HB 131 – Enacted!!!

Legislation to update the practice act for physical therapists was introduced by Representatives Bill Reineke (R- Tiffin) and Theresa Gavarone (R – Bowling Green) in 2017. House Bill 131 clarifies that “physical therapy” includes determining a diagnosis. The bill also makes additional updates to the PT practice act, including removing the requirement that potential licensees submit a notarized copy of their application and aligning regulations for foreign educated PTAs with the laws for foreign educated PTs.

The agreed to diagnosis language reads: "Physical therapy diagnosis" means a judgment that is made after examining the neuromusculoskeletal system or evaluating or studying its symptoms and that utilizes the techniques and science of physical therapy to establish a plan of therapeutic intervention. "Physical therapy diagnosis" does not include a medical diagnosis.

HB 131 was voted unanimously out of the House Health Committee on March 21, 2018. On April 11th, HB 131 went on to pass out of the House of Representatives unanimously by a vote of 95-0. The speeches and vote can be found by going to: http://www.ohiochannel.org/video/ohio-house-of-representatives-4-11-2018

HB 131 was referred to the Senate Health, Human Services and Medicaid Committee. Representatives Gavarone and Reineke gave testimony before the committee on May 22nd. They received no questions, but committee member Senator Randy Gardner commented that he was impressed that a bill on this topic was voted out of the House 95-0. He went further to state it was a testament to the work the sponsors must have done and commended them on their work.

OPTA President Tonya Apke gave proponent testimony on June 5th. Tonya did not receive any questions, but Chairman Burke did comment and thank Tonya for her testimony and for reminding the committee how highly trained and educated PTs are. At this hearing, the committee accepted an amendment regarding physiotherapy which take language regarding physiotherapy back to current law. It was previously changed by LSC but it was not a change requested by OPTA, so the amendment simply restores current law.

You can watch the proponent hearing using this link: http://www.ohiochannel.org/collections/ohio-senate-health-human- services-and-medicaid-committee?2. HB 131 hearing starts at about 53:40.

One additional hearing was held June 26th. No testimony was submitted for this hearing, so there were not opponent remarks submitted to the committee. When the legislature returned from summer recess the bill had 2 additional hearings in committee. The bill was unanimously reported by the committee on December 4, 2018 and went on to be voted by the Ohio Senate unanimously on December 13, 2018. That floor vote can be watched here: http://www.ohiochannel.org/video/ohio-senate-12-13-2018-part-2

The bill went on to be signed by Governor Kasich on December 19, 2018. This was a long process for OPTA and we couldn’t be more pleased with the outcome!

Bills To Require Review of All Boards and Commissions Passes

Legislation introduced by Rob McColley (R – Napoleon) that would require the Ohio General Assembly to review and evaluate all boards and commissions was identified as a Senate lame duck priority. Senate Bill 255 specifies that without the legislature passing legislation to continue the operation of each licensing board, boards would automatically expire. During the review process “each board shall have the burden of demonstrating to the standing committee a public need for its continued existence.”

SB 255 was referred to Senate Government Oversight and Reform where it had had four hearings. The bill was reported out of the Senate Committee and passed the full Ohio Senate on June 27, 2018 by a vote of 24-8. The legislation was then considered by the House of Representatives.

Under SB 255, the legislative committee reviewing the board will look to provide for the “least restrictive regulation” for each profession to protect consumers from present, significant, and substantiated harms that threaten public health, safety, and welfare. They would also be charged at looking at licensing policies of other states related to the profession. The Legislative Service Commission (LSC) would be charged with evaluating for the “least restrictive regulation”.

"Least restrictive regulation" means the public policy of relying on one of the following, listed from the least to the most restrictive, as a means of consumer protection: market competition; third-party or consumer-created ratings and reviews; private certification; specific private civil cause of action to remedy consumer harm; actions under Chapter 1345. of the Revised Code; regulation of the process of providing the specific goods or services to consumers; inspection; bonding or insurance; registration; government certification; specialty occupational license for medical reimbursement; and occupational license.

A group of effected professions worked on alternative language to the legislation. Of concern was the automatic expiration as well as other provisions. We were able to meet with Senator McColley and other legislative leaders. McColley was adamant that he did not support any occupational carve outs to the legislation. He also thought the automatic expiration was key to giving the bill teeth. However, he did agree to some changes that were accepted by the House Committee.

• The bill extends the full rule process by 1 year. So instead of occupations being reviewed every 5 years it, it would be every 6 years. (So, 1/3 of boards would be reviewed every 2 years) • The substitute bill also gives the General Assembly an extra 6 months to renew a license. So, if your license was set to expire at the end of 2020, the legislature would have until the June 30, 2021 to renew the occupation. This timing corresponds with the legislative budget process. The budget is when all boards and commissions are granted funding. • The bill still contains language regarding the standard of “least restrictive regulations”. • "Specialty occupational license for medical reimbursement" is defined as a nontransferable authorization in law for an individual to qualify for payment or reimbursement from a government agency, for providing identified medical services, based on meeting personal qualifications established in law, which may be recognized by a private company. • The bill specifies that “Where the state finds it is necessary to displace competition, the state will use the least restrictive regulation to protect consumers from present, significant, and substantiated harms that threaten public health, safety and welfare. The policy of employing the least restrictive regulation shall presume that market competition and private remedies are sufficient to protect consumers. Where needed, regulations shall be tailored to meet the predominate identified need to protect consumers, as follows: If regulations are intended to facilitate governmental reimbursement for providing medical services for an emerging medical specialty, the appropriate state action shall be to require a specialty occupational license for medical reimbursement.

The legislation was ultimately passed by the House of Representatives during the lame duck session by a vote of 55-27 and delivered to the Governor for enactment.

