As Passed by the Senate

127th General Assembly Regular Session 2007-2008

Sub. H. B. No. 331

Representative Wagoner 

Cosponsors: Representatives McGregor, J., Schindel, Fende, Goodwin, Stewart, J., Seitz, Brown, Sears, Bacon, Batchelder, Bolon, Chandler, Combs, Dyer, Evans, Flowers, Hughes, Patton, Schneider, Uecker, Ujvagi, Wachtmann, Williams, B. 

Senators Schuring, Padgett, Fedor, Goodman, Harris, Kearney, Sawyer, Spada, Wilson 

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A BILL

To amend sections 3701.83, 3702.11, 3702.55, and

1

3709.09; to enact sections 3711.14, 3711.16,

2

3711.20, 3711.21, and 3711.22; to enact new

3

sections 3711.01, 3711.02, 3711.04, 3711.05,

4

3711.06, 3711.08, 3711.10, and 3711.12; and to

5

repeal sections 3711.01, 3711.02, 3711.021,

6

3711.03, 3711.04, 3711.05, 3711.06, 3711.07,

7

3711.08, 3711.09, 3711.10, 3711.11, 3711.12,

8

3711.13, and 3711.99 of the Revised Code

9

regarding the licensure of hospital maternity

10

units, hospital newborn care nurseries, and

11

maternity homes.

12

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

Section 1. That sections 3701.83, 3702.11, 3702.55, and	13
3709.09 be amended and new sections 3711.01, 3711.02, 3711.04,	14
3711.05, 3711.06, 3711.08, 3711.10, and 3711.12 and sections	15
3711.14, 3711.16, 3711.20, 3711.21, and 3711.22 of the Revised	16
Code be enacted to read as follows:	17

Sec. 3701.83.  (A) There is hereby created in the state	18
treasury the general operations fund. Moneys in the fund shall be	19
used for the purposes specified in sections 3701.04, 3701.344,	20
3702.20, 3710.15, 3711.0213711.16, 3717.45, 3718.06, 3721.02,	21
3722.04, 3729.07, 3733.04, 3733.25, 3733.43, 3748.04, 3748.05,	22
3748.07, 3748.12, 3748.13, 3749.04, 3749.07, 4747.04, 4751.04, and	23
4769.09 of the Revised Code.	24

(B) The alcohol testing program fund is hereby created in the	25
state treasury. The director of health shall use the fund to	26
administer and enforce the alcohol testing and permit program	27
authorized by section 3701.143 of the Revised Code.	28

The fund shall receive transfers from the liquor control fund	29
created under section 4301.12 of the Revised Code. All investment	30
earnings of the alcohol testing program fund shall be credited to	31
the fund.	32

Sec. 3702.11.  The director of health shall adopt rules	33
establishing safety standards and quality-of-care standards for	34
each of the following:	35

(A) Solid organ and bone marrow transplantation;

36

(B) Stem cell harvesting and reinfusion;

37

(C) Cardiac catheterization;

38

(D) Open-heart surgery;

39

(E) Obstetric and newborn care;

40

(F) Pediatric intensive care;

41

(G)(F) Operation of linear accelerators;

42

(H)(G) Operation of cobalt radiation therapy units;

43

(I)(H) Operation of gamma knives.

44

Sec. 3702.55.  Except as provided in section 3702.542 of the	45
Revised Code, a person that the director of health determines has	46
violated section 3702.53 of the Revised Code shall cease	47
conducting the activity that constitutes the violation or	48
utilizing the equipment or facility resulting from the violation	49
not later than thirty days after the person receives the notice	50
mailed under section 3702.532 of the Revised Code or, if the	51
person appeals the director's determination under section 3702.60	52
of the Revised Code, thirty days after the person receives an	53
order upholding the director's determination that is not subject	54
to further appeal. A person that applies for a certificate of need	55
as described in section 3702.542 of the Revised Code shall cease	56
conducting the activity or using the equipment or facility in	57
accordance with the timetable established by the director of	58
health under that section.	59

If any person determined to have violated section 3702.53 of	60
the Revised Code fails to cease conducting an activity or using	61
equipment or a facility as required by this section or a timetable	62
established under section 3702.542 of the Revised Code, or if the	63
person continues to seek payment or reimbursement for services	64
rendered or costs incurred in conducting the activity as	65
prohibited by section 3702.56 of the Revised Code, in addition to	66
the penalties imposed under section 3702.54, 3702.541, or 3702.542	67
or former section 3702.543 of the Revised Code:	68

