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To amend sections 4723.482 and 4762.03 and to enact | 1 |
sections 2925.61, 4723.488, 4729.511, 4730.431, | 2 |
and 4731.94 of the Revised Code to provide for | 3 |
increased access to naloxone, to ensure English | 4 |
proficiency in licensed practitioners of Oriental | 5 |
medicine and acupuncture, to permit certain nurses | 6 |
seeking prescriptive authority to complete a | 7 |
portion of their study through Internet-based | 8 |
study and to declare an emergency. | 9 |
Section 1. That sections 4723.482 and 4762.03 be amended and | 10 |
sections 2925.61, 4723.488, 4729.511, 4730.431, and 4731.94 of the | 11 |
Revised Code be enacted to read as follows: | 12 |
Sec. 2925.61. (A) As used in this section: | 13 |
(1) "Administer naloxone" means to give naloxone to a person | 14 |
by either of the following routes: | 15 |
(a) Using a device manufactured for the intranasal | 16 |
administration of liquid drugs; | 17 |
(b) Using an autoinjector in a manufactured dosage form. | 18 |
(2) "Law enforcement agency" means a government entity that | 19 |
employs peace officers to perform law enforcement duties. | 20 |
(3) "Licensed health professional" means all of the | 21 |
following: | 22 |
(a) A physician who is authorized under Chapter 4731. of the | 23 |
Revised Code to practice medicine and surgery, osteopathic | 24 |
medicine and surgery, or podiatric medicine and surgery; | 25 |
(b) A physician assistant who holds a certificate to | 26 |
prescribe issued under Chapter 4730. of the Revised Code; | 27 |
(c) A clinical nurse specialist, certified nurse-midwife, or | 28 |
certified nurse practitioner who holds a certificate to prescribe | 29 |
issued under section 4723.48 of the Revised Code. | 30 |
(4) "Peace officer" has the same meaning as in section | 31 |
2921.51 of the Revised Code. | 32 |
(B) A family member, friend, or other individual who is in a | 33 |
position to assist an individual who is apparently experiencing or | 34 |
at risk of experiencing an opioid-related overdose, is not subject | 35 |
to criminal prosecution for a violation of section 4731.41 of the | 36 |
Revised Code or criminal prosecution under this chapter if the | 37 |
individual, acting in good faith, does all of the following: | 38 |
(1) Obtains naloxone from a licensed health professional or a | 39 |
prescription for naloxone from a licensed health professional; | 40 |
(2) Administers that naloxone to an individual who is | 41 |
apparently experiencing an opioid-related overdose; | 42 |
(3) Attempts to summon emergency services either immediately | 43 |
before or immediately after administering the naloxone. | 44 |
(C) Division (B) of this section does not apply to a peace | 45 |
officer or to an emergency medical technician-basic, emergency | 46 |
medical technician-intermediate, or emergency medical | 47 |
technician-paramedic, as defined in section 4765.01 of the Revised | 48 |
Code. | 49 |
(D) A peace officer employed by a law enforcement agency | 50 |
licensed under Chapter 4729. of the Revised Code as a terminal | 51 |
distributor of dangerous drugs is not subject to administrative | 52 |
action, criminal prosecution for a violation of section 4731.41 of | 53 |
the Revised Code, or criminal prosecution under this chapter if | 54 |
the peace officer, acting in good faith, obtains naloxone from the | 55 |
peace officer's law enforcement agency and administers the | 56 |
naloxone to an individual who is apparently experiencing an | 57 |
opioid-related overdose. | 58 |
Sec. 4723.482. (A) Except as provided in divisions (C) and | 59 |
(D) of this section, an applicant shall include with the | 60 |
application submitted under section 4723.48 of the Revised Code | 61 |
all of the following: | 62 |
(1) Evidence of holding a current, valid certificate of | 63 |
authority to practice as a clinical nurse specialist, certified | 64 |
nurse-midwife, or certified nurse practitioner that was issued by | 65 |
meeting the requirements of division (A) of section 4723.41 of the | 66 |
Revised Code; | 67 |
(2) Evidence of successfully completing the course of study | 68 |
in advanced pharmacology and related topics in accordance with the | 69 |
requirements specified in division (B) of this section; | 70 |
(3) The fee required by section 4723.08 of the Revised Code | 71 |
for a certificate to prescribe; | 72 |
(4) Any additional information the board of nursing requires | 73 |
pursuant to rules adopted under section 4723.50 of the Revised | 74 |
Code. | 75 |
(B) With respect to the course of study in advanced | 76 |
