REPRESENTATIVES Skindell, S. Smith, Price, Sferra, Cirelli, S. Patton, Sykes, Barrett, Miller, Key, Beatty, Koziura, Woodard

To enact sections 3922.01 to 3922.15, 3922.21 to

1

3922.28, 3922.31, 3922.32, and 3922.33 of the

2

Revised Code to establish and operate the Ohio

3

Health Care Plan to provide universal health care

4

coverage to all Ohio residents.

5

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1. That sections 3922.01, 3922.02, 3922.03, 3922.04,	6
3922.05, 3922.06, 3922.07, 3922.08, 3922.09, 3922.10, 3922.11,	7
3922.12, 3922.13, 3922.14, 3922.15, 3922.21, 3922.22, 3922.23,	8
3922.24, 3922.25, 3922.26, 3922.27, 3922.28, 3922.31, 3922.32, and	9
3922.33 of the Revised Code be enacted to read as follows:	10

Sec. 3922.01.  As used in this chapter:

11

(A) "Blind trust" means an independently managed trust in	12
which the beneficiary has no management rights and in which the	13
beneficiary is not given notice of alterations in or other	14
dispositions of the stock, mutual funds, or other property subject	15
to the trust.	16

(B) "Health care facility" means any facility, except a	17
health care practitioner's office, that provides preventive,	18
diagnostic, therapeutic, acute convalescent, rehabilitation,	19
mental health, mental retardation, intermediate care, or skilled	20
nursing services.	21

(C) "Provider" means a hospital or other health care	22
facility, and physicians, podiatrists, dentists, pharmacists,	23
chiropractors, and other health care personnel, licensed,	24
certified, accredited, or otherwise authorized in this state to	25
furnish health care services.	26

Sec. 3922.02.  (A)(1) There is hereby created the Ohio health	27
care plan, which shall be administered by the Ohio health care	28
agency under the direction of the Ohio health care board.	29

(2) The Ohio health care plan shall provide universal and	30
affordable health care coverage for all Ohio residents, consisting	31
of a comprehensive benefit package that includes benefits for	32
prescription drugs. The Ohio health care plan shall work	33
simultaneously to control health care costs, control health care	34
spending, achieve measurable improvement in health care outcomes,	35
increase all parties' satisfaction with the health care system,	36
implement policies that strengthen and improve culturally and	37
linguistically sensitive care, and develop an integrated health	38
care database to support health care planning.	39

(B) There is hereby created the Ohio health care agency. The	40
Ohio health care agency shall administer the Ohio health care plan	41
and is the sole agency authorized to accept applicable	42
grants-in-aid from the federal and state government, using the	43
funds in order to secure full compliance with provisions of state	44
and federal law and to carry out the purposes of sections 3922.01	45
to 3922.33 of the Revised Code. All grants-in-aid accepted by the	46
Ohio health care agency shall be deposited into the Ohio health	47
care fund established under section 3922.09 of the Revised Code.	48

Sections 101.82 to 101.87 of the Revised Code do not apply to	49
the Ohio health care agency.	50

Sec. 3922.03.  (A) There is hereby created the Ohio health	51
care board. The Ohio health care board shall consist of fifteen	52
voting members, consisting of the director of health and fourteen	53
members elected in accordance with this section.	54

(B) For purposes of representation on the Ohio health care	55
board, the state shall be divided into seven regions each composed	56
of designated counties as follows:	57

(1) Region 1: Ashtabula, Cuyahoga, Geauga, Lake, Lorain;

58

(2) Region 2: Allen, Auglaize, Defiance, Erie, Fulton,	59
Hancock, Henry, Huron, Lucas, Mercer, Ottawa, Paulding, Putnam,	60
Sandusky, Seneca, Van Wert, Williams, Wood;	61

(3) Region 3: Athens, Belmont, Coshocton, Gallia, Guernsey,	62
Harrison, Hocking, Jackson, Jefferson, Lawrence, Meigs, Monroe,	63
Morgan, Muskingum, Noble, Perry, Pike, Ross, Scioto, Vinton,	64
Washington;	65

(4) Region 4: Adams, Brown, Butler, Clermont, Clinton,	66
Hamilton, Highland, Warren;	67

(5) Region 5: Crawford, Delaware, Fairfield, Fayette,	68
Franklin, Hardin, Knox, Licking, Logan, Madison, Marion, Morrow,	69
Pickaway, Union, Wyandot;	70

(6) Region 6: Ashland, Carroll, Columbiana, Holmes, Mahoning,	71
Medina, Portage, Richland, Stark, Summit, Trumbull, Tuscarawas,	72
Wayne;	73

(7) Region 7: Champaign, Clark, Darke, Greene, Miami,	74
Montgomery, Preble, Shelby.	75

(C)(1) The health commissioner of the most populous county in	76
each region shall convene a meeting of all county and city health	77
commissioners in the region within ninety days following the	78
effective date of this section. If there are two or more health	79
districts located wholly or partially in the most populous county	80
of the region, the health commissioner of the health district with	81
the largest territorial jurisdiction in that county shall convene	82
the meeting of all county and city health commissioners within	83
ninety days following the effective date of this section.	84

(2) At the meeting called pursuant to division (C)(1) of this	85
section, the county and city health commissioners in each region	86
shall elect one resident from each county in the region to	87
represent the county on a regional health advisory committee	88
established for that region. The county and city health	89
commissioners also shall set a date, not sooner than one hundred	90
days and not later than one hundred ten days after the effective	91
date of this section, for the initial meeting of the regional	92
health advisory committee.	93

(3) Following the initial meetings of county and city health	94
commissioners called pursuant to division (C)(1) of this section,	95
the county and city health commissioners in each region shall	96
convene a meeting every two years to elect representatives to the	97
regional health advisory committee in accordance with this	98
division. Each biennial meeting shall be held within five days of	99
the same day of the same month as the initial meeting.	100

(4) Each representative elected under this division shall	101
hold office for two years, starting on the date of the	102
representative's election. Any individual appointed to fill a	103
vacancy occurring prior to the expiration of the term for which a	104
representative is elected shall hold office for the remainder of	105
the predecessor's term.	106

