates of accreditation and
certificates of approval; (10) Qualifications for certificates to teach; (11) Requirements for a certificate to practice; (12) The curricula, number of hours of instruction and
training, and instructional materials to be used in adult and pediatric
emergency
medical services training programs and adult and pediatric emergency
medical services
continuing education programs; (13) Procedures for conducting courses in recognizing
symptoms of life-threatening allergic reactions and in
calculating proper dosage levels and administering injections of
epinephrine to adult and pediatric patients who suffer
life-threatening allergic
reactions; (14) Examinations for certificates to practice; (15) Procedures for administering examinations for
certificates to practice; (16) Procedures for approving examinations that
demonstrate competence to have a certificate to practice renewed
without completing an emergency medical services continuing
education program; (17) Procedures for granting extensions and exemptions of
emergency medical services continuing education requirements; (18) Procedures for approving the additional emergency
medical services first responders are authorized by division (C)
of section 4765.35 of the Revised Code to perform, EMTs-basic are
authorized by division (C) of section 4765.37 of the
Revised Code to perform, EMTs-I are authorized by division (B)(5) of
section 4765.38 of the Revised Code to perform, and paramedics are authorized
by division (B)(6) of section 4765.39 of the Revised Code to perform; (19) Standards and procedures for implementing the requirements of
section 4765.06 of the Revised
Code, including designations of the persons who are required to
report information to the board and the types of information to
be reported; (20) Procedures for administering the emergency medical
services grant program established under section 4765.07 of the
Revised Code; (21) Procedures consistent with Chapter 119. of the
Revised Code for appealing decisions of the board; (22) Minimum qualifications and peer review and quality improvement
requirements for persons who provide medical direction to emergency medical
service personnel; (23) The manner in which a patient, or a patient's parent, guardian, or custodian may consent to the board releasing identifying information about the patient under division (D) of section 4765.102 of the Revised Code; (24) Circumstances under which a training program or continuing education program, or portion of either type of program, may be taught by a person who does not hold a certificate to teach issued under section 4765.23 of the Revised Code. (B) The board may adopt, and may amend and rescind, rules
in accordance with Chapter 119. of the Revised Code and division
(C) of this section that establish the following: (1) Specifications of information that may be collected
under the trauma system registry and incidence reporting system
created under section 4765.06 of the Revised Code; (2) Standards and procedures for implementing any of the
recommendations made by any
committees of the board or under
section 4765.57 of the Revised Code; (3) Requirements that a person must meet to receive a certificate to
practice as a first responder pursuant to division (A)(2) of section
4765.30 of the Revised Code; (4) Any other rules necessary to implement this chapter. (C) In developing and administering rules adopted under this
chapter, the state board of emergency medical services shall consult
with regional directors and regional physician advisory boards created by
section 4765.05 of the Revised Code and emphasize the special
needs of pediatric and
geriatric patients. (D) Except as otherwise provided in this division, before
adopting, amending, or rescinding any rule under this chapter,
the board shall submit the proposed rule to the director of
public safety for review. The director may review the
proposed rule for not more than sixty days after the date it is
submitted. If, within this sixty-day period, the director
approves the proposed rule or does not notify the board that the rule is
disapproved, the board may adopt, amend, or rescind the rule
as proposed. If, within this sixty-day period, the director
notifies the board that the proposed rule is disapproved, the
board shall not adopt, amend, or rescind the rule as proposed
unless at least twelve members of the board vote to adopt, amend,
or rescind it. This division does not apply to an emergency rule adopted
in accordance with section 119.03 of the Revised Code.
Sec. 4765.111. Except as provided in this section or sections 4765.112 to 4765.116 of the Revised Code, the state board of emergency medical services shall conduct disciplinary proceedings regarding the holder of a certificate issued under this chapter in accordance with rules adopted by the board under section 4765.11 of the Revised Code. The board and a holder of a certificate are the parties to a hearing conducted under this chapter. Either party may submit a written request to the other party for a list of witnesses and copies of documents intended to be introduced at the hearing. The request shall be in writing and shall be served not less than thirty-seven days prior to the commencement of the hearing, unless the hearing officer or presiding board member grants an extension of time to make the request. Not later than thirty days before the hearing, the responding party shall provide the requested list of witnesses and copies of documents to the requesting party, unless the hearing officer or presiding board member grants an extension of time to provide the list and copies.
