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Sub. H. B. No. 165 As Enrolled
(130th General Assembly)
(Substitute House Bill Number 165)
AN ACT
To amend sections 4761.01, 4761.03, 4761.07, and
4761.11 of the Revised Code to exempt certified
hyperbaric technologists from the laws governing
the practice of respiratory care.
Be it enacted by the General Assembly of the State of Ohio:
SECTION 1. That sections 4761.01, 4761.03, 4761.07, and
4761.11 of the Revised Code be amended to read as follows:
Sec. 4761.01. As used in this chapter:
(A) "Respiratory care" means rendering or offering to render
to individuals, groups, organizations, or the public any service
involving the evaluation of cardiopulmonary function, the
treatment of cardiopulmonary impairment, the assessment of
treatment effectiveness, and the care of patients with
deficiencies and abnormalities associated with the cardiopulmonary
system. The practice of respiratory care includes:
(1) Obtaining, analyzing, testing, measuring, and monitoring
blood and gas samples in the determination of cardiopulmonary
parameters and related physiologic data, including flows,
pressures, and volumes, and the use of equipment employed for this
purpose;
(2) Administering, monitoring, recording the results of, and
instructing in the use of medical gases, aerosols, and
bronchopulmonary hygiene techniques, including drainage,
aspiration, and sampling, and applying, maintaining, and
instructing in the use of artificial airways, ventilators, and
other life support equipment employed in the treatment of
cardiopulmonary impairment and provided in collaboration with
other licensed health care professionals responsible for providing
care;
(3) Performing cardiopulmonary resuscitation and respiratory
rehabilitation techniques;
(4) Administering medications for the testing or treatment of
cardiopulmonary impairment.
(B) "Respiratory care professional" means a person who is
licensed under this chapter to practice the full range of
respiratory care services as defined in division (A) of this
section.
(C) "Physician" means an individual authorized under Chapter
4731. of the Revised Code to practice medicine and surgery or
osteopathic medicine and surgery.
(D) "Registered nurse" means an individual licensed under
Chapter 4723. of the Revised Code to engage in the practice of
nursing as a registered nurse.
(E) "Hospital" means a facility that meets the operating
standards of section 3727.02 of the Revised Code.
(F) "Nursing facility" has the same meaning as in section
5165.01 of the Revised Code.
(G) "Certified hyperbaric technologist" means a person who
administers hyperbaric oxygen therapy and is certified as a
hyperbaric technologist by the national board of diving and
hyperbaric medical technology or its successor organization.
(H) "Hyperbaric oxygen therapy" means the administration of
pure oxygen in a pressurized room or chamber, except that it does
not include ventilator management.
(I) "Advanced practice registered nurse" has the same meaning
as in section 4723.01 of the Revised Code.
(J) "Physician assistant" means an individual who holds a
valid certificate to practice issued under Chapter 4730. of the
Revised Code authorizing the individual to provide services as a
physician assistant to patients under the supervision, control,
and direction of one or more physicians.
Sec. 4761.03. The Ohio respiratory care board shall regulate
the practice of respiratory care in this state and the persons to
whom the board issues licenses and limited permits under this
chapter and shall license and register home medical equipment
services providers under Chapter 4752. of the Revised Code. Rules
adopted under this chapter that deal with the provision of
respiratory care in a hospital, other than rules regulating the
issuance of licenses or limited permits, shall be consistent with
the conditions for participation under medicare, Title XVIII of
the "Social Security Act," 79 Stat. 286 (1965), 42 U.S.C.A. 1395,
as amended, and with the respiratory care accreditation standards
of the joint commission on accreditation of healthcare
organizations or the American osteopathic association.