pharmacology and related topics that must be successfully | 77 |
completed to obtain a certificate to prescribe, all of the | 78 |
following requirements apply: | 79 |
(1) The course of study shall be completed not longer than | 80 |
three years before the application for the certificate to | 81 |
prescribe is filed. | 82 |
(2) | 83 |
the course of study shall consist of planned classroom and | 84 |
clinical instruction | 85 |
study shall be not less than forty-five contact hours. | 86 |
(3) The course of study shall meet the requirements to be | 87 |
approved by the board in accordance with standards established in | 88 |
rules adopted under section 4723.50 of the Revised Code. | 89 |
(4) The content of the course of study shall be specific to | 90 |
the applicant's nursing specialty. | 91 |
(5) The instruction provided in the course of study shall | 92 |
include all of the following: | 93 |
(a) A minimum of thirty-six contact hours of instruction in | 94 |
advanced pharmacology that includes pharmacokinetic principles and | 95 |
clinical application and the use of drugs and therapeutic devices | 96 |
in the prevention of illness and maintenance of health; | 97 |
(b) Instruction in the fiscal and ethical implications of | 98 |
prescribing drugs and therapeutic devices; | 99 |
(c) Instruction in the state and federal laws that apply to | 100 |
the authority to prescribe; | 101 |
(d) Instruction that is specific to schedule II controlled | 102 |
substances, including instruction in all of the following: | 103 |
(i) Indications for the use of schedule II controlled | 104 |
substances in drug therapies; | 105 |
(ii) The most recent guidelines for pain management | 106 |
therapies, as established by state and national organizations such | 107 |
as the Ohio pain initiative and the American pain society; | 108 |
(iii) Fiscal and ethical implications of prescribing schedule | 109 |
II controlled substances; | 110 |
(iv) State and federal laws that apply to the authority to | 111 |
prescribe schedule II controlled substances; | 112 |
(v) Prevention of abuse and diversion of schedule II | 113 |
controlled substances, including identification of the risk of | 114 |
abuse and diversion, recognition of abuse and diversion, types of | 115 |
assistance available for prevention of abuse and diversion, and | 116 |
methods of establishing safeguards against abuse and diversion. | 117 |
(e) Any additional instruction required pursuant to rules | 118 |
adopted under section 4723.50 of the Revised Code. | 119 |
(C) An applicant who practiced or is practicing as a clinical | 120 |
nurse specialist, certified nurse-midwife, or certified nurse | 121 |
practitioner in another jurisdiction or as an employee of the | 122 |
United States government, and is not seeking authority to | 123 |
prescribe drugs and therapeutic devices by meeting the | 124 |
requirements of division (A) or (D) of this section, shall include | 125 |
with the application submitted under section 4723.48 of the | 126 |
Revised Code all of the following: | 127 |
(1) Evidence of holding a current, valid certificate of | 128 |
authority issued under this chapter to practice as a clinical | 129 |
nurse specialist, certified nurse-midwife, or certified nurse | 130 |
practitioner; | 131 |
(2) The fee required by section 4723.08 of the Revised Code | 132 |
for a certificate to prescribe; | 133 |
(3) Either of the following: | 134 |
(a) Evidence of having held, for a continuous period of at | 135 |
least one year during the three years immediately preceding the | 136 |
date of application, valid authority issued by another | 137 |
jurisdiction to prescribe therapeutic devices and drugs, including | 138 |
at least some controlled substances; | 139 |
(b) Evidence of having been employed by the United States | 140 |
government and authorized, for a continuous period of at least one | 141 |
year during the three years immediately preceding the date of | 142 |
application, to prescribe therapeutic devices and drugs, including | 143 |
at least some controlled substances, in conjunction with that | 144 |
employment. | 145 |
(4) Evidence of having completed a two-hour course of | 146 |
instruction approved by the board in the laws of this state that | 147 |
govern drugs and prescriptive authority; | 148 |
(5) Any additional information the board requires pursuant to | 149 |
rules adopted under section 4723.50 of the Revised Code. | 150 |
(D) An applicant who practiced or is practicing as a clinical | 151 |
nurse specialist, certified nurse-midwife, or certified nurse | 152 |
practitioner in another jurisdiction or as an employee of the | 153 |
