OHIO LEGISLATIVE SERVICE COMMISSION
Office of Research Legislative Budget
www.lsc.ohio.gov and Drafting Office
S.B. 95 Bill Analysis
135th General Assembly
Click here for S.B. 95’s Fiscal Note
Version: As Reported by House Health Provider Services
Primary Sponsor: Sen. Reynolds
Effective date:
Emma Carroll, Research Analyst
SUMMARY
Remote dispensing pharmacies
▪ Authorizes the operation of remote dispensing pharmacies and requires the State Board
of Pharmacy to regulate them.
▪ Requires a remote dispensing pharmacy to be staffed by two or more pharmacy interns
or certified pharmacy technicians and overseen and operated by both a supervising
pharmacy and pharmacist through the use of a telepharmacy system.
▪ Requires the Board to adopt rules governing the operation of remote dispensing
pharmacies within 18 months of the bill’s effective date and, if the Board fails to do so,
authorizes the Ohio Attorney General or a county prosecuting attorney to apply for a
court order requiring their adoption.
Mailing drugs to patients
▪ Prohibits health plan issuers, pharmacy benefit managers, and other administrators from
prohibiting a pharmacy from mailing or delivering drugs to patients as an ancillary service.
Pharmacist administration of injectable drugs
▪ Authorizes a pharmacist to administer by injection the following drugs if prescribed by a
physician and if other conditions specified in current law are met: HIV treatment drugs in
long-acting or extended-release forms and any other drug specified in Board rules.
 This analysis was prepared before the report of the Health Provider Services Committee appeared in the
House Journal. Note that the legislative history may be incomplete.
Office of Research and Drafting LSC Legislative Budget Office
Pharmacy technician trainees
▪ Authorizes the Board to register as a pharmacy technician trainee an applicant who is age
17 and possesses a high school diploma or certificate of high school equivalence.
Certified mental health assistants
▪ Establishes licensure by the State Medical Board for certified mental health assistants
(CMHAs).
▪ Authorizes CMHAs to provide mental health care under the supervision, control, and
direction of a physician with whom the CMHA has entered into a supervision agreement.
▪ Authorizes CMHAs to prescribe and personally furnish drugs and therapeutic devices in
the exercise of physician-delegated prescriptive authority, including certain identified
controlled substances.
▪ Specifies application procedures including education requirements, renewal procedures,
and continuing education requirements for CMHAs.
▪ Establishes within the Medical Board an advisory committee to advise the Board and the
Department of Higher Education regarding CMHA education programs.
▪ Authorizes the Medical Board to discipline CMHAs in a manner similar to that of other
Board licensees.
▪ Prohibits an individual from claiming to be able to function as a CMHA if that individual
does not hold a CMHA license, and imposes criminal penalties for violations of that and
other related prohibitions.
Uniform Duties to Incapacitated Persons Act
▪ Modifies the law governing the use of medical identifying devices, including by
recognizing devices containing bar or quick response codes that may be scanned to obtain
medical information in an emergency.
▪ Names these provisions of the act “Paige’s Law.”
TABLE OF CONTENTS
Pharmacies ...................................................................................................................................... 4
Remote dispensing pharmacies .................................................................................................. 4
Eligibility conditions ................................................................................................................ 4
Exceptions to the exclusion area surrounding an outpatient pharmacy ............................... 5
Operational conditions ........................................................................................................... 5
Pharmacy interns and technicians ......................................................................................... 6
Supervising pharmacies .......................................................................................................... 6
Supervising pharmacists ......................................................................................................... 6
Rulemaking ............................................................................................................................. 7
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Telehealth ............................................................................................................................... 8
Mailing drugs to patients ............................................................................................................ 9
Pharmacist administration of injectable drugs ........................................................................... 9
Pharmacy technician trainees ..................................................................................................... 9
Certified mental health assistant licensure .................................................................................... 9
Services that may be performed by a CMHA ........................................................................ 9
Delegation of tasks ................................................................................................................. 10
Prohibited services ................................................................................................................. 10
Supervision agreements ........................................................................................................ 11
Supervision requirements ..................................................................................................... 11
Communication .................................................................................................................. 11
Diagnosis and reevaluation .............................................................................................. 12
Quality assurance and review .......................................................................................... 12
Limit on the number of CMHAs that may be supervised at one time ........................ 13
Liability – termination of agreement .............................................................................. 13
Physician-delegated prescriptive authority ........................................................................ 13
Controlled substances ....................................................................................................... 13
Controlled substances that may be prescribed ............................................................ 13
Compliance with OARRS ................................................................................................. 14
Other provisions related to prescribing .......................................................................... 14
License issuance and renewal ............................................................................................... 15
Application and education requirements ....................................................................... 15
Renewal ............................................................................................................................... 15
Continuing education ........................................................................................................ 16
Requirements ..................................................................................................................... 16
Reductions and extensions ............................................................................................... 16
Investigating compliance ................................................................................................. 16
