As Concurred by the Senate

129th General Assembly Regular Session 2011-2012

Am. Sub. S. B. No. 83

Senators Oelslager, Tavares 

Cosponsors: Senators Cafaro, Brown, Coley, Daniels, Hughes, Niehaus, Sawyer, Schiavoni, Turner, Wilson 

Representatives Goodwin, Fende, Antonio, Barnes, Gardner, Garland, Hackett, Hagan, R., Hill, Ramos, Yuko, Amstutz, Anielski, Blessing, Brenner, Celebrezze, Celeste, Cera, Damschroder, Driehaus, Fedor, Foley, Gerberry, Hagan, C., Heard, Hottinger, Huffman, Kozlowski, Letson, Luckie, Milkovich, Murray, O'Brien, Okey, Pillich, Reece, Ruhl, Sears, Slaby, Szollosi, Weddington, Williams, Winburn Speaker Batchelder 

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A BILL

To amend sections 3719.06, 4723.28, 4723.481,

1

4723.482, 4723.492, and 4723.50 of the Revised

2

Code to modify the authority of certain advanced

3

practice nurses to prescribe schedule II

4

controlled substances and to authorize the Board

5

of Nursing to take disciplinary actions for

6

self-administration of schedule I controlled

7

substances.

8

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

Section 1. That sections 3719.06, 4723.28, 4723.481,	9
4723.482, 4723.492, and 4723.50 of the Revised Code be amended to	10
read as follows:	11

Sec. 3719.06.  (A)(1) A licensed health professional	12
authorized to prescribe drugs, if acting in the course of	13
professional practice, in accordance with the laws regulating the	14
professional's practice, and in accordance with rules adopted by	15
the state board of pharmacy, may, except as provided in division	16
(A)(2) or (3) of this section, do the following:	17

(a) Prescribe schedule II, III, IV, and V controlled	18
substances;	19

(b) Administer or personally furnish to patients schedule II,	20
III, IV, and V controlled substances;	21

(c) Cause schedule II, III, IV, and V controlled substances	22
to be administered under the prescriber's direction and	23
supervision.	24

(2) A licensed health professional authorized to prescribe	25
drugs who is a clinical nurse specialist, certified nurse-midwife,	26
or certified nurse practitioner is subject to both of the	27
following:	28

(a) A schedule II controlled substance may be prescribed only	29
for a patient with a terminal condition, as defined in section	30
2133.01 of the Revised Code, only if the nurse's collaborating	31
physician initially prescribed the substance for the patient, and	32
only in an amount that does not exceed the amount necessary for	33
the patient's use in a single, twenty-four-hour periodin	34
accordance with division (C) of section 4723.481 of the Revised	35
Code.	36

(b) No schedule II controlled substance shall be personally	37
furnished to any patient.	38

(3) A licensed health professional authorized to prescribe	39
drugs who is a physician assistant shall not prescribe or	40
personally furnish to patients any controlled substance that is	41
not included in the physician-delegated prescriptive authority	42
granted to the physician assistant in accordance with Chapter	43
4730. of the Revised Code.	44

(B) No licensed health professional authorized to prescribe	45
drugs shall prescribe, administer, or personally furnish a	46
schedule III anabolic steroid for the purpose of human muscle	47
building or enhancing human athletic performance and no pharmacist	48
shall dispense a schedule III anabolic steroid for either purpose,	49
unless it has been approved for that purpose under the "Federal	50
Food, Drug, and Cosmetic Act," 52 Stat. 1040 (1938), 21 U.S.C.A.	51
301, as amended.	52

(C) Each written prescription shall be properly executed,	53
dated, and signed by the prescriber on the day when issued and	54
shall bear the full name and address of the person for whom, or	55
the owner of the animal for which, the controlled substance is	56
prescribed and the full name, address, and registry number under	57
the federal drug abuse control laws of the prescriber. If the	58
prescription is for an animal, it shall state the species of the	59
animal for which the controlled substance is prescribed.	60

Sec. 4723.28.  (A) The board of nursing, by a vote of a	61
quorum, may revoke or may refuse to grant a nursing license,	62
certificate of authority, or dialysis technician certificate to a	63
person found by the board to have committed fraud in passing an	64
examination required to obtain the license, certificate of	65
authority, or dialysis technician certificate or to have committed	66
fraud, misrepresentation, or deception in applying for or securing	67
any nursing license, certificate of authority, or dialysis	68
technician certificate issued by the board.	69

(B) Subject to division (N) of this section, the board of	70
nursing, by a vote of a quorum, may impose one or more of the	71
following sanctions: deny, revoke, suspend, or place restrictions	72
on any nursing license, certificate of authority, or dialysis	73
technician certificate issued by the board; reprimand or otherwise	74
discipline a holder of a nursing license, certificate of	75
authority, or dialysis technician certificate; or impose a fine of	76
not more than five hundred dollars per violation. The sanctions	77
may be imposed for any of the following:	78

(1) Denial, revocation, suspension, or restriction of	79
authority to practice a health care occupation, including nursing	80
or practice as a dialysis technician, for any reason other than a	81
failure to renew, in Ohio or another state or jurisdiction;	82

(2) Engaging in the practice of nursing or engaging in	83
practice as a dialysis technician, having failed to renew a	84
nursing license or dialysis technician certificate issued under	85
this chapter, or while a nursing license or dialysis technician	86
certificate is under suspension;	87

