Bill Text: OH HB667 | 2013-2014 | 130th General Assembly | Introduced

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Bill Title: To make changes to the law governing respiratory care professionals.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2014-11-13 - To Health and Aging [HB667 Detail]

Download: Ohio-2013-HB667-Introduced.html

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As Introduced

130th General Assembly Regular Session 2013-2014

H. B. No. 667

Representative Schuring 

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A BILL

To amend sections 4730.09, 4761.01, 4761.03, 4761.04,

1

4761.05, 4761.06, 4761.07, 4761.09, and 4761.17 of

2

the Revised Code to make changes to the law

3

governing respiratory care professionals.

4

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1. That sections 4730.09, 4761.01, 4761.03, 4761.04,	5
4761.05, 4761.06, 4761.07, 4761.09, and 4761.17 of the Revised	6
Code be amended to read as follows:	7

Sec. 4730.09. (A) Under a physician supervisory plan approved	8
under section 4730.17 of the Revised Code, a physician assistant	9
may provide any or all of the following services without approval	10
by the state medical board as special services:	11

(1) Obtaining comprehensive patient histories;

12

(2) Performing physical examinations, including audiometry	13
screening, routine visual screening, and pelvic, rectal, and	14
genital-urinary examinations, when indicated;	15

(3) Ordering, performing, or ordering and performing routine	16
diagnostic procedures, as indicated;	17

(4) Identifying normal and abnormal findings on histories,	18
physical examinations, and commonly performed diagnostic studies;	19

(5) Assessing patients and developing and implementing	20
treatment plans for patients;	21

(6) Monitoring the effectiveness of therapeutic	22
interventions;	23

(7) Exercising physician-delegated prescriptive authority	24
pursuant to a certificate to prescribe issued under this chapter;	25

(8) Carrying out or relaying the supervising physician's	26
orders for the administration of medication, to the extent	27
permitted by law;	28

(9) Providing patient education;

29

(10) Instituting and changing orders on patient charts;

30

(11) Performing developmental screening examinations on	31
children with regard to neurological, motor, and mental functions;	32

(12) Performing wound care management, suturing minor	33
lacerations and removing the sutures, and incision and drainage of	34
uncomplicated superficial abscesses;	35

(13) Removing superficial foreign bodies;

36

(14) Administering intravenous fluids;

37

(15) Inserting a foley or cudae catheter into the urinary	38
bladder and removing the catheter;	39

(16) Performing biopsies of superficial lesions;

40

(17) Making appropriate referrals as directed by the	41
supervising physician;	42

(18) Performing penile duplex ultrasound;

43

(19) Changing of a tracheostomy;

44

(20) Performing bone marrow aspirations from the posterior	45
iliac crest;	46

(21) Performing bone marrow biopsies from the posterior iliac	47
crest;	48

(22) Performing cystograms;

49

(23) Performing nephrostograms after physician placement of	50
nephrostomy tubes;	51

(24) Fitting, inserting, or removing birth control devices;

52

(25) Removing cervical polyps;

53

(26) Performing nerve conduction testing;

54

(27) Performing endometrial biopsies;

55

(28) Inserting filiform and follower catheters;

56

(29) Performing arthrocentesis of the knee;

57

(30) Performing knee joint injections;

58

(31) Performing endotracheal intubation with successful	59
completion of an advanced cardiac life support course;	60

(32) Performing lumbar punctures;

61

(33) In accordance with rules adopted by the board, using	62
light-based medical devices for the purpose of hair removal;	63

(34) Administering, monitoring, or maintaining local	64
anesthesia, as defined in section 4730.091 of the Revised Code;	65

(35) Applying or removing a cast or splint;

66

(36) Inserting or removing chest tubes;

67

(37) Prescribing physical therapy or referring a patient to a	68
physical therapist for the purpose of receiving physical therapy;	69

(38) Ordering occupational therapy or referring a patient to	70
an occupational therapist for the purpose of receiving	71
occupational therapy;	72

