HB 567

As Reported by the House Health Committee
136th General Assembly
   Regular Session  Sub. H. B. No. 567
       2025-2026
  Representative Deeter
  Cosponsor: Representative Schmidt
  To amend sections 109.71, 3129.01, 3313.5310,  1
  3333.28, 3701.69, 3701.92, 3701.921, 3705.01,  2
  3705.30, 3707.58, 3721.011, 3728.01, 4503.44,  3
  4723.01, 4723.063, 4723.18, 4723.181, 4723.28,  4
  4723.34, 4723.35, 4723.36, 4723.43, 4723.431,  5
  4723.47, 4723.481, 4723.482, 4723.483, 4723.493,        6
  4723.52, 4723.66, 4723.67, 4723.69, 4731.297,  7
  and 5122.10 and to repeal sections 3701.923,  8
  3701.924, 3701.925, 3701.926, 3701.927, and  9
  3701.929 of the Revised Code to modify the laws  10
  governing a Board of Nursing advisory body for  11
  advanced practice registered nurses and to make  12
  various corrections in other laws pertaining to  13
  the Board and the professionals it regulates.  14
 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
     Section 1. That sections 109.71, 3129.01, 3313.5310,  15
3333.28, 3701.69, 3701.92, 3701.921, 3705.01, 3705.30, 3707.58,        16
3721.011, 3728.01, 4503.44, 4723.01, 4723.063, 4723.18,  17
4723.181, 4723.28, 4723.34, 4723.35, 4723.36, 4723.43, 4723.431,       18
4723.47, 4723.481, 4723.482, 4723.483, 4723.493, 4723.52,  19
4723.66, 4723.67, 4723.69, 4731.297, and 5122.10 of the Revised        20
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Code be amended to read as follows:  21
       Sec. 109.71. There is hereby created in the office of the  22
attorney general the Ohio peace officer training commission. The  23
commission shall consist of ten members appointed by the  24
governor with the advice and consent of the senate and selected  25
as follows: one member representing the public; one member who  26
represents a fraternal organization representing law enforcement  27
officers; two members who are incumbent sheriffs; two members  28
who are incumbent chiefs of police; one member from the bureau  29
of criminal identification and investigation; one member from  30
the state highway patrol; one member who is the special agent in  31
charge of a field office of the federal bureau of investigation  32
in this state; and one member from the department of education  33
and workforce, trade and industrial education services, law  34
enforcement training.  35
       This section does not confer any arrest authority or any  36
ability or authority to detain a person, write or issue any  37
citation, or provide any disposition alternative, as granted  38
under Chapter 2935. of the Revised Code.  39
       The commission is exempt from the requirements of sections  40
101.82 to 101.87 of the Revised Code.  41
       As used in sections 109.71 to 109.801 of the Revised Code:  42
       (A) "Peace officer" means:  43
       (1) A deputy sheriff, marshal, deputy marshal, member of  44
the organized police department of a township or municipal  45
corporation, member of a township police district or joint  46
police district police force, member of a police force employed  47
by a metropolitan housing authority under division (D) of  48
section 3735.31 of the Revised Code, or township constable, who  49
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is commissioned and employed as a peace officer by a political  50
subdivision of this state or by a metropolitan housing  51
authority, and whose primary duties are to preserve the peace,  52
to protect life and property, and to enforce the laws of this  53
state, ordinances of a municipal corporation, resolutions of a  54
township, or regulations of a board of county commissioners or  55
board of township trustees, or any of those laws, ordinances,  56
resolutions, or regulations;  57
       (2) A police officer who is employed by a railroad company  58
and appointed and commissioned by the secretary of state  59
pursuant to sections 4973.17 to 4973.22 of the Revised Code;  60
       (3) Employees of the department of taxation engaged in the  61
enforcement of Chapter 5743. of the Revised Code and designated  62
by the tax commissioner for peace officer training for purposes  63
of the delegation of investigation powers under section 5743.45  64
of the Revised Code;  65
       (4) An undercover drug agent;  66
       (5) Enforcement agents of the department of public safety  67
whom the director of public safety designates under section  68
5502.14 of the Revised Code;  69
       (6) An employee of the department of natural resources who  70
is a natural resources law enforcement staff officer designated  71
pursuant to section 1501.013, a natural resources officer  72
appointed pursuant to section 1501.24, a forest-fire  73
investigator appointed pursuant to section 1503.09, or a  74
wildlife officer designated pursuant to section 1531.13 of the  75
Revised Code;  76
       (7) An employee of a park district who is designated  77
pursuant to section 511.232 or 1545.13 of the Revised Code;  78
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       (8) An employee of a conservancy district who is  79
designated pursuant to section 6101.75 of the Revised Code;  80
       (9) A police officer who is employed by a hospital that  81
employs and maintains its own proprietary police department or  82
security department, and who is appointed and commissioned by  83
the secretary of state pursuant to sections 4973.17 to 4973.22  84
of the Revised Code;  85
       (10) Veterans' homes police officers designated under  86
section 5907.02 of the Revised Code;  87
       (11) A police officer who is employed by a qualified  88
nonprofit corporation police department pursuant to section  89
1702.80 of the Revised Code;  90
       (12) A state university law enforcement officer appointed  91
under section 3345.04 of the Revised Code or a person serving as  92
a state university law enforcement officer on a permanent basis  93
on June 19, 1978, who has been awarded a certificate by the  94
executive director of the Ohio peace officer training commission  95
attesting to the person's satisfactory completion of an approved  96
state, county, municipal, or department of natural resources  97
peace officer basic training program;  98
       (13) A special police officer employed by the department  99
of mental behavioral health and addiction services pursuant to  100
section 5119.08 of the Revised Code or the department of  101
developmental disabilities pursuant to section 5123.13 of the  102
Revised Code;  103
       (14) A member of a campus police department appointed  104
under section 1713.50 of the Revised Code;  105
       (15) A member of a police force employed by a regional  106
transit authority under division (Y) of section 306.35 of the  107
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Revised Code;  108
       (16) Investigators appointed by the auditor of state  109
pursuant to section 117.091 of the Revised Code and engaged in  110
the enforcement of Chapter 117. of the Revised Code;  111
       (17) A special police officer designated by the  112
superintendent of the state highway patrol pursuant to section  113
5503.09 of the Revised Code or a person who was serving as a  114
special police officer pursuant to that section on a permanent  115
basis on October 21, 1997, and who has been awarded a  116
certificate by the executive director of the Ohio peace officer  117
training commission attesting to the person's satisfactory  118
completion of an approved state, county, municipal, or  119
department of natural resources peace officer basic training  120
program;  121
       (18) A special police officer employed by a port authority  122
under section 4582.04 or 4582.28 of the Revised Code or a person  123
serving as a special police officer employed by a port authority  124
on a permanent basis on May 17, 2000, who has been awarded a  125
certificate by the executive director of the Ohio peace officer  126
training commission attesting to the person's satisfactory  127
completion of an approved state, county, municipal, or  128
department of natural resources peace officer basic training  129
program;  130
       (19) A special police officer employed by a municipal  131
corporation who has been awarded a certificate by the executive  132
director of the Ohio peace officer training commission for  133
satisfactory completion of an approved peace officer basic  134
training program and who is employed on a permanent basis on or  135
after March 19, 2003, at a municipal airport, or other municipal  136
air navigation facility, that has scheduled operations, as  137
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defined in section 119.3 of Title 14 of the Code of Federal  138
Regulations, 14 C.F.R. 119.3, as amended, and that is required  139
to be under a security program and is governed by aviation  140
security rules of the transportation security administration of  141
the United States department of transportation as provided in  142
Parts 1542. and 1544. of Title 49 of the Code of Federal  143
Regulations, as amended;  144
       (20) A police officer who is employed by an owner or  145
operator of an amusement park that has an average yearly  146
attendance in excess of six hundred thousand guests and that  147
employs and maintains its own proprietary police department or  148
security department, and who is appointed and commissioned by a  149
judge of the appropriate municipal court or county court  150
pursuant to section 4973.17 of the Revised Code;  151
       (21) A police officer who is employed by a bank, savings  152
and loan association, savings bank, credit union, or association  153
of banks, savings and loan associations, savings banks, or  154
credit unions, who has been appointed and commissioned by the  155
secretary of state pursuant to sections 4973.17 to 4973.22 of  156
the Revised Code, and who has been awarded a certificate by the  157
executive director of the Ohio peace officer training commission  158
attesting to the person's satisfactory completion of a state,  159
county, municipal, or department of natural resources peace  160
officer basic training program;  161
       (22) An investigator, as defined in section 109.541 of the  162
Revised Code, of the bureau of criminal identification and  163
investigation who is commissioned by the superintendent of the  164
bureau as a special agent for the purpose of assisting law  165
enforcement officers or providing emergency assistance to peace  166
officers pursuant to authority granted under that section;  167
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       (23) A state fire marshal law enforcement officer  168
appointed under section 3737.22 of the Revised Code or a person  169
serving as a state fire marshal law enforcement officer on a  170
permanent basis on or after July 1, 1982, who has been awarded a  171
certificate by the executive director of the Ohio peace officer  172
training commission attesting to the person's satisfactory  173
completion of an approved state, county, municipal, or  174
department of natural resources peace officer basic training  175
program;  176
       (24) A gaming agent employed under section 3772.03 of the  177
Revised Code;  178
       (25) An employee of the state board of pharmacy designated  179
by the executive director of the board pursuant to section  180
4729.04 of the Revised Code to investigate violations of  181
Chapters 2925., 3715., 3719., 3796., 4729., and 4752. of the  182
Revised Code and rules adopted thereunder.  183
       (B) "Undercover drug agent" has the same meaning as in  184
division (B)(2) of section 109.79 of the Revised Code.  185
       (C) "Crisis intervention training" means training in the  186
use of interpersonal and communication skills to most  187
effectively and sensitively interview victims of rape.  188
       (D) "Missing children" has the same meaning as in section  189
2901.30 of the Revised Code.  190
       (E) "Tactical medical professional" means an EMT, EMT-  191
basic, AEMT, EMT-I, paramedic, nurse, or physician who is  192
trained and certified in a nationally recognized tactical  193
medical training program that is equivalent to "tactical combat  194
casualty care" (TCCC) and "tactical emergency medical support"  195
(TEMS) and who functions in the tactical or austere environment  196
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while attached to a law enforcement agency of either this state  197
or a political subdivision of this state.  198
       (F) "EMT-basic," "EMT-I," and "paramedic" have the same  199
meanings as in section 4765.01 of the Revised Code and "EMT" and  200
"AEMT" have the same meanings, respectively, as "EMT-basic" and  201
"EMT-I" in section 4765.01 and as recognized in section 4765.011  202
of the Revised Code, and "paramedic" has the same meaning as in  203
section 4765.01 of the Revised Code.  204
       (G) "Nurse" means any of the following:  205
       (1) Any person who is licensed to practice nursing as a  206
registered nurse by the board of nursing pursuant to Chapter  207
4723. of the Revised Code;  208
       (2) Any certified nurse practitioner, clinical nurse  209
specialist, certified registered nurse anesthetist, or certified  210
nurse-midwife who holds a certificate of authority issued by the  211
board of nursing under Chapter 4723. , as defined in section  212
4723.01 of the Revised Code;  213
       (3) Any person who is licensed to practice nursing as a  214
licensed practical nurse by the board of nursing pursuant to  215
Chapter 4723. of the Revised Code.  216
       (H) "Physician" means a person who is licensed pursuant to  217
Chapter 4731. of the Revised Code to practice medicine and  218
surgery or osteopathic medicine and surgery.  219
       (I) "County correctional officer" has the same meaning as  220
in section 341.41 of the Revised Code.  221
       (J)(1) "Fire investigator" means an employee of a fire  222
department charged with investigating fires and explosions who  223
has been authorized, in accordance with sections 737.27 and  224
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3737.24 of the Revised Code, to perform the duties of  225
investigating the origin and cause of fires and explosions using  226
the scientific method to investigate elements of the event  227
including the circumstances, actions, persons, means, and  228
motives that resulted in the fire or explosion or the report of  229
a fire or explosion within this state.  230
       (2) "Fire investigator" does not include a person who is  231
acting as a fire investigator on behalf of an insurance company  232
or any other privately owned or operated enterprise.  233
       (K) "Fire department" means a fire department of the state  234
or an instrumentality of the state or of a municipal  235
corporation, township, joint fire district, or other political  236
subdivision.  237
       (L) "At-risk youth" means an individual who is all of the  238
following:  239
       (1) Under twenty-one years of age;  240
       (2) One of the following:  241
       (a) At risk of becoming an abused, neglected, or dependent  242
child, delinquent or unruly child, or juvenile traffic offender;  243
       (b) An abused, neglected, or dependent child, delinquent  244
or unruly child, or juvenile traffic offender.  245
       (3) Residing in a state correctional institution, a  246
department of youth services institution, or a residential  247
facility.  248
       (M) "Residential facility" has the same meaning as in  249
section 2151.46 of the Revised Code.  250
       Sec. 3129.01. As used in this chapter:  251
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       (A) "Biological sex," "birth sex," and "sex" mean the  252
biological indication of male and female, including sex  253
chromosomes, naturally occurring sex hormones, gonads, and  254
nonambiguous internal and external genitalia present at birth,  255
without regard to an individual's psychological, chosen, or  256
subjective experience of gender.  257
       (B) "Cross-sex hormone" means testosterone, estrogen, or  258
progesterone given to a minor individual in an amount greater  259
than would normally be produced endogenously in a healthy  260
individual of the minor individual's age and sex.  261
       (C) "Gender reassignment surgery" means any surgery  262
performed for the purpose of assisting an individual with gender  263
transition that seeks to surgically alter or remove healthy  264
physical or anatomical characteristics or features that are  265
typical for the individual's biological sex, in order to instill  266
or create physiological or anatomical characteristics that  267
resemble a sex different from the individual's birth sex,  268
including genital or non-genital gender reassignment surgery.  269
       (D) "Gender-related condition" means any condition where  270
an individual feels an incongruence between the individual's  271
gender identity and biological sex. "Gender-related condition"  272
includes gender dysphoria.  273
       (E) "Gender transition" means the process in which an  274
individual goes from identifying with and living as a gender  275
that corresponds to his or her biological sex to identifying  276
with and living as a gender different from his or her biological  277
sex, including social, legal, or physical changes.  278
       (F) "Gender transition services" means any medical or  279
surgical service (including physician services, inpatient and  280
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outpatient hospital services, or prescription drugs or hormones)  281
provided for the purpose of assisting an individual with gender  282
transition that seeks to alter or remove physical or anatomical  283
characteristics or features that are typical for the  284
individual's biological sex, or to instill or create  285
physiological or anatomical characteristics that resemble a sex  286
different from the individual's birth sex, including medical  287
services that provide puberty blocking drugs, cross-sex  288
hormones, or other mechanisms to promote the development of  289
feminizing or masculinizing features in the opposite sex, or  290
genital or non-genital gender reassignment surgery.  291
       (G) "Genital gender reassignment surgery" means surgery  292
performed for the purpose of assisting an individual with gender  293
transition and includes both of the following:  294
       (1) Surgeries that sterilize, such as castration,  295
vasectomy, hysterectomy, oophorectomy, orchiectomy, and  296
penectomy;  297
       (2) Surgeries that artificially construct tissue with the  298
appearance of genitalia that differs from the individual's  299
biological sex, such as metoidiplasty, phalloplasty, and  300
vaginoplasty.  301
       (H) "Mental health professional" means all of the  302
following:  303
       (1) Either of the following advanced practice registered  304
nurses who holds a current, valid license issued under Chapter  305
4723. of the Revised Code that authorizes the practice of  306
nursing as an advanced practice registered nurse:  307
       (a) A clinical nurse specialist who is certified as a  308
psychiatric-mental health CNS, or the equivalent of such title,  309
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by the American nurses credentialing center;  310
       (b) A certified nurse practitioner who is certified as a  311
psychiatric-mental health NP, or the equivalent of such title,  312
by the American nurses credentialing center or American academy  313
of nurse practitioners certification board.  314
       (2) A physician specializing in psychiatry;  315
       (3) A psychologist, school psychologist, or independent  316
school psychologist licensed under Chapter 4732. of the Revised  317
Code or under rules adopted in accordance with sections 3301.07  318
and 3319.22 of the Revised Code;  319
       (4) An independent social worker, social worker, licensed  320
professional clinical counselor, licensed professional  321
counselor, independent marriage and family therapist, or  322
marriage and family therapist licensed under Chapter 4757. of  323
the Revised Code.  324
       (I) "Minor individual" means an individual under eighteen  325
years of age.  326
       (J) "Non-genital gender reassignment surgery" means  327
surgery performed for the purpose of assisting an individual  328
with gender transition such as augmentation mammoplasty, facial  329
feminization surgery, liposuction, lipofilling, voice surgery,  330
thyroid cartilage reduction, gluteal augmentation, pectoral  331
implants, or other aesthetic procedures.  332
       (K) "Physician" means an individual authorized under  333
Chapter 4731. of the Revised Code to practice medicine and  334
surgery or osteopathic medicine and surgery.  335
       (L) "Puberty-blocking drugs" means Gonadotropin-releasing  336
hormone analogs or other synthetic drugs used to stop  337
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luteinizing hormone and follicle stimulating hormone secretion,  338
synthetic antiandrogen drugs used to block the androgen  339
receptor, or any drug to delay or suppress normal puberty.  340
       Sec. 3313.5310. (A)(1) This section applies to both of the  341
following:  342
       (a) Any school operated by a school district board of  343
education;  344
       (b) Any chartered or nonchartered nonpublic school that is  345
subject to the rules of an interscholastic conference or an  346
organization that regulates interscholastic conferences or  347
events.  348
       (2) As used in this section, "athletic activity" means all  349
of the following:  350
       (a) Interscholastic athletics;  351
       (b) An athletic contest or competition that is sponsored  352
by or associated with a school that is subject to this section,  353
including cheerleading, club-sponsored sports activities, and  354
sports activities sponsored by school-affiliated organizations;  355
       (c) Noncompetitive cheerleading that is sponsored by  356
school-affiliated organizations;  357
       (d) Practices, interschool practices, and scrimmages for  358
all of the activities described in divisions (A)(2)(a), (b), and  359
(c) of this section.  360
       (B) Prior to the start of each athletic season, a school  361
that is subject to this section shall hold an informational  362
meeting for students, parents, guardians, other persons having  363
care or charge of a student, physicians, pediatric  364
cardiologists, athletic trainers, and any other persons  365
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regarding the symptoms and warning signs of sudden cardiac  366
arrest for all ages of students.  367
       (C) No student shall participate in an athletic activity  368
until the student has submitted to a designated school official  369
a form signed by the student and the parent, guardian, or other  370
person having care or charge of the student stating that the  371
student and the parent, guardian, or other person having care or  372
charge of the student have received and reviewed a copy of the  373
information jointly developed by the department of health and  374
the department of education and workforce and posted on their  375
respective web sites as required by section 3707.59 of the  376
Revised Code. A completed form shall be submitted each school  377
year, as defined in section 3313.62 of the Revised Code, in  378
which the student participates in an athletic activity.  379
       (D) No individual, including coaches and assistant  380
coaches, shall coach an athletic activity unless the individual  381
has completed the sudden cardiac arrest training course approved  382
by the department of health under division (C) of section  383
3707.59 of the Revised Code in accordance with section 3319.303  384
of the Revised Code.  385
       (E)(1) A student shall not be allowed to participate in an  386
athletic activity if either of the following is the case:  387
       (a) The student's biological parent, biological sibling,  388
or biological child has previously experienced sudden cardiac  389
arrest, and the student has not been evaluated and cleared for  390
participation in an athletic activity by a physician authorized  391
under Chapter 4731. of the Revised Code to practice medicine and  392
surgery or osteopathic medicine and surgery.  393
       (b) The student is known to have exhibited syncope or  394
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fainting at any time prior to or following an athletic activity  395
and has not been evaluated and cleared for return under division  396
(E)(3) of this section after exhibiting syncope or fainting.  397
       (2) A student shall be removed by the student's coach from  398
participation in an athletic activity if the student exhibits  399
syncope or fainting.  400
       (3) If a student is not allowed to participate in or is  401
removed from participation in an athletic activity under  402
division (E)(1) or (2) of this section, the student shall not be  403
allowed to return to participation until the student is  404
evaluated and cleared for return in writing by any of the  405
following:  406
       (a) A physician authorized under Chapter 4731. of the  407
Revised Code to practice medicine and surgery or osteopathic  408
medicine and surgery, including a physician who specializes in  409
cardiology;  410
       (b) A certified nurse practitioner, clinical nurse  411