Failure to timely provide a list or copies requested in accordance with this section shall result in exclusion from the hearing of the witnesses, testimony, or documents. Sec. 4765.112. (A) The state board of emergency medical services, by an affirmative vote of the majority of its members, may suspend without a prior hearing a certificate to practice issued under this chapter if the board determines that there is clear and convincing evidence that continued practice by the certificate holder presents a danger of immediate and serious harm to the public and that the certificate holder has done any of the following:
(1) Furnished false, fraudulent, or misleading information to the board;
(2) Engaged in activities that exceed those permitted by the individual's certificate;
(3) In a court of this or any other state or federal court been convicted of, pleaded guilty to, or been the subject of a judicial finding of guilt of, a judicial finding of guilt resulting from a plea of no contest to, or a judicial finding of eligibility for intervention in lieu of conviction for, a felony or for a misdemeanor committed in the course of practice or involving gross immorality or moral turpitude. (B) Immediately following the decision to impose a summary suspension, the board, in accordance with section 119.07 of the Revised Code, shall issue a written order of suspension, cause it to be delivered to the certificate holder, and notify the certificate holder of the opportunity for a hearing. If timely requested by the certificate holder, a hearing shall be conducted in accordance with section 4765.115 of the Revised Code.
Sec. 4765.113. If the state board of emergency medical services imposes a suspension on the basis of a conviction, judicial finding, or plea as described in division (A)(3) of section 4765.112 of the Revised Code that is overturned on appeal, the certificate holder, on exhaustion of the criminal appeal process, may file with the board a petition for reconsideration of the suspension along with appropriate court documents. On receipt of the petition and documents, the board shall reinstate the certificate holder's certificate to practice.
Sec. 4765.114. (A) A certificate to practice emergency medical services issued under this chapter is automatically suspended on the certificate holder's conviction of, plea of guilty to, or judicial finding of guilt of any of the following: aggravated murder, murder, voluntary manslaughter, felonious assault, kidnapping, rape, sexual battery, gross sexual imposition, aggravated arson, aggravated burglary, aggravated robbery, or a substantially equivalent offense committed in this or another jurisdiction. Continued practice after the suspension is practicing without a certificate.
(B) If the state board of emergency medical services has knowledge that an automatic suspension has occurred, it shall notify, in accordance with section 119.07 of the Revised Code, the certificate holder of the suspension and of the opportunity for a hearing. If timely requested by the certificate holder, a hearing shall be conducted in accordance with section 4765.115 of the Revised Code.
Sec. 4765.115. (A) A suspension order issued under section 4765.112 or automatic suspension under section 4765.114 of the Revised Code is not subject to suspension by a court prior to a hearing under this section or during the pendency of any appeal filed under section 119.12 of the Revised Code.
(B) A suspension order issued under section 4765.112 or automatic suspension under section 4765.114 of the Revised Code remains in effect, unless reversed by the state board of emergency medical services, until a final adjudication order issued by the board pursuant to this section becomes effective.
(C) Hearings requested pursuant to section 4765.112 or 4765.114 of the Revised Code shall be conducted under this section in accordance with Chapter 119. of the Revised Code.
(D) A hearing under this section shall be held not later than forty-five days but not earlier than forty days after the certificate holder requests it, unless another date is agreed to by the certificate holder and the board.
(E) After completion of an adjudication hearing, the board may adopt, by an affirmative vote of the majority of its members, a final adjudication order that imposes any of the following sanctions:
(1) Suspension of the holder's certificate to practice;
(2) Revocation of the holder's certificate to practice;
(3) Issuance of a written reprimand;
(4) A refusal to renew or a limitation on the holder's certificate to practice.
The board shall issue its final adjudication order not later than forty-five days after completion of an adjudication hearing. If the board does not issue a final order within that time period, the suspension order is void, but any final adjudication order subsequently issued is not affected.
(F) Any action taken by the board under this section resulting in a suspension from practice shall be accompanied by a written statement of the conditions under which the certificate to practice may be reinstated. Reinstatement of a certificate suspended under this section requires an affirmative vote by the majority of the members of the board.
(G) When the board revokes or refuses to reinstate a certificate to practice, the board may specify that its action is permanent. An individual subject to permanent action taken by the board is forever ineligible to hold a certificate of the type revoked or refused, and the board shall not accept from the individual an application for reinstatement of the certificate or for a new certificate.
Sec. 4765.116. If a certificate holder subject to a suspension order issued by the state board of emergency medical services under section 4765.112 or an automatic suspension order under section 4765.114 of the Revised Code fails to make a timely request for a hearing, the following apply:
(A) In the case of a certificate holder subject to a summary suspension order, the board is not required to hold a hearing, but may adopt, by an affirmative vote of a majority of its members, a final order that contains the board's findings. In the final order, the board may order any of the sanctions listed in division (E) of section 4765.115 of the Revised Code.