(39) Prescribing or ordering respiratory care or referring a	73
patient to a respiratory care professional for the purpose of	74
receiving respiratory care;	75

(40) Taking any action that may be taken by an attending	76
physician under sections 2133.21 to 2133.26 of the Revised Code,	77
as specified in section 2133.211 of the Revised Code;	78

(40)(41) Determining and pronouncing death in accordance with	79
section 4730.092 of the Revised Code;	80

(41)(42) Admitting patients to hospitals in accordance with	81
section 3727.06 of the Revised Code;	82

(42)(43) Performing other services that are within the	83
supervising physician's normal course of practice and expertise,	84
if the services are included in any model physician supervisory	85
plan approved under section 4730.06 of the Revised Code or the	86
services are designated by the board by rule or other means as	87
services that are not subject to approval as special services.	88

(B) Under the policies of a health care facility, the	89
services a physician assistant may provide are limited to the	90
services the facility has authorized the physician assistant to	91
provide for the facility. The services a health care facility may	92
authorize a physician assistant to provide for the facility	93
include the following:	94

(1) Any or all of the services specified in division (A) of	95
this section;	96

(2) Assisting in surgery in the health care facility;

97

(3) Any other services permitted by the policies of the	98
health care facility, except that the facility may not authorize a	99
physician assistant to perform a service that is prohibited by	100
this chapter.	101

Sec. 4761.01.  As used in this chapter:

102

(A) "Respiratory care" means rendering or offering to render	103
to individuals, groups, organizations, or the public any service	104
involving the evaluation of cardiopulmonary function, the	105
treatment of cardiopulmonary impairment, the assessment of	106
treatment effectiveness, and the care of patients with	107
deficiencies and abnormalities associated with the cardiopulmonary	108
system. The practice of respiratory care includes:	109

(1) Obtaining, analyzing, testing, measuring, and monitoring	110
blood and gas samples in the determination of cardiopulmonary	111
parameters and related physiologic data, including flows,	112
pressures, and volumes, and the use of equipment employed for this	113
purpose;	114

(2) Administering, monitoring, recording the results of, and	115
instructing in the use of medical gases, aerosols, and	116
bronchopulmonary hygiene techniques, including drainage,	117
aspiration, and sampling, and applying, maintaining, and	118
instructing in the use of artificial airways, ventilators, and	119
other life support equipment employed in the treatment of	120
cardiopulmonary impairment and provided in collaboration with	121
other licensed health care professionals responsible for providing	122
care;	123

(3) Performing cardiopulmonary resuscitation and respiratory	124
rehabilitation techniques;	125

(4) Administering medications for the testing or treatment of	126
cardiopulmonary impairment.	127

(B) "Respiratory care professional" means a person who is	128
licensed under this chapter to practice the full range of	129
respiratory care services as defined in division (A) of this	130
section.	131

(C) "Physician" means an individual authorized under Chapter	132
4731. of the Revised Code to practice medicine and surgery or	133
osteopathic medicine and surgery.	134

(D) "Registered nurse" means an individual licensed under	135
Chapter 4723. of the Revised Code to engage in the practice of	136
nursing as a registered nurse.	137

(E) "Hospital" means a facility that meets the operating	138
standards of section 3727.02 of the Revised Code.	139

(F) "Nursing facility" has the same meaning as in section	140
5165.01 of the Revised Code.	141

(G) "Nursing home" has the same meaning as in section 3721.01	142
of the Revised Code.	143

(H) "Dangerous drug" has the same meaning as in section	144
4729.01 of the Revised Code.	145

(I) "Certified hyperbaric technologist" means a person who	146
administers hyperbaric oxygen therapy and is certified as a	147
hyperbaric technologist by the national board of diving and	148
hyperbaric medical technology or its successor organization.	149

(H)(J) "Hyperbaric oxygen therapy" means the administration	150
of pure oxygen in a pressurized room or chamber, except that it	151
does not include ventilator management.	152