specialist, or certified nurse-midwife who holds a certificate  412
of authority issued under Chapter 4723., as defined in section  413
4723.01 of the Revised Code;  414
       (c) A physician assistant licensed under Chapter 4730. of  415
the Revised Code;  416
       (d) An athletic trainer licensed under Chapter 4755. of  417
the Revised Code.  418
       The licensed health care providers specified in divisions  419
(E)(3)(a) to (d) of this section may consult with any other  420
licensed or certified health care providers in order to  421
determine whether a student is ready to return to participation.  422
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       (F) A school that is subject to this section shall  423
establish penalties for a coach who violates the provisions of  424
division (E) of this section.  425
       (G) Nothing in this section shall be construed to abridge  426
or limit any rights provided under a collective bargaining  427
agreement entered into under Chapter 4117. of the Revised Code  428
prior to March 14, 2017.  429
       (H)(1) A school district, member of a school district  430
board of education, or school district employee or volunteer,  431
including a coach, is not liable in damages in a civil action  432
for injury, death, or loss to person or property allegedly  433
arising from providing services or performing duties under this  434
section, unless the act or omission constitutes willful or  435
wanton misconduct.  436
       This section does not eliminate, limit, or reduce any  437
other immunity or defense that a school district, member of a  438
school district board of education, or school district employee  439
or volunteer, including a coach, may be entitled to under  440
Chapter 2744. or any other provision of the Revised Code or  441
under the common law of this state.  442
       (2) A chartered or nonchartered nonpublic school or any  443
officer, director, employee, or volunteer of the school,  444
including a coach, is not liable in damages in a civil action  445
for injury, death, or loss to person or property allegedly  446
arising from providing services or performing duties under this  447
section, unless the act or omission constitutes willful or  448
wanton misconduct.  449
       Sec. 3333.28. (A) The chancellor of higher education shall  450
establish the nurse education assistance program, the purpose of  451
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which shall be to make loans to students enrolled in  452
prelicensure nurse nursing education programs at institutions  453
approved by the board of nursing under section 4723.06 of the  454
Revised Code and postlicensure nurse nursing education programs  455
approved by the chancellor under section 3333.04 of the Revised  456
Code or offered by an institution holding a certificate of  457
authorization issued under Chapter 1713. of the Revised Code.  458
The  459
       The chancellor shall determine the manner in which to  460
distribute loans under the program. The board of nursing shall  461
assist the chancellor in administering the program.  462
       (B) There is hereby created in the state treasury the  463
nurse education assistance fund, which shall consist of all  464
money transferred to it pursuant to section 4743.05 of the  465
Revised Code. The fund shall be used by the chancellor for loans  466
made under division (A) of this section and for expenses of  467
administering the loan program.  468
       (C) Between July 1, 2005, and January 1, 2012, the  469
chancellor shall distribute money in the nurse education  470
assistance fund in the following manner:  471
       (1)(a) Fifty per cent of available funds shall be awarded  472
as loans to registered nurses enrolled in postlicensure nurse  473
education programs described in division (A) of this section. To  474
be eligible for a loan, the applicant shall provide the  475
chancellor with a letter of intent to practice as a faculty  476
member at a prelicensure or postlicensure program for nursing in  477
this state upon completion of the applicant's academic program.  478
       (b) If the borrower of a loan under division (C)(1)(a) of  479
this section secures employment as a faculty member of an  480
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approved nursing education program in this state within six  481
months following graduation from an approved nurse education  482
program, the chancellor may forgive the principal and interest  483
of the student's loans received under division (C)(1)(a) of this  484
section at a rate of twenty-five per cent per year, for a  485
maximum of four years, for each year in which the borrower is so  486
employed. A deferment of the service obligation, and other  487
conditions regarding the forgiveness of loans may be granted as  488
provided by the rules adopted under division (D)(7) of this  489
section.  490
       (c) Loans awarded under division (C)(1)(a) of this section  491
shall be awarded on the basis of the student's expected family  492
contribution, with preference given to those applicants with the  493
lowest expected family contribution. However, the chancellor may  494
consider other factors the chancellor determines relevant in  495
ranking the applications.  496
       (d) Each loan awarded to a student under division (C)(1)  497
(a) of this section shall be not less than five thousand dollars  498
per year.  499
       (2) Twenty-five per cent of available funds shall be  500
awarded to students enrolled in prelicensure nurse education  501
programs for registered nurses, as defined in section 4723.01 of  502
the Revised Code.  503
       (3) Twenty-five per cent of available funds shall be  504
awarded to students enrolled in nurse education programs as  505
determined by the chancellor, with preference given to programs  506
aimed at increasing enrollment in an area of need.  507
       After January 1, 2012, the chancellor shall determine the  508
manner in which to distribute loans under this section.  509
Sub. H. B. No. 567  Page 19
As Reported by the House Health Committee
       (D) Subject to the requirements specified in division (C)  510
of this section, the The chancellor shall adopt rules in  511
accordance with Chapter 119. of the Revised Code establishing:  512
       (1) Eligibility criteria for receipt of a loan;  513
       (2) Loan application procedures;  514
       (3) The amounts in which loans may be made and the total  515
amount that may be loaned to an individual;  516
       (4) The total amount of loans that can be made each year;  517
       (5) The percentage of the money in the fund that must  518
remain in the fund at all times as a fund balance;  519
       (6) Interest and principal repayment schedules;  520
       (7) Conditions under which a portion of principal and  521
interest obligations incurred by an individual under the program  522
will be forgiven;  523
       (8) Conditions under which all or a portion of the  524
principal and interest obligations incurred by an individual who  525
is deployed on active duty outside of the state or who is the  526
spouse of a person deployed on active duty outside of the state  527
may be deferred or forgiven. ;  528
       (9) Ways that the program may be used to encourage  529
individuals who are members of minority groups to enter the  530
nursing profession;  531
       (10) Any other matters incidental to the operation of the  532
program.  533
       (E)(D)(1) The obligation to repay a portion of the  534
principal and interest on a loan made under this section shall  535
be forgiven if the recipient of the loan meets the criteria  536
Sub. H. B. No. 567  Page 20
As Reported by the House Health Committee
conditions for forgiveness established by division (C)(1)(b) of  537
this section, in the case of loans awarded under division (C)(1)  538
(a) of this section, or by the chancellor under the rule adopted  539
under division (D)(7)(C)(7) of this section, in the case of  540
other loans awarded under this section.  541
       (F)(2) The obligation to repay all or a portion of the  542
principal and interest on a loan made under this section may be  543
deferred or forgiven if the recipient of the loan meets the  544
criteria conditions for deferment or forgiveness established by  545
the chancellor under the rule adopted under division (D)(8)(C)  546
(8) of this section.  547
       (G)(E) The receipt of a loan under this section shall not  548
affect a student's eligibility for assistance, or the amount of  549
that assistance, granted under section 3333.122, 3333.22,  550
3333.26, 5910.03, 5910.032, or 5919.34 of the Revised Code, but  551
the rules of the chancellor may provide for taking assistance  552
received under those sections into consideration when  553
determining a student's eligibility for a loan under this  554
section.  555
       (H)(F) As used in this section, "active duty" means active  556
duty pursuant to an executive order of the president of the  557
United States, an act of the congress of the United States, or  558
section 5919.29 or 5923.21 of the Revised Code.  559
       Sec. 3701.69. (A)(1) The department of health shall create  560
a Down syndrome information sheet that includes all of the  561
following:  562
       (a) A description of Down syndrome, including its causes,  563
effects on development, and potential complications;  564
       (b) Diagnostic tests;  565
Sub. H. B. No. 567  Page 21
As Reported by the House Health Committee
       (c) Options for treatment and therapy;  566
       (d) Contact information for local, state, and national  567
organizations that provide Down syndrome educational and support  568
services and programs.  569
       (2) With respect to the medical information included in  570
the information sheet, the department shall include only  571
information that is current and based on medical evidence.  572
       (3) The department shall periodically review and update  573
the information sheet and shall make it available on the  574
department's internet web site.  575
       (B) If a patient under the care of any of the following  576
health care professionals or facilities receives either a test  577
result indicating Down syndrome or a prenatal or postnatal  578
diagnosis of Down syndrome, the health care professional or  579
facility shall provide to the patient or the patient's  580
representative a copy of the information sheet created under  581
division (A) of this section:  582
       (1) A physician authorized under Chapter 4731. of the  583
Revised Code to practice medicine and surgery or osteopathic  584
medicine and surgery;  585
       (2) A certified nurse-midwife who holds a certificate of  586
authority issued under Chapter 4723., as defined in section  587
4723.01 of the Revised Code;  588
       (3) A genetic counselor licensed under Chapter 4778. of  589
the Revised Code;  590
       (4) A hospital licensed under Chapter 3722. of the Revised  591
Code that operates a maternity unit or newborn care nursery;  592
       (5) A maternity home licensed under Chapter 3711. of the  593
Sub. H. B. No. 567  Page 22
As Reported by the House Health Committee
Revised Code;  594
       (6) A freestanding birthing center licensed under section  595
3702.30 of the Revised Code.  596
       Sec. 3701.92. As used in sections 3701.921 to 3701.929  597
3701.928 of the Revised Code:  598
       (A) "Advanced practice registered nurse" has the same  599
meaning as in section 4723.01 of the Revised Code.  600
       (B) "Patient centered medical home education advisory  601
group" means the entity established under section 3701.924 of  602
the Revised Code.  603
       (C) "Patient centered medical home education program"  604
means the program established under section 3701.921 of the  605
Revised Code and any pilot projects operated pursuant to that  606
section.  607
       (D) "Patient centered medical home education pilot  608
project" means the pilot project established under section  609
3701.923 of the Revised Code.  610
       (E)(C) "Physician assistant" means a person who is  611
licensed as a physician assistant under Chapter 4730. of the  612
Revised Code.  613
       Sec. 3701.921. There is hereby established the patient  614
centered medical home education program in the department of  615
health. For the purpose of advancing education in the patient  616
centered medical home model of care, the director of health may  617
implement and administer the program pursuant to sections  618
3701.922 to 3701.929 3701.928 of the Revised Code. The patient  619
centered medical home model of care is an enhanced model of  620
primary care in which care teams attend to the multifaceted  621
Sub. H. B. No. 567  Page 23
As Reported by the House Health Committee
needs of patients, providing whole person comprehensive and  622
coordinate patient centered care.  623
       To the extent that funds are available, the program shall  624
include the patient centered medical home education pilot  625
project and may include any other projects the director  626
establishes pursuant to division (A)(3) of section 3701.922 of  627
the Revised Code.  628
       Sec. 3705.01. As used in this chapter:  629
       (A) "Live birth" means the complete expulsion or  630
extraction from its mother of a product of human conception that  631
after such expulsion or extraction breathes or shows any other  632
evidence of life such as beating of the heart, pulsation of the  633
umbilical cord, or definite movement of voluntary muscles,  634
whether or not the umbilical cord has been cut or the placenta  635
is attached.  636
       (B)(1) "Fetal death" means death prior to the complete  637
expulsion or extraction from its mother of a product of human  638
conception, irrespective of the duration of pregnancy, which  639
after such expulsion or extraction does not breathe or show any  640
other evidence of life such as beating of the heart, pulsation  641
of the umbilical cord, or definite movement of voluntary  642
muscles.  643
       (2) "Stillborn" means that an infant of at least twenty  644
weeks of gestation suffered a fetal death.  645
       (C) "Dead body" means a human body or part of a human body  646
from the condition of which it reasonably may be concluded that  647
death recently occurred.  648
       (D) "Physician" means a person licensed pursuant to  649
Chapter 4731. of the Revised Code to practice medicine or  650
Sub. H. B. No. 567  Page 24
As Reported by the House Health Committee
surgery or osteopathic medicine and surgery.  651
        (E) "Attending physician," when used in the context of the  652
death of a patient, means the physician in charge of the  653
patient's care for the illness or condition that resulted in  654
death.  655
        (F) "Institution" means any establishment, public or  656
private, that provides medical, surgical, or diagnostic care or  657
treatment, or domiciliary care, to two or more unrelated  658
individuals, or to persons committed by law.  659
        (G) "Funeral director" has the meaning given in section  660
4717.01 of the Revised Code.  661
        (H) "State registrar" means the head of the office of  662
vital statistics in the department of health.  663
        (I) "Medical certification" means completion of the  664
medical certification portion of the certificate of death or  665
fetal death as to the cause of death or fetal death.  666
        (J) "Final disposition" means the interment, cremation,  667
removal from the state, donation, or other authorized  668
disposition of a dead body or a fetal death.  669
        (K) "Interment" means the final disposition of the remains  670
of a dead body by burial or entombment.  671
        (L) "Cremation" means the reduction to ashes of a dead  672
body.  673
        (M) "Donation" means gift of a dead body to a research  674
institution or medical school.  675
        (N) "System of vital statistics" means the registration,  676
collection, preservation, amendment, and certification of vital  677
Sub. H. B. No. 567  Page 25
As Reported by the House Health Committee
records, the collection of other reports required by this  678
chapter, and activities related thereto.  679
       (O) "Vital records" means certificates or reports of  680
birth, death, fetal death, marriage, divorce, dissolution of  681
marriage, annulment, and data related thereto and other  682
documents maintained as required by statute.  683
       (P) "File" means the presentation of vital records for  684
registration by the office of vital statistics.  685
       (Q) "Registration" means the acceptance by the office of  686
vital statistics and the incorporation of vital records into its  687
official records.  688
       (R) "Birth record" means a birth certificate that has been  689
registered with the office of vital statistics; or, if  690
registered prior to March 16, 1989, with the division of vital  691
statistics; or, if registered prior to the establishment of the  692
division of vital statistics, with the department of health or a  693
local registrar.  694
       (S) "Certification of birth" means a document issued by  695
the director of health or state registrar or a local registrar  696
under division (B) of section 3705.23 of the Revised Code.  697
       (T) "Certified nurse-midwife," has "clinical nurse  698
specialist," and "certified nurse practitioner" have the same  699
meaning meanings as in section 4723.01 of the Revised Code.  700
       Sec. 3705.30. (A) As used in this section:  701
       (1) "Certified nurse-midwife," "clinical nurse  702
specialist," and "certified nurse practitioner" have the same  703
meanings as in section 4723.01 of the Revised Code.  704
       (2) "Freestanding birthing center" has the same meaning as  705
Sub. H. B. No. 567  Page 26
As Reported by the House Health Committee
in section 3701.503 of the Revised Code.  706
       (3)(2) "Hospital" has the same meaning as in section  707
3722.01 means an institution or facility licensed under Chapter  708
3722. of the Revised Code.  709
       (4) "Physician" means an individual authorized under  710
Chapter 4731. of the Revised Code to practice medicine and  711
surgery or osteopathic medicine and surgery.  712
       (B) The director of health shall establish and, if funds  713
for this purpose are available, implement a statewide birth  714
defects information system for the collection of information  715
concerning congenital anomalies, stillbirths, and abnormal  716
conditions of newborns.  717
       (C) If the system is implemented under division (B) of  718
this section, all of the following apply:  719
       (1) The director may require each physician, certified  720
nurse-midwife, clinical nurse specialist, certified nurse  721
practitioner, hospital, and freestanding birthing center to  722
report to the system information concerning all patients under  723
five years of age with a primary diagnosis of a congenital  724
anomaly or abnormal condition. The director shall not require a  725
hospital, freestanding birthing center, physician, certified  726
nurse-midwife, clinical nurse specialist, or certified nurse  727
practitioner to report to the system any information that is  728
reported to the director or department of health under another  729
provision of the Revised Code or Administrative Code.  730
       (2) On request, each physician, certified nurse-midwife,  731
clinical nurse specialist, certified nurse practitioner,  732
hospital, and freestanding birthing center shall give the  733
director or authorized employees of the department of health  734
Sub. H. B. No. 567  Page 27
As Reported by the House Health Committee
access to the medical records of any patient described in  735
division (C)(1) of this section. The department shall pay the  736
costs of copying any medical records pursuant to this division.  737
       (3) The director may review vital statistics records and  738
shall consider expanding the list of congenital anomalies and  739
abnormal conditions of newborns reported on birth certificates  740
pursuant to section 3705.08 of the Revised Code.  741
       (D) A physician, certified nurse-midwife, clinical nurse  742
specialist, certified nurse practitioner, hospital, or  743
freestanding birthing center that provides information to the  744
system under division (C) of this section shall not be subject  745
to criminal or civil liability for providing the information.  746
       Sec. 3707.58. (A) As used in this section:  747
       (1) "Youth athlete" means an individual who wishes to  748
practice for or compete in athletic activities organized by a  749
youth sports organization;  750
       (2) "Youth sports organization" has the same meaning as in  751
section 3707.51 of the Revised Code.  752
       (B) Prior to the start of each athletic season, a youth  753
sports organization that is subject to this section shall hold  754
an informational meeting for youth athletes, parents, guardians,  755
other persons having care or charge of a youth athlete,  756
physicians, pediatric cardiologists, athletic trainers, and any  757
other persons regarding the symptoms and warning signs of sudden  758
cardiac arrest for all ages of youth athletes.  759
       (C) No youth athlete shall participate in an athletic  760
activity organized by a youth sports organization until the  761
youth athlete has submitted to a designated official of the  762
youth sports organization a form signed by the youth athlete and  763
Sub. H. B. No. 567  Page 28
As Reported by the House Health Committee
the parent, guardian, or other person having care or charge of  764
the youth athlete stating that the youth athlete and the parent,  765
guardian, or other person having care or charge of the youth  766
athlete have received and reviewed a copy of the information  767
developed by the department of health and the department of  768
education and workforce and posted on their respective internet  769
web sites as required by section 3707.59 of the Revised Code. A  770
completed form shall be submitted each calendar year to each  771
youth sports organization that organizes an athletic activity in  772
which the youth athlete participates.  773
       (D) No individual shall coach an athletic activity  774
organized by a youth sports organization unless the individual  775
has completed, on an annual basis, the sudden cardiac arrest  776
training course approved by the department of health under  777
division (C) of section 3707.59 of the Revised Code.  778
       (E)(1) A youth athlete shall not be allowed to participate  779
in an athletic activity organized by a youth sports organization  780
if either of the following is the case:  781
       (a) The youth athlete's biological parent, biological  782
sibling, or biological child has previously experienced sudden  783
cardiac arrest, and the youth athlete has not been evaluated and  784
cleared for participation in an athletic activity organized by a  785
youth sports organization by a physician authorized under  786
Chapter 4731. of the Revised Code to practice medicine and  787
surgery or osteopathic medicine and surgery.  788
       (b) The youth athlete is known to have exhibited syncope  789
or fainting at any time prior to or following an athletic  790
activity and has not been evaluated and cleared for return under  791
division (E)(3) of this section after exhibiting syncope or  792
fainting.  793
Sub. H. B. No. 567  Page 29
As Reported by the House Health Committee
       (2) A youth athlete shall be removed by the youth  794
athlete's coach from participation in an athletic activity  795
organized by a youth sports organization if the youth athlete  796
exhibits syncope or fainting.  797
       (3) If a youth athlete is not allowed to participate in or  798
is removed from participation in an athletic activity organized  799
by a youth sports organization under division (E)(1) or (2) of  800
this section, the youth athlete shall not be allowed to return  801
to participation until the youth athlete is evaluated and  802
cleared for return in writing by any of the following:  803
       (a) A physician authorized under Chapter 4731. of the  804
Revised Code to practice medicine and surgery or osteopathic  805
medicine and surgery, including a physician who specializes in  806
cardiology;  807
       (b) A certified nurse practitioner, clinical nurse  808
specialist, or certified nurse-midwife who holds a certificate  809
of authority issued under Chapter 4723., as defined in section  810
4723.01 of the Revised Code.  811
       The licensed health care providers specified in divisions  812
(E)(3)(a) and (b) of this section may consult with any other  813
licensed or certified health care providers in order to  814
determine whether a youth athlete is ready to return to  815
participation.  816
       (F) A youth sports organization that is subject to this  817
section shall establish penalties for a coach who violates the  818
provisions of division (E) of this section.  819
       (G)(1) A youth sports organization or official, employee,  820
or volunteer of a youth sports organization, including a coach,  821
is not liable in damages in a civil action for injury, death, or  822
Sub. H. B. No. 567  Page 30
As Reported by the House Health Committee
loss to person or property allegedly arising from providing  823
services or performing duties under this section, unless the act  824
or omission constitutes willful or wanton misconduct.  825