(A) The director of health may refuse to include any beds	69
involved in the activity in the bed capacity of a hospital for	70
purposes of registration under section 3701.07 of the Revised	71
Code;	72

(B) The director of health may refuse to license, or may	73
revoke a license or reduce bed capacity previously granted to, a	74
maternity boardinghouse or lying-in hospital under section 3711.02	75
of the Revised Code; a hospice care program under section 3712.04	76
of the Revised Code; a nursing home, rest home, or home for the	77
aging under section 3721.02 of the Revised Code; or any beds	78
within any of those facilities that are involved in the activity;	79

(C) A political subdivision certified under section 3721.09	80
of the Revised Code may refuse to license, or may revoke a license	81
or reduce bed capacity previously granted to, a nursing home, rest	82
home, or home for the aging, or any beds within any of those	83
facilities that are involved in the activity;	84

(D) The director of mental health may refuse to license under	85
section 5119.20 of the Revised Code, or may revoke a license or	86
reduce bed capacity previously granted to, a hospital receiving	87
mentally ill persons or beds within such a hospital that are	88
involved in the activity;	89

(E) The department of job and family services may refuse to	90
enter into a provider agreement that includes a facility, beds, or	91
services that result from the activity.	92

Sec. 3709.09.  (A) The board of health of a city or general	93
health district may, by rule, establish a uniform system of fees	94
to pay the costs of any services provided by the board.	95

The fee for issuance of a certified copy of a vital record or	96
a certification of birth shall not be less than the fee prescribed	97
for the same service under division (A)(1) of section 3705.24 of	98
the Revised Code and shall include the fees required by division	99
(B) of section 3705.24 and section 3109.14 of the Revised Code.	100

Fees for services provided by the board for purposes	101
specified in sections 3701.344, 3711.053711.10, 3718.06, 3729.07,	102
3730.03, 3733.04, 3733.25, and 3749.04 of the Revised Code shall	103
be established in accordance with rules adopted under division (B)	104
of this section. The district advisory council, in the case of a	105
general health district, and the legislative authority of the	106
city, in the case of a city health district, may disapprove any	107
fee established by the board of health under this division, and	108
any such fee, as disapproved, shall not be charged by the board of	109
health.	110

(B) The public health council shall adopt rules under section	111
111.15 of the Revised Code that establish fee categories and	112
uniform methodologies for use in calculating the costs of services	113
provided for purposes specified in sections 3701.344, 3711.05	114
3711.10, 3718.06, 3729.07, 3730.03, 3733.04, 3733.25, and 3749.04	115
of the Revised Code. In adopting the rules, the public health	116
council shall consider recommendations it receives from advisory	117
boards established either by statute or the director of health	118
for entities subject to the fees.	119

(C) At least thirty days prior to establishing a fee for a	120
service provided by the board for a purpose specified in section	121
3701.344, 3711.053711.10, 3718.06, 3729.07, 3730.03, 3733.04,	122
3733.25, or 3749.04 of the Revised Code, a board of health shall	123
notify any entity that would be affected by the proposed fee of	124
the amount of the proposed fee.	125

Sec. 3711.01. As used in this chapter:

126

(A) "Board of health" means a board of health of a city or	127
general health district or the authority having the duties of a	128
board of health under section 3709.05 of the Revised Code.	129

(B) "Maternity home" means a facility for pregnant girls and	130
women where accommodations, medical care, and social services are	131
provided during the prenatal and postpartal periods. "Maternity	132
home" does not include a private residence where obstetric or	133
newborn services are received by a resident of the home.	134

(C) "Maternity unit" means a distinct portion of a hospital	135
in which inpatient care is provided to women during all or part of	136
the maternity cycle.	137

(D) "Newborn care nursery" means a distinct portion of a	138
hospital in which inpatient care is provided to infants. "Newborn	139
care nursery" includes a distinct portion of a hospital in which	140
intensive care is provided to infants.	141

Sec. 3711.02. (A) Except as provided in division (B) of this	142
section, no person shall operate any of the following, unless the	143
person holds the appropriate license issued under this chapter and	144
the license is valid:	145

(1) A maternity unit;

146

(2) A newborn care nursery;

147

(3) A maternity home.

