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Sub. H. B. No. 412 As Passed by the SenateAs Passed by the Senate
130th General Assembly | Regular Session | 2013-2014 |
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Cosponsors:
Representatives Bishoff, Terhar, Young, Wachtmann, Schuring, Brown, Anielski, Baker, Blessing, Carney, Green, Grossman, Hackett, Huffman, Landis, Perales, Pillich, Rogers, Scherer Speaker Batchelder
Senators Beagle, Brown, Cafaro, Eklund, Gentile, Hite, Hughes, Jones, Kearney, LaRose, Lehner, Manning, Patton, Sawyer, Schaffer, Schiavoni, Uecker, Widener
A BILL
To amend sections 1.64, 2133.211, 2151.3515,
2305.113, 2925.61, 3701.92, 3727.06, 3729.05,
4123.01, 4123.026, 4123.46, 4503.44, 4723.01,
4723.06, 4723.07, 4723.18, 4723.181, 4723.48,
4723.482, 4723.50, 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, 4730.19, 4730.21, 4730.22, 4730.25,
4730.251, 4730.27, 4730.28, 4730.31, 4730.32,
4730.33, 4730.38, 4730.39, 4730.41, 4730.42,
4730.43, 4730.431, 4730.49, 4730.51, 4730.53,
4731.07, 4761.01, 4761.17, 4765.01, 4765.51,
5122.11, 5122.111, and 5123.47; to amend, for the
purpose of adopting new section numbers as
indicated in parentheses, section 4730.091
(4730.201) and 4730.092 (4730.202); to enact new
section 4730.20 and sections 4723.489, 4730.111,
and 4730.203; and to repeal sections 4730.081,
4730.09, 4730.15, 4730.16, 4730.17, 4730.18,
4730.20, 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, the practice of advanced
practice registered nurses, eligibility for
compensation and benefits under Ohio's Workers'
Compensation Law, the proceedings for
court-ordered treatment of a mentally ill person,
and the licensure of recreational vehicle parks
and recreation camps, and to amend the versions of
sections 4730.25 and 4730.53 of the Revised Code
that are scheduled to take effect April 1, 2015,
to continue the provisions of this act on and
after that effective date.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 1.64, 2133.211, 2151.3515, 2305.113,
2925.61, 3701.92, 3727.06, 3729.05, 4123.01, 4123.026, 4123.46,
4503.44, 4723.01, 4723.06, 4723.07, 4723.18, 4723.181, 4723.48,
4723.482, 4723.50, 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, 4730.19, 4730.21, 4730.22, 4730.25, 4730.251,
4730.27, 4730.28, 4730.31, 4730.32, 4730.33, 4730.38, 4730.39,
4730.41, 4730.42, 4730.43, 4730.431, 4730.49, 4730.51, 4730.53,
4731.07, 4761.01, 4761.17, 4765.01, 4765.51, 5122.11, 5122.111,
and 5123.47 be amended, 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 and
sections 4723.489, 4730.111, and 4730.203 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 section 4723.42 Chapter 4723. 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 license to practice as a
physician assistant issued under Chapter 4730. 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 4730.19 of the Revised Code or, including, if applicable
the policies of a health care facility in which the physician
assistant is practicing.
Sec. 2151.3515. As used in sections 2151.3515 to 2151.3530
of the Revised Code:
(A) "Deserted child" means a child whose parent has
voluntarily delivered the child to an emergency medical service
worker, peace officer, or hospital employee without expressing an
intent to return for the child.
(B) "Emergency medical service organization," "emergency
medical technician-basic," "emergency medical
technician-intermediate," "first responder," and "paramedic" have
the same meanings as in section 4765.01 of the Revised Code.
(C) "Emergency medical service worker" means a first
responder, emergency medical technician-basic, emergency medical
technician-intermediate, or paramedic.
(D) "Hospital" has the same meaning as in section 3727.01 of
the Revised Code.
(E) "Hospital employee" means any of the following persons:
(1) A physician who has been granted privileges to practice
at the hospital;
(2) A nurse, physician assistant, or nursing assistant
employed by the hospital;
(3) An authorized person employed by the hospital who is
acting under the direction of a physician described in division
(E)(1) of this section.
(F) "Law enforcement agency" means an organization or entity
made up of peace officers.
(G) "Nurse" means a person who is licensed under Chapter
4723. of the Revised Code to practice as a registered nurse or
licensed practical nurse.
(H) "Nursing assistant" means a person designated by a
hospital as a nurse aide or nursing assistant whose job is to aid
nurses, physicians, and physician assistants in the performance of
their duties.
(I) "Peace officer" means a sheriff, deputy sheriff,
constable, police officer of a township or joint police district,
marshal, deputy marshal, municipal police officer, or a state
highway patrol trooper.
(J) "Physician" and "physician assistant" have the same
meanings as in section 4730.01 means an individual authorized
under Chapter 4731. of the Revised Code to practice medicine and
surgery, osteopathic medicine and surgery, or podiatric medicine
and surgery.
(K) "Physician assistant" means an individual who holds a
current, valid license to practice as a physician assistant issued
under Chapter 4730. of the Revised Code.
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 is licensed as a
physician assistant under Chapter 4730. 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. 2925.61. (A) As used in this section:
(1) "Administer naloxone" means to give naloxone to a person
by either of the following routes:
(a) Using a device manufactured for the intranasal
administration of liquid drugs;
(b) Using an autoinjector in a manufactured dosage form.
(2) "Law enforcement agency" means a government entity that
employs peace officers to perform law enforcement duties.
(3) "Licensed health professional" means all of the
following:
(a) A physician who is authorized under Chapter 4731. of the
Revised Code to practice medicine and surgery, osteopathic
medicine and surgery, or podiatric medicine and surgery;
(b) A physician assistant who is licensed under Chapter 4730.
of the Revised Code, holds a certificate to prescribe valid
prescriber number issued under Chapter 4730. of the Revised Code
by the state medical board, and has been granted
physician-delegated prescriptive authority;
(c) A clinical nurse specialist, certified nurse-midwife, or
certified nurse practitioner who holds a certificate to prescribe
issued under section 4723.48 of the Revised Code.
(4) "Peace officer" has the same meaning as in section
2921.51 of the Revised Code.
(B) A family member, friend, or other individual who is in a
position to assist an individual who is apparently experiencing or
at risk of experiencing an opioid-related overdose, is not subject
to criminal prosecution for a violation of section 4731.41 of the
Revised Code or criminal prosecution under this chapter if the
individual, acting in good faith, does all of the following:
(1) Obtains naloxone from a licensed health professional or a
prescription for naloxone from a licensed health professional;
(2) Administers that naloxone to an individual who is
apparently experiencing an opioid-related overdose;
(3) Attempts to summon emergency services either immediately
before or immediately after administering the naloxone.
(C) Division (B) of this section does not apply to a peace
officer or to an emergency medical technician-basic, emergency
medical technician-intermediate, or emergency medical
technician-paramedic, as defined in section 4765.01 of the Revised
Code.
(D) A peace officer employed by a law enforcement agency is
not subject to administrative action, criminal prosecution for a
violation of section 4731.41 of the Revised Code, or criminal
prosecution under this chapter if the peace officer, acting in
good faith, obtains naloxone from the peace officer's law
enforcement agency and administers the naloxone to an individual
who is apparently experiencing an opioid-related overdose.
Sec. 3701.92. As used in sections 3701.921 to 3701.929 of
the Revised Code:
(A) "Advanced practice registered nurse" has the same meaning
as in section 4723.01 of the Revised Code.
(B) "Patient centered medical home education advisory group"
means the entity established under section 3701.924 of the Revised
Code.
(C) "Patient centered medical home education program" means
the program established under section 3701.921 of the Revised Code
and any pilot projects operated pursuant to that section.
(D) "Patient centered medical home education pilot project"
means the pilot project established under section 3701.923 of the
Revised Code.
(E) "Physician assistant" has the same meaning as in section
4730.01 means any person who is licensed as a physician assistant
under Chapter 4730. of the Revised Code.
Sec. 3727.06. (A) As used in this section:
(1) "Doctor" means an individual authorized to practice
medicine and surgery or osteopathic medicine and surgery.
(2) "Podiatrist" means an individual authorized to practice
podiatric medicine and surgery.
(B)(1) Only the following may admit a patient to a hospital:
(a) A doctor who is a member of the hospital's medical staff;
(b) A dentist who is a member of the hospital's medical
staff;
(c) A podiatrist who is a member of the hospital's medical
staff;
(d) A clinical nurse specialist, certified nurse-midwife, or
certified nurse practitioner if all of the following conditions
are met:
(i) The clinical nurse specialist, certified nurse-midwife,
or certified nurse practitioner has a standard care arrangement
entered into pursuant to section 4723.431 of the Revised Code with
a collaborating doctor or podiatrist who is a member of the
medical staff;
(ii) The patient will be under the medical supervision of the
collaborating doctor or podiatrist;
(iii) The hospital has granted the clinical nurse specialist,
certified nurse-midwife, or certified nurse practitioner admitting
privileges and appropriate credentials.
(e) A physician assistant if all of the following conditions
are met:
(i) The physician assistant is listed on a supervision
agreement approved entered into under section 4730.19 of the
Revised Code for a doctor or podiatrist who is a member of the
hospital's medical staff.
(ii) The patient will be under the medical supervision of the
supervising doctor or podiatrist.
(iii) The hospital has granted the physician assistant
admitting privileges and appropriate credentials.
(2) Prior to admitting a patient, a clinical nurse
specialist, certified nurse-midwife, certified nurse practitioner,
or physician assistant shall notify the collaborating or
supervising doctor or podiatrist of the planned admission.
(C) All hospital patients shall be under the medical
supervision of a doctor, except that services that may be rendered
by a licensed dentist pursuant to Chapter 4715. of the Revised
Code provided to patients admitted solely for the purpose of
receiving such services shall be under the supervision of the
admitting dentist and that services that may be rendered by a
podiatrist pursuant to section 4731.51 of the Revised Code
provided to patients admitted solely for the purpose of receiving
such services shall be under the supervision of the admitting
podiatrist. If treatment not within the scope of Chapter 4715. or
section 4731.51 of the Revised Code is required at the time of
admission by a dentist or podiatrist, or becomes necessary during
the course of hospital treatment by a dentist or podiatrist, such
treatment shall be under the supervision of a doctor who is a
member of the medical staff. It shall be the responsibility of the
admitting dentist or podiatrist to make arrangements with a doctor
who is a member of the medical staff to be responsible for the
patient's treatment outside the scope of Chapter 4715. or section
4731.51 of the Revised Code when necessary during the patient's
stay in the hospital.
Sec. 3729.05. (A)(1) On Except as otherwise provided in this
section, on or after the first day of April, but before the first
day of May of each year, every person who intends to operate a
recreational vehicle park, recreation camp, or combined park-camp
shall procure a license to operate the park or camp from the
licensor. If the applicable license fee prescribed under section
3729.07 of the Revised Code is not received by the licensor by the
close of business on the last day of April, the applicant for the
license shall pay a penalty equal to twenty-five per cent of the
applicable license fee. The penalty shall accompany the license
fee. If the last day of April is not a business day, the penalty
attaches upon the close of business on the next business day.
(2) Every person who intends to operate a temporary park-camp
shall obtain a license to operate the temporary park-camp from the
licensor at any time before the person begins operation of the
temporary park-camp during the calendar year.
(3) No recreational vehicle park, recreation camp, combined
park-camp, or temporary park-camp shall be maintained or operated
in this state without a license. However, no person who neither
intends to receive nor receives anything of value arising from the
use of, or the sale of goods or services in connection with the
use of, a recreational vehicle park, recreation camp, combined
park-camp, or temporary park-camp is required to procure a license
under this division. If any health hazard exists at such an
unlicensed park, camp, or park-camp, the health hazard shall be
corrected in a manner consistent with the appropriate rule adopted
under division (A) or (B) of section 3729.02 of the Revised Code.