(3) Conviction of, a plea of guilty to, a judicial finding of	88
guilt of, a judicial finding of guilt resulting from a plea of no	89
contest to, or a judicial finding of eligibility for intervention	90
in lieu of conviction for, a misdemeanor committed in the course	91
of practice;	92

(4) Conviction of, a plea of guilty to, a judicial finding of	93
guilt of, a judicial finding of guilt resulting from a plea of no	94
contest to, or a judicial finding of eligibility for intervention	95
in lieu of conviction for, any felony or of any crime involving	96
gross immorality or moral turpitude;	97

(5) Selling, giving away, or administering drugs or	98
therapeutic devices for other than legal and legitimate	99
therapeutic purposes; or conviction of, a plea of guilty to, a	100
judicial finding of guilt of, a judicial finding of guilt	101
resulting from a plea of no contest to, or a judicial finding of	102
eligibility for intervention in lieu of conviction for, violating	103
any municipal, state, county, or federal drug law;	104

(6) Conviction of, a plea of guilty to, a judicial finding of	105
guilt of, a judicial finding of guilt resulting from a plea of no	106
contest to, or a judicial finding of eligibility for intervention	107
in lieu of conviction for, an act in another jurisdiction that	108
would constitute a felony or a crime of moral turpitude in Ohio;	109

(7) Conviction of, a plea of guilty to, a judicial finding of	110
guilt of, a judicial finding of guilt resulting from a plea of no	111
contest to, or a judicial finding of eligibility for intervention	112
in lieu of conviction for, an act in the course of practice in	113
another jurisdiction that would constitute a misdemeanor in Ohio;	114

(8) Self-administering or otherwise taking into the body any	115
dangerous drug, as defined in section 4729.01 of the Revised Code,	116
in any way not in accordance with a legal, valid prescription	117
issued for that individual, or self-administering or otherwise	118
taking into the body any drug that is a schedule I controlled	119
substance;	120

(9) Habitual indulgence in the use of controlled substances,	121
other habit-forming drugs, or alcohol or other chemical substances	122
to an extent that impairs ability to practice;	123

(10) Impairment of the ability to practice according to	124
acceptable and prevailing standards of safe nursing care because	125
of habitual or excessive use of drugs, alcohol, or other chemical	126
substances that impair the ability to practice;	127

(11) Impairment of the ability to practice according to	128
acceptable and prevailing standards of safe nursing care because	129
of a physical or mental disability;	130

(12) Assaulting or causing harm to a patient or depriving a	131
patient of the means to summon assistance;	132

(13) Obtaining or attempting to obtain money or anything of	133
value by intentional misrepresentation or material deception in	134
the course of practice;	135

(14) Adjudication by a probate court of being mentally ill or	136
mentally incompetent. The board may restore the person's nursing	137
license or dialysis technician certificate upon adjudication by a	138
probate court of the person's restoration to competency or upon	139
submission to the board of other proof of competency.	140

(15) The suspension or termination of employment by the	141
department of defense or the veterans administration of the United	142
States for any act that violates or would violate this chapter;	143

(16) Violation of this chapter or any rules adopted under it;

144

(17) Violation of any restrictions placed on a nursing	145
license or dialysis technician certificate by the board;	146

(18) Failure to use universal blood and body fluid	147
precautions established by rules adopted under section 4723.07 of	148
the Revised Code;	149

(19) Failure to practice in accordance with acceptable and	150
prevailing standards of safe nursing care or safe dialysis care;	151

(20) In the case of a registered nurse, engaging in	152
activities that exceed the practice of nursing as a registered	153
nurse;	154

(21) In the case of a licensed practical nurse, engaging in	155
activities that exceed the practice of nursing as a licensed	156
practical nurse;	157

(22) In the case of a dialysis technician, engaging in	158
activities that exceed those permitted under section 4723.72 of	159
the Revised Code;	160

(23) Aiding and abetting a person in that person's practice	161
of nursing without a license or practice as a dialysis technician	162
without a certificate issued under this chapter;	163

(24) In the case of a certified registered nurse anesthetist,	164
clinical nurse specialist, certified nurse-midwife, or certified	165
nurse practitioner, except as provided in division (M) of this	166
section, either of the following:	167

(a) Waiving the payment of all or any part of a deductible or	168
copayment that a patient, pursuant to a health insurance or health	169
care policy, contract, or plan that covers such nursing services,	170
would otherwise be required to pay if the waiver is used as an	171
enticement to a patient or group of patients to receive health	172
care services from that provider;	173

(b) Advertising that the nurse will waive the payment of all	174
or any part of a deductible or copayment that a patient, pursuant	175
to a health insurance or health care policy, contract, or plan	176
that covers such nursing services, would otherwise be required to	177
pay.	178

(25) Failure to comply with the terms and conditions of	179
participation in the chemical dependency monitoring program	180
established under section 4723.35 of the Revised Code;	181

(26) Failure to comply with the terms and conditions required	182
under the practice intervention and improvement program	183
established under section 4723.282 of the Revised Code;	184

(27) In the case of a certified registered nurse anesthetist,	185
clinical nurse specialist, certified nurse-midwife, or certified	186
nurse practitioner:	187

(a) Engaging in activities that exceed those permitted for	188
the nurse's nursing specialty under section 4723.43 of the Revised	189
Code;	190