United States government, and is not seeking authority to | 154 |
prescribe drugs and therapeutic devices by meeting the | 155 |
requirements of division (A) or (C) of this section, shall include | 156 |
with the application submitted under section 4723.48 of the | 157 |
Revised Code all of the following: | 158 |
(1) Evidence of holding a current, valid certificate of | 159 |
authority issued under this chapter to practice as a clinical | 160 |
nurse specialist, certified nurse-midwife, or certified nurse | 161 |
practitioner; | 162 |
(2) The fee required by section 4723.08 of the Revised Code | 163 |
for a certificate to prescribe; | 164 |
(3) Either of the following: | 165 |
(a) Evidence of having held, for a continuous period of at | 166 |
least one year during the three years immediately preceding the | 167 |
date of application, valid authority issued by another | 168 |
jurisdiction to prescribe therapeutic devices and drugs, excluding | 169 |
controlled substances; | 170 |
(b) Evidence of having been employed by the United States | 171 |
government and authorized, for a continuous period of at least one | 172 |
year during the three years immediately preceding the date of | 173 |
application, to prescribe therapeutic devices and drugs, excluding | 174 |
controlled substances, in conjunction with that employment. | 175 |
(4) Any additional information the board requires pursuant to | 176 |
rules adopted under section 4723.50 of the Revised Code. | 177 |
(E) In the case of an applicant who meets the requirements of | 178 |
division (C) or (D) of this section other than the requirements of | 179 |
division (C)(3) or (D)(3) of this section and is seeking authority | 180 |
to prescribe drugs and therapeutic devices by meeting the | 181 |
requirements of division (A) of this section, the applicant may | 182 |
complete the instruction that is specific to schedule II | 183 |
controlled substances, as required by division (B)(5)(d) of this | 184 |
section, through an internet-based course of study in lieu of | 185 |
completing the instruction through a course of study consisting of | 186 |
planned classroom and clinical instruction. | 187 |
Sec. 4723.488. (A) Notwithstanding any provision of this | 188 |
chapter or rule adopted by the board of nursing, a clinical nurse | 189 |
specialist, certified nurse-midwife, or certified nurse | 190 |
practitioner who holds a certificate to prescribe issued under | 191 |
section 4723.48 of the Revised Code may personally furnish a | 192 |
supply of naloxone, or issue a prescription for naloxone, without | 193 |
having examined the individual to whom it may be administered if | 194 |
all of the following conditions are met: | 195 |
(1) The naloxone supply is furnished to, or the prescription | 196 |
is issued to and in the name of, a family member, friend, or other | 197 |
individual in a position to assist an individual who there is | 198 |
reason to believe is at risk of experiencing an opioid-related | 199 |
overdose. | 200 |
(2) The nurse instructs the individual receiving the naloxone | 201 |
supply or prescription to summon emergency services either | 202 |
immediately before or immediately after administering naloxone to | 203 |
an individual apparently experiencing an opioid-related overdose. | 204 |
(3) The naloxone is personally furnished or prescribed in | 205 |
such a manner that it may be administered by only either of the | 206 |
following routes: | 207 |
(a) Using a device manufactured for the intranasal | 208 |
administration of liquid drugs; | 209 |
(b) Using an autoinjector in a manufactured dosage form. | 210 |
(B) A nurse who under division (A) of this section in good | 211 |
faith furnishes a supply of naloxone or issues a prescription for | 212 |
naloxone is not liable for or subject to any of the following for | 213 |
any action or omission of the individual to whom the naloxone is | 214 |
furnished or the prescription is issued: damages in any civil | 215 |
action, prosecution in any criminal proceeding, or professional | 216 |
disciplinary action. | 217 |
Sec. 4729.511. (A) As used in this section, "naloxone | 218 |
distributor" means either of the following: | 219 |
(1) A wholesale distributor of dangerous drugs; | 220 |
(2) A terminal distributor of dangerous drugs that supplies | 221 |
naloxone to any entity under division (B)(1) of this section. | 222 |
(B)(1) A naloxone distributor shall prioritize the sale, | 223 |
distribution, and delivery of naloxone to all of the following: | 224 |
(a) A children's hospital, as defined in section 3727.01 of | 225 |
