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Sub. H. B. No. 170 As Enrolled
(130th General Assembly)
(Substitute House Bill Number 170)
AN ACT
To amend sections 4723.482 and 4762.03 and to enact
sections 2925.61, 4723.488, 4729.511, 4730.431,
and 4731.94 of the Revised Code to provide for
increased access to naloxone, to ensure English
proficiency in licensed practitioners of Oriental
medicine and acupuncture, to permit certain nurses
seeking prescriptive authority to complete a
portion of their study through Internet-based
study and to declare an emergency.
Be it enacted by the General Assembly of the State of Ohio:
SECTION 1. That sections 4723.482 and 4762.03 be amended and
sections 2925.61, 4723.488, 4729.511, 4730.431, and 4731.94 of the
Revised Code be enacted to read as follows:
Sec. 2925.61. (A) As used in this section:
(1) "Administer naloxone" means to give naloxone to a person
by either of the following routes:
(a) Using a device manufactured for the intranasal
administration of liquid drugs;
(b) Using an autoinjector in a manufactured dosage form.
(2) "Law enforcement agency" means a government entity that
employs peace officers to perform law enforcement duties.
(3) "Licensed health professional" means all of the
following:
(a) A physician who is authorized under Chapter 4731. of the
Revised Code to practice medicine and surgery, osteopathic
medicine and surgery, or podiatric medicine and surgery;
(b) A physician assistant who holds a certificate to
prescribe issued under Chapter 4730. of the Revised Code;
(c) A clinical nurse specialist, certified nurse-midwife, or
certified nurse practitioner who holds a certificate to prescribe
issued under section 4723.48 of the Revised Code.
(4) "Peace officer" has the same meaning as in section
2921.51 of the Revised Code.
(B) A family member, friend, or other individual who is in a
position to assist an individual who is apparently experiencing or
at risk of experiencing an opioid-related overdose, is not subject
to criminal prosecution for a violation of section 4731.41 of the
Revised Code or criminal prosecution under this chapter if the
individual, acting in good faith, does all of the following:
(1) Obtains naloxone from a licensed health professional or a
prescription for naloxone from a licensed health professional;
(2) Administers that naloxone to an individual who is
apparently experiencing an opioid-related overdose;
(3) Attempts to summon emergency services either immediately
before or immediately after administering the naloxone.
(C) Division (B) of this section does not apply to a peace
officer or to an emergency medical technician-basic, emergency
medical technician-intermediate, or emergency medical
technician-paramedic, as defined in section 4765.01 of the Revised
Code.
(D) A peace officer employed by a law enforcement agency
licensed under Chapter 4729. of the Revised Code as a terminal
distributor of dangerous drugs is not subject to administrative
action, criminal prosecution for a violation of section 4731.41 of
the Revised Code, or criminal prosecution under this chapter if
the peace officer, acting in good faith, obtains naloxone from the
peace officer's law enforcement agency and administers the
naloxone to an individual who is apparently experiencing an
opioid-related overdose.
Sec. 4723.482. (A) Except as provided in divisions (C) and
(D) of this section, an applicant shall include with the
application submitted under section 4723.48 of the Revised Code
all of the following:
(1) Evidence of holding a current, valid certificate of
authority to practice as a clinical nurse specialist, certified
nurse-midwife, or certified nurse practitioner that was issued by
meeting the requirements of division (A) of section 4723.41 of the
Revised Code;
(2) Evidence of successfully completing the course of study
in advanced pharmacology and related topics in accordance with the
requirements specified in division (B) of this section;
(3) The fee required by section 4723.08 of the Revised Code
for a certificate to prescribe;
(4) Any additional information the board of nursing requires
pursuant to rules adopted under section 4723.50 of the Revised
Code.
(B) With respect to the course of study in advanced
pharmacology and related topics that must be successfully
completed to obtain a certificate to prescribe, all of the
following requirements apply:
(1) The course of study shall be completed not longer than
three years before the application for the certificate to
prescribe is filed.
(2) The Except as provided in division (E) of this section,
the course of study shall consist of planned classroom and
clinical instruction for a. The total length of the course of
study shall be not less than forty-five contact hours.
