Ohio House Health Committee - 3-11-2026

Chair Schmidt.

Ranking Member Simani.

Representative Baker.

Representative Barhorse.

Representative Brownlee?

Representative Craig?

Here.

Here.

Here.

Representative Stewart?

Checked in.

Thank you.

You know, I'm on the hot seat, but I think I'll make it through.

I'll be all right. Thank you, though, Chair. Chair Schmidt, Vice Chair Dieter, Ranking Member Tsunami, and members of the House Committee, thank you for the opportunity to provide testimony on House Bill 535. So House Bill 535 represents a practical step forward for Ohio's health care system. It gives nurses a meaningful voice in staffing decisions, increases transparency for patients and policymakers, and creates a balanced accountability system that encourages hospitals to follow safe staffing plans. Across Ohio, nurses and other health care professionals constantly tell us that staffing levels are the single biggest factor affecting both patient safety and workforce retention When nurses are responsible for too many patients at once patients wait longer for care complications increase and experienced nurses are more likely to leave the profession For me this issue is not just a policy it personal My wife has been a nurse for many years and like many nurses across Ohio, she has experienced the stress and uncertainty that comes with being mandated to stay for extra shifts because the next shift simply didn't have enough staff to safely care for patients. I've seen the toll this takes. I've watched her come home after working long hours, worried not just about how exhausted she was, but about whether there were simply too many patients and not enough nurses to give each one the attention that they deserved. And I know she is far from alone. Nurses across Ohio face those same concerns every day. They want to do their jobs well, they want to take care of their patients, and they know they want the system to work to support safe care. So House Bill 535 addresses these challenges by strengthening Ohio's existing hospital staffing committee law rather than imposing a one-size-fits-all mandate. This legislation was developed through conversations between the Ohio Nurses Association and the Ohio Hospitals Association. Nurse managers shared best practices for staffing committees, and those practices helped shape the framework of this bill. First, the bill ensures that nurses have a real voice in staffing decisions. Hospitals already operate nursing care committees under current law, but this bill strengthens those committees by requiring that the majority of the members be direct care registered nurses. And in our unionized hospitals, the nurse's bargaining representative selects the majority of the nurse members, ensuring authentic frontline representation. The professionals closest to the patient care should help design the staffing plans that protect patients. Second, this bill requires hospitals to develop evidence-based, unit-specific staffing plans. These plans must reflect the realities of patient care and consider factors such as patient acuity and complexity, admissions and discharges, patient education needs, and the specialized nursing skills required in each unit. Staffing levels may be expressed as a nurse-to-patient ratio or as a safe range of patients per nurse, depending on the unit. Third, House Bill 535 introduces transparency and accountability. Hospitals must implement the staffing plan approved by the committee and meet the plan at least 80% of the time in each unit. Hospitals will submit quarterly compliance reports to the Ohio Department of Health, and those reports will be publicly available online. The bill also creates balanced initiatives to encourage compliance. Hospitals that consistently meet their staffing plans may receive compensation premium discounts, while other hospitals that repeatedly fail to follow the plans may face financial penalties tied to the cost of understaffing. And finally, the bill recognizes the extraordinary situations occur. hospitals may temporarily adjust staffing plans during patient surges or public health emergencies but those changes must still be approved by the staffing committee Safe staffing is not only a patient safety issue it a workforce issue When staffing is unsafe, nurses burn out, turnover increases, and hospitals rely more heavily on costly temporary staff. By strengthening staffing structures and ensuring nurses have a voice in staffing decisions, House Bill 535 helps retain experienced nurses, stabilize hospital workforces, and improve patient outcomes. And for families like mine, where we've seen firsthand the pressure that nurses face, it's about making sure the people who care for our communities have the support they need to do their jobs safely. Thank you for the opportunity to testify, and I'm happy to answer any questions.

