Ohio Occupational Therapy, Physical Therapy and Athletic Trainers Board Joint Board Meeting June 5, 2020 8:00 AM Roll Call Dial

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Ohio Occupational Therapy, Physical Therapy and Athletic Trainers Board Joint Board Meeting June 5, 2020 8:00 AM Roll Call Dial 614-721-2972; Conference ID: 744 216 497#

Ohio OTPTAT Board Mission Statement:

The mission of the Ohio Occupational Therapy, Physical Therapy, and Athletic Trainers Board is to actively promote and protect the health of Ohioans through effective regulation of the professions of occupational therapy, physical therapy, athletic training, orthotics, prosthetics, and pedorthics. Goals to achieve this mission include: • Ensuring that individuals practicing occupational therapy, physical therapy, athletic training, orthotics, prosthetics, and pedorthics. meet sufficient standards of education, training, competence, and ethics, as defined in the laws and rules governing the profession. • Investigate and discipline licensees whose practice falls below the minimal standards of care. • Define and advocate for standards of safe OT, PT, AT, OPP practice, and ensure that the laws and rules governing the practice accurately reflect current standards. • Provide information about the licensees of the OTPTAT Board, the Board’s functions and operations, and the laws governing the practice of OT, PT, AT, LO, LP, LPED, and LPO. • Achieve and maintain the highest possible levels of organizational efficiency.

1. Administrative Matters 1.1 Agenda Review 1.2 Approval of Minutes Action Required 1.3 Executive Director Report 1.4 Executive Session: TBA 1.4.1 To discuss pending and imminent court action (ORC 121.22 (G)(3)) 1.4.2 To discuss personnel matters related to: • Appointment; Employment; Dismissal; Discipline; Promotion; Demotion; Compensation (ORC 121.22 (G)(1) - see Item 4.5) • Investigation of charges/complaints against a public employee, licensee, or regulated individual in lieu of a public hearing (ORC 121.22 (G)(1)) 1.4.3 To discuss matters required to be kept confidential by federal law, federal rules, or state statutes (ORC 121.22 (G)(5)) 1.5 Discussion of Law and Rule Changes 1.5.1 Waiver for endorsement applicants 1.5.2 House Bill 679 (telehealth) 1.5.3 House Bill 484 (AT Practice Act)

OTPTAT Joint Board Meeting June 5, 2020 Page 1 of 2

1.5.4 House Bill 606/Senate Bill 308 (Immunity for COVID-19) 4. Open Forum 5. Old Business 6. New Business 7. Next Meeting Preparation 7.1 Agenda Items 7.2 Executive Director Assignments 8. Adjournment

OTPTAT Joint Board Meeting June 5, 2020 Page 2 of 2

hio Occupational Therapy, Physical Therapy, and Athletic Trainers Board

Joint Board Meeting May 14, 2020 9:00 AM

Virtual Meeting via Microsoft Team

Members Member Absent Mario Baker, PT Trevor Vessels, Public Member Guests Beth Ann Ball, OT – Victoria Gresh, OPTA Trevor Bates, AT Legal Counsel Amanda Sines Lynn Busdeker, PT, Emily Pelfrey, AAG Kristen Neville Joanne Phillips Estes, OT Erin Hofmeyer, PT Section Anthony Ganim, PT Staff Timothy McIntire, PT Section Ronald Kleinman, PT Melissa Anthony, Executive Brian Weaver, OPP Ad. Council Hollie Kozak AT Director Karen McIntyre, PT Section Gary Lake, AT Jeffery Duvall, Enforcement Chad Miller, PT Section Mary Beth Lavey, OTA Division Supervisor Benjamin Burkam, MD, AT Linda Lowes, PT Jan Hills, Executive Assistant Section Jeffrey Sczpanski, AT Jaklyn Shucofsky, Paralegal Anissa Siefert, OT Debbie Fulk, Licensure Melissa Van Allen, OT Rosa Avery, Licensure

Mission Statement The mission of the Ohio Occupational Therapy, Physical Therapy, and Athletic Trainers Board is to actively promote and protect the health of Ohioans through effective regulation of the professions of occupational therapy, physical therapy, athletic training, orthotics, prosthetics, and pedorthics. Goals to achieve this mission include: • Ensuring that individuals practicing occupational therapy, physical therapy, athletic training, orthotics, prosthetics, and pedorthics. meet sufficient standards of education, training, competence, and ethics, as defined in the laws and rules governing the profession. • Investigate and discipline licensees whose practice falls below the minimal standards of care. • Define and advocate for standards of safe OT, PT, AT, and OPP practice, and ensure that the laws and rules governing the practice accurately reflect current standards. • Provide information about the licensees of the OTPTAT Board, the Board’s functions and operations, and the laws governing the practice of OT, PT, AT, and OPP. • Achieve and maintain the highest possible levels of organizational efficiency.

Call to Order The meeting was called to order by Joint Board President Hollie Kozak, AT at 9:06 AM.

Approval of Minutes Action: Lynn Busdeker made a motion that the minutes from the January 16, 2020 meeting be approved as amended. Second by Beth Ann Ball. Motion passed.

Joint Board Meeting May 14, 2020 Page 1 of 3

Executive Director Report

The Executive Director presented the following information to the Board: • The Executive Director reported on recent licensure statistics. • The Executive Director reported the OT audit is on hold. The PTA audit will be wrapping up shortly. • The Executive Director informed the Board on the status of changes the agency is seeking related to eLicense Ohio. • The Executive Director reported on the Board’s revenue and expenditures. The state has asked that we approach the budget quarter by quarter for more flexibility. • There is a hiring freeze at the state therefore the open position in enforcement will remain unfilled. • The Executive Director reported that the JAM has been posted. • The Executive Director reported on several legislative updates pertaining to licensure. • The Executive Director reported that outreach opportunities are temporarily on hold due to COVID-19.

Discussion of Law and Rule Changes

3D Printing Beth Ann Ball made a motion that the Executive Director final file rule 4755-70-01 related to 3D printing with JCARR. Lynn Busdeker moved to second the motion. Vote taken. Motion passed.

Waiver for endorsement applicants Hollie Kozak recommended that a workgroup be created involving members from each section as well as the Advisory Council to come up with legislative language to move forward with law changes. This will create a pathway for licensure for people who have alternative qualifications or certifications and are in good standing and have a deadline set for this group that by June 1 or thereabout. A special meeting will be called to review and vote to keep this process moving forward. Lynn Busdeker made the motion, second by Beth Ann Ball. Motion passed.

OPP Rule rewrite Hollie Kozak recommended that the Executive Director file updated and renumbered OPP Rules with the Common Sense Initiative. Lynn Busdeker made a motion, second by Ron Kleinman. Motion passed.

Licensure Applications Action: Beth Ann Ball moved that the OTPTAT Board ratify as submitted, orthotics, prosthetics, and pedorthics full and temporary licenses issued by examination, reciprocity, and reinstatement from January 16, 2020 to May 14, 2020, taking into account those licenses subject to discipline, surrender, or non-renewal. Mary Beth Lavey seconded the motion. The motion carried.

Kristen McDonald Licensed Orthotist Endorsement MaryFrances Walsh Licensed Orthotist Endorsement

Louis Mason Grove Licensed Pedorthist Endorsement Sara Emma Goldberg Licensed Prosthetist Endorsement Michael Ball Licensed Prosthetist Examination Katie Johnson Licensed Prosthetist-Orthotist Examination Elisabeth Bradley Licensed Prosthetist-Orthotist Examination

Licensure Withdrawal Action: Beth Ann Ball made a motion that the Joint Board grant the application withdrawal requests for OPP examination/endorsement applications on file with the Board on May 14, 2020 based on documentation provided. Second by Melissa Van Allen. Motion passed.

Dustin Rieman APP-000324604

Joint Board Meeting May 14, 2020 Page 2 of 3

Enforcement Division Enforcement Statistics “New” cases opened since the last meeting: 1 Cases” closed” at the last meeting: 0 Cases “currently open”: 2 Active consent agreements: 0 Adjudication orders being monitored: 0

Open Forum None

Old Business None

New Business Occupational Therapy Section Report • Mary Beth Lavey thanked the members of the staff for their continued work during the remote work sessions. • The section is exploring the Texas Lonestar re-entry program and will be following it closely. • There have been many comments involving the number of CEU’s and limiting the number of CEUs that can be obtained by student supervision field work.

Physical Therapy Section Report Erin Hofmeyer reported the JAM is now live. There have been many inquiries to the section on how to handle telehealth. These and more topics will be discussed at the section meeting on May 14.

Athletic Trainers Section Report Trevor Bates reported the section is happy to announce the appointment of Dr. Ben Burkam to the physician appointment on the board. waiting for the physician appointment. Reviewing questions for Juris Prudence examination. Jeff Sczpanski is taking the lead in creating a virtual presentation for OATA.

Orthotics, Prosthetics, Pedorthics Advisory Council No report.

Next Meeting Preparation The workgroup will be reporting to the Joint Board at the next meeting in June regarding OPP waiver of endorsement applicants.

Adjournment There being no further business and there is no objection, the meeting was adjourned at 10:04 AM.

Respectfully submitted,

Jan Hills

Hollie Kozak, President Anissa Seifert, Secretary Ohio Occupational Therapy, Physical Therapy, Ohio Occupational Therapy, Physical Therapy, and Athletic Trainers Board and Athletic Trainers Board

Missy Anthony, MPA, Executive Director Ohio Occupational Therapy, Physical Therapy, and Athletic Trainers Board

Joint Board Meeting May 14, 2020 Page 3 of 3

New Section: 4779.16

(A) A person may apply for licensure by alternate path notwithstanding the qualifications established under Ohio Revised Code Sections 4779.10, 4779.11, or 4779.12 if the person presents evidence satisfactory to the Board that the person possesses unique qualifications to practice orthotics, prosthetics, or orthotics and prosthetics, as defined by rules adopted by the Board in consultation with the Orthotics, Prosthetics, and Pedorthics Advisory Council. (B) A uniquely qualified person is a person who, through education, training, and experience, is qualified to perform prosthetic or orthotic care.

Section 4779.08 (Board rule making authority)

(A)(17) Requirements, standards, and procedures to qualify for licensure via unique qualifications As Introduced

133rd General Assembly Regular Session H. B. No. 679 2019-2020 Representatives Fraizer, Holmes, A. Cosponsors: Representatives Abrams, Butler, Crossman, Patton, Seitz, Swearingen

A B I L L

To amend sections 3902.30, 4723.94, 4732.33, 1 5123.60, and 5164.95; to amend, for the purpose 2 of adopting a new section number as indicated in 3 parentheses, section 4731.2910 (4743.09); and to 4 enact sections 3721.60, 4730.60, 4753.20, 5 4755.90, 4757.50, 4758.80, 4759.20, 5119.368, 6 and 5123.603 of the Revised Code to establish 7 and modify requirements regarding the provision 8 of telehealth services and to declare an 9 emergency. 10

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

Section 1. That sections 3902.30, 4723.94, 4732.33, 11 5123.60, and 5164.95 be amended; section 4731.2910 (4743.09) be 12 amended for the purpose of adopting a new section number as 13 indicated in parentheses; and sections 3721.60, 4730.60, 14 4753.20, 4755.90, 4757.50, 4758.80, 4759.20, 5119.368, and 15 5123.603 of the Revised Code be enacted to read as follows: 16

Sec. 3721.60. (A) As used in this section, "long-term care 17 facility" means all of the following: 18 H. B. No. 679 Page 2 As Introduced

(1) A home, as defined in section 3721.10 of the Revised 19 Code; 20

(2) A residential facility licensed by the department of 21 mental health and addiction services under section 5119.34 of 22 the Revised Code; 23

(3) A residential facility licensed by the department of 24 developmental disabilities under section 5123.19 of the Revised 25 Code; 26

(4) A facility operated by a hospice care program licensed 27 by the department of health under Chapter 3712. of the Revised 28 Code that is used exclusively for care of hospice patients. 29

(B) During any declared disaster, epidemic, pandemic, 30 public health emergency, or public safety emergency, each long- 31 term care facility shall provide residents and their families 32 with a video-conference visitation option if the governor, the 33 director of health, other government official or entity, or the 34 long-term care facility determines that allowing in-person 35 visits at the facility would create a risk to the health of the 36 residents. 37

Sec. 3902.30. (A) As used in this section: 38

(1) "Cost-sharing" means the cost to a covered individual 39 under a health benefit plan according to any coverage limit, 40 copayment, coinsurance, deductible, or other out-of-pocket 41 expense requirements imposed by the plan. 42

(2) "Health benefit plan," "health care services," and 43 "health plan issuer" have the same meanings as in section 44 3922.01 of the Revised Code. 45

(2) (3) "Health care professional" means any of the 46 H. B. No. 679 Page 3 As Introduced following: 47

(a) A physician licensed under Chapter 4731. of the 48 Revised Code to practice medicine and surgery, osteopathic 49 medicine and surgery, or podiatric medicine and surgery; 50

(b) A physician assistant licensed under Chapter 47314730. 51 of the Revised Code; 52

(3) (4) "In-person health care services" means health care 55 services delivered by a health care professional through the use 56 of any communication method where the professional and patient 57 are simultaneously present in the same geographic location. 58

(4) (5) "Recipient" means a patient receiving health care 59 services or a health care professional with whom the provider of 60 health care services is consulting regarding the patient. 61

(5) "Telemedicine (6) "Telehealth services" means a mode 62 of providing health care services through synchronous or 63 asynchronous information and communication technology by a 64 health care professional, within the professional's scope of 65 practice, who is located at a site other than the site where the 66 recipient is located. 67

(B)(1) A health benefit plan shall provide coverage for 68 telemedicine telehealth services on the same basis and to the 69 same extent that the plan provides coverage for the provision of 70 in-person health care services. 71

(2) A health benefit plan shall not exclude coverage for a 72 service solely because it is provided as a telemedicine 73 telehealth service. 74 H. B. No. 679 Page 4 As Introduced

(C) A health benefit plan shall not impose any annual or 75 lifetime benefit maximum in relation to telemedicine telehealth 76 services other than such a benefit maximum imposed on all 77 benefits offered under the plan. 78

(D) This A health plan issuer may impose cost-sharing 79 requirements with regard to telehealth services in accordance 80 with both of the following: 81

(1) A health benefit plan shall not impose a cost-sharing 82 requirement for telehealth services provided via telephone or 83 electronic mail. 84

(2) A health benefit plan shall not impose a cost-sharing 85 requirement for telehealth services that exceeds the cost- 86 sharing requirement for comparable in-person health care 87 services. 88

(E) Telehealth services provided by electronic mail or 89 telephone shall be tallied using the minutes spent per patient 90 on a running total. Health plan issuers shall reimburse 91 providers for a block of time spent on such services that is 92 equivalent to the standard amount of time spent on a telehealth 93 service. 94

(F) This section shall not be construed as doing any 95 either of the following: 96

(1) Prohibiting a health benefit plan from assessing cost- 97 sharing requirements to a covered individual for telemedicine 98 services, provided that such cost-sharing requirements for 99 telemedicine services are not greater than those for comparable 100 in-person health care services; 101

(2) Requiring a health plan issuer to reimburse a health 102 care professional for any costs or fees associated with the 103 H. B. No. 679 Page 5 As Introduced provision of telemedicine telehealth services that would be in 104 addition to or greater than the standard reimbursement for 105 comparable in-person health care services; 106

(3) (2) Requiring a health plan issuer to reimburse a 107 telemedicine telehealth provider for telemedicine telehealth 108 services at the same rate as in-person services. 109

(E) This section applies to all health benefit plans 110 issued, offered, or renewed on or after January 1, 2021. 111

(G) Except as provided in division (D) of this section, 112 coverage for telehealth services shall be provided on the same 113 terms and the same basis as in-person health care services. 114

(H) The superintendent of insurance may adopt rules in 115 accordance with Chapter 119. of the Revised Code as necessary to 116 carry out the requirements of this section. Any such rules shall 117 be exempted from the requirements of division (F) of section 118 121.95 of the Revised Code. 119

Sec. 4723.94. (A) As used in this section: 120

(1) "Facility fee" means any fee charged or billed for 121 telemedicine services provided in a facility that is intended to 122 compensate the facility for its operational expenses and is 123 separate and distinct from a professional fee. 124

(2) "Health plan issuer" has the same meaning as in 125 section 3922.01 of the Revised Code. 126

(3) "Telemedicine services" has the same meaning as in 127 section 3902.30 of the Revised Code. 128

(B) An advanced practice registered nurse providing 129 telemedicine may provide telehealth services shall not charge a 130 facility fee, an origination fee, or any fee associated with the 131 H. B. No. 679 Page 6 As Introduced cost of the equipment used to provide telemedicine services to a 132 health plan issuer covering telemedicine services under in 133 accordance with section 3902.30 4743.09 of the Revised Code. 134