(D)(1) Each of the seven regional health advisory committees	107
shall elect a chairperson from among the representatives to their	108
committees. Each chairperson shall convene and preside over the	109
initial meeting of that regional health advisory committee on the	110
date set pursuant to division (C) of this section. At the initial	111
meeting of the regional health advisory committees, the	112
committees' representatives shall elect two residents from the	113
region to represent that region as members of the Ohio health care	114
board. One of the two residents elected from each region to serve	115
on the Ohio health care board shall be a resident of the region's	116
most populous county and the other shall be a resident of any	117
county in the region other than the region's most populous county.	118

Except for the elections to the Ohio health care board at the	119
initial meeting of each regional health advisory committee, each	120
resident elected to the board shall be elected to a two-year term	121
of office. At the initial meeting, the resident from the most	122
populous county in the region shall be elected to a term of three	123
years.	124

(2) Annually, beginning in the second year following the	125
initial elections to the Ohio health care board, the chairperson	126
of each regional health advisory committee shall convene a meeting	127
within five calendar days of the same date of the same month as	128
the initial meeting of that regional health advisory committee to	129
elect a resident from the region to serve as a member of the Ohio	130
health care board. The regional health advisory committee shall	131
elect a resident of a county as is necessary to meet the	132
representation requirements set by division (D)(1) of this	133
section. No individual may serve as a member of the Ohio health	134
care board for more than four consecutive terms.	135

(3) In addition to meeting for the election of Ohio health	136
care board members, the regional health advisory committees shall	137
meet as necessary to fulfill any functions and responsibilities	138
assigned to them under sections 3922.01 to 3922.15 of the Revised	139
Code. Meetings shall be held at the call of the chairperson and as	140
may be provided by procedures adopted by the regional health	141
advisory committee.	142

(4) In addition to the fourteen members of the Ohio health	143
care board elected by the seven regional health advisory	144
committees, the director of health shall be a voting ex officio	145
member of the Ohio health care board.	146

(E)(1) The director of health shall set the time, place, and	147
date for the initial meeting of the Ohio health care board and	148
shall preside over the Ohio health care board's initial meeting.	149
The initial meeting shall be set not sooner than one hundred	150
fifteen days and not later than one hundred twenty-five days after	151
the effective date of this section.	152

(2) The members of the Ohio health care board annually shall	153
elect a member of the board to serve as chairperson at meetings of	154
the board. Meetings shall be held upon the call of the chairperson	155
and as provided by procedures prescribed by the Ohio health care	156
board. Two-thirds of the members of the Ohio health care board	157
shall constitute a quorum for the conduct of business at meetings	158
of the board. Decisions at meetings of the Ohio health care board	159
shall be reached by majority vote.	160

(3) All meetings of the Ohio health care board are open to	161
the public unless questions of patient confidentiality arise. The	162
Ohio health care board may go into closed executive session with	163
regard to issues related to confidential patient information. The	164
fourteen members of the Ohio health care board elected by the	165
regional health advisory committees shall receive an annual salary	166
and benefits established in accordance with division (J) of	167
section 124.15 of the Revised Code.	168

(F) The seven regional health advisory committees shall act	169
as advisory bodies to the Ohio health care board, representing	170
their individual regions. The regional health advisory committees	171
shall oversee the management of consumer and provider complaints	172
originating in their respective regions and shall hold a hearing	173
on all such complaints. The regional health advisory committees	174
shall offer assistance to resolve consumer and provider disputes	175
and shall seek the agreement of all parties to the dispute to	176
submit the dispute to negotiation or binding arbitration. A	177
regional health advisory committee shall transfer any dispute that	178
is not resolved at the regional level to the director of the Ohio	179
health care agency's department of consumer affairs within six	180
months; however, the committee may vote to transfer individual	181
disputes at an earlier date.	182

(G)(1) If a vacancy occurs on the Ohio health care board for	183
any reason, resulting in a region being without full	184
representation on the board, that region's health advisory	185
committee shall elect a resident of that region to fill the	186
vacancy. Any resident elected to fill a vacancy shall serve the	187
remainder of the departing member's term. The health advisory	188
committee shall elect a resident of a county as necessary to meet	189
the representation requirements set by division (D)(1) of this	190
section.	191

(2) A serving member of the Ohio health care board shall	192
continue to serve following the expiration of their term until a	193
successor takes office or a period of ninety days has elapsed,	194
whichever occurs first.	195

(H)(1) Members of the Ohio health care board and employees of	196
the Ohio health care agency, and their immediate families, are	197
prohibited from having any pecuniary interest in any business with	198
a contract, or in negotiation for a contract, with either the Ohio	199
health care board or Ohio health care agency, or that is subject	200
to the Ohio health care board's oversight. No member of the Ohio	201
health care board or employee of the Ohio health care agency shall	202
receive remuneration for health care service of any kind during	203
their term of service or employment. No member of the Ohio health	204
care board or employee of the Ohio health care agency, nor members	205
of their immediate families, shall receive consulting fees of any	206
kind from any source that is directly or indirectly related to the	207
delivery of health care services pursuant to the Ohio health care	208
plan. Members of the Ohio health care board and employees of the	209
Ohio health care agency, and their immediate families, are	210
prohibited from owning stock in, and from investing in mutual	211
funds holding stock in, pharmaceutical companies, health	212
maintenance organizations, or other businesses that relate	213
directly or indirectly to the delivery of health care services,	214
unless the stock or mutual funds are in a blind trust.	215

(2) No member of the Ohio health care board other than the	216
director of health shall hold any other salaried public position	217
with the state, either elected or appointed, during the member's	218
tenure on the board. The director of health shall receive no	219
salary or benefits by virtue of the director's service on the Ohio	220
health care board.	221

(3) The chairperson of the Ohio health care board may conduct	222
hearings to determine if a violation of this division has	223
occurred. Notice of any hearing, the conduct of the hearing, and	224
all other matters relating to the holding of the hearing shall be	225
governed by Chapter 119. of the Revised Code. If a member of the	226
Ohio health care board, or of the member's immediate family, is	227
found to have violated this division, the chairperson of the Ohio	228
health care board of health shall remove the member from the Ohio	229
health care board. If an employee of the Ohio health care agency,	230
or of the employee's immediate family, is found to have violated	231
this division, the Ohio health care agency shall take appropriate	232
disciplinary action against the employee, which action may include	233
termination of employment.	234

Sections 101.82 to 101.87 of the Revised Code do not apply to	235
the Ohio health care board and the regional health advisory	236
committees.	237