(B) In the case of a certificate holder subject to an automatic suspension order, the board may adopt, by an affirmative vote of a majority of its members, a final order that permanently revokes the holder's certificate to practice.
Sec. 4765.16. (A) All courses offered through an
emergency medical services training program or an emergency
medical services continuing education program, other than
ambulance driving, shall be developed under the direction of a
physician who specializes in emergency medicine. Each course that
deals with trauma care shall be developed in consultation with a
physician who specializes in trauma surgery. Each Except as specified by the state board of emergency medical services pursuant to rules adopted under section 4765.11 of the Revised Code, each course offered
through a training program or
continuing education program shall be taught by a person who
holds the appropriate certificate to teach issued under
section 4765.23 of the Revised Code. (B) A training program for first responders shall meet the standards
established in rules adopted by the state board of emergency medical
services under section 4765.11 of the Revised
Code. The program shall include courses in both of the following areas for at
least the number of hours established by the board's rules: (1) Emergency victim care; (2) Reading and interpreting a trauma victim's vital signs. (C) A training program for emergency medical technicians-basic shall
meet the standards established in rules adopted by the board
under section 4765.11 of the Revised
Code. The
program shall include courses in each of the following areas for at least the
number of hours established by the board's rules: (1) Emergency victim care; (2) Reading and interpreting a trauma victim's vital
signs; (3) Triage protocols for adult and pediatric trauma victims; (4) In-hospital training; (6) Training as an ambulance driver. Each operator of a training program for emergency medical
technicians-basic shall allow any pupil in the twelfth grade
in a secondary school who is at least seventeen years old and who
otherwise meets the requirements for admission into such a
training program to be admitted to and complete the program and,
as part of the training, to ride in an ambulance with emergency medical
technicians-basic, emergency medical technicians-intermediate, and emergency
medical technicians-paramedic. Each emergency medical service organization
shall allow pupils participating in training programs to ride in an ambulance
with emergency medical technicians-basic, advanced emergency medical
technicians-intermediate, and emergency medical
technicians-paramedic. (D) A training program for emergency medical
technicians-intermediate shall meet the standards established in rules adopted
by the board under section 4765.11 of the Revised Code. The program shall
include, or require as a prerequisite, the training
specified in division (C) of this section and courses in each of
the following areas for at least the number of
hours established by the board's rules: (1) Recognizing symptoms of life-threatening allergic
reactions and in calculating proper dosage levels and
administering injections of epinephrine to persons who suffer
life-threatening allergic reactions, conducted in accordance with
rules adopted by the board under section 4765.11 of the Revised
Code; (2) Venous access procedures; (3) Cardiac monitoring and electrical interventions to
support or correct the cardiac function. (E) A training program for emergency medical
technicians-paramedic shall meet the standards established in
rules adopted by the board under section 4765.11 of the Revised
Code. The program shall include, or require as a prerequisite, the
training specified in divisions (C) and (D) of this section
and courses in each of the following
areas for at least the number of hours established by the board's
rules: (2) Venous access procedures; (4) Patient assessment and triage; (5) Acute cardiac care, including administration of
parenteral injections, electrical interventions, and other
emergency medical services; (6) Emergency and trauma victim care beyond that required
under division (C) of this section; (7) Clinical training beyond that required under division
(C) of this section. (F) A continuing education program for first
responders, EMTs-basic, EMTs-I, or
paramedics shall meet the standards
established in rules adopted by the board under section 4765.11 of the Revised
Code. A continuing education program shall include instruction and training
in subjects established by the board's rules for at least the number of hours
established by the board's rules. Sec. 4766.01. As used in this chapter: (A)
"Advanced life support" means treatment described in
section 4765.39 of the Revised Code that a paramedic is certified
to perform. (B)
"Air medical service organization program" means a program operated by a person that provides air medical transportation to the
public which furnishes, conducts, maintains, advertises, promotes, or otherwise engages in providing emergency medical services with a rotorcraft air ambulance or fixed wing air ambulance. (C) "Air medical transportation" is the use of a rotorcraft
air ambulance or fixed wing air ambulance to provide
transportation and advanced life support to seriously ill,
injured, wounded, or otherwise incapacitated or helpless
individuals who require use of a stretcher from airport to airport
or from an emergency scene to a hospital or other medical care
setting means the transporting of a patient by rotorcraft air ambulance or fixed wing air ambulance with appropriately licensed and certified medical personnel. (D) "Ambulance" means any motor
vehicle that is specifically
designed, constructed, or modified
and equipped and is intended to
be used
to provide basic life support, intermediate life
support, advanced life support, or mobile intensive care unit
services and transportation
upon the streets or highways of
this
state of persons
who
are
seriously ill, injured, wounded, or
otherwise incapacitated or
helpless.