(b) Failure to meet the quality assurance standards	191
established under section 4723.07 of the Revised Code.	192

(28) In the case of a clinical nurse specialist, certified	193
nurse-midwife, or certified nurse practitioner, failure to	194
maintain a standard care arrangement in accordance with section	195
4723.431 of the Revised Code or to practice in accordance with the	196
standard care arrangement;	197

(29) In the case of a clinical nurse specialist, certified	198
nurse-midwife, or certified nurse practitioner who holds a	199
certificate to prescribe issued under section 4723.48 of the	200
Revised Code, failure to prescribe drugs and therapeutic devices	201
in accordance with section 4723.481 of the Revised Code;	202

(30) Prescribing any drug or device to perform or induce an	203
abortion, or otherwise performing or inducing an abortion;	204

(31) Failure to establish and maintain professional	205
boundaries with a patient, as specified in rules adopted under	206
section 4723.07 of the Revised Code;	207

(32) Regardless of whether the contact or verbal behavior is	208
consensual, engaging with a patient other than the spouse of the	209
registered nurse, licensed practical nurse, or dialysis technician	210
in any of the following:	211

(a) Sexual contact, as defined in section 2907.01 of the	212
Revised Code;	213

(b) Verbal behavior that is sexually demeaning to the patient	214
or may be reasonably interpreted by the patient as sexually	215
demeaning.	216

(33) Assisting suicide as defined in section 3795.01 of the	217
Revised Code.	218

(C) Disciplinary actions taken by the board under divisions	219
(A) and (B) of this section shall be taken pursuant to an	220
adjudication conducted under Chapter 119. of the Revised Code,	221
except that in lieu of a hearing, the board may enter into a	222
consent agreement with an individual to resolve an allegation of a	223
violation of this chapter or any rule adopted under it. A consent	224
agreement, when ratified by a vote of a quorum, shall constitute	225
the findings and order of the board with respect to the matter	226
addressed in the agreement. If the board refuses to ratify a	227
consent agreement, the admissions and findings contained in the	228
agreement shall be of no effect.	229

(D) The hearings of the board shall be conducted in	230
accordance with Chapter 119. of the Revised Code, the board may	231
appoint a hearing examiner, as provided in section 119.09 of the	232
Revised Code, to conduct any hearing the board is authorized to	233
hold under Chapter 119. of the Revised Code.	234

In any instance in which the board is required under Chapter	235
119. of the Revised Code to give notice of an opportunity for a	236
hearing and the applicant or license holder does not make a timely	237
request for a hearing in accordance with section 119.07 of the	238
Revised Code, the board is not required to hold a hearing, but may	239
adopt, by a vote of a quorum, a final order that contains the	240
board's findings. In the final order, the board may order any of	241
the sanctions listed in division (A) or (B) of this section.	242

(E) If a criminal action is brought against a registered	243
nurse, licensed practical nurse, or dialysis technician for an act	244
or crime described in divisions (B)(3) to (7) of this section and	245
the action is dismissed by the trial court other than on the	246
merits, the board shall conduct an adjudication to determine	247
whether the registered nurse, licensed practical nurse, or	248
dialysis technician committed the act on which the action was	249
based. If the board determines on the basis of the adjudication	250
that the registered nurse, licensed practical nurse, or dialysis	251
technician committed the act, or if the registered nurse, licensed	252
practical nurse, or dialysis technician fails to participate in	253
the adjudication, the board may take action as though the	254
registered nurse, licensed practical nurse, or dialysis technician	255
had been convicted of the act.	256

If the board takes action on the basis of a conviction, plea,	257
or a judicial finding as described in divisions (B)(3) to (7) of	258
this section that is overturned on appeal, the registered nurse,	259
licensed practical nurse, or dialysis technician may, on	260
exhaustion of the appeal process, petition the board for	261
reconsideration of its action. On receipt of the petition and	262
supporting court documents, the board shall temporarily rescind	263
its action. If the board determines that the decision on appeal	264
was a decision on the merits, it shall permanently rescind its	265
action. If the board determines that the decision on appeal was	266
not a decision on the merits, it shall conduct an adjudication to	267
determine whether the registered nurse, licensed practical nurse,	268
or dialysis technician committed the act on which the original	269
conviction, plea, or judicial finding was based. If the board	270
determines on the basis of the adjudication that the registered	271
nurse, licensed practical nurse, or dialysis technician committed	272
such act, or if the registered nurse, licensed practical nurse, or	273
dialysis technician does not request an adjudication, the board	274
shall reinstate its action; otherwise, the board shall permanently	275
rescind its action.	276

Notwithstanding the provision of division (C)(2) of section	277
2953.32 of the Revised Code specifying that if records pertaining	278
to a criminal case are sealed under that section the proceedings	279
in the case shall be deemed not to have occurred, sealing of the	280
records of a conviction on which the board has based an action	281
under this section shall have no effect on the board's action or	282
any sanction imposed by the board under this section.	283

The board shall not be required to seal, destroy, redact, or	284
otherwise modify its records to reflect the court's sealing of	285
conviction records.	286

(F) The board may investigate an individual's criminal	287
background in performing its duties under this section.	288

