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Am. Sub. H. B. No. 284 As Enrolled
(129th General Assembly)
(Amended Substitute House Bill Number 284)
AN ACT
To amend sections 2133.211, 3719.06, 4730.06,
4730.09, 4730.10, 4730.11, 4730.38, 4730.39,
4730.40, 4730.41, 4730.42, 4730.44, 4730.46,
4755.48, 4755.481, 4757.41,
4758.01, 4758.02, 4758.10, 4758.20, 4758.21, 4758.22, 4758.23,
4758.24, 4758.26, 4758.27, 4758.30, 4758.40, 4758.41, 4758.42,
4758.43, 4758.44, 4758.45, 4758.51, 4758.55, 4758.56, 4758.59,
4758.61, 4758.70, 4765.01, 4765.35, 4765.36,
4765.37, 4765.38, 4765.39, 4765.49, and 4765.51,
to enact sections 4723.36, 4730.04, 4730.092, 4730.411, 4758.221,
4758.241, 4758.39, 4758.46, 4758.47, 4758.52, 4758.54, and
4758.561, and to repeal sections 3793.07, 4730.401 , 4758.04, 4758.53, and 4758.58 of the
Revised Code to modify the laws governing
physician assistants, to authorize certain
nurses to determine and pronounce death under
specified circumstances, and
to revise the laws governing the professions of chemical
dependency counseling and alcohol and other drug prevention.
Be it enacted by the General Assembly of the State of Ohio:
SECTION 1. That sections 2133.211, 3719.06, 4730.06,
4730.09, 4730.10, 4730.11, 4730.38, 4730.39, 4730.40, 4730.41,
4730.42, 4730.44, 4730.46, 4755.48, 4755.481, 4757.41, 4758.01,
4758.02, 4758.10, 4758.20, 4758.21, 4758.22, 4758.23, 4758.24,
4758.26, 4758.27, 4758.30, 4758.40, 4758.41, 4758.42, 4758.43,
4758.44, 4758.45, 4758.51, 4758.55, 4758.56, 4758.59, 4758.61,
4758.70, 4765.01, 4765.35,
4765.36, 4765.37, 4765.38, 4765.39, 4765.49, and 4765.51 be
amended and sections 4723.36, 4730.04, 4730.092, 4730.411,
4758.221, 4758.241, 4758.39, 4758.46, 4758.47, 4758.52, 4758.54,
and 4758.561 of
the Revised Code be enacted to read as follows:
Sec. 2133.211. A person who holds a certificate of authority
to practice as a certified nurse practitioner or clinical nurse
specialist issued under section 4723.42 of the Revised Code may
take any action that may be taken by an attending physician under
sections 2133.21 to 2133.26 of the Revised Code and has the
immunity provided by section 2133.22 of the Revised Code if the
action is taken pursuant to a standard care arrangement with a
collaborating physician.
A person who holds a certificate to practice as a physician
assistant issued under Chapter 4730. of the Revised Code may take
any action that may be taken by an attending physician under
sections 2133.21 to 2133.26 of the Revised Code and has the
immunity provided by section 2133.22 of the Revised Code if the
action is taken pursuant to a physician supervisory plan approved
pursuant to section 4730.17 of the Revised Code or the policies of
a health care facility in which the physician assistant is
practicing.
Sec. 3719.06. (A)(1) A licensed health professional
authorized to prescribe drugs, if acting in the course of
professional practice, in accordance with the laws regulating the
professional's practice, and in accordance with rules adopted by
the state board of pharmacy, may, except as provided in division
(A)(2) or (3) of this section, do the following:
(a) Prescribe schedule II, III, IV, and V controlled
substances;
(b) Administer or personally furnish to patients schedule II,
III, IV, and V controlled substances;
(c) Cause schedule II, III, IV, and V controlled substances
to be administered under the prescriber's direction and
supervision.
(2) A licensed health professional authorized to prescribe
drugs who is a clinical nurse specialist, certified nurse-midwife,
or certified nurse practitioner is subject to both of the
following:
(a) A schedule II controlled substance may be prescribed only
in accordance with division (C) of section 4723.481 of the Revised
Code.
(b) No schedule II controlled substance shall be personally
furnished to any patient.
(3) A licensed health professional authorized to prescribe
drugs who is a physician assistant shall not prescribe or
personally furnish to patients any is subject to all of the
following:
(a) A controlled substance that is not may be prescribed or
personally furnished only if it is included in the
physician-delegated prescriptive authority granted to the
physician assistant in accordance with Chapter 4730. of the
Revised Code.
(b) A schedule II controlled substance may be prescribed only
in accordance with division (B)(4) of section 4730.41 and section
4730.411 of the Revised Code.
(c) No schedule II controlled substance shall be personally
furnished to any patient.
(B) No licensed health professional authorized to prescribe
drugs shall prescribe, administer, or personally furnish a
schedule III anabolic steroid for the purpose of human muscle
building or enhancing human athletic performance and no pharmacist
shall dispense a schedule III anabolic steroid for either purpose,
unless it has been approved for that purpose under the "Federal
Food, Drug, and Cosmetic Act," 52 Stat. 1040 (1938), 21 U.S.C.A.
301, as amended.
(C) Each written prescription shall be properly executed,
dated, and signed by the prescriber on the day when issued and
shall bear the full name and address of the person for whom, or
the owner of the animal for which, the controlled substance is
prescribed and the full name, address, and registry number under
the federal drug abuse control laws of the prescriber. If the
prescription is for an animal, it shall state the species of the
animal for which the controlled substance is prescribed.
Sec. 4723.36. (A) A certified nurse practitioner or clinical
nurse specialist may determine and pronounce an individual's
death, but only if the individual's respiratory and circulatory
functions are not being artificially sustained and, at the time
the determination and pronouncement of death is made, either or
both of the following apply:
(1) The individual was receiving care in one of the
following:
(a) A nursing home licensed under section 3721.02 of the
Revised Code or by a political subdivision under section 3721.09
of the Revised Code;
(b) A residential care facility or home for the aging
licensed under Chapter 3721. of the Revised Code;
(c) A county home or district home operated pursuant to
Chapter 5155. of the Revised Code;
(d) A residential facility licensed under section 5123.19 of
the Revised Code.
(2) The certified nurse practitioner or clinical nurse
specialist is providing or supervising the individual's care
through a hospice care program licensed under Chapter 3712. of the
Revised Code or any other entity that provides palliative care.
(B) A registered nurse may determine and pronounce an
individual's death, but only if the individual's respiratory and
circulatory functions are not being artificially sustained and, at
the time the determination and pronouncement of death is made, the
registered nurse is providing or supervising the individual's care
through a hospice care program licensed under Chapter 3712. of the
Revised Code or any other entity that provides palliative care.
(C) If a certified nurse practitioner, clinical nurse
specialist, or registered nurse determines and pronounces an
individual's death, the nurse shall comply with both of the
following:
(1) The nurse shall not complete any portion of the
individual's death certificate.
(2) The nurse shall notify the individual's attending
physician of the determination and pronouncement of death in order
for the physician to fulfill the physician's duties under section
3705.16 of the Revised Code. The nurse shall provide the
notification within a period of time that is reasonable but not
later than twenty-four hours following the determination and
pronouncement of the individual's death.
Sec. 4730.04. (A) As used in this section:
(1) "Disaster" means any imminent threat or actual occurrence
of widespread or severe damage to or loss of property, personal
hardship or injury, or loss of life that results from any natural
phenomenon or act of a human.
(2) "Emergency" means an occurrence or event that poses an
imminent threat to the health or life of a human.
(B) Nothing in this chapter prohibits any of the following
individuals from providing medical care, to the extent the
individual is able, in response to a need for medical care
precipitated by a disaster or emergency:
(1) An individual who holds a certificate to practice as a
physician assistant issued under this chapter;
(2) An individual licensed or authorized to practice as a
physician assistant in another state;
(3) An individual credentialed or employed as a physician
assistant by an agency, office, or other instrumentality of the
federal government.
(C) For purposes of the medical care provided by a physician
assistant pursuant to division (B)(1) of this section, both of the
following apply notwithstanding any supervision requirement of
this chapter to the contrary:
(1) The physician who supervises the physician assistant
pursuant to a physician supervisory plan approved by the state
medical board under section 4730.17 of the Revised Code is not
required to meet the supervision requirements established under
this chapter.
(2) The physician designated as the medical director of the
disaster or emergency may supervise the medical care provided by
the physician assistant.
Sec. 4730.06. (A) The physician assistant policy committee
of the state medical board shall review, and shall submit to the
board recommendations concerning, all of the following:
(1) Requirements for issuance of certificates to practice as
a physician assistant, including the educational requirements that
must be met to receive a certificate to practice;
(2) Existing and proposed rules pertaining to the practice of
physician assistants, the supervisory relationship between
physician assistants and supervising physicians, and the
administration and enforcement of this chapter;
(3) Physician-delegated In accordance with section 4730.38 of
the Revised Code, physician-delegated prescriptive authority for
physician assistants, in accordance with and proposed changes to
the physician assistant formulary the board adopts pursuant to
division (A)(1) of section 4730.38 4730.39 of the Revised Code;
(4) Application procedures and forms for certificates to
practice as a physician assistant, physician supervisory plans,
and supervision agreements;
(5) Fees required by this chapter for issuance and renewal of
certificates to practice as a physician assistant;
(6) Criteria to be included in applications submitted to the
board for approval of physician supervisory plans, including
criteria to be included in applications for approval to delegate
to physician assistants the performance of special services;
(7) Criteria to be included in supervision agreements
submitted to the board for approval and renewal of the board's
approval;
(8) Any issue the board asks the committee to consider.
(B) In addition to the matters that are required to be
reviewed under division (A) of this section, the committee may
review, and may submit to the board recommendations concerning,
either or both of the following:
(1) Quality assurance activities to be performed by a
supervising physician and physician assistant under a quality
assurance system established pursuant to division (F) of section
4730.21 of the Revised Code;
(2) The development and approval of one or more model
physician supervisory plans and one or more models for a special
services portion of the one or more model physician supervisory
plans. The committee may submit recommendations for model plans
that reflect various medical specialties.
(C) The board shall take into consideration all
recommendations submitted by the committee. Not later than ninety
days after receiving a recommendation from the committee, the
board shall approve or disapprove the recommendation and notify
the committee of its decision. If a recommendation is disapproved,
the board shall inform the committee of its reasons for making
that decision. The committee may resubmit the recommendation after
addressing the concerns expressed by the board and modifying the
disapproved recommendation accordingly. Not later than ninety days
after receiving a resubmitted recommendation, the board shall
approve or disapprove the recommendation. There is no limit on the
number of times the committee may resubmit a recommendation for
consideration by the board.
(D)(1) Except as provided in division (D)(2) of this section,
the board may not take action regarding a matter that is subject
to the committee's review under division (A) or (B) of this
section unless the committee has made a recommendation to the
board concerning the matter.
(2) If the board submits to the committee a request for a
recommendation regarding a matter that is subject to the
committee's review under division (A) or (B) of this section, and
the committee does not provide a recommendation before the
sixty-first day after the request is submitted, the board may take
action regarding the matter without a recommendation.
Sec. 4730.09. (A) Under a physician supervisory plan approved
under section 4730.17 of the Revised Code, a physician assistant
may provide any or all of the following services without approval
by the state medical board as special services:
(1) Obtaining comprehensive patient histories;
(2) Performing physical examinations, including audiometry
screening, routine visual screening, and pelvic, rectal, and
genital-urinary examinations, when indicated;
(3) Ordering, performing, or ordering and performing routine
diagnostic procedures, as indicated;
(4) Identifying normal and abnormal findings on histories,
physical examinations, and commonly performed diagnostic studies;
(5) Assessing patients and developing and implementing
treatment plans for patients;
(6) Monitoring the effectiveness of therapeutic
interventions;
(7) Exercising physician-delegated prescriptive authority
pursuant to a certificate to prescribe issued under this chapter;
(8) Carrying out or relaying the supervising physician's
orders for the administration of medication, to the extent
permitted by law;
(9) Providing patient education;
(10) Instituting and changing orders on patient charts;
(11) Performing developmental screening examinations on
children with regard to neurological, motor, and mental functions;
(12) Performing wound care management, suturing minor
lacerations and removing the sutures, and incision and drainage of
uncomplicated superficial abscesses;
(13) Removing superficial foreign bodies;
(14) Administering intravenous fluids;
(15) Inserting a foley or cudae catheter into the urinary
bladder and removing the catheter;
(16) Removing intrauterine devices;
(17) Performing biopsies of superficial lesions;
(18)(17) Making appropriate referrals as directed by the
supervising physician;
(19) Removing norplant capsules;
(20)(18) Performing penile duplex ultrasound;
(21)(19) Changing of a tracheostomy;
(22)(20) Performing bone marrow aspirations from the
posterior iliac crest;
(23)(21) Performing bone marrow biopsies from the posterior
iliac crest;
(24)(22) Performing cystograms;
(25)(23) Performing nephrostograms after physician placement
of nephrostomy tubes;
(26)(24) Fitting or, inserting family planning, or removing
birth control devices, including intrauterine devices, diaphragms,
and cervical caps;
(27)(25) Removing cervical polyps;
(28)(26) Performing nerve conduction testing;
(29)(27) Performing endometrial biopsies;
(30)(28) Inserting filiform and follower catheters;
(31)(29) Performing arthrocentesis of the knee;
(32)(30) Performing knee joint injections;
(33)(31) Performing endotracheal intubation with successful
completion of an advanced cardiac life support course;
(34)(32) Performing lumbar punctures;
(35)(33) In accordance with rules adopted by the board, using
light-based medical devices for the purpose of hair removal;
(36)(34) Administering, monitoring, or maintaining local
anesthesia, as defined in section 4730.091 of the Revised Code;
(37)(35) Applying or removing a cast or splint;
(38)(36) Inserting or removing chest tubes;
(37) Prescribing physical therapy or referring a patient to a
physical therapist for the purpose of receiving physical therapy;
(38) Ordering occupational therapy or referring a patient to
an occupational therapist for the purpose of receiving
occupational therapy;
(39) Taking any action that may be taken by an attending
physician under sections 2133.21 to 2133.26 of the Revised Code,
as specified in section 2133.211 of the Revised Code;
(40) Determining and pronouncing death in accordance with
section 4730.092 of the Revised Code;
(41) Performing other services that are within the
supervising physician's normal course of practice and expertise,
if the services are included in any model physician supervisory
plan approved under section 4730.06 of the Revised Code or the
services are designated by the board by rule or other means as
services that are not subject to approval as special services.