Thank you, Chair. Thank you for this bill. It makes a ton of sense, and I think one of the concerns that I've heard in the workplace is that these staffing committees exist, but there aren't really any teeth to them or any requirement that they have an actual say. So this bill, I think, is a great compromise between actually ratios that are really hard to make, standard for the whole state, and letting organizations and the people doing the work have a voice in what they do. So thank you. I just had one little question, which is I also appreciated the idea of transparency in the compliance reports. I think that that holds people to public eye and making sure that they're reportable and transparent to the public. So the only question I have is on that report. It says that there are approved variances, so hospitals have to report the approved variances. Is that just public health emergencies, or are there other times that the staffing can be disregarded? Thank you.

Through the chair to the representative, and I appreciate your comments. As one of these professionals, you know firsthand everything that I'm testifying about.

Yeah, of course.

Got off easy.

I did. Thanks a lot.

Thank you. I grew up in one of these households that the thermostat was always at 75 degrees, so I feel pretty good. I feel pretty comfortable.

Thank you, Representative Fizzouli. I just think that shows how popular crap is on social media. I want to thank Rep. Pizzulli.

I have a two-part question. I'm aware of other states, such as Tennessee, that require the undisturbed soil. In your bill analysis on the very end, it does say that the Board of Health would not be able to require undisturbed soil. soil and then also on a slope. That is also the same in Tennessee. So I'm wondering if you happen to know if engineering requires that. And then I want to follow up with, have you found that if we do not require an annual inspection of these, how much money we might save for the Ohio Department of Health by not doing these inspections? Because I'm sure we could find another place for that.

Thank you, Madam Chair.

Through the chair to the representative, that is a correct statement.

I do have a comment. I want to applaud you for this. Now, I had a cavitat. I didn't have a septic, but I had yearly inspections. They cost me money. they came back and said that I would have to put a new one in. Thank God the subdivision behind me offered me the opportunity to tie into their sewer, or I would have been out almost $50,000. Does this include cavitets, or is this only for septics? And would you be willing to extend it to cavitets as well? Nobody wants unsafe poop running around. But these departments are making unreasonable demands on homeowners that are not needed. I have a 140-acre farm. We have a leech line. They wanted to inspect that. Good luck.

Representative Bromley.

Through the chair to the representative. So I think it's clear to distinct between what may sound good and what works in practice. And, for example, to address your question on the soil sample, it's a very good idea to get a soil sample, and everyone should get one. The problem I had was, luckily, in-house, there was one soil samplist in my county that was through the health department. Now, in Brown County, they don't have anyone in-house. And so I called through every soil samplist. The nearest one I could get was in Parkersburg, West Virginia, two and a half hours away from my house. And so, of course, my intent of this bill is to work with our health departments. We have IP meetings set up to hear from them, actually just next week, I believe. And so we look forward to hearing from those concerns. And, of course, we want to balance out the safety. We don't want, as you said, anything running downhill. For some owners in southern Ohio, if they choose to not get a soil sample, that would only affect them. or the septic company. That's a lot of liability to take on for them if they don't get a soil sample. But we have to look at everything and see what is working. Where can we help? Does anyone in this room know of a soil scientist? I didn't even know that was a profession. I don't know many young people getting into soil science. And so this idea that we need to do this on every situation I think is something that we have to look at. Thank you so much.

Thank you for that. Through the chair. Yeah, because we are not soil sample specialists, it would be, I think, really interesting to find out what they do think, and getting their participation is probably really instructive for all of us. Thanks.

Representative Craig?

We'd love to have them in the discussion.

Thank you, Chair Schmidt. Thank you, representatives. Sorry, I had to come late from another committee, so I haven't had time to really dig into this. But I did want to tell you that I 100% support this because what my communities have told me is just the ability to get people who can do the permitting process. In some ways, like where my jurisdiction, there's not that many septic tanks as compared to the more suburban urban sewer systems. But we have a shortage in other types of people doing permitting and all of those things. And so I guess what I wondered is, do you think that from a standpoint of the business community who does this work, having to deal with one set of regulations statewide is going to help streamline the process for them, but what impact as far as other types of permitting, do you think this could potentially have like a nice trickle-down effect? Can I answer that?

you know, two counties right beside each other, and this business has a different set of rules depending on which side of the county line he's on. So greater consistency, yeah, a lot less, I think, in government waste.

