Oregon Bulletin
March 1, 2011
Rule Caption: Adds Advanced EMT (AEMT) to the scope and adds language
to clarify associated duties.
Adm.
Order No.: OMB 1-2011
Filed with Sec. of
State: 2-11-2011
Certified to be
Effective: 2-11-11
Notice Publication
Date: 11-1-2010
Rules Amended: 847-035-0001, 847-035-0030
Subject: Adopted rule add definition and scope of practice for
Advanced Emergency Medical Technician (AEMT) and add language on monitoring
patients who have isotonic intravenous fluids flowing in the event of Declared
Mass Casualty (MCI) to the EMT-Basic scope of practice.
Rules Coordinator: Malar Ratnathicam—(971) 673-2713
847-035-0001
Definitions
(1) “Agent” means a medical or osteopathic physician
licensed under ORS Chapter 677, actively registered and in good standing with
the Board, a resident of or actively practicing in the area in which the
emergency service is located, designated by the supervising physician to
provide direction of the medical services of EMTs and First Responders as
specified in these rules.
(2) “Board” means the Oregon Medical Board for the
State of Oregon.
(3) “Committee” means the EMT Advisory Committee to the
Oregon Medical Board.
(4) “Emergency Care” as defined in ORS 682.025(5) means
the performance of acts or procedures under emergency conditions in the
observation, care and counsel of the ill, injured or disabled; in the
administration of care or medications as prescribed by a licensed physician,
insofar as any of these acts is based upon knowledge and application of the
principles of biological, physical and social science as required by a
completed course utilizing an approved curriculum in prehospital emergency
care. However, “emergency care” does not include acts of medical diagnosis or
prescription of therapeutic or corrective measures.
(5) “Section” means the Emergency Medical Services and
Trauma Systems Section of the Public Health Division of the Department of Human
Services.
(6) “First Responder” means a person who has
successfully completed a first responder course approved by the Section and has
been examined and certified as a First Responder by an authorized
representative of the Section to perform basic emergency and nonemergency care
procedures.
(7) “Emergency Medical Technician-Basic (EMT-Basic)”
means a person certified under ORS Chapter 682 and in good standing with the
Section, who has completed an EMT-Basic course as prescribed by OAR 333,
Division 265, and is certified by the Section.
(8) “Advanced Emergency Medical Technician (Advanced
EMT)” means a person certified under ORS Chapter 682 by the Division as an
Advanced Emergency Medical Technician (AEMT).
(9) “Emergency Medical Technician-Intermediate
(EMT-Intermediate)” means a person certified under ORS Chapter 682 and in good
standing with the Section, who has completed an EMT-Intermediate course as
prescribed by OAR 333, division 265, and is certified by the Section.
(10) “Emergency Medical Technician-Paramedic
(EMT-Paramedic)” means a person certified under ORS Chapter 682 and in good
standing with the Section, who has completed an EMT-Paramedic course as
prescribed by OAR 333, division 265, and is certified by the Section.
(11) “In Good Standing” means a person who is currently
certified or licensed, who does not have any restrictions placed on his/her
certificate or license, or who is not on probation with the certifying or
licensing agency for any reason.
(12) “Nonemergency care” as defined in ORS 682.025 (11)
means the performance of acts or procedures on a patient who is not expected to
die, become permanently disabled or suffer permanent harm within the next 24
hours, including but not limited to observation, care and counsel of a patient
and the administration of medications prescribed by a physician licensed under
ORS 677, insofar as any of these acts are based upon knowledge and application
of the principles of biological, physical and social science and are performed
in accordance with scope of practice rules adopted by the Oregon Medical Board
in the course of providing prehospital care.
(13) “Supervising Physician” means a person licensed
under ORS Chapter 677, actively registered and in good standing with the Board
as a Medical Doctor or Doctor of Osteopathic Medicine, approved by the Board,
and who provides direction of, and is ultimately responsible for emergency and
nonemergency care rendered by EMTs and First Responders as specified in these
rules. The supervising physician is also ultimately responsible for the agent
designated by the supervising physician to provide direction of the medical
services of the EMT and First Responder as specified in these rules.
(14) “Scope of Practice” means the maximum level of
emergency and nonemergency care that an EMT or First Responder may provide as
defined in OAR 847-035-0030.