"Ambulance" does not include
air medical transportation or a vehicle designed and
used
solely
for the transportation of nonstretcher-bound persons,
whether
hospitalized or
handicapped or whether ambulatory or
confined to a
wheelchair. (E) "Ambulette" means a motor vehicle that is
specifically
designed, constructed, or modified and equipped and
is intended to
be used for
transportation upon the
streets or
highways of this
state of persons who require use of a
wheelchair. (F)
"Basic life support" means treatment described in
section
4765.37 of the Revised Code that an
EMT-basic is certified
to
perform. (G)
"Disaster situation" means any condition or situation
described by rule of the Ohio
medical
transportation board
as a mass
casualty, major emergency, natural
disaster, or
national
emergency. (H)
"Emergency medical service organization" means an
organization that uses EMTs-basic,
EMTs-I, or
paramedics, or a
combination thereof of EMTs-basic, EMTs-I, and paramedics, to provide medical care to victims of
illness
or injury. An emergency medical service organization
includes,
but is not limited to, a commercial ambulance service
organization, a hospital, and a funeral home.
(I)
"EMT-basic,"
"EMT-I," and
"paramedic" have the same
meanings as in section 4765.01 of the Revised Code. (J) "Fixed wing air ambulance" means a fixed wing
aircraft operated that is specifically designed, constructed, or modified and equipped and is intended to be used as a means of air medical transportation. (K)
"Intermediate life support" means treatment described
in
section 4765.38 of the Revised Code that an EMT-I is
certified
to
perform. (L)
"Major emergency" means any emergency event that
cannot be resolved through the use of locally available emergency
resources. (M)
"Mass casualty" means an emergency event that results
in ten or more persons being injured, incapacitated, made ill, or
killed. (N)
"Medical emergency" means an unforeseen event
affecting an individual in such a manner that a need for
immediate
care is created. (O) "Mobile intensive care unit" means an
ambulance used
only for
maintaining specialized or intensive care treatment and
used primarily for
interhospital transports
of patients whose
conditions require care beyond the scope of a paramedic as
provided in section 4765.39 of the Revised Code. (P)(1)
"Nonemergency medical service organization" means a person that does both of the following: (a) Provides services to the
public on a regular
basis for
the purpose of transporting individuals who require the use of a wheelchair or are confined to a wheelchair to receive
health care services at health care facilities or health care
practitioners' offices in nonemergency circumstances; (b) Provides the services for a fee, regardless of whether
the fee is paid by the person being transported, a third party
payer, as defined in section 3702.51 of the Revised Code, or any
other person or government entity. (2) "Nonemergency medical service organization" does not include a health
care facility, as defined in section 1751.01 of the Revised Code,
that provides ambulette services only to patients of that
facility. (P)
"Mobile intensive care unit" means an
ambulance used
only for
maintaining specialized or intensive care treatment and
used primarily for
interhospital transports
of patients whose
conditions require care beyond the scope of a paramedic as
provided in section 4765.39 of the Revised Code.
(Q)
"Nontransport vehicle" means a motor vehicle operated
by a licensed
emergency
medical
service organization not as an
ambulance, but as a vehicle for providing
services in conjunction
with the ambulances operated by the organization or
other
emergency medical service organizations. (R)
"Patient" means any individual who as a result of
illness or injury needs medical attention, whose physical or
mental condition is such that there is imminent danger of
loss of
life or significant health impairment,
who may be otherwise
incapacitated or helpless as a result of a physical or mental
condition,
or whose physical condition requires the use of a
wheelchair. (S) "Rotorcraft air ambulance" means a helicopter or other
aircraft capable of vertical takeoffs, vertical landings, and
hovering that is specifically designed, constructed, or modified and equipped and is intended to be used as a means of air medical transportation. Sec. 4766.02. (A) There is hereby created the Ohio
medical transportation board, consisting of
nine
voting
members
and
one nonvoting member, who shall be
residents of
this state and
appointed by the governor with the
advice and
consent of the
senate. Except as provided in division
(B) of this
section,
members shall serve terms of two years. One
voting
member shall
be a member of the Ohio ambulance association;
two
voting
members, one of whom shall be a licensed funeral
director,
shall
be owners or operators of private emergency
medical service
organizations operating in this state; one
voting
member shall be
a consumer of emergency medical services who is
not associated
with any public or private emergency medical
service
organization;
one
voting member shall be an official
with a
public emergency
medical service organization; two voting
members shall
be
owners or
operators of nonemergency medical service
organizations
that
provide ambulette services only,; and two voting
members shall be members of the Ohio association of critical care
transport, one member representing air-based services and the
other representing a ground-based mobile intensive care unit
organization. A physician who
holds a
certificate to practice
issued under Chapter 4731. of the
Revised
Code and who is a member of
the American college of emergency
physicians shall serve as
the
nonvoting member.