(B) Under the policies of a health care facility, the
services a physician assistant may provide are limited to the
services the facility has authorized the physician assistant to
provide for the facility. The services a health care facility may
authorize a physician assistant to provide for the facility
include the following:
(1) Any or all of the services specified in division (A) of
this section;
(2) Assisting in surgery in the health care facility;
(3) Any other services permitted by the policies of the
health care facility, except that the facility may not authorize a
physician assistant to perform a service that is prohibited by
this chapter.
Sec. 4730.092. (A) A physician assistant may determine and
pronounce an individual's death, but only if the individual's
respiratory and circulatory functions are not being artificially
sustained and, at the time the determination and pronouncement of
death is made, either or both of the following apply:
(1) The individual was receiving care in one of the
following:
(a) A nursing home licensed under section 3721.02 of the
Revised Code or by a political subdivision under section 3721.09
of the Revised Code;
(b) A residential care facility or home for the aging
licensed under Chapter 3721. of the Revised Code;
(c) A county home or district home operated pursuant to
Chapter 5155. of the Revised Code;
(d) A residential facility licensed under section 5123.19 of
the Revised Code.
(2) The physician assistant is providing or supervising the
individual's care through a hospice care program licensed under
Chapter 3712. of the Revised Code or any other entity that
provides palliative care.
(B) If a physician assistant determines and pronounces an
individual's death, the physician assistant shall comply with both
of the following:
(1) The physician assistant shall not complete any portion of
the individual's death certificate.
(2) The physician assistant shall notify the individual's
attending physician of the determination and pronouncement of
death in order for the physician to fulfill the physician's duties
under section 3705.16 of the Revised Code. The physician assistant
shall provide the notification within a period of time that is
reasonable but not later than twenty-four hours following the
determination and pronouncement of the individual's death.
Sec. 4730.10. (A) An individual seeking a certificate to
practice as a physician assistant shall file with the state
medical board a written application on a form prescribed and
supplied by the board. The application shall include all of the
following:
(1) The applicant's name, residential address, business
address, if any, and social security number;
(2) Satisfactory proof that the applicant meets the age and
moral character requirements specified in divisions (A)(1) and (2)
of section 4730.11 of the Revised Code;
(3) Effective January 1, 2008, except as provided in division
(B) of section 4730.11 of the Revised Code, satisfactory
Satisfactory proof that the applicant meets one of either the
educational requirements specified in division (A)(4) (B)(1) or
(2) of section 4730.11 of the Revised Code or the educational or
other applicable requirements specified in division (C)(1), (2),
or (3) of that section;
(4) Any other information the board requires.
(B) At the time of making application for a certificate to
practice, the applicant shall pay the board a fee of two hundred
dollars, no part of which shall be returned. Such The fees shall
be deposited in accordance with section 4731.24 of the Revised
Code.
Sec. 4730.11. (A) For an individual to To be eligible to
receive a certificate to practice as a physician assistant, all of
the following apply to an applicant:
(1) The applicant shall be at least eighteen years of age.
(2) The applicant shall be of good moral character.
(3) The applicant shall hold current certification by the
national commission on certification of physician assistants or a
successor organization that is recognized by the state medical
board.
(4) The applicant shall meet either of the following
requirements:
(a) The educational requirements specified in division (B)(1)
or (2) of this section;
(b) The educational or other applicable requirements
specified in division (C)(1), (2), or (3) of this section.
(B) Effective January 1, 2008, except as provided in for
purposes of division
(B)(A)(4)(a) of this section, the an
applicant shall meet one either of the following educational
requirements:
(a)(1) The applicant shall hold a master's or higher degree
that was obtained from a program accredited by the accreditation
review commission on education for the physician assistant or a
predecessor or successor organization recognized by the board.
(b)(2) The applicant shall hold a both of the following
degrees:
(a) A degree other than a master's or higher degree that was
obtained from a program accredited by the accreditation review
commission on education for the physician assistant or a
predecessor or successor organization recognized by the board and
shall hold a;
(b) A master's or higher degree in a course of study with
clinical relevance to the practice of physician assistants that
was and obtained from a program accredited by a regional or
specialized and professional accrediting agency recognized by the
council for higher education accreditation.
(B) It is not necessary for an applicant to hold a master's
or higher degree as a condition of receiving a certificate to
practice as a physician assistant if the applicant presents
(C)
For purposes of division (A)(4)(b) of this section, an applicant
shall present evidence satisfactory to the board of holding either
meeting one of the following requirements in lieu of meeting the
educational requirements specified in division (B)(1) or (2) of
this section:
(1) A The applicant shall hold a current, valid license or
other form of authority to practice as a physician assistant that
was issued by another jurisdiction prior to January 1, 2008;.
(2) A degree, other than a master's or higher degree, that is
The applicant shall hold a degree obtained as a result of being
enrolled on January 1, 2008, in a program in this state that was
accredited by the accreditation review commission on education for
the physician assistant but did not grant a master's or higher
degree to individuals enrolled in the program on that date, and
completing the program on or before December 31, 2009.
(C)(3) The applicant shall meet both of the following
educational and military experience requirements:
(a) Hold a degree obtained from a program accredited by the
accreditation review commission on education for the physician
assistant;
(b) Have experience practicing as a physician assistant for
at least three consecutive years while on active duty, with
evidence of service under honorable conditions, in any of the
armed forces of the United States or the national guard of any
state, including any experience attained while practicing as a
physician assistant at a health care facility or clinic operated
by the United States department of veterans affairs.
(D) This section does not require an individual to obtain a
master's or higher degree as a condition of retaining or renewing
a certificate to practice as a physician assistant if any
the
individual received the certificate without holding a master's or
higher degree as provided in either of the following apply:
(1) Prior to Before the educational requirements specified in
division (B)(1) or (2) of this section became effective January 1,
2008, the individual received a certificate to practice as a
physician assistant under this chapter without holding a master's
or higher degree.;
(2) On or after January 1, 2008, the individual received a
certificate to practice as a physician assistant under this
chapter on the basis of holding a license issued in another
jurisdiction, as specified in division (B)(1) of this section.
(3) On or after January 1, 2008, the individual received a
certificate to practice as a physician assistant under this
chapter on the basis of obtaining a degree as specified in
division (B)(2) By meeting the educational or other applicable
requirements specified in division (C)(1), (2), or (3) of this
section.
Sec. 4730.38. (A) Not later than six months after the
effective date Except as provided in division (B) of this section,
the physician assistant policy committee of the state medical
board shall, at such times the committee determines to be
necessary, submit to the board its initial recommendations
regarding physician-delegated prescriptive authority for physician
assistants. The committee's recommendations shall address all both
of the following:
(1) Policy and procedures regarding physician-delegated
prescriptive authority, including the issuance of certificates to
prescribe under this chapter;
(2) Subject to the limitations specified in section 4730.40
of the Revised Code, a formulary listing the drugs and therapeutic
devices by class and specific nomenclature that a supervising
physician may include in the physician-delegated prescriptive
authority granted to a physician assistant who holds a certificate
to prescribe issued under this chapter;
(3) Any issue the committee considers necessary to assist the
board in fulfilling its duty to adopt rules governing
physician-delegated prescriptive authority, including the issuance
of certificates to prescribe.
(B) After the board's adoption of initial rules under section
4730.39 of the Revised Code, the committee shall conduct an annual
review of its recommendations regarding physician-delegated
prescriptive authority. Based on its review, the committee shall
submit recommendations to the board as the committee considers
necessary Not less than every six months beginning on the first
day of June following the effective date of this amendment, the
committee shall review the physician assistant formulary the board
adopts pursuant to division (A)(1) of section 4730.39 of the
Revised Code and, to the extent it determines to be necessary,
submit recommendations proposing changes to the formulary.
(C) Recommendations submitted under this section are subject
to the procedures and time frames specified in division (C) of
section 4730.06 of the Revised Code.
Sec. 4730.39. (A) Not later than six months after receiving
the initial recommendations of the physician assistant policy
committee submitted pursuant to division (A) of section 4730.38 of
the Revised Code, the The state medical board shall adopt do both
of the following:
(1) Adopt a formulary listing the drugs and therapeutic
devices by class and specific generic nomenclature that a
physician may include in the physician-delegated prescriptive
authority granted to a physician assistant who holds a certificate
to prescribe under this chapter;
(2) Adopt rules governing physician-delegated prescriptive
authority for physician assistants, including the issuance of
certificates to prescribe under this chapter. The
(B) The board's rules governing physician-delegated
prescriptive authority adopted pursuant to division (A)(2) of this
section shall be adopted in accordance with Chapter 119. of the
Revised Code and shall establish all of the following:
(1) Subject to the limitations specified in section 4730.40
of the Revised Code, a formulary listing the drugs and therapeutic
devices by class and specific generic nomenclature that a
physician may include in the physician-delegated prescriptive
authority granted to a physician assistant who holds a certificate
to prescribe under this chapter;
(2) Requirements regarding the pharmacology courses that a
physician assistant is required to complete to receive a
certificate to prescribe;
(3)(2) Standards and procedures for the issuance and renewal
of certificates to prescribe to physician assistants;
(4)(3) Standards and procedures for the appropriate conduct
of the provisional period that a physician assistant is required
to complete pursuant to section 4730.45 of the Revised Code and
for determining whether a physician assistant has successfully
completed the provisional period;
(5)(4) A specific prohibition against prescribing any drug or
device to perform or induce an abortion;
(6)(5) Standards and procedures to be followed by a physician
assistant in personally furnishing samples of drugs or complete or
partial supplies of drugs to patients under section 4730.43 of the
Revised Code;
(7)(6) Any other requirements the board considers necessary
to implement the provisions of this chapter regarding
physician-delegated prescriptive authority and the issuance of
certificates to prescribe.
(B)(C)(1) After adopting the initial rules considering
recommendations submitted by the physician assistant policy
committee pursuant to sections 4730.06 and 4730.38 of the Revised
Code, the board shall conduct an annual review either or both of
the rules. Based following, as appropriate according to the
submitted recommendations:
(a) The formulary the board adopts under division (A)(1) of
this section;
(b) The rules the board adopts under division (A)(2) of this
section regarding physician-delegated prescriptive authority.
(2) Based on its review, the board shall make any necessary
modifications to the formulary or rules.
(C) All rules adopted under this section shall be adopted in
accordance with Chapter 119. of the Revised Code. When adopting
the initial rules, the board shall consider the recommendations of
the physician assistant policy committee submitted pursuant to
division (A) of section 4730.38 of the Revised Code. When making
any modifications to the rules subsequent to its annual review of
the rules, the board shall consider the committee's
recommendations submitted pursuant to division (B) of section
4730.38 of the Revised Code.
Sec. 4730.40. (A) Subject to divisions division (B) and (C)
of this section, the physician assistant formulary established
adopted by the state medical board in rules adopted under section
4730.39 of the Revised Code
listing the drugs and therapeutic
devices by class and specific nomenclature that a supervising
physician may include in the physician-delegated prescriptive
authority granted to a physician assistant who holds a certificate
to prescribe issued under this chapter may include any or all of
the following drugs:
(1) Schedule II, III, IV, and V controlled substances;
(2) Drugs that under state or federal law may be dispensed
only pursuant to a prescription by a licensed health professional
authorized to prescribe drugs, as defined in section 4729.01 of
the Revised Code;
(3) Any drug that is not a dangerous drug, as defined in
section 4729.01 of the Revised Code.
(B) The formulary established in the board's rules adopted by
the board shall not include, and shall specify that it does not
include, the following:
(1) Any schedule II controlled substance;
(2) Any any drug or device used to perform or induce an
abortion.
(C) When adopting rules establishing the initial formulary,
the board shall include provisions ensuring that a physician
assistant who holds a certificate to prescribe issued under this
chapter may be granted physician-delegated prescriptive authority
for all drugs and therapeutic devices that may be prescribed on
the effective date of the rules by a holder of a certificate to
prescribe issued by the board of nursing under Chapter 4723. of
the Revised Code, with the exception of schedule II controlled
substances. To the extent permitted by division (A) of this
section, the initial formulary may include additional drugs or
therapeutic devices.
Sec. 4730.41. (A) A certificate to prescribe issued under
this chapter authorizes a physician assistant to prescribe and
personally furnish drugs and therapeutic devices in the exercise
of physician-delegated prescriptive authority.
(B) In exercising physician-delegated prescriptive authority,
a physician assistant is subject to all of the following:
(1) The physician assistant shall exercise
physician-delegated prescriptive authority only to the extent that
the physician supervising the physician assistant has granted that
authority.
(2) The physician assistant shall comply with all conditions
placed on the physician-delegated prescriptive authority, as
specified by the supervising physician who is supervising the
physician assistant in the exercise of physician-delegated
prescriptive authority.
(3) If the physician assistant possesses physician-delegated
prescriptive authority for controlled substances, the physician
assistant shall register with the federal drug enforcement
administration.
(4) If the physician assistant possesses physician-delegated
prescriptive authority for schedule II controlled substances, the
physician assistant shall comply with section 4730.411 of the
Revised Code.