       (2) This section does not eliminate, limit, or reduce any  826
other immunity or defense that a public entity, public official,  827
or public employee may be entitled to under Chapter 2744. or any  828
other provision of the Revised Code or under the common law of  829
this state.  830
       Sec. 3721.011. (A) In addition to providing  831
accommodations, supervision, and personal care services to its  832
residents, a residential care facility may do the following:  833
       (1) Provide the following skilled nursing care to its  834
residents:  835
       (a) Supervision of special diets;  836
       (b) Application of dressings, in accordance with rules  837
adopted under section 3721.04 of the Revised Code;  838
       (c) Subject to division (B)(1) of this section,  839
administration of medication.  840
       (2) Subject to division (C) of this section, provide other  841
skilled nursing care on a part-time, intermittent basis for not  842
more than a total of one hundred twenty days in a twelve-month  843
period;  844
       (3) Provide skilled nursing care for more than one hundred  845
twenty days in a twelve-month period to a resident when the  846
requirements of division (D) of this section are met.  847
       A residential care facility may not admit or retain an  848
individual requiring skilled nursing care that is not authorized  849
by this section. A residential care facility may not provide  850
Sub. H. B. No. 567  Page 31
As Reported by the House Health Committee
skilled nursing care beyond the limits established by this  851
section.  852
       (B)(1) A residential care facility may admit or retain an  853
individual requiring medication, including biologicals, only if  854
the individual's personal physician, certified nurse-midwife if  855
authorized as described in section 4723.438 of the Revised Code,  856
clinical nurse specialist, or certified nurse practitioner has  857
determined in writing that the individual is capable of self-  858
administering the medication or the facility provides for the  859
medication to be administered to the individual by a home health  860
agency certified under Title XVIII of the "Social Security Act,"  861
79 Stat. 620 (1965), 42 U.S.C. 1395, as amended; a hospice care  862
program licensed under Chapter 3712. of the Revised Code; or a  863
member of the staff of the residential care facility who is  864
qualified to perform medication administration. Medication may  865
be administered in a residential care facility only by the  866
following persons authorized by law to administer medication:  867
       (a) A registered nurse licensed under Chapter 4723. of the  868
Revised Code, including a certified nurse-midwife, clinical  869
nurse specialist, or certified nurse practitioner;  870
       (b) A licensed practical nurse licensed under Chapter  871
4723. of the Revised Code who holds proof of successful  872
completion of a course in medication administration approved by  873
the board of nursing and who administers the medication only at  874
the direction of a registered nurse or a physician authorized  875
under Chapter 4731. of the Revised Code to practice medicine and  876
surgery or osteopathic medicine and surgery;  877
       (c) A medication aide certified under Chapter 4723. of the  878
Revised Code;  879
Sub. H. B. No. 567  Page 32
As Reported by the House Health Committee
       (d) A physician authorized under Chapter 4731. of the  880
Revised Code to practice medicine and surgery or osteopathic  881
medicine and surgery.  882
       (2) In assisting a resident with self-administration of  883
medication, any member of the staff of a residential care  884
facility may do the following:  885
       (a) Remind a resident when to take medication and watch to  886
ensure that the resident follows the directions on the  887
container;  888
       (b) Assist a resident by taking the medication from the  889
locked area where it is stored, in accordance with rules adopted  890
pursuant to section 3721.04 of the Revised Code, and handing it  891
to the resident. If the resident is physically unable to open  892
the container, a staff member may open the container for the  893
resident.  894
       (c) Assist a resident who is physically impaired but  895
mentally alert, such as a resident with arthritis, cerebral  896
palsy, or Parkinson's disease, in removing oral or topical  897
medication from containers and in consuming or applying the  898
medication, upon request by or with the consent of the resident.  899
If a resident is physically unable to place a dose of medicine  900
to the resident's mouth without spilling it, a staff member may  901
place the dose in a container and place the container to the  902
mouth of the resident.  903
       (C) Except as provided in division (D) of this section, a  904
residential care facility may admit or retain individuals who  905
require skilled nursing care beyond the supervision of special  906
diets, application of dressings, or administration of  907
medication, only if the care will be provided on a part-time,  908
Sub. H. B. No. 567  Page 33
As Reported by the House Health Committee
intermittent basis for not more than a total of one hundred  909
twenty days in any twelve-month period. In accordance with  910
Chapter 119. of the Revised Code, the director of health shall  911
adopt rules specifying what constitutes the need for skilled  912
nursing care on a part-time, intermittent basis. The director  913
shall adopt rules that are consistent with rules pertaining to  914
home health care adopted by the medicaid director for the  915
medicaid program. Skilled nursing care provided pursuant to this  916
division may be provided by a home health agency certified for  917
participation in the medicare program, a hospice care program  918
licensed under Chapter 3712. of the Revised Code, or a member of  919
the staff of a residential care facility who is qualified to  920
perform skilled nursing care.  921
       A residential care facility that provides skilled nursing  922
care pursuant to this division shall do both of the following:  923
       (1) Evaluate each resident receiving the skilled nursing  924
care at least once every seven days to determine whether the  925
resident should be transferred to a nursing home;  926
       (2) Meet the skilled nursing care needs of each resident  927
receiving the care.  928
       (D)(1) A residential care facility may admit or retain an  929
individual who requires skilled nursing care for more than one  930
hundred twenty days in any twelve-month period only if the  931
facility has entered into a written agreement with each of the  932
following:  933
       (a) The individual or individual's sponsor;  934
       (b) The individual's personal physician, certified nurse-  935
midwife if authorized as described in section 4723.438 of the  936
Revised Code, clinical nurse specialist, or certified nurse  937
Sub. H. B. No. 567  Page 34
As Reported by the House Health Committee
practitioner;  938
       (c) Unless the individual's personal physician, certified  939
nurse-midwife, clinical nurse specialist, or certified nurse  940
practitioner oversees the skilled nursing care, the provider of  941
the skilled nursing care;  942
       (d) If the individual is a hospice patient as defined in  943
section 3712.01 of the Revised Code, a hospice care program  944
licensed under Chapter 3712. of the Revised Code.  945
       (2) The agreement required by division (D)(1) of this  946
section shall include all of the following provisions:  947
       (a) That the individual will be provided skilled nursing  948
care in the facility only if a determination has been made that  949
the individual's needs can be met at the facility;  950
       (b) That the individual will be retained in the facility  951
only if periodic redeterminations are made that the individual's  952
needs are being met at the facility;  953
       (c) That the redeterminations will be made according to a  954
schedule specified in the agreement;  955
       (d) If the individual is a hospice patient, that the  956
individual has been given an opportunity to choose the hospice  957
care program that best meets the individual's needs;  958
       (e) Unless the individual is a hospice patient, that the  959
individual's personal physician, certified nurse-midwife,  960
clinical nurse specialist, or certified nurse practitioner has  961
determined that the skilled nursing care the individual needs is  962
routine.  963
       (E) Notwithstanding any other provision of this chapter, a  964
residential care facility in which residents receive skilled  965
Sub. H. B. No. 567  Page 35
As Reported by the House Health Committee
nursing care pursuant to this section is not a nursing home.  966
        Sec. 3728.01. As used in this chapter:  967
        (A) "Administer epinephrine" means to inject an individual  968
with epinephrine using an autoinjector in a manufactured dosage  969
form.  970
        (B) "Peace officer" has the same meaning as in section  971
109.71 of the Revised Code and also includes a sheriff.  972
        (C) "Prescriber" means an individual who is authorized by  973
law to prescribe drugs or dangerous drugs or drug therapy  974
related devices in the course of the individual's professional  975
practice, including only the following:  976
        (1) A clinical nurse specialist, certified nurse-midwife,  977
or certified nurse practitioner who holds a certificate to  978
prescribe issued under section 4723.48 of the Revised Code;  979
        (2) A physician authorized under Chapter 4731. of the  980
Revised Code to practice medicine and surgery, osteopathic  981
medicine and surgery, or podiatric medicine and surgery;  982
        (3) A physician assistant who is licensed under Chapter  983
4730. of the Revised Code, holds a valid prescriber number  984
issued by the state medical board, and has been granted  985
physician-delegated prescriptive authority.  986
        (D) "Qualified entity" means either of the following:  987
        (1) Any public or private entity that is associated with a  988
location where allergens capable of causing anaphylaxis may be  989
present, including child care centers, colleges and  990
universities, places of employment, restaurants, amusement  991
parks, recreation camps, sports playing fields and arenas, and  992
other similar locations, except that "qualified entity" does not  993
Sub. H. B. No. 567  Page 36
As Reported by the House Health Committee
include either of the following:  994
       (a) A chartered or nonchartered nonpublic school;  995
community school; science, technology, engineering, and  996
mathematics school; college-preparatory boarding school; or a  997
school operated by the board of education of a city, local,  998
exempted village, or joint vocational school district, as those  999
entities are otherwise authorized to procure epinephrine  1000
autoinjectors pursuant to sections 3313.7110, 3313.7111,  1001
3314.143, 3326.28, or 3328.29 of the Revised Code;  1002
       (b) A camp described in section 5180.26 of the Revised  1003
Code that is authorized to procure epinephrine autoinjectors  1004
pursuant to that section;  1005
       (2) Either of the following served by a peace officer: a  1006
law enforcement agency or other entity described in division (A)  1007
of section 109.71 of the Revised Code.  1008
       Sec. 4503.44. (A) As used in this section and in section  1009
4511.69 of the Revised Code:  1010
       (1) "Person with a disability that limits or impairs the  1011
ability to walk" means any person who, as determined by a health  1012
care provider, meets any of the following criteria:  1013
       (a) Cannot walk two hundred feet without stopping to rest;  1014
       (b) Cannot walk without the use of, or assistance from, a  1015
brace, cane, crutch, another person, prosthetic device,  1016
wheelchair, or other assistive device;  1017
       (c) Is restricted by a lung disease to such an extent that  1018
the person's forced (respiratory) expiratory volume for one  1019
second, when measured by spirometry, is less than one liter, or  1020
the arterial oxygen tension is less than sixty millimeters of  1021
Sub. H. B. No. 567  Page 37
As Reported by the House Health Committee
mercury on room air at rest;  1022
       (d) Uses portable oxygen;  1023
       (e) Has a cardiac condition to the extent that the  1024
person's functional limitations are classified in severity as  1025
class III or class IV according to standards set by the American  1026
heart association;  1027
       (f) Is severely limited in the ability to walk due to an  1028
arthritic, neurological, or orthopedic condition;  1029
       (g) Is blind, legally blind, or severely visually  1030
impaired.  1031
       (2) "Organization" means any private organization or  1032
corporation, or any governmental board, agency, department,  1033
division, or office, that, as part of its business or program,  1034
transports persons with disabilities that limit or impair the  1035
ability to walk on a regular basis in a motor vehicle that has  1036
not been altered for the purpose of providing it with accessible  1037
equipment for use by persons with disabilities. This definition  1038
does not apply to division (I) of this section.  1039
       (3) "Health care provider" means a physician, physician  1040
assistant, advanced practice registered nurse, optometrist, or  1041
chiropractor as defined in this section except that an  1042
optometrist shall only make determinations as to division (A)(1)  1043
(g) of this section.  1044
       (4) "Physician" means a person licensed to practice  1045
medicine or surgery or osteopathic medicine and surgery under  1046
Chapter 4731. of the Revised Code.  1047
       (5) "Chiropractor" means a person licensed to practice  1048
chiropractic under Chapter 4734. of the Revised Code.  1049
Sub. H. B. No. 567  Page 38
As Reported by the House Health Committee
        (6) "Advanced practice registered nurse" means a certified  1050
nurse practitioner, clinical nurse specialist, certified  1051
registered nurse anesthetist, or certified nurse-midwife who  1052
holds a certificate of authority issued by the board of nursing  1053
under Chapter 4723. has the same meaning as in section 4723.01  1054
of the Revised Code.  1055
        (7) "Physician assistant" means a person who is licensed  1056
as a physician assistant under Chapter 4730. of the Revised  1057
Code.  1058
        (8) "Optometrist" means a person licensed to engage in the  1059
practice of optometry under Chapter 4725. of the Revised Code.  1060
        (9) "Removable windshield placard" includes a standard  1061
removable windshield placard, a temporary removable windshield  1062
placard, or a permanent removable windshield placard, unless  1063
otherwise specified.  1064
        (B)(1) An organization, or a person with a disability that  1065
limits or impairs the ability to walk, may apply for the  1066
registration of any motor vehicle the organization or person  1067
owns or leases. When an adaptive mobility vehicle is owned or  1068
leased by someone other than a person with a disability that  1069
limits or impairs the ability to walk, the owner or lessee may  1070
apply to the registrar of motor vehicles or a deputy registrar  1071
for registration under this section. The application for  1072
registration of a motor vehicle owned or leased by a person with  1073
a disability that limits or impairs the ability to walk shall be  1074
accompanied by a signed statement from the applicant's health  1075
care provider certifying that the applicant meets at least one  1076
of the criteria contained in division (A)(1) of this section and  1077
that the disability is expected to continue for more than six  1078
consecutive months. The application for registration of an  1079
Sub. H. B. No. 567  Page 39
As Reported by the House Health Committee
adaptive mobility vehicle that is owned by someone other than a  1080
person with a disability that limits or impairs the ability to  1081
walk shall be accompanied by such documentary evidence of  1082
vehicle specifications or alterations as the registrar may  1083
require by rule.  1084
       (2) When an organization, a person with a disability that  1085
limits or impairs the ability to walk, or a person who does not  1086
have a disability that limits or impairs the ability to walk but  1087
owns a motor vehicle that has been altered for the purpose of  1088
providing it with accessible equipment for a person with a  1089
disability that limits or impairs the ability to walk first  1090
submits an application for registration of a motor vehicle under  1091
this section and every fifth year thereafter, the organization  1092
or person shall submit a signed statement from the applicant's  1093
health care provider, a completed application, and any required  1094
documentary evidence of vehicle specifications or alterations as  1095
provided in division (B)(1) of this section, and also a power of  1096
attorney from the owner of the motor vehicle if the applicant  1097
leases the vehicle. Upon submission of these items, the  1098
registrar or deputy registrar shall issue to the applicant  1099
appropriate vehicle registration and a set of license plates and  1100
validation stickers, or validation stickers alone when required  1101
by section 4503.191 of the Revised Code. In addition to the  1102
letters and numbers ordinarily inscribed thereon, the license  1103
plates shall be imprinted with the international symbol of  1104
access. The license plates and validation stickers shall be  1105
issued upon payment of the regular license fee as prescribed  1106
under section 4503.04 of the Revised Code and any motor vehicle  1107
tax levied under Chapter 4504. of the Revised Code, and the  1108
payment of a service fee equal to the amount established under  1109
section 4503.038 of the Revised Code.  1110
Sub. H. B. No. 567  Page 40
As Reported by the House Health Committee
       (C)(1) A person with a disability that limits or impairs  1111
the ability to walk may apply to the registrar for a removable  1112
windshield placard by completing and signing an application  1113
provided by the registrar.  1114
       (2) The person shall include with the application a  1115
prescription from the person's health care provider prescribing  1116
such a placard for the person based upon a determination that  1117
the person meets at least one of the criteria contained in  1118
division (A)(1) of this section. The health care provider shall  1119
state on the prescription the length of time the health care  1120
provider expects the applicant to have the disability that  1121
limits or impairs the person's ability to walk. If the length of  1122
time the applicant is expected to have the disability is six  1123
consecutive months or less, the applicant shall submit an  1124
application for a temporary removable windshield placard. If the  1125
length of time the applicant is expected to have the disability  1126
is permanent, the applicant shall submit an application for a  1127
permanent removable windshield placard. All other applicants  1128
shall submit an application for a standard removable windshield  1129
placard.  1130
       (3) In addition to one placard or one or more sets of  1131
license plates, a person with a disability that limits or  1132
impairs the ability to walk is entitled to one additional  1133
placard, but only if the person applies separately for the  1134
additional placard, states the reasons why the additional  1135
placard is needed, and the registrar, in the registrar's  1136
discretion determines that good and justifiable cause exists to  1137
approve the request for the additional placard.  1138
       (4) An organization may apply to the registrar of motor  1139
vehicles for a standard removable windshield placard by  1140
Sub. H. B. No. 567  Page 41
As Reported by the House Health Committee
completing and signing an application provided by the registrar.  1141
The organization shall comply with any procedures the registrar  1142
establishes by rule. The organization shall include with the  1143
application documentary evidence that the registrar requires by  1144
rule showing that the organization regularly transports persons  1145
with disabilities that limit or impair the ability to walk.  1146
       (5) The registrar or deputy registrar shall issue to an  1147
applicant a standard removable windshield placard, a temporary  1148
removable windshield placard, or a permanent removable  1149
windshield placard, as applicable, upon receipt of all of the  1150
following:  1151
       (a) A completed and signed application for a removable  1152
windshield placard;  1153
       (b) The accompanying documents required under division (C)  1154
(2) or (4) of this section;  1155
       (c) Payment of a service fee equal to the amount  1156
established under section 4503.038 of the Revised Code for a  1157
standard removable windshield placard or a temporary removable  1158
windshield placard, or payment of fifteen dollars for a  1159
permanent removable windshield placard.  1160
       (6) The removable windshield placard shall display the  1161
date of expiration on both sides of the placard, or the word  1162
"permanent" if the placard is a permanent removable windshield  1163
placard, and shall be valid until expired, revoked, or  1164
surrendered. Except for a permanent removable windshield  1165
placard, which has no expiration, a removable windshield placard  1166
expires on the earliest of the following two dates:  1167
       (a) The date that the person issued the placard is  1168
expected to no longer have the disability that limits or impairs  1169
Sub. H. B. No. 567  Page 42
As Reported by the House Health Committee
the ability to walk, as indicated on the prescription submitted  1170
with the application for the placard;  1171
       (b) Ten years after the date of issuance on the placard.  1172
       In no case shall a removable windshield placard be valid  1173
for a period of less than sixty days.  1174
       (7) Standard removable windshield placards shall be  1175
renewable upon application and upon payment of a service fee  1176
equal to the amount established under section 4503.038 of the  1177
Revised Code. The registrar shall provide the application form  1178
and shall determine the information to be included thereon.  1179
       (8) The registrar shall determine the form and size of  1180
each type of the removable windshield placard, the material of  1181
which it is to be made, any differences in color between each  1182
type of placard to make them readily identifiable, and any other  1183
information to be included thereon, and shall adopt rules  1184
relating to the issuance, expiration, revocation, surrender, and  1185
proper display of such placards. A temporary removable  1186
windshield placard shall display the word "temporary" in letters  1187
of such size as the registrar shall prescribe. Any placard  1188
issued after October 14, 1999, shall be manufactured in a manner  1189
that allows the expiration date of the placard to be indicated  1190
on it through the punching, drilling, boring, or creation by any  1191
other means of holes in the placard.  1192
       (9) At the time a removable windshield placard is issued  1193
to a person with a disability that limits or impairs the ability  1194
to walk, the registrar or deputy registrar shall enter into the  1195
records of the bureau of motor vehicles the last date on which  1196
the person will have that disability, as indicated on the  1197
accompanying prescription. For a standard removable windshield  1198
Sub. H. B. No. 567  Page 43
As Reported by the House Health Committee
placard, not less than thirty days prior to that date and any  1199
renewal dates, the bureau shall send a renewal notice to that  1200
person at the person's last known address as shown in the  1201
records of the bureau, informing the person that the person's  1202
removable windshield placard will expire on the indicated date,  1203
and that the person is required to renew the placard by  1204
submitting to the registrar or a deputy registrar another  1205
prescription, and by complying with the renewal provisions. If  1206
such a prescription is not received by the registrar or a deputy  1207
registrar by that date, the placard issued to that person  1208
expires and no longer is valid, and this fact shall be recorded  1209
in the records of the bureau.  1210
       (10) At least once every year, on a date determined by the  1211
registrar, the bureau shall examine the records of the office of  1212
vital statistics, located within the department of health, that  1213
pertain to deceased persons, and also the bureau's records of  1214
all persons who have been issued removable windshield placards.  1215
If the records of the office of vital statistics indicate that a  1216
person to whom a removable windshield placard has been issued is  1217
deceased, the bureau shall cancel that placard, and note the  1218
cancellation in its records.  1219
       The office of vital statistics shall make available to the  1220
bureau all information necessary to enable the bureau to comply  1221
with division (C)(10) of this section.  1222
       (11) Nothing in this section shall be construed to require  1223