(4) No person who has received a license under division
(A)(1) of this section, upon the sale or disposition of the
recreational vehicle park, recreation camp, or combined park-camp,
may have the license transferred to the new operator. A person
shall obtain a separate license to operate each recreational
vehicle park, recreation camp, or combined park-camp. No license
to operate a temporary park-camp shall be transferred. A person
shall obtain a separate license for each temporary park-camp that
the person intends to operate, and the license shall be valid for
a period of not longer than seven consecutive days. A person who
operates a temporary park-camp on a tract of land for more than
twenty-one days or parts thereof in a calendar year shall obtain a
license to operate a recreational vehicle park, recreation camp,
or combined park-camp.
(B)(1) Before a license is initially issued under division
(A)(1) of this section and annually thereafter, or more often if
necessary, the licensor shall cause each recreational vehicle
park, recreation camp, or combined park-camp to be inspected to
determine compliance with this chapter and rules adopted under it.
A record shall be made of each inspection on a form prescribed by
the director of health.
(2) When a license is initially issued under division (A)(2)
of this section, and more often if necessary, the licensor shall
cause each temporary park-camp to be inspected to determine
compliance with this chapter and rules adopted under it during the
period that the temporary park-camp is in operation. A record
shall be made of each inspection on a form prescribed by the
director.
(C) Each person applying for an initial license to operate a
recreational vehicle park, recreation camp, combined park-camp, or
temporary park-camp shall provide acceptable proof to the
director, or to the licensor in the case of a temporary park-camp,
that adequate fire protection will be provided and that applicable
fire codes will be adhered to in the construction and operation of
the park, camp, or park-camp.
(D) Any person that operates a county or state fair or any
independent agricultural society organized pursuant to section
1711.02 of the Revised Code that operates a fair shall not be
required to obtain a license under this chapter if recreational
vehicles, portable camping units, or any combination of them are
parked at the site of the fair only during the time of preparation
for, operation of, and dismantling of the fair and if the
recreational vehicles, portable camping units, or any combination
of them belong to participants in the fair.
(E) The following entities that operate a fair and that hold
a license issued under this chapter are not required to comply
with the requirements normally imposed on a licensee under this
chapter and rules adopted under it during the time of preparation
for, operation of, and dismantling of the fair:
(1) A county agricultural society organized pursuant to
section 1711.01 of the Revised Code;
(2) An independent agricultural society organized pursuant to
section 1711.02 of the Revised Code;
(3) The Ohio expositions commission.
(F) A motorsports park is exempt from the license
requirements established in divisions (A)(1) and (2) of this
section if the motorsports park does both of the following:
(1) Holds at least one annual event sanctioned by the
national association for stock car auto racing or the national hot
rod association during a motor sports racing event;
(2) Provides parking for recreational vehicles, dependent
recreational vehicles, and portable camping units that belong to
participants in that event.
The exemption established in this division applies to
participant-only areas during the time of preparation for and
operation of the event.
(G) A person subject to this chapter or rules adopted under
it may apply to the director for a waiver of or variance from a
provision of this chapter or rules adopted under it. The director
may grant a waiver or variance if the person demonstrates, to the
satisfaction of the director, that the waiver or variance will not
result in any adverse effect on the public health and safety. The
director shall adopt rules in accordance with Chapter 119. of the
Revised Code establishing requirements and procedures governing
the application for and granting of a waiver or variance under
this division.
Sec. 4123.01. As used in this chapter:
(a) Every person in the service of the state, or of any
county, municipal corporation, township, or school district
therein, including regular members of lawfully constituted police
and fire departments of municipal corporations and townships,
whether paid or volunteer, and wherever serving within the state
or on temporary assignment outside thereof, and executive officers
of boards of education, under any appointment or contract of hire,
express or implied, oral or written, including any elected
official of the state, or of any county, municipal corporation, or
township, or members of boards of education.
As used in division (A)(1)(a) of this section, the term
"employee" includes the following persons when responding to an
inherently dangerous situation that calls for an immediate
response on the part of the person, regardless of whether the
person is within the limits of the jurisdiction of the person's
regular employment or voluntary service when responding, on the
condition that the person responds to the situation as the person
otherwise would if the person were on duty in the person's
jurisdiction:
(i) Off-duty peace officers. As used in division (A)(1)(a)(i)
of this section, "peace officer" has the same meaning as in
section 2935.01 of the Revised Code.;
(ii) Off-duty firefighters, whether paid or volunteer, of a
lawfully constituted fire department.;
(iii) Off-duty first responders, emergency medical
technicians-basic, emergency medical technicians-intermediate, or
emergency medical technicians-paramedic, whether paid or
volunteer, emergency medical workers of an ambulance service
organization or emergency medical service organization pursuant to
Chapter 4765. of the Revised Code.
(b) Every person in the service of any person, firm, or
private corporation, including any public service corporation,
that (i) employs one or more persons regularly in the same
business or in or about the same establishment under any contract
of hire, express or implied, oral or written, including aliens and
minors, household workers who earn one hundred sixty dollars or
more in cash in any calendar quarter from a single household and
casual workers who earn one hundred sixty dollars or more in cash
in any calendar quarter from a single employer, or (ii) is bound
by any such contract of hire or by any other written contract, to
pay into the state insurance fund the premiums provided by this
chapter.
(c) Every person who performs labor or provides services
pursuant to a construction contract, as defined in section 4123.79
of the Revised Code, if at least ten of the following criteria
apply:
(i) The person is required to comply with instructions from
the other contracting party regarding the manner or method of
performing services;
(ii) The person is required by the other contracting party to
have particular training;
(iii) The person's services are integrated into the regular
functioning of the other contracting party;
(iv) The person is required to perform the work personally;
(v) The person is hired, supervised, or paid by the other
contracting party;
(vi) A continuing relationship exists between the person and
the other contracting party that contemplates continuing or
recurring work even if the work is not full time;
(vii) The person's hours of work are established by the other
contracting party;
(viii) The person is required to devote full time to the
business of the other contracting party;
(ix) The person is required to perform the work on the
premises of the other contracting party;
(x) The person is required to follow the order of work set by
the other contracting party;
(xi) The person is required to make oral or written reports
of progress to the other contracting party;
(xii) The person is paid for services on a regular basis such
as hourly, weekly, or monthly;
(xiii) The person's expenses are paid for by the other
contracting party;
(xiv) The person's tools and materials are furnished by the
other contracting party;
(xv) The person is provided with the facilities used to
perform services;
(xvi) The person does not realize a profit or suffer a loss
as a result of the services provided;
(xvii) The person is not performing services for a number of
employers at the same time;
(xviii) The person does not make the same services available
to the general public;
(xix) The other contracting party has a right to discharge
the person;
(xx) The person has the right to end the relationship with
the other contracting party without incurring liability pursuant
to an employment contract or agreement.
Every person in the service of any independent contractor or
subcontractor who has failed to pay into the state insurance fund
the amount of premium determined and fixed by the administrator of
workers' compensation for the person's employment or occupation or
if a self-insuring employer has failed to pay compensation and
benefits directly to the employer's injured and to the dependents
of the employer's killed employees as required by section 4123.35
of the Revised Code, shall be considered as the employee of the
person who has entered into a contract, whether written or verbal,
with such independent contractor unless such employees or their
legal representatives or beneficiaries elect, after injury or
death, to regard such independent contractor as the employer.
(2) "Employee" does not mean:
(a) A duly ordained, commissioned, or licensed minister or
assistant or associate minister of a church in the exercise of
ministry;
(b) Any officer of a family farm corporation;
(c) An individual incorporated as a corporation; or
(d) An individual who otherwise is an employee of an employer
but who signs the waiver and affidavit specified in section
4123.15 of the Revised Code on the condition that the
administrator has granted a waiver and exception to the
individual's employer under section 4123.15 of the Revised Code.
Any employer may elect to include as an "employee" within
this chapter, any person excluded from the definition of
"employee" pursuant to division (A)(2) of this section. If an
employer is a partnership, sole proprietorship, individual
incorporated as a corporation, or family farm corporation, such
employer may elect to include as an "employee" within this
chapter, any member of such partnership, the owner of the sole
proprietorship, the individual incorporated as a corporation, or
the officers of the family farm corporation. In the event of an
election, the employer shall serve upon the bureau of workers'
compensation written notice naming the persons to be covered,
include such employee's remuneration for premium purposes in all
future payroll reports, and no person excluded from the definition
of "employee" pursuant to division (A)(2) of this section,
proprietor, individual incorporated as a corporation, or partner
shall be deemed an employee within this division until the
employer has served such notice.
For informational purposes only, the bureau shall prescribe
such language as it considers appropriate, on such of its forms as
it considers appropriate, to advise employers of their right to
elect to include as an "employee" within this chapter a sole
proprietor, any member of a partnership, an individual
incorporated as a corporation, the officers of a family farm
corporation, or a person excluded from the definition of
"employee" under division (A)(2) of this section, that they should
check any health and disability insurance policy, or other form of
health and disability plan or contract, presently covering them,
or the purchase of which they may be considering, to determine
whether such policy, plan, or contract excludes benefits for
illness or injury that they might have elected to have covered by
workers' compensation.
(1) The state, including state hospitals, each county,
municipal corporation, township, school district, and hospital
owned by a political subdivision or subdivisions other than the
state;
(2) Every person, firm, professional employer organization,
and private corporation, including any public service corporation,
that (a) has in service one or more employees or shared employees
regularly in the same business or in or about the same
establishment under any contract of hire, express or implied, oral
or written, or (b) is bound by any such contract of hire or by any
other written contract, to pay into the insurance fund the
premiums provided by this chapter.
All such employers are subject to this chapter. Any member of
a firm or association, who regularly performs manual labor in or
about a mine, factory, or other establishment, including a
household establishment, shall be considered an employee in
determining whether such person, firm, or private corporation, or
public service corporation, has in its service, one or more
employees and the employer shall report the income derived from
such labor to the bureau as part of the payroll of such employer,
and such member shall thereupon be entitled to all the benefits of
an employee.
(C) "Injury" includes any injury, whether caused by external
accidental means or accidental in character and result, received
in the course of, and arising out of, the injured employee's
employment. "Injury" does not include:
(1) Psychiatric conditions except where as follows:
(a) Where the claimant's psychiatric conditions have arisen
from an injury or occupational disease sustained by that claimant
or where;
(b) Where the claimant's psychiatric conditions have arisen
from sexual conduct in which the claimant was forced by threat of
physical harm to engage or participate;
(c) Where the claimant is a peace officer, firefighter, or
emergency medical worker and is diagnosed with post-traumatic
stress disorder that has been received in the course of, and has
arisen out of, the claimant's employment as a peace officer,
firefighter, or emergency medical worker.
(2) Injury or disability caused primarily by the natural
deterioration of tissue, an organ, or part of the body;
(3) Injury or disability incurred in voluntary participation
in an employer-sponsored recreation or fitness activity if the
employee signs a waiver of the employee's right to compensation or
benefits under this chapter prior to engaging in the recreation or
fitness activity;
(4) A condition that pre-existed an injury unless that
pre-existing condition is substantially aggravated by the injury.
Such a substantial aggravation must be documented by objective
diagnostic findings, objective clinical findings, or objective
test results. Subjective complaints may be evidence of such a
substantial aggravation. However, subjective complaints without
objective diagnostic findings, objective clinical findings, or
objective test results are insufficient to substantiate a
substantial aggravation.
(D) "Child" includes a posthumous child and a child legally
adopted prior to the injury.
(E) "Family farm corporation" means a corporation founded for
the purpose of farming agricultural land in which the majority of
the voting stock is held by and the majority of the stockholders
are persons or the spouse of persons related to each other within
the fourth degree of kinship, according to the rules of the civil
law, and at least one of the related persons is residing on or
actively operating the farm, and none of whose stockholders are a
corporation. A family farm corporation does not cease to qualify
under this division where, by reason of any devise, bequest, or
the operation of the laws of descent or distribution, the
ownership of shares of voting stock is transferred to another
person, as long as that person is within the degree of kinship
stipulated in this division.
(F) "Occupational disease" means a disease contracted in the
course of employment, which by its causes and the characteristics
of its manifestation or the condition of the employment results in
a hazard which distinguishes the employment in character from
employment generally, and the employment creates a risk of
contracting the disease in greater degree and in a different
manner from the public in general.
