S. B. No. 134 As Introduced

As Introduced

128th General Assembly

Regular Session

2009-2010

S. B. No. 134

Senator Miller, R.

A BILL

To amend sections 9.231, 9.239, 9.24, 101.39,

101.391, 103.144, 109.572, 109.85, 117.10, 119.01,

121.02, 121.03, 122.15, 124.30, 124.301, 127.16,

131.23, 145.27, 145.58, 149.431, 169.02, 173.14,

173.20, 173.21, 173.26, 173.35, 173.351, 173.394,

173.40, 173.401, 173.42, 173.45, 173.47, 173.50,

173.71, 173.72, 173.721, 173.722, 173.723,

173.724, 173.73, 173.731, 173.732, 173.74,

173.741, 173.742, 173.75, 173.751, 173.752,

173.753, 173.76, 173.77, 173.771, 173.772,

173.773, 173.78, 173.79, 173.791, 173.80,

173.801, 173.802, 173.803, 173.81, 173.811,

173.812, 173.813, 173.814, 173.815, 173.82,

173.83, 173.831, 173.832, 173.833, 173.84,

173.85, 173.86, 173.861, 173.87, 173.88, 173.89,

173.891, 173.892, 173.90, 173.91, 173.99, 317.08,

317.36, 323.01, 329.04, 329.051, 329.06, 329.14,

340.03, 340.091, 340.16, 341.192, 505.84, 742.41,

955.201, 1337.11, 1347.08, 1731.04, 1739.061,

1751.01, 1751.11, 1751.12, 1751.18, 1751.271,

1751.31, 1751.60, 1751.88, 1751.89, 1923.14,

2113.041, 2113.06, 2117.061, 2117.25, 2133.01,

2151.3514, 2305.234, 2307.65, 2317.02, 2335.39,

2505.02, 2705.02, 2744.05, 2903.33, 2913.40,

2913.401, 2921.01, 2921.13, 2945.401, 3101.051,

3107.083, 3111.04, 3111.72, 3113.06, 3119.29,

3119.54, 3121.441, 3121.898, 3125.36, 3307.20,

3309.22, 3313.714, 3313.715, 3323.021, 3599.45,

3701.023, 3701.024, 3701.027, 3701.043, 3701.132,

3701.243, 3701.507, 3701.74, 3701.741, 3701.881,

3702.30, 3702.31, 3702.51, 3702.522, 3702.591,

3702.62, 3702.74, 3702.91, 3712.07, 3712.09,

3721.01, 3721.011, 3721.021, 3721.022, 3721.024,

3721.026, 3721.042, 3721.071, 3721.08, 3721.10,

3721.12, 3721.121, 3721.13, 3721.15, 3721.16,

3721.17, 3721.19, 3721.21, 3721.28, 3721.32,

3721.50, 3721.51, 3721.52, 3721.53, 3721.54,

3721.541, 3721.55, 3721.56, 3721.561, 3721.57,

3721.58, 3722.10, 3722.16, 3727.02, 3742.30,

3742.51, 3793.07, 3901.3814, 3903.14, 3916.06,

3923.122, 3923.27, 3923.281, 3923.33, 3923.38,

3923.49, 3923.50, 3923.58, 3923.601, 3923.70,

3923.79, 3923.83, 3924.41, 3924.42, 3963.01,

4123.27, 4141.162, 4719.01, 4723.063, 4723.17,

4723.63, 4731.151, 4731.65, 4731.71, 4752.02,

4752.09, 4753.071, 4755.481, 4758.02, 4758.04,

4761.01, 4761.03, 4769.01, 5101.07, 5101.071,

5101.11, 5101.16, 5101.162, 5101.18, 5101.181,

5101.182, 5101.184, 5101.21, 5101.212, 5101.214,

5101.216, 5101.22, 5101.221, 5101.23, 5101.24,

5101.243, 5101.25, 5101.26, 5101.31, 5101.35,

5101.36, 5101.47, 5101.50, 5101.501, 5101.502,

5101.503, 5101.51, 5101.511, 5101.512, 5101.513,

5101.514, 5101.515, 5101.516, 5101.517, 5101.518,

5101.519, 5101.5110, 5101.52, 5101.521, 5101.522,

5101.523, 5101.524, 5101.525, 5101.526, 5101.527,

5101.528, 5101.529, 5101.5211, 5101.5212,

5101.5213, 5101.5214, 5101.5215, 5101.5216,

5101.571, 5101.572, 5101.573, 5101.575, 5101.58,

5101.59, 5101.591, 5101.97, 5103.02, 5107.10,

5107.14, 5107.16, 5107.20, 5107.26, 5111.01,

5111.011, 5111.013, 5111.014, 5111.015, 5111.016,

5111.018, 5111.019, 5111.0110, 5111.0111,

5111.0112, 5111.0113, 5111.0114, 5111.0115,

5111.0116, 5111.0117, 5111.0118, 5111.0119,

5111.02, 5111.021, 5111.022, 5111.023, 5111.024,

5111.025, 5111.028, 5111.029, 5111.03, 5111.031,

5111.032, 5111.033, 5111.034, 5111.04, 5111.042,

5111.05, 5111.06, 5111.061, 5111.062, 5111.07,

5111.071, 5111.08, 5111.081, 5111.082, 5111.083,

5111.084, 5111.09, 5111.091, 5111.10, 5111.102,

5111.11, 5111.111, 5111.112, 5111.113, 5111.114,

5111.12, 5111.121, 5111.13, 5111.14, 5111.15,

5111.151, 5111.16, 5111.162, 5111.163, 5111.17,

5111.171, 5111.172, 5111.173, 5111.174, 5111.175,

5111.176, 5111.177, 5111.178, 5111.18, 5111.181,

5111.19, 5111.191, 5111.20, 5111.201, 5111.202,

5111.203, 5111.204, 5111.21, 5111.211, 5111.22,

5111.221, 5111.222, 5111.23, 5111.231, 5111.232,

5111.235, 5111.24, 5111.241, 5111.242, 5111.243,

5111.244, 5111.25, 5111.251, 5111.254, 5111.255,

5111.258, 5111.26, 5111.261, 5111.263, 5111.264,

5111.265, 5111.266, 5111.27, 5111.28, 5111.29,

5111.291, 5111.30, 5111.31, 5111.32, 5111.33,

5111.34, 5111.35, 5111.36, 5111.37, 5111.38,

5111.39, 5111.41, 5111.411, 5111.42, 5111.43,

5111.44, 5111.45, 5111.46, 5111.47, 5111.48,

5111.49, 5111.50, 5111.51, 5111.52, 5111.53,

5111.54, 5111.55, 5111.56, 5111.57, 5111.58,

5111.59, 5111.60, 5111.61, 5111.62, 5111.63,

5111.65, 5111.651, 5111.66, 5111.67, 5111.671,

5111.672, 5111.673, 5111.674, 5111.675, 5111.676,

5111.677, 5111.68, 5111.681, 5111.682, 5111.683,

5111.684, 5111.685, 5111.686, 5111.687, 5111.688,

5111.70, 5111.701, 5111.702, 5111.703, 5111.704,

5111.705, 5111.707, 5111.708, 5111.709, 5111.7010,

5111.7011, 5111.71, 5111.711, 5111.712, 5111.713,

5111.714, 5111.715, 5111.84, 5111.85, 5111.851,

5111.852, 5111.853, 5111.855, 5111.856, 5111.86,

5111.87, 5111.871, 5111.872, 5111.873, 5111.874,

100

5111.875, 5111.876, 5111.877, 5111.878, 5111.879,

101

5111.8710, 5111.89, 5111.891, 5111.894, 5111.90,

102

5111.91, 5111.911, 5111.912, 5111.913, 5111.914,

103

5111.915, 5111.92, 5111.93, 5111.94, 5111.941,

104

5111.942, 5111.943, 5111.97, 5111.971, 5111.98,

105

5111.99, 5112.01, 5112.03, 5112.04, 5112.05,

106

5112.06, 5112.07, 5112.08, 5112.09, 5112.10,

107

5112.11, 5112.17, 5112.18, 5112.19, 5112.21,

108

5112.30, 5112.31, 5112.32, 5112.33, 5112.34,

109

5112.341, 5112.35, 5112.37, 5112.371, 5112.38,

110

5112.39, 5112.99, 5115.02, 5115.10, 5115.11,

111

5115.12, 5115.13, 5115.14, 5115.20, 5115.22,

112

5115.23, 5117.10, 5119.04, 5119.061, 5119.16,

113

5119.351, 5119.61, 5120.65, 5120.652, 5121.04,

114

5123.01, 5123.021, 5123.0412, 5123.0417,

115

5123.171, 5123.181, 5123.19, 5123.192, 5123.198,

116

5123.211, 5123.71, 5123.76, 5126.01, 5126.042,

117

5126.046, 5126.054, 5126.055, 5126.0512,

118

5126.082, 5126.12, 5302.221, 5309.082, 5505.04,

119

5725.18, 5729.03, 5731.39, 5747.01, 5747.122,

120

5747.18, 5751.081, 5815.28, and 5907.04, to

121

amend, for the purpose of adopting a new section

122

number as indicated in parentheses sections

123

173.35 (5160.80), 173.351 (5160.81), 173.71

124

(5169.01), 173.72 (5169.02), 173.721 (5169.021),

125

173.722 (5169.022), 173.723 (5169.023), 173.724

126

(5169.024), 173.73 (5169.03), 173.731 (5169.031),

127

173.732 (5169.032), 173.74 (5169.04), 173.741

128

(5169.041), 173.742 (5169.042), 173.75 (5169.05),

129

173.751 (5169.051), 173.752 (5169.052), 173.753

130

(5169.053), 173.76 (5169.06), 173.77 (5169.07),

131

173.771 (5169.071), 173.772 (5169.072), 173.773

132

(5169.073), 173.78 (5169.08), 173.79 (5169.09),

133

173.791 (5169.091), 173.80 (5169.10), 173.801

134

(5169.101), 173.802 (5169.102), 173.803

135

(5169.103), 173.81 (5169.11), 173.811 (5169.111),

136

173.812 (5169.112), 173.813 (5169.113), 173.814

137

(5169.114), 173.815 (5169.115), 173.82 (5169.12),

138

173.83 (5169.13), 173.831 (5169.131), 173.832

139

(5169.132), 173.833 (5169.133), 173.84 (5169.14),

140

173.85 (5169.15), 173.86 (5169.16), 173.861

141

(5169.161), 173.87 (5169.17), 173.871 (5169.171),

142

173.872 (5169.172), 173.873 (5169.173), 173.874

143

(5169.174), 173.875 (5169.175), 173.876

144

(5169.176), 173.88 (5169.18), 173.89 (5169.19),

145

173.891 (5169.191), 173.892 (5169.192), 173.90

146

(5169.20), 173.91 (5169.21), 3721.50 (5166.20),

147

3721.51 (5166.21), 3721.52 (5166.22), 3721.53

148

(5166.23), 3721.54 (5166.24), 3721.541 (5166.25),

149

3721.55 (5166.26), 3721.56 (5166.27), 3721.561

150

(5166.28), 3721.57 (5166.29), 3721.58 (5166.30),

151

5101.31 (5160.67), 5101.50 (5167.05), 5101.501

152

(5167.06), 5101.502 (5167.07), 5101.503 (5167.08),

153

5101.51 (5167.10), 5101.511 (5167.11), 5101.512

154

(5167.12), 5101.513 (5167.13), 5101.514 (5167.14),

155

5101.515 (5167.15), 5101.516 (5167.16), 5101.517

156

(5167.17), 5101.518 (5167.18), 5101.519 (5167.19),

157

5101.5110 (5167.32), 5101.52 (5167.21), 5101.521

158

(5167.22), 5101.522 (5167.23), 5101.523 (5167.24),

159

5101.524 (5167.25), 5101.525 (5167.26), 5101.526

160

(5167.27), 5101.527 (5167.28), 5101.528 (5167.29),

161

5101.529 (5167.30), 5101.5211 (5167.35), 5101.5212

162

(5167.36), 5101.5213 (5167.37), 5101.5214

163

(5167.38), 5101.5215 (5167.39), 5101.5216

164

(5167.40), 5101.571 (5160.36), 5101.572

165

(5160.40), 5101.573 (5160.401), 5101.574

166

(5160.402), 5101.575 (5160.403), 5101.58

167

(5160.38), 5101.59 (5160.37), 5101.591 (5160.41),

168

5111.01 (5162.01), 5111.011 (5162.20), 5111.013

169

(5162.15), 5111.014 (5162.04), 5111.015 (5162.24),

170

5111.016 (5162.16), 5111.018 (5163.18), 5111.019

171

(5162.05), 5111.0110 (5162.08), 5111.0111

172

(5162.06), 5111.0112 (5162.35), 5111.0113

173

(5162.07), 5111.0114 (5163.261), 5111.0115

174

(5162.09), 5111.0116 (5162.21), 5111.0117

175

(5162.22), 5111.0118 (5162.23), 5111.0119

176

(5162.18), 5111.02 (5163.15), 5111.021 (5163.16),

177

5111.022 (5163.08), 5111.023 (5163.20), 5111.024

178

(5163.19), 5111.025 (5163.17), 5111.027

179

(5163.242), 5111.028 (5163.011), 5111.029

180

(5163.27), 5111.03 (5163.03), 5111.031 (5163.031),

181

5111.032 (5163.032), 5111.033 (5163.033), 5111.034

182

(5163.034), 5111.04 (5163.21), 5111.042

183

(5163.28), 5111.05 (5163.02), 5111.06 (5163.01),

184

5111.061 (5163.07), 5111.062 (5163.09), 5111.07

185

(5163.25), 5111.071 (5163.251), 5111.08

186

(5163.241), 5111.081 (5163.26), 5111.082

187

(5163.24), 5111.083 (5163.243), 5111.084

188

(5160.04), 5111.09 (5161.32), 5111.091 (5161.33),

189

5111.10 (5161.30), 5111.101 (5163.12), 5111.102

190

(5161.011), 5111.11 (5162.40), 5111.111

191

(5162.41), 5111.112 (5162.42), 5111.113

192

(5162.37), 5111.114 (5162.36), 5111.12 (5162.45),

193

5111.121 (5160.39), 5111.13 (5165.30), 5111.14

194

(5163.22), 5111.15 (5162.25), 5111.151 (5162.26),

195

5111.16 (5165.03), 5111.162 (5165.14), 5111.163

196

(5165.15), 5111.17 (5165.05), 5111.171 (5165.07),

197

5111.172 (5165.09), 5111.173 (5165.10), 5111.174

198

(5165.12), 5111.175 (5165.13), 5111.176

199

(5166.60), 5111.177 (5165.11), 5111.178

200

(5165.16), 5111.18 (5162.43), 5111.181 (5162.30),

201

5111.19 (5163.23), 5111.191 (5163.231), 5111.20

202

(5164.01), 5111.201 (5164.011), 5111.202

203

(5164.45), 5111.203 (5164.46), 5111.204 (5164.47),

204

5111.21 (5164.02), 5111.211 (5164.14), 5111.22

205

(5164.03), 5111.221 (5164.40), 5111.222 (5164.18),

206

5111.223 (5164.031), 5111.23 (5164.05), 5111.231

207

(5164.19), 5111.232 (5164.191), 5111.235

208

(5164.06), 5111.24 (5164.20), 5111.241 (5164.07),

209

5111.242 (5164.21), 5111.243 (5164.22), 5111.244

210

(5164.23), 5111.25 (5164.24), 5111.251 (5164.08),

211

5111.254 (5164.32), 5111.255 (5164.12), 5111.257

212

(5164.27), 5111.258 (5164.34), 5111.26 (5164.37),

213

5111.261 (5164.10), 5111.263 (5164.26), 5111.264

214

(5164.372), 5111.265 (5164.28), 5111.266

215

(5164.371), 5111.27 (5164.38), 5111.28 (5164.39),

216

5111.29 (5164.41), 5111.291 (5164.13), 5111.30

217

(5164.032), 5111.31 (5164.033), 5111.32

218

(5164.034), 5111.33 (5164.35), 5111.34 (5164.30),

219

5111.35 (5164.50), 5111.36 (5164.51), 5111.37

220

(5164.52), 5111.38 (5164.53), 5111.39 (5164.54),

221

5111.40 (5164.55), 5111.41 (5164.56), 5111.411

222

(5164.57), 5111.42 (5164.58), 5111.43 (5164.59),

223

5111.44 (5164.60), 5111.45 (5164.61), 5111.46

224

(5164.62), 5111.47 (5164.63), 5111.48 (5164.64),

225

5111.49 (5164.65), 5111.50 (5164.66), 5111.51

226

(5164.67), 5111.52 (5164.68), 5111.53 (5164.69),

227

5111.54 (5164.70), 5111.55 (5164.71), 5111.56

228

(5164.72), 5111.57 (5164.73), 5111.58 (5164.74),

229

5111.59 (5164.75), 5111.60 (5164.76), 5111.61

230

(5164.77), 5111.62 (5164.78), 5111.63 (5164.79),

231

5111.65 (5164.82), 5111.651 (5164.821), 5111.66

232

(5164.83), 5111.67 (5164.84), 5111.671 (5164.841),

233

5111.672 (5164.842), 5111.673 (5164.843), 5111.674

234

(5164.844), 5111.675 (5164.845), 5111.676

235

(5164.846), 5111.677 (5164.847), 5111.68

236

(5164.85), 5111.681 (5164.851), 5111.682

237

(5164.852), 5111.683 (5164.853), 5111.684

238

(5164.854), 5111.685 (5164.855), 5111.686

239

(5164.856), 5111.687 (5164.857), 5111.688

240

(5164.858), 5111.70 (5162.10), 5111.701

241

(5162.101), 5111.702 (5162.102), 5111.703

242

(5162.103), 5111.704 (5162.104) 5111.705

243

(5162.105), 5111.706 (5162.106), 5111.707

244

(5162.107), 5111.708 (5162.108), 5111.709

245

(5162.109), 5111.7010 (5162.1010), 5111.7011

246

(5162.1011), 5111.71 (5163.30), 5111.711

247

(5163.301), 5111.712 (5163.302), 5111.713

248

(5163.303), 5111.714 (5163.304), 5111.715

249

(5163.305), 5111.84 (5163.501), 5111.85 (5163.50),

250

5111.851 (5163.51), 5111.852 (5163.52), 5111.853

251

(5163.53), 5111.854 (5163.54), 5111.855

252

(5163.55), 5111.856 (5163.56), 5111.86 (5163.60),

253

5111.87 (5163.65), 5111.871 (5163.651), 5111.872

254

(5163.652), 5111.873 (5163.653), 5111.874

255

(5163.66), 5111.875 (5163.661), 5111.876

256

(5163.662), 5111.877 (5163.663), 5111.878

257

(5163.664), 5111.879 (5163.665), 5111.8710

258

(5163.666), 5111.89 (5163.68), 5111.891

259

(5163.681), 5111.892 (5163.682), 5111.893

260

(5163.683), 5111.894 (5163.684), 5111.90

261

(5161.10), 5111.91 (5161.05), 5111.911 (5161.06),

262

5111.912 (5161.07), 5111.913 (5161.08), 5111.914

263

(5163.06), 5111.915 (5161.25), 5111.92 (5161.12),

264

5111.93 (5161.13), 5111.94 (5161.15), 5111.941

265

(5161.16), 5111.942 (5161.17), 5111.943

266

(5161.18), 5111.97 (5163.73), 5111.971 (5163.69),

267

5111.98 (5161.02), 5111.99 (5164.99), 5112.01

268

(5166.01), 5112.03 (5166.02), 5112.04 (5166.03),

269

5112.05 (5166.04), 5112.06 (5166.05), 5112.07

270

(5166.06), 5112.08 (5166.07), 5112.09 (5166.08),

271

5112.10 (5166.09), 5112.11 (5166.10), 5112.17

272

(5166.11), 5112.18 (5166.12), 5112.19 (5166.13),

273

5112.21 (5166.14), 5112.30 (5166.40), 5112.31

274

(5166.41), 5112.32 (5166.43), 5112.33 (5166.44),

275

5112.34 (5166.45), 5112.341 (5166.46), 5112.35

276

(5166.47), 5112.37 (5166.48), 5112.371 (5166.481),

277

5112.38 (5166.49), 5112.39 (5166.50), 5112.99

278

(5166.99), 5115.10 (5168.01), 5115.11 (5168.02),

279

5115.12 (5168.05), 5115.13 (5168.07), 5115.14

280

(5168.06), to enact sections 117.54, 117.55,

281

117.56, 117.57, 329.043, 5160.01, 5160.02,

282

5160.03, 5160.05, 5160.06, 5160.08, 5160.10,

283

5160.101, 5160.12, 5160.13, 5160.15, 5160.151,

284

5160.152, 5160.17, 5160.18, 5160.19, 5160.191,

285

5160.192, 5160.20, 5160.21, 5160.211, 5160.22,

286

5160.23, 5160.24, 5160.26, 5160.261, 5160.262,

287

5160.28, 5160.29, 5160.30, 5160.32, 5160.34,

288

5160.341, 5160.42, 5160.43, 5160.44, 5160.45,

289

5160.46, 5160.50, 5160.51, 5160.52, 5160.53,

290

5160.54, 5160.55, 5160.56, 5160.57, 5160.58,

291

5160.59, 5160.60, 5160.61, 5160.62, 5160.63,

292

5160.64, 5160.65, 5160.66, 5160.70, 5160.71,

293

5160.75, 5160.99, 5161.01, 5161.03, 5162.02,

294

5162.03, 5162.17, 5163.04, 5164.051, 5165.01,

295

5165.02, 5165.04, 5165.06, 5165.08, 5165.17,

296

5165.18, 5167.01, 5168.03, 5168.04, 5168.08,

297

5168.09, 5168.10, and 5169.99, and to repeal

298

section 5111.012 of the Revised Code; to amend

299

Section 7 of Am. Sub. H.B. 468 of the 126th

300

General Assembly; to create the Department of

301

Health Care Administration; to transfer the

302

Medicaid Program, Children's Health Insurance

303

Program, Children's Buy-In Program, Hospital Care

304

Assurance Program, Disability Medical Assistance

305

Program, Ohio's Best Rx Program, and Residential

306

State Supplement Program to the new department;

307

to require the new department to create a central

308

pharmaceutical purchasing office; and to make an

309

appropriation.

310

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

Section 1. That sections 9.231, 9.239, 9.24, 101.39,	311
101.391, 103.144, 109.572, 109.85, 117.10, 119.01, 121.02,	312
121.03, 122.15, 124.30, 124.301, 127.16, 131.23, 145.27, 145.58,	313
149.431, 169.02, 173.14, 173.20, 173.21, 173.26, 173.35, 173.351,	314
173.394, 173.40, 173.401, 173.42, 173.45, 173.47, 173.50, 173.71,	315
173.72, 173.721, 173.722, 173.723, 173.724, 173.73, 173.731,	316
173.732, 173.74, 173.741, 173.742, 173.75, 173.751, 173.752,	317
173.753, 173.76, 173.77, 173.771, 173.772, 173.773, 173.78,	318
173.79, 173.791, 173.80, 173.801, 173.802, 173.803, 173.81,	319
173.811, 173.812, 173.813, 173.814, 173.815, 173.82, 173.83,	320
173.831, 173.832, 173.833, 173.84, 173.85, 173.86, 173.861,	321
173.87, 173.88, 173.89, 173.891, 173.892, 173.90, 173.91, 173.99,	322
317.08, 317.36, 323.01, 329.04, 329.051, 329.06, 329.14, 340.03,	323
340.091, 340.16, 341.192, 505.84, 742.41, 955.201, 1337.11,	324
1347.08, 1731.04, 1739.061, 1751.01, 1751.11, 1751.12, 1751.18,	325
1751.271, 1751.31, 1751.60, 1751.88, 1751.89, 1923.14, 2113.041,	326
2113.06, 2117.061, 2117.25, 2133.01, 2151.3514, 2305.234,	327
2307.65, 2317.02, 2335.39, 2505.02, 2705.02, 2744.05, 2903.33,	328
2913.40, 2913.401, 2921.01, 2921.13, 2945.401, 3101.051,	329
3107.083, 3111.04, 3111.72, 3113.06, 3119.29, 3119.54, 3121.441,	330
3121.898, 3125.36, 3307.20, 3309.22, 3313.714, 3313.715,	331
3323.021, 3599.45, 3701.023, 3701.024, 3701.027, 3701.043,	332
3701.132, 3701.243, 3701.507, 3701.74, 3701.741, 3701.881,	333
3702.30, 3702.31, 3702.51, 3702.522, 3702.591, 3702.62, 3702.74,	334
3702.91, 3712.07, 3712.09, 3721.01, 3721.011, 3721.021, 3721.022,	335
3721.024, 3721.026, 3721.042, 3721.071, 3721.08, 3721.10,	336
3721.12, 3721.121, 3721.13, 3721.15, 3721.16, 3721.17, 3721.19,	337
3721.21, 3721.28, 3721.32, 3721.50, 3721.51, 3721.52, 3721.53,	338
3721.54, 3721.541, 3721.55, 3721.56, 3721.561, 3721.57, 3721.58,	339
3722.10, 3722.16, 3727.02, 3742.30, 3742.51, 3793.07, 3901.3814,	340
3903.14, 3916.06, 3923.122, 3923.27, 3923.281, 3923.33, 3923.38,	341
3923.49, 3923.50, 3923.58, 3923.601, 3923.70, 3923.79, 3923.83,	342
3924.41, 3924.42, 3963.01, 4123.27, 4141.162, 4719.01, 4723.063,	343
4723.17, 4723.63, 4731.151, 4731.65, 4731.71, 4752.02, 4752.09,	344
4753.071, 4755.481, 4758.02, 4758.04, 4761.01, 4761.03, 4769.01,	345
5101.07, 5101.071, 5101.11, 5101.16, 5101.162, 5101.18, 5101.181,	346
5101.182, 5101.184, 5101.21, 5101.212, 5101.214, 5101.216,	347
5101.22, 5101.221, 5101.23, 5101.24, 5101.243, 5101.25, 5101.26,	348
5101.31, 5101.35, 5101.36, 5101.47, 5101.50, 5101.501, 5101.502,	349
5101.503, 5101.51, 5101.511, 5101.512, 5101.513, 5101.514,	350
5101.515, 5101.516, 5101.517, 5101.518, 5101.519, 5101.5110,	351
5101.52, 5101.521, 5101.522, 5101.523, 5101.524, 5101.525,	352
5101.526, 5101.527, 5101.528, 5101.529, 5101.5211, 5101.5212,	353
5101.5213, 5101.5214, 5101.5215, 5101.5216, 5101.571, 5101.572,	354
5101.573, 5101.575, 5101.58, 5101.59, 5101.591, 5101.97, 5103.02,	355
5107.10, 5107.14, 5107.16, 5107.20, 5107.26, 5111.01, 5111.011,	356
5111.013, 5111.014, 5111.015, 5111.016, 5111.018, 5111.019,	357
5111.0110, 5111.0111, 5111.0112, 5111.0113, 5111.0114, 5111.0115,	358
5111.0116, 5111.0117, 5111.0118, 5111.0119, 5111.02, 5111.021,	359
5111.022, 5111.023, 5111.024, 5111.025, 5111.028, 5111.029,	360
5111.03, 5111.031, 5111.032, 5111.033, 5111.034, 5111.04,	361
5111.042, 5111.05, 5111.06, 5111.061, 5111.062, 5111.07,	362
5111.071, 5111.08, 5111.081, 5111.082, 5111.083, 5111.084,	363
5111.09, 5111.091, 5111.10, 5111.102, 5111.11, 5111.111,	364
5111.112, 5111.113, 5111.114, 5111.12, 5111.121, 5111.13,	365
5111.14, 5111.15, 5111.151, 5111.16, 5111.162, 5111.163, 5111.17,	366
5111.171, 5111.172, 5111.173, 5111.174, 5111.175, 5111.176,	367
5111.177, 5111.178, 5111.18, 5111.181, 5111.19, 5111.191,	368
5111.20, 5111.201, 5111.202, 5111.203, 5111.204, 5111.21,	369
5111.211, 5111.22, 5111.221, 5111.222, 5111.23, 5111.231,	370
5111.232, 5111.235, 5111.24, 5111.241, 5111.242, 5111.243,	371
5111.244, 5111.25, 5111.251, 5111.254, 5111.255, 5111.258,	372
5111.26, 5111.261, 5111.263, 5111.264, 5111.265, 5111.266,	373
5111.27, 5111.28, 5111.29, 5111.291, 5111.30, 5111.31, 5111.32,	374
5111.33, 5111.34, 5111.35, 5111.36, 5111.37, 5111.38, 5111.39,	375
5111.41, 5111.411, 5111.42, 5111.43, 5111.44, 5111.45, 5111.46,	376
5111.47, 5111.48, 5111.49, 5111.50, 5111.51, 5111.52, 5111.53,	377
5111.54, 5111.55, 5111.56, 5111.57, 5111.58, 5111.59, 5111.60,	378
5111.61, 5111.62, 5111.63, 5111.65, 5111.651, 5111.66, 5111.67,	379
5111.671, 5111.672, 5111.673, 5111.674, 5111.675, 5111.676,	380
5111.677, 5111.68, 5111.681, 5111.682, 5111.683, 5111.684,	381
5111.685, 5111.686, 5111.687, 5111.688, 5111.70, 5111.701,	382
5111.702, 5111.703, 5111.704, 5111.705, 5111.707, 5111.708,	383
5111.709, 5111.7010, 5111.7011, 5111.71, 5111.711, 5111.712,	384
5111.713, 5111.714, 5111.715, 5111.84, 5111.85, 5111.851,	385
5111.852, 5111.853, 5111.855, 5111.856, 5111.86, 5111.87,	386
5111.871, 5111.872, 5111.873, 5111.874, 5111.875, 5111.876,	387
5111.877, 5111.878, 5111.879, 5111.8710, 5111.89, 5111.891,	388
5111.894, 5111.90, 5111.91, 5111.911, 5111.912, 5111.913,	389
5111.914, 5111.915, 5111.92, 5111.93, 5111.94, 5111.941,	390
5111.942, 5111.943, 5111.97, 5111.971, 5111.98, 5111.99, 5112.01,	391
5112.03, 5112.04, 5112.05, 5112.06, 5112.07, 5112.08, 5112.09,	392
5112.10, 5112.11, 5112.17, 5112.18, 5112.19, 5112.21, 5112.30,	393
5112.31, 5112.32, 5112.33, 5112.34, 5112.341, 5112.35, 5112.37,	394
5112.371, 5112.38, 5112.39, 5112.99, 5115.02, 5115.10, 5115.11,	395
5115.12, 5115.13, 5115.14, 5115.20, 5115.22, 5115.23, 5117.10,	396
5119.04, 5119.061, 5119.16, 5119.351, 5119.61, 5120.65, 5120.652,	397
5121.04, 5123.01, 5123.021, 5123.0412, 5123.0417, 5123.171,	398
5123.181, 5123.19, 5123.192, 5123.198, 5123.211, 5123.71,	399
5123.76, 5126.01, 5126.042, 5126.046, 5126.054, 5126.055,	400
5126.0512, 5126.082, 5126.12, 5302.221, 5309.082, 5505.04,	401
5725.18, 5729.03, 5731.39, 5747.01, 5747.122, 5747.18, 5751.081,	402
5815.28, and 5907.04 be amended, sections 173.35 (5160.80),	403
173.351 (5160.81), 173.71 (5169.01), 173.72 (5169.02), 173.721	404
(5169.021), 173.722 (5169.022), 173.723 (5169.023), 173.724	405
(5169.024), 173.73 (5169.03), 173.731 (5169.031), 173.732	406
(5169.032), 173.74 (5169.04), 173.741 (5169.041), 173.742	407
(5169.042), 173.75 (5169.05), 173.751 (5169.051), 173.752	408
(5169.052), 173.753 (5169.053), 173.76 (5169.06), 173.77	409
(5169.07), 173.771 (5169.071), 173.772 (5169.072), 173.773	410
(5169.073), 173.78 (5169.08), 173.79 (5169.09), 173.791	411
(5169.091), 173.80 (5169.10), 173.801 (5169.101), 173.802	412
(5169.102), 173.803 (5169.103), 173.81 (5169.11), 173.811	413
(5169.111), 173.812 (5169.112), 173.813 (5169.113), 173.814	414
(5169.114), 173.815 (5169.115), 173.82 (5169.12), 173.83	415
(5169.13), 173.831 (5169.131), 173.832 (5169.132), 173.833	416
(5169.133), 173.84 (5169.14), 173.85 (5169.15), 173.86 (5169.16),	417
173.861 (5169.161), 173.87 (5169.17), 173.871 (5169.171),	418
173.872 (5169.172), 173.873 (5169.173), 173.874 (5169.174),	419
173.875 (5169.175), 173.876 (5169.176), 173.88 (5169.18), 173.89	420
(5169.19), 173.891 (5169.191), 173.892 (5169.192), 173.90	421
(5169.20), 173.91 (5169.21), 3721.50 (5166.20), 3721.51	422
(5166.21), 3721.52 (5166.22), 3721.53 (5166.23), 3721.54	423
(5166.24), 3721.541 (5166.25), 3721.55 (5166.26), 3721.56	424
(5166.27), 3721.561 (5166.28), 3721.57 (5166.29), 3721.58	425
(5166.30), 5101.31 (5160.67), 5101.50 (5167.05), 5101.501	426
(5167.06), 5101.502 (5167.07), 5101.503 (5167.08), 5101.51	427
(5167.10), 5101.511 (5167.11), 5101.512 (5167.12), 5101.513	428
(5167.13), 5101.514 (5167.14), 5101.515 (5167.15), 5101.516	429
(5167.16), 5101.517 (5167.17), 5101.518 (5167.18), 5101.519	430
(5167.19), 5101.5110 (5167.32), 5101.52 (5167.21), 5101.521	431
(5167.22), 5101.522 (5167.23), 5101.523 (5167.24), 5101.524	432
(5167.25), 5101.525 (5167.26), 5101.526 (5167.27), 5101.527	433
(5167.28), 5101.528 (5167.29), 5101.529 (5167.30), 5101.5211	434
(5167.35), 5101.5212 (5167.36), 5101.5213 (5167.37), 5101.5214	435
(5167.38), 5101.5215 (5167.39), 5101.5216 (5167.40), 5101.571	436
(5160.36), 5101.572 (5160.40), 5101.573 (5160.401), 5101.574	437
(5160.402), 5101.575 (5160.403), 5101.58 (5160.38), 5101.59	438
(5160.37), 5101.591 (5160.41), 5111.01 (5162.01), 5111.011	439
(5162.20), 5111.013 (5162.15), 5111.014 (5162.04), 5111.015	440
(5162.24), 5111.016 (5162.16), 5111.018 (5163.18), 5111.019	441
(5162.05), 5111.0110 (5162.08), 5111.0111 (5162.06), 5111.0112	442
(5162.35), 5111.0113 (5162.07), 5111.0114 (5163.261), 5111.0115	443
(5162.09), 5111.0116 (5162.21), 5111.0117 (5162.22), 5111.0118	444
(5162.23), 5111.0119 (5162.18), 5111.02 (5163.15), 5111.021	445
(5163.16), 5111.022 (5163.08), 5111.023 (5163.20), 5111.024	446
(5163.19), 5111.025 (5163.17), 5111.027 (5163.242), 5111.028	447
(5163.011), 5111.029 (5163.27), 5111.03 (5163.03), 5111.031	448
(5163.031), 5111.032 (5163.032), 5111.033 (5163.033), 5111.034	449
(5163.034), 5111.04 (5163.21), 5111.042 (5163.28), 5111.05	450
(5163.02), 5111.06 (5163.01), 5111.061 (5163.07), 5111.062	451
(5163.09), 5111.07 (5163.25), 5111.071 (5163.251), 5111.08	452
(5163.241), 5111.081 (5163.26), 5111.082 (5163.24), 5111.083	453
(5163.243), 5111.084 (5160.04), 5111.09 (5161.32), 5111.091	454
(5161.33), 5111.10 (5161.30), 5111.101 (5163.12), 5111.102	455
(5161.011), 5111.11 (5162.40), 5111.111 (5162.41), 5111.112	456
(5162.42), 5111.113 (5162.37), 5111.114 (5162.36), 5111.12	457
(5162.45), 5111.121 (5160.39), 5111.13 (5165.30), 5111.14	458
(5163.22), 5111.15 (5162.25), 5111.151 (5162.26), 5111.16	459
(5165.03), 5111.162 (5165.14), 5111.163 (5165.15), 5111.17	460
(5165.05), 5111.171 (5165.07), 5111.172 (5165.09), 5111.173	461
(5165.10), 5111.174 (5165.12), 5111.175 (5165.13), 5111.176	462
(5166.60), 5111.177 (5165.11), 5111.178 (5165.16), 5111.18	463
(5162.43), 5111.181 (5162.30), 5111.19 (5163.23), 5111.191	464
(5163.231), 5111.20 (5164.01), 5111.201 (5164.011), 5111.202	465
(5164.45), 5111.203 (5164.46), 5111.204 (5164.47), 5111.21	466
(5164.02), 5111.211 (5164.14), 5111.22 (5164.03), 5111.221	467
(5164.40), 5111.222 (5164.18), 5111.223 (5164.031), 5111.23	468
(5164.05), 5111.231 (5164.19), 5111.232 (5164.191), 5111.235	469
(5164.06), 5111.24 (5164.20), 5111.241 (5164.07), 5111.242	470
(5164.21), 5111.243 (5164.22), 5111.244 (5164.23), 5111.25	471
(5164.24), 5111.251 (5164.08), 5111.254 (5164.32), 5111.255	472
(5164.12), 5111.257 (5164.27), 5111.258 (5164.34), 5111.26	473
(5164.37), 5111.261 (5164.10), 5111.263 (5164.26), 5111.264	474
(5164.372), 5111.265 (5164.28), 5111.266 (5164.371), 5111.27	475
(5164.38), 5111.28 (5164.39), 5111.29 (5164.41), 5111.291	476
(5164.13), 5111.30 (5164.032), 5111.31 (5164.033), 5111.32	477
(5164.034), 5111.33 (5164.35), 5111.34 (5164.30), 5111.35	478
(5164.50), 5111.36 (5164.51), 5111.37 (5164.52), 5111.38	479
(5164.53), 5111.39 (5164.54), 5111.40 (5164.55), 5111.41	480
(5164.56), 5111.411 (5164.57), 5111.42 (5164.58), 5111.43	481
(5164.59), 5111.44 (5164.60), 5111.45 (5164.61), 5111.46	482
(5164.62), 5111.47 (5164.63), 5111.48 (5164.64), 5111.49	483
(5164.65), 5111.50 (5164.66), 5111.51 (5164.67), 5111.52	484
(5164.68), 5111.53 (5164.69), 5111.54 (5164.70), 5111.55	485
(5164.71), 5111.56 (5164.72), 5111.57 (5164.73), 5111.58	486
(5164.74), 5111.59 (5164.75), 5111.60 (5164.76), 5111.61	487
(5164.77), 5111.62 (5164.78), 5111.63 (5164.79), 5111.65	488
(5164.82), 5111.651 (5164.821), 5111.66 (5164.83), 5111.67	489
(5164.84), 5111.671 (5164.841), 5111.672 (5164.842), 5111.673	490
(5164.843), 5111.674 (5164.844), 5111.675 (5164.845), 5111.676	491
(5164.846), 5111.677 (5164.847), 5111.68 (5164.85), 5111.681	492
(5164.851), 5111.682 (5164.852), 5111.683 (5164.853), 5111.684	493
(5164.854), 5111.685 (5164.855), 5111.686 (5164.856), 5111.687	494
(5164.857), 5111.688 (5164.858), 5111.70 (5162.10), 5111.701	495
(5162.101), 5111.702 (5162.102), 5111.703 (5162.103), 5111.704	496
(5162.104) 5111.705 (5162.105), 5111.706 (5162.106), 5111.707	497
(5162.107), 5111.708 (5162.108), 5111.709 (5162.109), 5111.7010	498
(5162.1010), 5111.7011 (5162.1011), 5111.71 (5163.30), 5111.711	499
(5163.301), 5111.712 (5163.302), 5111.713 (5163.303), 5111.714	500
(5163.304), 5111.715 (5163.305), 5111.84 (5163.501), 5111.85	501
(5163.50), 5111.851 (5163.51), 5111.852 (5163.52), 5111.853	502
(5163.53), 5111.854 (5163.54), 5111.855 (5163.55), 5111.856	503
(5163.56), 5111.86 (5163.60), 5111.87 (5163.65), 5111.871	504
(5163.651), 5111.872 (5163.652), 5111.873 (5163.653), 5111.874	505
(5163.66), 5111.875 (5163.661), 5111.876 (5163.662), 5111.877	506
(5163.663), 5111.878 (5163.664), 5111.879 (5163.665), 5111.8710	507
(5163.666), 5111.89 (5163.68), 5111.891 (5163.681), 5111.892	508
(5163.682), 5111.893 (5163.683), 5111.894 (5163.684), 5111.90	509
(5161.10), 5111.91 (5161.05), 5111.911 (5161.06), 5111.912	510
(5161.07), 5111.913 (5161.08), 5111.914 (5163.06), 5111.915	511
(5161.25), 5111.92 (5161.12), 5111.93 (5161.13), 5111.94	512
(5161.15), 5111.941 (5161.16), 5111.942 (5161.17), 5111.943	513
(5161.18), 5111.97 (5163.73), 5111.971 (5163.69), 5111.98	514
(5161.02), 5111.99 (5164.99), 5112.01 (5166.01), 5112.03	515
(5166.02), 5112.04 (5166.03), 5112.05 (5166.04), 5112.06	516
(5166.05), 5112.07 (5166.06), 5112.08 (5166.07), 5112.09	517
(5166.08), 5112.10 (5166.09), 5112.11 (5166.10), 5112.17	518
(5166.11), 5112.18 (5166.12), 5112.19 (5166.13), 5112.21	519
(5166.14), 5112.30 (5166.40), 5112.31 (5166.41), 5112.32	520
(5166.43), 5112.33 (5166.44), 5112.34 (5166.45), 5112.341	521
(5166.46), 5112.35 (5166.47), 5112.37 (5166.48), 5112.371	522
(5166.481), 5112.38 (5166.49), 5112.39 (5166.50), 5112.99	523
(5166.99), 5115.10 (5168.01), 5115.11 (5168.02), 5115.12	524
(5168.05), 5115.13 (5168.07), 5115.14 (5168.06) be amended for	525
the purpose of adopting a new section number as indicated in	526
parentheses, and that sections 117.54, 117.55, 117.56, 117.57,	527
329.043, 5160.01, 5160.02, 5160.03, 5160.05, 5160.06, 5160.08,	528
5160.10, 5160.101, 5160.12, 5160.13, 5160.15, 5160.151,	529
5160.152, 5160.17, 5160.18, 5160.19, 5160.191, 5160.192, 5160.20,	530
5160.21, 5160.211, 5160.22, 5160.23, 5160.24, 5160.26, 5160.261,	531
5160.262, 5160.28, 5160.29, 5160.30, 5160.32, 5160.34, 5160.341,	532
5160.42, 5160.43, 5160.44, 5160.45, 5160.46, 5160.50, 5160.51,	533
5160.52, 5160.53, 5160.54, 5160.55, 5160.56, 5160.57, 5160.58,	534
5160.59, 5160.60, 5160.61, 5160.62, 5160.63, 5160.64, 5160.65,	535
5160.66, 5160.70, 5160.71, 5160.75, 5160.99, 5161.01, 5161.03,	536
5162.02, 5162.03, 5162.17, 5163.04, 5164.051, 5165.01, 5165.02,	537
5165.04, 5165.06, 5165.08, 5165.17, 5165.18, 5167.01, 5168.03,	538
5168.04, 5168.08, 5168.09, 5168.10, and 5169.99 of the Revised	539
Code be enacted to read as follows:	540

Sec. 9.231. (A)(1) Subject to divisions (A)(2) and (3) of	541
this section, a governmental entity shall not disburse money	542
totaling twenty-five thousand dollars or more to any person for	543
the provision of services for the primary benefit of individuals	544
or the public and not for the primary benefit of a governmental	545
entity or the employees of a governmental entity, unless the	546
contracting authority of the governmental entity first enters into	547
a written contract with the person that is signed by the person or	548
by an officer or agent of the person authorized to legally bind	549
the person and that embodies all of the requirements and	550
conditions set forth in sections 9.23 to 9.236 of the Revised	551
Code. If the disbursement of money occurs over the course of a	552
governmental entity's fiscal year, rather than in a lump sum, the	553
contracting authority of the governmental entity shall enter into	554
the written contract with the person at the point during the	555
governmental entity's fiscal year that at least seventy-five	556
thousand dollars has been disbursed by the governmental entity to	557
the person. Thereafter, the contracting authority of the	558
governmental entity shall enter into the written contract with the	559
person at the beginning of the governmental entity's fiscal year,	560
if, during the immediately preceding fiscal year, the governmental	561
entity disbursed to that person an aggregate amount totaling at	562
least seventy-five thousand dollars.	563

(2) If the money referred to in division (A)(1) of this	564
section is disbursed by or through more than one state agency to	565
the person for the provision of services to the same population,	566
the contracting authorities of those agencies shall determine	567
which one of them will enter into the written contract with the	568
person.	569

(3) The requirements and conditions set forth in divisions	570
(A), (B), (C), and (F) of section 9.232, divisions (A)(1) and (2)	571
and (B) of section 9.234, divisions (A)(2) and (B) of section	572
9.235, and sections 9.233 and 9.236 of the Revised Code do not	573
apply with respect to the following:	574

(a) Contracts to which all of the following apply:

575

(i) The amount received for the services is a set fee for	576
each time the services are provided, is determined in accordance	577
with a fixed rate per unit of time or per service, or is a	578
capitated rate, and the fee or rate is established by competitive	579
bidding or by a market rate survey of similar services provided in	580
a defined market area. The market rate survey may be one conducted	581
by or on behalf of the governmental entity or an independent	582
survey accepted by the governmental entity as statistically valid	583
and reliable.	584

(ii) The services are provided in accordance with standards	585
established by state or federal law, or by rules or regulations	586
adopted thereunder, for their delivery, which standards are	587
enforced by the federal government, a governmental entity, or an	588
accrediting organization recognized by the federal government or a	589
governmental entity.	590

(iii) Payment for the services is made after the services are	591
delivered and upon submission to the governmental entity of an	592
invoice or other claim for payment as required by any applicable	593
local, state, or federal law or, if no such law applies, by the	594
terms of the contract.	595

(b) Contracts under which the services are reimbursed through	596
or in a manner consistent with a federal program that meets all of	597
the following requirements:	598

(i) The program calculates the reimbursement rate on the	599
basis of the previous year's experience or in accordance with an	600
alternative method set forth in rules adopted by the Ohio	601
department of job and family services.	602

(ii) The reimbursement rate is derived from a breakdown of	603
direct and indirect costs.	604

(iii) The program's guidelines describe types of expenditures	605
that are allowable and not allowable under the program and	606
delineate which costs are acceptable as direct costs for purposes	607
of calculating the reimbursement rate.	608

(iv) The program includes a uniform cost reporting system	609
with specific audit requirements.	610

(c) Contracts under which the services are reimbursed through	611
or in a manner consistent with a federal program that calculates	612
the reimbursement rate on a fee for service basis in compliance	613
with United States office of management and budget Circular A-87,	614
as revised May 10, 2004.	615

(d) Contracts for services that are paid pursuant to the	616
earmarking of an appropriation made by the general assembly for	617
that purpose.	618

(B) Division (A) of this section does not apply if the money	619
is disbursed to a person pursuant to a contract with the United	620
States or a governmental entity under any of the following	621
circumstances:	622

(1) The person receives the money directly or indirectly from	623
the United States, and no governmental entity exercises any	624
oversight or control over the use of the money.	625

(2) The person receives the money solely in return for the	626
performance of one or more of the following types of services:	627

(a) Medical, therapeutic, or other health-related services	628
provided by a person if the amount received is a set fee for each	629
time the person provides the services, is determined in accordance	630
with a fixed rate per unit of time, or is a capitated rate, and	631
the fee or rate is reasonable and customary in the person's trade	632
or profession;	633

(b) Medicaid-funded services, including administrative and	634
management services, provided pursuant to a contract or medicaid	635
provider agreement that meets the requirements of the medicaid	636
program ~~established under Chapter 5111. of the Revised Code~~.	637

(c) Services, other than administrative or management	638
services or any of the services described in division (B)(2)(a) or	639
(b) of this section, that are commonly purchased by the public at	640
an hourly rate or at a set fee for each time the services are	641
provided, unless the services are performed for the benefit of	642
children, persons who are eligible for the services by reason of	643
advanced age, medical condition, or financial need, or persons who	644
are confined in a detention facility as defined in section 2921.01	645
of the Revised Code, and the services are intended to help promote	646
the health, safety, or welfare of those children or persons;	647

(d) Educational services provided by a school to children	648
eligible to attend that school. For purposes of division (B)(2)(d)	649
of this section, "school" means any school operated by a school	650
district board of education, any community school established	651
under Chapter 3314. of the Revised Code, or any nonpublic school	652
for which the state board of education prescribes minimum	653
education standards under section 3301.07 of the Revised Code.	654

(e) Services provided by a foster home as defined in section	655
5103.02 of the Revised Code;	656

(f) "Routine business services other than administrative or	657
management services," as that term is defined by the attorney	658
general by rule adopted in accordance with Chapter 119. of the	659
Revised Code;	660

(g) Services to protect the environment or promote	661
environmental education that are provided by a nonprofit entity or	662
services to protect the environment that are funded with federal	663
grants or revolving loan funds and administered in accordance with	664
federal law;	665

(h) Services, including administrative and management	666
services, provided under the children's buy-in program established	667
under sections ~~5101.5211~~5167.35 to ~~5101.5216~~5167.40 of the	668
Revised Code.	669

(3) The person receives the money solely in return for the	670
performance of services intended to help preserve public health or	671
safety under circumstances requiring immediate action as a result	672
of a natural or man-made emergency.	673

(C) With respect to a nonprofit association, corporation, or	674
organization established for the purpose of providing educational,	675
technical, consulting, training, financial, or other services to	676
its members in exchange for membership dues and other fees, any of	677
the services provided to a member that is a governmental entity	678
shall, for purposes of this section, be considered services "for	679
the primary benefit of a governmental entity or the employees of a	680
governmental entity.	681

Sec. 9.239. (A) There is hereby created the government	682
contracting advisory council. The attorney general and auditor of	683
state shall consult with the council on the performance of their	684
rule-making functions under sections 9.237 and 9.238 of the	685
Revised Code and shall consider any recommendations of the	686
council. ~~The director of job and family services shall annually~~	687
~~report to the council the cost methodology of the medicaid-funded~~	688
~~services described in division (A)(3)(d) of section 9.231 of the~~	689
~~Revised Code.~~ The council shall consist of the following members	690
or their designees:	691

(1) The attorney general;

692

(2) The auditor of state;

693

(3) The director of administrative services;

694

(4) The director of aging;

695

(5) The director of alcohol and drug addiction services;

696

(6) The director of budget and management;

697

(7) The director of development;

698

(8) The director of job and family services;

699

(9) The director of mental health;

700

(10) The director of mental retardation and developmental	701
disabilities;	702

(11) The director of rehabilitation and correction;

703

(12) The administrator of workers' compensation;

704

(13) The executive director of the county commissioners'	705
association of Ohio;	706

(14) The president of the Ohio grantmakers forum;

707

(15) The president of the Ohio chamber of commerce;

708

(16) The president of the Ohio state bar association;

709

(17) The president of the Ohio society of certified public	710
accountants;	711

(18) The executive director of the Ohio association of	712
nonprofit organizations;	713

(19) The president of the Ohio united way;

714

(20) One additional member appointed by the attorney general;

715

(21) One additional member appointed by the auditor of state.

716

(B) If an agency or organization represented on the council	717
ceases to exist in the form it has on ~~the effective date of this~~	718
~~section~~September 29, 2005, the successor agency or organization	719
shall be represented in its place. If there is no successor agency	720
or organization, or if it is not clear what agency or organization	721
is the successor, the attorney general shall designate an agency	722
or organization to be represented in place of the agency or	723
organization originally represented on the council.	724

(C) The two members appointed to the council shall serve	725
three-year terms. Original appointments shall be made not later	726
than sixty days after ~~the effective date of this section~~September	727
29, 2005. Vacancies on the council shall be filled in the same	728
manner as the original appointment.	729

(D) The attorney general or the attorney general's designee	730
shall be the chairperson of the council. The council shall meet at	731
least once every two years to review the rules adopted under	732
sections 9.237 and 9.238 of the Revised Code and to make	733
recommendations to the attorney general and auditor of state	734
regarding the adoption, amendment, or repeal of those rules. The	735
council shall also meet at other times as requested by the	736
attorney general or auditor of state.	737

(E) Members of the council shall serve without compensation	738
or reimbursement.	739

(F) The office of the attorney general shall provide	740
necessary staff, facilities, supplies, and services to the	741
council.	742

(G) Sections 101.82 to 101.87 of the Revised Code do not	743
apply to the council.	744

Sec. 9.24. (A) Except as may be allowed under division (F) of	745
this section, no state agency and no political subdivision shall	746
award a contract as described in division (G)(1) of this section	747
for goods, services, or construction, paid for in whole or in part	748
with state funds, to a person against whom a finding for recovery	749
has been issued by the auditor of state on and after January 1,	750
2001, if the finding for recovery is unresolved.	751

A contract is considered to be awarded when it is entered	752
into or executed, irrespective of whether the parties to the	753
contract have exchanged any money.	754

(B) For purposes of this section, a finding for recovery is	755
unresolved unless one of the following criteria applies:	756

(1) The money identified in the finding for recovery is paid	757
in full to the state agency or political subdivision to whom the	758
money was owed;	759

(2) The debtor has entered into a repayment plan that is	760
approved by the attorney general and the state agency or political	761
subdivision to whom the money identified in the finding for	762
recovery is owed. A repayment plan may include a provision	763
permitting a state agency or political subdivision to withhold	764
payment to a debtor for goods, services, or construction provided	765
to or for the state agency or political subdivision pursuant to a	766
contract that is entered into with the debtor after the date the	767
finding for recovery was issued.	768

(3) The attorney general waives a repayment plan described in	769
division (B)(2) of this section for good cause;	770

(4) The debtor and state agency or political subdivision to	771
whom the money identified in the finding for recovery is owed have	772
agreed to a payment plan established through an enforceable	773
settlement agreement.	774

(5) The state agency or political subdivision desiring to	775
enter into a contract with a debtor certifies, and the attorney	776
general concurs, that all of the following are true:	777

(a) Essential services the state agency or political	778
subdivision is seeking to obtain from the debtor cannot be	779
provided by any other person besides the debtor;	780

(b) Awarding a contract to the debtor for the essential	781
services described in division (B)(5)(a) of this section is in the	782
best interest of the state;	783

(c) Good faith efforts have been made to collect the money	784
identified in the finding of recovery.	785

(6) The debtor has commenced an action to contest the finding	786
for recovery and a final determination on the action has not yet	787
been reached.	788

(C) The attorney general shall submit an initial report to	789
the auditor of state, not later than December 1, 2003, indicating	790
the status of collection for all findings for recovery issued by	791
the auditor of state for calendar years 2001, 2002, and 2003.	792
Beginning on January 1, 2004, the attorney general shall submit to	793
the auditor of state, on the first day of every January, April,	794
July, and October, a list of all findings for recovery that have	795
been resolved in accordance with division (B) of this section	796
during the calendar quarter preceding the submission of the list	797
and a description of the means of resolution. The attorney general	798
shall notify the auditor of state when a judgment is issued	799
against an entity described in division (F)(1) of this section.	800

(D) The auditor of state shall maintain a database,	801
accessible to the public, listing persons against whom an	802
unresolved finding for recovery has been issued, and the amount of	803
the money identified in the unresolved finding for recovery. The	804
auditor of state shall have this database operational on or before	805
January 1, 2004. The initial database shall contain the	806
information required under this division for calendar years 2001,	807
2002, and 2003.	808

Beginning January 15, 2004, the auditor of state shall update	809
the database by the fifteenth day of every January, April, July,	810
and October to reflect resolved findings for recovery that are	811
reported to the auditor of state by the attorney general on the	812
first day of the same month pursuant to division (C) of this	813
section.	814

(E) Before awarding a contract as described in division	815
(G)(1) of this section for goods, services, or construction, paid	816
for in whole or in part with state funds, a state agency or	817
political subdivision shall verify that the person to whom the	818
state agency or political subdivision plans to award the contract	819
has no unresolved finding for recovery issued against the person.	820
A state agency or political subdivision shall verify that the	821
person does not appear in the database described in division (D)	822
of this section or shall obtain other proof that the person has no	823
unresolved finding for recovery issued against the person.	824

(F) The prohibition of division (A) of this section and the	825
requirement of division (E) of this section do not apply with	826
respect to the companies, payments, or agreements described in	827
divisions (F)(1) and (2) of this section, or in the circumstance	828
described in division (F)(3) of this section.	829

(1) A bonding company or a company authorized to transact the	830
business of insurance in this state, a self-insurance pool, joint	831
self-insurance pool, risk management program, or joint risk	832
management program, unless a court has entered a final judgment	833
against the company and the company has not yet satisfied the	834
final judgment.	835

(2) To ~~medicaid~~ provider agreements under ~~Chapter 5111. of~~	836
~~the Revised Code~~the medicaid program, payments or provider	837
agreements under disability assistance medical assistance	838
~~established under Chapter 5115. of the Revised Code~~, or payments	839
or provider agreements under the children's buy-in program	840
~~established under sections 5101.5211 to 5101.5216 of the Revised~~	841
~~Code~~.	842

(3) When federal law dictates that a specified entity provide	843
the goods, services, or construction for which a contract is being	844
awarded, regardless of whether that entity would otherwise be	845
prohibited from entering into the contract pursuant to this	846
section.	847

(G)(1) This section applies only to contracts for goods,	848
services, or construction that satisfy the criteria in either	849
division (G)(1)(a) or (b) of this section. This section may apply	850
to contracts for goods, services, or construction that satisfy the	851
criteria in division (G)(1)(c) of this section, provided that the	852
contracts also satisfy the criteria in either division (G)(1)(a)	853
or (b) of this section.	854

(a) The cost for the goods, services, or construction	855
provided under the contract is estimated to exceed twenty-five	856
thousand dollars.	857

(b) The aggregate cost for the goods, services, or	858
construction provided under multiple contracts entered into by the	859
particular state agency and a single person or the particular	860
political subdivision and a single person within the fiscal year	861
preceding the fiscal year within which a contract is being entered	862
into by that same state agency and the same single person or the	863
same political subdivision and the same single person, exceeded	864
fifty thousand dollars.	865

(c) The contract is a renewal of a contract previously	866
entered into and renewed pursuant to that preceding contract.	867

(2) This section does not apply to employment contracts.