The board shall:
(A) Adopt, and may rescind or amend, rules in accordance with
Chapter 119. of the Revised Code to carry out the purposes of this
chapter, including rules prescribing:
(1) The form and manner for filing applications for licensure
and renewal, limited permits, and limited permit extensions under
sections 4761.05 and 4761.06 of the Revised Code;
(2) The form, scoring, and scheduling of examinations and
reexaminations for licensure and license renewal;
(3) Standards for the approval of educational programs
required to qualify for licensure and continuing education
programs required for license renewal;
(4) Continuing education courses and the number of hour
requirements necessary for license renewal, in accordance with
section 4761.06 of the Revised Code;
(5) Procedures for the issuance and renewal of licenses and
limited permits, including the duties that may be fulfilled by the
board's executive director and other board employees;
(6) Procedures for the denial, suspension, permanent
revocation, refusal to renew, and reinstatement of licenses and
limited permits, the conduct of hearings, and the imposition of
fines for engaging in conduct that is grounds for such action and
hearings under section 4761.09 of the Revised Code;
(7) Standards of ethical conduct for the practice of
respiratory care;
(8) Conditions under which the license renewal fee and
continuing education requirements may be waived at the request of
a licensee who is not in active practice;
(9) The respiratory care tasks that may be performed by an
individual practicing as a polysomnographic technologist pursuant
to division (B)(3) of section 4761.10 of the Revised Code;
(10) Procedures for registering out-of-state respiratory care
providers authorized to practice in this state under division
(A)(4) of section 4761.11 of the Revised Code;
(11) Requirements for criminal records checks of applicants
under section 4776.03 of the Revised Code;
(12) Procedures for accepting and storing copies of
hyperbaric technologist certifications filed with the board
pursuant to division (A)(11) of section 4761.11 of the Revised
Code.
(B) Determine the sufficiency of an applicant's
qualifications for admission to the licensing examination or a
reexamination, and for the issuance or renewal of a license or
limited permit;
(C) Determine the respiratory care educational programs that
are acceptable for fulfilling the requirements of division (A) of
section 4761.04 of the Revised Code;
(D) Schedule, administer, and score the licensing examination
or any reexamination for license renewal or reinstatement. The
board shall administer the licensing examinations at least twice a
year and notify applicants of the time and place of the
examinations.
(E) Investigate complaints concerning alleged violations of
section 4761.10 of the Revised Code or grounds for the suspension,
permanent revocation, or refusal to issue licenses or limited
permits under section 3123.47 or 4761.09 of the Revised Code. The
board shall employ investigators who shall, under the direction of
the executive director of the board, investigate complaints and
make inspections and other inquiries as, in the judgment of the
board, are appropriate to enforce sections 3123.41 to 3123.50,
4761.09, and 4761.10 of the Revised Code. Pursuant to an
investigation and inspection, the investigators may review and
audit records during normal business hours at the place of
business of a licensee or person who is the subject of a complaint
filed with the board or at any place where the records are kept.
Except when required by court order, the board and its
employees shall not disclose confidential information obtained
during an investigation or identifying information about any
person who files a complaint with the board.
The board may hear testimony in matters relating to the
duties imposed upon it and issue subpoenas pursuant to an
investigation. The president and secretary of the board may
administer oaths.
(F) Conduct hearings, keep records of its proceedings, and do
other things as are necessary and proper to carry out and enforce
the provisions of this chapter;
(G) Maintain, publish, and make available upon request, for a
fee not to exceed the actual cost of printing and mailing:
(1) The requirements for the issuance of licenses and limited
permits under this chapter and rules adopted by the board;
(2) A current register of every person licensed to practice
respiratory care in this state, to include the addresses of the
person's last known place of business and residence, the effective
date and identification number of the license, the name and
location of the institution that granted the person's degree or
certificate of completion of respiratory care educational
requirements, and the date the degree or certificate was issued;
(3) A list of the names and locations of the institutions
that each year granted degrees or certificates of completion in
respiratory care;
(4) After the administration of each examination, a list of
persons who passed the examination.
(H) Submit to the governor and to the general assembly each
year a report of all of its official actions during the preceding
year, together with any findings and recommendations with regard
to the improvement of the profession of respiratory care;
(I) Administer and enforce Chapter 4752. of the Revised Code.
Sec. 4761.07. (A) The Ohio respiratory care board shall
charge any license applicant or holder who is to take an
examination required under division (A)(3) of section 4761.04 or a
reexamination required under division (B) of section 4761.06 of
the Revised Code for license renewal or under section 4761.09 of
the Revised Code for license reinstatement, a nonrefundable
examination fee, not to exceed the amount necessary to cover the
expense of administering the examination. The license applicant or
holder shall pay the fee at the time of application for licensure
or renewal.
(B) The board shall establish the following additional
nonrefundable fees and penalty:
(1) An initial license fee, not to exceed seventy-five
dollars;
(2) A biennial license renewal fee, not to exceed one hundred
dollars;
(3) A limited permit fee, not to exceed twenty dollars;
(4) A limited permit renewal fee, not to exceed ten dollars;
(5) A late renewal penalty, not to exceed fifty per cent of
the renewal fee;
(6) A fee for accepting and storing hyperbaric technologist
certifications filed with the board under division (A)(11) of
section 4761.11 of the Revised Code, not to exceed twenty dollars.