(G) "Self-insuring employer" means an employer who is granted
the privilege of paying compensation and benefits directly under
section 4123.35 of the Revised Code, including a board of county
commissioners for the sole purpose of constructing a sports
facility as defined in section 307.696 of the Revised Code,
provided that the electors of the county in which the sports
facility is to be built have approved construction of a sports
facility by ballot election no later than November 6, 1997.
(H) "Private employer" means an employer as defined in
division (B)(2) of this section.
(I) "Professional employer organization" has the same meaning
as in section 4125.01 of the Revised Code.
(J) "Public employer" means an employer as defined in
division (B)(1) of this section.
(K) "Sexual conduct" means vaginal intercourse between a male
and female; anal intercourse, fellatio, and cunnilingus between
persons regardless of gender; and, without privilege to do so, the
insertion, however slight, of any part of the body or any
instrument, apparatus, or other object into the vaginal or anal
cavity of another. Penetration, however slight, is sufficient to
complete vaginal or anal intercourse.
(L) "Other-states' insurer" means an insurance company that
is authorized to provide workers' compensation insurance coverage
in any of the states that permit employers to obtain insurance for
workers' compensation claims through insurance companies.
(M) "Other-states' coverage" means both of the following:
(1) Insurance coverage secured by an eligible employer for
workers' compensation claims of employees who are in employment
relationships localized in a state other than this state or those
employees' dependents;
(2) Insurance coverage secured by an eligible employer for
workers' compensation claims that arise in a state other than this
state where an employer elects to obtain coverage through either
the administrator or an other-states' insurer.
(N) "Limited other-states coverage" means insurance coverage
provided by the administrator to an eligible employer for workers'
compensation claims of employees who are in an employment
relationship localized in this state but are temporarily working
in a state other than this state, or those employees' dependents.
(O) "Peace officer" has the same meaning as in section
2935.01 of the Revised Code.
(P) "Firefighter" means a firefighter, whether paid or
volunteer, of a lawfully constituted fire department.
(Q) "Emergency medical worker" means a first responder,
emergency medical technician-basic, emergency medical
technician-intermediate, or emergency medical
technician-paramedic, certified under Chapter 4765. of the Revised
Code, whether paid or volunteer.
Sec. 4123.026. (A) The administrator of workers'
compensation, or a self-insuring public employer for the peace
officers, firefighters, and emergency medical workers employed by
or volunteering for that self-insuring public employer, shall pay
the costs of conducting post-exposure medical diagnostic services,
consistent with the standards of medical care existing at the time
of the exposure, to investigate whether an injury or occupational
disease was sustained by a peace officer, firefighter, or
emergency medical worker when coming into contact with the blood
or other body fluid of another person in the course of and arising
out of the peace officer's, firefighter's, or emergency medical
worker's employment, or when responding to an inherently dangerous
situation in the manner described in, and in accordance with the
conditions specified under, division (A)(1)(a) of section 4123.01
of the Revised Code, through any of the following means:
(1)(A) Splash or spatter in the eye or mouth, including when
received in the course of conducting mouth-to-mouth resuscitation;
(2)(B) A puncture in the skin;
(3)(C) A cut in the skin or another opening in the skin such
as an open sore, wound, lesion, abrasion, or ulcer.
(B) As used in this section:
(1) "Peace officer" has the same meaning as in section
2935.01 of the Revised Code.
(2) "Firefighter" means a firefighter, whether paid or
volunteer, of a lawfully constituted fire department.
(3) "Emergency medical worker" means a first responder,
emergency medical technician-basic, emergency medical
technician-intermediate, or emergency medical
technician-paramedic, certified under Chapter 4765. of the Revised
Code, whether paid or volunteer.
Sec. 4123.46. (A)(1) Except as provided in division (A)(2)
of this section, the bureau of workers' compensation shall
disburse the state insurance fund to employees of employers who
have paid into the fund the premiums applicable to the classes to
which they belong when the employees have been injured in the
course of their employment, wherever the injuries have occurred,
and provided the injuries have not been purposely self-inflicted,
or to the dependents of the employees in case death has ensued.
(2) As long as injuries have not been purposely
self-inflicted, the bureau shall disburse the surplus fund created
under section 4123.34 of the Revised Code to off-duty peace
officers, firefighters, and emergency medical technicians, and
first responders workers, or to their dependents if death ensues,
who are injured while responding to inherently dangerous
situations that call for an immediate response on the part of the
person, regardless of whether the person was within the limits of
the person's jurisdiction when responding, on the condition that
the person responds to the situation as the person otherwise would
if the person were on duty in the person's jurisdiction.
As used in division (A)(2) of this section, "peace officer,"
"firefighter," and "emergency medical technician," "first
responder worker," and "jurisdiction" have the same meanings as in
section 4123.01 of the Revised Code.
(B) All self-insuring employers, in compliance with this
chapter, shall pay the compensation to injured employees, or to
the dependents of employees who have been killed in the course of
their employment, unless the injury or death of the employee was
purposely self-inflicted, and shall furnish the medical, surgical,
nurse, and hospital care and attention or funeral expenses as
would have been paid and furnished by virtue of this chapter under
a similar state of facts by the bureau out of the state insurance
fund if the employer had paid the premium into the fund.
If any rule or regulation of a self-insuring employer
provides for or authorizes the payment of greater compensation or
more complete or extended medical care, nursing, surgical, and
hospital attention, or funeral expenses to the injured employees,
or to the dependents of the employees as may be killed, the
employer shall pay to the employees, or to the dependents of
employees killed, the amount of compensation and furnish the
medical care, nursing, surgical, and hospital attention or funeral
expenses provided by the self-insuring employer's rules and
regulations.
(C) Payment to injured employees, or to their dependents in
case death has ensued, is in lieu of any and all rights of action
against the employer of the injured or killed employees.
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;
(g) Is blind, legally blind, or severely visually impaired.
(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 (I) of this section.
(3) "Health care provider" means a physician, physician
assistant, advanced practice registered nurse, optometrist, or
chiropractor as defined in this section except that an optometrist
shall only make determinations as to division (A)(1)(g) of 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 is
licensed as a physician assistant under Chapter 4730. of the
Revised Code.
(8) "Optometrist" means a person licensed to engage in the
practice of optometry under Chapter 4725. of the Revised Code.
(B)(1) An organization, or a person with a disability that
limits or impairs the ability to walk, may apply for the
registration of any motor vehicle the organization or person owns
or leases. 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 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.
(2) 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)(1) 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.
(C)(1) A 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 by completing and signing an
application provided by the registrar. The person shall include
with the application a prescription from the person's health care
provider prescribing such a placard for the person based upon a
determination that the person 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 person's ability to walk.
In addition to one placard or one or more sets of license
plates, 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.
(2) An organization may apply to the registrar of motor
vehicles for a removable windshield placard by completing and
signing an application provided by the registrar. The organization
shall comply with any procedures the registrar establishes by
rule. The organization shall include with the application
documentary evidence that the registrar requires by rule showing
that the organization regularly transports persons with
disabilities that limit or impair the ability to walk.
(3) Upon receipt of a completed and signed application for a
removable windshield placard, the accompanying documents required
under division (C)(1) or (2) of this section, 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 (C)(4) 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 (C)(1) or (2) of this section
and upon payment of a service fee equal to the amount specified in
division (D) or (G) of section 4503.10 of the Revised Code 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.
(4) 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 (C)(1) or (2) of this section, and by
complying with the renewal provisions prescribed in division
(C)(3) 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.
(5) 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 (C)(5) of this section.
(6) 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 special license plates issued to
the person or organization under prior law have not expired or
been surrendered or revoked.
(D)(1)(a) A 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 (D)(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.
(E) 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.
(F) Upon a conviction of a violation of division (H) or (I)
of this section, the court shall report the conviction, and send
the placard, if available, to the registrar, who thereupon shall
revoke the privilege of using the placard and send notice in
writing to the placardholder at that holder's last known address
as shown in the records of the bureau, and the placardholder shall
return the placard 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 has
been issued moves to another state, the person shall surrender the
placard to the registrar; and whenever an organization to which a
placard has been issued changes its place of operation to another
state, the organization shall surrender the placard to the
registrar.
(G) 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, 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.
(H) No person or organization that is not eligible for the
issuance of license plates or any placard under 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.
(I) 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.
(J) 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.
(K)(1) 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.
(2) 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.
(L) 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.
(M) 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.
(N) Whoever violates this section is guilty of a misdemeanor
of the fourth degree.
Sec. 4723.01. As used in this chapter:
(A) "Registered nurse" means an individual who holds a
current, valid license issued under this chapter that authorizes
the practice of nursing as a registered nurse.
(B) "Practice of nursing as a registered nurse" means
providing to individuals and groups nursing care requiring
specialized knowledge, judgment, and skill derived from the
principles of biological, physical, behavioral, social, and
nursing sciences. Such nursing care includes:
(1) Identifying patterns of human responses to actual or
potential health problems amenable to a nursing regimen;
(2) Executing a nursing regimen through the selection,
performance, management, and evaluation of nursing actions;
(3) Assessing health status for the purpose of providing
nursing care;
(4) Providing health counseling and health teaching;
(5) Administering medications, treatments, and executing
regimens authorized by an individual who is authorized to practice
in this state and is acting within the course of the individual's
professional practice;
(6) Teaching, administering, supervising, delegating, and
evaluating nursing practice.
(C) "Nursing regimen" may include preventative, restorative,
and health-promotion activities.
(D) "Assessing health status" means the collection of data
through nursing assessment techniques, which may include
interviews, observation, and physical evaluations for the purpose
of providing nursing care.
(E) "Licensed practical nurse" means an individual who holds
a current, valid license issued under this chapter that authorizes
the practice of nursing as a licensed practical nurse.
(F) "The practice of nursing as a licensed practical nurse"
means providing to individuals and groups nursing care requiring
the application of basic knowledge of the biological, physical,
behavioral, social, and nursing sciences at the direction of any
of the following who is authorized to practice in this state: a
licensed physician, physician assistant, dentist, podiatrist,
optometrist, chiropractor, or registered nurse. Such nursing care
includes:
(1) Observation, patient teaching, and care in a diversity of
health care settings;
(2) Contributions to the planning, implementation, and
evaluation of nursing;
(3) Administration of medications and treatments authorized
by an individual who is authorized to practice in this state and
is acting within the course of the individual's professional
practice on the condition that the licensed practical nurse is
authorized under section 4723.17 of the Revised Code to administer
medications;
(4) Administration to an adult of intravenous therapy
authorized by an individual who is authorized to practice in this
state and is acting within the course of the individual's
professional practice, on the condition that the licensed
practical nurse is authorized under section 4723.18 or 4723.181 of
the Revised Code to perform intravenous therapy and performs
intravenous therapy only in accordance with those sections;
(5) Delegation of nursing tasks as directed by a registered
nurse;
(6) Teaching nursing tasks to licensed practical nurses and
individuals to whom the licensed practical nurse is authorized to
delegate nursing tasks as directed by a registered nurse.
(G) "Certified registered nurse anesthetist" means a
registered nurse who holds a valid certificate of authority issued
under this chapter that authorizes the practice of nursing as a
certified registered nurse anesthetist in accordance with section
4723.43 of the Revised Code and rules adopted by the board of
nursing.
(H) "Clinical nurse specialist" means a registered nurse who
holds a valid certificate of authority issued under this chapter
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.
(I) "Certified nurse-midwife" means a registered nurse who
holds a valid certificate of authority issued under this chapter
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.
(J) "Certified nurse practitioner" means a registered nurse
who holds a valid certificate of authority issued under this
chapter 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.
(K) "Physician" means an individual authorized under Chapter
4731. of the Revised Code to practice medicine and surgery or
osteopathic medicine and surgery.
(L) "Collaboration" or "collaborating" means the following:
(1) In the case of a clinical nurse specialist, except as
provided in division (L)(3) of this section, or a certified nurse
practitioner, that one or more podiatrists acting within the scope
of practice of podiatry in accordance with section 4731.51 of the
Revised Code and with whom the nurse has entered into a standard
care arrangement or one or more physicians with whom the nurse has
entered into a standard care arrangement are continuously
available to communicate with the clinical nurse specialist or
certified nurse practitioner either in person or by radio,
telephone, or other form of telecommunication;
(2) In the case of a certified nurse-midwife, that one or
more physicians with whom the certified nurse-midwife has entered
into a standard care arrangement are continuously available to
communicate with the certified nurse-midwife either in person or
by radio, telephone, or other form of telecommunication;
(3) In the case of a clinical nurse specialist who practices
the nursing specialty of mental health or psychiatric mental
health without being authorized to prescribe drugs and therapeutic
devices, that one or more physicians are continuously available to
communicate with the nurse either in person or by radio,
telephone, or other form of telecommunication.