Duplicate license ................................................................................................................ 16
CMHA education programs .................................................................................................. 17
Discipline ................................................................................................................................. 18
Against CMHAs .................................................................................................................. 18
Against supervising physicians ........................................................................................ 19
Criminal penalties .................................................................................................................. 19
Prohibited conduct ............................................................................................................ 19
Penalties .............................................................................................................................. 20
Rulemaking ............................................................................................................................. 20
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Miscellaneous provisions applicable to the Medical Board .............................................. 20
Bill interpretation ................................................................................................................... 20
Medicaid coverage .................................................................................................................. 21
Miscellaneous provisions ...................................................................................................... 21
Uniform Duties to Incapacitated Persons Act – Paige’s Law ........................................................ 22
Identifying device and identification card ................................................................................. 22
Authority to scan an identifying device .................................................................................... 23
Prompt and reasonable search ................................................................................................. 24
Incapacitated condition and person ......................................................................................... 24
Emergency medical service provider ........................................................................................ 24
Health care practitioner ............................................................................................................ 24
Physical and mental illness ........................................................................................................ 24
DETAILED ANALYSIS
Pharmacies
Remote dispensing pharmacies
The bill requires the State Board of Pharmacy to regulate remote dispensing pharmacies.1
The bill defines “remote dispensing pharmacy” as one where the dispensing of drugs, counseling
of patients, and other pharmacist care is provided through a telepharmacy system. Dispensing of
drugs at the pharmacy may include the dispensing of drug therapy related devices.2 A
telepharmacy system is one that monitors the dispensing of drugs and provides for related drug
utilization review and patient counseling services by an electronic method.3
Eligibility conditions
To operate as a remote dispensing pharmacy, the pharmacy must satisfy all of the
following:
▪ Be licensed by the Board as a terminal distributor of dangerous drugs;
▪ Use only a telepharmacy system that meets standards established by the Board in rules;
▪ Be staffed by two or more pharmacy interns or certified pharmacy technicians;
▪ Have a supervising pharmacy and supervising pharmacist;
▪ Be located in Ohio, in a building that is zoned for commercial use;
1 R.C. 4729.554(B).
2 R.C. 4729.554(A)(1).
3 R.C. 4729.554(A)(2).
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▪ In general, not be located within a ten-mile radius of an outpatient pharmacy.4
Exceptions to the exclusion area surrounding an outpatient
pharmacy
The bill establishes circumstances when a remote dispensing pharmacy’s proximity to an
outpatient pharmacy may be closer than ten miles. Specifically, the ten-mile radius around an
outpatient pharmacy that otherwise constitutes an area of exclusion does not apply in relation
to (1) federally qualified health centers (FQHCs) and (2) locations approved by the Board based
on a demonstration of need.5
Regarding FQHCs, the bill permits a remote dispensing pharmacy to be within the ten-mile
radius of an outpatient pharmacy if the remote pharmacy is part of an FQHC or an FQHC look-
alike, which is a facility that meets the eligibility requirements for federal FQHC funding but does
not receive it. The remote pharmacy must be located on the same property as, or a campus
contiguous to, the FQHC or look-alike.
Regarding location approvals based on a demonstration of need, the bill requires a
remote dispensing pharmacy to meet standards established by the Board in rules for
demonstrating the need. Further, as part of the Board’s approval process, the bill requires the
Board to establish a method by which persons may register to receive notice from the Board of
requests for location approvals. The Board also must establish a system for accepting public
comments regarding the requests. When the Board receives a request, it must electronically
notify persons who register to be notified, and post notice on its website regarding a public
comment period of 60 days. During that 60-day period, the Board must permit other pharmacies
to submit requests for location approvals. After that period ends, the Board, in determining
whether any of the location requests should be approved, must consider public comments,
supervising pharmacy location in relation to the proposed remote dispensing pharmacy, and any
other standards specified in rules. The determination must be made at the Board’s next regularly
scheduled meeting that occurs on or after the date that is 90 days after the electronic notices
described above were sent.6
Operational conditions
The bill establishes conditions on the operation of each remote dispensing pharmacy.
These include all of the following:
▪ The pharmacy must not fill prescriptions at a rate that exceeds an average of
150 prescriptions per day during a 90-day period, unless otherwise approved by the
Board.
4 R.C. 4729.554(B) and (C).
5 R.C. 4729.554(C)(2)(b).
6 R.C. 4729.554(C)(2)(c).
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▪ The pharmacy must implement a quality assurance plan to ensure that there is a planned
and systematic process for (1) monitoring and evaluating the quality and appropriateness
of the pharmacy services and (2) identifying and resolving problems.
▪ If the pharmacy holds a category III terminal distributor of dangerous drugs license, it
must maintain a perpetual controlled substance inventory, as specified in Board rules. 7
Pharmacy interns and technicians
The bill sets limits on the practice of pharmacy interns and certified pharmacy technicians
when assisting in the process of dispensing drugs.8 When staffing a remote dispensing pharmacy,
these practitioners are prohibited from doing any of the following:
▪ Counseling an individual regarding drugs that are dispensed, recommending drugs and
drug therapy related devices or otherwise providing advice, or assisting with the selection
of drugs and drug therapy related devices for treatment of common diseases and injuries
or with providing instruction on their use;
▪ Performing sterile or nonsterile drug compounding, except for the reconstitution of
prepackaged dangerous drugs;
▪ Engaging in the repackaging of dangerous drugs;
▪ Administering immunizations or performing diagnostic testing, unless a pharmacist is
onsite to provide direct supervision;
▪ Performing any other activities prohibited in Boa