Ohio Legislative Goals

OSRC Legislative Goals

  • Pass legislation to license the Advanced Practice Respiratory Therapist in Ohio.
  • Monitor and formally comment on all law and rule changes proposed by the State Medical Board of Ohio which impact the profession of respiratory care.
  • Monitor all proposed bills of the Ohio legislature and testify at hearings to support the qualifications, scope, and inclusion of the RCP in bills to provide safe, quality respiratory care to protect the public.
  • Engage state agencies (i.e., Medicaid, Ohio Board of Pharmacy, Dept. of Developmental Disability, etc.) to include the OSRC as an interested party when promulgating regulations which impact the roles and services provided by respiratory care professionals.
  • Support all AARC led efforts to expand the recognition and scope of the respiratory therapist in Federal law and regulation, especially CMS, including participating in Hill Day and Lobbying Campaigns.
  • Communicate and engage RCPs throughout Ohio in legislative efforts through newsletters, email blasts, social media, and events when possible.
  • Utilize the OSRC Judicial Committee for scope of practice inquiries referred to the OSRC office from the SMBO, the profession, or the public.
  • Improve relations with the Ohio Board of Pharmacy, particularly related to respiratory care home medical equipment services.

Contacts for OSRC Legislative Efforts

OSRC Legislative Committee Report

APRT Update:  Sub HB 102 “License Advanced Practice Respiratory Therapists” was introduced in the House Health Provider Services Committee on 6/11/24, and was voted out of committee on 6/27/24. Changes were made in the substitute bill to respond to concerns from opponents, specifically OSMA. The bill’s sponsors, Reps. Young & John, remain committed to moving this legislation forward. These changes take a “first bite” at the new profession with potential for adjustments to these restrictions as the APRT demonstrates value in the field.

  1. Prescription of controlled substances

                        No Controlled substance prescribing: It does restrict our ability to prescribe controlled substances:  On page 174, under section 4761.44 APRT Authority to prescribe: (D) An advanced practice respiratory therapist’s physician-delegated prescriptive authority shall not include the authority to do either of the following: (1) Prescribe a controlled substance; (2) Personally furnish any drug.

                                In section 4761.381 the section on APRT Delegation, Lines 4833-4842  refer to the restrictions that have always been in our bill under the APRT’s ability to delegate to a non-licensed person in a medical office environment:  (C) An advanced practice respiratory therapist may delegate administration of a drug only if all of the following conditions are met: (1) The advanced practice respiratory therapist has been granted physician-delegated prescriptive authority and is authorized to prescribe the drug. (2) The drug is not a controlled substance. (3) The drug will not be administered intravenously. (4) The drug will not be administered in a hospital inpatient care unit, as defined in section 3727.50 of the Revised Code; a hospital emergency department; a freestanding emergency department; or an ambulatory surgical facility licensed under section 3702.30 of the Revised Code.

  • On site supervision

                        Supervising Physician to be physically present: The Sub bill includes language that requires the supervising physician to be physically on site. On page 169, Section 4761.39 (A)(1) The supervising physician shall be continuously available for direct communication with the advanced practice respiratory therapist by being physically present at the location where the advanced practice respiratory therapist is practicing.

  • Location of APRT practice

                        Where we can practice: (K) “Health care facility” means any of the following: (1) A hospital; (2) Any other hospital-based facility designated by the state medical board in rules adopted pursuant to division (B) of section 4761.36 of the Revised Code.

                                Reference:  4761.36 (B) The state medical board may adopt rules designating facilities to be included as health care facilities that are in addition to hospitals as specified in division (K)(1) of section 4761.01 of the Revised Code. Any rules adopted shall be adopted in accordance with Chapter 119. of the Revised Code.

The Sub bill has no other limitation to prescribing (all other devices, medications, etc are included). Restriction is only for controlled substances, which is very different from NC legislation that does not allow for any prescription. 

OSRC PAC: The OSRC’s Political Action Committee Fund is in need of donations. For OSRC to be able to ‘get legislators’ attention,’ it is sometimes necessary to donate OSRC – PAC funds to those state representatives’ and state senators’ campaigns that are sympathetic and supportive of our issues. A request will be made at the Annual Business Meeting Tuesday, July 30th.

SMBO Update: The 2023 Workforce Report was presented to the RCAC on June 11th.  Executive Director Stephanie Loucka and the new SMBO Liaison physician, Dr. Elaine Lewis from Columbus, were in attendance.