(I)(K) "Advanced practice registered nurse" has the same	153
meaning as in section 4723.01 of the Revised Code.	154

(J)(L) "Physician assistant" means an individual who holds a	155
valid certificate to practice issued under Chapter 4730. of the	156
Revised Code authorizing the individual to provide services as a	157
physician assistant to patients under the supervision, control,	158
and direction of one or more physicians.	159

Sec. 4761.03.  The Ohio respiratory care board shall regulate	160
the practice of respiratory care in this state and the persons to	161
whom the board issues licenses and limited permits under this	162
chapter and shall license and register home medical equipment	163
services providers under Chapter 4752. of the Revised Code. Rules	164
adopted under this chapter that deal with the provision of	165
respiratory care in a hospital, other than rules regulating the	166
issuance of licenses or limited permits, shall be consistent with	167
the conditions for participation under medicare, Title XVIII of	168
the "Social Security Act," 79 Stat. 286 (1965), 42 U.S.C.A. 1395,	169
as amended, and with the respiratory care accreditation standards	170
of the joint commission on accreditation of healthcare	171
organizations or the American osteopathic association.	172

(A) The board shall:

173

(A) Adoptadopt, and may rescind or amend, rules in	174
accordance with Chapter 119. of the Revised Code to carry out the	175
purposes of this chapter, including rules prescribing:	176

(1) The form and manner for filing applications for licensure	177
and renewal, limited permits, and limited permit extensions under	178
sections 4761.05 and 4761.06 of the Revised Code;	179

(2) The form, scoring, and scheduling of examinations and	180
reexaminations administered by the board for licensure and,	181
license renewal, and license reinstatement or standards for the	182
board's recognition of examinations administered by state or	183
national organizations;	184

(3) Standards for the approval of educational programs	185
required to qualify for licensure and continuing education	186
programs required for license renewal;	187

(4) Continuing education courses and the number of hour	188
requirements necessary for license renewal, in accordance with	189
section 4761.06 of the Revised Code;	190

(5) Procedures for the issuance and renewal of licenses and	191
limited permits, including the duties that may be fulfilled by the	192
board's executive director and other board employees;	193

(6) Procedures for the denial, suspension, permanent	194
revocation, refusal to renew, and reinstatement of licenses and	195
limited permits, the conduct of hearings, and the imposition of	196
fines for engaging in conduct that is grounds for such action and	197
hearings under section 4761.09 of the Revised Code;	198

(7) Standards of ethical conduct for the practice of	199
respiratory care;	200

(8) Conditions under which the license renewal fee and	201
continuing education requirements may be waived at the request of	202
a licensee who is not in active practice;	203

(9) The respiratory care tasks that may be performed by an	204
individual practicing as a polysomnographic technologist pursuant	205
to division (B)(3) of section 4761.10 of the Revised Code;	206

(10) Procedures for registering out-of-state respiratory care	207
providers authorized to practice in this state under division	208
(A)(4) of section 4761.11 of the Revised Code;	209

(11) Requirements for criminal records checks of applicants	210
under section 4776.03 of the Revised Code;	211

(12) Procedures for accepting and storing copies of	212
hyperbaric technologist certifications filed with the board	213
pursuant to division (A)(11) of section 4761.11 of the Revised	214
Code;	215

(13) Standards to be followed by a hospital or nursing home	216
in developing a protocol for purposes of section 4761.17 of the	217
Revised Code;	218

(14) Conditions that must be met to be considered in good	219
standing in a board-approved respiratory care educational program.	220

(B) DetermineThe board shall determine the sufficiency of an	221
applicant's qualifications for admission to the licensing	222
examination or a reexamination, and for the issuance or renewal of	223
a license or limited permit;.	224

(C) DetermineThe board shall determine the respiratory care	225
educational programs that are acceptable for fulfilling the	226
requirements of division (A) of section 4761.04 of the Revised	227
Code;.	228