Substitute Licenses for Licensed Medical Professionals – Enacted

Representative Jay Edwards (R- Nelsonville) introduced House Bill 491 which is intended to help cut down the burden of dual licensing for certain licensed related service personnel and their ability to work in a school based setting as a short and long-term substitute.

Currently, the Ohio Department of Education requires that school based PTs must obtain a Pupil Services License to practice in a school setting, in addition to the board license issued by the State. Many school districts across the State are seeing a shortage in many specified disciplines and it is becoming difficult to find short and long-term substitutes that need to have the additional professional licensure to provide the service to students. This legislation would apply for short and long-term substitute purposes only.

The proposed legislation would apply to the following licensed professionals: School Speech-Language Pathologist, School Nurse, School Audiologist, Occupational Therapist, Physical Therapist, Occupational Therapy Assistant, Physical Therapy Assistant and School Social Worker

House Bill 491 was reported out of House Education and Career Readiness Committee on March 21st with an amendment that requires substitute nurses to hold bachelor's degrees. This bill was favorable voted on by the House of Representatives on June 7, 2018 by a vote of 80-2. The legislation was then considered by the Senate Education Committee. The bill picked up several education amendments during the lame duck process, including extending alternative education pathways for Ohio students. But the amendments did not change the original provisions in the bill. HB 491 was opposed by the Ohio Occupational Therapy Association and they provided testimony at the December 5, 2018 hearing. The bill went on to be favorably reported by the Senate committee and passed the Ohio Senate unanimously on December 6, 2018. The Governor went on to sign the bill on December 19, 2018.

APRN Independent Practice and Youth Concussion Legislation

House Bill 726 has been introduced by Representative Theresa Gavarone (R – Bowling Green) to remove a requirement that advance practice registered nurses work under a standard care agreement with a physician. This would give APRNs independent practice in Ohio. The bill also includes a provision to allow any licensed healthcare professional who is 1) designated by a school district and 2) meets the requirements set by their licensure board, to assess and clear student athletes after a concussion.

This legislation did have one hearing in House Health Committee before the legislature finished their work for the year.

Massage Parlor Legislation

Representative Andy Brenner introduced legislation to • Provide townships with the optional authority to regulate massage establishments without requiring the current preliminary registration requirements, • Create a criminal penalty for failure to have the requisite state occupational and professional licenses a township may require for a person to perform massages in the township, and • Make changes to the current registration requirements. A major provision of the bill requires that all massages be provided by a person who has an appropriate license that includes massage in their scope of practice. This includes: nurses, chiropractors, cosmetologists, etc. However, PTs were not included in the as-introduced version of the bill.

The practice act for PTs includes language that states the practice of physical therapy includes: “Physiotherapy. Physical measures include massage, heat, cold, air, light, water, electricity, sound, and the performance of tests of neuromuscular function as an aid to such treatment.” http://codes.ohio.gov/orc/4755.40v1

There was talk that a version this legislation could pass during the lame duck session. The OPTA worked with the bill sponsor and the proponents to clarify the language. Our amendment to include physical therapist with the other providers authorized to utilize massage as part of their practice was agreed to by all parties. The legislation did not move forward, however, it is expected to be re-considered in 2019.

DeWine Appointments

Governor Elect has begun announcing cabinet appointments. For example, he has named Kim Murnieks to serve as the Director of the Office of Budget and Management and Alisha Nelson as the head of RecoveryOhio which is a newly created position.

According the transition website: RECOVERYOHIO will be a new initiative designated within the Office of the Governor to fight the opioid crisis. The Director will report directly to the Governor and will coordinate the work of numerous state departments, boards, and commissions impacting substance abuse and mental health services in Ohio by leveraging Ohio’s existing resources and by seeking new opportunities. The Director’s goal is to create a system that helps make treatment available to Ohioans in need; provides support services for those in recovery and their families; offers direction for the state’s prevention and education efforts; and works with local law enforcement to provide resources to fight illicit drugs at their source. The Director will also serve as the Chair for a Governor-appointed team of experts from across the state in both the public and private sector with experience in the fields of treatment, prevention, recovery supports, and criminal justice who will make up the Recovery Ohio Advisory Committee.

DeWine has yet to announcement his selections for Directors of Medicaid, Insurance, or Mental Health and Addiction Services.

Legislative Leadership for 133rd General Assembly

House and Senate caucus’s typically informally elect their leadership in advance of the official swearing in ceremony scheduled for January 7, 2019.

The House Republicans held an informal vote, however, several incoming members did not participate. There is still much jockeying going on behind the scenes between current Speaker of the House Ryan Smith and former Speaker of the House Larry Householder. This could lead up to to a showdown on the House floor in January with neither candidate having the required 50 votes. However, the informal vote resulted in the following leadership team: Speaker Ryan Smith along with Representatives Rick Carfagna, Bill Seitz, Sarah LaTourette, Tom Patton and Bill Reineke.

The Senate Republicans will continue to be led by Senate President Larry Obhof. Also on the Senate Republican leadership team is Senator Bob Peterson, Senator Randy Gardner and Senator Matt Huffman.

The Senate Democrats have informally voted to retain Senator Kenny Yuko as Minority Leader. Filling out the Senate Democrat leadership team are Senators Cecil Thomas, Sean O’Brien and Sandra Williams.

The House Democrats will continue under the leadership of Minority Leader Fred Strahorn. Rounding out the House Democrat leaders are Representatives Emilia Sykes, Brigid Kelly and Kent Smith.

Copies of legislation – Go to www.legislature.state.oh.us

How to Contact Your Lobbyist

Amanda Sines Government Advantage Group 17 South High Street, Suite 750 Columbus, Ohio 43215 614-221-7157 [email protected]