a person or organization to apply for a removable windshield  1224
placard or accessible license plates if the accessible license  1225
plates issued to the person or organization under prior law have  1226
not expired or been surrendered or revoked.  1227
       (D) Any active-duty member of the armed forces of the  1228
Sub. H. B. No. 567  Page 44
As Reported by the House Health Committee
United States, including the reserve components of the armed  1229
forces and the national guard, who has an illness or injury that  1230
limits or impairs the ability to walk may apply to the registrar  1231
or a deputy registrar for a temporary removable windshield  1232
placard. With the application, the person shall present evidence  1233
of the person's active-duty status and the illness or injury.  1234
Evidence of the illness or injury may include a current  1235
department of defense convalescent leave statement, any  1236
department of defense document indicating that the person  1237
currently has an ill or injured casualty status or has limited  1238
duties, or a prescription from any health care provider  1239
prescribing the placard for the applicant. Upon receipt of the  1240
application and the necessary evidence, the registrar or deputy  1241
registrar shall issue the applicant the temporary removable  1242
windshield placard without the payment of any service fee.  1243
       (E) If an applicant for a removable windshield placard is  1244
a veteran of the armed forces of the United States whose  1245
disability, as defined in division (A)(1) of this section, is  1246
service-connected, the registrar or deputy registrar, upon  1247
receipt of the application, presentation of a signed statement  1248
from the applicant's health care provider certifying the  1249
applicant's disability, and presentation of such documentary  1250
evidence from the department of veterans affairs that the  1251
disability of the applicant meets at least one of the criteria  1252
identified in division (A)(1) of this section and is service-  1253
connected as the registrar may require by rule, but without the  1254
payment of any service fee, shall issue the applicant a  1255
removable windshield placard that is valid until expired,  1256
surrendered, or revoked.  1257
       (F)(1) Upon a conviction of a violation of division (H) or  1258
(I) of this section, the court shall report the conviction, and  1259
Sub. H. B. No. 567  Page 45
As Reported by the House Health Committee
send the placard, if available, to the registrar, who thereupon  1260
shall revoke the privilege of using the placard and send notice  1261
in writing to the placardholder at that holder's last known  1262
address as shown in the records of the bureau, and the  1263
placardholder shall return the placard if not previously  1264
surrendered to the court, to the registrar within ten days  1265
following mailing of the notice.  1266
       (2) Whenever a person to whom a removable windshield  1267
placard has been issued moves to another state, the person shall  1268
surrender the placard to the registrar; and whenever an  1269
organization to which a placard has been issued changes its  1270
place of operation to another state, the organization shall  1271
surrender the placard to the registrar.  1272
       (3) If a person no longer requires a permanent removable  1273
windshield placard, the person shall notify and surrender the  1274
placard to the registrar or deputy registrar within ten days of  1275
no longer requiring the placard. The person may still apply for  1276
a standard removable windshield placard or temporary removable  1277
windshield placard, if applicable.  1278
       (G) Subject to division (F) of section 4511.69 of the  1279
Revised Code, the operator of a motor vehicle displaying a  1280
removable windshield placard or the accessible license plates  1281
authorized by this section is entitled to park the motor vehicle  1282
in any accessible parking location reserved for persons with  1283
disabilities that limit or impair the ability to walk.  1284
       (H) No person or organization that is not eligible for the  1285
issuance of license plates or any placard under this section  1286
shall willfully and falsely represent that the person or  1287
organization is so eligible.  1288
Sub. H. B. No. 567  Page 46
As Reported by the House Health Committee
       No person or organization shall display license plates  1289
issued under this section unless the license plates have been  1290
issued for the vehicle on which they are displayed and are  1291
valid.  1292
       (I) No person or organization to which a removable  1293
windshield placard is issued shall do either of the following:  1294
       (1) Display or permit the display of the placard on any  1295
motor vehicle when having reasonable cause to believe the motor  1296
vehicle is being used in connection with an activity that does  1297
not include providing transportation for persons with  1298
disabilities that limit or impair the ability to walk;  1299
       (2) Refuse to return or surrender the placard, when  1300
required.  1301
       (J) If a removable windshield placard or parking card is  1302
lost, destroyed, or mutilated, the placardholder or cardholder  1303
may obtain a duplicate by doing both of the following:  1304
       (1) Furnishing suitable proof of the loss, destruction, or  1305
mutilation to the registrar;  1306
       (2) Paying a service fee equal to the amount paid when the  1307
placardholder obtained the original placard.  1308
       Any placardholder who loses a placard and, after obtaining  1309
a duplicate, finds the original, immediately shall surrender the  1310
original placard to the registrar.  1311
       (K)(1) The registrar shall pay all fees received under  1312
this section for the issuance of removable windshield placards  1313
or duplicate removable windshield placards into the state  1314
treasury to the credit of the public safety - highway purposes  1315
fund created in section 4501.06 of the Revised Code.  1316
Sub. H. B. No. 567  Page 47
As Reported by the House Health Committee
       (2) In addition to the fees collected under this section,  1317
the registrar or deputy registrar shall ask each person applying  1318
for a removable windshield placard or duplicate removable  1319
windshield placard or license plate issued under this section,  1320
whether the person wishes to make a two-dollar voluntary  1321
contribution to support rehabilitation employment services. The  1322
registrar shall transmit the contributions received under this  1323
division to the treasurer of state for deposit into the  1324
rehabilitation employment fund, which is hereby created in the  1325
state treasury. A deputy registrar shall transmit the  1326
contributions received under this division to the registrar in  1327
the time and manner prescribed by the registrar. The  1328
contributions in the fund shall be used by the opportunities for  1329
Ohioans with disabilities agency to purchase services related to  1330
vocational evaluation, work adjustment, personal adjustment, job  1331
placement, job coaching, and community-based assessment from  1332
accredited community rehabilitation program facilities.  1333
       (L) For purposes of enforcing this section, every peace  1334
officer is deemed to be an agent of the registrar. Any peace  1335
officer or any authorized employee of the bureau of motor  1336
vehicles who, in the performance of duties authorized by law,  1337
becomes aware of a person whose removable windshield placard or  1338
parking card has been revoked pursuant to this section, may  1339
confiscate that placard or parking card and return it to the  1340
registrar. The registrar shall prescribe any forms used by law  1341
enforcement agencies in administering this section.  1342
       No peace officer, law enforcement agency employing a peace  1343
officer, or political subdivision or governmental agency  1344
employing a peace officer, and no employee of the bureau is  1345
liable in a civil action for damages or loss to persons arising  1346
out of the performance of any duty required or authorized by  1347
Sub. H. B. No. 567  Page 48
As Reported by the House Health Committee
this section. As used in this division, "peace officer" has the  1348
same meaning as in division (B) of section 2935.01 of the  1349
Revised Code.  1350
       (M) All applications for registration of motor vehicles  1351
and removable windshield placards issued under this section, all  1352
renewal notices for such items, and all other publications  1353
issued by the bureau that relate to this section shall set forth  1354
the criminal penalties that may be imposed upon a person who  1355
violates any provision relating to accessible license plates  1356
issued under this section, the parking of vehicles displaying  1357
such license plates, and the issuance, procurement, use, and  1358
display of removable windshield placards issued under this  1359
section.  1360
       (N) Whoever violates this section is guilty of a  1361
misdemeanor of the fourth degree.  1362
       Sec. 4723.01. As used in this chapter:  1363
       (A) "Registered nurse" means an individual who holds a  1364
current, valid license issued under this chapter that authorizes  1365
the practice of nursing as a registered nurse.  1366
       (B) "Practice of nursing as a registered nurse" means  1367
providing to individuals and groups nursing care requiring  1368
specialized knowledge, judgment, and skill derived from the  1369
principles of biological, physical, behavioral, social, and  1370
nursing sciences. Such nursing care includes:  1371
       (1) Identifying patterns of human responses to actual or  1372
potential health problems amenable to a nursing regimen;  1373
       (2) Executing a nursing regimen through the selection,  1374
performance, management, and evaluation of nursing actions;  1375
Sub. H. B. No. 567  Page 49
As Reported by the House Health Committee
       (3) Assessing health status for the purpose of providing  1376
nursing care;  1377
       (4) Providing health counseling and health teaching;  1378
       (5) Administering medications, treatments, and executing  1379
regimens authorized by an individual who is authorized to  1380
practice in this state and is acting within the course of the  1381
individual's professional practice;  1382
       (6) Teaching, administering, supervising, delegating, and  1383
evaluating nursing practice.  1384
       (C) "Nursing regimen" may include preventative,  1385
restorative, and health-promotion activities.  1386
       (D) "Assessing health status" means the collection of data  1387
through nursing assessment techniques, which may include  1388
interviews, observation, and physical evaluations for the  1389
purpose of providing nursing care.  1390
       (E) "Licensed practical nurse" means an individual who  1391
holds a current, valid license issued under this chapter that  1392
authorizes the practice of nursing as a licensed practical  1393
nurse.  1394
       (F) "The practice of nursing as a licensed practical  1395
nurse" means providing to individuals and groups nursing care  1396
requiring the application of basic knowledge of the biological,  1397
physical, behavioral, social, and nursing sciences at the  1398
direction of a registered nurse or any of the following who is  1399
authorized to practice in this state: a physician, physician  1400
assistant, dentist, podiatrist, optometrist, or chiropractor.  1401
Such nursing care includes:  1402
       (1) Observation, patient teaching, and care in a diversity  1403
Sub. H. B. No. 567  Page 50
As Reported by the House Health Committee
of health care settings;  1404
       (2) Contributions to the planning, implementation, and  1405
evaluation of nursing;  1406
       (3) Administration of medications and treatments  1407
authorized by an individual who is authorized to practice in  1408
this state and is acting within the course of the individual's  1409
professional practice;  1410
       (4) Administration to an adult Performance of intravenous  1411
therapy authorized by an individual who is authorized to  1412
practice in this state and is acting within the course of the  1413
individual's professional practice, on the condition that the  1414
licensed practical nurse is authorized under section 4723.18 or  1415
4723.181 of the Revised Code to perform intravenous therapy and  1416
performs intravenous therapy procedures, but only in accordance  1417
with those sections 4723.18 and 4723.181 of the Revised Code;  1418
       (5) Delegation of nursing tasks as directed by a  1419
registered nurse;  1420
       (6) Teaching nursing tasks to licensed practical nurses  1421
and individuals to whom the licensed practical nurse is  1422
authorized to delegate nursing tasks as directed by a registered  1423
nurse.  1424
       (G) "Certified registered nurse anesthetist" means an  1425
advanced practice registered nurse who holds a current, valid  1426
license issued under this chapter and is designated as a  1427
certified registered nurse anesthetist in accordance with  1428
section 4723.42 of the Revised Code and rules adopted by the  1429
board of nursing.  1430
       (H) "Clinical nurse specialist" means an advanced practice  1431
registered nurse who holds a current, valid license issued under  1432
Sub. H. B. No. 567  Page 51
As Reported by the House Health Committee
this chapter and is designated as a clinical nurse specialist in  1433
accordance with section 4723.42 of the Revised Code and rules  1434
adopted by the board of nursing.  1435
       (I) "Certified nurse-midwife" means an advanced practice  1436
registered nurse who holds a current, valid license issued under  1437
this chapter and is designated as a certified nurse-midwife in  1438
accordance with section 4723.42 of the Revised Code and rules  1439
adopted by the board of nursing.  1440
       (J) "Certified nurse practitioner" means an advanced  1441
practice registered nurse who holds a current, valid license  1442
issued under this chapter and is designated as a certified nurse  1443
practitioner in accordance with section 4723.42 of the Revised  1444
Code and rules adopted by the board of nursing.  1445
       (K) "Physician" means an individual authorized under  1446
Chapter 4731. of the Revised Code to practice medicine and  1447
surgery or osteopathic medicine and surgery.  1448
       (L) "Collaboration" or "collaborating" means the  1449
following:  1450
       (1) In the case of a clinical nurse specialist or a  1451
certified nurse practitioner, that one or more podiatrists  1452
acting within the scope of practice of podiatry in accordance  1453
with section 4731.51 of the Revised Code and with whom the nurse  1454
has entered into a standard care arrangement or one or more  1455
physicians with whom the nurse has entered into a standard care  1456
arrangement are continuously available to communicate with the  1457
clinical nurse specialist or certified nurse practitioner either  1458
in person or by electronic communication;  1459
       (2) In the case of a certified nurse-midwife, that one or  1460
more physicians with whom the certified nurse-midwife has  1461
Sub. H. B. No. 567  Page 52
As Reported by the House Health Committee
entered into a standard care arrangement are continuously  1462
available to communicate with the certified nurse-midwife either  1463
in person or by electronic communication.  1464
       (M) "Supervision," as it pertains to a certified  1465
registered nurse anesthetist, means that the certified  1466
registered nurse anesthetist is under the direction of a  1467
podiatrist acting within the podiatrist's scope of practice in  1468
accordance with section 4731.51 of the Revised Code, a dentist  1469
acting within the dentist's scope of practice in accordance with  1470
Chapter 4715. of the Revised Code, or a physician, and, when  1471
administering anesthesia, the certified registered nurse  1472
anesthetist is in the immediate presence of the podiatrist,  1473
dentist, or physician.  1474
       (N) "Standard care arrangement" means a written, formal  1475
guide for planning and evaluating a patient's health care that  1476
is developed by one or more collaborating physicians or  1477
podiatrists and a clinical nurse specialist, certified nurse-  1478
midwife, or certified nurse practitioner and meets the  1479
requirements of section 4723.431 of the Revised Code.  1480
       (O) "Advanced practice registered nurse" means an  1481
individual who holds a current, valid license issued under this  1482
chapter that authorizes the practice of nursing as an advanced  1483
practice registered nurse and is designated as any of the  1484
following:  1485
       (1) A certified registered nurse anesthetist;  1486
       (2) A clinical nurse specialist;  1487
       (3) A certified nurse-midwife;  1488
       (4) A certified nurse practitioner.  1489
Sub. H. B. No. 567  Page 53
As Reported by the House Health Committee
       (P) "Practice of nursing as an advanced practice  1490
registered nurse" means providing to individuals and groups  1491
nursing care that requires knowledge and skill obtained from  1492
advanced formal education, training, and clinical experience.  1493
Such nursing care includes the care described in section 4723.43  1494
of the Revised Code.  1495
       (Q) "Dialysis care" means the care and procedures that a  1496
dialysis technician or dialysis technician intern is authorized  1497
to provide and perform, as specified in section 4723.72 of the  1498
Revised Code.  1499
       (R) "Dialysis technician" means an individual who holds a  1500
current, valid certificate to practice as a dialysis technician  1501
issued under section 4723.75 of the Revised Code.  1502
       (S) "Dialysis technician intern" means an individual who  1503
has not passed the dialysis technician certification examination  1504
required by section 4723.751 of the Revised Code, but who has  1505
successfully completed a dialysis training program approved by  1506
the board of nursing under section 4723.74 of the Revised Code  1507
within the previous eighteen months.  1508
       (T) "Certified community health worker" means an  1509
individual who holds a current, valid certificate as a community  1510
health worker issued under section 4723.85 of the Revised Code.  1511
       (U) "Medication aide" means an individual who holds a  1512
current, valid certificate issued under this chapter that  1513
authorizes the individual to administer medication in accordance  1514
with section 4723.67 of the Revised Code;  1515
       (V) "Nursing specialty" means a specialty in practice as a  1516
certified registered nurse anesthetist, clinical nurse  1517
specialist, certified nurse-midwife, or certified nurse  1518
Sub. H. B. No. 567  Page 54
As Reported by the House Health Committee
practitioner.  1519
       (W) "Physician assistant" means an individual who is  1520
licensed to practice as a physician assistant under Chapter  1521
4730. of the Revised Code.  1522
       Sec. 4723.063. (A) As used in this section:  1523
       (1) "Health care facility" means:  1524
       (a) A hospital as defined in section licensed under  1525
Chapter 3722.01 of the Revised Code;  1526
       (b) A nursing home licensed under section 3721.02 of the  1527
Revised Code, or by a political subdivision certified under  1528
section 3721.09 of the Revised Code;  1529
       (c) A county home or a county nursing home as defined in  1530
section 5155.31 of the Revised Code that is certified under  1531
Title XVIII or XIX of the "Social Security Act," 49 Stat. 620  1532
(1935), 42 U.S.C. 301, as amended;  1533
       (d) A freestanding dialysis center;  1534
       (e) A freestanding inpatient rehabilitation facility;  1535
       (f) An ambulatory surgical facility;  1536
       (g) A freestanding cardiac catheterization facility;  1537
       (h) A freestanding birthing center;  1538
       (i) A freestanding or mobile diagnostic imaging center;  1539
       (j) A freestanding radiation therapy center.  1540
       (2) "Nurse Nursing education program" means a prelicensure  1541
nurse nursing education program approved by the board of nursing  1542
under section 4723.06 of the Revised Code or a postlicensure  1543
nurse nursing education program approved by the chancellor of  1544
Sub. H. B. No. 567  Page 55
As Reported by the House Health Committee
higher education under section 3333.04 of the Revised Code.  1545
       (B) The state board of nursing shall establish and  1546
administer the nurse education grant program. Under the program,  1547
the board shall award grants to nurse nursing education programs  1548
that have partnerships with other education programs, community  1549
health agencies, health care facilities, or patient centered  1550
medical homes. Grant recipients shall use the money to fund  1551
partnerships to increase the nurse education program's  1552
enrollment capacity. Methods of increasing a program's  1553
enrollment capacity may include hiring faculty and preceptors,  1554
purchasing educational equipment and materials, and other  1555
actions acceptable to the board. Grant money shall not be used  1556
to construct or renovate buildings. Partnerships may be  1557
developed between one or more nurse nursing education programs  1558
and one or more health care facilities.  1559
       In awarding grants, the board shall give preference to  1560
partnerships between nurse nursing education programs and  1561
hospitals, nursing homes, and county homes or county nursing  1562
homes, but may also award grants to fund partnerships between  1563
nurse nursing education programs and other health care  1564
facilities and between nurse nursing education programs and  1565
patient centered medical homes.  1566
       (C) The board shall adopt rules in accordance with Chapter  1567
119. of the Revised Code establishing the following:  1568
       (1) Eligibility requirements for receipt of a grant;  1569
       (2) Grant application forms and procedures;  1570
       (3) The amounts in which grants may be made and the total  1571
amount that may be awarded to a nurse nursing education program  1572
that has a partnership with other education programs, a  1573
Sub. H. B. No. 567  Page 56
As Reported by the House Health Committee
community health agency, a health care facility, or a patient  1574
centered medical home;  1575
       (4) A method whereby the board may evaluate the  1576
effectiveness of a partnership between joint recipients in  1577
increasing the nurse nursing education program's enrollment  1578
capacity;  1579
       (5) The percentage of the money in the fund that must  1580
remain in the fund at all times to maintain a fiscally  1581
responsible fund balance;  1582
       (6) The percentage of available grants to be awarded to  1583
licensed practical nurse education programs, registered nurse  1584
education programs, and graduate programs;  1585
       (7) Any other matters incidental to the operation of the  1586
program.  1587
       (D) Until December 31, 2033, ten dollars of each nursing  1588
license renewal fee collected under section 4723.08 of the  1589
Revised Code shall be dedicated to the nurse education grant  1590
program fund, which is hereby created in the state treasury. The  1591
board shall use money in the fund for grants awarded under  1592
division (A)(B) of this section and for expenses of  1593
administering the grant program. The amount used for  1594
administrative expenses in any year shall not exceed ten per  1595
cent of the amount transferred to the fund in that year.  1596
       (E) Each quarter, for the purposes of transferring funds  1597
to the nurse education grant program, the board of nursing shall  1598
certify to the director of budget and management the number of  1599
licenses renewed under this chapter during the preceding quarter  1600
and the amount equal to that number times ten dollars.  1601
       (F) Notwithstanding the requirements of section 4743.05 of  1602
Sub. H. B. No. 567  Page 57
As Reported by the House Health Committee
the Revised Code, from January 1, 2004, until December 31, 2033,  1603
at the end of each quarter, the director of budget and  1604
management shall transfer from the occupational licensing and  1605
regulatory fund to the nurse education grant program fund the  1606
amount certified under division (E) of this section.  1607
       Sec. 4723.18. (A) Except as provided in the case of an  1608
intravenous therapy procedure that may be performed under  1609
section 4723.181 of the Revised Code and subject to the  1610
restrictions in division (C) of this section, a licensed  1611
practical nurse may perform intravenous therapy on an adult  1612
patient, subject to the restrictions in division (C) of this  1613
section, only at the direction of one of the following:  1614
       (1) A registered nurse in accordance with division (B) of  1615
this section;  1616
       (2) A physician, physician assistant, dentist,  1617
optometrist, or podiatrist who is authorized to practice in this  1618
state and, except as provided in division (B)(2) of this  1619
section, is present and readily available at the facility where  1620
the intravenous therapy procedure is performed;  1621
       (2) A registered nurse in accordance with division (B) of  1622
this section.  1623
       (B)(1) Except as provided in division (B)(2) of this  1624
