Ohio Passes Senate Bill 110

I am happy to report that the Ohio Legislature has passed Senate Bill (SB) 110, which has now been signed into law by Governor John Kasich. The bill becomes effective 90 days after signing.

This bill gives nurse practitioners (NPs) and physician assistants (PAs) the ability to delegate medication administration to unlicensed allied health professionals, such as medical assistants working under their supervision in outpatient settings.

See the following relevant passages from SB 110, the first from page 20 of the attached, which is the version that has passed both Houses of the Ohio legislature:

Sec. 4723.48. (A) A clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner seeking authority to prescribe drugs and therapeutic devices shall file with the board of nursing a written application for a certificate to prescribe. The board of nursing shall issue a certificate to prescribe to each applicant who meets the requirements specified in section 4723.482 or 4723.485 of the Revised Code. …

(C)(1) The holder of a certificate issued under this section may delegate to a person not otherwise authorized to administer drugs the authority to administer to a specified patient a drug, other than a controlled substance, listed in the formulary established in rules adopted under section 4723.50 of the Revised Code. The delegation shall be in accordance with division (C)(2) of this section and standards and procedures established in rules adopted under division (Q) of section 4723.07 of the Revised Code.

(2) Prior to delegating the authority, the certificate holder shall do both of the following:

(a) Assess the patient and determine that the drug is appropriate for the patient;

(b) Determine that the person to whom the authority will be delegated has met the conditions specified in division (D) of section 4723.489 of the Revised Code.

Note also the following on pages 22 and 23:

Sec. 4723.489. A person not otherwise authorized to administer drugs may administer a drug to a specified patient if all of the following conditions are met:

(A) The authority to administer the drug is delegated to the person by an advanced practice registered nurse who is a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner and holds a certificate to prescribe issued under section 4723.48 of the Revised Code.

(B) The drug is listed in the formulary established in rules adopted under section 4723.50 of the Revised Code but is not a controlled substance and is not to be administered intravenously.

(C) The drug is to be administered at a location other than a hospital inpatient care unit, as defined in section 3727.50 of the Revised Code; a hospital emergency department or a freestanding emergency department; or an ambulatory surgical facility, as defined in section 3702.30 of the Revised Code.

(D) The person has successfully completed education based on a recognized body of knowledge concerning drug administration and demonstrates to the person’s employer the knowledge, skills, and ability to administer the drug safely.

(E) The person’s employer has given the advanced practice registered nurse access to documentation, in written or electronic form, showing that the person has met the conditions specified in division (D) of this section.Sub. S. B. No. 110 131st G.A. 23

(F) The advanced practice registered nurse is physically present at the location where the drug is administered.

Note the following from pages 36 and 37:

Sec. 4730.203. (A) Acting pursuant to a supervision agreement, a physician assistant may Sub. S. B. No. 110 131st G.A. 37

delegate performance of a task to implement a patient’s plan of care or, if the conditions in division (C) of this section are met, may delegate administration of a drug. Subject to division (D) of section 4730.03 of the Revised Code, delegation may be to any person. The physician assistant must be physically present at the location where the task is performed or the drug administered.

(B) Prior to delegating a task or administration of a drug, a physician assistant shall determine that the task or drug is appropriate for the patient and the person to whom the delegation is to be made may safely perform the task or administer the drug.

(C) A physician assistant may delegate administration of a drug only if all of the following conditions are met:

(1) The physician assistant has been granted physician-delegated prescriptive authority.

(2) The drug is included in the formulary established under division (A) of section 4730.39 of the Revised Code.

(3) The drug is not a controlled substance.

(4) The drug will not be administered intravenously.

(5) The drug will not be administered in a hospital inpatient care unit, as defined in section 3727.50 of the Revised Code; a hospital emergency department; a freestanding emergency department; or an ambulatory surgical facility licensed under section 3702.30 of the Revised Code.

(D) A person not otherwise authorized to administer a drug or perform a specific task may do so in accordance with a physician assistant’s delegation under this section.

About Donald Balasa

Donald A. Balasa, JD, MBA, chief executive officer and legal counsel for the American Association of Medical Assistants, keeps his eye on what is happening in the profession.
This entry was posted in On the Job, Professional Identity, Scope of Practice and tagged , , , , , , , . Bookmark the permalink.

10 Responses to Ohio Passes Senate Bill 110

  1. Kathy says:

    Do you know if there is a law for PA’s and NPs in the state of Colorado regarding delegation of medications?

  2. lsealing@verizon.net says:

    This is good for the Ohio Society of Medical Assistants. I wonder if this could be done for the Connecticut Society of medical Assistants with their bill.

  3. Sarah says:

    In Lexington, KY CMAs have always given medications orally, IM, & SQ, Is this what the law passed for Ohio? I think this should only be given to a CMA that has completed their Associate Degree with a AAMA Certification. These new Medical Assisting schools that offer a diploma should be stopped. Maybe the senate should look into this matter.

    • Amanda says:

      Agreed. I think these new diploma programs are an insult to us, who worked so much harder, and have a lot more education under us, to have those diploma program graduates representing us.

  4. Tiffany Heath says:

    To say that “those” diploma programs should be stopped is not fair to the schools and programs that are accredited. The process is grueling and the requirements are forever changing so to lump all of the schools together is unfair. If the schools do not have the backing or ability to gain accreditation then yes they should be required to or close. If the AAMA and AMT along with the state say they meet the standards who are you to say otherwise. Having concern for your profession the way I do is one thing but to assume good quality MA’s do not come from “those” schools is absurd.

    • Melissa says:

      Thank you, I take great pride as a medical assistant with a diploma. I work hard and my employer trust me and my work as well as many pleased patients because I efficient and have compassion, I get the work done safely and within guidelines and time frame. I proudly hold the MA diploma title.

  5. Lena Lee says:

    I live in New York State and I am wondering about the laws concerning CMAs giving injections such as vaccines, ie flu shots, ppd, etc

  6. Melissa says:

    I received my medical assistant diploma at Remington college and worked as a medical assistant for over 10 years , become a lead MA. Supervisor and medical office manager in the first 2 years in the healthcare field. I take pride as a medical assistant. I may not be certified but I was educated by 3 physicians by Remington college. Proudly! I’ve worked with CMA/ RMA/CCMA and honestly the education is not different . most times I questioned what they learned? So you can’t compare when the process is the same. Laws : rules: HIPAA all the same. Thank you.

  7. Pingback: Further Information on SB 110 | Legal Eye

  8. Haley Thomas says:

    I am a medical assistant in South Carolina and out state laws still state that nurse practitioners cannot delegate medications to us only medical doctors. I have been working with the same nurse practitioner for 2 years now at a community health center and so when she orders a medication for the patient I’m not “legally” able to give it and this really burns me up. My question is how do I get the nursing board to consider passing this law? What can I do to get it recognized for consideration to be passed in South Carolina? Thanks so much.

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