Sec. 4730.411. (A) Except as provided in division (B) or (C)
of this section, a physician assistant may prescribe to a patient
a schedule II controlled substance only if all of the following
are the case:
(1) The patient is in a terminal condition, as defined in
section 2133.01 of the Revised Code.
(2) The physician assistant's supervising physician initially
prescribed the substance for the patient.
(3) The prescription is for an amount that does not exceed
the amount necessary for the patient's use in a single,
twenty-four-hour period.
(B) The restrictions on prescriptive authority in division
(A) of this section do not apply if a physician assistant issues
the prescription to the patient from any of the following
locations:
(1) A hospital registered under section 3701.07 of the
Revised Code;
(2) An entity owned or controlled, in whole or in part, by a
hospital or by an entity that owns or controls, in whole or in
part, one or more hospitals;
(3) A health care facility operated by the department of
mental health or the department of developmental disabilities;
(4) A nursing home licensed under section 3721.02 of the
Revised Code or by a political subdivision certified under section
3721.09 of the Revised Code;
(5) A county home or district home operated under Chapter
5155. of the Revised Code that is certified under the medicare or
medicaid program;
(6) A hospice care program, as defined in section 3712.01 of
the Revised Code;
(7) A community mental health agency, as defined in section
5122.01 of the Revised Code;
(8) An ambulatory surgical facility, as defined in section
3702.30 of the Revised Code;
(9) A freestanding birthing center, as defined in section
3702.51 of the Revised Code;
(10) A federally qualified health center, as defined in
section 3701.047 of the Revised Code;
(11) A federally qualified health center look-alike, as
defined in section 3701.047 of the Revised Code;
(12) A health care office or facility operated by the board
of health of a city or general health district or the authority
having the duties of a board of health under section 3709.05 of
the Revised Code;
(13) A site where a medical practice is operated, but only if
the practice is comprised of one or more physicians who also are
owners of the practice; the practice is organized to provide
direct patient care; and the physician assistant has entered into
a supervisory agreement with at least one of the physician owners
who practices primarily at that site.
(C) A physician assistant shall not issue to a patient a
prescription for a schedule II controlled substance from a
convenience care clinic even if the convenience care clinic is
owned or operated by an entity specified in division (B) of this
section.
(D) A pharmacist who acts in good faith reliance on a
prescription issued by a physician assistant under division (B) of
this section is not liable for or subject to any of the following
for relying on the prescription: damages in any civil action,
prosecution in any criminal proceeding, or professional
disciplinary action by the state board of pharmacy under Chapter
4729. of the Revised Code.
Sec. 4730.42. (A) In granting physician-delegated
prescriptive authority to a particular physician assistant who
holds a certificate to prescribe issued under this chapter, the
supervising physician is subject to all of the following:
(1) The supervising physician shall not grant
physician-delegated prescriptive authority for any drug or
therapeutic device that is not listed on the physician assistant
formulary established in rules adopted under section 4730.39 of
the Revised Code as a drug or therapeutic device that may be
included in the physician-delegated prescriptive authority granted
to a physician assistant.
(2) The supervising physician shall not grant
physician-delegated prescriptive authority for any drug or device
that may be used to perform or induce an abortion.
(3) The supervising physician shall not grant
physician-delegated prescriptive authority in a manner that
exceeds the supervising physician's prescriptive authority,
including the physician's authority to treat chronic pain with
controlled substances and products containing tramadol as
described in section 4731.052 of the Revised Code.
(4) The supervising physician shall supervise the physician
assistant in accordance with all of the following:
(a) The supervision requirements specified in section 4730.21
of the Revised Code and, in the case of supervision provided
during a provisional period of physician-delegated prescriptive
authority, the supervision requirements specified in section
4730.45 of the Revised Code;
(b) The physician supervisory plan approved for the
supervising physician or the policies of the health care facility
in which the physician and physician assistant are practicing;
(c) The supervision agreement approved under section 4730.19
of the Revised Code that applies to the supervising physician and
the physician assistant.
(B)(1) The supervising physician of a physician assistant may
place conditions on the physician-delegated prescriptive authority
granted to the physician assistant. If conditions are placed on
that authority, the supervising physician shall maintain a written
record of the conditions and make the record available to the
state medical board on request.
(2) The conditions that a supervising physician may place on
the physician-delegated prescriptive authority granted to a
physician assistant include the following:
(a) Identification by class and specific generic nomenclature
of drugs and therapeutic devices that the physician chooses not to
permit the physician assistant to prescribe;
(b) Limitations on the dosage units or refills that the
physician assistant is authorized to prescribe;
(c) Specification of circumstances under which the physician
assistant is required to refer patients to the supervising
physician or another physician when exercising physician-delegated
prescriptive authority;
(d) Responsibilities to be fulfilled by the physician in
supervising the physician assistant that are not otherwise
specified in the physician supervisory plan or otherwise required
by this chapter.
Sec. 4730.44. (A) A physician assistant seeking a certificate
to prescribe shall submit to the state medical board a written
application on a form prescribed and supplied by the board. The
application shall include all of the following information:
(1) The applicant's name, residential address, business
address, if any, and social security number;
(2) Evidence of holding a valid certificate to practice as a
physician assistant issued under this chapter;
(3) Satisfactory proof that the applicant meets the
requirements specified in section 4730.46 of the Revised Code to
participate in a provisional period of physician-delegated
prescriptive authority or satisfactory proof of successful
completion of the provisional period, evidenced by a letter or
copy of a letter attesting to the successful completion written by
a supervising physician of the physician assistant at the time of
completion of eligibility to receive a certificate to prescribe by
meeting one of the requirements specified in division (B) of this
section;
(4) Any other information the board requires.
(B) To be eligible to receive a certificate to prescribe, an
applicant shall meet one of the following requirements:
(1) In the case of an applicant seeking to participate in a
provisional period of physician-delegated prescriptive authority
under section 4730.45 of the Revised Code, the applicant must meet
the requirements to participate in the provisional period, as
specified in section 4730.46 of the Revised Code.
(2) In the case of an applicant seeking a certificate to
prescribe after participating in a provisional period of
physician-delegated prescriptive authority, the applicant must
have successfully completed the provisional period, evidenced by a
letter or copy of a letter attesting to the successful completion
written by a physician who supervised the applicant at the time of
completion.
(3) In the case of an applicant who received a certificate to
practice by meeting the educational and military experience
requirements specified in division (C)(3) of section 4730.11 of
the Revised Code, the applicant must have been authorized to
prescribe drugs and therapeutic devices while practicing as a
physician assistant.
(4) In the case of an applicant who is not seeking a
certificate to prescribe by meeting the requirements of division
(B)(1), (2), or (3) of this section and has practiced as a
physician assistant in another state or was credentialed or
employed as a physician assistant by the United States government,
the applicant must meet both of the following requirements:
(a) Hold a master's or higher degree obtained from a program
accredited by the accreditation review commission on education for
the physician assistant or a predecessor or successor organization
recognized by the board;
(b) Have held valid authority issued by the other state or
the United States government to prescribe therapeutic devices and
drugs, including at least some controlled substances, evidenced by
an affidavit issued by an appropriate agency or office of the
other state or the United States government attesting to that
prescriptive authority.
(C) At the time of making application for a certificate to
prescribe, the applicant shall pay the board a fee of one hundred
dollars, no part of which shall be returned. The fees shall be
deposited in accordance with section 4731.24 of the Revised Code.
(C)(D) The board shall review all applications received. If
an application is complete and the board determines that the
applicant meets the requirements for a certificate to prescribe,
the board shall issue the certificate to the applicant. The
initial certificate to prescribe issued to an applicant seeking to
participate in a provisional period of physician-delegated
prescriptive authority shall be issued as a provisional
certificate to prescribe.
Sec. 4730.46. (A) To be eligible to participate in the
provisional period of physician-delegated prescriptive authority
required by section 4730.45 of the Revised Code, both of the
following apply to a physician assistant:
(1) The physician assistant shall meet the educational
requirements specified in division (B)(1) or (2) of this section
or the educational and clinical experience requirements specified
in division (B)(2) of this section.
(2) The physician assistant shall successfully complete the
pharmacology instruction specified in division (C) of this
section.
(B)(1) For purposes of division (A)(1) of this section, a
physician assistant shall meet either of the following educational
requirements unless division (B)(2) of this section applies:
(a)(1) The physician assistant shall hold a master's or
higher degree that was obtained from a program accredited by the
accreditation review commission on education for the physician
assistant or a predecessor or successor organization recognized by
the state medical board.
(b)(2) The physician assistant shall hold a both of the
following degrees:
(a) A degree other than a master's or higher degree that was
obtained from a school or program accredited by the accreditation
review commission on education for the physician assistant or a
predecessor or successor organization recognized by the board and
shall hold a;
(b) A master's or higher degree in a course of study with
clinical relevance to the practice of physician assistants that
was obtained from a program accredited by a regional or
specialized and professional accrediting agency recognized by the
council for higher education accreditation.
(2) Until two years after the effective date of the initial
rules adopted under section 4730.39 of the Revised Code, a
physician assistant who does not hold a master's or higher degree
as specified in division (B)(1) of this section is eligible to
participate in a provisional period if both of the following
apply:
(a) The physician assistant holds a degree other than a
master's or higher degree that was obtained from a program
accredited by the accreditation review commission on education for
the physician assistant or a predecessor or successor organization
recognized by the board.
(b) The physician assistant has obtained not less than ten
years of clinical experience as a physician assistant in this
state or another jurisdiction, three years of which were obtained
in the five-year period immediately preceding the date the
evidence is submitted to the supervising physician.
(C) For purposes of division (A)(2) of this section, all of
the following conditions shall be met:
(1) The pharmacology instruction shall be completed not
longer than three years prior to applying for the certificate to
prescribe.
(2) The instruction shall be obtained through a course of
study consisting of planned classroom or continued education and
clinical study that meets either of the following conditions:
(a) It is accredited by the accreditation review commission
on education for the physician assistant or a predecessor or
successor organization recognized by the board.
(b) It is approved by the board in accordance with standards
established in rules adopted under section 4730.39 of the Revised
Code.
(3) The content of the instruction shall include all of the
following:
(a) A minimum of thirty contact hours of training in
pharmacology that includes pharmacokinetic principles and clinical
application and the use of drugs and therapeutic devices in the
prevention of illness and maintenance of health;
(b) A minimum of twenty contact hours of clinical training in
pharmacology;
(c) A minimum of fifteen contact hours including training in
the fiscal and ethical implications of prescribing drugs and
therapeutic devices and training in the state and federal laws
that apply to the authority to prescribe;
(d) Any additional training required pursuant to rules
adopted under section 4730.39 of the Revised Code.
Sec. 4755.48. (A) No person shall employ fraud or deception
in applying for or securing a license to practice physical therapy
or to be a physical therapist assistant.
(B) No person shall practice or in any way imply or claim to
the public by words, actions, or the use of letters as described
in division (C) of this section to be able to practice physical
therapy or to provide physical therapy services, including
practice as a physical therapist assistant, unless the person
holds a valid license under sections 4755.40 to 4755.56 of the
Revised Code or except for submission of claims as provided in
section 4755.56 of the Revised Code.
(C) No person shall use the words or letters, physical
therapist, physical therapy, physical therapy services,
physiotherapist, physiotherapy, physiotherapy services, licensed
physical therapist, P.T., Ph.T., P.T.T., R.P.T., L.P.T., M.P.T.,
D.P.T., M.S.P.T., P.T.A., physical therapy assistant, physical
therapist assistant, physical therapy technician, licensed
physical therapist assistant, L.P.T.A., R.P.T.A., or any other
letters, words, abbreviations, or insignia, indicating or implying
that the person is a physical therapist or physical therapist
assistant without a valid license under sections 4755.40 to
4755.56 of the Revised Code.
(D) No person who practices physical therapy or assists in
the provision of physical therapy treatments under the supervision
of a physical therapist shall fail to display the person's current
license granted under sections 4755.40 to 4755.56 of the Revised
Code in a conspicuous location in the place where the person
spends the major part of the person's time so engaged.
(E) Nothing in sections 4755.40 to 4755.56 of the Revised
Code shall affect or interfere with the performance of the duties
of any physical therapist or physical therapist assistant in
active service in the army, navy, coast guard, marine corps, air
force, public health service, or marine hospital service of the
United States, while so serving.
(F) Nothing in sections 4755.40 to 4755.56 of the Revised
Code shall prevent or restrict the activities or services of a
person pursing pursuing a course of study leading to a degree in
physical therapy in an accredited or approved educational program
if the activities or services constitute a part of a supervised
course of study and the person is designated by a title that
clearly indicates the person's status as a student.
(G) No (1) Except as provided in division (G)(2) of this
section and subject to division (H) of this section, no person
shall practice physical therapy other than on the prescription of,
or the referral of a patient by, a person who is licensed in this
or another state to practice do at least one of the following:
(a) Practice medicine and surgery, chiropractic, dentistry,
osteopathic medicine and surgery, podiatric medicine and surgery,
or to practice;
(b) Practice as a physician assistant;
(c) Practice nursing as a certified registered nurse
anesthetist, clinical nurse specialist, certified nurse-midwife,
or certified nurse practitioner, within the scope of such
practices, and whose license is in good standing, unless either of
the following conditions is met:.
(1)(2) The prohibition in division (G)(1) of this section on
practicing physical therapy other than on the prescription of, or
the referral of a patient by, any of the persons described in that
division does not apply if either of the following applies to the
person:
(a) The person holds a master's or doctorate degree from a
professional physical therapy program that is accredited by a
national physical therapy accreditation agency recognized by the
United States department of education.
(2)(b) On or before December 31, 2004, the person has
completed at least two years of practical experience as a licensed
physical therapist.
