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Important Information

from the State Medical Board of Ohio

Board Seeks Comment on Proposed Actions to Respiratory Care Rules

The Medical Board is seeking public comment on the proposed actions for the following rules. Click the link to view the rule and the Business Impact Analysis filed with the Common Sense Initiative: Respiratory Care Rules  


Comments on the proposed rules must be received no later than November 22, 2019. Please provide comments to both of the following:  

Board Releases Cultural Competency Video

As Ohio continues to grow in diversity, the State Medical Board of Ohio recognizes the positive impact well-prepared health care professionals can have on their patients. To support best practices, the Medical Board has created a cultural competency educational video. The video provides guidance on how to interact with patients from different ethnicities, genders, disability status and cultures and features our board president, subject matter experts and other health care professionals who encounter unique challenges in the field. 

 
 To view in fullscreen, after pressing play, click on the YouTube logo below the video.
 

Please explore these resources as we seek to increase the incorporation of culturally competent practices by practitioners, ensuring Ohioans continue to have access to outstanding health care across the state.

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National Lead Poisoning Prevention Week

National Lead Poisoning Prevention Week is October 20 - 26. It is a call to bring together individuals, organizations, industry, and government to raise awareness of lead poisoning prevention and reduce childhood exposure to lead. No safe blood lead level in children has been identified. Elevated lead levels in children can potentially have long-term health consequences. Ohio law requires physicians to screen children younger than 6 years old at risk of lead poisoning, and Medicaid regulations require screening children at ages 1 and 2. Watch this video collaboration with Ohio Department of Health for more information about lead exposure risk factors, recommendations for screening and medical management of lead poisoning.

Ohio's Law Changes Will Affect Med Board Licensees

Ohio’s biennium budget (House Bill 166) contains many policy changes in addition to financial appropriations. A number of those statutory changes will impact State Medical Board of Ohio licensees. 

The following is a summary of changes in Ohio law that will become effective October 17, 2019. Licensees are encouraged to read the complete law in the Ohio Revised Code (ORC). Information on laws and rules for licensees is also available in the LAWS & RULES section.

All license types

• Eliminates a requirement under which an affirmative vote of at least six members of the board is necessary to grant a license to an applicant. This change will allow the Medical Board to issue licenses faster, instead of waiting for monthly board meetings.

• Licenses will expire two years after the original date of issuance. For existing license holders, the renewal deadline will continue to be on the same date as it is currently; for new license holders this means renewal will occur on the two-year anniversary of initial issuance and every two years thereafter.

• The board can now impose terms and conditions to ensure an applicant’s fitness to practice, as follows: (1) when seeking issuance of a license without having been engaged in practice or participating in a training or educational program for more than two years, and (2) when seeking restoration of a license that has been inactive for more than two years.

 

Allied health professionals

• Clarifies an eligibility requirement that applies to a person seeking licensure to practice a limited branch of medicine based on holding a license in another state, by specifying that the applicant must have held a license to practice massage therapy or cosmetic therapy during the five-year period preceding the date of application.

• Authorizes the board to impose a civil penalty of not more than $5,000 if the license holder fails to complete the continuing education required to maintain a license.

 

Physicians

• Ohio MDs, DOs, and DPMs will need to complete a total of 50 hours Category 1 CME every two years to be eligible for license renewal. Previously, physicians were required to complete a total of 100 hours, of which 40 needed to be Category 1.

• The amount of continuing education hours a physician may earn providing health care services as a volunteer will be reduced to three hours.

• Expedited licensure: Clarifies an eligibility requirement that applies to a physician seeking an expedited license by endorsement by specifying that the applicant must not have been the subject of more than two malpractice claims resulting in a finding of liability in the ten years preceding the date of application.

• Training certificates: Allows a holder of a physician training certificate to apply for late renewal not more than 30 days after the certificate’s expiration date if the individual pays a $150 reinstatement fee.

• Clinical fellowship programs: Specifies that an accredited clinical fellowship program constitutes (1) graduate medical education recognized by the board and (2) a program that an individual may participate in by obtaining a training certificate.

• Clinical research faculty: Specifies that holders of clinical research faculty certificates will need to complete 75 hours Category 1 CME every three years to renew their certificates.