Sec. 4730.60. A physician assistant may provide telehealth 135 services in accordance with section 4743.09 of the Revised Code. 136

Sec. 4732.33. (A) The state board of psychology shall 137 adopt rules governing the use of telepsychology for the purpose 138 of protecting the welfare of recipients of telepsychology 139 services and establishing requirements for the responsible use 140 of telepsychology in the practice of psychology and school 141 psychology, including supervision of persons registered with the 142 state board of psychology as described in division (B) of 143 section 4732.22 of the Revised Code. The rules shall be 144 consistent with section 4743.09 of the Revised Code. 145

(B) A psychologist or school psychologist may provide 146 telehealth services in accordance with section 4743.09 of the 147 Revised Code. 148

Sec. 4731.2910 4743.09. (A) As used in this section: 149

(1) "Facility fee" has the same meaning as in section 150 4723.94 of the Revised Code means any fee charged or billed for 151 telehealth services provided in a facility that is intended to 152 compensate the facility for its operational expenses and is 153 separate and distinct from a professional fee. 154

(2) "Health care professional" means: 155

(a) An advanced practice registered nurse, as defined in 156 section 4723.01 of the Revised Code; 157

(b) A physician assistant licensed under Chapter 4730. of 158 the Revised Code; 159 H. B. No. 679 Page 7 As Introduced

(c) A physician licensed under this chapter to practice 160 medicine and surgery, osteopathic medicine and surgery, or 161 podiatric medicine and surgery; 162

(b) A physician assistant licensed under Chapter 4730. 163

(d) A psychologist or school psychologist licensed under 164 Chapter 4732. of the Revised Code; 165

(e) An audiologist or speech-language pathologist licensed 166 under Chapter 4753. of the Revised Code; 167

(f) An occupational therapist or physical therapist 168 licensed under Chapter 4755. of the Revised Code; 169

(g) A professional clinical counselor, independent social 170 worker, or independent marriage and family therapist licensed 171 under Chapter 4757. of the Revised Code; 172

(h) An independent chemical dependency counselor licensed 173 under Chapter 4758. of the Revised Code; 174

(i) A dietitian licensed under Chapter 4759. of the 175 Revised Code. 176

(3) "Health care professional licensing board" means any 177 of the following: 178

(a) The board of nursing; 179

(b) The state medical board; 180

(d) The state speech and hearing professionals board; 182

(e) The Ohio occupational therapy, physical therapy, and 183 athletic trainers board; 184

(f) The counselor, social worker, and marriage and family 185 H. B. No. 679 Page 8 As Introduced therapist board; 186

(g) The chemical dependency professionals board. 187

(4) "Health plan issuer" has the same meaning as in 188 section 3922.01 of the Revised Code. 189

(4) (5) "Telemedicine Telehealth services" has the same 190 meaning as in section 3902.30 of the Revised Code. 191

(B) Each health care professional licensing board shall 192 permit a health care professional under its jurisdiction to 193 provide the professional's services as telehealth services in 194 accordance with this section. The board may adopt any rules it 195 considers necessary to implement this section. The rules shall 196 be adopted in accordance with Chapter 119. of the Revised Code. 197

(1) A health care professional shall conduct an initial 200 in-person visit with a patient before providing telehealth 201 services to the patient, except that the professional may waive 202 this requirement if the professional determines that a situation 203 is critical and an in-person visit is not practical. 204

(2) A health care professional may deny a patient 205 telehealth services and, instead, require the patient to undergo 206 an in-person visit. 207

(3) When providing telehealth services, a health care 208 professional shall use technology with secure video 209 capabilities. A health care professional shall ensure that any 210 username or password information and any electronic 211 communications between the professional and a patient are 212 securely transmitted and stored. 213 H. B. No. 679 Page 9 As Introduced

(4) A health care professional shall conduct at least one 214 in-person visit each year with each patient who receives 215 telehealth services from the professional, except that the 216 professional may waive this requirement if the professional 217 determines that a situation is critical and an in-person visit 218 is not practical. 219

(5) In the case of a health care professional who is a 220 physician, physician assistant, or advanced practice registered 221 nurse, both of the following apply: 222

(a) The professional may provide telehealth services to a 223 patient located outside of this state if permitted by the laws 224 of the state in which the patient is located. 225

(b) The professional may provide telehealth services 226 through the use of medical devices that enable remote 227 monitoring, including such activities as monitoring a patient's 228 blood pressure, heart rate, or glucose level. 229

(D) When a patient has consented to receiving telehealth 230 services, the health care professional who provides those 231 services is not liable in damages under any claim made on the 232 basis that the services do not meet the same standard of care 233 that would apply if the services were provided in-person. 234

(E)(1) A health care professional providing telemedicine 235 telehealth services shall not charge a health plan issuer 236 covering telehealth services under section 3902.30 of the 237 Revised Code any of the following: a facility fee, an 238 origination fee, a fee associated with the administrative costs 239 incurred in providing telehealth services, or any fee associated 240 with the cost of the equipment used to provide telemedicine 241 telehealth services to a health plan issuer covering 242 H. B. No. 679 Page 10 As Introduced telemedicine services under section 3902.30 of the Revised Code. 243

(2) A health care professional providing telehealth 244 services is not required to receive a patient's consent before 245 billing for the cost of providing the services. 246

(F) Nothing in this section eliminates or modifies any 247 other provision of the Revised Code that requires a health care 248 professional who is not a physician to practice under the 249 supervision of, in collaboration with, in consultation with, or 250 pursuant to the referral of another health care professional. 251

Sec. 4753.20. An audiologist or speech-language 252 pathologist may provide telehealth services in accordance with 253 section 4743.09 of the Revised Code. 254

Sec. 4755.90. An occupational therapist or physical 255 therapist may provide telehealth services in accordance with 256 section 4743.09 of the Revised Code. 257

Sec. 4757.50. A professional clinical counselor, 258 independent social worker, or independent marriage and family 259 therapist may provide telehealth services in accordance with 260 section 4743.09 of the Revised Code. 261

Sec. 4758.80. An independent chemical dependency counselor 262 may provide telehealth services in accordance with section 263 4743.09 of the Revised Code. 264

Sec. 4759.20. A dietitian may provide telehealth services 265 in accordance with section 4743.09 of the Revised Code. 266

Sec. 5119.368. (A) As used in this section, "telehealth 267 services" has the same meaning as in section 3902.30 of the 268 Revised Code. 269

(B) The following services may be provided as telehealth 270 H. B. No. 679 Page 11 As Introduced services and are considered to have been provided on a face-to- 271 face basis: 272

(1) General services; 273

(2) Community psychiatric supportive treatment services; 274

(3) Therapeutic behavioral services and psychosocial 275 rehabilitation services; 276

(4) Peer recovery services; 277

(5) Substance use disorder case management services; 278

(6) Crisis intervention services; 279

(7) Assertive community treatment services; 280

(8) Intensive home-based treatment services. 281

(C) Each provider shall establish a written policy and 282 procedures describing how the provider will ensure that staff 283 assisting clients with receiving telehealth services or 284 providing telehealth services are fully trained in using 285 equipment necessary for providing the services. 286

(D) Prior to providing telehealth services to a client, a 287 provider shall describe to the client the potential risks 288 associated with receiving treatment through telehealth services 289 and shall document that the client was provided with the risks 290 and agreed to assume those risks. The risks communicated to a 291 client must address the following: 292

(1) Clinical aspects of receiving treatment through 293 telehealth services; 294

(2) Security considerations when receiving treatment 295 through telehealth services; 296 H. B. No. 679 Page 12 As Introduced

(3) Confidentiality for individual and group counseling. 297

(E) It is the responsibility of the provider, to the 298 extent possible, to ensure contractually that any entity or 299 individuals involved in the transmission of information through 300 telehealth mechanisms guarantee that the confidentiality of the 301 information is protected. 302

(F) Every provider shall have a contingency plan for 303 providing telehealth services to clients in the event that 304 technical problems occur during the provision of those services. 305

(G) Providers shall maintain, at a minimum, the following 306 information pertaining to local resources: 307

(1) The local suicide prevention hotline, if available, or 308 the national suicide prevention hotline. 309

(2) Contact information for the local police and fire 310 departments. 311

The provider shall provide the client written information 312 on how to access assistance in a crisis, including one caused by 313 equipment malfunction or failure. 314

(H) It is the responsibility of the provider to assure 315 that equipment meets standards sufficient to do the following: 316

(1) To the extent possible, ensure confidentiality of 317 communication; 318

(2) Provide for interactive communication between the 319 provider and the client; 320

(3) Ensure that both picture and audio are sufficient to 321 enable real-time interaction between the client and the provider 322 and to ensure the quality of the service provided. 323 H. B. No. 679 Page 13 As Introduced

(I) The client site shall be maintained in such a manner 324 that appropriate staff persons are on hand in the event of a 325 malfunction with the equipment used to provide telehealth 326 services. 327

(J) (1) All telehealth services provided by interactive 328 videoconferencing shall meet both of the following conditions: 329

(a) Begin with the verification of the client through a 330 name and password or personal identification number when 331 treatment services are being provided; 332

(b) Be provided in accordance with state and federal law . 333

(2) Each provider shall ensure that any username or 334 password information and any electronic communications between 335 the provider and a client are securely transmitted and stored . 336

(K) The department of mental health and addiction services 337 may adopt rules as it considers necessary to implement this 338 section. The rules shall be adopted in accordance with Chapter 339 119. of the Revised Code. Any such rules are not subject to the 340 requirements of division (F) of section 121.95 of the Revised 341 Code. 342

Sec. 5123.60. (A) As used in this section and section in 343 sections 5123.601 to 5123.603 of the Revised Code, "Ohio 344 protection and advocacy system" means the nonprofit entity 345 designated by the governor in accordance with Am. Sub. H.B. 153 346 of the 129th general assembly to serve as the state's protection 347 and advocacy system and client assistance program. 348

(B) The Ohio protection and advocacy system shall provide 349 both of the following: 350

(1) Advocacy services for people with disabilities, as 351 H. B. No. 679 Page 14 As Introduced provided under section 101 of the "Developmental Disabilities 352 Assistance and Bill of Rights Act of 2000," 114 Stat. 1678 353 (2000), 42 U.S.C. 15001; 354

(2) A client assistance program, as provided under section 355 112 of the "Rehabilitation Act of 1973," 29 U.S.C. 732. 356

Sec. 5123.603. During any declared disaster, epidemic, 359 pandemic, public health emergency, or public safety emergency, 360 an individual with a developmental disability or any other 361 permanent disability who is in need of surgery or any other 362 health care procedure, any medical or other health care test, or 363 any clinical care visit shall be given the opportunity to have 364 at least one parent or legal guardian present if the presence of 365 the individual's parent or legal guardian is necessary to 366 alleviate any negative reaction that may be experienced by the 367 individual who is the patient. 368

The Ohio protection and advocacy system may enforce this 369 section. 370

Sec. 5164.95. (A) As used in this section, "telehealth 371 service" means a health care service delivered to a patient 372 through the use of interactive audio, video, or other 373 telecommunications or electronic technology from a site other 374 than the site where the patient is located. 375

(B) The department of medicaid shall establish standards 376 for medicaid payments for health care services the department 377 determines are appropriate to be covered by the medicaid program 378 when provided as telehealth services. The standards shall be 379 established in rules adopted under section 5164.02 of the 380 H. B. No. 679 Page 15 As Introduced

Revised Code. 381

In accordance with section 5162.021 of the Revised Code, 382 the medicaid director shall adopt rules authorizing the 383 directors of other state agencies to adopt rules regarding the 384 medicaid coverage of telehealth services under programs 385 administered by the other state agencies. Any such rules adopted 386 by the medicaid director or the directors of other state 387 agencies are not subject to the requirements of division (F) of 388 section 121.95 of the Revised Code. 389

(C)(1) The following practitioners are eligible to render 390 telehealth services covered pursuant to this section: 391

(a) A physician licensed under Chapter 4731. of the 392 Revised Code to practice medicine and surgery, osteopathic 393 medicine and surgery, or podiatric medicine and surgery; 394

(b) A psychologist licensed under Chapter 4732. of the 395 Revised Code; 396

(d) A clinical nurse specialist, certified nurse-midwife, 399 or certified nurse practitioner licensed under Chapter 4723. of 400 the Revised Code; 401

(e) An independent social worker, independent marriage and 402 family therapist, or professional clinical counselor licensed 403 under Chapter 4757. of the Revised Code; 404

(f) An independent chemical dependency counselor licensed 405 under Chapter 4758. of the Revised Code; 406

(g) A supervised practitioner or supervised trainee; 407 H. B. No. 679 Page 16 As Introduced

(h) An audiologist or speech-language pathologist licensed 408 under Chapter 4753. of the Revised Code; 409

(i) An audiology aide or speech-language pathology aide, 410 as defined in section 4753.072 of the Revised Code, or an 411 individual holding a conditional license under section 4753.071 412 of the Revised Code; 413

(j) An occupational therapist or physical therapist 414 licensed under Chapter 4755. of the Revised Code; 415

(k) An occupational therapy assistant or physical 416 therapist assistant licensed under Chapter 4755. of the Revised 417 Code. 418

(l) A dietitian licensed under Chapter 4759. of the 419 Revised Code; 420

(m) A medicaid school program; 421

(n) Any other practitioner the medicaid director considers 422 eligible to provide the services. 423

(2) The following provider types are eligible to submit 424 claims for medicaid payments for providing telehealth services: 425

(a) Any practitioner described in division (B)(1) of this 426 section, except for those described in divisions (B)(1)(g), (i), 427 and (k) of this section; 428

(b) A professional medical group; 429

(d) An ambulatory health care clinic; 432

(e) An outpatient hospital; 433 H. B. No. 679 Page 17 As Introduced

(f) A medicaid school program; 434

(g) Any other provider type the medicaid directors 435 considers eligible to submit the claims for payment. 436

(D)(1) When providing telehealth services under this 437 section, a practitioner shall comply with all requirements under 438 state and federal law regarding the protection of patient 439 information. A practitioner shall ensure that any username or 440 password information and any electronic communications between 441 the practitioner and a patient are securely transmitted and 442 stored. 443

(2) When providing telehealth services under this section, 444 every practitioner site shall have access to the medical records 445 of the patient at the time telehealth services are provided. 446

(E) Payment may be made only for the following medically 447 necessary health care services when delivered as telehealth 448 services: 449

(1) Evaluation and management of a new patient described 450 with medical decision making not to exceed moderate complexity; 451

(2) Evaluation and management of an established patient 452 described with medical decision making not to exceed moderate 453 complexity; 454

(3) Inpatient or office consultation for a new or 455 established patient when providing the same quality and 456 timeliness of care to the patient is not possible other than by 457 telehealth; 458

(4) Mental health or substance use disorder services 459 described as psychiatric diagnostic evaluation or psychotherapy; 460

(5) Remote evaluation of recorded video or images 461 H. B. No. 679 Page 18 As Introduced submitted by an established patient; 462

(6) Virtual check-in by a physician or other qualified 463 health care professional who can report evaluation and 464 management services, provided to an established patient; 465

(7) Online digital evaluation and management service for 466 an established patient; 467

(8) Remote patient monitoring; 468

(9) Audiology, speech-language pathology, physical 469 therapy, and occupational therapy services; 470

(10) Medical nutrition services; 471

(11) Lactation counseling provided by dietitians; 472

(12) Psychological and neuropsychological testing; 473

(13) Smoking and tobacco use cessation counseling; 474

(14) Developmental test administration; 475

(15) Services provided under the specialized recovery 476 services program; 477

(16) Any other services designated by the medicaid 478 director. 479

Section 2. That existing sections 3902.30, 4723.94, 480 4732.33, 5123.60, 5164.95, and 4731.2910 of the Revised Code are 481 hereby repealed. 482

Section 3. Section 3902.30 of the Revised Code, as amended 483 by this act, shall apply to health benefit plans, as defined in 484 section 3922.01 of the Revised Code, that are in effect on the 485 effective date of the amendment to that section and to plans 486 that are issued, renewed, modified, or amended on or after the 487 H. B. No. 679 Page 19 As Introduced effective date of that amendment. 488

Section 4. This act is hereby declared to be an emergency 489 measure necessary for the immediate preservation of the public 490 peace, health, and safety. The reason for such necessity is that 491 increased access to and use of telehealth services is vital 492 during the global health emergency related to COVID-19. 493 Therefore, this act shall go into immediate effect. 494 As Introduced

133rd General Assembly Regular Session H. B. No. 484 2019-2020 Representatives Abrams, Carfagna Cosponsors: Representatives Russo, Carruthers, Miller, J., Seitz, Swearingen