868

(H) As used in this section:

869

(1) "State agency" has the same meaning as in section 9.66 of	870
the Revised Code.	871

(2) "Political subdivision" means a political subdivision as	872
defined in section 9.82 of the Revised Code that has received more	873
than fifty thousand dollars of state money in the current fiscal	874
year or the preceding fiscal year.	875

(3) "Finding for recovery" means a determination issued by	876
the auditor of state, contained in a report the auditor of state	877
gives to the attorney general pursuant to section 117.28 of the	878
Revised Code, that public money has been illegally expended,	879
public money has been collected but not been accounted for, public	880
money is due but has not been collected, or public property has	881
been converted or misappropriated.	882

(4) "Debtor" means a person against whom a finding for	883
recovery has been issued.	884

(5) "Person" means the person named in the finding for	885
recovery.	886

(6) "State money" does not include funds the state receives	887
from another source and passes through to a political	888
subdivision.	889

Sec. 101.39. (A) There is hereby created the joint	890
legislative committee on health care oversight. The committee may	891
review or study any matter related to the provision of health care	892
services that it considers of significance to the citizens of this	893
state, including the availability of health care, the quality of	894
health care, the effectiveness and efficiency of managed care	895
systems, and the operation of the ~~medical assistance~~medicaid	896
program ~~established under Chapter 5111. of the Revised Code~~ or	897
other government health programs.	898

The department of health care administration, department of	899
job and family services, department of health, department of	900
aging, department of mental health, department of mental	901
retardation and developmental disabilities, department of alcohol	902
and drug addiction services, and other state agencies shall	903
cooperate with the committee in its study and review of health	904
care issues. On request, the departments shall provide the	905
committee with reports and other information sufficient for the	906
committee to fulfill its duties.	907

The committee may issue recommendations as it determines	908
appropriate. The recommendations may be made to the general	909
assembly, state agencies, private industry, or any other entity.	910

(B) The committee shall consist of the following members of	911
the general assembly: the chairperson of the senate's standing	912
committee with primary responsibility for health legislation, the	913
chairperson of the house of representatives' standing committee	914
with primary responsibility for health legislation, four members	915
of the house of representatives appointed by the speaker of the	916
house of representatives, and four members of the senate appointed	917
by the president of the senate. Not more than two members	918
appointed by the speaker of the house of representatives and not	919
more than two members appointed by the president of the senate may	920
be of the same political party. Except in 1995, appointments	921
shall be made not later than fifteen days after the commencement	922
of the first regular session of each general assembly. The	923
chairpersons of the standing committees with primary	924
responsibility for health legislation shall serve as	925
co-chairpersons of the committee.	926

Each member of the committee shall hold office during the	927
general assembly in which the member is appointed and until a	928
successor has been appointed, notwithstanding the adjournment sine	929
die of the general assembly in which the member was appointed or	930
the expiration of the member's term as a member of the general	931
assembly. Any vacancies occurring among the members of the	932
committee shall be filled in the manner of the original	933
appointment.	934

The committee shall meet at least quarterly and at the call	935
of the co-chairpersons. The co-chairpersons shall determine the	936
time, place, and agenda for each meeting of the committee.	937

The committee has the same powers as other standing or select	938
committees of the general assembly. The committee may request	939
assistance from the legislative service commission ~~and the~~	940
~~legislative budget office of the legislative service commission~~.	941

Sec. 101.391. (A) There is hereby created the joint	942
legislative committee on medicaid technology and reform. The	943
committee may review or study any matter that it considers	944
relevant to the operation of the medicaid program ~~established~~	945
~~under Chapter 5111. of the Revised Code~~, with priority given to	946
the study or review of mechanisms to enhance the program's	947
effectiveness through improved technology systems and program	948
reform.	949

(B) The committee shall consist of five members of the house	950
of representatives appointed by the speaker of the house of	951
representatives and five members of the senate appointed by the	952
president of the senate. Not more than three members appointed by	953
the speaker of the house of representatives and not more than	954
three members appointed by the president of the senate may be of	955
the same political party.	956

Each member of the committee shall hold office during the	957
general assembly in which the member is appointed and until a	958
successor has been appointed, notwithstanding the adjournment sine	959
die of the general assembly in which the member was appointed or	960
the expiration of the member's term as a member of the general	961
assembly. Any vacancies occurring among the members of the	962
committee shall be filled in the manner of the original	963
appointment.	964

(C) The committee has the same powers as other standing or	965
select committees of the general assembly. The committee may	966
employ an executive director.	967

Sec. 103.144. As used in sections 103.144 to 103.146 of the	968
Revised Code:	969

(A) "Mandated benefit" means the following, when considered	970
in the context of a sickness and accident insurance policy or a	971
health insuring corporation policy, contract, or agreement:	972

(1) Any required coverage for a specific medical or	973
health-related service, treatment, medication, or practice;	974

(2) Any required coverage for the services of specific health	975
care providers;	976

(3) Any requirement that an insurer or health insuring	977
corporation offer coverage to specific individuals or groups;	978

(4) Any requirement that an insurer or health insuring	979
corporation offer specific medical or health-related services,	980
treatments, medications, or practices to existing insureds or	981
enrollees;	982

(5) Any required expansion of, or addition to, existing	983
coverage;	984

(6) Any mandated reimbursement amount to specific health care	985
providers.	986

(B) "Mandated benefit" does not include any required coverage	987
or offer of coverage, any required expansion of, or addition to,	988
existing coverage, or any mandated reimbursement amount to	989
specific providers, as described in division (A) of this section,	990
within the context of any public health benefits arrangement,	991
including but not limited to, the coverage of beneficiaries	992
enrolled in ~~Title XVIII of~~ the ~~"Social Security Act," 49 Stat. 620~~	993
~~(1935), 42 U.S.C.A. 301, as amended~~medicare program, pursuant to	994
a medicare risk contract or medicare cost contract, or to the	995
coverage of ~~beneficiaries enrolled in Title XIX of the "Social~~	996
~~Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended,~~	997
~~known as~~recipients of the ~~medical assistance program or~~ medicaid,	998
~~provided by the Ohio department of job and family services under~~	999
~~Chapter 5111. of the Revised Code~~program.	1000

Sec. 109.572. (A)(1) Upon receipt of a request pursuant to	1001
section 121.08, 3301.32, 3301.541, or 3319.39 of the Revised	1002
Code, a completed form prescribed pursuant to division (C)(1) of	1003
this section, and a set of fingerprint impressions obtained in	1004
the manner described in division (C)(2) of this section, the	1005
superintendent of the bureau of criminal identification and	1006
investigation shall conduct a criminal records check in the	1007
manner described in division (B) of this section to determine	1008
whether any information exists that indicates that the person who	1009
is the subject of the request previously has been convicted of or	1010
pleaded guilty to any of the following:	1011

(a) A violation of section 2903.01, 2903.02, 2903.03,	1012
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34,	1013
2905.01, 2905.02, 2905.05, 2907.02, 2907.03, 2907.04, 2907.05,	1014
2907.06, 2907.07, 2907.08, 2907.09, 2907.21, 2907.22, 2907.23,	1015
2907.25, 2907.31, 2907.32, 2907.321, 2907.322, 2907.323, 2911.01,	1016
2911.02, 2911.11, 2911.12, 2919.12, 2919.22, 2919.24, 2919.25,	1017
2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.04, 2925.05,	1018
2925.06, or 3716.11 of the Revised Code, felonious sexual	1019
penetration in violation of former section 2907.12 of the Revised	1020
Code, a violation of section 2905.04 of the Revised Code as it	1021
existed prior to July 1, 1996, a violation of section 2919.23 of	1022
the Revised Code that would have been a violation of section	1023
2905.04 of the Revised Code as it existed prior to July 1, 1996,	1024
had the violation been committed prior to that date, or a	1025
violation of section 2925.11 of the Revised Code that is not a	1026
minor drug possession offense;	1027

(b) A violation of an existing or former law of this state,	1028
any other state, or the United States that is substantially	1029
equivalent to any of the offenses listed in division (A)(1)(a) of	1030
this section.	1031

(2) On receipt of a request pursuant to section 5123.081 of	1032
the Revised Code with respect to an applicant for employment in	1033
any position with the department of mental retardation and	1034
developmental disabilities, pursuant to section 5126.28 of the	1035
Revised Code with respect to an applicant for employment in any	1036
position with a county board of mental retardation and	1037
developmental disabilities, or pursuant to section 5126.281 of the	1038
Revised Code with respect to an applicant for employment in a	1039
direct services position with an entity contracting with a county	1040
board for employment, a completed form prescribed pursuant to	1041
division (C)(1) of this section, and a set of fingerprint	1042
impressions obtained in the manner described in division (C)(2) of	1043
this section, the superintendent of the bureau of criminal	1044
identification and investigation shall conduct a criminal records	1045
check. The superintendent shall conduct the criminal records check	1046
in the manner described in division (B) of this section to	1047
determine whether any information exists that indicates that the	1048
person who is the subject of the request has been convicted of or	1049
pleaded guilty to any of the following:	1050

(a) A violation of section 2903.01, 2903.02, 2903.03,	1051
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34,	1052
2903.341, 2905.01, 2905.02, 2905.04, 2905.05, 2907.02, 2907.03,	1053
2907.04, 2907.05, 2907.06, 2907.07, 2907.08, 2907.09, 2907.12,	1054
2907.21, 2907.22, 2907.23, 2907.25, 2907.31, 2907.32, 2907.321,	1055
2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 2911.12, 2919.12,	1056
2919.22, 2919.24, 2919.25, 2923.12, 2923.13, 2923.161, 2925.02,	1057
2925.03, or 3716.11 of the Revised Code;	1058

(b) An existing or former municipal ordinance or law of this	1059
state, any other state, or the United States that is substantially	1060
equivalent to any of the offenses listed in division (A)(2)(a) of	1061
this section.	1062

(3) On receipt of a request pursuant to section 173.27,	1063
173.394, 3712.09, 3721.121, or 3722.151 of the Revised Code, a	1064
completed form prescribed pursuant to division (C)(1) of this	1065
section, and a set of fingerprint impressions obtained in the	1066
manner described in division (C)(2) of this section, the	1067
superintendent of the bureau of criminal identification and	1068
investigation shall conduct a criminal records check with respect	1069
to any person who has applied for employment in a position for	1070
which a criminal records check is required by those sections. The	1071
superintendent shall conduct the criminal records check in the	1072
manner described in division (B) of this section to determine	1073
whether any information exists that indicates that the person who	1074
is the subject of the request previously has been convicted of or	1075
pleaded guilty to any of the following:	1076

(a) A violation of section 2903.01, 2903.02, 2903.03,	1077
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34,	1078
2905.01, 2905.02, 2905.11, 2905.12, 2907.02, 2907.03, 2907.05,	1079
2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 2907.25, 2907.31,	1080
2907.32, 2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11,	1081
2911.12, 2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21,	1082
2913.31, 2913.40, 2913.43, 2913.47, 2913.51, 2919.25, 2921.36,	1083
2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.11, 2925.13,	1084
2925.22, 2925.23, or 3716.11 of the Revised Code;	1085

(b) An existing or former law of this state, any other state,	1086
or the United States that is substantially equivalent to any of	1087
the offenses listed in division (A)(3)(a) of this section.	1088

(4) On receipt of a request pursuant to section 3701.881 of	1089
the Revised Code with respect to an applicant for employment with	1090
a home health agency as a person responsible for the care,	1091
custody, or control of a child, a completed form prescribed	1092
pursuant to division (C)(1) of this section, and a set of	1093
fingerprint impressions obtained in the manner described in	1094
division (C)(2) of this section, the superintendent of the bureau	1095
of criminal identification and investigation shall conduct a	1096
criminal records check. The superintendent shall conduct the	1097
criminal records check in the manner described in division (B) of	1098
this section to determine whether any information exists that	1099
indicates that the person who is the subject of the request	1100
previously has been convicted of or pleaded guilty to any of the	1101
following:	1102

(a) A violation of section 2903.01, 2903.02, 2903.03,	1103
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34,	1104
2905.01, 2905.02, 2905.04, 2905.05, 2907.02, 2907.03, 2907.04,	1105
2907.05, 2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 2907.21,	1106
2907.22, 2907.23, 2907.25, 2907.31, 2907.32, 2907.321, 2907.322,	1107
2907.323, 2911.01, 2911.02, 2911.11, 2911.12, 2919.12, 2919.22,	1108
2919.24, 2919.25, 2923.12, 2923.13, 2923.161, 2925.02, 2925.03,	1109
2925.04, 2925.05, 2925.06, or 3716.11 of the Revised Code or a	1110
violation of section 2925.11 of the Revised Code that is not a	1111
minor drug possession offense;	1112

(b) An existing or former law of this state, any other state,	1113
or the United States that is substantially equivalent to any of	1114
the offenses listed in division (A)(4)(a) of this section.	1115

(5) On receipt of a request pursuant to section ~~5111.032~~	1116
5163.032, ~~5111.033~~5163.033, or ~~5111.034~~5163.034 of the Revised	1117
Code, a completed form prescribed pursuant to division (C)(1) of	1118
this section, and a set of fingerprint impressions obtained in	1119
the manner described in division (C)(2) of this section, the	1120
superintendent of the bureau of criminal identification and	1121
investigation shall conduct a criminal records check. The	1122
superintendent shall conduct the criminal records check in the	1123
manner described in division (B) of this section to determine	1124
whether any information exists that indicates that the person	1125
who is the subject of the request previously has been convicted	1126
of, has pleaded guilty to, or has been found eligible for	1127
intervention in lieu of conviction for any of the following:	1128

(a) A violation of section 2903.01, 2903.02, 2903.03,	1129
2903.04, 2903.041, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21,	1130
2903.34, 2905.01, 2905.02, 2905.05, 2905.11, 2905.12, 2907.02,	1131
2907.03, 2907.04, 2907.05, 2907.06, 2907.07, 2907.08, 2907.09,	1132
2907.21, 2907.22, 2907.23, 2907.24, 2907.25, 2907.31, 2907.32,	1133
2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 2911.12,	1134
2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21, 2913.31,	1135
2913.40, 2913.43, 2913.47, 2913.48, 2913.49, 2913.51, 2917.11,	1136
2919.12, 2919.22, 2919.24, 2919.25, 2921.13, 2921.36, 2923.02,	1137
2923.12, 2923.13, 2923.161, 2923.32, 2925.02, 2925.03, 2925.04,	1138
2925.05, 2925.06, 2925.11, 2925.13, 2925.14, 2925.22, 2925.23, or	1139
3716.11 of the Revised Code, felonious sexual penetration in	1140
violation of former section 2907.12 of the Revised Code, a	1141
violation of section 2905.04 of the Revised Code as it existed	1142
prior to July 1, 1996, a violation of section 2919.23 of the	1143
Revised Code that would have been a violation of section 2905.04	1144
of the Revised Code as it existed prior to July 1, 1996, had the	1145
violation been committed prior to that date;	1146

(b) An existing or former law of this state, any other state,	1147
or the United States that is substantially equivalent to any of	1148
the offenses listed in division (A)(5)(a) of this section.	1149

(6) On receipt of a request pursuant to section 3701.881 of	1150
the Revised Code with respect to an applicant for employment with	1151
a home health agency in a position that involves providing direct	1152
care to an older adult, a completed form prescribed pursuant to	1153
division (C)(1) of this section, and a set of fingerprint	1154
impressions obtained in the manner described in division (C)(2) of	1155
this section, the superintendent of the bureau of criminal	1156
identification and investigation shall conduct a criminal records	1157
check. The superintendent shall conduct the criminal records check	1158
in the manner described in division (B) of this section to	1159
determine whether any information exists that indicates that the	1160
person who is the subject of the request previously has been	1161
convicted of or pleaded guilty to any of the following:	1162

(a) A violation of section 2903.01, 2903.02, 2903.03,	1163
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34,	1164
2905.01, 2905.02, 2905.11, 2905.12, 2907.02, 2907.03, 2907.05,	1165
2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 2907.25, 2907.31,	1166
2907.32, 2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11,	1167
2911.12, 2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21,	1168
2913.31, 2913.40, 2913.43, 2913.47, 2913.51, 2919.25, 2921.36,	1169
2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.11, 2925.13,	1170
2925.22, 2925.23, or 3716.11 of the Revised Code;	1171

(b) An existing or former law of this state, any other state,	1172
or the United States that is substantially equivalent to any of	1173
the offenses listed in division (A)(6)(a) of this section.	1174

(7) When conducting a criminal records check upon a request	1175
pursuant to section 3319.39 of the Revised Code for an applicant	1176
who is a teacher, in addition to the determination made under	1177
division (A)(1) of this section, the superintendent shall	1178
determine whether any information exists that indicates that the	1179
person who is the subject of the request previously has been	1180
convicted of or pleaded guilty to any offense specified in section	1181
3319.31 of the Revised Code.	1182

(8) On receipt of a request pursuant to section 2151.86 of	1183
the Revised Code, a completed form prescribed pursuant to	1184
division (C)(1) of this section, and a set of fingerprint	1185
impressions obtained in the manner described in division (C)(2)	1186
of this section, the superintendent of the bureau of criminal	1187
identification and investigation shall conduct a criminal records	1188
check in the manner described in division (B) of this section to	1189
determine whether any information exists that indicates that the	1190
person who is the subject of the request previously has been	1191
convicted of or pleaded guilty to any of the following:	1192

(a) A violation of section 959.13, 2903.01, 2903.02, 2903.03,	1193
2903.04, 2903.11, 2903.12, 2903.13, 2903.15, 2903.16, 2903.21,	1194
2903.211, 2903.22, 2903.34, 2905.01, 2905.02, 2905.05, 2907.02,	1195
2907.03, 2907.04, 2907.05, 2907.06, 2907.07, 2907.08, 2907.09,	1196
2907.21, 2907.22, 2907.23, 2907.25, 2907.31, 2907.32, 2907.321,	1197
2907.322, 2907.323, 2909.02, 2909.03, 2909.22, 2909.23, 2909.24,	1198
2911.01, 2911.02, 2911.11, 2911.12, 2913.49, 2917.01, 2917.02,	1199
2919.12, 2919.22, 2919.24, 2919.25, 2923.12, 2923.13, 2923.161,	1200
2925.02, 2925.03, 2925.04, 2925.05, 2925.06, 2927.12, or 3716.11	1201
of the Revised Code, a violation of section 2905.04 of the	1202
Revised Code as it existed prior to July 1, 1996, a violation of	1203
section 2919.23 of the Revised Code that would have been a	1204
violation of section 2905.04 of the Revised Code as it existed	1205
prior to July 1, 1996, had the violation been committed prior to	1206
that date, a violation of section 2925.11 of the Revised Code	1207
that is not a minor drug possession offense, two or more OVI or	1208
OVUAC violations committed within the three years immediately	1209
preceding the submission of the application or petition that is	1210
the basis of the request, or felonious sexual penetration in	1211
violation of former section 2907.12 of the Revised Code;	1212

(b) A violation of an existing or former law of this state,	1213
any other state, or the United States that is substantially	1214
equivalent to any of the offenses listed in division (A)(8)(a) of	1215
this section.	1216

(9) Upon receipt of a request pursuant to section 5104.012	1217
or 5104.013 of the Revised Code, a completed form prescribed	1218
pursuant to division (C)(1) of this section, and a set of	1219
fingerprint impressions obtained in the manner described in	1220
division (C)(2) of this section, the superintendent of the bureau	1221
of criminal identification and investigation shall conduct a	1222
criminal records check in the manner described in division (B) of	1223
this section to determine whether any information exists that	1224
indicates that the person who is the subject of the request has	1225
been convicted of or pleaded guilty to any of the following:	1226

(a) A violation of section 2903.01, 2903.02, 2903.03,	1227
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.22,	1228
2903.34, 2905.01, 2905.02, 2905.05, 2907.02, 2907.03, 2907.04,	1229
2907.05, 2907.06, 2907.07, 2907.08, 2907.09, 2907.21, 2907.22,	1230
2907.23, 2907.25, 2907.31, 2907.32, 2907.321, 2907.322, 2907.323,	1231
2911.01, 2911.02, 2911.11, 2911.12, 2913.02, 2913.03, 2913.04,	1232
2913.041, 2913.05, 2913.06, 2913.11, 2913.21, 2913.31, 2913.32,	1233
2913.33, 2913.34, 2913.40, 2913.41, 2913.42, 2913.43, 2913.44,	1234
2913.441, 2913.45, 2913.46, 2913.47, 2913.48, 2913.49, 2919.12,	1235
2919.22, 2919.24, 2919.25, 2921.11, 2921.13, 2923.01, 2923.12,	1236
2923.13, 2923.161, 2925.02, 2925.03, 2925.04, 2925.05, 2925.06, or	1237
3716.11 of the Revised Code, felonious sexual penetration in	1238
violation of former section 2907.12 of the Revised Code, a	1239
violation of section 2905.04 of the Revised Code as it existed	1240
prior to July 1, 1996, a violation of section 2919.23 of the	1241
Revised Code that would have been a violation of section 2905.04	1242
of the Revised Code as it existed prior to July 1, 1996, had the	1243
violation been committed prior to that date, a violation of	1244
section 2925.11 of the Revised Code that is not a minor drug	1245
possession offense, a violation of section 2923.02 or 2923.03 of	1246
the Revised Code that relates to a crime specified in this	1247
division, or a second violation of section 4511.19 of the	1248
Revised Code within five years of the date of application for	1249
licensure or certification.	1250

(b) A violation of an existing or former law of this state,	1251
any other state, or the United States that is substantially	1252
equivalent to any of the offenses or violations described in	1253
division (A)(9)(a) of this section.	1254

(10) Upon receipt of a request pursuant to section 5153.111	1255
of the Revised Code, a completed form prescribed pursuant to	1256
division (C)(1) of this section, and a set of fingerprint	1257
impressions obtained in the manner described in division (C)(2) of	1258
this section, the superintendent of the bureau of criminal	1259
identification and investigation shall conduct a criminal records	1260
check in the manner described in division (B) of this section to	1261
determine whether any information exists that indicates that the	1262
person who is the subject of the request previously has been	1263
convicted of or pleaded guilty to any of the following:	1264

(a) A violation of section 2903.01, 2903.02, 2903.03,	1265
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34,	1266
2905.01, 2905.02, 2905.05, 2907.02, 2907.03, 2907.04, 2907.05,	1267
2907.06, 2907.07, 2907.08, 2907.09, 2907.21, 2907.22, 2907.23,	1268
2907.25, 2907.31, 2907.32, 2907.321, 2907.322, 2907.323, 2909.02,	1269
2909.03, 2911.01, 2911.02, 2911.11, 2911.12, 2919.12, 2919.22,	1270
2919.24, 2919.25, 2923.12, 2923.13, 2923.161, 2925.02, 2925.03,	1271
2925.04, 2925.05, 2925.06, or 3716.11 of the Revised Code,	1272
felonious sexual penetration in violation of former section	1273
2907.12 of the Revised Code, a violation of section 2905.04 of the	1274
Revised Code as it existed prior to July 1, 1996, a violation of	1275
section 2919.23 of the Revised Code that would have been a	1276
violation of section 2905.04 of the Revised Code as it existed	1277
prior to July 1, 1996, had the violation been committed prior to	1278
that date, or a violation of section 2925.11 of the Revised Code	1279
that is not a minor drug possession offense;	1280

(b) A violation of an existing or former law of this state,	1281
any other state, or the United States that is substantially	1282
equivalent to any of the offenses listed in division (A)(10)(a) of	1283
this section.	1284

(11) On receipt of a request for a criminal records check	1285
from an individual pursuant to section 4749.03 or 4749.06 of the	1286
Revised Code, accompanied by a completed copy of the form	1287
prescribed in division (C)(1) of this section and a set of	1288
fingerprint impressions obtained in a manner described in division	1289
(C)(2) of this section, the superintendent of the bureau of	1290
criminal identification and investigation shall conduct a criminal	1291
records check in the manner described in division (B) of this	1292
section to determine whether any information exists indicating	1293
that the person who is the subject of the request has been	1294
convicted of or pleaded guilty to a felony in this state or in any	1295
other state. If the individual indicates that a firearm will be	1296
carried in the course of business, the superintendent shall	1297
require information from the federal bureau of investigation as	1298
described in division (B)(2) of this section. The superintendent	1299
shall report the findings of the criminal records check and any	1300
information the federal bureau of investigation provides to the	1301
director of public safety.	1302

(12) On receipt of a request pursuant to section 1321.37,	1303
1322.03, 1322.031, or 4763.05 of the Revised Code, a completed	1304
form prescribed pursuant to division (C)(1) of this section, and	1305
a set of fingerprint impressions obtained in the manner described	1306
in division (C)(2) of this section, the superintendent of the	1307
bureau of criminal identification and investigation shall conduct	1308
a criminal records check with respect to any person who has	1309
applied for a license, permit, or certification from the	1310
department of commerce or a division in the department. The	1311
superintendent shall conduct the criminal records check in the	1312
manner described in division (B) of this section to determine	1313
whether any information exists that indicates that the person who	1314
is the subject of the request previously has been convicted of or	1315
pleaded guilty to any of the following: a violation of section	1316
2913.02, 2913.11, 2913.31, 2913.51, or 2925.03 of the Revised	1317
Code; any other criminal offense involving theft, receiving	1318
stolen property, embezzlement, forgery, fraud, passing bad	1319
checks, money laundering, or drug trafficking, or any criminal	1320
offense involving money or securities, as set forth in Chapters	1321
2909., 2911., 2913., 2915., 2921., 2923., and 2925. of the	1322
Revised Code; or any existing or former law of this state, any	1323
other state, or the United States that is substantially	1324
equivalent to those offenses.	1325

(13) On receipt of a request for a criminal records check	1326
from the treasurer of state under section 113.041 of the Revised	1327
Code or from an individual under section 4701.08, 4715.101,	1328
4717.061, 4725.121, 4725.501, 4729.071, 4730.101, 4730.14,	1329
4730.28, 4731.081, 4731.15, 4731.171, 4731.222, 4731.281,	1330
4731.296, 4731.531, 4732.091, 4734.202, 4740.061, 4741.10,	1331
4755.70, 4757.101, 4759.061, 4760.032, 4760.06, 4761.051,	1332
4762.031, 4762.06, or 4779.091 of the Revised Code, accompanied	1333
by a completed form prescribed under division (C)(1) of this	1334
section and a set of fingerprint impressions obtained in the	1335
manner described in division (C)(2) of this section, the	1336
superintendent of the bureau of criminal identification and	1337
investigation shall conduct a criminal records check in the	1338
manner described in division (B) of this section to determine	1339
whether any information exists that indicates that the person who	1340
is the subject of the request has been convicted of or pleaded	1341
guilty to any criminal offense in this state or any other state.	1342
The superintendent shall send the results of a check requested	1343
under section 113.041 of the Revised Code to the treasurer of	1344
state and shall send the results of a check requested under any of	1345
the other listed sections to the licensing board specified by the	1346
individual in the request.	1347

(14) On receipt of a request pursuant to section 1121.23,	1348
1155.03, 1163.05, 1315.141, 1733.47, or 1761.26 of the Revised	1349
Code, a completed form prescribed pursuant to division (C)(1) of	1350
this section, and a set of fingerprint impressions obtained in the	1351
manner described in division (C)(2) of this section, the	1352
superintendent of the bureau of criminal identification and	1353
investigation shall conduct a criminal records check in the manner	1354
described in division (B) of this section to determine whether any	1355
information exists that indicates that the person who is the	1356
subject of the request previously has been convicted of or pleaded	1357
guilty to any criminal offense under any existing or former law of	1358
this state, any other state, or the United States.	1359

(15) Not later than thirty days after the date the	1360
superintendent receives a request of a type described in division	1361
(A)(1), (2), (3), (4), (5), (6), (7), (8), (9), (10), (11),	1362
(12), or (14) of this section, the completed form, and the	1363
fingerprint impressions, the superintendent shall send the	1364
person, board, or entity that made the request any information,	1365
other than information the dissemination of which is prohibited	1366
by federal law, the superintendent determines exists with respect	1367
to the person who is the subject of the request that indicates	1368
that the person previously has been convicted of or pleaded	1369
guilty to any offense listed or described in division (A)(1),	1370
(2), (3), (4), (5), (6), (7), (8), (9), (10), (11), (12), or	1371
(14) of this section, as appropriate. The superintendent shall	1372
send the person, board, or entity that made the request a copy of	1373
the list of offenses specified in division (A)(1), (2), (3), (4),	1374
(5), (6), (7), (8), (9), (10), (11), (12), or (14) of this	1375
section, as appropriate. If the request was made under section	1376
3701.881 of the Revised Code with regard to an applicant who may	1377
be both responsible for the care, custody, or control of a child	1378
and involved in providing direct care to an older adult, the	1379
superintendent shall provide a list of the offenses specified in	1380
divisions (A)(4) and (6) of this section.	1381

Not later than thirty days after the superintendent receives	1382
a request for a criminal records check pursuant to section 113.041	1383
of the Revised Code, the completed form, and the fingerprint	1384
impressions, the superintendent shall send the treasurer of state	1385
any information, other than information the dissemination of which	1386
is prohibited by federal law, the superintendent determines exist	1387
with respect to the person who is the subject of the request that	1388
indicates that the person previously has been convicted of or	1389
pleaded guilty to any criminal offense in this state or any other	1390
state.	1391

(B) The superintendent shall conduct any criminal records	1392
check requested under section 113.041, 121.08, 173.27, 173.394,	1393
1121.23, 1155.03, 1163.05, 1315.141, 1322.03, 1322.031, 1733.47,	1394
1761.26, 2151.86, 3301.32, 3301.541, 3319.39, 3701.881, 3712.09,	1395
3721.121, 3722.151, 4701.08, 4715.101, 4717.061, 4725.121,	1396
4725.501, 4729.071, 4730.101, 4730.14, 4730.28, 4731.081,	1397
4731.15, 4731.171, 4731.222, 4731.281, 4731.296, 4731.531,	1398
4732.091, 4734.202, 4740.061, 4741.10, 4749.03, 4749.06,	1399
4755.70, 4757.101, 4759.061, 4760.032, 4760.06, 4761.051,	1400
4762.031, 4762.06, 4763.05, 4779.091, 5104.012, 5104.013,	1401
~~5111.032~~5163.032, ~~5111.033~~5163.033, ~~5111.034~~5163.034, 5123.081,	1402
5126.28, 5126.281, or 5153.111 of the Revised Code as follows:	1403

(1) The superintendent shall review or cause to be reviewed	1404
any relevant information gathered and compiled by the bureau under	1405
division (A) of section 109.57 of the Revised Code that relates to	1406
the person who is the subject of the request, including, if the	1407
criminal records check was requested under section 113.041,	1408
121.08, 173.27, 173.394, 1121.23, 1155.03, 1163.05, 1315.141,	1409
1321.37, 1322.03, 1322.031, 1733.47, 1761.26, 2151.86, 3301.32,	1410
3301.541, 3319.39, 3701.881, 3712.09, 3721.121, 3722.151,	1411
4749.03, 4749.06, 4763.05, 5104.012, 5104.013, ~~5111.032~~5163.032,	1412
~~5111.033~~5163.033, ~~5111.034~~5163.034, 5123.081, 5126.28,	1413
5126.281, or 5153.111 of the Revised Code, any relevant	1414
information contained in records that have been sealed under	1415
section 2953.32 of the Revised Code;	1416

(2) If the request received by the superintendent asks for	1417
information from the federal bureau of investigation, the	1418
superintendent shall request from the federal bureau of	1419
investigation any information it has with respect to the person	1420
who is the subject of the request, including fingerprint-based	1421
checks of national crime information databases as described in 42	1422
U.S.C. 671 if the request is made pursuant to section 2151.86,	1423
5104.012, or 5104.013 of the Revised Code or if any other Revised	1424
Code section requires fingerprint-based checks of that nature, and	1425
shall review or cause to be reviewed any information the	1426
superintendent receives from that bureau.	1427

(3) The superintendent or the superintendent's designee may	1428
request criminal history records from other states or the federal	1429
government pursuant to the national crime prevention and privacy	1430
compact set forth in section 109.571 of the Revised Code.	1431

(C)(1) The superintendent shall prescribe a form to obtain	1432
the information necessary to conduct a criminal records check from	1433
any person for whom a criminal records check is requested under	1434
section 113.041 of the Revised Code or required by section	1435
121.08, 173.27, 173.394, 1121.23, 1155.03, 1163.05, 1315.141,	1436
1322.03, 1322.031, 1733.47, 1761.26, 2151.86, 3301.32, 3301.541,	1437
3319.39, 3701.881, 3712.09, 3721.121, 3722.151, 4701.08,	1438
4715.101, 4717.061, 4725.121, 4725.501, 4729.071, 4730.101,	1439
4730.14, 4730.28, 4731.081, 4731.15, 4731.171, 4731.222,	1440
4731.281, 4731.296, 4731.531, 4732.091, 4734.202, 4740.061,	1441
4741.10, 4749.03, 4749.06, 4755.70, 4757.101, 4759.061, 4760.032,	1442
4760.06, 4761.051, 4762.031, 4762.06, 4763.05, 4779.091,	1443
5104.012, 5104.013, ~~5111.032~~5163.032, ~~5111.033~~5163.033,	1444
~~5111.034~~5163.034, 5123.081, 5126.28, 5126.281, or 5153.111 of	1445
the Revised Code. The form that the superintendent prescribes	1446
pursuant to this division may be in a tangible format, in an	1447
electronic format, or in both tangible and electronic formats.	1448

(2) The superintendent shall prescribe standard impression	1449
sheets to obtain the fingerprint impressions of any person for	1450
whom a criminal records check is requested under section 113.041	1451
of the Revised Code or required by section 121.08, 173.27,	1452
173.394, 1121.23, 1155.03, 1163.05, 1315.141, 1322.03, 1322.031,	1453
1733.47, 1761.26, 2151.86, 3301.32, 3301.541, 3319.39, 3701.881,	1454
3712.09, 3721.121, 3722.151, 4701.08, 4715.101, 4717.061,	1455
4725.121, 4725.501, 4729.071, 4730.101, 4730.14, 4730.28,	1456
4731.081, 4731.15, 4731.171, 4731.222, 4731.281, 4731.296,	1457
4731.531, 4732.091, 4734.202, 4740.061, 4741.10, 4749.03,	1458
4749.06, 4755.70, 4757.101, 4759.061, 4760.032, 4760.06,	1459
4761.051, 4762.031, 4762.06, 4763.05, 4779.091, 5104.012,	1460
5104.013, ~~5111.032~~5163.032, ~~5111.033~~5163.033, ~~5111.034~~	1461
5163.034, 5123.081, 5126.28, 5126.281, or 5153.111 of the	1462
Revised Code. Any person for whom a records check is requested	1463
under or required by any of those sections shall obtain the	1464
fingerprint impressions at a county sheriff's office, municipal	1465
police department, or any other entity with the ability to make	1466
fingerprint impressions on the standard impression sheets	1467
prescribed by the superintendent. The office, department, or	1468
entity may charge the person a reasonable fee for making the	1469
impressions. The standard impression sheets the superintendent	1470
prescribes pursuant to this division may be in a tangible format,	1471
in an electronic format, or in both tangible and electronic	1472
formats.	1473

(3) Subject to division (D) of this section, the	1474
superintendent shall prescribe and charge a reasonable fee for	1475
providing a criminal records check requested under section	1476
113.041, 121.08, 173.27, 173.394, 1121.23, 1155.03, 1163.05,	1477
1315.141, 1322.03, 1322.031, 1733.47, 1761.26, 2151.86, 3301.32,	1478
3301.541, 3319.39, 3701.881, 3712.09, 3721.121, 3722.151,	1479
4701.08, 4715.101, 4717.061, 4725.121, 4725.501, 4729.071,	1480
4730.101, 4730.14, 4730.28, 4731.081, 4731.15, 4731.171,	1481
4731.222, 4731.281, 4731.296, 4731.531, 4732.091, 4734.202,	1482
4740.061, 4741.10, 4749.03, 4749.06, 4755.70, 4757.101,	1483
4759.061, 4760.032, 4760.06, 4761.051, 4762.031, 4762.06,	1484
4763.05, 4779.091, 5104.012, 5104.013, ~~5111.032~~5163.032,	1485
~~5111.033~~5163.033, ~~5111.034~~5163.034, 5123.081, 5126.28,	1486
5126.281, or 5153.111 of the Revised Code. The person making a	1487
criminal records request under any of those sections shall pay	1488
the fee prescribed pursuant to this division. A person making	1489
a request under section 3701.881 of the Revised Code for a	1490
criminal records check for an applicant who may be both	1491
responsible for the care, custody, or control of a child and	1492
involved in providing direct care to an older adult shall pay	1493
one fee for the request. In the case of a request under section	1494
1121.23, 1155.03, 1163.05, 1315.141, 1733.47, 1761.26, or	1495
~~5111.032~~5163.032 of the Revised Code, the fee shall be paid in	1496
the manner specified in that section.	1497

(4) The superintendent of the bureau of criminal	1498
identification and investigation may prescribe methods of	1499
forwarding fingerprint impressions and information necessary to	1500
conduct a criminal records check, which methods shall include, but	1501
not be limited to, an electronic method.	1502

(D) A determination whether any information exists that	1503
indicates that a person previously has been convicted of or	1504
pleaded guilty to any offense listed or described in division	1505
(A)(1)(a) or (b), (A)(2)(a) or (b), (A)(3)(a) or (b), (A)(4)(a) or	1506
(b), (A)(5)(a) or (b), (A)(6)(a) or (b), (A)(7), (A)(8)(a) or	1507
(b), (A)(9)(a) or (b), (A)(10)(a) or (b), (A)(12), or (A)(14) of	1508
this section, or that indicates that a person previously has	1509
been convicted of or pleaded guilty to any criminal offense in	1510
this state or any other state regarding a criminal records check	1511
of a type described in division (A)(13) of this section, and	1512
that is made by the superintendent with respect to information	1513
considered in a criminal records check in accordance with this	1514
section is valid for the person who is the subject of the	1515
criminal records check for a period of one year from the date	1516
upon which the superintendent makes the determination. During the	1517
period in which the determination in regard to a person is valid,	1518
if another request under this section is made for a criminal	1519
records check for that person, the superintendent shall provide	1520
the information that is the basis for the superintendent's	1521
initial determination at a lower fee than the fee prescribed for	1522
the initial criminal records check.	1523

(E) As used in this section:

1524

(1) "Criminal records check" means any criminal records check	1525
conducted by the superintendent of the bureau of criminal	1526
identification and investigation in accordance with division (B)	1527
of this section.	1528

(2) "Minor drug possession offense" has the same meaning as	1529
in section 2925.01 of the Revised Code.	1530

(3) "Older adult" means a person age sixty or older.

1531

(4) "OVI or OVUAC violation" means a violation of section	1532
4511.19 of the Revised Code or a violation of an existing or	1533
former law of this state, any other state, or the United States	1534
that is substantially equivalent to section 4511.19 of the Revised	1535
Code.	1536

Sec. 109.85. (A) Upon the written request of the governor,	1537
the general assembly, the auditor of state, the director of ~~job~~	1538
~~and family services~~health care administration, the director of	1539
health, or the director of budget and management, or upon the	1540
attorney general's becoming aware of criminal or improper activity	1541
related to Chapter 3721. and the ~~medical assistance~~medicaid	1542
program ~~established under section 5111.01 of the Revised Code~~, the	1543
attorney general shall investigate any criminal or civil violation	1544
of law related to Chapter 3721. of the Revised Code or the ~~medical~~	1545
~~assistance~~medicaid program.	1546

(B) When it appears to the attorney general, as a result of	1547
an investigation under division (A) of this section, that there is	1548
cause to prosecute for the commission of a crime or to pursue a	1549
civil remedy, the attorney general may refer the evidence to the	1550
prosecuting attorney having jurisdiction of the matter, or to a	1551
regular grand jury drawn and impaneled pursuant to sections	1552
2939.01 to 2939.24 of the Revised Code, or to a special grand jury	1553
drawn and impaneled pursuant to section 2939.17 of the Revised	1554
Code, or the attorney general may initiate and prosecute any	1555
necessary criminal or civil actions in any court or tribunal of	1556
competent jurisdiction in this state. When proceeding under this	1557
section, the attorney general, and any assistant or special	1558
counsel designated by the attorney general for that purpose, have	1559
all rights, privileges, and powers of prosecuting attorneys. The	1560
attorney general shall have exclusive supervision and control of	1561
all investigations and prosecutions initiated by the attorney	1562
general under this section. The forfeiture provisions of Chapter	1563
2981. of the Revised Code apply in relation to any such criminal	1564
action initiated and prosecuted by the attorney general.	1565

(C) Nothing in this section shall prevent a county	1566
prosecuting attorney from investigating and prosecuting criminal	1567
activity related to Chapter 3721. of the Revised Code and the	1568
~~medical assistance~~medicaid program ~~established under section~~	1569
~~5111.01 of the Revised Code~~. The forfeiture provisions of Chapter	1570
2981. of the Revised Code apply in relation to any prosecution of	1571
criminal activity related to the ~~medical assistance~~medicaid	1572
program undertaken by the prosecuting attorney.	1573

Sec. 117.10. The auditor of state shall audit all public	1574
offices as provided in this chapter. The auditor of state also may	1575
audit the accounts of private institutions, associations, boards,	1576
and corporations receiving public money for their use and may	1577
require of them annual reports in such form as the auditor of	1578
state prescribes.	1579

If the auditor of state performs or contracts for the	1580
performance of an audit, including a special audit, of the public	1581
employees retirement system, school employees retirement system,	1582
state teachers retirement system, state highway patrol retirement	1583
system, or Ohio police and fire pension fund, the auditor of state	1584
shall make a timely report of the results of the audit to the Ohio	1585
retirement study council.	1586

The auditor of state may audit the accounts of any provider	1587
as defined in section ~~5111.06~~5163.01 of the Revised Code.	1588

If a public office has been audited by an agency of the	1589
United States government, the auditor of state may, if satisfied	1590
that the federal audit has been conducted according to principles	1591
and procedures not contrary to those of the auditor of state, use	1592
and adopt the federal audit and report in lieu of an audit by the	1593
auditor of state's own office.	1594

Within thirty days after the creation or dissolution or the	1595
winding up of the affairs of any public office, that public office	1596
shall notify the auditor of state in writing that this action has	1597
occurred.	1598

Sec. 117.54. The auditor of state may enter into agreements	1599
with the director of health care administration, director of job	1600
and family services, and comparable officers of other states for	1601
the exchange of names, current or most recent addresses, and	1602
social security numbers of medicaid recipients and participants	1603
and recipients of Title IV-A programs as defined in section	1604
5101.80 of the Revised Code.	1605

Sec. 117.55. The auditor of state shall retain, for not less	1606
than two years, at least one copy of all materials containing	1607
information received under sections 117.54, 117.56, 145.27,	1608
742.41, 3307.21, 3309.22, 4123.27, 5101.181, 5101.182, 5160.43,	1609
5160.44, and 5505.04 of the Revised Code. The auditor of state	1610
shall review the information to determine whether overpayments	1611
were made to participants and recipients of public assistance	1612
under Chapters 5107., 5108., and 5115. of the Revised Code and	1613
whether benefits were incorrectly paid on behalf of medicaid	1614
recipients and disability medical assistance recipients. The	1615
auditor of state shall initiate action leading to prosecution,	1616
where warranted, of participants and recipients who received	1617
overpayments or had benefits incorrectly paid on their behalf by	1618
forwarding the name of each such participant or recipient,	1619
together with other pertinent information, to the following:	1620

(A) The attorney general;

1621

(B) The director of job and family services or director of	1622
health care administration, as appropriate;	1623

(C) In the case of public assistance under Chapters 5107.,	1624
5108., and 5115. of the Revised Code, the district director of job	1625
and family services of the district through which the public	1626
assistance was received;	1627

(D) The county director of job and family services and county	1628
prosecutor of the county through which the public assistance,	1629
medicaid, or disability medical assistance was received.	1630

Sec. 117.56. The auditor of state and the attorney general	1631
and persons acting at their direction may examine any records,	1632
whether in computer or printed format, in the possession of the	1633
department of health care administration, the department of job	1634
and family services, or a county department of job and family	1635
services. The auditor of state and attorney general shall provide	1636
safeguards that restrict access to the records to purposes	1637
directly connected with an audit or investigation, prosecution, or	1638
criminal or civil proceeding conducted in connection with the	1639
administration of the medicaid program, the disability medical	1640
assistance program, or a public assistance program under Chapter	1641
5107., 5108., or 5115. of the Revised Code. Persons acting under	1642
this section shall comply with the rules of the director of job	1643
and family services restricting the disclosure of information	1644
regarding participants and recipients of public assistance and	1645
rules of the director of health care administration restricting	1646
the disclosure of information regarding medicaid and disability	1647
medical assistance recipients. A person determined to have failed	1648
to comply with these rules shall thereafter be disqualified from	1649
acting as an agent or employee or in any other capacity under	1650
appointment or employment of any state board, commission, or	1651
agency.	1652

Sec. 117.57. The auditor of state is responsible for the	1653
costs incurred by the auditor of state in carrying out the auditor	1654
of state's duties under sections 117.55 and 117.56 of the Revised	1655
Code.	1656

Sec. 119.01. As used in sections 119.01 to 119.13 of the	1657
Revised Code:	1658

(A)(1) "Agency" means, except as limited by this division,	1659
any official, board, or commission having authority to promulgate	1660
rules or make adjudications in the civil service commission, the	1661
division of liquor control, the department of taxation, the	1662
industrial commission, the bureau of workers' compensation, the	1663
functions of any administrative or executive officer, department,	1664
division, bureau, board, or commission of the government of the	1665
state specifically made subject to sections 119.01 to 119.13 of	1666
the Revised Code, and the licensing functions of any	1667
administrative or executive officer, department, division, bureau,	1668
board, or commission of the government of the state having the	1669
authority or responsibility of issuing, suspending, revoking, or	1670
canceling licenses.	1671

Except as otherwise provided in division (I) of this section,	1672
sections 119.01 to 119.13 of the Revised Code do not apply to the	1673
public utilities commission. Sections 119.01 to 119.13 of the	1674
Revised Code do not apply to the utility radiological safety	1675
board; to the controlling board; to actions of the superintendent	1676
of financial institutions and the superintendent of insurance in	1677
the taking possession of, and rehabilitation or liquidation of,	1678
the business and property of banks, savings and loan associations,	1679
savings banks, credit unions, insurance companies, associations,	1680
reciprocal fraternal benefit societies, and bond investment	1681
companies; to any action taken by the division of securities under	1682
section 1707.201 of the Revised Code; or to any action that may be	1683
taken by the superintendent of financial institutions under	1684
section 1113.03, 1121.06, 1121.10, 1125.09, 1125.12, 1125.18,	1685
1157.01, 1157.02, 1157.10, 1165.01, 1165.02, 1165.10, 1349.33,	1686
1733.35, 1733.361, 1733.37, or 1761.03 of the Revised Code.	1687

Sections 119.01 to 119.13 of the Revised Code do not apply to	1688
actions of the industrial commission or the bureau of workers'	1689
compensation under sections 4123.01 to 4123.94 of the Revised Code	1690
with respect to all matters of adjudication, or to the actions of	1691
the industrial commission, bureau of workers' compensation board	1692
of directors, and bureau of workers' compensation under division	1693
(D) of section 4121.32, sections 4123.29, 4123.34, 4123.341,	1694
4123.342, 4123.40, 4123.411, 4123.44, 4123.442, 4127.07,	1695
divisions (B), (C), and (E) of section 4131.04, and divisions (B),	1696
(C), and (E) of section 4131.14 of the Revised Code with respect	1697
to all matters concerning the establishment of premium,	1698
contribution, and assessment rates.	1699

(2) "Agency" also means any official or work unit having	1700
authority to promulgate rules or make adjudications in the	1701
department of job and family services, but only with respect to	1702
both of the following:	1703

(a) The adoption, amendment, or rescission of rules that	1704
section 5101.09 of the Revised Code requires be adopted in	1705
accordance with this chapter;	1706

(b) The issuance, suspension, revocation, or cancellation of	1707
licenses.	1708

(B) "License" means any license, permit, certificate,	1709
commission, or charter issued by any agency. "License" does not	1710
include any arrangement whereby a person, institution, or entity	1711
furnishes medicaid services under a provider agreement with the	1712
department of ~~job and family services pursuant to Title XIX of the~~	1713
~~"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, as~~	1714
~~amended~~health care administration.	1715

(C) "Rule" means any rule, regulation, or standard, having a	1716
general and uniform operation, adopted, promulgated, and enforced	1717
by any agency under the authority of the laws governing such	1718
agency, and includes any appendix to a rule. "Rule" does not	1719
include any internal management rule of an agency unless the	1720
internal management rule affects private rights and does not	1721
include any guideline adopted pursuant to section 3301.0714 of the	1722
Revised Code.	1723

(D) "Adjudication" means the determination by the highest or	1724
ultimate authority of an agency of the rights, duties, privileges,	1725
benefits, or legal relationships of a specified person, but does	1726
not include the issuance of a license in response to an	1727
application with respect to which no question is raised, nor other	1728
acts of a ministerial nature.	1729

(E) "Hearing" means a public hearing by any agency in	1730
compliance with procedural safeguards afforded by sections 119.01	1731
to 119.13 of the Revised Code.	1732

(F) "Person" means a person, firm, corporation, association,	1733
or partnership.	1734

(G) "Party" means the person whose interests are the subject	1735
of an adjudication by an agency.	1736

(H) "Appeal" means the procedure by which a person, aggrieved	1737
by a finding, decision, order, or adjudication of any agency,	1738
invokes the jurisdiction of a court.	1739

(I) "Rule-making agency" means any board, commission,	1740
department, division, or bureau of the government of the state	1741
that is required to file proposed rules, amendments, or	1742
rescissions under division (D) of section 111.15 of the Revised	1743
Code and any agency that is required to file proposed rules,	1744
amendments, or rescissions under divisions (B) and (H) of section	1745
119.03 of the Revised Code. "Rule-making agency" includes the	1746
public utilities commission. "Rule-making agency" does not include	1747
any state-supported college or university.	1748

(J) "Substantive revision" means any addition to, elimination	1749
from, or other change in a rule, an amendment of a rule, or a	1750
rescission of a rule, whether of a substantive or procedural	1751
nature, that changes any of the following:	1752

(1) That which the rule, amendment, or rescission permits,	1753
authorizes, regulates, requires, prohibits, penalizes, rewards, or	1754
otherwise affects;	1755

(2) The scope or application of the rule, amendment, or	1756
rescission.	1757

(K) "Internal management rule" means any rule, regulation, or	1758
standard governing the day-to-day staff procedures and operations	1759
within an agency.	1760

Sec. 121.02. The following administrative departments and	1761
their respective directors are hereby created:	1762

(A) The office of budget and management, which shall be	1763
administered by the director of budget and management;	1764

(B) The department of commerce, which shall be administered	1765
by the director of commerce;	1766

(C) The department of administrative services, which shall be	1767
administered by the director of administrative services;	1768

(D) The department of transportation, which shall be	1769
administered by the director of transportation;	1770

(E) The department of agriculture, which shall be	1771
administered by the director of agriculture;	1772

(F) The department of natural resources, which shall be	1773
administered by the director of natural resources;	1774

(G) The department of health, which shall be administered by	1775
the director of health;	1776

(H) The department of job and family services, which shall	1777
be administered by the director of job and family services;	1778

(I) Until July 1, 1997, the department of liquor control,	1779
which shall be administered by the director of liquor control;	1780

(J) The department of public safety, which shall be	1781
administered by the director of public safety;	1782

(K) The department of mental health, which shall be	1783
administered by the director of mental health;	1784

(L) The department of mental retardation and developmental	1785
disabilities, which shall be administered by the director of	1786
mental retardation and developmental disabilities;	1787

(M) The department of insurance, which shall be administered	1788
by the superintendent of insurance as director thereof;	1789

(N) The department of development, which shall be	1790
administered by the director of development;	1791

(O) The department of youth services, which shall be	1792
administered by the director of youth services;	1793

(P) The department of rehabilitation and correction, which	1794
shall be administered by the director of rehabilitation and	1795
correction;	1796

(Q) The environmental protection agency, which shall be	1797
administered by the director of environmental protection;	1798

(R) The department of aging, which shall be administered by	1799
the director of aging;	1800

(S) The department of alcohol and drug addiction services,	1801
which shall be administered by the director of alcohol and drug	1802
addiction services;	1803

(T) The department of veterans services, which shall be	1804
administered by the director of veterans services;	1805

(U) The department of health care administration, which shall	1806
be administered by the director of health care administration.	1807

The director of each department shall exercise the powers and	1808
perform the duties vested by law in such department.	1809

Sec. 121.03. The following administrative department heads	1810
shall be appointed by the governor, with the advice and consent of	1811
the senate, and shall hold their offices during the term of the	1812
appointing governor, and are subject to removal at the pleasure of	1813
the governor.	1814

(A) The director of budget and management;

1815

(B) The director of commerce;

1816

1817

(D) The director of agriculture;

1818

(E) The director of job and family services;

1819

(F) Until July 1, 1997, the director of liquor control;

1820

(G) The director of public safety;

1821

(H) The superintendent of insurance;

1822

(I) The director of development;

1823

(J) The tax commissioner;

1824

(K) The director of administrative services;

1825

(L) The director of natural resources;

1826

(M) The director of mental health;

1827

(N) The director of mental retardation and developmental	1828
disabilities;	1829

(O) The director of health;

1830

(P) The director of youth services;

1831

(Q) The director of rehabilitation and correction;

1832

(R) The director of environmental protection;

1833

(S) The director of aging;

1834

(T) The director of alcohol and drug addiction services;

1835

(U) The administrator of workers' compensation who meets the	1836
qualifications required under division (A) of section 4121.121 of	1837
the Revised Code;	1838

(V) The director of veterans services who meets the	1839
qualifications required under section 5902.01 of the Revised Code;	1840

(W) The director of health care administration.

1841

Sec. 122.15. As used in sections 122.15 to 122.154 of the	1842
Revised Code:	1843

(A) "Edison center" means a cooperative research and	1844
development facility that receives funding through the Thomas Alva	1845
Edison grant program under division (C) of section 122.33 of the	1846
Revised Code.	1847

(B) "Ohio entity" means any corporation, limited liability	1848
company, or unincorporated business organization, including a	1849
general or limited partnership, that has its principal place of	1850
business located in this state and has at least fifty per cent of	1851
its gross assets and fifty per cent of its employees located in	1852
this state. If a corporation, limited liability company, or	1853
unincorporated business organization is a member of an affiliated	1854
group, the gross assets and the number of employees of all of the	1855
members of that affiliated group, wherever those assets and	1856
employees are located, shall be included for the purpose of	1857
determining the percentage of the corporation's, company's, or	1858
organization's gross assets and employees that are located in this	1859
state.	1860

(C) "Qualified trade or business" means any trade or business	1861
that primarily involves research and development, technology	1862
transfer, bio-technology, information technology, or the	1863
application of new technology developed through research and	1864
development or acquired through technology transfer. "Qualified	1865
trade or business" does not include any of the following:	1866

(1) Any trade or business involving the performance of	1867
services in the field of law, engineering, architecture,	1868
accounting, actuarial science, performing arts, consulting,	1869
athletics, financial services, or brokerage services, or any trade	1870
or business where the principal asset of the trade or business is	1871
the reputation or skill of one or more of its employees;	1872

(2) Any banking, insurance, financing, leasing, rental,	1873
investing, or similar business;	1874

(3) Any farming business, including the business of raising	1875
or harvesting trees;	1876

(4) Any business involving the production or extraction of	1877
products of a character with respect to which a deduction is	1878
allowable under section 611, 613, or 613A of the "Internal Revenue	1879
Code of 1986," 100 Stat. 2085, 26 U.S.C.A. 611, 613, or 613A;	1880

(5) Any business of operating a hotel, motel, restaurant, or	1881
similar business;	1882

(6) Any trade or business involving a hospital, a private	1883
office of a licensed health care professional, a group practice of	1884
licensed health care professionals, or a nursing home. As used in	1885
division (C)(6) of this section:	1886

(a) "Nursing home" has the same meaning as in section ~~3721.50~~	1887
5166.20 of the Revised Code.	1888

(b) "Hospital" has the same meaning as in section 3727.01 of	1889
the Revised Code.	1890

(D) "Information technology" means the branch of technology	1891
devoted to the study and application of data and the processing	1892
thereof; the automatic acquisition, storage, manipulation or	1893
transformation, management, movement, control, display, switching,	1894
interchange, transmission or reception of data, and the	1895
development or use of hardware, software, firmware, and procedures	1896
associated with this processing. Information technology includes	1897
matters concerned with the furtherance of computer science and	1898
technology, design, development, installation and implementation	1899
of information systems and applications that in turn will be	1900
licensed or sold to a specific target market. Information	1901
technology does not include the creation of a distribution method	1902
for existing products and services.	1903

(E) "Insider" means an individual who owns, controls, or	1904
holds power to vote five per cent or more of the outstanding	1905
securities of a business. For purposes of determining whether an	1906
investor is an insider, the percentage of voting power in the Ohio	1907
entity held by a person related to the investor shall be added to	1908
the investor's percentage of voting power in the same Ohio entity,	1909
if the investor claimed the person related to the investor as a	1910
dependent or a spouse on the investor's federal income tax return	1911
for the previous tax year.	1912

(F) "Related to" means being the spouse, parent, child, or	1913
sibling of an individual.	1914

(G) "Research and development" means designing, creating, or	1915
formulating new or enhanced products, equipment, or processes, and	1916
conducting scientific or technological inquiry and experimentation	1917
in the physical sciences with the goal of increasing scientific	1918
knowledge that may reveal the bases for new or enhanced products,	1919
equipment, or processes.	1920

(H) "State tax liability" means any tax liability incurred	1921
under division (D) of section 5707.03, section 5727.24, 5727.38,	1922
or 5747.02, or Chapter 5733. of the Revised Code.	1923

(I) "Technology transfer" means the transfer of technology	1924
from one sector of the economy to another, including the transfer	1925
of military technology to civilian applications, civilian	1926
technology to military applications, or technology from public or	1927
private research laboratories to military or civilian	1928
applications.	1929

(J) "Affiliated group" means two or more persons related in	1930
such a way that one of the persons owns or controls the business	1931
operations of another of those persons. In the case of a	1932
corporation issuing capital stock, one corporation owns or	1933
controls the business operations of another corporation if it owns	1934
more than fifty per cent of the other corporation's capital stock	1935
with voting rights. In the case of a limited liability company,	1936
one person owns or controls the business operations of the company	1937
if that person's membership interest, as defined in section	1938
1705.01 of the Revised Code, is greater than fifty per cent of	1939
combined membership interest of all persons owning such interests	1940
in the company. In the case of an unincorporated business	1941
organization, one person owns or controls the business operations	1942
of the organization if, under the articles of organization or	1943
other instrument governing the affairs of the organization, that	1944
person has a beneficial interest in the organization's profits,	1945
surpluses, losses, or other distributions greater than fifty per	1946
cent of the combined beneficial interests of all persons having	1947
such an interest in the organization.	1948

(K) "Money" means United States currency, or a check, draft,	1949
or cashier's check for United States currency, payable on demand	1950
and drawn on a bank.	1951

(L) "EDGE business enterprise" means an Ohio entity certified	1952
by the director of administrative services as a participant in the	1953
encouraging diversity, growth, and equity program established by	1954
the governor's executive order 2002-17T.	1955

(M) "Distressed area" has the same meaning as in section	1956
122.23 of the Revised Code.	1957

Sec. 124.30. (A) Positions in the classified service may be	1958
filled without competition as follows:	1959

(1) Whenever there are urgent reasons for filling a vacancy	1960
in any position in the classified service and the director of	1961
administrative services is unable to certify to the appointing	1962
authority, upon its request, a list of persons eligible for	1963
appointment to the position after a competitive examination, the	1964
appointing authority may fill the position by noncompetitive	1965
examination.	1966

A temporary appointment may be made without regard to the	1967
rules of sections 124.01 to 124.64 of the Revised Code. Except as	1968
otherwise provided in this division, the temporary appointment may	1969
not continue longer than one hundred twenty days, and in no case	1970
shall successive temporary appointments be made. A temporary	1971
appointment longer than one hundred twenty days may be made if	1972
necessary by reason of sickness, disability, or other approved	1973
leave of absence of regular officers or employees, in which case	1974
it may continue during the period of sickness, disability, or	1975
other approved leave of absence, subject to the rules of the	1976
director.	1977

(2) In case of a vacancy in a position in the classified	1978
service where peculiar and exceptional qualifications of a	1979
scientific, managerial, professional, or educational character are	1980
required, and upon satisfactory evidence that for specified	1981
reasons competition in this special case is impracticable and that	1982
the position can best be filled by a selection of some designated	1983
person of high and recognized attainments in those qualities, the	1984
director may suspend the provisions of sections 124.01 to 124.64	1985
of the Revised Code that require competition in this special case,	1986
but no suspension shall be general in its application. All such	1987
cases of suspension shall be reported in the annual report of the	1988
director with the reasons for each suspension. The director shall	1989
suspend the provisions when the director of job and family	1990
services or director of health care administration provides the	1991
certification under section 5101.051 or 5160.05 of the Revised	1992
Code that a position with the department of job and family	1993
services or department of health care administration can best be	1994
filled if the provisions are suspended.	1995

(3) The acceptance or refusal by an eligible person of a	1996
temporary appointment shall not affect the person's standing on	1997
the eligible list for permanent appointment, nor shall the period	1998
of temporary service be counted as a part of the probationary	1999
service in case of subsequent appointment to a permanent position.	2000

(B) Persons who receive temporary or intermittent	2001
appointments are in the unclassified civil service and serve at	2002
the pleasure of their appointing authority.	2003

Sec. 124.301. The director of administrative services shall	2004
waive any residency requirement for the civil service established	2005
by a rule adopted under division (A) of section 124.09 of the	2006
Revised Code if the director of job and family services or	2007
director of health care administration provides the director	2008
certification under section 5101.051 or 5160.05 of the Revised	2009
Code that a position with the department of job and family	2010
services or department of health care administration can best be	2011
filled if the residency requirement is waived.	2012

Sec. 127.16. (A) Upon the request of either a state agency	2013
or the director of budget and management and after the controlling	2014
board determines that an emergency or a sufficient economic reason	2015
exists, the controlling board may approve the making of a purchase	2016
without competitive selection as provided in division (B) of this	2017
section.	2018

(B) Except as otherwise provided in this section, no state	2019
agency, using money that has been appropriated to it directly,	2020
shall:	2021

(1) Make any purchase from a particular supplier, that would	2022
amount to fifty thousand dollars or more when combined with both	2023
the amount of all disbursements to the supplier during the fiscal	2024
year for purchases made by the agency and the amount of all	2025
outstanding encumbrances for purchases made by the agency from the	2026
supplier, unless the purchase is made by competitive selection or	2027
with the approval of the controlling board;	2028

(2) Lease real estate from a particular supplier, if the	2029
lease would amount to seventy-five thousand dollars or more when	2030
combined with both the amount of all disbursements to the supplier	2031
during the fiscal year for real estate leases made by the agency	2032
and the amount of all outstanding encumbrances for real estate	2033
leases made by the agency from the supplier, unless the lease is	2034
made by competitive selection or with the approval of the	2035
controlling board.	2036

(C) Any person who authorizes a purchase in violation of	2037
division (B) of this section shall be liable to the state for any	2038
state funds spent on the purchase, and the attorney general shall	2039
collect the amount from the person.	2040

(D) Nothing in division (B) of this section shall be	2041
construed as:	2042

(1) A limitation upon the authority of the director of	2043
transportation as granted in sections 5501.17, 5517.02, and	2044
5525.14 of the Revised Code;	2045

(2) Applying to medicaid provider agreements under Chapter	2046
~~5111.~~5163. or 5164. of the Revised Code or payments or provider	2047
agreements under the disability medical assistance program	2048
established under Chapter ~~5115.~~5168. of the Revised Code;	2049

(3) Applying to the purchase of examinations from a sole	2050
supplier by a state licensing board under Title XLVII of the	2051
Revised Code;	2052

(4) Applying to entertainment contracts for the Ohio state	2053
fair entered into by the Ohio expositions commission, provided	2054
that the controlling board has given its approval to the	2055
commission to enter into such contracts and has approved a total	2056
budget amount for such contracts as agreed upon by commission	2057
action, and that the commission causes to be kept itemized records	2058
of the amounts of money spent under each contract and annually	2059
files those records with the clerk of the house of representatives	2060
and the clerk of the senate following the close of the fair;	2061

(5) Limiting the authority of the chief of the division of	2062
mineral resources management to contract for reclamation work with	2063
an operator mining adjacent land as provided in section 1513.27 of	2064
the Revised Code;	2065

(6) Applying to investment transactions and procedures of any	2066
state agency, except that the agency shall file with the board the	2067
name of any person with whom the agency contracts to make, broker,	2068
service, or otherwise manage its investments, as well as the	2069
commission, rate, or schedule of charges of such person with	2070
respect to any investment transactions to be undertaken on behalf	2071
of the agency. The filing shall be in a form and at such times as	2072
the board considers appropriate.	2073

(7) Applying to purchases made with money for the per cent	2074
for arts program established by section 3379.10 of the Revised	2075
Code;	2076

(8) Applying to purchases made by the rehabilitation services	2077
commission of services, or supplies, that are provided to persons	2078
with disabilities, or to purchases made by the commission in	2079
connection with the eligibility determinations it makes for	2080
applicants of programs administered by the social security	2081
administration;	2082

(9) Applying to payments by the department of ~~job and family~~	2083
~~services~~health care administration under section ~~5111.13~~5165.30	2084
of the Revised Code for group health plan premiums, deductibles,	2085
coinsurance, and other cost-sharing expenses;	2086

(10) Applying to any agency of the legislative branch of the	2087
state government;	2088

(11) Applying to agreements or contracts entered into under	2089
section 5101.11, 5101.20, 5101.201, 5101.21, or 5101.214, 5160.13,	2090
5160.15, or 5160.17 of the Revised Code;	2091

(12) Applying to purchases of services by the adult parole	2092
authority under section 2967.14 of the Revised Code or by the	2093
department of youth services under section 5139.08 of the Revised	2094
Code;	2095

(13) Applying to dues or fees paid for membership in an	2096
organization or association;	2097

(14) Applying to purchases of utility services pursuant to	2098
section 9.30 of the Revised Code;	2099

(15) Applying to purchases made in accordance with rules	2100
adopted by the department of administrative services of motor	2101
vehicle, aviation, or watercraft fuel, or emergency repairs of	2102
such vehicles;	2103

(16) Applying to purchases of tickets for passenger air	2104
transportation;	2105

(17) Applying to purchases necessary to provide public	2106
notifications required by law or to provide notifications of job	2107
openings;	2108

(18) Applying to the judicial branch of state government;

2109

(19) Applying to purchases of liquor for resale by the	2110
division of liquor control;	2111

(20) Applying to purchases of motor courier and freight	2112
services made in accordance with department of administrative	2113
services rules;	2114

(21) Applying to purchases from the United States postal	2115
service and purchases of stamps and postal meter replenishment	2116
from vendors at rates established by the United States postal	2117
service;	2118

(22) Applying to purchases of books, periodicals, pamphlets,	2119
newspapers, maintenance subscriptions, and other published	2120
materials;	2121

(23) Applying to purchases from other state agencies,	2122
including state-assisted institutions of higher education;	2123

(24) Limiting the authority of the director of environmental	2124
protection to enter into contracts under division (D) of section	2125
3745.14 of the Revised Code to conduct compliance reviews, as	2126
defined in division (A) of that section;	2127

(25) Applying to purchases from a qualified nonprofit agency	2128
pursuant to sections 125.60 to 125.6012 or 4115.31 to 4115.35 of	2129
the Revised Code;	2130

(26) Applying to payments by the department of job and family	2131
services to the United States department of health and human	2132
services for printing and mailing notices pertaining to the tax	2133
refund offset program of the internal revenue service of the	2134
United States department of the treasury;	2135

(27) Applying to contracts entered into by the department of	2136
mental retardation and developmental disabilities under section	2137
5123.18 of the Revised Code;	2138

(28) Applying to payments made by the department of mental	2139
health under a physician recruitment program authorized by section	2140
5119.101 of the Revised Code;	2141

(29) Applying to contracts entered into with persons by the	2142
director of commerce for unclaimed funds collection and remittance	2143
efforts as provided in division (F) of section 169.03 of the	2144
Revised Code. The director shall keep an itemized accounting of	2145
unclaimed funds collected by those persons and amounts paid to	2146
them for their services.	2147

(30) Applying to purchases made by a state institution of	2148
higher education in accordance with the terms of a contract	2149
between the vendor and an inter-university purchasing group	2150
comprised of purchasing officers of state institutions of higher	2151
education;	2152

(31) Applying to the department of ~~job and family services'~~	2153
health care administration's purchases of health assistance	2154
services under the children's health insurance program ~~part I~~	2155
~~provided for under section 5101.50 of the Revised Code, the~~	2156
~~children's health insurance program part II provided for under~~	2157
~~section 5101.51 of the Revised Code, or the children's health~~	2158
~~insurance program part III provided for under section 5101.52 of~~	2159
~~the Revised Code,~~ or the children's buy-in program ~~provided for~~	2160
~~under sections 5101.5211 to 5101.5216 of the Revised Code~~;	2161

(32) Applying to payments by the attorney general from the	2162
reparations fund to hospitals and other emergency medical	2163
facilities for performing medical examinations to collect physical	2164
evidence pursuant to section 2907.28 of the Revised Code;	2165

(33) Applying to contracts with a contracting authority or	2166
administrative receiver under division (B) of section 5126.056 of	2167
the Revised Code;	2168

(34) Applying to reimbursements paid to the United States	2169
department of veterans affairs for pharmaceutical and patient	2170
supply purchases made on behalf of the Ohio veterans' home agency;	2171

(35) Applying to agreements entered into with terminal	2172
distributors of dangerous drugs under section 173.79 of the	2173
Revised Code;	2174

(36) Applying to payments by the superintendent of the bureau	2175
of criminal identification and investigation to the federal bureau	2176
of investigation for criminal records checks pursuant to section	2177
109.572 of the Revised Code.	2178

(E) When determining whether a state agency has reached the	2179
cumulative purchase thresholds established in divisions (B)(1) and	2180
(2) of this section, all of the following purchases by such agency	2181
shall not be considered:	2182

(1) Purchases made through competitive selection or with	2183
controlling board approval;	2184

(2) Purchases listed in division (D) of this section;

2185

(3) For the purposes of the threshold of division (B)(1) of	2186
this section only, leases of real estate.	2187

(F) As used in this section, "competitive selection,"	2188
"purchase," "supplies," and "services" have the same meanings as	2189
in section 125.01 of the Revised Code.	2190

Sec. 131.23. The various political subdivisions of this	2191
state may issue bonds, and any indebtedness created by that	2192
issuance shall not be subject to the limitations or included in	2193
the calculation of indebtedness prescribed by sections 133.05,	2194
133.06, 133.07, and 133.09 of the Revised Code, but the bonds may	2195
be issued only under the following conditions:	2196

(A) The subdivision desiring to issue the bonds shall obtain	2197
from the county auditor a certificate showing the total amount of	2198
delinquent taxes due and unpayable to the subdivision at the last	2199
semiannual tax settlement.	2200

(B) The fiscal officer of that subdivision shall prepare a	2201
statement, from the books of the subdivision, verified by the	2202
fiscal officer under oath, which shall contain the following facts	2203
of the subdivision:	2204

(1) The total bonded indebtedness;

2205

(2) The aggregate amount of notes payable or outstanding	2206
accounts of the subdivision, incurred prior to the commencement of	2207
the current fiscal year, which shall include all evidences of	2208
indebtedness issued by the subdivision except notes issued in	2209
anticipation of bond issues and the indebtedness of any	2210
nontax-supported public utility;	2211

(3) Except in the case of school districts, the aggregate	2212
current year's requirement for disability financial assistance ~~and~~	2213
~~disability medical assistance~~ provided under Chapter ~~5115.~~5168.	2214
of the Revised Code and the disability medical assistance program	2215
that the subdivision is unable to finance except by the issue of	2216
bonds;	2217

(4) The indebtedness outstanding through the issuance of any	2218
bonds or notes pledged or obligated to be paid by any delinquent	2219
taxes;	2220

(5) The total of any other indebtedness;

2221

(6) The net amount of delinquent taxes unpledged to pay any	2222
bonds, notes, or certificates, including delinquent assessments on	2223
improvements on which the bonds have been paid;	2224

(7) The budget requirements for the fiscal year for bond and	2225
note retirement;	2226

(8) The estimated revenue for the fiscal year.