• Telemedicine certificates: Specifies telemedicine certificates will be converted to standard MD or DO licenses. Ohio’s law regarding telemedicine certificates will be repealed, eliminating the need for a separate certificate. All active telemedicine certificate holders, upon conversion to holders of a full MD or DO license, will be required to meet Ohio’s continuing education requirements in order to renew their license (50 hours of Category 1 CME every two years). Physicians wishing to provide health care via telemedicine to individuals located in Ohio may do so under their full Ohio license.

 

Physician assistants (PAs)

• The physician assistant continuing education (CE) requirements for Ohio will mirror the National Commission on Certification of Physician Assistants (NCCPA) requirements. Previously, a physician assistant needed to complete a minimum of 100 hours of continuing education every two years, which did not align with the NCCPA certification cycle. Physician assistants who hold prescriptive authority will continue to be required to complete at least twelve hours of continuing education in pharmacology.

• Changes in the law will now require both the supervising physician and the physician assistant to retain a copy of their supervision agreement in their records. The law also permits the board to assess a civil penalty upon a finding that a supervision agreement has not been retained as required.

• PA initial application fee reduced from $500 to $400.

• Limits a physician assistant’s existing authority to personally furnish samples of drugs and therapeutic devices to the drugs and devices included in the physician assistant’s physician-delegated prescriptive authority.

• Requires that medical care provided by an out-of-state physician assistant at a charitable event in Ohio be supervised by the event’s medical director or another physician authorized to practice in Ohio.

 

Severe Pulmonary Illness Associated with E-cigarettes or Vaping

 

The State of Ohio Board of Pharmacy and the Ohio Medical Marijuana Control Program (OMMCP) continue to work with the Ohio Department of Health (ODH) and monitor the Centers for Disease Control and Prevention’s (CDC) efforts to understand the causes of vaping illness that have been reported across the country. The OMMCP provided an update on October 5, 2019 that reflected the U.S. Food and Drug Administration’s strengthened message:

•  The public should not use any vaping product using tetrahydrocannabinol.

•  Consumers who choose to use any vaping products should not modify or add any substances such as THC or other oils to products purchased in stores.

•  Individuals should not purchase any vaping products, including those containing THC, off the street or from other illicit channels.

Anyone who thinks that they may be experiencing serious breathing problems linked to vaping should seek immediate medical attention. Patients should report any adverse events related to medical marijuana to the MMCP Toll-Free Helpline at 1-833-464-6627. Patients who are vaping medical marijuana as part of the Ohio Medical Marijuana Control Program should contact their recommending physician about how to best manage the condition being treated with medical marijuana.

 

On September 30, 2019 the Ohio Department of Health issued an updated alert regarding the public health vaping investigation.

 

Health care providers are now required to report suspected cases of severe pulmonary disease of unclear etiology with a history of vaping in the past 90 days. The cases are to be reported to the patient’s local health department (LHD) by the end of the next business day.

 

Multiple states across the country have reported clusters of patients experiencing severe respiratory disease after using e-cigarette or vapor products. As of September 26, 2019, 805 cases have been reported across 46 states and one U.S. territory. Twelve deaths have been confirmed in ten states. CDC’s clinician outreach and communication activity (COCA) document and CDC HAN with recommendations for clinicians can be found here.

 

Patients have reported vaping in the weeks to months prior to illness. Many patients have reported using THC and nicotine. The latest findings from the national investigation into lung injuries associated with e-cigarette use, or vaping, suggest products containing THC play a role in the outbreak. The investigation is ongoing. No specific product has been identified by all cases, nor has any product been conclusively linked to this clinical syndrome.

 

Symptoms and Imaging

Patients present with respiratory symptoms including cough, shortness of breath and fatigue. Symptoms worsen over a period of days or weeks before admission to the hospital. Other symptoms may include fever, anorexia, pleuritic chest pain, nausea, abdominal pain and diarrhea. Chest radiographs show bilateral opacities, typically in the lower lobes and CT imaging of the chest shows diffuse ground glass opacities, often with subpleural sparing. Evaluation for infectious etiologies were negative in all patients. Some patients had progressive respiratory compromise requiring endotracheal intubation but subsequently improved with systemic steroids.

 

Management

At this time, it is unknown what is causing or contributing to the symptoms. Infectious etiologies should be ruled out and all associated testing should be documented on the clinician report form. Aggressive supportive care is warranted, and in severe cases, it is recommended that pulmonary and critical care specialists are consulted. If an e-cigarette or vaping product is suspected as a possible etiology of a patient’s illness, it is important to inquire about the type of product and where the product was obtained and if samples of the product are available for possible analysis.

