App-booked health care shifts get a contractor test in Ohio

In Ohio, a proposal would give health care workers booked through apps and other digital platforms a clearer rulebook on when they are treated as independent contractors instead of employees for certain state laws. That question matters because the label can shape how the work is governed, who carries legal responsibility and how much control a platform can have over the job.

The measure is aimed at a part of the care economy that has grown more complicated. Health care workers may now pick up shifts through an electronic platform, system or application, then go to a health care facility to perform related services. The bill tries to say when that arrangement should be treated as contractor work, not regular employment, if the relationship meets the standards set out in the proposal.

The core idea is not subtle. If the platform is really matching workers with shifts while the worker stays in charge of how the job is done, the state would treat that as a contractor relationship for the laws named in the bill. If the platform starts looking and acting like an employer, the line gets less clear. The proposal is meant to draw that line in plain statutory terms.

A federal standard for a state problem

Rather than invent a brand-new Ohio definition from scratch, the proposal points to the federal Fair Labor Standards Act, or FLSA. That law is the longtime federal wage standard that has shaped the way employers, workers and courts talk about employment. Under the proposal, terms such as employer, employee, employ, person and independent contractor would carry the same meanings they have under the FLSA.

The bill also says state decision-makers should give due consideration and great weight to interpretations from the U.S. Department of Labor and federal courts. In practice, that means people applying the law would be steered toward federal guidance when there is a dispute over what a term means. It is a way of borrowing a familiar legal framework instead of building a separate one only for this corner of the health care market.

That choice matters because worker classification fights often turn on small details. One agency may see a worker as independent. Another may see the same work as employment. By leaning on federal definitions, the proposal tries to reduce that uncertainty for platforms, facilities and workers who need to know which rules apply before a shift is booked.

It also means the bill is not just about one job title. It is about the legal vocabulary that sits underneath the arrangement. Once the state fixes the meaning of the words, it becomes easier to decide who fits inside the contractor category and who does not.

Who the bill covers

The proposal uses broad definitions. A health care worker would be any health care professional or worker who provides health care or directly related services to patients through a health care worker platform. The definition also reaches people who are providing services to patients that do not require a license.

That is an important detail. The measure is not limited to doctors, nurses or other obviously licensed professionals. It is written to cover a wider range of patient-facing and patient-adjacent work that may now be arranged through digital platforms. That could include workers whose jobs sit closer to the edges of the system, as long as they are providing health care or directly related services through the platform.

A health care worker platform is defined just as broadly. It would be any person operating or offering an electronic platform, system or application through which health care workers can accept one or more shifts to perform health care related services at a health care facility. A health care facility, in turn, means any facility used to provide health care or related services.

Those definitions help show how the bill is built. It is not trying to regulate every health care setting in the state. It is focused on a specific kind of relationship, where a platform stands between the worker and the facility. The worker finds shifts through the platform, then shows up to perform the work at the facility. That is the relationship the legislation wants to classify more carefully.

What has to be true for contractor status

The bill says a health care worker is not the employee of a health care worker platform or a health care facility for work booked through a platform if the listed conditions are met. The first one is a written or electronic agreement saying the worker is an independent contractor for all work booked through the platform. That agreement has to be in place, but it is only one part of the test.

The second condition is control. The platform cannot prescribe or control the means and methods for the services performed by the worker at the facility. That is a familiar line in worker-classification law. A true contractor can be hired for a result without the company telling the worker exactly how to get there. If the platform is steering the day-to-day method of the work, the relationship starts to look more like employment.

The proposal also says the worker must be able to accept or reject shifts without being penalized by the platform. It does not require the worker to be available for specific hours or on specific days. It also says the contract or other agreement between the worker and the platform may be terminated by either side, with or without cause. Those features all point in the same direction. The worker is supposed to have room to choose when and whether to take work.

