(D) To the extent permitted by federal law and subject to | 67 |
the provisions of division (C)(2) of this section pertaining to | 68 |
the enforcement of specific instructions or conditions governing
a | 69 |
trustee's discretion, a trust authorized by division (B) of
this | 70 |
section that confers discretion upon the trustee shall not
be | 71 |
considered an asset or resource of the beneficiary,
his
the | 72 |
beneficiary's estate,
the settlor, or the
testator's
settlor's | 73 |
estate and shall be exempt from
the
claims of creditors, political | 74 |
subdivisions, the state, other
governmental entities, and other | 75 |
claimants against the
beneficiary,
his
the beneficiary's estate, | 76 |
the settlor, or the
testator's
settlor's
estate, including
claims | 77 |
based on provisions of Chapters 5111., 5121., or 5123. of
the | 78 |
Revised Code and claims sought to be satisfied by way of a
civil | 79 |
action, subrogation, execution, garnishment, attachment,
judicial | 80 |
sale, or other legal process, if all of the following
apply: | 81 |
Sec. 5111.15. If a recipient of medical assistance is the | 126 |
beneficiary of a trust created pursuant to section 1339.51 of the | 127 |
Revised
Code, then, notwithstanding any contrary provision of this | 128 |
chapter or of a
rule adopted pursuant to this chapter, divisions | 129 |
(C) and (D) of that section
shall apply in
determining the assets | 130 |
or resources of the recipient,
his
the
recipient's estate,
the | 131 |
settlor, or the
testator's
settlor's estate and to claims arising | 132 |
under
this chapter against the recipient,
his
the recipient's | 133 |
estate,
the settlor,
or the
testator's
settlor's estate. | 134 |
Sec. 5121.04. (A) The department of mental health and the | 135 |
department of mental retardation and developmental disabilities | 136 |
shall investigate the financial condition of the patients in | 137 |
hospitals and residents in institutions, residents
whose care or | 138 |
treatment is being paid for in a private facility or home under | 139 |
the control of the department of mental retardation and | 140 |
developmental disabilities, and of the relatives named in section | 141 |
5121.06 of the Revised Code as liable for the support of such | 142 |
patients or residents, in order to determine the ability of any | 143 |
patient, resident, or such relatives to pay for the support of
the | 144 |
patient or resident and to provide suitable clothing as
required | 145 |
by the superintendent of the institution. | 146 |
|
(1) Subject to divisions (B)(10) and
(11) of this section, a | 159 |
patient
or resident without dependents shall be liable for the | 160 |
full applicable
cost. A patient or resident without dependents | 161 |
who has a
gross annual income equal to or exceeding the sum of the | 162 |
full applicable
cost, plus fifty dollars per month, regardless of | 163 |
the source of
such income, shall pay currently the full amount of | 164 |
the applicable cost;
if the patient's or resident's gross annual | 165 |
income is less than such sum,
not more than fifty dollars per | 166 |
month shall be kept for personal
use by or on behalf of the | 167 |
patient or resident, except as
permitted in the state plan for | 168 |
providing medical assistance
under Title XIX of the
"Social | 169 |
Security Act," 49 Stat. 620
(1935), 42 U.S.C. 301, as amended, and | 170 |
the balance shall be paid
currently on the patient's or resident's | 171 |
support. Subject
to divisions (B)(10) and (11) of this
section, | 172 |
the estate of a patient or resident without dependents
shall pay | 173 |
currently any remaining difference between the applicable cost
and | 174 |
the amounts prescribed in this section,
or shall
execute an | 175 |
agreement with the department for payment to be made
at some | 176 |
future date under terms suitable to the department.
However, no | 177 |
security interest, mortgage, or lien shall be taken,
granted, or | 178 |
charged against any principal residence of a patient
or resident | 179 |
without dependents under an agreement or otherwise to
secure | 180 |
support payments, and no foreclosure actions shall be
taken on | 181 |
security interests, mortgages, or liens taken, granted,
or charged | 182 |
against principal residences of patients or residents
prior to | 183 |
October 7, 1977. | 184 |
For the first thirty days of care and treatment of each | 192 |
admission and for the first thirty days of care and treatment from | 193 |
state-operated community mental health services, but in no event | 194 |
for more
than thirty days in any
calendar year, the mentally ill | 195 |
patient or mentally retarded
resident with dependents or the | 196 |
liable relative of a mentally ill
patient or a mentally retarded | 197 |
resident either with or without
dependents shall be charged an | 198 |
amount equal to the percentage of
the average applicable cost | 199 |
determined in accordance
with the
schedule of adjusted gross | 200 |
annual income contained after this
paragraph. After such first | 201 |
thirty days of care and treatment,
such mentally ill patient or | 202 |
mentally retarded resident or such
liable relative shall be | 203 |
charged an amount equal to the
percentage of a base support rate | 204 |
of four dollars per day for
mentally ill patients and mentally | 205 |
retarded residents, as
determined in accordance with the schedule | 206 |
of gross annual income
contained after this paragraph, or in | 207 |
accordance with division
(B)(5) of this section. Beginning | 208 |
January 1, 1978, the
department shall increase the base rate when | 209 |
the consumer price
index average is more than 4.0 for the | 210 |
preceding calendar year by
not more than the average for such | 211 |
calendar year. | 212 |
(5) If with respect to any patient or resident with | 256 |
dependents there is chargeable under division (B)(2) of this | 257 |
section less than fifty per cent of the applicable
cost or, if the | 258 |
base support rate was used, less than fifty per cent of the
amount | 259 |
determined by use of the base support rate, and if with
respect to | 260 |
such patient or resident there is a liable relative
who has an | 261 |
estate having a value in excess of fifteen thousand
dollars or if | 262 |
such patient or resident has a dependent and an
estate having a | 263 |