2227

(C) The certificate and statement provided for in divisions	2228
(A) and (B) of this section shall be forwarded to the tax	2229
commissioner together with a request for authority to issue bonds	2230
of the subdivision in an amount not to exceed seventy per cent of	2231
the net unobligated delinquent taxes and assessments due and owing	2232
to the subdivision, as set forth in division (B)(6) of this	2233
section.	2234

(D) No subdivision may issue bonds under this section in	2235
excess of a sufficient amount to pay the indebtedness of the	2236
subdivision as shown by division (B)(2) of this section and,	2237
except in the case of school districts, to provide funds for	2238
disability financial assistance and disability medical assistance,	2239
as shown by division (B)(3) of this section.	2240

(E) The tax commissioner shall grant to the subdivision	2241
authority requested by the subdivision as restricted by divisions	2242
(C) and (D) of this section and shall make a record of the	2243
certificate, statement, and grant in a record book devoted solely	2244
to such recording and which shall be open to inspection by the	2245
public.	2246

(F) The commissioner shall immediately upon issuing the	2247
authority provided in division (E) of this section notify the	2248
proper authority having charge of the retirement of bonds of the	2249
subdivision by forwarding a copy of the grant of authority and of	2250
the statement provided for in division (B) of this section.	2251

(G) Upon receipt of authority, the subdivision shall proceed	2252
according to law to issue the amount of bonds authorized by the	2253
commissioner, and authorized by the taxing authority, provided the	2254
taxing authority of that subdivision may submit, by resolution, to	2255
the electors of that subdivision the question of issuing the	2256
bonds. The resolution shall make the declarations and statements	2257
required by section 133.18 of the Revised Code. The county auditor	2258
and taxing authority shall thereupon proceed as set forth in	2259
divisions (C) and (D) of that section. The election on the	2260
question of issuing the bonds shall be held under divisions (E),	2261
(F), and (G) of that section, except that publication of the	2262
notice of the election shall be made on two separate days prior to	2263
the election in one or more newspapers of general circulation in	2264
the subdivision, and, if the board of elections operates and	2265
maintains a web site, notice of the election also shall be posted	2266
on that web site for thirty days prior to the election. The bonds	2267
may be exchanged at their face value with creditors of the	2268
subdivision in liquidating the indebtedness described and	2269
enumerated in division (B)(2) of this section or may be sold as	2270
provided in Chapter 133. of the Revised Code, and in either event	2271
shall be uncontestable.	2272

(H) The per cent of delinquent taxes and assessments	2273
collected for and to the credit of the subdivision after the	2274
exchange or sale of bonds as certified by the commissioner shall	2275
be paid to the authority having charge of the sinking fund of the	2276
subdivision, which money shall be placed in a separate fund for	2277
the purpose of retiring the bonds so issued. The proper authority	2278
of the subdivisions shall provide for the levying of a tax	2279
sufficient in amount to pay the debt charges on all such bonds	2280
issued under this section.	2281

(I) This section is for the sole purpose of assisting the	2282
various subdivisions in paying their unsecured indebtedness, and	2283
providing funds for disability financial assistance and the	2284
disability medical assistance program. The bonds issued under	2285
authority of this section shall not be used for any other purpose,	2286
and any exchange for other purposes, or the use of the money	2287
derived from the sale of the bonds by the subdivision for any	2288
other purpose, is misapplication of funds.	2289

(J) The bonds authorized by this section shall be redeemable	2290
or payable in not to exceed ten years from date of issue and shall	2291
not be subject to or considered in calculating the net	2292
indebtedness of the subdivision. The budget commission of the	2293
county in which the subdivision is located shall annually allocate	2294
such portion of the then delinquent levy due the subdivision which	2295
is unpledged for other purposes to the payment of debt charges on	2296
the bonds issued under authority of this section.	2297

(K) The issue of bonds under this section shall be governed	2298
by Chapter 133. of the Revised Code, respecting the terms used,	2299
forms, manner of sale, and redemption except as otherwise provided	2300
in this section.	2301

The board of county commissioners of any county may issue	2302
bonds authorized by this section and distribute the proceeds of	2303
the bond issues to any or all of the cities and townships of the	2304
county, according to their relative needs for disability financial	2305
assistance and the disability medical assistance program as	2306
determined by the county.	2307

All sections of the Revised Code inconsistent with or	2308
prohibiting the exercise of the authority conferred by this	2309
section are inoperative respecting bonds issued under this	2310
section.	2311

Sec. 145.27. (A)(1) As used in this division, "personal	2312
history record" means information maintained by the public	2313
employees retirement board on an individual who is a member,	2314
former member, contributor, former contributor, retirant, or	2315
beneficiary that includes the address, telephone number, social	2316
security number, record of contributions, correspondence with the	2317
public employees retirement system, or other information the board	2318
determines to be confidential.	2319

(2) The records of the board shall be open to public	2320
inspection, except that the following shall be excluded, except	2321
with the written authorization of the individual concerned:	2322

(a) The individual's statement of previous service and other	2323
information as provided for in section 145.16 of the Revised Code;	2324

(b) The amount of a monthly allowance or benefit paid to the	2325
individual;	2326

2327

(B) All medical reports and recommendations required by this	2328
chapter are privileged, except that copies of such medical reports	2329
or recommendations shall be made available to the personal	2330
physician, attorney, or authorized agent of the individual	2331
concerned upon written release from the individual or the	2332
individual's agent, or when necessary for the proper	2333
administration of the fund, to the board assigned physician.	2334

(C) Any person who is a member or contributor of the system	2335
shall be furnished with a statement of the amount to the credit of	2336
the individual's account upon written request. The board is not	2337
required to answer more than one such request of a person in any	2338
one year. The board may issue annual statements of accounts to	2339
members and contributors.	2340

(D) Notwithstanding the exceptions to public inspection in	2341
division (A)(2) of this section, the board may furnish the	2342
following information:	2343

(1) If a member, former member, contributor, former	2344
contributor, or retirant is subject to an order issued under	2345
section 2907.15 of the Revised Code or an order issued under	2346
division (A) or (B) of section 2929.192 of the Revised Code or is	2347
convicted of or pleads guilty to a violation of section 2921.41 of	2348
the Revised Code, on written request of a prosecutor as defined in	2349
section 2935.01 of the Revised Code, the board shall furnish to	2350
the prosecutor the information requested from the individual's	2351
personal history record.	2352

(2) Pursuant to a court or administrative order issued	2353
pursuant to Chapter 3119., 3121., 3123., or 3125. of the Revised	2354
Code, the board shall furnish to a court or child support	2355
enforcement agency the information required under that section.	2356

(3) At the written request of any person, the board shall	2357
provide to the person a list of the names and addresses of	2358
members, former members, contributors, former contributors,	2359
retirants, or beneficiaries. The costs of compiling, copying, and	2360
mailing the list shall be paid by such person.	2361

(4) Within fourteen days after receiving ~~from the director of~~	2362
~~job and family services~~ a list of the names and social security	2363
numbers of recipients of public assistance pursuant to section	2364
5101.181 of the Revised Code or a list of the names and social	2365
security numbers of public medical assistance recipients pursuant	2366
to section 5160.43 of the Revised Code, the board shall inform the	2367
auditor of state of the name, current or most recent employer	2368
address, and social security number of each member whose name and	2369
social security number are the same as that of a person whose name	2370
or social security number ~~was submitted by the director~~is	2371
included on the list. The board and its employees shall, except	2372
for purposes of furnishing the auditor of state with information	2373
required by this section, preserve the confidentiality of	2374
recipients of public assistance in compliance with ~~division (A) of~~	2375
section 5101.181 of the Revised Code and preserve the	2376
confidentiality of public medical assistance recipients with	2377
section 5160.43 of the Revised Code.	2378

(5) The system shall comply with orders issued under section	2379
3105.87 of the Revised Code.	2380

On the written request of an alternate payee, as defined in	2381
section 3105.80 of the Revised Code, the system shall furnish to	2382
the alternate payee information on the amount and status of any	2383
amounts payable to the alternate payee under an order issued under	2384
section 3105.171 or 3105.65 of the Revised Code.	2385

(6) At the request of any person, the board shall make	2386
available to the person copies of all documents, including	2387
resumes, in the board's possession regarding filling a vacancy of	2388
an employee member or retirant member of the board. The person who	2389
made the request shall pay the cost of compiling, copying, and	2390
mailing the documents. The information described in division	2391
(D)(6) of this section is a public record.	2392

(E) A statement that contains information obtained from the	2393
system's records that is signed by the executive director or an	2394
officer of the system and to which the system's official seal is	2395
affixed, or copies of the system's records to which the signature	2396
and seal are attached, shall be received as true copies of the	2397
system's records in any court or before any officer of this state.	2398

Sec. 145.58. (A) As used in this section, "ineligible	2399
individual" means all of the following:	2400

(1) A former member receiving benefits pursuant to section	2401
145.32, 145.33, 145.331, 145.34, or 145.46 of the Revised Code for	2402
whom eligibility is established more than five years after June	2403
13, 1981, and who, at the time of establishing eligibility, has	2404
accrued less than ten years' service credit, exclusive of credit	2405
obtained pursuant to section 145.297 or 145.298 of the Revised	2406
Code, credit obtained after January 29, 1981, pursuant to section	2407
145.293 or 145.301 of the Revised Code, and credit obtained after	2408
May 4, 1992, pursuant to section 145.28 of the Revised Code;	2409

(2) The spouse of the former member;

2410

(3) The beneficiary of the former member receiving benefits	2411
pursuant to section 145.46 of the Revised Code.	2412

(B) The public employees retirement board may enter into	2413
agreements with insurance companies, health insuring corporations,	2414
or government agencies authorized to do business in the state for	2415
issuance of a policy or contract of health, medical, hospital, or	2416
surgical benefits, or any combination thereof, for those	2417
individuals receiving age and service retirement or a disability	2418
or survivor benefit subscribing to the plan, or for PERS retirants	2419
employed under section 145.38 of the Revised Code, for coverage of	2420
benefits in accordance with division (D)(2) of section 145.38 of	2421
the Revised Code. Notwithstanding any other provision of this	2422
chapter, the policy or contract may also include coverage for any	2423
eligible individual's spouse and dependent children and for any of	2424
the individual's sponsored dependents as the board determines	2425
appropriate. If all or any portion of the policy or contract	2426
premium is to be paid by any individual receiving age and service	2427
retirement or a disability or survivor benefit, the individual	2428
shall, by written authorization, instruct the board to deduct the	2429
premium agreed to be paid by the individual to the company,	2430
corporation, or agency.	2431

The board may contract for coverage on the basis of part or	2432
all of the cost of the coverage to be paid from appropriate funds	2433
of the public employees retirement system. The cost paid from the	2434
funds of the system shall be included in the employer's	2435
contribution rate provided by sections 145.48 and 145.51 of the	2436
Revised Code. The board may by rule provide coverage to ineligible	2437
individuals if the coverage is provided at no cost to the	2438
retirement system. The board shall not pay or reimburse the cost	2439
for coverage under this section or section 145.325 of the Revised	2440
Code for any ineligible individual.	2441

The board may provide for self-insurance of risk or level of	2442
risk as set forth in the contract with the companies,	2443
corporations, or agencies, and may provide through the	2444
self-insurance method specific benefits as authorized by rules of	2445
the board.	2446

(C) The board shall, beginning the month following receipt of	2447
satisfactory evidence of the payment for coverage, pay monthly to	2448
each recipient of service retirement, or a disability or survivor	2449
benefit under the public employees retirement system who is	2450
eligible for medical insurance coverage under part B of ~~Title~~	2451
~~XVIII of "The Social Security Act," 79 Stat. 301 (1965), 42~~	2452
~~U.S.C.A. 1395j, as amended~~the medicare program, an amount	2453
determined by the board for such coverage that is not less than	2454
ninety-six dollars and forty cents, except that the board shall	2455
make no such payment to any ineligible individual or pay an	2456
amount that exceeds the amount paid by the recipient for the	2457
coverage.	2458

At the request of the board, the recipient shall certify to	2459
the retirement system the amount paid by the recipient for	2460
coverage described in this division.	2461

(D) The board shall establish by rule requirements for the	2462
coordination of any coverage, payment, or benefit provided under	2463
this section or section 145.325 of the Revised Code with any	2464
similar coverage, payment, or benefit made available to the same	2465
individual by the Ohio police and fire pension fund, state	2466
teachers retirement system, school employees retirement system, or	2467
state highway patrol retirement system.	2468

(E) The board shall make all other necessary rules pursuant	2469
to the purpose and intent of this section.	2470

Sec. 149.431. (A) Any governmental entity or agency and any	2471
nonprofit corporation or association, except a corporation	2472
organized pursuant to Chapter 1719. of the Revised Code prior to	2473
January 1, 1980 or organized pursuant to Chapter 3941. of the	2474
Revised Code, that enters into a contract or other agreement with	2475
the federal government, a unit of state government, or a political	2476
subdivision or taxing unit of this state for the provision of	2477
services shall keep accurate and complete financial records of any	2478
moneys expended in relation to the performance of the services	2479
pursuant to such contract or agreement according to generally	2480
accepted accounting principles. Such contract or agreement and	2481
such financial records shall be deemed to be public records as	2482
defined in division (A)(1) of section 149.43 of the Revised Code	2483
and are subject to the requirements of division (B) of that	2484
section, except that:	2485

(1) Any information directly or indirectly identifying a	2486
present or former individual patient or client or ~~his~~such an	2487
individual patient's or client's diagnosis, prognosis, or medical	2488
treatment, treatment for a mental or emotional disorder, treatment	2489
for mental retardation or a developmental disability, treatment	2490
for drug abuse or alcoholism, or counseling for personal or social	2491
problems is not a public record;	2492

(2) If disclosure of the contract or agreement or financial	2493
records is requested at a time when confidential professional	2494
services are being provided to a patient or client whose	2495
confidentiality might be violated if disclosure were made at that	2496
time, disclosure may be deferred if reasonable times are	2497
established when the contract or agreement or financial records	2498
will be disclosed.	2499

(3) Any nonprofit corporation or association that receives	2500
both public and private funds in fulfillment of any such contract	2501
or other agreement is not required to keep as public records the	2502
financial records of any private funds expended in relation to the	2503
performance of services pursuant to the contract or agreement.	2504

(B) Any nonprofit corporation or association that receives	2505
more than fifty per cent of its gross receipts excluding moneys	2506
received pursuant to ~~Title XVIII of~~ the ~~"Social Security Act," 49~~	2507
~~Stat. 620 (1935), 42 U.S.C. 301, as amended~~medicare program, in a	2508
calendar year in fulfillment of a contract or other agreement for	2509
services with a governmental entity shall maintain information	2510
setting forth the compensation of any individual serving the	2511
nonprofit corporation or association in an executive or	2512
administrative capacity. Such information shall be deemed to be	2513
public records as defined in division (A)(1) of section 149.43 of	2514
the Revised Code and is subject to the requirements of division	2515
(B) of that section.	2516

Nothing in this section shall be construed to otherwise limit	2517
the provisions of section 149.43 of the Revised Code.	2518

Sec. 169.02. Subject to division (B) of section 169.01 of	2519
the Revised Code, the following constitute unclaimed funds:	2520

(A) Except as provided in division (R) of this section, any	2521
demand, savings, or matured time deposit account, or matured	2522
certificate of deposit, together with any interest or dividend on	2523
it, less any lawful claims, that is held or owed by a holder which	2524
is a financial organization, unclaimed for a period of five years;	2525

(B) Any funds paid toward the purchase of withdrawable shares	2526
or other interest in a financial organization, and any interest or	2527
dividends on them, less any lawful claims, that is held or owed by	2528
a holder which is a financial organization, unclaimed for a period	2529
of five years;	2530

(C) Except as provided in division (A) of section 3903.45 of	2531
the Revised Code, moneys held or owed by a holder, including a	2532
fraternal association, providing life insurance, including annuity	2533
or endowment coverage, unclaimed for three years after becoming	2534
payable as established from the records of such holder under any	2535
life or endowment insurance policy or annuity contract that has	2536
matured or terminated. An insurance policy, the proceeds of which	2537
are payable on the death of the insured, not matured by proof of	2538
death of the insured is deemed matured and the proceeds payable if	2539
such policy was in force when the insured attained the limiting	2540
age under the mortality table on which the reserve is based.	2541

Moneys otherwise payable according to the records of such	2542
holder are deemed payable although the policy or contract has not	2543
been surrendered as required.	2544

(D) Any deposit made to secure payment or any sum paid in	2545
advance for utility services of a public utility and any amount	2546
refundable from rates or charges collected by a public utility for	2547
utility services held or owed by a holder, less any lawful claims,	2548
that has remained unclaimed for one year after the termination of	2549
the services for which the deposit or advance payment was made or	2550
one year from the date the refund was payable, whichever is	2551
earlier;	2552

(E) Except as provided in division (R) of this section, any	2553
certificates, securities as defined in section 1707.01 of the	2554
Revised Code, nonwithdrawable shares, other instruments evidencing	2555
ownership, or rights to them or funds paid toward the purchase of	2556
them, or any dividend, capital credit, profit, distribution,	2557
interest, or payment on principal or other sum, held or owed by a	2558
holder, including funds deposited with a fiscal agent or fiduciary	2559
for payment of them, and instruments representing an ownership	2560
interest, unclaimed for five years. Any underlying share or other	2561
intangible instrument representing an ownership interest in a	2562
business association, in which the issuer has recorded on its	2563
books the issuance of the share but has been unable to deliver the	2564
certificate to the shareholder, constitutes unclaimed funds if	2565
such underlying share is unclaimed for five years. In addition, an	2566
underlying share constitutes unclaimed funds if a dividend,	2567
distribution, or other sum payable as a result of the underlying	2568
share has remained unclaimed by the owner for five years.	2569

This division shall not prejudice the rights of fiscal agents	2570
or fiduciaries for payment to return the items described in this	2571
division to their principals, according to the terms of an agency	2572
or fiduciary agreement, but such a return shall constitute the	2573
principal as the holder of the items and shall not interrupt the	2574
period for computing the time for which the items have remained	2575
unclaimed.	2576

In the case of any such funds accruing and held or owed by a	2577
corporation under division (E) of section 1701.24 of the Revised	2578
Code, such corporation shall comply with this chapter, subject to	2579
the limitation contained in section 1701.34 of the Revised Code.	2580
The period of time for which such funds have gone unclaimed	2581
specified in section 1701.34 of the Revised Code shall be	2582
computed, with respect to dividends or distributions, commencing	2583
as of the dates when such dividends or distributions would have	2584
been payable to the shareholder had such shareholder surrendered	2585
the certificates for cancellation and exchange by the date	2586
specified in the order relating to them.	2587

Capital credits of a cooperative which after January 1, 1972,	2588
have been allocated to members and which by agreement are	2589
expressly required to be paid if claimed after death of the owner	2590
are deemed payable, for the purpose of this chapter, fifteen years	2591
after either the termination of service by the cooperative to the	2592
owner or upon the nonactivity as provided in division (B) of	2593
section 169.01 of the Revised Code, whichever occurs later,	2594
provided that this provision does not apply if the payment is not	2595
mandatory.	2596

(F) Any sum payable on certified checks or other written	2597
instruments certified or issued and representing funds held or	2598
owed by a holder, less any lawful claims, that are unclaimed for	2599
five years from the date payable or from the date of issuance if	2600
payable on demand; except that the unclaimed period for money	2601
orders that are not third party bank checks is seven years, and	2602
the unclaimed period for traveler's checks is fifteen years, from	2603
the date payable or from the date of issuance if payable on	2604
demand.	2605

As used in this division, "written instruments" include, but	2606
are not limited to, certified checks, cashier's checks, bills of	2607
exchange, letters of credit, drafts, money orders, and traveler's	2608
checks.	2609

If there is no address of record for the owner or other	2610
person entitled to the funds, such address is presumed to be the	2611
address where the instrument was certified or issued.	2612

(G) Except as provided in division (R) of this section, all	2613
moneys, rights to moneys, or other intangible property, arising	2614
out of the business of engaging in the purchase or sale of	2615
securities, or otherwise dealing in intangibles, less any lawful	2616
claims, that are held or owed by a holder and are unclaimed for	2617
five years from the date of transaction.	2618

(H) Except as provided in division (A) of section 3903.45 of	2619
the Revised Code, all moneys, rights to moneys, and other	2620
intangible property distributable in the course of dissolution or	2621
liquidation of a holder that are unclaimed for one year after the	2622
date set by the holder for distribution;	2623

(I) All moneys, rights to moneys, or other intangible	2624
property removed from a safe-deposit box or other safekeeping	2625
repository located in this state or removed from a safe-deposit	2626
box or other safekeeping repository of a holder, on which the	2627
lease or rental period has expired, or any amount arising from the	2628
sale of such property, less any lawful claims, that are unclaimed	2629
for three years from the date on which the lease or rental period	2630
expired;	2631

(J) Subject to division (M)(2) of this section, all moneys,	2632
rights to moneys, or other intangible property, and any income or	2633
increment on them, held or owed by a holder which is a fiduciary	2634
for the benefit of another, or a fiduciary or custodian of a	2635
qualified retirement plan or individual retirement arrangement	2636
under section 401 or 408 of the Internal Revenue Code, unclaimed	2637
for three years after the final date for distribution;	2638

(K) All moneys, rights to moneys, or other intangible	2639
property held or owed in this state or held for or owed to an	2640
owner whose last known address is within this state, by the United	2641
States government or any state, as those terms are described in	2642
division (E) of section 169.01 of the Revised Code, unclaimed by	2643
the owner for three years, excluding any property in the control	2644
of any court in a proceeding in which a final adjudication has not	2645
been made;	2646

(L) Amounts payable pursuant to the terms of any policy of	2647
insurance, other than life insurance, or any refund available	2648
under such a policy, held or owed by any holder, unclaimed for	2649
three years from the date payable or distributable;	2650

(M)(1) Subject to division (M)(2) of this section, any funds	2651
constituting rents or lease payments due, any deposit made to	2652
secure payment of rents or leases, or any sum paid in advance for	2653
rents, leases, possible damage to property, unused services,	2654
performance requirements, or any other purpose, held or owed by a	2655
holder unclaimed for one year;	2656

(2) Any escrow funds, security deposits, or other moneys that	2657
are received by a licensed broker in a fiduciary capacity and	2658
that, pursuant to division (A)(26) of section 4735.18 of the	2659
Revised Code, are required to be deposited into and maintained in	2660
a special or trust, noninterest-bearing bank account separate and	2661
distinct from any personal or other account of the licensed	2662
broker, held or owed by the licensed broker unclaimed for two	2663
years.	2664

(N) Any sum greater than fifty dollars payable as wages, any	2665
sum payable as salaries or commissions, any sum payable for	2666
services rendered, funds owed or held as royalties, oil and	2667
mineral proceeds, funds held for or owed to suppliers, and moneys	2668
owed under pension and profit-sharing plans, held or owed by any	2669
holder unclaimed for one year from date payable or distributable,	2670
and all other credits held or owed, or to be refunded to a retail	2671
customer, by any holder unclaimed for three years from date	2672
payable or distributable;	2673

(O) Amounts held in respect of or represented by lay-aways	2674
sold after January 1, 1972, less any lawful claims, when such	2675
lay-aways are unclaimed for three years after the sale of them;	2676

(P) All moneys, rights to moneys, and other intangible	2677
property not otherwise constituted as unclaimed funds by this	2678
section, including any income or increment on them, less any	2679
lawful claims, which are held or owed by any holder, other than a	2680
holder which holds a permit issued pursuant to Chapter 3769. of	2681
the Revised Code, and which have remained unclaimed for three	2682
years after becoming payable or distributable;	2683

(Q) All moneys that arise out of a sale held pursuant to	2684
section 5322.03 of the Revised Code, that are held by a holder for	2685
delivery on demand to the appropriate person pursuant to division	2686
(I) of that section, and that are unclaimed for two years after	2687
the date of the sale.	2688

(R)(1) Any funds that are subject to an agreement between the	2689
holder and owner providing for automatic reinvestment and that	2690
constitute dividends, distributions, or other sums held or owed by	2691
a holder in connection with a security as defined in section	2692
1707.01 of the Revised Code, an ownership interest in an	2693
investment company registered under the "Investment Company Act of	2694
1940," 54 Stat. 789, 15 U.S.C. 80a-1, as amended, or a certificate	2695
of deposit, unclaimed for a period of five years.	2696

(2) The five-year period under division (R)(1) of this	2697
section commences from the date a second shareholder notification	2698
or communication mailing to the owner of the funds is returned to	2699
the holder as undeliverable by the United States postal service or	2700
other carrier. The notification or communication mailing by the	2701
holder shall be no less frequent than quarterly.	2702

All moneys in a personal allowance account, as defined by	2703
rules adopted by the director of ~~job and family services~~health	2704
care administration, up to and including the maximum resource	2705
limitation, of a medicaid patient who has died after receiving	2706
care in a long-term care facility, and for whom there is no	2707
identifiable heir or sponsor, are not subject to this chapter.	2708

Sec. 173.14. As used in sections 173.14 to 173.27 of the	2709
Revised Code:	2710

(A)(1) Except as otherwise provided in division (A)(2) of	2711
this section, "long-term care facility" includes any residential	2712
facility that provides personal care services for more than	2713
twenty-four hours for two or more unrelated adults, including all	2714
of the following:	2715

(a) A "nursing home," "residential care facility," or "home	2716
for the aging" as defined in section 3721.01 of the Revised Code;	2717

(b) A facility authorized to provide extended care services	2718
under ~~Title XVIII of~~ the ~~"Social Security Act," 49 Stat. 620~~	2719
~~(1935), 42 U.S.C. 301, as amended~~medicare program;	2720

(c) A county home or district home operated pursuant to	2721
Chapter 5155. of the Revised Code;	2722

(d) An "adult care facility" as defined in section 3722.01 of	2723
the Revised Code;	2724

(e) A facility approved by the veterans administration under	2725
section 104(a) of the "Veterans Health Care Amendments of 1983,"	2726
97 Stat. 993, 38 U.S.C. 630, as amended, and used exclusively for	2727
the placement and care of veterans;	2728

(f) An adult foster home certified under section 173.36 of	2729
the Revised Code.	2730

(2) "Long-term care facility" does not include a "residential	2731
facility" as defined in section 5119.22 of the Revised Code or a	2732
"residential facility" as defined in section 5123.19 of the	2733
Revised Code.	2734

(B) "Resident" means a resident of a long-term care facility	2735
and, where appropriate, includes a prospective, previous, or	2736
deceased resident of a long-term care facility.	2737

(C) "Community-based long-term care services" means health	2738
and social services provided to persons in their own homes or in	2739
community care settings, and includes any of the following:	2740

(1) Case management;

2741

(2) Home health care;

2742

(3) Homemaker services;

2743

(4) Chore services;

2744

(5) Respite care;

2745

(6) Adult day care;

2746

(7) Home-delivered meals;

2747

(8) Personal care;

2748

(9) Physical, occupational, and speech therapy;

2749

(10) Transportation;

2750

(11) Any other health and social services provided to persons	2751
that allow them to retain their independence in their own homes or	2752
in community care settings.	2753

(D) "Recipient" means a recipient of community-based	2754
long-term care services and, where appropriate, includes a	2755
prospective, previous, or deceased recipient of community-based	2756
long-term care services.	2757

(E) "Sponsor" means an adult relative, friend, or guardian	2758
who has an interest in or responsibility for the welfare of a	2759
resident or a recipient.	2760

(F) "Personal care services" has the same meaning as in	2761
section 3721.01 of the Revised Code.	2762

(G) "Regional long-term care ombudsperson program" means an	2763
entity, either public or private and nonprofit, designated as a	2764
regional long-term care ombudsperson program by the state	2765
long-term care ombudsperson.	2766

(H) "Representative of the office of the state long-term care	2767
ombudsperson program" means the state long-term care ombudsperson	2768
or a member of the ombudsperson's staff, or a person certified as	2769
a representative of the office under section 173.21 of the Revised	2770
Code.	2771

(I) "Area agency on aging" means an area agency on aging	2772
established under the "Older Americans Act of 1965," 79 Stat. 219,	2773
42 U.S.C.A. 3001, as amended.	2774

Sec. 173.20. (A) If consent is given and unless otherwise	2775
prohibited by law, a representative of the office of the state	2776
long-term care ~~ombudsman~~ombudsperson program shall have access to	2777
any records, including medical records, of a resident or a	2778
recipient that are reasonably necessary for investigation of a	2779
complaint. Consent may be given in any of the following ways:	2780

(1) In writing by the resident or recipient;

2781

(2) Orally by the resident or recipient, witnessed in writing	2782
at the time it is given by one other person, and, if the records	2783
involved are being maintained by a long-term care provider, also	2784
by an employee of the long-term care provider designated under	2785
division (E)(1) of this section;	2786

(3) In writing by the guardian of the resident or recipient;

2787

(4) In writing by the attorney in fact of the resident or	2788
recipient, if the resident or recipient has authorized the	2789
attorney in fact to give such consent;	2790

(5) In writing by the executor or administrator of the estate	2791
of a deceased resident or recipient.	2792

(B) If consent to access to records is not refused by a	2793
resident or recipient or ~~his~~the resident's or recipient's legal	2794
representative but cannot be obtained and any of the following	2795
circumstances exist, a representative of the office of the state	2796
long-term care ~~ombudsman~~ombudsperson program, on approval of the	2797
state long-term care ~~ombudsman~~ombudsperson, may inspect the	2798
records of a resident or a recipient, including medical records,	2799
that are reasonably necessary for investigation of a complaint:	2800

(1) The resident or recipient is unable to express written or	2801
oral consent and there is no guardian or attorney in fact;	2802

(2) There is a guardian or attorney in fact, but hethe	2803
guardian or attorney in fact cannot be contacted within three	2804
working days;	2805

(3) There is a guardianship or durable power of attorney, but	2806
its existence is unknown by the long-term care provider and the	2807
representative of the office at the time of the investigation;	2808

(4) There is no executor or administrator of the estate of a	2809
deceased resident or recipient.	2810

(C) If a representative of the office of the state long-term	2811
care ~~ombudsman~~ombudsperson program has been refused access to	2812
records by a guardian or attorney in fact, but has reasonable	2813
cause to believe that the guardian or attorney in fact is not	2814
acting in the best interests of the resident or recipient, the	2815
representative may, on approval of the state long-term care	2816
~~ombudsman~~ombudsperson, inspect the records of the resident or	2817
recipient, including medical records, that are reasonably	2818
necessary for investigation of a complaint.	2819

(D) A representative of the office of the state long-term	2820
care ~~ombudsman~~ombudsperson program shall have access to any	2821
records of a long-term care provider reasonably necessary to an	2822
investigation conducted under this section, including but not	2823
limited to: incident reports, dietary records, policies and	2824
procedures of a facility required to be maintained under section	2825
~~5111.21~~5164.02 of the Revised Code, admission agreements,	2826
staffing schedules, any document depicting the actual staffing	2827
pattern of the provider, any financial records that are matters of	2828
public record, resident council and grievance committee minutes,	2829
and any waiting list maintained by a facility in accordance with	2830
section ~~5111.31~~5164.033 of the Revised Code, or any similar	2831
records or lists maintained by a provider of community-based	2832
long-term care services. Pursuant to division (E)(2) of this	2833
section, a representative shall be permitted to make or obtain	2834
copies of any of these records after giving the long-term care	2835
provider twenty-four hours' notice. A long-term care provider may	2836
impose a charge for providing copies of records under this	2837
division that does not exceed the actual and necessary expense of	2838
making the copies.	2839

The state ~~ombudsman~~ombudsperson shall take whatever action	2840
is necessary to ensure that any copy of a record made or obtained	2841
under this division is returned to the long-term care provider no	2842
later than three years after the date the investigation for which	2843
the copy was made or obtained is completed.	2844

(E)(1) Each long-term care provider shall designate one or	2845
more of its employees to be responsible for witnessing the giving	2846
of oral consent under division (A) of this section. In the event	2847
that a designated employee is not available when a resident or	2848
recipient attempts to give oral consent, the provider shall	2849
designate another employee to witness the consent.	2850

(2) Each long-term care provider shall designate one or more	2851
of its employees to be responsible for releasing records for	2852
copying to representatives of the office of the long-term care	2853
~~ombudsman~~ombudsperson program who request permission to make or	2854
obtain copies of records specified in division (D) of this	2855
section. In the event that a designated employee is not available	2856
when a representative of the office makes the request, the	2857
long-term care provider shall designate another employee to	2858
release the records for copying.	2859

(F) A long-term care provider or any employee of such a	2860
provider is immune from civil or criminal liability or action	2861
taken pursuant to a professional disciplinary procedure for the	2862
release or disclosure of records to a representative of the office	2863
pursuant to this section.	2864

(G) A state or local government agency or entity with records	2865
relevant to a complaint or investigation being conducted by a	2866
representative of the office shall provide the representative	2867
access to the records.	2868

(H) The state ~~ombudsman~~ombudsperson, with the approval of	2869
the director of aging, may issue a subpoena to compel any person	2870
hethe ombudsperson reasonably believes may be able to provide	2871
information to appear before ~~him~~the ombudsperson or ~~his~~the	2872
ombudsperson's designee and give sworn testimony and to produce	2873
documents, books, records, papers, or other evidence the state	2874
~~ombudsman~~ombudsperson believes is relevant to the investigation.	2875
On the refusal of a witness to be sworn or to answer any question	2876
put to ~~him~~the witness, or if a person disobeys a subpoena, the	2877
~~ombudsman~~ombudsperson shall apply to the Franklin county court of	2878
common pleas for a contempt order, as in the case of disobedience	2879
of the requirements of a subpoena issued from the court, or a	2880
refusal to testify in the court.	2881

(I) The state ~~ombudsman~~ombudsperson may petition the court	2882
of common pleas in the county in which a long-term care facility	2883
is located to issue an injunction against any long-term care	2884
facility in violation of sections 3721.10 to 3721.17 of the	2885
Revised Code.	2886

(J) Any suspected violation of Chapter 3721. of the Revised	2887
Code discovered during the course of an investigation may be	2888
reported to the department of health. Any suspected criminal	2889
violation discovered during the course of an investigation shall	2890
be reported to the attorney general or other appropriate law	2891
enforcement authorities.	2892

(K) The department of aging shall adopt rules in accordance	2893
with Chapter 119. of the Revised Code for referral by the state	2894
~~ombudsman~~ombudsperson and regional long-term care ~~ombudsman~~	2895
ombudsperson programs of complaints to other public agencies or	2896
entities. A public agency or entity to which a complaint is	2897
referred shall keep the state ~~ombudsman~~ombudsperson or regional	2898
program handling the complaint advised and notified in writing in	2899
a timely manner of the disposition of the complaint to the extent	2900
permitted by law.	2901

Sec. 173.21. (A) The office of the state long-term care	2902
~~ombudsman~~ombudsperson program, through the state long-term care	2903
~~ombudsman~~ombudsperson and the regional long-term care ~~ombudsman~~	2904
ombudsperson programs, shall require each representative of the	2905
office to complete a training and certification program in	2906
accordance with this section and to meet the continuing education	2907
requirements established under this section.	2908

(B) The department of aging shall adopt rules under Chapter	2909
119. of the Revised Code specifying the content of training	2910
programs for representatives of the office of the state long-term	2911
care ~~ombudsman~~ombudsperson program. Training for representatives	2912
other than those who are volunteers providing services through	2913
regional long-term care ~~ombudsman~~ombudsperson programs shall	2914
include instruction regarding federal, state, and local laws,	2915
rules, and policies on long-term care facilities and	2916
community-based long-term care services; investigative techniques;	2917
and other topics considered relevant by the department and shall	2918
consist of the following:	2919

(1) A minimum of forty clock hours of basic instruction,	2920
which shall be completed before the trainee is permitted to handle	2921
complaints without the supervision of a representative of the	2922
office certified under this section;	2923

(2) An additional sixty clock hours of instruction, which	2924
shall be completed within the first fifteen months of employment;	2925

(3) An internship of twenty clock hours, which shall be	2926
completed within the first twenty-four months of employment,	2927
including instruction in, and observation of, basic nursing care	2928
and long-term care provider operations and procedures. The	2929
internship shall be performed at a site that has been approved as	2930
an internship site by the state long-term care ~~ombudsman~~	2931
ombudsperson.	2932

(4) One of the following, which shall be completed within the	2933
first twenty-four months of employment:	2934

(a) Observation of a survey conducted by the director of	2935
health to certify a facility to receive funds under sections	2936
~~5111.20~~5164.01 to ~~5111.32~~5164.35 of the Revised Code;	2937

(b) Observation of an inspection conducted by the director of	2938
health to license an adult care facility under section 3722.04 of	2939
the Revised Code.	2940

(5) Any other training considered appropriate by the	2941
department.	2942

(C) Persons who for a period of at least six months prior to	2943
June 11, 1990, served as ombudsmen through the long-term care	2944
~~ombudsman~~ombudsperson program established by the department of	2945
aging under division (M) of section 173.01 of the Revised Code	2946
shall not be required to complete a training program. These	2947
persons and persons who complete a training program shall take an	2948
examination administered by the department of aging. On attainment	2949
of a passing score, the person shall be certified by the	2950
department as a representative of the office. The department shall	2951
issue the person an identification card, which the representative	2952
shall show at the request of any person with whom hethe	2953
representative deals while performing ~~his~~the representative's	2954
duties and which he shall ~~surrender~~be surrendered at the time he	2955
the representative separates from the office.	2956

(D) The state ~~ombudsman~~ombudsperson and each regional	2957
program shall conduct training programs for volunteers on their	2958
respective staffs in accordance with the rules of the department	2959
of aging adopted under division (B) of this section. Training	2960
programs may be conducted that train volunteers to complete some,	2961
but not all, of the duties of a representative of the office. Each	2962
regional office shall bear the cost of training its	2963
representatives who are volunteers. On completion of a training	2964
program, the representative shall take an examination administered	2965
by the department of aging. On attainment of a passing score, hea	2966
volunteer shall be certified by the department as a representative	2967
authorized to perform services specified in the certification. The	2968
department shall issue an identification card, which the	2969
representative shall show at the request of any person with whom	2970
hethe representative deals while performing ~~his~~the	2971
representative's duties and which he shall ~~surrender~~be	2972
surrendered at the time hethe representative separates from the	2973
office. Except as a supervised part of a training program, no	2974
volunteer shall perform any duty unless he is certified as a	2975
representative having received appropriate training for that duty.	2976

(E) The state ~~ombudsman~~ombudsperson shall provide technical	2977
assistance to regional programs conducting training programs for	2978
volunteers and shall monitor the training programs.	2979

(F) Prior to scheduling an observation of a certification	2980
survey or licensing inspection for purposes of division (B)(4) of	2981
this section, the state ~~ombudsman~~ombudsperson shall obtain	2982
permission to have the survey or inspection observed from both the	2983
director of health and the long-term care facility at which the	2984
survey or inspection is to take place.	2985

(G) The department of aging shall establish continuing	2986
education requirements for representatives of the office.	2987

Sec. 173.26. (A) Each of the following facilities shall	2988
annually pay to the department of aging six dollars for each bed	2989
maintained by the facility for use by a resident during any part	2990
of the previous year:	2991

(1) Nursing homes, residential care facilities, and homes for	2992
the aging as defined in section 3721.01 of the Revised Code;	2993

(2) Facilities authorized to provide extended care services	2994
under ~~Title XVIII of~~ the ~~"Social Security Act," 49 Stat. 620~~	2995
~~(1935), 42 U.S.C. 301, as amended~~medicare program;	2996

(3) County homes and district homes operated pursuant to	2997
Chapter 5155. of the Revised Code;	2998

(4) Adult care facilities as defined in section 3722.01 of	2999
the Revised Code;	3000

(5) Facilities approved by the Veterans Administration under	3001
Section 104(a) of the "Veterans Health Care Amendments of 1983,"	3002
97 Stat. 993, 38 U.S.C. 630, as amended, and used exclusively for	3003
the placement and care of veterans.	3004

The department shall, by rule adopted in accordance with	3005
Chapter 119. of the Revised Code, establish deadlines for payments	3006
required by this section. A facility that fails, within ninety	3007
days after the established deadline, to pay a payment required by	3008
this section shall be assessed at two times the original invoiced	3009
payment.	3010

(B) All money collected under this section shall be deposited	3011
in the state treasury to the credit of the office of the state	3012
long-term care ombudsperson program fund, which is hereby created.	3013
Money credited to the fund shall be used solely to pay the costs	3014
of operating the regional long-term care ombudsperson programs.	3015

(C) The state long-term care ombudsperson and the regional	3016
programs may solicit and receive contributions to support the	3017
operation of the office or a regional program, except that no	3018
contribution shall be solicited or accepted that would interfere	3019
with the independence or objectivity of the office or program.	3020

Sec. 173.394. (A) As used in this section:

3021

(1) "Applicant" means a person who is under final	3022
consideration for employment with a community-based long-term care	3023
agency in a full-time, part-time, or temporary position that	3024
involves providing direct care to an individual. "Applicant" does	3025
not include a person who provides direct care as a volunteer	3026
without receiving or expecting to receive any form of remuneration	3027
other than reimbursement for actual expenses.	3028

(2) "Criminal records check" has the same meaning as in	3029
section 109.572 of the Revised Code.	3030

(B)(1) Except as provided in division (I) of this section,	3031
the chief administrator of a community-based long-term care agency	3032
shall request that the superintendent of the bureau of criminal	3033
identification and investigation conduct a criminal records check	3034
with respect to each applicant. If an applicant for whom a	3035
criminal records check request is required under this division	3036
does not present proof of having been a resident of this state for	3037
the five-year period immediately prior to the date the criminal	3038
records check is requested or provide evidence that within that	3039
five-year period the superintendent has requested information	3040
about the applicant from the federal bureau of investigation in a	3041
criminal records check, the chief administrator shall request that	3042
the superintendent obtain information from the federal bureau of	3043
investigation as part of the criminal records check of the	3044
applicant. Even if an applicant for whom a criminal records check	3045
request is required under this division presents proof of having	3046
been a resident of this state for the five-year period, the chief	3047
administrator may request that the superintendent include	3048
information from the federal bureau of investigation in the	3049
criminal records check.	3050

(2) A person required by division (B)(1) of this section to	3051
request a criminal records check shall do both of the following:	3052

(a) Provide to each applicant for whom a criminal records	3053
check request is required under that division a copy of the form	3054
prescribed pursuant to division (C)(1) of section 109.572 of the	3055
Revised Code and a standard fingerprint impression sheet	3056
prescribed pursuant to division (C)(2) of that section, and obtain	3057
the completed form and impression sheet from the applicant;	3058

(b) Forward the completed form and impression sheet to the	3059
superintendent of the bureau of criminal identification and	3060
investigation.	3061

(3) An applicant provided the form and fingerprint impression	3062
sheet under division (B)(2)(a) of this section who fails to	3063
complete the form or provide fingerprint impressions shall not be	3064
employed in any position for which a criminal records check is	3065
required by this section.	3066

(C)(1) Except as provided in rules adopted by the department	3067
of aging in accordance with division (F) of this section and	3068
subject to division (C)(2) of this section, no community-based	3069
long-term care agency shall employ a person in a position that	3070
involves providing direct care to an individual if the person has	3071
been convicted of or pleaded guilty to any of the following:	3072

(a) A violation of section 2903.01, 2903.02, 2903.03,	3073
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34,	3074
2905.01, 2905.02, 2905.11, 2905.12, 2907.02, 2907.03, 2907.05,	3075
2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 2907.25, 2907.31,	3076
2907.32, 2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11,	3077
2911.12, 2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21,	3078
2913.31, 2913.40, 2913.43, 2913.47, 2913.51, 2919.25, 2921.36,	3079
2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.11, 2925.13,	3080
2925.22, 2925.23, or 3716.11 of the Revised Code.	3081

(b) A violation of an existing or former law of this state,	3082
any other state, or the United States that is substantially	3083
equivalent to any of the offenses listed in division (C)(1)(a) of	3084
this section.	3085

(2)(a) A community-based long-term care agency may employ	3086
conditionally an applicant for whom a criminal records check	3087
request is required under division (B) of this section prior to	3088
obtaining the results of a criminal records check regarding the	3089
individual, provided that the agency shall request a criminal	3090
records check regarding the individual in accordance with division	3091
(B)(1) of this section not later than five business days after the	3092
individual begins conditional employment. In the circumstances	3093
described in division (I)(2) of this section, a community-based	3094
long-term care agency may employ conditionally an applicant who	3095
has been referred to the agency by an employment service that	3096
supplies full-time, part-time, or temporary staff for positions	3097
involving the direct care of individuals and for whom, pursuant to	3098
that division, a criminal records check is not required under	3099
division (B) of this section.	3100

(b) A community-based long-term care agency that employs an	3101
individual conditionally under authority of division (C)(2)(a) of	3102
this section shall terminate the individual's employment if the	3103
results of the criminal records check request under division (B)	3104
of this section or described in division (I)(2) of this section,	3105
other than the results of any request for information from the	3106
federal bureau of investigation, are not obtained within the	3107
period ending sixty days after the date the request is made.	3108
Regardless of when the results of the criminal records check are	3109
obtained, if the results indicate that the individual has been	3110
convicted of or pleaded guilty to any of the offenses listed or	3111
described in division (C)(1) of this section, the agency shall	3112
terminate the individual's employment unless the agency chooses to	3113
employ the individual pursuant to division (F) of this section.	3114
Termination of employment under this division shall be considered	3115
just cause for discharge for purposes of division (D)(2) of	3116
section 4141.29 of the Revised Code if the individual makes any	3117
attempt to deceive the agency about the individual's criminal	3118
record.	3119

(D)(1) Each community-based long-term care agency shall pay	3120
to the bureau of criminal identification and investigation the fee	3121
prescribed pursuant to division (C)(3) of section 109.572 of the	3122
Revised Code for each criminal records check conducted pursuant to	3123
a request made under division (B) of this section.	3124

(2) A community-based long-term care agency may charge an	3125
applicant a fee not exceeding the amount the agency pays under	3126
division (D)(1) of this section. An agency may collect a fee only	3127
if both of the following apply:	3128

(a) The agency notifies the person at the time of initial	3129
application for employment of the amount of the fee and that,	3130
unless the fee is paid, the person will not be considered for	3131
employment;	3132

(b) The medicaid program ~~established under Chapter 5111. of~~	3133
~~the Revised Code~~ does not reimburse the agency the fee it pays	3134
under division (D)(1) of this section.	3135

(E) The report of any criminal records check conducted	3136
pursuant to a request made under this section is not a public	3137
record for the purposes of section 149.43 of the Revised Code and	3138
shall not be made available to any person other than the	3139
following:	3140

(1) The individual who is the subject of the criminal records	3141
check or the individual's representative;	3142

(2) The chief administrator of the agency requesting the	3143
criminal records check or the administrator's representative;	3144

(3) The administrator of any other facility, agency, or	3145
program that provides direct care to individuals that is owned or	3146
operated by the same entity that owns or operates the	3147
community-based long-term care agency;	3148

(4) The director of aging or a person authorized by the	3149
director to monitor a community-based long-term care agency's	3150
compliance with this section;	3151

(5) A court, hearing officer, or other necessary individual	3152
involved in a case dealing with a denial of employment of the	3153
applicant or dealing with employment or unemployment benefits of	3154
the applicant;	3155

(6) Any person to whom the report is provided pursuant to,	3156
and in accordance with, division (I)(1) or (2) of this section.	3157

(F) The department of aging shall adopt rules in accordance	3158
with Chapter 119. of the Revised Code to implement this section.	3159
The rules shall specify circumstances under which a	3160
community-based long-term care agency may employ a person who has	3161
been convicted of or pleaded guilty to an offense listed or	3162
described in division (C)(1) of this section but meets personal	3163
character standards set by the department.	3164

(G) The chief administrator of a community-based long-term	3165
care agency shall inform each person, at the time of initial	3166
application for a position that involves providing direct care to	3167
an individual, that the person is required to provide a set of	3168
fingerprint impressions and that a criminal records check is	3169
required to be conducted if the person comes under final	3170
consideration for employment.	3171

(H) In a tort or other civil action for damages that is	3172
brought as the result of an injury, death, or loss to person or	3173
property caused by an individual who a community-based long-term	3174
care agency employs in a position that involves providing direct	3175
care to individuals, all of the following shall apply:	3176

(1) If the agency employed the individual in good faith and	3177
reasonable reliance on the report of a criminal records check	3178
requested under this section, the agency shall not be found	3179
negligent solely because of its reliance on the report, even if	3180
the information in the report is determined later to have been	3181
incomplete or inaccurate;	3182

(2) If the agency employed the individual in good faith on a	3183
conditional basis pursuant to division (C)(2) of this section, the	3184
agency shall not be found negligent solely because it employed the	3185
individual prior to receiving the report of a criminal records	3186
check requested under this section;	3187

(3) If the agency in good faith employed the individual	3188
according to the personal character standards established in rules	3189
adopted under division (F) of this section, the agency shall not	3190
be found negligent solely because the individual prior to being	3191
employed had been convicted of or pleaded guilty to an offense	3192
listed or described in division (C)(1) of this section.	3193

(I)(1) The chief administrator of a community-based	3194
long-term care agency is not required to request that the	3195
superintendent of the bureau of criminal identification and	3196
investigation conduct a criminal records check of an applicant if	3197
the applicant has been referred to the agency by an employment	3198
service that supplies full-time, part-time, or temporary staff for	3199
positions involving the direct care of individuals and both of the	3200
following apply:	3201

(a) The chief administrator receives from the employment	3202
service or the applicant a report of the results of a criminal	3203
records check regarding the applicant that has been conducted by	3204
the superintendent within the one-year period immediately	3205
preceding the applicant's referral;	3206

(b) The report of the criminal records check demonstrates	3207
that the person has not been convicted of or pleaded guilty to an	3208
offense listed or described in division (C)(1) of this section, or	3209
the report demonstrates that the person has been convicted of or	3210
pleaded guilty to one or more of those offenses, but the	3211
community-based long-term care agency chooses to employ the	3212
individual pursuant to division (F) of this section.	3213

(2) The chief administrator of a community-based long-term	3214
care agency is not required to request that the superintendent of	3215
the bureau of criminal identification and investigation conduct a	3216
criminal records check of an applicant and may employ the	3217
applicant conditionally as described in this division, if the	3218
applicant has been referred to the agency by an employment service	3219
that supplies full-time, part-time, or temporary staff for	3220
positions involving the direct care of individuals and if the	3221
chief administrator receives from the employment service or the	3222
applicant a letter from the employment service that is on the	3223
letterhead of the employment service, dated, and signed by a	3224
supervisor or another designated official of the employment	3225
service and that states that the employment service has requested	3226
the superintendent to conduct a criminal records check regarding	3227
the applicant, that the requested criminal records check will	3228
include a determination of whether the applicant has been	3229
convicted of or pleaded guilty to any offense listed or described	3230
in division (C)(1) of this section, that, as of the date set forth	3231
on the letter, the employment service had not received the results	3232
of the criminal records check, and that, when the employment	3233
service receives the results of the criminal records check, it	3234
promptly will send a copy of the results to the community-based	3235
long-term care agency. If a community-based long-term care agency	3236
employs an applicant conditionally in accordance with this	3237
division, the employment service, upon its receipt of the results	3238
of the criminal records check, promptly shall send a copy of the	3239
results to the community-based long-term care agency, and division	3240
(C)(2)(b) of this section applies regarding the conditional	3241
employment.	3242

Sec. 173.40. There is hereby created a medicaid waiver	3243
component, as defined in section ~~5111.85~~5163.50 of the Revised	3244
Code, to be known as the preadmission screening system providing	3245
options and resources today program, or PASSPORT. The PASSPORT	3246
program shall provide home and community-based services as an	3247
alternative to nursing facility placement for aged and disabled	3248
medicaid recipients. The program shall be operated pursuant to a	3249
home and community-based waiver granted by the United States	3250
secretary of health and human services under ~~section 1915 of the~~	3251
~~"Social Security Act," 49 Stat. 620 (1935),~~ 42 U.S.C. 1396n~~, as~~	3252
~~amended~~. The department of aging shall administer the program	3253
through a contract entered into with the department of ~~job and~~	3254
~~family services~~health care administration under section ~~5111.91~~	3255
5161.05 of the Revised Code. The director of ~~job and family~~	3256
~~services~~health care administration shall adopt rules under	3257
section ~~5111.85~~5163.50 of the Revised Code and the director of	3258
aging shall adopt rules in accordance with Chapter 119. of the	3259
Revised Code to implement the program.	3260

Sec. 173.401. (A) As used in this section:

3261

"Area agency on aging" has the same meaning as in section	3262
173.14 of the Revised Code.	3263

"Long-term care consultation program" means the program the	3264
department of aging is required to develop under section 173.42 of	3265
the Revised Code.	3266

"Long-term care consultation program administrator" or	3267
"administrator" means the department of aging or, if the	3268
department contracts with an area agency on aging or other entity	3269
to administer the long-term care consultation program for a	3270
particular area, that agency or entity.	3271

"Nursing facility" has the same meaning as in section ~~5111.20~~	3272
5164.01 of the Revised Code.	3273

"PASSPORT program" means the program created under section	3274
173.40 of the Revised Code.	3275

"PASSPORT waiver" means the federal medicaid waiver granted	3276
by the United States secretary of health and human services that	3277
authorizes the PASSPORT program.	3278

(B) The director of ~~job and family services~~health care	3279
administration shall submit to the United States secretary of	3280
health and human services an amendment to the PASSPORT waiver	3281
that authorizes additional enrollments in the PASSPORT program	3282
pursuant to this section. Beginning with the month following the	3283
month in which the United States secretary approves the amendment	3284
and each month thereafter, each area agency on aging shall	3285
determine whether individuals who reside in the area that the	3286
area agency on aging serves and are on a waiting list for the	3287
PASSPORT program have been admitted to a nursing facility. If an	3288
area agency on aging determines that such an individual has been	3289
admitted to a nursing facility, the agency shall notify the	3290
long-term care consultation program administrator serving the	3291
area in which the individual resides about the determination. The	3292
administrator shall determine whether the PASSPORT program is	3293
appropriate for the individual and whether the individual would	3294
rather participate in the PASSPORT program than continue residing	3295
in the nursing facility. If the administrator determines that the	3296
PASSPORT program is appropriate for the individual and the	3297
individual would rather participate in the PASSPORT program than	3298
continue residing in the nursing facility, the administrator	3299
shall so notify the department of aging. On receipt of the notice	3300
from the administrator, the department of aging shall approve the	3301
individual's enrollment in the PASSPORT program regardless of the	3302
PASSPORT program's waiting list and even though the enrollment	3303
causes enrollment in the program to exceed the limit that would	3304
otherwise apply. Each quarter, the department of aging shall	3305
certify to the director of budget and management the estimated	3306
increase in costs of the PASSPORT program resulting from	3307
enrollment of individuals in the PASSPORT program pursuant to	3308
this section.	3309

(C) Not later than the last day of each calendar year, the	3310
director of ~~job and family services~~health care administration	3311
shall submit to the general assembly a report regarding the	3312
number of individuals enrolled in the PASSPORT program pursuant	3313
to this section and the costs incurred and savings achieved as a	3314
result of the enrollments.	3315

Sec. 173.42. (A) As used in this section:

3316

(1) "Area agency on aging" means a public or private	3317
nonprofit entity designated under section 173.011 of the Revised	3318
Code to administer programs on behalf of the department of aging.	3319

(2) "Long-term care consultation" means the process used to	3320
provide services under the long-term care consultation program	3321
established pursuant to this section, including, but not limited	3322
to, such services as the provision of information about long-term	3323
care options and costs, the assessment of an individual's	3324
functional capabilities, and the conduct of all or part of the	3325
reviews, assessments, and determinations specified in sections	3326
~~5111.202, 5111.204,~~ 5119.061, ~~and~~ 5123.021, 5164.45, and 5164.47	3327
of the Revised Code and the rules adopted under those sections.	3328

(3) ~~"Medicaid" means the medical assistance program~~	3329
~~established under Chapter 5111. of the Revised Code.~~	3330

~~(4)~~ "Nursing facility" has the same meaning as in section	3331
~~5111.20~~5164.01 of the Revised Code.	3332

~~(5)~~(4) "Representative" means a person acting on behalf of an	3333
individual seeking a long-term care consultation, applying for	3334
admission to a nursing facility, or residing in a nursing	3335
facility. A representative may be a family member, attorney,	3336
hospital social worker, or any other person chosen to act on	3337
behalf of the individual.	3338

(B) The department of aging shall develop a long-term care	3339
consultation program whereby individuals or their representatives	3340
are provided with long-term care consultations and receive through	3341
these professional consultations information about options	3342
available to meet long-term care needs and information about	3343
factors to consider in making long-term care decisions. The	3344
long-term care consultations provided under the program may be	3345
provided at any appropriate time, as permitted or required under	3346
this section and the rules adopted under it, including either	3347
prior to or after the individual who is the subject of a	3348
consultation has been admitted to a nursing facility.	3349

(C) The long-term care consultation program shall be	3350
administered by the department of aging, except that the	3351
department may enter into a contract with an area agency on aging	3352
or other entity selected by the department under which the program	3353
for a particular area is administered by the area agency on aging	3354
or other entity pursuant to the contract.	3355

(D) The long-term care consultations provided for purposes of	3356
the program shall be provided by individuals certified by the	3357
department under section 173.43 of the Revised Code.	3358

(E) The information provided through a long-term care	3359
consultation shall be appropriate to the individual's needs and	3360
situation and shall address all of the following:	3361

(1) The availability of any long-term care options open to	3362
the individual;	3363

(2) Sources and methods of both public and private payment	3364
for long-term care services;	3365

(3) Factors to consider when choosing among the available	3366
programs, services, and benefits;	3367

(4) Opportunities and methods for maximizing independence and	3368
self-reliance, including support services provided by the	3369
individual's family, friends, and community.	3370

(F) An individual's long-term care consultation may include	3371
an assessment of the individual's functional capabilities. The	3372
consultation may incorporate portions of the determinations	3373
required under sections ~~5111.202,~~ 5119.061, ~~and~~ 5123.021, and	3374
5164.45 of the Revised Code and may be provided concurrently with	3375
the assessment required under section ~~5111.204~~5164.47 of the	3376
Revised Code.	3377

(G)(1) Unless an exemption specified in division (I) of this	3378
section is applicable, each individual in the following categories	3379
shall be provided with a long-term care consultation:	3380

(a) Individuals who apply or indicate an intention to apply	3381
for admission to a nursing facility, regardless of the source of	3382
payment to be used for their care in a nursing facility;	3383

(b) Nursing facility residents who apply or indicate an	3384
intention to apply for medicaid;	3385

(c) Nursing facility residents who are likely to spend down	3386
their resources within six months after admission to a nursing	3387
facility to a level at which they are financially eligible for	3388
medicaid;	3389

(d) Individuals who request a long-term care consultation.