(H) To be authorized to prescribe physical therapy or refer
a patient to a physical therapist for physical therapy, a person
described in division (G)(1) of this section must be in good
standing with the relevant licensing board in this state or the
state in which the person is licensed and must act only within the
person's scope of practice.
(I) In the prosecution of any person for violation of
division (B) or (C) of this section, it is not necessary to allege
or prove want of a valid license to practice physical therapy or
to practice as a physical therapist assistant, but such matters
shall be a matter of defense to be established by the accused.
Sec. 4755.481. (A) If a physical therapist evaluates and
treats a patient without the prescription of, or the referral of
the patient by, a person who is licensed to practice medicine and
surgery, chiropractic, dentistry, osteopathic medicine and
surgery, podiatric medicine and surgery, or nursing as a certified
registered nurse anesthetist, clinical nurse specialist, certified
nurse-midwife, or certified nurse practitioner described in
division (G)(1) of section 4755.48 of the Revised Code, all of the
following apply:
(1) The physical therapist shall, upon consent of the
patient, inform the patient's physician, chiropractor, dentist,
podiatrist, certified registered nurse anesthetist, clinical nurse
specialist, certified nurse-midwife, or certified nurse
practitioner relevant person described in division (G)(1) of
section 4755.48 of the Revised Code of the evaluation not later
than five business days after the evaluation is made.
(2) If the physical therapist determines, based on reasonable
evidence, that no substantial progress has been made with respect
to that patient during the thirty-day period immediately following
the date of the patient's initial visit with the physical
therapist, the physical therapist shall consult with or refer the
patient to a licensed physician, chiropractor, dentist,
podiatrist, certified registered nurse anesthetist, clinical nurse
specialist, certified nurse-midwife, or certified nurse
practitioner person described in division (G)(1) of section
4755.48 of the Revised Code, unless either of the following
applies:
(a) The evaluation, treatment, or services are being provided
for fitness, wellness, or prevention purposes.
(b) The patient previously was diagnosed with chronic,
neuromuscular, or developmental conditions and the evaluation,
treatment, or services are being provided for problems or symptoms
associated with one or more of those previously diagnosed
conditions.
(3) If the physical therapist determines that orthotic
devices are necessary to treat the patient, the physical therapist
shall be limited to the application of the following orthotic
devices:
(a) Upper extremity adaptive equipment used to facilitate the
activities of daily living;
(b) Finger splints;
(c) Wrist splints;
(d) Prefabricated elastic or fabric abdominal supports with
or without metal or plastic reinforcing stays and other
prefabricated soft goods requiring minimal fitting;
(e) Nontherapeutic accommodative inlays;
(f) Shoes that are not manufactured or modified for a
particular individual;
(g) Prefabricated foot care products;
(h) Custom foot orthotics;
(i) Durable medical equipment.
(4) If, at any time, the physical therapist has reason to
believe that the patient has symptoms or conditions that require
treatment or services beyond the scope of practice of a physical
therapist, the physical therapist shall refer the patient to a
licensed health care practitioner acting within the practitioner's
scope of practice.
(B) Nothing in sections 4755.40 to 4755.56 of the Revised
Code shall be construed to require reimbursement under any health
insuring corporation policy, contract, or agreement, any sickness
and accident insurance policy, the medical assistance program as
defined in section 5111.01 of the Revised Code, or the health
partnership program or qualified health plans established pursuant
to sections 4121.44 to 4121.442 of the Revised Code, for any
physical therapy service rendered without the prescription of, or
the referral of the patient by, a licensed physician,
chiropractor, dentist, podiatrist, certified registered nurse
anesthetist, clinical nurse specialist, certified nurse-midwife,
or certified nurse practitioner person described in division
(G)(1) of section 4755.48 of the Revised Code.
(C) For purposes of this section, "business day" means any
calendar day that is not a Saturday, Sunday, or legal holiday.
"Legal holiday" has the same meaning as in section 1.14 of the
Revised Code.
Sec. 4757.41. (A) This chapter shall not apply to the
following:
(1) A person certified by the state board of education under
Chapter 3319. of the Revised Code while performing any services
within the person's scope of employment by a board of education or
by a private school meeting the standards prescribed by the state
board of education under division (D) of section 3301.07 of the
Revised Code or in a program operated under Chapter 5126. of the
Revised Code for training individuals with mental retardation or
other developmental disabilities;
(2) Psychologists or school psychologists licensed under
Chapter 4732. of the Revised Code;
(3) Members of other professions licensed, certified, or
registered by this state while performing services within the
recognized scope, standards, and ethics of their respective
professions;
(4) Rabbis, priests, Christian science practitioners, clergy,
or members of religious orders and other individuals participating
with them in pastoral counseling when the counseling activities
are within the scope of the performance of their regular or
specialized ministerial duties and are performed under the
auspices or sponsorship of an established and legally cognizable
church, denomination, or sect or an integrated auxiliary of a
church as defined in federal tax regulations, paragraph (g)(5) of
26 C.F.R. 1.6033-2 (1995), and when the individual rendering the
service remains accountable to the established authority of that
church, denomination, sect, or integrated auxiliary;
(5) Any person employed in the civil service as defined in
section 124.01 of the Revised Code while engaging in social work
or professional counseling as a civil service employee;
(6) A student in an accredited educational institution while
carrying out activities that are part of the student's prescribed
course of study if the activities are supervised as required by
the educational institution and if the student does not hold
herself or himself out as a person licensed or registered under
this chapter;
(7)
Until two years after the date the department of alcohol
and drug addiction services ceases to administer its process for
the certification or credentialing of chemical dependency
counselors and alcohol and other drug prevention specialists under
section 3793.07 of the Revised Code, as specified in division (B)
of that section, or in the case of an individual who has the
expiration date of the individual's certificate or credentials
delayed under section 4758.04 of the Revised Code, until the date
of the delayed expiration, individuals with certification or
credentials accepted by the department under that section who are
acting within the scope of their certification or credentials as
members of the profession of chemical dependency counseling or as
alcohol and other drug prevention specialists;
(8) Individuals who hold a license or certificate under
Chapter 4758. of the Revised Code who are acting within the scope
of their license or certificate as members of the profession of
chemical dependency counseling or alcohol and other drug
prevention services;
(9)(8) Any person employed by the American red cross while
engaging in activities relating to services for military families
and veterans and disaster relief, as described in the "American
National Red Cross Act," 33 Stat. 599 (1905), 36 U.S.C.A. 1, as
amended;
(10)(9) Members of labor organizations who hold union
counselor certificates while performing services in their official
capacity as union counselors;
(11)(10) Any person employed in a hospital as defined in
section 3727.01 of the Revised Code or in a nursing home as
defined in section 3721.01 of the Revised Code while providing as
a hospital employee or nursing home employee, respectively, social
services other than counseling and the use of psychosocial
interventions and social psychotherapy.
(B) Divisions (A)(5),
(9)(8), and
(11)(10) of this section do
not prevent a person described in those divisions from obtaining a
license or certificate of registration under this chapter.
Sec. 4758.01. As used in this chapter:
(A) "Accredited educational institution" means an educational
institution accredited by an accrediting agency accepted by the
Ohio board of regents.
(B)(1) "Alcohol and other drug clinical counseling
principles, methods, or procedures" means an approach to chemical
dependency counseling that emphasizes the chemical dependency
counselor's role in systematically assisting clients through all
of the following:
(a) Analyzing background and current information;
(b) Exploring possible solutions;
(c) Developing and providing a treatment plan;
(d) In the case of an independent chemical dependency
counselor-clinical supervisor, independent chemical dependency
counselor, or chemical dependency counselor III only, diagnosing
chemical dependency conditions.
(2) "Alcohol and other drug clinical counseling principles,
methods, or procedures" includes counseling, assessing,
consulting, and referral as they relate to chemical dependency
conditions.
(C) "Alcohol and other drug prevention services" means a
planned process of strategies and activities designed to preclude
the onset of the use of alcohol and other drugs, reduce
problematic use of alcohol and other drugs, or both.
(D) "Chemical dependency conditions" means those conditions
relating to the abuse of or dependency on alcohol or other drugs
that are classified in accepted nosologies, including the
diagnostic and statistical manual of mental disorders and the
international classification of diseases, and in editions of those
nosologies published after the effective date of this section
December 23, 2002.
(E) "Chemical dependency counseling" means rendering or
offering to render to individuals, groups, or the public a
counseling service involving the application of alcohol and other
drug clinical counseling principles, methods, or procedures to
assist individuals who are abusing or dependent on alcohol or
other drugs.
(F) "Scope Unless the context provides otherwise, "scope of
practice" means the services, methods, and techniques in which and
the areas for which a person who holds a license or certificate
under this chapter is trained and qualified.
(G) "Substance abuse professional" has the same meaning as in
49 C.F.R. 40.3.
(H) "U.S. department of transportation drug and alcohol
testing program" means a transportation workplace drug and alcohol
testing program governed by 49 C.F.R. part 40.
Sec. 4758.02. (A) Effective two years after the date the
department of alcohol and drug addiction services ceases to
administer its certification and credentialing process under
section 3793.07 of the Revised Code as specified in division (B)
of that section and except Except as provided in sections section
4758.03 and 4758.04 of the Revised Code, no person shall do any of
the following:
(1) Engage in or represent to the public that the person
engages in chemical dependency counseling for a fee, salary, or
other consideration unless the person holds a valid independent
chemical dependency counselor-clinical supervisor license,
independent chemical dependency counselor license, chemical
dependency counselor III license, chemical dependency counselor II
license,
chemical dependency counselor I certificate, or chemical
dependency counselor assistant certificate issued under this
chapter;
(2) Use the title "licensed independent chemical dependency
counselor-clinical supervisor," "LICDC-CS," "licensed independent
chemical dependency counselor," "LICDC," "licensed chemical
dependency counselor III," "LCDC III," "licensed chemical
dependency counselor II," "LCDC II," "certified chemical
dependency counselor I," "CCDC I," "chemical dependency counselor
assistant," "CDCA," or any other title or description
incorporating the word "chemical dependency counselor" or any
other initials used to identify persons acting in those capacities
unless currently authorized under this chapter to act in the
capacity indicated by the title or initials;
(3) Represent to the public that the person is a registered
applicant unless the person holds a valid registered applicant
certificate issued under this chapter;
(4) Use the title "certified prevention specialist II," "CPS
II," "certified prevention specialist I," "CPS I," "certified
prevention specialist assistant," "CPSA," "registered applicant,"
"RA," or any other title, description, or initials used to
identify persons acting in those capacities unless currently
authorized under this chapter to act in the capacity indicated by
the title or initials.
(B) Effective six years after the effective date of this
section, no No person shall engage in or represent to the public
that the person engages in chemical dependency counseling as a
chemical dependency counselor I.
Sec. 4758.10. (A) There is hereby created the chemical
dependency professionals board.
(B) The governor shall appoint all of the following voting
members of the board with the advice and consent of the senate:
(1) Four individuals who hold a valid independent chemical
dependency counselor-clinical supervisor license or independent
chemical dependency counselor license issued under this chapter,
including at least two of whom have received at least a master's
degree in a field related to chemical dependency counseling from
an accredited educational institution;
(2) Two individuals who hold a valid chemical dependency
counselor III license issued under this chapter;
(3) One individual who holds a valid chemical dependency
counselor II license issued under this chapter;
(4) Two individuals who hold a valid prevention specialist II
certificate or prevention specialist I certificate issued under
this chapter;
(5) One individual who is authorized under Chapter 4731. of
the Revised Code to practice medicine and surgery or osteopathic
medicine and surgery and has experience practicing in a field
related to chemical dependency counseling;
(6) Two individuals who represent the public and have not
practiced chemical dependency counseling or alcohol and other drug
prevention services and have not been involved in the delivery of
chemical dependency counseling services or alcohol and other drug
prevention services. At least one of these individuals shall be at
least sixty years of age. During their terms, the public members
shall not practice chemical dependency counseling or alcohol and
other drug prevention services or be involved in the delivery of
chemical dependency counseling services or alcohol and other drug
prevention services.
(C) Not later than ninety days after the effective date of
this section December 23, 2002, the director of alcohol and drug
addiction services shall appoint an individual who represents the
department of alcohol and drug addiction services to serve as an
ex officio member of the chemical dependency professionals board.
(D) Not more than one-half of the voting members of the board
may be of the same gender or members of the same political party.
At least two voting members of the board shall be of African,
Native American, Hispanic, or Asian descent.
Sec. 4758.20. (A) The chemical dependency professionals board
shall adopt rules to establish, specify, or provide for all of the
following:
(1) Fees for the purposes authorized by section 4758.21 of
the Revised Code;
(2) If the board, pursuant to section 4758.221 of the Revised
Code, elects to administer examinations for individuals seeking to
act as substance abuse professionals in a U.S. department of
transportation drug and alcohol testing program, the board's
administration of the examinations;
(3) For the purpose of section 4758.23 of the Revised Code,
codes of ethical practice and professional conduct for individuals
who hold a license or certificate issued under this chapter;
(3)(4) For the purpose of section 4758.24 of the Revised
Code, all of the following:
(a) Good moral character requirements for an individual who
seeks or holds a license or certificate issued under this chapter;
(b) The documents that an individual seeking such a license
or certificate must submit to the board;
(c) Requirements to obtain the license or certificate that
are in addition to the requirements established under sections
4758.39, 4758.40, 4758.41, 4758.42, 4758.43, 4758.44, and 4758.45,
4758.46, and 4758.47 of the Revised Code. The additional
requirements may include preceptorships.
(4) Procedures for renewal of a chemical dependency counselor
I license under section 4758.27 of the Revised Code;
(d) The period of time that an individual whose registered
applicant certificate has expired must wait before applying for a
new registered applicant certificate.
