OHIO LEGISLATIVE SERVICE COMMISSION
Office of Research Legislative Budget
www.lsc.ohio.gov and Drafting Office
S.B. 21 Final Analysis
134th General Assembly
Click here for S.B. 21’s Fiscal Note
Version: As Passed by the General Assembly
Primary Sponsors: Sens. Antonio and Manning
Effective date: September 21, 2021
Effective Date:
Elizabeth Molnar, Attorney
SUMMARY
 Requires the State Board of Emergency Medical, Fire, and Transportation Services to
develop guidelines for the assessment, triage, and transport to hospitals of stroke
patients.
 Directs each emergency medical service organization to base its stroke patient
protocols, required by continuing law, on the State Board’s guidelines.
 Requires the State Board to make available to the public copies of stroke patient
protocols established by emergency medical service organizations.
 Requires each emergency medical service organization to provide to its emergency
medical service personnel training in the assessment and treatment of stroke patients.
DETAILED ANALYSIS
S.B. 21 revises the law governing protocols for the assessment, triage, and transport to
hospitals of stroke patients by emergency medical service personnel. Under continuing law, the
medical director or cooperating physician advisory board of each emergency medical service
organization (1) must establish written protocols for the organization’s emergency medical
service personnel to follow when treating and transporting stroke patients and (2) must provide
copies of its protocols to certain entities. The act requires these protocols to be based on
guidelines the State Board of Emergency Medical, Fire, and Transportation Services must
develop.1 It also directs emergency medical service organizations to submit protocols to
specified entities on an annual basis and provide certain stroke-related training to its
emergency medical service personnel.
1 R.C. 4765.401.
July 1, 2021
Office of Research and Drafting LSC Legislative Budget Office
Stroke patient guidelines
Under S.B. 21, the State Board must devise – not later than December 20, 2021 –
guidelines for the assessment, triage, and transport to hospitals of stroke patients. In doing so,
the State Board must consult with a diverse group of hospital leaders around Ohio, including
those that represent large health systems, hospitals not affiliated with a large health system,
and hospitals located in rural communities, as well as comprehensive stroke centers, primary
stroke centers, and acute stroke ready hospitals recognized under continuing law by the
Department of Health. Once developed, the guidelines must be made available on the Board’s
website.2
The act also requires the State Board to review and update its guidelines periodically. If
updates are made, the Board must post the updated versions to its website. Additionally, the
act allows the State Board to distribute guidelines and their updated versions in any other
manner it finds acceptable.3
Emergency medical service organization stroke patient protocols
Continuing law requires each emergency medical service organization to establish
written protocols to be followed by its emergency medical service personnel when assessing
stroke patients and transporting them to hospitals. Under S.B. 21, these protocols must be
based on the guidelines to be developed by the State Board. The act grants the organizations
until March 20, 2022, to do so.4
Protocol copies
Each emergency medical service organization must provide copies of its protocols to the
State Board as well as the Regional Director or Regional Advisory Board for the organization’s
emergency medical services region. The act maintains this requirement, but directs emergency
medical service organizations to submit them on an annual basis and also to the Ohio
Department of Health. It further requires the State Board to make copies available to the
public.5
Training
S.B. 21 requires each emergency medical service organization to provide periodically to
its emergency medical service personnel training in the assessment and treatment of stroke
patients, including training in the assessment of stroke severity.6
2 R.C. 4765.401(A).
3 R.C. 4765.401(A).
4 R.C. 4765.401(A).
5 R.C. 4765.401(B).
6 R.C. 4765.401(C).
P a g e |2 S.B. 21
As Passed by the General Assembly
Office of Research and Drafting LSC Legislative Budget Office
Immunity from civil liability
Continuing law generally grants immunity from civil liability to an emergency medical
service organization’s medical director and members of its cooperating physician advisory
board when performing official duties.7 S.B. 21 makes clear that such immunity extends to any
of their duties established by the act.8
HISTORY
Action Date
Introduced 01-26-21
Reported, S. Health 03-03-21
Passed Senate (32-0) 03-03-21
Reported, H. Transportation & Public Safety 05-18-21
Passed House (91-0) 06-10-21
21-SB21-134/ks
7 R.C. 4765.49, not in the act.
8 R.C. 4765.401(D).
P a g e |3 S.B. 21
As Passed by the General Assembly


Statutes affected:
As Introduced: 4765.401
As Reported By Senate Committee: 4765.401
As Passed By Senate: 4765.401
As Reported By House Committee: 4765.401
As Passed By House: 4765.401
As Enrolled: 4765.401