(D) ScheduleThe board shall schedule, administer, and score	229
the licensing examination or any reexamination for license renewal	230
or reinstatement or, for use as the licensing examination or any	231
reexamination for license renewal or reinstatement, recognize one	232
or more examinations that meet the standards prescribed by the	233
board in rules adopted under this section and are administered by	234
state or national organizations. TheIf the board shall administer	235
administers the licensing examinationsexamination, it shall be	236
administered at least twice a year and the board shall notify	237
applicants of the time and place of the examinations.	238

(E) InvestigateThe board shall investigate complaints	239
concerning alleged violations of section 4761.10 of the Revised	240
Code or grounds for the suspension, permanent revocation, or	241
refusal to issue licenses or limited permits under section 3123.47	242
or 4761.09 of the Revised Code. The board shall employ	243
investigators who shall, under the direction of the executive	244
director of the board, investigate complaints and make inspections	245
and other inquiries as, in the judgment of the board, are	246
appropriate to enforce sections 3123.41 to 3123.50, 4761.09, and	247
4761.10 of the Revised Code. Pursuant to an investigation and	248
inspection, the investigators may review and audit records during	249
normal business hours at the place of business of a licensee or	250
person who is the subject of a complaint filed with the board or	251
at any place where the records are kept.	252

Except when required by court order, the board and its	253
employees shall not disclose confidential information obtained	254
during an investigation or identifying information about any	255
person who files a complaint with the board.	256

The board may hear testimony in matters relating to the	257
duties imposed upon it and issue subpoenas pursuant to an	258
investigation. The president and secretary of the board may	259
administer oaths.	260

(F) ConductThe board shall conduct hearings, keep records of	261
its proceedings, and do other things as are necessary and proper	262
to carry out and enforce the provisions of this chapter;.	263

(G) MaintainThe board shall maintain, publish, and make	264
available upon request, for a fee not to exceed the actual cost of	265
printing and mailing:	266

(1) The requirements for the issuance of licenses and limited	267
permits under this chapter and rules adopted by the board;	268

(2) A current register of every person licensed to practice	269
respiratory care in this state, to include the addresses of the	270
person's last known place of business and residence, the effective	271
date and identification number of the license, the name and	272
location of the institution that granted the person's degree or	273
certificate of completion of respiratory care educational	274
requirements, and the date the degree or certificate was issued;	275

(3) A list of the names and locations of the institutions	276
that each year granted degrees or certificates of completion in	277
respiratory care;	278

(4) After the administration of each examination, a list of	279
persons who passed the examination.	280

(H) SubmitThe board shall submit to the governor and to the	281
general assembly each year a report of all of its official actions	282
during the preceding year, together with any findings and	283
recommendations with regard to the improvement of the profession	284
of respiratory care;.	285

(I) AdministerThe board shall administer and enforce Chapter	286
4752. of the Revised Code.	287

Sec. 4761.04.  (A) Except as provided in division (B) of this	288
section, no person is eligible for licensure as a respiratory care	289
professional unless the person has shown, to the satisfaction of	290
the Ohio respiratory care board, all of the following:	291

(1) That the person is of good moral character;

292

(2) That the person has successfully completed the	293
requirements of an educational program approved by the board that	294
includes instruction in the biological and physical sciences,	295
pharmacology, respiratory care theory, procedures, and clinical	296
practice, and cardiopulmonary rehabilitation techniques;	297

(3) That the person has passed an examination administered by	298
the board that tests the applicant's knowledge of the basic and	299
clinical sciences relating to respiratory care theory and	300
practice, professional skills and judgment in the utilization of	301
respiratory care techniques, and such other subjects as the board	302
considers useful in determining fitness to practice.	303

(B) The board may waive the requirements of division (A) of	304
this section with respect to any applicant who presents proof of	305
current licensure in another state whose standards for licensure	306
are at least equal to those in effect in this state on the date of	307
application. The board may waive the requirements of divisions	308
(A)(2) and (3) of this section with respect to any applicant who	309
presents proof of having successfully completed anya licensing	310
examination administered by a state or national organization	311
recognized by the board as meetingan examination that meets the	312
requirements of division (A)(3) of this section and the standards	313
for recognition prescribed by the board in rules adopted under	314
section 4761.03 of the Revised Code.	315