(C) Notwithstanding division (B)(4) of this section, after
the third renewal of a limited permit that meets the exception in
division (B)(3) of section 4761.05 of the Revised Code, the
limited permit renewal fee shall be one-half the amount of the
biennial license renewal fee established under division (B)(2) of
this section and section 4761.08 of the Revised Code.
(D) The board shall adjust the fees biennially and within the
limits established by division (B) of this section to provide
sufficient revenues to meet its expenses.
(E) The board may, by rule, provide for the waiver of all or
part of a license fee when the license is issued less than
eighteen months before its expiration date.
(F) All fees received by the board shall be deposited into
the state treasury to the credit of the occupational licensing and
regulatory fund.
Sec. 4761.11. (A) Nothing in this chapter shall be construed
to prevent or restrict the practice, services, or activities of
any person who:
(1) Is a health care professional licensed by this state
providing respiratory care services included in the scope of
practice established by the license held, as long as the person
does not represent that the person is engaged in the practice of
respiratory care;
(2) Is employed as a respiratory care professional by an
agency of the United States government and provides respiratory
care solely under the direction or control of the employing
agency;
(3) Is a student enrolled in a board-approved respiratory
care education program leading to a certificate of completion in
respiratory care and is performing duties that are part of a
supervised course of study;
(4) Is a nonresident of this state practicing or offering to
practice respiratory care, if the respiratory care services are
offered for not more than thirty days in a year, services are
provided under the supervision of a respiratory care professional
licensed under this chapter, and the nonresident registers with
the board in accordance with rules adopted by the board under
section 4761.03 of the Revised Code and meets either of the
following requirements:
(a) Qualifies for licensure under this chapter, except for
passage of the examination required under division (A)(3) of
section 4761.04 of the Revised Code;
(b) Holds a valid license issued by a state that has
licensure requirements considered by the board to be comparable to
those of this state and has not been issued a license in another
state that has been revoked or is currently under suspension or on
probation.
(5) Provides respiratory care only to relatives or in medical
emergencies;
(6) Provides gratuitous care to friends or personal family
members;
(7) Provides only self care;
(8) Is employed in the office of a physician and renders
medical assistance under the physician's direct supervision
without representing that the person is engaged in the practice of
respiratory care;
(9) Is employed in a clinical chemistry or arterial blood gas
laboratory and is supervised by a physician without representing
that the person is engaged in the practice of respiratory care;
(10) Is engaged in the practice of respiratory care as an
employee of a person or governmental entity located in another
state and provides respiratory care services for less than
seventy-two hours to patients being transported into, out of, or
through this state;
(11) Is employed as a certified hyperbaric technologist, has
filed with the board a copy of the person's current certification
as a hyperbaric technologist in accordance with the rules adopted
by the board under section 4761.03 of the Revised Code, has paid
the fee established pursuant to section 4761.07 of the Revised
Code, and administers hyperbaric oxygen therapy under the direct
supervision of a physician, a physician assistant, or an advanced
practice registered nurse and without representing that the person
is engaged in the practice of respiratory care.
(B) Nothing in this chapter shall be construed to prevent any
person from advertising, describing, or offering to provide
respiratory care or billing for respiratory care when the
respiratory care services are provided by a health care
professional licensed by this state practicing within the scope of
practice established by the license held. Nothing in this chapter
shall be construed to prevent a hospital or nursing facility from
advertising, describing, or offering to provide respiratory care,
or billing for respiratory care rendered by a person licensed
under this chapter or persons who may provide limited aspects of
respiratory care or respiratory care tasks pursuant to division
(B) of section 4761.10 of the Revised Code.
(C) Notwithstanding division (A) of section 4761.10 of the
Revised Code, in a life-threatening situation, in the absence of
licensed personnel, unlicensed persons shall not be prohibited
from taking life-saving measures.
(D) Nothing in this chapter shall be construed as authorizing
a respiratory care professional to practice medicine and surgery
or osteopathic medicine and surgery. This division does not
prohibit a respiratory care professional from administering
topical or intradermal medications for the purpose of producing
localized decreased sensation as part of a procedure or task that
is within the scope of practice of a respiratory care
professional.
SECTION 2. That existing sections 4761.01, 4761.03, 4761.07,
and 4761.11 of the Revised Code are hereby repealed.
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