OSRC Recruitment and Retention Series:  The series concluded in May; thank you to Karla Balasko for coordinating this well attended forum for managers and educators. Slides and recordings of these webinars are available upon request to the OSRC office.

HB 102 OSRC Testimony Synopsis 

The committee heard proponent testimony from Dr. Karen McCoy, a pediatric pulmonary specialist at Nationwide Children’s Hospital, and five witnesses from the Ohio Society for Respiratory Care (OSRC).

McCoy said a shortage of 1,300 to 12,000 cardiologists and pulmonologists is expected nationally by 2030 and that is made “more concerning” by the fact that three of the five leading causes of death involve the cardiopulmonary system. Rural areas face an even more dire shortages, as some do not have any qualified providers for advanced cardiopulmonary management.

She said creation of the Advanced Practice Respiratory Therapist (APRT) position will help to address that, and clinical training has been provided at Nationwide and the Ohio State University Medical Center since 2021. McCoy described how hospital bed demand has increased in general and especially during the pandemic, as some patients had to be transported to out-of-state hospitals to receive a bed.

APRTs could help chronically ventilated children by providing care in their homes, relieving ICU space for “more appropriate and efficient use,” McCoy said. The position would also provide a path for professional growth and advancement, similar to registered nurses who become advanced practice nurses. 

She and Rep. Liston discussed other benefits to APRTs, with McCoy saying their knowledge of respiratory equipment can be useful in a variety of settings including sleep clinics. She also told Liston that telehealth services and respiratory care don’t go well together. 

OSRC President Nancy Colletti said APRTs would have at least master’s degree completion of a curriculum equivalent to other advanced practice providers. The scope of their work would be managing the care of patients with cardiopulmonary disorders and conditions under the supervision of physicians who are specialists in cardiopulmonary medicine. The new position is not an attempt to intrude on other advanced practice providers’ scope, she continued, and APRTs would not be able to work in general practice. 

Colletti also said APRTs could help address current and future needs of Ohioans with ailments such as COPD, asthma, occupational lung disease, smoking cessation, pulmonary fibrosis, pulmonary hypertension, sleep-related disorders, pneumonia, respiratory failure and COVID-related lung damage. Those will only increase as Ohio’s population ages, she added.

Liston asked if other states are looking at licensing APRTs. Colletti said North Carolina, Illinois and Texas are among ones that are.

In response to Rep. T. Young, Colletti said there are around 8,000 respiratory therapists in Ohio now and discussed how current respiratory therapists could become APRTs if the bill is passed. She noted that will require the supervisory agreements. 

OSRC Legislative Committee Chair Courtney Kallergis gave similar comments on the need for APRTs due to the aging pulmonary care workforce and the use of advanced practice providers to expand health care access in other fields. She also described OSRC’s work to help develop the bill.

Ranking Member Somani and Chair Cutrona asked how the bill would ensure more care is available in rural areas. Kallergis said the growth of the profession as a whole would help it expand beyond larger cities. She also told Cutrona the APRT curriculum is “robust” and would ensure competency, and detailed to Liston their work with other stakeholders.

Rep. Brewer asked if people who studied in Ohio could leave for other states after graduating, and how diversity would be assured in the new workforce. Kallergis responded to the first point that students are currently learning while they do not have an available license to practice. Making Ohio one of the first to create the license will help retain them, she continued. OSU is the only place offering that education and it is committed to diversity as well, Kallergis said. 

Sarah Varekojis, a member of the OSRC Legislative Committee and director of the APRT graduate education program at OSU, detailed the history of the program. Three student cohorts have graduated since 2021, with one graduate hired by the Veterans Affairs Maryland Health Care System and two others likely to work there in the near future as well. 

She told Young the rest of the graduates previously worked as respiratory therapists and leveraged their new education into leadership roles while they wait for APRT licensure to be created. Varekojis shared other details on the program in response to Liston, and described how APRT-related billing would work in response to Rep. Gross. She also told Gross APRNs and APRTs would have a very complementary role and said that providing care sooner could reduce health care costs.

Dr. Emily Amin, a practicing pulmonary and critical care physician, also described the need for APRTs. 

She and McCoy discussed technical aspects of the potential APRT work in response to Rep. Baker. Amin also told Cutrona the APRT would bring a “unique background” and expertise on the equipment.