130th Ohio General Assembly
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H. B. No. 170  As Introduced
As Introduced

130th General Assembly
Regular Session
2013-2014
H. B. No. 170


Representatives Johnson, Stinziano 

Cosponsors: Representatives Amstutz, Antonio, Gonzales, Grossman, Letson, Lynch, Maag, Milkovich, Phillips, Reece, Rogers, Sprague, Stebelton, Ramos 



A BILL
To amend sections 4765.11, 4765.37, and 4765.38 and to enact sections 2305.331, 2925.61, and 2925.611 of the Revised Code to provide that a licensed health professional authorized to prescribe naloxone, if acting with reasonable care, may prescribe, administer, dispense, or furnish naloxone to a person who is, or a person who is in a position to assist a person who is, apparently experiencing or who is likely to experience an opioid-related overdose without being subject to administrative action or criminal prosecution, to provide that a person who is in a position to assist a person who is apparently experiencing or who is likely to experience an opioid-related overdose is not subject to actions of professional licensing boards, administrative action, or criminal prosecution for a drug offense or practicing medicine without a license if the person, acting in good faith, obtains naloxone or a naloxone prescription from a licensed health professional and administers it to a person for an opioid-related overdose, and to provide that peace officers and licensed emergency responders who are acting in good faith are not subject to administrative action or criminal prosecution for a drug offense or practicing medicine without a license for administering naloxone to a person who is apparently experiencing an opioid-related overdose.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 4765.11, 4765.37, and 4765.38 be amended and sections 2305.331, 2925.61, and 2925.611 of the Revised Code be enacted to read as follows:
Sec. 2305.331. (A) As used in this section:
(1) "Administer" means the direct application of a drug to a person by inhalation.
(2) "Dispense" has the same meaning as in section 3719.01 of the Revised Code.
(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) "Naloxone" means naloxone hydrochloride.
(B) A licensed health professional who is authorized to prescribe naloxone, if acting with reasonable care, may prescribe, administer, dispense, or personally furnish naloxone to any of the following persons without being subject to administrative action or criminal prosecution:
(1) A person who is apparently experiencing or who is likely to experience an opioid-related overdose;
(2) A family member, friend, or other person in a position to assist a person who is apparently experiencing or who is likely to experience an opioid-related overdose.
Sec. 2925.61. (A) As used in sections 2925.61 and 2925.611 of the Revised Code:
(1) "Administer" means the direct application of naloxone to a person by inhalation.
(2) "Dispense" means to personally furnish, leave with, give away, or deliver.
(3) "Emergency medical technician-basic," "emergency medical technician-intermediate," and "emergency medical technician-paramedic" have the same meanings as in section 4765.01 of the Revised Code.
(4) "Law enforcement agency" means an organization or entity made up of peace officers.
(5) "Licensed emergency responder" means an emergency medical technician-basic, emergency medical technician-intermediate, or emergency medical technician-paramedic.
(6) "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.
(7) "Naloxone" means naloxone hydrochloride.
(8) "Peace officer" has the same meaning as in section 2921.51 of the Revised Code.
(B) A family member, friend, or other person who is in a position to assist a person who is apparently experiencing or who is likely to experience an opioid-related overdose, other than a licensed emergency responder or peace officer who is subject to section 2925.611 of the Revised Code, is not subject to actions by professional licensing boards, administrative action, criminal prosecution for a violation of section 4731.41 of the Revised Code, or criminal prosecution under Chapter 2925. of the Revised Code if the person, acting in good faith, obtains naloxone from a licensed health professional or a prescription for naloxone from a licensed health professional and administers the naloxone obtained from the licensed health professional or acquired pursuant to the prescription to a person who is apparently experiencing an opioid-related overdose.
Sec. 2925.611.  (A) A licensed emergency responder is not subject to administrative action, criminal prosecution for a violation of section 4731.41 of the Revised Code, or criminal prosecution under Chapter 2925. of the Revised Code if the licensed emergency responder, acting in good faith, obtains naloxone from the licensed emergency responder's emergency medical service organization and administers the naloxone to a person who is apparently experiencing an opioid-related overdose if the emergency medical service organization is licensed under Chapter 4729. of the Revised Code as a terminal distributor of dangerous drugs.
(B) A peace officer is not subject to administrative action, criminal prosecution for a violation of section 4731.41 of the Revised Code, or criminal prosecution under Chapter 2925. of the Revised Code if the peace officer, acting in good faith, obtains naloxone from the peace officer's law enforcement agency and administers the naloxone to a person who is apparently experiencing an opioid-related overdose, contingent on the law enforcement agency being licensed under Chapter 4729. of the Revised Code as a limited category II terminal distributor of dangerous drugs.
Sec. 4765.11.  (A) The state board of emergency medical, fire, and transportation services shall adopt, and may amend and rescind, rules in accordance with Chapter 119. of the Revised Code and division (C) of this section that establish all of the following:
(1) Procedures for its governance and the control of its actions and business affairs;
(2) Standards for the performance of emergency medical services by first responders, emergency medical technicians-basic, emergency medical technicians-intermediate, and emergency medical technicians-paramedic;
(3) Application fees for certificates of accreditation, certificates of approval, certificates to teach, and certificates to practice, which shall be deposited into the trauma and emergency medical services fund created in section 4513.263 of the Revised Code;
(4) Criteria for determining when the application or renewal fee for a certificate to practice may be waived because an applicant cannot afford to pay the fee;