(M) "Supervision," as it pertains to a certified registered
nurse anesthetist, means that the certified registered nurse
anesthetist is under the direction of a podiatrist acting within
the podiatrist's scope of practice in accordance with section
4731.51 of the Revised Code, a dentist acting within the dentist's
scope of practice in accordance with Chapter 4715. of the Revised
Code, or a physician, and, when administering anesthesia, the
certified registered nurse anesthetist is in the immediate
presence of the podiatrist, dentist, or physician.
(N) "Standard care arrangement" means a written, formal guide
for planning and evaluating a patient's health care that is
developed by one or more collaborating physicians or podiatrists
and a clinical nurse specialist, certified nurse-midwife, or
certified nurse practitioner and meets the requirements of section
4723.431 of the Revised Code.
(O) "Advanced practice registered nurse" means a certified
registered nurse anesthetist, clinical nurse specialist, certified
nurse-midwife, or certified nurse practitioner.
(P) "Dialysis care" means the care and procedures that a
dialysis technician or dialysis technician intern is authorized to
provide and perform, as specified in section 4723.72 of the
Revised Code.
(Q) "Dialysis technician" means an individual who holds a
current, valid certificate to practice as a dialysis technician
issued under section 4723.75 of the Revised Code.
(R) "Dialysis technician intern" means an individual who
holds a current, valid certificate to practice as a dialysis
technician intern issued under section 4723.75 of the Revised
Code.
(S) "Certified community health worker" means an individual
who holds a current, valid certificate as a community health
worker issued under section 4723.85 of the Revised Code.
(T) "Medication aide" means an individual who holds a
current, valid certificate issued under this chapter that
authorizes the individual to administer medication in accordance
with section 4723.67 of the Revised Code.
Sec. 4723.06. (A) The board of nursing shall:
(1) Administer and enforce the provisions of this chapter,
including the taking of disciplinary action for violations of
section 4723.28 of the Revised Code, any other provisions of this
chapter, or rules adopted under this chapter;
(2) Develop criteria that an applicant must meet to be
eligible to sit for the examination for licensure to practice as a
registered nurse or as a licensed practical nurse;
(3) Issue and renew nursing licenses, dialysis technician
certificates, and community health worker certificates, as
provided in this chapter;
(4) Define the minimum standards for educational programs of
the schools of registered nursing and schools of practical nursing
in this state;
(5) Survey, inspect, and grant full approval to prelicensure
nursing education programs in this state that meet the standards
established by rules adopted under section 4723.07 of the Revised
Code. Prelicensure nursing education programs include, but are not
limited to, diploma, associate degree, baccalaureate degree,
master's degree, and doctor of nursing programs leading to initial
licensure to practice nursing as a registered nurse and practical
nurse programs leading to initial licensure to practice nursing as
a licensed practical nurse.
(6) Grant conditional approval, by a vote of a quorum of the
board, to a new prelicensure nursing education program or a
program that is being reestablished after having ceased to
operate, if the program meets and maintains the minimum standards
of the board established by rules adopted under section 4723.07 of
the Revised Code. If the board does not grant conditional
approval, it shall hold an adjudication under Chapter 119. of the
Revised Code to consider conditional approval of the program. If
the board grants conditional approval, at the first meeting
following completion of the survey process required by division
(A)(5) of this section, the board shall determine whether to grant
full approval to the program. If the board does not grant full
approval or if it appears that the program has failed to meet and
maintain standards established by rules adopted under section
4723.07 of the Revised Code, the board shall hold an adjudication
under Chapter 119. of the Revised Code to consider the program.
Based on results of the adjudication, the board may continue or
withdraw conditional approval, or grant full approval.
(7) Place on provisional approval, for a period of time
specified by the board, a program that has ceased to meet and
maintain the minimum standards of the board established by rules
adopted under section 4723.07 of the Revised Code. Prior to or at
the end of the period, the board shall reconsider whether the
program meets the standards and shall grant full approval if it
does. If it does not, the board may withdraw approval, pursuant to
an adjudication under Chapter 119. of the Revised Code.
(8) Approve continuing education programs and courses under
standards established in rules adopted under sections 4723.07,
4723.69, 4723.79, and 4723.88 of the Revised Code;
(9) Establish a program for monitoring chemical dependency in
accordance with section 4723.35 of the Revised Code;
(10) Establish the practice intervention and improvement
program in accordance with section 4723.282 of the Revised Code;
(11) Issue and renew certificates of authority to practice
nursing as a certified registered nurse anesthetist, clinical
nurse specialist, certified nurse-midwife, or certified nurse
practitioner;
(12) Approve under section 4723.46 of the Revised Code
national certifying organizations for examination and
certification of certified registered nurse anesthetists, clinical
nurse specialists, certified nurse-midwives, or certified nurse
practitioners;
(13) Issue and renew certificates to prescribe in accordance
with sections 4723.48 and 4723.486 of the Revised Code;
(14) Grant approval to the planned classroom and clinical
course of study in advanced pharmacology and related topics
required by section 4723.482 of the Revised Code to be eligible
for a certificate to prescribe;
(15) Make an annual edition of the formulary established in
rules adopted under section 4723.50 of the Revised Code available
to the public either in printed form or by electronic means and,
as soon as possible after any revision of the formulary becomes
effective, make the revision available to the public in printed
form or by electronic means;
(16) Provide guidance and make recommendations to the general
assembly, the governor, state agencies, and the federal government
with respect to the regulation of the practice of nursing and the
enforcement of this chapter;
(17) Make an annual report to the governor, which shall be
open for public inspection;
(18) Maintain and have open for public inspection the
following records:
(a) A record of all its meetings and proceedings;
(b) A record of all applicants for, and holders of, licenses
and certificates issued by the board under this chapter or in
accordance with rules adopted under this chapter. The record shall
be maintained in a format determined by the board.
(c) A list of education and training programs approved by the
board.
(19) Deny approval to a person who submits or causes to be
submitted false, misleading, or deceptive statements, information,
or documentation to the board in the process of applying for
approval of a new education or training program. If the board
proposes to deny approval of a new education or training program,
it shall do so pursuant to an adjudication conducted under Chapter
119. of the Revised Code.
(B) The board may fulfill the requirement of division (A)(8)
of this section by authorizing persons who meet the standards
established in rules adopted under section 4723.07 of the Revised
Code to approve continuing education programs and courses. Persons
so authorized shall approve continuing education programs and
courses in accordance with standards established in rules adopted
under section 4723.07 of the Revised Code.
Persons seeking authorization to approve continuing education
programs and courses shall apply to the board and pay the
appropriate fee established under section 4723.08 of the Revised
Code. Authorizations to approve continuing education programs and
courses shall expire, and may be renewed according to the schedule
established in rules adopted under section 4723.07 of the Revised
Code.
In addition to approving continuing education programs under
division (A)(8) of this section, the board may sponsor continuing
education activities that are directly related to the statutes and
rules the board enforces.
Sec. 4723.07. In accordance with Chapter 119. of the Revised
Code, the board of nursing shall adopt and may amend and rescind
rules that establish all of the following:
(A) Provisions for the board's government and control of its
actions and business affairs;
(B) Minimum standards for nursing education programs that
prepare graduates to be licensed under this chapter and procedures
for granting, renewing, and withdrawing approval of those
programs;
(C) Criteria that applicants for licensure must meet to be
eligible to take examinations for licensure;
(D) Standards and procedures for renewal of the licenses and
certificates issued by the board;
(E) Standards for approval of continuing nursing education
programs and courses for registered nurses, licensed practical
nurses, certified registered nurse anesthetists, clinical nurse
specialists, certified nurse-midwives, and certified nurse
practitioners. The standards may provide for approval of
continuing nursing education programs and courses that have been
approved by other state boards of nursing or by national
accreditation systems for nursing, including, but not limited to,
the American nurses' credentialing center and the national
association for practical nurse education and service.
(F) Standards that persons must meet to be authorized by the
board to approve continuing education programs and courses and a
schedule by which that authorization expires and may be renewed;
(G) Requirements, including continuing education
requirements, for reactivating inactive licenses or certificates,
and for reinstating licenses or certificates that have lapsed;
(H) Conditions that may be imposed for reinstatement of a
license or certificate following action taken under section
3123.47, 4723.28, 4723.281, 4723.652, or 4723.86 of the Revised
Code resulting in a license or certificate suspension;
(I) Requirements for board approval of courses in medication
administration by licensed practical nurses;
(J) Criteria for evaluating the qualifications of an
applicant for a license to practice nursing as a registered nurse,
a license to practice nursing as a licensed practical nurse, or a
certificate of authority issued under division (B) of section
4723.41 of the Revised Code for the purpose of issuing the license
or certificate by the board's endorsement of the applicant's
authority to practice issued by the licensing agency of another
state;
(K) Universal and standard precautions that shall be used by
each licensee or certificate holder. The rules shall define and
establish requirements for universal and standard precautions that
include the following:
(1) Appropriate use of hand washing;
(2) Disinfection and sterilization of equipment;
(3) Handling and disposal of needles and other sharp
instruments;
(4) Wearing and disposal of gloves and other protective
garments and devices.
(L) Standards and procedures for approving certificates of
authority to practice nursing as a certified registered nurse
anesthetist, clinical nurse specialist, certified nurse-midwife,
or certified nurse practitioner, and for renewal of those
certificates;
(M) Quality assurance standards for certified registered
nurse anesthetists, clinical nurse specialists, certified
nurse-midwives, or certified nurse practitioners;
(N) Additional criteria for the standard care arrangement
required by section 4723.431 of the Revised Code entered into by a
clinical nurse specialist, certified nurse-midwife, or certified
nurse practitioner and the nurse's collaborating physician or
podiatrist;
(O) Continuing education standards for clinical nurse
specialists who were issued a certificate of authority to practice
as a clinical nurse specialist under division (C) of section
4723.41 of the Revised Code as that division existed at any time
before the effective date of this amendment March 20, 2013;
(P) For purposes of division (B)(31) of section 4723.28 of
the Revised Code, the actions, omissions, or other circumstances
that constitute failure to establish and maintain professional
boundaries with a patient;
(Q) Standards and procedures for delegation under division
(C) of section 4723.48 of the Revised Code of the authority to
administer drugs.
The board may adopt other rules necessary to carry out the
provisions of this chapter. The rules shall be adopted in
accordance with Chapter 119. of the Revised Code.
Sec. 4723.18. (A) The board of nursing shall authorize a
licensed practical nurse to administer to an adult intravenous
therapy if the nurse supplies evidence satisfactory to the board
that all of the following are the case:
(1) The nurse holds a current, valid license issued under
this chapter to practice nursing as a licensed practical nurse.
(2) The nurse has been authorized under section 4723.18
4723.17 of the Revised Code to administer medications.
(3) The nurse successfully completed a course of study in the
safe performance of intravenous therapy approved by the board
pursuant to section 4723.19 of the Revised Code or by an agency in
another jurisdiction that regulates the practice of nursing and
has requirements for intravenous therapy course approval that are
substantially similar to the requirements in division (B) of
section 4723.19 of the Revised Code, as determined by the board.
(4) The nurse has successfully completed a minimum of forty
hours of training that includes all of the following:
(a) The curriculum established by rules adopted by the board;
(b) Training in the anatomy and physiology of the
cardiovascular system, signs and symptoms of local and systemic
complications in the administration of fluids and antibiotic
additives, and guidelines for management of these complications;
(c) Any other training or instruction the board considers
appropriate;
(d) A testing component that requires the nurse to perform a
successful demonstration of the intravenous procedures, including
all skills needed to perform them safely.
(B) Except as provided in section 4723.181 of the Revised
Code and subject to the restrictions in division (D) of this
section, a licensed practical nurse may perform intravenous
therapy on an adult patient only if authorized by the board
pursuant to division (A) of this section and only at the direction
of one of the following:
(1) A licensed physician, physician assistant, dentist,
optometrist, or podiatrist who is authorized to practice in this
state and, except as provided in division (C)(2) of this section,
is present and readily available at the facility where the
intravenous therapy procedure is performed;
(2) A registered nurse in accordance with division (C) of
this section.