(5) For the purpose of section 4758.28 of the Revised Code,
requirements for approval of continuing education courses of study
for individuals who hold a license or certificate issued under
this chapter;
(6) For the purpose of section 4758.30 of the Revised Code,
the intervention for and treatment of an individual holding a
license or certificate issued under this chapter whose abilities
to practice are impaired due to abuse of or dependency on alcohol
or other drugs or other physical or mental condition;
(7) Requirements governing reinstatement of a suspended or
revoked license or certificate under division (B) of section
4758.30 of the Revised Code, including requirements for
determining the amount of time an individual must wait to apply
for reinstatement;
(8) For the purpose of section 4758.31 of the Revised Code,
methods of ensuring that all records the board holds pertaining to
an investigation remain confidential during the investigation;
(9) Criteria for employees of the board to follow when
performing their duties under division (B) of section 4758.35 of
the Revised Code;
(10) For the purpose of division (A)(1) of section 4758.39
and division (A)(1) of section 4758.40 of the Revised Code, course
requirements for a degree in a behavioral sciences science or
nursing that shall, at a minimum, include at least
sixty quarter
forty semester hours, or the equivalent number of semester hours,
in all of the following courses:
(a) Theories of counseling and psychotherapy;
(b) Counseling procedures;
(c) Group process and techniques;
(d) Relationship therapy;
(e) Research methods and statistics;
(f) Fundamentals of assessment and diagnosis, including
measurement and appraisal;
(g) Psychopathology;
(h) Human development;
(i) Cultural competence in counseling;
(j) Ethics.
(11) For the purpose of division (A)(3) of section 4758.39,
division (A)(3) of section 4758.40, division (A)(3) of section
4758.41, and division (A)(3) of section 4758.42 of the Revised
Code, training requirements for chemical dependency that shall, at
a minimum, include qualifications for the individuals who provide
the training and instruction in all of the following courses:
(a) Theories of addiction;
(b) Counseling procedures and strategies with addicted
populations;
(c) Group process and techniques working with addicted
populations;
(d) Assessment and diagnosis of addiction;
(e) Relationship counseling with addicted populations;
(f) Pharmacology;
(g) Prevention strategies;
(h) Treatment planning;
(i) Legal and ethical issues.
(12) For the purpose of division (B)(2)(b) of section 4758.40
and division (B)(2) of section 4758.41 of the Revised Code,
requirements for the forty clock hours of training on the version
of the diagnostic and statistical manual of mental disorders that
is current at the time of the training, including the number of
the clock hours that must be on substance-related disorders, the
number of the clock hours that must be on chemical dependency
conditions, and the number of the clock hours that must be on
awareness of other mental and emotional disorders;
(13) For the purpose of division (A)(1) of section 4758.41 of
the Revised Code, course requirements for a bachelor's degree in a
behavioral sciences science or nursing;
(14) For the purpose of division (A) of section 4758.43 of
the Revised Code, training requirements for chemical dependency
counseling that shall, at a minimum, include qualifications for
the individuals who provide the training and instruction in one or
more of the courses listed in division (A)(11)(10) of this section
as selected by the individual seeking the chemical dependency
counselor assistant certificate;
(15) For the purpose of division (A)(2) of section 4758.44 of
the Revised Code, the field of study in which an individual must
obtain at least a bachelor's degree;
(16) For the purpose of division (A)(3) of section 4758.44,
division (A)(3) of section 4758.45, and division (A)(2)(D) of
section
4758.53
4758.46 of the Revised Code, requirements for
prevention-related education;
(16)(17) For the purpose of division (A)(4) of section
4758.44 of the Revised Code, the number of hours of administrative
or supervisory education that an individual must have;
(18) For the purpose of division (A)(2) of section 4758.45 of
the Revised Code, the field of study in which an individual must
obtain at least an associate's degree;
(19) For the purpose of section 4758.51 of the Revised Code,
continuing education requirements for individuals who hold a
license or certificate issued under this chapter;
(17)(20) For the purpose of section 4758.51 of the Revised
Code, the number of hours of continuing education that an
individual must complete to have an expired license or certificate
restored under section 4758.26 of the Revised Code;
(18)(21) For the purpose of divisions (A) and (B) of section
4758.53 4758.52 of the Revised Code, the training requirements an
individual holding a registered applicant certificate must
complete to take an examination administered pursuant to section
4758.22 of the Revised Code to obtain a prevention specialist II
certificate or prevention specialist I certificate and the
documentation the individual must submit to the board showing that
the individual has completed the requirements for chemical
dependency counseling;
(19) The method of determining the amount of time an
individual must wait to apply to the board for a new registered
applicant certificate under division (B) of section 4758.53 of the
Revised Code;
(20)(22) The duties, which may differ, of an all of the
following:
(a) An independent chemical dependency
counselor
counselor-clinical supervisor licensed under this chapter who
supervises a chemical dependency counselor III under section
4758.56 of the Revised Code; independent
(b) An independent chemical dependency counselor-clinical
supervisor, independent chemical dependency counselor, or chemical
dependency counselor III licensed under this chapter who
supervises a chemical dependency counselor assistant under section
4758.59 of the Revised Code; or
(c) A prevention specialist II or prevention specialist I
certified under this chapter or independent chemical dependency
counselor-clinical supervisor, independent chemical dependency
counselor, or chemical dependency counselor III, or chemical
dependency counselor II licensed under this chapter who supervises
a prevention specialist assistant or registered applicant under
section 4758.61 of the Revised Code.
The duties may differ.
(21)(23) Anything else necessary to administer this chapter.
(B) All rules adopted under this section shall be adopted in
accordance with Chapter 119. of the Revised Code and any
applicable federal laws and regulations. Initial rules shall be
adopted not later than nine months after December 23, 2002.
(C) When it adopts rules under this section, the board may
consider standards established by any national association or
other organization representing the interests of those involved in
chemical dependency counseling or alcohol and other drug
prevention services.
Sec. 4758.21. (A) In accordance with rules adopted under
section 4758.20 of the Revised Code and subject to division (B) of
this section, the chemical dependency professionals board shall
establish, and may from time to time adjust, fees to be charged
for the following:
(1) Admitting an individual to an examination administered
pursuant to section 4758.22 of the Revised Code;
(2) Issuing an initial independent chemical dependency
counselor-clinical supervisor license, independent chemical
dependency counselor license, chemical dependency counselor III
license, chemical dependency counselor II license, chemical
dependency counselor assistant certificate, prevention specialist
II certificate, prevention specialist I certificate, prevention
specialist assistant certificate, or registered applicant
certificate;
(3) Renewing an independent chemical dependency
counselor-clinical supervisor license, independent chemical
dependency counselor license, chemical dependency counselor III
license, chemical dependency counselor II license, chemical
dependency counselor I certificate, chemical dependency counselor
assistant certificate, prevention specialist II certificate,
prevention specialist I certificate, or registered applicant
prevention specialist assistant certificate;
(4) Approving continuing education courses under section
4758.28 of the Revised Code;
(5) Doing anything else the board determines necessary to
administer this chapter.
(B) The fees established under division (A) of this section
are nonrefundable. They shall be in amounts sufficient to cover
the necessary expenses of the board in administering this chapter
and rules adopted under it. The fees for a license or certificate
and the renewal of a license or certificate may differ for the
various types of licenses and certificates, but shall not exceed
one hundred seventy-five dollars each, unless the board determines
that amounts in excess of one hundred seventy-five dollars are
needed to cover its necessary expenses in administering this
chapter and rules adopted under it and the amounts in excess of
one hundred seventy-five dollars are approved by the controlling
board.
(C) All vouchers of the board shall be approved by the
chairperson or executive director of the board, or both, as
authorized by the board.
Sec. 4758.22. The chemical dependency professionals board
shall prepare, cause to be prepared, or procure the use of, and
grade, cause to be graded, or procure the grading of, examinations
to determine the competence of individuals seeking an independent
chemical dependency counselor-clinical supervisor license,
independent chemical dependency counselor license, chemical
dependency counselor III license, chemical dependency counselor II
license, prevention specialist II certificate, or prevention
specialist I certificate. The board may develop the examinations
or use examinations prepared by state or national organizations
that represent the interests of those involved in chemical
dependency counseling or alcohol and other drug prevention
services. The board shall conduct examinations at least twice each
year and shall determine the level of competence necessary for a
passing score.
An individual may not sit for an examination administered
pursuant to this section unless the individual meets the
requirements to obtain the license or certificate the individual
seeks, other than the requirement to have passed the examination,
and pays the fee established under section 4758.21 of the Revised
Code. An individual who is denied admission to the examination may
appeal the denial in accordance with Chapter 119. of the Revised
Code.
Sec. 4758.221. In accordance with rules adopted under
section 4758.20 of the Revised Code, the chemical dependency
professionals board may administer examinations for individuals
seeking to act as substance abuse professionals in a U.S.
department of transportation drug and alcohol testing program. If
it elects to administer the examinations, the board shall use
examinations that comprehensively cover all the elements of
substance abuse professional qualification training listed in 49
C.F.R. 40.281(c)(1) and are prepared by a nationally recognized
professional or training organization that represents the
interests of those involved in chemical dependency counseling
services.
Sec. 4758.23. (A) In rules adopted under section 4758.20 of
the Revised Code, the chemical dependency professionals board
shall establish codes of ethical practice and professional conduct
for the following:
(1) Individuals who hold a valid independent chemical
dependency counselor-clinical supervisor license, independent
chemical dependency counselor license, chemical dependency
counselor III license, chemical dependency counselor II license,
chemical dependency counselor I certificate, or chemical
dependency counselor assistant certificate issued under this
chapter;
(2) Individuals who hold a valid prevention specialist II
certificate, prevention specialist I certificate, prevention
specialist assistant certificate, or registered applicant
certificate issued under this chapter.
(B) The codes for individuals identified under division
(A)(1) of this section shall define unprofessional conduct, which
shall include engaging in a dual relationship with a client,
former client, consumer, or former consumer; committing an act of
sexual abuse, misconduct, or exploitation of a client, former
client, consumer, or former consumer; and, except as permitted by
law, violating client or consumer confidentiality.
(C) The codes for individuals identified under division
(A)(1) of this section may be based on any codes of ethical
practice and professional conduct developed by national
associations or other organizations representing the interests of
those involved in chemical dependency counseling. The codes for
individuals identified under division (A)(2) of this section may
be based on any codes of ethical practice and professional conduct
developed by national associations or other organizations
representing the interests of those involved in alcohol and other
drug prevention services. The board may establish standards in the
codes that are more stringent than those established by the
national associations or other organizations.
Sec. 4758.24. (A) The chemical dependency professionals board
shall issue a license or certificate under this chapter to an
individual who meets all of the following requirements:
(1) Is of good moral character as determined in accordance
with rules adopted under section 4758.20 of the Revised Code;
(2) Submits Except as provided in section 4758.241 of the
Revised Code, submits a properly completed application and all
other documentation specified in rules adopted under section
4758.20 of the Revised Code;
(3) Pays Except as provided in section 4758.241 of the
Revised Code, pays the fee established under section 4758.21 of
the Revised Code for the license or certificate that the
individual seeks;
(4) Meets the requirements to obtain the license or
certificate that the individual seeks as specified in section
4758.39, 4758.40, 4758.41, 4758.42, 4758.43, 4758.44, or 4758.45,
4758.46, or 4758.47 of the Revised Code;
(5) Meets any additional requirements specified in rules
adopted under section 4758.20 of the Revised Code to obtain the
license or certificate that the individual seeks.
(B) The board shall not issue an initial do either of the
following:
(1) Issue a certificate to practice as a chemical dependency
counselor I;
(2) Issue a new registered applicant certificate to an
individual whose previous registered applicant certificate has
been expired for less than the period of time specified in rules
adopted under section 4758.20 of the Revised Code.
Sec. 4758.241. The chemical dependency professionals board
shall issue an independent chemical dependency counselor-clinical
supervisor license under section 4758.24 of the Revised Code to
each individual who, on the effective date of this section, holds
a valid independent chemical dependency counselor license without
requiring the individual to comply with divisions (A)(2) and (3)
of that section.
Sec. 4758.26. (A) Except as provided in Subject to section
4758.27 4758.30 of the Revised Code, a license or certificate
issued under this chapter, other than a registered applicant
certificate, expires
two years the following period of time after
it is issued and may be renewed in accordance with the standard
renewal procedure established under Chapter 4745. of the Revised
Code:
(1) In the case of an initial chemical dependency counselor
assistant certificate, thirteen months;
(2) In the case of any other license or certificate, two
years.
(B) Subject to section 4758.30 of the Revised Code and except
as provided in section 4758.27 of the Revised Code, the chemical
dependency professionals board shall renew a license or
certificate issued under this chapter, other than a registered
applicant certificate, in accordance with the standard renewal
procedure established under Chapter 4745. of the Revised Code if
the individual seeking the renewal pays the renewal fee
established under section 4758.21 of the Revised Code and does the
following:
(1) In the case of an individual seeking renewal of an
initial chemical dependency counselor assistant certificate,
satisfies the additional training requirement established under
section 4758.52 of the Revised Code;
(2) In the case of any other individual, satisfies the
continuing education requirements established under section
4758.51 of the Revised Code.
(C) Except Subject to section 4758.30 of the Revised Code and
except as provided in section 4758.27 of the Revised Code, a
license or certificate issued under this chapter, other than a
registered applicant certificate, that has expired may be restored
if the individual seeking the restoration, not later than two
years after the license or certificate expires, applies for
restoration of the license or certificate. The board shall issue a
restored license or certificate to the individual if the
individual pays the renewal fee established under section 4758.21
of the Revised Code and does the following:
(1) In the case of an individual whose initial chemical
dependency counselor assistant certificate expired, satisfies the
additional training requirement established under section 4758.52
of the Revised Code;
(2) In the case of any other individual, satisfies the
continuing education requirements established under section
4758.51 of the Revised Code for restoring the license or
certificate. The
The board shall not require an individual to take an
examination as a condition of having an expired license or
certificate restored under this section.