3390

(2) In addition to the individuals included in the categories	3391
specified in division (G)(1) of this section, long-term care	3392
consultations may be provided to nursing facility residents who	3393
have not applied and have not indicated an intention to apply for	3394
medicaid. The purpose of the consultations provided to these	3395
individuals shall be to determine continued need for nursing	3396
facility services, to provide information on alternative services,	3397
and to make referrals to alternative services.	3398

(H)(1) When a long-term care consultation is required to be	3399
provided pursuant to division (G)(1) of this section, the	3400
consultation shall be provided as follows or pursuant to division	3401
(H)(2) or (3) of this section:	3402

(a) If the individual for whom the consultation is being	3403
provided has applied for medicaid and the consultation is being	3404
provided concurrently with the assessment required under section	3405
~~5111.204~~5164.47 of the Revised Code, the consultation shall be	3406
completed in accordance with the applicable time frames specified	3407
in that section for providing a level of care determination based	3408
on the assessment.	3409

(b) In all other cases, the consultation shall be provided	3410
not later than five calendar days after the department or the	3411
program administrator under contract with the department receives	3412
notice of the reason for which the consultation is required to be	3413
provided pursuant to division (G)(1) of this section.	3414

(2) An individual or the individual's representative may	3415
request that a long-term care consultation be provided on a date	3416
that is later than the date required under division (H)(1)(a) or	3417
(b) of this section.	3418

(3) If a long-term care consultation cannot be completed	3419
within the number of days required by division (H)(1) or (2) of	3420
this section, the department or the program administrator under	3421
contract with the department may do any of the following:	3422

(a) Exempt the individual from the consultation pursuant to	3423
rules that may be adopted under division (L) of this section;	3424

(b) In the case of an applicant for admission to a nursing	3425
facility, provide the consultation after the individual is	3426
admitted to the nursing facility;	3427

(c) In the case of a resident of a nursing facility, provide	3428
the consultation as soon as practicable.	3429

(I) An individual is not required to be provided a long-term	3430
care consultation under this section if any of the following	3431
apply:	3432

(1) The individual or the individual's representative chooses	3433
to forego participation in the consultation pursuant to criteria	3434
specified in rules adopted under division (L) of this section;	3435

(2) The individual is to receive care in a nursing facility	3436
under a contract for continuing care as defined in section 173.13	3437
of the Revised Code;	3438

(3) The individual has a contractual right to admission to a	3439
nursing facility operated as part of a system of continuing care	3440
in conjunction with one or more facilities that provide a less	3441
intensive level of services, including a residential care facility	3442
licensed under Chapter 3721. of the Revised Code, an adult care	3443
facility licensed under Chapter 3722. of the Revised Code, or an	3444
independent living arrangement;	3445

(4) The individual is to receive continual care in a home for	3446
the aged exempt from taxation under section 5701.13 of the Revised	3447
Code;	3448

(5) The individual is seeking admission to a facility that is	3449
not a nursing facility with a provider agreement under section	3450
~~5111.22~~5164.03 of the Revised Code;	3451

(6) The individual is to be transferred from another nursing	3452
facility;	3453

(7) The individual is to be readmitted to a nursing facility	3454
following a period of hospitalization;	3455

(8) The individual is exempted from the long-term care	3456
consultation requirement by the department or the program	3457
administrator pursuant to rules that may be adopted under division	3458
(L) of this section.	3459

(J) At the conclusion of an individual's long-term care	3460
consultation, the department or the program administrator under	3461
contract with the department shall provide the individual or	3462
individual's representative with a written summary of options and	3463
resources available to meet the individual's needs. Even though	3464
the summary may specify that a source of long-term care other than	3465
care in a nursing facility is appropriate and available, the	3466
individual is not required to seek an alternative source of	3467
long-term care and may be admitted to or continue to reside in a	3468
nursing facility.	3469

(K) No nursing facility for which an operator has a provider	3470
agreement under section ~~5111.22~~5164.03 of the Revised Code shall	3471
admit or retain any individual as a resident, unless the nursing	3472
facility has received evidence that a long-term care consultation	3473
has been completed for the individual or division (I) of this	3474
section is applicable to the individual.	3475

(L) The director of aging may adopt any rules the director	3476
considers necessary for the implementation and administration of	3477
this section. The rules shall be adopted in accordance with	3478
Chapter 119. of the Revised Code and may specify any or all of the	3479
following:	3480

(1) Procedures for providing long-term care consultations	3481
pursuant to this section;	3482

(2) Information to be provided through long-term care	3483
consultations regarding long-term care services that are	3484
available;	3485

(3) Criteria under which an individual or the individual's	3486
representative may choose to forego participation in a long-term	3487
care consultation;	3488

(4) Criteria for exempting individuals from the long-term	3489
care consultation requirement;	3490

(5) Circumstances under which it may be appropriate to	3491
provide an individual's long-term care consultation after the	3492
individual's admission to a nursing facility rather than before	3493
admission;	3494

(6) Criteria for identifying nursing facility residents who	3495
would benefit from the provision of a long-term care consultation.	3496

(M) The director of aging may fine a nursing facility an	3497
amount determined by rules the director shall adopt in accordance	3498
with Chapter 119. of the Revised Code if the nursing facility	3499
admits or retains an individual, without evidence that a long-term	3500
care consultation has been provided, as required by this section.	3501

In accordance with section ~~5111.62~~5164.78 of the Revised	3502
Code, all fines collected under this division shall be deposited	3503
into the state treasury to the credit of the residents protection	3504
fund.	3505

Sec. 173.45. As used in this section and in sections 173.46	3506
to 173.49 of the Revised Code:	3507

(A) "Long-term care facility" means a nursing home or	3508
residential care facility.	3509

(B) "Nursing home" and "residential care facility" have the	3510
same meanings as in section 3721.01 of the Revised Code.	3511

(C) "Nursing facility" has the same meaning as in section	3512
~~5111.20~~5164.01 of the Revised Code.	3513

Sec. 173.47. (A) For purposes of publishing the Ohio	3514
long-term care consumer guide, the department of aging shall	3515
conduct or provide for the conduct of an annual customer	3516
satisfaction survey of each long-term care facility. The results	3517
of the surveys may include information obtained from long-term	3518
care facility residents, their families, or both.	3519

(B)(1) The department may charge fees for the conduct of	3520
annual customer satisfaction surveys. The department may contract	3521
with any person or government entity to collect the fees on its	3522
behalf. All fees collected under this section shall be deposited	3523
in accordance with section 173.48 of the Revised Code.	3524

(2) The fees charged under this section shall not exceed the	3525
following amounts:	3526

(a) Four hundred dollars for the customer satisfaction survey	3527
of a long-term care facility that is a nursing home;	3528

(b) Three hundred dollars for the customer satisfaction	3529
survey pertaining to a long-term care facility that is a	3530
residential care facility.	3531

(3) Fees paid by a long-term care facility that is a nursing	3532
facility shall be reimbursed through the medicaid program ~~operated~~	3533
~~under Chapter 5111. of the Revised Code~~.	3534

(C) Each long-term care facility shall cooperate in the	3535
conduct of its annual customer satisfaction survey.	3536

Sec. 173.50. (A) Pursuant to a contract entered into with the	3537
department of ~~job and family services~~health care administration	3538
as an interagency agreement under section ~~5111.91~~5161.05 of the	3539
Revised Code, the department of aging shall carry out the	3540
day-to-day administration of the component of the medicaid program	3541
~~established under Chapter 5111. of the Revised Code~~ known as the	3542
program of all-inclusive care for the elderly or PACE. The	3543
department of aging shall carry out its PACE administrative duties	3544
in accordance with the provisions of the interagency agreement and	3545
all applicable federal laws, including the "Social Security Act,"	3546
79 Stat. 286 (1965), 42 U.S.C. 1396u-4, as amended.	3547

(B) The department of aging may adopt rules in accordance	3548
with Chapter 119. of the Revised Code regarding the PACE program,	3549
subject to both of the following:	3550

(1) The rules shall be authorized by rules adopted by the	3551
department of job and family services.	3552

(2) The rules shall address only those issues that are not	3553
addressed in rules adopted by the department of job and family	3554
services for the PACE program.	3555

Sec. 173.99. (A) A long-term care provider, person employed	3556
by a long-term care provider, other entity, or employee of such	3557
other entity that violates division (C) of section 173.24 of the	3558
Revised Code is subject to a fine not to exceed one thousand	3559
dollars for each violation.	3560

(B) Whoever violates division (C) of section 173.23 of the	3561
Revised Code is guilty of registering a false complaint, a	3562
misdemeanor of the first degree.	3563

(C) A long-term care provider, other entity, or person	3564
employed by a long-term care provider or other entity that	3565
violates division (E) of section 173.19 of the Revised Code by	3566
denying a representative of the office of the state long-term care	3567
ombudsperson program the access required by that division is	3568
subject to a fine not to exceed five hundred dollars for each	3569
violation.	3570

(D) Whoever violates division (C) of section 173.44 of the	3571
Revised Code is subject to a fine of one hundred dollars.	3572

~~(E) Whoever violates division (B) of section 173.90 of the~~	3573
~~Revised Code is guilty of a misdemeanor of the first degree.~~	3574

Sec. 317.08. (A) Except as provided in divisions (C) and (D)	3575
of this section, the county recorder shall keep six separate sets	3576
of records as follows:	3577

(1) A record of deeds, in which shall be recorded all deeds	3578
and other instruments of writing for the absolute and	3579
unconditional sale or conveyance of lands, tenements, and	3580
hereditaments; all notices as provided in sections 5301.47 to	3581
5301.56 of the Revised Code; all judgments or decrees in actions	3582
brought under section 5303.01 of the Revised Code; all	3583
declarations and bylaws, and all amendments to declarations and	3584
bylaws, as provided in Chapter 5311. of the Revised Code;	3585
affidavits as provided in sections 5301.252 and 5301.56 of the	3586
Revised Code; all certificates as provided in section 5311.17 of	3587
the Revised Code; all articles dedicating archaeological preserves	3588
accepted by the director of the Ohio historical society under	3589
section 149.52 of the Revised Code; all articles dedicating nature	3590
preserves accepted by the director of natural resources under	3591
section 1517.05 of the Revised Code; all agreements for the	3592
registration of lands as archaeological or historic landmarks	3593
under section 149.51 or 149.55 of the Revised Code; all	3594
conveyances of conservation easements and agricultural easements	3595
under section 5301.68 of the Revised Code; all instruments	3596
extinguishing agricultural easements under section 901.21 or	3597
5301.691 of the Revised Code or pursuant to terms of such an	3598
easement granted to a charitable organization under section	3599
5301.68 of the Revised Code; all instruments or orders described	3600
in division (B)(2)(b) of section 5301.56 of the Revised Code; all	3601
no further action letters issued under section 122.654 or 3746.11	3602
of the Revised Code; all covenants not to sue issued under section	3603
3746.12 of the Revised Code, including all covenants not to sue	3604
issued pursuant to section 122.654 of the Revised Code; any	3605
restrictions on the use of property contained in a no further	3606
action letter issued under section 122.654 of the Revised Code,	3607
any restrictions on the use of property identified pursuant to	3608
division (C)(3)(a) of section 3746.10 of the Revised Code, and any	3609
restrictions on the use of property contained in a deed or other	3610
instrument as provided in division (E) or (F) of section 3737.882	3611
of the Revised Code; any easement executed or granted under	3612
section 3734.22, 3734.24, 3734.25, or 3734.26 of the Revised Code;	3613
any environmental covenant entered into in accordance with	3614
sections 5301.80 to 5301.92 of the Revised Code; all memoranda of	3615
trust, as described in division (A) of section 5301.255 of the	3616
Revised Code, that describe specific real property; and all	3617
agreements entered into under division (A) of section 1506.44 of	3618
the Revised Code;	3619

(2) A record of mortgages, in which shall be recorded all of	3620
the following:	3621

(a) All mortgages, including amendments, supplements,	3622
modifications, and extensions of mortgages, or other instruments	3623
of writing by which lands, tenements, or hereditaments are or may	3624
be mortgaged or otherwise conditionally sold, conveyed, affected,	3625
or encumbered;	3626

(b) All executory installment contracts for the sale of land	3627
executed after September 29, 1961, that by their terms are not	3628
required to be fully performed by one or more of the parties to	3629
them within one year of the date of the contracts;	3630

(c) All options to purchase real estate, including	3631
supplements, modifications, and amendments of the options, but no	3632
option of that nature shall be recorded if it does not state a	3633
specific day and year of expiration of its validity;	3634

(d) Any tax certificate sold under section 5721.33 of the	3635
Revised Code, or memorandum of it, that is presented for filing of	3636
record.	3637

(3) A record of powers of attorney, including all memoranda	3638
of trust, as described in division (A) of section 5301.255 of the	3639
Revised Code, that do not describe specific real property;	3640

(4) A record of plats, in which shall be recorded all plats	3641
and maps of town lots, of the subdivision of town lots, and of	3642
other divisions or surveys of lands, any center line survey of a	3643
highway located within the county, the plat of which shall be	3644
furnished by the director of transportation or county engineer,	3645
and all drawings and amendments to drawings, as provided in	3646
Chapter 5311. of the Revised Code;	3647

(5) A record of leases, in which shall be recorded all	3648
leases, memoranda of leases, and supplements, modifications, and	3649
amendments of leases and memoranda of leases;	3650

(6) A record of declarations executed pursuant to section	3651
2133.02 of the Revised Code and durable powers of attorney for	3652
health care executed pursuant to section 1337.12 of the Revised	3653
Code.	3654

(B) All instruments or memoranda of instruments entitled to	3655
record shall be recorded in the proper record in the order in	3656
which they are presented for record. The recorder may index, keep,	3657
and record in one volume unemployment compensation liens, internal	3658
revenue tax liens and other liens in favor of the United States as	3659
described in division (A) of section 317.09 of the Revised Code,	3660
personal tax liens, mechanic's liens, agricultural product liens,	3661
notices of liens, certificates of satisfaction or partial release	3662
of estate tax liens, discharges of recognizances, excise and	3663
franchise tax liens on corporations, broker's liens, and liens	3664
provided for in sections 1513.33, 1513.37, 3752.13, ~~5111.022~~	3665
5163.08, and 5311.18 of the Revised Code.	3666

The recording of an option to purchase real estate, including	3667
any supplement, modification, and amendment of the option, under	3668
this section shall serve as notice to any purchaser of an interest	3669
in the real estate covered by the option only during the period of	3670
the validity of the option as stated in the option.	3671

(C) In lieu of keeping the six separate sets of records	3672
required in divisions (A)(1) to (6) of this section and the	3673
records required in division (D) of this section, a county	3674
recorder may record all the instruments required to be recorded by	3675
this section in two separate sets of record books. One set shall	3676
be called the "official records" and shall contain the instruments	3677
listed in divisions (A)(1), (2), (3), (5), and (6) and (D) of this	3678
section. The second set of records shall contain the instruments	3679
listed in division (A)(4) of this section.	3680

(D) Except as provided in division (C) of this section, the	3681
county recorder shall keep a separate set of records containing	3682
all corrupt activity lien notices filed with the recorder pursuant	3683
to section 2923.36 of the Revised Code and a separate set of	3684
records containing all medicaid fraud lien notices filed with the	3685
recorder pursuant to section 2933.75 of the Revised Code.	3686

Sec. 317.36. (A) The county recorder shall collect the low-	3687
and moderate-income housing trust fund fee as specified in	3688
sections 317.114, 317.32, 1563.42, 1702.59, 2505.13, 4141.23,	3689
4509.60, ~~5111.022~~5163.08, 5310.15, 5719.07, 5727.56, 5733.18,	3690
5733.22, 6101.09, and 6115.09 of the Revised Code. The amount of	3691
any housing trust fund fee the recorder is authorized to collect	3692
is equal to the amount of any base fee the recorder is authorized	3693
to collect for services. The housing trust fund fee shall be	3694
collected in addition to the base fee.	3695

(B) The recorder shall certify the amounts collected as	3696
housing trust fund fees pursuant to division (A) of this section	3697
into the county treasury as housing trust fund fees to be paid to	3698
the treasurer of state pursuant to section 319.63 of the Revised	3699
Code.	3700

Sec. 323.01. Except as otherwise provided, as used in	3701
Chapter 323. of the Revised Code:	3702

(A) "Subdivision" means any county, township, school	3703
district, or municipal corporation.	3704

(B) "Municipal corporation" includes charter municipalities.

3705

(C) "Taxes" means the total amount of all charges against an	3706
entry appearing on a tax list and the duplicate thereof that was	3707
prepared and certified in accordance with section 319.28 of the	3708
Revised Code, including taxes levied against real estate; taxes on	3709
property whose value is certified pursuant to section 5727.23 of	3710
the Revised Code; recoupment charges applied pursuant to section	3711
5713.35 of the Revised Code; all assessments; penalties and	3712
interest charged pursuant to section 323.121 of the Revised Code;	3713
charges added pursuant to section 319.35 of the Revised Code; and	3714
all of such charges which remain unpaid from any previous tax	3715
year.	3716

(D) "Current taxes" means all taxes charged against an entry	3717
on the general tax list and duplicate of real and public utility	3718
property that have not appeared on such list and duplicate for any	3719
prior tax year and any penalty thereon charged by division (A) of	3720
section 323.121 of the Revised Code. Current taxes, whether or not	3721
they have been certified delinquent, become delinquent taxes if	3722
they remain unpaid after the last day prescribed for payment of	3723
the second installment of current taxes without penalty.	3724

(E) "Delinquent taxes" means:

3725

(1) Any taxes charged against an entry on the general tax	3726
list and duplicate of real and public utility property that were	3727
charged against an entry on such list and duplicate for a prior	3728
tax year and any penalties and interest charged against such	3729
taxes.	3730

(2) Any current taxes charged on the general tax list and	3731
duplicate of real and public utility property that remain unpaid	3732
after the last day prescribed for payment of the second	3733
installment of such taxes without penalty, whether or not they	3734
have been certified delinquent, and any penalties and interest	3735
charged against such taxes.	3736

(F) "Current tax year" means, with respect to particular	3737
taxes, the calendar year in which the first installment of taxes	3738
is due prior to any extension granted under section 323.17 of the	3739
Revised Code.	3740

(G) "Liquidated claim" means:

3741

(1) Any sum of money due and payable, upon a written	3742
contractual obligation executed between the subdivision and the	3743
taxpayer, but excluding any amount due on general and special	3744
assessment bonds and notes;	3745

(2) Any sum of money due and payable, for disability	3746
financial assistance ~~or disability medical assistance~~ provided	3747
under Chapter 5115. of the Revised Code or the disability medical	3748
assistance program that is furnished to or in behalf of a	3749
subdivision, provided that such claim is recognized by a	3750
resolution or ordinance of the legislative body of such	3751
subdivision;	3752

(3) Any sum of money advanced and paid to or received and	3753
used by a subdivision, pursuant to a resolution or ordinance of	3754
such subdivision or its predecessor in interest, and the moral	3755
obligation to repay which sum, when in funds, shall be recognized	3756
by resolution or ordinance by the subdivision.	3757

Sec. 329.04. (A) The county department of job and family	3758
services shall have, exercise, and perform the following powers	3759
and duties:	3760

(1) Perform any duties assigned by the state department of	3761
job and family services regarding the provision of public family	3762
services, including the provision of the following services to	3763
prevent or reduce economic or personal dependency and to	3764
strengthen family life:	3765

(a) Services authorized by a Title IV-A program, as defined	3766
in section 5101.80 of the Revised Code;	3767

(b) Social services authorized by Title XX of the "Social	3768
Security Act" and provided for by section 5101.46 or 5101.461 of	3769
the Revised Code;	3770

(c) If the county department is designated as the child	3771
support enforcement agency, services authorized by Title IV-D of	3772
the "Social Security Act" and provided for by Chapter 3125. of	3773
the Revised Code. The county department may perform the services	3774
itself or contract with other government entities, and, pursuant	3775
to division (C) of section 2301.35 and section 2301.42 of the	3776
Revised Code, private entities, to perform the Title IV-D	3777
services.	3778

(d) Duties assigned under section ~~5111.98~~5161.02 of the	3779
Revised Code.	3780

(2) Administer disability financial assistance, as required	3781
by the state department of job and family services under section	3782
5115.03 of the Revised Code;	3783

(3) Administer disability medical assistance program, as	3784
required by the ~~state~~ department of ~~job and family services under~~	3785
~~section 5115.13 of the Revised Code~~health care administration;	3786

(4) Administer burials insofar as the administration of	3787
burials was, prior to September 12, 1947, imposed upon the board	3788
of county commissioners and if otherwise required by state law;	3789

(5) Cooperate with state and federal authorities in any	3790
matter relating to family services and to act as the agent of such	3791
authorities;	3792

(6) Submit an annual account of its work and expenses to the	3793
board of county commissioners and to the state department of job	3794
and family services at the close of each fiscal year;	3795

(7) Exercise any powers and duties relating to family	3796
services duties or workforce development activities imposed upon	3797
the county department of job and family services by law, by	3798
resolution of the board of county commissioners, or by order of	3799
the governor, when authorized by law, to meet emergencies during	3800
war or peace;	3801

(8) ~~Determine the~~Make eligibility determinations for ~~medical~~	3802
~~assistance of recipients of aid under Title XVI of the "Social~~	3803
~~Security Act"~~the medicaid program in accordance with rules	3804
adopted under section 5162.20 of the Revised Code;	3805

(9) If assigned by the ~~state~~ director of ~~job and family~~	3806
~~services~~health care administration under section ~~5101.515~~5167.15	3807
or ~~5101.525~~5167.26 of the Revised Code, determine applicants'	3808
eligibility for health assistance under the children's health	3809
insurance program part II or part III;	3810

(10) Enter into a plan of cooperation with the board of	3811
county commissioners under section 307.983, consult with the board	3812
in the development of the transportation work plan developed under	3813
section 307.985, establish with the board procedures under section	3814
307.986 for providing services to children whose families relocate	3815
frequently, and comply with the contracts the board enters into	3816
under sections 307.981 and 307.982 of the Revised Code that affect	3817
the county department;	3818

(11) For the purpose of complying with a grant agreement the	3819
board of county commissioners enters into under sections 307.98	3820
and 5101.21 of the Revised Code, exercise the powers and perform	3821
the duties the grant agreement assigns to the county department;	3822

(12) If the county department is designated as the workforce	3823
development agency, provide the workforce development activities	3824
specified in the contract required by section 330.05 of the	3825
Revised Code.	3826

(B) The powers and duties of a county department of job and	3827
family services are, and shall be exercised and performed, under	3828
the control and direction of the board of county commissioners.	3829
The board may assign to the county department any power or duty of	3830
the board regarding family services duties and workforce	3831
development activities. If the new power or duty necessitates the	3832
state department of job and family services changing its federal	3833
cost allocation plan, the county department may not implement the	3834
power or duty unless the United States department of health and	3835
human services approves the changes.	3836

Sec. 329.043. With regard to applicants for and recipients of	3837
disability financial assistance or disability medical assistance,	3838
each county department of job and family services shall do all of	3839
the following:	3840

(A) Identify applicants and recipients who might be eligible	3841
for benefits under the supplemental security income program;	3842

(B) Assist applicants and recipients in securing	3843
documentation of disabling conditions or refer them for such	3844
assistance to a person or government entity with which the	3845
department of job and family services or county department has	3846
contracted under section 5115.20 of the Revised Code;	3847

(C) Inform applicants and recipients of available sources of	3848
representation, which may include a person or government entity	3849
with which the department of job and family services or county	3850
department has contracted under section 5115.20 of the Revised	3851
Code, and of their right to represent themselves in	3852
reconsiderations and appeals of social security administration	3853
decisions that deny them supplemental security income benefits.	3854
The county department may require the applicants and recipients,	3855
as a condition of eligibility for disability financial assistance	3856
or disability medical assistance, to pursue reconsiderations and	3857
appeals of social security administration decisions that deny them	3858
supplemental security income benefits, and shall assist applicants	3859
and recipients as necessary to obtain such benefits or refer them	3860
to a person or government entity with which the department or	3861
county department has contracted under section 5115.20 of the	3862
Revised Code.	3863

(D) Require applicants and recipients who, in the judgment of	3864
the county department, are or may be aged, blind, or disabled, to	3865
apply for the medicaid program, make determinations when	3866
appropriate as to eligibility for medicaid, and refer their	3867
applications when necessary to the disability determination unit	3868
established in accordance with section 5162.17 of the Revised Code	3869
for expedited review;	3870

(E) Require each applicant and recipient who in the judgment	3871
of the department of job and family services or the county	3872
department might be eligible for supplemental security income	3873
benefits, as a condition of eligibility for disability financial	3874
assistance or disability medical assistance, to execute a written	3875
authorization for the secretary of health and human services to	3876
withhold benefits due that individual and pay to the director of	3877
job and family services, director of health care administration,	3878
or either director's designee an amount sufficient to reimburse	3879
the state and county shares of interim assistance furnished to the	3880
individual. For the purposes of this division, "benefits" and	3881
"interim assistance" have the meanings given in Title XVI of the	3882
"Social Security Act of 1935."	3883

Sec. 329.051. The county department of job and family	3884
services shall make voter registration applications as prescribed	3885
by the secretary of state under section 3503.10 of the Revised	3886
Code available to persons who are applying for, receiving	3887
assistance from, or participating in any of the following:	3888

(A) The disability financial assistance program established	3889
under Chapter 5115. of the Revised Code;	3890

(B) The disability medical assistance program ~~established~~	3891
~~under Chapter 5115. of the Revised Code~~;	3892

(C) The ~~medical assistance~~medicaid program ~~established under~~	3893
~~Chapter 5111. of the Revised Code~~;	3894

(D) The Ohio works first program established under Chapter	3895
5107. of the Revised Code;	3896

(E) The prevention, retention, and contingency program	3897
established under Chapter 5108. of the Revised Code.	3898

Sec. 329.06. (A) Except as provided in division (C) of this	3899
section and section 6301.08 of the Revised Code, the board of	3900
county commissioners shall establish a county family services	3901
planning committee. The board shall appoint a member to represent	3902
the county department of job and family services; an employee in	3903
the classified civil service of the county department of job and	3904
family services, if there are any such employees; and a member to	3905
represent the public. The board shall appoint other individuals to	3906
the committee in such a manner that the committee's membership is	3907
broadly representative of the groups of individuals and the public	3908
and private entities that have an interest in the family services	3909
provided in the county. The board shall make appointments in a	3910
manner that reflects the ethnic and racial composition of the	3911
county. The following groups and entities may be represented on	3912
the committee:	3913

(1) Consumers of family services;

3914

(2) The public children services agency;

3915

(3) The child support enforcement agency;

3916

(4) The county family and children first council;

3917

(5) Public and private colleges and universities;

3918

(6) Public entities that provide family services, including	3919
boards of health, boards of education, the county board of mental	3920
retardation and developmental disabilities, and the board of	3921
alcohol, drug addiction, and mental health services that serves	3922
the county;	3923

(7) Private nonprofit and for-profit entities that provide	3924
family services in the county or that advocate for consumers of	3925
family services in the county, including entities that provide	3926
services to or advocate for victims of domestic violence;	3927

(8) Labor organizations;

3928

(9) Any other group or entity that has an interest in the	3929
family services provided in the county, including groups or	3930
entities that represent any of the county's business, urban, and	3931
rural sectors.	3932

(B) The county family services planning committee shall do	3933
all of the following:	3934

(1) Serve as an advisory body to the board of county	3935
commissioners with regard to the family services provided in the	3936
county, including assistance under Chapters 5107. and 5108. of the	3937
Revised Code, publicly funded child care under Chapter 5104. of	3938
the Revised Code, and social services provided under section	3939
5101.46 of the Revised Code;	3940

(2) At least once a year, review and analyze the county	3941
department of job and family services' implementation of the	3942
programs established under Chapters 5107. and 5108. of the Revised	3943
Code. In its review, the committee shall use information available	3944
to it to examine all of the following:	3945

(a) Return of assistance groups to participation in either	3946
program after ceasing to participate;	3947

(b) Teen pregnancy rates among the programs' participants;

3948

(c) The other types of assistance the programs' participants	3949
receive, including ~~medical assistance under Chapter 5111. of the~~	3950
~~Revised Code~~medicaid, publicly funded child care under Chapter	3951
5104. of the Revised Code, food stamp benefits under section	3952
5101.54 of the Revised Code, and energy assistance under Chapter	3953
5117. of the Revised Code;	3954

(d) Other issues the committee considers appropriate.

3955

The committee shall make recommendations to the board of	3956
county commissioners and county department of job and family	3957
services regarding the committee's findings.	3958

(3) Conduct public hearings on proposed county profiles for	3959
the provision of social services under section 5101.46 of the	3960
Revised Code;	3961

(4) At the request of the board, make recommendations and	3962
provide assistance regarding the family services provided in the	3963
county;	3964

(5) At any other time the committee considers appropriate,	3965
consult with the board and make recommendations regarding the	3966
family services provided in the county. The committee's	3967
recommendations may address the following:	3968

(a) Implementation and administration of family service	3969
programs;	3970

(b) Use of federal, state, and local funds available for	3971
family service programs;	3972

(c) Establishment of goals to be achieved by family service	3973
programs;	3974

(d) Evaluation of the outcomes of family service programs;

3975

(e) Any other matter the board considers relevant to the	3976
provision of family services.	3977

(C) If there is a committee in existence in a county on	3978
October 1, 1997, that the board of county commissioners determines	3979
is capable of fulfilling the responsibilities of a county family	3980
services planning committee, the board may designate the committee	3981
as the county's family services planning committee and the	3982
committee shall serve in that capacity.	3983

Sec. 329.14. (A) An individual whose household income does	3984
not exceed two hundred per cent of the federal poverty line is	3985
eligible to participate in an individual development account	3986
program established by the county department of job and family	3987
services of the county in which the individual resides. An	3988
eligible individual seeking to be a participant in the program	3989
shall enter into an agreement with the fiduciary organization	3990
administering the program. The agreement shall specify the terms	3991
and conditions of uses of funds deposited, financial documentation	3992
required to be maintained by the participant, expectations and	3993
responsibilities of the participant, and services to be provided	3994
by the fiduciary organization.	3995

(B) A participant may deposit earned income, as defined in 26	3996
U.S.C. 911(d)(2), as amended, into the account. The fiduciary	3997
organization may deposit into the account an amount not exceeding	3998
four times the amount deposited by the participant except that a	3999
fiduciary organization may not, pursuant to an agreement with an	4000
employer, deposit an amount into an account held by a participant	4001
who is employed by the employer. An account may have no more than	4002
ten thousand dollars in it at any time.	4003

(C) Notwithstanding eligibility requirements established in	4004
or pursuant to Chapter 5107.,or 5108.~~, or 5111.~~ of the Revised	4005
Code or for the medicaid program, to the extent permitted by	4006
federal statutes and regulations, money in an individual	4007
development account, including interest, is exempt from	4008
consideration in determining whether the participant or a member	4009
of the participant's assistance group is eligible for assistance	4010
under Chapter 5107.,or 5108.~~, or 5111.~~ of the Revised Code or the	4011
medicaid program and the amount of assistance the participant or	4012
assistance group is eligible to receive.	4013

(D)(1) Except as provided in division (D)(2) of this section,	4014
an individual development account program participant may use	4015
money in the account only for the following purposes:	4016

(a) Postsecondary educational expenses paid directly from the	4017
account to an eligible education institution or vendor;	4018

(b) Qualified acquisition expenses of a principal residence,	4019
as defined in 26 U.S.C. 1034, as amended, paid directly from the	4020
account to the person or government entity to which the expenses	4021
are due;	4022

(c) Qualified business capitalization expenses made in	4023
accordance with a qualified business plan that has been approved	4024
by a financial institution or by a nonprofit microenterprise	4025
program having demonstrated business expertise and paid directly	4026
from the account to the person to whom the expenses are due.	4027

(2) A fiduciary organization shall permit a participant to	4028
withdraw money deposited by the participant if it is needed to	4029
deal with a personal emergency of the participant or a member of	4030
the participant's family or household. Withdrawal shall result in	4031
the loss of any matching funds in an amount equal to the amount of	4032
the withdrawal.	4033

(3) Regardless of the reason for the withdrawal, a withdrawal	4034
from an individual development account may be made only with the	4035
approval of the fiduciary organization.	4036

Sec. 340.03. (A) Subject to rules issued by the director of	4037
mental health after consultation with relevant constituencies as	4038
required by division (A)(11) of section 5119.06 of the Revised	4039
Code, with regard to mental health services, the board of alcohol,	4040
drug addiction, and mental health services shall:	4041

(1) Serve as the community mental health planning agency for	4042
the county or counties under its jurisdiction, and in so doing it	4043
shall:	4044

(a) Evaluate the need for facilities and community mental	4045
health services;	4046

(b) In cooperation with other local and regional planning and	4047
funding bodies and with relevant ethnic organizations, assess the	4048
community mental health needs, set priorities, and develop plans	4049
for the operation of facilities and community mental health	4050
services;	4051

(c) In accordance with guidelines issued by the director of	4052
mental health after consultation with board representatives,	4053
develop and submit to the department of mental health, no later	4054
than six months prior to the conclusion of the fiscal year in	4055
which the board's current plan is scheduled to expire, a community	4056
mental health plan listing community mental health needs,	4057
including the needs of all residents of the district now residing	4058
in state mental institutions and severely mentally disabled	4059
adults, children, and adolescents; all children subject to a	4060
determination made pursuant to section 121.38 of the Revised Code;	4061
and all the facilities and community mental health services that	4062
are or will be in operation or provided during the period for	4063
which the plan will be in operation in the service district to	4064
meet such needs.	4065

The plan shall include, but not be limited to, a statement of	4066
which of the services listed in section 340.09 of the Revised Code	4067
the board intends to make available. The board must include crisis	4068
intervention services for individuals in an emergency situation in	4069
the plan and explain how the board intends to make such services	4070
available. The plan must also include an explanation of how the	4071
board intends to make any payments that it may be required to pay	4072
under section 5119.62 of the Revised Code, a statement of the	4073
inpatient and community-based services the board proposes that the	4074
department operate, an assessment of the number and types of	4075
residential facilities needed, such other information as the	4076
department requests, and a budget for moneys the board expects to	4077
receive. The board shall also submit an allocation request for	4078
state and federal funds. Within sixty days after the department's	4079
determination that the plan and allocation request are complete,	4080
the department shall approve or disapprove the plan and request,	4081
in whole or in part, according to the criteria developed pursuant	4082
to section 5119.61 of the Revised Code. The department's statement	4083
of approval or disapproval shall specify the inpatient and the	4084
community-based services that the department will operate for the	4085
board. Eligibility for state and federal funding shall be	4086
contingent upon an approved plan or relevant part of a plan.	4087

If the director disapproves all or part of any plan, the	4088
director shall inform the board of the reasons for the disapproval	4089
and of the criteria that must be met before the plan may be	4090
approved. The director shall provide the board an opportunity to	4091
present its case on behalf of the plan. The director shall give	4092
the board a reasonable time in which to meet the criteria, and	4093
shall offer the board technical assistance to help it meet the	4094
criteria.	4095

If the approval of a plan remains in dispute thirty days	4096
prior to the conclusion of the fiscal year in which the board's	4097
current plan is scheduled to expire, the board or the director may	4098
request that the dispute be submitted to a mutually agreed upon	4099
third-party mediator with the cost to be shared by the board and	4100
the department. The mediator shall issue to the board and the	4101
department recommendations for resolution of the dispute. Prior to	4102
the conclusion of the fiscal year in which the current plan is	4103
scheduled to expire, the director, taking into consideration the	4104
recommendations of the mediator, shall make a final determination	4105
and approve or disapprove the plan, in whole or in part.	4106

If a board determines that it is necessary to amend a plan or	4107
an allocation request that has been approved under division	4108
(A)(1)(c) of this section, the board shall submit a proposed	4109
amendment to the director. The director may approve or disapprove	4110
all or part of the amendment. If the director does not approve all	4111
or part of the amendment within thirty days after it is submitted,	4112
the amendment or part of it shall be considered to have been	4113
approved. The director shall inform the board of the reasons for	4114
disapproval of all or part of an amendment and of the criteria	4115
that must be met before the amendment may be approved. The	4116
director shall provide the board an opportunity to present its	4117
case on behalf of the amendment. The director shall give the board	4118
a reasonable time in which to meet the criteria, and shall offer	4119
the board technical assistance to help it meet the criteria.	4120

The board shall implement the plan approved by the	4121
department.	4122

(d) Receive, compile, and transmit to the department of	4123
mental health applications for state reimbursement;	4124

(e) Promote, arrange, and implement working agreements with	4125
social agencies, both public and private, and with judicial	4126
agencies.	4127

(2) Investigate, or request another agency to investigate,	4128
any complaint alleging abuse or neglect of any person receiving	4129
services from a community mental health agency as defined in	4130
section 5122.01 of the Revised Code, or from a residential	4131
facility licensed under section 5119.22 of the Revised Code. If	4132
the investigation substantiates the charge of abuse or neglect,	4133
the board shall take whatever action it determines is necessary to	4134
correct the situation, including notification of the appropriate	4135
authorities. Upon request, the board shall provide information	4136
about such investigations to the department.	4137

(3) For the purpose of section 5119.611 of the Revised Code,	4138
cooperate with the director of mental health in visiting and	4139
evaluating whether the services of a community mental health	4140
agency satisfy the certification standards established by rules	4141
adopted under that section;	4142

(4) In accordance with criteria established under division	4143
(G) of section 5119.61 of the Revised Code, review and evaluate	4144
the quality, effectiveness, and efficiency of services provided	4145
through its community mental health plan and submit its findings	4146
and recommendations to the department of mental health;	4147

(5) In accordance with section 5119.22 of the Revised Code,	4148
review applications for residential facility licenses and	4149
recommend to the department of mental health approval or	4150
disapproval of applications;	4151

(6) Audit, in accordance with rules adopted by the auditor of	4152
state pursuant to section 117.20 of the Revised Code, at least	4153
annually all programs and services provided under contract with	4154
the board. In so doing, the board may contract for or employ the	4155
services of private auditors. A copy of the fiscal audit report	4156
shall be provided to the director of mental health, the auditor of	4157
state, and the county auditor of each county in the board's	4158
district.	4159

(7) Recruit and promote local financial support for mental	4160
health programs from private and public sources;	4161

(8)(a) Enter into contracts with public and private	4162
facilities for the operation of facility services included in the	4163
board's community mental health plan and enter into contracts with	4164
public and private community mental health agencies for the	4165
provision of community mental health services that are listed in	4166
section 340.09 of the Revised Code and included in the board's	4167
community mental health plan. The board may not contract with a	4168
community mental health agency to provide community mental health	4169
services included in the board's community mental health plan	4170
unless the services are certified by the director of mental health	4171
under section 5119.611 of the Revised Code. Section 307.86 of the	4172
Revised Code does not apply to contracts entered into under this	4173
division. In contracting with a community mental health agency, a	4174
board shall consider the cost effectiveness of services provided	4175
by that agency and the quality and continuity of care, and may	4176
review cost elements, including salary costs, of the services to	4177
be provided. A utilization review process shall be established as	4178
part of the contract for services entered into between a board and	4179
a community mental health agency. The board may establish this	4180
process in a way that is most effective and efficient in meeting	4181
local needs. In the case of a contract with a community mental	4182
health facility, as defined in section ~~5111.023~~5163.20 of the	4183
Revised Code, to provide services listed in division (B) of that	4184
section, the contract shall provide for the facility to be paid	4185
in accordance with the contract entered into between the	4186
departments of ~~job and family services~~health care administration	4187
and mental health under section ~~5111.91~~5161.05 of the Revised	4188
Code and any rules adopted under division (A) of section 5119.61	4189
of the Revised Code.	4190

If either the board or a facility or community mental health	4191
agency with which the board contracts under division (A)(8)(a) of	4192
this section proposes not to renew the contract or proposes	4193
substantial changes in contract terms, the other party shall be	4194
given written notice at least one hundred twenty days before the	4195
expiration date of the contract. During the first sixty days of	4196
this one hundred twenty-day period, both parties shall attempt to	4197
resolve any dispute through good faith collaboration and	4198
negotiation in order to continue to provide services to persons in	4199
need. If the dispute has not been resolved sixty days before the	4200
expiration date of the contract, either party may notify the	4201
department of mental health of the unresolved dispute. The	4202
director may require both parties to submit the dispute to a third	4203
party with the cost to be shared by the board and the facility or	4204
community mental health agency. The third party shall issue to the	4205
board, the facility or agency, and the department recommendations	4206
on how the dispute may be resolved twenty days prior to the	4207
expiration date of the contract, unless both parties agree to a	4208
time extension. The director shall adopt rules establishing the	4209
procedures of this dispute resolution process.	4210

(b) With the prior approval of the director of mental health,	4211
a board may operate a facility or provide a community mental	4212
health service as follows, if there is no other qualified private	4213
or public facility or community mental health agency that is	4214
immediately available and willing to operate such a facility or	4215
provide the service:	4216

(i) In an emergency situation, any board may operate a	4217
facility or provide a community mental health service in order to	4218
provide essential services for the duration of the emergency;	4219

(ii) In a service district with a population of at least one	4220
hundred thousand but less than five hundred thousand, a board may	4221
operate a facility or provide a community mental health service	4222
for no longer than one year;	4223

(iii) In a service district with a population of less than	4224
one hundred thousand, a board may operate a facility or provide a	4225
community mental health service for no longer than one year,	4226
except that such a board may operate a facility or provide a	4227
community mental health service for more than one year with the	4228
prior approval of the director and the prior approval of the board	4229
of county commissioners, or of a majority of the boards of county	4230
commissioners if the district is a joint-county district.	4231

The director shall not give a board approval to operate a	4232
facility or provide a community mental health service under	4233
division (A)(8)(b)(ii) or (iii) of this section unless the	4234
director determines that it is not feasible to have the department	4235
operate the facility or provide the service.	4236

The director shall not give a board approval to operate a	4237
facility or provide a community mental health service under	4238
division (A)(8)(b)(iii) of this section unless the director	4239
determines that the board will provide greater administrative	4240
efficiency and more or better services than would be available if	4241
the board contracted with a private or public facility or	4242
community mental health agency.	4243

The director shall not give a board approval to operate a	4244
facility previously operated by a person or other government	4245
entity unless the board has established to the director's	4246
satisfaction that the person or other government entity cannot	4247
effectively operate the facility or that the person or other	4248
government entity has requested the board to take over operation	4249
of the facility. The director shall not give a board approval to	4250
provide a community mental health service previously provided by a	4251
community mental health agency unless the board has established to	4252
the director's satisfaction that the agency cannot effectively	4253
provide the service or that the agency has requested the board	4254
take over providing the service.	4255

The director shall review and evaluate a board's operation of	4256
a facility and provision of community mental health service under	4257
division (A)(8)(b) of this section.	4258

Nothing in division (A)(8)(b) of this section authorizes a	4259
board to administer or direct the daily operation of any facility	4260
or community mental health agency, but a facility or agency may	4261
contract with a board to receive administrative services or staff	4262
direction from the board under the direction of the governing body	4263
of the facility or agency.	4264

(9) Approve fee schedules and related charges or adopt a unit	4265
cost schedule or other methods of payment for contract services	4266
provided by community mental health agencies in accordance with	4267
guidelines issued by the department as necessary to comply with	4268
state and federal laws pertaining to financial assistance;	4269

(10) Submit to the director and the county commissioners of	4270
the county or counties served by the board, and make available to	4271
the public, an annual report of the programs under the	4272
jurisdiction of the board, including a fiscal accounting;	4273

(11) Establish, to the extent resources are available, a	4274
community support system, which provides for treatment, support,	4275
and rehabilitation services and opportunities. The essential	4276
elements of the system include, but are not limited to, the	4277
following components in accordance with section 5119.06 of the	4278
Revised Code:	4279

(a) To locate persons in need of mental health services to	4280
inform them of available services and benefits mechanisms;	4281

(b) Assistance for clients to obtain services necessary to	4282
meet basic human needs for food, clothing, shelter, medical care,	4283
personal safety, and income;	4284

(c) Mental health care, including, but not limited to,	4285
outpatient, partial hospitalization, and, where appropriate,	4286
inpatient care;	4287

(d) Emergency services and crisis intervention;

4288

(e) Assistance for clients to obtain vocational services and	4289
opportunities for jobs;	4290

(f) The provision of services designed to develop social,	4291
community, and personal living skills;	4292

(g) Access to a wide range of housing and the provision of	4293
residential treatment and support;	4294

(h) Support, assistance, consultation, and education for	4295
families, friends, consumers of mental health services, and	4296
others;	4297

(i) Recognition and encouragement of families, friends,	4298
neighborhood networks, especially networks that include racial and	4299
ethnic minorities, churches, community organizations, and	4300
meaningful employment as natural supports for consumers of mental	4301
health services;	4302

(j) Grievance procedures and protection of the rights of	4303
consumers of mental health services;	4304

(k) Case management, which includes continual individualized	4305
assistance and advocacy to ensure that needed services are offered	4306
and procured.	4307

(12) Designate the treatment program, agency, or facility for	4308
each person involuntarily committed to the board pursuant to	4309
Chapter 5122. of the Revised Code and authorize payment for such	4310
treatment. The board shall provide the least restrictive and most	4311
appropriate alternative that is available for any person	4312
involuntarily committed to it and shall assure that the services	4313
listed in section 340.09 of the Revised Code are available to	4314
severely mentally disabled persons residing within its service	4315
district. The board shall establish the procedure for authorizing	4316
payment for services, which may include prior authorization in	4317
appropriate circumstances. The board may provide for services	4318
directly to a severely mentally disabled person when life or	4319
safety is endangered and when no community mental health agency is	4320
available to provide the service.	4321

(13) Establish a method for evaluating referrals for	4322
involuntary commitment and affidavits filed pursuant to section	4323
5122.11 of the Revised Code in order to assist the probate	4324
division of the court of common pleas in determining whether there	4325
is probable cause that a respondent is subject to involuntary	4326
hospitalization and what alternative treatment is available and	4327
appropriate, if any;	4328

(14) Ensure that apartments or rooms built, subsidized,	4329
renovated, rented, owned, or leased by the board or a community	4330
mental health agency have been approved as meeting minimum fire	4331
safety standards and that persons residing in the rooms or	4332
apartments are receiving appropriate and necessary services,	4333
including culturally relevant services, from a community mental	4334
health agency. This division does not apply to residential	4335
facilities licensed pursuant to section 5119.22 of the Revised	4336
Code.	4337

(15) Establish a mechanism for involvement of consumer	4338
recommendation and advice on matters pertaining to mental health	4339
services in the alcohol, drug addiction, and mental health service	4340
district;	4341

(16) Perform the duties under section 3722.18 of the Revised	4342
Code required by rules adopted under section 5119.61 of the	4343
Revised Code regarding referrals by the board or mental health	4344
agencies under contract with the board of individuals with mental	4345
illness or severe mental disability to adult care facilities and	4346
effective arrangements for ongoing mental health services for the	4347
individuals. The board is accountable in the manner specified in	4348
the rules for ensuring that the ongoing mental health services are	4349
effectively arranged for the individuals.	4350

(B) The board shall establish such rules, operating	4351
procedures, standards, and bylaws, and perform such other duties	4352
as may be necessary or proper to carry out the purposes of this	4353
chapter.	4354

(C) A board of alcohol, drug addiction, and mental health	4355
services may receive by gift, grant, devise, or bequest any	4356
moneys, lands, or property for the benefit of the purposes for	4357
which the board is established, and may hold and apply it	4358
according to the terms of the gift, grant, or bequest. All money	4359
received, including accrued interest, by gift, grant, or bequest	4360
shall be deposited in the treasury of the county, the treasurer of	4361
which is custodian of the alcohol, drug addiction, and mental	4362
health services funds to the credit of the board and shall be	4363
available for use by the board for purposes stated by the donor or	4364
grantor.	4365

(D) No board member or employee of a board of alcohol, drug	4366
addiction, and mental health services shall be liable for injury	4367
or damages caused by any action or inaction taken within the scope	4368
of the board member's official duties or the employee's	4369
employment, whether or not such action or inaction is expressly	4370
authorized by this section, section 340.033, or any other section	4371
of the Revised Code, unless such action or inaction constitutes	4372
willful or wanton misconduct. Chapter 2744. of the Revised Code	4373
applies to any action or inaction by a board member or employee of	4374
a board taken within the scope of the board member's official	4375
duties or employee's employment. For the purposes of this	4376
division, the conduct of a board member or employee shall not be	4377
considered willful or wanton misconduct if the board member or	4378
employee acted in good faith and in a manner that the board member	4379
or employee reasonably believed was in or was not opposed to the	4380
best interests of the board and, with respect to any criminal	4381
action or proceeding, had no reasonable cause to believe the	4382
conduct was unlawful.	4383

(E) The meetings held by any committee established by a board	4384
of alcohol, drug addiction, and mental health services shall be	4385
considered to be meetings of a public body subject to section	4386
121.22 of the Revised Code.	4387

Sec. 340.091. Each board of alcohol, drug addiction, and	4388
mental health services shall contract with a community mental	4389
health agency under division (A)(8)(a) of section 340.03 of the	4390
Revised Code for the agency to do all of the following in	4391
accordance with rules adopted under section 5119.61 of the Revised	4392
Code for an individual referred to the agency under division	4393
(C)(2) of section ~~173.35~~5160.80 of the Revised Code:	4394

(A) Assess the individual to determine whether to recommend	4395
that a PASSPORT administrative agency determine that the	4396
environment in which the individual will be living while receiving	4397
residential state supplement payments is appropriate for the	4398
individual's needs and, if it determines the environment is	4399
appropriate, issue the recommendation to the PASSPORT	4400
administrative agency;	4401

(B) Provide ongoing monitoring to ensure that services	4402
provided under section 340.09 of the Revised Code are available to	4403
the individual;	4404

(C) Provide discharge planning to ensure the individual's	4405
earliest possible transition to a less restrictive environment.	4406

Sec. 340.16. Not later than ninety days after September 5,	4407
2001, the department of mental health and the department of job	4408
and family services shall adopt rules that establish requirements	4409
and procedures for prior notification and service coordination	4410
between public children services agencies and boards of alcohol,	4411
drug addiction, and mental health services when a public children	4412
services agency refers a child in its custody to a board for	4413
services funded by the board. The rules shall be adopted in	4414
accordance with Chapter 119. of the Revised Code.	4415

The department of mental health and department of ~~job and~~	4416
~~family services~~health care administration shall collaborate in	4417
formulating a plan that delineates the funding responsibilities of	4418
public children services agencies and boards of alcohol, drug	4419
addiction, and mental health services for services provided under	4420
section ~~5111.023~~5163.20 of the Revised Code to children in the	4421
custody of public children services agencies. ~~The departments~~	4422
~~shall complete the plan not later than ninety days after September~~	4423
~~5, 2001.~~	4424

Sec. 341.192. (A) As used in this section:

4425

(1) ~~"Medical assistance program" has the same meaning as in~~	4426
~~section 2913.40 of the Revised Code.~~	4427

~~(2)~~ "Medical provider" means a physician, hospital,	4428
laboratory, pharmacy, or other health care provider that is not	4429
employed by or under contract to a county, the department of youth	4430
services, or the department of rehabilitation and correction to	4431
provide medical services to persons confined in the county jail or	4432
a state correctional institution.	4433

~~(3)~~(2) "Necessary care" means medical care of a nonelective	4434
nature that cannot be postponed until after the period of	4435
confinement of a person who is confined in a county jail or a	4436
state correctional institution or is in the custody of a law	4437
enforcement officer without endangering the life or health of the	4438
person.	4439

(B) If a physician employed by or under contract to a county,	4440
the department of youth services, or the department of	4441
rehabilitation and correction to provide medical services to	4442
persons confined in the county jail or state correctional	4443
institution determines that a person who is confined in the county	4444
jail or a state correctional institution or who is in the custody	4445
of a law enforcement officer prior to the person's confinement in	4446
the county jail or a state correctional institution requires	4447
necessary care that the physician cannot provide, the necessary	4448
care shall be provided by a medical provider. The county, the	4449
department of youth services, or the department of rehabilitation	4450
and correction shall pay a medical provider for necessary care an	4451
amount not exceeding the authorized reimbursement rate for the	4452
same service established by the department of ~~job and family~~	4453
~~services~~health care administration under the ~~medical assistance~~	4454
medicaid program.	4455

Sec. 505.84. As used in this section, "authorized medicare	4456
reimbursement rate" means such rate established for the locality	4457
under ~~Title XVIII of~~ the ~~"Social Security Act," 49 Stat. 620~~	4458
~~(1935), 42 U.S.C.A. 301, as amended~~medicare program.	4459

A board of township trustees may establish reasonable charges	4460
for the use of fire and rescue services, ambulance services, or	4461
emergency medical services. The board may establish different	4462
charges for township residents and nonresidents, and may, in its	4463
discretion, waive all or part of the charge for any resident. The	4464
charge for ambulance transportation for nonresidents shall be an	4465
amount not less than the authorized medicare reimbursement rate,	4466
except that, if prior to September 9, 1988, the board had	4467
different charges for residents and nonresidents and the charge	4468
for nonresidents was less than the authorized medicare	4469
reimbursement rate, the board may charge nonresidents less than	4470
the authorized medicare reimbursement rate.	4471

Charges collected under this section shall be kept in a	4472
separate fund designated as "the fire and rescue services,	4473
ambulance services, and emergency medical services fund," and	4474
shall be appropriated and administered by the board. The fund	4475
shall be used for the payment of the costs of the management,	4476
maintenance, and operation of fire and rescue services, ambulance	4477
services, and emergency medical services in the township. If the	4478
fire and rescue services, ambulance services, and emergency	4479
medical services are discontinued in the township, any balance	4480
remaining in the fund shall be paid into the general fund of the	4481
township.	4482

Sec. 742.41. (A) As used in this section:

4483

(1) "Other system retirant" has the same meaning as in	4484
section 742.26 of the Revised Code.	4485

(2) "Personal history record" includes a member's, former	4486
member's, or other system retirant's name, address, telephone	4487
number, social security number, record of contributions,	4488
correspondence with the Ohio police and fire pension fund, status	4489
of any application for benefits, and any other information deemed	4490
confidential by the trustees of the fund.	4491

(B) The treasurer of state shall furnish annually to the	4492
board of trustees of the fund a sworn statement of the amount of	4493
the funds in the treasurer of state's custody belonging to the	4494
Ohio police and fire pension fund. The records of the fund shall	4495
be open for public inspection except for the following, which	4496
shall be excluded, except with the written authorization of the	4497
individual concerned:	4498

(1) The individual's personal history record;

4499

(2) Any information identifying, by name and address, the	4500
amount of a monthly allowance or benefit paid to the individual.	4501

(C) All medical reports and recommendations required are	4502
privileged, except that copies of such medical reports or	4503
recommendations shall be made available to the personal physician,	4504
attorney, or authorized agent of the individual concerned upon	4505
written release received from the individual or the individual's	4506
agent or, when necessary for the proper administration of the	4507
fund, to the board-assigned physician.	4508

(D) Any person who is a member of the fund or an other system	4509
retirant shall be furnished with a statement of the amount to the	4510
credit of the person's individual account upon the person's	4511
written request. The fund need not answer more than one such	4512
request of a person in any one year.	4513

(E) Notwithstanding the exceptions to public inspection in	4514
division (B) of this section, the fund may furnish the following	4515
information:	4516

(1) If a member, former member, or other system retirant is	4517
subject to an order issued under section 2907.15 of the Revised	4518
Code or an order issued under division (A) or (B) of section	4519
2929.192 of the Revised Code or is convicted of or pleads guilty	4520
to a violation of section 2921.41 of the Revised Code, on written	4521
request of a prosecutor as defined in section 2935.01 of the	4522
Revised Code, the fund shall furnish to the prosecutor the	4523
information requested from the individual's personal history	4524
record.	4525

(2) Pursuant to a court order issued pursuant to Chapter	4526
3119., 3121., 3123., or 3125. of the Revised Code, the fund shall	4527
furnish to a court or child support enforcement agency the	4528
information required under that section.	4529

(3) At the request of any organization or association of	4530
members of the fund, the fund shall provide a list of the names	4531
and addresses of members of the fund and other system retirants.	4532
The fund shall comply with the request of such organization or	4533
association at least once a year and may impose a reasonable	4534
charge for the list.	4535

(4) Within fourteen days after receiving ~~from the director of~~	4536
~~job and family services~~ a list of the names and social security	4537
numbers of recipients of public assistance pursuant to section	4538
5101.181 of the Revised Code or a list of the names and social	4539
security numbers of public medical assistance program recipients	4540
pursuant to section 5160.43 of the Revised Code, the fund shall	4541
inform the auditor of state of the name, current or most recent	4542
employer address, and social security number of each member or	4543
other system retirant whose name and social security number are	4544
the same as that of a person whose name or social security number	4545
~~was submitted by the director~~is included on the list. The fund	4546
and its employees shall, except for purposes of furnishing the	4547
auditor of state with information required by this section,	4548
preserve the confidentiality of recipients of public assistance in	4549
compliance with ~~division (A) of~~ section 5101.181 of the Revised	4550
Code and preserve the confidentiality of public medical assistance	4551
program recipients in compliance with section 5160.43 of the	4552
Revised Code.	4553

(5) The fund shall comply with orders issued under section	4554
3105.87 of the Revised Code.	4555

On the written request of an alternate payee, as defined in	4556
section 3105.80 of the Revised Code, the fund shall furnish to the	4557
alternate payee information on the amount and status of any	4558
amounts payable to the alternate payee under an order issued under	4559
section 3105.171 or 3105.65 of the Revised Code.	4560

(6) At the request of any person, the fund shall make	4561
available to the person copies of all documents, including	4562
resumes, in the fund's possession regarding filling a vacancy of a	4563
police officer employee member, firefighter employee member,	4564
police retirant member, or firefighter retirant member of the	4565
board of trustees. The person who made the request shall pay the	4566
cost of compiling, copying, and mailing the documents. The	4567
information described in this division is a public record.	4568

(F) A statement that contains information obtained from the	4569
fund's records that is signed by the secretary of the board of	4570
trustees of the Ohio police and fire pension fund and to which the	4571
board's official seal is affixed, or copies of the fund's records	4572
to which the signature and seal are attached, shall be received as	4573
true copies of the fund's records in any court or before any	4574
officer of this state.	4575

Sec. 955.201. (A) As used in this section and in section	4576
955.202 of the Revised Code, "Ohio pet fund" means a nonprofit	4577
corporation organized by that name under Chapter 1702. of the	4578
Revised Code that consists of humane societies, veterinarians,	4579
animal shelters, companion animal breeders, dog wardens, and	4580
similar individuals and entities.	4581

(B) The Ohio pet fund shall do all of the following:

4582

(1) Establish eligibility criteria for organizations that may	4583
receive financial assistance from the pets program funding board	4584
created in section 955.202 of the Revised Code. Those	4585
organizations may include any of the following:	4586

(a) An animal shelter as defined in section 4729.01 of the	4587
Revised Code;	4588

(b) A local nonprofit veterinary association that operates a	4589
program for the sterilization of dogs and cats;	4590

(c) A charitable organization that is exempt from federal	4591
income taxation under subsection 501(c)(3) of the Internal Revenue	4592
Code and the primary purpose of which is to support programs for	4593
the sterilization of dogs and cats and educational programs	4594
concerning the proper veterinary care of those animals.	4595

(2) Establish procedures for applying for financial	4596
assistance from the pets program funding board. Application	4597
procedures shall require eligible organizations to submit detailed	4598
proposals that outline the intended uses of the moneys sought.	4599

(3) Establish eligibility criteria for sterilization and	4600
educational programs for which moneys from the pets program	4601
funding board may be used and, consistent with division (C) of	4602
this section, establish eligibility criteria for individuals who	4603
seek sterilization for their dogs and cats from eligible	4604
organizations;	4605

(4) Establish procedures for the disbursement of moneys the	4606
pets program funding board receives from license plate	4607
contributions pursuant to division (C) of section 4503.551 of the	4608
Revised Code;	4609

(5) Advertise or otherwise provide notification of the	4610
availability of financial assistance from the pets program funding	4611
board for eligible organizations;	4612

(6) Design markings to be inscribed on "pets" license plates	4613
under section 4503.551 of the Revised Code.	4614

(C)(1) The owner of a dog or cat is eligible for dog or cat	4615
sterilization services from an eligible organization when those	4616
services are subsidized in whole or in part by money from the pets	4617
program funding board if any of the following applies:	4618

(a) The income of the owner's family does not exceed one	4619
hundred fifty per cent of the federal poverty guideline.	4620

(b) The owner, or any member of the owner's family who	4621
resides with the owner, is a recipient or beneficiary of one of	4622
the following government assistance programs:	4623

(i) Low-income housing assistance under the "United States	4624
Housing Act of 1937," 42 U.S.C.A. 1437f, as amended, known as the	4625
federal section 8 housing program;	4626

(ii) The Ohio works first program established by Chapter	4627
5107. of the Revised Code;	4628

(iii) ~~Title XIX of the "Social Security Act," 49 Stat. 620~~	4629
~~(1935), 42 U.S.C.A. 301, as amended, known as the medical~~	4630
~~assistance program or~~The medicaid~~, provided by the department of~~	4631
~~job and family services under Chapter 5111. of the Revised Code~~	4632
program;	4633

(iv) A program or law administered by the United States	4634
department of veterans' affairs or veterans' administration for	4635
any service-connected disability;	4636

(v) The food stamp program established under the "Food Stamp	4637
Act of 1977," 91 Stat. 958, 7 U.S.C.A. 2011, as amended,	4638
administered by the department of job and family services under	4639
section 5101.54 of the Revised Code;	4640

(vi) The "special supplemental nutrition program for women,	4641
infants, and children" established under the "Child Nutrition Act	4642
of 1966," 80 Stat. 885, 42 U.S.C. 1786, as amended, administered	4643
by the department of health under section 3701.132 of the Revised	4644
Code;	4645

(vii) Supplemental security income ~~under Title XVI of the~~	4646
~~"Social Security Act," 86 Stat. 1475 (1972), 42 U.S.C.A. 1383, as~~	4647
~~amended~~;	4648

(viii) Social security disability insurance benefits provided	4649
under Title II of the "Social Security Act," 49 Stat. 620 (1935),	4650
42 U.S.C.A. 401, as amended.	4651

(c) The owner of the dog or cat submits to the eligible	4652
organization operating the sterilization program either of the	4653
following:	4654

(i) A certificate of adoption showing that the dog or cat was	4655
adopted from a licensed animal shelter, a municipal, county, or	4656
regional pound, or a holding and impoundment facility that	4657
contracts with a municipal corporation;	4658

(ii) A certificate of adoption showing that the dog or cat	4659
was adopted through a nonprofit corporation operating an animal	4660
adoption referral service whose holding facility, if any, is	4661
licensed in accordance with state law or a municipal ordinance.	4662

(2) The Ohio pet fund shall determine the type of documentary	4663
evidence that must be presented by the owner of a dog or cat to	4664
show that the income of the owner's family does not exceed one	4665
hundred fifty per cent of the federal poverty guideline or that	4666
the owner is eligible under division (C)(1)(b) of this section.	4667

(D) As used in division (C) of this section, "federal poverty	4668
guideline" means the official poverty guideline as revised	4669
annually by the United States department of health and human	4670
services in accordance with section 673(2) of the "Omnibus Budget	4671
Reconciliation Act of 1981," 95 Stat. 511, 42 U.S.C.A. 9902, as	4672
amended, for a family size equal to the size of the family of the	4673
person whose income is being determined.	4674

Sec. 1337.11. As used in sections 1337.11 to 1337.17 of the	4675
Revised Code:	4676

(A) "Adult" means a person who is eighteen years of age or	4677
older.	4678

(B) "Attending physician" means the physician to whom a	4679
principal or the family of a principal has assigned primary	4680
responsibility for the treatment or care of the principal or, if	4681
the responsibility has not been assigned, the physician who has	4682
accepted that responsibility.	4683

4684

(1) Nutrition when administered to diminish the pain or	4685
discomfort of a principal, but not to postpone death;	4686

(2) Hydration when administered to diminish the pain or	4687
discomfort of a principal, but not to postpone death;	4688

(3) Any other medical or nursing procedure, treatment,	4689
intervention, or other measure that is taken to diminish the pain	4690
or discomfort of a principal, but not to postpone death.	4691

(D) "Consulting physician" means a physician who, in	4692
conjunction with the attending physician of a principal, makes one	4693
or more determinations that are required to be made by the	4694
attending physician, or to be made by the attending physician and	4695
one other physician, by an applicable provision of sections	4696
1337.11 to 1337.17 of the Revised Code, to a reasonable degree of	4697
medical certainty and in accordance with reasonable medical	4698
standards.	4699

(E) "Declaration for mental health treatment" has the same	4700
meaning as in section 2135.01 of the Revised Code.	4701

(F) "Guardian" means a person appointed by a probate court	4702
pursuant to Chapter 2111. of the Revised Code to have the care and	4703
management of the person of an incompetent.	4704

(G) "Health care" means any care, treatment, service, or	4705
procedure to maintain, diagnose, or treat an individual's physical	4706
or mental condition or physical or mental health.	4707

(H) "Health care decision" means informed consent, refusal to	4708
give informed consent, or withdrawal of informed consent to health	4709
care.	4710

(I) "Health care facility" means any of the following:

4711

(1) A hospital;

4712

(2) A hospice care program or other institution that	4713
specializes in comfort care of patients in a terminal condition or	4714
in a permanently unconscious state;	4715

(3) A nursing home;

4716

(4) A home health agency;

4717

(5) An intermediate care facility for the mentally retarded;

4718

(6) A regulated community mental health organization.