(3) The course of study shall meet the requirements to be
approved by the board in accordance with standards established in
rules adopted under section 4723.50 of the Revised Code.
(4) The content of the course of study shall be specific to
the applicant's nursing specialty.
(5) The instruction provided in the course of study shall
include all of the following:
(a) A minimum of thirty-six contact hours of instruction in
advanced 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) Instruction in the fiscal and ethical implications of
prescribing drugs and therapeutic devices;
(c) Instruction in the state and federal laws that apply to
the authority to prescribe;
(d) Instruction that is specific to schedule II controlled
substances, including instruction in all of the following:
(i) Indications for the use of schedule II controlled
substances in drug therapies;
(ii) The most recent guidelines for pain management
therapies, as established by state and national organizations such
as the Ohio pain initiative and the American pain society;
(iii) Fiscal and ethical implications of prescribing schedule
II controlled substances;
(iv) State and federal laws that apply to the authority to
prescribe schedule II controlled substances;
(v) Prevention of abuse and diversion of schedule II
controlled substances, including identification of the risk of
abuse and diversion, recognition of abuse and diversion, types of
assistance available for prevention of abuse and diversion, and
methods of establishing safeguards against abuse and diversion.
(e) Any additional instruction required pursuant to rules
adopted under section 4723.50 of the Revised Code.
(C) An applicant who practiced or is practicing as a clinical
nurse specialist, certified nurse-midwife, or certified nurse
practitioner in another jurisdiction or as an employee of the
United States government, and is not seeking authority to
prescribe drugs and therapeutic devices by meeting the
requirements of division (A) or (D) of this section, shall include
with the application submitted under section 4723.48 of the
Revised Code all of the following:
(1) Evidence of holding a current, valid certificate of
authority issued under this chapter to practice as a clinical
nurse specialist, certified nurse-midwife, or certified nurse
practitioner;
(2) The fee required by section 4723.08 of the Revised Code
for a certificate to prescribe;
(3) Either of the following:
(a) Evidence of having held, for a continuous period of at
least one year during the three years immediately preceding the
date of application, valid authority issued by another
jurisdiction to prescribe therapeutic devices and drugs, including
at least some controlled substances;
(b) Evidence of having been employed by the United States
government and authorized, for a continuous period of at least one
year during the three years immediately preceding the date of
application, to prescribe therapeutic devices and drugs, including
at least some controlled substances, in conjunction with that
employment.
(4) Evidence of having completed a two-hour course of
instruction approved by the board in the laws of this state that
govern drugs and prescriptive authority;
(5) Any additional information the board requires pursuant to
rules adopted under section 4723.50 of the Revised Code.
(D) An applicant who practiced or is practicing as a clinical
nurse specialist, certified nurse-midwife, or certified nurse
practitioner in another jurisdiction or as an employee of the
United States government, and is not seeking authority to
prescribe drugs and therapeutic devices by meeting the
requirements of division (A) or (C) of this section, shall include
with the application submitted under section 4723.48 of the
Revised Code all of the following:
(1) Evidence of holding a current, valid certificate of
authority issued under this chapter to practice as a clinical
nurse specialist, certified nurse-midwife, or certified nurse
practitioner;
(2) The fee required by section 4723.08 of the Revised Code
for a certificate to prescribe;
(3) Either of the following:
(a) Evidence of having held, for a continuous period of at
least one year during the three years immediately preceding the
date of application, valid authority issued by another
jurisdiction to prescribe therapeutic devices and drugs, excluding
controlled substances;
(b) Evidence of having been employed by the United States
government and authorized, for a continuous period of at least one
year during the three years immediately preceding the date of
application, to prescribe therapeutic devices and drugs, excluding
controlled substances, in conjunction with that employment.
(4) Any additional information the board requires pursuant to
rules adopted under section 4723.50 of the Revised Code.
(E) In the case of an applicant who meets the requirements of
division (C) or (D) of this section other than the requirements of
division (C)(3) or (D)(3) of this section and is seeking authority
to prescribe drugs and therapeutic devices by meeting the
requirements of division (A) of this section, the applicant may
complete the instruction that is specific to schedule II
controlled substances, as required by division (B)(5)(d) of this
section, through an internet-based course of study in lieu of
completing the instruction through a course of study consisting of
planned classroom and clinical instruction.