section and section 4723.181 of the Revised Code, when a  1625
licensed practical nurse performs an intravenous therapy  1626
procedure under this section at the direction of a registered  1627
nurse, the registered nurse or another registered nurse shall be  1628
readily available at the site where the intravenous therapy is  1629
performed, and before the licensed practical nurse initiates the  1630
intravenous therapy, the registered nurse shall personally  1631
Sub. H. B. No. 567  Page 58
As Reported by the House Health Committee
perform an on-site assessment of the adult patient who is to  1632
receive the intravenous therapy.  1633
       (2) When a licensed practical nurse performs an  1634
intravenous therapy procedure in a home as defined in section  1635
3721.10 of the Revised Code, or in an intermediate care facility  1636
for individuals with intellectual disabilities as defined in  1637
section 5124.01 of the Revised Code, at the direction of a  1638
registered nurse or licensed at the direction of a physician,  1639
physician assistant, dentist, optometrist, or podiatrist who is  1640
authorized to practice in this state, a registered nurse shall  1641
be on the premises of the home or facility or accessible by some  1642
form of telecommunication.  1643
       (C) No licensed practical nurse shall perform any of the  1644
following intravenous therapy procedures:  1645
       (1) Initiating or maintaining any of the following:  1646
       (a) Blood or blood components;  1647
       (b) Solutions for total parenteral nutrition;  1648
       (c) Any cancer therapeutic medication including, but not  1649
limited to, cancer chemotherapy or an anti-neoplastic agent;  1650
       (d) Solutions administered through any central venous line  1651
or arterial line or any other line that does not terminate in a  1652
peripheral vein, except that a licensed practical nurse may  1653
maintain the solutions specified in division (C)(6)(a) of this  1654
section that are being administered through a central venous  1655
line or peripherally inserted central catheter;  1656
       (e) Any investigational or experimental medication.  1657
       (2) Initiating intravenous therapy in any vein, except  1658
that a licensed practical nurse may initiate intravenous therapy  1659
Sub. H. B. No. 567  Page 59
As Reported by the House Health Committee
in accordance with this section in a vein of the hand, forearm,  1660
or antecubital fossa;  1661
       (3) Discontinuing a central venous, arterial, or any other  1662
line that does not terminate in a peripheral vein;  1663
       (4) Initiating or discontinuing a peripherally inserted  1664
central catheter;  1665
       (5) Mixing, preparing, or reconstituting any medication  1666
for intravenous therapy, except that a licensed practical nurse  1667
may prepare or reconstitute an antibiotic additive;  1668
       (6) Administering medication via the intravenous route,  1669
including all of the following activities:  1670
       (a) Adding medication to an intravenous solution or to an  1671
existing infusion, except that a licensed practical nurse may do  1672
any of the following:  1673
       (i) Initiate an intravenous infusion containing one or  1674
more of the following elements: dextrose 5%, normal saline,  1675
lactated ringers, sodium chloride.45%, sodium chloride 0.2%,  1676
sterile water;  1677
       (ii) Hang subsequent containers of the intravenous  1678
solutions specified in division (C)(6)(a)(i) of this section  1679
that contain vitamins or electrolytes, if a registered nurse  1680
initiated the infusion of that same intravenous solution;  1681
       (iii) Initiate or maintain an intravenous infusion  1682
containing an antibiotic additive.  1683
       (b) Injecting medication via a direct intravenous route,  1684
except that a licensed practical nurse may inject heparin or  1685
normal saline to flush an intermittent infusion device or  1686
heparin lock including, but not limited to, bolus or push.  1687
Sub. H. B. No. 567  Page 60
As Reported by the House Health Committee
        (7) Changing tubing on any line including, but not limited  1688
to, an arterial line or a central venous line, except that a  1689
licensed practical nurse may change tubing on an intravenous  1690
line that terminates in a peripheral vein;  1691
        (8) Programming or setting any function of a patient  1692
controlled infusion pump.  1693
        (D) Notwithstanding divisions (B) and (C) of this section,  1694
at the direction of a registered nurse or at the direction of a  1695
physician or a registered nurse, a licensed practical nurse may  1696
perform the following activities for the purpose of performing  1697
dialysis:  1698
        (1) The routine administration and regulation of saline  1699
solution for the purpose of maintaining an established fluid  1700
plan;  1701
        (2) The administration of a heparin dose intravenously;  1702
        (3) The administration of a heparin dose peripherally via  1703
a fistula needle;  1704
        (4) The loading and activation of a constant infusion  1705
pump;  1706
        (5) The intermittent injection of a dose of medication  1707
that is administered via the hemodialysis blood circuit and  1708
through the patient's venous access.  1709
        Sec. 4723.181. (A) A licensed practical nurse may perform  1710
on any person, whether an adult or pediatric patient, any of the  1711
intravenous therapy procedures specified in division (B) of this  1712
section if both of the following apply:  1713
        (1) The licensed practical nurse acts at the direction of  1714
a registered nurse or at the direction of a physician, physician  1715
Sub. H. B. No. 567  Page 61
As Reported by the House Health Committee
assistant, dentist, optometrist, or podiatrist who is authorized  1716
to practice in this state and the registered nurse, physician,  1717
physician assistant, dentist, optometrist, or podiatrist is on  1718
the premises where the procedure is to be performed or  1719
accessible by some form of telecommunication.  1720
       (2) The licensed practical nurse can demonstrate the  1721
knowledge, skills, and ability to perform the procedure safely.  1722
       (B) The intravenous therapy procedures that a licensed  1723
practical nurse may perform pursuant to division (A) of this  1724
section are limited to the following:  1725
       (1) Verification of the type of peripheral intravenous  1726
solution being administered;  1727
       (2) Examination of a peripheral infusion site and the  1728
extremity for possible infiltration;  1729
       (3) Regulation of a peripheral intravenous infusion  1730
according to the prescribed flow rate;  1731
       (4) Discontinuation of a peripheral intravenous device at  1732
the appropriate time;  1733
       (5) Performance of routine dressing changes at the  1734
insertion site of a peripheral venous or arterial infusion,  1735
peripherally inserted central catheter infusion, or central  1736
venous pressure subclavian infusion.  1737
       Sec. 4723.28. (A) The board of nursing, by a vote of a  1738
quorum, may impose one or more of the following sanctions  1739
pursuant to divisions (A) and (B) of this section: deny, revoke,  1740
suspend, or place restrictions on any nursing license or  1741
dialysis technician certificate issued by the board; reprimand  1742
or otherwise discipline a holder of a nursing license or  1743
Sub. H. B. No. 567  Page 62
As Reported by the House Health Committee
dialysis technician certificate; or impose a fine of not more  1744
than five hundred dollars per violation.  1745
       (A) One or more of the sanctions authorized by this  1746
section may be imposed by the board if it finds that either of  1747
the following:  1748
       (1) That a person committed fraud in passing an  1749
examination required to obtain a license or dialysis technician  1750
certificate issued by the board or to have ;  1751
       (2) That a person committed fraud, misrepresentation, or  1752
deception in applying for or securing any nursing license or  1753
dialysis technician certificate issued by the board: deny,  1754
revoke, suspend, or place restrictions on any nursing license or  1755
dialysis technician certificate issued by the board; reprimand  1756
or otherwise discipline a holder of a nursing license or  1757
dialysis technician certificate; or impose a fine of not more  1758
than five hundred dollars per violation.  1759
       (B) Except as provided in section 4723.092 of the Revised  1760
Code, the board of nursing, by a vote of a quorum, may impose  1761
one or more of the following sanctions: deny, revoke, suspend,  1762
or place restrictions on any nursing license or dialysis  1763
technician certificate issued by the board; reprimand or  1764
otherwise discipline a holder of a nursing license or dialysis  1765
technician certificate; or impose a fine of not more than five  1766
hundred dollars per violation. The sanctions authorized by this  1767
section may be imposed by the board for any of the following:  1768
       (1) Denial, revocation, suspension, or restriction of  1769
authority to engage in a licensed profession or practice a  1770
health care occupation, including nursing or practice as a  1771
dialysis technician, for any reason other than a failure to  1772
Sub. H. B. No. 567  Page 63
As Reported by the House Health Committee
renew, in Ohio or another state or jurisdiction;  1773
       (2) Engaging in the practice of nursing or engaging in  1774
practice as a dialysis technician, having failed to renew a  1775
nursing license or dialysis technician certificate issued under  1776
this chapter, or while a nursing license or dialysis technician  1777
certificate is under suspension;  1778
       (3) Conviction of, a plea of guilty to, a judicial finding  1779
of guilt of, a judicial finding of guilt resulting from a plea  1780
of no contest to, or a judicial finding of eligibility for a  1781
pretrial diversion or similar program or for intervention in  1782
lieu of conviction for, a misdemeanor committed in the course of  1783
practice;  1784
       (4) Conviction of, a plea of guilty to, a judicial finding  1785
of guilt of, a judicial finding of guilt resulting from a plea  1786
of no contest to, or a judicial finding of eligibility for a  1787
pretrial diversion or similar program or for intervention in  1788
lieu of conviction for, any felony or of any crime involving  1789
gross immorality or moral turpitude;  1790
       (5) Selling, giving away, or administering drugs or  1791
therapeutic devices for other than legal and legitimate  1792
therapeutic purposes; or conviction of, a plea of guilty to, a  1793
judicial finding of guilt of, a judicial finding of guilt  1794
resulting from a plea of no contest to, or a judicial finding of  1795
eligibility for a pretrial diversion or similar program or for  1796
intervention in lieu of conviction for, violating any municipal,  1797
state, county, or federal drug law;  1798
       (6) Conviction of, a plea of guilty to, a judicial finding  1799
of guilt of, a judicial finding of guilt resulting from a plea  1800
of no contest to, or a judicial finding of eligibility for a  1801
Sub. H. B. No. 567  Page 64
As Reported by the House Health Committee
pretrial diversion or similar program or for intervention in  1802
lieu of conviction for, an act in another jurisdiction that  1803
would constitute a felony or a crime of moral turpitude in Ohio;  1804
        (7) Conviction of, a plea of guilty to, a judicial finding  1805
of guilt of, a judicial finding of guilt resulting from a plea  1806
of no contest to, or a judicial finding of eligibility for a  1807
pretrial diversion or similar program or for intervention in  1808
lieu of conviction for, an act in the course of practice in  1809
another jurisdiction that would constitute a misdemeanor in  1810
Ohio;  1811
        (8) Self-administering or otherwise taking into the body  1812
any dangerous drug, as defined in section 4729.01 of the Revised  1813
Code, in any way that is not in accordance with a legal, valid  1814
prescription issued for that individual, or self-administering  1815
or otherwise taking into the body any drug that is a schedule I  1816
controlled substance;  1817
        (9) Habitual or excessive use of controlled substances,  1818
other habit-forming drugs, or alcohol or other chemical  1819
substances to an extent that impairs the individual's ability to  1820
provide safe nursing care or safe dialysis care;  1821
        (10) Impairment of the ability to practice according to  1822
acceptable and prevailing standards of safe nursing care or safe  1823
dialysis care because of the use of drugs, alcohol, or other  1824
chemical substances;  1825
        (11) Impairment of the ability to practice according to  1826
acceptable and prevailing standards of safe nursing care or safe  1827
dialysis care because of a physical or mental disability;  1828
        (12) Assaulting or causing harm to a patient or depriving  1829
a patient of the means to summon assistance;  1830
Sub. H. B. No. 567  Page 65
As Reported by the House Health Committee
       (13) Misappropriation or attempted misappropriation of  1831
money or anything of value in the course of practice;  1832
       (14) Adjudication by a probate court of being mentally ill  1833
or mentally incompetent. The board may reinstate the person's  1834
nursing license or dialysis technician certificate upon  1835
adjudication by a probate court of the person's restoration to  1836
competency or upon submission to the board of other proof of  1837
competency.  1838
       (15) The suspension or termination of employment by the  1839
United States department of defense or department of veterans  1840
affairs for any act that violates or would violate this chapter;  1841
       (16) Violation of this chapter or any rules adopted under  1842
it;  1843
       (17) Violation of any restrictions placed by the board on  1844
a nursing license or dialysis technician certificate;  1845
       (18) Failure to use universal and standard precautions  1846
established by rules adopted under section 4723.07 of the  1847
Revised Code;  1848
       (19) Failure to practice in accordance with acceptable and  1849
prevailing standards of safe nursing care or safe dialysis care;  1850
       (20) In the case of a registered nurse, engaging in  1851
activities that exceed the practice of nursing as a registered  1852
nurse;  1853
       (21) In the case of a licensed practical nurse, engaging  1854
in activities that exceed the practice of nursing as a licensed  1855
practical nurse;  1856
       (22) In the case of a dialysis technician, engaging in  1857
activities that exceed those permitted under section 4723.72 of  1858
Sub. H. B. No. 567  Page 66
As Reported by the House Health Committee
the Revised Code;  1859
       (23) Aiding and abetting a person in that person's  1860
practice of nursing without a license or practice as a dialysis  1861
technician without a certificate issued under this chapter;  1862
       (24) In the case of an advanced practice registered nurse,  1863
except as provided in division (M) of this section, either of  1864
the following:  1865
       (a) Waiving the payment of all or any part of a deductible  1866
or copayment that a patient, pursuant to a health insurance or  1867
health care policy, contract, or plan that covers such nursing  1868
services, would otherwise be required to pay if the waiver is  1869
used as an enticement to a patient or group of patients to  1870
receive health care services from that provider;  1871
       (b) Advertising that the nurse will waive the payment of  1872
all or any part of a deductible or copayment that a patient,  1873
pursuant to a health insurance or health care policy, contract,  1874
or plan that covers such nursing services, would otherwise be  1875
required to pay.  1876
       (25) Failure to comply with the terms and conditions of  1877
participation in the safe haven program conducted under sections  1878
4723.35 and 4723.351 of the Revised Code;  1879
       (26) Failure to comply with the terms and conditions  1880
required under the practice intervention and improvement program  1881
established under section 4723.282 of the Revised Code;  1882
       (27) In the case of an advanced practice registered nurse:  1883
       (a) Engaging in activities that exceed those permitted for  1884
the nurse's nursing specialty under section 4723.43 of the  1885
Revised Code;  1886
Sub. H. B. No. 567  Page 67
As Reported by the House Health Committee
       (b) Failure to meet the quality assurance standards  1887
established under section 4723.07 of the Revised Code.  1888
       (28) In the case of an advanced practice registered nurse  1889
other than a certified registered nurse anesthetist, failure to  1890
maintain a standard care arrangement in accordance with section  1891
4723.431 of the Revised Code or to practice in accordance with  1892
the standard care arrangement;  1893
       (29) In the case of an advanced practice registered nurse  1894
who is designated as a clinical nurse specialist, certified  1895
nurse-midwife, or certified nurse practitioner, failure to  1896
prescribe drugs and therapeutic devices in accordance with  1897
section 4723.481 of the Revised Code;  1898
       (30) Prescribing any drug or device to perform or induce  1899
an abortion, or otherwise performing or inducing an abortion;  1900
       (31) Failure to establish and maintain professional  1901
boundaries with a patient, as specified in rules adopted under  1902
section 4723.07 of the Revised Code;  1903
       (32) Regardless of whether the contact or verbal behavior  1904
is consensual, engaging with a patient other than the spouse of  1905
the registered nurse, licensed practical nurse, or dialysis  1906
technician in any of the following:  1907
       (a) Sexual contact, as defined in section 2907.01 of the  1908
Revised Code;  1909
       (b) Verbal behavior that is sexually demeaning to the  1910
patient or may be reasonably interpreted by the patient as  1911
sexually demeaning.  1912
       (33) Assisting suicide, as defined in section 3795.01 of  1913
the Revised Code;  1914
Sub. H. B. No. 567  Page 68
As Reported by the House Health Committee
       (34) Failure to comply with the requirements in section  1915
3719.061 of the Revised Code before issuing for a minor a  1916
prescription for an opioid analgesic, as defined in section  1917
3719.01 of the Revised Code;  1918
       (35) Failure to comply with section 4723.487 of the  1919
Revised Code, unless the state board of pharmacy no longer  1920
maintains a drug database pursuant to section 4729.75 of the  1921
Revised Code;  1922
       (36) The revocation, suspension, restriction, reduction,  1923
or termination of clinical privileges by the United States  1924
department of defense or department of veterans affairs or the  1925
termination or suspension of a certificate of registration to  1926
prescribe drugs by the drug enforcement administration of the  1927
United States department of justice;  1928
       (37) In the case of an advanced practice registered nurse  1929
who is designated as a clinical nurse specialist, certified  1930
nurse-midwife, or certified nurse practitioner, failure to  1931
comply with the terms of a consult agreement entered into with a  1932
pharmacist pursuant to section 4729.39 of the Revised Code;  1933
       (38) Violation of section 4723.93 of the Revised Code;  1934
       (39) Failure to cooperate with an investigation conducted  1935
by the board under this chapter, including failure to comply  1936
with a subpoena or order issued by the board or failure to  1937
answer truthfully a question presented by the board in an  1938
investigative interview, in an investigative office conference,  1939
at a deposition, or in written interrogatories, except that  1940
failure to cooperate with an investigation does not constitute  1941
grounds for discipline if a court of competent jurisdiction has  1942
issued an order that either quashes a subpoena or permits the  1943
Sub. H. B. No. 567  Page 69
As Reported by the House Health Committee
individual to withhold testimony or evidence at issue.  1944
       (C) Disciplinary actions taken by the board under  1945
divisions (A) and (B) of this section shall be taken pursuant to  1946
an adjudication conducted under Chapter 119. of the Revised  1947
Code, except that in lieu of a hearing, the board may enter into  1948
a consent agreement with an individual to resolve an allegation  1949
of a violation of this chapter or any rule adopted under it. A  1950
consent agreement, when ratified by a vote of a quorum, shall  1951
constitute the findings and order of the board with respect to  1952
the matter addressed in the agreement. If the board refuses to  1953
ratify a consent agreement, the admissions and findings  1954
contained in the agreement shall be of no effect.  1955
       (D) The hearings of the board shall be conducted in  1956
accordance with Chapter 119. of the Revised Code, the board may  1957
appoint a hearing examiner, as provided in section 119.09 of the  1958
Revised Code, to conduct any hearing the board is authorized to  1959
hold under Chapter 119. of the Revised Code.  1960
       In any instance in which the board is required under  1961
Chapter 119. of the Revised Code to give notice of an  1962
opportunity for a hearing and the applicant, licensee, or  1963
certificate holder does not make a timely request for a hearing  1964
in accordance with section 119.07 of the Revised Code, the board  1965
is not required to hold a hearing, but may adopt, by a vote of a  1966
quorum, a final order that contains the board's findings. In the  1967
final order, the board may order any of the sanctions listed in  1968
division (A) or (B) of authorized by this section.  1969
       (E) If a criminal action is brought against a registered  1970
nurse, licensed practical nurse, or dialysis technician for an  1971
act or crime described in divisions (B)(3) to (7) of this  1972
section and the action is dismissed by the trial court other  1973
Sub. H. B. No. 567  Page 70
As Reported by the House Health Committee
than on the merits, the board shall conduct an adjudication to  1974
determine whether the registered nurse, licensed practical  1975
nurse, or dialysis technician committed the act on which the  1976
action was based. If the board determines on the basis of the  1977
adjudication that the registered nurse, licensed practical  1978
nurse, or dialysis technician committed the act, or if the  1979
registered nurse, licensed practical nurse, or dialysis  1980
technician fails to participate in the adjudication, the board  1981
may take action as though the registered nurse, licensed  1982
practical nurse, or dialysis technician had been convicted of  1983
the act.  1984
       If the board takes action on the basis of a conviction,  1985
plea, or a judicial finding as described in divisions (B)(3) to  1986
(7) of this section that is overturned on appeal, the registered  1987
nurse, licensed practical nurse, or dialysis technician may, on  1988
exhaustion of the appeal process, petition the board for  1989
reconsideration of its action. On receipt of the petition and  1990
supporting court documents, the board shall temporarily rescind  1991
its action. If the board determines that the decision on appeal  1992
was a decision on the merits, it shall permanently rescind its  1993
action. If the board determines that the decision on appeal was  1994
not a decision on the merits, it shall conduct an adjudication  1995
to determine whether the registered nurse, licensed practical  1996
nurse, or dialysis technician committed the act on which the  1997
original conviction, plea, or judicial finding was based. If the  1998
board determines on the basis of the adjudication that the  1999
registered nurse, licensed practical nurse, or dialysis  2000
technician committed such act, or if the registered nurse,  2001
licensed practical nurse, or dialysis technician does not  2002
request an adjudication, the board shall reinstate its action;  2003
otherwise, the board shall permanently rescind its action.  2004
Sub. H. B. No. 567  Page 71
As Reported by the House Health Committee
       Notwithstanding the provision of division (D)(2) of  2005
section 2953.32 or division (F)(1) of section 2953.39 of the  2006
Revised Code specifying that if records pertaining to a criminal  2007
case are sealed or expunged under that section the proceedings  2008
in the case shall be deemed not to have occurred, sealing or  2009
expungement of the following records on which the board has  2010
based an action under this section shall have no effect on the  2011
board's action or any sanction imposed by the board under this  2012
section: records of any conviction, guilty plea, judicial  2013
finding of guilt resulting from a plea of no contest, or a  2014
judicial finding of eligibility for a pretrial diversion program  2015
or intervention in lieu of conviction.  2016
       The board shall not be required to seal, destroy, redact,  2017
or otherwise modify its records to reflect the court's sealing  2018
or expungement of conviction records.  2019
       (F) The board may investigate an individual's criminal  2020
background in performing its duties under this section. As part  2021
of such investigation, the board may order the individual to  2022