4719

(J) "Health care personnel" means physicians, nurses,	4720
physician assistants, emergency medical technicians-basic,	4721
emergency medical technicians-intermediate, emergency medical	4722
technicians-paramedic, medical technicians, dietitians, other	4723
authorized persons acting under the direction of an attending	4724
physician, and administrators of health care facilities.	4725

(K) "Home health agency" has the same meaning as in section	4726
3701.881 of the Revised Code.	4727

(L) "Hospice care program" has the same meaning as in section	4728
3712.01 of the Revised Code.	4729

(M) "Hospital" has the same meanings as in sections 3701.01,	4730
3727.01, and 5122.01 of the Revised Code.	4731

(N) "Hydration" means fluids that are artificially or	4732
technologically administered.	4733

(O) "Incompetent" has the same meaning as in section 2111.01	4734
of the Revised Code.	4735

(P) "Intermediate care facility for the mentally retarded"	4736
has the same meaning as in section ~~5111.20~~5164.01 of the Revised	4737
Code.	4738

(Q) "Life-sustaining treatment" means any medical procedure,	4739
treatment, intervention, or other measure that, when administered	4740
to a principal, will serve principally to prolong the process of	4741
dying.	4742

(R) "Medical claim" has the same meaning as in section	4743
2305.113 of the Revised Code.	4744

(S) "Mental health treatment" has the same meaning as in	4745
section 2135.01 of the Revised Code.	4746

(T) "Nursing home" has the same meaning as in section 3721.01	4747
of the Revised Code.	4748

(U) "Nutrition" means sustenance that is artificially or	4749
technologically administered.	4750

(V) "Permanently unconscious state" means a state of	4751
permanent unconsciousness in a principal that, to a reasonable	4752
degree of medical certainty as determined in accordance with	4753
reasonable medical standards by the principal's attending	4754
physician and one other physician who has examined the principal,	4755
is characterized by both of the following:	4756

(1) Irreversible unawareness of one's being and environment.

4757

(2) Total loss of cerebral cortical functioning, resulting in	4758
the principal having no capacity to experience pain or suffering.	4759

(W) "Person" has the same meaning as in section 1.59 of the	4760
Revised Code and additionally includes political subdivisions and	4761
governmental agencies, boards, commissions, departments,	4762
institutions, offices, and other instrumentalities.	4763

(X) "Physician" means a person who is authorized under	4764
Chapter 4731. of the Revised Code to practice medicine and surgery	4765
or osteopathic medicine and surgery.	4766

(Y) "Political subdivision" and "state" have the same	4767
meanings as in section 2744.01 of the Revised Code.	4768

(Z) "Professional disciplinary action" means action taken by	4769
the board or other entity that regulates the professional conduct	4770
of health care personnel, including the state medical board and	4771
the board of nursing.	4772

(AA) "Regulated community mental health organization" means a	4773
residential facility as defined and licensed under section 5119.22	4774
of the Revised Code or a community mental health agency as defined	4775
in section 5122.01 of the Revised Code.	4776

(BB) "Terminal condition" means an irreversible, incurable,	4777
and untreatable condition caused by disease, illness, or injury	4778
from which, to a reasonable degree of medical certainty as	4779
determined in accordance with reasonable medical standards by a	4780
principal's attending physician and one other physician who has	4781
examined the principal, both of the following apply:	4782

(1) There can be no recovery.

4783

(2) Death is likely to occur within a relatively short time	4784
if life-sustaining treatment is not administered.	4785

(CC) "Tort action" means a civil action for damages for	4786
injury, death, or loss to person or property, other than a civil	4787
action for damages for a breach of contract or another agreement	4788
between persons.	4789

Sec. 1347.08. (A) Every state or local agency that maintains	4790
a personal information system, upon the request and the proper	4791
identification of any person who is the subject of personal	4792
information in the system, shall:	4793

(1) Inform the person of the existence of any personal	4794
information in the system of which the person is the subject;	4795

(2) Except as provided in divisions (C) and (E)(2) of this	4796
section, permit the person, the person's legal guardian, or an	4797
attorney who presents a signed written authorization made by the	4798
person, to inspect all personal information in the system of which	4799
the person is the subject;	4800

(3) Inform the person about the types of uses made of the	4801
personal information, including the identity of any users usually	4802
granted access to the system.	4803

(B) Any person who wishes to exercise a right provided by	4804
this section may be accompanied by another individual of the	4805
person's choice.	4806

(C)(1) A state or local agency, upon request, shall disclose	4807
medical, psychiatric, or psychological information to a person who	4808
is the subject of the information or to the person's legal	4809
guardian, unless a physician, psychiatrist, or psychologist	4810
determines for the agency that the disclosure of the information	4811
is likely to have an adverse effect on the person, in which case	4812
the information shall be released to a physician, psychiatrist, or	4813
psychologist who is designated by the person or by the person's	4814
legal guardian.	4815

(2) Upon the signed written request of either a licensed	4816
attorney at law or a licensed physician designated by the inmate,	4817
together with the signed written request of an inmate of a	4818
correctional institution under the administration of the	4819
department of rehabilitation and correction, the department shall	4820
disclose medical information to the designated attorney or	4821
physician as provided in division (C) of section 5120.21 of the	4822
Revised Code.	4823

(D) If an individual who is authorized to inspect personal	4824
information that is maintained in a personal information system	4825
requests the state or local agency that maintains the system to	4826
provide a copy of any personal information that the individual is	4827
authorized to inspect, the agency shall provide a copy of the	4828
personal information to the individual. Each state and local	4829
agency may establish reasonable fees for the service of copying,	4830
upon request, personal information that is maintained by the	4831
agency.	4832

(E)(1) This section regulates access to personal information	4833
that is maintained in a personal information system by persons who	4834
are the subject of the information, but does not limit the	4835
authority of any person, including a person who is the subject of	4836
personal information maintained in a personal information system,	4837
to inspect or have copied, pursuant to section 149.43 of the	4838
Revised Code, a public record as defined in that section.	4839

(2) This section does not provide a person who is the subject	4840
of personal information maintained in a personal information	4841
system, the person's legal guardian, or an attorney authorized by	4842
the person, with a right to inspect or have copied, or require an	4843
agency that maintains a personal information system to permit the	4844
inspection of or to copy, a confidential law enforcement	4845
investigatory record or trial preparation record, as defined in	4846
divisions (A)(2) and (4) of section 149.43 of the Revised Code.	4847

(F) This section does not apply to any of the following:

4848

(1) The contents of an adoption file maintained by the	4849
department of health under section 3705.12 of the Revised Code;	4850

(2) Information contained in the putative father registry	4851
established by section 3107.062 of the Revised Code, regardless of	4852
whether the information is held by the department of job and	4853
family services or, pursuant to section 3111.69 of the Revised	4854
Code, the office of child support in the department or a child	4855
support enforcement agency;	4856

(3) Papers, records, and books that pertain to an adoption	4857
and that are subject to inspection in accordance with section	4858
3107.17 of the Revised Code;	4859

(4) Records listed in division (A) of section 3107.42 of the	4860
Revised Code or specified in division (A) of section 3107.52 of	4861
the Revised Code;	4862

(5) Records that identify an individual described in division	4863
(A)(1) of section 3721.031 of the Revised Code, or that would tend	4864
to identify such an individual;	4865

(6) Files and records that have been expunged under division	4866
(D)(1) of section 3721.23 of the Revised Code;	4867

(7) Records that identify an individual described in division	4868
(A)(1) of section 3721.25 of the Revised Code, or that would tend	4869
to identify such an individual;	4870

(8) Records that identify an individual described in division	4871
(A)(1) of section ~~5111.61~~5164.77 of the Revised Code, or that	4872
would tend to identify such an individual;	4873

(9) Test materials, examinations, or evaluation tools used in	4874
an examination for licensure as a nursing home administrator that	4875
the board of examiners of nursing home administrators administers	4876
under section 4751.04 of the Revised Code or contracts under that	4877
section with a private or government entity to administer;	4878

(10) Information contained in a database established and	4879
maintained pursuant to section 5101.13 of the Revised Code.	4880

Sec. 1731.04. (A) An agreement between an alliance and an	4881
insurer referred to in division (B) of section 1731.01 of the	4882
Revised Code shall contain at least the following:	4883

(1) A provision requiring the insurer to offer and sell to	4884
small employers served or to be served by an alliance one or more	4885
health benefit plan options for coverage of their eligible	4886
employees and the eligible dependents and members of the families	4887
of the eligible employees and, if applicable, such members'	4888
eligible retirees and the eligible dependents and members of the	4889
families of the retirees, subject to such conditions and	4890
restrictions as may be set forth or incorporated into the	4891
agreement;	4892

(2) A brief description of each type of health benefit plan	4893
option that is to be so offered and the conditions for the	4894
modification, continuation, and termination of the coverage and	4895
benefits thereunder;	4896

(3) A statement of the eligibility requirements that an	4897
employee or retiree must meet in order for the employee or retiree	4898
to be eligible to obtain and retain coverage under any health	4899
benefit plan option so offered and, if one of such requirements is	4900
that an employee must regularly work for a minimum number of hours	4901
per week, a statement of such minimum number of hours, which	4902
minimum shall not exceed twenty-five hours per week;	4903

(4) A description of any pre-existing condition and waiting	4904
period rules;	4905

(5) A statement of the premium rates or other charges that	4906
apply to each health benefit plan option or a formula or method of	4907
determining the rates or charges;	4908

(6) A provision prescribing the minimum employer contribution	4909
toward premiums or other charges required in order to permit a	4910
small employer to obtain coverage under a health benefit plan	4911
option offered under an alliance program;	4912

(7) A provision requiring that each health benefit plan under	4913
the alliance program must provide for the continuation of coverage	4914
of participants of an enrolled small employer so long as the small	4915
employer determines that such person is a qualified beneficiary	4916
entitled to such coverage pursuant to Part 6 of Title I of the	4917
"Federal Employee Retirement Income Security Act of 1974," 88	4918
Stat. 832, 29 U.S.C.A. 1001, and the laws of this state, and	4919
regulations or rulings interpreting such provisions. Such coverage	4920
provided by the insurer under the plan to participants shall	4921
comply with the "Federal Employee Retirement Income Security Act	4922
of 1974" and the relevant statutes, regulations, and rulings	4923
interpreting that act, including provisions regarding types of	4924
coverage to be provided, apportionments of limitations on	4925
coverage, apportionments of deductibles, and the rights of	4926
qualified beneficiaries to elect coverage options relating to	4927
types of coverage and otherwise.	4928

(B) An agreement between an alliance and an insurer referred	4929
to in division (B) of section 1731.01 of the Revised Code may	4930
contain provisions relating to, but not limited to, any of the	4931
following:	4932

(1) The application and enrollment process for a small	4933
employer and related provisions pertaining to historical	4934
experience, health statements, and underwriting standards;	4935

(2) The minimum number of those employees eligible to be	4936
participants that are required to participate in order to permit a	4937
small employer to obtain coverage under a health benefit plan	4938
option offered under the alliance program, which may vary with the	4939
number of employees or those eligible to be participants in	4940
respect of the small employer;	4941

(3) A procedure for allowing an enrolled small employer to	4942
change from one plan option to another under the alliance program,	4943
subject to qualifying by size or otherwise under the alliance	4944
program;	4945

(4) The application of any risk-related pooling or grouping	4946
programs and related premiums, conditions, reviews, and	4947
alternatives offered by the insurer;	4948

(5) The availability of a medicare supplement coverage option	4949
for eligible participants who are covered by Parts A and B of the	4950
medicare~~, Title XVIII of the "Social Security Act," 49 Stat. 620~~	4951
~~(1935), 42 U.S.C.A. 301~~program;	4952

(6) Relevant experience periods, enrollment periods, and	4953
contract periods;	4954

(7) Effective dates for coverage of eligible participants;

4955

(8) Conditions under which denial or withdrawal of coverage	4956
of participants or small employers and their employees may occur	4957
by reason of falsification or misrepresentation of material facts	4958
or criminal conduct toward the insurer, small employer, or	4959
alliance under the program;	4960

(9) Premium rate structures, which may be uniform or make	4961
provision for age-specific rates, differentials based on number of	4962
participants of an enrolled small employer, products and plan	4963
options selected, and other factors, rate adjustments based on	4964
consumer price indices, utilization, or other relevant factors,	4965
notification of rate adjustments, and arbitration;	4966

(10) Any responsibilities of the alliance for billing,	4967
collection, and transmittal of premiums;	4968

(11) Inclusion under the alliance program of small employers	4969
that are members of other organizations described in division	4970
(A)(1) of section 1731.01 of the Revised Code that contract with	4971
the alliance for this purpose, and conditions pertaining to those	4972
small employer members and to their employees and retirees, and	4973
dependents and family members of those employees or retirees, as	4974
applicable under the alliance program;	4975

(12) The agreement of the insurer to offer and sell one or	4976
more health benefit plans to small employer members of another	4977
small employer health care alliance that contracts with the	4978
alliance for this purpose;	4979

(13) Use of the health benefit plan options of the insurer in	4980
the alliance program and use of the names of the alliance and the	4981
insurer;	4982

(14) Indemnification from claims and liability by reason of	4983
acts or omissions of others;	4984

(15) Ownership, use, availability, and maintenance of	4985
confidentiality of data and records relating to the alliance	4986
program;	4987

(16) Utilization reports to be provided to the alliance by	4988
the insurer;	4989

(17) Such other provisions as may be agreed upon by the	4990
alliance and the insurer to better provide for the articulation,	4991
promotion, financing, and operation of the alliance program or a	4992
health benefit plan under the program in furtherance of the public	4993
purposes stated in section 1731.02 of the Revised Code.	4994

(C) Neither an alliance program nor an agreement between an	4995
alliance and an insurer is itself a policy or contract of	4996
insurance, or a certificate, indorsement, rider, or application	4997
forming any part of a policy, contract, or certificate of	4998
insurance. Chapters 3905., 3933., and 3959. of the Revised Code do	4999
not apply to an alliance program or to an agreement between an	5000
alliance and an insurer thereunder, as such, or to the functions	5001
of the alliance under an alliance program.	5002

Sec. 1739.061. (A)(1) This section applies to both of the	5003
following:	5004

(a) A multiple employer welfare arrangement that issues or	5005
requires the use of a standardized identification card or an	5006
electronic technology for submission and routing of prescription	5007
drug claims;	5008

(b) A person or entity that a multiple employer welfare	5009
arrangement contracts with to issue a standardized identification	5010
card or an electronic technology described in division (A)(1)(a)	5011
of this section.	5012

(2) Notwithstanding division (A)(1) of this section, this	5013
section does not apply to the issuance or required use of a	5014
standardized identification card or an electronic technology for	5015
the submission and routing of prescription drug claims in	5016
connection with any of the following:	5017

(a) Any program or arrangement covering only accident,	5018
credit, dental, disability income, long-term care, hospital	5019
indemnity, medicare supplement, medicare, tricare, specified	5020
disease, or vision care; coverage under a	5021
one-time-limited-duration policy of not longer than six months;	5022
coverage issued as a supplement to liability insurance; insurance	5023
arising out of workers' compensation or similar law; automobile	5024
medical payment insurance; or insurance under which benefits are	5025
payable with or without regard to fault and which is statutorily	5026
required to be contained in any liability insurance policy or	5027
equivalent self-insurance.	5028

(b) Coverage provided under the medicaid~~, as defined in~~	5029
~~section 5111.01 of the Revised Code~~program.	5030

(c) Coverage provided under an employer's self-insurance plan	5031
or by any of its administrators, as defined in section 3959.01 of	5032
the Revised Code, to the extent that federal law supersedes,	5033
preempts, prohibits, or otherwise precludes the application of	5034
this section to the plan and its administrators.	5035

(B) A standardized identification card or an electronic	5036
technology issued or required to be used as provided in division	5037
(A)(1) of this section shall contain uniform prescription drug	5038
information in accordance with either division (B)(1) or (2) of	5039
this section.	5040

(1) The standardized identification card or the electronic	5041
technology shall be in a format and contain information fields	5042
approved by the national council for prescription drug programs or	5043
a successor organization, as specified in the council's or	5044
successor organization's pharmacy identification card	5045
implementation guide in effect on the first day of October most	5046
immediately preceding the issuance or required use of the	5047
standardized identification card or the electronic technology.	5048

(2) If the multiple employer welfare arrangement or person	5049
under contract with it to issue a standardized identification card	5050
or an electronic technology requires the information for the	5051
submission and routing of a claim, the standardized identification	5052
card or the electronic technology shall contain any of the	5053
following information:	5054

(a) The name of the multiple employer welfare arrangement;

5055

(b) The individual's name, group number, and identification	5056
number;	5057

(c) A telephone number to inquire about pharmacy-related	5058
issues;	5059

(d) The issuer's international identification number, labeled	5060
as "ANSI BIN" or "RxBIN";	5061

(e) The processor's control number, labeled as "RxPCN";

5062

(f) The individual's pharmacy benefits group number if	5063
different from the insured's medical group number, labeled as	5064
"RxGrp."	5065

(C) If the standardized identification card or the electronic	5066
technology issued or required to be used as provided in division	5067
(A)(1) of this section is also used for submission and routing of	5068
nonpharmacy claims, the designation "Rx" is required to be	5069
included as part of the labels identified in divisions (B)(2)(d)	5070
and (e) of this section if the issuer's international	5071
identification number or the processor's control number is	5072
different for medical and pharmacy claims.	5073

(D) Each multiple employer welfare arrangement described in	5074
division (A) of this section shall annually file a certificate	5075
with the superintendent of insurance certifying that it or any	5076
person it contracts with to issue a standardized identification	5077
card or electronic technology for submission and routing of	5078
prescription drug claims complies with this section.	5079

(E)(1) Except as provided in division (E)(2) of this section,	5080
if there is a change in the information contained in the	5081
standardized identification card or the electronic technology	5082
issued to an individual, the multiple employer welfare arrangement	5083
or person under contract with it to issue a standardized	5084
identification card or an electronic technology shall issue a new	5085
card or electronic technology to the individual.	5086

(2) A multiple employer welfare arrangement or person under	5087
contract with it is not required under division (E)(1) of this	5088
section to issue a new card or electronic technology to an	5089
individual more than once during a twelve-month period.	5090

(F) Nothing in this section shall be construed as requiring a	5091
multiple employer welfare arrangement to produce more than one	5092
standardized identification card or one electronic technology for	5093
use by individuals accessing health care benefits provided under a	5094
multiple employer welfare arrangement.	5095

Sec. 1751.01. As used in this chapter:

5096

(A)(1) "Basic health care services" means the following	5097
services when medically necessary:	5098

(a) Physician's services, except when such services are	5099
supplemental under division (B) of this section;	5100

(b) Inpatient hospital services;

5101

5102

(d) Emergency health services;

5103

(e) Urgent care services;

5104

(f) Diagnostic laboratory services and diagnostic and	5105
therapeutic radiologic services;	5106

(g) Diagnostic and treatment services, other than	5107
prescription drug services, for biologically based mental	5108
illnesses;	5109

(h) Preventive health care services, including, but not	5110
limited to, voluntary family planning services, infertility	5111
services, periodic physical examinations, prenatal obstetrical	5112
care, and well-child care;	5113

(i) Routine patient care for patients enrolled in an eligible	5114
cancer clinical trial pursuant to section 3923.80 of the Revised	5115
Code.	5116

"Basic health care services" does not include experimental	5117
procedures.	5118

Except as provided by divisions (A)(2) and (3) of this	5119
section in connection with the offering of coverage for diagnostic	5120
and treatment services for biologically based mental illnesses, a	5121
health insuring corporation shall not offer coverage for a health	5122
care service, defined as a basic health care service by this	5123
division, unless it offers coverage for all listed basic health	5124
care services. However, this requirement does not apply to the	5125
coverage of beneficiaries enrolled in medicare pursuant to a	5126
medicare contract, or to the coverage of beneficiaries enrolled	5127
in the federal employee health benefits program pursuant to 5	5128
U.S.C.A. 8905, or to the coverage of medicaid recipients, or to	5129
the coverage of participants of the children's buy-in program, or	5130
to the coverage of beneficiaries under any federal health care	5131
program regulated by a federal regulatory body, or to the	5132
coverage of beneficiaries under any contract covering officers or	5133
employees of the state that has been entered into by the	5134
department of administrative services.	5135

(2) A health insuring corporation may offer coverage for	5136
diagnostic and treatment services for biologically based mental	5137
illnesses without offering coverage for all other basic health	5138
care services. A health insuring corporation may offer coverage	5139
for diagnostic and treatment services for biologically based	5140
mental illnesses alone or in combination with one or more	5141
supplemental health care services. However, a health insuring	5142
corporation that offers coverage for any other basic health care	5143
service shall offer coverage for diagnostic and treatment services	5144
for biologically based mental illnesses in combination with the	5145
offer of coverage for all other listed basic health care services.	5146

(3) A health insuring corporation that offers coverage for	5147
basic health care services is not required to offer coverage for	5148
diagnostic and treatment services for biologically based mental	5149
illnesses in combination with the offer of coverage for all other	5150
listed basic health care services if all of the following apply:	5151

(a) The health insuring corporation submits documentation	5152
certified by an independent member of the American academy of	5153
actuaries to the superintendent of insurance showing that incurred	5154
claims for diagnostic and treatment services for biologically	5155
based mental illnesses for a period of at least six months	5156
independently caused the health insuring corporation's costs for	5157
claims and administrative expenses for the coverage of basic	5158
health care services to increase by more than one per cent per	5159
year.	5160

(b) The health insuring corporation submits a signed letter	5161
from an independent member of the American academy of actuaries to	5162
the superintendent of insurance opining that the increase in costs	5163
described in division (A)(3)(a) of this section could reasonably	5164
justify an increase of more than one per cent in the annual	5165
premiums or rates charged by the health insuring corporation for	5166
the coverage of basic health care services.	5167

(c) The superintendent of insurance makes the following	5168
determinations from the documentation and opinion submitted	5169
pursuant to divisions (A)(3)(a) and (b) of this section:	5170

(i) Incurred claims for diagnostic and treatment services for	5171
biologically based mental illnesses for a period of at least six	5172
months independently caused the health insuring corporation's	5173
costs for claims and administrative expenses for the coverage of	5174
basic health care services to increase by more than one per cent	5175
per year.	5176

(ii) The increase in costs reasonably justifies an increase	5177
of more than one per cent in the annual premiums or rates charged	5178
by the health insuring corporation for the coverage of basic	5179
health care services.	5180

Any determination made by the superintendent under this	5181
division is subject to Chapter 119. of the Revised Code.	5182

(B)(1) "Supplemental health care services" means any health	5183
care services other than basic health care services that a health	5184
insuring corporation may offer, alone or in combination with	5185
either basic health care services or other supplemental health	5186
care services, and includes:	5187

(a) Services of facilities for intermediate or long-term	5188
care, or both;	5189

(b) Dental care services;

5190

(c) Vision care and optometric services including lenses and	5191
frames;	5192

(d) Podiatric care or foot care services;

5193

(e) Mental health services, excluding diagnostic and	5194
treatment services for biologically based mental illnesses;	5195

(f) Short-term outpatient evaluative and crisis-intervention	5196
mental health services;	5197

(g) Medical or psychological treatment and referral services	5198
for alcohol and drug abuse or addiction;	5199

(h) Home health services;

5200

(i) Prescription drug services;

5201

(j) Nursing services;

5202

(k) Services of a dietitian licensed under Chapter 4759. of	5203
the Revised Code;	5204

(l) Physical therapy services;

5205

(m) Chiropractic services;

5206

(n) Any other category of services approved by the	5207
superintendent of insurance.	5208

(2) If a health insuring corporation offers prescription	5209
drug services under this division, the coverage shall include	5210
prescription drug services for the treatment of biologically based	5211
mental illnesses on the same terms and conditions as other	5212
physical diseases and disorders.	5213

(C) "Specialty health care services" means one of the	5214
supplemental health care services listed in division (B) of this	5215
section, when provided by a health insuring corporation on an	5216
outpatient-only basis and not in combination with other	5217
supplemental health care services.	5218

(D) "Biologically based mental illnesses" means	5219
schizophrenia, schizoaffective disorder, major depressive	5220
disorder, bipolar disorder, paranoia and other psychotic	5221
disorders, obsessive-compulsive disorder, and panic disorder, as	5222
these terms are defined in the most recent edition of the	5223
diagnostic and statistical manual of mental disorders published by	5224
the American psychiatric association.	5225

(E) ~~"Children's buy-in program" has the same meaning as in~~	5226
~~section 5101.5211 of the Revised Code.~~	5227

~~(F)~~ "Closed panel plan" means a health care plan that	5228
requires enrollees to use participating providers.	5229

~~(G)~~(F) "Compensation" means remuneration for the provision of	5230
health care services, determined on other than a fee-for-service	5231
or discounted-fee-for-service basis.	5232

~~(H)~~(G) "Contractual periodic prepayment" means the formula	5233
for determining the premium rate for all subscribers of a health	5234
insuring corporation.	5235

~~(I)~~(H) "Corporation" means a corporation formed under Chapter	5236
1701. or 1702. of the Revised Code or the similar laws of another	5237
state.	5238

~~(J)~~(I) "Emergency health services" means those health care	5239
services that must be available on a seven-days-per-week,	5240
twenty-four-hours-per-day basis in order to prevent jeopardy to an	5241
enrollee's health status that would occur if such services were	5242
not received as soon as possible, and includes, where appropriate,	5243
provisions for transportation and indemnity payments or service	5244
agreements for out-of-area coverage.	5245

~~(K)~~(J) "Enrollee" means any natural person who is entitled to	5246
receive health care benefits provided by a health insuring	5247
corporation.	5248

~~(L)~~(K) "Evidence of coverage" means any certificate,	5249
agreement, policy, or contract issued to a subscriber that sets	5250
out the coverage and other rights to which such person is	5251
entitled under a health care plan.	5252

~~(M)~~(L) "Health care facility" means any facility, except a	5253
health care practitioner's office, that provides preventive,	5254
diagnostic, therapeutic, acute convalescent, rehabilitation,	5255
mental health, mental retardation, intermediate care, or skilled	5256
nursing services.	5257

~~(N)~~(M) "Health care services" means basic, supplemental, and	5258
specialty health care services.	5259

~~(O)~~(N) "Health delivery network" means any group of providers	5260
or health care facilities, or both, or any representative thereof,	5261
that have entered into an agreement to offer health care services	5262
in a panel rather than on an individual basis.	5263

~~(P)~~(O) "Health insuring corporation" means a corporation, as	5264
defined in division ~~(I)~~(H) of this section, that, pursuant to a	5265
policy, contract, certificate, or agreement, pays for, reimburses,	5266
or provides, delivers, arranges for, or otherwise makes available,	5267
basic health care services, supplemental health care services, or	5268
specialty health care services, or a combination of basic health	5269
care services and either supplemental health care services or	5270
specialty health care services, through either an open panel plan	5271
or a closed panel plan.	5272

"Health insuring corporation" does not include a limited	5273
liability company formed pursuant to Chapter 1705. of the Revised	5274
Code, an insurer licensed under Title XXXIX of the Revised Code if	5275
that insurer offers only open panel plans under which all	5276
providers and health care facilities participating receive their	5277
compensation directly from the insurer, a corporation formed by or	5278
on behalf of a political subdivision or a department, office, or	5279
institution of the state, or a public entity formed by or on	5280
behalf of a board of county commissioners, a county board of	5281
mental retardation and developmental disabilities, an alcohol and	5282
drug addiction services board, a board of alcohol, drug addiction,	5283
and mental health services, or a community mental health board, as	5284
those terms are used in Chapters 340. and 5126. of the Revised	5285
Code. Except as provided by division (D) of section 1751.02 of	5286
the Revised Code, or as otherwise provided by law, no board,	5287
commission, agency, or other entity under the control of a	5288
political subdivision may accept insurance risk in providing for	5289
health care services. However, nothing in this division shall be	5290
construed as prohibiting such entities from purchasing the	5291
services of a health insuring corporation or a third-party	5292
administrator licensed under Chapter 3959. of the Revised Code.	5293

~~(Q)~~(P) "Intermediary organization" means a health delivery	5294
network or other entity that contracts with licensed health	5295
insuring corporations or self-insured employers, or both, to	5296
provide health care services, and that enters into contractual	5297
arrangements with other entities for the provision of health care	5298
services for the purpose of fulfilling the terms of its contracts	5299
with the health insuring corporations and self-insured employers.	5300

~~(R)~~(Q) "Intermediate care" means residential care above the	5301
level of room and board for patients who require personal	5302
assistance and health-related services, but who do not require	5303
skilled nursing care.	5304

~~(S) "Medicaid" has the same meaning as in section 5111.01 of~~	5305
~~the Revised Code.~~	5306

~~(T)~~(R) "Medical record" means the personal information that	5307
relates to an individual's physical or mental condition, medical	5308
history, or medical treatment.	5309

~~(U) "Medicare" means the program established under Title~~	5310
~~XVIII of the "Social Security Act" 49 Stat. 620 (1935), 42 U.S.C.~~	5311
~~1395, as amended.~~	5312

~~(V)~~(S)(1) "Open panel plan" means a health care plan that	5313
provides incentives for enrollees to use participating providers	5314
and that also allows enrollees to use providers that are not	5315
participating providers.	5316

(2) No health insuring corporation may offer an open panel	5317
plan, unless the health insuring corporation is also licensed as	5318
an insurer under Title XXXIX of the Revised Code, the health	5319
insuring corporation, on June 4, 1997, holds a certificate of	5320
authority or license to operate under Chapter 1736. or 1740. of	5321
the Revised Code, or an insurer licensed under Title XXXIX of the	5322
Revised Code is responsible for the out-of-network risk as	5323
evidenced by both an evidence of coverage filing under section	5324
1751.11 of the Revised Code and a policy and certificate filing	5325
under section 3923.02 of the Revised Code.	5326

~~(W)~~(T) "Panel" means a group of providers or health care	5327
facilities that have joined together to deliver health care	5328
services through a contractual arrangement with a health insuring	5329
corporation, employer group, or other payor.	5330

~~(X)~~(U) "Person" has the same meaning as in section 1.59 of	5331
the Revised Code, and, unless the context otherwise requires,	5332
includes any insurance company holding a certificate of authority	5333
under Title XXXIX of the Revised Code, any subsidiary and	5334
affiliate of an insurance company, and any government agency.	5335

~~(Y)~~(V) "Premium rate" means any set fee regularly paid by a	5336
subscriber to a health insuring corporation. A "premium rate" does	5337
not include a one-time membership fee, an annual administrative	5338
fee, or a nominal access fee, paid to a managed health care system	5339
under which the recipient of health care services remains solely	5340
responsible for any charges accessed for those services by the	5341
provider or health care facility.	5342

~~(Z)~~(W) "Primary care provider" means a provider that is	5343
designated by a health insuring corporation to supervise,	5344
coordinate, or provide initial care or continuing care to an	5345
enrollee, and that may be required by the health insuring	5346
corporation to initiate a referral for specialty care and to	5347
maintain supervision of the health care services rendered to the	5348
enrollee.	5349

~~(AA)~~(X) "Provider" means any natural person or partnership of	5350
natural persons who are licensed, certified, accredited, or	5351
otherwise authorized in this state to furnish health care	5352
services, or any professional association organized under Chapter	5353
1785. of the Revised Code, provided that nothing in this chapter	5354
or other provisions of law shall be construed to preclude a health	5355
insuring corporation, health care practitioner, or organized	5356
health care group associated with a health insuring corporation	5357
from employing certified nurse practitioners, certified nurse	5358
anesthetists, clinical nurse specialists, certified nurse	5359
midwives, dietitians, physician assistants, dental assistants,	5360
dental hygienists, optometric technicians, or other allied health	5361
personnel who are licensed, certified, accredited, or otherwise	5362
authorized in this state to furnish health care services.	5363

~~(BB)~~(Y) "Provider sponsored organization" means a	5364
corporation, as defined in division ~~(I)~~(H) of this section, that	5365
is at least eighty per cent owned or controlled by one or more	5366
hospitals, as defined in section 3727.01 of the Revised Code, or	5367
one or more physicians licensed to practice medicine or surgery	5368
or osteopathic medicine and surgery under Chapter 4731. of the	5369
Revised Code, or any combination of such physicians and hospitals.	5370
Such control is presumed to exist if at least eighty per cent of	5371
the voting rights or governance rights of a provider sponsored	5372
organization are directly or indirectly owned, controlled, or	5373
otherwise held by any combination of the physicians and hospitals	5374
described in this division.	5375

~~(CC)~~(Z) "Solicitation document" means the written materials	5376
provided to prospective subscribers or enrollees, or both, and	5377
used for advertising and marketing to induce enrollment in the	5378
health care plans of a health insuring corporation.	5379

~~(DD)~~(AA) "Subscriber" means a person who is responsible for	5380
making payments to a health insuring corporation for participation	5381
in a health care plan, or an enrollee whose employment or other	5382
status is the basis of eligibility for enrollment in a health	5383
insuring corporation.	5384

~~(EE)~~(BB) "Urgent care services" means those health care	5385
services that are appropriately provided for an unforeseen	5386
condition of a kind that usually requires medical attention	5387
without delay but that does not pose a threat to the life, limb,	5388
or permanent health of the injured or ill person, and may include	5389
such health care services provided out of the health insuring	5390
corporation's approved service area pursuant to indemnity	5391
payments or service agreements.	5392

Sec. 1751.11. (A) Every subscriber of a health insuring	5393
corporation is entitled to an evidence of coverage for the health	5394
care plan under which health care benefits are provided.	5395

(B) Every subscriber of a health insuring corporation that	5396
offers basic health care services is entitled to an identification	5397
card or similar document that specifies the health insuring	5398
corporation's name as stated in its articles of incorporation, and	5399
any trade or fictitious names used by the health insuring	5400
corporation. The identification card or document shall list at	5401
least one toll-free telephone number that provides the subscriber	5402
with access, to information on a twenty-four-hours-per-day,	5403
seven-days-per-week basis, as to how health care services may be	5404
obtained. The identification card or document shall also list at	5405
least one toll-free number that, during normal business hours,	5406
provides the subscriber with access to information on the coverage	5407
available under the subscriber's health care plan and information	5408
on the health care plan's internal and external review processes.	5409

(C) No evidence of coverage, or amendment to the evidence of	5410
coverage, shall be delivered, issued for delivery, renewed, or	5411
used, until the form of the evidence of coverage or amendment has	5412
been filed by the health insuring corporation with the	5413
superintendent of insurance. If the superintendent does not	5414
disapprove the evidence of coverage or amendment within sixty days	5415
after it is filed it shall be deemed approved, unless the	5416
superintendent sooner gives approval for the evidence of coverage	5417
or amendment. With respect to an amendment to an approved evidence	5418
of coverage, the superintendent only may disapprove provisions	5419
amended or added to the evidence of coverage. If the	5420
superintendent determines within the sixty-day period that any	5421
evidence of coverage or amendment fails to meet the requirements	5422
of this section, the superintendent shall so notify the health	5423
insuring corporation and it shall be unlawful for the health	5424
insuring corporation to use such evidence of coverage or	5425
amendment. At any time, the superintendent, upon at least thirty	5426
days' written notice to a health insuring corporation, may	5427
withdraw an approval, deemed or actual, of any evidence of	5428
coverage or amendment on any of the grounds stated in this	5429
section. Such disapproval shall be effected by a written order,	5430
which shall state the grounds for disapproval and shall be issued	5431
in accordance with Chapter 119. of the Revised Code.	5432

(D) No evidence of coverage or amendment shall be delivered,	5433
issued for delivery, renewed, or used:	5434

(1) If it contains provisions or statements that are	5435
inequitable, untrue, misleading, or deceptive;	5436

(2) Unless it contains a clear, concise, and complete	5437
statement of the following:	5438

(a) The health care services and insurance or other benefits,	5439
if any, to which an enrollee is entitled under the health care	5440
plan;	5441

(b) Any exclusions or limitations on the health care	5442
services, type of health care services, benefits, or type of	5443
benefits to be provided, including copayments and deductibles;	5444

(c) An enrollee's personal financial obligation for	5445
noncovered services;	5446

(d) Where and in what manner general information and	5447
information as to how health care services may be obtained is	5448
available, including a toll-free telephone number;	5449

(e) The premium rate with respect to individual and	5450
conversion contracts, and relevant copayment and deductible	5451
provisions with respect to all contracts. The statement of the	5452
premium rate, however, may be contained in a separate insert.	5453

(f) The method utilized by the health insuring corporation	5454
for resolving enrollee complaints;	5455

(g) The utilization review, internal review, and external	5456
review procedures established under sections 1751.77 to 1751.85 of	5457
the Revised Code.	5458

(3) Unless it provides for the continuation of an enrollee's	5459
coverage, in the event that the enrollee's coverage under the	5460
group policy, contract, certificate, or agreement terminates while	5461
the enrollee is receiving inpatient care in a hospital. This	5462
continuation of coverage shall terminate at the earliest	5463
occurrence of any of the following:	5464

(a) The enrollee's discharge from the hospital;

5465

(b) The determination by the enrollee's attending physician	5466
that inpatient care is no longer medically indicated for the	5467
enrollee; however, nothing in division (D)(3)(b) of this section	5468
precludes a health insuring corporation from engaging in	5469
utilization review as described in the evidence of coverage.	5470

(c) The enrollee's reaching the limit for contractual	5471
benefits;	5472

(d) The effective date of any new coverage.

5473

(4) Unless it contains a provision that states, in substance,	5474
that the health insuring corporation is not a member of any	5475
guaranty fund, and that in the event of the health insuring	5476
corporation's insolvency, an enrollee is protected only to the	5477
extent that the hold harmless provision required by section	5478
1751.13 of the Revised Code applies to the health care services	5479
rendered;	5480

(5) Unless it contains a provision that states, in substance,	5481
that in the event of the insolvency of the health insuring	5482
corporation, an enrollee may be financially responsible for health	5483
care services rendered by a provider or health care facility that	5484
is not under contract to the health insuring corporation, whether	5485
or not the health insuring corporation authorized the use of the	5486
provider or health care facility.	5487

(E) Notwithstanding divisions (C) and (D) of this section, a	5488
health insuring corporation may use an evidence of coverage that	5489
provides for the coverage of beneficiaries enrolled in medicare	5490
pursuant to a medicare contract, or an evidence of coverage that	5491
provides for the coverage of beneficiaries enrolled in the	5492
federal employees health benefits program pursuant to 5 U.S.C.A.	5493
8905, or an evidence of coverage that provides for the coverage	5494
of medicaid recipients, or an evidence of coverage that provides	5495
for coverage of participants of the children's buy-in program, or	5496
an evidence of coverage that provides for the coverage of	5497
beneficiaries under any other federal health care program	5498
regulated by a federal regulatory body, or an evidence of	5499
coverage that provides for the coverage of beneficiaries under	5500
any contract covering officers or employees of the state that has	5501
been entered into by the department of administrative services,	5502
if both of the following apply:	5503

(1) The evidence of coverage has been approved by the United	5504
States department of health and human services, the United States	5505
office of personnel management, the ~~Ohio~~ department of ~~job and~~	5506
~~family services~~health care administration, or the department of	5507
administrative services.	5508

(2) The evidence of coverage is filed with the superintendent	5509
of insurance prior to use and is accompanied by documentation of	5510
approval from the United States department of health and human	5511
services, the United States office of personnel management, the	5512
~~Ohio~~ department of ~~job and family services~~health care	5513
administration, or the department of administrative services.	5514

Sec. 1751.12. (A)(1) No contractual periodic prepayment and	5515
no premium rate for nongroup and conversion policies for health	5516
care services, or any amendment to them, may be used by any health	5517
insuring corporation at any time until the contractual periodic	5518
prepayment and premium rate, or amendment, have been filed with	5519
the superintendent of insurance, and shall not be effective until	5520
the expiration of sixty days after their filing unless the	5521
superintendent sooner gives approval. The filing shall be	5522
accompanied by an actuarial certification in the form prescribed	5523
by the superintendent. The superintendent shall disapprove the	5524
filing, if the superintendent determines within the sixty-day	5525
period that the contractual periodic prepayment or premium rate,	5526
or amendment, is not in accordance with sound actuarial principles	5527
or is not reasonably related to the applicable coverage and	5528
characteristics of the applicable class of enrollees. The	5529
superintendent shall notify the health insuring corporation of the	5530
disapproval, and it shall thereafter be unlawful for the health	5531
insuring corporation to use the contractual periodic prepayment or	5532
premium rate, or amendment.	5533

(2) No contractual periodic prepayment for group policies for	5534
health care services shall be used until the contractual periodic	5535
prepayment has been filed with the superintendent. The filing	5536
shall be accompanied by an actuarial certification in the form	5537
prescribed by the superintendent. The superintendent may reject a	5538
filing made under division (A)(2) of this section at any time,	5539
with at least thirty days' written notice to a health insuring	5540
corporation, if the contractual periodic prepayment is not in	5541
accordance with sound actuarial principles or is not reasonably	5542
related to the applicable coverage and characteristics of the	5543
applicable class of enrollees.	5544

(3) At any time, the superintendent, upon at least thirty	5545
days' written notice to a health insuring corporation, may	5546
withdraw the approval given under division (A)(1) of this section,	5547
deemed or actual, of any contractual periodic prepayment or	5548
premium rate, or amendment, based on information that either of	5549
the following applies:	5550

(a) The contractual periodic prepayment or premium rate, or	5551
amendment, is not in accordance with sound actuarial principles.	5552

(b) The contractual periodic prepayment or premium rate, or	5553
amendment, is not reasonably related to the applicable coverage	5554
and characteristics of the applicable class of enrollees.	5555

(4) Any disapproval under division (A)(1) of this section,	5556
any rejection of a filing made under division (A)(2) of this	5557
section, or any withdrawal of approval under division (A)(3) of	5558
this section, shall be effected by a written notice, which shall	5559
state the specific basis for the disapproval, rejection, or	5560
withdrawal and shall be issued in accordance with Chapter 119. of	5561
the Revised Code.	5562

(B) Notwithstanding division (A) of this section, a health	5563
insuring corporation may use a contractual periodic prepayment or	5564
premium rate for policies used for the coverage of beneficiaries	5565
enrolled in medicare pursuant to a medicare risk contract or	5566
medicare cost contract, or for policies used for the coverage of	5567
beneficiaries enrolled in the federal employees health benefits	5568
program pursuant to 5 U.S.C.A. 8905, or for policies used for the	5569
coverage of medicaid recipients, or for policies used for	5570
coverage of participants of the children's buy-in program, or for	5571
policies used for the coverage of beneficiaries under any other	5572
federal health care program regulated by a federal regulatory	5573
body, or for policies used for the coverage of beneficiaries	5574
under any contract covering officers or employees of the state	5575
that has been entered into by the department of administrative	5576
services, if both of the following apply:	5577

(1) The contractual periodic prepayment or premium rate has	5578
been approved by the United States department of health and human	5579
services, the United States office of personnel management, the	5580
department of ~~job and family services~~health care administration,	5581
or the department of administrative services.	5582

(2) The contractual periodic prepayment or premium rate is	5583
filed with the superintendent prior to use and is accompanied by	5584
documentation of approval from the United States department of	5585
health and human services, the United States office of personnel	5586
management, the department of ~~job and family services~~health care	5587
administration, or the department of administrative services.	5588

(C) The administrative expense portion of all contractual	5589
periodic prepayment or premium rate filings submitted to the	5590
superintendent for review must reflect the actual cost of	5591
administering the product. The superintendent may require that the	5592
administrative expense portion of the filings be itemized and	5593
supported.	5594

(D)(1) Copayments must be reasonable and must not be a	5595
barrier to the necessary utilization of services by enrollees.	5596

(2) A health insuring corporation, in order to ensure that	5597
copayments are reasonable and not a barrier to the necessary	5598
utilization of basic health care services by enrollees, may do one	5599
of the following:	5600

(a) Impose copayment charges on any single covered basic	5601
health care service that does not exceed forty per cent of the	5602
average cost to the health insuring corporation of providing the	5603
service;	5604

(b) Impose copayment charges that annually do not exceed	5605
twenty per cent of the total annual cost to the health insuring	5606
corporation of providing all covered basic health care services,	5607
including physician office visits, urgent care services, and	5608
emergency health services, when aggregated as to all persons	5609
covered under the filed product in question. In addition, annual	5610
copayment charges as to each enrollee shall not exceed twenty per	5611
cent of the total annual cost to the health insuring corporation	5612
of providing all covered basic health care services, including	5613
physician office visits, urgent care services, and emergency	5614
health services, as to such enrollee. The total annual cost of	5615
providing a health care service is the cost to the health insuring	5616
corporation of providing the health care service to its enrollees	5617
as reduced by any applicable provider discount.	5618

(3) To ensure that copayments are reasonable and not a	5619
barrier to the utilization of basic health care services, a health	5620
insuring corporation may not impose, in any contract year, on any	5621
subscriber or enrollee, copayments that exceed two hundred per	5622
cent of the average annual premium rate to subscribers or	5623
enrollees.	5624

(4) For purposes of division (D) of this section, both of the	5625
following apply:	5626

(a) Copayments imposed by health insuring corporations in	5627
connection with a high deductible health plan that is linked to a	5628
health savings account are reasonable and are not a barrier to the	5629
necessary utilization of services by enrollees.	5630

(b) Divisions (D)(2) and (3) of this section do not apply to	5631
a high deductible health plan that is linked to a health savings	5632
account.	5633

(E) A health insuring corporation shall not impose lifetime	5634
maximums on basic health care services. However, a health insuring	5635
corporation may establish a benefit limit for inpatient hospital	5636
services that are provided pursuant to a policy, contract,	5637
certificate, or agreement for supplemental health care services.	5638

(F) A health insuring corporation may require that an	5639
enrollee pay an annual deductible that does not exceed one	5640
thousand dollars per enrollee or two thousand dollars per family,	5641
except that:	5642

(1) A health insuring corporation may impose higher	5643
deductibles for high deductible health plans that are linked to	5644
health savings accounts;	5645

(2) The superintendent may adopt rules allowing different	5646
annual deductible amounts for plans with a medical savings	5647
account, health reimbursement arrangement, flexible spending	5648
account, or similar account;	5649

(3) A health insuring corporation may impose higher	5650
deductibles under health plans if requested by the group contract,	5651
policy, certificate, or agreement holder, or an individual seeking	5652
coverage under an individual health plan. This shall not be	5653
construed as requiring the health insuring corporation to create	5654
customized health plans for group contract holders or individuals.	5655

(G) As used in this section, "health savings account" and	5656
"high deductible health plan" have the same meanings as in the	5657
"Internal Revenue Code of 1986," 100 Stat. 2085, 26 U.S.C. 223, as	5658
amended.	5659

Sec. 1751.18. (A)(1) No health insuring corporation shall	5660
cancel or fail to renew the coverage of a subscriber or enrollee	5661
because of any health status-related factor in relation to the	5662
subscriber or enrollee, the subscriber's or enrollee's	5663
requirements for health care services, or for any other reason	5664
designated under rules adopted by the superintendent of insurance.	5665

(2) Unless otherwise required by state or federal law, no	5666
health insuring corporation, or health care facility or provider	5667
through which the health insuring corporation has made	5668
arrangements to provide health care services, shall discriminate	5669
against any individual with regard to enrollment, disenrollment,	5670
or the quality of health care services rendered, on the basis of	5671
the individual's race, color, sex, age, religion, military status	5672
as defined in section 4112.01 of the Revised Code, or status as a	5673
recipient of medicare or medicaid, or any health status-related	5674
factor in relation to the individual. However, a health insuring	5675
corporation shall not be required to accept a recipient of	5676
medicare or ~~medical assistance~~medicaid, if an agreement has not	5677
been reached on appropriate payment mechanisms between the health	5678
insuring corporation and the governmental agency administering	5679
these programs. Further, except during a period of open	5680
enrollment under section 1751.15 of the Revised Code, a health	5681
insuring corporation may reject an applicant for nongroup	5682
enrollment on the basis of any health status-related factor in	5683
relation to the applicant.	5684

(B) A health insuring corporation may cancel or decide not to	5685
renew the coverage of an enrollee if the enrollee has performed an	5686
act or practice that constitutes fraud or intentional	5687
misrepresentation of material fact under the terms of the coverage	5688
and if the cancellation or nonrenewal is not based, either	5689
directly or indirectly, on any health status-related factor in	5690
relation to the enrollee.	5691

(C) An enrollee may appeal any action or decision of a health	5692
insuring corporation taken pursuant to section 2742(b) to (e) of	5693
the "Health Insurance Portability and Accountability Act of 1996,"	5694
Pub. L. No. 104-191, 110 Stat. 1955, 42 U.S.C.A. 300gg-42, as	5695
amended. To appeal, the enrollee may submit a written complaint	5696
to the health insuring corporation pursuant to section 1751.19 of	5697
the Revised Code. The enrollee may, within thirty days after	5698
receiving a written response from the health insuring corporation,	5699
appeal the health insuring corporation's action or decision to the	5700
superintendent.	5701

(D) As used in this section, "health status-related factor"	5702
means any of the following:	5703

(1) Health status;

5704

(2) Medical condition, including both physical and mental	5705
illnesses;	5706

(3) Claims experience;

5707

(4) Receipt of health care;

5708

(5) Medical history;

5709

(6) Genetic information;

5710

(7) Evidence of insurability, including conditions arising	5711
out of acts of domestic violence;	5712

(8) Disability.