(15) “Standing Orders” means the written detailed
procedures for medical or trauma emergencies and nonemergency care to be
performed by an EMT or First Responder issued by the supervising physician
commensurate with the scope of practice and level of certification of the EMT
or First Responder.
Stat. Auth.: ORS 682.245
Stats. Implemented: ORS
682.015(11)
Hist.: ME 2-1983, f. & ef.
7-21-83; ME 7-1985, f. & ef. 8-5-85; ME 11-1986, f. & ef. 7-31-86; ME
15-1988, f. & cert. ef. 10-20-88; ME 6-1991, f. & cert. ef. 7-24-91; ME
1-1996, f. & cert. ef. 2-15-96; ME 3-1996, f. & cert. efg. 7-25-96; BME
6-1998, f. & cert. ef. 4-27-98; BME 13-1999, f. & cert. ef. 7-23-99;
BME 10-2002, f. & cert. ef. 7-22-02; BME 18-2010, f. & cert. ef.
10-25-10; OMB 1-2011, f. & cert. ef. 2-11-11
847-035-0030
Scope of Practice
(1) The Oregon Medical Board has established a scope of
practice for emergency and nonemergency care for First Responders and EMTs.
First Responders and EMTs may provide emergency and nonemergency care in the
course of providing prehospital care as an incident of the operation of ambulance
and as incidents of other public or private safety duties, but is not limited
to “emergency care” as defined in OAR 847-035-0001(5).
(2) The scope of practice for First Responders and EMTs
is not intended as statewide standing orders or protocols. The scope of
practice is the maximum functions which may be assigned to a First Responder or
EMT by a Board-approved supervising physician.
(3) Supervising physicians may not assign functions
exceeding the scope of practice; however, they may limit the functions within
the scope at their discretion.
(4) Standing orders for an individual EMT may be
requested by the Board or Section and shall be furnished upon request.
(5) No EMT may function without assigned standing
orders issued by Board-approved supervising physician.
(6) An Oregon-certified First Responder or EMT, acting
through standing orders, shall respect the patient’s wishes including
life-sustaining treatments. Physician supervised First Responders and EMTs
shall request and honor life-sustaining treatment orders executed by a
physician, nurse practitioner or physician assistant if available. A patient
with life-sustaining treatment orders always requires respect, comfort and
hygienic care.
(7) A First Responder may perform the following
procedures without having signed standing orders from a supervising physician:
(a) Conduct primary and secondary patient examinations;
(b) Take and record vital signs;
(c) Utilize noninvasive diagnostic devices in
accordance with manufacturer’s recommendation;
(d) Open and maintain an airway by positioning the
patient’s head;
(e) Provide external cardiopulmonary resuscitation and
obstructed airway care for infants, children, and adults;
(f) Provide care for soft tissue injuries;
(g) Provide care for suspected fractures;
(h) Assist with prehospital childbirth; and
(i) Complete a clear and accurate prehospital emergency
care report form on all patient contacts and provide a copy of that report to
the senior EMT with the transporting ambulance.
(8) A First Responder may perform the following
additional procedures only when the First Responder is part of an agency which
has a Board-approved supervising physician who has issued written standing
orders to that First Responder authorizing the following:
(a) Administration of medical oxygen;
(b) Maintain an open airway through the use of:
(A) A nasopharyngeal airway device;
(B) A noncuffed oropharyngeal airway device;
(C) A Pharyngeal suctioning device.
(c) Operate a bag mask ventilation device with
reservoir;
(d) Provision of care for suspected medical
emergencies, including administering liquid oral glucose for hypoglycemia; and
(e) Administer epinephrine by automatic injection
device for anaphylaxis;
(f) Perform cardiac defibrillation with an automatic or
semi-automatic defibrillator, only when the First Responder:
(A) Has successfully completed a Section- approved
course of instruction in the use of the automatic or semi-automatic
defibrillator; and
(B) Complies with the periodic requalification
requirements for automatic or semi-automatic defibrillator as established by
the Section.
(9) An Oregon-certified EMT-Basic may perform the
following procedures:
(a) Perform all procedures that an Oregon-certified
First Responder can perform;
(b) Ventilate with a non-invasive positive pressure
delivery device;
(c) Insert a cuffed pharyngeal airway device in the
practice of airway maintenance. A cuffed pharyngeal airway device is:
(A) A single lumen airway device designed for blind
insertion into the esophagus providing airway protection where the cuffed tube
prevents gastric contents from entering the pharyngeal space; or
(B) A multi-lumen airway device designed to function
either as the single lumen device when placed in the esophagus, or by insertion
into the trachea where the distal cuff creates an endotracheal seal around the
ventilatory tube preventing aspiration of gastric contents.