submit, at the individual's expense, a request to the bureau of  2023
criminal identification and investigation for a criminal records  2024
check and check of federal bureau of investigation records in  2025
accordance with the procedure described in section 4723.091 of  2026
the Revised Code.  2027
       (G) During the course of an investigation conducted under  2028
this section, the board may compel any registered nurse,  2029
licensed practical nurse, or dialysis technician or applicant  2030
under this chapter to submit to a mental or physical  2031
examination, or both, as required by the board and at the  2032
expense of the individual, if the board finds reason to believe  2033
that the individual under investigation may have a physical or  2034
Sub. H. B. No. 567  Page 72
As Reported by the House Health Committee
mental impairment that may affect the individual's ability to  2035
provide safe nursing or dialysis care.  2036
       The board shall not compel an individual who has been  2037
referred to the safe haven program as described in sections  2038
4723.35 and 4723.351 of the Revised Code to submit to a mental  2039
or physical examination.  2040
       Failure of any individual to submit to a mental or  2041
physical examination when directed constitutes an admission of  2042
the allegations, unless the failure is due to circumstances  2043
beyond the individual's control, and a default and final order  2044
may be entered without the taking of testimony or presentation  2045
of evidence.  2046
       If the board finds that an individual is impaired, the  2047
board shall require the individual to submit to care,  2048
counseling, or treatment approved or designated by the board, as  2049
a condition for initial, continued, reinstated, or renewed  2050
authority to practice. The individual shall be afforded an  2051
opportunity to demonstrate to the board that the individual can  2052
begin or resume the individual's occupation in compliance with  2053
acceptable and prevailing standards of care under the provisions  2054
of the individual's authority to practice.  2055
       For purposes of this division, any registered nurse,  2056
licensed practical nurse, or dialysis technician or applicant  2057
under this chapter shall be deemed to have given consent to  2058
submit to a mental or physical examination when directed to do  2059
so in writing by the board, and to have waived all objections to  2060
the admissibility of testimony or examination reports that  2061
constitute a privileged communication.  2062
       (H) The board shall investigate evidence that appears to  2063
Sub. H. B. No. 567  Page 73
As Reported by the House Health Committee
show that any person has violated any provision of this chapter  2064
or any rule of the board. Any person may report to the board any  2065
information the person may have that appears to show a violation  2066
of any provision of this chapter or rule of the board. In the  2067
absence of bad faith, any person who reports such information or  2068
who testifies before the board in any adjudication conducted  2069
under Chapter 119. of the Revised Code shall not be liable for  2070
civil damages as a result of the report or testimony.  2071
       (I) All of the following apply under this chapter with  2072
respect to the confidentiality of information:  2073
       (1) Information received by the board pursuant to a  2074
complaint or an investigation is confidential and not subject to  2075
discovery in any civil action, except that the board may  2076
disclose information to law enforcement officers and government  2077
entities for purposes of an investigation of either a licensed  2078
health care professional, including a registered nurse, licensed  2079
practical nurse, or dialysis technician, or a person who may  2080
have engaged in the unauthorized practice of nursing or dialysis  2081
care. No law enforcement officer or government entity with  2082
knowledge of any information disclosed by the board pursuant to  2083
this division shall divulge the information to any other person  2084
or government entity except for the purpose of a government  2085
investigation, a prosecution, or an adjudication by a court or  2086
government entity.  2087
       (2) If an investigation requires a review of patient  2088
records, the investigation and proceeding shall be conducted in  2089
such a manner as to protect patient confidentiality.  2090
       (3) All adjudications and investigations of the board  2091
shall be considered civil actions for the purposes of section  2092
2305.252 of the Revised Code.  2093
Sub. H. B. No. 567  Page 74
As Reported by the House Health Committee
       (4) Any board activity that involves continued monitoring  2094
of an individual as part of or following any disciplinary action  2095
taken under this section shall be conducted in a manner that  2096
maintains the individual's confidentiality. Information received  2097
or maintained by the board with respect to the board's  2098
monitoring activities is not subject to discovery in any civil  2099
action and is confidential, except that the board may disclose  2100
information to law enforcement officers and government entities  2101
for purposes of an investigation of a licensee or certificate  2102
holder.  2103
       (J) Any action taken by the board under this section  2104
resulting in a suspension from practice shall be accompanied by  2105
a written statement of the conditions under which the person may  2106
be reinstated to practice.  2107
       (K) When the board refuses to grant a license or  2108
certificate to an applicant, revokes a license or certificate,  2109
or refuses to reinstate a license or certificate, the board may  2110
specify that its action is permanent. An individual subject to  2111
permanent action taken by the board is forever ineligible to  2112
hold a license or certificate of the type that was refused or  2113
revoked and the board shall not accept from the individual an  2114
application for reinstatement of the license or certificate or  2115
for a new license or certificate.  2116
       (L) No unilateral surrender of a nursing license or  2117
dialysis technician certificate issued under this chapter shall  2118
be effective unless accepted by majority vote of the board. No  2119
application for a nursing license or dialysis technician  2120
certificate issued under this chapter may be withdrawn without a  2121
majority vote of the board. The board's jurisdiction to take  2122
disciplinary action under this section is not removed or limited  2123
Sub. H. B. No. 567  Page 75
As Reported by the House Health Committee
when an individual has a license or certificate classified as  2124
inactive or fails to renew a license or certificate.  2125
       (M) Sanctions shall not be imposed under division (B)(24)  2126
of this section against any licensee who waives deductibles and  2127
copayments as follows:  2128
       (1) In compliance with the health benefit plan that  2129
expressly allows such a practice. Waiver of the deductibles or  2130
copayments shall be made only with the full knowledge and  2131
consent of the plan purchaser, payer, and third-party  2132
administrator. Documentation of the consent shall be made  2133
available to the board upon request.  2134
       (2) For professional services rendered to any other person  2135
licensed pursuant to this chapter to the extent allowed by this  2136
chapter and the rules of the board.  2137
       Sec. 4723.34. (A) A person or governmental entity that  2138
employs, or contracts directly or through another person or  2139
governmental entity for the provision of services by, registered  2140
nurses, licensed practical nurses, nurses holding multistate  2141
licenses to practice registered or licensed practical nursing  2142
issued pursuant to section 4723.11 of the Revised Code, dialysis  2143
technicians, medication aides, or certified community health  2144
workers and that knows or has reason to believe that a current  2145
or former employee or person providing services under a contract  2146
who holds a license or certificate issued under this chapter  2147
engaged in conduct that would be grounds for disciplinary action  2148
by the board of nursing under this chapter or rules adopted  2149
under it shall report to the board of nursing the name of such  2150
current or former employee or person providing services under a  2151
contract. The report shall be made on the person's or  2152
governmental entity's behalf by an individual licensed or  2153
Sub. H. B. No. 567  Page 76
As Reported by the House Health Committee
certified by the board who the person or governmental entity has  2154
designated to make such reports.  2155
       A prosecutor in a case described in divisions (B)(3) to  2156
(5) of section 4723.28 of the Revised Code, or in a case where  2157
the trial court issued an order of dismissal upon technical or  2158
procedural grounds of a charge of a misdemeanor committed in the  2159
course of practice, a felony charge, or a charge of gross  2160
immorality or moral turpitude, who knows or has reason to  2161
believe that the person charged is licensed under this chapter  2162
to practice nursing as a registered nurse or as a licensed  2163
practical nurse or holds a certificate issued under this chapter  2164
to practice as a dialysis technician shall notify the board of  2165
nursing of the charge. With regard to certified community health  2166
workers and medication aides, the prosecutor in a case involving  2167
a charge of a misdemeanor committed in the course of employment,  2168
a felony charge, or a charge of gross immorality or moral  2169
turpitude, including a case dismissed on technical or procedural  2170
grounds, who knows or has reason to believe that the person  2171
charged holds a community health worker or medication aide  2172
certificate issued under this chapter shall notify the board of  2173
the charge.  2174
       Each notification from a prosecutor shall be made on forms  2175
prescribed and provided by the board. The report shall include  2176
the name and address of the license or certificate holder, the  2177
charge, and the certified court documents recording the action.  2178
       (B) If any person or governmental entity fails to provide  2179
a report required by this section, the board may seek an order  2180
from a court of competent jurisdiction compelling submission of  2181
the report.  2182
       Sec. 4723.35. (A) As used in this section and section  2183
Sub. H. B. No. 567  Page 77
As Reported by the House Health Committee
4723.351 of the Revised Code:  2184
       (1) "Applicant" means an individual who has applied for a  2185
license or certificate to practice issued under this chapter.  2186
"Applicant" may include an individual who has been granted  2187
authority by the board of nursing a license or certificate under  2188
this chapter to practice as one type of practitioner, but has  2189
applied under this chapter for authority a license or  2190
certificate to practice as another type of practitioner.  2191
       (2) "Impaired" or "impairment" means either or both of the  2192
following:  2193
       (a) Impairment of the ability to practice as described in  2194
division (B)(10) of section 4723.28 of the Revised Code;  2195
       (b) Impairment of the ability to practice as described in  2196
division (B)(11) of section 4723.28 of the Revised Code.  2197
       (3) "Practitioner" means an individual authorized who  2198
holds a license or certificate issued under this chapter to  2199
practice as a registered nurse, including as an advanced  2200
practice registered nurse, licensed practical nurse, dialysis  2201
technician, community health worker, or medication aide.  2202
       (B) The board of nursing shall establish the safe haven  2203
program to monitor applicants and practitioners who are or may  2204
be impaired, but against whom the board has abstained from  2205
taking disciplinary action. The program is to be conducted by  2206
the monitoring organization under contract with the board as  2207
described in section 4723.351 of the Revised Code.  2208
       (C)(1) On the establishment of the program, the board may  2209
transfer to the monitoring organization, in whole or in part,  2210
either or both of the following responsibilities:  2211
Sub. H. B. No. 567  Page 78
As Reported by the House Health Committee
       (a) The monitoring and oversight of licensees  2212
practitioners as part of the substance use disorder program as  2213
that program existed on or before the effective date of this  2214
section September 20, 2024;  2215
       (b) The monitoring and oversight of licensees  2216
practitioners under terms specified in a board adjudication  2217
order or consent agreement.  2218
       (2) If the board transfers the responsibilities described  2219
in division (C)(1) of this section, both of the following apply:  2220
       (a) The monitoring organization shall provide to the board  2221
quarterly reports regarding the compliance of transferred  2222
licenseespractitioners.  2223
       (b) The monitoring organization shall immediately report  2224
to the board any licensee practitioner who is not in compliance  2225
with the terms and conditions of monitoring.  2226
       (D) The board shall refer to the monitoring organization  2227
any applicant or practitioner whose health and effectiveness  2228
show signs of impairment or potential impairment, but only if  2229
the applicant or practitioner meets the eligibility conditions  2230
of division (G) of this section.  2231
       (E) Determinations regarding an applicant's or  2232
practitioner's eligibility for admission to, continued  2233
participation in, and successful completion of the safe haven  2234
program shall be made by the monitoring organization in  2235
accordance with rules adopted under section 4723.351 of the  2236
Revised Code.  2237
       (F) The board shall abstain from taking disciplinary  2238
action under section 4723.28, 4723.652, or 4723.86 of the  2239
Revised Code against an individual whose health and  2240
Sub. H. B. No. 567  Page 79
As Reported by the House Health Committee
effectiveness show signs of impairment or potential impairment,  2241
but who is not currently under the terms of a consent agreement  2242
with the board for impairment or an order issued by the board  2243
for impairment if the individual is participating in the safe  2244
haven program.  2245
       An applicant's or practitioner's impairment neither  2246
excuses an applicant or practitioner who has committed other  2247
violations of this chapter nor precludes the board from  2248
investigating or taking disciplinary action against an applicant  2249
or practitioner for other violations of this chapter.  2250
       (G) An applicant or practitioner is eligible to  2251
participate in the safe haven program if both of the following  2252
conditions are met:  2253
       (1) The applicant or practitioner needs assistance with  2254
impairment or potential impairment.  2255
       (2) The applicant or practitioner has an unencumbered  2256
license or certificate to practice and is not currently under  2257
the terms of a consent agreement with the board for impairment  2258
or an order issued by the board for impairment.  2259
       Sec. 4723.36. (A) A certified nurse-midwife, certified  2260
nurse practitioner, or clinical nurse specialist may determine  2261
and pronounce an individual's death.  2262
       (B)(1)(B) A registered nurse who is not described in  2263
division (A) of this section may determine and pronounce an  2264
individual's death, but only if the individual's respiratory and  2265
circulatory functions are not being artificially sustained and,  2266
at the time the determination and pronouncement of death is  2267
made, the registered nurse is providing or supervising the  2268
individual's care through a hospice care program licensed under  2269
Sub. H. B. No. 567  Page 80
As Reported by the House Health Committee
Chapter 3712. of the Revised Code or any other entity that  2270
provides palliative care.  2271
       (2)(C) A registered nurse who determines and pronounces an  2272
individual's death under division (B)(1)(A) or (B) of this  2273
section shall comply with both of the following:  2274
       (a) The nurse shall not complete any portion of the  2275
individual's death certificate.  2276
       (b) The nurse shall notify the individual's attending  2277
physician, certified nurse-midwife, certified nurse  2278
practitioner, or clinical nurse specialist of the determination  2279
and pronouncement of death in order for the physician, certified  2280
nurse-midwife, certified nurse practitioner, or clinical nurse  2281
specialist to fulfill the physician's, certified nurse-  2282
midwife's, certified nurse practitioner's, or clinical nurse  2283
specialist's duties under section 3705.16 of the Revised Code.  2284
The nurse shall provide the notification within a period of time  2285
that is reasonable but not later than twenty-four hours  2286
following the determination and pronouncement of the  2287
individual's death.  2288
       Sec. 4723.43. A certified registered nurse anesthetist,  2289
clinical nurse specialist, certified nurse-midwife, or certified  2290
nurse practitioner may provide to individuals and groups nursing  2291
care that requires knowledge and skill obtained from advanced  2292
formal education and clinical experience. In providing this  2293
capacity nursing care as an advanced practice registered nurse,  2294
a certified nurse-midwife is subject to division (A) of this  2295
section, a certified registered nurse anesthetist is subject to  2296
division (B) of this section, a certified nurse practitioner is  2297
subject to division (C) of this section, and a clinical nurse  2298
specialist is subject to division (D) of this section.  2299
Sub. H. B. No. 567  Page 81
As Reported by the House Health Committee
       (A) A nurse authorized to practice as a certified nurse-  2300
midwife, in collaboration with one or more physicians, may  2301
provide the management of preventive services and those primary  2302
care services necessary to provide health care to women  2303
antepartally, intrapartally, postpartally, and gynecologically,  2304
consistent with the nurse's education and certification, and in  2305
accordance with rules adopted by the board of nursing.  2306
       No certified nurse-midwife may perform version, deliver  2307
breech or face presentation, use forceps, do any obstetric  2308
operation, or treat any other abnormal condition, except in  2309
emergencies. Division (A) of this section This division does not  2310
prohibit a certified nurse-midwife from performing episiotomies  2311
or normal vaginal deliveries, or repairing vaginal tears. A  2312
certified nurse-midwife may, in collaboration with one or more  2313
physicians, prescribe drugs and therapeutic devices in  2314
accordance with section 4723.481 of the Revised Code.  2315
       (B) A nurse authorized to practice as a certified  2316
registered nurse anesthetist, consistent with the nurse's  2317
education and certification and in accordance with rules adopted  2318
by the board, may do the following:  2319
       (1) With supervision and in the immediate presence of a  2320
physician, podiatrist, or dentist, administer anesthesia and  2321
perform anesthesia induction, maintenance, and emergence;  2322
       (2) With supervision, obtain informed consent for  2323
anesthesia care and perform preanesthetic preparation and  2324
evaluation, postanesthetic preparation and evaluation,  2325
postanesthesia care, and, subject to section 4723.433 of the  2326
Revised Code, clinical support functions;  2327
       (3) With supervision and in accordance with section  2328
Sub. H. B. No. 567  Page 82
As Reported by the House Health Committee
4723.434 of the Revised Code, engage in the activities described  2329
in division (A) of that section.  2330
       The physician, podiatrist, or dentist supervising a  2331
certified registered nurse anesthetist must be actively engaged  2332
in practice in this state. When a certified registered nurse  2333
anesthetist is supervised by a podiatrist, the nurse's scope of  2334
practice is limited to the anesthesia procedures that the  2335
podiatrist has the authority under section 4731.51 of the  2336
Revised Code to perform. A certified registered nurse  2337
anesthetist may not administer general anesthesia under the  2338
supervision of a podiatrist in a podiatrist's office. When a  2339
certified registered nurse anesthetist is supervised by a  2340
dentist, the nurse's scope of practice is limited to the  2341
anesthesia procedures that the dentist has the authority under  2342
Chapter 4715. of the Revised Code to perform.  2343
       (C) A nurse authorized to practice as a certified nurse  2344
practitioner, in collaboration with one or more physicians or  2345
podiatrists, may provide preventive and primary care services,  2346
provide services for acute illnesses, and evaluate and promote  2347
patient wellness within the nurse's nursing specialty,  2348
consistent with the nurse's education and certification, and in  2349
accordance with rules adopted by the board. A certified nurse  2350
practitioner may, in collaboration with one or more physicians  2351
or podiatrists, prescribe drugs and therapeutic devices in  2352
accordance with section 4723.481 of the Revised Code.  2353
       When a certified nurse practitioner is collaborating with  2354
a podiatrist, the nurse's scope of practice is limited to the  2355
procedures that the podiatrist has the authority under section  2356
4731.51 of the Revised Code to perform.  2357
       (D) A nurse authorized to practice as a clinical nurse  2358
Sub. H. B. No. 567  Page 83
As Reported by the House Health Committee
specialist, in collaboration with one or more physicians or  2359
podiatrists, may provide and manage the care of individuals and  2360
groups with complex health problems and provide health care  2361
services that promote, improve, and manage health care within  2362
the nurse's nursing specialty, consistent with the nurse's  2363
education and in accordance with rules adopted by the board. A  2364
clinical nurse specialist may, in collaboration with one or more  2365
physicians or podiatrists, prescribe drugs and therapeutic  2366
devices in accordance with section 4723.481 of the Revised Code.  2367
       When a clinical nurse specialist is collaborating with a  2368
podiatrist, the nurse's scope of practice is limited to the  2369
procedures that the podiatrist has the authority under section  2370
4731.51 of the Revised Code to perform.  2371
       Sec. 4723.431. (A)(1) An advanced practice registered  2372
nurse who is designated as a clinical nurse specialist,  2373
certified nurse-midwife, or certified nurse practitioner may  2374
practice only in accordance with a standard care arrangement  2375
entered into with each physician or podiatrist with whom the  2376
nurse collaborates. A copy of the standard care arrangement  2377
shall be retained on file by the nurse's employer. Prior  2378
approval of the standard care arrangement by the board of  2379
nursing is not required, but the board may periodically review  2380
it for compliance with this section.  2381
       A clinical nurse specialist, certified nurse-midwife, or  2382
certified nurse practitioner may enter into a standard care  2383
arrangement with one or more collaborating physicians or  2384
podiatrists. If a collaborating physician or podiatrist enters  2385
into standard care arrangements with more than five nurses, the  2386
physician or podiatrist shall not collaborate at the same time  2387
with more than five nurses in the prescribing component of their  2388
Sub. H. B. No. 567  Page 84
As Reported by the House Health Committee
practices.  2389
       Not later than thirty days after first engaging in the  2390
practice of nursing as a clinical nurse specialist, certified  2391
nurse-midwife, or certified nurse practitioner, the nurse shall  2392
submit to the board the name and business address of each  2393
collaborating physician or podiatrist. Thereafter, the nurse  2394
shall notify the board of any additions or deletions to the  2395
nurse's collaborating physicians or podiatrists. Except as  2396
provided in division (D) of this section, the notice must be  2397
provided not later than thirty days after the change takes  2398
effect.  2399
       (2) All of the following conditions apply with respect to  2400
the practice of a collaborating physician or podiatrist with  2401
whom a clinical nurse specialist, certified nurse-midwife, or  2402
certified nurse practitioner may enter into a standard care  2403
arrangement:  2404
       (a) The physician or podiatrist must be authorized to  2405
practice in this state.  2406
       (b) Except as provided in division (A)(2)(c) of this  2407
section, the physician or podiatrist must be practicing in a  2408
specialty that is the same as or similar to the nurse's nursing  2409
specialty.  2410
       (c) If the nurse is a clinical nurse specialist who is  2411
certified as a psychiatric-mental health CNS or the equivalent  2412
of such title by the American nurses credentialing center or a  2413
certified nurse practitioner who is certified as a psychiatric-  2414
