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H. B. No. 412 As IntroducedAs Introduced
130th General Assembly | Regular Session | 2013-2014 |
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Cosponsors:
Representatives Bishoff, Hood, Terhar, Young
A BILL
To amend sections 1.64, 2133.211, 2305.113, 4503.44,
4729.01, 4730.01, 4730.02, 4730.03, 4730.04,
4730.06, 4730.08, 4730.091, 4730.10, 4730.101,
4730.11, 4730.12, 4730.13, 4730.14, 4730.16,
4730.21, 4730.25, 4730.251, 4730.27, 4730.28,
4730.31, 4730.32, 4730.33, 4730.38, 4730.39,
4730.41, 4730.42, 4730.43, 4730.49, 4730.51,
4730.53, 4765.01, 4765.51, and 5123.47, to amend,
for the purpose of adopting a new section number
as shown in parentheses, sections 4730.091
(4730.201) and 4730.092 (4730.202), to enact new
section 4730.20, and to repeal sections 4730.081,
4730.09, 4730.15, 4730.17, 4730.18, 4730.19,
4730.20, 4730.401, 4730.44, 4730.45, 4730.46,
4730.47, 4730.48, 4730.50, and 4730.52 of the
Revised Code to revise the law governing the
practice of physician assistants.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 1.64, 2133.211, 2305.113, 4503.44,
4729.01, 4730.01, 4730.02, 4730.03, 4730.04, 4730.06, 4730.08,
4730.091, 4730.10, 4730.101, 4730.11, 4730.12, 4730.13, 4730.14,
4730.16, 4730.21, 4730.25, 4730.251, 4730.27, 4730.28, 4730.31,
4730.32, 4730.33, 4730.38, 4730.39, 4730.41, 4730.42, 4730.43,
4730.49, 4730.51, 4730.53, 4765.01, 4765.51, and 5123.47 be
amended, and sections 4730.091 (4730.201) and 4730.092 (4730.202)
be amended for the purpose of adopting new section numbers as
indicated in parentheses, and new section 4730.20 of the Revised
Code be enacted to read as follows:
Sec. 1.64. As used in the Revised Code:
(A) "Certified nurse-midwife" means a registered nurse who
holds a valid certificate of authority issued under Chapter 4723.
of the Revised Code that authorizes the practice of nursing as a
certified nurse-midwife in accordance with section 4723.43 of the
Revised Code and rules adopted by the board of nursing.
(B) "Certified nurse practitioner" means a registered nurse
who holds a valid certificate of authority issued under Chapter
4723. of the Revised Code that authorizes the practice of nursing
as a certified nurse practitioner in accordance with section
4723.43 of the Revised Code and rules adopted by the board of
nursing.
(C) "Clinical nurse specialist" means a registered nurse who
holds a valid certificate of authority issued under Chapter 4723.
of the Revised Code that authorizes the practice of nursing as a
clinical nurse specialist in accordance with section 4723.43 of
the Revised Code and rules adopted by the board of nursing.
(D) "Physician assistant" means an individual who holds a
valid certificate to practice issued is licensed under Chapter
4730. of the Revised Code authorizing the individual to provide
services as a physician assistant to patients under the
supervision, control, and direction of one or more physicians.
Sec. 2133.211. A person who holds a certificate of authority
to practice as a certified nurse practitioner or clinical nurse
specialist issued under, as defined in section 4723.42 1.64 of the
Revised Code, may take any action that may be taken by an
attending physician under sections 2133.21 to 2133.26 of the
Revised Code and has the immunity provided by section 2133.22 of
the Revised Code if the action is taken pursuant to a standard
care arrangement with a collaborating physician.
A person who holds a certificate to practice as a physician
assistant issued under Chapter 4730., as defined in section 1.64
of the Revised Code, may take any action that may be taken by an
attending physician under sections 2133.21 to 2133.26 of the
Revised Code and has the immunity provided by section 2133.22 of
the Revised Code if the action is taken pursuant to a physician
supervisory plan approved pursuant to supervision agreement
entered into under section 4730.17 4730.16 of the Revised Code or
the policies of a health care facility in which the physician
assistant is practicing.
Sec. 2305.113. (A) Except as otherwise provided in this
section, an action upon a medical, dental, optometric, or
chiropractic claim shall be commenced within one year after the
cause of action accrued.
(B)(1) If prior to the expiration of the one-year period
specified in division (A) of this section, a claimant who
allegedly possesses a medical, dental, optometric, or chiropractic
claim gives to the person who is the subject of that claim written
notice that the claimant is considering bringing an action upon
that claim, that action may be commenced against the person
notified at any time within one hundred eighty days after the
notice is so given.
(2) An insurance company shall not consider the existence or
nonexistence of a written notice described in division (B)(1) of
this section in setting the liability insurance premium rates that
the company may charge the company's insured person who is
notified by that written notice.
(C) Except as to persons within the age of minority or of
unsound mind as provided by section 2305.16 of the Revised Code,
and except as provided in division (D) of this section, both of
the following apply:
(1) No action upon a medical, dental, optometric, or
chiropractic claim shall be commenced more than four years after
the occurrence of the act or omission constituting the alleged
basis of the medical, dental, optometric, or chiropractic claim.
(2) If an action upon a medical, dental, optometric, or
chiropractic claim is not commenced within four years after the
occurrence of the act or omission constituting the alleged basis
of the medical, dental, optometric, or chiropractic claim, then,
any action upon that claim is barred.
(D)(1) If a person making a medical claim, dental claim,
optometric claim, or chiropractic claim, in the exercise of
reasonable care and diligence, could not have discovered the
injury resulting from the act or omission constituting the alleged
basis of the claim within three years after the occurrence of the
act or omission, but, in the exercise of reasonable care and
diligence, discovers the injury resulting from that act or
omission before the expiration of the four-year period specified
in division (C)(1) of this section, the person may commence an
action upon the claim not later than one year after the person
discovers the injury resulting from that act or omission.
(2) If the alleged basis of a medical claim, dental claim,
optometric claim, or chiropractic claim is the occurrence of an
act or omission that involves a foreign object that is left in the
body of the person making the claim, the person may commence an
action upon the claim not later than one year after the person
discovered the foreign object or not later than one year after the
person, with reasonable care and diligence, should have discovered
the foreign object.
(3) A person who commences an action upon a medical claim,
dental claim, optometric claim, or chiropractic claim under the
circumstances described in division (D)(1) or (2) of this section
has the affirmative burden of proving, by clear and convincing
evidence, that the person, with reasonable care and diligence,
could not have discovered the injury resulting from the act or
omission constituting the alleged basis of the claim within the
three-year period described in division (D)(1) of this section or
within the one-year period described in division (D)(2) of this
section, whichever is applicable.
(E) As used in this section:
(1) "Hospital" includes any person, corporation, association,
board, or authority that is responsible for the operation of any
hospital licensed or registered in the state, including, but not
limited to, those that are owned or operated by the state,
political subdivisions, any person, any corporation, or any
combination of the state, political subdivisions, persons, and
corporations. "Hospital" also includes any person, corporation,
association, board, entity, or authority that is responsible for
the operation of any clinic that employs a full-time staff of
physicians practicing in more than one recognized medical
specialty and rendering advice, diagnosis, care, and treatment to
individuals. "Hospital" does not include any hospital operated by
the government of the United States or any of its branches.
(2) "Physician" means a person who is licensed to practice
medicine and surgery or osteopathic medicine and surgery by the
state medical board or a person who otherwise is authorized to
practice medicine and surgery or osteopathic medicine and surgery
in this state.
(3) "Medical claim" means any claim that is asserted in any
civil action against a physician, podiatrist, hospital, home, or
residential facility, against any employee or agent of a
physician, podiatrist, hospital, home, or residential facility, or
against a licensed practical nurse, registered nurse, advanced
practice registered nurse, physical therapist, physician
assistant, emergency medical technician-basic, emergency medical
technician-intermediate, or emergency medical
technician-paramedic, and that arises out of the medical
diagnosis, care, or treatment of any person. "Medical claim"
includes the following:
(a) Derivative claims for relief that arise from the medical
diagnosis, care, or treatment of a person;
(b) Claims that arise out of the medical diagnosis, care, or
treatment of any person and to which either of the following
applies:
(i) The claim results from acts or omissions in providing
medical care.
(ii) The claim results from the hiring, training,
supervision, retention, or termination of caregivers providing
medical diagnosis, care, or treatment.
(c) Claims that arise out of the medical diagnosis, care, or
treatment of any person and that are brought under section 3721.17
of the Revised Code.
(4) "Podiatrist" means any person who is licensed to practice
podiatric medicine and surgery by the state medical board.
(5) "Dentist" means any person who is licensed to practice
dentistry by the state dental board.
(6) "Dental claim" means any claim that is asserted in any
civil action against a dentist, or against any employee or agent
of a dentist, and that arises out of a dental operation or the
dental diagnosis, care, or treatment of any person. "Dental claim"
includes derivative claims for relief that arise from a dental
operation or the dental diagnosis, care, or treatment of a person.
(7) "Derivative claims for relief" include, but are not
limited to, claims of a parent, guardian, custodian, or spouse of
an individual who was the subject of any medical diagnosis, care,
or treatment, dental diagnosis, care, or treatment, dental
operation, optometric diagnosis, care, or treatment, or
chiropractic diagnosis, care, or treatment, that arise from that
diagnosis, care, treatment, or operation, and that seek the
recovery of damages for any of the following:
(a) Loss of society, consortium, companionship, care,
assistance, attention, protection, advice, guidance, counsel,
instruction, training, or education, or any other intangible loss
that was sustained by the parent, guardian, custodian, or spouse;
(b) Expenditures of the parent, guardian, custodian, or
spouse for medical, dental, optometric, or chiropractic care or
treatment, for rehabilitation services, or for other care,
treatment, services, products, or accommodations provided to the
individual who was the subject of the medical diagnosis, care, or
treatment, the dental diagnosis, care, or treatment, the dental
operation, the optometric diagnosis, care, or treatment, or the
chiropractic diagnosis, care, or treatment.
(8) "Registered nurse" means any person who is licensed to
practice nursing as a registered nurse by the board of nursing.
(9) "Chiropractic claim" means any claim that is asserted in
any civil action against a chiropractor, or against any employee
or agent of a chiropractor, and that arises out of the
chiropractic diagnosis, care, or treatment of any person.
"Chiropractic claim" includes derivative claims for relief that
arise from the chiropractic diagnosis, care, or treatment of a
person.
(10) "Chiropractor" means any person who is licensed to
practice chiropractic by the state chiropractic board.
(11) "Optometric claim" means any claim that is asserted in
any civil action against an optometrist, or against any employee
or agent of an optometrist, and that arises out of the optometric
diagnosis, care, or treatment of any person. "Optometric claim"
includes derivative claims for relief that arise from the
optometric diagnosis, care, or treatment of a person.
(12) "Optometrist" means any person licensed to practice
optometry by the state board of optometry.
(13) "Physical therapist" means any person who is licensed to
practice physical therapy under Chapter 4755. of the Revised Code.
(14) "Home" has the same meaning as in section 3721.10 of the
Revised Code.
(15) "Residential facility" means a facility licensed under
section 5123.19 of the Revised Code.
(16) "Advanced practice registered nurse" means any certified
nurse practitioner, clinical nurse specialist, certified
registered nurse anesthetist, or certified nurse-midwife who holds
a certificate of authority issued by the board of nursing under
Chapter 4723. of the Revised Code.
(17) "Licensed practical nurse" means any person who is
licensed to practice nursing as a licensed practical nurse by the
board of nursing pursuant to Chapter 4723. of the Revised Code.
(18) "Physician assistant" means any person who holds a valid
certificate to practice issued pursuant to Chapter 4730. has the
same meaning as in section 1.64 of the Revised Code.
(19) "Emergency medical technician-basic," "emergency medical
technician-intermediate," and "emergency medical
technician-paramedic" means any person who is certified under
Chapter 4765. of the Revised Code as an emergency medical
technician-basic, emergency medical technician-intermediate, or
emergency medical technician-paramedic, whichever is applicable.
Sec. 4503.44. (A) As used in this section and in section
4511.69 of the Revised Code:
(1) "Person with a disability that limits or impairs the
ability to walk" means any person who, as determined by a health
care provider, meets any of the following criteria:
(a) Cannot walk two hundred feet without stopping to rest;
(b) Cannot walk without the use of, or assistance from, a
brace, cane, crutch, another person, prosthetic device,
wheelchair, or other assistive device;
(c) Is restricted by a lung disease to such an extent that
the person's forced (respiratory) expiratory volume for one
second, when measured by spirometry, is less than one liter, or
the arterial oxygen tension is less than sixty millimeters of
mercury on room air at rest;
(d) Uses portable oxygen;
(e) Has a cardiac condition to the extent that the person's
functional limitations are classified in severity as class III or
class IV according to standards set by the American heart
association;
(f) Is severely limited in the ability to walk due to an
arthritic, neurological, or orthopedic condition;
(2) "Organization" means any private organization or
corporation, or any governmental board, agency, department,
division, or office, that, as part of its business or program,
transports persons with disabilities that limit or impair the
ability to walk on a regular basis in a motor vehicle that has not
been altered for the purpose of providing it with special
equipment for use by persons with disabilities. This definition
does not apply to division (J) of this section.
(3) "Health care provider" means a physician, physician
assistant, advanced practice registered nurse, or chiropractor as
defined in this section.
(4) "Physician" means a person licensed to practice medicine
or surgery or osteopathic medicine and surgery under Chapter 4731.
of the Revised Code.
(5) "Chiropractor" means a person licensed to practice
chiropractic under Chapter 4734. of the Revised Code.
(6) "Advanced practice registered nurse" means a certified
nurse practitioner, clinical nurse specialist, certified
registered nurse anesthetist, or certified nurse-midwife who holds
a certificate of authority issued by the board of nursing under
Chapter 4723. of the Revised Code.
(7) "Physician assistant" means a person who holds a
certificate to practice as a physician assistant issued under
Chapter 4730. has the same meaning as in section 1.64 of the
Revised Code.