Sec. 3922.04.  (A) The Ohio health care board is responsible	238
for directing the Ohio health care agency in the performance of	239
all duties, the exercise of all powers, and the assumption and	240
discharge of all functions vested in the Ohio health care agency.	241
The Ohio health care board shall adopt rules in accordance with	242
Chapter 119. of the Revised Code as needed to carry out the	243
purposes of, and to enforce, Chapter 3922. of the Revised Code.	244

(B) The duties and functions of the Ohio health care board	245
include, but are not limited to, the following:	246

(1) Implementing statutory eligibility standards for	247
benefits;	248

(2) Annually adopting a benefits package for participants of	249
the Ohio health care plan;	250

(3) Acting directly or through one or more contractors as the	251
single payer for all claims for health care services made under	252
the Ohio health care plan;	253

(4) Developing and implementing separate formula for	254
determining budgets under sections 3922.21 to 3922.28 of the	255
Revised Code;	256

(5) Annually reviewing the formulae for determining the	257
appropriateness and sufficiency of rates, fees, and prices;	258

(6) Providing for timely payments to providers through a	259
structure that is well organized and that eliminates unnecessary	260
administrative costs;	261

(7) Implementing, to the extent permitted by federal law,	262
standardized claims and reporting methods for use by the Ohio	263
health care plan;	264

(8) Developing a system of centralized electronic claims and	265
payments;	266

(9) Establishing an enrollment system that will ensure that	267
all eligible Ohio residents, including those who travel	268
frequently, those who cannot read, and those who do not speak	269
English, are aware of their right to health care and are formally	270
enrolled in the Ohio health care plan;	271

(10) Reporting annually to the general assembly and the	272
governor, on or before the first day of October, on the	273
performance of the Ohio health care plan, the fiscal condition of	274
the Ohio health care plan, any need for rate adjustments,	275
recommendations for statutory changes, the receipt of payments	276
from the federal government, whether current year goals and	277
priorities were met, future goals and priorities, and major new	278
technology or prescription drugs that may affect the cost of the	279
health care services provided by the Ohio health care plan;	280

(11) Administering the revenues of the Ohio health care fund	281
pursuant to section 3922.09 of the Revised Code;	282

(12) Obtaining appropriate liability and other forms of	283
insurance to provide coverage for the Ohio health care plan, the	284
Ohio health care board, the Ohio health care agency, and their	285
employees and agents;	286

(13) Establishing, appointing, and funding appropriate staff	287
for the Ohio health care agency throughout Ohio;	288

(14) Procuring requisite office space and administrative	289
support;	290

(15) Administering aspects of the Ohio health care agency by	291
taking actions that include, but are not limited to, the	292
following:	293

(a) Establishing standards and criteria for the allocation of	294
operating funds;	295

(b) Meeting regularly with the executive director and	296
administrators of the Ohio health care agency to review the impact	297
of the agency and its policies on the regional districts	298
established under section 3922.03 of the Revised Code;	299

(c) Establishing goals for the health care system established	300
pursuant to the Ohio health care plan in measurable terms;	301

(d) Establishing statewide health care databases to support	302
health care services planning;	303

(e) Implementing policies, and developing mechanisms and	304
incentives, to assure culturally and linguistically sensitive	305
care;	306

(f) Establishing standards and criteria for the determination	307
of appropriate compensation and training for residents of Ohio who	308
are displaced from work due to the implementation of the Ohio	309
health care plan;	310

(g) Establishing methods for the recovery of costs for health	311
care services provided pursuant to the Ohio health care plan to a	312
participant that are covered under the terms of a policy of	313
insurance, a health benefit plan, or other collateral source	314
available to the participant under which the participant has a	315
right of action for compensation. Receipt of health care services	316
pursuant to the Ohio health care plan shall be deemed an	317
assignment by the participant of any right to payment for services	318
from any policy, plan, or other source. The other source of health	319
care benefits shall pay to the Ohio health care fund all amounts	320
it is obligated to pay to the participant for covered health care	321
services. The Ohio health care board may commence any action	322
necessary to recover the amounts due.	323

(16) Appointing a technical and medical advisory board. The	324
members of the technical and medical advisory board shall	325
represent a cross section of the medical and provider community	326
and consumers, and shall include two persons, one being a provider	327
and the other representing consumers, from each region designated	328
in section 3922.03 of the Revised Code. The members of the	329
technical and medical advisory board shall be reimbursed for	330
actual and necessary expenses incurred in the performance of their	331
duties. The technical and medical advisory board's duties include:	332

(a) Advising the Ohio health care board on the establishment	333
of policy on medical issues, population-based public health	334
issues, research priorities, scope of services, expanding access	335
to health care services, and evaluating the performance of the	336
Ohio health care plan;	337

(b) Investigating proposals for innovative approaches to the	338
promotion of health, the prevention of disease and injury, patient	339
education, research, and health care delivery;	340

(c) Advising the Ohio health care board on the establishment	341
of standards and criteria to evaluate requests from health care	342
facilities for capital improvements.	343

(C) The Ohio health care board shall employ and fix the	344
compensation of Ohio health care agency personnel, with the	345
approval of the department of administrative services, as needed	346
by the agency to properly discharge the agency's duties. The	347
employment of personnel by the Ohio health care board is subject	348
to the civil service laws of this state. The Ohio health care	349
board shall employ personnel including, but not limited to, the	350
following:	351

(1) Executive director;

352

(2) Administrator of planning, research, and development;

353

(3) Administrator of finance;

354

(4) Administrator of quality assurance;

355

(5) Administrator of consumer affairs;

356

(6) Legal counsel to represent the board in any legal action	357
brought by or against the board under or pursuant to any provision	358
of the Revised Code under the board's jurisdiction.	359

(D) No member of the Ohio health care board or individual on	360
the staff of the Ohio health care board or Ohio health care agency	361
shall use for personal benefit any information filed with or	362
obtained by the Ohio health care board that is not then readily	363
available to the public. No member of the Ohio health care board	364
shall use or in any way attempt to use their position as a member	365
to influence a decision of any other governmental body.	366

Sections 101.82 to 101.87 of the Revised Code do not apply to	367
the technical and medical advisory board established pursuant to	368
this section.	369

Sec. 3922.05.  The executive director of the Ohio health care	370
agency appointed under section 3922.04 of the Revised Code is the	371
chief administrator of the Ohio health care plan and shall	372
administer and enforce Chapter 3922. of the Revised Code. The	373
executive director shall oversee the operation of the Ohio health	374
care agency and the agency's performance of any duties assigned by	375
the Ohio health care board.	376