The board
shall
annually select from its
membership a chair and a
vice-chair
to
act as chair in the chair's
absence. (B)
Any member appointed to fill a vacancy occurring prior to the
expiration
date of the term for which the member's predecessor was
appointed shall hold office for the remainder of that term. Every
member shall continue in office subsequent to the expiration date
of
the member's term until the member's
successor takes office, or
until a period of sixty days has elapsed, whichever
occurs first. (C)
Five members shall constitute a quorum for
the
transaction of business, and the affirmative vote of
five
members is required for the board to take any official
action.
The board, after notice and hearing, may remove a member
by
majority vote for malfeasance, misfeasance, or nonfeasance. Members of the board shall be reimbursed for actual and
necessary expenses incurred in attending meetings of the board
and
in the performance of their official duties. The board may
hire
such employees as are necessary to enable it to execute its
duties. (D) The division of emergency medical services within the
department of public safety shall provide the board with office
space, but the board shall not be a part of the
division or the
department. (E) The board is the sole supervisory body regarding the
licensing of private ambulance service organizations in this
state. (F)
The board is the sole supervisory body regarding the
licensing of private nonemergency medical service organizations in this state. (G) The board is the sole supervisory body regarding the
licensing of private air medical service organizations programs in this state. Sec. 4766.03. (A) The Ohio
medical
transportation board
shall adopt rules, in accordance with Chapter
119.
of the Revised Code,
implementing the requirements of this
chapter. The rules shall
include provisions relating to the
following: (1) Requirements for an emergency medical
service
organization to receive a permit for an
ambulance or nontransport
vehicle; (2) Requirements for an emergency
medical service
organization to receive a license as
a basic life-support,
intermediate life-support,
advanced life-support, or mobile
intensive care unit
organization; (3)
Requirements for a nonemergency medical service organization to
receive a
permit for an ambulette vehicle; (4)
Requirements for a nonemergency medical service organization to
receive a
license for an ambulette service; (5) Requirements for an air medical service organization program to
receive a permit for a rotorcraft air ambulance or fixed wing air
ambulance; (6) Requirements for licensure of air medical service
organizations programs; (7) Forms for applications and renewals of licenses and
permits; (8) Requirements for record keeping of service responses
made by licensed emergency medical
service organizations; (9) Fee amounts for licenses and permits, and their renewals
thereof; (10) Inspection requirements for licensees' vehicles
or
aircraft,
records, and physical facilities; (11) Fee amounts for inspections of ambulances,
ambulettes, rotorcraft air ambulances, fixed wing air ambulances,
and
nontransport vehicles; (12) Requirements for ambulances and nontransport
vehicles
used by licensed
emergency medical service organizations,
for ambulette vehicles
used by licensed nonemergency medical service
organizations, and for rotorcraft air ambulances or fixed wing air
ambulances used by licensed air medical service organizations programs that
specify for
each type of vehicle
or aircraft the types of
equipment that must
be carried, the communication systems that
must be maintained, and
the personnel who must staff the vehicle
or aircraft; (13) The level of care each type of emergency medical
service
organization, nonemergency medical service organization, and air
medical service organization program is
authorized to provide; (14)
Eligibility requirements for employment as an
ambulette
driver, including grounds for disqualification due to
the results of a motor
vehicle law violation check, chemical
test,
or criminal records check. The rule may require that an
applicant
for employment as an ambulette driver provide a set of
fingerprints to law enforcement authorities if the applicant comes
under final consideration for employment. (15) Any other rules that the board determines necessary
for
the implementation and enforcement of this chapter. (B) In the rules for ambulances and nontransport vehicles
adopted under division (A)(12) of this section, the board
may
establish requirements that vary according to whether the
emergency medical
service organization using the vehicles is
licensed as a basic life-support, intermediate life-support,
advanced life-support, or
mobile intensive care unit
organization. (C) A mobile intensive care unit that
is not dually
certified to provide advanced life-support and meets the
requirements
of the rules adopted under this section is not
required to carry
immobilization equipment, including board
splint
kits, traction
splints, backboards, backboard straps,
cervical
immobilization
devices, cervical collars, stairchairs stair chairs,
folding
cots, or other
types of immobilization equipment
determined by the
board to be
unnecessary for mobile intensive care units. A mobile intensive care unit is exempt from the
emergency
medical technician staffing requirements of division (B) of
section 4765.43 of the Revised Code when it is staffed
by at least
one physician or registered nurse and another person,
designated
by a physician, who holds a valid license or
certificate to
practice in a health care profession, and when at
least one of the
persons staffing the mobile intensive care unit
is a registered
nurse whose training meets or exceeds the
training required for a
paramedic. Sec. 4766.04. (A) Except as otherwise provided in this
chapter, no person shall furnish, operate, conduct, maintain,
advertise, engage in, or propose or profess to engage in the
business or service
in this state of transporting persons who are
seriously
ill, injured, or otherwise incapacitated
or who require the use of a wheelchair or are confined to a wheelchair
unless the
person is
licensed pursuant to this section. (B) To qualify for a license as a basic life-support,