(C)(1) Except as provided in division (C)(2) of this section
and section 4723.181 of the Revised Code, when a licensed
practical nurse authorized by the board to perform intravenous
therapy performs an intravenous therapy procedure at the direction
of a registered nurse, the registered nurse or another registered
nurse shall be readily available at the site where the intravenous
therapy is performed, and before the licensed practical nurse
initiates the intravenous therapy, the registered nurse shall
personally perform an on-site assessment of the adult patient who
is to receive the intravenous therapy.
(2) When a licensed practical nurse authorized by the board
to perform intravenous therapy performs an intravenous therapy
procedure in a home as defined in section 3721.10 of the Revised
Code, or in an intermediate care facility for individuals with
intellectual disabilities as defined in section 5124.01 of the
Revised Code, at the direction of a registered nurse or licensed
physician, physician assistant, dentist, optometrist, or
podiatrist who is authorized to practice in this state, a
registered nurse shall be on the premises of the home or facility
or accessible by some form of telecommunication.
(D) No licensed practical nurse shall perform any of the
following intravenous therapy procedures:
(1) Initiating or maintaining any of the following:
(a) Blood or blood components;
(b) Solutions for total parenteral nutrition;
(c) Any cancer therapeutic medication including, but not
limited to, cancer chemotherapy or an anti-neoplastic agent;
(d) Solutions administered through any central venous line or
arterial line or any other line that does not terminate in a
peripheral vein, except that a licensed practical nurse authorized
by the board to perform intravenous therapy may maintain the
solutions specified in division (D)(6)(a) of this section that are
being administered through a central venous line or peripherally
inserted central catheter;
(e) Any investigational or experimental medication.
(2) Initiating intravenous therapy in any vein, except that a
licensed practical nurse authorized by the board to perform
intravenous therapy may initiate intravenous therapy in accordance
with this section in a vein of the hand, forearm, or antecubital
fossa;
(3) Discontinuing a central venous, arterial, or any other
line that does not terminate in a peripheral vein;
(4) Initiating or discontinuing a peripherally inserted
central catheter;
(5) Mixing, preparing, or reconstituting any medication for
intravenous therapy, except that a licensed practical nurse
authorized by the board to perform intravenous therapy may prepare
or reconstitute an antibiotic additive;
(6) Administering medication via the intravenous route,
including all of the following activities:
(a) Adding medication to an intravenous solution or to an
existing infusion, except that a licensed practical nurse
authorized by the board to perform intravenous therapy may do any
of the following:
(i) Initiate an intravenous infusion containing one or more
of the following elements: dextrose 5%, normal saline, lactated
ringers, sodium chloride .45%, sodium chloride 0.2%, sterile
water;
(ii) Hang subsequent containers of the intravenous solutions
specified in division (D)(6)(a)(i) of this section that contain
vitamins or electrolytes, if a registered nurse initiated the
infusion of that same intravenous solution;
(iii) Initiate or maintain an intravenous infusion containing
an antibiotic additive.
(b) Injecting medication via a direct intravenous route,
except that a licensed practical nurse authorized by the board to
perform intravenous therapy may inject heparin or normal saline to
flush an intermittent infusion device or heparin lock including,
but not limited to, bolus or push.
(7) Changing tubing on any line including, but not limited
to, an arterial line or a central venous line, except that a
licensed practical nurse authorized by the board to perform
intravenous therapy may change tubing on an intravenous line that
terminates in a peripheral vein;
(8) Programming or setting any function of a patient
controlled infusion pump.
(E) Notwithstanding divisions (A) and (D) of this section, at
the direction of a physician or a registered nurse, a licensed
practical nurse authorized by the board to perform intravenous
therapy may perform the following activities for the purpose of
performing dialysis:
(1) The routine administration and regulation of saline
solution for the purpose of maintaining an established fluid plan;
(2) The administration of a heparin dose intravenously;
(3) The administration of a heparin dose peripherally via a
fistula needle;
(4) The loading and activation of a constant infusion pump;
(5) The intermittent injection of a dose of medication that
is administered via the hemodialysis blood circuit and through the
patient's venous access.
(F) No person shall employ or direct a licensed practical
nurse to perform an intravenous therapy procedure without first
verifying that the licensed practical nurse is authorized by the
board to perform intravenous therapy.
Sec. 4723.181. (A) A licensed practical nurse may perform on
any person any of the intravenous therapy procedures specified in
division (B) of this section without receiving authorization to
perform intravenous therapy from the board of nursing under
section 4723.18 of the Revised Code, if both of the following
apply:
(1) The licensed practical nurse acts at the direction of a
registered nurse or a licensed physician, physician assistant,
dentist, optometrist, or podiatrist who is authorized to practice
in this state and the registered nurse, physician, physician
assistant, dentist, optometrist, or podiatrist is on the premises
where the procedure is to be performed or accessible by some form
of telecommunication.
(2) The licensed practical nurse can demonstrate the
knowledge, skills, and ability to perform the procedure safely.
(B) The intravenous therapy procedures that a licensed
practical nurse may perform pursuant to division (A) of this
section are limited to the following:
(1) Verification of the type of peripheral intravenous
solution being administered;
(2) Examination of a peripheral infusion site and the
extremity for possible infiltration;
(3) Regulation of a peripheral intravenous infusion according
to the prescribed flow rate;
(4) Discontinuation of a peripheral intravenous device at the
appropriate time;
(5) Performance of routine dressing changes at the insertion
site of a peripheral venous or arterial infusion, peripherally
inserted central catheter infusion, or central venous pressure
subclavian infusion.
Sec. 4723.48. (A) A clinical nurse specialist, certified
nurse-midwife, or certified nurse practitioner seeking authority
to prescribe drugs and therapeutic devices shall file with the
board of nursing a written application for a certificate to
prescribe. The board of nursing shall issue a certificate to
prescribe to each applicant who meets the requirements specified
in section 4723.482 or 4723.485 of the Revised Code.
Except as provided in division (B) of this section, the
initial certificate to prescribe that the board issues to an
applicant shall be issued as an externship certificate. Under an
externship certificate, the nurse may obtain experience in
prescribing drugs and therapeutic devices by participating in an
externship that evaluates the nurse's competence, knowledge, and
skill in pharmacokinetic principles and their clinical application
to the specialty being practiced. During the externship, the nurse
may prescribe drugs and therapeutic devices only when one or more
physicians are providing supervision in accordance with rules
adopted under section 4723.50 of the Revised Code.
After completing the externship, the holder of an externship
certificate may apply for a new certificate to prescribe. On
receipt of the new certificate, the nurse may prescribe drugs and
therapeutic devices in collaboration with one or more physicians
or podiatrists.
(B) In the case of an applicant who meets the requirements of
division (C) of section 4723.482 of the Revised Code, the initial
certificate to prescribe that the board issues to the applicant
under this section shall not be an externship certificate. The
applicant shall be issued a certificate to prescribe that permits
the recipient to prescribe drugs and therapeutic devices in
collaboration with one or more physicians or podiatrists.
(C)(1) The holder of a certificate issued under this section
may delegate to a person not otherwise authorized to administer
drugs the authority to administer a drug, other than a controlled
substance, listed in the formulary established under division
(B)(1) of section 4723.50 of the Revised Code to a specified
patient. The delegation shall be in accordance with division
(C)(2) of this section and standards and procedures established in
rules adopted under division (O) of section 4723.07 of the Revised
Code.
(2) Prior to delegating authority, the certificate holder
shall do both of the following:
(a) Assess the patient and determine that the drug is
appropriate for the patient;
(b) Determine that the person to whom the authority will be
delegated has met the conditions specified in division (D) of
section 4723.489 of the Revised Code.
Sec. 4723.482. (A) Except as provided in divisions (C) and
(D) of this section, an applicant shall include with the
application submitted under section 4723.48 of the Revised Code
all of the following:
(1) Evidence of holding a current, valid certificate of
authority to practice as a clinical nurse specialist, certified
nurse-midwife, or certified nurse practitioner that was issued by
meeting the requirements of division (A) of section 4723.41 of the
Revised Code;
(2) Evidence of successfully completing the course of study
in advanced pharmacology and related topics in accordance with the
requirements specified in division (B) of this section;
(3) The fee required by section 4723.08 of the Revised Code
for a certificate to prescribe;
(4) Any additional information the board of nursing requires
pursuant to rules adopted under section 4723.50 of the Revised
Code.
(B) With respect to the course of study in advanced
pharmacology and related topics that must be successfully
completed to obtain a certificate to prescribe, all of the
following requirements apply:
(1) The course of study shall be completed not longer than
three years before the application for the certificate to
prescribe is filed.
(2) Except as provided in division (E) of this section, the
course of study shall consist of planned classroom and clinical
instruction. The total length of the course of study shall be not
less than forty-five contact hours.
(3) The course of study shall meet the requirements to be
approved by the board in accordance with standards established in
rules adopted under section 4723.50 of the Revised Code.
(4) The content of the course of study shall be specific to
the applicant's nursing specialty.
(5) The instruction provided in the course of study shall
include all of the following:
(a) A minimum of thirty-six contact hours of instruction in
advanced pharmacology that includes pharmacokinetic principles and
clinical application and the use of drugs and therapeutic devices
in the prevention of illness and maintenance of health;
(b) Instruction in the fiscal and ethical implications of
prescribing drugs and therapeutic devices;
(c) Instruction in the state and federal laws that apply to
the authority to prescribe;
(d) Instruction that is specific to schedule II controlled
substances, including instruction in all of the following:
(i) Indications for the use of schedule II controlled
substances in drug therapies;
(ii) The most recent guidelines for pain management
therapies, as established by state and national organizations such
as the Ohio pain initiative and the American pain society;
(iii) Fiscal and ethical implications of prescribing schedule
II controlled substances;
(iv) State and federal laws that apply to the authority to
prescribe schedule II controlled substances;
(v) Prevention of abuse and diversion of schedule II
controlled substances, including identification of the risk of
abuse and diversion, recognition of abuse and diversion, types of
assistance available for prevention of abuse and diversion, and
methods of establishing safeguards against abuse and diversion.
(e) Any additional instruction required pursuant to rules
adopted under section 4723.50 of the Revised Code.
(C) An applicant who practiced or is practicing as a clinical
nurse specialist, certified nurse-midwife, or certified nurse
practitioner in another jurisdiction or as an employee of the
United States government, and is not seeking authority to
prescribe drugs and therapeutic devices by meeting the
requirements of division (A) or (D) of this section, shall include
with the application submitted under section 4723.48 of the
Revised Code all of the following:
(1) Evidence of holding a current, valid certificate of
authority issued under this chapter to practice as a clinical
nurse specialist, certified nurse-midwife, or certified nurse
practitioner;
(2) The fee required by section 4723.08 of the Revised Code
for a certificate to prescribe;
(3) Either of the following:
(a) Evidence of having held, for a continuous period of at
least one year during the three years immediately preceding the
date of application, valid authority issued by another
jurisdiction to prescribe therapeutic devices and drugs, including
at least some controlled substances;
(b) Evidence of having been employed by the United States
government and authorized, for a continuous period of at least one
year during the three years immediately preceding the date of
application, to prescribe therapeutic devices and drugs, including
at least some controlled substances, in conjunction with that
employment.
(4) Evidence of having completed a two-hour course of
instruction approved by the board in the laws of this state that
govern drugs and prescriptive authority;
(5) Any additional information the board requires pursuant to
rules adopted under section 4723.50 of the Revised Code.
(D) An applicant who practiced or is practicing as a clinical
nurse specialist, certified nurse-midwife, or certified nurse
practitioner in another jurisdiction or as an employee of the
United States government, and is not seeking authority to
prescribe drugs and therapeutic devices by meeting the
requirements of division (A) or (C) of this section, shall include
with the application submitted under section 4723.48 of the
Revised Code all of the following:
(1) Evidence of holding a current, valid certificate of
authority issued under this chapter to practice as a clinical
nurse specialist, certified nurse-midwife, or certified nurse
practitioner;
(2) The fee required by section 4723.08 of the Revised Code
for a certificate to prescribe;
(3) Either of the following:
(a) Evidence of having held, for a continuous period of at
least one year during the three years immediately preceding the
date of application, valid authority issued by another
jurisdiction to prescribe therapeutic devices and drugs, excluding
controlled substances;
(b) Evidence of having been employed by the United States
government and authorized, for a continuous period of at least one
year during the three years immediately preceding the date of
application, to prescribe therapeutic devices and drugs, excluding
controlled substances, in conjunction with that employment.