A B I L L

To amend section 4755.60 and to enact section 1 4755.621 of the Revised Code regarding the 2 practice of athletic training. 3

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

Section 1. That section 4755.60 be amended and section 4 4755.621 of the Revised Code be enacted to read as follows: 5

Sec. 4755.60. As used in sections 4755.60 to 4755.65 and 6 4755.99 of the Revised Code: 7

(A) "Athletic training" means the practice of all of the 8 following: 9

(1) The prevention, recognition, and assessment of an 10 athletic injury and the examination, and athletic training 11 diagnosis of injuries resulting from physical or daily living 12 activities; 13

(2) The complete management, treatment, disposition, and 14 reconditioning of acute athletic injuries upon the referral of 15 an individual authorized under Chapter 4731. of the Revised Code 16 to practice medicine and surgery, osteopathic medicine and 17 H. B. No. 484 Page 2 As Introduced surgery, or podiatry, a dentist licensed under Chapter 4715. of 18 the Revised Code, a physical therapist licensed under this 19 chapter, or a chiropractor licensed under Chapter 4734. of the 20 Revised Code. Athletic training includes the resulting from 21 physical or daily living activities; 22

(3) The provision of emergent care, therapeutic 23 interventions, and rehabilitation for injuries resulting from 24 physical or daily living activities; 25

(4) The promotion of and education about wellness; 26

(5) The administration of topical drugs that have been 27 prescribed by a licensed health professional authorized to 28 prescribe drugs, as defined in section 4729.01 of the Revised 29 Code. Athletic training also includes the, and are administered 30 under the direction of the prescriber; 31

(5) The organization and administration of educational 32 programs and athletic training facilities, and the; 33

(6) The performance of athletic training research; 34

(7) The education of and consulting with the public as it 35 pertains to athletic training. 36

(B) "Athletic trainer" means a person who meets the 37 qualifications of this chapter for licensure and who is employed 38 by an educational institution, professional or amateur 39 organization, athletic facility, or health care facility to 40 practice engages in the practice of athletic training consistent 41 with the person's education and training. 42

(C) "The national athletic trainers association, inc." 43 means the national professional organization of athletic 44 trainers that provides direction and leadership for quality 45 H. B. No. 484 Page 3 As Introduced athletic training practice, education, and researchAthletic 46 training diagnosis" means the judgment made after examining, 47 evaluating, assessing, or interpreting symptoms presented by a 48 patient to establish the cause and nature of the patient's 49 injury, condition, or functional impairment and the plan of care 50 for that injury, condition, or impairment within the scope of 51 athletic training. "Athletic training diagnosis" does not 52 include a medical diagnosis. 53

(D) "Athletic injury" means any injury sustained by an 54 individual that affects the individual's participation or 55 performance in sports, games, recreation, exercise, or other 56 activity that requires physical strength, agility, flexibility, 57 speed, stamina, or range of motionCollaboration agreement" is an 58 agreement that satisfies the requirements of section 4755.621 of 59 the Revised Code. 60

Sec. 4755.621. (A) As used in this section, "physician" 61 means an individual authorized under Chapter 4731. of the 62 Revised Code to practice medicine and surgery, osteopathic 63 medicine and surgery, or podiatric medicine and surgery. 64

(B) A person licensed as an athletic trainer pursuant to 65 this chapter shall engage in the practice of athletic training 66 only if the person acts as follows: 67

(1) Upon the referral of one or more of the following: 68

(a) A physician; 69

(b) A dentist licensed under Chapter 4715. of the Revised 70 Code; 71

(d) A chiropractor licensed under Chapter 4734. of the 73 H. B. No. 484 Page 4 As Introduced

Revised Code; 74

(e) An athletic trainer licensed under this chapter; 75

(f) A physician assistant licensed under Chapter 4730. of 76 the Revised Code; 77

(g) A certified nurse practitioner licensed under Chapter 78 4723. of the Revised Code. 79

(2) Pursuant to a collaboration agreement that satisfies 80 the requirements of division (C) of this section. 81

(C) A person licensed as an athletic trainer pursuant to 82 this chapter shall enter into a collaboration agreement with one 83 or more physicians. The agreement shall be in writing and signed 84 by the athletic trainer and each physician with whom the 85 athletic trainer collaborates. A copy of the agreement shall be 86 maintained in the records of the athletic trainer and each 87 collaborating physician. The agreement shall address all of the 88 following: 89

(1) The duties and responsibilities to be fulfilled by the 90 athletic trainer when engaging in the practice of athletic 91 training; 92

(2) Any limitations on the athletic trainer's practice of 93 athletic training; 94

(3) A plan of care for patients treated by the athletic 95 trainer. 96

Section 2. That existing section 4755.60 of the Revised 97 Code is hereby repealed. 98 Amendment No. AM_133_2423-1 H. B. No. 484 As Introduced

______moved to amend as follows:

In line 1 of the title, delete "section" and insert "sections"; 1 after "4755.60" insert "and 4755.62" 2

In line 4, delete "section" and insert "sections"; after "4755.60" 3 insert "and 4755.62" 4

In line 12, after "injuries" insert "or conditions"; delete "or 5 daily living" 6

In line 13, after "activities" insert "that require physical skill 7 and utilize strength, power, endurance, speed, flexibility, range of 8 motion, or agility" 9

In line 21, after "the" insert "or conditions" 10

In line 22, delete "or daily living" 11

In line 24, after "injuries" insert "or conditions" 12

In line 25, delete "or daily living" 13

After line 60, insert: 14

"Sec. 4755.62. (A) No person shall claim to the public to 15 be an athletic trainer or imply by words, actions, or letters 16

Legislative Service Commission - 1 - Ñmdkyw7tyy23hahsl39usrlÎÓ mdkyw7tyy23hahsl39usrl that the person is an athletic trainer, or otherwise engage in 17 the practice of athletic training, unless the person is licensed 18 as an athletic trainer pursuant to this chapter. 19

(B) Except as otherwise provided in division (B) of 20 section 4755.65 of the Revised Code, no educational institution, 21 partnership, association, or corporation shall advertise or 22 otherwise offer to provide or convey the impression that it is 23 providing athletic training unless an individual licensed as an 24 athletic trainer pursuant to this chapter is employed by, or 25 under contract to, the educational institution, partnership, 26 association, or corporation and will be performing the athletic 27 training services to which reference is made. 28

(1) Have satisfactorily completed an application for 31 licensure in accordance with rules adopted by the athletic 32 trainers section of the Ohio occupational therapy, physical 33 therapy, and athletic trainers board under section 4755.61 of 34 the Revised Code; 35

(2) Have paid the examination fee required under this 36 section; 37

(3) Be of good moral character; 38

(4) Have shown, to the satisfaction of the athletic 39 trainers section, that the applicant has received a 40 baccalaureate or higher degree from an institution of higher 41 education, approved by the athletic trainers section of the 42 board and the federal regional accreditation agency and 43 recognized by the council on postsecondary accreditation, and 44 has satisfactorily completed the educational course work 45

Legislative Service Commission - 2 - requirements established by rule of the athletic trainers 46 section under section 4755.61 of the Revised Code. 47

(5) In addition to educational course work requirements, 48 have obtained supervised clinical experience that meets the 49 requirements established in rules adopted by the athletic 50 trainers section under section 4755.61 of the Revised Code; 51

(6) Have passed an examination adopted by the athletic 52 trainers section under division (A)(8) of section 4755.61 of the 53 Revised Code. Each applicant for licensure shall pay, at the 54 time of application, the nonrefundable examination fee set by 55 the athletic trainers section. 56

(D) The section may waive the requirements of division (C) 57 of this section for any applicant who presents proof of current 58 licensure in another state whose standards for licensure, as 59 determined by the section, are equal to or greater than those in 60 effect in this state on the date of application. 61

(E) The section shall issue a license to every applicant 62 who complies with the requirements of division (C) of this 63 section, files the required application form, and pays the fees 64 required by section 4755.61 of the Revised Code. A Each licensee 65 shall display the licensee's license in a conspicuous place at 66 the licensee's principal place of employment. 67

A license issued under this section entitles the holder to 68 engage in the practice of athletic training, claim to the public 69 to be an athletic trainer, or to imply by words or letters that 70 the licensee is an athletic trainer. Each licensee shall display 71 the licensee's license in a conspicuous place at the licensee's 72 principal place of employmentA license issued under this section 73 does not entitle the holder to provide, offer to provide, or 74

Legislative Service Commission - 3 - represent that the holder is qualified to provide any care or 75 services for which the holder lacks the education, training, or 76 experience to provide or is prohibited by law from providing." 77 In line 65, after "(B)" insert "(1)" 78

In line 68, delete "(1)" and insert "(a)" 79

In line 69, delete "(a)" and insert "(i)" 80

In line 70, delete "(b)" and insert "(ii)" 81

In line 72, delete "(c)" and insert "(iii)" 82

In line 73, delete "(d)" and insert "(iv)" 83

In line 75, delete "(e) An" and insert "(v) Subject to division (B) 84 (2) of this section, an" 85

In line 76, delete "(f)" and insert "(vi)" 86

In line 78, delete "(g)" and insert "(vii)" 87

In line 80, delete "(2)" and insert "(b)" 88

After line 81, insert: 89

"(2) A person licensed as an athletic trainer may practice 90 athletic training upon the referral of an athletic trainer 91 described in division (B)(1)(a)(v) of this section only if the 92 athletic training has already been recommended and referred by a 93 health care provider described in division (B)(1)(a) of this 94 section who is not an athletic trainer." 95 In line 97, delete "section" and insert "sections"; after "4755.60" 96 insert "and 4755.62" 97

In line 98, delete "is" and insert "are" 98

Legislative Service Commission - 4 - The motion was ______agreed to.

SYNOPSIS 99

Referrals by athletic trainers; License qualifications; 100 Daily living activities; Injuries or conditions 101

R.C. 4755.60, 4755.62, and 4755.621 102

Specifies that an athletic trainer may practice upon the 103 referral of another athletic trainer, but only if the athletic 104 training has already been recommended and referred by a health 105 care professional other than an athletic trainer. 106

Clarifies that a license to practice as an athletic 107 trainer does not entitle its holder to provide, offer to 108 provide, or represent that he or she is qualified to provide 109 care or services for which he or she lacks the education, 110 training, or experience to provide or is prohibited by law from 111 providing. 112

Removes references to daily living activities added by the 113 As Introduced version for purposes of the law defining "athletic 114 training." 115

Specifies that athletic training includes the prevention, 116 examination, management, and treatment of injuries or 117 conditions, rather than just injuries as under the As Introduced 118 version of the bill. 119

Legislative Service Commission - 5 - As Passed by the House

133rd General Assembly Regular Session Am. Sub. H. B. No. 606 2019-2020 Representative Grendell Cosponsors: Representatives Seitz, Baldridge, Carfagna, Cross, DeVitis, Fraizer, Ginter, Green, Greenspan, Holmes, A., Hoops, Jones, Jordan, Keller, Kick, Koehler, Lanese, Lang, LaRe, McClain, Patton, Perales, Plummer, Reineke, Richardson, Riedel, Roemer, Scherer, Smith, T., Stein, Stephens, Wiggam, Wilkin

A B I L L

To amend sections 9.87, 2743.02, 2744.01, and 1 4123.68 of the Revised Code to make temporary 2 changes related to qualified civil immunity for 3 health care and emergency services provided 4 during a government-declared disaster or 5 emergency and for exposure to or transmission or 6 contraction of certain coronaviruses, to expand 7 the definition of "governmental function" 8 regarding political subdivision tort liability 9 in relation to emergency declarations, to expand 10 state immunity to include actions undertaken 11 under a duty during the COVID-19 pandemic, to 12 make COVID-19 contracted by certain employees an 13 occupational disease under the Workers' 14 Compensation Law under specific circumstances, 15 and to declare an emergency. 16

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

Section 1. That sections 9.87, 2743.02, 2744.01, and 17 Am. Sub. H. B. No. 606 Page 2 As Passed by the House

4123.68 of the Revised Code be amended to read as follows: 18

Sec. 9.87. (A) The state, except as provided in division 19 (B) of this section, shall indemnify an officer or employee from 20 liability incurred in the performance of official duties by 21 paying any judgment in, or amount negotiated in settlement of, 22 any civil action arising under federal law, the law of another 23 state, or the law of a foreign jurisdiction. The reasonableness 24 of the amount of any consent judgment or settlement is subject 25 to the review and approval of the attorney general and of the 26 director, administrative chief, or governing body of the 27 employer of the officer or employee who is to be indemnified. 28 The maximum aggregate amount of indemnification paid directly 29 from state funds to or on behalf of any officer or employee 30 pursuant to this division shall be one million dollars per 31 occurrence, regardless of the number of persons who suffer 32 damage, injury, or death as a result of the occurrence. 33

(B) The state shall not indemnify an officer or employee 34 under any of the following circumstances: 35

(1) To the extent the officer or employee is covered by a 36 policy of insurance for civil liability purchased by the state; 37

(2) When the officer or employee acts manifestly outside 38 the scope of the officer's or employee's employment or official 39 responsibilities, with malicious purpose, in bad faith, or in a 40 wanton or reckless manner, as determined by the employer of the 41 officer or employee or by the attorney general. 42

(3) For any portion of a judgment that represents punitive 43 or exemplary damages, except that this prohibition does not 44 apply if the employer of the officer or employee and the 45 attorney general determine that the acts or omissions of the 46 Am. Sub. H. B. No. 606 Page 3 As Passed by the House officer or employee were not within the terms of division (B)(2) 47 of this section; 48

(4) For any portion of a consent judgment or settlement 49 that is unreasonable; 50

(5) For any portion of a judgment where a cause of action 51 exists on or after the effective date of this amendment that 52 involves the performance or nonperformance of a governmental 53 function or public duty as a result of a state agency's response 54 to the COVID-19 pandemic by arranging or providing care, 55 protection, or treatment for any person committed to the custody 56 of the state, including health care services, or that, as a 57 result of the performance or nonperformance of a governmental 58 function or public duty, an officer or employee becomes infected 59 with COVID-19. 60

(C) The director of administrative services may purchase a 61 policy or policies of insurance on behalf of officers and 62 employees of the state from an insurer or insurers licensed to 63 do business in this state providing coverage for amounts in 64 excess of one million dollars per occurrence incurred in 65 connection with any civil action, demand, or claim against the 66 officer or employee by reason of an act or omission by the 67 officer or employee occurring in the performance of the 68 officer's or employee's duties and not coming within the terms 69 of division (B)(2) of this section. 70

(D) This section does not affect any of the following: 71

(1) The waiver arising under division (A)(1) of section 72 2743.02 of the Revised Code; 73

(2) Any defense that would otherwise be available in an 74 action alleging personal liability of an officer or employee; 75 Am. Sub. H. B. No. 606 Page 4 As Passed by the House

(3) The operation of section 9.83 of the Revised Code. 76

(E) The indemnification of officers or employees against 77 judgments or settlements pursuant to this section shall be 78 accomplished only through the following procedure: 79

(1) If the employer of the defendant officer or employee 80 to be indemnified determines that the actions or omissions of 81 its officer or employee giving rise to the claim were not within 82 the terms of division (B)(2) of this section, an indemnity 83 agreement shall be prepared by the attorney general, specifying 84 that the employer will indemnify the officer or employee from a 85 particular judgment that has been rendered or a particular 86 settlement amount that has been negotiated. The agreement shall 87 name the person or entity to whom payment by the state of the 88 judgment or settlement amount will be made, and the agreement 89 shall not be effective until it is approved by the officer or 90 employee to be indemnified, the director, administrative chief, 91 or other governing body of the employer, and by the attorney 92 general. The attorney general shall approve the indemnity 93 agreement, unless the attorney general finds that division (B) 94 of this section prohibits the state from indemnifying the 95 officer or employee, or prohibits the state from indemnifying 96 the officer or employee for a portion of a judgment or 97 settlement and the indemnity agreement would indemnify the 98 officer or employee for all or a part of that portion. 99

(2) The attorney general shall forward a copy of the 100 agreement to the director of budget and management. 101

(3) Any indemnification paid shall be charged by the 102 director of budget and management against available unencumbered 103 moneys in the appropriations of the employer of the officer or 104 employee to be indemnified. The director of budget and 105 Am. Sub. H. B. No. 606 Page 5 As Passed by the House management shall have sole discretion to determine whether or 106 not unencumbered moneys in a particular appropriation are 107 available for payment of the indemnification. 108

(4) The director of budget and management shall, upon 109 receipt of the agreement from the attorney general pursuant to 110 division (E)(2) of this section, provide for payment to the 111 person or entity named in the agreement, in the amount specified 112 in the agreement. 113