(B) Any organization or person with a disability that limits
or impairs the ability to walk may apply to the registrar of motor
vehicles for a removable windshield placard or, if the person owns
or leases a motor vehicle, the person may apply for the
registration of any motor vehicle the person owns or leases. In
addition to one or more sets of license plates or one placard, a
person with a disability that limits or impairs the ability to
walk is entitled to one additional placard, but only if the person
applies separately for the additional placard, states the reasons
why the additional placard is needed, and the registrar, in the
registrar's discretion, determines that good and justifiable cause
exists to approve the request for the additional placard. When a
motor vehicle has been altered for the purpose of providing it
with special equipment for a person with a disability that limits
or impairs the ability to walk, but is owned or leased by someone
other than such a person, the owner or lessee may apply to the
registrar or a deputy registrar for registration under this
section. The application for registration of a motor vehicle owned
or leased by a person with a disability that limits or impairs the
ability to walk shall be accompanied by a signed statement from
the applicant's health care provider certifying that the applicant
meets at least one of the criteria contained in division (A)(1) of
this section and that the disability is expected to continue for
more than six consecutive months. The application for a removable
windshield placard made by a person with a disability that limits
or impairs the ability to walk shall be accompanied by a
prescription from the applicant's health care provider prescribing
such a placard for the applicant, provided that the applicant
meets at least one of the criteria contained in division (A)(1) of
this section. The health care provider shall state on the
prescription the length of time the health care provider expects
the applicant to have the disability that limits or impairs the
applicant's ability to walk. The application for a removable
windshield placard made by an organization shall be accompanied by
such documentary evidence of regular transport of persons with
disabilities that limit or impair the ability to walk by the
organization as the registrar may require by rule and shall be
completed in accordance with procedures that the registrar may
require by rule. The application for registration of a motor
vehicle that has been altered for the purpose of providing it with
special equipment for a person with a disability that limits or
impairs the ability to walk but is owned by someone other than
such a person shall be accompanied by such documentary evidence of
vehicle alterations as the registrar may require by rule.
(C) When an organization, a person with a disability that
limits or impairs the ability to walk, or a person who does not
have a disability that limits or impairs the ability to walk but
owns a motor vehicle that has been altered for the purpose of
providing it with special equipment for a person with a disability
that limits or impairs the ability to walk first submits an
application for registration of a motor vehicle under this section
and every fifth year thereafter, the organization or person shall
submit a signed statement from the applicant's health care
provider, a completed application, and any required documentary
evidence of vehicle alterations as provided in division (B) of
this section, and also a power of attorney from the owner of the
motor vehicle if the applicant leases the vehicle. Upon submission
of these items, the registrar or deputy registrar shall issue to
the applicant appropriate vehicle registration and a set of
license plates and validation stickers, or validation stickers
alone when required by section 4503.191 of the Revised Code. In
addition to the letters and numbers ordinarily inscribed thereon,
the license plates shall be imprinted with the international
symbol of access. The license plates and validation stickers shall
be issued upon payment of the regular license fee as prescribed
under section 4503.04 of the Revised Code and any motor vehicle
tax levied under Chapter 4504. of the Revised Code, and the
payment of a service fee equal to the amount specified in division
(D) or (G) of section 4503.10 of the Revised Code.
(D)(1) Upon receipt of a completed and signed application for
a removable windshield placard, a prescription as described in
division (B) of this section, documentary evidence of regular
transport of persons with disabilities that limit or impair the
ability to walk, if required, and payment of a service fee equal
to the amount specified in division (D) or (G) of section 4503.10
of the Revised Code, the registrar or deputy registrar shall issue
to the applicant a removable windshield placard, which shall bear
the date of expiration on both sides of the placard and shall be
valid until expired, revoked, or surrendered. Every removable
windshield placard expires as described in division (D)(2) of this
section, but in no case shall a removable windshield placard be
valid for a period of less than sixty days. Removable windshield
placards shall be renewable upon application as provided in
division (B) of this section, and a service fee equal to the
amount specified in division (D) or (G) of section 4503.10 of the
Revised Code shall be charged for the renewal of a removable
windshield placard. The registrar shall provide the application
form and shall determine the information to be included thereon.
The registrar also shall determine the form and size of the
removable windshield placard, the material of which it is to be
made, and any other information to be included thereon, and shall
adopt rules relating to the issuance, expiration, revocation,
surrender, and proper display of such placards. Any placard issued
after October 14, 1999, shall be manufactured in a manner that
allows the expiration date of the placard to be indicated on it
through the punching, drilling, boring, or creation by any other
means of holes in the placard.
(2) At the time a removable windshield placard is issued to a
person with a disability that limits or impairs the ability to
walk, the registrar or deputy registrar shall enter into the
records of the bureau of motor vehicles the last date on which the
person will have that disability, as indicated on the accompanying
prescription. Not less than thirty days prior to that date and all
removable windshield placard renewal dates, the bureau shall send
a renewal notice to that person at the person's last known address
as shown in the records of the bureau, informing the person that
the person's removable windshield placard will expire on the
indicated date not to exceed five years from the date of issuance,
and that the person is required to renew the placard by submitting
to the registrar or a deputy registrar another prescription, as
described in division (B) of this section, and by complying with
the renewal provisions prescribed in division (D)(1) of this
section. If such a prescription is not received by the registrar
or a deputy registrar by that date, the placard issued to that
person expires and no longer is valid, and this fact shall be
recorded in the records of the bureau.
(3) At least once every year, on a date determined by the
registrar, the bureau shall examine the records of the office of
vital statistics, located within the department of health, that
pertain to deceased persons, and also the bureau's records of all
persons who have been issued removable windshield placards and
temporary removable windshield placards. If the records of the
office of vital statistics indicate that a person to whom a
removable windshield placard or temporary removable windshield
placard has been issued is deceased, the bureau shall cancel that
placard, and note the cancellation in its records.
The office of vital statistics shall make available to the
bureau all information necessary to enable the bureau to comply
with division (D)(3) of this section.
(4) Nothing in this section shall be construed to require a
person or organization to apply for a removable windshield placard
or special license plates if the parking card or special license
plates issued to the person or organization under prior law have
not expired or been surrendered or revoked.
(E)(1)(a) Any person with a disability that limits or impairs
the ability to walk may apply to the registrar or a deputy
registrar for a temporary removable windshield placard. The
application for a temporary removable windshield placard shall be
accompanied by a prescription from the applicant's health care
provider prescribing such a placard for the applicant, provided
that the applicant meets at least one of the criteria contained in
division (A)(1) of this section and that the disability is
expected to continue for six consecutive months or less. The
health care provider shall state on the prescription the length of
time the health care provider expects the applicant to have the
disability that limits or impairs the applicant's ability to walk,
which cannot exceed six months from the date of the prescription.
Upon receipt of an application for a temporary removable
windshield placard, presentation of the prescription from the
applicant's health care provider, and payment of a service fee
equal to the amount specified in division (D) or (G) of section
4503.10 of the Revised Code, the registrar or deputy registrar
shall issue to the applicant a temporary removable windshield
placard.
(b) Any active-duty member of the armed forces of the United
States, including the reserve components of the armed forces and
the national guard, who has an illness or injury that limits or
impairs the ability to walk may apply to the registrar or a deputy
registrar for a temporary removable windshield placard. With the
application, the person shall present evidence of the person's
active-duty status and the illness or injury. Evidence of the
illness or injury may include a current department of defense
convalescent leave statement, any department of defense document
indicating that the person currently has an ill or injured
casualty status or has limited duties, or a prescription from any
health care provider prescribing the placard for the applicant.
Upon receipt of the application and the necessary evidence, the
registrar or deputy registrar shall issue the applicant the
temporary removable windshield placard without the payment of any
service fee.
(2) The temporary removable windshield placard shall be of
the same size and form as the removable windshield placard, shall
be printed in white on a red-colored background, and shall bear
the word "temporary" in letters of such size as the registrar
shall prescribe. A temporary removable windshield placard also
shall bear the date of expiration on the front and back of the
placard, and shall be valid until expired, surrendered, or
revoked, but in no case shall such a placard be valid for a period
of less than sixty days. The registrar shall provide the
application form and shall determine the information to be
included on it, provided that the registrar shall not require a
health care provider's prescription or certification for a person
applying under division (E)(1)(b) of this section. The registrar
also shall determine the material of which the temporary removable
windshield placard is to be made and any other information to be
included on the placard and shall adopt rules relating to the
issuance, expiration, surrender, revocation, and proper display of
those placards. Any temporary removable windshield placard issued
after October 14, 1999, shall be manufactured in a manner that
allows for the expiration date of the placard to be indicated on
it through the punching, drilling, boring, or creation by any
other means of holes in the placard.
(F) If an applicant for a removable windshield placard is a
veteran of the armed forces of the United States whose disability,
as defined in division (A)(1) of this section, is
service-connected, the registrar or deputy registrar, upon receipt
of the application, presentation of a signed statement from the
applicant's health care provider certifying the applicant's
disability, and presentation of such documentary evidence from the
department of veterans affairs that the disability of the
applicant meets at least one of the criteria identified in
division (A)(1) of this section and is service-connected as the
registrar may require by rule, but without the payment of any
service fee, shall issue the applicant a removable windshield
placard that is valid until expired, surrendered, or revoked.
(G) Upon a conviction of a violation of division (I), (J), or
(K) of this section, the court shall report the conviction, and
send the placard or parking card, if available, to the registrar,
who thereupon shall revoke the privilege of using the placard or
parking card and send notice in writing to the placardholder or
cardholder at that holder's last known address as shown in the
records of the bureau, and the placardholder or cardholder shall
return the placard or card if not previously surrendered to the
court, to the registrar within ten days following mailing of the
notice.
Whenever a person to whom a removable windshield placard or
parking card has been issued moves to another state, the person
shall surrender the placard or card to the registrar; and whenever
an organization to which a placard or card has been issued changes
its place of operation to another state, the organization shall
surrender the placard or card to the registrar.
(H) Subject to division (F) of section 4511.69 of the Revised
Code, the operator of a motor vehicle displaying a removable
windshield placard, temporary removable windshield placard,
parking card, or the special license plates authorized by this
section is entitled to park the motor vehicle in any special
parking location reserved for persons with disabilities that limit
or impair the ability to walk, also known as handicapped parking
spaces or disability parking spaces.
(I) No person or organization that is not eligible under
division (B) or (E) of this section shall willfully and falsely
represent that the person or organization is so eligible.
No person or organization shall display license plates issued
under this section unless the license plates have been issued for
the vehicle on which they are displayed and are valid.
(J) No person or organization to which a removable windshield
placard or temporary removable windshield placard is issued shall
do either of the following:
(1) Display or permit the display of the placard on any motor
vehicle when having reasonable cause to believe the motor vehicle
is being used in connection with an activity that does not include
providing transportation for persons with disabilities that limit
or impair the ability to walk;
(2) Refuse to return or surrender the placard, when required.
(K)(1) No person or organization to which a parking card is
issued shall do either of the following:
(a) Display or permit the display of the parking card on any
motor vehicle when having reasonable cause to believe the motor
vehicle is being used in connection with an activity that does not
include providing transportation for a person with a disability;
(b) Refuse to return or surrender the parking card, when
required.
(2) As used in division (K) of this section:
(a) "Person with a disability" means any person who has lost
the use of one or both legs or one or both arms, who is blind,
deaf, or so severely disabled as to be unable to move about
without the aid of crutches or a wheelchair, or whose mobility is
restricted by a permanent cardiovascular, pulmonary, or other
disabling condition.
(b) "Organization" means any private organization or
corporation, or any governmental board, agency, department,
division, or office, that, as part of its business or program,
transports persons with disabilities on a regular basis in a motor
vehicle that has not been altered for the purposes of providing it
with special equipment for use by persons with disabilities.
(L) If a removable windshield placard, temporary removable
windshield placard, or parking card is lost, destroyed, or
mutilated, the placardholder or cardholder may obtain a duplicate
by doing both of the following:
(1) Furnishing suitable proof of the loss, destruction, or
mutilation to the registrar;
(2) Paying a service fee equal to the amount specified in
division (D) or (G) of section 4503.10 of the Revised Code.
Any placardholder or cardholder who loses a placard or card
and, after obtaining a duplicate, finds the original, immediately
shall surrender the original placard or card to the registrar.
(M) The registrar shall pay all fees received under this
section for the issuance of removable windshield placards or
temporary removable windshield placards or duplicate removable
windshield placards or cards into the state treasury to the credit
of the state bureau of motor vehicles fund created in section
4501.25 of the Revised Code.
(N) In addition to the fees collected under this section, the
registrar or deputy registrar shall ask each person applying for a
removable windshield placard or temporary removable windshield
placard or duplicate removable windshield placard or license plate
issued under this section, whether the person wishes to make a
two-dollar voluntary contribution to support rehabilitation
employment services. The registrar shall transmit the
contributions received under this division to the treasurer of
state for deposit into the rehabilitation employment fund, which
is hereby created in the state treasury. A deputy registrar shall
transmit the contributions received under this division to the
registrar in the time and manner prescribed by the registrar. The
contributions in the fund shall be used by the opportunities for
Ohioans with disabilities agency to purchase services related to
vocational evaluation, work adjustment, personal adjustment, job
placement, job coaching, and community-based assessment from
accredited community rehabilitation program facilities.
(O) For purposes of enforcing this section, every peace
officer is deemed to be an agent of the registrar. Any peace
officer or any authorized employee of the bureau of motor vehicles
who, in the performance of duties authorized by law, becomes aware
of a person whose placard or parking card has been revoked
pursuant to this section, may confiscate that placard or parking
card and return it to the registrar. The registrar shall prescribe
any forms used by law enforcement agencies in administering this
section.
No peace officer, law enforcement agency employing a peace
officer, or political subdivision or governmental agency employing
a peace officer, and no employee of the bureau is liable in a
civil action for damages or loss to persons arising out of the
performance of any duty required or authorized by this section. As
used in this division, "peace officer" has the same meaning as in
division (B) of section 2935.01 of the Revised Code.
(P) All applications for registration of motor vehicles,
removable windshield placards, and temporary removable windshield
placards issued under this section, all renewal notices for such
items, and all other publications issued by the bureau that relate
to this section shall set forth the criminal penalties that may be
imposed upon a person who violates any provision relating to
special license plates issued under this section, the parking of
vehicles displaying such license plates, and the issuance,
procurement, use, and display of removable windshield placards and
temporary removable windshield placards issued under this section.