(G) During the course of an investigation conducted under	289
this section, the board may compel any registered nurse, licensed	290
practical nurse, or dialysis technician or applicant under this	291
chapter to submit to a mental or physical examination, or both, as	292
required by the board and at the expense of the individual, if the	293
board finds reason to believe that the individual under	294
investigation may have a physical or mental impairment that may	295
affect the individual's ability to provide safe nursing care.	296
Failure of any individual to submit to a mental or physical	297
examination when directed constitutes an admission of the	298
allegations, unless the failure is due to circumstances beyond the	299
individual's control, and a default and final order may be entered	300
without the taking of testimony or presentation of evidence.	301

If the board finds that an individual is impaired, the board	302
shall require the individual to submit to care, counseling, or	303
treatment approved or designated by the board, as a condition for	304
initial, continued, reinstated, or renewed authority to practice.	305
The individual shall be afforded an opportunity to demonstrate to	306
the board that the individual can begin or resume the individual's	307
occupation in compliance with acceptable and prevailing standards	308
of care under the provisions of the individual's authority to	309
practice.	310

For purposes of this division, any registered nurse, licensed	311
practical nurse, or dialysis technician or applicant under this	312
chapter shall be deemed to have given consent to submit to a	313
mental or physical examination when directed to do so in writing	314
by the board, and to have waived all objections to the	315
admissibility of testimony or examination reports that constitute	316
a privileged communication.	317

(H) The board shall investigate evidence that appears to show	318
that any person has violated any provision of this chapter or any	319
rule of the board. Any person may report to the board any	320
information the person may have that appears to show a violation	321
of any provision of this chapter or rule of the board. In the	322
absence of bad faith, any person who reports such information or	323
who testifies before the board in any adjudication conducted under	324
Chapter 119. of the Revised Code shall not be liable for civil	325
damages as a result of the report or testimony.	326

(I) All of the following apply under this chapter with	327
respect to the confidentiality of information:	328

(1) Information received by the board pursuant to an	329
investigation is confidential and not subject to discovery in any	330
civil action, except that the board may disclose information to	331
law enforcement officers and government entities investigating	332
either a licensed health care professional, including a registered	333
nurse, licensed practical nurse, or dialysis technician, or a	334
person who may have engaged in the unauthorized practice of	335
nursing. No law enforcement officer or government entity with	336
knowledge of any information disclosed by the board pursuant to	337
this division shall divulge the information to any other person or	338
government entity except for the purpose of a government	339
investigation, a prosecution, or an adjudication by a court or	340
government entity.	341

(2) If an investigation requires a review of patient records,	342
the investigation and proceeding shall be conducted in such a	343
manner as to protect patient confidentiality.	344

(3) All adjudications and investigations of the board shall	345
be considered civil actions for the purposes of section 2305.252	346
of the Revised Code.	347

(4) Any board activity that involves continued monitoring of	348
an individual as part of or following any disciplinary action	349
taken under this section shall be conducted in a manner that	350
maintains the individual's confidentiality. Information received	351
or maintained by the board with respect to the board's monitoring	352
activities is confidential and not subject to discovery in any	353
civil action.	354

(J) Any action taken by the board under this section	355
resulting in a suspension from practice shall be accompanied by a	356
written statement of the conditions under which the person may be	357
reinstated to practice.	358

(K) When the board refuses to grant a license or certificate	359
to an applicant, revokes a license or certificate, or refuses to	360
reinstate a license or certificate, the board may specify that its	361
action is permanent. An individual subject to permanent action	362
taken by the board is forever ineligible to hold a license or	363
certificate of the type that was refused or revoked and the board	364
shall not accept from the individual an application for	365
reinstatement of the license or certificate or for a new license	366
or certificate.	367

(L) No unilateral surrender of a nursing license, certificate	368
of authority, or dialysis technician certificate issued under this	369
chapter shall be effective unless accepted by majority vote of the	370
board. No application for a nursing license, certificate of	371
authority, or dialysis technician certificate issued under this	372
chapter may be withdrawn without a majority vote of the board. The	373
board's jurisdiction to take disciplinary action under this	374
section is not removed or limited when an individual has a license	375
or certificate classified as inactive or fails to renew a license	376
or certificate.	377

(M) Sanctions shall not be imposed under division (B)(24) of	378
this section against any licensee who waives deductibles and	379
copayments as follows:	380

(1) In compliance with the health benefit plan that expressly	381
allows such a practice. Waiver of the deductibles or copayments	382
shall be made only with the full knowledge and consent of the plan	383
purchaser, payer, and third-party administrator. Documentation of	384
the consent shall be made available to the board upon request.	385

(2) For professional services rendered to any other person	386
licensed pursuant to this chapter to the extent allowed by this	387
chapter and the rules of the board.	388

(N)(1) Any person who enters a prelicensure nursing education	389
program on or after June 1, 2003, and who subsequently applies	390
under division (A) of section 4723.09 of the Revised Code for	391
licensure to practice as a registered nurse or as a licensed	392
practical nurse and any person who applies under division (B) of	393
that section for license by endorsement to practice nursing as a	394
registered nurse or as a licensed practical nurse shall submit a	395
request to the bureau of criminal identification and investigation	396
for the bureau to conduct a criminal records check of the	397
applicant and to send the results to the board, in accordance with	398
section 4723.09 of the Revised Code.	399