Sec. 3922.06.  (A) The executive director of the Ohio health	377
care agency shall determine the duties of the administrator of	378
planning, research, and development. Those duties shall include,	379
but not be limited to, the following:	380

(1) Establishing policy on medical issues, population-based	381
public health issues, research priorities, scope of services, the	382
expansion of participants' access to health care services, and	383
evaluating the performance of the Ohio health care plan;	384

(2) Investigating proposals for innovative approaches for the	385
promotion of health, the prevention of disease and injury, patient	386
education, research, and the delivery of health care services;	387

(3) Establishing standards and criteria for evaluating	388
applications from health care facilities for capital improvements.	389

(B)(1) The executive director shall determine the duties of	390
the administrator of consumer affairs. Those duties shall include,	391
but not be limited to, the following:	392

(a) Developing educational and informational guides for	393
consumers that describe consumer rights and responsibilities and	394
that inform consumers of effective ways to exercise consumer	395
rights to obtain health care services. The guides shall be easy to	396
read and understand and available in English and in other	397
languages. The Ohio health care agency shall make the guide	398
available to the public through public outreach and educational	399
programs and through the internet web site of the Ohio health care	400
agency.	401

(b) Establishing a toll-free telephone number to receive	402
questions and complaints regarding the Ohio health care agency and	403
the agency's services. The Ohio health care agency's internet web	404
site shall provide complaint forms and instructions online.	405

(c) Examining suggestions from the public;

406

(d) Making recommendations for improvements to the Ohio	407
health care board;	408

(e) Examining the extent to which individual health care	409
facilities in a region meet the needs of the community in which	410
they are located;	411

(f) Receiving, investigating, and responding to all	412
complaints about any aspect of the Ohio health care plan and	413
referring the results of all investigations into the provision of	414
health care services by health care providers or facilities to the	415
appropriate provider or health care facility licensing board, or	416
when appropriate, to a law enforcement agency;	417

(g) Publishing an annual report for the public and the	418
general assembly that contains a statewide evaluation of the Ohio	419
health care agency and of the delivery of health care services in	420
each region established under section 3922.03 of the Revised Code;	421

(h) Holding public hearings, at least annually, within each	422
region established under section 3922.03 of the Revised Code for	423
public suggestions and complaints.	424

(2) The administrator of consumer affairs shall work closely	425
with the seven regional health advisory committees on the	426
resolution of complaints. In the discharge of the administrator's	427
duties, the administrator shall have unlimited access to all	428
nonconfidential and nonprivileged documents in the custody and	429
control of the agency. Nothing in Chapter 3922. of the Revised	430
Code prohibits a consumer or class of consumers, or the	431
administrator of consumer affairs, from seeking relief through the	432
courts.	433

(C) The executive director, in consultation with the	434
technical and medical advisory board, shall determine the duties	435
of the administrator of quality assurance. Those duties shall	436
include, but not be limited to, the following:	437

(1) Studying and reporting on the efficacy of health care	438
treatments and medications for particular conditions;	439

(2) Identifying causes of medical errors and devising	440
procedures to decrease medical errors;	441

(3) Establishing an evidence-based formulary;

442

(4) Identifying treatments and medications that are unsafe or	443
have no proven value;	444

(5) Establishing a process for soliciting information on	445
medical standards from providers and consumers for purposes of	446
this division.	447

(D) The executive director shall determine the duties of the	448
administrator of finance. Those duties shall include, but not be	449
limited to, the following:	450

(1) Administering the Ohio health care fund;

451

(2) Making prompt payments to providers;

452

(3) Developing a system of centralized claims and payments;

453

(4) Communicating to the treasurer of state when funds are	454
needed for the operation of the Ohio health care plan;	455

(5) Developing information systems for utilization review;

456

(6) Investigating possible provider or consumer fraud.

457

Sec. 3922.07.  (A) All Ohio residents and individuals	458
employed in Ohio, including the homeless and migrant workers, are	459
eligible for coverage under the Ohio health care plan. The Ohio	460
health care board shall establish standards and a simplified	461
procedure to demonstrate proof of residency. The Ohio health care	462
board shall establish a procedure to enroll eligible residents and	463
employees and to provide each individual covered under the Ohio	464
health care plan with identification that providers may use to	465
determine eligibility for health care services under the Ohio	466
health care plan.	467

(B) If waivers are not obtained under sections 3922.31 to	468
3922.33 of the Revised Code from the medical assistance and	469
medicare programs operated under Title XVIII or XIX of the "Social	470
Security Act," 49 Stat. 20 (1935), 42 U.S.C. 301, as amended, or	471
whenever a necessary waiver is not in effect, the medical	472
assistance and medicare programs shall act as the primary insurers	473
for Ohio residents and individuals employed in Ohio for health	474
coverage and the Ohio health care plan shall serve as the	475
secondary or supplemental plan of health coverage. When the Ohio	476
health care plan serves as a secondary or supplemental plan of	477
health coverage the Ohio health care plan shall not provide	478
coverage to an Ohio resident or individual employed in Ohio for	479
any covered health care service that the resident or worker is	480
then eligible to receive under the medical assistance or medicare	481
program.	482

(C) A plan of employee health coverage provided by an	483
out-of-state employer to an Ohio resident working outside of Ohio	484
shall serve as the employee's primary plan of health coverage and	485
the Ohio health care plan shall serve as the employee's secondary	486
plan of health coverage.	487

(D) The Ohio health care agency shall bill out-of-state	488
employers or the employers' insurers for the cost of covered	489
health care services provided in accordance with the Ohio health	490
care plan to residents of this state employed by the out-of-state	491
employer when the health care services provided are covered under	492
the terms of the employer's plan of employee health coverage.	493

(E) The Ohio health care plan shall reimburse Ohio health	494
care board approved providers practicing outside of Ohio at Ohio	495
health care plan rates for health care services rendered to a plan	496
participant while the participant is out of state.	497

(F) Any employer operating in Ohio may purchase coverage	498
under the Ohio health care plan for an employee who lives out of	499
state but who works in Ohio.	500

(G) Any institution of higher education, as defined in	501
section 2741.01 of the Revised Code, located in Ohio may purchase	502
coverage under the Ohio health care plan for a student who does	503
not otherwise have status as a resident of this state.	504