(Q) Whoever violates this section is guilty of a misdemeanor
of the fourth degree.
Sec. 4729.01. As used in this chapter:
(A) "Pharmacy," except when used in a context that refers to
the practice of pharmacy, means any area, room, rooms, place of
business, department, or portion of any of the foregoing where the
practice of pharmacy is conducted.
(B) "Practice of pharmacy" means providing pharmacist care
requiring specialized knowledge, judgment, and skill derived from
the principles of biological, chemical, behavioral, social,
pharmaceutical, and clinical sciences. As used in this division,
"pharmacist care" includes the following:
(1) Interpreting prescriptions;
(2) Dispensing drugs and drug therapy related devices;
(4) Counseling individuals with regard to their drug therapy,
recommending drug therapy related devices, and assisting in the
selection of drugs and appliances for treatment of common diseases
and injuries and providing instruction in the proper use of the
drugs and appliances;
(5) Performing drug regimen reviews with individuals by
discussing all of the drugs that the individual is taking and
explaining the interactions of the drugs;
(6) Performing drug utilization reviews with licensed health
professionals authorized to prescribe drugs when the pharmacist
determines that an individual with a prescription has a drug
regimen that warrants additional discussion with the prescriber;
(7) Advising an individual and the health care professionals
treating an individual with regard to the individual's drug
therapy;
(8) Acting pursuant to a consult agreement with a physician
authorized under Chapter 4731. of the Revised Code to practice
medicine and surgery or osteopathic medicine and surgery, if an
agreement has been established with the physician;
(9) Engaging in the administration of immunizations to the
extent authorized by section 4729.41 of the Revised Code.
(C) "Compounding" means the preparation, mixing, assembling,
packaging, and labeling of one or more drugs in any of the
following circumstances:
(1) Pursuant to a prescription issued by a licensed health
professional authorized to prescribe drugs;
(2) Pursuant to the modification of a prescription made in
accordance with a consult agreement;
(3) As an incident to research, teaching activities, or
chemical analysis;
(4) In anticipation of orders for drugs pursuant to
prescriptions, based on routine, regularly observed dispensing
patterns;
(5) Pursuant to a request made by a licensed health
professional authorized to prescribe drugs for a drug that is to
be used by the professional for the purpose of direct
administration to patients in the course of the professional's
practice, if all of the following apply:
(a) At the time the request is made, the drug is not
commercially available regardless of the reason that the drug is
not available, including the absence of a manufacturer for the
drug or the lack of a readily available supply of the drug from a
manufacturer.
(b) A limited quantity of the drug is compounded and provided
to the professional.
(c) The drug is compounded and provided to the professional
as an occasional exception to the normal practice of dispensing
drugs pursuant to patient-specific prescriptions.
(D) "Consult agreement" means an agreement to manage an
individual's drug therapy that has been entered into by a
pharmacist and a physician authorized under Chapter 4731. of the
Revised Code to practice medicine and surgery or osteopathic
medicine and surgery.
(1) Any article recognized in the United States pharmacopoeia
and national formulary, or any supplement to them, intended for
use in the diagnosis, cure, mitigation, treatment, or prevention
of disease in humans or animals;
(2) Any other article intended for use in the diagnosis,
cure, mitigation, treatment, or prevention of disease in humans or
animals;
(3) Any article, other than food, intended to affect the
structure or any function of the body of humans or animals;
(4) Any article intended for use as a component of any
article specified in division (E)(1), (2), or (3) of this section;
but does not include devices or their components, parts, or
accessories.
(F) "Dangerous drug" means any of the following:
(1) Any drug to which either of the following applies:
(a) Under the "Federal Food, Drug, and Cosmetic Act," 52
Stat. 1040 (1938), 21 U.S.C.A. 301, as amended, the drug is
required to bear a label containing the legend "Caution: Federal
law prohibits dispensing without prescription" or "Caution:
Federal law restricts this drug to use by or on the order of a
licensed veterinarian" or any similar restrictive statement, or
the drug may be dispensed only upon a prescription;
(b) Under Chapter 3715. or 3719. of the Revised Code, the
drug may be dispensed only upon a prescription.
(2) Any drug that contains a schedule V controlled substance
and that is exempt from Chapter 3719. of the Revised Code or to
which that chapter does not apply;
(3) Any drug intended for administration by injection into
the human body other than through a natural orifice of the human
body.
(G) "Federal drug abuse control laws" has the same meaning as
in section 3719.01 of the Revised Code.
(H) "Prescription" means a written, electronic, or oral order
for drugs or combinations or mixtures of drugs to be used by a
particular individual or for treating a particular animal, issued
by a licensed health professional authorized to prescribe drugs.
(I) "Licensed health professional authorized to prescribe
drugs" or "prescriber" means an individual who is authorized by
law to prescribe drugs or dangerous drugs or drug therapy related
devices in the course of the individual's professional practice,
including only the following:
(1) A dentist licensed under Chapter 4715. of the Revised
Code;
(2) 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;
(3) An optometrist licensed under Chapter 4725. of the
Revised Code to practice optometry under a therapeutic
pharmaceutical agents certificate;
(4) A physician authorized under Chapter 4731. of the Revised
Code to practice medicine and surgery, osteopathic medicine and
surgery, or podiatric medicine and surgery;
(5) A physician assistant who holds a certificate to
prescribe valid prescriber number issued under Chapter 4730. of
the Revised Code by the state medical board;
(6) A veterinarian licensed under Chapter 4741. of the
Revised Code.
(J) "Sale" and "sell" include delivery, transfer, barter,
exchange, or gift, or offer therefor, and each such transaction
made by any person, whether as principal proprietor, agent, or
employee.
(K) "Wholesale sale" and "sale at wholesale" mean any sale in
which the purpose of the purchaser is to resell the article
purchased or received by the purchaser.
(L) "Retail sale" and "sale at retail" mean any sale other
than a wholesale sale or sale at wholesale.
(M) "Retail seller" means any person that sells any dangerous
drug to consumers without assuming control over and responsibility
for its administration. Mere advice or instructions regarding
administration do not constitute control or establish
responsibility.
(N) "Price information" means the price charged for a
prescription for a particular drug product and, in an easily
understandable manner, all of the following:
(1) The proprietary name of the drug product;
(2) The established (generic) name of the drug product;
(3) The strength of the drug product if the product contains
a single active ingredient or if the drug product contains more
than one active ingredient and a relevant strength can be
associated with the product without indicating each active
ingredient. The established name and quantity of each active
ingredient are required if such a relevant strength cannot be so
associated with a drug product containing more than one
ingredient.
(5) The price charged for a specific quantity of the drug
product. The stated price shall include all charges to the
consumer, including, but not limited to, the cost of the drug
product, professional fees, handling fees, if any, and a statement
identifying professional services routinely furnished by the
pharmacy. Any mailing fees and delivery fees may be stated
separately without repetition. The information shall not be false
or misleading.
(O) "Wholesale distributor of dangerous drugs" means a person
engaged in the sale of dangerous drugs at wholesale and includes
any agent or employee of such a person authorized by the person to
engage in the sale of dangerous drugs at wholesale.
(P) "Manufacturer of dangerous drugs" means a person, other
than a pharmacist, who manufactures dangerous drugs and who is
engaged in the sale of those dangerous drugs within this state.
(Q) "Terminal distributor of dangerous drugs" means a person
who is engaged in the sale of dangerous drugs at retail, or any
person, other than a wholesale distributor or a pharmacist, who
has possession, custody, or control of dangerous drugs for any
purpose other than for that person's own use and consumption, and
includes pharmacies, hospitals, nursing homes, and laboratories
and all other persons who procure dangerous drugs for sale or
other distribution by or under the supervision of a pharmacist or
licensed health professional authorized to prescribe drugs.
(R) "Promote to the public" means disseminating a
representation to the public in any manner or by any means, other
than by labeling, for the purpose of inducing, or that is likely
to induce, directly or indirectly, the purchase of a dangerous
drug at retail.
(S) "Person" includes any individual, partnership,
association, limited liability company, or corporation, the state,
any political subdivision of the state, and any district,
department, or agency of the state or its political subdivisions.
(T) "Finished dosage form" has the same meaning as in section
3715.01 of the Revised Code.
(U) "Generically equivalent drug" has the same meaning as in
section 3715.01 of the Revised Code.
(V) "Animal shelter" means a facility operated by a humane
society or any society organized under Chapter 1717. of the
Revised Code or a dog pound operated pursuant to Chapter 955. of
the Revised Code.
(W) "Food" has the same meaning as in section 3715.01 of the
Revised Code.
(X) "Pain management clinic" has the same meaning as in
section 4731.054 of the Revised Code.
Sec. 4730.01. As used in this chapter:
(A) "Physician assistant" means a skilled person qualified by
academic and clinical training to provide services to patients as
a physician assistant under the supervision, control, and
direction of one or more physicians who are responsible for the
physician assistant's performance "Critical care unit" means a
hospital unit, other than an emergency department, that is devoted
to providing "critical care services," as defined by the American
medical association in its current procedural terminology code set
or a successor document.
(B) "Physician" means an individual who is authorized under
Chapter 4731. of the Revised Code to practice medicine and
surgery, osteopathic medicine and surgery, or podiatric medicine
and surgery.
(C) "Health care facility" means any of the following:
(1) A hospital registered with the department of health under
section 3701.07 of the Revised Code;
(2) A health care facility licensed by the department of
health under section 3702.30 of the Revised Code;
(3) Any other facility designated by the state medical board
in rules adopted pursuant to division (B)(2) of section 4730.08 of
the Revised Code.
(D) "Special services" means the health care services that a
physician assistant may be authorized to provide under the special
services portion of a physician supervisory plan approved under
section 4730.17 of the Revised Code "Service" means a medical
activity that requires training in the diagnosis, treatment, or
prevention of disease.
Sec. 4730.02. (A) No person shall hold that person out as
being able to function as a physician assistant, or use any words
or letters indicating or implying that the person is a physician
assistant, without a current, valid
certificate license to
practice as a physician assistant issued pursuant to this chapter.
(B) No person shall practice as a physician assistant without
the supervision, control, and direction of a physician.
(C) No person shall act as the supervising physician of a
physician assistant without having received the state medical
board's approval of a supervision agreement entered into with the
physician assistant.
(D) No person shall practice as a physician assistant without
having entered into a supervision agreement that has been approved
by the state medical board with a supervising physician under
section 4730.16 of the Revised Code.
(E)(D) No person acting as the supervising physician of a
physician assistant shall authorize the physician assistant to
perform services if either of the following is the case:
(1) The services are not within the physician's normal course
of practice and expertise;
(2) The services are inconsistent with the physician
supervisory plan approved by the state medical board for the
supervising physician supervision agreement entered into under
section 4730.16 of the Revised Code or the policies of the health
care facility in which the physician and physician assistant are
practicing.
(F)(E) No person shall practice as a physician assistant in a
manner that is inconsistent with the physician supervisory plan
approved for the physician who is responsible for supervising the
physician assistant supervision agreement entered into under
section 4730.16 of the Revised Code or the policies of the health
care facility in which the physician assistant is practicing.
(G)(F) No person practicing as a physician assistant shall
prescribe any drug or device to perform or induce an abortion, or
otherwise perform or induce an abortion.
(H)(G) No person shall advertise to provide services as a
physician assistant, except for the purpose of seeking employment.
(I)(H) No person practicing as a physician assistant shall
fail to wear at all times when on duty a placard, plate, or other
device identifying that person as a "physician assistant."
Sec. 4730.03. Nothing in this chapter shall:
(A) Be construed to affect or interfere with the performance
of duties of any medical personnel who are either of the
following:
(1) In active service in the army, navy, coast guard, marine
corps, air force, public health service, or marine hospital
service of the United States while so serving;
(2) Employed by the veterans administration of the United
States while so employed;.
(B) Prevent any person from performing any of the services a
physician assistant may be authorized to perform, if the person's
professional scope of practice established under any other chapter
of the Revised Code authorizes the person to perform the services;
(C) Prohibit a physician from delegating responsibilities to
any nurse or other qualified person who does not hold a
certificate license to practice as a physician assistant, provided
that the individual does not hold the individual out to be a
physician assistant;
(D) Be construed as authorizing a physician assistant
independently to order or direct the execution of procedures or
techniques by a registered nurse or licensed practical nurse in
the care and treatment of a person in any setting, except to the
extent that the physician assistant is authorized to do so by the
physician supervisory plan approved under section 4730.17 of the
Revised Code for the physician who is responsible for supervising
the physician assistant or the policies of the health care
facility in which the physician assistant is practicing;
(E) Authorize a physician assistant to engage in the practice
of optometry, except to the extent that the physician assistant is
authorized by a supervising physician acting in accordance with
this chapter to perform routine visual screening, provide medical
care prior to or following eye surgery, or assist in the care of
diseases of the eye;
(F)(E) Be construed as authorizing a physician assistant to
prescribe any drug or device to perform or induce an abortion, or
as otherwise authorizing a physician assistant to perform or
induce an abortion.
Sec. 4730.04. (A) As used in this section:
(1) "Disaster" means any imminent threat or actual occurrence
of widespread or severe damage to or loss of property, personal
hardship or injury, or loss of life that results from any natural
phenomenon or act of a human.
(2) "Emergency" means an occurrence or event that poses an
imminent threat to the health or life of a human.
(B) Nothing in this chapter prohibits any of the following
individuals from providing medical care, to the extent the
individual is able, in response to a need for medical care
precipitated by a disaster or emergency:
(1) An individual who holds a certificate license to practice
as a physician assistant issued under this chapter;
(2) An individual licensed or authorized to practice as a
physician assistant in another state;
(3) An individual credentialed or employed as a physician
assistant by an agency, office, or other instrumentality of the
federal government.
(C) For purposes of the medical care provided by a physician
assistant pursuant to division (B)(1) of this section, both of the
following apply notwithstanding any supervision requirement of
this chapter to the contrary:
(1) The physician who supervises the physician assistant
pursuant to a physician supervisory plan approved by the state
medical board under section 4730.17 of the Revised Code
supervision agreement entered into under section 4730.16 of the
Revised Code is not required to meet the supervision requirements
established under this chapter.