Sec. 4758.27. Until the date that is six years after the
effective date of this section, the chemical dependency
professionals board shall renew a certificate that on the
effective date of this section is accepted under section 3793.07
of the Revised Code as authority to practice as a chemical
dependency counselor I if the individual holding the certificate
renews the certificate in accordance with rules adopted under
section 4758.20 of the Revised Code and pays the renewal fee
established under section 4758.21 of the Revised Code. Subsequent
renewals shall be done under section 4758.26 of the Revised Code.
After the date that is six years after the effective date of
this section, the The chemical dependency professionals board
shall not renew under this section, or renew or restore under
section 4758.26 of the Revised Code, a either of the following:
(A) A certificate to practice as a certified chemical
dependency counselor I;
(B) A registered applicant certificate.
Sec. 4758.30. (A) The chemical dependency professionals
board, in accordance with Chapter 119. of the Revised Code, may
refuse to issue a license or certificate applied for under this
chapter; refuse to renew or restore a license or certificate
issued under this chapter; suspend, revoke, or otherwise restrict
a license or certificate issued under this chapter; or reprimand
an individual holding a license or certificate issued under this
chapter. These actions may be taken by the board regarding the
applicant for a license or certificate or the individual holding a
license or certificate for one or more of the following reasons:
(1) Violation of any provision of this chapter or rules
adopted under it;
(2) Knowingly making a false statement on an application for
a license or certificate or for renewal, restoration, or
reinstatement of a license or certificate;
(3) Acceptance of a commission or rebate for referring an
individual to a person who holds a license or certificate issued
by, or who is registered with, an entity of state government,
including persons practicing chemical dependency counseling,
alcohol and other drug prevention services, or fields related to
chemical dependency counseling or alcohol and other drug
prevention services;
(4) Conviction in this or any other state of any crime that
is a felony in this state;
(5) Conviction in this or any other state of a misdemeanor
committed in the course of practice as an independent chemical
dependency counselor-clinical supervisor, independent chemical
dependency counselor, chemical dependency counselor III, chemical
dependency counselor II, chemical dependency counselor I, chemical
dependency counselor assistant, prevention specialist II,
prevention specialist I, prevention specialist assistant, or
registered applicant;
(6) Inability to practice as an independent chemical
dependency counselor-clinical supervisor, independent chemical
dependency counselor, chemical dependency counselor III, chemical
dependency counselor II, chemical dependency counselor I, chemical
dependency counselor assistant, prevention specialist II,
prevention specialist I, prevention specialist assistant, or
registered applicant due to abuse of or dependency on alcohol or
other drugs or other physical or mental condition;
(7) Practicing outside the individual's scope of practice;
(8) Practicing without complying with the supervision
requirements specified under section 4758.56, 4758.59, or 4758.61
of the Revised Code;
(9) Violation of the code of ethical practice and
professional conduct for chemical dependency counseling or alcohol
and other drug prevention services adopted by the board pursuant
to section 4758.23 of the Revised Code;
(10) Revocation of a license or certificate or voluntary
surrender of a license or certificate in another state or
jurisdiction for an offense that would be a violation of this
chapter.
(B) An individual whose license or certificate has been
suspended or revoked under this section may apply to the board for
reinstatement after an amount of time the board shall determine in
accordance with rules adopted under section 4758.20 of the Revised
Code. The board may accept or refuse an application for
reinstatement. The board may require an examination for
reinstatement of a license or certificate that has been suspended
or revoked.
Sec. 4758.39. An individual seeking an independent chemical
dependency counselor-clinical supervisor license shall meet the
requirements of division (A) or (B) of this section.
(A) To meet the requirements of this division, an individual
must meet all of the following requirements:
(1) Hold from an accredited educational institution at least
a master's degree in either a behavioral science or nursing that
meets the course requirements specified in rules adopted under
section 4758.20 of the Revised Code;
(2) Have not less than six thousand hours of compensated work
or supervised internship experience (including at least two
thousand hours of clinical supervisory experience as part of the
compensated work or supervised internship) in any of the
following, not less than one thousand two hundred hours of which
are in chemical dependency counseling:
(a) Chemical dependency services, substance abuse services,
or both types of services;
(b) The practice of psychology, as defined in section 4732.01
of the Revised Code;
(c) The practice of professional counseling, the practice of
social work, or the practice of marriage and family therapy, all
as defined in section 4757.01 of the Revised Code.
(3) Have a minimum of one hundred eighty hours of training in
chemical dependency that meets the requirements specified in rules
adopted under section 4758.20 of the Revised Code;
(4) Unless the individual holds a valid license,
registration, certificate, or credentials issued under another
chapter of the Revised Code that authorizes the individual to
engage in a profession whose scope of practice includes the
clinical supervision of chemical dependency counseling, chemical
dependency counseling, and diagnosing and treating chemical
dependency conditions, pass one or more examinations administered
pursuant to section 4758.22 of the Revised Code for the purpose of
determining competence to practice as an independent chemical
dependency counselor-clinical supervisor.
(B) To meet the requirement of this division, an individual
must hold, on the effective date of this section, a valid
independent chemical dependency counselor license.
Sec. 4758.40. An individual seeking an independent chemical
dependency counselor license shall meet either of the following
requirements: of division (A) or (B) of this section.
(A) Meet To meet the requirements of this division, an
individual must meet all of the following requirements:
(1) Hold from an accredited educational institution at least
a master's degree in a behavioral sciences science or nursing that
meets the course requirements specified in rules adopted under
section 4758.20 of the Revised Code;
(2) Have not less than four two thousand hours of compensated
work or supervised internship experience in either any of the
following, not less than eight four hundred hours of which are in
chemical dependency counseling:
(a) Chemical dependency services, substance abuse services,
or both types of services;
(b) The practice of psychology, as defined in section 4732.01
of the Revised Code, or the;
(c) The practice of professional counseling or, the practice
of social work, both or the practice of marriage and family
therapy, all as defined in section 4757.01 of the Revised Code.
(3) Have a minimum of two one hundred seventy eighty hours of
training in chemical dependency that meets the requirements
specified in rules adopted under section 4758.20 of the Revised
Code;
(4) Pass Unless the individual holds a valid license,
registration, certificate, or credentials issued under another
chapter of the Revised Code that authorizes the individual to
engage in a profession whose scope of practice includes chemical
dependency counseling and diagnosing and treating chemical
dependency conditions, pass one or more examinations administered
pursuant to section 4758.22 of the Revised Code for the purpose of
determining competence to practice as an independent chemical
dependency counselor.
(B) Meet To meet the requirements of this division, an
individual must meet both of the following requirements:
(1) Hold, on December 23, 2002, a certificate or credentials
that were accepted under former section 3793.07 of the Revised
Code as authority to practice as a certified chemical dependency
counselor III or certified chemical dependency counselor III-E;
(2) Meet one of the following requirements:
(a) Hold the degree described in division (A)(1) of this
section;
(b) Have held a chemical dependency counselor III, II, or I
certificate for at least eight consecutive years and have not less
than forty clock hours of training on the version of the
diagnostic and statistical manual of mental disorders that is
current at the time of the training. The training must meet the
requirements specified in rules adopted under section 4758.20 of
the Revised Code. An individual authorized under Chapter 4731. of
the Revised Code to practice medicine and surgery or osteopathic
medicine and surgery, a psychologist licensed under Chapter 4732.
of the Revised Code, or a professional clinical counselor or
independent social worker licensed under Chapter 4757. of the
Revised Code may provide any portion of the training. An
independent chemical dependency counselor licensed under this
chapter who holds the degree described in division (A)(1) of this
section may provide the portion of the training on chemical
dependency conditions.
Sec. 4758.41. An individual seeking a chemical dependency
counselor III license shall meet any of the following
requirements: of division (A), (B), or (C) of this section.
(A) Meet To meet the requirements of this division, an
individual must meet all of the following requirements:
(1) Hold from an accredited educational institution at least
a bachelor's degree in a behavioral science or nursing that meets
the course requirements specified in rules adopted under section
4758.20 of the Revised Code;
(2) Have not less than four two thousand hours of compensated
work or supervised internship experience in either any of the
following, not less than
eight four hundred work hours of which
are in chemical dependency counseling:
(a) Chemical dependency services, substance abuse services,
or both types of services;
(b) The practice of psychology, as defined in section 4732.01
of the Revised Code, or the;
(c) The practice of professional counseling or, the practice
of social work, both or the practice of marriage and family
therapy, all as defined in section 4757.01 of the Revised Code.
(3) Have a minimum of two one hundred seventy eighty hours of
training in chemical dependency that meets the requirements
specified in rules adopted under section 4758.20 of the Revised
Code;
(4) Pass Unless the individual holds a valid license,
registration, certificate, or credentials issued under another
chapter of the Revised Code that authorizes the individual to
engage in a profession whose scope of practice includes chemical
dependency counseling and diagnosing and treating chemical
dependency conditions, pass one or more examinations administered
pursuant to section 4758.22 of the Revised Code for the purpose of
determining competence to practice as a chemical dependency
counselor III.
(B) Meet To meet the requirements of this division, an
individual must meet both of the following requirements:
(1) Hold, on December 23, 2002, a certificate or credentials
that were accepted under former section 3793.07 of the Revised
Code as authority to practice as a certified chemical dependency
counselor III or certified chemical dependency counselor III-E;
(2) Have not less than forty clock hours of training on the
version of the diagnostic and statistical manual of mental
disorders that is current at the time of the training. The
training must meet the requirements specified in rules adopted
under section 4758.20 of the Revised Code. An individual
authorized under Chapter 4731. of the Revised Code to practice
medicine and surgery or osteopathic medicine and surgery, a
psychologist licensed under Chapter 4732. of the Revised Code, or
a professional clinical counselor or independent social worker
licensed under Chapter 4757. of the Revised Code may provide any
portion of the training. An independent chemical dependency
counselor licensed under this chapter who holds the degree
described in division (A)(1) of section 4758.40 of the Revised
Code may provide the portion of the training on chemical
dependency conditions.
(C) Meet To meet the requirements of this division, an
individual must meet all of the following requirements:
(1) Hold, on December 23, 2002, a certificate or credentials
that were accepted under former section 3793.07 of the Revised
Code as authority to practice as a certified chemical dependency
counselor II;
(2) Meet the requirement of division (B)(2) of this section;
(3) Hold a bachelor's degree in a behavioral science.
Sec. 4758.42. An individual seeking a chemical dependency
counselor II license shall meet either of the following
requirements: of division (A) or (B) of this section.
(A) Meet To meet the requirements of this division, an
individual must meet all of the following requirements:
(1) Hold from an accredited educational institution an
associate's degree in a behavioral science or nursing or a
bachelor's degree in any field;
(2)(a) If the individual holds an associate's degree, have
Have not less than five two thousand hours of compensated or
volunteer work, field placement, intern, or
practicum supervised
internship experience in either any of the following, not less
than
one thousand four hundred hours of which are in chemical
dependency counseling:
(i)(a) Chemical dependency services, substance abuse
services, or both types of services;
(ii)(b) The practice of psychology, as defined in section
4732.01 of the Revised Code, or the;
(c) The practice of professional counseling or, the practice
of social work, both or the practice of marriage and family
therapy, all as defined in section 4757.01 of the Revised Code.
(b) If the individual holds a bachelor's degree, have not
less than six thousand hours of compensated or volunteer work,
field placement, intern, or practicum experience in either of the
following, not less than one thousand two hundred hours of which
are in chemical dependency counseling:
(i) Chemical dependency services, substance abuse services,
or both types of services;
(ii) The practice of psychology, as defined in section
4732.01 of the Revised Code, or the practice of professional
counseling or the practice of social work, both as defined in
section 4757.01 of the Revised Code.
(3) Have a minimum of two one hundred seventy eighty hours of
training in chemical dependency that meets the requirements
specified in rules adopted under section 4758.20 of the Revised
Code;
(4) Pass one or more examinations administered pursuant to
section 4758.22 of the Revised Code for the purpose of determining
competence to practice as a chemical dependency counselor II.
(B) Hold To meet the requirement of this division, an
individual must hold, on December 23, 2002, a certificate or
credentials that were accepted under former section 3793.07 of the
Revised Code as authority to practice as a certified chemical
dependency counselor II.
Sec. 4758.43. An individual seeking a chemical dependency
counselor assistant certificate shall meet either of the following
requirements:
(A) Have at least forty hours of training in chemical
dependency counseling that meets the requirements specified in
rules adopted under section 4758.20 of the Revised Code.;
(B) Hold, on the effective date of this section December 23,
2002, a certificate or credentials that were accepted under former
section 3793.07 of the Revised Code as authority to practice as a
registered candidate.
Sec. 4758.44. An individual seeking a prevention specialist
II certificate shall meet either of the following requirements: of
division (A) or (B) of this section.
(A) Meet To meet the requirements of this division, an
individual must meet all of the following requirements:
(1) Have at least six thousand hours of compensated work
experience in which not less than fifty per cent of the
individual's time was devoted to planning, coordinating in alcohol
and other drug prevention services, including at least four
thousand hours of administering or delivering alcohol and other
drug prevention supervising the services;
(2) Have one of the following:
(a) A bachelor's degree in a behavioral science and at least
six thousand hours of compensated work experience in alcohol and
other drug prevention services;
(b) A master's or doctoral degree in a behavioral science and
at least four thousand hours of compensated work experience in
alcohol and other drug prevention services. Hold from an
accredited educational institution at least a bachelor's degree in
a field of study specified in rules adopted under section 4758.20
of the Revised Code;
(3) Have at least two one hundred seventy hours of
prevention-related education that meets the requirements specified
in rules adopted under section 4758.20 of the Revised Code;
(4) Obtain a registered applicant certificate under this
chapter and comply with the requirements of Have at least the
number of hours of administrative or supervisory education
specified in rules adopted under section 4758.53 4758.20 of the
Revised Code;
(5) Pass the examination one or more examinations
administered pursuant to section 4758.22 of the Revised Code for
the purpose of determining competence to practice as a prevention
specialist II.