Baker. Thank you. Thank you, Chair. Thank you for this bill. And I am going to go where I thought Representative Stewart was going to go. If this looked a lot like what we tried to do in the budget and what was taken out, added in, taken out, and added in, and then it eventually made it to the governor's office and he line item vetoed it. Do you have – what is the difference between what he vetoed and what you guys did? Do you have reason to think that he won't veto this after putting in a lot of work? Thanks.

Hearing no more questions, this is the first testimony on House Bill 692. We will now call up House Bill 449 for its first hearing. Our representative, yes, Barhorst and McLean are both here. Thank you, gentlemen.

Chair Schmidt, Vice Chair Dieter, Ranking Member Samani, and members of the Ohio House Health Committee, thank you for the opportunity to provide sponsor testimony for HB 449, which aims to improve access to affordable, high-quality health care for Ohioans. As a business owner and licensed Ohio Life and Health agent, I have a personal understanding of the challenges families and employers face in obtaining quality, affordable care. Many Ohioans are burdened with high premiums, limited options, and difficulty accessing timely health care services. Business owners often pay expensive premiums only to find their health plans insufficient for themselves, their employees, and their families. Ohioans want the General Assembly to reduce regulations that interfere with their ability to access high-quality, affordable care in their communities. Advanced Practice Registered Nurses, a.k.a. APRNs, are highly trained professionals capable of providing both basic and comprehensive care. They represent a ready workforce strategically positioned to improve access to care, reduce costs, and address health care disparities. This is particularly important in rural areas where provider shortages are most severe and the difference between a good health outcome or a bad one can hinge on timely access to skilled care APRNs have the education training and experience to deliver care safely and effectively and HP 449 helps unlock their ability to serve Ohioans where they are needed the most. HP 449 allows an APRN who has completed 2,000 clinical practice hours under a standard care arrangement to practice independently. It also permits less experienced APRNs to enter standard care arrangements with those who have met the practice requirement. This legislation does not expand the services APNs are authorized to provide. It simply removes unnecessary regulatory barriers that limit access to care. Over half the U.S. states, including many that border Ohio, have enacted similar laws and experienced positive outcomes. improved access to care, lower costs, reduced travel and wait times, and better management of chronic conditions. Malpractice claims have not increased, and insurance rates remain stable. Ohio's own temporary suspension of standard of care requirements during the COVID showed no harm to patients and improved access to residents and districts like mine. However bad that period of Ohio history was, some good came out because we got to see how the health care system could adjust and those that had expanded services could work within that in a positive manner. Currently, physicians often charge APRNs or health care facilities hundreds of dollars each month for standard care arrangements, sometimes without providing meaningful services to support them. While some physicians benefit financially from this current law, our duty as legislators is to prioritize the health and well-being of all Ohioans over the financial interests of a few. The legislation ensures that Ohioans have more affordable and timely access to care they need. HB 449 is jointly sponsored by Representative McLean and myself, as companion legislation is also in the Senate, along with another bill in the House. Passing this bill will expand access to quality care, particularly in underserved areas, improve health outcomes, and reduce the financial burden on families and businesses. I respectfully ask for your support to allow Representative McLean to now speak to this bill. We are both happy to answer questions after he's finished. Thank you.