(5) If the director of budget and management determines 114 that sufficient unencumbered moneys do not exist in the 115 particular appropriations to pay the indemnification, the 116 director shall make application for payment of the 117 indemnification out of the emergency purposes account or any 118 other appropriation for emergencies or contingencies, and 119 payment out of this account or other appropriation shall be 120 authorized if there are sufficient moneys greater than the sum 121 total of then pending emergency purposes account requests, or 122 requests for releases from the other appropriation. 123

(6) If sufficient moneys do not exist in the emergency 124 purposes account or any other appropriation for emergencies or 125 contingencies to pay the indemnification, the employer named in 126 the agreement shall request the general assembly to make an 127 appropriation sufficient to pay the indemnification, and no 128 payment shall be made until the appropriation has been made. The 129 employer shall make this appropriation request during the 130 current biennium and during each succeeding biennium until a 131 sufficient appropriation is made. 132

(7) If the indemnification is to be made by an employer 133 whose funds are not handled by the director of budget and 134 management, the employer shall pay the person or entity named in 135 Am. Sub. H. B. No. 606 Page 6 As Passed by the House the agreement. 136

If the employer determines that sufficient unencumbered 137 moneys do not exist to pay the indemnification, the employer 138 shall make application for payment of the indemnification out of 139 the emergency purposes account or any other appropriation for 140 emergencies or contingencies, and payment out of this account or 141 other appropriation shall be authorized if there are sufficient 142 moneys greater than the sum total of then pending emergency 143 purposes account requests, or requests for releases from the 144 other appropriation. 145

If sufficient moneys do not exist in the emergency 146 purposes account or any other appropriation for emergencies or 147 contingencies to pay the indemnification, the employer named in 148 the agreement shall request the general assembly to make an 149 appropriation sufficient to pay the indemnification, and no 150 payment shall be made until such an appropriation has been made. 151 The employer shall make this appropriation request during the 152 current biennium and during each succeeding biennium until a 153 sufficient appropriation is made. 154

(F)(1) Subject to division (F)(2) of this section, if an 155 employer or the attorney general fails to approve 156 indemnification or limits indemnification of an officer or 157 employee of the employer, the officer or employee may commence 158 an action against the employer in the court of claims pursuant 159 to sections 2743.01 to 2743.20 of the Revised Code to prove that 160 the officer or employee is entitled to indemnification pursuant 161 to division (A) of this section and that division (B) of this 162 section does not prohibit or limit the officer's or employee's 163 indemnification and seeking either a judgment against the 164 employer for a sum of money that the officer or employee has 165 Am. Sub. H. B. No. 606 Page 7 As Passed by the House paid to satisfy a judgment or settlement or an order directing 166 the employer to pay a judgment or settlement against the officer 167 or employee that has not been satisfied. Section 109.365 of the 168 Revised Code does not prohibit any information obtained by the 169 attorney general in the attorney general's investigation 170 conducted pursuant to division (A) of section 109.362 of the 171 Revised Code to determine whether to defend the officer or 172 employee from being admitted as evidence in any action brought 173 pursuant to this section. 174

An action brought pursuant to division (F)(1) of this 175 section shall be commenced no later than two years after the 176 cause of action arising under division (F)(1) of this section 177 accrues. A cause of action arising under this section accrues 178 upon the entry of a money judgment against the officer or 179 employee if the time for filing an appeal in the action lapses 180 without the filing of an appeal, upon the conclusion of the 181 final appeal in any action in which a money judgment is entered 182 against the officer or employee if an appeal is filed in the 183 action, or upon execution of any settlement agreement requiring 184 payment of money by the officer or employee. 185

(2) Notwithstanding division (F)(1) of this section, an 186 officer or employee may not commence an action against the 187 employer in the court of claims or in any other court regarding 188 a refusal of the employer or the attorney general to indemnify 189 punitive or exemplary damages pursuant to this section or for 190 any action described in division (I) of section 2743.02 of the 191 Revised Code. 192

Sec. 2743.02. (A)(1) The Except as provided in division 193 (I) of this section, the state hereby waives its immunity from 194 liability, except as provided for the office of the state fire 195 Am. Sub. H. B. No. 606 Page 8 As Passed by the House marshal in division (G)(1) of section 9.60 and division (B) of 196 section 3737.221 of the Revised Code and subject to division (H) 197 of this section, and consents to be sued, and have its liability 198 determined, in the court of claims created in this chapter in 199 accordance with the same rules of law applicable to suits 200 between private parties, except that the determination of 201 liability is subject to the limitations set forth in this 202 chapter and, in the case of state universities or colleges, in 203 section 3345.40 of the Revised Code, and except as provided in 204 division (A)(2) or (3) of this section. To the extent that the 205 state has previously consented to be sued, this chapter has no 206 applicability. 207

Except in the case of a civil action filed by the state, 208 filing a civil action in the court of claims results in a 209 complete waiver of any cause of action, based on the same act or 210 omission, that the filing party has against any officer or 211 employee, as defined in section 109.36 of the Revised Code. The 212 waiver shall be void if the court determines that the act or 213 omission was manifestly outside the scope of the officer's or 214 employee's office or employment or that the officer or employee 215 acted with malicious purpose, in bad faith, or in a wanton or 216 reckless manner. 217

(2) If a claimant proves in the court of claims that an 218 officer or employee, as defined in section 109.36 of the Revised 219 Code, would have personal liability for the officer's or 220 employee's acts or omissions but for the fact that the officer 221 or employee has personal immunity under section 9.86 of the 222 Revised Code, the state shall be held liable in the court of 223 claims in any action that is timely filed pursuant to section 224 2743.16 of the Revised Code and that is based upon the acts or 225 omissions. 226 Am. Sub. H. B. No. 606 Page 9 As Passed by the House

(3)(a) Except as provided in division (A)(3)(b) of this 227 section and as set forth in division (I) of this section , the 228 state is immune from liability in any civil action or proceeding 229 involving the performance or nonperformance of a public duty, 230 including the performance or nonperformance of a public duty 231 that is owed by the state in relation to any action of an 232 individual who is committed to the custody of the state. 233

(b) The state immunity provided in division (A)(3)(a) of 234 this section does not apply to any action of the state under 235 circumstances in which a special relationship can be established 236 between the state and an injured party. A special relationship 237 under this division is demonstrated if all of the following 238 elements exist: 239

(i) An assumption by the state, by means of promises or 240 actions, of an affirmative duty to act on behalf of the party 241 who was allegedly injured; 242

(ii) Knowledge on the part of the state's agents that 243 inaction of the state could lead to harm; 244

(iii) Some form of direct contact between the state's 245 agents and the injured party; 246

(iv) The injured party's justifiable reliance on the 247 state's affirmative undertaking. 248

(B) The state hereby waives the immunity from liability of 249 all hospitals owned or operated by one or more political 250 subdivisions and consents for them to be sued, and to have their 251 liability determined, in the court of common pleas, in 252 accordance with the same rules of law applicable to suits 253 between private parties, subject to the limitations set forth in 254 this chapter. This division is also applicable to hospitals 255 Am. Sub. H. B. No. 606 Page 10 As Passed by the House owned or operated by political subdivisions that have been 256 determined by the supreme court to be subject to suit prior to 257 July 28, 1975. 258

(C) Any hospital, as defined in section 2305.113 of the 259 Revised Code, may purchase liability insurance covering its 260 operations and activities and its agents, employees, nurses, 261 interns, residents, staff, and members of the governing board 262 and committees, and, whether or not such insurance is purchased, 263 may, to the extent that its governing board considers 264 appropriate, indemnify or agree to indemnify and hold harmless 265 any such person against expense, including attorney's fees, 266 damage, loss, or other liability arising out of, or claimed to 267 have arisen out of, the death, disease, or injury of any person 268 as a result of the negligence, malpractice, or other action or 269 inaction of the indemnified person while acting within the scope 270 of the indemnified person's duties or engaged in activities at 271 the request or direction, or for the benefit, of the hospital. 272 Any hospital electing to indemnify those persons, or to agree to 273 so indemnify, shall reserve any funds that are necessary, in the 274 exercise of sound and prudent actuarial judgment, to cover the 275 potential expense, fees, damage, loss, or other liability. The 276 superintendent of insurance may recommend, or, if the hospital 277 requests the superintendent to do so, the superintendent shall 278 recommend, a specific amount for any period that, in the 279 superintendent's opinion, represents such a judgment. This 280 authority is in addition to any authorization otherwise provided 281 or permitted by law. 282

(D) Recoveries against the state shall be reduced by the 283 aggregate of insurance proceeds, disability award, or other 284 collateral recovery received by the claimant. This division does 285 not apply to civil actions in the court of claims against a 286 Am. Sub. H. B. No. 606 Page 11 As Passed by the House state university or college under the circumstances described in 287 section 3345.40 of the Revised Code. The collateral benefits 288 provisions of division (B)(2) of that section apply under those 289 circumstances. 290

(E) The only defendant in original actions in the court of 291 claims is the state. The state may file a third-party complaint 292 or counterclaim in any civil action, except a civil action for 293 ten thousand dollars or less, that is filed in the court of 294 claims. 295

(F) A civil action against an officer or employee, as 296 defined in section 109.36 of the Revised Code, that alleges that 297 the officer's or employee's conduct was manifestly outside the 298 scope of the officer's or employee's employment or official 299 responsibilities, or that the officer or employee acted with 300 malicious purpose, in bad faith, or in a wanton or reckless 301 manner shall first be filed against the state in the court of 302 claims that has exclusive, original jurisdiction to determine, 303 initially, whether the officer or employee is entitled to 304 personal immunity under section 9.86 of the Revised Code and 305 whether the courts of common pleas have jurisdiction over the 306 civil action. The officer or employee may participate in the 307 immunity determination proceeding before the court of claims to 308 determine whether the officer or employee is entitled to 309 personal immunity under section 9.86 of the Revised Code. 310

The filing of a claim against an officer or employee under 311 this division tolls the running of the applicable statute of 312 limitations until the court of claims determines whether the 313 officer or employee is entitled to personal immunity under 314 section 9.86 of the Revised Code. 315

(G) If a claim lies against an officer or employee who is 316 Am. Sub. H. B. No. 606 Page 12 As Passed by the House a member of the Ohio national guard, and the officer or employee 317 was, at the time of the act or omission complained of, subject 318 to the "Federal Tort Claims Act," 60 Stat. 842 (1946), 28 U.S.C. 319 2671, et seq., the Federal Tort Claims Act is the exclusive 320 remedy of the claimant and the state has no liability under this 321 section. 322

(H) If an inmate of a state correctional institution has a 323 claim against the state for the loss of or damage to property 324 and the amount claimed does not exceed three hundred dollars, 325 before commencing an action against the state in the court of 326 claims, the inmate shall file a claim for the loss or damage 327 under the rules adopted by the director of rehabilitation and 328 correction pursuant to this division. The inmate shall file the 329 claim within the time allowed for commencement of a civil action 330 under section 2743.16 of the Revised Code. If the state admits 331 or compromises the claim, the director shall make payment from a 332 fund designated by the director for that purpose. If the state 333 denies the claim or does not compromise the claim at least sixty 334 days prior to expiration of the time allowed for commencement of 335 a civil action based upon the loss or damage under section 336 2743.16 of the Revised Code, the inmate may commence an action 337 in the court of claims under this chapter to recover damages for 338 the loss or damage. 339

The director of rehabilitation and correction shall adopt 340 rules pursuant to Chapter 119. of the Revised Code to implement 341 this division. 342

(I) Notwithstanding any provision of law to the contrary, 343 the state is immune from liability in any civil action or 344 proceeding existing on or after the effective date of this 345 amendment that involves the performance or nonperformance of a 346 Am. Sub. H. B. No. 606 Page 13 As Passed by the House governmental function or public duty as a result of a state 347 agency's response to the COVID-19 pandemic by arranging or 348 providing care, protection, or treatment for any person 349 committed to the custody of the state, including health care 350 services, or that, as a result of the performance or 351 nonperformance of a governmental function or public duty, an 352 officer or employee becomes infected with COVID-19. The state 353 expressly does not consent to be sued as set forth in this 354 division. Neither the court of claims nor any courts of common 355 pleas shall have jurisdiction to hear any case or controversy, 356 initiate any immunity determination, or have the state's 357 liability subject to any determination, nor shall the state 358 indemnify any employee found liable in any court of competent 359 jurisdiction. 360

Sec. 2744.01. As used in this chapter: 361

(A) "Emergency call" means a call to duty, including, but 362 not limited to, communications from citizens, police dispatches, 363 and personal observations by peace officers of inherently 364 dangerous situations that demand an immediate response on the 365 part of a peace officer. 366

(B) "Employee" means an officer, agent, employee, or 367 servant, whether or not compensated or full-time or part-time, 368 who is authorized to act and is acting within the scope of the 369 officer's, agent's, employee's, or servant's employment for a 370 political subdivision. "Employee" does not include an 371 independent contractor and does not include any individual 372 engaged by a school district pursuant to section 3319.301 of the 373 Revised Code. "Employee" includes any elected or appointed 374 official of a political subdivision. "Employee" also includes a 375 person who has been convicted of or pleaded guilty to a criminal 376 Am. Sub. H. B. No. 606 Page 14 As Passed by the House offense and who has been sentenced to perform community service 377 work in a political subdivision whether pursuant to section 378 2951.02 of the Revised Code or otherwise, and a child who is 379 found to be a delinquent child and who is ordered by a juvenile 380 court pursuant to section 2152.19 or 2152.20 of the Revised Code 381 to perform community service or community work in a political 382 subdivision. 383

(C)(1) "Governmental function" means a function of a 384 political subdivision that is specified in division (C)(2) of 385 this section or that satisfies any of the following: 386

(a) A function that is imposed upon the state as an 387 obligation of sovereignty and that is performed by a political 388 subdivision voluntarily or pursuant to legislative requirement; 389

(b) A function that is for the common good of all citizens 390 of the state; 391

(c) A function that promotes or preserves the public 392 peace, health, safety, or welfare; that involves activities that 393 are not engaged in or not customarily engaged in by 394 nongovernmental persons; and that is not specified in division 395 (G)(2) of this section as a proprietary function. 396

(2) A "governmental function" includes, but is not limited 397 to, the following: 398

(a) The provision or nonprovision of police, fire, 399 emergency medical, ambulance, and rescue services or protection; 400

(b) The power to preserve the peace; to prevent and 401 suppress riots, disturbances, and disorderly assemblages; to 402 prevent, mitigate, and clean up releases of oil and hazardous 403 and extremely hazardous substances as defined in section 3750.01 404 of the Revised Code; and to protect persons and property; 405 Am. Sub. H. B. No. 606 Page 15 As Passed by the House

(d) The provision of a free public library system; 407

(e) The regulation of the use of, and the maintenance and 408 repair of, roads, highways, streets, avenues, alleys, sidewalks, 409 bridges, aqueducts, viaducts, and public grounds; 410

(f) Judicial, quasi-judicial, prosecutorial, legislative, 411 and quasi-legislative functions; 412

(g) The construction, reconstruction, repair, renovation, 413 maintenance, and operation of buildings that are used in 414 connection with the performance of a governmental function, 415 including, but not limited to, office buildings and courthouses; 416

(h) The design, construction, reconstruction, renovation, 417 repair, maintenance, and operation of jails, places of juvenile 418 detention, workhouses, or any other detention facility, as 419 defined in section 2921.01 of the Revised Code; 420

(i) The enforcement or nonperformance of any law; 421

(j) The regulation of traffic, and the erection or 422 nonerection of traffic signs, signals, or control devices; 423

(k) The collection and disposal of solid wastes, as 424 defined in section 3734.01 of the Revised Code, including, but 425 not limited to, the operation of solid waste disposal 426 facilities, as "facilities" is defined in that section, and the 427 collection and management of hazardous waste generated by 428 households. As used in division (C)(2)(k) of this section, 429 "hazardous waste generated by households" means solid waste 430 originally generated by individual households that is listed 431 specifically as hazardous waste in or exhibits one or more 432 characteristics of hazardous waste as defined by rules adopted 433 Am. Sub. H. B. No. 606 Page 16 As Passed by the House under section 3734.12 of the Revised Code, but that is excluded 434 from regulation as a hazardous waste by those rules. 435

(l) The provision or nonprovision, planning or design, 436 construction, or reconstruction of a public improvement, 437 including, but not limited to, a sewer system; 438

(m) The operation of a job and family services department 439 or agency, including, but not limited to, the provision of 440 assistance to aged and infirm persons and to persons who are 441 indigent; 442

(n) The operation of a health board, department, or 443 agency, including, but not limited to, any statutorily required 444 or permissive program for the provision of immunizations or 445 other inoculations to all or some members of the public, 446 provided that a "governmental function" does not include the 447 supply, manufacture, distribution, or development of any drug or 448 vaccine employed in any such immunization or inoculation program 449 by any supplier, manufacturer, distributor, or developer of the 450 drug or vaccine; 451

