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H. B. No. 170 As IntroducedAs Introduced
130th General Assembly | Regular Session | 2013-2014 |
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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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