(d) Perform tracheobronchial tube suctioning on the
endotracheal intubated patient;
(e) Provide external cardiopulmonary resuscitation and
obstructed airway care for infants, children, and adults;
(f) Provide care for suspected shock, including the use
of the pneumatic anti-shock garment;
(g) Provide care for suspected medical emergencies,
including:
(A) Obtaining a capillary blood specimen for blood
glucose monitoring;
(B) Administer epinephrine by subcutaneous injection or
automatic injection device for anaphylaxis;
(C) Administer activated charcoal for poisonings; and
(D) Administer aspirin for suspected myocardial
infarction.
(h) Perform cardiac defibrillation with an automatic or
semi-automatic defibrillator;
(i) Transport stable patients with saline locks,
heparin locks, foley catheters, or in-dwelling vascular devices;
(j) Perform other emergency tasks as requested if under
the direct visual supervision of a physician and then only under the order of
that physician;
(k) Complete a clear and accurate prehospital emergency
care report form on all patient contacts;
(l) Assist a patient with administration of sublingual
nitroglycerine tablets or spray and with metered dose inhalers that have been
previously prescribed by that patient’s personal physician and that are in the
possession of the patient at the time the EMT-Basic is summoned to assist that
patient;
(m) In the event of a release of military chemical
warfare agents from the Umatilla Army Depot, the EMT-Basic who is a member or
employee of an EMS agency serving the DOD-designated Immediate Response Zone
who has completed a Section-approved training program may administer atropine
sulfate and pralidoxime chloride from a Section-approved pre-loaded
auto-injector device, and perform endotracheal intubation, using protocols
promulgated by the Section and adopted by the supervising physician. 100% of
EMT-Basic actions taken pursuant to this section shall be reported to the
Section via a copy of the prehospital emergency care report and shall be
reviewed for appropriateness by Section staff and the Subcommittee on EMT
Certification, Education and Discipline;
(n) In the event of a release of organophosphate agents
the EMT-Basic, who has completed Section-approved training, may administer
atropine sulfate and pralidoxime chloride by autoinjector, using protocols
approved by the Section and adopted by the supervising physician; and
(o) In the event of a declared Mass Casualty Incident
(MCI) as defined in the local Mass Casualty Incident plan, the EMT-Basic may
monitor patients who have isotonic intravenous fluids flowing.
(10) An Oregon certified Advanced Emergency Medical
Technician (AEMT) may perform the following procedures:
(a) Perform all procedures that an Oregon-certified
EMT-Basic can perform;
(b) Initiate and maintain peripheral intravenous (I.V.)
lines;
(c) Initiate saline or similar locks;
(d) Draw peripheral blood specimens;
(e) Initiate and maintain an intraosseous in the
pediatric patient;
(f) Tracheobronchial suctioning of an already intubated
patient;
(g) Adminster the following medications under specific
written protocols authorized by the supervising physician or direct orders from
a licensed physician:
(A) Physiologic isotonic crystalloid solution.
(B) Anaphylaxis; epinephrine
(C) Antidotes: Naloxene hydrochloride;
(D) Anthihypoglycemics:
(i) Hypertonic glucose,
(ii) Glucagon
(E) Vasodilators: Nitroglycerine;
(F) Nebulized bronchodilators:
(i) Albuterol;
(ii) Ipratropium bromide;
(G) Analgesics for acute pain: nitrous oxide.