the Revised Code; | 226 |
(b) A hospital, as defined in section 3727.01 of the Revised | 227 |
Code; | 228 |
(c) An emergency medical service organization, as defined in | 229 |
section 4765.01 of the Revised Code; | 230 |
(d) A facility that is operated as an urgent care center. | 231 |
(2) The order in which the entities are listed in division | 232 |
(B)(1) of this section does not establish levels of priority among | 233 |
the listed entities. | 234 |
(C) A naloxone distributor who in good faith complies with | 235 |
division (B) of this section is not liable for or subject to any | 236 |
of the following for an act or omission arising from that | 237 |
compliance: damages in any civil action, prosecution in any | 238 |
criminal proceeding, or professional disciplinary action. | 239 |
Sec. 4730.431. (A) Notwithstanding any provision of this | 240 |
chapter or rule adopted by the state medical board, a physician | 241 |
assistant who holds a certificate to prescribe issued under this | 242 |
chapter may personally furnish a supply of naloxone, or issue a | 243 |
prescription for naloxone, without having examined the individual | 244 |
to whom it may be administered if all of the following conditions | 245 |
are met: | 246 |
(1) The naloxone supply is furnished to, or the prescription | 247 |
is issued to and in the name of, a family member, friend, or other | 248 |
individual in a position to assist an individual who there is | 249 |
reason to believe is at risk of experiencing an opioid-related | 250 |
overdose. | 251 |
(2) The physician assistant instructs the individual | 252 |
receiving the naloxone supply or prescription to summon emergency | 253 |
services either immediately before or immediately after | 254 |
administering naloxone to an individual apparently experiencing an | 255 |
opioid-related overdose. | 256 |
(3) The naloxone is personally furnished or prescribed in | 257 |
such a manner that it may be administered by only either of the | 258 |
following routes: | 259 |
(a) Using a device manufactured for the intranasal | 260 |
administration of liquid drugs; | 261 |
(b) Using an autoinjector in a manufactured dosage form. | 262 |
(B) A physician assistant who under division (A) of this | 263 |
section in good faith furnishes a supply of naloxone or issues a | 264 |
prescription for naloxone is not liable for or subject to any of | 265 |
the following for any action or omission of the individual to whom | 266 |
the naloxone is furnished or the prescription is issued: damages | 267 |
in any civil action, prosecution in any criminal proceeding, or | 268 |
professional disciplinary action. | 269 |
Sec. 4731.94. (A) As used in this section, "physician" means | 270 |
an individual authorized under this chapter to practice medicine | 271 |
and surgery, osteopathic medicine and surgery, or podiatric | 272 |
medicine and surgery. | 273 |
(B) Notwithstanding any provision of this chapter or rule | 274 |
adopted by the state medical board, a physician may personally | 275 |
furnish a supply of naloxone, or issue a prescription for | 276 |
naloxone, without having examined the individual to whom it may be | 277 |
administered if all of the following conditions are met: | 278 |
(1) The naloxone supply is furnished to, or the prescription | 279 |
is issued to and in the name of, a family member, friend, or other | 280 |
individual in a position to assist an individual who there is | 281 |
reason to believe is at risk of experiencing an opioid-related | 282 |
overdose. | 283 |
(2) The physician instructs the individual receiving the | 284 |
naloxone supply or prescription to summon emergency services | 285 |
either immediately before or immediately after administering the | 286 |
naloxone to an individual apparently experiencing an | 287 |
opioid-related overdose. | 288 |
(3) The naloxone is personally furnished or prescribed in | 289 |
such a manner that it may be administered by only either of the | 290 |
following routes: | 291 |
(a) Using a device manufactured for the intranasal | 292 |
administration of liquid drugs; | 293 |
(b) Using an autoinjector in a manufactured dosage form. | 294 |
(C) A physician who under division (B) of this section in | 295 |
good faith furnishes a supply of naloxone or issues a prescription | 296 |
for naloxone is not liable for or subject to any of the following | 297 |
for any action or omission of the individual to whom the naloxone | 298 |
is furnished or the prescription is issued: damages in any civil | 299 |
action, prosecution in any criminal proceeding, or professional | 300 |
disciplinary action. | 301 |