Sec. 4723.488. (A) Notwithstanding any provision of this
chapter or rule adopted by the board of nursing, a clinical nurse
specialist, certified nurse-midwife, or certified nurse
practitioner who holds a certificate to prescribe issued under
section 4723.48 of the Revised Code may personally furnish a
supply of naloxone, or issue a prescription for naloxone, without
having examined the individual to whom it may be administered if
all of the following conditions are met:
(1) The naloxone supply is furnished to, or the prescription
is issued to and in the name of, a family member, friend, or other
individual in a position to assist an individual who there is
reason to believe is at risk of experiencing an opioid-related
overdose.
(2) The nurse instructs the individual receiving the naloxone
supply or prescription to summon emergency services either
immediately before or immediately after administering naloxone to
an individual apparently experiencing an opioid-related overdose.
(3) The naloxone is personally furnished or prescribed in
such a manner that it may be administered by only either of the
following routes:
(a) Using a device manufactured for the intranasal
administration of liquid drugs;
(b) Using an autoinjector in a manufactured dosage form.
(B) A nurse who under division (A) of this section in good
faith furnishes a supply of naloxone or issues a prescription for
naloxone is not liable for or subject to any of the following for
any action or omission of the individual to whom the naloxone is
furnished or the prescription is issued: damages in any civil
action, prosecution in any criminal proceeding, or professional
disciplinary action.
Sec. 4729.511. (A) As used in this section, "naloxone
distributor" means either of the following:
(1) A wholesale distributor of dangerous drugs;
(2) A terminal distributor of dangerous drugs that supplies
naloxone to any entity under division (B)(1) of this section.
(B)(1) A naloxone distributor shall prioritize the sale,
distribution, and delivery of naloxone to all of the following:
(a) A children's hospital, as defined in section 3727.01 of
the Revised Code;
(b) A hospital, as defined in section 3727.01 of the Revised
Code;
(c) An emergency medical service organization, as defined in
section 4765.01 of the Revised Code;
(d) A facility that is operated as an urgent care center.
(2) The order in which the entities are listed in division
(B)(1) of this section does not establish levels of priority among
the listed entities.
(C) A naloxone distributor who in good faith complies with
division (B) of this section is not liable for or subject to any
of the following for an act or omission arising from that
compliance: damages in any civil action, prosecution in any
criminal proceeding, or professional disciplinary action.
Sec. 4730.431. (A) Notwithstanding any provision of this
chapter or rule adopted by the state medical board, a physician
assistant who holds a certificate to prescribe issued under this
chapter may personally furnish a supply of naloxone, or issue a
prescription for naloxone, without having examined the individual
to whom it may be administered if all of the following conditions
are met:
(1) The naloxone supply is furnished to, or the prescription
is issued to and in the name of, a family member, friend, or other
individual in a position to assist an individual who there is
reason to believe is at risk of experiencing an opioid-related
overdose.
(2) The physician assistant instructs the individual
receiving the naloxone supply or prescription to summon emergency
services either immediately before or immediately after
administering naloxone to an individual apparently experiencing an
opioid-related overdose.
(3) The naloxone is personally furnished or prescribed in
such a manner that it may be administered by only either of the
following routes:
(a) Using a device manufactured for the intranasal
administration of liquid drugs;
(b) Using an autoinjector in a manufactured dosage form.
(B) A physician assistant who under division (A) of this
section in good faith furnishes a supply of naloxone or issues a
prescription for naloxone is not liable for or subject to any of
the following for any action or omission of the individual to whom
the naloxone is furnished or the prescription is issued: damages
in any civil action, prosecution in any criminal proceeding, or
professional disciplinary action.
Sec. 4731.94. (A) As used in this section, "physician" means
an individual authorized under this chapter to practice medicine
and surgery, osteopathic medicine and surgery, or podiatric
medicine and surgery.
(B) Notwithstanding any provision of this chapter or rule
adopted by the state medical board, a physician may personally
furnish a supply of naloxone, or issue a prescription for
naloxone, without having examined the individual to whom it may be
administered if all of the following conditions are met:
(1) The naloxone supply is furnished to, or the prescription
is issued to and in the name of, a family member, friend, or other
individual in a position to assist an individual who there is
reason to believe is at risk of experiencing an opioid-related
overdose.