(4) Any additional information the board requires pursuant to
rules adopted under section 4723.50 of the Revised Code.
(E) In the case of an applicant who meets the requirements of
division (C) or (D) of this section other than the requirements of
division (C)(3) or (D)(3) of this section and is seeking authority
to prescribe drugs and therapeutic devices by meeting the
requirements of division (A) of this section, the applicant may
complete the instruction that is specific to schedule II
controlled substances, as required by division (B)(5)(d) of this
section, through an internet-based course of study in lieu of
completing the instruction through a course of study consisting of
planned classroom and clinical instruction.
Sec. 4723.489. A person not otherwise authorized to
administer drugs may administer a drug to a specified patient if
all of the following conditions are met:
(A) The authority to administer the drug is delegated to the
person by an advanced practice registered nurse who is a clinical
nurse specialist, certified nurse-midwife, or certified nurse
practitioner and holds a certificate to prescribe issued under
section 4723.48 of the Revised Code.
(B) The drug is listed in the formulary established under
division (B) of section 4723.50 of the Revised Code but is not a
controlled substance and is not to be administered intravenously.
(C) The drug is to be administered at a location other than a
hospital inpatient care unit, as defined in section 3727.50 of the
Revised Code; a hospital emergency department or a freestanding
emergency department; or an ambulatory surgical facility, as
defined in section 3702.30 of the Revised Code.
(D) The person has successfully completed education based on
a recognized body of knowledge concerning drug administration and
demonstrates to the person's employer the knowledge, skills, and
ability to administer the drug safely.
(E) The person's employer has given the advanced practice
registered nurse access to documentation, in written or electronic
form, showing that the person has met the conditions specified in
division (D) of this section.
(F) The advanced practice registered nurse is physically
present at the location where the drug is administered.
Sec. 4723.50. (A) In accordance with Chapter 119. of the
Revised Code, the board of nursing shall adopt rules as necessary
to implement the provisions of this chapter pertaining to the
authority of clinical nurse specialists, certified nurse-midwives,
and certified nurse practitioners to prescribe drugs and
therapeutic devices and the issuance and renewal of certificates
to prescribe.
The board shall adopt rules that are consistent with the
recommendations the board receives from the committee on
prescriptive governance pursuant to section 4723.492 of the
Revised Code. After reviewing a recommendation submitted by the
committee, the board may either adopt the recommendation as a rule
or ask the committee to reconsider and resubmit the
recommendation. The board shall not adopt any rule that does not
conform to a recommendation made by the committee.
(B) The board shall adopt rules under this section that do
all of the following:
(1) Establish a formulary listing the types of drugs and
therapeutic devices that may be prescribed by a clinical nurse
specialist, certified nurse-midwife, or certified nurse
practitioner. The formulary may include controlled substances, as
defined in section 3719.01 of the Revised Code. The formulary
shall not permit the prescribing of any drug or device to perform
or induce an abortion.
(2) Establish safety standards to be followed by a clinical
nurse specialist, certified nurse-midwife, or certified nurse
practitioner when personally furnishing to patients complete or
partial supplies of 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;
(3) Establish criteria for the components of the standard
care arrangements described in section 4723.431 of the Revised
Code that apply to the authority to prescribe, including the
components that apply to the authority to prescribe schedule II
controlled substances. The rules shall be consistent with that
section and include all of the following:
(a) Quality assurance standards;
(b) Standards for periodic review by a collaborating
physician or podiatrist of the records of patients treated by the
clinical nurse specialist, certified nurse-midwife, or certified
nurse practitioner;
(c) Acceptable travel time between the location at which the
clinical nurse specialist, certified nurse-midwife, or certified
nurse practitioner is engaging in the prescribing components of
the nurse's practice and the location of the nurse's collaborating
physician or podiatrist;
(d) Any other criteria recommended by the committee on
prescriptive governance.
(4) Establish standards and procedures for issuance and
renewal of a certificate to prescribe, including specification of
any additional information the board may require under division
(A)(4), (C)(5), or (D)(5)(4) of section 4723.482 or, division
(B)(3) of section 4723.485, or division (B)(3) of section 4723.486
of the Revised Code;
(5) Establish standards for board approval of the course of
study in advanced pharmacology and related topics required by
section 4723.482 of the Revised Code;
(6) Establish requirements for board approval of the two-hour
course of instruction in the laws of this state as required under
division (C)(4) of section 4723.482 of the Revised Code and
division (B)(2) of section 4723.484 of the Revised Code;
(7) Establish standards and procedures for the appropriate
conduct of an externship as described in section 4723.484 of the
Revised Code, including the following:
(a) Standards and procedures to be used in evaluating an
individual's participation in an externship;
(b) Standards and procedures for the supervision that a
physician must provide during an externship, including supervision
provided by working with the participant and supervision provided
by making timely reviews of the records of patients treated by the
participant. The manner in which supervision must be provided may
vary according to the location where the participant is practicing
and with the participant's level of experience.
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 and has been granted
physician-delegated prescriptive authority;
(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.
(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)(B) "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 (C) "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 4730.19 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 or supervision agreement under which the
physician assistant is being supervised, including, if applicable,
the policies of the health care facility in which the physician
and physician assistant are practicing.
(F) 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 or the policies of the health care facility in
which the physician assistant is practicing.
(G)(E) 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)(F) No person shall advertise to provide services as a
physician assistant, except for the purpose of seeking employment.
(I)(G) 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 a physician who is responsible for
supervising the physician assistant or and, if applicable, 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) 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 4730.19 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 of the
following as follows:
(1) The physician assistant shall practice only under 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 4730.19
of the Revised Code.
(2) When the physician assistant practices outside a health
care facility, the The physician assistant shall practice in
accordance with the physician supervisory plan approved under
section 4730.17 of the Revised Code for supervision agreement
entered into with 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, including, if applicable, the policies of the
health care facility in which the physician assistant is
practicing.
(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)(B)(1) and
(2) of section 4730.01 of the Revised Code. The Any 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 five 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 any jurisdiction throughout the
three-year period immediately preceding the date of application.
(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 hold a degree obtained from a program accredited by
the accreditation review commission on education for the physician
assistant; and meet either of the following experience
requirements:
(b)(a) 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.
(b) 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, in
the military, or in the public health service, 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)(1) 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:
(1)(a) Before the educational requirements specified in
division (B)(1) or (2) of this section became effective January 1,
2008;
(2)(b) By meeting the educational or other applicable
requirements specified in division (C)(1), (2), or (3) of this
section.
(2) A license described in division (E)(1) of this section
authorizes the license holder to exercise physician-delegated
prescriptive authority if, on the effective date of this
amendment, the license holder held a valid certificate to
prescribe issued under former section 4730.44 of the Revised Code,
as it existed immediately prior to the effective date of this
amendment.
(3) On application of an individual who received a license
without having first obtained a master's or higher degree and is
not authorized under division (E)(2) of this section to exercise
physician-delegated prescriptive authority, the board shall grant
the individual the authority to exercise physician-delegated
prescriptive authority if the individual provides evidence
satisfactory to the board of having obtained a master's or higher
degree from either of the following:
(a) 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 program accredited by a regional or specialized and
professional accrediting agency recognized by the council for
higher education accreditation, if the degree is in a course of
study with clinical relevance to the practice of physician
assistants.
Sec. 4730.111. A physician assistant whose certification by
the national commission on certification of physician assistants
or a successor organization recognized by the state medical board
is suspended or revoked shall give notice of that occurrence to
the board not later than fourteen days after the physician
assistant receives notice of the change in certification status. A
physician assistant who fails to renew the certification shall
notify the board not later than fourteen days after the
certification expires.
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)(1) During the first five hundred hours of the first one
thousand hours of a physician assistant's exercise of
physician-delegated prescriptive authority, the physician
assistant shall exercise that authority only under the on-site
supervision of a supervising physician.
(2) A physician assistant shall be excused from the
requirement established in division (C)(1) of this section if
prior to application the physician assistant held a prescriber
number, or the equivalent, from another jurisdiction and practiced
with prescriptive authority in that jurisdiction for not less than
one thousand hours.
(3) A record of a physician assistant's completion of the
hours required by division (C)(1) of this section or issuance of a
prescriber number or equivalent by another jurisdiction shall be
kept on file by a supervising physician of the physician
assistant. The record shall be made 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 license. 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 two 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 of a license, a physician
assistant shall certify to the board both an applicant is subject
to all of the following:
(1) That the physician assistant The applicant shall certify
to the board that the applicant 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, the applicant shall certify
to the board that the physician assistant applicant has completed
during the current certification licensure period not less than
one hundred hours of continuing medical education acceptable to
the board.
(3) The applicant shall comply with the renewal eligibility
requirements established under section 4730.49 of the Revised Code
that pertain to the applicant.
(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 licensure
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
licensure 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 license 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. 4730.19. (A) For a supervision agreement to be approved
by the board, all of the following apply:
(1) Before initiating supervision of one or more physician
assistants licensed under this chapter, a physician shall enter
into a supervision agreement with each physician assistant who
will be supervised. A supervision agreement may apply to one or
more physician assistants, but, except as provided in division
(B)(2)(e) of this section, may apply to not more than one
physician. The supervision agreement shall specify that the
physician agrees to supervise the physician assistant and the
physician assistant agrees to practice in accordance with the
conditions specified in the physician supervisory plan approved
for that physician or the policies of the health care facility in
which the supervising physician and physician assistant are
practicing under that physician's supervision.
(2) The agreement shall clearly state that the supervising
physician is legally responsible and assumes legal liability for
the services provided by the physician assistant. The agreement
shall be signed by the physician and the physician assistant.
(3) The physician assistant shall hold a current certificate
to practice as a physician assistant.
(4) If a physician supervisory plan applies to the physician
assistant's practice, the physician shall hold an approved
physician supervisory plan.
(5) If the physician intends to grant physician-delegated
prescriptive authority to a physician assistant, the physician
assistant shall hold a certificate to prescribe issued under this
chapter.
(6) If the physician holds approval of more than one
physician supervisory plan, the agreement shall specify the plan
under which the physician assistant will practice.
(B) The board shall review each application received. If the
board finds that the requirements specified in division (A) of
this section have been met and the applicant has paid the fee
specified in section 4730.18 of the Revised Code, the board shall
approve the supervision agreement and notify the supervising
physician of the board's approval. If physician-delegated
prescriptive authority will be granted to more than one physician
assistant under the supervision agreement, the board shall specify
in the notice that its approval is specific to each physician
assistant. The board shall provide notice of its approval of a
supervision agreement not later than thirty days after the board
receives a complete application for approval. A supervision
agreement shall include either or both of the following:
(1) If a physician assistant will practice within a health
care facility, the agreement shall include terms that require the
physician assistant to practice in accordance with the policies of
the health care facility.
(2) If a physician assistant will practice outside a health
care facility, the agreement shall include terms that specify all
of the following:
(a) The responsibilities to be fulfilled by the physician in
supervising the physician assistant;
(b) The responsibilities to be fulfilled by the physician
assistant when performing services under the physician's
supervision;
(c) Any limitations on the responsibilities to be fulfilled
by the physician assistant;
(d) The circumstances under which the physician assistant is
required to refer a patient to the supervising physician;
(e) If the supervising physician chooses to designate
physicians to act as alternate supervising physicians, the names,
business addresses, and business telephone numbers of the
physicians who have agreed to act in that capacity.
(C) After a supervision agreement is approved, a physician
may apply to the board for approval to initiate supervision of a
physician assistant who is not listed on the agreement. There is
no fee for applying for the addition of a physician assistant to a
supervision agreement.