5713

Sec. 1751.271. (A) Each health insuring corporation that	5714
provides coverage to medicaid recipients shall post a performance	5715
bond in the amount of three million dollars as security to fulfill	5716
the obligations of the health insuring corporation to pay claims	5717
of contracted providers for covered health care services provided	5718
to medicaid recipients. The bond shall be payable to the	5719
department of insurance in the event that the health insuring	5720
corporation is placed in rehabilitation or liquidation proceedings	5721
under Chapter 3903. of the Revised Code, and shall become a	5722
special deposit subject to section 3903.14 or 3903.421 of the	5723
Revised Code, as applicable. In lieu of the performance bond, a	5724
medicaid health insuring corporation may deposit securities with	5725
the superintendent of insurance, acceptable to the superintendent,	5726
in the amount of three million dollars, to satisfy the bonding	5727
requirements of this section. Upon rehabilitation or liquidation,	5728
the securities shall become a special deposit subject to sections	5729
3903.14 and 3903.421 of the Revised Code, as applicable. The	5730
health insuring corporation shall receive the interest on the	5731
deposited securities as long as the health insuring corporation	5732
remains solvent.	5733

(B) The bond shall be issued by a surety company licensed	5734
with the department of insurance. The bond or deposit, or any	5735
replacement bond or deposit, shall be in a form acceptable to the	5736
superintendent, and shall remain in effect during the duration of	5737
the medicaid health insuring corporation's license and thereafter	5738
until all claims against the medicaid health insuring corporation	5739
have been paid in full.	5740

(C) Documentation of the bond acceptable to the	5741
superintendent of insurance shall be filed with the superintendent	5742
prior to the issuance of a certificate of authority. Annually,	5743
thirty days prior to the renewal of its certificate of authority,	5744
every medicaid health insuring corporation shall furnish the	5745
superintendent of insurance with evidence that the required bond	5746
is still in effect.	5747

(D) As used in this section:

5748

(1) "Contracted provider" means a provider that has a	5749
contract with a medicaid health insuring corporation to provide	5750
covered health care services to medicaid recipients.	5751

(2) "Medicaid health insuring corporation" means a health	5752
insuring corporation that provides health insurance coverage or	5753
otherwise assumes claims liabilities for medicaid recipients.	5754

(3) "Medicaid recipient" means a person eligible for medical	5755
assistance under the medicaid program ~~operated pursuant to Chapter~~	5756
~~5111. of the Revised Code~~.	5757

Sec. 1751.31. (A) Any changes in a health insuring	5758
corporation's solicitation document shall be filed with the	5759
superintendent of insurance. The superintendent, within sixty days	5760
of filing, may disapprove any solicitation document or amendment	5761
to it on any of the grounds stated in this section. Such	5762
disapproval shall be effected by written notice to the health	5763
insuring corporation. The notice shall state the grounds for	5764
disapproval and shall be issued in accordance with Chapter 119. of	5765
the Revised Code.	5766

(B) The solicitation document shall contain all information	5767
necessary to enable a consumer to make an informed choice as to	5768
whether or not to enroll in the health insuring corporation. The	5769
information shall include a specific description of the health	5770
care services to be available and the approximate number and type	5771
of full-time equivalent medical practitioners. The information	5772
shall be presented in the solicitation document in a manner that	5773
is clear, concise, and intelligible to prospective applicants in	5774
the proposed service area.	5775

(C) Every potential applicant whose subscription to a health	5776
care plan is solicited shall receive, at or before the time of	5777
solicitation, a solicitation document approved by the	5778
superintendent.	5779

(D) Notwithstanding division (A) of this section, a health	5780
insuring corporation may use a solicitation document that the	5781
corporation uses in connection with policies for medicare	5782
beneficiaries pursuant to a medicare risk contract or medicare	5783
cost contract, or for policies for beneficiaries of the federal	5784
employees health benefits program pursuant to 5 U.S.C.A. 8905, or	5785
for policies for medicaid recipients, or for policies for	5786
beneficiaries of any other federal health care program regulated	5787
by a federal regulatory body, or for policies for participants of	5788
the children's buy-in program, or for policies for beneficiaries	5789
of contracts covering officers or employees of the state entered	5790
into by the department of administrative services, if both of the	5791
following apply:	5792

(1) The solicitation document has been approved by the United	5793
States department of health and human services, the United States	5794
office of personnel management, the department of ~~job and family~~	5795
~~services~~health care administration, or the department of	5796
administrative services.	5797

(2) The solicitation document is filed with the	5798
superintendent of insurance prior to use and is accompanied by	5799
documentation of approval from the United States department of	5800
health and human services, the United States office of personnel	5801
management, the department of ~~job and family services~~health care	5802
administration, or the department of administrative services.	5803

(E) No health insuring corporation, or its agents or	5804
representatives, shall use monetary or other valuable	5805
consideration, engage in misleading or deceptive practices, or	5806
make untrue, misleading, or deceptive representations to induce	5807
enrollment. Nothing in this division shall prohibit incentive	5808
forms of remuneration such as commission sales programs for the	5809
health insuring corporation's employees and agents.	5810

(F) Any person obligated for any part of a premium rate in	5811
connection with an enrollment agreement, in addition to any right	5812
otherwise available to revoke an offer, may cancel such agreement	5813
within seventy-two hours after having signed the agreement or	5814
offer to enroll. Cancellation occurs when written notice of the	5815
cancellation is given to the health insuring corporation or its	5816
agents or other representatives. A notice of cancellation mailed	5817
to the health insuring corporation shall be considered to have	5818
been filed on its postmark date.	5819

(G) Nothing in this section shall prohibit healthy lifestyle	5820
programs.	5821

Sec. 1751.60. (A) Except as provided for in divisions (E)	5822
and (F) of this section, every provider or health care facility	5823
that contracts with a health insuring corporation to provide	5824
health care services to the health insuring corporation's	5825
enrollees or subscribers shall seek compensation for covered	5826
services solely from the health insuring corporation and not,	5827
under any circumstances, from the enrollees or subscribers, except	5828
for approved copayments and deductibles.	5829

(B) No subscriber or enrollee of a health insuring	5830
corporation is liable to any contracting provider or health care	5831
facility for the cost of any covered health care services, if the	5832
subscriber or enrollee has acted in accordance with the evidence	5833
of coverage.	5834

(C) Except as provided for in divisions (E) and (F) of this	5835
section, every contract between a health insuring corporation and	5836
provider or health care facility shall contain a provision	5837
approved by the superintendent of insurance requiring the provider	5838
or health care facility to seek compensation solely from the	5839
health insuring corporation and not, under any circumstances, from	5840
the subscriber or enrollee, except for approved copayments and	5841
deductibles.	5842

(D) Nothing in this section shall be construed as preventing	5843
a provider or health care facility from billing the enrollee or	5844
subscriber of a health insuring corporation for noncovered	5845
services.	5846

(E) Upon application by a health insuring corporation and a	5847
provider or health care facility, the superintendent may waive the	5848
requirements of divisions (A) and (C) of this section when, in	5849
addition to the reserve requirements contained in section 1751.28	5850
of the Revised Code, the health insuring corporation provides	5851
sufficient assurances to the superintendent that the provider or	5852
health care facility has been provided with financial guarantees.	5853
No waiver of the requirements of divisions (A) and (C) of this	5854
section is effective as to enrollees or subscribers for whom the	5855
health insuring corporation is compensated under a provider	5856
agreement or risk contract entered into pursuant to Chapter ~~5111.~~	5857
or 5115. or 5168. of the Revised Code or under the children's	5858
buy-in program.	5859

(F) The requirements of divisions (A) to (C) of this section	5860
apply only to health care services provided to an enrollee or	5861
subscriber prior to the effective date of a termination of a	5862
contract between the health insuring corporation and the provider	5863
or health care facility.	5864

Sec. 1751.88. Consistent with the Rules of Evidence, a	5865
written decision or opinion prepared by or for an independent	5866
review organization under section 1751.84 or 1751.85 of the	5867
Revised Code shall be admissible in any civil action related to	5868
the coverage decision that was the subject of the decision or	5869
opinion. The independent review organization's decision or opinion	5870
shall be presumed to be a scientifically valid and accurate	5871
description of the state of medical knowledge at the time it was	5872
written.	5873

Consistent with the Rules of Evidence, any party to a civil	5874
action related to a health insuring corporation's coverage	5875
decision involving an investigational or experimental drug,	5876
device, or treatment may introduce into evidence any applicable	5877
medicare reimbursement standards established under ~~Title XVIII of~~	5878
the ~~"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301,~~	5879
~~as amended~~medicare program.	5880

Sec. 1751.89. Sections 1751.77 to 1751.85 of the Revised	5881
Code do not apply to either of the following:	5882

(A) Coverage provided to beneficiaries enrolled in the	5883
medicare+choice program operated under ~~Title XVIII of the "Social~~	5884
~~Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended~~	5885
the medicare program;	5886

(B) Coverage provided to medicaid recipients;

5887

(C) Coverage provided to participants of the children's	5888
buy-in program.	5889

Sec. 1923.14. (A) Except as otherwise provided in this	5890
section, within ten days after receiving a writ of execution	5891
described in division (A) or (B) of section 1923.13 of the Revised	5892
Code, the sheriff, police officer, constable, or bailiff shall	5893
execute it by restoring the plaintiff to the possession of the	5894
premises, and shall levy and collect the costs and make return, as	5895
upon other executions. If an appeal from the judgment of	5896
restitution is filed and if, following the filing of the appeal, a	5897
stay of execution is obtained and any required bond is filed with	5898
the court of common pleas, municipal court, or county court, the	5899
judge of that court immediately shall issue an order to the	5900
sheriff, police officer, constable, or bailiff commanding the	5901
delay of all further proceedings upon the execution. If the	5902
premises have been restored to the plaintiff, the sheriff, police	5903
officer, constable, or bailiff shall forthwith place the defendant	5904
in possession of them, and return the writ with the sheriff's,	5905
police officer's, constable's, or bailiff's proceedings and the	5906
costs taxed on it.	5907

(B)(1) After a court of common pleas, municipal court, or	5908
county court issues a writ of execution described in division (B)	5909
of section 1923.13 of the Revised Code, the clerk of the court	5910
shall send by regular mail, to the last known address of the	5911
titled owner of the manufactured home, mobile home, or	5912
recreational vehicle that is the subject of the writ and to the	5913
last known address of each other person who is listed on the writ	5914
as having any outstanding right, title, or interest in the home,	5915
vehicle, or personal property and to the auditor and treasurer of	5916
the county in which the court is located, a written notice that	5917
the home or vehicle potentially may be sold, destroyed, or have	5918
its title transferred under the circumstances described in	5919
division (B)(3) or (4) of this section.	5920

(2) Except as otherwise provided in this division, after	5921
receiving a writ of execution described in division (B) of	5922
section 1923.13 of the Revised Code, and after causing the	5923
defendant to be removed from the residential premises of the	5924
manufactured home park, if necessary, in accordance with the writ,	5925
the sheriff, police officer, constable, or bailiff may cause the	5926
manufactured home, mobile home, or recreational vehicle that is	5927
the subject of the writ, and all personal property on the	5928
residential premises, at the sheriff's, police officer's,	5929
constable's, or bailiff's option, either to be removed from the	5930
manufactured home park and, if necessary, moved to a storage	5931
facility of the sheriff's, police officer's, constable's, or	5932
bailiff's choice, or to be retained at their current location on	5933
the residential premises, until they are claimed by the defendant	5934
or they are disposed of in a manner authorized by division (B)(3),	5935
(4), or (6) of this section or by another section of the Revised	5936
Code. The sheriff, police officer, constable, or bailiff shall	5937
not cause the manufactured home, mobile home, or recreational	5938
vehicle that is the subject of the writ, or the personal	5939
property, to be removed from the manufactured home park or moved	5940
to a storage facility if the holder of any outstanding lien,	5941
right, title, or interest in the home or vehicle, other than the	5942
titled owner of the home or vehicle, meets the conditions set	5943
forth in division (B)(6) or (7) of this section.	5944

The sheriff, police officer, constable, or bailiff who	5945
removes the manufactured home, mobile home, or recreational	5946
vehicle, or the abandoned personal property, from the residential	5947
premises shall be immune from civil liability pursuant to section	5948
2744.03 of the Revised Code for any damage caused to the home,	5949
vehicle, or any personal property during the removal. The park	5950
operator shall not be liable for any damage caused by the park	5951
operator's removal of the manufactured home, mobile home, or	5952
recreational vehicle or the removal of the personal property	5953
from the residential premises, or for any damage to the home,	5954
vehicle, or personal property during the time the home, vehicle,	5955
or property remains abandoned or stored in the manufactured home	5956
park, unless the damage is the result of acts that the park	5957
operator or the park operator's agents or employees performed	5958
with malicious purpose, in bad faith, or in a wanton or reckless	5959
manner. The reasonable costs for a removal of the manufactured	5960
home, mobile home, or recreational vehicle and personal property	5961
and, as applicable, the reasonable costs for its storage shall	5962
constitute a lien upon the home or vehicle payable by the titled	5963
owner of the home or vehicle or payable pursuant to division	5964
(B)(3) of this section.	5965

(3) Except as provided in divisions (B)(4), (5), and (6) of	5966
this section and division (D) of section 1923.12 of the Revised	5967
Code, within sixty days after receiving a writ of execution	5968
described in division (B) of section 1923.13 of the Revised Code,	5969
the sheriff, police officer, constable, or bailiff shall commence	5970
proceedings for the sale of the manufactured home, mobile home, or	5971
recreational vehicle that is the subject of the writ, and the	5972
abandoned personal property on the residential premises, if the	5973
home or vehicle is determined to be abandoned in accordance with	5974
the procedures for the sale of goods on execution under Chapter	5975
2329. of the Revised Code. In addition to all notices required to	5976
be given under section 2329.13 of the Revised Code, the sheriff,	5977
police officer, constable, or bailiff shall serve at their	5978
respective last known addresses a written notice of the date,	5979
time, and place of the sale upon all persons who are listed on the	5980
writ of execution as having any outstanding right, title, or	5981
interest in the abandoned manufactured home, mobile home, or	5982
recreational vehicle and the personal property and shall provide	5983
written notice to the auditor and the treasurer of the county in	5984
which the court issuing the writ is located.	5985

Unless the proceedings are governed by division (D) of	5986
section 1923.12 of the Revised Code, notwithstanding any	5987
statutory provision to the contrary, including, but not limited	5988
to, section 2329.66 of the Revised Code, there shall be no stay of	5989
execution or exemption from levy or sale on execution available to	5990
the titled owner of the abandoned manufactured home, mobile home,	5991
or recreational vehicle in relation to a sale under this division.	5992
Except as otherwise provided in sections 2113.031, 2117.25, and	5993
~~5111.11~~5162.40 of the Revised Code in a case involving a	5994
deceased resident or resident's estate, the sheriff, police	5995
officer, constable, or bailiff shall distribute the proceeds	5996
from the sale of an abandoned manufactured home, mobile home, or	5997
recreational vehicle and any personal property under this	5998
division in the following manner:	5999

(a) The sheriff, police officer, constable, or bailiff shall	6000
first pay the costs for any moving of and any storage outside the	6001
manufactured home park of the home or vehicle and any personal	6002
property pursuant to division (B)(2) of this section, the costs of	6003
the sale, including reimbursing the park operator for the deposit	6004
that the park operator paid to the clerk of court under division	6005
(C) of section 1923.12 of the Revised Code, and any unpaid court	6006
costs assessed against the defendant in the underlying action.	6007

(b) Following the payment required by division (B)(3)(a) of	6008
this section, the sheriff, police officer, constable, or bailiff	6009
shall pay all outstanding tax liens on the home or vehicle.	6010

(c) Following the payment required by division (B)(3)(b) of	6011
this section, the sheriff, police officer, constable, or bailiff	6012
shall pay all other outstanding security interests, liens, or	6013
encumbrances on the home or vehicle by priority of filing or other	6014
priority.	6015

(d) Following the payment required by division (B)(3)(c) of	6016
this section, the sheriff, police officer, constable, or bailiff	6017
shall pay any outstanding monetary judgment rendered under section	6018
1923.09 or 1923.11 of the Revised Code in favor of the plaintiff	6019
and any costs associated with retaining the home or vehicle prior	6020
to the sale at its location on the residential premises within the	6021
manufactured home park pursuant to division (B)(2) of this	6022
section.	6023

(e) After complying with divisions (B)(3)(a) to (d) of this	6024
section, the sheriff, police officer, constable, or bailiff shall	6025
report any remaining money as unclaimed funds pursuant to Chapter	6026
169. of the Revised Code.	6027

Upon the return of any writ of execution for the satisfaction	6028
of which an abandoned manufactured home, mobile home, or	6029
recreational vehicle has been sold under this division, on careful	6030
examination of the proceedings of the sheriff, police officer,	6031
constable, or bailiff conducting the sale, if the court that	6032
issued the writ finds that the sale was made, in all respects, in	6033
conformity with the relevant provisions of Chapter 2329. of the	6034
Revised Code and with this division, it shall direct the clerk of	6035
the court to make an entry on the journal that the court is	6036
satisfied with the legality of the sale and the court shall direct	6037
the clerk of the court of common pleas of the county in which the	6038
writ was issued to issue a certificate of title, free and clear of	6039
all security interests, liens, and encumbrances, to the purchaser	6040
of the home or vehicle. The clerk of the court of common pleas	6041
shall issue the new certificate of title to the purchaser of the	6042
home or vehicle regardless of whether the writ was issued by the	6043
court of common pleas or another court duly authorized to issue	6044
the writ. If the manufactured home, mobile home, or recreational	6045
vehicle sold under this division is located in a manufactured home	6046
park, the purchaser of the home or vehicle shall have no right to	6047
maintain the home or vehicle in the manufactured home park without	6048
the park operator's consent and the sheriff, police officer,	6049
constable, or bailiff conducting the sale shall notify all	6050
prospective purchasers of this fact prior to the commencement of	6051
the sale.	6052

If, after it is offered for sale on two occasions under this	6053
division, the abandoned manufactured home, mobile home, or	6054
recreational vehicle cannot be sold due to a want of bidders, the	6055
sheriff, police officer, constable, or bailiff shall present the	6056
writ of execution unsatisfied to the clerk of the court of common	6057
pleas of the county in which the writ was issued for the issuance	6058
by the clerk in the manner prescribed in section 4505.10 of the	6059
Revised Code of a certificate of title transferring the title of	6060
the home or vehicle to the plaintiff, free and clear of all	6061
security interests, liens, and encumbrances. The clerk of the	6062
court of common pleas shall issue the new certificate of title	6063
transferring the title of the manufactured home, mobile home, or	6064
recreational vehicle to the plaintiff regardless of whether the	6065
writ was issued by the court of common pleas or another court duly	6066
authorized to issue the writ. If any taxes are owed on the home or	6067
vehicle at this time, the county auditor shall remove the	6068
delinquent taxes from the manufactured home tax list and the	6069
delinquent manufactured home tax list and remit any penalties for	6070
late payment of manufactured home taxes. Acceptance of the	6071
certificate of title by the plaintiff terminates all further	6072
proceedings under this section.	6073

(4) Except as provided in division (B)(5) or (6) of this	6074
section and division (D) of section 1923.12 of the Revised Code,	6075
within sixty days after receiving a writ of execution described in	6076
division (B) of section 1923.13 of the Revised Code, if the	6077
manufactured home, mobile home, or recreational vehicle is	6078
determined to be abandoned and to have a value of less than three	6079
thousand dollars, the sheriff, police officer, constable, or	6080
bailiff shall serve at their respective last known addresses a	6081
written notice of potential action as described in this division	6082
upon all persons who are listed on the writ as having any	6083
outstanding right, title, or interest in the home or vehicle. This	6084
notice shall be in addition to all notices required to be given	6085
under section 2329.13 of the Revised Code. Subject to the	6086
fulfillment of these notice requirements, the sheriff, police	6087
officer, constable, or bailiff shall take one of the following	6088
actions with respect to the abandoned manufactured home, mobile	6089
home, or recreational vehicle:	6090

(a) Cause its destruction if there is no person having an	6091
outstanding right, title, or interest in the home or vehicle,	6092
other than the titled owner of the home or vehicle;	6093

(b) Proceed with its sale under division (B)(3) of this	6094
section;	6095

(c) If there is no person having an outstanding right, title,	6096
or interest in the home or vehicle other than the titled owner of	6097
the home or vehicle, or if there is an outstanding right, title,	6098
or interest in the home or vehicle and the lienholder consents in	6099
writing, present the writ of execution to the clerk of the court	6100
of common pleas of the county in which the writ was issued for	6101
the issuance by the clerk in the manner prescribed in section	6102
4505.10 of the Revised Code of a certificate of title	6103
transferring the title of the home or vehicle to the plaintiff,	6104
free and clear of all security interests, liens, and encumbrances.	6105
The clerk of the court of common pleas shall issue the new	6106
certificate of title transferring the title of the home or vehicle	6107
regardless of whether the writ was issued by the court of common	6108
pleas or another court duly authorized to issue the writ. If any	6109
taxes are owed on the home or vehicle at this time, the county	6110
auditor shall remove the delinquent taxes from the manufactured	6111
home tax list and the delinquent manufactured home tax list and	6112
remit any penalties for late payment of manufactured home taxes.	6113
Acceptance of the certificate of title by the plaintiff terminates	6114
all further proceedings under this section.	6115

(5) At any time prior to the issuance of the writ of	6116
execution described in division (B) of section 1923.13 of the	6117
Revised Code, the titled owner of the manufactured home, mobile	6118
home, or recreational vehicle that would be the subject of the	6119
writ may remove the abandoned home or vehicle from the	6120
manufactured home park or other place of storage upon payment to	6121
the county auditor of all outstanding tax liens on the home or	6122
vehicle and, unless the owner is indigent, payment to the clerk of	6123
court of all unpaid court costs assessed against the defendant in	6124
the underlying action. After the issuance of the writ of	6125
execution, the titled owner of the home or vehicle may remove the	6126
abandoned home or vehicle from the manufactured home park or other	6127
place of storage at any time up to the day before the scheduled	6128
sale, destruction, or transfer of the home or vehicle pursuant to	6129
division (B)(3) or (4) of this section upon payment of all of the	6130
following:	6131

(a) All costs for moving and storage of the home or vehicle	6132
pursuant to division (B)(2) of this section and all costs incurred	6133
by the sheriff, police officer, constable, or bailiff up to and	6134
including the date of the removal of the home or vehicle;	6135

(b) All outstanding tax liens on the home or vehicle;

6136

(c) Unless the owner is indigent, all unpaid court costs	6137
assessed against the defendant in the underlying action.	6138

(6) At any time after the issuance of the writ of execution	6139
described in division (B) of section 1923.13 of the Revised Code,	6140
the holder of any outstanding lien, right, title, or interest in	6141
the manufactured home, mobile home, or recreational vehicle, other	6142
than the titled owner of the home or vehicle, may stop the	6143
sheriff, police officer, constable, or bailiff from proceeding	6144
with the sale under this division by doing both of the following:	6145

(a) Commencing a proceeding to repossess the home or vehicle	6146
pursuant to Chapters 1309. and 1317. of the Revised Code;	6147

(b) Paying to the park operator all monthly rental payments	6148
for the lot on which the home or vehicle is located from the time	6149
of the issuance of the writ of execution until the time that the	6150
home or vehicle is sold pursuant to Chapters 1309. and 1317. of	6151
the Revised Code.	6152

(7)(a) At any time prior to the day before the scheduled sale	6153
of the property pursuant to division (B)(3) of this section, the	6154
defendant may remove any personal property of the defendant from	6155
the abandoned home or vehicle or other place of storage.	6156

(b) If personal property owned by a person other than the	6157
defendant is abandoned on the residential premises and has not	6158
previously been removed, the owner of the personal property may	6159
remove the personal property from the abandoned home or vehicle or	6160
other place of storage up to the day before the scheduled sale of	6161
the property pursuant to division (B)(3) of this section upon	6162
presentation of proof of ownership of the property that is	6163
satisfactory to the sheriff, police officer, constable, or bailiff	6164
conducting the sale.	6165

Sec. 2113.041. (A) The administrator of the medicaid estate	6166
recovery program established pursuant to section ~~5111.11~~5162.40	6167
of the Revised Code may present an affidavit to a financial	6168
institution requesting that the financial institution release	6169
account proceeds to recover the cost of services correctly	6170
provided to a medicaid recipient who is subject to the medicaid	6171
estate recovery program. The affidavit shall include all of the	6172
following information:	6173

(1) The name of the decedent;

6174

(2) The name of any person who gave notice that the decedent	6175
was a medicaid recipient and that person's relationship to the	6176
decedent;	6177

(3) The name of the financial institution;

6178

(4) The account number;

6179

(5) A description of the claim for estate recovery;

6180

(6) The amount of funds to be recovered.

6181

(B) A financial institution may release account proceeds to	6182
the administrator of the medicaid estate recovery program if all	6183
of the following apply:	6184

(1) The decedent held an account at the financial	6185
institution that was in the decedent's name only.	6186

(2) No estate has been, and it is reasonable to assume that	6187
no estate will be, opened for the decedent.	6188

(3) The decedent has no outstanding debts known to the	6189
administrator of the medicaid estate recovery program.	6190

(4) The financial institution has received no objections or	6191
has determined that no valid objections to release of proceeds	6192
have been received.	6193

(C) If proceeds have been released pursuant to division (B)	6194
of this section and the department of ~~job and family services~~	6195
health care administration receives notice of a valid claim to	6196
the proceeds that has a higher priority under section 2117.25 of	6197
the Revised Code than the claim of the medicaid estate recovery	6198
program, the department may refund the proceeds to the financial	6199
institution or pay them to the person or government entity with	6200
the claim.	6201

Sec. 2113.06. Administration of the estate of an intestate	6202
shall be granted to persons mentioned in this section, in the	6203
following order:	6204

(A) To the surviving spouse of the deceased, if resident of	6205
the state;	6206

(B) To one of the next of kin of the deceased, resident of	6207
the state.	6208

If the persons entitled to administer the estate fail to take	6209
or renounce administration voluntarily, they shall be cited by the	6210
probate court for that purpose.	6211

If there are no persons entitled to administration, or if	6212
they are for any reason unsuitable for the discharge of the trust,	6213
or if without sufficient cause they neglect to apply within a	6214
reasonable time for the administration of the estate, their right	6215
to priority shall be lost, and the court shall commit the	6216
administration to some suitable person who is a resident of the	6217
state, or to the attorney general or the attorney general's	6218
designee, if the department of ~~job and family services~~health care	6219
administration is seeking to recover ~~medical assistance~~medicaid	6220
costs from the deceased pursuant to section ~~5111.11~~5162.40 or	6221
~~5111.111~~5162.41 of the Revised Code. Such person may be a	6222
creditor of the estate.	6223

This section applies to the appointment of an administrator	6224
de bonis non.	6225

Sec. 2117.061. (A) As used in this section:

6226

(1) "Medicaid estate recovery program" means the program	6227
instituted under section ~~5111.11~~5162.40 of the Revised Code.	6228

(2) "Permanently institutionalized individual" has the same	6229
meaning as in section ~~5111.11~~5162.40 of the Revised Code.	6230

(3) "Person responsible for the estate" means the executor,	6231
administrator, commissioner, or person who filed pursuant to	6232
section 2113.03 of the Revised Code for release from	6233
administration of an estate.	6234

(B) The person responsible for the estate of a decedent	6235
subject to the medicaid estate recovery program or the estate of	6236
a decedent who was the spouse of a decedent subject to the	6237
medicaid estate recovery program shall submit a properly	6238
completed medicaid estate recovery reporting form prescribed	6239
under division (D) of this section to the administrator of the	6240
medicaid estate recovery program not later than thirty days after	6241
the occurrence of any of the following:	6242

(1) The granting of letters testamentary;

6243

(2) The administration of the estate;

6244

(3) The filing of an application for release from	6245
administration or summary release from administration.	6246

(C) The person responsible for the estate shall mark the	6247
appropriate box on the appropriate probate form to indicate	6248
compliance with the requirements of division (B) of this section.	6249

The probate court shall send a copy of the completed probate	6250
form to the administrator of the medicaid estate recovery program.	6251

(D) The administrator of the medicaid estate recovery program	6252
shall prescribe a medicaid estate recovery reporting form for the	6253
purpose of division (B) of this section. In the case of a	6254
decedent subject to the medicaid estate recovery program, the form	6255
shall require, at a minimum, that the person responsible for the	6256
estate list all of the decedent's real and personal property and	6257
other assets that are part of the decedent's estate as defined in	6258
section ~~5111.11~~5162.40 of the Revised Code. In the case of a	6259
decedent who was the spouse of a decedent subject to the medicaid	6260
estate recovery program, the form shall require, at a minimum,	6261
that the person responsible for the estate list all of the	6262
decedent's real and personal property and other assets that are	6263
part of the decedent's estate as defined in section ~~5111.11~~	6264
5162.40 of the Revised Code and were also part of the estate, as	6265
so defined, of the decedent subject to the medicaid estate	6266
recovery program. The administrator shall include on the form a	6267
statement printed in bold letters informing the person	6268
responsible for the estate that knowingly making a false	6269
statement on the form is falsification under section 2921.13 of	6270
the Revised Code, a misdemeanor of the first degree.	6271

(E) The administrator of the medicaid estate recovery	6272
program shall present a claim for estate recovery to the person	6273
responsible for the estate of the decedent or the person's legal	6274
representative not later than ninety days after the date on which	6275
the medicaid estate recovery reporting form is received under	6276
division (B) of this section or one year after the decedent's	6277
death, whichever is later.	6278

Sec. 2117.25. (A) Every executor or administrator shall	6279
proceed with diligence to pay the debts of the decedent and shall	6280
apply the assets in the following order:	6281

(1) Costs and expenses of administration;

6282

(2) An amount, not exceeding four thousand dollars, for	6283
funeral expenses that are included in the bill of a funeral	6284
director, funeral expenses other than those in the bill of a	6285
funeral director that are approved by the probate court, and an	6286
amount, not exceeding three thousand dollars, for burial and	6287
cemetery expenses, including that portion of the funeral	6288
director's bill allocated to cemetery expenses that have been paid	6289
to the cemetery by the funeral director.	6290

For purposes of this division, burial and cemetery expenses	6291
shall be limited to the following:	6292

(a) The purchase of a right of interment;

6293

(b) Monuments or other markers;

6294

6295

(d) The cost of opening and closing the place of interment;

6296

(e) The urn.

6297

(3) The allowance for support made to the surviving spouse,	6298
minor children, or both under section 2106.13 of the Revised Code;	6299

(4) Debts entitled to a preference under the laws of the	6300
United States;	6301

(5) Expenses of the last sickness of the decedent;

6302

(6) If the total bill of a funeral director for funeral	6303
expenses exceeds four thousand dollars, then, in addition to the	6304
amount described in division (A)(2) of this section, an amount,	6305
not exceeding two thousand dollars, for funeral expenses that are	6306
included in the bill and that exceed four thousand dollars;	6307

(7) Personal property taxes, claims made under the medicaid	6308
estate recovery program instituted pursuant to section ~~5111.11~~	6309
5162.40 of the Revised Code, and obligations for which the	6310
decedent was personally liable to the state or any of its	6311
subdivisions;	6312

(8) Debts for manual labor performed for the decedent within	6313
twelve months preceding the decedent's death, not exceeding three	6314
hundred dollars to any one person;	6315

(9) Other debts for which claims have been presented and	6316
finally allowed.	6317

(B) The part of the bill of a funeral director that exceeds	6318
the total of six thousand dollars as described in divisions (A)(2)	6319
and (6) of this section, and the part of a claim included in	6320
division (A)(8) of this section that exceeds three hundred dollars	6321
shall be included as a debt under division (A)(9) of this section,	6322
depending upon the time when the claim for the additional amount	6323
is presented.	6324

(C) Any natural person or fiduciary who pays a claim of any	6325
creditor described in division (A) of this section shall be	6326
subrogated to the rights of that creditor proportionate to the	6327
amount of the payment and shall be entitled to reimbursement for	6328
that amount in accordance with the priority of payments set forth	6329
in that division.	6330

(D)(1) Chapters 2113. to 2125. of the Revised Code, relating	6331
to the manner in which and the time within which claims shall be	6332
presented, shall apply to claims set forth in divisions (A)(2),	6333
(6), and (8) of this section. Claims for an expense of	6334
administration or for the allowance for support need not be	6335
presented. The executor or administrator shall pay debts included	6336
in divisions (A)(4) and (7) of this section, of which the executor	6337
or administrator has knowledge, regardless of presentation.	6338

(2) The giving of written notice to an executor or	6339
administrator of a motion or application to revive an action	6340
pending against the decedent at the date of death shall be	6341
equivalent to the presentation of a claim to the executor or	6342
administrator for the purpose of determining the order of payment	6343
of any judgment rendered or decree entered in such an action.	6344

(E) No payments shall be made to creditors of one class until	6345
all those of the preceding class are fully paid or provided for.	6346
If the assets are insufficient to pay all the claims of one class,	6347
the creditors of that class shall be paid ratably.	6348

(F) If it appears at any time that the assets have been	6349
exhausted in paying prior or preferred charges, allowances, or	6350
claims, those payments shall be a bar to an action on any claim	6351
not entitled to that priority or preference.	6352

Sec. 2133.01. Unless the context otherwise requires, as used	6353
in sections 2133.01 to 2133.15 of the Revised Code:	6354

(A) "Adult" means an individual who is eighteen years of age	6355
or older.	6356

(B) "Attending physician" means the physician to whom a	6357
declarant or other patient, or the family of a declarant or other	6358
patient, has assigned primary responsibility for the treatment or	6359
care of the declarant or other patient, or, if the responsibility	6360
has not been assigned, the physician who has accepted that	6361
responsibility.	6362

6363

(1) Nutrition when administered to diminish the pain or	6364
discomfort of a declarant or other patient, but not to postpone	6365
the declarant's or other patient's death;	6366

(2) Hydration when administered to diminish the pain or	6367
discomfort of a declarant or other patient, but not to postpone	6368
the declarant's or other patient's death;	6369

(3) Any other medical or nursing procedure, treatment,	6370
intervention, or other measure that is taken to diminish the pain	6371
or discomfort of a declarant or other patient, but not to postpone	6372
the declarant's or other patient's death.	6373

(D) "Consulting physician" means a physician who, in	6374
conjunction with the attending physician of a declarant or other	6375
patient, makes one or more determinations that are required to be	6376
made by the attending physician, or to be made by the attending	6377
physician and one other physician, by an applicable provision of	6378
this chapter, to a reasonable degree of medical certainty and in	6379
accordance with reasonable medical standards.	6380

(E) "Declarant" means any adult who has executed a	6381
declaration in accordance with section 2133.02 of the Revised	6382
Code.	6383

(F) "Declaration" means a written document executed in	6384
accordance with section 2133.02 of the Revised Code.	6385

(G) "Durable power of attorney for health care" means a	6386
document created pursuant to sections 1337.11 to 1337.17 of the	6387
Revised Code.	6388

(H) "Guardian" means a person appointed by a probate court	6389
pursuant to Chapter 2111. of the Revised Code to have the care and	6390
management of the person of an incompetent.	6391

(I) "Health care facility" means any of the following:

6392

(1) A hospital;

6393

(2) A hospice care program or other institution that	6394
specializes in comfort care of patients in a terminal condition or	6395
in a permanently unconscious state;	6396

(3) A nursing home or residential care facility, as defined	6397
in section 3721.01 of the Revised Code;	6398

(4) A home health agency and any residential facility where a	6399
person is receiving care under the direction of a home health	6400
agency;	6401

(5) An intermediate care facility for the mentally retarded.

6402

(J) "Health care personnel" means physicians, nurses,	6403
physician assistants, emergency medical technicians-basic,	6404
emergency medical technicians-intermediate, emergency medical	6405
technicians-paramedic, medical technicians, dietitians, other	6406
authorized persons acting under the direction of an attending	6407
physician, and administrators of health care facilities.	6408

(K) "Home health agency" has the same meaning as in section	6409
3701.881 of the Revised Code.	6410

(L) "Hospice care program" has the same meaning as in section	6411
3712.01 of the Revised Code.	6412

(M) "Hospital" has the same meanings as in sections 3701.01,	6413
3727.01, and 5122.01 of the Revised Code.	6414

(N) "Hydration" means fluids that are artificially or	6415
technologically administered.	6416

(O) "Incompetent" has the same meaning as in section 2111.01	6417
of the Revised Code.	6418

(P) "Intermediate care facility for the mentally retarded"	6419
has the same meaning as in section ~~5111.20~~5164.01 of the Revised	6420
Code.	6421

(Q) "Life-sustaining treatment" means any medical procedure,	6422
treatment, intervention, or other measure that, when administered	6423
to a qualified patient or other patient, will serve principally to	6424
prolong the process of dying.	6425

(R) "Nurse" means a person who is licensed to practice	6426
nursing as a registered nurse or to practice practical nursing as	6427
a licensed practical nurse pursuant to Chapter 4723. of the	6428
Revised Code.	6429

(S) "Nursing home" has the same meaning as in section 3721.01	6430
of the Revised Code.	6431

(T) "Nutrition" means sustenance that is artificially or	6432
technologically administered.	6433

(U) "Permanently unconscious state" means a state of	6434
permanent unconsciousness in a declarant or other patient that, to	6435
a reasonable degree of medical certainty as determined in	6436
accordance with reasonable medical standards by the declarant's or	6437
other patient's attending physician and one other physician who	6438
has examined the declarant or other patient, is characterized by	6439
both of the following:	6440

(1) Irreversible unawareness of one's being and environment.

6441

(2) Total loss of cerebral cortical functioning, resulting in	6442
the declarant or other patient having no capacity to experience	6443
pain or suffering.	6444

(V) "Person" has the same meaning as in section 1.59 of the	6445
Revised Code and additionally includes political subdivisions and	6446
governmental agencies, boards, commissions, departments,	6447
institutions, offices, and other instrumentalities.	6448

(W) "Physician" means a person who is authorized under	6449
Chapter 4731. of the Revised Code to practice medicine and surgery	6450
or osteopathic medicine and surgery.	6451

(X) "Political subdivision" and "state" have the same	6452
meanings as in section 2744.01 of the Revised Code.	6453

(Y) "Professional disciplinary action" means action taken by	6454
the board or other entity that regulates the professional conduct	6455
of health care personnel, including the state medical board and	6456
the board of nursing.	6457

(Z) "Qualified patient" means an adult who has executed a	6458
declaration and has been determined to be in a terminal condition	6459
or in a permanently unconscious state.	6460

(AA) "Terminal condition" means an irreversible, incurable,	6461
and untreatable condition caused by disease, illness, or injury	6462
from which, to a reasonable degree of medical certainty as	6463
determined in accordance with reasonable medical standards by a	6464
declarant's or other patient's attending physician and one other	6465
physician who has examined the declarant or other patient, both of	6466
the following apply:	6467

(1) There can be no recovery.

6468

(2) Death is likely to occur within a relatively short time	6469
if life-sustaining treatment is not administered.	6470

(BB) "Tort action" means a civil action for damages for	6471
injury, death, or loss to person or property, other than a civil	6472
action for damages for breach of a contract or another agreement	6473
between persons.	6474

Sec. 2151.3514. (A) As used in this section:

6475

(1) "Alcohol and drug addiction program" has the same meaning	6476
as in section 3793.01 of the Revised Code;	6477

(2) "Chemical dependency" means either of the following:

6478

(a) The chronic and habitual use of alcoholic beverages to	6479
the extent that the user no longer can control the use of alcohol	6480
or endangers the user's health, safety, or welfare or that of	6481
others;	6482

(b) The use of a drug of abuse to the extent that the user	6483
becomes physically or psychologically dependent on the drug or	6484
endangers the user's health, safety, or welfare or that of others.	6485

(3) "Drug of abuse" has the same meaning as in section	6486
3719.011 of the Revised Code.	6487

~~(4) "Medicaid" means the program established under Chapter~~	6488
~~5111. of the Revised Code.~~	6489

(B) If the juvenile court issues an order of temporary	6490
custody or protective supervision under division (A) of section	6491
2151.353 of the Revised Code with respect to a child adjudicated	6492
to be an abused, neglected, or dependent child and the alcohol or	6493
other drug addiction of a parent or other caregiver of the child	6494
was the basis for the adjudication of abuse, neglect, or	6495
dependency, the court shall issue an order requiring the parent or	6496
other caregiver to submit to an assessment and, if needed,	6497
treatment from an alcohol and drug addiction program certified by	6498
the department of alcohol and drug addiction services. The court	6499
may order the parent or other caregiver to submit to alcohol or	6500
other drug testing during, after, or both during and after, the	6501
treatment. The court shall send any order issued pursuant to this	6502
division to the public children services agency that serves the	6503
county in which the court is located for use as described in	6504
section 340.15 of the Revised Code.	6505

(C) Any order requiring alcohol or other drug testing that is	6506
issued pursuant to division (B) of this section shall require one	6507
alcohol or other drug test to be conducted each month during a	6508
period of twelve consecutive months beginning the month	6509
immediately following the month in which the order for alcohol or	6510
other drug testing is issued. Arrangements for administering the	6511
alcohol or other drug tests, as well as funding the costs of the	6512
tests, shall be locally determined in accordance with sections	6513
340.033 and 340.15 of the Revised Code. If a parent or other	6514
caregiver required to submit to alcohol or other drug tests under	6515
this section is not a recipient of medicaid, the agency that	6516
refers the parent or caregiver for the tests may require the	6517
parent or caregiver to reimburse the agency for the cost of	6518
conducting the tests.	6519

(D) The certified alcohol and drug addiction program that	6520
conducts any alcohol or other drug tests ordered in accordance	6521
with divisions (B) and (C) of this section shall send the results	6522
of the tests, along with the program's recommendations as to the	6523
benefits of continued treatment, to the court and to the public	6524
children services agency providing services to the involved	6525
family, according to federal regulations set forth in 42 C.F.R.	6526
Part 2, and division (B) of section 340.15 of the Revised Code.	6527
The court shall consider the results and the recommendations sent	6528
to it under this division in any adjudication or review by the	6529
court, according to section 2151.353, 2151.414, or 2151.419 of the	6530
Revised Code.	6531

Sec. 2305.234. (A) As used in this section:

6532

(1) "Chiropractic claim," "medical claim," and "optometric	6533
claim" have the same meanings as in section 2305.113 of the	6534
Revised Code.	6535

(2) "Dental claim" has the same meaning as in section	6536
2305.113 of the Revised Code, except that it does not include any	6537
claim arising out of a dental operation or any derivative claim	6538
for relief that arises out of a dental operation.	6539

(3) "Governmental health care program" has the same meaning	6540
as in section 4731.65 of the Revised Code.	6541

(4) "Health care facility or location" means a hospital,	6542
clinic, ambulatory surgical facility, office of a health care	6543
professional or associated group of health care professionals,	6544
training institution for health care professionals, or any other	6545
place where medical, dental, or other health-related diagnosis,	6546
care, or treatment is provided to a person.	6547

(5) "Health care professional" means any of the following who	6548
provide medical, dental, or other health-related diagnosis, care,	6549
or treatment:	6550

(a) Physicians authorized under Chapter 4731. of the Revised	6551
Code to practice medicine and surgery or osteopathic medicine and	6552
surgery;	6553

(b) Registered nurses and licensed practical nurses licensed	6554
under Chapter 4723. of the Revised Code and individuals who hold a	6555
certificate of authority issued under that chapter that authorizes	6556
the practice of nursing as a certified registered nurse	6557
anesthetist, clinical nurse specialist, certified nurse-midwife,	6558
or certified nurse practitioner;	6559

(c) Physician assistants authorized to practice under Chapter	6560
4730. of the Revised Code;	6561

(d) Dentists and dental hygienists licensed under Chapter	6562
4715. of the Revised Code;	6563

(e) Physical therapists, physical therapist assistants,	6564
occupational therapists, and occupational therapy assistants	6565
licensed under Chapter 4755. of the Revised Code;	6566

(f) Chiropractors licensed under Chapter 4734. of the Revised	6567
Code;	6568

(g) Optometrists licensed under Chapter 4725. of the Revised	6569
Code;	6570

(h) Podiatrists authorized under Chapter 4731. of the Revised	6571
Code to practice podiatry;	6572

(i) Dietitians licensed under Chapter 4759. of the Revised	6573
Code;	6574

(j) Pharmacists licensed under Chapter 4729. of the Revised	6575
Code;	6576

(k) Emergency medical technicians-basic, emergency medical	6577
technicians-intermediate, and emergency medical	6578
technicians-paramedic, certified under Chapter 4765. of the	6579
Revised Code;	6580

(l) Respiratory care professionals licensed under Chapter	6581
4761. of the Revised Code;	6582

(m) Speech-language pathologists and audiologists licensed	6583
under Chapter 4753. of the Revised Code.	6584

(6) "Health care worker" means a person other than a health	6585
care professional who provides medical, dental, or other	6586
health-related care or treatment under the direction of a health	6587
care professional with the authority to direct that individual's	6588
activities, including medical technicians, medical assistants,	6589
dental assistants, orderlies, aides, and individuals acting in	6590
similar capacities.	6591

(7) "Indigent and uninsured person" means a person who meets	6592
all of the following requirements:	6593

(a) The person's income is not greater than two hundred per	6594
cent of the current poverty line as defined by the United States	6595
office of management and budget and revised in accordance with	6596
section 673(2) of the "Omnibus Budget Reconciliation Act of 1981,"	6597
95 Stat. 511, 42 U.S.C. 9902, as amended.	6598

(b) The person is ~~not eligible to receive medical assistance~~	6599
~~under Chapter 5111.~~ineligible for the medicaid program, the	6600
disability medical assistance ~~under Chapter 5115. of the Revised~~	6601
~~Code or~~program, and assistance under any other governmental	6602
health care program.	6603

6604

(i) The person is not a policyholder, certificate holder,	6605
insured, contract holder, subscriber, enrollee, member,	6606
beneficiary, or other covered individual under a health insurance	6607
or health care policy, contract, or plan.	6608

(ii) The person is a policyholder, certificate holder,	6609
insured, contract holder, subscriber, enrollee, member,	6610
beneficiary, or other covered individual under a health insurance	6611
or health care policy, contract, or plan, but the insurer, policy,	6612
contract, or plan denies coverage or is the subject of insolvency	6613
or bankruptcy proceedings in any jurisdiction.	6614

(8) "Nonprofit health care referral organization" means an	6615
entity that is not operated for profit and refers patients to, or	6616
arranges for the provision of, health-related diagnosis, care, or	6617
treatment by a health care professional or health care worker.	6618

(9) "Operation" means any procedure that involves cutting or	6619
otherwise infiltrating human tissue by mechanical means, including	6620
surgery, laser surgery, ionizing radiation, therapeutic	6621
ultrasound, or the removal of intraocular foreign bodies.	6622
"Operation" does not include the administration of medication by	6623
injection, unless the injection is administered in conjunction	6624
with a procedure infiltrating human tissue by mechanical means	6625
other than the administration of medicine by injection.	6626
"Operation" does not include routine dental restorative	6627
procedures, the scaling of teeth, or extractions of teeth that are	6628
not impacted.	6629

(10) "Tort action" means a civil action for damages for	6630
injury, death, or loss to person or property other than a civil	6631
action for damages for a breach of contract or another agreement	6632
between persons or government entities.	6633

(11) "Volunteer" means an individual who provides any	6634
medical, dental, or other health-care related diagnosis, care, or	6635
treatment without the expectation of receiving and without receipt	6636
of any compensation or other form of remuneration from an indigent	6637
and uninsured person, another person on behalf of an indigent and	6638
uninsured person, any health care facility or location, any	6639
nonprofit health care referral organization, or any other person	6640
or government entity.	6641

(12) "Community control sanction" has the same meaning as in	6642
section 2929.01 of the Revised Code.	6643

(13) "Deep sedation" means a drug-induced depression of	6644
consciousness during which a patient cannot be easily aroused but	6645
responds purposefully following repeated or painful stimulation, a	6646
patient's ability to independently maintain ventilatory function	6647
may be impaired, a patient may require assistance in maintaining a	6648
patent airway and spontaneous ventilation may be inadequate, and	6649
cardiovascular function is usually maintained.	6650

(14) "General anesthesia" means a drug-induced loss of	6651
consciousness during which a patient is not arousable, even by	6652
painful stimulation, the ability to independently maintain	6653
ventilatory function is often impaired, a patient often requires	6654
assistance in maintaining a patent airway, positive pressure	6655
ventilation may be required because of depressed spontaneous	6656
ventilation or drug-induced depression of neuromuscular function,	6657
and cardiovascular function may be impaired.	6658

(B)(1) Subject to divisions (F) and (G)(3) of this section, a	6659
health care professional who is a volunteer and complies with	6660
division (B)(2) of this section is not liable in damages to any	6661
person or government entity in a tort or other civil action,	6662
including an action on a medical, dental, chiropractic,	6663
optometric, or other health-related claim, for injury, death, or	6664
loss to person or property that allegedly arises from an action or	6665
omission of the volunteer in the provision to an indigent and	6666
uninsured person of medical, dental, or other health-related	6667
diagnosis, care, or treatment, including the provision of samples	6668
of medicine and other medical products, unless the action or	6669
omission constitutes willful or wanton misconduct.	6670

(2) To qualify for the immunity described in division (B)(1)	6671
of this section, a health care professional shall do all of the	6672
following prior to providing diagnosis, care, or treatment:	6673

(a) Determine, in good faith, that the indigent and uninsured	6674
person is mentally capable of giving informed consent to the	6675
provision of the diagnosis, care, or treatment and is not subject	6676
to duress or under undue influence;	6677

(b) Inform the person of the provisions of this section,	6678
including notifying the person that, by giving informed consent to	6679
the provision of the diagnosis, care, or treatment, the person	6680
cannot hold the health care professional liable for damages in a	6681
tort or other civil action, including an action on a medical,	6682
dental, chiropractic, optometric, or other health-related claim,	6683
unless the action or omission of the health care professional	6684
constitutes willful or wanton misconduct;	6685

(c) Obtain the informed consent of the person and a written	6686
waiver, signed by the person or by another individual on behalf of	6687
and in the presence of the person, that states that the person is	6688
mentally competent to give informed consent and, without being	6689
subject to duress or under undue influence, gives informed consent	6690
to the provision of the diagnosis, care, or treatment subject to	6691
the provisions of this section. A written waiver under division	6692
(B)(2)(c) of this section shall state clearly and in conspicuous	6693
type that the person or other individual who signs the waiver is	6694
signing it with full knowledge that, by giving informed consent to	6695
the provision of the diagnosis, care, or treatment, the person	6696
cannot bring a tort or other civil action, including an action on	6697
a medical, dental, chiropractic, optometric, or other	6698
health-related claim, against the health care professional unless	6699
the action or omission of the health care professional constitutes	6700
willful or wanton misconduct.	6701

(3) A physician or podiatrist who is not covered by medical	6702
malpractice insurance, but complies with division (B)(2) of this	6703
section, is not required to comply with division (A) of section	6704
4731.143 of the Revised Code.	6705

(C) Subject to divisions (F) and (G)(3) of this section,	6706
health care workers who are volunteers are not liable in damages	6707
to any person or government entity in a tort or other civil	6708
action, including an action upon a medical, dental, chiropractic,	6709
optometric, or other health-related claim, for injury, death, or	6710
loss to person or property that allegedly arises from an action or	6711
omission of the health care worker in the provision to an indigent	6712
and uninsured person of medical, dental, or other health-related	6713
diagnosis, care, or treatment, unless the action or omission	6714
constitutes willful or wanton misconduct.	6715

(D) Subject to divisions (F) and (G)(3) of this section, a	6716
nonprofit health care referral organization is not liable in	6717
damages to any person or government entity in a tort or other	6718
civil action, including an action on a medical, dental,	6719
chiropractic, optometric, or other health-related claim, for	6720
injury, death, or loss to person or property that allegedly arises	6721
from an action or omission of the nonprofit health care referral	6722
organization in referring indigent and uninsured persons to, or	6723
arranging for the provision of, medical, dental, or other	6724
health-related diagnosis, care, or treatment by a health care	6725
professional described in division (B)(1) of this section or a	6726
health care worker described in division (C) of this section,	6727
unless the action or omission constitutes willful or wanton	6728
misconduct.	6729

(E) Subject to divisions (F) and (G)(3) of this section and	6730
to the extent that the registration requirements of section	6731
3701.071 of the Revised Code apply, a health care facility or	6732
location associated with a health care professional described in	6733
division (B)(1) of this section, a health care worker described in	6734
division (C) of this section, or a nonprofit health care referral	6735
organization described in division (D) of this section is not	6736
liable in damages to any person or government entity in a tort or	6737
other civil action, including an action on a medical, dental,	6738
chiropractic, optometric, or other health-related claim, for	6739
injury, death, or loss to person or property that allegedly arises	6740
from an action or omission of the health care professional or	6741
worker or nonprofit health care referral organization relative to	6742
the medical, dental, or other health-related diagnosis, care, or	6743
treatment provided to an indigent and uninsured person on behalf	6744
of or at the health care facility or location, unless the action	6745
or omission constitutes willful or wanton misconduct.	6746

(F)(1) Except as provided in division (F)(2) of this section,	6747
the immunities provided by divisions (B), (C), (D), and (E) of	6748
this section are not available to a health care professional,	6749
health care worker, nonprofit health care referral organization,	6750
or health care facility or location if, at the time of an alleged	6751
injury, death, or loss to person or property, the health care	6752
professionals or health care workers involved are providing one of	6753
the following:	6754

(a) Any medical, dental, or other health-related diagnosis,	6755
care, or treatment pursuant to a community service work order	6756
entered by a court under division (B) of section 2951.02 of the	6757
Revised Code or imposed by a court as a community control	6758
sanction;	6759

(b) Performance of an operation to which any one of the	6760
following applies:	6761

(i) The operation requires the administration of deep	6762
sedation or general anesthesia.	6763

(ii) The operation is a procedure that is not typically	6764
performed in an office.	6765

(iii) The individual involved is a health care professional,	6766
and the operation is beyond the scope of practice or the	6767
education, training, and competence, as applicable, of the health	6768
care professional.	6769

(c) Delivery of a baby or any other purposeful termination of	6770
a human pregnancy.	6771

(2) Division (F)(1) of this section does not apply when a	6772
health care professional or health care worker provides medical,	6773
dental, or other health-related diagnosis, care, or treatment that	6774
is necessary to preserve the life of a person in a medical	6775
emergency.	6776

(G)(1) This section does not create a new cause of action or	6777
substantive legal right against a health care professional, health	6778
care worker, nonprofit health care referral organization, or	6779
health care facility or location.	6780

(2) This section does not affect any immunities from civil	6781
liability or defenses established by another section of the	6782
Revised Code or available at common law to which a health care	6783
professional, health care worker, nonprofit health care referral	6784
organization, or health care facility or location may be entitled	6785
in connection with the provision of emergency or other medical,	6786
dental, or other health-related diagnosis, care, or treatment.	6787

(3) This section does not grant an immunity from tort or	6788
other civil liability to a health care professional, health care	6789
worker, nonprofit health care referral organization, or health	6790
care facility or location for actions that are outside the scope	6791
of authority of health care professionals or health care workers.	6792

(4) This section does not affect any legal responsibility of	6793
a health care professional, health care worker, or nonprofit	6794
health care referral organization to comply with any applicable	6795
law of this state or rule of an agency of this state.	6796

(5) This section does not affect any legal responsibility of	6797
a health care facility or location to comply with any applicable	6798
law of this state, rule of an agency of this state, or local code,	6799
ordinance, or regulation that pertains to or regulates building,	6800
housing, air pollution, water pollution, sanitation, health, fire,	6801
zoning, or safety.	6802

Sec. 2307.65. (A) The attorney general may bring a civil	6803
action in the Franklin county court of common pleas on behalf of	6804
the department of ~~job and family services~~health care	6805
administration, and the prosecuting attorney of the county in	6806
which a violation of division (B) of section 2913.401 of the	6807
Revised Code occurs may bring a civil action in the court of	6808
common pleas of that county on behalf of the county department of	6809
job and family services, against a person who violates division	6810
(B) of section 2913.401 of the Revised Code for the recovery of	6811
the amount of benefits paid on behalf of a person that either	6812
department would not have paid but for the violation minus any	6813
amounts paid in restitution under division (C)(2) of section	6814
2913.401 of the Revised Code and for reasonable attorney's fees	6815
and all other fees and costs of litigation.	6816

(B) In a civil action brought under division (A) of this	6817
section, if the defendant failed to disclose a transfer of	6818
property in violation of division (B)(3) of section 2913.401 of	6819
the Revised Code, the court may also grant any of the following	6820
relief to the extent permitted by 42 U.S.C. 1396p:	6821

(1) Avoidance of the transfer of property that was not	6822
disclosed in violation of division (B)(3) of section 2913.401 of	6823
the Revised Code to the extent of the amount of benefits the	6824
department would not have paid but for the violation;	6825

(2) An order of attachment or garnishment against the	6826
property in accordance with Chapter 2715. or 2716. of the Revised	6827
Code;	6828

(3) An injunction against any further disposition by the	6829
transferor or transferee, or both, of the property the transfer of	6830
which was not disclosed in violation of division (B)(3) of section	6831
2913.401 of the Revised Code or against the disposition of other	6832
property by the transferor or transferee;	6833

(4) Appointment of a receiver to take charge of the property	6834
transferred or of other property of the transferee;	6835

(5) Any other relief that the court considers just and	6836
equitable.	6837

(C) To the extent permitted by 42 U.S.C. 1396p, the	6838
department of ~~job and family services~~health care administration	6839
or the county department of job and family services may enforce a	6840
judgment obtained under this section by levying on property the	6841
transfer of which was not disclosed in violation of division	6842
(B)(3) of section 2913.401 of the Revised Code or on the proceeds	6843
of the transfer of that property in accordance with Chapter 2329.	6844
of the Revised Code.	6845

(D) The remedies provided in divisions (B) and (C) of this	6846
section do not apply if the transferee of the property the	6847
transfer of which was not disclosed in violation of division	6848
(B)(3) of section 2913.401 of the Revised Code acquired the	6849
property in good faith and for fair market value.	6850

(E) The remedies provided in this section are not exclusive	6851
and do not preclude the use of any other criminal or civil remedy	6852
for any act that is in violation of section 2913.401 of the	6853
Revised Code.	6854

(F) Amounts of medicaid benefits paid and recovered in an	6855
action brought under this section shall be credited to the general	6856
revenue fund, and any applicable federal share shall be returned	6857
to the appropriate agency or department of the United States.	6858

Sec. 2317.02. The following persons shall not testify in	6859
certain respects:	6860

(A)(1) An attorney, concerning a communication made to the	6861
attorney by a client in that relation or the attorney's advice to	6862
a client, except that the attorney may testify by express consent	6863
of the client or, if the client is deceased, by the express	6864
consent of the surviving spouse or the executor or administrator	6865
of the estate of the deceased client. However, if the client	6866
voluntarily testifies or is deemed by section 2151.421 of the	6867
Revised Code to have waived any testimonial privilege under this	6868
division, the attorney may be compelled to testify on the same	6869
subject.	6870

The testimonial privilege established under this division	6871
does not apply concerning a communication between a client who has	6872
since died and the deceased client's attorney if the communication	6873
is relevant to a dispute between parties who claim through that	6874
deceased client, regardless of whether the claims are by testate	6875
or intestate succession or by inter vivos transaction, and the	6876
dispute addresses the competency of the deceased client when the	6877
deceased client executed a document that is the basis of the	6878
dispute or whether the deceased client was a victim of fraud,	6879
undue influence, or duress when the deceased client executed a	6880
document that is the basis of the dispute.	6881

(2) An attorney, concerning a communication made to the	6882
attorney by a client in that relationship or the attorney's advice	6883
to a client, except that if the client is an insurance company,	6884
the attorney may be compelled to testify, subject to an in camera	6885
inspection by a court, about communications made by the client to	6886
the attorney or by the attorney to the client that are related to	6887
the attorney's aiding or furthering an ongoing or future	6888
commission of bad faith by the client, if the party seeking	6889
disclosure of the communications has made a prima facie showing of	6890
bad faith, fraud, or criminal misconduct by the client.	6891

(B)(1) A physician or a dentist concerning a communication	6892
made to the physician or dentist by a patient in that relation or	6893
the physician's or dentist's advice to a patient, except as	6894
otherwise provided in this division, division (B)(2), and division	6895
(B)(3) of this section, and except that, if the patient is deemed	6896
by section 2151.421 of the Revised Code to have waived any	6897
testimonial privilege under this division, the physician may be	6898
compelled to testify on the same subject.	6899

The testimonial privilege established under this division	6900
does not apply, and a physician or dentist may testify or may be	6901
compelled to testify, in any of the following circumstances:	6902

(a) In any civil action, in accordance with the discovery	6903
provisions of the Rules of Civil Procedure in connection with a	6904
civil action, or in connection with a claim under Chapter 4123. of	6905
the Revised Code, under any of the following circumstances:	6906

(i) If the patient or the guardian or other legal	6907
representative of the patient gives express consent;	6908

(ii) If the patient is deceased, the spouse of the patient or	6909
the executor or administrator of the patient's estate gives	6910
express consent;	6911

(iii) If a medical claim, dental claim, chiropractic claim,	6912
or optometric claim, as defined in section 2305.113 of the Revised	6913
Code, an action for wrongful death, any other type of civil	6914
action, or a claim under Chapter 4123. of the Revised Code is	6915
filed by the patient, the personal representative of the estate of	6916
the patient if deceased, or the patient's guardian or other legal	6917
representative.	6918

(b) In any civil action concerning court-ordered treatment or	6919
services received by a patient, if the court-ordered treatment or	6920
services were ordered as part of a case plan journalized under	6921
section 2151.412 of the Revised Code or the court-ordered	6922
treatment or services are necessary or relevant to dependency,	6923
neglect, or abuse or temporary or permanent custody proceedings	6924
under Chapter 2151. of the Revised Code.	6925

(c) In any criminal action concerning any test or the results	6926
of any test that determines the presence or concentration of	6927
alcohol, a drug of abuse, a combination of them, a controlled	6928
substance, or a metabolite of a controlled substance in the	6929
patient's whole blood, blood serum or plasma, breath, urine, or	6930
other bodily substance at any time relevant to the criminal	6931
offense in question.	6932

(d) In any criminal action against a physician or dentist. In	6933
such an action, the testimonial privilege established under this	6934
division does not prohibit the admission into evidence, in	6935
accordance with the Rules of Evidence, of a patient's medical or	6936
dental records or other communications between a patient and the	6937
physician or dentist that are related to the action and obtained	6938
by subpoena, search warrant, or other lawful means. A court that	6939
permits or compels a physician or dentist to testify in such an	6940
action or permits the introduction into evidence of patient	6941
records or other communications in such an action shall require	6942
that appropriate measures be taken to ensure that the	6943
confidentiality of any patient named or otherwise identified in	6944
the records is maintained. Measures to ensure confidentiality that	6945
may be taken by the court include sealing its records or deleting	6946
specific information from its records.	6947

(e)(i) If the communication was between a patient who has	6948
since died and the deceased patient's physician or dentist, the	6949
communication is relevant to a dispute between parties who claim	6950
through that deceased patient, regardless of whether the claims	6951
are by testate or intestate succession or by inter vivos	6952
transaction, and the dispute addresses the competency of the	6953
deceased patient when the deceased patient executed a document	6954
that is the basis of the dispute or whether the deceased patient	6955
was a victim of fraud, undue influence, or duress when the	6956
deceased patient executed a document that is the basis of the	6957
dispute.	6958

(ii) If neither the spouse of a patient nor the executor or	6959
administrator of that patient's estate gives consent under	6960
division (B)(1)(a)(ii) of this section, testimony or the	6961
disclosure of the patient's medical records by a physician,	6962
dentist, or other health care provider under division (B)(1)(e)(i)	6963
of this section is a permitted use or disclosure of protected	6964
health information, as defined in 45 C.F.R. 160.103, and an	6965
authorization or opportunity to be heard shall not be required.	6966

(iii) Division (B)(1)(e)(i) of this section does not require	6967
a mental health professional to disclose psychotherapy notes, as	6968
defined in 45 C.F.R. 164.501.	6969

(iv) An interested person who objects to testimony or	6970
disclosure under division (B)(1)(e)(i) of this section may seek a	6971
protective order pursuant to Civil Rule 26.	6972

(v) A person to whom protected health information is	6973
disclosed under division (B)(1)(e)(i) of this section shall not	6974
use or disclose the protected health information for any purpose	6975
other than the litigation or proceeding for which the information	6976
was requested and shall return the protected health information to	6977
the covered entity or destroy the protected health information,	6978
including all copies made, at the conclusion of the litigation or	6979
proceeding.	6980

(2)(a) If any law enforcement officer submits a written	6981
statement to a health care provider that states that an official	6982
criminal investigation has begun regarding a specified person or	6983
that a criminal action or proceeding has been commenced against a	6984
specified person, that requests the provider to supply to the	6985
officer copies of any records the provider possesses that pertain	6986
to any test or the results of any test administered to the	6987
specified person to determine the presence or concentration of	6988
alcohol, a drug of abuse, a combination of them, a controlled	6989
substance, or a metabolite of a controlled substance in the	6990
person's whole blood, blood serum or plasma, breath, or urine at	6991
any time relevant to the criminal offense in question, and that	6992
conforms to section 2317.022 of the Revised Code, the provider,	6993
except to the extent specifically prohibited by any law of this	6994
state or of the United States, shall supply to the officer a copy	6995
of any of the requested records the provider possesses. If the	6996
health care provider does not possess any of the requested	6997
records, the provider shall give the officer a written statement	6998
that indicates that the provider does not possess any of the	6999
requested records.	7000

(b) If a health care provider possesses any records of the	7001
type described in division (B)(2)(a) of this section regarding the	7002
person in question at any time relevant to the criminal offense in	7003
question, in lieu of personally testifying as to the results of	7004
the test in question, the custodian of the records may submit a	7005
certified copy of the records, and, upon its submission, the	7006
certified copy is qualified as authentic evidence and may be	7007
admitted as evidence in accordance with the Rules of Evidence.	7008
Division (A) of section 2317.422 of the Revised Code does not	7009
apply to any certified copy of records submitted in accordance	7010
with this division. Nothing in this division shall be construed to	7011
limit the right of any party to call as a witness the person who	7012
administered the test to which the records pertain, the person	7013
under whose supervision the test was administered, the custodian	7014
of the records, the person who made the records, or the person	7015
under whose supervision the records were made.	7016

(3)(a) If the testimonial privilege described in division	7017
(B)(1) of this section does not apply as provided in division	7018
(B)(1)(a)(iii) of this section, a physician or dentist may be	7019
compelled to testify or to submit to discovery under the Rules of	7020
Civil Procedure only as to a communication made to the physician	7021
or dentist by the patient in question in that relation, or the	7022
physician's or dentist's advice to the patient in question, that	7023
related causally or historically to physical or mental injuries	7024
that are relevant to issues in the medical claim, dental claim,	7025
chiropractic claim, or optometric claim, action for wrongful	7026
death, other civil action, or claim under Chapter 4123. of the	7027
Revised Code.	7028

(b) If the testimonial privilege described in division (B)(1)	7029
of this section does not apply to a physician or dentist as	7030
provided in division (B)(1)(c) of this section, the physician or	7031
dentist, in lieu of personally testifying as to the results of the	7032
test in question, may submit a certified copy of those results,	7033
and, upon its submission, the certified copy is qualified as	7034
authentic evidence and may be admitted as evidence in accordance	7035
with the Rules of Evidence. Division (A) of section 2317.422 of	7036
the Revised Code does not apply to any certified copy of results	7037
submitted in accordance with this division. Nothing in this	7038
division shall be construed to limit the right of any party to	7039
call as a witness the person who administered the test in	7040
question, the person under whose supervision the test was	7041
administered, the custodian of the results of the test, the person	7042
who compiled the results, or the person under whose supervision	7043
the results were compiled.	7044

(4) The testimonial privilege described in division (B)(1) of	7045
this section is not waived when a communication is made by a	7046
physician to a pharmacist or when there is communication between a	7047
patient and a pharmacist in furtherance of the physician-patient	7048
relation.	7049

(5)(a) As used in divisions (B)(1) to (4) of this section,	7050
"communication" means acquiring, recording, or transmitting any	7051
information, in any manner, concerning any facts, opinions, or	7052
statements necessary to enable a physician or dentist to diagnose,	7053
treat, prescribe, or act for a patient. A "communication" may	7054
include, but is not limited to, any medical or dental, office, or	7055
hospital communication such as a record, chart, letter,	7056
memorandum, laboratory test and results, x-ray, photograph,	7057
financial statement, diagnosis, or prognosis.	7058

(b) As used in division (B)(2) of this section, "health care	7059
provider" means a hospital, ambulatory care facility, long-term	7060
care facility, pharmacy, emergency facility, or health care	7061
practitioner.	7062

7063

(i) "Ambulatory care facility" means a facility that provides	7064
medical, diagnostic, or surgical treatment to patients who do not	7065
require hospitalization, including a dialysis center, ambulatory	7066
surgical facility, cardiac catheterization facility, diagnostic	7067
imaging center, extracorporeal shock wave lithotripsy center, home	7068
health agency, inpatient hospice, birthing center, radiation	7069
therapy center, emergency facility, and an urgent care center.	7070
"Ambulatory health care facility" does not include the private	7071
office of a physician or dentist, whether the office is for an	7072
individual or group practice.	7073

(ii) "Emergency facility" means a hospital emergency	7074
department or any other facility that provides emergency medical	7075
services.	7076

(iii) "Health care practitioner" has the same meaning as in	7077
section 4769.01 of the Revised Code.	7078

(iv) "Hospital" has the same meaning as in section 3727.01 of	7079
the Revised Code.	7080

(v) "Long-term care facility" means a nursing home,	7081
residential care facility, or home for the aging, as those terms	7082
are defined in section 3721.01 of the Revised Code; an adult care	7083
facility, as defined in section 3722.01 of the Revised Code; a	7084
nursing facility or intermediate care facility for the mentally	7085
retarded, as those terms are defined in section ~~5111.20~~5164.01 of	7086
the Revised Code; a facility or portion of a facility certified as	7087
a skilled nursing facility under Title XVIII of the "Social	7088
Security Act," 49 Stat. 286 (1965), 42 U.S.C.A. 1395, as amended.	7089

(vi) "Pharmacy" has the same meaning as in section 4729.01 of	7090
the Revised Code.	7091

(d) As used in divisions (B)(1) and (2) of this section,	7092
"drug of abuse" has the same meaning as in section 4506.01 of the	7093
Revised Code.	7094

(6) Divisions (B)(1), (2), (3), (4), and (5) of this section	7095
apply to doctors of medicine, doctors of osteopathic medicine,	7096
doctors of podiatry, and dentists.	7097

(7) Nothing in divisions (B)(1) to (6) of this section	7098
affects, or shall be construed as affecting, the immunity from	7099
civil liability conferred by section 307.628 of the Revised Code	7100
or the immunity from civil liability conferred by section 2305.33	7101
of the Revised Code upon physicians who report an employee's use	7102
of a drug of abuse, or a condition of an employee other than one	7103
involving the use of a drug of abuse, to the employer of the	7104
employee in accordance with division (B) of that section. As used	7105
in division (B)(7) of this section, "employee," "employer," and	7106
"physician" have the same meanings as in section 2305.33 of the	7107
Revised Code.	7108

(C)(1) A cleric, when the cleric remains accountable to the	7109
authority of that cleric's church, denomination, or sect,	7110
concerning a confession made, or any information confidentially	7111
communicated, to the cleric for a religious counseling purpose in	7112
the cleric's professional character. The cleric may testify by	7113
express consent of the person making the communication, except	7114
when the disclosure of the information is in violation of a sacred	7115
trust and except that, if the person voluntarily testifies or is	7116
deemed by division (A)(4)(c) of section 2151.421 of the Revised	7117
Code to have waived any testimonial privilege under this division,	7118
the cleric may be compelled to testify on the same subject except	7119
when disclosure of the information is in violation of a sacred	7120
trust.	7121

(2) As used in division (C) of this section:

7122

(a) "Cleric" means a member of the clergy, rabbi, priest,	7123
Christian Science practitioner, or regularly ordained, accredited,	7124
or licensed minister of an established and legally cognizable	7125
church, denomination, or sect.	7126

(b) "Sacred trust" means a confession or confidential	7127
communication made to a cleric in the cleric's ecclesiastical	7128
capacity in the course of discipline enjoined by the church to	7129
which the cleric belongs, including, but not limited to, the	7130
Catholic Church, if both of the following apply:	7131

(i) The confession or confidential communication was made	7132
directly to the cleric.	7133

(ii) The confession or confidential communication was made in	7134
the manner and context that places the cleric specifically and	7135
strictly under a level of confidentiality that is considered	7136
inviolate by canon law or church doctrine.	7137

(D) Husband or wife, concerning any communication made by one	7138
to the other, or an act done by either in the presence of the	7139
other, during coverture, unless the communication was made, or act	7140
done, in the known presence or hearing of a third person competent	7141
to be a witness; and such rule is the same if the marital relation	7142
has ceased to exist;	7143

(E) A person who assigns a claim or interest, concerning any	7144
matter in respect to which the person would not, if a party, be	7145
permitted to testify;	7146

(F) A person who, if a party, would be restricted under	7147
section 2317.03 of the Revised Code, when the property or thing is	7148
sold or transferred by an executor, administrator, guardian,	7149
trustee, heir, devisee, or legatee, shall be restricted in the	7150
same manner in any action or proceeding concerning the property or	7151
thing.	7152

(G)(1) A school guidance counselor who holds a valid educator	7153
license from the state board of education as provided for in	7154
section 3319.22 of the Revised Code, a person licensed under	7155
Chapter 4757. of the Revised Code as a professional clinical	7156
counselor, professional counselor, social worker, independent	7157
social worker, marriage and family therapist or independent	7158
marriage and family therapist, or registered under Chapter 4757.	7159
of the Revised Code as a social work assistant concerning a	7160
confidential communication received from a client in that relation	7161
or the person's advice to a client unless any of the following	7162
applies:	7163

(a) The communication or advice indicates clear and present	7164
danger to the client or other persons. For the purposes of this	7165
division, cases in which there are indications of present or past	7166
child abuse or neglect of the client constitute a clear and	7167
present danger.	7168

(b) The client gives express consent to the testimony.