(11) An Oregon certified EMT-Intermediate may perform
the following procedures:
(a) Perform all procedures that an Oregon-certified
Advanced EMTcan perform;
(b) Initiate and maintain an intraosseous infusion;
(c) Administer the following medications under specific
written protocols authorized by the supervising physician, or direct orders
from a licensed physician:
(A) Vasoconstrictors:
(i) Epinephrine;
(ii) Vasopressin;
(B) Antiarrhythmics:
(i) Atropine sulfate;
(ii) Lidocaine;
(iii) Amiodarone;
(C) Analgesics for acute pain:
(i) Morphine;
(ii) Nalbuphine Hydrochloride;
(iii) Ketorolac tromethamine;
(iv) Fentanyl;
(D) Antihistamine: Diphenhydramine;
(E) Diuretic: Furosemide;
(F) Intraosseous infusion anesthetic; Lidocaine;
(G) Anti-Emetic: Ondansetron;
(d) Administer immunizations in the event of an
outbreak or epidemic as declared by the Governor of the state of Oregon, the
State Public Health Officer or a county health officer, as part of an emergency
immunization program, under the agency’s supervising physician’s standing
order;
(e) Administer immunizations for seasonal and pandemic
influenza vaccinations according to the CDC Advisory Committee on Immunization
Practices (ACIP), and/or the Oregon State Public Health Officer’s recommended
immunization guidelines as directed by the agency’s supervising physician’s
standing order.
(f) Distribute medications at the direction of the
Oregon State Public Health Officer as a component of a mass distribution
effort.
(g) Administer routine or emergency immunizations, as
part of an EMS Agency’s occupational health program, to the EMT’s EMS agency
personnel, under the supervising physician’s standing order.
(h) Insert an orogastric tube;
(i) Maintain during transport any intravenous
medication infusions or other procedures which were initiated in a medical
facility, and if clear and understandable written and verbal instructions for
such maintenance have been provided by the physician, nurse practitioner or
physician assistant at the sending medical facility;
(j) Electrocardiographic rhythm interpretation;
(k) Perform cardiac defibrillation with a manual
defibrillator.
(12) An Oregon-certified EMT-Paramedic may perform the
following procedures:
(a) Perform all procedures that an Oregon-certified
EMT-Intermediate can perform;
(b) Initiate the following airway management
techniques:
(A) Endotracheal intubation;
(B) Cricothyrotomy; and
(C) Transtracheal jet insufflation which may be used when
no other mechanism is available for establishing an airway.
(c) Initiate a nasogastric tube;
(d) Provide advanced life support in the resuscitation
of patients in cardiac arrest;
(e) Perform emergency cardioversion in the compromised
patient;
(f) Attempt external transcutaneous pacing of
bradycardia that is causing hemodynamic compromise;
(g) Electrocardiographic interpretation.
(h) Initiate needle thoracentesis for tension
pneumothorax in a prehospital setting;
(i) Initiate placement of a femoral intravenous line
when a peripheral line cannot be placed;
(j) Initiate placement of a urinary catheter for trauma
patients in a prehospital setting who have received diuretics and where the
transport time is greater than thirty minutes; and
(k) Initiate or administer any medications or blood
products under specific written protocols authorized by the supervising
physician, or direct orders from a licensed physician.
(13) The Board has delegated to the Section the
following responsibilities for ensuring that these rules are adhered to:
(a) Designing the supervising physician and agent
application;
(b) Approving a supervising physician or agent; and
(c) Investigating and disciplining any EMT or First
Responder who violates their scope of practice.
(d) The Section shall provide copies of any supervising
physician or agent applications and any EMT or First Responder disciplinary
action reports to the Board upon their request.
(14) The Section shall immediately notify the Board
when questions arise regarding the qualifications or responsibilities of the
supervising physician or agent of the supervising physician.
Stat. Auth.: ORS 682.245
Stats. Implemented: ORS 682.245
Hist.: ME 2-1983, f. & ef.
7-21-83; ME 3-1984, f. & ef. 1-20-84; ME 12-1984, f. & ef. 8-2-84; ME
7-1985, f. & ef. 8-5-85; ME 12-1987, f. & ef. 4-28-87; ME
27-1987(Temp), f. & ef. 11-5-87; ME 5-1988, f. & cert. ef. 1-29-88; ME
12-1988, f. & cert. ef. 8-5-88; ME 15-1988, f. & cert. ef. 10-20-88; ME
2-1989, f. & cert. ef. 1-25-89; ME 15-1989, f. & cert. ef. 9-5-89,
& corrected 9-22-89; ME 6-1991, f. & cert. ef. 7-24-91; ME 10-1993, f.
& cert. ef. 7-27-93; ME 3-1995, f. & cert. ef. 2-1-95; ME 1-1996, f.
& cert. ef. 2-15-96; ME 3-1996, f. & cert. ef. 7-25-96; BME 6-1998, f.