To receive the board's approval of the addition to the
supervision agreement, the physician assistant shall hold a
current certificate to practice as a physician assistant. If the
physician intends to grant physician-delegated prescriptive
authority to the physician assistant, the physician assistant
shall hold a current certificate to prescribe. If these
requirements are met, the board shall notify the physician of its
approval of the addition to the supervision agreement. The board
shall provide notice of its approval not later than thirty days
after the board receives a complete application for approval (1)
The supervising physician shall submit a copy of each supervision
agreement to the board. The board may review the supervision
agreement at any time for compliance with this section and for
verification of licensure of the supervising physician and the
physician assistant. All of the following apply to the submission
and review process:
(a) If the board reviews a supervision agreement, the board
shall notify the supervising physician of any way that the
agreement fails to comply with this section.
(b) A supervision agreement becomes effective at the end of
the fifth business day after the day the board receives the
agreement unless the board notifies the supervising physician that
the agreement fails to comply with this section.
A supervision agreement expires two years after the day it
takes effect. The agreement may be renewed by submitting a copy of
it to the board.
(c) If a physician receives a notice under division (C)(1)(a)
of this section, the physician may revise the supervision
agreement and resubmit the agreement to the board. The board may
review the agreement as provided in division (C)(1) of this
section.
(d) Until July 1, 2015, each initial or renewed agreement
submitted under division (C)(1) of this section shall be
accompanied by a fee of twenty-five dollars. No fee is required
for submitting a revised agreement under division (C)(1)(c) of
this section or for submitting an amendment under division (C)(2)
of this section. Fees shall be deposited in accordance with
section 4731.24 of the Revised Code.
(2) Before expiration, a supervision agreement may be amended
by including one or more additional physician assistants. An
amendment to a supervision agreement shall be submitted to the
board for review in the manner provided for review of an initial
agreement under division (C)(1) of this section. The amendment
does not alter the agreement's expiration date.
(D) A supervision agreement shall be kept in the records
maintained by the supervising physician who entered into the
agreement.
(E) The board may impose a civil penalty of not more than one
thousand dollars if it finds through a review conducted under this
section or through any other means either of the following:
(1) A physician assistant has practiced pursuant to a
supervision agreement that fails to comply with this section;
(2) That a physician has acted as the supervising physician
of a physician assistant pursuant to a supervision agreement that
fails to comply with this section.
The board's finding shall be made pursuant to an adjudication
conducted under Chapter 119. of the Revised Code. 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.
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 4730.202 of the Revised Code;
(6) Assisting in surgery;
(7) If the physician assistant holds a valid prescriber
number issued by the state medical board and has been granted
physician-delegated prescriptive authority, 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) 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 shall not authorize a physician assistant to
perform a service that is prohibited under this chapter. 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.
Sec. 4730.091 4730.201. (A) As used in this section, "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.
(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 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. 4730.203. (A) Acting pursuant to a supervision
agreement, a physician assistant may delegate performance of a
task to implement a patient's plan of care or, if the conditions
in division (C) of this section are met, may delegate
administration of a drug. Delegation may be to a person 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, subject to division (D) of section 4730.03
of the Revised Code, any other person. The physician assistant
must be physically present at the location where the task is
performed or the drug administered.
(B) Prior to delegating a task or administration of a drug, a
physician assistant shall determine that the task or drug is
appropriate for the patient and the person to whom the delegation
is to be made may safely perform the task or administer the drug.
(C) A physician assistant may delegate administration of a
drug only if all of the following conditions are met:
(1) The physician assistant has physician-delegated
prescriptive authority.
(2) The drug is included in the formulary established under
division (A) of section 4730.39 of the Revised Code.
(3) The drug is not a controlled substance.
(4) The drug will not be administered intravenously.
(5) The drug will not be administered in a hospital inpatient
care unit, as defined in section 3727.50 of the Revised Code; a
hospital emergency department; a freestanding emergency
department; or an ambulatory surgical facility licensed under
section 3702.30 of the Revised Code.
(D) A person not otherwise authorized to administer a drug or
perform a specific task may do so in accordance with a physician
assistant's delegation under this section.
Sec. 4730.21. (A) The supervising physician of a physician
assistant exercises supervision, control, and direction of the
physician assistant. In A physician assistant may practice in any
setting within which the supervising physician has 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 three 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 practice in any setting within which 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. 4730.22. (A) A When performing authorized services, a
physician assistant acts as the agent of the physician assistant's
supervising physician. The supervising physician is legally
responsible and assumes legal liability for the services provided
by the physician assistant.
The physician is not responsible or liable for any services
provided by the physician assistant after their supervision
agreement expires or is terminated.
(B) When a health care facility permits physician assistants
to practice within that facility or any other health care facility
under its control, the health care facility shall make reasonable
efforts to explain to each individual who may work with a
particular physician assistant the scope of that physician
assistant's practice within the facility. The appropriate
credentialing body within the health care facility shall provide,
on request of an individual practicing in the facility with a
physician assistant, a copy of the facility's policies on the
practice of physician assistants within the facility and a copy of
each physician supervisory plan and supervision agreement
applicable to the physician assistant.
An individual who follows the orders of a physician assistant
practicing in a health care facility is not subject to
disciplinary action by any administrative agency that governs that
individual's conduct and is not liable in damages in a civil
action for injury, death, or loss to person or property resulting
from the individual's acts or omissions in the performance of any
procedure, treatment, or other health care service if the
individual reasonably believed that the physician assistant was
acting within the proper scope of practice or was relaying medical
orders from a supervising physician, unless the act or omission
constitutes willful or wanton misconduct.
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 prescriber number,
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,
including, if applicable, 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;
(25) Failure to comply with the requirements in section
3719.061 of the Revised Code before issuing to for a minor a
prescription for a controlled substance containing an opioid;
(26) Having certification by the national commission on
certification of physician assistants or a successor organization
expire, lapse, or be suspended or revoked.
(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
authority to 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 to practice as a physician
assistant 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 to practice as a physician assistant 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 issued under this chapter 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
to practice as a physician assistant 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 issued under this chapter, 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 issued under this chapter 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 all
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;
(3) Establish standards and procedures for delegation under
division (A) of section 4730.203 of the Revised Code of the
authority to administer drugs.
(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.
(5) If the physician assistant possesses physician-delegated
prescriptive authority to prescribe for a minor, as defined in
section 3719.061 of the Revised Code, a compound that is a
controlled substance containing an opioid, the physician assistant
shall comply with section 3719.061 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 both 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 supervision agreement entered into with
the physician assistant under section 4730.19 of the Revised Code,
including, if applicable, 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 supervision agreement
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. 4730.431. (A) Notwithstanding any provision of this
chapter or rule adopted by the state medical board, a physician
assistant who holds a certificate to prescribe valid prescriber
number issued under this chapter by the board may personally
furnish a supply of naloxone, or issue a prescription for
naloxone, without having examined the individual to whom it may be
administered if all of the following conditions are met:
(1) The naloxone supply is furnished to, or the prescription
is issued to and in the name of, a family member, friend, or other
individual in a position to assist an individual who there is
reason to believe is at risk of experiencing an opioid-related
overdose.
(2) The physician assistant instructs the individual
receiving the naloxone supply or prescription to summon emergency
services either immediately before or immediately after
administering naloxone to an individual apparently experiencing an
opioid-related overdose.
(3) The naloxone is personally furnished or prescribed in
such a manner that it may be administered by only either of the
following routes:
(a) Using a device manufactured for the intranasal
administration of liquid drugs;
(b) Using an autoinjector in a manufactured dosage form.
(B) A physician assistant who under division (A) of this
section in good faith furnishes a supply of naloxone or issues a
prescription for naloxone is not liable for or subject to any of
the following for any action or omission of the individual to whom
the naloxone is furnished or the prescription is issued: damages
in any civil action, prosecution in any criminal proceeding, or
professional disciplinary action.
Sec. 4730.49. (A) To be eligible for renewal of a
certificate to prescribe license to practice as a physician
assistant, an applicant who has been granted physician-delegated
prescriptive authority is subject to both of the following:
(1) The 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.
(2)(a) Except as provided in division (A)(2)(b) of this
section, in the case of an applicant who prescribes opioid
analgesics or benzodiazepines, the applicant shall certify to the
board whether the applicant has been granted access to the drug
database established and maintained by the state board of pharmacy
pursuant to section 4729.75 of the Revised Code.
(b) The requirement in division (A)(2)(a) of this section
does not apply if either of the following is the case:
(i) The state board of pharmacy notifies the state medical
board pursuant to section 4729.861 of the Revised Code that the
applicant has been restricted from obtaining further information
from the drug database.
(ii) The state board of pharmacy no longer maintains the drug
database.
(c) If an applicant certifies to the state medical board that
the applicant has been granted access to the drug database and the
board finds through an audit or other means that the applicant has
not been granted access, the board may take action under section
4730.25 of the Revised Code.
(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
its internet web site, 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 state 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 who
has been granted physician-delegated prescriptive authority
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. 4731.07. (A) The state medical board shall keep a record
of its proceedings. The minutes of a meeting of the board shall,
on approval by the board, constitute an official record of its
proceedings.
(B) The board shall keep a register of applicants for
certificates of registration and certificates to practice issued
under this chapter and Chapters 4730., 4760., 4762., and 4774. of
the Revised Code and licenses issued under Chapter Chapters 4730.
and 4778. of the Revised Code. The register shall show the name of
the applicant and whether the applicant was granted or refused a
certificate or license. With respect to applicants to practice
medicine and surgery or osteopathic medicine and surgery, the
register shall show the name of the institution that granted the
applicant the degree of doctor of medicine or osteopathic
medicine. The books and records of the board shall be prima-facie
evidence of matters therein contained.
Sec. 4761.01. As used in this chapter:
(A) "Respiratory care" means rendering or offering to render
to individuals, groups, organizations, or the public any service
involving the evaluation of cardiopulmonary function, the
treatment of cardiopulmonary impairment, the assessment of
treatment effectiveness, and the care of patients with
deficiencies and abnormalities associated with the cardiopulmonary
system. The practice of respiratory care includes:
(1) Obtaining, analyzing, testing, measuring, and monitoring
blood and gas samples in the determination of cardiopulmonary
parameters and related physiologic data, including flows,
pressures, and volumes, and the use of equipment employed for this
purpose;
(2) Administering, monitoring, recording the results of, and
instructing in the use of medical gases, aerosols, and
bronchopulmonary hygiene techniques, including drainage,
aspiration, and sampling, and applying, maintaining, and
instructing in the use of artificial airways, ventilators, and
other life support equipment employed in the treatment of
cardiopulmonary impairment and provided in collaboration with
other licensed health care professionals responsible for providing
care;
(3) Performing cardiopulmonary resuscitation and respiratory
rehabilitation techniques;
(4) Administering medications for the testing or treatment of
cardiopulmonary impairment.
(B) "Respiratory care professional" means a person who is
licensed under this chapter to practice the full range of
respiratory care services as defined in division (A) of this
section.
(C) "Physician" means an individual authorized under Chapter
4731. of the Revised Code to practice medicine and surgery or
osteopathic medicine and surgery.
(D) "Registered nurse" means an individual licensed under
Chapter 4723. of the Revised Code to engage in the practice of
nursing as a registered nurse.
(E) "Hospital" means a facility that meets the operating
standards of section 3727.02 of the Revised Code.
(F) "Nursing facility" has the same meaning as in section
5165.01 of the Revised Code.
(G) "Certified hyperbaric technologist" means a person who
administers hyperbaric oxygen therapy and is certified as a
hyperbaric technologist by the national board of diving and
hyperbaric medical technology or its successor organization.
(H) "Hyperbaric oxygen therapy" means the administration of
pure oxygen in a pressurized room or chamber, except that it does
not include ventilator management.
(I) "Advanced practice registered nurse" has the same meaning
as in section 4723.01 of the Revised Code.
(J) "Physician assistant" means an individual who holds a
valid certificate license to practice issued 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. 4761.17. All of the following apply to the practice of
respiratory care by a person who holds a license or limited permit
issued under this chapter:
(A) The person shall practice only pursuant to a prescription
or other order for respiratory care issued by a any of the
following:
(2) A registered nurse who holds a certificate of authority
issued under Chapter 4723. of the Revised Code to practice as a
certified nurse practitioner or clinical nurse specialist and has
entered into a standard care arrangement with a physician that
allows the nurse to prescribe or order respiratory care services;
(3) A physician assistant who has been granted
physician-delegated prescriptive authority that allows the
physician assistant to prescribe or order respiratory care
services.