Sec. 4761.05.  (A) The Ohio respiratory care board shall	316
issue a license to any applicant who complies with the	317
requirements of section 4761.04 of the Revised Code, files the	318
prescribed application form, and pays the fee or fees required	319
under section 4761.07 of the Revised Code. The license entitles	320
the holder to practice respiratory care. The licensee shall	321
display the license in a conspicuous place at the licensee's	322
principal place of business.	323

(B)(1) The board shall issue a limited permit to any	324
applicant who meets the requirements of division (A)(1) of section	325
4761.04 of the Revised Code, files the prescribed application	326
form, pays the fee required under section 4761.07 of the Revised	327
Code, and meets either of the following requirements:	328

(a) Is enrolled in and ismeets the conditions prescribed by	329
the board in rules adopted under section 4761.03 of the Revised	330
Code to be considered in good standing in a respiratory care	331
educational program approved by the board that meets the	332
requirements of division (A)(2) of section 4761.04 of the Revised	333
Code leading to a degree or certificate of completion or is a	334
graduate of the program;	335

(b) Is employed as a provider of respiratory care in this	336
state and was employed as a provider of respiratory care in this	337
state prior to March 14, 1989.	338

(2) The limited permit authorizes the holder to provide	339
respiratory care under the supervision of a respiratory care	340
professional. A person issued a limited permit under division	341
(B)(1)(a) of this section may practice respiratory care under the	342
limited permit for not more thanuntil the earliest of the	343
following:	344

(a) Three years after the date the limited permit is issued;

345

(b) One year following the date of receipt of a certificate	346
of completion from a board-approved respiratory care education	347
program;	348

(c) UntilThe date that the holder discontinues participation	349
in thea board-approved respiratory care educational program;	350

(d) The date that the holder no longer meets the conditions	351
prescribed by the board in rules adopted under section 4761.03 of	352
the Revised Code to be considered in good standing in a	353
board-approved respiratory care educational program.	354

The board may extend the term of a limited permit in cases of	355
unusual hardship. The holder seeking an extension shall petition	356
the board in the form and manner prescribed by the board in rules	357
adopted under section 4761.03 of the Revised Code. This division	358
does not require a student enrolled in an educational program	359
leading to a degree or certificate of completion in respiratory	360
care approved by the board to obtain a limited permit to perform	361
any duties that are part of the required course of study.	362

(3) A person issued a limited permit under division (B)(1)(b)	363
of this section may practice under a limited permit for not more	364
than three years, except that this restriction does not apply to a	365
permit holder who, on March 14, 1989, has been employed as a	366
provider of respiratory care for an average of not less than	367
twenty-five hours per week for a period of not less than five	368
years by a hospital.	369

(C) All holders of licenses and limited permits issued under	370
this section shall display, in a conspicuous place on their	371
persons, information that identifies the type of authorization	372
under which they practice.	373

Sec. 4761.06.  (A) Each license to practice respiratory care	374
shall be renewed biennially. Each limited permit to practice	375
respiratory care shall be renewed annually. Each person holding a	376
license or limited permit to practice respiratory care shall apply	377
to the Ohio respiratory care board on the form and according to	378
the schedule prescribed by the board for renewal of the license or	379
limited permit. Licenses and limited permits shall be renewed in	380
accordance with the standard renewal procedure of Chapter 4745. of	381
the Revised Code. The board shall renew a license upon the payment	382
of the license renewal fee prescribed under section 4761.07 of the	383
Revised Code and proof of satisfactory completion of the	384
continuing education or reexamination requirements of division (B)	385
of this section. The board shall renew a limited permit upon	386
payment of the limited permit renewal fee prescribed under section	387
4761.07 of the Revised Code and submission of one of the	388
following:	389