148

(B) Division (A) of this section does not apply to a health	149
care facility as defined in division (A)(4) of section 3702.30 of	150
the Revised Code.	151

Sec. 3711.04. Each person seeking to operate a maternity	152
unit, newborn care nursery, or maternity home shall apply to the	153
director of health for a license under this chapter. The	154
application shall be submitted in the form and manner prescribed	155
by the public health council in rules adopted under section	156
3711.12 of the Revised Code.	157

A single application and license is required if an applicant	158
will operate both a maternity unit and newborn care nursery.	159

Sec. 3711.05.  (A) The director of health shall review all	160
applications received under section 3711.04 of the Revised Code.	161
On receipt of a complete application, the director shall send a	162
copy of the application to the board of health of the city or	163
general health district in which the maternity unit, newborn care	164
nursery, or maternity home is to be operated.	165

Unless the board finds that an applicant is not in compliance	166
with an applicable health regulation adopted by the board, the	167
board shall approve the application. The board shall notify the	168
director of its determination to approve or disapprove the	169
application. If the board does not notify the director of its	170
determination by the end of the thirtieth day after the board	171
receives the copy of the application, the application is deemed to	172
have been approved by the board.	173

(B) The director shall issue a license to an applicant if	174
all of the following requirements are met:	175

(1) The board of health approves the application or the	176
application is deemed to have been approved;	177

(2) The applicant meets the standards specified in rules	178
adopted under section 3711.12 of the Revised Code;	179

(3) The applicant passes the inspection required by section	180
3711.06 of the Revised Code.	181

(C) On issuance of a license, the director shall notify the	182
board of health to which the application was sent under division	183
(A) of this section. In the notice, the director shall specify the	184
terms that apply to the license.	185

Sec. 3711.06. The director of health shall inspect each	186
maternity unit, newborn care nursery, or maternity home for which	187
a person has applied for an initial license under section	188
3711.04 of the Revised Code prior to issuing the license.	189
Inspections shall be conducted in accordance with inspection	190
criteria, procedures, and guidelines adopted by the public	191
health council under section 3711.12 of the Revised Code.	192

Sec. 3711.08. A license issued under this chapter is valid	193
for three years, unless earlier revoked or suspended under	194
section 3711.14 of the Revised Code. The license may be renewed	195
in the manner prescribed by the public health council in rules	196
adopted under section 3711.12 of the Revised Code. The license	197
renewal fee specified in the rules shall be paid not later than	198
sixty days after the director of health mails an invoice for	199
the fee to the license holder. A penalty of ten per cent of the	200
amount of the renewal fee shall be assessed for each month the	201
fee is overdue.	202

Sec. 3711.10.  The director of health shall monitor	203
compliance with this chapter and the rules adopted under it. The	204
director may conduct inspections of a maternity unit, newborn care	205
nursery, or maternity home as necessary to adequately monitor	206
compliance with this chapter and the rules adopted under it. The	207
inspections may be scheduled or random.	208

The board of health of the city or general health district	209
in which a maternity unit, newborn care nursery, or maternity	210
home is located may conduct inspections of the unit, nursery, or	211
home as necessary to adequately monitor compliance with any	212
applicable health regulation adopted by the board. The inspections	213
may be scheduled or random.	214

Sec. 3711.12. (A) The public health council shall adopt	215
rules in accordance with Chapter 119. of the Revised Code as the	216
council considers necessary to implement the requirements of this	217
chapter for licensure and operation of maternity units, newborn	218
care nurseries, and maternity homes. The rules shall include	219
provisions for the following:	220

(1) Licensure application forms and procedures;

221

(2) Renewal procedures, including procedures that address	222
the right of the director of health, at the director's sole	223
discretion, to conduct an inspection prior to renewal of a	224
license;	225

(3) Initial license fees and license renewal fees;

226

(4) Fees for inspections conducted by the director under	227
section 3711.10 of the Revised Code;	228

(5) Safety standards, quality-of-care standards, and	229
quality-of-care data reporting requirements;	230

(6) Reporting and auditing requirements;

231

(7) Inspection criteria, procedures, and guidelines;

232

(8) Any other rules necessary to implement this chapter.