(2) The physician designated as the medical director of the
disaster or emergency may supervise the medical care provided by
the physician assistant.
Sec. 4730.06. (A) The physician assistant policy committee
of the state medical board shall review, and shall submit to the
board recommendations concerning, all of the following:
(1) Requirements for issuance of certificates issuing a
license to practice as a physician assistant, including the
educational requirements that must be met to receive a certificate
license to practice;
(2) Existing and proposed rules pertaining to the practice of
physician assistants, the supervisory relationship between
physician assistants and supervising physicians, and the
administration and enforcement of this chapter;
(3) In accordance with section 4730.38 of the Revised Code,
physician-delegated prescriptive authority for physician
assistants and proposed changes to the physician assistant
formulary the board adopts pursuant to division (A)(1) of section
4730.39 of the Revised Code;
(4) Application procedures and forms for certificates a
license to practice as a physician assistant, physician
supervisory plans, and supervision agreements;
(5) Fees required by this chapter for issuance and renewal of
certificates a license to practice as a physician assistant;
(6) Criteria to be included in applications submitted to the
board for approval of physician supervisory plans, including
criteria to be included in applications for approval to delegate
to physician assistants the performance of special services;
(7) Criteria to be included in supervision agreements
submitted to the board for approval and renewal of the board's
approval;
(8) Any issue the board asks the committee to consider.
(B) In addition to the matters that are required to be
reviewed under division (A) of this section, the committee may
review, and may submit to the board recommendations concerning,
either or both of the following:
(1) Quality quality assurance activities to be performed by a
supervising physician and physician assistant under a quality
assurance system established pursuant to division (F) of section
4730.21 of the Revised Code;
(2) The development and approval of one or more model
physician supervisory plans and one or more models for a special
services portion of the one or more model physician supervisory
plans. The committee may submit recommendations for model plans
that reflect various medical specialties.
(C) The board shall take into consideration all
recommendations submitted by the committee. Not later than ninety
days after receiving a recommendation from the committee, the
board shall approve or disapprove the recommendation and notify
the committee of its decision. If a recommendation is disapproved,
the board shall inform the committee of its reasons for making
that decision. The committee may resubmit the recommendation after
addressing the concerns expressed by the board and modifying the
disapproved recommendation accordingly. Not later than ninety days
after receiving a resubmitted recommendation, the board shall
approve or disapprove the recommendation. There is no limit on the
number of times the committee may resubmit a recommendation for
consideration by the board.
(D)(1) Except as provided in division (D)(2) of this section,
the board may not take action regarding a matter that is subject
to the committee's review under division (A) or (B) of this
section unless the committee has made a recommendation to the
board concerning the matter.
(2) If the board submits to the committee a request for a
recommendation regarding a matter that is subject to the
committee's review under division (A) or (B) of this section, and
the committee does not provide a recommendation before the
sixty-first day after the request is submitted, the board may take
action regarding the matter without a recommendation.
Sec. 4730.08. (A) A certificate license to practice as a
physician assistant issued under this chapter authorizes the
holder to practice as a physician assistant, subject to all both
of the following:
(1) The physician assistant shall practice only under with
the supervision, control, and direction of a physician with whom
the physician assistant has entered into a supervision agreement
approved by the state medical board under section 4730.17 4730.16
of the Revised Code.
(2) When the physician assistant practices outside a health
care facility, the physician assistant shall practice in
accordance with the physician supervisory plan approved under
section 4730.17 of the Revised Code for the physician who is
responsible for supervising the physician assistant.
(3) When the physician assistant practices within a health
care facility, the physician assistant shall practice in
accordance with the policies of the health care facility.
(B) For purposes of division (A) of this section and all
other provisions of this chapter pertaining to the practice of a
physician assistant under the policies of a health care facility,
both of the following apply:
(1) A physician who is supervising a physician assistant
within a health care facility may impose limitations on the
physician assistant's practice that are in addition to any
limitations applicable under the policies of the facility.
(2) The state medical board may, subject to division (D) of
section 4730.06 of the Revised Code, adopt rules designating
facilities to be included as health care facilities that are in
addition to the facilities specified in divisions (C)(1) and (2)
of section 4730.01 of the Revised Code. The rules adopted shall be
adopted in accordance with Chapter 119. of the Revised Code.
Sec. 4730.10. (A) An individual seeking a certificate
license to practice as a physician assistant shall file with the
state medical board a written application on a form prescribed and
supplied by the board. The application shall include all of the
following:
(1) The applicant's name, residential address, business
address, if any, and social security number;
(2) Satisfactory proof that the applicant meets the age and
moral character requirements specified in divisions (A)(1) and (2)
of section 4730.11 of the Revised Code;
(3) Satisfactory proof that the applicant meets either the
educational requirements specified in division (B)(1) or (2) of
section 4730.11 of the Revised Code or the educational or other
applicable requirements specified in division (C)(1), (2), or (3)
of that section;
(4) Any other information the board requires.
(B) At the time of making application for a certificate
license to practice, the applicant shall pay the board a fee of
two hundred dollars, no part of which shall be returned. The fees
shall be deposited in accordance with section 4731.24 of the
Revised Code.
Sec. 4730.101. In addition to any other eligibility
requirement set forth in this chapter, each applicant for a
certificate license to practice as a physician assistant shall
comply with sections 4776.01 to 4776.04 of the Revised Code. The
state medical board shall not grant to an applicant a certificate
license to practice as a physician assistant unless the board, in
its discretion, decides that the results of the criminal records
check do not make the applicant ineligible for a certificate
license issued pursuant to section 4730.12 of the Revised Code.
Sec. 4730.11. (A) To be eligible to receive a certificate
license to practice as a physician assistant, all of the following
apply to an applicant:
(1) The applicant shall be at least eighteen years of age.
(2) The applicant shall be of good moral character.
(3) The applicant shall hold current certification by the
national commission on certification of physician assistants or a
successor organization that is recognized by the state medical
board.
(4) The applicant shall meet either of the following
requirements:
(a) The educational requirements specified in division (B)(1)
or (2) of this section;
(b) The educational or other applicable requirements
specified in division (C)(1), (2), or (3) of this section.
(B) Effective January 1, 2008, for purposes of division
(A)(4)(a) of this section, an applicant shall meet either of the
following educational requirements:
(1) The applicant shall hold a master's or higher degree
obtained from a program accredited by the accreditation review
commission on education for the physician assistant or a
predecessor or successor organization recognized by the board.
(2) The applicant shall hold both of the following degrees:
(a) A degree other than a master's or higher degree obtained
from a program accredited by the accreditation review commission
on education for the physician assistant or a predecessor or
successor organization recognized by the board;
(b) A master's or higher degree in a course of study with
clinical relevance to the practice of physician assistants and
obtained from a program accredited by a regional or specialized
and professional accrediting agency recognized by the council for
higher education accreditation.
(C) For purposes of division (A)(4)(b) of this section, an
applicant shall present evidence satisfactory to the board of
meeting one of the following requirements in lieu of meeting the
educational requirements specified in division (B)(1) or (2) of
this section:
(1) The applicant shall hold a current, valid license or
other form of authority to practice as a physician assistant
issued by another jurisdiction prior to January 1, 2008 and have
been in active practice in that jurisdiction throughout the
immediately preceding three-year period.
(2) The applicant shall hold a degree obtained as a result of
being enrolled on January 1, 2008, in a program in this state that
was accredited by the accreditation review commission on education
for the physician assistant but did not grant a master's or higher
degree to individuals enrolled in the program on that date, and
completing the program on or before December 31, 2009.
(3) The applicant shall meet both of the following
educational and military experience requirements:
(a) Hold a degree obtained from a program accredited by the
accreditation review commission on education for the physician
assistant;
(b) Have experience practicing as a physician assistant for
at least three consecutive years while on active duty, with
evidence of service under honorable conditions, in any of the
armed forces of the United States or the national guard of any
state, including any experience attained while practicing as a
physician assistant at a health care facility or clinic operated
by the United States department of veterans affairs.
(c) Have experience practicing as a physician assistant for
at least three consecutive years while on active duty in the
United States public health service commissioned corps.
(D) Unless the applicant had prescriptive authority while
practicing as a physician assistant in another jurisdiction or in
the military, the license issued to an applicant who does not hold
a master's or higher degree described in division (B) of this
section does not authorize the holder to exercise
physician-delegated prescriptive authority and the state medical
board shall not issue a prescriber number.
(E) This section does not require an individual to obtain a
master's or higher degree as a condition of retaining or renewing
a certificate license to practice as a physician assistant if the
individual received the certificate license without holding a
master's or higher degree as provided in either of the following,
but the license will not include the authority to exercise
physician-delegated prescriptive authority:
(1) Before the educational requirements specified in division
(B)(1) or (2) of this section became effective January 1, 2008;
(2) By meeting the educational or other applicable
requirements specified in division (C)(1), (2), or (3) of this
section.
Sec. 4730.12. (A) The state medical board shall review all
applications each application received under section 4730.10 of
the Revised Code for certificates a license to practice as a
physician assistant. Not later than sixty days after receiving a
complete application, the board shall determine whether an
applicant meets the requirements to receive a certificate license
to practice, as specified in section 4730.11 of the Revised Code.
An affirmative vote of not fewer than six members of the board is
required to determine that an applicant meets the requirements to
receive a certificate license to practice as a physician
assistant.
(B) If the board determines that an applicant meets the
requirements to receive the certificate license, the secretary of
the board shall register the applicant as a physician assistant
and issue to the applicant a certificate license to practice as a
physician assistant.
(C) A physician assistant's first five hundred hours of
physician-delegated prescriptive authority shall be under the
supervision of the supervising physician, but a physician
assistant shall be excused from this requirement if prior to
application the physician assistant held a prescriber number, or
the equivalent, from another state.
A record of the hours required by this division or issuance
of a prescriber number or equivalent by another state shall be
kept on file at each site at which the physician assistant
routinely practices and be available for inspection by the board.
Sec. 4730.13. Upon application by the holder of a
certificate license to practice as a physician assistant, the
state medical board shall issue a duplicate certificate license to
replace one that is missing or damaged, to reflect a name change,
or for any other reasonable cause. The fee for a duplicate
certificate license shall be thirty-five dollars. All fees
collected under this section shall be deposited in accordance with
section 4731.24 of the Revised Code.
Sec. 4730.14. (A) A certificate license to practice as a
physician assistant shall expire biennially and may be renewed in
accordance with this section. A person seeking to renew a
certificate license to practice as a physician assistant shall, on
or before the thirty-first day of January of each even-numbered
year, apply for renewal of the certificate. The state medical
board shall send renewal notices at least one month prior to the
expiration date.
Applications shall be submitted to the board on forms the
board shall prescribe and furnish. Each application shall be
accompanied by a biennial renewal fee of one hundred dollars. The
board shall deposit the fees in accordance with section 4731.24 of
the Revised Code.
The applicant shall report any criminal offense that
constitutes grounds for refusing to issue a certificate license to
practice under section 4730.25 of the Revised Code to which the
applicant has pleaded guilty, of which the applicant has been
found guilty, or for which the applicant has been found eligible
for intervention in lieu of conviction, since last signing an
application for a
certificate license to practice as a physician
assistant.
(B) To be eligible for renewal, a physician assistant shall
certify to the board both of the following:
(1) That the physician assistant has maintained certification
by the national commission on certification of physician
assistants or a successor organization that is recognized by the
board by meeting the standards to hold current certification from
the commission or its successor, including completion of
continuing medical education requirements and passing periodic
recertification examinations;
(2) Except as provided in division (F) of this section and
section 5903.12 of the Revised Code, that the physician assistant
has completed during the current certification period not less
than one hundred hours of continuing medical education acceptable
to the board.
(C) The board shall adopt rules in accordance with Chapter
119. of the Revised Code specifying the types of continuing
medical education that must be completed to fulfill the board's
requirements under division (B)(2) of this section. Except when
additional continuing medical education is required to renew a
certificate to prescribe, as specified in section 4730.49 of the
Revised Code, the board shall not adopt rules that require a
physician assistant to complete in any certification period more
than one hundred hours of continuing medical education acceptable
to the board. In fulfilling the board's requirements, a physician
assistant may use continuing medical education courses or programs
completed to maintain certification by the national commission on
certification of physician assistants or a successor organization
that is recognized by the board if the standards for acceptable
courses and programs of the commission or its successor are at
least equivalent to the standards established by the board.
(D) If an applicant submits a complete renewal application
and qualifies for renewal pursuant to division (B) of this
section, the board shall issue to the applicant a renewed
certificate license to practice as a physician assistant.
(E) The board may require a random sample of physician
assistants to submit materials documenting certification by the
national commission on certification of physician assistants or a
successor organization that is recognized by the board and
completion of the required number of hours of continuing medical
education.
(F) The board shall provide for pro rata reductions by month
of the number of hours of continuing education that must be
completed for individuals who are in their first certification
period, who have been disabled due to illness or accident, or who
have been absent from the country. The board shall adopt rules, in
accordance with Chapter 119. of the Revised Code, as necessary to
implement this division.
(G)(1) A certificate license to practice that is not renewed
on or before its expiration date is automatically suspended on its
expiration date. Continued practice after suspension of the
certificate shall be considered as practicing in violation of
division (A) of section 4730.02 of the Revised Code.
(2) If a certificate license has been suspended pursuant to
division (G)(1) of this section for two years or less, it may be
reinstated. The board shall reinstate a
certificate license
suspended for failure to renew upon an applicant's submission of a
renewal application, the biennial renewal fee, and any applicable
monetary penalty.
If a certificate license has been suspended pursuant to
division (G)(1) of this division section for more than two years,
it may be restored. In accordance with section 4730.28 of the
Revised Code, the board may restore a certificate license
suspended for failure to renew upon an applicant's submission of a
restoration application, the biennial renewal fee, and any
applicable monetary penalty and compliance with sections 4776.01
to 4776.04 of the Revised Code. The board shall not restore to an
applicant a certificate license to practice as a physician
assistant unless the board, in its discretion, decides that the
results of the criminal records check do not make the applicant
ineligible for a certificate license issued pursuant to section
4730.12 of the Revised Code.
The penalty for reinstatement shall be fifty dollars and the
penalty for restoration shall be one hundred dollars. The board
shall deposit penalties in accordance with section 4731.24 of the
Revised Code.