Sec. 4762.03. (A) An individual seeking a certificate to | 302 |
practice as an oriental medicine practitioner or certificate to | 303 |
practice as an acupuncturist shall file with the state medical | 304 |
board a written application on a form prescribed and supplied by | 305 |
the board. | 306 |
(B) To be eligible for the certificate to practice, an | 307 |
applicant shall meet all of the following conditions, as | 308 |
applicable: | 309 |
(1) The applicant shall submit evidence satisfactory to the | 310 |
board that the applicant is at least eighteen years of age and of | 311 |
good moral character. | 312 |
(2) In the case of an applicant seeking a certificate to | 313 |
practice as an oriental medicine practitioner, the applicant shall | 314 |
submit evidence satisfactory to the board of both of the | 315 |
following: | 316 |
(a) That the applicant holds a current and active designation | 317 |
from the national certification commission for acupuncture and | 318 |
oriental medicine as either a diplomate in oriental medicine or | 319 |
diplomate of acupuncture and Chinese herbology; | 320 |
(b) That the applicant has successfully completed, in the | 321 |
two-year period immediately preceding application for the | 322 |
certificate to practice, one course approved by the commission on | 323 |
federal food and drug administration dispensary and compounding | 324 |
guidelines and procedures. | 325 |
(3) In the case of an applicant seeking a certificate to | 326 |
practice as an acupuncturist, the applicant shall submit evidence | 327 |
satisfactory to the board that the applicant holds a current and | 328 |
active designation from the national certification commission for | 329 |
acupuncture and oriental medicine as a diplomate in acupuncture. | 330 |
(4) The applicant shall demonstrate to the board proficiency | 331 |
in spoken English by | 332 |
following requirements: | 333 |
(a) Passing the examination described in section 4731.142 of | 334 |
the Revised Code | 335 |
(b) Submitting evidence satisfactory to the board that the | 336 |
applicant was required to demonstrate proficiency in spoken | 337 |
English as a condition of obtaining designation from the national | 338 |
certification commission for acupuncture and oriental medicine as | 339 |
a diplomate in oriental medicine, diplomate of acupuncture and | 340 |
Chinese herbology, or diplomate in acupuncture; | 341 |
(c) Submitting evidence satisfactory to the board that the | 342 |
applicant, in seeking a designation from the national | 343 |
certification commission for acupuncture and oriental medicine as | 344 |
a diplomate of oriental medicine, diplomate of acupuncture and | 345 |
Chinese herbology, or diplomate of acupuncture, has successfully | 346 |
completed in English the examination required for such a | 347 |
designation by the national certification commission for | 348 |
acupuncture and oriental medicine; | 349 |
(d) In the case of an applicant seeking a certificate to | 350 |
practice as an oriental medicine practitioner, submitting evidence | 351 |
satisfactory to the board that the applicant has previously held a | 352 |
certificate to practice as an acupuncturist issued under section | 353 |
4762.04 of the Revised Code. | 354 |
(5) The applicant shall submit to the board any other | 355 |
information the board requires. | 356 |
(6) The applicant shall pay to the board a fee of one hundred | 357 |
dollars, no part of which may be returned to the applicant. | 358 |
(C) The board shall review all applications received under | 359 |
this section. The board shall determine whether an applicant meets | 360 |
the requirements to receive a certificate to practice not later | 361 |
than sixty days after receiving a complete application. The | 362 |
affirmative vote of not fewer than six members of the board is | 363 |
required to determine that an applicant meets the requirements for | 364 |
a certificate. | 365 |
Section 2. That existing sections 4723.482 and 4762.03 of the | 366 |
Revised Code are hereby repealed. | 367 |
Section 3. This act is hereby declared to be an emergency | 368 |
measure necessary for the immediate preservation of the public | 369 |
peace, health, and safety. The reason for such necessity is to | 370 |
enhance the delivery of health services in this state by promptly | 371 |
increasing access to certain forms of care, including Oriental | 372 |
medicine, acupuncture, services of certain nurses with | 373 |
prescriptive authority, and emergency treatments for drug | 374 |
overdoses. Therefore, this act shall go into immediate effect. | 375 |