Advocacy Updates

On June 26, 2024, the Ohio House of Representatives and Ohio Senate held their last session days before breaking for the summer recess. The chambers considered dozens of bills with many being of interest to Ohio ACEP. The legislature is not expected to return to official business until the fall, or possibly after the November election. We are pleased to report one of Ohio ACEP’s priority bills cleared an important milestone in the legislative process with a favorable House vote.

Healthcare Workplace Safety Bill Passes House!

Ohio ACEP is excited to announce that House Bill 452, which addresses workplace safety for healthcare workers, has passed the Ohio House of Representatives. You can watch the floor debate here. (HB 452 is 2:12:30 in). The vote on the legislation was 71-20, with one member speaking against the bill on the floor. Ohio ACEP is grateful to the bill sponsors, Representatives Andrea White and Rachel Baker, for their work and commitment to this bill. Their floor speeches in favor of the bill highlight the stories our physicians told during supporting testimony, and we appreciate them continuing to shine a spotlight on this serious problem. We look forward to advocating for the bill in the Senate.

Highlights of the legislation include:

• Requiring hospitals to establish security plans for preventing workplace violence and managing aggressive behaviors. Healthcare workers who provide direct patient care will be part of the teams developing the plans. The plan must be based on a security risk assessment that specifically looks at high-risk areas, including the emergency departments.
• Requiring at least one employee trained in de-escalation be present at all times in the emergency department. The security plan will also address whether the emergency department needs a trained security/law enforcement officer on duty and what training those personnel shall have.
• Requiring hospitals to establish a workplace violence incident reporting system. This system will document, track and analyze reporting data to inform improvements to workplace safety.

Food Allergy Awareness Passes Senate

Senator Theresa Gavarone has proposed Senate Bill 234 to designate May as Allergy Awareness Month. The month was chosen to align with the national awareness week in May. Ohio ACEP weighed in with formal proponent testimony on May 22, 2024 with a submission to the Senate Health Committee. ACEP also recently highlighted a feature on allergies and anaphylaxis. During their last session day before breaking for a summer recess, the Senate unanimously passed this legislation, sending to the House for consideration.  

Governor Signs APRN/PA Legislation

Senate Bill 81 makes changes to APRNs’ and physician assistants’ scope of practice with the intent of increasing efficiencies in delivering behavioral healthcare. The bill does retain the requirement that APRNs have a standard care arrangement and that PAs have a supervisory agreement with a physician. Under the bill, those agreements could give APRNs and PAs the authority to “sign any document relating to the admission, treatment, or discharge of an inpatient receiving psychiatric or other behavioral health care services.” The APRN/PA and the collaborating physician must be employed by the hospital where the patient is receiving inpatient psychiatric or behavioral health services. 

The bill provides some civil liability protection to the physician for adverse action that could arise from the APRN or PA signing the forms. The House also added a provision to allow nurses to access safe haven programs related to impairment, similar to those allowed to physicians and other providers. After clearing both legislative chambers, the Governor signed the legislation into law on June 21, 2024, and will officially be in effect on September 30, 2024.

EMS Bill Clears House

House Bill 303 has been introduced by Representatives Thomas Hall and Nick Santucci, regarding EMS training. The legislation would require the EMFTS Board to establish a process by which any person may submit a petition to the board requesting that a topic be included in a training or continuing education program for first responders, EMTs-basic, EMTs-I, or paramedics that is in addition to the topics specified in section 4765.16 of Ohio law. The Board would also create a process to consider those submitted proposals. HB 303 was considered by the House Homeland Security Committee and is supported by EMS organizations, including the Ohio Fire Chiefs Association. The bill passed the House of Representatives on June 12, 2024, by a vote of 89-2 and will now be considered by the Senate Health Committee.

Hospital Price Transparency Changes Not Agreed To

Ohio ACEP has been tracking House Bill 49 regarding hospital price transparency. House Bill 49 passed the House of Representatives back in June of 2023 and has been under consideration in the Senate.

The Senate Small Business and Economic Opportunity Committee accepted a new version of HB 49 on April 9, 2024, changing the bill pretty significantly. A new version generally requires hospitals to comply with the federal transparency law and still creates penalties for non-compliance. Provisions regarding prohibitions on medical bills being sent to collections, going to court over medical debt, and filing reports on medical debt to impact consumer credit scores have been removed. Provisions were added that would say insurers cannot be required to reimburse hospitals a facility fee for services performed at a location that was previously an independent outpatient physician facility but was purchased by the hospital system.

The sponsors and proponents of the bill did not support the changes made in the Senate and indicated their position that the Senate weakened the bill.  So, in the rare move, the House voted to not concur with the Senate changes by a vote of 92-2. So, the bill will now either go to a conference committee for the chambers to negotiate a final version, or the bill will die. 

Vicarious Liability Bill Signed by the Governor

House Bill 179 is sponsored by Representatives Adam Mathews and Brian Stewart. The bill is regarding vicarious liability and statutes of repose. The bill is in response to some recent Supreme Court rulings and proposes to update Ohio’s laws on the matters. Vicarious liability deals with the liability relationship between an employee and an employer when negligence is alleged.  “An action upon a medical claim against a physician, podiatrist, or physical therapist” is included in the legislation. 

Proponents of the bill included the Ohio State Bar Association and the Ohio Association for Justice. The Ohio Hospital Association and the Ohio State Medical Association expressed support for the statute of repose provision that “would reverse what we believe to be an erroneous Ohio Supreme Court decision issued in 2022, Elliott v. Durrani.” They also shared concerns about the vicarious liability provisions. Their testimony made suggestions for amendments to clarify the bill. However, those were not adopted prior to passage. 

HB 179 passed both the House and Senate unanimously, with the Senate’s action on June 26, 2024. The Governor signed the bill on July 25, 2026 and it will officially be in effect on October 21, 2024.

APRN Legislation Clears Senate

Senator Kristina Roegner has introduced Senate Bill 196 regarding APRNs. The bill is lengthy but generally grants APRNs the authority to sign forms a physician can sign and make determinations a physician can make (including determining and pronouncing death), establishes certain prescribing protocols for pharmacists, and makes other scope of practice expansions.  The bill does, however, retain the requirement that APRNs have a collaboration agreement with physicians. Senator Roegner indicated in testimony that the OSMA worked closely with her to review the provisions included in the bill. The Senate Health Committee favorably reported the bill on June 26, 2024, and passed the full Senate later that day by a vote of 30-1.  This legislation will now be considered by the Ohio House.

Proposed CMHA Legislation Amended, Passes Senate

Senate Bill 60, regarding the creation of the new certified mental health assistants (CMHA) profession, passed out of the Senate Workforce and Higher Education Committee and was passed by the full Senate by a vote of 20-11 (four Republicans joined all Democrats in voting no) on June 26, 2024. It did undergo considerable changes in committee before passing, and some of the more significant ones were the removal of CMHAs authority to pink slip patients and removal of a provision allowing the Medical Board to establish additional rules regarding CMHAs' scope of practice. It also reinserts language with basic standards for the CMHA curriculum and ups the number of hours that their supervising physician must be available for direct communication. The Ohio State Medical Association worked on this language with the sponsor and noted that it took their position on the bill to neutral.

Want to Learn More?

If you’re interested in viewing the status of all of the bills Ohio ACEP is tracking, you can find the list here.