(H) If an individual certifies that the individual has
completed the number of hours and type of continuing medical
education required for renewal or reinstatement of a certificate
license to practice as a physician assistant, and the board finds
through a random sample conducted under division (E) of this
section or through any other means that the individual did not
complete the requisite continuing medical education, the board may
impose a civil penalty of not more than five thousand dollars. The
board's finding shall be made pursuant to an adjudication under
Chapter 119. of the Revised Code and by an affirmative vote of not
fewer than six members.
A civil penalty imposed under this division may be in
addition to or in lieu of any other action the board may take
under section 4730.25 of the Revised Code. The board shall deposit
civil penalties in accordance with section 4731.24 of the Revised
Code.
Sec. 4730.16. To be eligible for approval by the state
medical board under section 4730.17 of the Revised Code, a
physician supervisory plan shall meet the requirements of any
applicable rules adopted by the board (A) A supervision agreement
shall be in writing, be signed by the physician assistant and the
supervising physician, and shall specify all both of the
following:
(A)(1) The responsibilities to be fulfilled by the physician
supervising a physician assistant under the plan agreement;
(B)(2) The responsibilities to be fulfilled by a physician
assistant when performing services under the plan;
(C) Circumstances under which a physician assistant is
required to refer a patient to the supervising physician;
(D) Procedures to be followed by a physician assistant when
writing medical orders, including prescriptions written in the
exercise of the physician-delegated prescriptive authority granted
to the physician assistant;
(E) Any special services that the physician may delegate to a
physician assistant agreement.
(B) A supervision agreement shall clearly state that the
supervising physician is professionally and legally responsible
for services provided by the physician assistant.
(C) A supervision agreement expires two years after it is
executed or, if earlier, on execution of a new supervision
agreement by the supervising physician and physician assistant.
(D) A supervision agreement shall be kept on file at each
location at which the physician assistant regularly practices and
made available to the state medical board on request.
(E) The board shall adopt rules, in accordance with Chapter
119. of the Revised Code, as necessary to implement this section.
Sec. 4730.20. (A) A physician assistant licensed under this
chapter may perform any of the following services authorized by
the supervising physician that are part of the supervising
physician's normal course of practice and expertise:
(1) Ordering diagnostic, therapeutic, and other medical
services;
(2) Prescribing physical therapy or referring a patient to a
physical therapist for physical therapy;
(3) Ordering occupational therapy or referring a patient to
an occupational therapist for occupational therapy;
(4) Taking any action that may be taken by an attending
physician under sections 2133.21 to 2133.26 of the Revised Code,
as specified in section 2133.211 of the Revised Code;
(5) Determining and pronouncing death in accordance with
section 4730.092 of the Revised Code;
(6) Assisting in surgery;
(7) If the physician assistant holds a valid prescriber
number issued by the state medical board, ordering, prescribing,
personally furnishing, and administering drugs and medical
devices;
(8) Any other services that are part of the supervising
physician's normal course of practice and expertise.
(B) When performing authorized services, a physician
assistant acts as the agent of the supervising physician. The
supervising physician is professionally responsible for the
services performed by the physician assistant.
(C) A physician assistant who is authorized to perform
services may delegate a task the physician assistant is authorized
to perform that implements the plan of care for a patient to a
medical assistant, a nurse aide who has successfully completed a
training and competency evaluation program approved by the
director of health under section 3721.31 of the Revised Code, or
other personnel.
(D) The services a physician assistant may provide under the
policies of a health care facility are limited to the services the
facility authorizes the physician assistant to provide for the
facility. A facility may not authorize a physician assistant to
perform a service that is not authorized under this chapter.
Sec. 4730.091 4730.201. (A) As used in this section, "local:
(1) "Local anesthesia" means the injection of a drug or
combination of drugs to stop or prevent a painful sensation in a
circumscribed area of the body where a painful procedure is to be
performed. "Local anesthesia" includes only local infiltration
anesthesia, digital blocks, and pudendal blocks.
(2) "Conscious sedation" means a minimally depressed level of
consciousness induced by the administration of pharmacologic
agents in which a patient retains the ability to independently and
continuously maintain an open airway and a regular breathing
pattern, and to respond appropriately to physical stimulation and
verbal commands. Conscious sedation may be induced by parenteral
or oral medications or a combination thereof.
(B) A physician assistant may administer, monitor, or
maintain local anesthesia as a component of a procedure the
physician assistant is performing or as a separate service when
the procedure requiring local anesthesia is to be performed by the
physician assistant's supervising physician or another person. A
physician assistant may administer, monitor, and maintain
conscious sedation within a facility's critical care unit or, with
the supervision of a physician as described in division (D)(2) of
section 4730.21 of the Revised Code a facility's emergency
department. A physician assistant shall not administer, monitor,
or maintain any other form of anesthesia, including regional
anesthesia or any systemic sedation, regardless of whether the
physician assistant is practicing under a physician supervisory
plan or the policies of a health care facility.
Sec. 4730.092 4730.202. (A) A physician assistant may
determine and pronounce an individual's death, but only if the
individual's respiratory and circulatory functions are not being
artificially sustained and, at the time the determination and
pronouncement of death is made, either or both of the following
apply:
(1) The individual was receiving care in one of the
following:
(a) A nursing home licensed under section 3721.02 of the
Revised Code or by a political subdivision under section 3721.09
of the Revised Code;
(b) A residential care facility or home for the aging
licensed under Chapter 3721. of the Revised Code;
(c) A county home or district home operated pursuant to
Chapter 5155. of the Revised Code;
(d) A residential facility licensed under section 5123.19 of
the Revised Code.
(2) The physician assistant is providing or supervising the
individual's care through a hospice care program licensed under
Chapter 3712. of the Revised Code or any other entity that
provides palliative care.
(B) If a physician assistant determines and pronounces an
individual's death, the physician assistant shall comply with both
of the following:
(1) The physician assistant shall not complete any portion of
the individual's death certificate.
(2) The physician assistant shall notify the individual's
attending physician of the determination and pronouncement of
death in order for the physician to fulfill the physician's duties
under section 3705.16 of the Revised Code. The physician assistant
shall provide the notification within a period of time that is
reasonable but not later than twenty-four hours following the
determination and pronouncement of the individual's death.
Sec. 4730.21. (A) The supervising physician of a physician
assistant exercises supervision, control, and direction of the
physician assistant. In supervising a physician assistant, all of
the following apply:
(1) Except when the on-site supervision requirements
specified in section 4730.45 of the Revised Code are applicable,
the The supervising physician shall be continuously available for
direct communication with the physician assistant by either of the
following means:
(a) Being physically present at the location where the
physician assistant is practicing;
(b) Being readily available to the physician assistant
through some means of telecommunication and being in a location
that under normal conditions is not more than sixty minutes travel
time away a distance from the location where the physician
assistant is practicing that reasonably allows the physician to
assure proper care of patients.
(2) The supervising physician shall personally and actively
review the physician assistant's professional activities.
(3) The supervising physician shall regularly review the
condition of the patients treated by the physician assistant.
(4) The supervising physician shall ensure that the quality
assurance system established pursuant to division (F) of this
section is implemented and maintained.
(5)(4) The supervising physician shall regularly perform any
other reviews of the physician assistant that the supervising
physician considers necessary.
(B) A physician may enter into supervision agreements with
any number of physician assistants, but the physician may not
supervise more than two five physician assistants at any one time.
A physician assistant may enter into supervision agreements with
any number of supervising physicians, but when practicing under
the supervision of a particular physician, the physician
assistant's scope of practice is subject to the limitations of the
physician supervisory plan that has been approved under section
4730.17 of the Revised Code for that physician or the policies of
the health care facility in which the physician and physician
assistant are practicing.
(C) A supervising physician may authorize a physician
assistant to perform a service only if the service is authorized
under the physician supervisory plan approved for that physician
or the policies of the health care facility in which the physician
and physician assistant are practicing. A supervising physician
may authorize a physician assistant to perform a service only if
the physician is satisfied that the physician assistant is capable
of competently performing the service. A supervising physician
shall not authorize a physician assistant to perform any service
that is beyond the physician's or the physician assistant's normal
course of practice and expertise.
(D)(1) A supervising physician may authorize a physician
assistant to may practice in any setting within which authorized
by the supervising physician routinely practices.
(2) In the case of a health care facility with an emergency
department, if the supervising physician routinely practices in
the facility's emergency department, the supervising physician
shall provide on-site supervision of the physician assistant when
the physician assistant practices in the emergency department. If
the supervising physician does not routinely practice in the
facility's emergency department, the supervising physician may, on
occasion, send the physician assistant to the facility's emergency
department to assess and manage a patient. In supervising the
physician assistant's assessment and management of the patient,
the supervising physician shall determine the appropriate level of
supervision in compliance with the requirements of divisions (A)
to (C) of this section, except that the supervising physician must
be available to go to the emergency department to personally
evaluate the patient and, at the request of an emergency
department physician, the supervising physician shall go to the
emergency department to personally evaluate the patient.
(E) Each time a physician assistant writes a medical order,
including prescriptions written in the exercise of
physician-delegated prescriptive authority, the physician
assistant shall sign the form on which the order is written and
record on the form the time and date that the order is written.
When writing a medical order, the physician assistant shall
clearly identify the physician under whose supervision the
physician assistant is authorized to write the order.
(F)(1) The supervising physician of a physician assistant
shall establish a quality assurance system to be used in
supervising the physician assistant. All or part of the system may
be applied to other physician assistants who are supervised by the
supervising physician. The system shall be developed in
consultation with each physician assistant to be supervised by the
physician.
(2) In establishing the quality assurance system, the
supervising physician shall describe a process to be used for all
of the following:
(a) Routine review by the physician of selected patient
record entries made by the physician assistant and selected
medical orders issued by the physician assistant;
(b) Discussion of complex cases;
(c) Discussion of new medical developments relevant to the
practice of the physician and physician assistant;
(d) Performance of any quality assurance activities required
in rules adopted by state medical board pursuant to any
recommendations made by the physician assistant policy committee
under section 4730.06 of the Revised Code;
(e) Performance of any other quality assurance activities
that the supervising physician considers to be appropriate.
(3) The supervising physician and physician assistant shall
keep records of their quality assurance activities. On request,
the records shall be made available to the board and any health
care professional working with the supervising physician and
physician assistant.
Sec. 4730.25. (A) The state medical board, by an affirmative
vote of not fewer than six members, may revoke or may refuse to
grant a certificate license to practice as a physician assistant
or a certificate to prescribe to a person found by the board to
have committed fraud, misrepresentation, or deception in applying
for or securing the
certificate license.
(B) The board, by an affirmative vote of not fewer than six
members, shall, to the extent permitted by law, limit, revoke, or
suspend an individual's
certificate license to practice as a
physician assistant or certificate to prescribe, refuse to issue a
certificate license to an applicant, refuse to reinstate a
certificate license, or reprimand or place on probation the holder
of a certificate license for any of the following reasons:
(1) Failure to practice in accordance with the conditions
under which the supervising physician's supervision agreement with
the physician assistant was approved, including the requirement
that when practicing under a particular supervising physician, the
physician assistant must practice only according to the physician
supervisory plan the board approved for that physician or the
policies of the health care facility in which the supervising
physician and physician assistant are practicing;
(2) Failure to comply with the requirements of this chapter,
Chapter 4731. of the Revised Code, or any rules adopted by the
board;
(3) Violating or attempting to violate, directly or
indirectly, or assisting in or abetting the violation of, or
conspiring to violate, any provision of this chapter, Chapter
4731. of the Revised Code, or the rules adopted by the board;
(4) Inability to practice according to acceptable and
prevailing standards of care by reason of mental illness or
physical illness, including physical deterioration that adversely
affects cognitive, motor, or perceptive skills;
(5) Impairment of ability to practice according to acceptable
and prevailing standards of care because of habitual or excessive
use or abuse of drugs, alcohol, or other substances that impair
ability to practice;
(6) Administering drugs for purposes other than those
authorized under this chapter;
(7) Willfully betraying a professional confidence;
(8) Making a false, fraudulent, deceptive, or misleading
statement in soliciting or advertising for employment as a
physician assistant; in connection with any solicitation or
advertisement for patients; in relation to the practice of
medicine as it pertains to physician assistants; or in securing or
attempting to secure a certificate license to practice as a
physician assistant, a certificate to prescribe, or approval of a
supervision agreement.
As used in this division, "false, fraudulent, deceptive, or
misleading statement" means a statement that includes a
misrepresentation of fact, is likely to mislead or deceive because
of a failure to disclose material facts, is intended or is likely
to create false or unjustified expectations of favorable results,
or includes representations or implications that in reasonable
probability will cause an ordinarily prudent person to
misunderstand or be deceived.
(9) Representing, with the purpose of obtaining compensation
or other advantage personally or for any other person, that an
incurable disease or injury, or other incurable condition, can be
permanently cured;
(10) The obtaining of, or attempting to obtain, money or
anything of value by fraudulent misrepresentations in the course
of practice;
(11) A plea of guilty to, a judicial finding of guilt of, or
a judicial finding of eligibility for intervention in lieu of
conviction for, a felony;
(12) Commission of an act that constitutes a felony in this
state, regardless of the jurisdiction in which the act was
committed;
(13) A plea of guilty to, a judicial finding of guilt of, or
a judicial finding of eligibility for intervention in lieu of
conviction for, a misdemeanor committed in the course of practice;
(14) A plea of guilty to, a judicial finding of guilt of, or
a judicial finding of eligibility for intervention in lieu of
conviction for, a misdemeanor involving moral turpitude;
(15) Commission of an act in the course of practice that
constitutes a misdemeanor in this state, regardless of the
jurisdiction in which the act was committed;
(16) Commission of an act involving moral turpitude that
constitutes a misdemeanor in this state, regardless of the
jurisdiction in which the act was committed;
(17) A plea of guilty to, a judicial finding of guilt of, or
a judicial finding of eligibility for intervention in lieu of
conviction for violating any state or federal law regulating the
possession, distribution, or use of any drug, including
trafficking in drugs;
(18) Any of the following actions taken by the state agency
responsible for regulating the practice of physician assistants in
another state, for any reason other than the nonpayment of fees:
the limitation, revocation, or suspension of an individual's
license to practice; acceptance of an individual's license
surrender; denial of a license; refusal to renew or reinstate a
license; imposition of probation; or issuance of an order of
censure or other reprimand;
(19) A departure from, or failure to conform to, minimal
standards of care of similar physician assistants under the same
or similar circumstances, regardless of whether actual injury to a
patient is established;
(20) Violation of the conditions placed by the board on a
certificate license to practice as a physician assistant, a
certificate to prescribe, a physician supervisory plan, or
supervision agreement;
(21) Failure to use universal blood and body fluid
precautions established by rules adopted under section 4731.051 of
the Revised Code;
(22) Failure to cooperate in an investigation conducted by
the board under section 4730.26 of the Revised Code, including
failure to comply with a subpoena or order issued by the board or
failure to answer truthfully a question presented by the board at
a deposition or in written interrogatories, except that failure to
cooperate with an investigation shall not constitute grounds for
discipline under this section if a court of competent jurisdiction
has issued an order that either quashes a subpoena or permits the
individual to withhold the testimony or evidence in issue;
(23) Assisting suicide as defined in section 3795.01 of the
Revised Code;
(24) Prescribing any drug or device to perform or induce an
abortion, or otherwise performing or inducing an abortion.