The board shall refuse to grant a license to practice nursing	400
as a registered nurse or as a licensed practical nurse under	401
section 4723.09 of the Revised Code to a person who entered a	402
prelicensure nursing education program on or after June 1, 2003,	403
and applied under division (A) of section 4723.09 of the Revised	404
Code for the license or a person who applied under division (B) of	405
that section for the license, if the criminal records check	406
performed in accordance with division (C) of that section	407
indicates that the person has pleaded guilty to, been convicted	408
of, or has had a judicial finding of guilt for violating section	409
2903.01, 2903.02, 2903.03, 2903.11, 2905.01, 2907.02, 2907.03,	410
2907.05, 2909.02, 2911.01, or 2911.11 of the Revised Code or a	411
substantially similar law of another state, the United States, or	412
another country.	413

(2) Any person who enters a dialysis training program on or	414
after June 1, 2003, and who subsequently applies for a certificate	415
to practice as a dialysis technician shall submit a request to the	416
bureau of criminal identification and investigation for the bureau	417
to conduct a criminal records check of the applicant and to send	418
the results to the board, in accordance with section 4723.75 of	419
the Revised Code.	420

The board shall refuse to issue a certificate to practice as	421
a dialysis technician under section 4723.75 of the Revised Code to	422
a person who entered a dialysis training program on or after June	423
1, 2003, and whose criminal records check performed in accordance	424
with division (C) of that section indicates that the person has	425
pleaded guilty to, been convicted of, or has had a judicial	426
finding of guilt for violating section 2903.01, 2903.02, 2903.03,	427
2903.11, 2905.01, 2907.02, 2907.03, 2907.05, 2909.02, 2911.01, or	428
2911.11 of the Revised Code or a substantially similar law of	429
another state, the United States, or another country.	430

Sec. 4723.481. Under a certificate to prescribe issued under	431
section 4723.48 of the Revised Code,This section establishes	432
standards and conditions regarding the authority of a clinical	433
nurse specialist, certified nurse-midwife, or certified nurse	434
practitioner is subject to all of the following:to prescribe	435
drugs and therapeutic devices under a certificate to prescribe	436
issued under section 4723.481 of the Revised Code.	437

(A) TheA clinical nurse specialist, certified nurse-midwife,	438
or certified nurse practitioner shall not prescribe any drug or	439
therapeutic device that is not included in the types of drugs and	440
devices listed on the formulary established in rules adopted under	441
section 4723.50 of the Revised Code.	442

(B) The nurse's prescriptive authority of a clinical nurse	443
specialist, certified nurse-midwife, or certified nurse	444
practitioner shall not exceed the prescriptive authority of the	445
collaborating physician or podiatrist.	446

(C) The nurse may prescribe a schedule II controlled	447
substance as specified in division (A)(2) of section 3719.06 of	448
the Revised Code, but shall not prescribe a schedule II controlled	449
substance in collaboration with a podiatrist(1) Except as	450
provided in division (C)(2) or (3) of this section, a clinical	451
nurse specialist, certified nurse-midwife, or certified nurse	452
practitioner may prescribe to a patient a schedule II controlled	453
substance only if all of the following are the case:	454

(a) The patient has a terminal condition, as defined in	455
section 2133.01 of the Revised Code.	456

(b) The collaborating physician of the clinical nurse	457
specialist, certified nurse-midwife, or certified nurse	458
practitioner initially prescribed the substance for the patient.	459

(c) The prescription is for an amount that does not exceed	460
the amount necessary for the patient's use in a single,	461
twenty-four hour period.	462

(2) The restrictions on prescriptive authority in division	463
(C)(1) of this section do not apply if a clinical nurse	464
specialist, certified nurse-midwife, or certified nurse	465
practitioner issues the prescription to the patient from any of	466
the following locations:	467

(a) A hospital registered under section 3701.07 of the	468
Revised Code;	469

(b) An entity owned or controlled, in whole or in part, by a	470
hospital or by an entity that owns or controls, in whole or in	471
part, one or more hospitals;	472

(c) A health care facility operated by the department of	473
mental health or the department of developmental disabilities;	474

(d) A nursing home licensed under section 3721.02 of the	475
Revised Code or by a political subdivision certified under section	476
3721.09 of the Revised Code;	477

(e) A county home or district home operated under Chapter	478
5155. of the Revised Code that is certified under the medicare or	479
medicaid program;	480

(f) A hospice care program, as defined in section 3712.01 of	481
the Revised Code;	482

(g) A community mental health agency, as defined in section	483
5122.01 of the Revised Code;	484

(h) An ambulatory surgical facility, as defined in section	485
3702.30 of the Revised Code;	486

(i) A freestanding birthing center, as defined in section	487
3702.51 of the Revised Code;	488

(j) A federally qualified health center, as defined in	489
section 3701.047 of the Revised Code;	490

(k) A federally qualified health center look-alike, as	491
defined in section 3701.047 of the Revised Code;	492

(l) A health care office or facility operated by the board of	493
health of a city or general health district or the authority	494
having the duties of a board of health under section 3709.05 of	495
the Revised Code;	496

(m) A site where a medical practice is operated, but only if	497
the practice is comprised of one or more physicians who also are	498
owners of the practice; the practice is organized to provide	499
direct patient care; and the clinical nurse specialist, certified	500
nurse-midwife, or certified nurse practitioner providing services	501
at the site has a standard care arrangement and collaborates with	502
at least one of the physician owners who practices primarily at	503
that site.	504

