Ohio Legislative Summary: Scope of Practice Update
There are have been a number of scope of practice activities in Ohio—legislative and regulatory—in 2021. Some will continue into 2022. Here is a summary of the highlights. None of these details currently relate to optometry, but we will update OOS members immediately should there be any activity.
APRNs: House Bill 221 was introduced by Rep. Tom Brinkman (R-Mt. Lookout) and Rep. Jennifer Gross (R-Westchester). This legislation would give Ohio APRNs the ability to practice independently without any supervision by a physician. It has yet to have any hearings in the House Health Committee, but the Ohio State Medical Association (OSMA) is monitoring it carefully. APRNs have been and continue to be a valued part of the care team as they practice under the supervision of physicians across the state. During the pandemic, their role in patient care has remained the same, except for an allowance of flexibility for APRNs working in health systems that was implemented early in the pandemic in the case of hospital surges causing patient overflow in areas such as convention centers. Ohio made this temporary change in preparation for the worst, but fortunately, utilization of those overflow spaces was not required last spring.
Physician Assistants (PAs): OSMA expects legislation for independent practice for physician assistants to be introduced in the coming weeks, and we will similarly oppose this initiative. OSMA will continue to advocate against unsupervised practice by APRNs and PAs, stressing the importance of patient safety and physician oversight.
Midwives: There is a hard push for certified midwife and certified professional midwife licensure in Ohio on the horizon. OSMA, along with the Ohio Chapter of the American College of Obstetricians and Gynecologists, will be actively involved in the discussion and debate about the forthcoming legislation.
Podiatry: In June 2019, the State Medical Board of Ohio considered a request from a podiatrist as to whether five specific procedures were within the scope of practice of a podiatrist. The Board determined that four of the five procedures were within the scope of practice of a podiatrist. After the Board issued its determination on this issue, concerns were raised with respect to two of the specific procedures that were determined to be within the podiatric scope of practice:
- Is it permissible for a podiatrist in Ohio to perform a supramalleolar osteotomy of the tibia or fibula to correct a deformity?
- Is it permissible for a podiatrist in Ohio to harvest bone marrow aspirate from the proximal tibia?
In May 2021, the State Medical Board appeared before the Joint Commission on Agency Rule Review (“JCARR”) for consideration as to whether the policy determination should be specified in a rule. Prior to receiving the determination from JCARR, the State Medical Board of Ohio decided to commence the rule-making process on this issue and solicited comments from the medical community. The board received over 80 comments regarding this issue. At the board’s November meeting, the board discussed the feedback received from the medical community and the options before them. After much discussion, the board voted to withdraw the scope determinations put forth in the 2019 letter. The board opined that they acted precipitously when they made the determinations and that the proper venue to decide an unclear scope set forth in Ohio statute is the Ohio state legislature. The board also recommended that providers work with their hospital systems and legal counsel going forward on any issues relevant to this topic.