(C) Disciplinary actions taken by the board under divisions
(A) and (B) of this section shall be taken pursuant to an
adjudication under Chapter 119. of the Revised Code, except that
in lieu of an adjudication, the board may enter into a consent
agreement with a physician assistant or applicant to resolve an
allegation of a violation of this chapter or any rule adopted
under it. A consent agreement, when ratified by an affirmative
vote of not fewer than six members of the board, shall constitute
the findings and order of the board with respect to the matter
addressed in the agreement. If the board refuses to ratify a
consent agreement, the admissions and findings contained in the
consent agreement shall be of no force or effect.
(D) For purposes of divisions (B)(12), (15), and (16) of this
section, the commission of the act may be established by a finding
by the board, pursuant to an adjudication under Chapter 119. of
the Revised Code, that the applicant or certificate license holder
committed the act in question. The board shall have no
jurisdiction under these divisions in cases where the trial court
renders a final judgment in the certificate license holder's favor
and that judgment is based upon an adjudication on the merits. The
board shall have jurisdiction under these divisions in cases where
the trial court issues an order of dismissal upon technical or
procedural grounds.
(E) The sealing of conviction records by any court shall have
no effect upon a prior board order entered under the provisions of
this section or upon the board's jurisdiction to take action under
the provisions of this section if, based upon a plea of guilty, a
judicial finding of guilt, or a judicial finding of eligibility
for intervention in lieu of conviction, the board issued a notice
of opportunity for a hearing prior to the court's order to seal
the records. The board shall not be required to seal, destroy,
redact, or otherwise modify its records to reflect the court's
sealing of conviction records.
(F) For purposes of this division, any individual who holds a
certificate license issued under this chapter, or applies for a
certificate license issued under this chapter, shall be deemed to
have given consent to submit to a mental or physical examination
when directed to do so in writing by the board and to have waived
all objections to the admissibility of testimony or examination
reports that constitute a privileged communication.
(1) In enforcing division (B)(4) of this section, the board,
upon a showing of a possible violation, may compel any individual
who holds a certificate license issued under this chapter or who
has applied for a certificate license pursuant to this chapter to
submit to a mental examination, physical examination, including an
HIV test, or both a mental and physical examination. The expense
of the examination is the responsibility of the individual
compelled to be examined. Failure to submit to a mental or
physical examination or consent to an HIV test ordered by the
board constitutes an admission of the allegations against the
individual unless the failure is due to circumstances beyond the
individual's control, and a default and final order may be entered
without the taking of testimony or presentation of evidence. If
the board finds a physician assistant unable to practice because
of the reasons set forth in division (B)(4) of this section, the
board shall require the physician assistant to submit to care,
counseling, or treatment by physicians approved or designated by
the board, as a condition for an initial, continued, reinstated,
or renewed certificate license. An individual affected under this
division shall be afforded an opportunity to demonstrate to the
board the ability to resume practicing in compliance with
acceptable and prevailing standards of care.
(2) For purposes of division (B)(5) of this section, if the
board has reason to believe that any individual who holds a
certificate license issued under this chapter or any applicant for
a certificate license suffers such impairment, the board may
compel the individual to submit to a mental or physical
examination, or both. The expense of the examination is the
responsibility of the individual compelled to be examined. Any
mental or physical examination required under this division shall
be undertaken by a treatment provider or physician qualified to
conduct such examination and chosen by the board.
Failure to submit to a mental or physical examination ordered
by the board constitutes an admission of the allegations against
the individual unless the failure is due to circumstances beyond
the individual's control, and a default and final order may be
entered without the taking of testimony or presentation of
evidence. If the board determines that the individual's ability to
practice is impaired, the board shall suspend the individual's
certificate license or deny the individual's application and shall
require the individual, as a condition for initial, continued,
reinstated, or renewed certification licensure to practice or
prescribe, to submit to treatment.
Before being eligible to apply for reinstatement of a
certificate license suspended under this division, the physician
assistant shall demonstrate to the board the ability to resume
practice or prescribing in compliance with acceptable and
prevailing standards of care. The demonstration shall include the
following:
(a) Certification from a treatment provider approved under
section 4731.25 of the Revised Code that the individual has
successfully completed any required inpatient treatment;
(b) Evidence of continuing full compliance with an aftercare
contract or consent agreement;
(c) Two written reports indicating that the individual's
ability to practice has been assessed and that the individual has
been found capable of practicing according to acceptable and
prevailing standards of care. The reports shall be made by
individuals or providers approved by the board for making such
assessments and shall describe the basis for their determination.
The board may reinstate a certificate license suspended under
this division after such demonstration and after the individual
has entered into a written consent agreement.
When the impaired physician assistant resumes practice or
prescribing, the board shall require continued monitoring of the
physician assistant. The monitoring shall include compliance with
the written consent agreement entered into before reinstatement or
with conditions imposed by board order after a hearing, and, upon
termination of the consent agreement, submission to the board for
at least two years of annual written progress reports made under
penalty of falsification stating whether the physician assistant
has maintained sobriety.
(G) If the secretary and supervising member determine that
there is clear and convincing evidence that a physician assistant
has violated division (B) of this section and that the
individual's continued practice or prescribing presents a danger
of immediate and serious harm to the public, they may recommend
that the board suspend the individual's certificate license to
practice or authority to prescribe without a prior hearing.
Written allegations shall be prepared for consideration by the
board.
The board, upon review of those allegations and by an
affirmative vote of not fewer than six of its members, excluding
the secretary and supervising member, may suspend a certificate
license without a prior hearing. A telephone conference call may
be utilized for reviewing the allegations and taking the vote on
the summary suspension.
The board shall issue a written order of suspension by
certified mail or in person in accordance with section 119.07 of
the Revised Code. The order shall not be subject to suspension by
the court during pendency of any appeal filed under section 119.12
of the Revised Code. If the physician assistant requests an
adjudicatory hearing by the board, the date set for the hearing
shall be within fifteen days, but not earlier than seven days,
after the physician assistant requests the hearing, unless
otherwise agreed to by both the board and the certificate license
holder.
A summary suspension imposed under this division shall remain
in effect, unless reversed on appeal, until a final adjudicative
order issued by the board pursuant to this section and Chapter
119. of the Revised Code becomes effective. The board shall issue
its final adjudicative order within sixty days after completion of
its hearing. Failure to issue the order within sixty days shall
result in dissolution of the summary suspension order, but shall
not invalidate any subsequent, final adjudicative order.
(H) If the board takes action under division (B)(11), (13),
or (14) of this section, and the judicial finding of guilt, guilty
plea, or judicial finding of eligibility for intervention in lieu
of conviction is overturned on appeal, upon exhaustion of the
criminal appeal, a petition for reconsideration of the order may
be filed with the board along with appropriate court documents.
Upon receipt of a petition and supporting court documents, the
board shall reinstate the certificate license to practice or
prescribe. The board may then hold an adjudication under Chapter
119. of the Revised Code to determine whether the individual
committed the act in question. Notice of opportunity for hearing
shall be given in accordance with Chapter 119. of the Revised
Code. If the board finds, pursuant to an adjudication held under
this division, that the individual committed the act, or if no
hearing is requested, it may order any of the sanctions identified
under division (B) of this section.
(I) The certificate license to practice issued to a physician
assistant and the physician assistant's practice in this state are
automatically suspended as of the date the physician assistant
pleads guilty to, is found by a judge or jury to be guilty of, or
is subject to a judicial finding of eligibility for intervention
in lieu of conviction in this state or treatment or intervention
in lieu of conviction in another state for any of the following
criminal offenses in this state or a substantially equivalent
criminal offense in another jurisdiction: aggravated murder,
murder, voluntary manslaughter, felonious assault, kidnapping,
rape, sexual battery, gross sexual imposition, aggravated arson,
aggravated robbery, or aggravated burglary. Continued practice
after the suspension shall be considered practicing without a
certificate license.
The board shall notify the individual subject to the
suspension by certified mail or in person in accordance with
section 119.07 of the Revised Code. If an individual whose
certificate license is suspended under this division fails to make
a timely request for an adjudication under Chapter 119. of the
Revised Code, the board shall enter a final order permanently
revoking the individual's certificate license to practice.
(J) In any instance in which the board is required by Chapter
119. of the Revised Code to give notice of opportunity for hearing
and the individual subject to the notice does not timely request a
hearing in accordance with section 119.07 of the Revised Code, the
board is not required to hold a hearing, but may adopt, by an
affirmative vote of not fewer than six of its members, a final
order that contains the board's findings. In that final order, the
board may order any of the sanctions identified under division (A)
or (B) of this section.
(K) Any action taken by the board under division (B) of this
section resulting in a suspension shall be accompanied by a
written statement of the conditions under which the physician
assistant's
certificate license may be reinstated. The board shall
adopt rules in accordance with Chapter 119. of the Revised Code
governing conditions to be imposed for reinstatement.
Reinstatement of a certificate license suspended pursuant to
division (B) of this section requires an affirmative vote of not
fewer than six members of the board.
(L) When the board refuses to grant to an applicant a
certificate license to practice as a physician assistant or a
certificate to prescribe, revokes an individual's certificate
license, refuses to issue a
certificate license, or refuses to
reinstate an individual's certificate license, the board may
specify that its action is permanent. An individual subject to a
permanent action taken by the board is forever thereafter
ineligible to hold the certificate license and the board shall not
accept an application for reinstatement of the certificate license
or for issuance of a new
certificate license.
(M) Notwithstanding any other provision of the Revised Code,
all of the following apply:
(1) The surrender of a certificate license issued under this
chapter is not effective unless or until accepted by the board.
Reinstatement of a
certificate license surrendered to the board
requires an affirmative vote of not fewer than six members of the
board.
(2) An application made under this chapter for a certificate,
approval of a physician supervisory plan, or approval of a
supervision agreement license may not be withdrawn without
approval of the board.
(3) Failure by an individual to renew a certificate license
in accordance with section 4730.14 or section 4730.48 of the
Revised Code shall not remove or limit the board's jurisdiction to
take disciplinary action under this section against the
individual.
Sec. 4730.251. On receipt of a notice pursuant to section
3123.43 of the Revised Code, the state medical board shall comply
with sections 3123.41 to 3123.50 of the Revised Code and any
applicable rules adopted under section 3123.63 of the Revised Code
with respect to a certificate license issued pursuant to this
chapter.
Sec. 4730.27. If the state medical board has reason to
believe that any person who has been granted a certificate license
under this chapter is mentally ill or mentally incompetent, it may
file in the probate court of the county in which such person has a
legal residence an affidavit in the form prescribed in section
5122.11 of the Revised Code and signed by the board secretary or a
member of the secretary's staff, whereupon the same proceedings
shall be had as provided in Chapter 5122. of the Revised Code. The
attorney general may represent the board in any proceeding
commenced under this section.
If a physician assistant is adjudged by a probate court to be
mentally ill or mentally incompetent, the individual's certificate
license shall be automatically suspended until the individual has
filed with the board a certified copy of an adjudication by a
probate court of being restored to competency or has submitted to
the board proof, satisfactory to the board, of having been
discharged as being restored to competency in the manner and form
provided in section 5122.38 of the Revised Code. The judge of the
court shall immediately notify the board of an adjudication of
incompetence and note any suspension of a certificate license in
the margin of the court's record of the certificate license.
Sec. 4730.28. (A) An individual whose certificate license to
practice as a physician assistant has been suspended or is in an
inactive state for any cause for more than two years may apply to
the state medical board to have the
certificate license restored.
(B)(1) The board shall not restore a
certificate license
under this section unless the applicant complies with sections
4776.01 to 4776.04 of the Revised Code. The board shall determine
the applicant's present fitness to resume practice. The board
shall consider the moral background and the activities of the
applicant during the period of suspension or inactivity.
(2) When restoring a certificate license, the board may
impose terms and conditions, including the following:
(a) Requiring the applicant to obtain additional training and
pass an examination upon completion of the training;
(b) Restricting or limiting the extent, scope, or type of
practice as a physician assistant that the individual may resume.
Sec. 4730.31. (A) As used in this section, "prosecutor" has
the same meaning as in section 2935.01 of the Revised Code.
(B) Whenever any person holding a valid
certificate license
issued pursuant to this chapter pleads guilty to, is subject to a
judicial finding of guilt of, or is subject to a judicial finding
of eligibility for intervention in lieu of conviction for a
violation of Chapter 2907., 2925., or 3719. of the Revised Code or
of any substantively comparable ordinance of a municipal
corporation in connection with practicing as a physician
assistant, the prosecutor in the case shall, on forms prescribed
and provided by the state medical board, promptly notify the board
of the conviction. Within thirty days of receipt of such
information, the board shall initiate action in accordance with
Chapter 119. of the Revised Code to determine whether to suspend
or revoke the
certificate license under section 4730.25 of the
Revised Code.