(H) Any individual who arrives at a health care facility	505
unconscious or otherwise unable due to their mental or physical	506
condition to document eligibility for coverage shall be presumed	507
to be eligible.	508

Sec. 3922.08.  (A) The Ohio health care board shall establish	509
a single health benefits package that shall include, but not be	510
limited to, all of the following:	511

(1) Inpatient and outpatient provider care, both primary and	512
secondary;	513

(2) Emergency services, as defined in division (A) of section	514
3923.65 of the Revised Code, twenty-four hours each day on a	515
prudent layperson standard. Residents who are temporarily out of	516
state may receive benefits for emergency services rendered in that	517
state. The Ohio health care agency shall make timely emergency	518
services, including hospital care and triage, available to all	519
Ohio residents, including all residents not enrolled in the Ohio	520
health care plan.	521

(3) Emergency and other transportation services to covered	522
health care services, subject to division (B) of this section;	523

(4) Rehabilitation services, including speech, occupational,	524
and physical therapy;	525

(5) Inpatient and outpatient mental health services and	526
substance abuse treatment;	527

(6) Hospice care;

528

(7) Prescription drugs and prescribed medical nutrition;

529

(8) Vision care, aids, and equipment;

530

(9) Hearing care, hearing aids, and equipment;

531

(10) Diagnostic medical tests, including laboratory tests and	532
imaging procedures;	533

(11) Medical supplies and prescribed medical equipment, both	534
durable and nondurable;	535

(12) Immunizations, preventive care, health maintenance care,	536
and screening;	537

(13) Dental care;

538

(14) Home health care services.

539

(B) The Ohio health care plan shall provide necessary	540
transportation in each county to covered health care services.	541
Independent transportation providers shall be reimbursed on a	542
fee-for-service basis. Fee schedules for covered transportation	543
may take into account the recognized differences among geographic	544
areas regarding cost. A covered transportation benefits account is	545
hereby created within the Ohio health care fund.	546

(C) The Ohio health care plan shall not exclude or limit	547
coverage of its participants' pre-existing conditions.	548

(D) Residents enrolled in the Ohio health care plan are not	549
subject to copayments, point-of-service charges, or any other fee	550
or charge, and shall not be directly billed by providers for	551
covered health care services provided to the resident.	552

(E) The Ohio health care board, with the consent of the	553
technical and medical advisory board, shall remove or exclude	554
procedures and treatments, equipment, and prescription drugs from	555
the Ohio health care plan's benefit package that the board finds	556
unsafe, experimental, of no proven value, or which add no	557
therapeutic value.	558

(F) The Ohio health care board shall exclude coverage for any	559
surgical, orthodontic, or other medical procedure, or prescription	560
drug, that the technical and medical advisory board determines was	561
or will be provided primarily for cosmetic purposes, unless	562
required to correct a congenital defect, to restore or correct	563
disfigurements resulting from injury or disease, or that is	564
determined to be medically necessary by a qualified, licensed	565
provider.	566

(G) Participants shall have free choice of the providers	567
eligible to participate in the Ohio health care plan.	568

(H) No provider shall be compelled by the Ohio health care	569
agency to offer any particular service, provided that the provider	570
does not discriminate among patients in providing health care	571
services.	572

(I) The Ohio health care plan and the providers participating	573
in the plan shall not discriminate on the basis of race, color,	574
national origin, gender, age, religion, sexual orientation, health	575
status, mental or physical disability, employment status, veteran	576
status, or occupation.	577

Sec. 3922.09.  (A) The Ohio health care fund is hereby	578
established in the state treasury. The administrator of finance of	579
the Ohio health care agency shall administer and monitor the Ohio	580
health care fund. All moneys collected and received by the Ohio	581
health care plan shall be transmitted to the treasurer of state	582
for deposit into the Ohio health care fund, to be used to finance	583
the Ohio health care plan and to pay the costs of compensation and	584
training for displaced workers pursuant to section 3922.11 of the	585
Revised Code.	586

(B) The treasurer of state may invest the interest earned by	587
the Ohio health care fund in any manner authorized by the Revised	588
Code for the investment of state moneys. Any revenue or interest	589
earned from the investments shall be credited to the Ohio health	590
care fund.	591

(C) All provider claims for payment for health care services	592
rendered under the Ohio health care plan shall be transmitted to	593
the Ohio health care fund by the provider or the provider's agent.	594
The format of, and the method of transmitting, provider claims	595
shall be determined by the Ohio health care board.	596

(D) All payments for health care services rendered under the	597
Ohio health care plan shall be disbursed from the Ohio health care	598
fund. The administrator of finance of the Ohio health care agency	599
shall establish a reserve account within the Ohio health care	600
fund. When the revenue available to the Ohio health care plan in	601
any biennium exceeds the total amount expended or obligated during	602
that biennium, the excess revenue shall be transferred to the	603
reserve account. The Ohio health care board may use the money in	604
the reserve account for expenses of the Ohio health care agency or	605
the Ohio health care plan.	606

(E) The administrator of finance of the Ohio health care	607
agency shall notify the Ohio health care board when the annual	608
expenditures or anticipated future expenditures of the Ohio health	609
care plan appear to be in excess of the revenues or anticipated	610
revenues for the same period. The Ohio health care board shall	611
implement appropriate cost control measures based on the	612
notification. The Ohio health care board shall seek a special	613
appropriation for the Ohio health care fund if the cost control	614
measures implemented do not reduce the Ohio health care plan's	615
expenditures to an amount that may be covered by its revenue.	616

Sec. 3922.10.  (A) The Ohio health care board shall establish	617
written procedures for the receipt and resolution of disputes and	618
grievances. The procedures shall provide for an initial hearing	619
before the appropriate regional health advisory committee in	620
accordance with division (F) of section 3922.03 of the Revised	621
Code. The board shall accord to plaintiffs the right to be heard	622
at the hearing.	623

(B) Any party aggrieved by an order or decision issued	624
pursuant to the procedures established in division (A) of this	625
section may appeal the order or decision to the court of common	626
pleas. The appellant shall file a notice of appeal with the Ohio	627
health care board within fifteen days of the filing of the appeal	628
with the court of common pleas.	629

(C) Appeals of denied claims may be submitted by Ohio health	630
care plan beneficiaries or providers, or businesses selling	631
medical equipment and supplies to the Ohio health care board. The	632
board shall conduct appeals in compliance with its written	633
procedures and both Ohio and federal laws.	634