(o) The operation of mental health facilities, 452 developmental disabilities facilities, alcohol treatment and 453 control centers, and children's homes or agencies; 454

(p) The provision or nonprovision of inspection services 455 of all types, including, but not limited to, inspections in 456 connection with building, zoning, sanitation, fire, plumbing, 457 and electrical codes, and the taking of actions in connection 458 with those types of codes, including, but not limited to, the 459 approval of plans for the construction of buildings or 460 structures and the issuance or revocation of building permits or 461 stop work orders in connection with buildings or structures; 462 Am. Sub. H. B. No. 606 Page 17 As Passed by the House

(q) Urban renewal projects and the elimination of slum 463 conditions, including the performance of any activity that a 464 county land reutilization corporation is authorized to perform 465 under Chapter 1724. or 5722. of the Revised Code; 466

(r) Flood control measures; 467

(s) The design, construction, reconstruction, renovation, 468 operation, care, repair, and maintenance of a township cemetery; 469

(t) The issuance of revenue obligations under section 470 140.06 of the Revised Code; 471

(u) The design, construction, reconstruction, renovation, 472 repair, maintenance, and operation of any school athletic 473 facility, school auditorium, or gymnasium or any recreational 474 area or facility, including, but not limited to, any of the 475 following: 476

(i) A park, playground, or playfield; 477

(ii) An indoor recreational facility; 478

(iii) A zoo or zoological park; 479

(iv) A bath, swimming pool, pond, water park, wading pool, 480 wave pool, water slide, or other type of aquatic facility; 481

(v) A golf course; 482

(vi) A bicycle motocross facility or other type of 483 recreational area or facility in which bicycling, skating, skate 484 boarding, or scooter riding is engaged; 485

(vii) A rope course or climbing walls; 486

(viii) An all-purpose vehicle facility in which all- 487 purpose vehicles, as defined in section 4519.01 of the Revised 488 Code, are contained, maintained, or operated for recreational 489 Am. Sub. H. B. No. 606 Page 18 As Passed by the House activities. 490

(v) The provision of public defender services by a county 491 or joint county public defender's office pursuant to Chapter 492 120. of the Revised Code; 493

(w)(i) At any time before regulations prescribed pursuant 494 to 49 U.S.C.A 20153 become effective, the designation, 495 establishment, design, construction, implementation, operation, 496 repair, or maintenance of a public road rail crossing in a zone 497 within a municipal corporation in which, by ordinance, the 498 legislative authority of the municipal corporation regulates the 499 sounding of locomotive horns, whistles, or bells; 500

(ii) On and after the effective date of regulations 501 prescribed pursuant to 49 U.S.C.A. 20153, the designation, 502 establishment, design, construction, implementation, operation, 503 repair, or maintenance of a public road rail crossing in such a 504 zone or of a supplementary safety measure, as defined in 49 505 U.S.C.A 20153, at or for a public road rail crossing, if and to 506 the extent that the public road rail crossing is excepted, 507 pursuant to subsection (c) of that section, from the requirement 508 of the regulations prescribed under subsection (b) of that 509 section. 510

(x) Compliance with any order or directive issued as a 511 result of the COVID-19 pandemic by the state department of 512 health or a general health district or city health district 513 created by or under the authority of Chapter 3709. of the 514 Revised Code; 515

(y) Compliance with any order or directive issued as a 516 result of the COVID-19 pandemic by the state government, a 517 political subdivision, or an emergency management agency 518 Am. Sub. H. B. No. 606 Page 19 As Passed by the House established within the department of public safety under section 519 5502.22 of the Revised Code; 520

(z) Any operation or function to abate the effects of the 521 conditions for which either of the following have been issued: 522

(i) An emergency declaration issued by the state 523 government or any political subdivision; 524

(ii) A public health emergency issued by the federal 525 government, the state government, or any county or municipal 526 health department. 527

(aa) The provision or nonprovision of any function of 528 local government during an emergency declaration issued by the 529 state government or any political subdivision, or during a 530 public health emergency declaration issued by the federal 531 government, the state government, any county or municipal health 532 department, or any general health district created by or under 533 the authority of Chapter 3709. of the Revised Code; 534

(bb) A function that the general assembly mandates a 535 political subdivision to perform. 536

(D) "Law" means any provision of the constitution, 537 statutes, or rules of the United States or of this state; 538 provisions of charters, ordinances, resolutions, and rules of 539 political subdivisions; and written policies adopted by boards 540 of education. When used in connection with the "common law," 541 this definition does not apply. 542

(E) "Motor vehicle" has the same meaning as in section 543 4511.01 of the Revised Code. 544

(F) "Political subdivision" or "subdivision" means a 545 municipal corporation, township, county, school district, or 546 Am. Sub. H. B. No. 606 Page 20 As Passed by the House other body corporate and politic responsible for governmental 547 activities in a geographic area smaller than that of the state. 548 "Political subdivision" includes, but is not limited to, a 549 county hospital commission appointed under section 339.14 of the 550 Revised Code, board of hospital commissioners appointed for a 551 municipal hospital under section 749.04 of the Revised Code, 552 board of hospital trustees appointed for a municipal hospital 553 under section 749.22 of the Revised Code, regional planning 554 commission created pursuant to section 713.21 of the Revised 555 Code, county planning commission created pursuant to section 556 713.22 of the Revised Code, joint planning council created 557 pursuant to section 713.231 of the Revised Code, interstate 558 regional planning commission created pursuant to section 713.30 559 of the Revised Code, port authority created pursuant to section 560 4582.02 or 4582.26 of the Revised Code or in existence on 561 December 16, 1964, regional council established by political 562 subdivisions pursuant to Chapter 167. of the Revised Code, 563 emergency planning district and joint emergency planning 564 district designated under section 3750.03 of the Revised Code, 565 joint emergency medical services district created pursuant to 566 section 307.052 of the Revised Code, fire and ambulance district 567 created pursuant to section 505.375 of the Revised Code, joint 568 interstate emergency planning district established by an 569 agreement entered into under that section, county solid waste 570 management district and joint solid waste management district 571 established under section 343.01 or 343.012 of the Revised Code, 572 community school established under Chapter 3314. of the Revised 573 Code, county land reutilization corporation organized under 574 Chapter 1724. of the Revised Code, the county or counties served 575 by a community-based correctional facility and program or 576 district community-based correctional facility and program 577 established and operated under sections 2301.51 to 2301.58 of 578 Am. Sub. H. B. No. 606 Page 21 As Passed by the House the Revised Code, a community-based correctional facility and 579 program or district community-based correctional facility and 580 program that is so established and operated, and the facility 581 governing board of a community-based correctional facility and 582 program or district community-based correctional facility and 583 program that is so established and operated. 584

(G)(1) "Proprietary function" means a function of a 585 political subdivision that is specified in division (G)(2) of 586 this section or that satisfies both of the following: 587

(a) The function is not one described in division (C)(1) 588 (a) or (b) of this section and is not one specified in division 589 (C)(2) of this section; 590

(b) The function is one that promotes or preserves the 591 public peace, health, safety, or welfare and that involves 592 activities that are customarily engaged in by nongovernmental 593 persons. 594

(2) A "proprietary function" includes, but is not limited 595 to, the following: 596

(a) The operation of a hospital by one or more political 597 subdivisions; 598

(b) The design, construction, reconstruction, renovation, 599 repair, maintenance, and operation of a public cemetery other 600 than a township cemetery; 601

(c) The establishment, maintenance, and operation of a 602 utility, including, but not limited to, a light, gas, power, or 603 heat plant, a railroad, a busline or other transit company, an 604 airport, and a municipal corporation water supply system; 605

(d) The maintenance, destruction, operation, and upkeep of 606 Am. Sub. H. B. No. 606 Page 22 As Passed by the House a sewer system; 607

(e) The operation and control of a public stadium, 608 auditorium, civic or social center, exhibition hall, arts and 609 crafts center, band or orchestra, or off-street parking 610 facility. 611

(H) "Public roads" means public roads, highways, streets, 612 avenues, alleys, and bridges within a political subdivision. 613 "Public roads" does not include berms, shoulders, rights-of-way, 614 or traffic control devices unless the traffic control devices 615 are mandated by the Ohio manual of uniform traffic control 616 devices. 617

(I) "State" means the state of Ohio, including, but not 618 limited to, the general assembly, the supreme court, the offices 619 of all elected state officers, and all departments, boards, 620 offices, commissions, agencies, colleges and universities, 621 institutions, and other instrumentalities of the state of Ohio. 622 "State" does not include political subdivisions. 623

Sec. 4123.68. Every employee who is disabled because of 624 the contraction of an occupational disease or the dependent of 625 an employee whose death is caused by an occupational disease, is 626 entitled to the compensation provided by sections 4123.55 to 627 4123.59 and 4123.66 of the Revised Code subject to the 628 modifications relating to occupational diseases contained in 629 this chapter. An order of the administrator issued under this 630 section is appealable pursuant to sections 4123.511 and 4123.512 631 of the Revised Code. 632

The following diseases are occupational diseases and 633 compensable as such when contracted by an employee in the course 634 of the employment in which such employee was engaged and due to 635 Am. Sub. H. B. No. 606 Page 23 As Passed by the House the nature of any process described in this section. A disease 636 which meets the definition of an occupational disease is 637 compensable pursuant to this chapter though it is not 638 specifically listed in this section. 639

SCHEDULE 640

Description of disease or injury and description of 641 process: 642

(A) Anthrax: Handling of wool, hair, bristles, hides, and 643 skins. 644

(B) Glanders: Care of any equine animal suffering from 645 glanders; handling carcass of such animal. 646

(D) Mercury poisoning: Any industrial process involving 649 the use of mercury or its preparations or compounds. 650

(E) Phosphorous poisoning: Any industrial process 651 involving the use of phosphorous or its preparations or 652 compounds. 653

(F) Arsenic poisoning: Any industrial process involving 654 the use of arsenic or its preparations or compounds. 655

(G) Poisoning by benzol or by nitro-derivatives and amido- 656 derivatives of benzol (dinitro-benzol, anilin, and others): Any 657 industrial process involving the use of benzol or nitro- 658 derivatives or amido-derivatives of benzol or its preparations 659 or compounds. 660

(H) Poisoning by gasoline, benzine, naphtha, or other 661 volatile petroleum products: Any industrial process involving 662 Am. Sub. H. B. No. 606 Page 24 As Passed by the House the use of gasoline, benzine, naphtha, or other volatile 663 petroleum products. 664

(I) Poisoning by carbon bisulphide: Any industrial process 665 involving the use of carbon bisulphide or its preparations or 666 compounds. 667

(J) Poisoning by wood alcohol: Any industrial process 668 involving the use of wood alcohol or its preparations. 669

(K) Infection or inflammation of the skin on contact 670 surfaces due to oils, cutting compounds or lubricants, dust, 671 liquids, fumes, gases, or vapors: Any industrial process 672 involving the handling or use of oils, cutting compounds or 673 lubricants, or involving contact with dust, liquids, fumes, 674 gases, or vapors. 675

(L) Epithelion cancer or ulceration of the skin or of the 676 corneal surface of the eye due to carbon, pitch, tar, or tarry 677 compounds: Handling or industrial use of carbon, pitch, or tarry 678 compounds. 679

(M) Compressed air illness: Any industrial process carried 680 on in compressed air. 681

(N) Carbon dioxide poisoning: Any process involving the 682 evolution or resulting in the escape of carbon dioxide. 683

(O) Brass or zinc poisoning: Any process involving the 684 manufacture, founding, or refining of brass or the melting or 685 smelting of zinc. 686

(P) Manganese dioxide poisoning: Any process involving the 687 grinding or milling of manganese dioxide or the escape of 688 manganese dioxide dust. 689

(Q) Radium poisoning: Any industrial process involving the 690 Am. Sub. H. B. No. 606 Page 25 As Passed by the House use of radium and other radioactive substances in luminous 691 paint. 692

(R) Tenosynovitis and prepatellar bursitis: Primary 693 tenosynovitis characterized by a passive effusion or crepitus 694 into the tendon sheath of the flexor or extensor muscles of the 695 hand, due to frequently repetitive motions or vibrations, or 696 prepatellar bursitis due to continued pressure. 697

(S) Chrome ulceration of the skin or nasal passages: Any 698 industrial process involving the use of or direct contact with 699 chromic acid or bichromates of ammonium, potassium, or sodium or 700 their preparations. 701

(T) Potassium cyanide poisoning: Any industrial process 702 involving the use of or direct contact with potassium cyanide. 703

(U) Sulphur dioxide poisoning: Any industrial process in 704 which sulphur dioxide gas is evolved by the expansion of liquid 705 sulphur dioxide. 706

(V) Berylliosis: Berylliosis means a disease of the lungs 707 caused by breathing beryllium in the form of dust or fumes, 708 producing characteristic changes in the lungs and demonstrated 709 by x-ray examination, by biopsy or by autopsy. 710

This chapter does not entitle an employee or the 711 employee's dependents to compensation, medical treatment, or 712 payment of funeral expenses for disability or death from 713 berylliosis unless the employee has been subjected to injurious 714 exposure to beryllium dust or fumes in the employee's employment 715 in this state preceding the employee's disablement and only in 716 the event of such disability or death resulting within eight 717 years after the last injurious exposure; provided that such 718 eight-year limitation does not apply to disability or death from 719 Am. Sub. H. B. No. 606 Page 26 As Passed by the House exposure occurring after January 1, 1976. In the event of death 720 following continuous total disability commencing within eight 721 years after the last injurious exposure, the requirement of 722 death within eight years after the last injurious exposure does 723 not apply. 724

Before awarding compensation for partial or total 725 disability or death due to berylliosis, the administrator of 726 workers' compensation shall refer the claim to a qualified 727 medical specialist for examination and recommendation with 728 regard to the diagnosis, the extent of the disability, the 729 nature of the disability, whether permanent or temporary, the 730 cause of death, and other medical questions connected with the 731 claim. An employee shall submit to such examinations, including 732 clinical and x-ray examinations, as the administrator requires. 733 In the event that an employee refuses to submit to examinations, 734 including clinical and x-ray examinations, after notice from the 735 administrator, or in the event that a claimant for compensation 736 for death due to berylliosis fails to produce necessary consents 737 and permits, after notice from the administrator, so that such 738 autopsy examination and tests may be performed, then all rights 739 for compensation are forfeited. The reasonable compensation of 740 such specialist and the expenses of examinations and tests shall 741 be paid, if the claim is allowed, as part of the expenses of the 742 claim, otherwise they shall be paid from the surplus fund. 743

(W) Cardiovascular, pulmonary, or respiratory diseases 744 incurred by firefighters or police officers following exposure 745 to heat, smoke, toxic gases, chemical fumes and other toxic 746 substances: Any cardiovascular, pulmonary, or respiratory 747 disease of a firefighter or police officer caused or induced by 748 the cumulative effect of exposure to heat, the inhalation of 749 smoke, toxic gases, chemical fumes and other toxic substances in 750 Am. Sub. H. B. No. 606 Page 27 As Passed by the House the performance of the firefighter's or police officer's duty 751 constitutes a presumption, which may be refuted by affirmative 752 evidence, that such occurred in the course of and arising out of 753 the firefighter's or police officer's employment. For the 754 purpose of this section, "firefighter" means any regular member 755 of a lawfully constituted fire department of a municipal 756 corporation or township, whether paid or volunteer, and "police 757 officer" means any regular member of a lawfully constituted 758 police department of a municipal corporation, township or 759 county, whether paid or volunteer. 760

This chapter does not entitle a firefighter, or police 761 officer, or the firefighter's or police officer's dependents to 762 compensation, medical treatment, or payment of funeral expenses 763 for disability or death from a cardiovascular, pulmonary, or 764 respiratory disease, unless the firefighter or police officer 765 has been subject to injurious exposure to heat, smoke, toxic 766 gases, chemical fumes, and other toxic substances in the 767 firefighter's or police officer's employment in this state 768 preceding the firefighter's or police officer's disablement, 769 some portion of which has been after January 1, 1967, except as 770 provided in division (E) of section 4123.57 of the Revised Code. 771

Compensation on account of cardiovascular, pulmonary, or 772 respiratory diseases of firefighters and police officers is 773 payable only in the event of temporary total disability, 774 permanent total disability, or death, in accordance with section 775 4123.56, 4123.58, or 4123.59 of the Revised Code. Medical, 776 hospital, and nursing expenses are payable in accordance with 777 this chapter. Compensation, medical, hospital, and nursing 778 expenses are payable only in the event of such disability or 779 death resulting within eight years after the last injurious 780 exposure; provided that such eight-year limitation does not 781 Am. Sub. H. B. No. 606 Page 28 As Passed by the House apply to disability or death from exposure occurring after 782 January 1, 1976. In the event of death following continuous 783 total disability commencing within eight years after the last 784 injurious exposure, the requirement of death within eight years 785 after the last injurious exposure does not apply. 786