 

Prevention

No specific product has been identified by all cases, nor has any product been conclusively linked to this clinical syndrome. While the investigation is ongoing, CDC recommends that individuals consider refraining from e-cigarettes or vaping products, particularly those containing THC. People who use e-cigarette products should not buy them off the street and should not modify e-cigarette products or add any substances that are not intended by the manufacturer, regardless of the ongoing investigation.

 

CDC Guidance for Specimen Collection and Storage

CDC can receive select clinical specimens for evaluation. Please see documents linked below for guidance on specimen types, collection, and storage. If you are interested in submitting specimens to CDC, please contact your local health department or ODH to obtain pre-approval and shipping information.

Laboratory Clinical Specimen Collection and Storage Guidance For Lung Injury Related to e-Cigarette Exposures The purpose of this document is to provide general specimen collection and storage guidance for healthcare providers and public health laboratory personnel.

Specimen Submission Guidance for Pathologic Evaluation of Tissue Specimens from Cases of Pulmonary Disease Associated with E-Cigarette Product Use This guidance document will assist health departments, healthcare providers, and pathologists with submission of tissue specimens.

 

Reporting

Report all suspected cases to the local health department in the jurisdiction in which the case resides. Please report these suspect cases by the close of the next business day following patient presentation. To locate a local health department, please click here.

 

For additional information, clinicians can contact their local health department or the Ohio Department of Health, Tobacco Use Prevention and Cessation Program:

 

Kirtana Ramadugu, MPH

Tobacco Epidemiologist, Tobacco Use Prevention and Cessation Program, Ohio Department of Health

614-644-0743 or Kirtana.ramadugu@odh.ohio.gov

 

Courtney Dewart, PhD, MPH, RN

CDC Epidemic Intelligence Service Officer, Assigned to Ohio Department of Health

614-644-8784 or Courtney.dewart@odh.ohio.gov

 

House Bill 166 Changes Ohio Laws (October 2019 eNews)

The October 2019 issue of the Medical Board's eNews is available. Highlights: 

  • House Bill 166 changes Ohio laws

  • CME guidance

  • new rules effective 9/30/19 and 3/30/20

  • new Spanish documents available

  • board seeks victim coordinators and subject matter experts

  • medical marijuana control update

  • Drug Take Back Day

  • office closure

Click here to read the issue.

New Rules Effective September 30, 2019

There are rule changes that were adopted by the Medical Board on September 30, 2019. 

Standards for Surgery

4731-18-01 - rescinded

4731-25-08 - new

 

Cosmetic Therapy Rules

4731-1-08 - rescinded

 

Genetic Counselor Criminal Records Checks Rules

4778-2-01 Definitions - rescinded

4778-2-02 - rescinded

 

Radiological Assistant Criminal Records Checks Rules

4774-2-01 Definitions - rescinded

4774-2-02 - rescinded

 

Dietetics Criminal Records Checks Rules

4759-4-11 - rescinded

 

PA Criminal Records Checks Rules

4730-3-01 Definitions - rescinded

4730-3-02 - rescinded

 

Criminal Records Checks Rules

4731-4-01 Definitions - new

4731-4-01 Definitions - rescinded

4731-4-02 - amended

 

Medical Board Votes on Medical Marijuana Control Program Conditions

Today the State Medical Board of Ohio voted to reject the petitions for anxiety disorder and autism spectrum disorder; these conditions will not be added to Ohio’s Medical Marijuana Control Program at this time. 

The board could review these conditions at a later date if additional studies or evidence are brought forth in the petition process. The next window for petitions will be November 1, 2019 through December 31, 2019. Today the board also voted to set the follow year’s window. That will be November 1, 2020 through December 31, 2020.

Medical Board Responds to Governor's Working Group Report (September 2019 eNews)

The September 2019 issue of the Medical Board's eNews is available. Highlights: 

  • Medical Board responds to governor's working group report 

  • September is National Recovery Month 

  • new Spanish documents available 

  • October 1 renewal deadline 

  • notice of October 2 public hearing

  • board seeks victim coordinators and subject matter experts 

  • OMMCP update 

  • cosmetic therapy exam registration deadline 

  • board meeting dates

Click here to read the issue.

Notice of October 2, 2019 Public Hearing

A public hearing will be conducted on October 2, 2019, at 1:30 p.m. in the Lobby Hearing Room, Rhodes State Office Tower, 30 E. Broad Street, 1st Floor, Columbus, OH. Oral and written testimony may be presented by any person affected by the proposed rules.