Tax responsibility also falls on the worker under the bill. The health care worker would be responsible for paying all federal, state and local taxes on earnings from services performed for health care facilities booked through the platform. That is another sign that the proposal is building a contractor model, not a standard payroll job. In a contractor setup, the worker handles the tax obligation that would otherwise often be managed through an employer paycheck system.

No noncompetes, no hidden lock-in

The proposal does more than tell the platform how little control it can have. It also says the platform cannot require the worker to enter into a noncompete agreement. That matters because noncompetes can limit where workers go next and how freely they can take other work. By banning that requirement here, the bill is trying to preserve flexibility in a market that depends on workers moving between shifts and facilities.

The measure also says the platform cannot require the worker or the health care facility to pay any fee or compensation to the platform if the worker accepts an offer of employment from a facility. That is a practical safeguard. It keeps the platform from collecting a penalty or toll when a worker makes a direct move into a job with the facility.

The worker would also remain free to accept shifts through another platform or from a health care facility that does not offer shifts on the platform. There is one narrow exception in the text. A platform may remove a worker who accepts simultaneous shifts on two different health care worker platforms. That provision suggests lawmakers are trying to allow broad flexibility without opening the door to double-booking at the same time.

The bill also allows a platform to advertise to the public that it is seeking health care workers to use the platform. That sounds simple, but it shows the measure does not treat all platform activity as suspect. The bill appears to allow recruiting and matching. What it limits is control, lock-in and rules that start to look like old-fashioned employment in disguise.

Insurance and the edges of the relationship

Insurance is another part of the checklist. The platform would have to maintain, or verify that the worker maintains, occupational accident insurance that applies to the work booked through the platform. It would also have to maintain, or verify that the worker maintains, general liability insurance or professional liability insurance for that work. Those requirements suggest lawmakers are aware that even contractor work in health care can carry serious risk.

This is where the bill starts to look less like a simple classification rule and more like a full operating framework. A platform that wants contractor treatment would not just need the right agreement. It would also need to show that the worker is covered in the event of an accident or a liability claim. In other words, the proposal does not strip away protection and stop there. It pairs the looser employment label with insurance expectations.

The bill also contains an exception for some workers who already have an employment relationship with the health care facility or its parent company. In that setting, the contractor rules would not apply to a worker who books a shift through the platform during a period of employer-approved leave, including medical, parental, family or military leave, whether paid or unpaid.

That exception is important because it shows the proposal is not written only for people who move in and out of health care work on an app. It also reaches workers who are already part of a traditional workplace and may use a platform to pick up shifts while they are on leave. The bill is trying to sort out those overlapping roles without turning every platform shift into a separate employment relationship.

What the classification means for workers and platforms

The bigger point of the proposal is clarity. Ohio Sen. Susan Manchester, a Republican from District 12, is the sponsor behind the measure. But the policy itself is what will matter most to workers, facilities and platform operators. It would give all of them a more detailed checklist for deciding when a platform-booked health care shift counts as contractor work under the laws named in the bill.

For workers, that could mean more freedom to choose shifts, work across platforms and avoid a noncompete. It could also mean carrying their own tax obligations and operating under a relationship that is intentionally less like a traditional job. For platforms, it would mean that contractor status would not come from a label alone. They would have to meet the test in the text, including the written agreement, the lack of control over the work, the insurance requirements and the other limits on employer-style behavior.

For health care facilities, the proposal could offer a cleaner way to use platform-based staffing without automatically turning every booked shift into an employment relationship. But it also puts boundaries on that setup. If the platform starts controlling how the work is done, forcing scheduling requirements or using contract terms that lock the worker in, the relationship may no longer fit the bill’s contractor model.

The measure is best understood as an effort to catch the law up with a newer way of staffing care. Health care workers are still doing the same kinds of jobs at facilities. What has changed is how those shifts are arranged. Instead of a recruiter, a phone tree or a payroll office doing the matching, a platform can now handle it digitally. The bill asks Ohio to treat that arrangement as something distinct, with its own rules and limits, rather than squeezing it into older employment categories that may not fit as neatly.