intermediate life-support,
advanced life-support, or
mobile intensive care unit
organization, an emergency medical
service organization shall
do
all of the following: (1) Apply for a permit for each ambulance and nontransport
vehicle owned or leased as provided in
section 4766.07 of the
Revised Code; (2) Meet all requirements established in rules
adopted by
the Ohio
medical transportation board
regarding
ambulances and
nontransport vehicles, including
requirements
pertaining
to equipment, communications systems,
staffing, and
level of care the
particular organization is
permitted to render; (3) Maintain the appropriate type and amount of insurance
as specified in section 4766.06 of the Revised
Code; (4) Meet all other requirements established under rules
adopted by
the board for the particular license. (C) To
qualify for a license to provide ambulette
service, a nonemergency medical service
organization shall do all of the
following: (1)
Apply for a permit for each ambulette owned or leased as
provided in section 4766.07 of the Revised Code; (2)
Meet all requirements established in rules adopted by
the
Ohio
medical transportation board regarding
ambulettes,
including
requirements pertaining to equipment,
communication
systems,
staffing, and level of care the
organization
is
permitted to
render; (3)
Maintain the appropriate type and amount of insurance as specified in section 4766.06 of the Revised
Code; (4)
Meet all other requirements established under rules
adopted by
the board for the license. (D)
To qualify for a license to provide air medical
transportation, an the operator of an air medical service organization program shall do all
of the following: (1) Apply for a permit for each rotorcraft air ambulance and
fixed wing air ambulance owned or leased as provided in section
4766.07 of the Revised Code; (2) Meet all requirements established in rules adopted by the
Ohio medical transportation board regarding rotorcraft air
ambulances and fixed wing air ambulances, including requirements
pertaining to equipment, communication systems, staffing, and
level of care the organization program is permitted to render; (3) Maintain the appropriate type and amount of insurance as specified in section 4766.06 of the Revised
Code; (4) Meet all other requirements established under rules
adopted by the board for the license. (E)
An emergency medical service organization that applies
for a license as a basic life-support,
intermediate life-support,
advanced life-support, or mobile intensive care unit
organization; a nonemergency medical
service organization
that applies for a license to provide
ambulette
service; or an operator of an air medical service organization program that
applies for a license to provide air medical transportation shall
submit a completed application to
the board, on a form provided by
the board for each particular
license, together with the
appropriate fees established under
section 4766.05 of the Revised
Code. The application form shall
include all of the following: (1) The name and business address of the operator of the
organization or program for which licensure is sought; (2) The name under which the applicant will operate the
organization or program; (3) A list of the names and addresses of all officers and
directors of the organization or program; (4)
For emergency medical service organizations and nonemergency medical
service organizations, a description of each vehicle to be used,
including
the
make, model, year of manufacture, mileage, vehicle
identification
number, and the color scheme, insignia, name,
monogram, or other
distinguishing characteristics to be used to
designate the
applicant's vehicle; (5)
For air medical service organizations programs using fixed wing
air ambulances, a description of each aircraft to be used,
including the make, model, year of manufacture, and aircraft Hobbs
meter hour reading; (6) For air medical service organizations programs using rotorcraft
air ambulances, a description of each aircraft to be used,
including the make, model, year of manufacture, aircraft Hobbs
meter hour reading, aircraft identification number, and the color
scheme, insignia, name, monogram, or other distinguishing
characteristics to be used to designate the applicant's rotorcraft
air ambulance; (7) The location and description of each place from which
the organization or program will operate; (8) A description of the geographic area to be served by
the
applicant; (9) Any other information the board, by rule, determines
necessary. (F) Within sixty days after receiving a completed
application for licensure as a basic life-support, intermediate
life-support,
advanced life-support, or mobile
intensive care unit organization; an ambulette service; or an air
medical service organization program,
the
board shall approve or deny the
application. The board shall
deny an application if it determines
that the applicant does not
meet the requirements of this chapter
or any rules adopted
under it. The board shall send notice of the
denial
of an
application by certified mail to the applicant. The
applicant
may request a hearing within ten days after receipt of
the
notice. If the board receives a timely request, it
shall
hold
a hearing in accordance with Chapter 119. of the Revised
Code. (G) If an applicant or licensee operates or plans to
operate an organization in more than one location under the same
or different identities, the applicant or licensee shall apply
for
and meet all requirements for licensure or renewal of a
license,
other than payment of a license fee or renewal fee, for
operating
the organization at each separate location. An
applicant or
licensee that operates or plans to operate under the
same
organization identity in separate locations shall pay only a
single license fee. (H)
An emergency medical service organization that
wishes
to provide ambulette services to the public must apply for a
separate
license under division (C) of this section. (I) Each license issued under this section and each permit
issued under section 4766.07 of the Revised Code expires one year
after
the date of issuance and
may be renewed in accordance with
the
standard
renewal procedures of Chapter 4745.