(C) The prosecutor in any case against any person holding a
valid certificate license issued pursuant to this chapter shall,
on forms prescribed and provided by the state medical board,
notify the board of any of the following:
(1) A plea of guilty to, a judicial finding of guilt of, or
judicial finding of eligibility for intervention in lieu of
conviction for a felony, or a case where the trial court issues an
order of dismissal upon technical or procedural grounds of a
felony charge;
(2) A plea of guilty to, a judicial finding of guilt of, or
judicial finding or eligibility for intervention in lieu of
conviction for a misdemeanor committed in the course of practice,
or a case where the trial court issues an order of dismissal upon
technical or procedural grounds of a charge of a misdemeanor, if
the alleged act was committed in the course of practice;
(3) A plea of guilty to, a judicial finding of guilt of, or
judicial finding of eligibility for intervention in lieu of
conviction for a misdemeanor involving moral turpitude, or a case
where the trial court issues an order of dismissal upon technical
or procedural grounds of a charge of a misdemeanor involving moral
turpitude.
The report shall include the name and address of the
certificate license holder, the nature of the offense for which
the action was taken, and the certified court documents recording
the action.
Sec. 4730.32. (A) Within sixty days after the imposition of
any formal disciplinary action taken by a health care facility
against any individual holding a valid certificate license to
practice as a physician assistant, the chief administrator or
executive officer of the facility shall report to the state
medical board the name of the individual, the action taken by the
facility, and a summary of the underlying facts leading to the
action taken. Upon request, the board shall be provided certified
copies of the patient records that were the basis for the
facility's action. Prior to release to the board, the summary
shall be approved by the peer review committee that reviewed the
case or by the governing board of the facility.
The filing of a report with the board or decision not to file
a report, investigation by the board, or any disciplinary action
taken by the board, does not preclude a health care facility from
taking disciplinary action against a physician assistant.
In the absence of fraud or bad faith, no individual or entity
that provides patient records to the board shall be liable in
damages to any person as a result of providing the records.
(B) A physician assistant, professional association or
society of physician assistants, physician, or professional
association or society of physicians that believes a violation of
any provision of this chapter, Chapter 4731. of the Revised Code,
or rule of the board has occurred shall report to the board the
information upon which the belief is based. This division does not
require any treatment provider approved by the board under section
4731.25 of the Revised Code or any employee, agent, or
representative of such a provider to make reports with respect to
a physician assistant participating in treatment or aftercare for
substance abuse as long as the physician assistant maintains
participation in accordance with the requirements of section
4731.25 of the Revised Code and the treatment provider or
employee, agent, or representative of the provider has no reason
to believe that the physician assistant has violated any provision
of this chapter or rule adopted under it, other than being
impaired by alcohol, drugs, or other substances. This division
does not require reporting by any member of an impaired
practitioner committee established by a health care facility or by
any representative or agent of a committee or program sponsored by
a professional association or society of physician assistants to
provide peer assistance to physician assistants with substance
abuse problems with respect to a physician assistant who has been
referred for examination to a treatment program approved by the
board under section 4731.25 of the Revised Code if the physician
assistant cooperates with the referral for examination and with
any determination that the physician assistant should enter
treatment and as long as the committee member, representative, or
agent has no reason to believe that the physician assistant has
ceased to participate in the treatment program in accordance with
section 4731.25 of the Revised Code or has violated any provision
of this chapter or rule adopted under it, other than being
impaired by alcohol, drugs, or other substances.
(C) Any professional association or society composed
primarily of physician assistants that suspends or revokes an
individual's membership for violations of professional ethics, or
for reasons of professional incompetence or professional
malpractice, within sixty days after a final decision, shall
report to the board, on forms prescribed and provided by the
board, the name of the individual, the action taken by the
professional organization, and a summary of the underlying facts
leading to the action taken.
The filing or nonfiling of a report with the board,
investigation by the board, or any disciplinary action taken by
the board, shall not preclude a professional organization from
taking disciplinary action against a physician assistant.
(D) Any insurer providing professional liability insurance to
any person holding a valid certificate license to practice as a
physician assistant or any other entity that seeks to indemnify
the professional liability of a physician assistant shall notify
the board within thirty days after the final disposition of any
written claim for damages where such disposition results in a
payment exceeding twenty-five thousand dollars. The notice shall
contain the following information:
(1) The name and address of the person submitting the
notification;
(2) The name and address of the insured who is the subject of
the claim;
(3) The name of the person filing the written claim;
(4) The date of final disposition;
(5) If applicable, the identity of the court in which the
final disposition of the claim took place.
(E) The board may investigate possible violations of this
chapter or the rules adopted under it that are brought to its
attention as a result of the reporting requirements of this
section, except that the board shall conduct an investigation if a
possible violation involves repeated malpractice. As used in this
division, "repeated malpractice" means three or more claims for
malpractice within the previous five-year period, each resulting
in a judgment or settlement in excess of twenty-five thousand
dollars in favor of the claimant, and each involving negligent
conduct by the physician assistant.
(F) All summaries, reports, and records received and
maintained by the board pursuant to this section shall be held in
confidence and shall not be subject to discovery or introduction
in evidence in any federal or state civil action involving a
physician assistant, supervising physician, or health care
facility arising out of matters that are the subject of the
reporting required by this section. The board may use the
information obtained only as the basis for an investigation, as
evidence in a disciplinary hearing against a physician assistant
or supervising physician, or in any subsequent trial or appeal of
a board action or order.
The board may disclose the summaries and reports it receives
under this section only to health care facility committees within
or outside this state that are involved in credentialing or
recredentialing a physician assistant or supervising physician or
reviewing their privilege to practice within a particular
facility. The board shall indicate whether or not the information
has been verified. Information transmitted by the board shall be
subject to the same confidentiality provisions as when maintained
by the board.
(G) Except for reports filed by an individual pursuant to
division (B) of this section, the board shall send a copy of any
reports or summaries it receives pursuant to this section to the
physician assistant. The physician assistant shall have the right
to file a statement with the board concerning the correctness or
relevance of the information. The statement shall at all times
accompany that part of the record in contention.
(H) An individual or entity that reports to the board or
refers an impaired physician assistant to a treatment provider
approved by the board under section 4731.25 of the Revised Code
shall not be subject to suit for civil damages as a result of the
report, referral, or provision of the information.
(I) In the absence of fraud or bad faith, a professional
association or society of physician assistants that sponsors a
committee or program to provide peer assistance to a physician
assistant with substance abuse problems, a representative or agent
of such a committee or program, and a member of the state medical
board shall not be held liable in damages to any person by reason
of actions taken to refer a physician assistant to a treatment
provider approved under section 4731.25 of the Revised Code for
examination or treatment.
Sec. 4730.33. The secretary of the state medical board shall
enforce the laws relating to the practice of physician assistants.
If the secretary has knowledge or notice of a violation of this
chapter or the rules adopted under it, the secretary shall
investigate the matter, and, upon probable cause appearing, file a
complaint and prosecute the offender. When requested by the
secretary, the prosecuting attorney of the proper county shall
take charge of and conduct such prosecution.
In the prosecution of any person for violation of division
(A) of section 4730.02 of the Revised Code it shall not be
necessary to allege or prove want of a valid certificate license
to practice as a physician assistant, but such matters shall be a
matter of defense to be established by the accused.
Sec. 4730.38. (A) Except as provided in division (B) of this
section, the physician assistant policy committee of the state
medical board shall, at such times the committee determines to be
necessary, submit to the board recommendations regarding
physician-delegated prescriptive authority for physician
assistants. The committee's recommendations shall address both of
the following:
(1) Policy and procedures regarding physician-delegated
prescriptive authority, including the issuance of certificates to
prescribe under this chapter;
(2) Any issue the committee considers necessary to assist the
board in fulfilling its duty to adopt rules governing
physician-delegated prescriptive authority, including the issuance
of certificates to prescribe.
(B) Not less than every six months beginning on the first day
of June following the effective date of this amendment March 22,
2013, the committee shall review the physician assistant formulary
the board adopts pursuant to division (A)(1) of section 4730.39 of
the Revised Code and, to the extent it determines to be necessary,
submit recommendations proposing changes to the formulary.
(C) Recommendations submitted under this section are subject
to the procedures and time frames specified in division (C) of
section 4730.06 of the Revised Code.
Sec. 4730.39. (A) The state medical board shall do both of
the following:
(1) Adopt a formulary listing the drugs and therapeutic
devices by class and specific generic nomenclature that a
physician may include in the physician-delegated prescriptive
authority granted to a physician assistant who holds a certificate
to prescribe under this chapter valid prescriber number issued by
the state medical board;
(2) Adopt rules governing physician-delegated prescriptive
authority for physician assistants, including the issuance of
certificates to prescribe under this chapter.
(B) The board's rules governing physician-delegated
prescriptive authority adopted pursuant to division (A)(2) of this
section shall be adopted in accordance with Chapter 119. of the
Revised Code and shall establish all of the following:
(1) Requirements regarding the pharmacology courses that a
physician assistant is required to complete to receive a
certificate to prescribe;
(2) Standards and procedures for the issuance and renewal of
certificates to prescribe to physician assistants;
(3) Standards and procedures for the appropriate conduct of
the provisional period that a physician assistant is required to
complete pursuant to section 4730.45 of the Revised Code and for
determining whether a physician assistant has successfully
completed the provisional period;
(4) A specific prohibition against prescribing any drug or
device to perform or induce an abortion;
(5)(3) Standards and procedures to be followed by a physician
assistant in personally furnishing samples of drugs or complete or
partial supplies of drugs to patients under section 4730.43 of the
Revised Code;
(6)(4) Any other requirements the board considers necessary
to implement the provisions of this chapter regarding
physician-delegated prescriptive authority and the issuance of
certificates to prescribe.
(C)(1) After considering recommendations submitted by the
physician assistant policy committee pursuant to sections 4730.06
and 4730.38 of the Revised Code, the board shall review either or
both of the following, as appropriate according to the submitted
recommendations:
(a) The formulary the board adopts under division (A)(1) of
this section;
(b) The rules the board adopts under division (A)(2) of this
section regarding physician-delegated prescriptive authority.
(2) Based on its review, the board shall make any necessary
modifications to the formulary or rules.
Sec. 4730.41. (A) A certificate to prescribe issued under
this chapter authorizes a physician assistant who holds a valid
prescriber number issued by the state medical board is authorized
to prescribe and personally furnish drugs and therapeutic devices
in the exercise of physician-delegated prescriptive authority.
(B) In exercising physician-delegated prescriptive authority,
a physician assistant is subject to all of the following:
(1) The physician assistant shall exercise
physician-delegated prescriptive authority only to the extent that
the physician supervising the physician assistant has granted that
authority.
(2) The physician assistant shall comply with all conditions
placed on the physician-delegated prescriptive authority, as
specified by the supervising physician who is supervising the
physician assistant in the exercise of physician-delegated
prescriptive authority.
(3) If the physician assistant possesses physician-delegated
prescriptive authority for controlled substances, the physician
assistant shall register with the federal drug enforcement
administration.
(4) If the physician assistant possesses physician-delegated
prescriptive authority for schedule II controlled substances, the
physician assistant shall comply with section 4730.411 of the
Revised Code.
Sec. 4730.42. (A) In granting physician-delegated
prescriptive authority to a particular physician assistant who
holds a certificate to prescribe valid prescriber number issued
under this chapter by the state medical board, the supervising
physician is subject to all of the following:
(1) The supervising physician shall not grant
physician-delegated prescriptive authority for any drug or
therapeutic device that is not listed on the physician assistant
formulary adopted under section 4730.39 of the Revised Code as a
drug or therapeutic device that may be included in the
physician-delegated prescriptive authority granted to a physician
assistant.
(2) The supervising physician shall not grant
physician-delegated prescriptive authority for any drug or device
that may be used to perform or induce an abortion.
(3) The supervising physician shall not grant
physician-delegated prescriptive authority in a manner that
exceeds the supervising physician's prescriptive authority,
including the physician's authority to treat chronic pain with
controlled substances and products containing tramadol as
described in section 4731.052 of the Revised Code.
(4) The supervising physician shall supervise the physician
assistant in accordance with all of the following:
(a) The supervision requirements specified in section 4730.21
of the Revised Code and, in the case of supervision provided
during a provisional period of physician-delegated prescriptive
authority, the supervision requirements specified in section
4730.45 of the Revised Code;
(b) The physician supervisory plan approved for the
supervising physician or the policies of the health care facility
in which the physician and physician assistant are practicing;
(c) The supervision agreement approved under section 4730.19
of the Revised Code that applies to the supervising physician and
the physician assistant.
(B)(1) The supervising physician of a physician assistant may
place conditions on the physician-delegated prescriptive authority
granted to the physician assistant. If conditions are placed on
that authority, the supervising physician shall maintain a written
record of the conditions and make the record available to the
state medical board on request.
(2) The conditions that a supervising physician may place on
the physician-delegated prescriptive authority granted to a
physician assistant include the following:
(a) Identification by class and specific generic nomenclature
of drugs and therapeutic devices that the physician chooses not to
permit the physician assistant to prescribe;
(b) Limitations on the dosage units or refills that the
physician assistant is authorized to prescribe;
(c) Specification of circumstances under which the physician
assistant is required to refer patients to the supervising
physician or another physician when exercising physician-delegated
prescriptive authority;
(d) Responsibilities to be fulfilled by the physician in
supervising the physician assistant that are not otherwise
specified in the physician supervisory plan or otherwise required
by this chapter.
Sec. 4730.43. (A) A physician assistant who holds a
certificate to prescribe valid prescriber number issued under this
chapter by the state medical board and has been granted
physician-delegated prescriptive authority by a supervising
physician may personally furnish to a patient samples of drugs and
therapeutic devices that are included in the physician assistant's
physician-delegated prescriptive authority, subject to all of the
following:
(1) The amount of the sample furnished shall not exceed a
seventy-two-hour supply, except when the minimum available
quantity of the sample is packaged in an amount that is greater
than a seventy-two-hour supply, in which case the physician
assistant may furnish the sample in the package amount.
(2) No charge may be imposed for the sample or for furnishing
it.
(3) Samples of controlled substances may not be personally
furnished.