Thank you, Chairwoman Schmidt, Vice Chair Dieter, Ranking Member Samani. I appreciate the opportunity to be with you here today to discuss House Bill 449, which we've deemed the Better Access to Health Care Act. This bill modernizes Ohio's nursing practice laws by removing the outdated standard care arrangement, commonly known as the SCA, which I'll remind you is a state-mandated requirement that advanced practice registered nurses maintain a signed contract with a physician or a podiatrist in order to practice. The SEA was well-intentioned when it was created, but today it functions as a little more than an expensive and burdensome administrative formality. The challenge of finding a collaborating physician has become increasingly challenging for APRNs, especially those practicing in my area of the state, rural Ohio, primary care, mental health, and addiction treatment are among the hardest-hit specialties, where physician shortages are already severe and willing collaborators are increasingly scarce. In response a cottage industry of online platforms and brokerages has emerged specifically to connect Ohio APRNs with physicians both in and out of the state who are willing to sign an SCA for a monthly fee The result is a system that has drifted far away from the original intention of patient safety. An APRN may be the sole provider serving a rural community, treating patients every day with their skill and competence, while their required collaborating physician may sit on the other side of Ohio, or another state entirely, having never stepped foot in the practice, never reviewed a patient chart, and never lays hands on a single patient in the facility. That physician's only contribution is a signature on a form. This is not collaboration. It's not oversight. It's turned into a transaction. And Ohio law currently requires APRNs to participate in it or stop practicing altogether. This bill would put a stop to that. Critics of this legislation will argue that removing the SCA puts patients at risk. That claim doesn't hold up to scrutiny. Collaboration is not a form that gets signed once a month or a fee that's transacted. It's relational, and it's deeply ingrained in professional value that APRNs carry into every patient encounter. APRNs will continue to consult with physicians, specialists, and other members of the care team exactly as they do today because that's what good clinical practice looks like. And because of their training, ethics, and their licensure demands it. Every APRN that I've talked to about this bill has a strong desire for collaboration and someone to go to when they have concerns. The real-world impact of removing the SCA is not theoretical. It's well-documented across the states that have already taken the step. There's close to 30 states that have gone down this path. There is data on those. The access to care has measurably improved, particularly in rural and underserved communities that struggle to attract and retain providers. New clinics have opened in areas that have previously had none. Wait times for primary care, mental health, chronic disease management have dropped. The data is clear. Removing barriers to APR in practice increases access to care without compromising quality or safety. Rural communities in Ohio are watching neighboring states reap those benefits right now. This bill gives Ohio the opportunity to join them and close that gap. The primary care facility in my hometown that my grandmother worked at as a nurse for nearly 50 years is no longer there, and so many of us have those stories. House Bill 449 is a pro-patient, pro-access, and pro-business. It removes ineffective regulatory burdens, reduces costs for patients, expands access to care, and keeps Ohio competitive in attracting health care talent and investment, all while maintaining the safety standards and professional accountability Ohioans deserve. Thank you for the opportunity to present this testimony to you today, and we do stand ready for questions.

Thank you, Chairwoman Schmidt. Thank you, representatives, for bringing this bill forward. Our neighbor to the south, Kentucky, has full practice, and so a lot of us that can practice can practice without a collaborative agreement or an SCA in Kentucky from Ohio. In southwest Ohio, I have a group of federally qualified clinics. For those listening, those are clinics paid for by the federal government, supported by the state. My clinic system pays $100,000 a year for collaborative agreements on the federal government dime, so that's the taxpayer. Have you done an analysis to see how much could be saved with collaborative agreements in Ohio, even with hospital systems and federally qualified clinics,

Yes, thank you, Chairwoman Schmidt. And on that note, how many do I happen to know, I had an APRN call me this week, who had to choose between $1,000 a month in collaborative fees or pay her car payment. So after five years of paying $1,000 a month and over $60,000, she had to close up shop. have you done any analysis on how many practices or what access to care would look like should we open up policy like this? Thank you.

Okay.

I think that's the biggest difference. There may be a few nuances, but I would say that our requirement is probably the biggest difference we've got to figure out.