Sec. 3922.11.  (A) The department of job and family services	635
shall determine which residents of this state employed by a health	636
care insurer, health insuring corporation, or other health care	637
related business, have lost employment as a result of the	638
implementation and operation of the Ohio health care plan. The	639
department also shall determine the amount of monthly wages that	640
the resident lost due to the plan's implementation. The department	641
shall attempt to position these displaced workers in comparable	642
positions of employment with the Ohio health care agency.	643

(B) The department of job and family services shall forward	644
the information on the amount of monthly wages lost by Ohio	645
residents due to the implementation of the Ohio health care plan	646
to the Ohio health care agency. The Ohio health care agency shall	647
determine the amount of compensation and training that each	648
displaced worker shall receive and shall submit a claim to the	649
Ohio health care fund for payment. A displaced worker, however,	650
shall not receive compensation from the Ohio health care fund in	651
excess of sixty thousand dollars per year for two years.	652
Compensation paid to the displaced worker under this section shall	653
serve as a supplement to any compensation the worker receives from	654
the department of job and family services.	655

Sec. 3922.12.  (A) Any employer operating in Ohio and	656
providing employees with benefits under a public or private health	657
care policy, plan, or agreement as of the date that benefits are	658
initially provided pursuant to Chapter 3922. of the Revised Code,	659
which benefits are less valuable than those provided by the Ohio	660
health care plan, may participate in the Ohio health care plan or	661
shall provide additional benefits so that, until the expiration of	662
the policy, plan, or agreement, the benefits provided by the	663
employer at least equal the amount and scope of the benefits	664
provided by the Ohio health care plan. If an employer chooses to	665
provide additional benefits to match or exceed the benefits	666
provided by the Ohio health care plan the additional benefits	667
shall include the employer's payment of any employee premium	668
contributions, copayments, and deductible payments called for by	669
the policy, contract, or agreement. Employers are exempt from all	670
health taxes imposed under Chapter 3922. of the Revised Code until	671
the expiration of the policy, plan, or agreement, at which point	672
the employer and the employer's employees become participants in	673
the Ohio health care plan.	674

(B) A person covered by a health care policy, plan, or	675
agreement that has its premiums paid for in any part with public	676
money, including money from the state, a political subdivision,	677
state educational institution, public school, or other entity,	678
shall be covered by the Ohio health care plan on the day that	679
benefits become available under the Ohio health care plan.	680

(C) Health care insurers, health insuring corporations, and	681
other persons selling or providing health care benefits may	682
deliver, issue for delivery, renew, or provide health benefit	683
packages that do not duplicate the health benefit package provided	684
by the Ohio health care plan, but shall not, except as provided by	685
division (A) of this section, deliver, issue for delivery, renew,	686
or provide health benefit packages that duplicate the health	687
benefit package provided by the Ohio health care plan.	688

Sec. 3922.13. The Ohio health care agency is subrogated to	689
all rights of a participant who has received benefits, or who has	690
a right to benefits, under any other policy or contract of health	691
care.	692

Sec. 3922.14.  (A) All providers, as defined in section	693
3922.01 of the Revised Code, may participate in the Ohio health	694
care plan.	695

(B) The Ohio health care board and the technical and medical	696
advisory board shall assess the number of primary and specialty	697
providers needed to supply adequate health care services to all	698
participants in the Ohio health care plan, and shall develop a	699
plan to meet that need. The Ohio health care board shall develop	700
incentives for providers in order to increase residents' access to	701
health care services in unserved or underserved areas of the	702
state.	703

(C) The Ohio health care board annually shall evaluate	704
residents' access to trauma care, and shall establish measures to	705
ensure participants have equitable access to trauma care and to	706
specialized medical procedures and technology.	707

(D) The Ohio health care board, with the advice of the	708
technical and medical advisory board and the administrator of	709
quality assurance, shall define performance criteria and goals for	710
the Ohio health care plan and shall report to the general assembly	711
at least annually on the plan's performance. The Ohio health care	712
board shall establish a system to monitor the quality of health	713
care and patient and provider satisfaction with that care and a	714
system to devise improvements to the provision of health care	715
services.	716

(E) All providers subject to the Ohio health care plan shall	717
provide data upon request to the Ohio health care board, which	718
data the board requires to devise methods to maintain and improve	719
the provision of health care services.	720

(F) The Ohio health care board, with the advice of the	721
technical and medical advisory board, shall coordinate the Ohio	722
health care plan's provision of health care services with any	723
other state and local agencies that provide health care services	724
directly to their residents.	725

Sec. 3922.15.  In the absence of fraud or bad faith, county	726
and city health commissioners, regional health advisory	727
committees, and the Ohio health care board and Ohio health care	728
agency and their members and employees, shall incur no liability	729
in relation to the performance of their duties and	730
responsibilities under sections 3922.01 to 3922.15 of the Revised	731
Code. The state shall incur no liability in relation to the	732
implementation and operation of the Ohio health care plan.	733

Sec. 3922.21.  (A) The Ohio health care board shall prepare	734
and recommend to the general assembly an annual budget for health	735
care, which budget specifies and establishes a limit on total	736
annual state expenditures for health care provided pursuant to	737
sections 3922.01 to 3922.15 of the Revised Code. The budget shall	738
include all of the following components:	739

(1) A system budget covering all expenditures for the system,	740
in accordance with section 3922.22 of the Revised Code;	741

(2) Facility and provider budgets for the fee-for-service and	742
integrated health delivery system and for individual health care	743
facilities and their associated clinics, in accordance with	744
section 3922.23 of the Revised Code;	745

(3) A capital investment budget in accordance with section	746
3922.24 of the Revised Code;	747

(4) A purchasing budget in accordance with section 3922.25 of	748
the Revised Code;	749

(5) A research and innovation budget in accordance with	750
section 3922.26 of the Revised Code.	751

(B) In preparing the budget, the board shall consider	752
anticipated increased expenditures and savings, including, but not	753
limited to, projected increases in expenditures due to improved	754
access for underserved populations and improved reimbursement for	755
primary care, projected administrative savings under the	756
single-payer mechanism, projected savings in prescription drug	757
expenditures under competitive bidding and a single buyer, and	758
projected savings due to provision of primary care rather than	759
emergency room treatment.	760