of the Revised
Code, except that a license or permit issued in 1998
or in 1999
prior to
June
30, 1999, shall
expire two
years after the date of issuance. An application for
renewal shall
include the license or
permit
renewal fee
established under section
4766.05 of the Revised Code. An
applicant for renewal
of a permit also shall submit to the board
proof of an annual inspection
of
the vehicle
or aircraft for which
permit
renewal is sought. The board shall renew a license if the
applicant
meets the
requirements for licensure and shall renew a
permit if the applicant and
vehicle
or aircraft meet the
requirements to
maintain a permit for that vehicle
or aircraft. (J) Each licensee shall maintain accurate records of all
service responses conducted. The records shall be maintained
on
forms prescribed by the board and shall contain
information
as
specified by rule by the board. Sec. 4766.06. (A)(1) Every
emergency medical service
organization and nonemergency medical service organization licensee under this
chapter
shall furnish adequate evidence of liability insurance
coverage,
in an amount of not less than five hundred thousand
dollars per
occurrence and not less than five hundred thousand
dollars in the
aggregate, for any cause for which the licensee
would be liable. (2)
Every operator of an air medical service organization licensee program licensed under
this chapter shall furnish adequate evidence of liability
insurance coverage, in an amount not less than twenty million
dollars per occurrence and not less than twenty million dollars in
the aggregate, for any cause for which the licensee would be
liable. (B) In addition to the insurance requirements of
division
(A) of this section, every licensee shall carry bodily
injury and
property damage insurance with solvent and responsible
insurers
licensed to do business in this state for any loss or
damage
resulting from any occurrence arising out of or caused by
the
operation or use of any ambulance,
ambulette, rotorcraft air
ambulance, fixed wing air ambulance, or
nontransport
vehicle.
The
insurance shall insure each vehicle or aircraft for the sum of
not less
than
one hundred thousand dollars for bodily injury to or
death
of any
one person arising out of any one accident and the
sum of
not less
than three hundred thousand dollars for bodily
injury to
or death
of more than one person in any one accident and
for the
sum of
fifty thousand dollars for damage to property
arising from
any one
accident. (C) Each policy or contract of insurance issued shall
provide for the payment and satisfaction of any financial
judgment
entered against the licensee and any person operating
the vehicle or aircraft
and for a thirty-day cancellation notice to the
board. Sec. 4766.07. (A) Each emergency medical service organization, nonemergency medical service organization, and operator of an air medical
service organization program subject to licensure
under this chapter shall
possess a valid permit for each
ambulance,
ambulette, rotorcraft
air ambulance, fixed wing air ambulance, and
nontransport
vehicle
it owns or leases
that
is or will be used by the licensee
to
perform the services
permitted by the license. Each licensee
and
license applicant
shall submit the appropriate fee and an
application for a permit
for each ambulance,
ambulette, rotorcraft
air ambulance, fixed wing air ambulance,
and nontransport vehicle
to
the
Ohio
medical transportation board on
forms provided by
the
board.
The application shall include
documentation that the
vehicle
or aircraft meets the appropriate
standards set by the board, that the
vehicle
or aircraft has been
inspected pursuant to division
(C) of this
section, that the
permit applicant maintains
insurance as provided
in section 4766.06 of the Revised
Code,
and that the vehicle
or
aircraft and
permit applicant meet any other
requirements
established
under rules adopted by the
board. (B)(1) Within sixty days after receiving a completed
application for a permit, the board shall issue or deny the
permit. The board shall deny an application if it determines
that
the permit applicant, vehicle, or aircraft does not meet the
requirements of
this
chapter and the rules adopted under it that
apply to
permits
for ambulances,
ambulettes, rotorcraft air
ambulances, fixed wing air ambulances, and nontransport
vehicles.