Thank you, Chair. Thank you, Representatives. I had just a couple questions. So I'm trying to get an understanding of the collaborating physician agreement, right, and the different costs associated with it. One thing that concerns me is the consistency of what certified nurse practitioners, or advanced practitioners are getting for that. And is there any consistency as in the as is right now Before we do away with it is there any consistency in what they getting for that Is that all about insurance Just the requirements for them to be more present And then I'm also wondering about the abnormal conditions that you are crossing out that nurse midwives would be able to take care of. I think it's very inconsistent across the board. I don't think the fee, it's more of a negotiation. And we probably lowballed it in my testimony when we said hundreds of dollars. It gets into the hundreds and over a thousand dollars a month, as Rep Gross alluded to in her question. So I don't think there's any consistency. And you want to answer

Thank you, Chair, and thank you, Representative. I think what I was getting at is that some of these will continue to happen even if your bill is passed, right? So my point is, should we be looking at consistency and what is expected for the physicians who get in these arrangements? Should there be some general standards and guidelines? Because it sounds like you were saying, you know, there's shortages of physicians, there's shortages of being able to find these. But what's expected of a collaborating physician? Should there be some baseline standards in the event? I was just throwing that out there for something to consider and discuss further. Thank you.

Thank you, Chair, and thank you, gentlemen. I have a question, and it kind of piggybacks on Rep. Gross's story that she shared. She knew someone that had left the practice because of the fee, the collaboration fee. And so I just wanted to know if you had any insight. I mean, because the hope is to increase services for individuals, especially in the rural community, but is that collaboration fee, is that to help offset, is there an increased fee in the physician's insurance because of the liability because they're supervising someone? If that collaboration fee is eliminated and the APRN practices on their own, does their insurance change? Is it just a wash? Do you have any insider information on the impact on insurance? Is it because of liability so they charge the fee? If we do away with that, how will that impact the APR in malpractice insurance? I'm just curious if you have any thoughts on that. Thank you.

Representative Simani?

Thank you, Ranking Member Somani, Rep. Schmidt. I've not seen any data that indicates an increased cost or, you know, excess requirements that, misdiagnosis, things like that. I'd be certainly willing to entertain anything that you may find or see, but I've not seen any of that. And like we said, within your system, it sounds like it essentially is working the way we want it to. You have APRNs who have an established structure where they can operate within what they're capable of doing. That's great, and I think we should encourage that, but that situation does not exist everywhere across the state of Ohio, And so certainly this bill is tailored to make sure that we allow and focus care everywhere throughout the state of Ohio.

I do have a few questions. The first is, and I know you talked about a shortage because they can't find collaborators, but I believe one collaborator can have five APRNs. We have over 45,000 licensed physicians in the state of Ohio. So that's about 200,000 opportunities for collaboration. I would like to have specific data showing that is not enough. And the second is you're saying that other states that have done this have shown an increase in access to care. I'd like data on that. And then the third thing is I'd like data on I'm concerned about the safety. Having a collaborator watching over I think is important for patients going into an urgent care, and so that's my other concern. But the data I really want is that you're saying you can't find enough collaborators, but it looks like we have a whole lot of opportunities to do that. And number two, data to show that states that have enacted this have shown a direct increase in access to care. Your homework assignment is accepted.

Yeah, we'll provide those through the chair. We'll provide definitely everything we have, and there will be a lot of proponents that want to tell their story as well. So we welcome that opportunity. And I think just because sort of the number capacity is there doesn't mean the actual, you know, opportunity is there with all those physicians for whatever reason, you know, workload or, you know, just desire to do so. There's a lot of factors in there that prevent standard care arrangements from being accepted today and or accepted at essentially a reasonable price for some of these APRNs. APRN. So, yeah, we will definitely provide all the data from, you know, because we said close to 30 states have already done this. Many of the states around us, you know, West Virginia, Kentucky, the other states around us have active legislation like this to go that path. I mean, New York has done the removal of the SCA as well. So there's a lot of states that have done this. Ohio, you know, we know we don't like to be the first to do anything except flying an airplane. But in terms of legislation, we like to see what other states typically have done, and so this is not new. This is something that's established and we can follow. Thank you.

Correct. That is my understanding.

He really was just a member of the Washington Post.