(5) Procedures for issuance and renewal of certificates of accreditation, certificates of approval, certificates to teach, and certificates to practice, including any procedures necessary to ensure that adequate notice of renewal is provided in accordance with division (D) of section 4765.30 of the Revised Code;
(6) Procedures for suspending or revoking certificates of accreditation, certificates of approval, certificates to teach, and certificates to practice;
(7) Grounds for suspension or revocation of a certificate to practice issued under section 4765.30 of the Revised Code and for taking any other disciplinary action against a first responder, EMT-basic, EMT-I, or paramedic;
(8) Procedures for taking disciplinary action against a first responder, EMT-basic, EMT-I, or paramedic;
(9) Standards for certificates of accreditation and certificates of approval;
(10) Qualifications for certificates to teach;
(11) Requirements for a certificate to practice;
(12) The curricula, number of hours of instruction and training, and instructional materials to be used in adult and pediatric emergency medical services training programs and adult and pediatric emergency medical services continuing education programs;
(13) Procedures for conducting courses in recognizing symptoms of life-threatening allergic reactions and in calculating proper dosage levels and administering injections of epinephrine to adult and pediatric patients who suffer life-threatening allergic reactions;
(14) Examinations for certificates to practice;
(15) Procedures for administering examinations for certificates to practice;
(16) Procedures for approving examinations that demonstrate competence to have a certificate to practice renewed without completing an emergency medical services continuing education program;
(17) Procedures for granting extensions and exemptions of emergency medical services continuing education requirements;
(18) Procedures for approving the additional emergency medical services first responders are authorized by division (C) of section 4765.35 of the Revised Code to perform, EMTs-basic are authorized by division (C) of section 4765.37 of the Revised Code to perform, EMTs-I are authorized by division (B)(5)(7) of section 4765.38 of the Revised Code to perform, and paramedics are authorized by division (B)(6) of section 4765.39 of the Revised Code to perform;
(19) Standards and procedures for implementing the requirements of section 4765.06 of the Revised Code, including designations of the persons who are required to report information to the board and the types of information to be reported;
(20) Procedures for administering the emergency medical services grant program established under section 4765.07 of the Revised Code;
(21) Procedures consistent with Chapter 119. of the Revised Code for appealing decisions of the board;
(22) Minimum qualifications and peer review and quality improvement requirements for persons who provide medical direction to emergency medical service personnel;
(23) The manner in which a patient, or a patient's parent, guardian, or custodian may consent to the board releasing identifying information about the patient under division (D) of section 4765.102 of the Revised Code;
(24) Circumstances under which a training program or continuing education program, or portion of either type of program, may be taught by a person who does not hold a certificate to teach issued under section 4765.23 of the Revised Code;
(25) Certification cycles for certificates issued under sections 4765.23 and 4765.30 of the Revised Code and certificates issued by the executive director of the state board of emergency medical, fire, and transportation services under section 4765.55 of the Revised Code that establish a common expiration date for all certificates.
(B) The board may adopt, and may amend and rescind, rules in accordance with Chapter 119. of the Revised Code and division (C) of this section that establish the following:
(1) Specifications of information that may be collected under the trauma system registry and incidence reporting system created under section 4765.06 of the Revised Code;
(2) Standards and procedures for implementing any of the recommendations made by any committees of the board or under section 4765.04 of the Revised Code;
(3) Requirements that a person must meet to receive a certificate to practice as a first responder pursuant to division (A)(2) of section 4765.30 of the Revised Code;
(4) Any other rules necessary to implement this chapter.
(C) In developing and administering rules adopted under this chapter, the state board of emergency medical, fire, and transportation services shall consult with regional directors and regional physician advisory boards created by section 4765.05 of the Revised Code and emphasize the special needs of pediatric and geriatric patients.
(D) Except as otherwise provided in this division, before adopting, amending, or rescinding any rule under this chapter, the board shall submit the proposed rule to the director of public safety for review. The director may review the proposed rule for not more than sixty days after the date it is submitted. If, within this sixty-day period, the director approves the proposed rule or does not notify the board that the rule is disapproved, the board may adopt, amend, or rescind the rule as proposed. If, within this sixty-day period, the director notifies the board that the proposed rule is disapproved, the board shall not adopt, amend, or rescind the rule as proposed unless at least twelve members of the board vote to adopt, amend, or rescind it.
This division does not apply to an emergency rule adopted in accordance with section 119.03 of the Revised Code.
Sec. 4765.37.  (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, fire, and transportation services.
(B)(1) 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.
(2) An EMT-basic may administer naloxone hydrochloride to a person who is apparently experiencing an opioid-related overdose by direct application of the naloxone to the person by inhalation.
(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)(3) 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) Except as provided in division (D)(3) of this section, an EMT-basic shall administer naloxone hydrochloride 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.
(3) 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) Administer naloxone hydrochloride to a person who is apparently experiencing an opioid-related overdose by direct application of the naloxone to the person by inhalation;
(6) Determine triage of adult and pediatric trauma victims;
(6)(7) 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, fire, and transportation services.
Section 2. That existing sections 4765.11, 4765.37, and 4765.38 of the Revised Code are hereby repealed.
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