(B) A physician assistant who holds a certificate to
prescribe valid prescriber number issued under this chapter by the
board and has been granted physician-delegated prescriptive
authority by a supervising physician may personally furnish to a
patient a complete or partial supply of the drugs and therapeutic
devices that are included in the physician assistant's
physician-delegated prescriptive authority, subject to all of the
following:
(1) The physician assistant shall personally furnish only
antibiotics, antifungals, scabicides, contraceptives, prenatal
vitamins, antihypertensives, drugs and devices used in the
treatment of diabetes, drugs and devices used in the treatment of
asthma, and drugs used in the treatment of dyslipidemia.
(2) The physician assistant shall not furnish the drugs and
devices in locations other than a health department operated by
the board of health of a city or general health district or the
authority having the duties of a board of health under section
3709.05 of the Revised Code, a federally funded comprehensive
primary care clinic, or a nonprofit health care clinic or program.
(3) The physician assistant shall comply with all standards
and procedures for personally furnishing supplies of drugs and
devices, as established in rules adopted under section 4730.39 of
the Revised Code.
Sec. 4730.49. (A) To be eligible for renewal of a
certificate to prescribe license, an applicant shall complete
every two years at least twelve hours of continuing education in
pharmacology from an accredited institution recognized by the
state medical board. Except as provided in division (B) of this
section and in section 5903.12 of the Revised Code, the continuing
education shall be completed not later than the thirty-first day
of January of each even-numbered year.
(B) The state medical board shall provide for pro rata
reductions by month of the number of hours of continuing education
in pharmacology that is required to be completed for physician
assistants who are in their first certification licensure period
after completing the provisional period of supervision required
under section 4730.45 4730.12 of the Revised Code, who have been
disabled due to illness or accident, or who have been absent from
the country. The board shall adopt rules, in accordance with
Chapter 119. of the Revised Code, as necessary to implement this
division.
(C) The continuing education required by this section is in
addition to the continuing education required under section
4730.14 of the Revised Code.
Sec. 4730.51. In the information the board maintains on the
internet, the state medical board shall include the following:
(A) The name of each physician assistant who holds a
certificate to prescribe license under this chapter;
(B) For each physician assistant who holds a certificate to
prescribe valid prescriber number issued by the state medical
board, the name of each supervising physician who has authority to
grant physician-delegated prescriptive authority to the physician
assistant.
Sec. 4730.53. (A) As used in this section, "drug database"
means the database established and maintained by the state board
of pharmacy pursuant to section 4729.75 of the Revised Code.
(B) The medical board shall adopt rules in accordance with
Chapter 119. of the Revised Code that establish standards and
procedures to be followed by a physician assistant who holds a
certificate to prescribe issued licensed under this chapter
regarding the review of patient information available through the
drug database under division (A)(5) of section 4729.80 of the
Revised Code.
(C) This section and the rules adopted under it do not apply
if the state board of pharmacy no longer maintains the drug
database.
Sec. 4765.01. As used in this chapter:
(A) "First responder" means an individual who holds a
current, valid certificate issued under section 4765.30 of the
Revised Code to practice as a first responder.
(B) "Emergency medical technician-basic" or "EMT-basic" means
an individual who holds a current, valid certificate issued under
section 4765.30 of the Revised Code to practice as an emergency
medical technician-basic.
(C) "Emergency medical technician-intermediate" or "EMT-I"
means an individual who holds a current, valid certificate issued
under section 4765.30 of the Revised Code to practice as an
emergency medical technician-intermediate.
(D) "Emergency medical technician-paramedic" or "paramedic"
means an individual who holds a current, valid certificate issued
under section 4765.30 of the Revised Code to practice as an
emergency medical technician-paramedic.
(E) "Ambulance" means any motor vehicle that is used, or is
intended to be used, for the purpose of responding to emergency
medical situations, transporting emergency patients, and
administering emergency medical service to patients before,
during, or after transportation.
(F) "Cardiac monitoring" means a procedure used for the
purpose of observing and documenting the rate and rhythm of a
patient's heart by attaching electrical leads from an
electrocardiograph monitor to certain points on the patient's body
surface.
(G) "Emergency medical service" means any of the services
described in sections 4765.35, 4765.37, 4765.38, and 4765.39 of
the Revised Code that are performed by first responders, emergency
medical technicians-basic, emergency medical
technicians-intermediate, and paramedics. "Emergency medical
service" includes such services performed before or during any
transport of a patient, including transports between hospitals and
transports to and from helicopters.
(H) "Emergency medical service organization" means a public
or private organization using first responders, EMTs-basic,
EMTs-I, or paramedics, or a combination of first responders,
EMTs-basic, EMTs-I, and paramedics, to provide emergency medical
services.
(I) "Physician" means an individual who holds a current,
valid certificate issued under Chapter 4731. of the Revised Code
authorizing the practice of medicine and surgery or osteopathic
medicine and surgery.
(J) "Registered nurse" means an individual who holds a
current, valid license issued under Chapter 4723. of the Revised
Code authorizing the practice of nursing as a registered nurse.
(K) "Volunteer" means a person who provides services either
for no compensation or for compensation that does not exceed the
actual expenses incurred in providing the services or in training
to provide the services.
(L) "Emergency medical service personnel" means first
responders, emergency medical service technicians-basic, emergency
medical service technicians-intermediate, emergency medical
service technicians-paramedic, and persons who provide medical
direction to such persons.
(M) "Hospital" has the same meaning as in section 3727.01 of
the Revised Code.
(N) "Trauma" or "traumatic injury" means severe damage to or
destruction of tissue that satisfies both of the following
conditions:
(1) It creates a significant risk of any of the following:
(c) Significant, permanent disfigurement;
(d) Significant, permanent disability.
(2) It is caused by any of the following:
(a) Blunt or penetrating injury;
(b) Exposure to electromagnetic, chemical, or radioactive
energy;
(c) Drowning, suffocation, or strangulation;
(d) A deficit or excess of heat.
(O) "Trauma victim" or "trauma patient" means a person who
has sustained a traumatic injury.
(P) "Trauma care" means the assessment, diagnosis,
transportation, treatment, or rehabilitation of a trauma victim by
emergency medical service personnel or by a physician, nurse,
physician assistant, respiratory therapist, physical therapist,
chiropractor, occupational therapist, speech-language pathologist,
audiologist, or psychologist licensed to practice as such in this
state or another jurisdiction.
(Q) "Trauma center" means all of the following:
(1) Any hospital that is verified by the American college of
surgeons as an adult or pediatric trauma center;
(2) Any hospital that is operating as an adult or pediatric
trauma center under provisional status pursuant to section
3727.101 of the Revised Code;
(3) Until December 31, 2004, any hospital in this state that
is designated by the director of health as a level II pediatric
trauma center under section 3727.081 of the Revised Code;
(4) Any hospital in another state that is licensed or
designated under the laws of that state as capable of providing
specialized trauma care appropriate to the medical needs of the
trauma patient.
(R) "Pediatric" means involving a patient who is less than
sixteen years of age.
(S) "Adult" means involving a patient who is not a pediatric
patient.
(T) "Geriatric" means involving a patient who is at least
seventy years old or exhibits significant anatomical or
physiological characteristics associated with advanced aging.
(U) "Air medical organization" means an organization that
provides emergency medical services, or transports emergency
victims, by means of fixed or rotary wing aircraft.
(V) "Emergency care" and "emergency facility" have the same
meanings as in section 3727.01 of the Revised Code.
(W) "Stabilize," except as it is used in division (B) of
section 4765.35 of the Revised Code with respect to the manual
stabilization of fractures, has the same meaning as in section
1753.28 of the Revised Code.
(X) "Transfer" has the same meaning as in section 1753.28 of
the Revised Code.
(Y) "Firefighter" means any member of a fire department as
defined in section 742.01 of the Revised Code.
(Z) "Volunteer firefighter" has the same meaning as in
section 146.01 of the Revised Code.
(AA) "Part-time paid firefighter" means a person who provides
firefighting services on less than a full-time basis, is routinely
scheduled to be present on site at a fire station or other
designated location for purposes of responding to a fire or other
emergency, and receives more than nominal compensation for the
provision of firefighting services.
(BB) "Physician assistant" means an individual who holds a
valid certificate to practice as a physician assistant issued
under Chapter 4730. has the same meaning as in section 1.64 of the
Revised Code.
Sec. 4765.51. Nothing in this chapter prevents or restricts
the practice, services, or activities of any registered nurse
practicing within the scope of the registered nurse's practice.
Nothing in this chapter prevents or restricts the practice,
services, or activities of any physician assistant practicing in
accordance with a physician supervisory plan approved supervision
agreement entered into under section 4730.17 4730.16 of the
Revised Code or the policies of the health care facility in which
the physician assistant is practicing.
Sec. 5123.47. (A) As used in this section:
(1) "In-home care" means the supportive services provided
within the home of an individual with mental retardation or a
developmental disability who receives funding for the services
through a county board of developmental disabilities, including
any recipient of residential services funded as home and
community-based services, family support services provided under
section 5126.11 of the Revised Code, or supported living provided
in accordance with sections 5126.41 to 5126.47 of the Revised
Code. "In-home care" includes care that is provided outside an
individual's home in places incidental to the home, and while
traveling to places incidental to the home, except that "in-home
care" does not include care provided in the facilities of a county
board of developmental disabilities or care provided in schools.
(2) "Parent" means either parent of a child, including an
adoptive parent but not a foster parent.
(3) "Unlicensed in-home care worker" means an individual who
provides in-home care but is not a health care professional.
(4) "Family member" means a parent, sibling, spouse, son,
daughter, grandparent, aunt, uncle, cousin, or guardian of the
individual with mental retardation or a developmental disability
if the individual with mental retardation or developmental
disabilities lives with the person and is dependent on the person
to the extent that, if the supports were withdrawn, another living
arrangement would have to be found.
(5) "Health care professional" means any of the following:
(a) A dentist who holds a valid license issued under Chapter
4715. of the Revised Code;
(b) A registered or licensed practical nurse who holds a
valid license issued under Chapter 4723. of the Revised Code;
(c) An optometrist who holds a valid license issued under
Chapter 4725. of the Revised Code;
(d) A pharmacist who holds a valid license issued under
Chapter 4729. of the Revised Code;
(e) A person who holds a valid certificate issued under
Chapter 4731. of the Revised Code to practice medicine and
surgery, osteopathic medicine and surgery, podiatric medicine and
surgery, or a limited brand of medicine;
(f) A physician assistant who holds a valid certificate
license issued under Chapter 4730. of the Revised Code;
(g) An occupational therapist or occupational therapy
assistant or a physical therapist or physical therapist assistant
who holds a valid license issued under Chapter 4755. of the
Revised Code;
(h) A respiratory care professional who holds a valid license
issued under Chapter 4761. of the Revised Code.
(6) "Health care task" means a task that is prescribed,
ordered, delegated, or otherwise directed by a health care
professional acting within the scope of the professional's
practice.
(B) Except as provided in division (E) of this section, a
family member of an individual with mental retardation or a
developmental disability may authorize an unlicensed in-home care
worker to administer oral and topical prescribed medications or
perform other health care tasks as part of the in-home care the
worker provides to the individual, if all of the following apply:
(1) The family member is the primary supervisor of the care.
(2) The unlicensed in-home care worker has been selected by
the family member or the individual receiving care and is under
the direct supervision of the family member.
(3) The unlicensed in-home care worker is providing the care
through an employment or other arrangement entered into directly
with the family member and is not otherwise employed by or under
contract with a person or government entity to provide services to
individuals with mental retardation and developmental
disabilities.
(C) A family member shall obtain a prescription, if
applicable, and written instructions from a health care
professional for the care to be provided to the individual. The
family member shall authorize the unlicensed in-home care worker
to provide the care by preparing a written document granting the
authority. The family member shall provide the unlicensed in-home
care worker with appropriate training and written instructions in
accordance with the instructions obtained from the health care
professional.
(D) A family member who authorizes an unlicensed in-home care
worker to administer oral and topical prescribed medications or
perform other health care tasks retains full responsibility for
the health and safety of the individual receiving the care and for
ensuring that the worker provides the care appropriately and
safely. No entity that funds or monitors the provision of in-home
care may be held liable for the results of the care provided under
this section by an unlicensed in-home care worker, including such
entities as the county board of developmental disabilities and the
department of developmental disabilities.
An unlicensed in-home care worker who is authorized under
this section by a family member to provide care to an individual
may not be held liable for any injury caused in providing the
care, unless the worker provides the care in a manner that is not
in accordance with the training and instructions received or the
worker acts in a manner that constitutes wanton or reckless
misconduct.
(E) A county board of developmental disabilities may evaluate
the authority granted by a family member under this section to an
unlicensed in-home care worker at any time it considers necessary
and shall evaluate the authority on receipt of a complaint. If the
board determines that a family member has acted in a manner that
is inappropriate for the health and safety of the individual
receiving the care, the authorization granted by the family member
to an unlicensed in-home care worker is void, and the family
member may not authorize other unlicensed in-home care workers to
provide the care. In making such a determination, the board shall
use appropriately licensed health care professionals and shall
provide the family member an opportunity to file a complaint under
section 5126.06 of the Revised Code.
Section 2. That existing sections 1.64, 2133.211, 2305.113,
4503.44, 4729.01, 4730.01, 4730.02, 4730.03, 4730.04, 4730.06,
4730.08, 4730.091, 4730.092, 4730.10, 4730.101, 4730.11, 4730.12,
4730.13, 4730.14, 4730.16, 4730.21, 4730.25, 4730.251, 4730.27,
4730.28, 4730.31, 4730.32, 4730.33, 4730.38, 4730.39, 4730.41,
4730.42, 4730.43, 4730.49, 4730.51, 4730.53, 4765.01, 4765.51, and
5123.47 and sections 4730.081, 4730.09, 4730.15, 4730.17, 4730.18,
4730.19, 4730.20, 4730.401, 4730.44, 4730.45, 4730.46, 4730.47,
4730.48, 4730.50, and 4730.52 of the Revised Code are hereby
repealed.
Section 3. (A) The State Medical Board may continue to issue
certificates to practice and certificates to prescribe pursuant to
Chapter 4730. of the Revised Code for not longer than ninety days
after the effective date of this section. Thereafter, the Board
shall issue licenses in compliance with this act.
(B) Existing certificates to practice and certificates to
prescribe issued pursuant to Chapter 4730. of the Revised Code
shall satisfy the requirements for licenses as created by this act
until the thirty-first day of January of the first even-numbered
year following the effective date of this section.
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