Chair Schmidt, Vice Chair Dieter, Ranking Member Samani, members of the Ohio House Committee, thank you for your opportunity to provide sponsored testimony on House Bill 629, the Pharmacists' Describing Authority Act. House Bill 629 is designed to fill gaps in Ohio's health care system by allowing pharmacists to use their clinical training and accessibility to provide treatment for minor health conditions. More Ohioans than ever are struggling to access primary care, with routine appointments often being weeks away. At the same time, Ohio is experiencing rising healthcare demand due to an aging population, workforce shortages, and widespread chronic conditions. Primary care providers are increasingly overburdened, managing larger patient panels and limited appointment availability, which can result in long delays. Pharmacists are highly educated and an accessible health care resource, providing immunizations, medication therapy, management, and patient counseling in nearly every Ohio community. Allowing pharmacists to test and treat minor conditions builds on their existing training, while easing pressure on primary care providers in emergency and urgent care departments. This legislation addresses a clear gap in care. Many Ohioans currently experience delays for minor illnesses, often traveling long distances or relying on emergency rooms or conditions that could be treated more efficiently in local pharmacies. House Bill 629 empowers pharmacists to provide these services under standardized protocols, ensuring patient safety while making better use of existing and accessible workforce. By expanding pharmacists' ability to test, prescribe, and treat minor conditions, we can improve timely access, reduce strain on primary care, and increase overall system efficiency. This is especially important in rural Ohio, where hospitals often struggle to meet patient access metrics. Passing this legislation will also help Ohio meet key requirements in the new rural hospital transformation funds, demonstrating innovative strategies to improve access, reduce unnecessary ER visits, and strengthen local health care capacity. Insurance reimbursement provisions further ensure these services remain affordable and widely available. This legislation strengthens collaboration across health care providers and ensures patients receive safe, timely care in their communities. Pharmacists will operate under rules established by the State Board of Pharmacy, follow approved training and protocols, and refer patients to primary care providers whenever follow-up or more advanced care is needed or required. House Bill 629 is a practical, evidence-based solution to improve access, utilize the skills of trained pharmacists, reduce unnecessary strain on the health care system, and support Ohio's compliance with the new Rural Hospital Transformation Funds. I respectfully ask for your support and will allow Representative Gross to now speak on the bill We are both happy to answer questions after her testimony Thank you Good afternoon Chairwoman Schmidt Vice Chair Dieter Ranking Member Samani

Thank you for your testimony. Are there any questions? Yeah, Representative King.

It's exactly what you said. So if they have access, and it's not required. So say a chain like CVS Walgreens whomever Walmart whoever has a pharmacy doesn have to implement this But if the patient needed for instance maybe they had HIV exposure and they wanted preventive care they would walk up and say I believe I had exposure to HIV I like to start PrEP and the pharmacist would then be able to just prescribe it. They would have a limited list. So UTIs, upper respiratory infections, strep, PrEP. There's a very limited list in the bill that describes each one, approximately eight or nine. conditions. But those are the things most formally seen, like you heard with Representative Barhorst's son and the need to just walk in. So you just walk in like a same-day visit, like you would urgent care or anything else. And the pharmacy or the chain would develop their policy as to who's seen first and all of those. Does that answer your question,

Thank you.

pharmacists? Through the chair to Representative King. That's a great question. It would be the business model according to the business. So as we have in private industry, the contract with the pharmacist or the chain that they work for or their own business, if they decide that it's a good business model for them, then they would choose to use some of their time for that. If it's not a business model that would fit within what they are able to handle, this bill does not require. It just makes it optional. It's not a shall, but a may. Thank you.

Thank you. So I guess I'm a little confused through the chair. I went to medical school. I learned not only about drugs, you know, how to, how to, interactions, how to prescribe them, what diseases to prescribe them for all of those things. But pharmacy, and obviously learned, you know, the illnesses, you're creating a limited list of illnesses, but pharmacy school does not include treatment or diagnosis. It includes only the parts of learning the chemical process or how drugs are made and how to dispense them, you know, that part of it. So this isn part of their current learning experience So how are we going to make sure that patients are safe Yes this may improve access to care but I don't understand how you're going to say that this is the best model. And pharmacies are not open any bigger, wider hours than physicians are. So it's not improving access to care after working hours. So I'm still not convinced that this is a good bill in the sense of increasing access to care for patients or helping reduce costs. Chair Schmidt, thank you, Representative Samani.