(1) If the limited permit was issued on the basis of division	390
(B)(1)(a) of section 4761.05 of the Revised Code, proof acceptable	391
to the board of enrollmentbeing enrolled in and meeting the	392
conditions prescribed by the board in rules adopted under section	393
4761.03 of the Revised Code to be considered in good standing in	394
an educational program that meets the requirements of division	395
(A)(2) of section 4761.04 of the Revised Code or of graduation	396
from such a program;	397

(2) If the limited permit was issued on the basis of division	398
(B)(1)(b) of section 4761.05 of the Revised Code, proof acceptable	399
to the board of employment as a provider of respiratory care.	400

(B) On and after March 14, 1991, and every year thereafter,	401
on or before the annual renewal date, the holder of a limited	402
permit issued under division (B)(1)(b) of section 4761.05 of the	403
Revised Code shall submit proof to the board that the holder has	404
satisfactorily completed the number of hours of continuing	405
education required by the board, which shall not be less than	406
three nor more than ten hours of continuing education acceptable	407
to the board.	408

On or before the biennial renewal date, a license holder	409
shall submit proof to the board that the license holder has	410
satisfactorily completed the number of hours of continuing	411
education required by the board, which shall be not less than six	412
nor more than twenty hours of continuing education acceptable to	413
the board, or has passed a reexamination in accordance with the	414
board's renewal requirements. The board may waive all or part of	415
the continuing education requirement for a license holder who has	416
held the license for less than two years.	417

Sec. 4761.07.  (A) The(1) Except as provided in division	418
(A)(2) of this section, the Ohio respiratory care board shall	419
charge any license applicant or holder who is to take an	420
examination required under division (A)(3) of section 4761.04 or a	421
reexamination required under division (B) of section 4761.06 of	422
the Revised Code for license renewal or under section 4761.09 of	423
the Revised Code for license reinstatement, a nonrefundable	424
examination fee, not to exceed the amount necessary to cover the	425
expense of administering the examination. The license applicant or	426
holder shall pay the fee at the time of application for licensure	427
or, renewal, or reinstatement.	428

(2) The examination fees described in division (A)(1) of this	429
section shall not be charged if the board recognizes for use as	430
the licensing examination or the reexamination for license renewal	431
or reinstatement one or more examinations that meet the standards	432
prescribed by the board in rules adopted under section 4761.03 of	433
the Revised Code and are administered by state or national	434
organizations.	435

(B) The board shall establish the following additional	436
nonrefundable fees and penalty:	437

(1) An initial license fee, not to exceed seventy-five	438
dollars;	439

(2) A biennial license renewal fee, not to exceed one hundred	440
dollars;	441

(3) A limited permit fee, not to exceed twenty dollars;

442

(4) A limited permit renewal fee, not to exceed ten dollars;

443

(5) A late renewal penalty, not to exceed fifty per cent of	444
the renewal fee;	445

(6) A fee for accepting and storing hyperbaric technologist	446
certifications filed with the board under division (A)(11) of	447
section 4761.11 of the Revised Code, not to exceed twenty dollars.	448

(C) Notwithstanding division (B)(4) of this section, after	449
the third renewal of a limited permit that meets the exception in	450
division (B)(3) of section 4761.05 of the Revised Code, the	451
limited permit renewal fee shall be one-half the amount of the	452
biennial license renewal fee established under division (B)(2) of	453
this section and section 4761.08 of the Revised Code.	454

(D) The board shall adjust the fees biennially and within the	455
limits established by division (B) of this section to provide	456
sufficient revenues to meet its expenses.	457

(E) The board may, by rule, provide for the waiver of all or	458
part of a license fee when the license is issued less than	459
eighteen months before its expiration date.	460

(F) All fees received by the board shall be deposited into	461
the state treasury to the credit of the occupational licensing and	462
regulatory fund.	463

Sec. 4761.09.  (A) The Ohio respiratory care board may refuse	464
to issue or renew a license or a limited permit, may issue a	465
reprimand, may suspend or permanently revoke a license or limited	466
permit, or may place a license or limited permit holder on	467
probation, on any of the following grounds:	468