Sec. 3922.22. (A) The system budget referred to in division	761
(A)(1) of section 3922.21 of the Revised Code shall comprise the	762
cost of the system, services and benefits provided,	763
administration, data gathering, planning and other activities, and	764
revenues deposited with the system account of the Ohio health care	765
fund.	766

The Ohio health care board shall limit administrative costs	767
to five per cent of the system budget and shall annually evaluate	768
methods to reduce administrative costs and report the results of	769
that evaluation to the general assembly. The board shall also	770
limit growth of health care costs in the system budget by	771
reference to changes in state gross domestic product, population,	772
employment rates, and other demographic indicators, as	773
appropriate. Moneys in the reserve account of the Ohio health care	774
fund shall not be considered as available revenues for purposes of	775
preparing the system budget.	776

(B) The board shall implement cost control measures pursuant	777
to division (A) of this section. However, no cost control measure	778
shall limit access to care that is needed on an emergency basis or	779
that is determined by a patient's provider to be medically	780
appropriate for a patient's condition.	781

Mandatory cost control measures include, but are not limited	782
to, some or all of the following:	783

(1) Postponement of the introduction of new benefits or	784
benefit improvements;	785

(2) Postponement of new capital investment;

786

(3) Adjustment of provider budgets to correct for	787
inappropriate provider utilization;	788

(4) Establishment of a limit on provider reimbursement above	789
a specified amount of aggregate billing;	790

(5) Deferred funding of the reserve account;

791

(6) Establishment of a limit on aggregate reimbursements to	792
pharmaceutical manufacturers;	793

(7) Imposition of an eligibility waiting period in the event	794
of substantial influx of individuals into the state for purposes	795
of obtaining health care through the Ohio health care plan.	796

Sec. 3922.23. (A) The facility and provider budgets referred	797
to in division (A)(2) of section 3922.21 of the Revised Code shall	798
include allocations for fee-for-service providers, health	799
facilities and associated clinics that are not part of a capitated	800
provider network, and capitated providers. These allocations shall	801
consider the relative usage of fee-for-service providers,	802
capitated providers, and health care facilities and associated	803
clinics that are not part of a capitated provider network. Each	804
annual facility and provider budget shall include adjustments to	805
reflect changes in the utilization of services and the addition or	806
exclusion of covered services made by the Ohio health care board	807
upon the recommendation of the technical and medical advisory	808
board and its staff.	809

(B)(1) Providers and facilities shall choose whether they	810
will be compensated as fee-for-service providers or as part of a	811
capitated provider network. The budget for fee-for-service	812
providers shall be divided among categories of licensed health	813
care providers in order to establish a total annual budget for	814
each category. Each of these category budgets shall be sufficient	815
to cover all included services anticipated to be required by	816
eligible individuals choosing fee-for-service at the rates	817
negotiated or set by the Ohio health care board, except as	818
necessary for cost containment purposes pursuant to section	819
3922.22 of the Revised Code.	820

The board shall negotiate fee-for-service reimbursement rates	821
or salaries for licensed health care providers. In the event	822
negotiations are not concluded in a timely manner, the board shall	823
establish the reimbursement rates. Reimbursement rates shall	824
reflect the goals of the system.	825

(2) The budget shall encompass all operating expenses for	826
health care facilities or clinics that are not part of a capitated	827
provider network. In establishing a facility budget, the board	828
shall develop and utilize separate formulae that reflect the	829
differences in cost of primary, secondary, and tertiary care	830
services and health care services provided by academic medical	831
centers. The board shall negotiate reimbursement rates with	832
facilities and clinics. Reimbursement rates shall reflect the	833
goals of the system.	834

(3) The budget for capitated providers shall be sufficient to	835
cover all eligible individuals choosing an integrated health care	836
delivery system at the rates negotiated or set by the board.	837

(C)(1) The board shall prepare an annual operating budget for	838
all care provided by facilities, group practices, and integrated	839
health care systems, including the labor costs of providing care.	840
All facilities, group practices, and integrated health care	841
systems shall submit annual operating budget requests to the board	842
and may choose to be reimbursed through a global facility budget	843
or on a capitated basis. The board shall adjust budgets on the	844
basis of the health risk of enrollees; the scope of services	845
provided; proposed innovative programs that improve quality,	846
workplace safety, or consumer, provider, or employee satisfaction;	847
costs of providing care for nonmembers; and an appropriate	848
operating margin.	849

(2) Providers and facilities that choose to operate a	850
facility on a capitated basis shall not be paid additionally on a	851
fee-for-service basis unless they are providing services in a	852
separate private medical practice or facility. Providers and	853
facilities that operate on a capitated basis shall report	854
immediately any projected operating deficits to the board. The	855
board shall determine whether the projected deficits reflect	856
appropriate increases in health care needs, in which case the	857
board shall adjust the provider or facility budget appropriately.	858
If the board determines that the deficit is not justifiable, no	859
adjustment shall be made.	860

(3) The board may terminate the funding for facilities, group	861
practices, and integrated health care systems or particular	862
services provided by them if they fail to meet standards of care	863
and practice established by the board. The board shall make future	864
funding contingent on measurable improvements in quality of care	865
and health care outcomes.	866

(D) The board shall prohibit charges to the Ohio health care	867
plan or to patients for covered health care services other than	868
those established by regulation, negotiation, or the appeals	869
process. Licensed health care providers who provide services not	870
covered by sections 3922.01 to 3922.15 of the Revised Code may	871
charge patients for those services.	872

Sec. 3922.24. (A) The capital investment budget referred to	873
in division (A)(3) of section 3922.21 of the Revised Code shall be	874
established by the Ohio health care board, with the advice of the	875
technical and medical advisory board and its staff, and shall	876
provide for capital maintenance and development. In preparing the	877
budget, the Ohio health care board shall determine capital	878
investment priorities and evaluate whether the capital investment	879
program has improved access to services and has eliminated	880
redundant capital investments.	881

(B) All capital investments valued at five hundred thousand	882
dollars or greater, including the costs of studies, surveys,	883
design plans and working drawing specifications, and other	884
activities essential to planning and execution of capital	885
investment, and all capital investments that change the bed	886
capacity of a health care facility or add a new service or license	887
category incurred by any health system entity, shall require the	888
approval of the board. When a facility, or individual acting on	889
behalf of a facility, or any other purchaser, obtains by lease or	890
comparable arrangement any facility or part of a facility, or any	891
equipment for a facility, the market value of which would have	892
been a capital expenditure, the lease or arrangement shall be	893
considered a capital expenditure for purposes of sections 3922.01	894
to 3922.15 of the Revised Code.	895