(B) The person shall practice only under the supervision of a
any of the following:
(1) A physician or under the supervision of a;
(2) A certified nurse practitioner or clinical nurse
specialist who is authorized to prescribe or order respiratory
care services as provided in division (A)(2) of this section;
(3) A physician assistant who is authorized to prescribe or
order respiratory care services as provided in division (A)(3) of
this section.
(C) When practicing under the prescription or order of a
certified nurse practitioner or clinical nurse specialist or under
the supervision of such a nurse, the person's administration of
medication that requires a prescription is limited to the drugs
that the nurse is authorized to prescribe pursuant to the nurse's
certificate to prescribe issued under section 4723.48 of the
Revised Code.
(D) When practicing under the prescription or order of a
physician assistant or under the supervision of a physician
assistant, the person's administration of medication that requires
a prescription is limited to the drugs that the physician
assistant is authorized to prescribe pursuant to the physician
assistant's physician-delegated prescriptive authority.
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
current, valid certificate license to practice as a physician
assistant issued under Chapter 4730. 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 4730.19 of the
Revised Code or, including, if applicable, the policies of the
health care facility in which the physician assistant is
practicing.
Sec. 5122.11. Proceedings for a mentally ill person subject
to court order pursuant to sections 5122.11 to 5122.15 of the
Revised Code shall be commenced by the filing of an affidavit in
the manner prescribed by the department of mental health and
addiction services and in a form prescribed in section 5122.111 of
the Revised Code, by any person or persons with the probate court
in the county where the mentally ill person subject to court order
resides, either on reliable information or actual knowledge,
whichever is determined to be proper by the court. This section
does not apply to the hospitalization of a person pursuant to
section 2945.39, 2945.40, 2945.401, or 2945.402 of the Revised
Code.
The affidavit shall contain an allegation setting forth the
specific category or categories under division (B) of section
5122.01 of the Revised Code upon which the jurisdiction of the
court is based and a statement of alleged facts sufficient to
indicate probable cause to believe that the person is a mentally
ill person subject to court order. The affidavit may be
accompanied, or the court may require that the affidavit be
accompanied, by a certificate of a psychiatrist, or a certificate
signed by a licensed clinical psychologist and a certificate
signed by a licensed physician stating that the person who issued
the certificate has examined the person and is of the opinion that
the person is a mentally ill person subject to court order, or
shall be accompanied by a written statement by the applicant,
under oath, that the person has refused to submit to an
examination by a psychiatrist, or by a licensed clinical
psychologist and licensed physician.
Upon receipt of the affidavit, if a judge of the court or a
referee who is an attorney at law appointed by the court has
probable cause to believe that the person named in the affidavit
is a mentally ill person subject to court order, the judge or
referee may issue a temporary order of detention ordering any
health or police officer or sheriff to take into custody and
transport the person to a hospital or other place designated in
section 5122.17 of the Revised Code, or may set the matter for
further hearing. If a temporary order of detention is issued and
the person is transported to a hospital or other designated place,
the court that issued the order shall retain jurisdiction over the
case as it relates to the person's outpatient treatment,
notwithstanding that the hospital or other designated place to
which the person is transported is outside the territorial
jurisdiction of the court.
The person may be observed and treated until the hearing
provided for in section 5122.141 of the Revised Code. If no such
hearing is held, the person may be observed and treated until the
hearing provided for in section 5122.15 of the Revised Code.
Sec. 5122.111. To initiate proceedings for court-ordered
treatment of a person under section 5122.11 of the Revised Code, a
person or persons shall file an affidavit with the probate court
that is identical in form and content to the following:
AFFIDAVIT OF MENTAL ILLNESS
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The State of Ohio |
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the undersigned, residing at
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says, that he/she has information to believe or has actual knowledge that
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(Please specify specific category(ies) below with an X.)
[ ] Represents a substantial risk of physical harm to self as
manifested by evidence of threats of, or attempts at, suicide or
serious self-inflicted bodily harm;
[ ] Represents a substantial risk of physical harm to others as
manifested by evidence of recent homicidal or other violent
behavior or evidence of recent threats that place another in
reasonable fear of violent behavior and serious physical harm or
other evidence of present dangerousness;
[ ] Represents a substantial and immediate risk of serious
physical impairment or injury to self as manifested by evidence of
being unable to provide for and of not providing for basic
physical needs because of mental illness and that appropriate
provision for such needs cannot be made immediately available in
the community;
[ ] Would benefit from treatment for mental illness and is in need
of such treatment as manifested by evidence of behavior that
creates a grave and imminent risk to substantial rights of others
or the person; or
[ ] Would benefit from treatment as manifested by evidence of
behavior that indicates all of the following:
(a) The person is unlikely to survive safely in the community
without supervision, based on a clinical determination.
(b) The person has a history of lack of compliance with treatment
for mental illness and one of the following applies:
(i) At least twice within the thirty-six months prior to the
filing of an affidavit seeking court-ordered treatment of the
person under section 5122.111 of the Revised Code, the lack of
compliance has been a significant factor in necessitating
hospitalization in a hospital or receipt of services in a forensic
or other mental health unit of a correctional facility, provided
that the thirty-six-month period shall be extended by the length
of any hospitalization or incarceration of the person that
occurred within the thirty-six-month period.
(ii) Within the forty-eight months prior to the filing of an
affidavit seeking court-ordered treatment of the person under
section 5122.111 of the Revised Code, the lack of compliance
resulted in one or more acts of serious violent behavior toward
self or others or threats of, or attempts at, serious physical
harm to self or others, provided that the forty-eight-month period
shall be extended by the length of any hospitalization or
incarceration of the person that occurred within the
forty-eight-month period.
(c) The person, as a result of mental illness, is unlikely to
voluntarily participate in necessary treatment.
(d) In view of the person's treatment history and current
behavior, the person is in need of treatment in order to prevent a
relapse or deterioration that would be likely to result in
substantial risk of serious harm to the person or others.
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(Name of the party filing the affidavit) further says that the facts supporting this belief are as follows:
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These facts being sufficient to indicate probable cause that the
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above said person is a mentally ill person subject to
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court order.
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Name of Patient's Last Physician or Licensed Clinical Psychologist
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Address of Patient's Last Physician or Licensed Clinical Psychologist
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The name and address of respondent's legal guardian, spouse, and
adult next of kin are:
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Adult Next of Kin |
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The following constitutes additional information that may be
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necessary for the purpose of determining residence:
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Dated this ............. day of ..............., 20...
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Signature of the party filing the affidavit |
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Sworn to before me and signed in my presence on the day and year
above dated.
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Signature of Probate Judge |
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Signature of, Deputy Clerk, or Notary Public |
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WAIVER
I, the undersigned party filing the affidavit hereby waive the
issuing and service of notice of the hearing on said affidavit,
and voluntarily enter my appearance herein.
Dated this ............. day of ..............., 20...
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Signature of the party filing the affidavit |
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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, 2151.3515
2305.113, 2925.61, 3701.92, 3727.06, 3729.05, 4123.01, 4123.026,
4123.46, 4503.44, 4723.01, 4723.06, 4723.07, 4723.18, 4723.181,
4723.48, 4723.482, 4723.50, 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, 4730.19, 4730.21, 4730.22, 4730.25,
4730.251, 4730.27, 4730.28, 4730.31, 4730.32, 4730.33, 4730.38,
4730.39, 4730.41, 4730.42, 4730.43, 4730.431, 4730.49, 4730.51,
4730.53, 4731.07, 4761.01, 4761.17, 4765.01, 4765.51, 5122.11,
5122.111, and 5123.47 and sections
4730.081, 4730.09,
4730.15,
4730.16,
4730.17,
4730.18,
4730.20, 4730.44, 4730.45,
4730.46,
4730.47,
4730.48,
4730.50, and 4730.52 of the Revised Code are
hereby repealed.
Section 3. That the versions of sections 4730.25 and 4730.53
of the Revised Code that are scheduled to take effect April 1,
2015, be amended to read as follows:
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 prescriber number,
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,
including, if applicable, 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;
(25) Failure to comply with section 4730.53 of the Revised
Code, unless the board no longer maintains a drug database
pursuant to section 4729.75 of the Revised Code;
(25)(26) Failure to comply with the requirements in section
3719.061 of the Revised Code before issuing to for a minor a
prescription for a controlled substance containing an opioid;
(27) Having certification by the national commission on
certification of physician assistants or a successor organization
expire, lapse, or be suspended or revoked.
(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
authority to 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. 4730.53. (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) Except as provided in divisions (C) and (E) of this
section, a physician assistant holding a certificate to prescribe
issued licensed under this chapter who has been granted
physician-delegated prescriptive authority shall comply with all
of the following as conditions of prescribing a drug that is
either an opioid analgesic or a benzodiazepine as part of a
patient's course of treatment for a particular condition:
(1) Before initially prescribing the drug, the physician
assistant or the physician assistant's delegate shall request from
the drug database a report of information related to the patient
that covers at least the twelve months immediately preceding the
date of the request. If the physician assistant practices
primarily in a county of this state that adjoins another state,
the physician assistant or delegate also shall request a report of
any information available in the drug database that pertains to
prescriptions issued or drugs furnished to the patient in the
state adjoining that county.
(2) If the patient's course of treatment for the condition
continues for more than ninety days after the initial report is
requested, the physician assistant or delegate shall make periodic
requests for reports of information from the drug database until
the course of treatment has ended. The requests shall be made at
intervals not exceeding ninety days, determined according to the
date the initial request was made. The request shall be made in
the same manner provided in division (B)(1) of this section for
requesting the initial report of information from the drug
database.
(3) On receipt of a report under division (B)(1) or (2) of
this section, the physician assistant shall assess the information
in the report. The physician assistant shall document in the
patient's record that the report was received and the information
was assessed.
(C) Division (B) of this section does not apply in any of the
following circumstances:
(1) A drug database report regarding the patient is not
available, in which case the physician assistant shall document in
the patient's record the reason that the report is not available.
(2) The drug is prescribed in an amount indicated for a
period not to exceed seven days.
(3) The drug is prescribed for the treatment of cancer or
another condition associated with cancer.
(4) The drug is prescribed to a hospice patient in a hospice
care program, as those terms are defined in section 3712.01 of the
Revised Code, or any other patient diagnosed as terminally ill.
(5) The drug is prescribed for administration in a hospital,
nursing home, or residential care facility.
(D) With respect to prescribing any drug that is not an
opioid analgesic or a benzodiazepine but is included in the drug
database pursuant to rules adopted under section 4729.84 of the
Revised Code, the state medical board shall adopt rules that
establish standards and procedures to be followed by a physician
assistant who holds a certificate to prescribe issued licensed
under this chapter who has been granted physician-delegated
prescriptive authority regarding the review of patient information
available through the drug database under division (A)(5) of
section 4729.80 of the Revised Code. The rules shall be adopted in
accordance with Chapter 119. of the Revised Code.
(E) This section and the rules adopted under it do not apply
if the state board of pharmacy no longer maintains the drug
database.
Section 4. That the existing versions of sections 4730.25 and
4730.53 of the Revised Code that are scheduled to take effect
April 1, 2015, are hereby repealed.
Section 5. Sections 3 and 4 of this act shall take effect
April 1, 2015.
Section 6. (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 act. Thereafter, the Board shall
issue physician assistant licenses in compliance with this act.
(B) Certificates to practice and certificates to prescribe
issued pursuant to division (A) of this section or Chapter 4730.
of the Revised Code, as it existed immediately prior to the
effective date of this act, shall satisfy the requirements for
physician assistant 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 act.
Section 7. Section 4730.25 of the Revised Code is presented
in Section 4 of this act as a composite of the section as amended
by Sub. H.B. 314, Am. Sub. H.B. 341, and Am. Sub. H.B. 483, all of
the 130th General Assembly. The General Assembly, applying the
principle stated in division (B) of section 1.52 of the Revised
Code that amendments are to be harmonized if reasonably capable of
simultaneous operation, finds that the composite is the resulting
version of the section in effect prior to the effective date of
the section as presented in this act.
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