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Sub. H. B. No. 170 As Passed by the HouseAs Passed by the House
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, 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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