130th Ohio General Assembly
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Sub. H. B. No. 170  As Passed by the House
As Passed by the House

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


Representatives Johnson, Stinziano 

Cosponsors: Representatives Amstutz, Antonio, Gonzales, Grossman, Letson, Lynch, Maag, Milkovich, Phillips, Reece, Rogers, Sprague, Stebelton, Ramos, Barnes, Bishoff, Brown, Schuring, Sears, Smith, Adams, R., Anielski, Ashford, Baker, Beck, Blair, Blessing, Boose, Boyd, Buchy, Budish, Burkley, Butler, Carney, Celebrezze, Curtin, Damschroder, Derickson, DeVitis, Dovilla, Driehaus, Fedor, Gerberry, Green, Hackett, Hagan, C., Hall, Hayes, Heard, Henne, Hill, Huffman, Landis, Lundy, Mallory, McClain, Patterson, Perales, Redfern, Rosenberger, Ruhl, Sheehy, Slaby, Strahorn, Terhar, Thompson, Winburn, Young Speaker Batchelder 



A BILL
To amend sections 4762.03, 4765.35, and 4765.37 and to enact sections 2925.61, 4723.488, 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, and to declare an emergency.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 4762.03, 4765.35, and 4765.37 be amended and sections 2925.61, 4723.488, 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. 4723.488.  (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. 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.
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)(1) Subject to division (C)(2) of this section, a first responder may administer naloxone by either of the following routes to a person who is apparently experiencing an opioid-related overdose:
(a) Using a device manufactured for the intranasal administration of liquid drugs;
(b) Using an autoinjector in a manufactured dosage form.
(2) Except as provided in division (E) of this section, a first responder shall administer naloxone 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.
(D)(1) 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)(2) Except as provided in division (D)(2)(E) of this section, if the board determines under division (C)(D)(1) 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)(E) If communications fail during an emergency situation or the required response time prohibits communication, a first responder may perform services subject to this division (C)(2) or (D)(2) of this section, 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. 4765.37.  (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) 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)(1) Subject to division (C)(2) of this section, an EMT-basic may administer naloxone by either of the following routes to a person who is apparently experiencing an opioid-related overdose:
(a) Using a device manufactured for the intranasal administration of liquid drugs;
(b) Using an autoinjector in a manufactured dosage form.
(2) Except as provided in division (E) of this section, an EMT-basic shall administer naloxone 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.
(D)(1) 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)(2) Except as provided in division (D)(2)(E) of this section, if the board determines under division (C)(D)(1) 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)(E) If communications fail during an emergency situation or the required response time prohibits communication, an EMT-basic may perform services subject to this division (C)(2) or (D)(2) of this section, 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.
Section 2. That existing sections 4762.03, 4765.35, and 4765.37 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, and emergency treatments for drug overdoses. Therefore, this act shall go into immediate effect.
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