& cert. ef. 4-27-98; BME 13-1998(Temp), f. & cert. ef. 8-6-98 thru
2-2-99; BME 14-1998, f. & cert. ef. 10-26-98; BME 16-1998, f. & cert.
ef. 11-24-98; BME 13-1999, f. & cert. ef. 7-23-99; BME 14-2000, f. &
cert. ef. 10-30-00; BME 11-2001, f. & cert. ef. 10-30-01; BME 9-2002, f.
& cert. ef. 7-17-02; BME 10-2002, f. & cert. ef. 7-22-02; BME 1-2003,
f. & cert. ef. 1-27-03; BME 12-2003, f. & cert. ef. 7-15-03; BME
4-2004, f. & cert. ef. 1-27-04; BME 11-2004(Temp), f. & cert. ef.
4-22-04 thru 10-15-04; BME 12-2004(Temp), f. & cert. ef. 6-11-04 thru 12-8-04;
BME 21-2004(Temp), f. & cert. ef. 11-15-04 thru 4-15-05; BME 2-2005, f.
& cert. ef. 1-27-05; BME 5-2005, f. & cert. ef. 4-21-05; BME 9-2005, f.
& cert. ef. 7-20-05; BME 18-2006, f. & cert. ef. 7-25-06; BME 22-2006,
f. & cert. ef. 10-23-06; BME 7-2007, f. & cert. ef. 1-24-07; BME
11-2007, f. & cert. ef. 4-26-07; BME 24-2007, f. & cert. ef. 10-24-07;
BME 11-2008, f. & cert. ef. 4-24-08; BME 19-2008, f. & cert. ef.
7-21-08; BME 10-2009, f. & cert. ef. 5-1-09; BME 13-2009, f. & cert.
ef. 7-20-09; BME 18-2009, f. & cert. ef. 10-23-09; BME 22-2009(Temp), f.
& cert. ef. 10-23-09 thru 4-15-10; BME 5-2010, f. & cert. ef. 1-26-10;
BME 8-2010(Temp), f. & cert. ef. 4-26-10 thru 10-15-10; BME 12-2010, f.
& cert. ef. 7-26-10; BME 18-2010, f. & cert. ef. 10-25-10; OMB 1-2011,
f. & cert. ef. 2-11-11
Rule
Caption: Clarifies supervisory relationship
termination and edits unnecessary language.
Adm.
Order No.: OMB 2-2011
Filed with Sec. of
State: 2-11-2011
Certified to be
Effective: 2-11-11
Notice Publication
Date: 11-1-2010
Rules Amended: 847-050-0027
Subject: The adopted rule amendment clarifies supervisory
relationship termination and edits unnecessary language.
Rules Coordinator: Malar Ratnathicam—(971) 673-2713
847-050-0027
Temporary Approval of Registration
and Practice Changes
(1) Under the authority of the Oregon Medical Board,
the Physician Assistant Committee may grant to physician assistants
registration and/or practice description changes, subject to final Board
approval.
(2) Temporary approval of physician assistants
currently licensed in the state who wish to add or change a supervising
physician requires the following before approval may be granted:
(a) Letters of termination of previous supervision have
been submitted to the Board as required in OAR 847-050-0050, if the supervisory
relationship is terminating;
(b) The new supervising physician has submitted a
written request to be appointed as the supervising physician;
(c) The new supervising physician is in good standing
with the Board.
(3) Prescription privileges may be granted under
temporary privileges only if the following conditions are met:
(a) The physician assistant has met the requirements of
OAR 847-050-0020(1); or is an Oregon grandfathered physician assistant who has
passed the Physician Assistant National Certifying Examination (PANCE) or other
specialty examination approved by the Board prior to July 12, 1984; and
(b) The supervising physician requests prescription
privileges for the physician assistant in the practice description.
Stat. Auth.: ORS 677.265
Stats. Implemented: ORS 677.510
Hist.: ME 4-1981(Temp), f. &
ef. 10-20-81; ME 2-1982, f. & ef. 1-28-82; ME 5-1984, f. & ef. 1-20-84;
ME 8-1985, f. & ef. 8-5-85; ME 5-1986, f. & ef. 4-23-86; ME 21-1989, f.
& cert. ef. 10-20-89; ME 2-1990, f. & cert. ef. 1-29-90; ME 5-1994, f.