mental health NP or the equivalent of such title by the American  2415
nurses credentialing center or American academy of nurse  2416
practitioners certification board, the nurse may enter into a  2417
Sub. H. B. No. 567  Page 85
As Reported by the House Health Committee
standard care arrangement with a physician but not a podiatrist  2418
and the collaborating physician must be practicing in one of the  2419
following specialties:  2420
        (i) Psychiatry;  2421
        (ii) Pediatrics;  2422
        (iii) Primary care or family practice.  2423
        (B) A standard care arrangement shall be in writing and  2424
shall contain all of the following:  2425
        (1) Criteria for referral of a patient by the clinical  2426
nurse specialist, certified nurse-midwife, or certified nurse  2427
practitioner to a collaborating physician or podiatrist or  2428
another physician or podiatrist;  2429
        (2) A process for the clinical nurse specialist, certified  2430
nurse-midwife, or certified nurse practitioner to obtain a  2431
consultation with a collaborating physician or podiatrist or  2432
another physician or podiatrist;  2433
        (3) A plan for coverage in instances of emergency or  2434
planned absences of either the clinical nurse specialist,  2435
certified nurse-midwife, or certified nurse practitioner or a  2436
collaborating physician or podiatrist that provides the means  2437
whereby a physician or podiatrist is available for emergency  2438
care;  2439
        (4) The process for resolution of disagreements regarding  2440
matters of patient management between the clinical nurse  2441
specialist, certified nurse-midwife, or certified nurse  2442
practitioner and a collaborating physician or podiatrist;  2443
        (5) An agreement that, if the nurse determines and  2444
pronounces death as provided in section 4723.36 of the Revised  2445
Sub. H. B. No. 567  Page 86
As Reported by the House Health Committee
Code, the collaborating physician shall complete and sign the  2446
medical certificate of death pursuant to section 3705.16 of the  2447
Revised Code;  2448
        (6) Any other criteria required by rule of the board  2449
adopted pursuant to section 4723.07 or 4723.50 of the Revised  2450
Code.  2451
        (C) A standard care arrangement entered into pursuant to  2452
this section may permit a clinical nurse specialist, certified  2453
nurse-midwife, or certified nurse practitioner to do any of the  2454
following:  2455
        (1) Supervise services provided by a home health agency as  2456
defined in section 3740.01 of the Revised Code;  2457
        (2) Admit a patient to a hospital in accordance with  2458
section 3727.06 of the Revised Code;  2459
        (3) Sign any document relating to the admission,  2460
treatment, or discharge of an inpatient receiving psychiatric or  2461
other behavioral health care services, but only if the  2462
conditions of section 4723.436 of the Revised Code have been  2463
met.  2464
        (D)(1) Except as provided in division (D)(2) of this  2465
section, if a physician or podiatrist terminates the  2466
collaboration between the physician or podiatrist and a  2467
certified nurse-midwife, certified nurse practitioner, or  2468
clinical nurse specialist before their standard care arrangement  2469
expires, all of the following apply:  2470
        (a) The physician or podiatrist must give the nurse  2471
written or electronic notice of the termination.  2472
        (b) Once the nurse receives the termination notice, the  2473
Sub. H. B. No. 567  Page 87
As Reported by the House Health Committee
nurse must notify the board of nursing of the termination as  2474
soon as practicable by submitting to the board a copy of the  2475
physician's or podiatrist's termination notice.  2476
       (c) Notwithstanding the requirement of section 4723.43 of  2477
the Revised Code that the nurse practice in collaboration with a  2478
physician or podiatrist, the nurse may continue to practice  2479
under the existing standard care arrangement without a  2480
collaborating physician or podiatrist for not more than one  2481
hundred twenty days after submitting to the board a copy of the  2482
termination notice.  2483
       (2) In the event that the collaboration between a  2484
physician or podiatrist and a certified nurse-midwife, certified  2485
nurse practitioner, or clinical nurse specialist terminates  2486
because of the physician's or podiatrist's death, the nurse must  2487
notify the board of the death as soon as practicable. The nurse  2488
may continue to practice under the existing standard care  2489
arrangement without a collaborating physician or podiatrist for  2490
not more than one hundred twenty days after notifying the board  2491
of the physician's or podiatrist's death.  2492
       (E)(1) Nothing in this section prohibits a hospital from  2493
hiring a clinical nurse specialist, certified nurse-midwife, or  2494
certified nurse practitioner as an employee and negotiating  2495
standard care arrangements on behalf of the employee as  2496
necessary to meet the requirements of this section. A standard  2497
care arrangement between the hospital's employee and the  2498
employee's collaborating physician is subject to approval by the  2499
medical staff and governing body of the hospital prior to  2500
implementation of the arrangement at the hospital.  2501
       (2) Nothing in this section prohibits a standard care  2502
arrangement from specifying actions that a clinical nurse  2503
Sub. H. B. No. 567  Page 88
As Reported by the House Health Committee
specialist, certified nurse-midwife, or certified nurse  2504
practitioner is authorized to take, or is prohibited from  2505
taking, as part of the nurse's practice in collaboration with a  2506
physician or podiatrist. In specifying such actions, the  2507
standard care arrangement shall not authorize the nurse to take  2508
any action that is otherwise prohibited by the Revised Code or  2509
rule of the board.  2510
       Sec. 4723.47. If an advanced practice registered nurse's  2511
license to practice nursing as a registered nurse lapses for  2512
failure to renew under section 4723.24 of the Revised Code, the  2513
nurse's license to practice nursing as an advanced practice  2514
registered nurse is lapsed until the license to practice nursing  2515
as a registered nurse is reinstated. If an advanced practice  2516
registered nurse's license to practice nursing as a registered  2517
nurse is classified as inactive under section 4723.24 of the  2518
Revised Code, the nurse's license to practice nursing as an  2519
advanced practice registered nurse is automatically classified  2520
as inactive while the license to practice nursing as a  2521
registered nurse remains inactive. If either license held by an  2522
advanced practice registered nurse is revoked under section  2523
4723.28 or 4723.281 of the Revised Code, the other license is  2524
automatically revoked. If either license is suspended under  2525
section 4723.28 or 4728.281 of the Revised Code, the other  2526
license is automatically suspended while the suspension remains  2527
in effect.  2528
       Sec. 4723.481. This section establishes standards and  2529
conditions regarding the authority of an advanced practice  2530
registered nurse who is designated as a clinical nurse  2531
specialist, certified nurse-midwife, or certified nurse  2532
practitioner to prescribe and personally furnish drugs and  2533
therapeutic devices under a license issued under section 4723.42  2534
Sub. H. B. No. 567  Page 89
As Reported by the House Health Committee
of the Revised Code.  2535
       (A) A clinical nurse specialist, certified nurse-midwife,  2536
or certified nurse practitioner shall not prescribe or furnish  2537
any drug or therapeutic device that is listed on the  2538
exclusionary formulary established in rules adopted under  2539
section 4723.50 of the Revised Code.  2540
       (B) The prescriptive authority of a clinical nurse  2541
specialist, certified nurse-midwife, or certified nurse  2542
practitioner shall not exceed the prescriptive authority of the  2543
collaborating physician or podiatrist, including the  2544
collaborating physician's authority to treat chronic pain with  2545
controlled substances and , including products containing  2546
tramadol, as that authority is described in section 4731.052 of  2547
the Revised Code.  2548
       (C)(1) Except as provided in division (C)(2) or (3) of  2549
this section, a clinical nurse specialist, certified nurse-  2550
midwife, or certified nurse practitioner may prescribe to a  2551
patient a schedule II controlled substance only if all of the  2552
following are the case:  2553
       (a) The patient has a terminal condition, as defined in  2554
section 2133.01 of the Revised Code.  2555
       (b) A physician initially prescribed the substance for the  2556
patient.  2557
       (c) The prescription is for an amount that does not exceed  2558
the amount necessary for the patient's use in a single, seventy-  2559
two-hour period.  2560
       (2) The restrictions on prescriptive authority in division  2561
(C)(1) of this section do not apply if a clinical nurse  2562
specialist, certified nurse-midwife, or certified nurse  2563
Sub. H. B. No. 567  Page 90
As Reported by the House Health Committee
practitioner issues the prescription to the patient from any of  2564
the following entities:  2565
       (a) A hospital as defined in section 3722.01 licensed  2566
under Chapter 3722. of the Revised Code;  2567
       (b) An entity owned or controlled, in whole or in part, by  2568
a hospital or by an entity that owns or controls, in whole or in  2569
part, one or more hospitals;  2570
       (c) A health care facility operated by the department of  2571
mental behavioral health and addiction services or the  2572
department of developmental disabilities;  2573
       (d) A nursing home licensed under section 3721.02 of the  2574
Revised Code or by a political subdivision certified under  2575
section 3721.09 of the Revised Code;  2576
       (e) A county home or district home operated under Chapter  2577
5155. of the Revised Code that is certified under the medicare  2578
or medicaid program;  2579
       (f) A hospice care program, as defined in section 3712.01  2580
licensed under Chapter 3712. of the Revised Code;  2581
       (g) A community mental health services provider, as  2582
defined in section 5122.01 5119.01 of the Revised Code;  2583
       (h) An ambulatory surgical facility, as defined in  2584
licensed under section 3702.30 of the Revised Code;  2585
       (i) A freestanding birthing center, as defined in section  2586
3701.503 of the Revised Code;  2587
       (j) A federally qualified health center, as defined in  2588
section 3701.047 of the Revised Code;  2589
       (k) A federally qualified health center look-alike, as  2590
Sub. H. B. No. 567  Page 91
As Reported by the House Health Committee
defined in section 3701.047 of the Revised Code;  2591
       (l) A health care office or facility operated by the board  2592
of health of a city or general health district or the authority  2593
having the duties of a board of health under section 3709.05 of  2594
the Revised Code;  2595
       (m) A site where a medical practice is operated, but only  2596
if the practice is comprised of one or more physicians who also  2597
are owners of the practice; the practice is organized to provide  2598
direct patient care; and the clinical nurse specialist,  2599
certified nurse-midwife, or certified nurse practitioner  2600
providing services at the site has a standard care arrangement  2601
and collaborates with at least one of the physician owners who  2602
practices primarily at that site;  2603
       (n) A site where a behavioral health practice is operated  2604
that does not qualify as a location otherwise described in  2605
division (C)(2) of this section, but only if the practice is  2606
organized to provide outpatient services for the treatment of  2607
mental health conditions, substance use disorders, or both, and  2608
the clinical nurse specialist, certified nurse-midwife, or  2609
certified nurse practitioner providing services at the site of  2610
the practice has a standard care arrangement and collaborates  2611
with at least one physician who is employed by that practice;  2612
       (o) A residential care facility, as defined in section  2613
3721.01 licensed under Chapter 3721. of the Revised Code.  2614
       (3) A clinical nurse specialist, certified nurse-midwife,  2615
or certified nurse practitioner shall not issue to a patient a  2616
prescription for a schedule II controlled substance from a  2617
convenience care clinic even if the clinic is owned or operated  2618
by an entity specified in division (C)(2) of this section.  2619
Sub. H. B. No. 567  Page 92
As Reported by the House Health Committee
       (D) A pharmacist who acts in good faith reliance on a  2620
prescription issued by a clinical nurse specialist, certified  2621
nurse-midwife, or certified nurse practitioner under division  2622
(C)(2) of this section is not liable for or subject to any of  2623
the following for relying on the prescription: damages in any  2624
civil action, prosecution in any criminal proceeding, or  2625
professional disciplinary action by the state board of pharmacy  2626
under Chapter 4729. of the Revised Code.  2627
       (E) A clinical nurse specialist, certified nurse-midwife,  2628
or certified nurse practitioner shall comply with section  2629
3719.061 of the Revised Code if the nurse prescribes for a  2630
minor, as defined in that section, an opioid analgesic, as  2631
defined in section 3719.01 of the Revised Code.  2632
       Sec. 4723.482. (A) Except as provided in divisions (C) and  2633
(D) of this section, an applicant for a license to practice  2634
nursing as an advanced practice registered nurse who seeks  2635
designation as a clinical nurse specialist, certified nurse-  2636
midwife, or certified nurse practitioner shall include with the  2637
application submitted under section 4723.41 of the Revised Code  2638
evidence of successfully completing the course of study in  2639
advanced pharmacology and related topics in accordance with the  2640
requirements specified in division (B) of this section.  2641
       (B) With respect to the course of study in advanced  2642
pharmacology and related topics, all of the following  2643
requirements apply:  2644
       (1) The course of study shall be completed not longer than  2645
five years before the application is filed.  2646
       (2) The course of study shall be not less than forty-five  2647
contact hours.  2648
Sub. H. B. No. 567  Page 93
As Reported by the House Health Committee
       (3) The course of study shall meet the requirements to be  2649
approved by the board of nursing in accordance with standards  2650
established in rules adopted under section 4723.50 of the  2651
Revised Code.  2652
       (4) The content of the course of study shall be specific  2653
to the applicant's nursing specialty.  2654
       (5) The instruction provided in the course of study shall  2655
include all of the following:  2656
       (a) A minimum of thirty-six contact hours of instruction  2657
in advanced pharmacology that includes pharmacokinetic  2658
principles and clinical application and the use of drugs and  2659
therapeutic devices in the prevention of illness and maintenance  2660
of health;  2661
       (b) Instruction in the fiscal and ethical implications of  2662
prescribing drugs and therapeutic devices;  2663
       (c) Instruction in the state and federal laws that apply  2664
to the authority to prescribe;  2665
       (d) Instruction that is specific to schedule II controlled  2666
substances, including instruction in all of the following:  2667
       (i) Indications for the use of schedule II controlled  2668
substances in drug therapies;  2669
       (ii) The most recent guidelines for pain management  2670
therapies, as established by state and national organizations  2671
such as the Ohio pain initiative and the American pain society;  2672
       (iii) Fiscal and ethical implications of prescribing  2673
schedule II controlled substances;  2674
       (iv) State and federal laws that apply to the authority to  2675
Sub. H. B. No. 567  Page 94
As Reported by the House Health Committee
prescribe schedule II controlled substances;  2676
       (v) Prevention of abuse and diversion of schedule II  2677
controlled substances, including identification of the risk of  2678
abuse and diversion, recognition of abuse and diversion, types  2679
of assistance available for prevention of abuse and diversion,  2680
and methods of establishing safeguards against abuse and  2681
diversion.  2682
       (C) An applicant who practiced or is practicing as a  2683
clinical nurse specialist, certified nurse-midwife, or certified  2684
nurse practitioner in another jurisdiction or as an employee of  2685
the United States government shall include with the application  2686
submitted under section 4723.41 of the Revised Code all of the  2687
following:  2688
       (1) Evidence of having completed a two-hour course of  2689
instruction approved by the board in the laws of this state that  2690
govern drugs and prescriptive authority;  2691
       (2) Either of the following:  2692
       (a) Evidence of having held, for a continuous period of at  2693
least one year during the three years immediately preceding the  2694
date of application, valid authority issued by another  2695
jurisdiction to prescribe therapeutic devices and drugs,  2696
including at least some controlled substances;  2697
       (b) Evidence of having been employed by the United States  2698
government and authorized, for a continuous period of at least  2699
one year during the three years immediately preceding the date  2700
of application, to prescribe therapeutic devices and drugs,  2701
including at least some controlled substances, in conjunction  2702
with that employment.  2703
       (D) In lieu of including with an application submitted  2704
Sub. H. B. No. 567  Page 95
As Reported by the House Health Committee
under section 4723.41 of the Revised Code the evidence described  2705
in division (A) of this section, an applicant described in  2706
division (C) or (D) of section 4723.41 of the Revised Code may  2707
include evidence of all of the following:  2708
       (1) Successfully completing the course of study in  2709
advanced pharmacology and related topics more than five years  2710
before the date the application is filed;  2711
       (2) Holding, for a continuous period of at least one year  2712
during the three years immediately preceding the date of  2713
application, valid authority in any jurisdiction to prescribe  2714
therapeutic devices and drugs, including at least some  2715
controlled substances;  2716
       (3) Exercising the prescriptive authority described in  2717
division (D)(2) of this section for the minimum one-year period.  2718
       Sec. 4723.483. (A)(1) Subject to division (A)(2) of this  2719
section, and notwithstanding any provision of this chapter or  2720
rule adopted by the board of nursing, a clinical nurse  2721
specialist, certified nurse-midwife, or certified nurse  2722
practitioner who holds a certificate to prescribe issued under  2723
section 4723.48 of the Revised Code may do either of the  2724
following without having examined an individual to whom  2725
epinephrine may be administered:  2726
       (a) Personally furnish a supply of epinephrine  2727
autoinjectors for use in accordance with sections 3313.7110,  2728
3313.7111, 3314.143, 3326.28, 3328.29, 3728.03 to 3728.05, and  2729
5180.26 of the Revised Code;  2730
       (b) Issue a prescription for epinephrine autoinjectors for  2731
use in accordance with sections 3313.7110, 3313.7111, 3314.143,  2732
3326.28, 3328.29, 3728.03 to 3728.05, and 5180.26 of the Revised  2733
Sub. H. B. No. 567  Page 96
As Reported by the House Health Committee
Code.  2734
        (2) An epinephrine autoinjector personally furnished or  2735
prescribed under division (A)(1) of this section must be  2736
furnished or prescribed in such a manner that it may be  2737
administered only in a manufactured dosage form.  2738
        (B) A nurse who acts in good faith in accordance with this  2739
section is not liable for or subject to any of the following for  2740
any action or omission of an entity to which an epinephrine  2741
autoinjector is furnished or a prescription is issued: damages  2742
in any civil action, prosecution in any criminal proceeding, or  2743
professional disciplinary action.  2744
        Sec. 4723.493. (A) There is hereby created within the  2745
board of nursing the advisory committee group on advanced  2746
practice registered nursing. The committee shall consist of The  2747
advisory group shall advise the board regarding the practice and  2748
regulation of advanced practice registered nurses.  2749
        (B) The board shall appoint the following as members and  2750
any other members the board appoints under division (B) of this  2751
section of the advisory group:  2752
        (1) Four advanced practice registered nurses, each  2753
actively engaged in the practice of advanced practice registered  2754
nursing in a clinical setting in this state, at least one of  2755
whom is actively engaged in providing primary care, at least one  2756
of whom is actively engaged in practice as a certified  2757
registered nurse anesthetist, and at least one of whom is  2758
actively engaged in practice as a certified nurse-midwife;  2759
        (2) Two advanced practice registered nurses, each serving  2760
as a faculty member of an approved program of nursing education  2761
that prepares students for licensure as advanced practice  2762
Sub. H. B. No. 567  Page 97
As Reported by the House Health Committee
registered nurses;  2763
       (3) A member of the board of nursing who is an advanced  2764
practice registered nurse;  2765
       (4) A representative of an entity employing ten or more  2766
advanced practice registered nurses actively engaged in practice  2767
in this state.  2768
       (B) The board of nursing shall appoint the members  2769
described in division (A) of this section. (C) Recommendations  2770
for initial appointments and for filling any vacancies regarding  2771
individuals to serve as members under division (B) of this  2772
section may be submitted to the board by organizations  2773
representing advanced practice registered nurses practicing in  2774
this state and by schools of advanced practice registered  2775
nursing. The board shall appoint initial members and fill  2776
vacancies according to the recommendations it receives. If it  2777
does not receive any recommendations or receives an insufficient  2778
number of recommendations, the board shall appoint members and  2779
fill vacancies on its own advice.  2780
       (D) The members who serve under division (B) of this  2781
section may recommend to the board that an individual with  2782
expertise in a specialized area of advanced practice registered  2783
nursing be appointed as an additional member of the advisory  2784
group. If the board receives such a recommendation, the board  2785
may appoint the additional member.  2786
       Initial appointments to the committee shall be made not  2787
later than sixty days after April 6, 2017. Of the initial  2788
appointments described in division (A)(1) of this section, two  2789
shall be for terms of one year and two shall be for terms of two  2790
years. Of the initial appointments described in division (A)(2)  2791
Sub. H. B. No. 567  Page 98
As Reported by the House Health Committee
of this section, one shall be for a term of one year and one  2792
shall be for a term of two years. Of the initial appointments  2793
described in divisions (A)(3) and (4) of this section, each  2794
shall be for a term of two years. Thereafter, terms  2795
       (E) Terms for all members shall be for two years, with  2796
each term ending on the same day of the same month as did the  2797
term that it succeeds. Vacancies shall be filled in the same  2798
manner as appointments.  2799
       When the term of any member expires, a successor shall be  2800
appointed in the same manner as the initial original  2801
appointment. Any member appointed to fill a vacancy occurring  2802
prior to the expiration of the term for which the member's  2803
predecessor was appointed shall hold office for the remainder of  2804
that term. A member shall continue in office subsequent to the  2805
expiration date of the member's term until the member's  2806
successor takes office or until a period of sixty days has  2807
elapsed, whichever occurs first. A member may be reappointed for  2808
one additional term only.  2809
       (C) The committee shall organize by selecting a  2810
chairperson from among its members. The committee may select a  2811
new chairperson at any time(F) The member of the board appointed  2812
under division (B)(3) of this section shall serve as the  2813
advisory group's chairperson. Five members constitute a quorum  2814
for the transaction of official business. Members  2815
       Members shall serve without compensation but receive  2816
payment for their actual and necessary expenses incurred in the  2817
performance of their official duties. The expenses shall be paid  2818