value in excess of fifteen thousand dollars,
there shall be paid | 264 |
with respect to such patient or resident a
total of fifty per cent | 265 |
of the applicable cost or the
base support rate amount, as the | 266 |
case may be, on a current basis or
there shall be executed with | 267 |
respect to such patient or resident
an agreement with the | 268 |
department for payment to be made at some
future date under terms | 269 |
suitable to the department. | 270 |
(8) If a patient or resident is covered by an insurance | 280 |
policy, or other contract that provides for payment of expenses | 281 |
for care and treatment for mental illness or mental retardation
at | 282 |
or from an institution, facility
(including a hospital or | 283 |
community
service unit under the jurisdiction of the department), | 284 |
or
state-operated community mental health service, the other | 285 |
provisions of this section, except divisions (B)(8),
(10), and | 286 |
(11) of this section, and of section 5121.03
of the Revised Code | 287 |
shall be
suspended to the extent that such insurance policy or | 288 |
other
contract is in force, and such patient or resident shall be | 289 |
charged the full amount of the applicable cost. Any insurance | 290 |
carrier
or other third party payor providing coverage for such | 291 |
care and
treatment shall pay for this support obligation in an | 292 |
amount
equal to the lesser of either the applicable cost or the | 293 |
benefits
provided under the policy or other contract. Whether or | 294 |
not an insured, owner
of, or other person having an interest in | 295 |
such policy or other
contract is liable for support payments under | 296 |
other provisions of
this chapter, the insured, policy owner, or | 297 |
other person
shall assign payment directly to the department
of | 298 |
all assignable benefits under the policy or other contract and | 299 |
shall pay over to the department, within ten days of receipt, all | 300 |
insurance or other benefits received as
reimbursement or
payment | 301 |
for expenses incurred by the patient or resident or for
any other | 302 |
reason. If the insured, policy owner, or other
person refuses to | 303 |
assign such payment to the
department or refuses to pay such | 304 |
received reimbursements or
payments over to the department within | 305 |
ten days of receipt, the
insured's, policy owners', or other | 306 |
person's
total liability for the services equals the applicable | 307 |
statutory liability
for payment for the services as determined | 308 |
under other provisions
of this chapter, plus the amounts payable | 309 |
under the terms of the
policy or other contract. In no event | 310 |
shall this total liability
exceed the full amount of the | 311 |
applicable cost. Upon its request, the
department is
entitled to | 312 |
a court order that compels the insured, owner of, or
other person | 313 |
having an interest in the policy or other contract
to comply with | 314 |
the assignment requirements of this division or
that itself serves | 315 |
as a legally sufficient assignment in
compliance with such | 316 |
requirements. Notwithstanding section
5122.31 of the Revised Code | 317 |
and any other law relating to
confidentiality of records, the | 318 |
managing officer of the
institution or facility where a person is | 319 |
or has been a patient
or resident, or the managing officer of the | 320 |
state-operated community
mental health services from which the | 321 |
patient receives services,
shall disclose pertinent medical | 322 |
information
concerning the patient or resident to the insurance | 323 |
carrier or
other third party payor in question, in order to effect | 324 |
collection from the carrier or payor of the state's claim for
care | 325 |
and treatment under this division. For such disclosure, the | 326 |
managing officer is not subject to any civil or criminal | 327 |
liability. | 328 |
(10) If a patient or resident with or without dependents
is | 336 |
the beneficiary of a trust created pursuant to section 1339.51
of | 337 |
the Revised Code, then, notwithstanding any contrary provision
of | 338 |
this chapter or of a rule adopted pursuant to this chapter, | 339 |
divisions (C) and (D) of that section shall apply in determining | 340 |
the assets or resources of the patient or resident, the
patient's | 341 |
or resident's estate,
the settlor,
or the
testator's
settlor's | 342 |
estate and to claims
arising under this chapter
against the | 343 |
patient or resident, the
patient's or resident's
estate,
the | 344 |
settlor, or the
testator's
settlor's
estate. | 345 |
(C) The department may enter into agreements with a
patient | 351 |
or resident or a liable relative for support payments to
be made | 352 |
in the future. However, no security interest, mortgage,
or lien | 353 |
shall be taken, granted, or charged against any principal
family | 354 |
residence of a patient or resident with dependents or a
liable | 355 |
relative under an agreement or otherwise to secure support | 356 |
payments, and no foreclosure actions shall be taken on security | 357 |
interests, mortgages or liens taken, granted, or charged against | 358 |
principal residences of patients or residents or liable relatives | 359 |
prior to October 7, 1977. | 360 |
(E) All actions to enforce the collection of payments
agreed | 367 |
upon or charged by the department shall be commenced
within six | 368 |
years after the date of default of an agreement to pay
support | 369 |
charges or the date such payment becomes delinquent. If
a payment | 370 |
is made pursuant to an agreement which is in default, a
new | 371 |
six-year period for actions to enforce the collection of
payments | 372 |
under such agreement shall be computed from the date of
such | 373 |
payment. For purposes of this division an agreement is in
default | 374 |
or a payment is delinquent if a payment is not made
within thirty | 375 |
days after it is incurred or a payment, pursuant to
an agreement, | 376 |
is not made within thirty days after the date
specified for such | 377 |
payment. In all actions to enforce the
collection of payment for | 378 |
the liability for support, every court
of record shall receive | 379 |
into evidence the proof of claim made by
the state together with | 380 |
all debts and credits, and it shall be
prima-facie evidence of the | 381 |
facts contained in it. | 382 |