7169

(c) If the client is deceased, the surviving spouse or the	7170
executor or administrator of the estate of the deceased client	7171
gives express consent.	7172

(d) The client voluntarily testifies, in which case the	7173
school guidance counselor or person licensed or registered under	7174
Chapter 4757. of the Revised Code may be compelled to testify on	7175
the same subject.	7176

(e) The court in camera determines that the information	7177
communicated by the client is not germane to the counselor-client,	7178
marriage and family therapist-client, or social worker-client	7179
relationship.	7180

(f) A court, in an action brought against a school, its	7181
administration, or any of its personnel by the client, rules after	7182
an in-camera inspection that the testimony of the school guidance	7183
counselor is relevant to that action.	7184

(g) The testimony is sought in a civil action and concerns	7185
court-ordered treatment or services received by a patient as part	7186
of a case plan journalized under section 2151.412 of the Revised	7187
Code or the court-ordered treatment or services are necessary or	7188
relevant to dependency, neglect, or abuse or temporary or	7189
permanent custody proceedings under Chapter 2151. of the Revised	7190
Code.	7191

(2) Nothing in division (G)(1) of this section shall relieve	7192
a school guidance counselor or a person licensed or registered	7193
under Chapter 4757. of the Revised Code from the requirement to	7194
report information concerning child abuse or neglect under section	7195
2151.421 of the Revised Code.	7196

(H) A mediator acting under a mediation order issued under	7197
division (A) of section 3109.052 of the Revised Code or otherwise	7198
issued in any proceeding for divorce, dissolution, legal	7199
separation, annulment, or the allocation of parental rights and	7200
responsibilities for the care of children, in any action or	7201
proceeding, other than a criminal, delinquency, child abuse, child	7202
neglect, or dependent child action or proceeding, that is brought	7203
by or against either parent who takes part in mediation in	7204
accordance with the order and that pertains to the mediation	7205
process, to any information discussed or presented in the	7206
mediation process, to the allocation of parental rights and	7207
responsibilities for the care of the parents' children, or to the	7208
awarding of parenting time rights in relation to their children;	7209

(I) A communications assistant, acting within the scope of	7210
the communication assistant's authority, when providing	7211
telecommunications relay service pursuant to section 4931.35 of	7212
the Revised Code or Title II of the "Communications Act of 1934,"	7213
104 Stat. 366 (1990), 47 U.S.C. 225, concerning a communication	7214
made through a telecommunications relay service. Nothing in this	7215
section shall limit the obligation of a communications assistant	7216
to divulge information or testify when mandated by federal law or	7217
regulation or pursuant to subpoena in a criminal proceeding.	7218

Nothing in this section shall limit any immunity or privilege	7219
granted under federal law or regulation.	7220

(J)(1) A chiropractor in a civil proceeding concerning a	7221
communication made to the chiropractor by a patient in that	7222
relation or the chiropractor's advice to a patient, except as	7223
otherwise provided in this division. The testimonial privilege	7224
established under this division does not apply, and a chiropractor	7225
may testify or may be compelled to testify, in any civil action,	7226
in accordance with the discovery provisions of the Rules of Civil	7227
Procedure in connection with a civil action, or in connection with	7228
a claim under Chapter 4123. of the Revised Code, under any of the	7229
following circumstances:	7230

(a) If the patient or the guardian or other legal	7231
representative of the patient gives express consent.	7232

(b) If the patient is deceased, the spouse of the patient or	7233
the executor or administrator of the patient's estate gives	7234
express consent.	7235

(c) If a medical claim, dental claim, chiropractic claim, or	7236
optometric claim, as defined in section 2305.113 of the Revised	7237
Code, an action for wrongful death, any other type of civil	7238
action, or a claim under Chapter 4123. of the Revised Code is	7239
filed by the patient, the personal representative of the estate of	7240
the patient if deceased, or the patient's guardian or other legal	7241
representative.	7242

(2) If the testimonial privilege described in division (J)(1)	7243
of this section does not apply as provided in division (J)(1)(c)	7244
of this section, a chiropractor may be compelled to testify or to	7245
submit to discovery under the Rules of Civil Procedure only as to	7246
a communication made to the chiropractor by the patient in	7247
question in that relation, or the chiropractor's advice to the	7248
patient in question, that related causally or historically to	7249
physical or mental injuries that are relevant to issues in the	7250
medical claim, dental claim, chiropractic claim, or optometric	7251
claim, action for wrongful death, other civil action, or claim	7252
under Chapter 4123. of the Revised Code.	7253

(3) The testimonial privilege established under this division	7254
does not apply, and a chiropractor may testify or be compelled to	7255
testify, in any criminal action or administrative proceeding.	7256

(4) As used in this division, "communication" means	7257
acquiring, recording, or transmitting any information, in any	7258
manner, concerning any facts, opinions, or statements necessary to	7259
enable a chiropractor to diagnose, treat, or act for a patient. A	7260
communication may include, but is not limited to, any	7261
chiropractic, office, or hospital communication such as a record,	7262
chart, letter, memorandum, laboratory test and results, x-ray,	7263
photograph, financial statement, diagnosis, or prognosis.	7264

(K)(1) Except as provided under division (K)(2) of this	7265
section, a critical incident stress management team member	7266
concerning a communication received from an individual who	7267
receives crisis response services from the team member, or the	7268
team member's advice to the individual, during a debriefing	7269
session.	7270

(2) The testimonial privilege established under division	7271
(K)(1) of this section does not apply if any of the following are	7272
true:	7273

(a) The communication or advice indicates clear and present	7274
danger to the individual who receives crisis response services or	7275
to other persons. For purposes of this division, cases in which	7276
there are indications of present or past child abuse or neglect of	7277
the individual constitute a clear and present danger.	7278

(b) The individual who received crisis response services	7279
gives express consent to the testimony.	7280

(c) If the individual who received crisis response services	7281
is deceased, the surviving spouse or the executor or administrator	7282
of the estate of the deceased individual gives express consent.	7283

(d) The individual who received crisis response services	7284
voluntarily testifies, in which case the team member may be	7285
compelled to testify on the same subject.	7286

(e) The court in camera determines that the information	7287
communicated by the individual who received crisis response	7288
services is not germane to the relationship between the individual	7289
and the team member.	7290

(f) The communication or advice pertains or is related to any	7291
criminal act.	7292

(3) As used in division (K) of this section:

7293

(a) "Crisis response services" means consultation, risk	7294
assessment, referral, and on-site crisis intervention services	7295
provided by a critical incident stress management team to	7296
individuals affected by crisis or disaster.	7297

(b) "Critical incident stress management team member" or	7298
"team member" means an individual specially trained to provide	7299
crisis response services as a member of an organized community or	7300
local crisis response team that holds membership in the Ohio	7301
critical incident stress management network.	7302

(c) "Debriefing session" means a session at which crisis	7303
response services are rendered by a critical incident stress	7304
management team member during or after a crisis or disaster.	7305

(L)(1) Subject to division (L)(2) of this section and except	7306
as provided in division (L)(3) of this section, an employee	7307
assistance professional, concerning a communication made to the	7308
employee assistance professional by a client in the employee	7309
assistance professional's official capacity as an employee	7310
assistance professional.	7311

(2) Division (L)(1) of this section applies to an employee	7312
assistance professional who meets either or both of the following	7313
requirements:	7314

(a) Is certified by the employee assistance certification	7315
commission to engage in the employee assistance profession;	7316

(b) Has education, training, and experience in all of the	7317
following:	7318

(i) Providing workplace-based services designed to address	7319
employer and employee productivity issues;	7320

(ii) Providing assistance to employees and employees'	7321
dependents in identifying and finding the means to resolve	7322
personal problems that affect the employees or the employees'	7323
performance;	7324

(iii) Identifying and resolving productivity problems	7325
associated with an employee's concerns about any of the following	7326
matters: health, marriage, family, finances, substance abuse or	7327
other addiction, workplace, law, and emotional issues;	7328

(iv) Selecting and evaluating available community resources;

7329

(v) Making appropriate referrals;

7330

(vi) Local and national employee assistance agreements;

7331

(vii) Client confidentiality.

7332

(3) Division (L)(1) of this section does not apply to any of	7333
the following:	7334

(a) A criminal action or proceeding involving an offense	7335
under sections 2903.01 to 2903.06 of the Revised Code if the	7336
employee assistance professional's disclosure or testimony relates	7337
directly to the facts or immediate circumstances of the offense;	7338

(b) A communication made by a client to an employee	7339
assistance professional that reveals the contemplation or	7340
commission of a crime or serious, harmful act;	7341

(c) A communication that is made by a client who is an	7342
unemancipated minor or an adult adjudicated to be incompetent and	7343
indicates that the client was the victim of a crime or abuse;	7344

(d) A civil proceeding to determine an individual's mental	7345
competency or a criminal action in which a plea of not guilty by	7346
reason of insanity is entered;	7347

(e) A civil or criminal malpractice action brought against	7348
the employee assistance professional;	7349

(f) When the employee assistance professional has the express	7350
consent of the client or, if the client is deceased or disabled,	7351
the client's legal representative;	7352

(g) When the testimonial privilege otherwise provided by	7353
division (L)(1) of this section is abrogated under law.	7354

Sec. 2335.39. (A) As used in this section:

7355

(1) "Court" means any court of record.

7356

(2) "Eligible party" means a party to an action or appeal	7357
involving the state, other than the following:	7358

(a) The state;

7359

(b) An individual whose net worth exceeded one million	7360
dollars at the time the action or appeal was filed;	7361

(c) A sole owner of an unincorporated business that had, or a	7362
partnership, corporation, association, or organization that had, a	7363
net worth exceeding five million dollars at the time the action or	7364
appeal was filed, except that an organization that is described in	7365
subsection 501(c)(3) and is tax exempt under subsection 501(a) of	7366
the Internal Revenue Code shall not be excluded as an eligible	7367
party under this division because of its net worth;	7368

(d) A sole owner of an unincorporated business that employed,	7369
or a partnership, corporation, association, or organization that	7370
employed, more than five hundred persons at the time the action or	7371
appeal was filed.	7372

(3) "Fees" means reasonable attorney's fees, in an amount not	7373
to exceed seventy-five dollars per hour or a higher hourly fee	7374
approved by the court.	7375

(4) "Internal Revenue Code" means the "Internal Revenue Code	7376
of 1954," 68A Stat. 3, 26 U.S.C. 1, as amended.	7377

(5) "Prevailing eligible party" means an eligible party that	7378
prevails in an action or appeal involving the state.	7379

(6) "State" has the same meaning as in section 2743.01 of the	7380
Revised Code.	7381

(B)(1) Except as provided in divisions (B)(2) and (F) of this	7382
section, in a civil action, or appeal of a judgment in a civil	7383
action, to which the state is a party, or in an appeal of an	7384
adjudication order of an agency pursuant to section 119.12 of the	7385
Revised Code, the prevailing eligible party is entitled, upon	7386
filing a motion in accordance with this division, to compensation	7387
for fees incurred by that party in connection with the action or	7388
appeal. Compensation, when payable to a prevailing eligible party	7389
under this section, is in addition to any other costs and expenses	7390
that may be awarded to that party by the court pursuant to law or	7391
rule.	7392

A prevailing eligible party that desires an award of	7393
compensation for fees shall file a motion requesting the award	7394
with the court within thirty days after the court enters final	7395
judgment in the action or appeal. The motion shall do all of the	7396
following:	7397

(a) Identify the party;

7398

(b) Indicate that the party is the prevailing eligible party	7399
and is entitled to receive an award of compensation for fees;	7400

(c) Include a statement that the state's position in	7401
initiating the matter in controversy was not substantially	7402
justified;	7403

(d) Indicate the amount sought as an award;

7404

(e) Itemize all fees sought in the requested award. The	7405
itemization shall include a statement from any attorney who	7406
represented the prevailing eligible party, that indicates the fees	7407
charged, the actual time expended, and the rate at which the fees	7408
were calculated.	7409

(2) Upon the filing of a motion under this section, the court	7410
shall review the request for the award of compensation for fees	7411
and determine whether the position of the state in initiating the	7412
matter in controversy was substantially justified, whether special	7413
circumstances make an award unjust, and whether the prevailing	7414
eligible party engaged in conduct during the course of the action	7415
or appeal that unduly and unreasonably protracted the final	7416
resolution of the matter in controversy. The court shall issue an	7417
order, in writing, on the motion of the prevailing eligible party,	7418
which order shall include a statement indicating whether an award	7419
has been granted, the findings and conclusions underlying it, the	7420
reasons or bases for the findings and conclusions, and, if an	7421
award has been granted, its amount. The order shall be included in	7422
the record of the action or appeal, and the clerk of the court	7423
shall mail a certified copy of it to the state and the prevailing	7424
eligible party.	7425

With respect to a motion under this section, the state has	7426
the burden of proving that its position in initiating the matter	7427
in controversy was substantially justified, that special	7428
circumstances make an award unjust, or that the prevailing	7429
eligible party engaged in conduct during the course of the action	7430
or appeal that unduly and unreasonably protracted the final	7431
resolution of the matter in controversy.	7432

A court considering a motion under this section may deny an	7433
award entirely, or reduce the amount of an award that otherwise	7434
would be payable, to a prevailing eligible party only as follows:	7435

(a) If the court determines that the state has sustained its	7436
burden of proof that its position in initiating the matter in	7437
controversy was substantially justified or that special	7438
circumstances make an award unjust, the motion shall be denied;	7439

(b) If the court determines that the state has sustained its	7440
burden of proof that the prevailing eligible party engaged in	7441
conduct during the course of the action or appeal that unduly and	7442
unreasonably protracted the final resolution of the matter in	7443
controversy, the court may reduce the amount of an award, or deny	7444
an award, to that party to the extent of that conduct.	7445

An order of a court considering a motion under this section	7446
is appealable as in other cases, by a prevailing eligible party	7447
that is denied an award or receives a reduced award. If the case	7448
is an appeal of the adjudication order of an agency pursuant to	7449
section 119.12 of the Revised Code, the agency may appeal an order	7450
granting an award. The order of the court may be modified by the	7451
appellate court only if it finds that the grant or the failure to	7452
grant an award, or the calculation of the amount of an award,	7453
involved an abuse of discretion.	7454

(C) Compensation for fees awarded to a prevailing eligible	7455
party under this section may be paid by the specific branch of the	7456
state government or the state department, board, office,	7457
commission, agency, institution, or other instrumentality over	7458
which the party prevailed in the action or appeal from any funds	7459
available to it for payment of such compensation. If compensation	7460
is not paid from such funds or such funds are not available, upon	7461
the filing of the court's order in favor of the prevailing	7462
eligible party with the clerk of the court of claims, the order	7463
shall be treated as if it were a judgment under Chapter 2743. of	7464
the Revised Code and be payable in accordance with the procedures	7465
specified in section 2743.19 of the Revised Code, except that	7466
interest shall not be paid in relation to the award.	7467

(D) If compensation for fees is awarded under this section to	7468
a prevailing eligible party that is appealing an agency	7469
adjudication order pursuant to section 119.12 of the Revised Code,	7470
it shall include the fees incurred in the appeal and, if requested	7471
in the motion, the fees incurred by the party in the adjudication	7472
hearing conducted under Chapter 119. of the Revised Code. A motion	7473
containing such a request shall itemize, in the manner described	7474
in division (B)(1)(e) of section 119.092 of the Revised Code, the	7475
fees, as defined in that section, that are sought in an award.	7476

(E) Each court that orders during any fiscal year	7477
compensation for fees to be paid to a prevailing eligible party	7478
pursuant to this section shall prepare a report for that year. The	7479
report shall be completed no later than the first day of October	7480
of the fiscal year following the fiscal year covered by the	7481
report, and copies of it shall be filed with the general assembly.	7482
It shall contain the following information:	7483

(1) The total amount and total number of awards of	7484
compensation for fees required to be paid to prevailing eligible	7485
parties;	7486

(2) The amount and nature of each individual award ordered;

7487

(3) Any other information that may aid the general assembly	7488
in evaluating the scope and impact of awards of compensation for	7489
fees.	7490

(F) The provisions of this section do not apply in any of the	7491
following:	7492

(1) Appropriation proceedings under Chapter 163. of the	7493
Revised Code;	7494

(2) Civil actions or appeals of civil actions that involve	7495
torts;	7496

(3) An appeal pursuant to section 119.12 of the Revised Code	7497
that involves any of the following:	7498

(a) An adjudication order entered after a hearing described	7499
in division (F) of section 119.092 of the Revised Code;	7500

(b) A prevailing eligible party represented in the appeal by	7501
an attorney who was paid pursuant to an appropriation by the	7502
federal or state government or a local government;	7503

(c) An administrative appeal decision made under section	7504
5101.35 or 5160.34 of the Revised Code.	7505

Sec. 2505.02. (A) As used in this section:

7506

(1) "Substantial right" means a right that the United States	7507
Constitution, the Ohio Constitution, a statute, the common law, or	7508
a rule of procedure entitles a person to enforce or protect.	7509

(2) "Special proceeding" means an action or proceeding that	7510
is specially created by statute and that prior to 1853 was not	7511
denoted as an action at law or a suit in equity.	7512

(3) "Provisional remedy" means a proceeding ancillary to an	7513
action, including, but not limited to, a proceeding for a	7514
preliminary injunction, attachment, discovery of privileged	7515
matter, suppression of evidence, a prima-facie showing pursuant	7516
to section 2307.85 or 2307.86 of the Revised Code, a prima-facie	7517
showing pursuant to section 2307.92 of the Revised Code, or a	7518
finding made pursuant to division (A)(3) of section 2307.93 of the	7519
Revised Code.	7520

(B) An order is a final order that may be reviewed, affirmed,	7521
modified, or reversed, with or without retrial, when it is one of	7522
the following:	7523

(1) An order that affects a substantial right in an action	7524
that in effect determines the action and prevents a judgment;	7525

(2) An order that affects a substantial right made in a	7526
special proceeding or upon a summary application in an action	7527
after judgment;	7528

(3) An order that vacates or sets aside a judgment or grants	7529
a new trial;	7530

(4) An order that grants or denies a provisional remedy and	7531
to which both of the following apply:	7532

(a) The order in effect determines the action with respect to	7533
the provisional remedy and prevents a judgment in the action in	7534
favor of the appealing party with respect to the provisional	7535
remedy.	7536

(b) The appealing party would not be afforded a meaningful or	7537
effective remedy by an appeal following final judgment as to all	7538
proceedings, issues, claims, and parties in the action.	7539

(5) An order that determines that an action may or may not be	7540
maintained as a class action;	7541

(6) An order determining the constitutionality of any changes	7542
to the Revised Code made by Am. Sub. S.B. 281 of the 124th general	7543
assembly, including the amendment of sections 1751.67, 2117.06,	7544
2305.11, 2305.15, 2305.234, 2317.02, 2317.54, 2323.56, 2711.21,	7545
2711.22, 2711.23, 2711.24, 2743.02, 2743.43, 2919.16, 3923.63,	7546
3923.64, 4705.15, and ~~5111.018~~5163.17, and the enactment of	7547
sections 2305.113, 2323.41, 2323.43, and 2323.55 of the Revised	7548
Code or any changes made by Sub. S.B. 80 of the 125th general	7549
assembly, including the amendment of sections 2125.02, 2305.10,	7550
2305.131, 2315.18, 2315.19, and 2315.21 of the Revised Code;	7551

(7) An order in an appropriation proceeding that may be	7552
appealed pursuant to division (B)(3) of section 163.09 of the	7553
Revised Code.	7554

(C) When a court issues an order that vacates or sets aside a	7555
judgment or grants a new trial, the court, upon the request of	7556
either party, shall state in the order the grounds upon which the	7557
new trial is granted or the judgment vacated or set aside.	7558

(D) This section applies to and governs any action, including	7559
an appeal, that is pending in any court on July 22, 1998, and all	7560
claims filed or actions commenced on or after July 22, 1998,	7561
notwithstanding any provision of any prior statute or rule of law	7562
of this state.	7563

Sec. 2705.02. A person guilty of any of the following acts	7564
may be punished as for a contempt:	7565

(A) Disobedience of, or resistance to, a lawful writ,	7566
process, order, rule, judgment, or command of a court or officer;	7567

(B) Misbehavior of an officer of the court in the performance	7568
of official duties, or in official transactions;	7569

(C) A failure to obey a subpoena duly served, or a refusal to	7570
be sworn or to answer as a witness, when lawfully required;	7571

(D) The rescue, or attempted rescue, of a person or of	7572
property in the custody of an officer by virtue of an order or	7573
process of court held by the officer;	7574

(E) A failure upon the part of a person recognized to appear	7575
as a witness in a court to appear in compliance with the terms of	7576
the person's recognizance;	7577

(F) A failure to comply with an order issued pursuant to	7578
section 3109.19 or 3111.81 of the Revised Code;	7579

(G) A failure to obey a subpoena issued by the department of	7580
job and family services or a child support enforcement agency	7581
pursuant to section 5101.37 of the Revised Code;	7582

(H) A failure to obey a subpoena issued by the department of	7583
health care administration pursuant to section 5160.28 of the	7584
Revised Code;	7585

(I) A willful failure to submit to genetic testing, or a	7586
willful failure to submit a child to genetic testing, as required	7587
by an order for genetic testing issued under section 3111.41 of	7588
the Revised Code.	7589

Sec. 2744.05. Notwithstanding any other provisions of the	7590
Revised Code or rules of a court to the contrary, in an action	7591
against a political subdivision to recover damages for injury,	7592
death, or loss to person or property caused by an act or omission	7593
in connection with a governmental or proprietary function:	7594

(A) Punitive or exemplary damages shall not be awarded.

7595

(B)(1) If a claimant receives or is entitled to receive	7596
benefits for injuries or loss allegedly incurred from a policy or	7597
policies of insurance or any other source, the benefits shall be	7598
disclosed to the court, and the amount of the benefits shall be	7599
deducted from any award against a political subdivision recovered	7600
by that claimant. No insurer or other person is entitled to bring	7601
an action under a subrogation provision in an insurance or other	7602
contract against a political subdivision with respect to those	7603
benefits.	7604

The amount of the benefits shall be deducted from an award	7605
against a political subdivision under division (B)(1) of this	7606
section regardless of whether the claimant may be under an	7607
obligation to pay back the benefits upon recovery, in whole or in	7608
part, for the claim. A claimant whose benefits have been deducted	7609
from an award under division (B)(1) of this section is not	7610
considered fully compensated and shall not be required to	7611
reimburse a subrogated claim for benefits deducted from an award	7612
pursuant to division (B)(1) of this section.	7613

(2) Nothing in division (B)(1) of this section shall be	7614
construed to do either of the following:	7615

(a) Limit the rights of a beneficiary under a life insurance	7616
policy or the rights of sureties under fidelity or surety bonds;	7617

(b) Prohibit the department of ~~job and family services~~health	7618
care administration from recovering from the political	7619
subdivision, pursuant to section ~~5101.58~~5160.38 of the Revised	7620
Code, the cost of medical assistance benefits provided under	7621
~~sections 5101.5211 to 5101.5216 or Chapter 5107., 5111., or 5115.~~	7622
~~of the Revised Code~~the medicaid program, disability medical	7623
assistance program, or children's buy-in program.	7624

(C)(1) There shall not be any limitation on compensatory	7625
damages that represent the actual loss of the person who is	7626
awarded the damages. However, except in wrongful death actions	7627
brought pursuant to Chapter 2125. of the Revised Code, damages	7628
that arise from the same cause of action, transaction or	7629
occurrence, or series of transactions or occurrences and that do	7630
not represent the actual loss of the person who is awarded the	7631
damages shall not exceed two hundred fifty thousand dollars in	7632
favor of any one person. The limitation on damages that do not	7633
represent the actual loss of the person who is awarded the damages	7634
provided in this division does not apply to court costs that are	7635
awarded to a plaintiff, or to interest on a judgment rendered in	7636
favor of a plaintiff, in an action against a political	7637
subdivision.	7638

(2) As used in this division, "the actual loss of the person	7639
who is awarded the damages" includes all of the following:	7640

(a) All wages, salaries, or other compensation lost by the	7641
person injured as a result of the injury, including wages,	7642
salaries, or other compensation lost as of the date of a judgment	7643
and future expected lost earnings of the person injured;	7644

(b) All expenditures of the person injured or another person	7645
on behalf of the person injured for medical care or treatment, for	7646
rehabilitation services, or for other care, treatment, services,	7647
products, or accommodations that were necessary because of the	7648
injury;	7649

(c) All expenditures to be incurred in the future, as	7650
determined by the court, by the person injured or another person	7651
on behalf of the person injured for medical care or treatment, for	7652
rehabilitation services, or for other care, treatment, services,	7653
products, or accommodations that will be necessary because of the	7654
injury;	7655

(d) All expenditures of a person whose property was injured	7656
or destroyed or of another person on behalf of the person whose	7657
property was injured or destroyed in order to repair or replace	7658
the property that was injured or destroyed;	7659

(e) All expenditures of the person injured or of the person	7660
whose property was injured or destroyed or of another person on	7661
behalf of the person injured or of the person whose property was	7662
injured or destroyed in relation to the actual preparation or	7663
presentation of the claim involved;	7664

(f) Any other expenditures of the person injured or of the	7665
person whose property was injured or destroyed or of another	7666
person on behalf of the person injured or of the person whose	7667
property was injured or destroyed that the court determines	7668
represent an actual loss experienced because of the personal or	7669
property injury or property loss.	7670

"The actual loss of the person who is awarded the damages"	7671
does not include any fees paid or owed to an attorney for any	7672
services rendered in relation to a personal or property injury or	7673
property loss, and does not include any damages awarded for pain	7674
and suffering, for the loss of society, consortium, companionship,	7675
care, assistance, attention, protection, advice, guidance,	7676
counsel, instruction, training, or education of the person	7677
injured, for mental anguish, or for any other intangible loss.	7678

Sec. 2903.33. As used in sections 2903.33 to 2903.36 of the	7679
Revised Code:	7680

(A) "Care facility" means any of the following:

7681

(1) Any "home" as defined in section 3721.10 or ~~5111.20~~	7682
5164.01 of the Revised Code;	7683

(2) Any "residential facility" as defined in section 5123.19	7684
of the Revised Code;	7685

(3) Any institution or facility operated or provided by the	7686
department of mental health or by the department of mental	7687
retardation and developmental disabilities pursuant to sections	7688
5119.02 and 5123.03 of the Revised Code;	7689

(4) Any "residential facility" as defined in section 5119.22	7690
of the Revised Code;	7691

(5) Any unit of any hospital, as defined in section 3701.01	7692
of the Revised Code, that provides the same services as a nursing	7693
home, as defined in section 3721.01 of the Revised Code;	7694

(6) Any institution, residence, or facility that provides,	7695
for a period of more than twenty-four hours, whether for a	7696
consideration or not, accommodations to one individual or two	7697
unrelated individuals who are dependent upon the services of	7698
others;	7699

(7) Any "adult care facility" as defined in section 3722.01	7700
of the Revised Code;	7701

(8) Any adult foster home certified by the department of	7702
aging or its designee under section 173.36 of the Revised Code;	7703

(9) Any "community alternative home" as defined in section	7704
3724.01 of the Revised Code.	7705

(B) "Abuse" means knowingly causing physical harm or	7706
recklessly causing serious physical harm to a person by physical	7707
contact with the person or by the inappropriate use of a physical	7708
or chemical restraint, medication, or isolation on the person.	7709

(C)(1) "Gross neglect" means knowingly failing to provide a	7710
person with any treatment, care, goods, or service that is	7711
necessary to maintain the health or safety of the person when the	7712
failure results in physical harm or serious physical harm to the	7713
person.	7714

(2) "Neglect" means recklessly failing to provide a person	7715
with any treatment, care, goods, or service that is necessary to	7716
maintain the health or safety of the person when the failure	7717
results in serious physical harm to the person.	7718

(D) "Inappropriate use of a physical or chemical restraint,	7719
medication, or isolation" means the use of physical or chemical	7720
restraint, medication, or isolation as punishment, for staff	7721
convenience, excessively, as a substitute for treatment, or in	7722
quantities that preclude habilitation and treatment.	7723

Sec. 2913.40. (A) As used in this section:

7724

(1) "Statement or representation" means any oral, written,	7725
electronic, electronic impulse, or magnetic communication that is	7726
used to identify an item of goods or a service for which	7727
reimbursement may be made under the ~~medical assistance~~medicaid	7728
program or that states income and expense and is or may be used to	7729
determine a rate of reimbursement under the ~~medical assistance~~	7730
medicaid program.	7731

(2) ~~"Medical assistance program" means the program~~	7732
~~established by the department of job and family services to~~	7733
~~provide medical assistance under section 5111.01 of the Revised~~	7734
~~Code and the medicaid program of Title XIX of the "Social Security~~	7735
~~Act," 49 Stat. 620 (1935), 42 U.S.C. 301, as amended.~~	7736

~~(3)~~ "Provider" means any person who has signed a provider	7737
agreement with the department of ~~job and family services~~health	7738
care administration to provide goods or services pursuant to the	7739
~~medical assistance~~medicaid program or any person who has signed	7740
an agreement with a party to such a provider agreement under which	7741
the person agrees to provide goods or services that are	7742
reimbursable under the ~~medical assistance~~medicaid program.	7743

(4) "Provider agreement" means an oral or written agreement	7744
between the department of ~~job and family services~~health care	7745
administration and a person in which the person agrees to provide	7746
goods or services under the ~~medical assistance~~medicaid program.	7747

(5) "Recipient" means any individual who receives goods or	7748
services from a provider under the ~~medical assistance~~medicaid	7749
program.	7750

(6) "Records" means any medical, professional, financial, or	7751
business records relating to the treatment or care of any	7752
recipient, to goods or services provided to any recipient, or to	7753
rates paid for goods or services provided to any recipient and any	7754
records that are required by the rules of the director of ~~job and~~	7755
~~family services~~health care administration to be kept for the	7756
~~medical assistance~~medicaid program.	7757

(B) No person shall knowingly make or cause to be made a	7758
false or misleading statement or representation for use in	7759
obtaining reimbursement from the ~~medical assistance~~medicaid	7760
program.	7761

(C) No person, with purpose to commit fraud or knowing that	7762
the person is facilitating a fraud, shall do either of the	7763
following:	7764

(1) Contrary to the terms of the person's provider agreement,	7765
charge, solicit, accept, or receive for goods or services that the	7766
person provides under the ~~medical assistance~~medicaid program any	7767
property, money, or other consideration in addition to the amount	7768
of reimbursement under the ~~medical assistance~~medicaid program and	7769
the person's provider agreement for the goods or services and any	7770
cost-sharing expenses authorized by section ~~5111.0112~~5162.35 of	7771
the Revised Code or rules adopted pursuant to section ~~5111.01,~~	7772
~~5111.011,~~5162.20 or ~~5111.02~~5163.15 of the Revised Code.	7773

(2) Solicit, offer, or receive any remuneration, other than	7774
any cost-sharing expenses authorized by section ~~5111.0112~~5162.35	7775
of the Revised Code or rules adopted under section ~~5111.01,~~	7776
~~5111.011,~~5162.20 or ~~5111.02~~5163.15 of the Revised Code, in cash	7777
or in kind, including, but not limited to, a kickback or rebate,	7778
in connection with the furnishing of goods or services for which	7779
whole or partial reimbursement is or may be made under the ~~medical~~	7780
~~assistance~~medicaid program.	7781

(D) No person, having submitted a claim for or provided goods	7782
or services under the ~~medical assistance~~medicaid program, shall	7783
do either of the following for a period of at least six years	7784
after a reimbursement pursuant to that claim, or a reimbursement	7785
for those goods or services, is received under the ~~medical~~	7786
~~assistance~~medicaid program:	7787

(1) Knowingly alter, falsify, destroy, conceal, or remove any	7788
records that are necessary to fully disclose the nature of all	7789
goods or services for which the claim was submitted, or for which	7790
reimbursement was received, by the person;	7791

(2) Knowingly alter, falsify, destroy, conceal, or remove any	7792
records that are necessary to disclose fully all income and	7793
expenditures upon which rates of reimbursements were based for the	7794
person.	7795

(E) Whoever violates this section is guilty of medicaid	7796
fraud. Except as otherwise provided in this division, medicaid	7797
fraud is a misdemeanor of the first degree. If the value of	7798
property, services, or funds obtained in violation of this section	7799
is five hundred dollars or more and is less than five thousand	7800
dollars, medicaid fraud is a felony of the fifth degree. If the	7801
value of property, services, or funds obtained in violation of	7802
this section is five thousand dollars or more and is less than one	7803
hundred thousand dollars, medicaid fraud is a felony of the fourth	7804
degree. If the value of the property, services, or funds obtained	7805
in violation of this section is one hundred thousand dollars or	7806
more, medicaid fraud is a felony of the third degree.	7807

(F) Upon application of the governmental agency, office, or	7808
other entity that conducted the investigation and prosecution in a	7809
case under this section, the court shall order any person who is	7810
convicted of a violation of this section for receiving any	7811
reimbursement for furnishing goods or services under the ~~medical~~	7812
~~assistance~~medicaid program to which the person is not entitled to	7813
pay to the applicant its cost of investigating and prosecuting the	7814
case. The costs of investigation and prosecution that a defendant	7815
is ordered to pay pursuant to this division shall be in addition	7816
to any other penalties for the receipt of that reimbursement that	7817
are provided in this section, section ~~5111.03~~5163.03 of the	7818
Revised Code, or any other provision of law.	7819

(G) The provisions of this section are not intended to be	7820
exclusive remedies and do not preclude the use of any other	7821
criminal or civil remedy for any act that is in violation of this	7822
section.	7823

Sec. 2913.401. (A) As used in this section:

7824

(1) "Medicaid benefits" means benefits under the ~~medical~~	7825
~~assistance~~medicaid program ~~established under Chapter 5111. of the~~	7826
~~Revised Code~~.	7827

(2) "Property" means any real or personal property or other	7828
asset in which a person has any legal title or interest.	7829

(B) No person shall knowingly do any of the following in an	7830
application for medicaid benefits or in a document that requires a	7831
disclosure of assets for the purpose of determining eligibility to	7832
receive medicaid benefits:	7833

(1) Make or cause to be made a false or misleading statement;

7834

(2) Conceal an interest in property;

7835

(3)(a) Except as provided in division (B)(3)(b) of this	7836
section, fail to disclose a transfer of property that occurred	7837
during the period beginning thirty-six months before submission of	7838
the application or document and ending on the date the application	7839
or document was submitted;	7840

(b) Fail to disclose a transfer of property that occurred	7841
during the period beginning sixty months before submission of the	7842
application or document and ending on the date the application or	7843
document was submitted and that was made to an irrevocable trust a	7844
portion of which is not distributable to the applicant for	7845
medicaid benefits or the recipient of medicaid benefits or to a	7846
revocable trust.	7847

(C)(1) Whoever violates this section is guilty of medicaid	7848
eligibility fraud. Except as otherwise provided in this division,	7849
a violation of this section is a misdemeanor of the first degree.	7850
If the value of the medicaid benefits paid as a result of the	7851
violation is five hundred dollars or more and is less than five	7852
thousand dollars, a violation of this section is a felony of the	7853
fifth degree. If the value of the medicaid benefits paid as a	7854
result of the violation is five thousand dollars or more and is	7855
less than one hundred thousand dollars, a violation of this	7856
section is a felony of the fourth degree. If the value of the	7857
medicaid benefits paid as a result of the violation is one hundred	7858
thousand dollars or more, a violation of this section is a felony	7859
of the third degree.	7860

(2) In addition to imposing a sentence under division (C)(1)	7861
of this section, the court shall order that a person who is guilty	7862
of medicaid eligibility fraud make restitution in the full amount	7863
of any medicaid benefits paid on behalf of an applicant for or	7864
recipient of medicaid benefits for which the applicant or	7865
recipient was not eligible, plus interest at the rate applicable	7866
to judgments on unreimbursed amounts from the date on which the	7867
benefits were paid to the date on which restitution is made.	7868

(3) The remedies and penalties provided in this section are	7869
not exclusive and do not preclude the use of any other criminal or	7870
civil remedy for any act that is in violation of this section.	7871

(D) This section does not apply to a person who fully	7872
disclosed in an application for medicaid benefits or in a document	7873
that requires a disclosure of assets for the purpose of	7874
determining eligibility to receive medicaid benefits all of the	7875
interests in property of the applicant for or recipient of	7876
medicaid benefits, all transfers of property by the applicant for	7877
or recipient of medicaid benefits, and the circumstances of all	7878
those transfers.	7879

(E) Any amounts of medicaid benefits recovered as restitution	7880
under this section and any interest on those amounts shall be	7881
credited to the general revenue fund, and any applicable federal	7882
share shall be returned to the appropriate agency or department of	7883
the United States.	7884

Sec. 2921.01. As used in sections 2921.01 to 2921.45 of the	7885
Revised Code:	7886

(A) "Public official" means any elected or appointed officer,	7887
or employee, or agent of the state or any political subdivision,	7888
whether in a temporary or permanent capacity, and includes, but is	7889
not limited to, legislators, judges, and law enforcement officers.	7890

(B) "Public servant" means any of the following:

7891

(1) Any public official;

7892

(2) Any person performing ad hoc a governmental function,	7893
including, but not limited to, a juror, member of a temporary	7894
commission, master, arbitrator, advisor, or consultant;	7895

(3) A person who is a candidate for public office, whether or	7896
not the person is elected or appointed to the office for which the	7897
person is a candidate. A person is a candidate for purposes of	7898
this division if the person has been nominated according to law	7899
for election or appointment to public office, or if the person has	7900
filed a petition or petitions as required by law to have the	7901
person's name placed on the ballot in a primary, general, or	7902
special election, or if the person campaigns as a write-in	7903
candidate in any primary, general, or special election.	7904

(C) "Party official" means any person who holds an elective	7905
or appointive post in a political party in the United States or	7906
this state, by virtue of which the person directs, conducts, or	7907
participates in directing or conducting party affairs at any level	7908
of responsibility.	7909

(D) "Official proceeding" means any proceeding before a	7910
legislative, judicial, administrative, or other governmental	7911
agency or official authorized to take evidence under oath, and	7912
includes any proceeding before a referee, hearing examiner,	7913
commissioner, notary, or other person taking testimony or a	7914
deposition in connection with an official proceeding.	7915

(E) "Detention" means arrest; confinement in any vehicle	7916
subsequent to an arrest; confinement in any public or private	7917
facility for custody of persons charged with or convicted of crime	7918
in this state or another state or under the laws of the United	7919
States or alleged or found to be a delinquent child or unruly	7920
child in this state or another state or under the laws of the	7921
United States; hospitalization, institutionalization, or	7922
confinement in any public or private facility that is ordered	7923
pursuant to or under the authority of section 2945.37, 2945.371,	7924
2945.38, 2945.39, 2945.40, 2945.401, or 2945.402 of the Revised	7925
Code; confinement in any vehicle for transportation to or from any	7926
facility of any of those natures; detention for extradition or	7927
deportation; except as provided in this division, supervision by	7928
any employee of any facility of any of those natures that is	7929
incidental to hospitalization, institutionalization, or	7930
confinement in the facility but that occurs outside the facility;	7931
supervision by an employee of the department of rehabilitation and	7932
correction of a person on any type of release from a state	7933
correctional institution; or confinement in any vehicle, airplane,	7934
or place while being returned from outside of this state into this	7935
state by a private person or entity pursuant to a contract entered	7936
into under division (E) of section 311.29 of the Revised Code or	7937
division (B) of section 5149.03 of the Revised Code. For a person	7938
confined in a county jail who participates in a county jail	7939
industry program pursuant to section 5147.30 of the Revised Code,	7940
"detention" includes time spent at an assigned work site and going	7941
to and from the work site.	7942

(F) "Detention facility" means any public or private place	7943
used for the confinement of a person charged with or convicted of	7944
any crime in this state or another state or under the laws of the	7945
United States or alleged or found to be a delinquent child or	7946
unruly child in this state or another state or under the laws of	7947
the United States.	7948

(G) "Valuable thing or valuable benefit" includes, but is not	7949
limited to, a contribution. This inclusion does not indicate or	7950
imply that a contribution was not included in those terms before	7951
September 17, 1986.	7952

(H) "Campaign committee," "contribution," "political action	7953
committee," "legislative campaign fund," "political party," and	7954
"political contributing entity" have the same meanings as in	7955
section 3517.01 of the Revised Code.	7956

(I) "Provider agreement" ~~and "medical assistance program"~~	7957
~~have~~has the same ~~meanings~~meaning as in section 2913.40 of the	7958
Revised Code.	7959

Sec. 2921.13. (A) No person shall knowingly make a false	7960
statement, or knowingly swear or affirm the truth of a false	7961
statement previously made, when any of the following applies:	7962

(1) The statement is made in any official proceeding.

7963

(2) The statement is made with purpose to incriminate	7964
another.	7965

(3) The statement is made with purpose to mislead a public	7966
official in performing the public official's official function.	7967

(4) The statement is made with purpose to secure the payment	7968
of unemployment compensation; Ohio works first; prevention,	7969
retention, and contingency benefits and services; disability	7970
financial assistance; retirement benefits; economic development	7971
assistance, as defined in section 9.66 of the Revised Code; or	7972
other benefits administered by a governmental agency or paid out	7973
of a public treasury.	7974

(5) The statement is made with purpose to secure the issuance	7975
by a governmental agency of a license, permit, authorization,	7976
certificate, registration, release, or provider agreement.	7977

(6) The statement is sworn or affirmed before a notary public	7978
or another person empowered to administer oaths.	7979

(7) The statement is in writing on or in connection with a	7980
report or return that is required or authorized by law.	7981

(8) The statement is in writing and is made with purpose to	7982
induce another to extend credit to or employ the offender, to	7983
confer any degree, diploma, certificate of attainment, award of	7984
excellence, or honor on the offender, or to extend to or bestow	7985
upon the offender any other valuable benefit or distinction, when	7986
the person to whom the statement is directed relies upon it to	7987
that person's detriment.	7988

(9) The statement is made with purpose to commit or	7989
facilitate the commission of a theft offense.	7990

(10) The statement is knowingly made to a probate court in	7991
connection with any action, proceeding, or other matter within its	7992
jurisdiction, either orally or in a written document, including,	7993
but not limited to, an application, petition, complaint, or other	7994
pleading, or an inventory, account, or report.	7995

(11) The statement is made on an account, form, record,	7996
stamp, label, or other writing that is required by law.	7997

(12) The statement is made in connection with the purchase of	7998
a firearm, as defined in section 2923.11 of the Revised Code, and	7999
in conjunction with the furnishing to the seller of the firearm of	8000
a fictitious or altered driver's or commercial driver's license or	8001
permit, a fictitious or altered identification card, or any other	8002
document that contains false information about the purchaser's	8003
identity.	8004

(13) The statement is made in a document or instrument of	8005
writing that purports to be a judgment, lien, or claim of	8006
indebtedness and is filed or recorded with the secretary of state,	8007
a county recorder, or the clerk of a court of record.	8008

(14) The statement is made with purpose to obtain an Ohio's	8009
best Rx program enrollment card under section ~~173.773~~5169.073 of	8010
the Revised Code or a payment under section ~~173.801~~5169.101 of	8011
the Revised Code.	8012

(15) The statement is made in an application filed with a	8013
county sheriff pursuant to section 2923.125 of the Revised Code in	8014
order to obtain or renew a license to carry a concealed handgun or	8015
is made in an affidavit submitted to a county sheriff to obtain a	8016
temporary emergency license to carry a concealed handgun under	8017
section 2923.1213 of the Revised Code.	8018

(16) The statement is required under section 5743.71 of the	8019
Revised Code in connection with the person's purchase of	8020
cigarettes or tobacco products in a delivery sale.	8021

(B) No person, in connection with the purchase of a firearm,	8022
as defined in section 2923.11 of the Revised Code, shall knowingly	8023
furnish to the seller of the firearm a fictitious or altered	8024
driver's or commercial driver's license or permit, a fictitious or	8025
altered identification card, or any other document that contains	8026
false information about the purchaser's identity.	8027

(C) No person, in an attempt to obtain a license to carry a	8028
concealed handgun under section 2923.125 of the Revised Code,	8029
shall knowingly present to a sheriff a fictitious or altered	8030
document that purports to be certification of the person's	8031
competence in handling a handgun as described in division (B)(3)	8032
of section 2923.125 of the Revised Code.	8033

(D) It is no defense to a charge under division (A)(6) of	8034
this section that the oath or affirmation was administered or	8035
taken in an irregular manner.	8036

(E) If contradictory statements relating to the same fact are	8037
made by the offender within the period of the statute of	8038
limitations for falsification, it is not necessary for the	8039
prosecution to prove which statement was false but only that one	8040
or the other was false.	8041

(F)(1) Whoever violates division (A)(1), (2), (3), (4), (5),	8042
(6), (7), (8), (10), (11), (13), (14), or (16) of this section is	8043
guilty of falsification, a misdemeanor of the first degree.	8044

(2) Whoever violates division (A)(9) of this section is	8045
guilty of falsification in a theft offense. Except as otherwise	8046
provided in this division, falsification in a theft offense is a	8047
misdemeanor of the first degree. If the value of the property or	8048
services stolen is five hundred dollars or more and is less than	8049
five thousand dollars, falsification in a theft offense is a	8050
felony of the fifth degree. If the value of the property or	8051
services stolen is five thousand dollars or more and is less than	8052
one hundred thousand dollars, falsification in a theft offense is	8053
a felony of the fourth degree. If the value of the property or	8054
services stolen is one hundred thousand dollars or more,	8055
falsification in a theft offense is a felony of the third degree.	8056

(3) Whoever violates division (A)(12) or (B) of this section	8057
is guilty of falsification to purchase a firearm, a felony of the	8058
fifth degree.	8059

(4) Whoever violates division (A)(15) or (C) of this section	8060
is guilty of falsification to obtain a concealed handgun license,	8061
a felony of the fourth degree.	8062

(G) A person who violates this section is liable in a civil	8063
action to any person harmed by the violation for injury, death, or	8064
loss to person or property incurred as a result of the commission	8065
of the offense and for reasonable attorney's fees, court costs,	8066
and other expenses incurred as a result of prosecuting the civil	8067
action commenced under this division. A civil action under this	8068
division is not the exclusive remedy of a person who incurs	8069
injury, death, or loss to person or property as a result of a	8070
violation of this section.	8071

Sec. 2945.401. (A) A defendant found incompetent to stand	8072
trial and committed pursuant to section 2945.39 of the Revised	8073
Code or a person found not guilty by reason of insanity and	8074
committed pursuant to section 2945.40 of the Revised Code shall	8075
remain subject to the jurisdiction of the trial court pursuant to	8076
that commitment, and to the provisions of this section, until the	8077
final termination of the commitment as described in division	8078
(J)(1) of this section. If the jurisdiction is terminated under	8079
this division because of the final termination of the commitment	8080
resulting from the expiration of the maximum prison term or term	8081
of imprisonment described in division (J)(1)(b) of this section,	8082
the court or prosecutor may file an affidavit for the civil	8083
commitment of the defendant or person pursuant to Chapter 5122. or	8084
5123. of the Revised Code.	8085

(B) A hearing conducted under any provision of sections	8086
2945.37 to 2945.402 of the Revised Code shall not be conducted in	8087
accordance with Chapters 5122. and 5123. of the Revised Code. Any	8088
person who is committed pursuant to section 2945.39 or 2945.40 of	8089
the Revised Code shall not voluntarily admit the person or be	8090
voluntarily admitted to a hospital or institution pursuant to	8091
section 5122.02, 5122.15, 5123.69, or 5123.76 of the Revised Code.	8092
All other provisions of Chapters 5122. and 5123. of the Revised	8093
Code regarding hospitalization or institutionalization shall apply	8094
to the extent they are not in conflict with this chapter. A	8095
commitment under section 2945.39 or 2945.40 of the Revised Code	8096
shall not be terminated and the conditions of the commitment shall	8097
not be changed except as otherwise provided in division (D)(2) of	8098
this section with respect to a mentally retarded person subject to	8099
institutionalization by court order or except by order of the	8100
trial court.	8101

(C) The hospital, facility, or program to which a defendant	8102
or person has been committed under section 2945.39 or 2945.40 of	8103
the Revised Code shall report in writing to the trial court, at	8104
the times specified in this division, as to whether the defendant	8105
or person remains a mentally ill person subject to hospitalization	8106
by court order or a mentally retarded person subject to	8107
institutionalization by court order and, in the case of a	8108
defendant committed under section 2945.39 of the Revised Code, as	8109
to whether the defendant remains incompetent to stand trial. The	8110
hospital, facility, or program shall make the reports after the	8111
initial six months of treatment and every two years after the	8112
initial report is made. The trial court shall provide copies of	8113
the reports to the prosecutor and to the counsel for the defendant	8114
or person. Within thirty days after its receipt pursuant to this	8115
division of a report from a hospital, facility, or program, the	8116
trial court shall hold a hearing on the continued commitment of	8117
the defendant or person or on any changes in the conditions of the	8118
commitment of the defendant or person. The defendant or person may	8119
request a change in the conditions of confinement, and the trial	8120
court shall conduct a hearing on that request if six months or	8121
more have elapsed since the most recent hearing was conducted	8122
under this section.	8123

(D)(1) Except as otherwise provided in division (D)(2) of	8124
this section, when a defendant or person has been committed under	8125
section 2945.39 or 2945.40 of the Revised Code, at any time after	8126
evaluating the risks to public safety and the welfare of the	8127
defendant or person, the chief clinical officer of the hospital,	8128
facility, or program to which the defendant or person is committed	8129
may recommend a termination of the defendant's or person's	8130
commitment or a change in the conditions of the defendant's or	8131
person's commitment.	8132

Except as otherwise provided in division (D)(2) of this	8133
section, if the chief clinical officer recommends on-grounds	8134
unsupervised movement, off-grounds supervised movement, or	8135
nonsecured status for the defendant or person or termination of	8136
the defendant's or person's commitment, the following provisions	8137
apply:	8138

(a) If the chief clinical officer recommends on-grounds	8139
unsupervised movement or off-grounds supervised movement, the	8140
chief clinical officer shall file with the trial court an	8141
application for approval of the movement and shall send a copy of	8142
the application to the prosecutor. Within fifteen days after	8143
receiving the application, the prosecutor may request a hearing on	8144
the application and, if a hearing is requested, shall so inform	8145
the chief clinical officer. If the prosecutor does not request a	8146
hearing within the fifteen-day period, the trial court shall	8147
approve the application by entering its order approving the	8148
requested movement or, within five days after the expiration of	8149
the fifteen-day period, shall set a date for a hearing on the	8150
application. If the prosecutor requests a hearing on the	8151
application within the fifteen-day period, the trial court shall	8152
hold a hearing on the application within thirty days after the	8153
hearing is requested. If the trial court, within five days after	8154
the expiration of the fifteen-day period, sets a date for a	8155
hearing on the application, the trial court shall hold the hearing	8156
within thirty days after setting the hearing date. At least	8157
fifteen days before any hearing is held under this division, the	8158
trial court shall give the prosecutor written notice of the date,	8159
time, and place of the hearing. At the conclusion of each hearing	8160
conducted under this division, the trial court either shall	8161
approve or disapprove the application and shall enter its order	8162
accordingly.	8163

(b) If the chief clinical officer recommends termination of	8164
the defendant's or person's commitment at any time or if the chief	8165
clinical officer recommends the first of any nonsecured status for	8166
the defendant or person, the chief clinical officer shall send	8167
written notice of this recommendation to the trial court and to	8168
the local forensic center. The local forensic center shall	8169
evaluate the committed defendant or person and, within thirty days	8170
after its receipt of the written notice, shall submit to the trial	8171
court and the chief clinical officer a written report of the	8172
evaluation. The trial court shall provide a copy of the chief	8173
clinical officer's written notice and of the local forensic	8174
center's written report to the prosecutor and to the counsel for	8175
the defendant or person. Upon the local forensic center's	8176
submission of the report to the trial court and the chief clinical	8177
officer, all of the following apply:	8178

(i) If the forensic center disagrees with the recommendation	8179
of the chief clinical officer, it shall inform the chief clinical	8180
officer and the trial court of its decision and the reasons for	8181
the decision. The chief clinical officer, after consideration of	8182
the forensic center's decision, shall either withdraw, proceed	8183
with, or modify and proceed with the recommendation. If the chief	8184
clinical officer proceeds with, or modifies and proceeds with, the	8185
recommendation, the chief clinical officer shall proceed in	8186
accordance with division (D)(1)(b)(iii) of this section.	8187

(ii) If the forensic center agrees with the recommendation of	8188
the chief clinical officer, it shall inform the chief clinical	8189
officer and the trial court of its decision and the reasons for	8190
the decision, and the chief clinical officer shall proceed in	8191
accordance with division (D)(1)(b)(iii) of this section.	8192

(iii) If the forensic center disagrees with the	8193
recommendation of the chief clinical officer and the chief	8194
clinical officer proceeds with, or modifies and proceeds with, the	8195
recommendation or if the forensic center agrees with the	8196
recommendation of the chief clinical officer, the chief clinical	8197
officer shall work with the board of alcohol, drug addiction, and	8198
mental health services or community mental health board serving	8199
the area, as appropriate, to develop a plan to implement the	8200
recommendation. If the defendant or person is on medication, the	8201
plan shall include, but shall not be limited to, a system to	8202
monitor the defendant's or person's compliance with the prescribed	8203
medication treatment plan. The system shall include a schedule	8204
that clearly states when the defendant or person shall report for	8205
a medication compliance check. The medication compliance checks	8206
shall be based upon the effective duration of the prescribed	8207
medication, taking into account the route by which it is taken,	8208
and shall be scheduled at intervals sufficiently close together to	8209
detect a potential increase in mental illness symptoms that the	8210
medication is intended to prevent.	8211

The chief clinical officer, after consultation with the board	8212
of alcohol, drug addiction, and mental health services or the	8213
community mental health board serving the area, shall send the	8214
recommendation and plan developed under division (D)(1)(b)(iii) of	8215
this section, in writing, to the trial court, the prosecutor and	8216
the counsel for the committed defendant or person. The trial court	8217
shall conduct a hearing on the recommendation and plan developed	8218
under division (D)(1)(b)(iii) of this section. Divisions (D)(1)(c)	8219
and (d) and (E) to (J) of this section apply regarding the	8220
hearing.	8221

(c) If the chief clinical officer's recommendation is for	8222
nonsecured status or termination of commitment, the prosecutor may	8223
obtain an independent expert evaluation of the defendant's or	8224
person's mental condition, and the trial court may continue the	8225
hearing on the recommendation for a period of not more than thirty	8226
days to permit time for the evaluation.	8227

The prosecutor may introduce the evaluation report or present	8228
other evidence at the hearing in accordance with the Rules of	8229
Evidence.	8230

(d) The trial court shall schedule the hearing on a chief	8231
clinical officer's recommendation for nonsecured status or	8232
termination of commitment and shall give reasonable notice to the	8233
prosecutor and the counsel for the defendant or person. Unless	8234
continued for independent evaluation at the prosecutor's request	8235
or for other good cause, the hearing shall be held within thirty	8236
days after the trial court's receipt of the recommendation and	8237
plan.	8238

(2)(a) Division (D)(1) of this section does not apply to	8239
on-grounds unsupervised movement of a defendant or person who has	8240
been committed under section 2945.39 or 2945.40 of the Revised	8241
Code, who is a mentally retarded person subject to	8242
institutionalization by court order, and who is being provided	8243
residential habilitation, care, and treatment in a facility	8244
operated by the department of mental retardation and developmental	8245
disabilities.	8246

(b) If, pursuant to section 2945.39 of the Revised Code, the	8247
trial court commits a defendant who is found incompetent to stand	8248
trial and who is a mentally retarded person subject to	8249
institutionalization by court order, if the defendant is being	8250
provided residential habilitation, care, and treatment in a	8251
facility operated by the department of mental retardation and	8252
developmental disabilities, if an individual who is conducting a	8253
survey for the department of health to determine the facility's	8254
compliance with the certification requirements of the medicaid	8255
program ~~under chapter 5111. of the Revised Code and Title XIX of~~	8256
~~the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301,~~	8257
~~as amended,~~ cites the defendant's receipt of the residential	8258
habilitation, care, and treatment in the facility as being	8259
inappropriate under the certification requirements, if the	8260
defendant's receipt of the residential habilitation, care, and	8261
treatment in the facility potentially jeopardizes the facility's	8262
continued receipt of federal medicaid moneys, and if as a result	8263
of the citation the chief clinical officer of the facility	8264
determines that the conditions of the defendant's commitment	8265
should be changed, the department of mental retardation and	8266
developmental disabilities may cause the defendant to be removed	8267
from the particular facility and, after evaluating the risks to	8268
public safety and the welfare of the defendant and after	8269
determining whether another type of placement is consistent with	8270
the certification requirements, may place the defendant in another	8271
facility that the department selects as an appropriate facility	8272
for the defendant's continued receipt of residential habilitation,	8273
care, and treatment and that is a no less secure setting than the	8274
facility in which the defendant had been placed at the time of the	8275
citation. Within three days after the defendant's removal and	8276
alternative placement under the circumstances described in	8277
division (D)(2)(b) of this section, the department of mental	8278
retardation and developmental disabilities shall notify the trial	8279
court and the prosecutor in writing of the removal and alternative	8280
placement.	8281

The trial court shall set a date for a hearing on the removal	8282
and alternative placement, and the hearing shall be held within	8283
twenty-one days after the trial court's receipt of the notice from	8284
the department of mental retardation and developmental	8285
disabilities. At least ~~ten-days~~ten days before the hearing is	8286
held, the trial court shall give the prosecutor, the department of	8287
mental retardation and developmental disabilities, and the counsel	8288
for the defendant written notice of the date, time, and place of	8289
the hearing. At the hearing, the trial court shall consider the	8290
citation issued by the individual who conducted the survey for the	8291
department of health to be prima-facie evidence of the fact that	8292
the defendant's commitment to the particular facility was	8293
inappropriate under the certification requirements of the medicaid	8294
program ~~under Chapter 5111. of the Revised Code and Title XIX of~~	8295
~~the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301,~~	8296
~~as amended,~~ and potentially jeopardizes the particular facility's	8297
continued receipt of federal medicaid moneys. At the conclusion of	8298
the hearing, the trial court may approve or disapprove the	8299
defendant's removal and alternative placement. If the trial court	8300
approves the defendant's removal and alternative placement, the	8301
department of mental retardation and developmental disabilities	8302
may continue the defendant's alternative placement. If the trial	8303
court disapproves the defendant's removal and alternative	8304
placement, it shall enter an order modifying the defendant's	8305
removal and alternative placement, but that order shall not	8306
require the department of mental retardation and developmental	8307
disabilities to replace the defendant for purposes of continued	8308
residential habilitation, care, and treatment in the facility	8309
associated with the citation issued by the individual who	8310
conducted the survey for the department of health.	8311