& cert. ef. 1-24-94; ME 9-1995, f. & cert. ef. 7-28-95; BME 13-2003, f.
& cert. ef. 7-15-03; OMB 2-2011, f. & cert. ef. 2-11-11
Rule
Caption: Replaces language to Health
Professionals’ Services Program (HPSP) per House Bill 2345.
Adm.
Order No.: OMB 3-2011
Filed with Sec. of
State: 2-11-2011
Certified to be
Effective: 2-11-11
Notice Publication
Date: 11-1-2010
Rules Amended: 847-065-0005
Subject: The adopted rule amendment replaces “Health
Professionals Program” with “Health Professionals’ Services Program” (HPSP) per
House Bill 2345 (2009).
Rules Coordinator: Malar Ratnathicam—(971) 673-2713
847-065-0005
Licensees with Mental Illness
Treated in Hospital Exceeding 25 Consecutive Days
A licensee’s participation in the Health Professionals’
Services Program (HPSP), to include inpatient evaluations or treatment in a
treatment facility that exceeds 25 consecutive days, does not require an
automatic suspension of a licensee, if the licensee is in compliance with their
HPSP agreement and does not practice medicine during a period of impairment. If
the HPSP makes a determination that the licensee has a mental illness that
affects the ability of the licensee to safely practice medicine, the HPSP will
ask the licensee to immediately withdraw from practice. If the licensee
declines, the HPSP will immediately report to the Board that the licensee has a
mental illness that affects the ability of the licensee to safely practice, and
with this report provide a copy of the evaluation upon which this determination
is based.
Stat. Auth.: ORS 677.265
Stats. Implemented: ORS 677.225,
677.645
Hist.: BME 20-2009, f. & cert.
ef. 10-23-09; OMB 3-2011, f. & cert. ef. 2-11-11
Rule
Caption: Renumbering to be included in
division 8.
Adm.
Order No.: OMB 4-2011
Filed with Sec. of
State: 2-11-2011
Certified to be
Effective: 2-11-11
Notice Publication
Date:
Rules Renumbered: 847-010-0100 to 847-008-0075
Subject: Renumbering to be included in division 8.
Rules Coordinator: Malar Ratnathicam—(971) 673-2713
847-008-0075
Mandatory Pain Management
Education
(1) All licensees of the Oregon Medical Board, except
the licensees listed in section (2) of this rule, will complete mandatory
continuing medical education (CME) in the subjects of pain management and/or
the treatment of terminally ill and dying patients as follows:
(a) A one-hour pain management course specific to
Oregon provided by the Pain Management Commission of the Department of Human
Services; and
(b) A minimum of 6 (six) continuing medical education
credit hours in the subjects of pain management and/or the treatment of
terminally ill and dying patients. Any combination of CME coursework focusing
on pain management and/or treatment of terminally ill and dying patients may be
used to fulfill this requirement.
(2) Licensees holding the following types of licenses
shall not be required to meet this requirement:
(a) Lapsed license;
(b) Limited License;
(c) Telemedicine license;
(d) Teleradiology license; or
(e) Telemonitoring license.
(3) The required CME must be completed after January 1,
2000 and before January 2, 2009.
(4) Licensees must be prepared to provide documentation
of CME if requested by the Board.
(5) All applicants granted a license after January 2,
2009, excepting those with a type of license listed in Section (2), must obtain
the required CME coursework within no later than 12 months after the date the
Board granted licensure.
(6) Licensees who are approved to reactivate a license
previously in a registration status not requiring completion of the required
CME must obtain the required coursework no later than 12 months after the date
the Board approved reactivation of the license.
Stat. Auth.: ORS 677.265
Stats. Implemented: ORS 677.265
Hist.: BME 7-2005, f. & cert.
ef. 7-20-05; BME 3-2009, f. & cert. ef. 1-22-09; Renumbered from
847-010-0100 by OMB 4-2011, f. & cert. ef. 2-11-11
Notes
1.) This online version of the OREGON BULLETIN is provided for convenience of reference and enhanced access. The official, record copy of this publication is contained in the original Administrative Orders and Rulemaking Notices filed with the Secretary of State, Archives Division. Discrepancies, if any, are satisfied in favor of the original versions. Use the OAR Revision Cumulative Index found in the Oregon Bulletin to access a numerical list of rulemaking actions after November 15, 2010.
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