by the board of nursing.  2819
       (D) The committee shall advise the board regarding the  2820
Sub. H. B. No. 567  Page 99
As Reported by the House Health Committee
practice and regulation of advanced practice registered nurses.  2821
The committee may also recommend to the board that an individual  2822
with expertise in an advanced practice registered nursing  2823
specialty be appointed under division (B) of this section as an  2824
additional member of the committee.  2825
       Sec. 4723.52. (A) As used in this section:  2826
       (1) "Community addiction services provider" has the same  2827
meaning as in section 5119.01 of the Revised Code.  2828
       (2) "Medication-assisted , "medication-assisted treatment"  2829
has the same meaning as in section 340.01 of the Revised Code.  2830
       (B) An advanced practice registered nurse shall comply  2831
with section 3719.064 of the Revised Code and rules adopted  2832
under section 4723.51 of the Revised Code when treating a  2833
patient for addiction with medication-assisted treatment or  2834
proposing to initiate such treatment.  2835
       Sec. 4723.66. (A) A person or government entity seeking  2836
approval to provide a medication aide training program shall  2837
apply to the board of nursing on a form prescribed and provided  2838
by the board. The application shall be accompanied by a fee of  2839
fifty dollars.  2840
       (B) Except as provided in division (C)(D) of this section,  2841
the board shall approve the applicant to provide a medication  2842
aide training program if the content of the course of  2843
instruction to be provided by the program includes all of the  2844
following:  2845
       (1) Thirty clock-hours of instruction in medication  2846
administration, including both classroom instruction and at  2847
least sixteen clock-hours of supervised clinical practice;  2848
Sub. H. B. No. 567  Page 100
As Reported by the House Health Committee
       (2) A mechanism for evaluating whether an individual's  2849
reading, writing, and mathematical skills are sufficient for the  2850
individual to be able to administer prescription medications  2851
safely;  2852
       (3) An examination that tests the ability to administer  2853
prescription medications safely. The examination may be  2854
administered by the program that provides the instruction  2855
required by division (B)(1) of this section.  2856
       (C) Approval of a training program is valid for two years,  2857
unless earlier suspended or revoked. The approval of a training  2858
program may be renewed.  2859
       (D) The board shall deny the an application for initial  2860
approval or renewal of approval if an the applicant submits or  2861
causes to be submitted to the board false, misleading, or  2862
deceptive statements, information, or documentation in the  2863
process of applying for approval of the program.  2864
       (D) The board may deny an application for initial approval  2865
or renewal of approval, or suspend, or revoke the approval  2866
granted to a medication aide training program, for failure to  2867
meet any of the standards specified in division (B) of this  2868
section.  2869
       (E) All actions taken by the board to deny, suspend, or  2870
revoke the approval of a training program shall be taken in  2871
accordance with Chapter 119. of the Revised Code.  2872
       Sec. 4723.67. (A) In accordance with this section, a  2873
medication aide who holds a current, valid medication aide  2874
certificate issued under this chapter may administer  2875
prescription medications to the residents of nursing homes and  2876
residential care facilities, but only pursuant to the  2877
Sub. H. B. No. 567  Page 101
As Reported by the House Health Committee
supervision of a registered nurse or a licensed practical nurse  2878
acting at the direction of a registered nurse.  2879
       (B) In exercising the authority to administer prescription  2880
medications pursuant to nursing supervision, all of the  2881
following apply to a medication aide:  2882
       (1) Subject to division (B)(4) of this section, a  2883
medication aide may administer prescription medications by any  2884
of the following methods:  2885
       (a) Giving medications to be taken orally;  2886
       (b) Topical application;  2887
       (c) Application as drops to the eye, ear, or nose;  2888
       (d) Rectal insertion and vaginal insertion.  2889
       (2) A medication aide may administer medications  2890
prescribed with a designation authorizing or requiring  2891
administration on an as-needed basis, regardless of whether the  2892
supervising nurse is present at the home or facility.  2893
       (3) A medication aide may administer initial doses of  2894
prescription medications.  2895
       (4) A medication aide may administer medications  2896
containing a schedule II controlled substance, as defined in  2897
section 3719.01 of the Revised Code, but only by the methods  2898
described in divisions (B)(1)(a) and (b) of this section.  2899
       (C) All of the following limitations apply to the  2900
authority of a medication aide to administer prescription  2901
medication:  2902
       (1) A medication aide shall not administer prescription  2903
medications requiring dosage calculations.  2904
Sub. H. B. No. 567  Page 102
As Reported by the House Health Committee
       (2) A medication aide shall not administer prescription  2905
medications by any either of the following methods:  2906
       (a) Injection, except for insulin as provided in division  2907
(D) of this section;  2908
       (b) Intravenous therapy procedures;.  2909
       (3) A medication aide shall not split pills for purposes  2910
of changing the dose being given.  2911
       (D) A medication aide may administer insulin to a resident  2912
by injection, but only if both of the following are satisfied:  2913
       (1) The medication aide satisfies training and competency  2914
requirements established by the aide's employer.  2915
       (2) The insulin is injected using an insulin pen device  2916
that contains a dosage indicator.  2917
       Sec. 4723.69. (A) The board of nursing may adopt rules to  2918
implement sections 4723.63 to 4723.68 of the Revised Code. All  2919
rules adopted under this section shall be adopted in accordance  2920
with Chapter 119. of the Revised Code.  2921
       (B) If the board adopts rules under this section  2922
establishing standards governing approval of and participation  2923
in medication aide training programs, both of the following  2924
apply:  2925
       (1) With respect to supervised clinical practice  2926
components of training programs, when such training is provided  2927
in a nursing home or residential care facility and the home or  2928
facility has been notified by the department of health of real  2929
and present danger related to its administration of medications  2930
or provision of any other type of skilled nursing care, the  2931
board shall prohibit the home or facility from commencing any  2932
Sub. H. B. No. 567  Page 103
As Reported by the House Health Committee
further supervised clinical practice components until either of  2933
the following occurs:  2934
       (a) A plan of correction is approved.  2935
       (b) The home or facility resolves the danger.  2936
       The board shall allow a training program to continue any  2937
supervised clinical practice components that commenced prior to  2938
the department of health notifying the home or facility.  2939
       (2) If the rules establish a minimum or maximum number of  2940
days for participating in or completing a training program, the  2941
board shall base that number on calendar days rather than  2942
business days.  2943
       Sec. 4731.297. (A) As used in this section:  2944
       (1) "Academic medical center" means a medical school and  2945
its affiliated teaching hospitals and clinics partnering to do  2946
all of the following:  2947
       (a) Provide the highest quality of patient care from  2948
expert physicians;  2949
       (b) Conduct groundbreaking research leading to medical  2950
advancements for current and future patients;  2951
       (c) Provide medical education and graduate medical  2952
education to educate and train physicians.  2953
       (2) "Affiliated physician group practice" means a medical  2954
practice that consists of one or more physicians authorized  2955
under this chapter to practice medicine and surgery or  2956
osteopathic medicine and surgery and that is affiliated with an  2957
academic medical center to further the objectives described in  2958
divisions (A)(1)(a) to (c) of this section.  2959
Sub. H. B. No. 567  Page 104
As Reported by the House Health Committee
       (B) The state medical board shall issue, without  2960
examination, to an applicant who meets the requirements of this  2961
section a certificate of conceded eminence authorizing the  2962
practice of medicine and surgery or osteopathic medicine and  2963
surgery as part of the applicant's employment with an academic  2964
medical center in this state or affiliated physician group  2965
practice in this state.  2966
       (C) To be eligible for a certificate of conceded eminence,  2967
an applicant shall provide to the board all of the following:  2968
       (1) Evidence satisfactory to the board of all of the  2969
following:  2970
       (a) That the applicant is an international medical  2971
graduate who holds a medical degree from an educational  2972
institution listed in the international medical education  2973
directory;  2974
       (b) That the applicant has been appointed to serve in this  2975
state as a full-time faculty member of a medical school  2976
accredited by the liaison committee on medical education or an  2977
osteopathic medical school accredited by the American  2978
osteopathic association;  2979
       (c) That the applicant has accepted an offer of employment  2980
with an academic medical center in this state or affiliated  2981
physician group practice in this state;  2982
       (d) That the applicant holds a license in good standing in  2983
another state or country authorizing the practice of medicine  2984
and surgery or osteopathic medicine and surgery;  2985
       (e) That the applicant has unique talents and  2986
extraordinary abilities not generally found within the  2987
applicant's specialty, as demonstrated by satisfying at least  2988
Sub. H. B. No. 567  Page 105
As Reported by the House Health Committee
four of the following:  2989
       (i) The applicant has achieved educational qualifications  2990
beyond those that are required for entry into the applicant's  2991
specialty, including advanced degrees, special certifications,  2992
or other academic credentials.  2993
       (ii) The applicant has written multiple articles in  2994
journals listed in the index medicus or an equivalent scholarly  2995
publication acceptable to the board.  2996
       (iii) The applicant has a sustained record of excellence  2997
in original research, at least some of which involves serving as  2998
the principal investigator or co-principal investigator for a  2999
research project.  3000
       (iv) The applicant has received nationally or  3001
internationally recognized prizes or awards for excellence.  3002
       (v) The applicant has participated in peer review in a  3003
field of specialization that is the same as or similar to the  3004
applicant's specialty.  3005
       (vi) The applicant has developed new procedures or  3006
treatments for complex medical problems that are recognized by  3007
peers as a significant advancement in the applicable field of  3008
medicine.  3009
       (vii) The applicant has held previous academic  3010
appointments with or been employed by a health care organization  3011
that has a distinguished national or international reputation.  3012
       (viii) The applicant has been the recipient of a national  3013
institutes of health or other competitive grant award.  3014
       (f) That the applicant has received staff membership or  3015
professional privileges from the academic medical center  3016
Sub. H. B. No. 567  Page 106
As Reported by the House Health Committee
pursuant to standards adopted under section 3701.351 of the  3017
Revised Code on a basis that requires the applicant's medical  3018
education and graduate medical education to be at least  3019
equivalent to that of a physician educated and trained in the  3020
United States;  3021
       (g) That the applicant has sufficient written and oral  3022
English skills to communicate effectively and reliably with  3023
patients, their families, and other medical professionals;  3024
       (h) That the applicant will have professional liability  3025
insurance through the applicant's employment with the academic  3026
medical center or affiliated physician group practice.  3027
       (2) An attestation that the applicant agrees to practice  3028
only within the clinical setting of the academic medical center  3029
or for the affiliated physician group practice;  3030
       (3) Three letters of reference from distinguished experts  3031
in the applicant's specialty attesting to the unique  3032
capabilities of the applicant, at least one of which must be  3033
from outside the academic medical center or affiliated physician  3034
group practice;  3035
       (4) An affidavit from the dean of the medical school where  3036
the applicant has been appointed to serve as a faculty member  3037
stating that the applicant meets all of the requirements of  3038
division (C)(1) of this section and that the letters of  3039
reference submitted under division (C)(3) of this section are  3040
from distinguished experts in the applicant's specialty, and  3041
documentation to support the affidavit;  3042
       (5) A fee of one thousand dollars for the certificate.  3043
       (D)(1) The holder of a certificate of conceded eminence  3044
may practice medicine and surgery or osteopathic medicine and  3045
Sub. H. B. No. 567  Page 107
As Reported by the House Health Committee
surgery only within the clinical setting of the academic medical  3046
center with which the certificate holder is employed or for the  3047
affiliated physician group practice with which the certificate  3048
holder is employed.  3049
       (2) A certificate holder may supervise medical students,  3050
physicians participating in graduate medical education, advanced  3051
practice registered nurses, and physician assistants when  3052
performing clinical services in the certificate holder's area of  3053
specialty.  3054
       (E) The board may revoke a certificate issued under this  3055
section on receiving proof satisfactory to the board that the  3056
certificate holder has engaged in practice in this state outside  3057
the scope of the certificate or that there are grounds for  3058
action against the certificate holder under section 4731.22 of  3059
the Revised Code.  3060
       (F) A certificate of conceded eminence is valid for the  3061
shorter of two years or the duration of the certificate holder's  3062
employment with the academic medical center or affiliated  3063
physician group practice. The certificate ceases to be valid if  3064
the holder resigns or is otherwise terminated from the academic  3065
medical center or affiliated physician group practice.  3066
       (G) A certificate of conceded eminence may be renewed for  3067
an additional two-year period. There is no limit on the number  3068
of times a certificate may be renewed. A person seeking renewal  3069
of a certificate shall apply to the board and is eligible for  3070
renewal if the applicant does all of the following:  3071
       (1) Pays the renewal fee of one thousand dollars;  3072
       (2) Provides to the board an affidavit and supporting  3073
documentation from the academic medical center or affiliated  3074
Sub. H. B. No. 567  Page 108
As Reported by the House Health Committee
physician group practice of all of the following:  3075
       (a) That the applicant's initial appointment to the  3076
medical faculty is still valid or has been renewed;  3077
       (b) That the applicant's clinical practice is consistent  3078
with the established standards in the field;  3079
       (c) That the applicant has demonstrated continued  3080
scholarly achievement;  3081
       (d) That the applicant has demonstrated continued  3082
professional achievement consistent with the academic medical  3083
center's requirements, established pursuant to standards adopted  3084
under section 3701.351 of the Revised Code, for physicians with  3085
staff membership or professional privileges with the academic  3086
medical center.  3087
       (3) Satisfies the same continuing medical education  3088
requirements set forth in section 4731.282 of the Revised Code  3089
that apply to a person who holds a certificate to practice  3090
medicine and surgery or osteopathic medicine and surgery issued  3091
under this chapter.  3092
       (4) Complies with any other requirements established by  3093
the board.  3094
       (H) The board shall not require a person to obtain a  3095
certificate under Chapter 4796. of the Revised Code to practice  3096
medicine and surgery or osteopathic medicine and surgery if the  3097
person holds a certificate of conceded eminence issued under  3098
this section.  3099
       (I) The board may adopt any rules it considers necessary  3100
to implement this section. The rules shall be adopted in  3101
accordance with Chapter 119. of the Revised Code.  3102
Sub. H. B. No. 567  Page 109
As Reported by the House Health Committee
       Sec. 5122.10. (A)(1) Any of the following who has reason  3103
to believe that a person is a person with a mental illness  3104
subject to court order and represents a substantial risk of  3105
physical harm to self or others if allowed to remain at liberty  3106
pending examination may take the person into custody and may  3107
immediately transport the person to a hospital or,  3108
notwithstanding section 5119.33 of the Revised Code, to a  3109
general hospital not licensed by the department of behavioral  3110
health where the person may be held for the period prescribed in  3111
this section:  3112
       (a) A psychiatrist;  3113
       (b) A licensed physician;  3114
       (c) A licensed clinical psychologist;  3115
       (d) A clinical nurse specialist who is certified as a  3116
psychiatric-mental health CNS, or the equivalent of such title,  3117
by the American nurses credentialing center;  3118
       (e) A certified nurse practitioner who is certified as a  3119
psychiatric-mental health NP, or the equivalent of such title,  3120
by the American nurses credentialing center or American academy  3121
of nurse practitioners certification board;  3122
       (f) A health officer;  3123
       (g) A parole officer;  3124
       (h) A police officer;  3125
       (i) A sheriff.  3126
       (2) If the chief of the adult parole authority or a parole  3127
or probation officer with the approval of the chief of the  3128
authority has reason to believe that a parolee, an offender  3129
Sub. H. B. No. 567  Page 110
As Reported by the House Health Committee
under a community control sanction or post-release control  3130
sanction, or an offender under transitional control is a person  3131
with a mental illness subject to court order and represents a  3132
substantial risk of physical harm to self or others if allowed  3133
to remain at liberty pending examination, the chief or officer  3134
may take the parolee or offender into custody and may  3135
immediately transport the parolee or offender to a hospital or,  3136
notwithstanding section 5119.33 of the Revised Code, to a  3137
general hospital not licensed by the department of behavioral  3138
health where the parolee or offender may be held for the period  3139
prescribed in this section.  3140
       (B) A written statement shall be given to the hospital by  3141
the individual authorized under division (A)(1) or (2) of this  3142
section to transport the person. The statement shall specify the  3143
circumstances under which such person was taken into custody and  3144
the reasons for the belief that the person is a person with a  3145
mental illness subject to court order and represents a  3146
substantial risk of physical harm to self or others if allowed  3147
to remain at liberty pending examination. This statement shall  3148
be made available to the respondent or the respondent's attorney  3149
upon request of either.  3150
       (C) Every reasonable and appropriate effort shall be made  3151
to take persons into custody in the least conspicuous manner  3152
possible. A person taking the respondent into custody pursuant  3153
to this section shall explain to the respondent: the name and  3154
professional designation and affiliation of the person taking  3155
the respondent into custody; that the custody-taking is not a  3156
criminal arrest; and that the person is being taken for  3157
examination by mental health professionals at a specified mental  3158
health facility identified by name.  3159
Sub. H. B. No. 567  Page 111
As Reported by the House Health Committee
       (D) If a person taken into custody under this section is  3160
transported to a general hospital, the general hospital may  3161
admit the person, or provide care and treatment for the person,  3162
or both, notwithstanding section 5119.33 of the Revised Code,  3163
but by the end of twenty-four hours after arrival at the general  3164
hospital, the person shall be transferred to a hospital as  3165
defined in section 5122.01 of the Revised Code.  3166
       (E) A person transported or transferred to a hospital or  3167
community mental health services provider under this section  3168
shall be examined by the staff of the hospital or services  3169
provider within twenty-four hours after arrival at the hospital  3170
or services provider. If to conduct the examination requires  3171
that the person remain overnight, the hospital or services  3172
provider shall admit the person in an unclassified status until  3173
making a disposition under this section. After the examination,  3174
if the chief clinical officer of the hospital or services  3175
provider believes that the person is not a person with a mental  3176
illness subject to court order, the chief clinical officer shall  3177
release or discharge the person immediately unless a court has  3178
issued a temporary order of detention applicable to the person  3179
under section 5122.11 of the Revised Code. After the  3180
examination, if the chief clinical officer believes that the  3181
person is a person with a mental illness subject to court order,  3182
the chief clinical officer may detain the person for not more  3183
than three court days following the day of the examination and  3184
during such period admit the person as a voluntary patient under  3185
section 5122.02 of the Revised Code or file an affidavit under  3186
section 5122.11 of the Revised Code. If neither action is taken  3187
and a court has not otherwise issued a temporary order of  3188
detention applicable to the person under section 5122.11 of the  3189
Revised Code, the chief clinical officer shall discharge the  3190
Sub. H. B. No. 567  Page 112
As Reported by the House Health Committee
person at the end of the three-day period unless the person has  3191
been sentenced to the department of rehabilitation and  3192
correction and has not been released from the person's sentence,  3193
in which case the person shall be returned to that department.  3194
       Section 2. That existing sections 109.71, 3129.01,  3195
3313.5310, 3333.28, 3701.69, 3701.92, 3701.921, 3705.01,  3196
3705.30, 3707.58, 3721.011, 3728.01, 4503.44, 4723.01, 4723.063,  3197
4723.18, 4723.181, 4723.28, 4723.34, 4723.35, 4723.36, 4723.43,  3198
4723.431, 4723.47, 4723.481, 4723.482, 4723.483, 4723.493,  3199
4723.52, 4723.66, 4723.67, 4723.69, 4731.297, and 5122.10 of the  3200
Revised Code are hereby repealed.  3201
       Section 3. That sections 3701.923, 3701.924, 3701.925,  3202
3701.926, 3701.927, and 3701.929 of the Revised Code are hereby  3203
repealed.  3204
       Section 4. The amendment by this act of section 4723.063  3205
of the Revised Code does not supersede the repeal of that  3206
section on December 31, 2033, as prescribed by Section 610.110  3207
of H.B. 33 of the 135th General Assembly.  3208
       Section 5. The General Assembly, applying the principle  3209
stated in division (B) of section 1.52 of the Revised Code that  3210
amendments are to be harmonized if reasonably capable of  3211
simultaneous operation, finds that the following sections,  3212
presented in this act as composites of the sections as amended  3213
by the acts indicated, are the resulting versions of the  3214
sections in effect prior to the effective date of the sections  3215
as presented in this act:  3216
       Section 4503.44 of the Revised Code as amended by both  3217
H.B. 33 and H.B. 195 of the 135th General Assembly.  3218
       Section 4723.431 of the Revised Code as amended by both  3219
Sub. H. B. No. 567  Page 113
As Reported by the House Health Committee
H.B. 497 and S.B. 196 of the 135th General Assembly.  3220
       Section 4723.481 of the Revised Code as amended by H.B. 33  3221
of the 135th General Assembly and by H.B. 110 and H.B. 509 of  3222
the 134th General Assembly.  3223