If I could add to that before you follow up through the chair. The key language in here is test and treat. So we have this new, ever-developing innovation and technology in health care. So the pharmacist is going to have a machine and the technology to do the test, and then there's a protocol for what they treat with that, and that is a limited list. So everybody's education is super, super important. we're all going to be benefited by the technology that allows us to use that education at the top of its scope, per se. Follow through the chair.

Basically, through the chair, the Senate version is broader, and ours has more, I won't say, details. I have more specifics into it, and I anticipate we're probably going to have a long conversation of what them two bills look like and how that potentially can marry up. But when we saw the pace of the rural hospital transformation process ramping up, me and Rep. Gross thought there was opportunities to define and provide details and specifics within that. If you don't mind my adding, Chair, as well, Dr. Simone, we added PrEP in there because it felt like it was very important to be part of this. Thank you. Representative Baker?

Through the chair to Representative Baker, I don't believe so.

Though pharmacists approved emergency use authorization medications such as remdesivir in hospitals just, you know, as the main treatment through Ohio and treating COVID.

I do have a couple of questions. First off, I understand that the governor and the director of health put in the application, but they did so without legislative approval or input. So there's other things in there that are going to also need legislative approval. But having said that, I'm kind of data-driven. I'd like to see the data that shows that this really does increase access because I know that in our deserts, which are normally in rural communities, those deserts don't always have a lot of pharmacies. And the pharmacies that they have are not the Walgreens or the Kmarts They the mom and pop pharmacy which has one pharmacist that is working with maybe one tech if they have a tech at all And what I hearing from my own pharmacy which is Walgreens when I walked in to pick up my prescription, they knew about this bill and said, we don't want to do this. We don't have the time. But I also know when you go into places like Adams County, into Peebles in Manchester, those places in Adams County, where they don't have big box pharmacies, they just have the little mom and pop. How is that going to increase? I know it's permissive. How is that going to increase access when you don't have enough pharmacists as it is? You're putting more burdens on them, and now you're saying it's going to increase access.

Thank you, Chair Schmidt.

I believe that's an assumption and not exactly. I'll disagree with you on that point. But my concern is safety to the public. And you're saying it's access. I want to see the data on it. I also want to see the safety. When you give a drug to somebody, if it's the wrong diagnosis, there could be an adverse reaction to the person and the drug that is given. Maybe there's an underlying condition that the pharmacist wouldn't know about, that their primary care physician would know about. I mean, I understand we need to have access, But the argument for access I don't think is there. But what I want to see, is there a proof of it? And number two, the safety of the individual.

Back to your first request for data, homework assignment accepted again. I would argue that the pharmacist has more medical information on these patients than if they see multiple doctors. I mean, if they're getting their prescriptions through one pharmacy, they have all the pharmaceuticals that are being dispensed behind the counter So it could actually be safer if we had them more involved Just throwing it out there. I also share your concern on how the application and the transformational funds were done. It was probably a short timeline. Rep. Ty Moore and I have a co-sponsor request out right now that will help provide oversight for the legislature and general assembly, the Ohio House and the Senate on those funds going forward. Apparently there's an agreement between us of what could happen with those funds. I agree with Rep. Gross that we have to do a test and treat model somewhere in this application. We could be called back, or we could just not be appropriated the same amount of money or lose it all going forward. So either way, it's going to be less money for our rural health initiatives in Ohio, and I think this bill should be considered semi-urgent so we can preserve that and build upon those funds that were awarded to us.

Thank you, Chair. It would be really quick. Thank you guys for your testimony. Tony, does your bill include any increased educational requirements for pharmacists?

So will they do that or not?

Okay, thank you.

If there are no more questions, this concludes the first hearing on House Bill 629. With no further business, this committee is adjourned. Thank you.