The board
shall send notice of the denial of an application by
certified
mail to the
permit applicant. The permit applicant may
request a
hearing
within ten days after receipt of the notice. If
the
board
receives a timely request, it shall hold a hearing in
accordance
with Chapter 119. of the Revised Code. (2) If the board issues the vehicle permit
for an ambulance,
ambulette, or nontransport vehicle, it also shall
issue a decal,
in a form prescribed by rule, to be displayed on
the rear window
of the vehicle. The board shall not issue a
decal
until all of
the requirements for licensure and permit
issuance
have been met. (3) If the board issues the aircraft permit for a rotorcraft
air ambulance or fixed wing air ambulance, it also shall issue a
decal, in a form prescribed by rule, to be displayed on the left
fuselage aircraft window in a manner that complies with all
applicable federal aviation regulations. The board shall not
issue a decal until all of the requirements for licensure and
permit issuance have been met. (C) In addition to any other requirements that the board
establishes by rule, a licensee or license applicant applying for
an initial vehicle
or aircraft permit under division (A) of this
section
shall
submit to
the board the
vehicle
or aircraft for
which the permit is sought. Thereafter, a
licensee
shall annually
submit to
the
board
each vehicle
or aircraft for
which a permit has been issued. (1) The
board shall conduct a physical
inspection of an ambulance,
ambulette, or nontransport
vehicle to
determine its
roadworthiness and compliance with standard motor
vehicle
requirements. (2) The board shall conduct a physical inspection of the
medical equipment, communication system, and interior of
an
ambulance
to determine the
operational condition and safety of
the
equipment and the ambulance's interior and to
determine whether
the ambulance is in
compliance with the federal requirements for
ambulance
construction that
were in effect at the time
the
ambulance was manufactured,
as specified by
the general services
administration in the various
versions of its publication titled
"federal
specification for the star-of-life ambulance,
KKK-A-1822." (3)
The board shall conduct a physical inspection of the
equipment, communication system, and interior of an ambulette to
determine the
operational condition and safety of
the equipment
and the ambulette's interior and to determine
whether the
ambulette is in compliance with state requirements
for ambulette
construction.
The board shall determine by rule requirements for
the
equipment,
communication system, interior, and construction of
an
ambulette. (4) The board shall conduct a physical inspection of the
medical equipment, communication system, and interior of a
rotorcraft air ambulance or fixed wing air ambulance to determine
the operational condition and safety of the equipment and the
aircraft's interior. (5) The board
shall issue a
certificate to the applicant for each vehicle
or aircraft that
passes the
inspection and may assess a fee for each
inspection, as
established by the board. (6) The board shall adopt rules regarding the implementation and
coordination of
inspections.
The rules may permit the board to contract with a third party to
conduct the inspections required of the board under this section.
Sec. 4766.17. (A) An air medical service organization program
licensed under this chapter that uses a rotorcraft air ambulance shall do both of the following: (1) Use at a minimum both of the following to provide
advanced life support to seriously ill, injured, wounded, or
otherwise incapacitated or helpless individuals who require use of
a stretcher: (a) A paramedic a physician or registered nurse, both as defined in
section 4765.01 of the Revised Code;
(b) One, and one other person, designated by the medical director of
the air medical service organization program, who holds a current, valid
certificate or license to practice a health care profession in
this state.;
(2) Employ as a medical director 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. (B) An air medical program licensed under this chapter that uses a fixed wing air ambulance shall do both of the following: (1) Use at a minimum a person, designated by the medical director of the air medical program, who holds a current, valid certificate or license to practice a health care profession in the state; (2) Employ as a medical director a person who holds a current, valid certificate issued under Chapter 4731. of the Revised Code. (C) The medical director employed by a licensed air medical
service organization program pursuant to division (A)(2) of this section
is ultimately responsible for the medical care provided to each
patient by the organization program.
Sec. 4766.20. The Ohio medical transportation board may
create committees to review and make recommendations regarding
medical transportation services provided in this state. A
committee created under this section may receive information about
medical transportation services provided in this state from
emergency medical service organizations, nonemergency medical service
organizations, air medical service organizations programs, experts in the
field of medical transportation, and other entities or individuals
designated by the board. A committee created under this section shall meet all of the
following requirements: (A) Be composed of at least one member of the board and any
experts in the field of medical transportation designated by the
board; (B) Not exceed a total of six members; (C) Cease to exist at the pleasure of the board; (D) Meet any other requirements established by the board.
Section 2. That existing sections 4765.05, 4765.11, 4765.16, 4766.01, 4766.02, 4766.03, 4766.04, 4766.06, 4766.07, 4766.17, and 4766.20 of the Revised Code are hereby repealed.
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