(C) Health care facilities shall provide the board with at	896
least three-months advance notice of any planned capital	897
investment of more than fifty thousand dollars but less than five	898
hundred thousand dollars. These capital investments shall minimize	899
unneeded expansion of facilities and services based on the	900
priorities and goals for capital investment established by the	901
board.	902

(D) No capital investment shall be undertaken using funds	903
from a facility operating budget.	904

Sec. 3922.25. The purchasing budget referred to in division	905
(A)(4) of section 3922.21 of the Revised Code shall provide for	906
the purchase of prescription drugs and durable and nondurable	907
medical equipment for the system. The Ohio health care board shall	908
purchase all prescription drugs and durable and nondurable medical	909
equipment for the system from this budget.	910

Sec. 3922.26. The research and innovation budget referred to	911
in division (A)(5) of section 3922.21 of the Revised Code shall	912
support research and innovation that has been recommended by the	913
Ohio health care board, the technical and medical advisory board,	914
and the administrator of consumer affairs. This research and	915
innovation includes, but is not limited to, methods for improving	916
the administration of the system, improving the quality of health	917
care, educating patients, and improving communication among health	918
care providers.	919

Sec. 3922.27. The Ohio health care board shall establish a	920
capital account in the Ohio health care fund as part of the Ohio	921
health care plan. Moneys in the account shall be used solely to	922
pay for the establishment and maintenance of a loan program for	923
facilities and equipment for use by health care professionals who	924
desire to establish practices in areas of the state in which,	925
according to criteria established by the board, the level of	926
health care services is inadequate.	927

Sec. 3922.28. Funding of the Ohio health care plan shall be	928
obtained from the following sources:	929

(A) Funds made available to the Ohio health care plan	930
pursuant to sections 3922.31 to 3922.33 of the Revised Code;	931

(B) Funds obtained from other federal, state, and local	932
governmental sources and programs;	933

(C) Receipts from taxes levied on employers' payrolls to be	934
paid by employers. The tax rate in the first year shall not exceed	935
three and eighty-five hundredths per cent of the payroll.	936

(D) Receipts from taxes levied on businesses' gross receipts.	937
The tax rate in the first year shall not exceed three per cent of	938
the gross receipts.	939

(E) Receipts from additional income taxes, equal to six and	940
two-tenths per cent of an individual's compensation in excess of	941
the amount subject to the social security payroll tax.	942

(F) Receipts from additional income taxes, equal to five per	943
cent of all of an individual's Ohio adjusted gross income, less	944
the exemptions allowed under section 5747.025 of the Revised Code,	945
in excess of two hundred thousand dollars.	946

Sec. 3922.31.  (A) As used in sections 3922.31 to 3922.33 of	947
the Revised Code:	948

(1) "CHIP" means the children's health insurance program	949
parts I and II provided for by sections 5101.50 to 5101.5110 of	950
the Revised Code.	951

(2) "Federal employees health benefits program" means the	952
program of health insurance benefits available to employees of the	953
federal government that the United States office of personnel	954
management is authorized to contract for under 5 U.S.C. 8902.	955

(3) "Federal poverty guidelines" has the same meaning as in	956
section 5101.46 of the Revised Code.	957

(4) "Medicaid" means the program provided for under Title XIX	958
of the "Social Security Act," 79 Stat. 286 (1965), 42 U.S.C. 1396,	959
as amended.	960

(5) "Medicare" means the program provided for under Title	961
XVII of the "Social Security Act," 79 Stat. 286 (1965), 42 U.S.C.	962
1395, as amended.	963

(B) At the request of the Ohio health care board, the Ohio	964
health care agency's executive director shall seek federal	965
financial participation in the Ohio health care plan, including	966
funding otherwise available under medicare, medicaid, CHIP, and	967
the federal employees health benefits program. The executive	968
director shall request that the amount of the federal financial	969
participation be at least equal to the medicaid federal financial	970
participation rate in effect for this state on the effective date	971
of this section. The executive director shall periodically seek	972
adjustments to the federal financial participation rate for the	973
Ohio health care plan to reflect changes in the state domestic	974
gross product, the state's population, including changes in age	975
groups, and the number of residents with income below the federal	976
poverty guidelines.	977

Sec. 3922.32.  At the request of the Ohio health care board,	978
the Ohio health care agency's executive director shall negotiate	979
with the United States office of personnel management to have	980
included in the Ohio health care plan residents of this state who	981
would otherwise be covered by the federal employees health	982
benefits program. As part of the negotiations, the executive	983
director shall seek to have the federal government provide the	984
Ohio health care plan with amounts equal to the amount federal	985
employees participating in the Ohio health care plan would	986
otherwise pay as premiums under the federal employees health	987
benefits program.	988

Sec. 3922.33.  At the request of the Ohio health care board,	989
the director of job and family services shall seek any federal	990
waivers necessary for the Ohio health care plan to receive federal	991
financial participation under section 3922.31 of the Revised Code	992
otherwise available under the medicaid and CHIP programs.	993
Notwithstanding sections 5101.50 to 5101.5110 of the Revised Code	994
and Chapter 5111. of the Revised Code, the director of job and	995
family services shall cease to implement the medicaid and CHIP	996
programs on implementation of federal waivers authorizing the use	997
of federal medicaid and CHIP funds for the Ohio health care plan,	998
if necessary due to the implementation of the waivers.	999

Section 2. In the first two years following the enactment of	1000
sections 3922.01 to 3922.33 of the Revised Code, the Ohio Health	1001
Care Board shall prepare for the delivery of universal, affordable	1002
health care coverage to all eligible Ohio residents and	1003
individuals employed in Ohio. The Ohio Health Care Board shall	1004
appoint a Transition Advisory Group to assist with the transition	1005
to the provision of care under the Ohio Health Care Plan. The	1006
transition group shall include, but is not limitedto, a broad	1007
selection of experts in health care finance and administration,	1008
providers from a variety of medical fields, representatives of	1009
Ohio's counties, employers and employees, representatives of	1010
hospitals and clinics, and representatives from state regulatory	1011
bodies. Members of the Transition Advisory Group shall be	1012
reimbursed by the Ohio Health Care Agency for necessary and actual	1013
expenses incurred in the performance of their duties as members.	1014