This chapter does not entitle a firefighter or police 787 officer, or the firefighter's or police officer's dependents, to 788 compensation, medical, hospital, and nursing expenses, or 789 payment of funeral expenses for disability or death due to a 790 cardiovascular, pulmonary, or respiratory disease in the event 791 of failure or omission on the part of the firefighter or police 792 officer truthfully to state, when seeking employment, the place, 793 duration, and nature of previous employment in answer to an 794 inquiry made by the employer. 795

Before awarding compensation for disability or death under 796 this division, the administrator shall refer the claim to a 797 qualified medical specialist for examination and recommendation 798 with regard to the diagnosis, the extent of disability, the 799 cause of death, and other medical questions connected with the 800 claim. A firefighter or police officer shall submit to such 801 examinations, including clinical and x-ray examinations, as the 802 administrator requires. In the event that a firefighter or 803 police officer refuses to submit to examinations, including 804 clinical and x-ray examinations, after notice from the 805 administrator, or in the event that a claimant for compensation 806 for death under this division fails to produce necessary 807 consents and permits, after notice from the administrator, so 808 that such autopsy examination and tests may be performed, then 809 all rights for compensation are forfeited. The reasonable 810 compensation of such specialists and the expenses of examination 811 and tests shall be paid, if the claim is allowed, as part of the 812 Am. Sub. H. B. No. 606 Page 29 As Passed by the House expenses of the claim, otherwise they shall be paid from the 813 surplus fund. 814

(X)(1) Cancer contracted by a firefighter: Cancer 815 contracted by a firefighter who has been assigned to at least 816 six years of hazardous duty as a firefighter constitutes a 817 presumption that the cancer was contracted in the course of and 818 arising out of the firefighter's employment if the firefighter 819 was exposed to an agent classified by the international agency 820 for research on cancer or its successor organization as a group 821 1 or 2A carcinogen. 822

(2) The presumption described in division (X)(1) of this 823 section is rebuttable in any of the following situations: 824

(a) There is evidence that the firefighter's exposure, 825 outside the scope of the firefighter's official duties, to 826 cigarettes, tobacco products, or other conditions presenting an 827 extremely high risk for the development of the cancer alleged, 828 was probably a significant factor in the cause or progression of 829 the cancer. 830

(b) There is evidence that shows, by a preponderance of 831 competent scientific evidence, that exposure to the type of 832 carcinogen alleged did not or could not have caused the cancer 833 being alleged. 834

(c) There is evidence that the firefighter was not exposed 835 to an agent classified by the international agency for research 836 on cancer as a group 1 or 2A carcinogen. 837

(d) There is evidence that the firefighter incurred the 838 type of cancer alleged before becoming a member of the fire 839 department. 840

(e) The firefighter is seventy years of age or older. 841 Am. Sub. H. B. No. 606 Page 30 As Passed by the House

(3) The presumption described in division (X)(1) of this 842 section does not apply if it has been more than fifteen years 843 since the firefighter was last assigned to hazardous duty as a 844 firefighter. 845

(4) Compensation for cancer contracted by a firefighter in 846 the course of hazardous duty under division (X) of this section 847 is payable only in the event of temporary total disability, 848 working wage loss, permanent total disability, or death, in 849 accordance with division (A) or (B)(1) of section 4123.56 and 850 sections 4123.58 and 4123.59 of the Revised Code. 851

(5) As used in division (X) of this section, "hazardous 852 duty" has the same meaning as in 5 C.F.R. 550.902, as amended. 853

(Y) Silicosis: Silicosis means a disease of the lungs 854 caused by breathing silica dust (silicon dioxide) producing 855 fibrous nodules distributed through the lungs and demonstrated 856 by x-ray examination, by biopsy or by autopsy. 857

(Z) Coal miners' pneumoconiosis: Coal miners' 858 pneumoconiosis, commonly referred to as "black lung disease," 859 resulting from working in the coal mine industry and due to 860 exposure to the breathing of coal dust, and demonstrated by x- 861 ray examination, biopsy, autopsy or other medical or clinical 862 tests. 863

This chapter does not entitle an employee or the 864 employee's dependents to compensation, medical treatment, or 865 payment of funeral expenses for disability or death from 866 silicosis, asbestosis, or coal miners' pneumoconiosis unless the 867 employee has been subject to injurious exposure to silica dust 868 (silicon dioxide), asbestos, or coal dust in the employee's 869 employment in this state preceding the employee's disablement, 870 Am. Sub. H. B. No. 606 Page 31 As Passed by the House some portion of which has been after October 12, 1945, except as 871 provided in division (E) of section 4123.57 of the Revised Code. 872

Compensation on account of silicosis, asbestosis, or coal 873 miners' pneumoconiosis are payable only in the event of 874 temporary total disability, permanent total disability, or 875 death, in accordance with sections 4123.56, 4123.58, and 4123.59 876 of the Revised Code. Medical, hospital, and nursing expenses are 877 payable in accordance with this chapter. Compensation, medical, 878 hospital, and nursing expenses are payable only in the event of 879 such disability or death resulting within eight years after the 880 last injurious exposure; provided that such eight-year 881 limitation does not apply to disability or death occurring after 882 January 1, 1976, and further provided that such eight-year 883 limitation does not apply to any asbestosis cases. In the event 884 of death following continuous total disability commencing within 885 eight years after the last injurious exposure, the requirement 886 of death within eight years after the last injurious exposure 887 does not apply. 888

This chapter does not entitle an employee or the 889 employee's dependents to compensation, medical, hospital and 890 nursing expenses, or payment of funeral expenses for disability 891 or death due to silicosis, asbestosis, or coal miners' 892 pneumoconiosis in the event of the failure or omission on the 893 part of the employee truthfully to state, when seeking 894 employment, the place, duration, and nature of previous 895 employment in answer to an inquiry made by the employer. 896

Before awarding compensation for disability or death due 897 to silicosis, asbestosis, or coal miners' pneumoconiosis, the 898 administrator shall refer the claim to a qualified medical 899 specialist for examination and recommendation with regard to the 900 Am. Sub. H. B. No. 606 Page 32 As Passed by the House diagnosis, the extent of disability, the cause of death, and 901 other medical questions connected with the claim. An employee 902 shall submit to such examinations, including clinical and x-ray 903 examinations, as the administrator requires. In the event that 904 an employee refuses to submit to examinations, including 905 clinical and x-ray examinations, after notice from the 906 administrator, or in the event that a claimant for compensation 907 for death due to silicosis, asbestosis, or coal miners' 908 pneumoconiosis fails to produce necessary consents and permits, 909 after notice from the commission, so that such autopsy 910 examination and tests may be performed, then all rights for 911 compensation are forfeited. The reasonable compensation of such 912 specialist and the expenses of examinations and tests shall be 913 paid, if the claim is allowed, as a part of the expenses of the 914 claim, otherwise they shall be paid from the surplus fund. 915

(AA) Radiation illness: Any industrial process involving 916 the use of radioactive materials. 917

Claims for compensation and benefits due to radiation 918 illness are payable only in the event death or disability 919 occurred within eight years after the last injurious exposure 920 provided that such eight-year limitation does not apply to 921 disability or death from exposure occurring after January 1, 922 1976. In the event of death following continuous disability 923 which commenced within eight years of the last injurious 924 exposure the requirement of death within eight years after the 925 last injurious exposure does not apply. 926

(BB) Asbestosis: Asbestosis means a disease caused by 927 inhalation or ingestion of asbestos, demonstrated by x-ray 928 examination, biopsy, autopsy, or other objective medical or 929 clinical tests. 930 Am. Sub. H. B. No. 606 Page 33 As Passed by the House

(CC)(1) COVID-19: COVID-19 contracted by an employee 931 described in division (CC)(2) of this section during the 932 emergency declared by Executive Order 2020-01D, issued March 9, 933 2020, constitutes a presumption, which may be refuted by 934 affirmative evidence, that COVID-19 was contracted in the course 935 of and arising out of the employee's employment. This division 936 applies only to claims arising during the period that begins 937 with the issuance of Executive Order 2020-01D, issued on March 938 9, 2020 and ending December 31, 2020. 939

(2) Division (CC)(1) of this section applies to all of the 940 following: 941

(a) An employee of a retail food establishment as defined 942 in section 3717.01 of the Revised Code; 943

(b) An employee of a food processing establishment as 944 defined in section 3715.021 of the Revised Code; 945

(c) A peace officer, firefighter, or emergency medical 946 worker as those terms are defined in section 4123.026 of the 947 Revised Code; 948

(d) A person employed as a corrections officer by any 949 public or private place used for the confinement of a person 950 charged with or convicted of any crime in this state or another 951 state or under the laws of the United States or alleged or found 952 to be a delinquent child or unruly child in this state or 953 another state or under the laws of the United States. 954

All conditions, restrictions, limitations, and other 955 provisions of this section, with reference to the payment of 956 compensation or benefits on account of silicosis or coal miners' 957 pneumoconiosis apply to the payment of compensation or benefits 958 on account of any other occupational disease of the respiratory 959 Am. Sub. H. B. No. 606 Page 34 As Passed by the House tract resulting from injurious exposures to dust. 960

The refusal to produce the necessary consents and permits 961 for autopsy examination and testing shall not result in 962 forfeiture of compensation provided the administrator finds that 963 such refusal was the result of bona fide religious convictions 964 or teachings to which the claimant for compensation adhered 965 prior to the death of the decedent. 966

Section 2. That existing sections 9.87, 2743.02, 2744.01, 967 and 4123.68 of the Revised Code are hereby repealed. 968

Section 3. (A) As used in this section: 969

(1) "Advanced practice registered nurse" means an 970 individual who holds a current, valid license issued under 971 Chapter 4723. of the Revised Code to practice as an advanced 972 practice registered nurse. 973

(2) "Athletic trainer" means an individual licensed under 974 Chapter 4755. of the Revised Code to practice athletic training. 975

(3) "Audiologist" means an individual licensed under 976 Chapter 4753. of the Revised Code to practice audiology. 977

(4) "Behavioral health provider" means a provider of 978 alcohol and drug addiction services, mental health services, or 979 other behavioral health services and includes the following 980 providers: 981

(a) An independent chemical dependency counselor-clinical 982 supervisor, independent chemical dependency counselor, chemical 983 dependency counselor III, and chemical dependency counselor II, 984 licensed under Chapter 4758. of the Revised Code, and a chemical 985 dependency counselor assistant, prevention consultant, 986 prevention specialist, prevention specialist assistant, and 987 Am. Sub. H. B. No. 606 Page 35 As Passed by the House registered applicant, certified under that chapter; 988

(b) A licensed professional clinical counselor, licensed 989 professional counselor, independent social worker, social 990 worker, independent marriage and family therapist, or marriage 991 and family therapist who holds a current, valid license issued 992 under Chapter 4757. of the Revised Code; 993

(5) "Board of health" means the board of health of a city 995 or general health district or the authority having the duties of 996 a board of health under section 3709.05 of the Revised Code. 997

(6) "Chiropractor" means an individual who is authorized 998 under Chapter 4734. of the Revised Code to practice 999 chiropractic. 1000

(7) "Dental hygienist" means an individual licensed under 1001 Chapter 4715. of the Revised Code to practice as a dental 1002 hygienist. 1003

(8) "Dentist" has the same meaning as in section 2305.231 1004 of the Revised Code. 1005

(9) "Direct support professional" means an individual 1006 employed by an agency to provide direct care to individuals with 1007 developmental disabilities. 1008

(10) "Disaster" means any occurrence of widespread 1009 personal injury or loss of life that results from any natural or 1010 technological phenomenon or act of a human, or an epidemic and 1011 is declared to be a disaster by the federal government, the 1012 state government, or a political subdivision of this state. 1013

(11) "Emergency" has the same meaning as in section 1014 5502.21 of the Revised Code. 1015 Am. Sub. H. B. No. 606 Page 36 As Passed by the House

(12) "Emergency medical technician" means an EMT-basic, an 1016 EMT-I, or a paramedic. 1017

(13) "EMT-basic" means an individual who holds a current, 1018 valid certificate issued under section 4765.30 of the Revised 1019 Code to practice as an emergency medical technician-basic. 1020

(14) "EMT-I" means an individual who holds a current, 1021 valid certificate issued under section 4765.30 of the Revised 1022 Code to practice as an emergency medical technician- 1023 intermediate. 1024

(15) "Facility" means an institution or setting where 1025 health care services are provided, including, without 1026 limitation, a hospital, inpatient, ambulatory, surgical, 1027 emergency care, urgent care, treatment, laboratory, adult day- 1028 care, residential care, residential treatment, long-term care, 1029 or intermediate care facility, or a facility for individuals 1030 with developmental disabilities; a physician's office; a 1031 developmental, diagnostic, or imaging center; a rehabilitation 1032 or therapeutic health setting; a federally qualified health 1033 center or federally qualified health center look-alike; or any 1034 modular field treatment facility or alternative care site 1035 designated for temporary use for the purposes of providing 1036 health care services in response to a disaster or emergency. 1037

(16) "Facility for individuals with developmental 1038 disabilities" means a facility that provides services to two or 1039 more unrelated individuals with developmental disabilities in a 1040 residential setting, such as an institution for mental disease 1041 or a residential facility licensed under section 5123.19 of the 1042 Revised Code. 1043

(17) "Federally qualified health center" and "federally 1044 Am. Sub. H. B. No. 606 Page 37 As Passed by the House qualified health center look-alike" have the same meanings as in 1045 section 3701.047 of the Revised Code. 1046

(18) "Gross negligence" means a lack of care so great that 1047 it appears to be a conscious indifference to the rights of 1048 others. 1049

(19) "Health care professional" means an advanced practice 1050 registered nurse, a registered nurse, a licensed practical 1051 nurse, a pharmacist, a dentist, a dental hygienist, an 1052 optometrist, a physician, a physician assistant, a chiropractor, 1053 a physical therapist, an occupational therapist, an athletic 1054 trainer, a speech-language pathologist, an audiologist, a 1055 laboratory worker, a massage therapist, or a respiratory care 1056 professional. 1057

(20) "Health care provider" means a health care 1058 professional, health care worker, direct support professional, 1059 behavioral health provider, or emergency medical technician or a 1060 home health agency, hospice care program, home and community- 1061 based services provider, or facility, including any agent, board 1062 member, committee member, employee, employer, officer, or 1063 volunteer of the agency, program, provider, or facility acting 1064 in the course of the agent's, board member's, committee 1065 member's, employee's, employer's, officer's, or volunteer's 1066 service or employment. 1067

(21) "Health care services" means services rendered by a 1068 health care provider for the diagnosis, prevention, treatment, 1069 cure, or relief of a health condition, illness, injury, or 1070 disease, including the provision of any medication, medical 1071 equipment, or other medical product. "Health care services" 1072 includes personal care services and experimental treatments. 1073 Am. Sub. H. B. No. 606 Page 38 As Passed by the House

(22) "Health care worker" means a person other than a 1074 health care professional or emergency medical technician who 1075 provides medical, dental, or other health care services under 1076 the direction of a health care professional authorized to direct 1077 the individual's activities. "Health care worker" includes a 1078 medical technician, medical assistant, dental assistant, 1079 occupational therapy assistant, physical therapist assistant, 1080 orderly, nurse aide, and any other individual acting in a 1081 similar capacity. 1082

(23) "Home and community-based services provider" means a 1083 provider of services under a home and community-based services 1084 medicaid waiver component. 1085

(24) "Home health agency" has the same meaning as in 1086 section 3701.881 of the Revised Code. 1087

(25) "Hospice care program" has the same meaning as in 1088 section 3712.01 of the Revised Code. 1089

(26) "Hospital" and "medical claim" have the same meanings 1090 as in section 2305.113 of the Revised Code. 1091

(27) "Licensed practical nurse" means an individual who 1092 holds a current, valid license issued under Chapter 4723. of the 1093 Revised Code to practice as a licensed practical nurse. 1094

(28) "Long-term care facility" has the same meaning as in 1095 section 3701.74 of the Revised Code. 1096

(29) "Massage therapist" means an individual licensed 1097 under section 4731.15 of the Revised Code to practice massage 1098 therapy. 1099

(30) "Medicaid waiver component" has the same meaning as 1100 in section 5166.01 of the Revised Code. 1101 Am. Sub. H. B. No. 606 Page 39 As Passed by the House

(31) "Occupational therapist" means an individual who 1102 holds a current license or limited certificate under Chapter 1103 4755. of the Revised Code to practice occupational therapy. 1104