(B) Hold To meet the requirement of this division, an
individual must hold, on the effective date of this section
December 23, 2002, a certificate or credentials that were accepted
under former section 3793.07 of the Revised Code as authority to
practice as a certified prevention specialist II.
Sec. 4758.45. An individual seeking a prevention specialist I
certificate shall meet either of the following requirements: of
division (A) or (B) of this section.
(A) Meet To meet the requirements of this division, an
individual must meet all of the following requirements:
(1) Have at least two thousand hours of compensated or
volunteer work, field placement, intern, or practicum experience
in which not less than twenty per cent of the individual's time
was devoted to alcohol and other drug prevention services,
including at least four hundred hours of planning or delivering
alcohol and other drug prevention the services;
(2) Have one of the following:
(a) At least six thousand hours of compensated or volunteer
work, field placement, intern, or practicum experience in alcohol
and other drug prevention services;
(b) An associate's degree in a behavioral science and at
least four thousand hours of compensated or volunteer work, field
placement, intern, or practicum experience in alcohol and other
drug prevention services;
(c) A bachelor's, master's, or doctoral degree in a
behavioral science and at least two thousand hours of compensated
or volunteer work, field placement, intern, or practicum
experience in alcohol and other drug prevention services. Hold
from an accredited educational institution at least an associate's
degree in a field of study specified in rules adopted under
section 4758.20 of the Revised Code;
(3) Have at least one hundred eighty hours of
prevention-related education that meets the requirements specified
in rules adopted under section 4758.20 of the Revised Code;
(4) Obtain a registered applicant certificate under this
chapter and comply with the requirements of section 4758.53 of the
Revised Code;
(5) Pass the examination one or more examinations
administered pursuant to section 4758.22 of the Revised Code for
the purpose of determining competence to practice as a prevention
specialist I.
(B) Hold To meet the requirement of this division, an
individual must hold, on the effective date of this section
December 23, 2002, a certificate or credentials that were accepted
under former section 3793.07 of the Revised Code as authority to
practice as a certified prevention specialist I.
Sec. 4758.46. An individual seeking a prevention specialist
assistant certificate shall meet all of the following
requirements:
(A) Be at least eighteen years of age;
(B) Have at least a high school diploma or high school
equivalence diploma;
(C) Have at least one hundred hours of compensated or
volunteer work, field placement, intern, or practicum experience
in alcohol and other drug prevention services;
(D) Have at least forty-five hours of prevention-related
education that meets the requirements specified in rules adopted
under section 4758.20 of the Revised Code.
Sec. 4758.47. An individual seeking a registered applicant
certificate shall meet all of the following requirements:
(A) Be at least eighteen years of age;
(B) Have at least a high school diploma or high school
equivalence diploma;
(C) Submit to the chemical dependency professionals board a
professional development plan that is acceptable to the board.
Sec. 4758.51. (A) Except as provided in division (B)(C) of
this section and in accordance with rules adopted under section
4758.20 of the Revised Code, each individual who holds a license
or certificate issued under this chapter, other than an initial
chemical dependency counselor assistant certificate, shall
complete during the period that the license or certificate is in
effect not less than
forty the following number of clock hours of
continuing education as a condition of receiving a renewed license
or certificate:
(1) In the case of an individual holding a prevention
specialist assistant certificate, twenty;
(2) In the case of any other individual, forty. To have an
expired license or certificate restored,
(B) Except as provided in division (C) of this section, an
individual whose license or certificate issued under this chapter,
other than an initial chemical dependency counselor assistant
certificate, has expired shall complete the number of hours of
continuing education specified in rules adopted under section
4758.20 of the Revised Code as a condition of receiving a restored
license or certificate.
(B)(C) The chemical dependency professionals board may waive
the continuing education requirements established under this
section for individuals who are unable to fulfill them because of
military service, illness, residence outside the United States, or
any other reason the board considers acceptable.
Sec. 4758.52. (A) Except as provided in division (C) of this
section, each individual who holds an initial chemical dependency
counselor assistant certificate shall complete, during the first
twelve months that the initial certificate is in effect, at least
thirty additional hours of training in chemical dependency
counseling that meets the requirements specified in rules adopted
under section 4758.20 of the Revised Code as a condition of having
the initial certificate renewed.
(B) Except as provided in division (C) of this section, an
individual whose initial chemical dependency counselor assistant
certificate has expired shall complete at least thirty additional
hours of training in chemical dependency counseling that meets the
requirements specified in rules adopted under section 4758.20 of
the Revised Code as a condition of receiving a restored chemical
dependency counselor assistant certificate.
(C) The chemical dependency professionals board may waive the
additional training requirement established under this section for
individuals who are unable to fulfill the requirement because of
military service, illness, residence outside the United States, or
any other reason the board considers acceptable.
Sec. 4758.54. In addition to practicing chemical dependency
counseling, an individual holding a valid independent chemical
dependency counselor-clinical supervisor license may do all of the
following:
(A) Diagnose and treat chemical dependency conditions;
(B) Perform treatment planning, assessment, crisis
intervention, individual and group counseling, case management,
and education services as they relate to abuse of and dependency
on alcohol and other drugs;
(C) Provide clinical supervision of chemical dependency
counseling;
(D) Refer individuals with nonchemical dependency conditions
to appropriate sources of help.
Sec. 4758.55. In addition to practicing chemical dependency
counseling, an individual holding a valid independent chemical
dependency counselor license may do all of the following:
(A) Diagnose and treat chemical dependency conditions;
(B) Perform treatment planning, assessment, crisis
intervention, individual and group counseling, case management,
and education services as they relate to abuse of and dependency
on alcohol and other drugs;
(C) Provide clinical supervision of chemical dependency
counseling under the supervision of any of the following:
(1) An independent chemical dependency counselor-clinical
supervisor licensed under this chapter;
(2) An individual authorized under Chapter 4731. of the
Revised Code to practice medicine and surgery or osteopathic
medicine and surgery;
(3) A psychologist licensed under Chapter 4732. of the
Revised Code;
(4) A registered nurse licensed under Chapter 4723. of the
Revised Code or professional clinical counselor, independent
social worker, or independent marriage and family therapist
licensed under Chapter 4757. of the Revised Code if such
supervision is consistent with the scope of practice of the
registered nurse, professional clinical counselor, independent
social worker, or independent marriage and family therapist.
(D) Refer individuals with nonchemical dependency conditions
to appropriate sources of help.
Sec. 4758.56. (A) In addition to practicing chemical
dependency counseling, an individual holding a valid chemical
dependency counselor III license may do all of the following:
(1) Diagnose chemical dependency conditions under the
supervision of any of the following:
(a) An independent chemical dependency counselor licensed
under this chapter;
(b) An individual authorized under Chapter 4731. of the
Revised Code to practice medicine and surgery or osteopathic
medicine and surgery;
(c) A psychologist licensed under Chapter 4732. of the
Revised Code;
(d) A registered nurse licensed under Chapter 4723. of the
Revised Code or professional clinical counselor or independent
social worker licensed under Chapter 4757. of the Revised Code if
such supervision is consistent with the scope of practice of the
registered nurse, professional clinical counselor, or independent
social worker. professionals listed in section 4758.561 of the
Revised Code;
(2) Treat chemical dependency conditions;
(3) Perform treatment planning, assessment, crisis
intervention, individual and group counseling, case management,
and education services as they relate to abuse of and dependency
on alcohol and other drugs;
(4) Provide clinical supervision of chemical dependency
counseling under the supervision of any of the professionals
listed in section 4758.561 of the Revised Code;
(5) Refer individuals with nonchemical dependency conditions
to appropriate sources of help.
(B) A chemical dependency counselor III may not practice as
an individual practitioner.
Sec. 4758.561. Any of the following professionals may
supervise a chemical dependency counselor III for purposes of
divisions (A)(1) and (4) of section 4758.56 of the Revised Code:
(A) An independent chemical dependency counselor-clinical
supervisor licensed under this chapter;
(B) An individual authorized under Chapter 4731. of the
Revised Code to practice medicine and surgery or osteopathic
medicine and surgery;
(C) A psychologist licensed under Chapter 4732. of the
Revised Code;
(D) A registered nurse licensed under Chapter 4723. of the
Revised Code or professional clinical counselor, independent
social worker, or independent marriage and family therapist
licensed under Chapter 4757. of the Revised Code if such
supervision is consistent with the scope of practice of the
registered nurse, professional clinical counselor, independent
social worker, or independent marriage and family therapist.
Sec. 4758.59. (A) Subject to division (B) of this section, an
individual holding a valid chemical dependency counselor assistant
certificate may do both of the following in addition to practicing
chemical dependency counseling:
(1) Perform treatment planning, assessment, crisis
intervention, individual and group counseling, case management,
and education services as they relate to abuse of or dependency on
alcohol and other drugs;
(2) Refer individuals with nonchemical dependency conditions
to appropriate sources of help.
(B) An individual holding a valid chemical dependency
counselor assistant certificate may practice chemical dependency
counseling and perform the tasks specified in division (A) of this
section only while under the supervision of any of the following:
(1) An independent chemical dependency counselor-clinical
supervisor, independent chemical dependency counselor, or chemical
dependency counselor III licensed under this chapter;
(2) An individual authorized under Chapter 4731. of the
Revised Code to practice medicine and surgery or osteopathic
medicine and surgery;
(3) A psychologist licensed under Chapter 4732. of the
Revised Code;
(4) A registered nurse licensed under Chapter 4723. of the
Revised Code or professional clinical counselor or, independent
social worker, or independent marriage and family therapist
licensed under Chapter 4757. of the Revised Code if such
supervision is consistent with the scope of practice of the
registered nurse, professional clinical counselor, or independent
social worker, or independent marriage and family therapist.
(C) A chemical dependency counselor assistant may not
practice as an individual practitioner.
Sec. 4758.61. An individual who holds a valid prevention
specialist assistant certificate or registered applicant
certificate issued under this chapter may engage in the practice
of alcohol and other drug prevention services under the
supervision of any of the following:
(A) A prevention specialist II or prevention specialist I
certified under this chapter;
(B) An independent chemical dependency counselor-clinical
supervisor, an independent chemical dependency counselor, or a
chemical dependency counselor III, or a chemical dependency
counselor II licensed under this chapter;
(C) An individual authorized under Chapter 4731. of the
Revised Code to practice medicine and surgery or osteopathic
medicine and surgery;
(D) A psychologist licensed under Chapter 4732. of the
Revised Code;
(E) A registered nurse licensed under Chapter 4723. of the
Revised Code;
(F) A professional clinical counselor, a professional
counselor, an independent social worker, or a social worker, an
independent marriage and family therapist, or a marriage and
family therapist licensed under Chapter 4757. of the Revised Code;
(G) A school counselor licensed by the department of
education pursuant to section 3319.22 of the Revised Code;
(H) A health education specialist certified by the national
commission for health education credentialing.
Sec. 4758.70. Except to the extent of providing services
authorized by this chapter, this chapter does not authorize any
individual to engage in either of the following:
(A) The practice of psychology as defined in section 4732.01
of the Revised Code.
Except to the extent of providing services authorized by this
chapter, this chapter does not authorize any individual to engage
in the;
(B) The practice of professional counseling or, practice of
social work, or practice of marriage and family therapy, as those
terms are defined in section 4757.01 of the Revised Code.
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) "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:
(a) Loss of life;
(b) Loss of a limb;
(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 electromagnetic, chemical, or radioactive
energy;
(c) Drowning, suffocation, or strangulation;
(d) A deficit or excess of heat.
(O) "Trauma victim" or "trauma patient" means a person who
has sustained a traumatic injury.
(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;
(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.
(Y) "Firefighter" means any member of a fire department as
defined in section 742.01 of the Revised Code.
(Z) "Volunteer firefighter" has the same meaning as in
section 146.01 of the Revised Code.
(AA) "Part-time paid firefighter" means a person who provides
firefighting services on less than a full-time basis, is routinely
scheduled to be present on site at a fire station or other
designated location for purposes of responding to a fire or other
emergency, and receives more than nominal compensation for the
provision of firefighting services.
(BB) "Physician assistant" means an individual who holds a
valid certificate to practice as a physician assistant issued
under Chapter 4730. of the Revised Code.
Sec. 4765.35. (A) A first responder shall perform the
emergency medical services described in this section in accordance
with this chapter and any rules adopted under it.
(B) A first responder may provide limited emergency medical
services to patients until the arrival of an emergency medical
technician-basic, emergency medical technician-intermediate, or
emergency medical technician-paramedic. In an emergency, a first
responder may render emergency medical services such as opening
and maintaining an airway, giving mouth to barrier ventilation,
chest compressions, electrical interventions with automated
defibrillators to support or correct the cardiac function and
other methods determined by the board, controlling of hemorrhage,
manual stabilization of fractures, bandaging, assisting in
childbirth, and determining triage of trauma victims.
(C) A first responder may perform any other emergency medical
services approved pursuant to rules adopted under section 4765.11
of the Revised Code. The board shall determine whether the nature
of any such service requires that a first responder receive
authorization prior to performing the service.
(D)(1) Except as provided in division (D)(2) of this section,
if the board determines under division (C) of this section that a
service requires prior authorization, the service shall be
performed only pursuant to the written or verbal authorization of
a physician or of the cooperating physician advisory board, or
pursuant to an authorization transmitted through a direct
communication device by a physician, physician assistant
designated by a physician, or registered nurse designated by a
physician.
