What We Are Watching at the Ohio Statehouse
Ohio ACEP is following a number of legislative issues related to the practice of emergency care in the state of Ohio.
Senate Introduces Legislation to Enter the Medical Licensure Compact
Senators Kristina Roegner and Steve Huffman have introduced Senate Bill 6 to enter Ohio into the Interstate Medical Licensure Compact. Over half of the states have already passed legislation to enter the Compact. Ohio ACEP has lent their support to SB 6.
The Senate Health Committee had a sponsor and proponent hearing on January 27, 2020. In addition to Ohio ACEP, supportive testimony was submitted by the Ohio State Medical Association, the Ohio Hospital Association, several other medical specialty societies and a few hospital systems. We are expecting this legislation could pass the Ohio Senate quickly.
Stroke Legislation Re-Introduced
Senate Bill 21 is the reintroduction of legislation that would direct the State Board of Emergency Medical, Fire and Transportation Services to develop guidelines for the assessment, triage and hospital transport of stroke patients. The medical director or cooperating physician advisory board of each EMS organization would establish their written protocols based on that model. Under the legislation, medical directors or cooperating physician advisory boards must also periodically provide training in the assessment and treatment of stroke patients. That training must address the assessment of stroke severity.
SB 21 is sponsored by Senators Nickie Antonio (D) and Nathan Manning (R). The bill nearly made is over the finish line in 2020 but failed to get a vote scheduled in the House of Representatives. The Senate Health Committee has already had 2 hearings on the bill in 2021.
Budget Process Begins
The first half of 2021 will be dominated by the State biennial budget process. The Governor’s proposal has been unveiled; it is House Bill 110. Below are some details of interest to Ohio ACEP. The budget process begins in the House. They will likely make significant changes before passing their version and sending over the Senate. The Senate will then go through the same exercise. Finally, a conference committee will be formed in June to work through all of the differences of the 3 version to adopt a final version.
In HB 110, the Governor has proposed creating a licensing process for hospitals. If enacted the licensing would begin three years after the effective date. The license application process would start 1 year after the effective date and it would include paying a fee, being accredited, complying with standards, and specifying number of beds. The director could inspect the hospital prior to issuing/denying a license but the hospital could avoid the inspection if they submit a copy of the most recent on-site survey report certifying deemed status.
The legislation appropriates funds for addiction crisis care in the emergency department. The Chronic Disease, Injury Prevention and Drug Overdose line item appropriates $11,148,480 in the first fiscal year and $7,898,480 in the second fiscal year. Up to $3,000,000 in fiscal year 2022 must be used, in consultation with the Department of Mental Health and Addiction Services and the Governor's RecoveryOhio Initiative, to support the continuation of the Emergency Department Comprehensive Care Initiative to enhance Ohio's response to the addiction crisis by creating comprehensive system of care for patients who present in emergency departments with addiction.
Transportation Budget Process Begins
In addition to the main operating budget, the legislature will also be working towards passing the Transportation, BWC and Industrial Commission budgets. Included in the Transportation Budget, House Bill 74, is the Governor’s distracted driving proposal.
Legislation was introduced last year but stalled. So, the Governor has chosen to try to accomplish the enhanced distracted drive law in this budget. The proposal would make districted driving a primary enforcement offense, enhance penalties and broaden the scope of what distracted driving is beyond texting. By making distracted driving a primary offense, police would be able to pull a car over for that violation alone. Currently in Ohio it is a secondary offense, so a driver must be committing another traffic offense to be siting for distracted driving. The bill also increases penalties/fine for violations of the law.
EMS Dementia Training
Representatives Phil Plummer (R) and Thomas West (D) have introduced House Bill 23 to require EMS personnel to undergo training in dementia. The training course would be developed by the State Board of EMFTS in consultation with the Ohio Department of Aging. The training would be a part of all EMS training programs and approved CE programs. The amount of dementia training would need to be at least 2 hours for the training programs and 1 hour for the CE programs.
The legislation also specifies 7 areas of instruction that the training must include. This legislation will be considered by the House Commerce and Labor Committee.
Separately, Representative Scott Wiggam (R) has introduced House Bill 28 to create regulations and permits for “stretcher vans” under the State Board of EMFTS. HB 28 defines “stretcher van” as a motor vehicle specifically designed and equipped to provide nonemergency transportation to individuals on a stretcher.
“Save Our Mothers Act” Introduced
Representative Erica Crawley (D) has introduced legislation dubbed the “Save Our Mothers Act” House Bill 42 includes a provision that requires the Department of Health to adopt rules “establishing requirements for hospitals and freestanding birthing centers to conduct annual continuing education for employees and contractors who routinely care for pregnant and postpartum women, including employees and contractors of the facility's emergency department.” The bill also requires ODH to collaborate with the Ohio perinatal quality collaborative to develop an initiative to improve birth equity, reduce peripartum racial and ethnic disparities, and address implicit bias in the health care system.
HB 42 also requires ODH in collaboration with the pregnancy-associated mortality review (PAMR) board
to make available to all hospitals and freestanding birthing centers best practices for the timely identification of all pregnant and postpartum women in the emergency department and for the appropriate and timely consultation with an obstetrician, certified nurse-midwife, or physician assistant with obstetric expertise to provide input on patient management and follow-up. The bill allows a hospital or freestanding birthing center to use telemedicine services for the consultation.
This legislation will be considered by the House Health Committee.
Bills Introduced Regarding Health Emergencies and Executive Orders
Senate Bill 22 has been introduced by Senators Terry Johnson and Rob McColley and House Bill 90 has been introduced by Scott Wiggam and Jay Edwards. In short, the bills create a 10-person legislative panel that would have the authority to rescind health orders as well creates as a process for rescinding executive orders. It would be called the Ohio Health Oversight and Advisory Committee. If the Committee rescinds a health order, the Governor could not issue an identical or similar order for 90 days. The bills also established that a public health state of emergency cannot be issued for more than 30 days. For a state of emergency to last for more than 30 days, the general assembly would need to pass a concurrent resolution. The Governor has already indicated he would veto the legislation. However, the House and the Senate do have enough Republican members to entertain a veto override.