(1) A plea of guilty to, a judicial finding of guilt of, or a	469
judicial finding of eligibility for intervention in lieu of	470
conviction for an offense involving moral turpitude or of a	471
felony, in which case a certified copy of the court record shall	472
be conclusive evidence of the matter;	473

(2) Violating any provision of this chapter or an order or	474
rule of the board;	475

(3) Assisting another person in that person's violation of	476
any provision of this chapter or an order or rule of the board;	477

(4) Obtaining a license or limited permit by means of fraud,	478
false or misleading representation, or concealment of material	479
facts or making any other material misrepresentation to the board;	480

(5) Being guilty of negligence or gross misconduct in the	481
practice of respiratory care;	482

(6) Violating the standards of ethical conduct adopted by the	483
board, in the practice of respiratory care;	484

(7) Engaging in dishonorable, unethical, or unprofessional	485
conduct of a character likely to deceive, defraud, or harm the	486
public;	487

(8) UsingPracticing or being present with an intent to	488
practice respiratory care while showing signs of impairment from	489
being under the influence of any dangerous drug, as defined in	490
section 4729.01 of the Revised Code, or alcohol to the extent that	491
the use impairs the ability to practice respiratory care at an	492
acceptable level of competency;	493

(9) Self-administering or otherwise taking into the body any	494
dangerous drub in any way that is not in accordance with a legal,	495
valid prescription issued for that individual, or	496
self-administering or otherwise taking into the body any drug that	497
is a schedule I controlled substance;	498

(10) Habitual or excessive use of controlled substances,	499
alcohol, or other habit-forming drugs or chemical substances to	500
the extent that the use impairs the individual's ability to	501
provide safe respiratory care;	502

(11) Practicing respiratory care while mentally incompetent;

503

(10)(12) Accepting commissions, rebates, or other forms of	504
remuneration for patient referrals;	505

(11)(13) Practicing in an area of respiratory care for which	506
the person is clearly untrained or incompetent or practicing in a	507
manner that conflicts with section 4761.17 of the Revised Code;	508

(12)(14) Employing, directing, or supervising a person who is	509
not authorized to practice respiratory care under this chapter in	510
the performance of respiratory care procedures;	511

(13)(15) Misrepresenting educational attainments or	512
authorized functions for the purpose of obtaining some benefit	513
related to the practice of respiratory care;	514

(14)(16) Assisting suicide as defined in section 3795.01 of	515
the Revised Code;	516

(17) Denial, revocation, suspension, or restriction of	517
authority to engage in a licensed profession or practice a health	518
care occupation, including respiratory care, in this state or any	519
other state or jurisdiction for any reason other than failure to	520
renew.	521

Before the board may take any action under this section,	522
other than issuance of a summary suspension order under division	523
(C) of this section, the executive director of the board shall	524
prepare and file written charges with the board. Disciplinary	525
actions taken by the board under this section shall be taken	526
pursuant to an adjudication under Chapter 119. of the Revised	527
Code, except that in lieu of an adjudication, the board may enter	528
into a consent agreement to resolve an allegation of a violation	529
of this chapter or any rule adopted under it. A consent agreement,	530
when ratified by the board, shall constitute the findings and	531
order of the board with respect to the matter addressed in the	532
agreement. If the board refuses to ratify a consent agreement, the	533
admissions and findings contained in the consent agreement shall	534
be of no effect.	535

(B) If the board orders a license or limited permit holder	536
placed on probation, the order shall be accompanied by a written	537
statement of the conditions under which the person may be restored	538
to practice.	539

The person may reapply to the board for original issuance of	540
a license after one year following the date the license was	541
denied.	542

A person may apply to the board for the reinstatement of a	543
license or limited permit after one year following the date of	544
suspension or refusal to renew. The board may accept or refuse the	545
application for reinstatement and may require that the applicant	546
pass a reexamination as a condition of eligibility for	547
reinstatement.	548