(3) A clinical nurse specialist, certified nurse-midwife, or	505
certified nurse practitioner shall not issue to a patient a	506
prescription for a schedule II controlled substance from a	507
convenience care clinic even if the clinic is owned or operated by	508
an entity specified in division (C)(2) of this section.	509

(D) TheA pharmacist who acts in good faith reliance on a	510
prescription issued by a clinical nurse specialist, certified	511
nurse-midwife, or certified nurse practitioner under division	512
(C)(2) of this section is not liable for or subject to any of the	513
following for relying on the prescription: damages in any civil	514
action, prosecution in any criminal proceeding, or professional	515
disciplinary action by the state board of pharmacy under Chapter	516
4729. of the Revised Code.	517

(E) A clinical nurse specialist, certified nurse-midwife, or	518
certified nurse practitioner may personally furnish to a patient a	519
sample of any drug or therapeutic device included in the types of	520
drugs and devices listed on the formulary, subject toexcept that	521
all of the following conditions apply:	522

(1) The amount of the sample furnished shall not exceed a	523
seventy-two-hour supply, except when the minimum available	524
quantity of the sample is packaged in an amount that is greater	525
than a seventy-two-hour supply, in which case the nurse may	526
furnish the sample in the packaged amount may be furnished.	527

(2) No charge may be imposed for the sample or for furnishing	528
it.	529

(3) Samples of controlled substances may not be personally	530
furnished.	531

(E) The(F) A clinical nurse specialist, certified	532
nurse-midwife, or certified nurse practitioner may personally	533
furnish to a patient a complete or partial supply of a drug or	534
therapeutic device included in the types of drugs and devices	535
listed on the formulary, subject toexcept that all of the	536
following conditions apply:	537

(1) The clinical nurse specialist, certified nurse-midwife,	538
or certified nurse practitioner shall personally furnish only	539
antibiotics, antifungals, scabicides, contraceptives, prenatal	540
vitamins, antihypertensives, drugs and devices used in the	541
treatment of diabetes, drugs and devices used in the treatment of	542
asthma, and drugs used in the treatment of dyslipidemia.	543

(2) The clinical nurse specialist, certified nurse-midwife,	544
or certified nurse practitioner shall not furnish the drugs and	545
devices in locations other than a health department operated by	546
the board of health of a city or general health district or the	547
authority having the duties of a board of health under section	548
3709.05 of the Revised Code, a federally funded comprehensive	549
primary care clinic, or a nonprofit health care clinic or program.	550

(3) The clinical nurse specialist, certified nurse-midwife,	551
or certified nurse practitioner shall comply with all safety	552
standards for personally furnishing supplies of drugs and devices,	553
as established in rules adopted under section 4723.50 of the	554
Revised Code.	555

Sec. 4723.482.  (A) Except as provided in divisions (C) and	556
(D) of this section, an applicant shall include with the	557
application submitted under section 4723.48 of the Revised Code	558
all of the following:	559

(1) Subject to section 4723.483 of the Revised Code, evidence	560
of holding a current, valid certificate of authority issued under	561
this chapter to practice as a clinical nurse specialist, certified	562
nurse-midwife, or certified nurse practitioner;	563

(2) Except for a person who on May 17, 2000, was approved to	564
prescribe drugs and therapeutic devices under section 4723.56 of	565
the Revised Code, as that section existed on that date, evidence	566
Evidence of successfully completing the instructioncourse of	567
study in advanced pharmacology and related topics in accordance	568
with the requirements specified in division (B) of this section;	569

(3) The fee required by section 4723.08 of the Revised Code	570
for a certificate to prescribe;	571

(4) Any additional information the board of nursing requires	572
pursuant to rules adopted under section 4723.50 of the Revised	573
Code.	574

(B) AllWith respect to the course of study in advanced	575
pharmacology and related topics that must be successfully	576
completed to obtain a certificate to prescribe, all of the	577
following requirements apply to the instruction required under	578
division (A)(2) of this section:	579

(1) The instruction mustcourse of study shall be obtained	580
completed not longer than three years before the application for	581
the certificate to prescribe is filed.	582

(2) The instruction must be obtained through a course of	583
study consistingshall consist of planned classroom and clinical	584
study that isinstruction for a total of not less than forty-five	585
contact hours.	586

(3) The course of study shall meet the requirements to be	587
approved by the board of nursing in accordance with standards	588
established in rules adopted under section 4723.50 of the Revised	589
Code.	590

(3)(4) The content of the instruction mustcourse of study	591
shall be specific to the applicant's nursing specialty and.	592

(5) The instruction provided in the course of study shall	593
include all of the following:	594

(a) A minimum of thirtythirty-six contact hours of training	595
instruction in advanced pharmacology that includes pharmacokinetic	596
principles and clinical application and the use of drugs and	597
therapeutic devices in the prevention of illness and maintenance	598
of health;	599

(b) TrainingInstruction in the fiscal and ethical	600
implications of prescribing drugs and therapeutic devices;	601

(c) TrainingInstruction in the state and federal laws that	602
apply to the authority to prescribe;	603

(d) Instruction that is specific to schedule II controlled	604
substances, including instruction in all of the following:	605

(i) Indications for the use of schedule II controlled	606
substances in drug therapies;	607

(ii) The most recent guidelines for pain management	608
therapies, as established by state and national organizations such	609
as the Ohio pain initiative and the American pain society;	610

(iii) Fiscal and ethical implications of prescribing schedule	611
II controlled substances;	612