233

(B) When adopting rules under this section, the public health	234
council shall give consideration to recommendations regarding	235
obstetric and newborn care issued by the American college of	236
obstetricians and gynecologists; American academy of pediatrics;	237
American academy of family physicians; American society of	238
anesthesiologists; American college of nurse midwives; United	239
States centers for disease control and prevention; association	240
of women's health, obstetric and neonatal nurses; and	241
association of perioperative registered nurses, or their successor	242
organizations. The council shall also consider the	243
recommendations of the maternity and newborn advisory council	244
established in section 3711.20 of the Revised Code.	245

Sec. 3711.14. (A) In accordance with Chapter 119. of the	246
Revised Code, the director of health may do any of the following:	247

(1) Impose a civil penalty of not less than one thousand	248
dollars and not more than two hundred fifty thousand dollars on a	249
person who violates a provision of this chapter or the rules	250
adopted under it;	251

(2) Summarily suspend, in accordance with division (B) of	252
this section, a license issued under this chapter if the director	253
believes there is clear and convincing evidence that the	254
continued operation of a maternity unit, newborn care nursery, or	255
maternity home presents a danger of immediate and serious harm	256
to the public;	257

(3) Revoke a license issued under this chapter if the	258
director determines that a violation of a provision of this	259
chapter or the rules adopted under it has occurred in such a	260
manner as to pose an imminent threat of serious physical or	261
life-threatening danger.	262

(B) If the director suspends a license under division (A)(2)	263
of this section, the director shall issue a written order of	264
suspension and cause it to be delivered by certified mail or in	265
person in accordance with section 119.07 of the Revised Code. The	266
order shall not be subject to suspension by the court while an	267
appeal filed under section 119.12 of the Revised Code is pending.	268
If the individual subject to the suspension requests an	269
adjudication, the date set for the adjudication shall be within	270
fifteen days but not earlier than seven days after the individual	271
makes the request, unless another date is agreed to by both the	272
individual and the director. The summary suspension shall remain	273
in effect, unless reversed by the director, until a final	274
adjudication order issued by the director pursuant to this	275
section and Chapter 119. of the Revised Code becomes effective.	276

The director shall issue a final adjudication order not later	277
than ninety days after completion of the adjudication. If the	278
director does not issue a final order within the ninety-day	279
period, the summary suspension shall be void, but any final	280
adjudication order issued subsequent to the ninety-day period	281
shall not be affected.	282

(C) If the director issues an order revoking or suspending a	283
license issued under this chapter and the license holder	284
continues to operate a maternity unit, newborn care nursery, or	285
maternity home, the director may ask the attorney general to	286
apply to the court of common pleas of the county in which the	287
person is located for an order enjoining the person from	288
operating the unit, nursery, or home. The court shall grant the	289
order on a showing that the person is operating the unit, nursery,	290
or home.	291

Sec. 3711.16. All initial license fees, renewal fees, late	292
renewal penalties, fees for inspections conducted by the director	293
of health, and civil penalties collected under this chapter shall	294
be deposited in the state treasury to the credit of the general	295
operations fund created under section 3701.83 of the Revised	296
Code. The moneys shall be used solely for purposes of	297
administering and enforcing this chapter and the rules adopted	298
under it.	299

Sec. 3711.20. (A) As used in this section:

300

(1) "Board-certified" means that a physician has been	301
certified in an area of practice by a medical specialty board of	302
the American medical association or the American osteopathic	303
association.	304

(2) "Level I," "level II," or "level III" means the	305
service-level designation applicable to the portion of a hospital	306
in which obstetric care or newborn care is provided, as those	307
levels are reported by the hospital to the department of health	308
pursuant to section 3701.07 of the Revised Code.	309

(B) There is hereby created the maternity and newborn	310
advisory council within the department of health. The governor,	311
with the advice and consent of the senate, shall appoint the	312
following members:	313

(1) Two board-certified obstetricians;

314

(2) A board-certified pediatrician;

315

(3) A nurse manager or administrator responsible for the	316
organization and supervision of nursing services in a level I	317
obstetric care service;	318

(4) A nurse manager or administrator responsible for the	319
organization and supervision of nursing services in a level I	320
newborn care service;	321

(5) A nurse manager or administrator responsible for the	322
organization and supervision of nursing services in a level II	323
obstetric care service;	324

(6) A nurse manager or administrator responsible for the	325
organization and supervision of nursing services in a level II	326
newborn care service;	327

(7) A nurse manager or administrator responsible for the	328
organization and supervision of nursing services in a level III	329
obstetric care service;	330

(8) A nurse manager or administrator responsible for the	331
organization and supervision of nursing services in a level III	332
newborn care service;	333