(C) If the president and secretary of the board determine	549
that there is clear and convincing evidence that a license or	550
limited permit holder has committed an act that is grounds for	551
board action under division (A) of this section and that continued	552
practice by the license or permit holder presents a danger of	553
immediate and serious harm to the public, the president and	554
secretary may recommend that the board suspend the license or	555
limited permit without a prior hearing. The president and	556
secretary shall submit in writing to the board the allegations	557
causing them to recommend the suspension.	558

On review of the allegations, the board, by a vote of not	559
less than seven of its members, may suspend a license or limited	560
permit without a prior hearing. The board may review the	561
allegations and vote on the suspension by a telephone conference	562
call.	563

If the board votes to suspend a license or limited permit	564
under this division, the board shall issue a written order of	565
summary suspension to the license or limited permit holder in	566
accordance with section 119.07 of the Revised Code. If the license	567
or limited permit holder requests a hearing by the board, the	568
board shall conduct the hearing in accordance with Chapter 119. of	569
the Revised Code. Notwithstanding section 119.12 of the Revised	570
Code, a court of common pleas shall not grant a suspension of the	571
board's order of summary suspension pending determination of an	572
appeal filed under that section.	573

Any order of summary suspension issued under this division	574
shall remain in effect until a final adjudication order issued by	575
the board pursuant to division (A) of this section becomes	576
effective. The board shall issue its final adjudication order	577
regarding an order of summary suspension issued under this	578
division not later than sixty days after completion of its	579
hearing. Failure to issue the order within sixty days shall result	580
in immediate dissolution of the suspension order, but shall not	581
invalidate any subsequent, final adjudication order.	582

Sec. 4761.17.  All of the following apply to the practice of	583
respiratory care by a person who holds a license or limited permit	584
issued under this chapter:	585

(A) The person shall practice only pursuant to aone of the	586
following:	587

(1) A prescription or other order for respiratory care issued	588
by aone of the following:	589

(a) A physician or by a;

590

(b) A registered nurse who holds a certificate of authority	591
issued under Chapter 4723. of the Revised Code to practice as a	592
certified nurse practitioner or clinical nurse specialist and has	593
entered into a standard care arrangement with a physician that	594
allows the nurse to prescribe or order respiratory care services;	595

(c) A physician assistant who holds a certificate to practice	596
issued under Chapter 4730. of the Revised Code and has entered	597
into a supervision agreement approved under section 4730.18 of the	598
Revised Code with a physician who allows the physician assistant	599
to prescribe or order respiratory care services.	600

(2) A protocol consisting of a set of treatment or medication	601
administration guidelines that are developed by a hospital or	602
nursing home under appropriate medical direction and with medical	603
staff approval and that comply with standards prescribed by the	604
Ohio respiratory care board in rules adopted under section 4761.03	605
of the Revised Code.	606

(B) The person shall practice only under the supervision of a	607
physician or under the supervision of a certified nurse	608
practitioner or, clinical nurse specialist, or physician assistant	609
who is authorized to prescribe or order respiratory care services	610
as provided in division (A) of this section.	611

(C) When practicing under the prescription or order of a	612
certified nurse practitioner or clinical nurse specialist or under	613
the supervision of such a nurse, the person's administration of	614
medication that requires a prescription is limited to the drugs	615
that the nurse is authorized to prescribe pursuant to the nurse's	616
certificate to prescribe issued under section 4723.48 of the	617
Revised Code.	618

(D) When practicing under the prescription or order of a	619
physician assistant or under the supervision of a physician	620
assistant, the person's administration of medication that requires	621
a prescription is limited to the drugs that the physician	622
assistant is authorized to prescribe pursuant to the physician	623
assistant's certificate to prescribe issued under section 4730.44	624
of the Revised Code.	625

Section 2.  That existing sections 4730.09, 4761.01, 4761.03,	626
4761.04, 4761.05, 4761.06, 4761.07, 4761.09, and 4761.17 of the	627
Revised Code are hereby repealed.	628