(iv) State and federal laws that apply to the authority to	613
prescribe schedule II controlled substances;	614

(v) Prevention of abuse and diversion of schedule II	615
controlled substances, including identification of the risk of	616
abuse and diversion, recognition of abuse and diversion, types of	617
assistance available for prevention of abuse and diversion, and	618
methods of establishing safeguards against abuse and diversion.	619

(e) Any additional traininginstruction required pursuant to	620
rules adopted under section 4723.50 of the Revised Code.	621

(C) An applicant who practiced or is practicing as a clinical	622
nurse specialist, certified nurse-midwife, or certified nurse	623
practitioner in another jurisdiction or as an employee of the	624
United States government, and is not seeking authority to	625
prescribe drugs and therapeutic devices by meeting the	626
requirements of division (A) or (D) of this section, shall include	627
with the application submitted under section 4723.48 of the	628
Revised Code all of the following:	629

(1) Subject to section 4723.483 of the Revised Code, evidence	630
of holding a current, valid certificate of authority issued under	631
this chapter to practice as a clinical nurse specialist, certified	632
nurse-midwife, or certified nurse practitioner;	633

(2) The fee required by section 4723.08 of the Revised Code	634
for a certificate to prescribe;	635

(3) Either of the following:

636

(a) Evidence of having held, for a continuous period of at	637
least one year during the three years immediately preceding the	638
date of application, valid authority issued by another	639
jurisdiction to prescribe therapeutic devices and drugs, including	640
at least some controlled substances;	641

(b) Evidence of having been employed by the United States	642
government and authorized, for a continuous period of at least one	643
year during the three years immediately preceding the date of	644
application, to prescribe therapeutic devices and drugs, including	645
at least some controlled substances, in conjunction with that	646
employment.	647

(4) If the applicant includes the evidence described in	648
division (C)(3)(a) of this section, documentation from a licensed	649
physician in a form acceptable to the board that the prescribing	650
component of the nurse's practice was overseen or supervised by a	651
licensed physician in the other jurisdiction;	652

(5) If the applicant includes the evidence described in	653
division (C)(3)(b) of this section, documentation from a licensed	654
physician employed by the United States government in a form	655
acceptable to the board that the prescribing component of the	656
nurse's practice was overseen or supervised by a licensed	657
physician employed by the United States government;	658

(6) Evidence of having completed a two-hour course of	659
instruction approved by the board in the laws of this state that	660
govern drugs and prescriptive authority;	661

(7) Any additional information the board requires pursuant to	662
rules adopted under section 4723.50 of the Revised Code.	663

(D) An applicant who practiced or is practicing as a clinical	664
nurse specialist, certified nurse-midwife, or certified nurse	665
practitioner in another jurisdiction or as an employee of the	666
United States government, and is not seeking authority to	667
prescribe drugs and therapeutic devices by meeting the	668
requirements of division (A) or (C) of this section, shall include	669
with the application submitted under section 4723.48 of the	670
Revised Code all of the following:	671

(1) Subject to section 4723.483 of the Revised Code, evidence	672
of holding a current, valid certificate of authority issued under	673
this chapter to practice as a clinical nurse specialist, certified	674
nurse-midwife, or certified nurse practitioner;	675

(2) The fee required by section 4723.08 of the Revised Code	676
for a certificate to prescribe;	677

(3) Either of the following:

678

(a) Evidence of having held, for a continuous period of at	679
least one year during the three years immediately preceding the	680
date of application, valid authority issued by another	681
jurisdiction to prescribe therapeutic devices and drugs, excluding	682
controlled substances;	683

(b) Evidence of having been employed by the United States	684
government and authorized, for a continuous period of at least one	685
year during the three years immediately preceding the date of	686
application, to prescribe therapeutic devices and drugs, excluding	687
controlled substances, in conjunction with that employment.	688

(4) If the applicant includes the evidence described in	689
division (D)(3)(a) of this section, documentation from a licensed	690
physician in a form acceptable to the board that the prescribing	691
component of the nurse's practice was overseen or supervised by a	692
licensed physician in the other jurisdiction;	693

(5) If the applicant includes the evidence described in	694
division (D)(3)(b) of this section, documentation from a licensed	695
physician employed by the United States government in a form	696
acceptable to the board that the prescribing component of the	697
nurse's practice was overseen or supervised by a licensed	698
physician employed by the United States government;	699

(6) Any additional information the board requires pursuant to	700
rules adopted under section 4723.50 of the Revised Code.	701

Sec. 4723.492.  The committee on prescriptive governance	702
shall develop recommendations regarding the authority to prescribe	703
drugs and therapeutic devices pursuant to a certificate to	704
prescribe issued under section 4723.48 of the Revised Code. Not	705
later than fourteen months after the effective date of this	706
section, theThe recommendations shall include provisions that	707
apply specifically to the authority to prescribe schedule II	708
controlled substances.	709

The committee shall submit recommendations to the board of	710
nursing as necessary for the board to fulfill its duty to adopt	711
rules under section 4723.50 of the Revised Code. At the board's	712
request, the committee shall reconsider a recommendation it has	713
submitted and resubmit the recommendation to the board	714
accordingly.	715