(32) "Occupational therapy assistant" means an individual 1105 who holds a license or limited permit under Chapter 4755. of the 1106 Revised Code to practice as an occupational therapy assistant. 1107

(33) "Optometrist" means a person who is licensed under 1108 Chapter 4725. of the Revised Code to practice optometry. 1109

(34) "Paramedic" means an individual who holds a current, 1110 valid certificate issued under section 4765.30 of the Revised 1111 Code to practice as an emergency medical technician-paramedic. 1112

(35) "Personal care services" has the same meaning as in 1113 section 3721.01 of the Revised Code. 1114

(36) "Pharmacist" means an individual who holds a current, 1115 valid license issued under Chapter 4729. of the Revised Code to 1116 practice as a pharmacist. 1117

(37) "Physical therapist" means an individual licensed 1118 under Chapter 4755. of the Revised Code to practice physical 1119 therapy. 1120

(38) "Physical therapist assistant" means an individual 1121 licensed under Chapter 4755. of the Revised Code to practice as 1122 a physical therapist assistant. 1123

(39) "Physician" means an individual who is authorized 1124 under Chapter 4731. of the Revised Code to practice medicine and 1125 surgery, osteopathic medicine and surgery, or podiatric medicine 1126 and surgery. 1127

(40) "Physician assistant" means an individual who is 1128 authorized under Chapter 4730. of the Revised Code to practice 1129 Am. Sub. H. B. No. 606 Page 40 As Passed by the House as a physician assistant. 1130

(41) "Psychologist" means an individual who is licensed as 1131 a psychologist or school psychologist under Chapter 4732. of the 1132 Revised Code. 1133

(42) "Reckless disregard" means, as it applies to a given 1134 health care provider rendering health care services, emergency 1135 medical services, first-aid treatment, or other emergency 1136 professional care, conduct by which, with heedless indifference 1137 to the consequences, the health care provider disregards a 1138 substantial and unjustifiable risk that the health care 1139 provider's conduct is likely to cause, at the time those 1140 services or that treatment or care were rendered, an 1141 unreasonable risk of injury, death, or loss to person or 1142 property. 1143

(43) "Registered nurse" means an individual who holds a 1144 current, valid license issued under Chapter 4723. of the Revised 1145 Code to practice as a registered nurse. 1146

(44) "Respiratory care professional" has the same meaning 1147 as in section 4761.01 of the Revised Code. 1148

(45) "Speech-language pathologist" means an individual 1149 licensed under Chapter 4753. of the Revised Code to practice 1150 speech-language pathology. 1151

(46) "Tort action" means a civil action for damages for 1152 injury, death, or loss to person or property and includes claims 1153 arising under resident or patient bills of rights and 1154 contractual claims arising out of statutory or regulatory 1155 requirements applicable to health care providers. "Tort action" 1156 includes an action on a medical claim. 1157

(B)(1) Subject to division (C)(3) of this section, a 1158 Am. Sub. H. B. No. 606 Page 41 As Passed by the House health care provider that provides health care services, 1159 emergency medical services, first-aid treatment, or other 1160 emergency professional care, including the provision of any 1161 medication or other medical equipment or product, as a result of 1162 or in response to a disaster or emergency is not subject to 1163 professional disciplinary action and is not liable in damages to 1164 any person or government agency in a tort action for injury, 1165 death, or loss to person or property that allegedly arises from 1166 any of the following: 1167

(a) An act or omission of the health care provider in the 1168 health care provider's provision, withholding, or withdrawal of 1169 those services; 1170

(b) Any decision related to the provision, withholding, or 1171 withdrawal of those services; 1172

(c) Compliance with an executive order or director's order 1173 issued during and in response to the disaster or emergency. 1174

(2) Division (B)(1) of this section does not apply in a 1175 tort action if the health care provider's action, omission, 1176 decision, or compliance constitutes a reckless disregard for the 1177 consequences so as to affect the life or health of the patient 1178 or intentional conduct or willful or wanton misconduct on the 1179 part of the person against whom the action is brought. 1180

(3) Division (B)(1) of this section does not apply in a 1181 professional disciplinary action if the health care provider's 1182 action, omission, decision, or compliance constitutes gross 1183 negligence. 1184

(4) A health care provider is not subject to professional 1185 disciplinary action and is not liable in damages to any person 1186 or government agency in a tort action for injury, death, or loss 1187 Am. Sub. H. B. No. 606 Page 42 As Passed by the House to person or property that allegedly arises because the provider 1188 was unable to treat, diagnose, or test the person for any 1189 illness, disease, or condition, including the inability to 1190 perform any elective procedure, due to an executive or 1191 director's order or an order of a board of health of a city or 1192 general health district issued in relation to an epidemic or 1193 pandemic disease or other public health emergency. 1194

(C)(1) This section does not create a new cause of action 1195 or substantive legal right against a health care provider. 1196

(2) This section does not affect any immunities from civil 1197 liability or defenses established by another section of the 1198 Revised Code or available at common law to which a health care 1199 provider may be entitled in connection with the provision of 1200 health care services, emergency medical services, first-aid 1201 treatment, or other emergency professional care, including the 1202 provision of medication, medical equipment, or other medical 1203 product. 1204

(3) This section does not grant an immunity from tort or 1205 other civil liability or a professional disciplinary action to a 1206 health care provider for actions that are outside the skills, 1207 education, and training of the health care provider, unless the 1208 health care provider undertakes the action in good faith and in 1209 response to a lack of resources caused by a disaster or 1210 emergency. 1211

(4) This section does not affect any legal responsibility 1212 of a health care provider to comply with any applicable law of 1213 this state or rule of an agency of this state. 1214

(5) Division (B) of this section applies only to the 1215 provision, withholding, or withdrawal of health care services, 1216 Am. Sub. H. B. No. 606 Page 43 As Passed by the House emergency medical services, first-aid treatment, or other 1217 emergency professional care, including the provision of any 1218 medication or other medical equipment or product, decisions 1219 related to such services or care, or compliance with an 1220 executive order or director's order by a health care provider as 1221 a result of or in response to a disaster or emergency and 1222 through the duration of the disaster or emergency. 1223

(D) This section applies from the date of the Governor's 1224 Executive Order 2020-01D, issued on March 9, 2020, declaring a 1225 state of emergency due to COVID-19, through December 31, 2020, 1226 and supersedes section 2305.2311 of the Revised Code during that 1227 period. 1228

Section 4. (A) No civil action for damages for injury, 1229 death, or loss to person or property shall be brought against 1230 any person if the cause of action on which the civil action is 1231 based, in whole or in part, is that the injury, death, or loss 1232 to person or property is caused by the exposure to, or the 1233 transmission or contraction of, MERS-CoV, SARS-CoV, or SARS-CoV- 1234 2, or any mutation thereof, unless it is established that the 1235 exposure to, or the transmission or contraction of, any of those 1236 viruses or mutations was by reckless or intentional conduct or 1237 with willful or wanton misconduct on the part of the person 1238 against whom the action is brought. 1239

(B) A government order, recommendation, or guideline shall 1240 neither create nor be construed as creating a duty of care upon 1241 any person that may be enforced in a cause of action or that may 1242 create a new cause of action or substantive legal right against 1243 any person with respect to the matters contained in the 1244 government order, recommendation, or guideline. A presumption 1245 exists that any such government order, recommendation, or 1246 Am. Sub. H. B. No. 606 Page 44 As Passed by the House guideline is not admissible as evidence that a duty of care, a 1247 new cause of action, or a substantive legal right has been 1248 established. 1249

(1) "MERS-CoV" means the coronavirus that causes middle 1251 east respiratory syndrome. 1252

(2) "Person" has the same meaning as in section 1.59 of 1253 the Revised Code and includes a school, a for-profit, nonprofit, 1254 governmental, or religious entity, or a state institution of 1255 higher education. 1256

(3) "Reckless conduct" means conduct by which, with 1257 heedless indifference to the consequences, the person disregards 1258 a substantial and unjustifiable risk that the person's conduct 1259 is likely to cause an exposure to, or a transmission or 1260 contraction of, MERS-CoV, SARS-CoV, or SARS-CoV-2, or any 1261 mutation thereof, or is likely to be of a nature that results in 1262 an exposure to, or a transmission or contraction of, any of 1263 those viruses or mutations. A person is reckless with respect to 1264 circumstances in relation to causing an exposure to, or a 1265 transmission or contraction of, MERS-CoV, SARS-CoV, or SARS-CoV- 1266 2, or any mutation thereof, when, with heedless indifference to 1267 the consequences, the person disregards a substantial and 1268 unjustifiable risk that such circumstances are likely to exist. 1269

(4) "SARS-CoV" means the coronavirus that causes severe 1270 acute respiratory syndrome. 1271

(5) "SARS-CoV-2" means the novel coronavirus that causes 1272 coronavirus disease 2019 (COVID-19). 1273

(6) "State institution of higher education" has the same 1274 meaning as in section 3345.011 of the Revised Code. 1275 Am. Sub. H. B. No. 606 Page 45 As Passed by the House

(D) This section applies from the date of the Governor's 1276 Executive Order 2020-01D, issued on March 9, 2020, declaring a 1277 state of emergency due to COVID-19, through December 31, 2020. 1278

Section 5. (A) The General Assembly makes the following 1279 findings: 1280

(1) The General Assembly is aware that lawsuits related to 1281 the COVID-19 health emergency numbering in the thousands are 1282 being filed across the country. Ohio business owners, small and 1283 large, as they begin to re-open their businesses are unsure 1284 about what tort liability they may face. 1285

(2) It also is a fact that recommendations regarding how 1286 best to avoid infection with COVID-19 change frequently, and 1287 such recommendations are often not based on well-tested 1288 scientific information. For example, the Centers for Disease 1289 Control and Prevention (CDC) for the first eight weeks of the 1290 COVID-19 health emergency recommended that members of the 1291 general public not wear masks since most masks are ineffective 1292 in protecting individuals from viruses. The CDC then reversed 1293 its recommendation and started encouraging members of the 1294 general public to wear masks in public places. Ohio businesses 1295 need certainty and consistency to enable them to reopen. 1296

(3) The General Assembly is further aware that businesses 1297 and premises owners have not historically been required to keep 1298 members of the public from being exposed to airborne viruses, 1299 bacteria, and germs. In Ohio, it has been the responsibility of 1300 individuals going into public places to avoid exposure to 1301 individuals who are sick. The same is true today: those 1302 individuals who decide to go out into public places are 1303 responsible to take those steps they feel are necessary to avoid 1304 exposure to COVID-19, such as social distancing and wearing 1305 Am. Sub. H. B. No. 606 Page 46 As Passed by the House masks. 1306

(4) The current COVID-19 health emergency is new and 1307 novel. Past opinions of the Ohio Supreme Court do not deal with 1308 COVID-19 or duties to protect the public from exposure in public 1309 places to airborne germs and viruses. Nothing in the Ohio 1310 Revised Code establishes duties upon businesses and premises 1311 owners to ensure that members of the general public will not be 1312 exposed to such airborne germs and viruses. 1313

(5) Additionally, the General Assembly has not delegated 1314 to the Executive Branch of Ohio's government the authority or 1315 power to create new legal duties for businesses and premises 1316 owners. In Ohio's system of government, the General Assembly 1317 makes Ohio's laws, and the Executive Branch enforces those laws. 1318

(B) Based on its findings in division (A) of this section, 1319 the General Assembly declares its intent that orders and 1320 recommendations from the Executive Branch, from counties and 1321 local municipalities, from boards of health and other agencies, 1322 and from any federal government agency, do not create any new 1323 legal duties for purposes of tort liability. Any such orders and 1324 recommendations are presumed to be irrelevant to the issue of 1325 the existence of a duty or breach of a duty. Furthermore, any 1326 such orders and recommendations are presumed to be inadmissible 1327 at trial to establish proof of a duty or breach of a duty in 1328 tort actions. 1329

Section 6. This act applies to acts, omissions, conduct, 1330 decisions, or compliance from the date of the Governor's 1331 Executive Order 2020-01D, issued on March 9, 2020, declaring a 1332 state of emergency due to COVID-19 through December 31, 2020. 1333

Section 7. This act is hereby declared to be an emergency 1334 Am. Sub. H. B. No. 606 Page 47 As Passed by the House measure necessary for the immediate preservation of the public 1335 peace, health, and safety. The reason for such necessity is that 1336 it is crucial to provide protections for essential workers and 1337 immunity from law suits in response to a disaster or emergency 1338 declared by the federal government, state government, or 1339 political subdivision of the state. Therefore, this act shall 1340 go into immediate effect. 1341 As Passed by the Senate

133rd General Assembly Regular Session Sub. S. B. No. 308 2019-2020 Senator Huffman, M. Cosponsors: Senators Huffman, S., Roegner, Hottinger, Hackett, Schuring, Eklund, Coley, McColley, Blessing, Brenner, Dolan, Gavarone, Hoagland, Johnson, Obhof, Peterson, Schaffer, Wilson

A B I L L

To amend section 2305.2311 and to enact section 1 2305.2312 of the Revised Code to revise the law 2 governing immunity from civil liability for 3 health care providers during disasters, to 4 provide qualified civil immunity to service 5 providers providing services during and after a 6 government-declared disaster or emergency due to 7 COVID-19, and to declare an emergency. 8

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

Section 1. That section 2305.2311 be amended and section 9 2305.2312 of the Revised Code be enacted to read as follows: 10

Sec. 2305.2311. (A) As used in this section: 11

(1) "Advanced practice registered nurse" means an 12 individual who holds a current, valid license issued under 13 Chapter 4723. of the Revised Code to practice as an advanced 14 practice registered nurse. 15

(2) "Athletic trainer" means an individual licensed under 16 Sub. S. B. No. 308 Page 2 As Passed by the Senate

Chapter 4755. of the Revised Code to practice athletic training. 17

(3) "Audiologist" means an individual licensed under 18 Chapter 4753. of the Revised Code to practice audiology. 19

(4) "Behavioral health services" include alcohol and drug 20 addiction services and mental health services. 21

(5) "Behavioral health provider" means a provider of 22 behavioral health services, including the following providers: 23

(a) An independent chemical dependency counselor-clinical 24 supervisor, independent chemical dependency counselor, chemical 25 dependency counselor III, and chemical dependency counselor II, 26 licensed under Chapter 4758. of the Revised Code, and a chemical 27 dependency counselor assistant, prevention consultant, 28 prevention specialist, prevention specialist assistant, and 29 registered applicant, certified under that chapter; 30

(b) A licensed professional clinical counselor, licensed 31 professional counselor, independent social worker, social 32 worker, independent marriage and family therapist, or marriage 33 and family therapist who holds a current, valid license issued 34 under Chapter 4757. of the Revised Code; 35

(6) "Board of health" means the board of health of a city 37 or general health district or the authority having the duties of 38 a board of health under section 3709.05 of the Revised Code. 39

(7) "Chiropractor" means an individual who is authorized 40 under Chapter 4734. of the Revised Code to practice 41 chiropractic. 42

(8) "Dentist" has the same meaning as in section 2305.231 43 of the Revised Code. 44 Sub. S. B. No. 308 Page 3 As Passed by the Senate

(3) (9) "Direct support professional" means an individual 45 employed by an agency to provide direct care to individuals with 46 developmental disabilities. 47

(10) "Disaster" means any occurrence of widespread 48 personal injury or loss of life that results from any natural or 49 technological phenomenon or act of a human, or an epidemic and 50 is declared to be a disaster by the federal government, the 51 state government, or a political subdivision of this state. 52

(4) (11) "Emergency" has the same meaning as in section 53 5502.21 of the Revised Code. 54

(12) "Emergency medical technician" means an EMT-basic, an 55 EMT-I, or a paramedic. 56

(5) (13) "EMT-basic" means an individual who holds a 57 current, valid certificate issued under section 4765.30 of the 58 Revised Code to practice as an emergency medical technician- 59 basic. 60

(6) (14) "EMT-I" means an individual who holds a current, 61 valid certificate issued under section 4765.30 of the Revised 62 Code to practice as an emergency medical technician- 63 intermediate. 64

(7) (15) "Facility" means an institution or setting where 65 health care services are provided, including, without 66 limitation, a hospital, emergency department, inpatient, 67 ambulatory, surgical, ambulatory surgical, urgent care, 68 treatment, laboratory, adult day-care, residential care, 69 residential treatment, long-term care, or intermediate care 70 facility, or a facility for individuals with developmental 71 disabilities; a developmental, diagnostic, or imaging center; a 72 rehabilitation or therapeutic health setting; a federally 73 Sub. S. B. No. 308 Page 4 As Passed by the Senate qualified health center or federally qualified health center 74 look-alike; or any modular field treatment facility or 75 alternative care site designated for temporary use for the 76 purposes of providing health care services in response to a 77 disaster or emergency. 78