(9) A licensed dietitian with knowledge of newborn nutrition;

334

(10) A licensed social worker with knowledge of newborn	335
psychosocial and family support services;	336

(11) A lactation consultant certified by the international	337
board of lactation consultant examiners;	338

(12) An individual to represent the public;

339

(13) A board-certified perinatologist;

340

(14) A board-certified neonatologist;

341

(15) A certified nurse-midwife, certified nurse practitioner,	342
clinical nurse specialist, or certified registered nurse	343
anesthetist;	344

(16) A board-certified anesthesiologist;

345

(17) A board-certified family practice physician who delivers	346
children or provides newborn care.	347

(C) The governor shall make the initial appointments to the	348
council not later than sixty days after the effective date of this	349
section. Of the initial appointments, six shall be for a term of	350
three years, six for a term of four years, and six for a term of	351
five years. Thereafter, terms of office shall be five years with	352
each term ending on the same day of the same month as the term it	353
succeeds. Each member shall hold office from the date of the	354
member's appointment until the end of the term for which the	355
member was appointed. Members may be reappointed. Vacancies shall	356
be filled in the manner provided for original appointment. Any	357
member appointed to fill a vacancy prior to the expiration of the	358
term for which the member's predecessor was appointed shall hold	359
office for the remainder of that term. A member shall continue in	360
office subsequent to the expiration of the member's term or until	361
a period of sixty days has elapsed, whichever occurs first.	362

(D) The council shall hold four meetings in the first year	363
after the initial appointments to the council are made under	364
division (B) of this section. Thereafter, the council shall hold	365
two meetings each year. Additional meetings may be held at the	366
call of the chairperson or the director of health.	367

The chairperson shall be selected annually by members of the	368
council. Following each meeting, the chairperson may submit a	369
report to the director summarizing the activities, discussion, and	370
recommendations of the council. Eight voting members of the	371
council constitute a quorum.	372

(E) Members of the council shall be reimbursed for actual and	373
necessary expenses incurred in the performance of their official	374
duties.	375

(F) The department of health shall provide the council the	376
administrative support necessary to execute its duties.	377

Sec. 3711.21. The maternity and newborn advisory council	378
shall do all of the following:	379

(A) Advise and consult with the director of health in the	380
development of rules to be presented to the public health council	381
for proposed adoption under this chapter;	382

(B) Advise and consult with the director concerning the	383
implementation and enforcement of this chapter;	384

(C) Advise and consult with the director in the development	385
of inspection criteria, procedures, and guidelines to be used in	386
enforcement of this chapter;	387

(D) Advise and consult with the director regarding	388
recommendations to be presented to the public health council	389
regarding improving maternity and newborn care in this state;	390

(E) Prepare and submit to the director an annual report	391
evaluating the department's enforcement of this chapter.	392

Sec. 3711.22. The maternity and newborn advisory council may	393
establish committees to focus on specific components of the	394
enforcement of this chapter. Chairpersons of the committees shall	395
be appointed by the chairperson of the council and shall be	396
members of the council. Other members of the committees shall be	397
appointed by the chairperson of the council and may include	398
individuals who are not members of the council.	399

The membership and responsibilities of each committee	400
established under this section shall be subject to the approval of	401
the director of health. Members of the committees shall be	402
reimbursed for actual and necessary expenses incurred in the	403
performance of their official duties.	404

Committee reports shall be presented to the council at each	405
regular meeting of the council.	406

Section 2. That existing sections 3701.83, 3702.11, 3702.55,	407
and 3709.09 and sections 3711.01, 3711.02, 3711.021, 3711.03,	408
3711.04, 3711.05, 3711.06, 3711.07, 3711.08, 3711.09, 3711.10,	409
3711.11, 3711.12, 3711.13, and 3711.99 of the Revised Code are	410
hereby repealed.	411

Section 3. Notwithstanding the provisions of Sections 1 and 2	412
of this act, a person may continue to operate a maternity unit,	413
newborn care nursery, or maternity home pursuant to a license	414
issued under Chapter 3711. of the Revised Code, as that chapter	415
existed immediately prior to the effective date of this act,	416
until the person's license expires or is revoked.	417

Until the rules required by sections 3711.04 and 3711.10 of	418
the Revised Code as enacted by this act are adopted, the	419
Department of Health may renew licenses and issue new licenses	420
under the rules adopted under former Chapter 3711. of the Revised	421
Code.	422