Sec. 4723.50.  (A) In accordance with Chapter 119. of the	716
Revised Code, the board of nursing shall adopt rules as necessary	717
to implement the provisions of this chapter pertaining to the	718
authority of clinical nurse specialists, certified nurse-midwives,	719
and certified nurse practitioners to prescribe drugs and	720
therapeutic devices and the issuance and renewal of certificates	721
to prescribe. Initial rules shall be adopted not later than twenty	722
months after May 17, 2000.	723

The board shall adopt rules that are consistent with the	724
recommendations the board receives from the committee on	725
prescriptive governance pursuant to section 4723.492 of the	726
Revised Code. After reviewing a recommendation submitted by the	727
committee, the board may either adopt the recommendation as a rule	728
or ask the committee to reconsider and resubmit the	729
recommendation. The board shall not adopt any rule that does not	730
conform to a recommendation made by the committee.	731

(B) The board shall adopt rules under this section that do	732
all of the following:	733

(1) Establish a formulary listing the types of drugs and	734
therapeutic devices that may be prescribed by a clinical nurse	735
specialist, certified nurse-midwife, or certified nurse	736
practitioner. The formulary may include controlled substances, as	737
defined in section 3719.01 of the Revised Code. The formulary	738
shall not permit the prescribing of any drug or device to perform	739
or induce an abortion.	740

(2) Establish safety standards to be followed by a clinical	741
nurse specialist, certified nurse-midwife, or certified nurse	742
practitioner when personally furnishing to patients complete or	743
partial supplies of antibiotics, antifungals, scabicides,	744
contraceptives, prenatal vitamins, antihypertensives, drugs and	745
devices used in the treatment of diabetes, drugs and devices used	746
in the treatment of asthma, and drugs used in the treatment of	747
dyslipidemia.;	748

(3) Establish criteria for the components of the standard	749
care arrangements described in section 4723.431 of the Revised	750
Code that apply to a nurse'sthe authority to prescribe, including	751
the components that apply to the authority to prescribe schedule	752
II controlled substances. The rules shall be consistent with that	753
section and include all of the following:	754

(a) Quality assurance standards;

755

(b) Standards for periodic review by a collaborating	756
physician or podiatrist of the records of patients treated by the	757
clinical nurse specialist, certified nurse-midwife, or certified	758
nurse practitioner;	759

(c) Acceptable travel time between the location at which the	760
clinical nurse specialist, certified nurse-midwife, or certified	761
nurse practitioner is engaging in the prescribing components of	762
the nurse's practice and the location of the nurse's collaborating	763
physician or podiatrist;	764

(d) Any other criteria recommended by the committee on	765
prescriptive governance.	766

(4) Establish standards and procedures for issuance and	767
renewal of a certificate to prescribe, including specification of	768
any additional information the board may require under division	769
(A)(4), (C)(7), or (D)(6) of section 4723.482 or division (B)(3)	770
of section 4723.485 of the Revised Code;	771

(5) Establish requirementsstandards for board approval of	772
the instructioncourse of study in advanced pharmacology and	773
related topics required by section 4723.482 of the Revised Code;	774

(6) Establish requirements for board approval of the two-hour	775
course of instruction in the laws of this state as required under	776
division (C)(6) of section 4723.482 of the Revised Code and	777
division (B)(2) of section 4723.484 of the Revised Code;	778

(7) Establish standards and procedures for the appropriate	779
conduct of an externship as described in section 4723.484 of the	780
Revised Code, including the following:	781

(a) Standards and procedures to be used in evaluating a	782
nurse'san individual's participation in an externship;	783

(b) Standards and procedures for the supervision that a	784
physician must provide during an externship, including supervision	785
provided by working with the nurseparticipant and supervision	786
provided by making timely reviews of the records of patients	787
treated by the nurseparticipant. The manner in which supervision	788
must be provided may vary according to the location where the	789
nurseparticipant is practicing and with the nurse'sparticipant's	790
level of experience.	791

Section 2. That existing sections 3719.06, 4723.28, 4723.481,	792
4723.482, 4723.492, and 4723.50 of the Revised Code are hereby	793
repealed.	794

Section 3.  Beginning on the effective date of this act, the	795
authority of a clinical nurse specialist, certified nurse-midwife,	796
or certified nurse practitioner who holds a certificate to	797
prescribe, including an externship certificate, includes the	798
authority to prescribe schedule II controlled substances as	799
authorized by sections 3719.06 and 4723.481 of the Revised Code,	800
as amended by this act.	801

In the case of a clinical nurse specialist, certified	802
nurse-midwife, or certified nurse practitioner who received a	803
certificate to prescribe before the effective date of this act or	804
before the Board of Nursing has implemented the requirements of	805
this act pertaining to instruction specific to schedule II	806
controlled substances, the certificate holder shall submit	807
evidence satisfactory to the Board that the certificate holder has	808
completed a minimum of six contact hours of instruction specific	809
to schedule II controlled substances. The evidence of completing	810
the instruction shall be submitted by the certificate holder as a	811
condition of eligibility for renewal of the certificate to	812
prescribe or, in the case of an externship certificate holder, as	813
a condition of eligibility for receipt of a new certificate to	814
prescribe.	815

Section 4. The Board of Nursing shall adopt rules under	816
section 4723.50 of the Revised Code as necessary to implement the	817
provisions of this act pertaining to the authority to prescribe	818
schedule II controlled substances pursuant to a certificate to	819
prescribe. The rules shall conform to the recommendations	820
submitted by the Committee on Prescriptive Governance.	821