(16) "Facility for individuals with developmental 79 disabilities" means a facility that provides services to two or 80 more unrelated individuals with developmental disabilities in a 81 residential setting, such as an institution for mental disease 82 or a residential facility licensed under section 5123.19 of the 83 Revised Code. 84

(17) "Federally qualified health center" and "federally 85 qualified health center look-alike" have the same meanings as in 86 section 3701.047 of the Revised Code. 87

(18) "Gross negligence" means a lack of care so great that 88 it appears to be a conscious indifference to the rights of 89 others. 90

(19) "Health care providerprofessional" means an advanced 91 practice registered nurse, a registered nurse, a licensed 92 practical nurse, a pharmacist, a dentist, an optometrist, a 93 physician, a physician assistant, a chiropractor, a physical 94 therapist, an occupational therapist, an athletic trainer, a 95 speech-language pathologist, an audiologist, a laboratory 96 worker, a massage therapist, or a hospitalrespiratory care 97 professional. 98

(8) (20) "Health care provider" means a health care 99 professional, health care worker, direct support professional, 100 behavioral health provider, home medical equipment services 101 provider, or emergency medical technician or a home health 102 Sub. S. B. No. 308 Page 5 As Passed by the Senate agency, hospice care program, health care professional's 103 employer, physician practice, home and community-based services 104 provider, or facility, including any agent, board member, 105 committee member, employee, employer, officer, or volunteer of 106 the agency, program, provider, practice, or facility acting in 107 the course of the agent's, board member's, committee member's, 108 employee's, employer's, officer's, or volunteer's service or 109 employment. 110

(21) "Health care services" means services rendered by a 111 health care provider for the diagnosis, prevention, treatment, 112 cure, or relief of a health condition, illness, injury, or 113 disease, including the provision of any medication, medical 114 equipment, or other medical product. "Health care services" 115 includes behavioral health services, personal care services, and 116 experimental treatments. 117

(22) "Health care worker" means a person other than a 118 health care professional or emergency medical technician who 119 provides medical, dental, or other health care services under 120 the direction of a health care professional authorized to direct 121 the individual's activities. "Health care worker" includes a 122 medical technician, medical assistant, dental assistant, 123 occupational therapist assistant, physical therapist assistant, 124 orderly, nurse aide, and any other individual acting in a 125 similar capacity. 126

(23) "Home and community-based services provider" means a 127 provider of services under a home and community-based services 128 medicaid waiver component. 129

(24) "Home health agency" has the same meaning as in 130 section 3701.881 of the Revised Code. 131 Sub. S. B. No. 308 Page 6 As Passed by the Senate

(25) "Home medical equipment services provider" means an 132 individual licensed or certified under Chapter 4752. of the 133 Revised Code to offer home medical equipment services. 134

(26) "Hospice care program" has the same meaning as in 135 section 3712.01 of the Revised Code. 136

(27) "Hospital" and "medical claim" have the same meanings 137 as in section 2305.113 of the Revised Code. 138

(9) (28) "Licensed practical nurse" means an individual 139 who holds a current, valid license issued under Chapter 4723. of 140 the Revised Code to practice as a licensed practical nurse. 141

(29) "Long-term care facility" has the same meaning as in 142 section 3701.74 of the Revised Code. 143

(30) "Massage therapist" means an individual licensed 144 under section 4731.15 of the Revised Code to practice massage 145 therapy. 146

(31) "Medicaid waiver component" has the same meaning as 147 in section 5166.01 of the Revised Code. 148

(32) "Occupational therapist" means an individual who 149 holds a current license or limited certificate under Chapter 150 4755. of the Revised Code to practice occupational therapy. 151

(33) "Occupational therapy assistant" means an individual 152 who holds a license or limited permit under Chapter 4755. of the 153 Revised Code to practice as an occupational therapy assistant. 154

(34) "Optometrist" means a person who is licensed under 155 Chapter 4725. of the Revised Code to practice optometry. 156

(10) (35) "Paramedic" means an individual who holds a 157 current, valid certificate issued under section 4765.30 of the 158 Sub. S. B. No. 308 Page 7 As Passed by the Senate

Revised Code to practice as an emergency medical technician- 159 paramedic. 160

(11) (36) "Personal care services" has the same meaning as 161 in section 3721.01 of the Revised Code. 162

(37) "Pharmacist" means an individual who holds a current, 163 valid license issued under Chapter 4729. of the Revised Code to 164 practice as a pharmacist. 165

(12) (38) "Physical therapist" means an individual 166 licensed under Chapter 4755. of the Revised Code to practice 167 physical therapy. 168

(39) "Physical therapist assistant" means an individual 169 licensed under Chapter 4755. of the Revised Code to practice as 170 a physical therapist assistant. 171

(40) "Physician" means an individual who is authorized 172 under Chapter 4731. of the Revised Code to practice medicine and 173 surgery, osteopathic medicine and surgery, or podiatric medicine 174 and surgery. 175

(13) (41) "Physician assistant" means an individual who is 176 authorized under Chapter 4730. of the Revised Code to practice 177 as a physician assistant. 178

(14) (42) "Reckless disregard" means, as it applies to a 179 given health care provider or emergency medical technician 180 rendering health care services, emergency medical services, 181 first-aid treatment, or other emergency professional care, 182 including the provision of any medication or other medical 183 product, means conduct that a health care provider or emergency 184 medical technician knew or should have known, conduct by which, 185 with heedless indifference to the consequences, the health care 186 provider disregards a substantial and unjustifiable risk that 187 Sub. S. B. No. 308 Page 8 As Passed by the Senate the health care provider's conduct is likely to cause, at the 188 time those services or that treatment or care were rendered, 189 created an unreasonable risk of injury, death, or loss to person 190 or property so as to affect the life or health of another and 191 that risk was substantially greater than that which is necessary 192 to make the conduct negligent. 193

(15) (43) "Psychologist" means an individual who is 194 licensed as a psychologist or school psychologist under Chapter 195 4732. of the Revised Code. 196

(44) "Registered nurse" means an individual who holds a 197 current, valid license issued under Chapter 4723. of the Revised 198 Code to practice as a registered nurse. 199

(16) (45) "Residential treatment facility" has the same 200 meaning as in section 5166.01 of the Revised Code. 201

(46) "Respiratory care professional" has the same meaning 202 as in section 4761.01 of the Revised Code. 203

(47) "Speech-language pathologist" means an individual 204 licensed under Chapter 4753. of the Revised Code to practice 205 speech-language pathology. 206

(48) "Tort action" means a civil action for damages for 207 injury, death, or loss to person or property other than a civil 208 action for damages for a breach of contract or another agreement 209 between persons or governmental entities and includes claims 210 arising under resident or patient bills of rights and 211 contractual claims arising out of statutory or regulatory 212 requirements applicable to health care providers. "Tort action" 213 includes an action on a medical claim. 214

(B)(1) Subject to division (C)(3) of this section, a 215 health care provider or emergency medical technician that 216 Sub. S. B. No. 308 Page 9 As Passed by the Senate provides health care services, emergency medical services, 217 first-aid treatment, or other emergency professional care, 218 including the provision of any medication or other medical 219 equipment or product, as a result of or in response to a 220 disaster or emergency is not subject to professional 221 disciplinary action and is not liable in damages to any person 222 or government agency in a tort action for injury, death, or loss 223 to person or property that allegedly arises from an any of the 224 following: 225

(a) An act or omission of the health care provider or 226 emergency medical technician in the health care provider's or 227 emergency medical technician's provision, withholding, or 228 withdrawal of those services or that treatment or care; 229

(b) Any decision related to the provision, withholding, or 230 withdrawal of those services; 231

(c) Compliance with an executive order or director's order 232 issued during and in response to the disaster or emergency. 233

(2) Division (B)(1) of this section does not apply in a 234 tort action if that act oromission does not constitute the 235 health care provider's action, omission, decision, or compliance 236 constitutes a reckless disregard for the consequences so as to 237 affect the life or health of the patient or willful or wanton 238 misconduct. 239

(3) Division (B)(1) of this section does not apply in a 240 professional disciplinary action if the health care provider's 241 action, omission, decision, or compliance constitutes gross 242 negligence. 243

(4) A health care provider is not subject to professional 244 disciplinary action and is not liable in damages to any person 245 Sub. S. B. No. 308 Page 10 As Passed by the Senate or government agency in a tort action for injury, death, or loss 246 to person or property that allegedly arises because the provider 247 was prohibited from treating, diagnosing, or testing the person 248 for any illness, disease, or condition, including performing any 249 elective procedure, by an executive or director's order or an 250 order of a board of health of a city or general health district 251 issued in relation to an epidemic or pandemic disease or other 252 public health emergency. 253

(C)(1) This section does not create a new cause of action 254 or substantive legal right against a health care provider or 255 emergency medical technician. 256

(2) This section does not affect any immunities from civil 257 liability or defenses established by another section of the 258 Revised Code or available at common law to which a health care 259 provider or emergency medical technician may be entitled in 260 connection with the provision of health care services, emergency 261 medical services, first-aid treatment, or other emergency 262 professional care, including the provision of medication, 263 medical equipment, or other medical product. 264

(3) This section does not grant an immunity from tort or 265 other civil liability or a professional disciplinary action to a 266 health care provider or emergency medical technician for actions 267 that are outside the scope of authority skills, education, and 268 training of the health care provider or emergency medical 269 technician, unless the health care provider undertakes the 270 action in good faith and in response to a lack of resources 271 caused by a disaster or emergency. 272

(4) This section does not affect any legal responsibility 273 of a health care provider or emergency medical technician to 274 comply with any applicable law of this state or rule of an 275 Sub. S. B. No. 308 Page 11 As Passed by the Senate agency of this state. 276

(5) This Division (B) of this section applies only to the 277 provision, withholding, or withdrawal of health care services, 278 emergency medical services, first-aid treatment, or other 279 emergency professional care, including the provision of any 280 medication or other medical equipment or product, decisions 281 related to such services or care, or compliance with an 282 executive order or director's order by a health care provider or 283 emergency medical technician as a result of or in response to a 284 disaster or emergency and through the duration of the disaster 285 or emergency. 286

(D) This section does not apply to a tort action alleging 287 wrongful death against a health care provider or emergency 288 medical technician that provides health care services, emergency 289 medical services, first-aid treatment, or other emergency 290 professional care, including the provision of any medication or 291 other medical product, that allegedly arises from an act or 292 omission of the health care provider or emergency medical 293 technician in the health care provider's or emergency medical 294 technician's provision of those services or that treatment or 295 care as a result of during or in response to a disaster or 296 emergency. 297

(E) If the immunity described in division (B) of this 298 section does not apply, no class action shall be brought against 299 any health care provider alleging liability for damages for 300 injury, death, or loss to person or property on a cause of 301 action specified in that division. 302

Sec. 2305.2312. (A) As used in this section: 303

(1) "Board of health" means the board of health of a city 304 Sub. S. B. No. 308 Page 12 As Passed by the Senate or general health district or the authority having the duties of 305 a board of health under section 3709.05 of the Revised Code. 306

(2) "Disaster" has the same meaning as in section 307 2305.2311 of the Revised Code. 308

(3) "Government order" means an order, recommendation, or 309 guideline issued in response to a disaster or emergency due to 310 COVID-19 by a federal official or agency, a state official or 311 agency, a political subdivision, or a board of health. 312

(4) "Emergency" means any period during which the congress 313 of the United States or a chief executive has declared or 314 proclaimed that an emergency exists due to COVID-19. 315

(5) "Person" has the same meaning as in section 1.59 of 316 the Revised Code and includes a school, a for-profit, nonprofit, 317 religious, or governmental entity, or a state institution of 318 higher education. 319

(6) "Services" means any activity, including 320 manufacturing, that is part of or outside of a service 321 provider's normal course of business conducted during the period 322 of a disaster or emergency declared due to COVID-19 and ending 323 on April 1, 2021. 324

(7) "Service provider" means any person providing the 325 services described in division (A)(6) of this section, including 326 that person's owner, officer, director, employee, or agent. 327

(8) "State institution of higher education" has the same 328 meaning as in section 3345.011 of the Revised Code. 329

(B) Except as provided in division (D) of this section, no 330 service provider shall be liable in damages to any person in a 331 civil action for illness or for injury, death, or loss to person 332 Sub. S. B. No. 308 Page 13 As Passed by the Senate or property, allegedly arising directly or indirectly from the 333 service provider's act or omission in providing or performing 334 the service provider's services as a result of or in response to 335 a disaster or emergency declared due to COVID-19 or that are 336 intended to assist persons to recover from such a disaster or 337 emergency or otherwise sustain themselves during the period of 338 that declared disaster or emergency and ending on April 1, 2021. 339

(C) Except as provided in division (D) of this section, no 340 service provider shall be liable in damages to any person in a 341 civil action for injury, death, or loss to person or property 342 resulting directly or indirectly from, or related to, any 343 person's actual or alleged exposure to an illness in the course 344 of or through that service provider's provision of services 345 during the period of the disaster or emergency declared due to 346 COVID-19 and ending on April 1, 2021. 347

(D)(1) The immunity granted to a service provider in 348 division (B) or (C) of this section does not apply if it is 349 established that the service provider's act or omission is 350 reckless or intentional conduct or willful or wanton misconduct. 351

(2) As used in division (D)(1) of this section, "reckless 352 conduct" means conduct by which, with heedless indifference to 353 the consequences, the person disregards a substantial and 354 unjustifiable risk that the person's conduct is likely to cause 355 an illness or an injury, death, or loss to person or property as 356 described in division (B) or (C) of this section, whichever is 357 applicable, or is likely to be of a nature that results in such 358 an illness or an injury, death, or loss to person or property. A 359 person is reckless with respect to circumstances in relation to 360 causing an illness or an injury, death, or loss to person or 361 property as described in division (B) or (C) of this section, 362 Sub. S. B. No. 308 Page 14 As Passed by the Senate whichever is applicable, when, with heedless indifference to the 363 consequences, the person disregards a substantial and 364 unjustifiable risk that such circumstances are likely to exist. 365

(E) If the immunity described in division (B) or (C) of 366 this section does not apply, no class action shall be brought 367 against any service provider alleging liability for damages for 368 injury, death, or loss to person or property on a cause of 369 action specified in either division. 370

(F) This section does not do either of the following: 371

(1) Create a new cause of action, a third-party claim, or 372 a substantive legal right against any person; 373

(2) Affect any immunities from civil liability or defenses 374 established by another section of the Revised Code or available 375 at common law to a service provider that provides services under 376 this section. 377

(G) The immunity conferred in this section shall also 378 apply to any cause of action against a service provider for 379 contribution or indemnity for damages sustained by any person 380 during the period of the disaster or emergency declared due to 381 COVID-19 and ending on April 1, 2021. 382

(H) A government order shall not create nor shall be 383 construed as creating a duty of care upon any person that may be 384 enforced in a cause of action or create a new cause of action or 385 substantive legal right against any person with respect to the 386 matters contained in the government order. A presumption exists 387 that any such government order is not admissible as evidence 388 that a duty of care or substantive legal right has been 389 established. 390

Section 2. That existing section 2305.2311 of the Revised 391 Sub. S. B. No. 308 Page 15 As Passed by the Senate

Code is hereby repealed. 392

Section 3. Section 2305.2312 of the Revised Code, as 393 enacted by this act, is intended to apply broadly to all sectors 394 of the economy that own property, operate a business, engage in 395 a nonprofit or religious activity, or otherwise engage with the 396 public. The General Assembly declares its intent in enacting 397 section 2305.2312 of the Revised Code that the use of the terms 398 "services" and "service provider" in that section be broadly 399 construed in an effort to promote commerce, recovery from 400 disasters or emergencies, and to alleviate suffering throughout 401 this state. 402

Section 4. The General Assembly declares its intent that 403 orders and recommendations from the Executive Branch, from 404 counties and local municipalities, from boards of health and 405 other agencies, and from any federal government agency, do not 406 create any new legal duties for purposes of tort liability. Any 407 such orders and recommendations are presumed to be irrelevant to 408 the issue of the existence of a duty or breach of a duty. 409 Furthermore, any such orders and recommendations are presumed to 410 be inadmissible at trial to establish proof of a duty or breach 411 of a duty in tort actions. 412

Section 5. This act applies from the date of the 413 Governor's Executive Order 2020-01D, issued on March 9, 2020, 414 declaring a state of emergency due to COVID-19. 415

Section 6. This act is hereby declared to be an emergency 416 measure necessary for the immediate preservation of the public 417 peace, health, and safety. The reason for such necessity is that 418 it is crucial to provide immunity in response to a disaster or 419 emergency declared by the federal government, state government, 420 or political subdivision of the state. Therefore, this act shall 421 Sub. S. B. No. 308 Page 16 As Passed by the Senate go into immediate effect. 422