(2) The physician instructs the individual receiving the
naloxone supply or prescription to summon emergency services
either immediately before or immediately after administering the
naloxone to an individual apparently experiencing an
opioid-related overdose.
(3) The naloxone is personally furnished or prescribed in
such a manner that it may be administered by only either of the
following routes:
(a) Using a device manufactured for the intranasal
administration of liquid drugs;
(b) Using an autoinjector in a manufactured dosage form.
(C) A physician who under division (B) of this section in
good faith furnishes a supply of naloxone or issues a prescription
for naloxone is not liable for or subject to any of the following
for any action or omission of the individual to whom the naloxone
is furnished or the prescription is issued: damages in any civil
action, prosecution in any criminal proceeding, or professional
disciplinary action.
Sec. 4762.03. (A) An individual seeking a certificate to
practice as an oriental medicine practitioner or certificate to
practice as an acupuncturist shall file with the state medical
board a written application on a form prescribed and supplied by
the board.
(B) To be eligible for the certificate to practice, an
applicant shall meet all of the following conditions, as
applicable:
(1) The applicant shall submit evidence satisfactory to the
board that the applicant is at least eighteen years of age and of
good moral character.
(2) In the case of an applicant seeking a certificate to
practice as an oriental medicine practitioner, the applicant shall
submit evidence satisfactory to the board of both of the
following:
(a) That the applicant holds a current and active designation
from the national certification commission for acupuncture and
oriental medicine as either a diplomate in oriental medicine or
diplomate of acupuncture and Chinese herbology;
(b) That the applicant has successfully completed, in the
two-year period immediately preceding application for the
certificate to practice, one course approved by the commission on
federal food and drug administration dispensary and compounding
guidelines and procedures.
(3) In the case of an applicant seeking a certificate to
practice as an acupuncturist, the applicant shall submit evidence
satisfactory to the board that the applicant holds a current and
active designation from the national certification commission for
acupuncture and oriental medicine as a diplomate in acupuncture.
(4) The applicant shall demonstrate to the board proficiency
in spoken English by either passing satisfying one of the
following requirements:
(a) Passing the examination described in section 4731.142 of
the Revised Code or submitting;
(b) Submitting evidence satisfactory to the board that the
applicant was required to demonstrate proficiency in spoken
English as a condition of obtaining designation from the national
certification commission for acupuncture and oriental medicine as
a diplomate in oriental medicine, diplomate of acupuncture and
Chinese herbology, or diplomate in acupuncture;
(c) Submitting evidence satisfactory to the board that the
applicant, in seeking a designation from the national
certification commission for acupuncture and oriental medicine as
a diplomate of oriental medicine, diplomate of acupuncture and
Chinese herbology, or diplomate of acupuncture, has successfully
completed in English the examination required for such a
designation by the national certification commission for
acupuncture and oriental medicine;
(d) In the case of an applicant seeking a certificate to
practice as an oriental medicine practitioner, submitting evidence
satisfactory to the board that the applicant has previously held a
certificate to practice as an acupuncturist issued under section
4762.04 of the Revised Code.
(5) The applicant shall submit to the board any other
information the board requires.
(6) The applicant shall pay to the board a fee of one hundred
dollars, no part of which may be returned to the applicant.
(C) The board shall review all applications received under
this section. The board shall determine whether an applicant meets
the requirements to receive a certificate to practice not later
than sixty days after receiving a complete application. The
affirmative vote of not fewer than six members of the board is
required to determine that an applicant meets the requirements for
a certificate.
SECTION 2. That existing sections 4723.482 and 4762.03 of the
Revised Code are hereby repealed.
SECTION 3. This act is hereby declared to be an emergency
measure necessary for the immediate preservation of the public
peace, health, and safety. The reason for such necessity is to
enhance the delivery of health services in this state by promptly
increasing access to certain forms of care, including Oriental
medicine, acupuncture, services of certain nurses with
prescriptive authority, and emergency treatments for drug
overdoses. Therefore, this act shall go into immediate effect.
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