(2) If communications fail during an emergency situation or
the required response time prohibits communication, a first
responder may perform services subject to this division, if, in
the judgment of the first responder, the life of the patient is in
immediate danger. Services performed under these circumstances
shall be performed in accordance with the written protocols for
triage of adult and pediatric trauma victims established in rules
adopted under sections 4765.11 and 4765.40 of the Revised Code and
any applicable protocols adopted by the emergency medical service
organization with which the first responder is affiliated.
Sec. 4765.36. In a hospital, an emergency medical
technician-basic, emergency medical technician-intermediate, or
emergency medical technician-paramedic may perform emergency
medical services only under the direction and supervision of a
physician or registered nurse designated by a physician and only
if the services are performed in accordance with both of the
following conditions:
(A) Only in the hospital's emergency department or while
moving a patient between the emergency department and another part
of the hospital;
(B) Only under the direction and supervision of one of the
following:
(1) A physician;
(2) A physician assistant designated by a physician;
(3) A registered nurse designated by a physician.
Sec. 4765.37. (A) An emergency medical technician-basic
shall perform the emergency medical services described in this
section in accordance with this chapter and any rules adopted
under it by the state board of emergency medical services.
(B) An emergency medical technician-basic may operate, or be
responsible for operation of, an ambulance and may provide
emergency medical services to patients. In an emergency, an
EMT-basic may determine the nature and extent of illness or injury
and establish priority for required emergency medical services. An
EMT-basic may render emergency medical services such as opening
and maintaining an airway, giving positive pressure ventilation,
cardiac resuscitation, electrical interventions with automated
defibrillators to support or correct the cardiac function and
other methods determined by the board, controlling of hemorrhage,
treatment of shock, immobilization of fractures, bandaging,
assisting in childbirth, management of mentally disturbed
patients, initial care of poison and burn patients, and
determining triage of adult and pediatric trauma victims. Where
patients must in an emergency be extricated from entrapment, an
EMT-basic may assess the extent of injury and render all possible
emergency medical services and protection to the entrapped
patient; provide light rescue services if an ambulance has not
been accompanied by a specialized unit; and after extrication,
provide additional care in sorting of the injured in accordance
with standard emergency procedures.
(C) An EMT-basic may perform any other emergency medical
services approved pursuant to rules adopted under section 4765.11
of the Revised Code. The board shall determine whether the nature
of any such service requires that an EMT-basic receive
authorization prior to performing the service.
(D)(1) Except as provided in division (D)(2) of this section,
if the board determines under division (C) of this section that a
service requires prior authorization, the service shall be
performed only pursuant to the written or verbal authorization of
a physician or of the cooperating physician advisory board, or
pursuant to an authorization transmitted through a direct
communication device by a physician, physician assistant
designated by a physician, or registered nurse designated by a
physician.
(2) If communications fail during an emergency situation or
the required response time prohibits communication, an EMT-basic
may perform services subject to this division, if, in the judgment
of the EMT-basic, the life of the patient is in immediate danger.
Services performed under these circumstances shall be performed in
accordance with the protocols for triage of adult and pediatric
trauma victims established in rules adopted under sections 4765.11
and 4765.40 of the Revised Code and any applicable protocols
adopted by the emergency medical service organization with which
the EMT-basic is affiliated.
Sec. 4765.38. (A) An emergency medical
technician-intermediate shall perform the emergency medical
services described in this section in accordance with this chapter
and any rules adopted under it.
(B) An EMT-I may do any of the following:
(1) Establish and maintain an intravenous lifeline that has
been approved by a cooperating physician or physician advisory
board;
(2) Perform cardiac monitoring;
(3) Perform electrical interventions to support or correct
the cardiac function;
(4) Administer epinephrine;
(5) Determine triage of adult and pediatric trauma victims;
(6) Perform any other emergency medical services approved
pursuant to rules adopted under section 4765.11 of the Revised
Code.
(C)(1) Except as provided in division (C)(2) of this section,
the services described in division (B) of this section shall be
performed by an EMT-I only pursuant to the written or verbal
authorization of a physician or of the cooperating physician
advisory board, or pursuant to an authorization transmitted
through a direct communication device by a physician, physician
assistant designated by a physician, or registered nurse
designated by a physician.
(2) If communications fail during an emergency situation or
the required response time prohibits communication, an EMT-I may
perform any of the services described in division (B) of this
section, if, in the judgment of the EMT-I, the life of the patient
is in immediate danger. Services performed under these
circumstances shall be performed in accordance with the protocols
for triage of adult and pediatric trauma victims established in
rules adopted under sections 4765.11 and 4765.40 of the Revised
Code and any applicable protocols adopted by the emergency medical
service organization with which the EMT-I is affiliated.
(D) In addition to, and in the course of, providing emergency
medical treatment, an emergency medical technician-intermediate
may withdraw blood as provided under sections 1547.11, 4506.17,
and 4511.19 of the Revised Code. An emergency medical
technician-intermediate shall withdraw blood in accordance with
this chapter and any rules adopted under it by the state board of
emergency medical services.
Sec. 4765.39. (A) An emergency medical technician-paramedic
shall perform the emergency medical services described in this
section in accordance with this chapter and any rules adopted
under it.
(B) A paramedic may do any of the following:
(1) Perform cardiac monitoring;
(2) Perform electrical interventions to support or correct
the cardiac function;
(3) Perform airway procedures;
(4) Perform relief of pneumothorax;
(5) Administer appropriate drugs and intravenous fluids;
(6) Determine triage of adult and pediatric trauma victims;
(7) Perform any other emergency medical services, including
life support or intensive care techniques, approved pursuant to
rules adopted under section 4765.11 of the Revised Code.
(C)(1) Except as provided in division (C)(2) of this section,
the services described in division (B) of this section shall be
performed by a paramedic only pursuant to the written or verbal
authorization of a physician or of the cooperating physician
advisory board, or pursuant to an authorization transmitted
through a direct communication device by a physician, physician
assistant designated by a physician, or registered nurse
designated by a physician.
(2) If communications fail during an emergency situation or
the required response time prohibits communication, a paramedic
may perform any of the services described in division (B) of this
section, if, in the paramedic's judgment, the life of the patient
is in immediate danger. Services performed under these
circumstances shall be performed in accordance with the protocols
for triage of adult and pediatric trauma victims established in
rules adopted under sections 4765.11 and 4765.40 of the Revised
Code and any applicable protocols adopted by the emergency medical
service organization with which the paramedic is affiliated.
(D) In addition to, and in the course of, providing emergency
medical treatment, an emergency medical technician-paramedic may
withdraw blood as provided under sections 1547.11, 4506.17, and
4511.19 of the Revised Code. An emergency medical
technician-paramedic shall withdraw blood in accordance with this
chapter and any rules adopted under it by the state board of
emergency medical services.
Sec. 4765.49. (A) A first responder, emergency medical
technician-basic, emergency medical technician-intermediate, or
emergency medical technician-paramedic is not liable in damages in
a civil action for injury, death, or loss to person or property
resulting from the individual's administration of emergency
medical services, unless the services are administered in a manner
that constitutes willful or wanton misconduct. A physician,
physician assistant designated by a physician, or registered nurse
designated by a physician, who any of whom is advising or
assisting in the emergency medical services by means of any
communication device or telemetering system, is not liable in
damages in a civil action for injury, death, or loss to person or
property resulting from the individual's advisory communication or
assistance, unless the advisory communication or assistance is
provided in a manner that constitutes willful or wanton
misconduct. Medical directors and members of cooperating physician
advisory boards of emergency medical service organizations are not
liable in damages in a civil action for injury, death, or loss to
person or property resulting from their acts or omissions in the
performance of their duties, unless the act or omission
constitutes willful or wanton misconduct.
(B) A political subdivision, joint ambulance district, joint
emergency medical services district, or other public agency, and
any officer or employee of a public agency or of a private
organization operating under contract or in joint agreement with
one or more political subdivisions, that provides emergency
medical services, or that enters into a joint agreement or a
contract with the state, any political subdivision, joint
ambulance district, or joint emergency medical services district
for the provision of emergency medical services, is not liable in
damages in a civil action for injury, death, or loss to person or
property arising out of any actions taken by a first responder,
EMT-basic, EMT-I, or paramedic working under the officer's or
employee's jurisdiction, or for injury, death, or loss to person
or property arising out of any actions of licensed medical
personnel advising or assisting the first responder, EMT-basic,
EMT-I, or paramedic, unless the services are provided in a manner
that constitutes willful or wanton misconduct.
(C) A student who is enrolled in an emergency medical
services training program accredited under section 4765.17 of the
Revised Code or an emergency medical services continuing education
program approved under that section is not liable in damages in a
civil action for injury, death, or loss to person or property
resulting from either of the following:
(1) The student's administration of emergency medical
services or patient care or treatment, if the services, care, or
treatment is administered while the student is under the direct
supervision and in the immediate presence of an EMT-basic, EMT-I,
paramedic, registered nurse, physician assistant, or physician and
while the student is receiving clinical training that is required
by the program, unless the services, care, or treatment is
provided in a manner that constitutes willful or wanton
misconduct;
(2) The student's training as an ambulance driver, unless the
driving is done in a manner that constitutes willful or wanton
misconduct.
(D) An EMT-basic, EMT-I, paramedic, or other operator, who
holds a valid commercial driver's license issued pursuant to
Chapter 4506. of the Revised Code or driver's license issued
pursuant to Chapter 4507. of the Revised Code and who is employed
by an emergency medical service organization that is not owned or
operated by a political subdivision as defined in section 2744.01
of the Revised Code, is not liable in damages in a civil action
for injury, death, or loss to person or property that is caused by
the operation of an ambulance by the EMT-basic, EMT-I, paramedic,
or other operator while responding to or completing a call for
emergency medical services, unless the operation constitutes
willful or wanton misconduct or does not comply with the
precautions of section 4511.03 of the Revised Code. An emergency
medical service organization is not liable in damages in a civil
action for any injury, death, or loss to person or property that
is caused by the operation of an ambulance by its employee or
agent, if this division grants the employee or agent immunity from
civil liability for the injury, death, or loss.
(E) An employee or agent of an emergency medical service
organization who receives requests for emergency medical services
that are directed to the organization, dispatches first
responders, EMTs-basic, EMTs-I, or paramedics in response to those
requests, communicates those requests to those employees or agents
of the organization who are authorized to dispatch first
responders, EMTs-basic, EMTs-I, or paramedics, or performs any
combination of these functions for the organization, is not liable
in damages in a civil action for injury, death, or loss to person
or property resulting from the individual's acts or omissions in
the performance of those duties for the organization, unless an
act or omission constitutes willful or wanton misconduct.
(F) 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 state that borders this state and who provides
emergency medical services to or transportation of a patient in
this state is not liable in damages in a civil action for injury,
death, or loss to person or property resulting from the person's
administration of emergency medical services, unless the services
are administered in a manner that constitutes willful or wanton
misconduct. A physician, physician assistant designated by a
physician, or registered nurse designated by a physician, who any
of whom is licensed to practice in the adjoining state and who is
advising or assisting in the emergency medical services by means
of any communication device or telemetering system, is not liable
in damages in a civil action for injury, death, or loss to person
or property resulting from the person's advisory communication or
assistance, unless the advisory communication or assistance is
provided in a manner that constitutes willful or wanton
misconduct.
(G) A person certified under section 4765.23 of the Revised
Code to teach in an emergency medical services training program or
emergency medical services continuing education program, and a
person who teaches at the Ohio fire academy established under
section 3737.33 of the Revised Code or in a fire service training
program described in division (A) of section 4765.55 of the
Revised Code, is not liable in damages in a civil action for
injury, death, or loss to person or property resulting from the
person's acts or omissions in the performance of the person's
duties, unless an act or omission constitutes willful or wanton
misconduct.
(H) In the accreditation of emergency medical services
training programs or approval of emergency medical services
continuing education programs, the state board of emergency
medical services and any person or entity authorized by the board
to evaluate applications for accreditation or approval are not
liable in damages in a civil action for injury, death, or loss to
person or property resulting from their acts or omissions in the
performance of their duties, unless an act or omission constitutes
willful or wanton misconduct.
(I) A person authorized by an emergency medical service
organization to review the performance of first responders,
EMTs-basic, EMTs-I, and paramedics or to administer quality
assurance programs is not liable in damages in a civil action for
injury, death, or loss to person or property resulting from the
person's acts or omissions in the performance of the person's
duties, unless an act or omission constitutes willful or wanton
misconduct.
Sec. 4765.51. Nothing in this chapter prevents or restricts
the practice, services, or activities of any registered nurse
practicing within the scope of
his the registered nurse's
practice.
Nothing in this chapter prevents or restricts the practice,
services, or activities of any physician assistant practicing in
accordance with a physician supervisory plan approved under
section 4730.17 of the Revised Code or the policies of the health
care facility in which the physician assistant is practicing.
SECTION 2. That existing sections 2133.211, 3719.06,
4730.06, 4730.09, 4730.10, 4730.11, 4730.38, 4730.39, 4730.40,
4730.41, 4730.42, 4730.44, 4730.46, 4755.48, 4755.481, 4757.41, 4758.01,
4758.02, 4758.10, 4758.20, 4758.21, 4758.22, 4758.23, 4758.24,
4758.26, 4758.27, 4758.30, 4758.40, 4758.41, 4758.42, 4758.43,
4758.44, 4758.45, 4758.51, 4758.55, 4758.56, 4758.59, 4758.61,
4758.70, 4765.01,
4765.35, 4765.36, 4765.37, 4765.38, 4765.39, 4765.49, and 4765.51
and sections
3793.07, 4730.401, 4758.04, 4758.53, and
4758.58 of the Revised Code are hereby repealed.
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