(E) In making a determination under this section regarding	8312
nonsecured status or termination of commitment, the trial court	8313
shall consider all relevant factors, including, but not limited	8314
to, all of the following:	8315

(1) Whether, in the trial court's view, the defendant or	8316
person currently represents a substantial risk of physical harm to	8317
the defendant or person or others;	8318

(2) Psychiatric and medical testimony as to the current	8319
mental and physical condition of the defendant or person;	8320

(3) Whether the defendant or person has insight into the	8321
dependant's or person's condition so that the defendant or person	8322
will continue treatment as prescribed or seek professional	8323
assistance as needed;	8324

(4) The grounds upon which the state relies for the proposed	8325
commitment;	8326

(5) Any past history that is relevant to establish the	8327
defendant's or person's degree of conformity to the laws, rules,	8328
regulations, and values of society;	8329

(6) If there is evidence that the defendant's or person's	8330
mental illness is in a state of remission, the medically suggested	8331
cause and degree of the remission and the probability that the	8332
defendant or person will continue treatment to maintain the	8333
remissive state of the defendant's or person's illness should the	8334
defendant's or person's commitment conditions be altered.	8335

(F) At any hearing held pursuant to division (C) or (D)(1) or	8336
(2) of this section, the defendant or the person shall have all	8337
the rights of a defendant or person at a commitment hearing as	8338
described in section 2945.40 of the Revised Code.	8339

(G) In a hearing held pursuant to division (C) or (D)(1) of	8340
this section, the prosecutor has the burden of proof as follows:	8341

(1) For a recommendation of termination of commitment, to	8342
show by clear and convincing evidence that the defendant or person	8343
remains a mentally ill person subject to hospitalization by court	8344
order or a mentally retarded person subject to	8345
institutionalization by court order;	8346

(2) For a recommendation for a change in the conditions of	8347
the commitment to a less restrictive status, to show by clear and	8348
convincing evidence that the proposed change represents a threat	8349
to public safety or a threat to the safety of any person.	8350

(H) In a hearing held pursuant to division (C) or (D)(1) or	8351
(2) of this section, the prosecutor shall represent the state or	8352
the public interest.	8353

(I) At the conclusion of a hearing conducted under division	8354
(D)(1) of this section regarding a recommendation from the chief	8355
clinical officer of a hospital, program, or facility, the trial	8356
court may approve, disapprove, or modify the recommendation and	8357
shall enter an order accordingly.	8358

(J)(1) A defendant or person who has been committed pursuant	8359
to section 2945.39 or 2945.40 of the Revised Code continues to be	8360
under the jurisdiction of the trial court until the final	8361
termination of the commitment. For purposes of division (J) of	8362
this section, the final termination of a commitment occurs upon	8363
the earlier of one of the following:	8364

(a) The defendant or person no longer is a mentally ill	8365
person subject to hospitalization by court order or a mentally	8366
retarded person subject to institutionalization by court order, as	8367
determined by the trial court;	8368

(b) The expiration of the maximum prison term or term of	8369
imprisonment that the defendant or person could have received if	8370
the defendant or person had been convicted of the most serious	8371
offense with which the defendant or person is charged or in	8372
relation to which the defendant or person was found not guilty by	8373
reason of insanity;	8374

(c) The trial court enters an order terminating the	8375
commitment under the circumstances described in division	8376
(J)(2)(a)(ii) of this section.	8377

(2)(a) If a defendant is found incompetent to stand trial and	8378
committed pursuant to section 2945.39 of the Revised Code, if	8379
neither of the circumstances described in divisions (J)(1)(a) and	8380
(b) of this section applies to that defendant, and if a report	8381
filed with the trial court pursuant to division (C) of this	8382
section indicates that the defendant presently is competent to	8383
stand trial or if, at any other time during the period of the	8384
defendant's commitment, the prosecutor, the counsel for the	8385
defendant, or the chief clinical officer of the hospital,	8386
facility, or program to which the defendant is committed files an	8387
application with the trial court alleging that the defendant	8388
presently is competent to stand trial and requesting a hearing on	8389
the competency issue or the trial court otherwise has reasonable	8390
cause to believe that the defendant presently is competent to	8391
stand trial and determines on its own motion to hold a hearing on	8392
the competency issue, the trial court shall schedule a hearing on	8393
the competency of the defendant to stand trial, shall give the	8394
prosecutor, the counsel for the defendant, and the chief clinical	8395
officer notice of the date, time, and place of the hearing at	8396
least fifteen days before the hearing, and shall conduct the	8397
hearing within thirty days of the filing of the application or of	8398
its own motion. If, at the conclusion of the hearing, the trial	8399
court determines that the defendant presently is capable of	8400
understanding the nature and objective of the proceedings against	8401
the defendant and of assisting in the defendant's defense, the	8402
trial court shall order that the defendant is competent to stand	8403
trial and shall be proceeded against as provided by law with	8404
respect to the applicable offenses described in division (C)(1) of	8405
section 2945.38 of the Revised Code and shall enter whichever of	8406
the following additional orders is appropriate:	8407

(i) If the trial court determines that the defendant remains	8408
a mentally ill person subject to hospitalization by court order or	8409
a mentally retarded person subject to institutionalization by	8410
court order, the trial court shall order that the defendant's	8411
commitment to the hospital, facility, or program be continued	8412
during the pendency of the trial on the applicable offenses	8413
described in division (C)(1) of section 2945.38 of the Revised	8414
Code.	8415

(ii) If the trial court determines that the defendant no	8416
longer is a mentally ill person subject to hospitalization by	8417
court order or a mentally retarded person subject to	8418
institutionalization by court order, the trial court shall order	8419
that the defendant's commitment to the hospital, facility, or	8420
program shall not be continued during the pendency of the trial on	8421
the applicable offenses described in division (C)(1) of section	8422
2945.38 of the Revised Code. This order shall be a final	8423
termination of the commitment for purposes of division (J)(1)(c)	8424
of this section.	8425

(b) If, at the conclusion of the hearing described in	8426
division (J)(2)(a) of this section, the trial court determines	8427
that the defendant remains incapable of understanding the nature	8428
and objective of the proceedings against the defendant or of	8429
assisting in the defendant's defense, the trial court shall order	8430
that the defendant continues to be incompetent to stand trial,	8431
that the defendant's commitment to the hospital, facility, or	8432
program shall be continued, and that the defendant remains subject	8433
to the jurisdiction of the trial court pursuant to that	8434
commitment, and to the provisions of this section, until the final	8435
termination of the commitment as described in division (J)(1) of	8436
this section.	8437

Sec. 3101.051. (A) Except as provided in division (B) of	8438
this section, a probate court shall make available to any person	8439
for inspection the records pertaining to the issuance of marriage	8440
licenses as provided under section 149.43 of the Revised Code.	8441

(B) Before it makes available to a person any records	8442
pertaining to the issuance of a marriage license as described in	8443
division (A) of this section, subject to division (C) of this	8444
section, a probate court shall delete or otherwise remove any	8445
social security numbers of the parties to a marriage so that they	8446
are not available to the person inspecting the records.	8447

(C) Division (B) of this section does not apply in any of the	8448
following circumstances:	8449

(1) If the records in question are inspected by authorized	8450
personnel of the division of child support in the department of	8451
job and family services under section ~~5101.31~~3125.41 of the	8452
Revised Code;	8453

(2) If the records in question are inspected by law	8454
enforcement personnel for purposes of a criminal investigation;	8455

(3) If the records in question with the social security	8456
numbers are necessary for use in a civil or criminal trial and the	8457
release of the records with the social security numbers is ordered	8458
by a court with jurisdiction over the trial;	8459

(4) If the records in question are inspected by either party	8460
to the marriage to which the records pertain;	8461

(5) If the court possessed the records in question prior to	8462
~~the effective date of this section~~February 12, 2001.	8463

Sec. 3107.083. Not later than ninety days after June 20,	8464
1996, the director of job and family services shall do all of the	8465
following:	8466

(A)(1) For a parent of a child who, if adopted, will be an	8467
adopted person as defined in section 3107.45 of the Revised Code,	8468
prescribe a form that has the following six components:	8469

(a) A component the parent signs under section 3107.071,	8470
3107.081, or 5103.151 of the Revised Code to indicate the	8471
requirements of section 3107.082 or 5103.152 of the Revised Code	8472
have been met. The component shall be as follows:	8473

"Statement Concerning Ohio Law and Adoption Materials	8474

By signing this component of this form, I acknowledge that it	8475
has been explained to me, and I understand, that, if I check the	8476
space on the next component of this form that indicates that I	8477
authorize the release, the adoption file maintained by the Ohio	8478
Department of Health, which contains identifying information about	8479
me at the time of my child's birth, will be released, on request,	8480
to the adoptive parent when the adoptee is at least age eighteen	8481
but younger than age twenty-one and to the adoptee when he or she	8482
is age twenty-one or older. It has also been explained to me, and	8483
I understand, that I may prohibit the release of identifying	8484
information about me contained in the adoption file by checking	8485
the space on the next component of this form that indicates that I	8486
do not authorize the release of the identifying information. It	8487
has additionally been explained to me, and I understand, that I	8488
may change my mind regarding the decision I make on the next	8489
component of this form at any time and as many times as I desire	8490
by signing, dating, and having filed with the Ohio Department of	8491
Health a denial of release form or authorization of release form	8492
prescribed and provided by the Department of Health and providing	8493
the Department two items of identification.	8494

By signing this component of this form, I also acknowledge	8495
that I have been provided a copy of written materials about	8496
adoption prepared by the Ohio Department of Job and Family	8497
Services, the adoption process and ramifications of consenting to	8498
adoption or entering into a voluntary permanent custody surrender	8499
agreement have been discussed with me, and I have been provided	8500
the opportunity to review the materials and ask questions about	8501
the materials and discussion.	8502

Signature of biological parent:		8503
Signature of witness:		8504
Date:	"	8505

(b) A component the parent signs under section 3107.071,	8506
3107.081, or 5103.151 of the Revised Code regarding the parent's	8507
decision whether to allow identifying information about the parent	8508
contained in an adoption file maintained by the department of	8509
health to be released to the parent's child and adoptive parent	8510
pursuant to section 3107.47 of the Revised Code. The component	8511
shall be as follows:	8512

"Statement Regarding Release of Identifying Information	8513

The purpose of this component of this form is to allow a	8514
biological parent to decide whether to allow the Ohio Department	8515
of Health to provide an adoptee and adoptive parent identifying	8516
information about the adoptee's biological parent contained in an	8517
adoption file maintained by the Department. Please check one of	8518
the following spaces:	8519

	......		YES, I authorize the Ohio Department of Health to release identifying information about me, on request, to the adoptive parent when the adoptee is at least age eighteen but younger than age twenty-one and to the adoptee when he or she is age twenty-one or older.		8520
	......		NO, I do not authorize the release of identifying information about me to the adoptive parent or adoptee.		8521

Signature of biological parent:		8522
Signature of witness:		8523
Date:	"	8524

(c) A component the parent, if the mother of the child,	8525
completes and signs under section 3107.071, 3107.081, or 5103.151	8526
of the Revised Code to indicate, to the extent of the mother's	8527
knowledge, all of the following:	8528

(i) Whether the mother, during her pregnancy, was a recipient	8529
of the ~~medical assistance~~medicaid program ~~established under~~	8530
~~Chapter 5111. of the Revised Code~~ or other public health insurance	8531
program and, if so, the dates her eligibility began and ended;	8532

(ii) Whether the mother, during her pregnancy, was covered by	8533
private health insurance and, if so, the dates the coverage began	8534
and ended, the name of the insurance provider, the type of	8535
coverage, and the identification number of the coverage;	8536

(iii) The name and location of the hospital, freestanding	8537
birth center, or other place where the mother gave birth and, if	8538
different, received medical care immediately after giving birth;	8539

(iv) The expenses of the obstetrical and neonatal care;

8540

(v) Whether the mother has been informed that the adoptive	8541
parent or the agency or attorney arranging the adoption are to pay	8542
expenses involved in the adoption, including expenses the mother	8543
has paid and expects to receive or has received reimbursement,	8544
and, if so, what expenses are to be or have been paid and an	8545
estimate of the expenses;	8546

(vi) Any other information related to expenses the department	8547
determines appropriate to be included in this component.	8548

(d) A component the parent may sign to authorize the agency	8549
or attorney arranging the adoption to provide to the child or	8550
adoptive parent materials, other than photographs of the parent,	8551
that the parent requests be given to the child or adoptive parent	8552
pursuant to section 3107.68 of the Revised Code.	8553

(e) A component the parent may sign to authorize the agency	8554
or attorney arranging the adoption to provide to the child or	8555
adoptive parent photographs of the parent pursuant to section	8556
3107.68 of the Revised Code.	8557

(f) A component the parent may sign to authorize the agency	8558
or attorney arranging the adoption to provide to the child or	8559
adoptive parent the first name of the parent pursuant to section	8560
3107.68 of the Revised Code.	8561

(2) State at the bottom of the form that the parent is to	8562
receive a copy of the form the parent signed.	8563

(3) Provide copies of the form prescribed under this division	8564
to probate and juvenile courts, public children services agencies,	8565
private child placing agencies, private noncustodial agencies,	8566
attorneys, and persons authorized to take acknowledgments.	8567

(B)(1) For a parent of a child who, if adopted, will become	8568
an adopted person as defined in section 3107.39 of the Revised	8569
Code, prescribe a form that has the following five components:	8570

(a) A component the parent signs under section 3107.071,	8571
3107.081, or 5103.151 of the Revised Code to attest that the	8572
requirement of division (A) of section 3107.082 or division (A) of	8573
section 5103.152 of the Revised Code has been met;	8574

(b) A component the parent, if the mother of the child,	8575
completes and signs under section 3107.071, 3107.081, or 5103.151	8576
of the Revised Code to indicate, to the extent of the mother's	8577
knowledge, all of the following:	8578

(i) Whether the mother, during her pregnancy, was a recipient	8579
of the ~~medical assistance~~medicaid program ~~established under~~	8580
~~Chapter 5111. of the Revised Code~~ or other public health insurance	8581
program and, if so, the dates her eligibility began and ended;	8582

(ii) Whether the mother, during her pregnancy, was covered by	8583
private health insurance and, if so, the dates the coverage began	8584
and ended, the name of the insurance provider, the type of	8585
coverage, and the identification number of the coverage;	8586

(iii) The name and location of the hospital, freestanding	8587
birth center, or other place where the mother gave birth and, if	8588
different, received medical care immediately after giving birth;	8589

(iv) The expenses of the obstetrical and neonatal care;

8590

(v) Whether the mother has been informed that the adoptive	8591
parent or the agency or attorney arranging the adoption are to pay	8592
expenses involved in the adoption, including expenses the mother	8593
has paid and expects to receive or has received reimbursement for,	8594
and, if so, what expenses are to be or have been paid and an	8595
estimate of the expenses;	8596

(vi) Any other information related to expenses the department	8597
determines appropriate to be included in the component.	8598

(c) A component the parent may sign to authorize the agency	8599
or attorney arranging the adoption to provide to the child or	8600
adoptive parent materials, other than photographs of the parent,	8601
that the parent requests be given to the child or adoptive parent	8602
pursuant to section 3107.68 of the Revised Code.	8603

(d) A component the parent may sign to authorize the agency	8604
or attorney arranging the adoption to provide to the child or	8605
adoptive parent photographs of the parent pursuant to section	8606
3107.68 of the Revised Code.	8607

(e) A component the parent may sign to authorize the agency	8608
or attorney arranging the adoption to provide to the child or	8609
adoptive parent the first name of the parent pursuant to section	8610
3107.68 of the Revised Code.	8611

(2) State at the bottom of the form that the parent is to	8612
receive a copy of the form the parent signed.	8613

(3) Provide copies of the form prescribed under this division	8614
to probate and juvenile courts, public children services agencies,	8615
private child placing agencies, private noncustodial agencies, and	8616
attorneys.	8617

(C) Prepare the written materials about adoption that are	8618
required to be given to parents under division (A) of section	8619
3107.082 and division (A) of section 5103.152 of the Revised Code.	8620
The materials shall provide information about the adoption	8621
process, including ramifications of a parent consenting to a	8622
child's adoption or entering into a voluntary permanent custody	8623
surrender agreement. The materials also shall include referral	8624
information for professional counseling and adoption support	8625
organizations. The director shall provide the materials to	8626
assessors.	8627

(D) Adopt rules in accordance with Chapter 119. of the	8628
Revised Code specifying the documents that must be filed with a	8629
probate court under divisions (B) and (D) of section 3107.081 of	8630
the Revised Code and a juvenile court under divisions (C) and (E)	8631
of section 5103.151 of the Revised Code.	8632

Sec. 3111.04. (A) An action to determine the existence or	8633
nonexistence of the father and child relationship may be brought	8634
by the child or the child's personal representative, the child's	8635
mother or her personal representative, a man alleged or alleging	8636
himself to be the child's father, the child support enforcement	8637
agency of the county in which the child resides if the child's	8638
mother, father, or alleged father is a recipient of public	8639
assistance or of services under Title IV-D of the "Social Security	8640
Act," 88 Stat. 2351 (1975), 42 U.S.C.A. 651, as amended, or the	8641
alleged father's personal representative.	8642

(B) An agreement does not bar an action under this section.

8643

(C) If an action under this section is brought before the	8644
birth of the child and if the action is contested, all	8645
proceedings, except service of process and the taking of	8646
depositions to perpetuate testimony, may be stayed until after the	8647
birth.	8648

(D) A recipient of public assistance or of services under	8649
Title IV-D of the "Social Security Act," 88 Stat. 2351 (1975), 42	8650
U.S.C.A. 651, as amended, shall cooperate with the child support	8651
enforcement agency of the county in which a child resides to	8652
obtain an administrative determination pursuant to sections	8653
3111.38 to 3111.54 of the Revised Code, or, if necessary, a court	8654
determination pursuant to sections 3111.01 to 3111.18 of the	8655
Revised Code, of the existence or nonexistence of a parent and	8656
child relationship between the father and the child. If the	8657
recipient fails to cooperate, the agency may commence an action to	8658
determine the existence or nonexistence of a parent and child	8659
relationship between the father and the child pursuant to sections	8660
3111.01 to 3111.18 of the Revised Code.	8661

(E) As used in this section, "public assistance" means all	8662
of the following:	8663

(1) Medicaid ~~under Chapter 5111. of the Revised Code~~;

8664

(2) Ohio works first under Chapter 5107. of the Revised Code;

8665

(3) Disability financial assistance under Chapter 5115. of	8666
the Revised Code;	8667

(4) Disability medical assistance ~~under Chapter 5115. of the~~	8668
~~Revised Code~~;	8669

(5) Children's buy-in program ~~under sections 5101.5211 to~~	8670
~~5101.5216 of the Revised Code~~.	8671

Sec. 3111.72. The contract between the department of job and	8672
family services and a local hospital shall require all of the	8673
following:	8674

(A) That the hospital provide a staff person to meet with	8675
each unmarried mother who gave birth in or en route to the	8676
hospital within twenty-four hours of the birth or before the	8677
mother is released from the hospital;	8678

(B) That the staff person attempt to meet with the father of	8679
the unmarried mother's child if possible;	8680

(C) That the staff person explain to the unmarried mother and	8681
the father, if he is present, the benefit to the child of	8682
establishing a parent and child relationship between the father	8683
and the child and the various proper procedures for establishing a	8684
parent and child relationship;	8685

(D) That the staff person present to the unmarried mother	8686
and, if possible, the father, the pamphlet or statement regarding	8687
the rights and responsibilities of a natural parent that is	8688
prepared and provided by the department of job and family services	8689
pursuant to section 3111.32 of the Revised Code;	8690

(E) That the staff person provide the mother and, if	8691
possible, the father, all forms and statements necessary to	8692
voluntarily establish a parent and child relationship, including,	8693
but not limited to, the acknowledgment of paternity affidavit	8694
prepared by the department of job and family services pursuant to	8695
section 3111.31 of the Revised Code;	8696

(F) That the staff person, at the request of both the mother	8697
and father, help the mother and father complete any form or	8698
statement necessary to establish a parent and child relationship;	8699

(G) That the hospital provide a notary public to notarize an	8700
acknowledgment of paternity affidavit signed by the mother and	8701
father;	8702

(H) That the staff person present to an unmarried mother who	8703
is not participating in the Ohio works first program established	8704
under Chapter 5107. or receiving ~~medical assistance under Chapter~~	8705
~~5111. of the Revised Code~~medicaid an application for Title IV-D	8706
services;	8707

(I) That the staff person forward any completed	8708
acknowledgment of paternity, no later than ten days after it is	8709
completed, to the office of child support in the department of job	8710
and family services;	8711

(J) That the department of job and family services pay the	8712
hospital twenty dollars for every correctly signed and notarized	8713
acknowledgment of paternity affidavit from the hospital.	8714

Sec. 3113.06. No father, or mother when she is charged with	8715
the maintenance, of a child under eighteen years of age, or a	8716
mentally or physically handicapped child under age twenty-one, who	8717
is legally a ward of a public children services agency or is the	8718
recipient of aid pursuant to sections ~~5101.5211~~5167.35 to	8719
~~5101.5216~~5167.40 or Chapter 5107. or, 5115., or 5168. of the	8720
Revised Code, shall neglect or refuse to pay such agency the	8721
reasonable cost of maintaining such child when such father or	8722
mother is able to do so by reason of property, labor, or	8723
earnings.	8724

An offense under this section shall be held committed in the	8725
county in which the agency is located. The agency shall file	8726
charges against any parent who violates this section, unless the	8727
agency files charges under section 2919.21 of the Revised Code, or	8728
unless charges of nonsupport are filed by a relative or guardian	8729
of the child, or unless an action to enforce support is brought	8730
under Chapter 3115. of the Revised Code.	8731

Sec. 3119.29. (A) As used in this section and sections	8732
3119.30 to 3119.56 of the Revised Code:	8733

(1) "Cash medical support" means an amount ordered to be	8734
paid in a child support order toward the cost of health insurance	8735
provided by a public entity, another parent, or person with whom	8736
the child resides, through employment or otherwise, or for other	8737
medical cost not covered by insurance.	8738

(2) "Federal poverty line" has the same meaning as defined in	8739
section 5104.01 of the Revised Code.	8740

(3) "Health care" means such medical support that includes	8741
coverage under a health insurance plan, payment of costs of	8742
premiums, ~~co-payments~~copayments, and deductibles, or payment for	8743
medical expenses incurred on behalf of the child.	8744

(4) "Health insurance coverage" means accessible private	8745
health insurance that provides primary care services within thirty	8746
miles from the residence of the child subject to the child support	8747
order.	8748

(5) "Health plan administrator" means any entity authorized	8749
under Title XXXIX of the Revised Code to engage in the business of	8750
insurance in this state, any health insuring corporation, any	8751
legal entity that is self-insured and provides benefits to its	8752
employees or members, and the administrator of any such entity or	8753
corporation.	8754

(6) "National medical support notice" means a form required	8755
by the "Child Support Performance and Incentive Act of 1998,"	8756
P.L. 105-200, 112 Stat. 659, 42 U.S.C. 666(a)(19), as amended,	8757
and jointly developed and promulgated by the secretary of health	8758
and human services and the secretary of labor in federal	8759
regulations adopted under that act as modified by the department	8760
of job and family services under section 3119.291 of the Revised	8761
Code.	8762

(7) "Person required to provide health insurance coverage"	8763
means the obligor, obligee, or both, required by the court under a	8764
court child support order or by the child support enforcement	8765
agency under an administrative child support order to provide	8766
health insurance coverage pursuant to section 3119.30 of the	8767
Revised Code.	8768

(8) Subject to division (B) of this section, "reasonable	8769
cost" means the contributing cost of private family health	8770
insurance to the person responsible for the health care of the	8771
children subject to the child support order that does not exceed	8772
an amount equal to five per cent of the annual gross income of	8773
that person.	8774

(9) "Title XIX" has the same meaning as defined in section	8775
~~5111.20~~5164.01 of the Revised Code.	8776

(B) If the United States secretary of health and human	8777
services issues a regulation defining "reasonable cost" or a	8778
similar term or phrase relevant to the provisions in child support	8779
orders relating to the provision of health care for children	8780
subject to the orders, and if that definition is substantively	8781
different from the meaning of "reasonable cost" as defined in	8782
division (A) of this section, "reasonable cost" as used in this	8783
section shall have the meaning as defined by the United States	8784
secretary of health and human services.	8785

Sec. 3119.54. A party to a child support order issued in	8786
accordance with section 3119.30 of the Revised Code shall notify	8787
any physician, hospital, or other provider of medical services	8788
that provides medical services to the child who is the subject of	8789
the child support order of the number of any health insurance or	8790
health care policy, contract, or plan that covers the child if the	8791
child is eligible for medical assistance under ~~sections 5101.5211~~	8792
~~to 5101.5216 or Chapter 5111. or 5115. of the Revised Code~~the	8793
medicaid program, the disability medical assistance program, or	8794
the children's buy-in program. The party shall include in the	8795
notice the name and address of the insurer. Any physician,	8796
hospital, or other provider of medical services for which medical	8797
assistance is available under ~~sections 5101.5211 to 5101.5216 or~~	8798
~~Chapter 5111. or 5115. of the Revised Code~~the medicaid program,	8799
the disability medical assistance program, or the children's	8800
buy-in program who is notified under this section of the existence	8801
of a health insurance or health care policy, contract, or plan	8802
with coverage for children who are eligible for medical	8803
assistance shall first bill the insurer for any services provided	8804
for those children. If the insurer fails to pay all or any part	8805
of a claim filed under this section and the services for which	8806
the claim is filed are covered by ~~sections 5101.5211 to 5101.5216~~	8807
~~or Chapter 5111. or 5115. of the Revised Code~~the medicaid	8808
program, the disability medical assistance program, or the	8809
children's buy-in program, the physician, hospital, or other	8810
medical services provider shall bill the remaining unpaid costs	8811
of the services in accordance with ~~sections 5101.5211 to~~	8812
~~5101.5216 or Chapter 5111. or 5115. of the Revised Code~~the law	8813
governing the medicaid program, disability medical assistance	8814
program, or children's buy-in program.	8815

Sec. 3121.441. (A) Notwithstanding the provisions of this	8816
chapter, Chapters 3119., 3123., and 3125., and sections 3770.071	8817
and 5107.20 of the Revised Code providing for the office of child	8818
support in the department of job and family services to collect,	8819
withhold, or deduct spousal support, when a court pursuant to	8820
section 3105.18 or 3105.65 of the Revised Code issues or modifies	8821
an order requiring an obligor to pay spousal support or grants or	8822
modifies a decree of dissolution of marriage incorporating a	8823
separation agreement that provides for spousal support, or at any	8824
time after the issuance, granting, or modification of an order or	8825
decree of that type, the court may permit the obligor to make the	8826
spousal support payments directly to the obligee instead of to the	8827
office if the obligee and the obligor have no minor children born	8828
as a result of their marriage and the obligee has not assigned the	8829
spousal support amounts to the department pursuant to section	8830
~~5101.59 or~~ 5107.20 or 5160.37 of the Revised Code.	8831

(B) A court that permits an obligor to make spousal support	8832
payments directly to the obligee pursuant to division (A) of this	8833
section shall order the obligor to make the spousal support	8834
payments as a check, as a money order, or in any other form that	8835
establishes a clear record of payment.	8836

(C) If a court permits an obligor to make spousal support	8837
payments directly to an obligee pursuant to division (A) of this	8838
section and the obligor is in default in making any spousal	8839
support payment to the obligee, the court, upon motion of the	8840
obligee or on its own motion, may rescind the permission granted	8841
under that division. After the rescission, the court shall	8842
determine the amount of arrearages in the spousal support payments	8843
and order the obligor to make to the office of child support in	8844
the department of job and family services any spousal support	8845
payments that are in arrears and any future spousal support	8846
payments. Upon the issuance of the order of the court under this	8847
division, the provisions of this chapter, Chapters 3119., 3123.,	8848
and 3125., and sections 3770.071 and 5107.20 of the Revised Code	8849
apply with respect to the collection, withholding, or deduction of	8850
the obligor's spousal support payments that are the subject of	8851
that order of the court.	8852

Sec. 3121.898. ~~The~~As used in this section, "state agency"	8853
means every department, bureau, board, commission, office, or	8854
other organized body established by the constitution or laws of	8855
this state for the exercise of state government; every entity of	8856
county government that is subject to the rules of a state agency;	8857
and every contractual agent of a state agency.	8858

The department of job and family services shall use the new	8859
hire reports it receives for any of the following purposes set	8860
forth in 42 U.S.C. 653a, as amended, including:	8861

(A) To locate individuals for the purposes of establishing	8862
paternity and for establishing, modifying, and enforcing child	8863
support orders.	8864

(B) ~~As used in this division, "state agency" means every~~	8865
~~department, bureau, board, commission, office, or other organized~~	8866
~~body established by the constitution or laws of this state for the~~	8867
~~exercise of state government; every entity of county government~~	8868
~~that is subject to the rules of a state agency; and every~~	8869
~~contractual agent of a state agency.~~	8870

To make available to any state agency responsible for	8871
administering any of the following programs for purposes of	8872
verifying program eligibility:	8873

(1) Any Title IV-A program as defined in section 5101.80 of	8874
the Revised Code;	8875

(2) The medicaid program ~~authorized by Chapter 5111. of the~~	8876
~~Revised Code~~;	8877

(3) The unemployment compensation program authorized by	8878
Chapter 4141. of the Revised Code;	8879

(4) The food stamp program authorized by section 5101.54 of	8880
the Revised Code;	8881

(5) Any other program authorized in 42 U.S.C. 1320b-7(b), as	8882
amended.	8883

(C) The administration of the employment security program	8884
under the director of job and family services.	8885

Sec. 3125.36. (A) Subject to division (B) of this section,	8886
all support orders that are administered by a child support	8887
enforcement agency designated under section 307.981 of the Revised	8888
Code or former section 2301.35 of the Revised Code and are	8889
eligible for Title IV-D services shall be Title IV-D cases under	8890
Title IV-D of the "Social Security Act." Subject to division (B)	8891
of this section, all obligees of support orders administered by	8892
the agency shall be considered to have filed a signed application	8893
for Title IV-D services.	8894

(B) Except as provided in division (D) of this section, a	8895
court that issues or modifies a support order shall require the	8896
obligee under the order to sign, at the time of the issuance or	8897
modification of the order, an application for Title IV-D services	8898
and to file, as soon as possible, the signed application with the	8899
child support enforcement agency that will administer the order.	8900
The application shall be on a form prescribed by the department of	8901
job and family services. Except as provided in division (D) of	8902
this section, a support order that is administered by a child	8903
support enforcement agency, and that is eligible for Title IV-D	8904
services shall be a Title IV-D case under Title IV-D of the	8905
"Social Security Act" only upon the filing of the signed	8906
application for Title IV-D services.	8907

(C) A child support enforcement agency shall make available	8908
an application for Title IV-D services to all persons requesting a	8909
child support enforcement agency's assistance in an action under	8910
sections 3111.01 to 3111.18 of the Revised Code or in an	8911
administrative proceeding brought to establish a parent and child	8912
relationship, to establish or modify an administrative support	8913
order, or to establish or modify an order to provide health	8914
insurance coverage for the children subject to a support order.	8915

(D) An obligee under a support order who has assigned the	8916
right to the support pursuant to section ~~5101.59 or~~ 5107.20 or	8917
5160.37 of the Revised Code shall not be required to sign an	8918
application for Title IV-D services. The support order shall be	8919
considered a Title IV-D case.	8920

Sec. 3307.20. (A) As used in this section:

8921

(1) "Personal history record" means information maintained by	8922
the state teachers retirement board on an individual who is a	8923
member, former member, contributor, former contributor, retirant,	8924
or beneficiary that includes the address, telephone number, social	8925
security number, record of contributions, correspondence with the	8926
state teachers retirement system, or other information the board	8927
determines to be confidential.	8928

(2) "Retirant" has the same meaning as in section 3307.50 of	8929
the Revised Code.	8930

(B) The records of the board shall be open to public	8931
inspection, except for the following, which shall be excluded,	8932
except with the written authorization of the individual concerned:	8933

(1) The individual's personal records provided for in section	8934
3307.23 of the Revised Code;	8935

(2) The individual's personal history record;

8936

(3) Any information identifying, by name and address, the	8937
amount of a monthly allowance or benefit paid to the individual.	8938

(C) All medical reports and recommendations under sections	8939
3307.62, 3307.64, and 3307.66 of the Revised Code are privileged,	8940
except that copies of such medical reports or recommendations	8941
shall be made available to the personal physician, attorney, or	8942
authorized agent of the individual concerned upon written release	8943
received from the individual or the individual's agent, or, when	8944
necessary for the proper administration of the fund, to the board	8945
assigned physician.	8946

(D) Any person who is a member or contributor of the system	8947
shall be furnished, on written request, with a statement of the	8948
amount to the credit of the person's account. The board need not	8949
answer more than one request of a person in any one year.	8950

(E) Notwithstanding the exceptions to public inspection in	8951
division (B) of this section, the board may furnish the following	8952
information:	8953

(1) If a member, former member, retirant, contributor, or	8954
former contributor is subject to an order issued under section	8955
2907.15 of the Revised Code or an order issued under division (A)	8956
or (B) of section 2929.192 of the Revised Code or is convicted of	8957
or pleads guilty to a violation of section 2921.41 of the Revised	8958
Code, on written request of a prosecutor as defined in section	8959
2935.01 of the Revised Code, the board shall furnish to the	8960
prosecutor the information requested from the individual's	8961
personal history record.	8962

(2) Pursuant to a court or administrative order issued under	8963
section 3119.80, 3119.81, 3121.02, 3121.03, or 3123.06 of the	8964
Revised Code, the board shall furnish to a court or child support	8965
enforcement agency the information required under that section.	8966

(3) At the written request of any person, the board shall	8967
provide to the person a list of the names and addresses of	8968
members, former members, retirants, contributors, former	8969
contributors, or beneficiaries. The costs of compiling, copying,	8970
and mailing the list shall be paid by such person.	8971

(4) Within fourteen days after receiving ~~from the director of~~	8972
~~job and family services~~ a list of the names and social security	8973
numbers of recipients of public assistance pursuant to section	8974
5101.181 of the Revised Code or a list of the names and social	8975
security numbers of public medical assistance program recipients	8976
pursuant to section 5160.43 of the Revised Code, the board shall	8977
inform the auditor of state of the name, current or most recent	8978
employer address, and social security number of each member whose	8979
name and social security number are the same as that of a person	8980
whose name or social security number ~~was submitted by the director~~	8981
is included on the list. The board and its employees shall, except	8982
for purposes of furnishing the auditor of state with information	8983
required by this section, preserve the confidentiality of	8984
recipients of public assistance in compliance with ~~division (A) of~~	8985
section 5101.181 of the Revised Code and preserve the	8986
confidentiality of public medical assistance recipients in	8987
compliance with section 5160.43 of the Revised Code.	8988

(5) The system shall comply with orders issued under section	8989
3105.87 of the Revised Code.	8990

On the written request of an alternate payee, as defined in	8991
section 3105.80 of the Revised Code, the system shall furnish to	8992
the alternate payee information on the amount and status of any	8993
amounts payable to the alternate payee under an order issued under	8994
section 3105.171 or 3105.65 of the Revised Code.	8995

(6) At the request of any person, the board shall make	8996
available to the person copies of all documents, including	8997
resumes, in the board's possession regarding filling a vacancy of	8998
a contributing member or retired teacher member of the board. The	8999
person who made the request shall pay the cost of compiling,	9000
copying, and mailing the documents. The information described in	9001
this division is a public record.	9002

(F) A statement that contains information obtained from the	9003
system's records that is signed by an officer of the retirement	9004
system and to which the system's official seal is affixed, or	9005
copies of the system's records to which the signature and seal are	9006
attached, shall be received as true copies of the system's records	9007
in any court or before any officer of this state.	9008

Sec. 3309.22. (A)(1) As used in this division, "personal	9009
history record" means information maintained by the board on an	9010
individual who is a member, former member, contributor, former	9011
contributor, retirant, or beneficiary that includes the address,	9012
telephone number, social security number, record of contributions,	9013
correspondence with the system, and other information the board	9014
determines to be confidential.	9015

(2) The records of the board shall be open to public	9016
inspection, except for the following, which shall be excluded,	9017
except with the written authorization of the individual concerned:	9018

(a) The individual's statement of previous service and other	9019
information as provided for in section 3309.28 of the Revised	9020
Code;	9021

(b) Any information identifying by name and address the	9022
amount of a monthly allowance or benefit paid to the individual;	9023

9024

(B) All medical reports and recommendations required by the	9025
system are privileged except that copies of such medical reports	9026
or recommendations shall be made available to the personal	9027
physician, attorney, or authorized agent of the individual	9028
concerned upon written release received from the individual or the	9029
individual's agent, or when necessary for the proper	9030
administration of the fund, to the board assigned physician.	9031

(C) Any person who is a contributor of the system shall be	9032
furnished, on written request, with a statement of the amount to	9033
the credit of the person's account. The board need not answer more	9034
than one such request of a person in any one year.	9035

(D) Notwithstanding the exceptions to public inspection in	9036
division (A)(2) of this section, the board may furnish the	9037
following information:	9038

(1) If a member, former member, contributor, former	9039
contributor, or retirant is subject to an order issued under	9040
section 2907.15 of the Revised Code or an order issued under	9041
division (A) or (B) of section 2929.192 of the Revised Code or is	9042
convicted of or pleads guilty to a violation of section 2921.41 of	9043
the Revised Code, on written request of a prosecutor as defined in	9044
section 2935.01 of the Revised Code, the board shall furnish to	9045
the prosecutor the information requested from the individual's	9046
personal history record.	9047

(2) Pursuant to a court or administrative order issued under	9048
section 3119.80, 3119.81, 3121.02, 3121.03, or 3123.06 of the	9049
Revised Code, the board shall furnish to a court or child support	9050
enforcement agency the information required under that section.	9051

(3) At the written request of any person, the board shall	9052
provide to the person a list of the names and addresses of	9053
members, former members, retirants, contributors, former	9054
contributors, or beneficiaries. The costs of compiling, copying,	9055
and mailing the list shall be paid by such person.	9056

(4) Within fourteen days after receiving ~~from the director of~~	9057
~~job and family services~~ a list of the names and social security	9058
numbers of recipients of public assistance pursuant to section	9059
5101.181 of the Revised Code or a list of the names and social	9060
security numbers of public medical assistance program recipients	9061
pursuant to section 5160.43 of the Revised Code, the board shall	9062
inform the auditor of state of the name, current or most recent	9063
employer address, and social security number of each contributor	9064
whose name and social security number are the same as that of a	9065
person whose name or social security number ~~was submitted by the~~	9066
~~director~~is included on the list. The board and its employees	9067
shall, except for purposes of furnishing the auditor of state with	9068
information required by this section, preserve the confidentiality	9069
of recipients of public assistance in compliance with ~~division (A)~~	9070
of section 5101.181 of the Revised Code and preserve the	9071
confidentiality of public medical assistance program recipients in	9072
compliance with section 5160.43 of the Revised Code.	9073

(5) The system shall comply with orders issued under section	9074
3105.87 of the Revised Code.	9075

On the written request of an alternate payee, as defined in	9076
section 3105.80 of the Revised Code, the system shall furnish to	9077
the alternate payee information on the amount and status of any	9078
amounts payable to the alternate payee under an order issued under	9079
section 3105.171 or 3105.65 of the Revised Code.	9080

(6) At the request of any person, the board shall make	9081
available to the person copies of all documents, including	9082
resumes, in the board's possession regarding filling a vacancy of	9083
an employee member or retirant member of the board. The person who	9084
made the request shall pay the cost of compiling, copying, and	9085
mailing the documents. The information described in this division	9086
is a public record.	9087

(E) A statement that contains information obtained from the	9088
system's records that is signed by an officer of the retirement	9089
system and to which the system's official seal is affixed, or	9090
copies of the system's records to which the signature and seal are	9091
attached, shall be received as true copies of the system's records	9092
in any court or before any officer of this state.	9093

Sec. 3313.714. (A) As used in this section:

9094

(1) "Board of education" means the board of education of a	9095
city, local, exempted village, or joint vocational school	9096
district.	9097

(2) "Healthcheck" means the early and periodic screening,	9098
diagnosis, and treatment program, a component of the ~~medical~~	9099
~~assistance~~medicaid program ~~established under Title XIX of the~~	9100
~~"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 302, as~~	9101
~~amended, and Chapter 5111. of the Revised Code~~.	9102

(3) "Pupil" means a person under age twenty-two enrolled in	9103
the schools of a city, local, exempted village, or joint	9104
vocational school district.	9105

(4) "Parent" means either parent with the following	9106
exceptions:	9107

(a) If one parent has custody by court order, "parent" means	9108
the parent with custody.	9109

(b) If neither parent has legal custody, "parent" means the	9110
person or government entity with legal custody.	9111

(c) The child's legal guardian or a person who has accepted	9112
responsibility for the health, safety, and welfare of the child.	9113

(B) At the request of the department of ~~job and family~~	9114
~~services~~health care administration, a board of education shall	9115
establish and conduct a healthcheck program for pupils enrolled in	9116
the schools of the district who are medicaid recipients ~~of medical~~	9117
~~assistance under Chapter 5111. of the Revised Code~~. At the request	9118
of a board of education, the department may authorize the board to	9119
establish a healthcheck program. A board that establishes a	9120
healthcheck program shall enter into a ~~medical assistance~~medicaid	9121
provider agreement with the department.	9122

A healthcheck program established by a board of education	9123
shall be conducted in accordance with rules adopted by the	9124
director of ~~job and family services~~health care administration	9125
under division (F) of this section. The healthcheck program shall	9126
include all of the following components:	9127

(1) A comprehensive health and development history;

9128

(2) A comprehensive physical examination;

9129

(3) A developmental assessment;

9130

(4) A nutritional assessment;

9131

(5) A vision assessment;

9132

(6) A hearing assessment;

9133

(7) An immunization assessment;

9134

(8) Lead screening and laboratory tests ordered by a doctor	9135
of medicine or osteopathic medicine as part of one of the other	9136
components;	9137

(9) Such other assessment as may be required by the	9138
department of ~~job and family services~~health care administration	9139
in accordance with the requirements of the healthcheck program.	9140

All services included in a board of education's healthcheck	9141
program that the board provided under sections 3313.67, 3313.673,	9142
3313.68, 3313.69, and 3313.71 of the Revised Code during the	9143
1990-1991 school year shall continue to be provided to ~~medical~~	9144
~~assistance~~medicaid recipients by the board pursuant to those	9145
sections. The services shall be considered part of the healthcheck	9146
program for medicaid recipients ~~of medical assistance~~, and the	9147
board shall be eligible for reimbursement from the ~~state~~	9148
department in accordance with this division for providing the	9149
services.	9150

The department shall reimburse boards of education for	9151
healthcheck program services provided under this division at the	9152
rates paid under the ~~medical assistance~~medicaid program to	9153
physicians, dentists, nurses, and other providers of healthcheck	9154
services.	9155

(C) Each board of education that conducts a healthcheck	9156
program shall determine for each pupil enrolled in the schools of	9157
the district whether the pupil is a ~~medical assistance~~medicaid	9158
recipient. The department of ~~job and family services~~health care	9159
administration and county departments of ~~human~~job and family	9160
services shall assist the board in making these determinations.	9161
Except as necessary to carry out the purposes of this section, all	9162
information received by a board under this division shall be	9163
confidential.	9164

Before the first day of October of each year, each board that	9165
conducts a healthcheck program shall send the parent of each pupil	9166
who is under age eighteen and a medicaid recipient ~~of medical~~	9167
~~assistance~~ notice that the pupil will be examined under the	9168
district's healthcheck program unless the parent notifies the	9169
board that the parent denies consent for the examination. The	9170
notice shall include a form to be used by the parent to indicate	9171
that the parent denies consent. The denial shall be effective only	9172
if the form is signed by the parent and returned to the board or	9173
the school in which the pupil is enrolled. If the parent does not	9174
return a signed form indicating denial of consent within two weeks	9175
after the date the notice is sent, the school district and the	9176
department of ~~job and family services~~health care administration	9177
shall deem the parent to have consented to examination of the	9178
parent's child under the healthcheck program. In the case of a	9179
pupil age eighteen or older, the notice shall be given to the	9180
pupil, and the school district and the department ~~of job and~~	9181
~~family services~~ shall deem the pupil to have consented to	9182
examination unless the pupil returns the signed form indicating	9183
the pupil's denial of consent.	9184

(D)(1) As used in this division:

9185

(a) "Nonfederal share" means the portion of expenditures for	9186
services that is required under the ~~medical assistance~~medicaid	9187
program to be paid for with state or local government funds.	9188

(b) "Federal financial participation" means the portion of	9189
expenditures for services that is reimbursed under the ~~medical~~	9190
~~assistance~~medicaid program with federal funds.	9191

(2) At the request of a board of education, the ~~state~~	9192
department may enter into an agreement with board under which the	9193
board provides medical services to a medicaid recipient ~~of medical~~	9194
~~assistance~~ that are reimbursable under the ~~medical assistance~~	9195
medicaid program but not under the healthcheck program. The	9196
agreement may be for a term specified in the agreement and	9197
renewable by mutual consent of the board and the department, or	9198
may continue in force as long as agreeable to the board and the	9199
department.	9200

The board shall use state or local funds of the district to	9201
pay the nonfederal share of expenditures for services provided	9202
under this division. Prior to entering into or renewing an	9203
agreement and at any other time requested by the department while	9204
the agreement is in force, the board shall certify to the	9205
department in accordance with the rules adopted under division (F)	9206
of this section that it will have sufficient state or local funds	9207
to pay the nonfederal share of expenditures under this division.	9208
If the board fails to make the certification, the department shall	9209
not enter into or renew the agreement. If an agreement has been	9210
entered into, it shall be void unless the board makes the	9211
certification not later than fifteen days after receiving notice	9212
from the department that the certification is due. The board shall	9213
report to the department, in accordance with the rules, the amount	9214
of state or local funds it spends to provide services under this	9215
division.	9216

The department shall reimburse the board the federal	9217
financial participation allowed for the board's expenditures for	9218
services under this division. The total of the nonfederal share	9219
spent by the board and the federal financial participation	9220
reimbursed by the department for a service rendered under this	9221
division shall be an amount agreed to by the board and the	9222
department, but shall not exceed the maximum reimbursable for that	9223
service under rules adopted by the director of ~~job and family~~	9224
~~services~~health care administration under ~~Chapter 5111.~~section	9225
5163.15 of the Revised Code. The rules adopted under division (F)	9226
of this section shall include procedures under which the	9227
department will recover from a board overpayments and subsequent	9228
federal audit disallowances of federal financial participation	9229
reimbursed by the department.	9230

(E) A board of education shall provide services under	9231
division (D) of this section and under its healthcheck program as	9232
provided in division (E)(1), (2), or (3) of this section:	9233

(1) By having the services performed by physicians, dentists,	9234
and nurses employed by the board;	9235

(2) By contracting with physicians, dentists, nurses, and	9236
other providers of services who have ~~medical assistance~~medicaid	9237
provider agreements with the department of ~~job and family services~~	9238
health care administration;	9239

(3) By having some of the services performed by persons	9240
described in division (E)(1) of this section and others performed	9241
by persons described in division (E)(2) of this section.	9242

(F) The director of ~~job and family services~~health care	9243
administration shall adopt rules in accordance with Chapter 119.	9244
of the Revised Code governing healthcheck programs conducted under	9245
this section and services provided under division (D) of this	9246
section.	9247

Sec. 3313.715. The board of education of a school district	9248
may request from the director of mental retardation and	9249
developmental disabilities the appropriate identification numbers	9250
for all students residing in the district who are ~~medical~~	9251
~~assistance~~medicaid recipients ~~under Chapter 5111. of the Revised~~	9252
~~Code~~. The director shall furnish such numbers upon receipt of	9253
lists of student names furnished by the district board, in such	9254
form as the director may require.	9255

The director of ~~job and family services~~health care	9256
administration shall provide the director of mental retardation	9257
and developmental disabilities with the data necessary for	9258
compliance with this section.	9259

Section 3319.321 of the Revised Code does not apply to the	9260
release of student names or other data to the director of mental	9261
retardation and developmental disabilities for the purposes of	9262
this section. Chapter 1347. of the Revised Code does not apply to	9263
information required to be kept by a school board or the	9264
departments of ~~job and family services~~health care administration	9265
or mental retardation and developmental disabilities to the extent	9266
necessary to comply with this section and section 3313.714 of the	9267
Revised Code. However, any such information or data shall be used	9268
only for the specific legal purposes of such boards and	9269
departments and shall not be released to any unauthorized person.	9270

Sec. 3323.021. As used in this section, "participating	9271
county MR/DD board" means a county board of mental retardation and	9272
developmental disabilities electing to participate in the	9273
provision of or contracting for educational services for children	9274
under division (D) of section 5126.05 of the Revised Code.	9275

(A) When a school district, educational service center, or	9276
participating county MR/DD board enters into an agreement or	9277
contract with another school district, educational service center,	9278
or participating county MR/DD board to provide educational	9279
services to a disabled child during a school year, both of the	9280
following shall apply:	9281

(1) Beginning with fiscal year 1999, if the provider of the	9282
services intends to increase the amount it charges for some or all	9283
of those services during the next school year or if the provider	9284
intends to cease offering all or part of those services during the	9285
next school year, the provider shall notify the entity for which	9286
the services are provided of these intended changes no later ~~that~~	9287
than the first day of March of the current fiscal year.	9288

(2) Beginning with fiscal year 1999, if the entity for which	9289
services are provided intends to cease obtaining those services	9290
from the provider for the next school year or intends to change	9291
the type or amount of services it obtains from the provider for	9292
the next school year, the entity shall notify the service provider	9293
of these intended changes no later than the first day of March of	9294
the current fiscal year.	9295

(B) School districts, educational service centers,	9296
participating county MR/DD boards, and other applicable	9297
governmental entities shall collaborate where possible to maximize	9298
federal sources of revenue to provide additional funds for special	9299
education related services for disabled children. Annually, each	9300
school district shall report to the department of education any	9301
amounts of money the district received through ~~such medical~~	9302
~~assistance~~the medicaid program.	9303

(C) The state board of education, the department of mental	9304
retardation and developmental disabilities, and the department of	9305
~~job and family services~~health care administration shall develop	9306
working agreements for pursuing additional funds for services for	9307
disabled children.	9308

Sec. 3599.45. (A) No candidate for the office of attorney	9309
general or county prosecutor or such a candidate's campaign	9310
committee shall knowingly accept any contribution from a provider	9311
of services or goods under contract with the department of ~~job and~~	9312
~~family services~~health care administration pursuant to the	9313
medicaid program ~~of Title XIX of the "Social Security Act," 49~~	9314
~~Stat. 620 (1935), 42 U.S.C. 301, as amended,~~ or from any person	9315
having an ownership interest in the provider.	9316

As used in this section "candidate," "campaign committee,"	9317
and "contribution" have the same meaning as in section 3517.01 of	9318
the Revised Code.	9319

(B) Whoever violates this section is guilty of a misdemeanor	9320
of the first degree.	9321

Sec. 3701.023. (A) The department of health shall review	9322
applications for eligibility for the program for medically	9323
handicapped children that are submitted to the department by city	9324
and general health districts and physician providers approved in	9325
accordance with division (C) of this section. The department shall	9326
determine whether the applicants meet the medical and financial	9327
eligibility requirements established by the public health council	9328
pursuant to division (A)(1) of section 3701.021 of the Revised	9329
Code, and by the department in the manual of operational	9330
procedures and guidelines for the program for medically	9331
handicapped children developed pursuant to division (B) of that	9332
section. Referrals of potentially eligible children for the	9333
program may be submitted to the department on behalf of the child	9334
by parents, guardians, public health nurses, or any other	9335
interested person. The department of health may designate other	9336
agencies to refer applicants to the department of health.	9337

(B) In accordance with the procedures established in rules	9338
adopted under division (A)(4) of section 3701.021 of the Revised	9339
Code, the department of health shall authorize a provider or	9340
providers to provide to any Ohio resident under twenty-one years	9341
of age, without charge to the resident or the resident's family	9342
and without restriction as to the economic status of the resident	9343
or the resident's family, diagnostic services necessary to	9344
determine whether the resident has a medically handicapping or	9345
potentially medically handicapping condition.	9346

(C) The department of health shall review the applications of	9347
health professionals, hospitals, medical equipment suppliers, and	9348
other individuals, groups, or agencies that apply to become	9349
providers. The department shall enter into a written agreement	9350
with each applicant who is determined, pursuant to the	9351
requirements set forth in rules adopted under division (A)(2) of	9352
section 3701.021 of the Revised Code, to be eligible to be a	9353
provider in accordance with the provider agreement required by the	9354
~~medical assistance~~medicaid program ~~established under section~~	9355
~~5111.01 of the Revised Code~~. No provider shall charge a medically	9356
handicapped child or the child's parent or guardian for services	9357
authorized by the department under division (B) or (D) of this	9358
section.	9359

The department, in accordance with rules adopted under	9360
division (A)(3) of section 3701.021 of the Revised Code, may	9361
disqualify any provider from further participation in the program	9362
for violating any requirement set forth in rules adopted under	9363
division (A)(2) of that section. The disqualification shall not	9364
take effect until a written notice, specifying the requirement	9365
violated and describing the nature of the violation, has been	9366
delivered to the provider and the department has afforded the	9367
provider an opportunity to appeal the disqualification under	9368
division (H) of this section.	9369

(D) The department of health shall evaluate applications from	9370
city and general health districts and approved physician providers	9371
for authorization to provide treatment services, service	9372
coordination, and related goods to children determined to be	9373
eligible for the program for medically handicapped children	9374
pursuant to division (A) of this section. The department shall	9375
authorize necessary treatment services, service coordination, and	9376
related goods for each eligible child in accordance with an	9377
individual plan of treatment for the child. As an alternative, the	9378
department may authorize payment of health insurance premiums on	9379
behalf of eligible children when the department determines, in	9380
accordance with criteria set forth in rules adopted under division	9381
(A)(9) of section 3701.021 of the Revised Code, that payment of	9382
the premiums is cost-effective.	9383

(E) The department of health shall pay, from appropriations	9384
to the department, any necessary expenses, including but not	9385
limited to, expenses for diagnosis, treatment, service	9386
coordination, supportive services, transportation, and accessories	9387
and their upkeep, provided to medically handicapped children,	9388
provided that the provision of the goods or services is authorized	9389
by the department under division (B) or (D) of this section. Money	9390
appropriated to the department of health may also be expended for	9391
reasonable administrative costs incurred by the program. The	9392
department of health also may purchase liability insurance	9393
covering the provision of services under the program for medically	9394
handicapped children by physicians and other health care	9395
professionals.	9396

Payments made to providers by the department of health	9397
pursuant to this division for inpatient hospital care, outpatient	9398
care, and all other medical assistance furnished to eligible	9399
recipients shall be made in accordance with rules adopted by the	9400
public health council pursuant to division (A) of section 3701.021	9401
of the Revised Code.	9402

The departments of health and ~~job and family services~~health	9403
care administration shall jointly implement procedures to ensure	9404
that duplicate payments are not made under the program for	9405
medically handicapped children and the ~~medical assistance~~medicaid	9406
program ~~established under section 5111.01 of the Revised Code~~ and	9407
to identify and recover duplicate payments.	9408

(F) At the time of applying for participation in the program	9409
for medically handicapped children, a medically handicapped child	9410
or the child's parent or guardian shall disclose the identity of	9411
any third party against whom the child or the child's parent or	9412
guardian has or may have a right of recovery for goods and	9413
services provided under division (B) or (D) of this section. The	9414
department of health shall require a medically handicapped child	9415
who receives services from the program or the child's parent or	9416
guardian to apply for all third-party benefits for which the child	9417
may be eligible and require the child, parent, or guardian to	9418
apply all third-party benefits received to the amount determined	9419
under division (E) of this section as the amount payable for goods	9420
and services authorized under division (B) or (D) of this section.	9421
The department is the payer of last resort and shall pay for	9422
authorized goods or services, up to the amount determined under	9423
division (E) of this section for the authorized goods or services,	9424
only to the extent that payment for the authorized goods or	9425
services is not made through third-party benefits. When a third	9426
party fails to act on an application or claim for benefits by a	9427
medically handicapped child or the child's parent or guardian, the	9428
department shall pay for the goods or services only after ninety	9429
days have elapsed since the date the child, parents, or guardians	9430
made an application or claim for all third-party benefits.	9431
Third-party benefits received shall be applied to the amount	9432
determined under division (E) of this section. Third-party	9433
payments for goods and services not authorized under division (B)	9434
or (D) of this section shall not be applied to payment amounts	9435
determined under division (E) of this section. Payment made by the	9436
department shall be considered payment in full of the amount	9437
determined under division (E) of this section. Medicaid payments	9438
for persons eligible for the ~~medical assistance~~medicaid program	9439
~~established under section 5111.01 of the Revised Code~~ shall be	9440
considered payment in full of the amount determined under division	9441
(E) of this section.	9442

(G) The department of health shall administer a program to	9443
provide services to Ohio residents who are twenty-one or more	9444
years of age who have cystic fibrosis and who meet the eligibility	9445
requirements established by the rules of the public health council	9446
pursuant to division (A)(7) of section 3701.021 of the Revised	9447
Code, subject to all provisions of this section, but not subject	9448
to section 3701.024 of the Revised Code.	9449

(H) The department of health shall provide for appeals, in	9450
accordance with rules adopted under section 3701.021 of the	9451
Revised Code, of denials of applications for the program for	9452
medically handicapped children under division (A) or (D) of this	9453
section, disqualification of providers, or amounts paid under	9454
division (E) of this section. Appeals under this division are not	9455
subject to Chapter 119. of the Revised Code.	9456

The department may designate ombudspersons to assist	9457
medically handicapped children or their parents or guardians, upon	9458
the request of the children, parents, or guardians, in filing	9459
appeals under this division and to serve as children's, parents',	9460
or guardians' advocates in matters pertaining to the	9461
administration of the program for medically handicapped children	9462
and eligibility for program services. The ombudspersons shall	9463
receive no compensation but shall be reimbursed by the department,	9464
in accordance with rules of the office of budget and management,	9465
for their actual and necessary travel expenses incurred in the	9466
performance of their duties.	9467

(I) The department of health, and city and general health	9468
districts providing service coordination pursuant to division	9469
(A)(2) of section 3701.024 of the Revised Code, shall provide	9470
service coordination in accordance with the standards set forth in	9471
the rules adopted under section 3701.021 of the Revised Code,	9472
without charge, and without restriction as to economic status.	9473

Sec. 3701.024. (A)(1) Under a procedure established in rules	9474
adopted under section 3701.021 of the Revised Code, the department	9475
of health shall determine the amount each county shall provide	9476
annually for the program for medically handicapped children, based	9477
on a proportion of the county's total general property tax	9478
duplicate, not to exceed one-tenth of a mill, and charge the	9479
county for any part of expenses incurred under the program for	9480
treatment services on behalf of medically handicapped children	9481
having legal settlement in the county that is not paid from	9482
federal funds or through the ~~medical assistance~~medicaid program	9483
~~established under section 5111.01 of the Revised Code~~. The	9484
department shall not charge the county for expenses exceeding the	9485
difference between the amount determined under division (A)(1) of	9486
this section and any amounts retained under divisions (A)(2) and	9487
(3) of this section.	9488

All amounts collected by the department under division (A)(1)	9489
of this section shall be deposited into the state treasury to the	9490
credit of the medically handicapped children-county assessment	9491
fund, which is hereby created. The fund shall be used by the	9492
department to comply with sections 3701.021 to 3701.028 of the	9493
Revised Code.	9494

(2) The department, in accordance with rules adopted under	9495
section 3701.021 of the Revised Code, may allow each county to	9496
retain up to ten per cent of the amount determined under division	9497
(A)(1) of this section to provide funds to city or general health	9498
districts of the county with which the districts shall provide	9499
service coordination, public health nursing, or transportation	9500
services for medically handicapped children.	9501

(3) In addition to any amount retained under division (A)(2)	9502
of this section, the department, in accordance with rules adopted	9503
under section 3701.021 of the Revised Code, may allow counties	9504
that it determines have significant numbers of potentially	9505
eligible medically handicapped children to retain an amount equal	9506
to the difference between:	9507

(a) Twenty-five per cent of the amount determined under	9508
division (A)(1) of this section;	9509

(b) Any amount retained under division (A)(2) of this	9510
section.	9511

Counties shall use amounts retained under division (A)(3) of	9512
this section to provide funds to city or general health districts	9513
of the county with which the districts shall conduct outreach	9514
activities to increase participation in the program for medically	9515
handicapped children.	9516

(4) Prior to any increase in the millage charged to a county,	9517
the public health council shall hold a public hearing on the	9518
proposed increase and shall give notice of the hearing to each	9519
board of county commissioners that would be affected by the	9520
increase at least thirty days prior to the date set for the	9521
hearing. Any county commissioner may appear and give testimony at	9522
the hearing. Any increase in the millage any county is required to	9523
provide for the program for medically handicapped children shall	9524
be determined, and notice of the amount of the increase shall be	9525
provided to each affected board of county commissioners, no later	9526
than the first day of June of the fiscal year next preceding the	9527
fiscal year in which the increase will take effect.	9528

(B) Each board of county commissioners shall establish a	9529
medically handicapped children's fund and shall appropriate	9530
thereto an amount, determined in accordance with division (A)(1)	9531
of this section, for the county's share in providing medical,	9532
surgical, and other aid to medically handicapped children residing	9533
in such county and for the purposes specified in divisions (A)(2)	9534
and (3) of this section. Each county shall use money retained	9535
under divisions (A)(2) and (3) of this section only for the	9536
purposes specified in those divisions.	9537

Sec. 3701.027. The department of health shall administer	9538
funds received from the "Maternal and Child Health Block Grant,"	9539
Title V of the "Social Security Act," 95 Stat. 818 (1981), 42	9540
U.S.C.A. 701, as amended, for programs including the program for	9541
medically handicapped children, and to provide technical	9542
assistance and consultation to city and general health districts	9543
and local health planning organizations in implementing local,	9544
community-based, family-centered, coordinated systems of care for	9545
medically handicapped children. The department may make grants to	9546
persons and other entities for the provision of services with the	9547
funds. In addition, the department may use the funds to purchase	9548
liability insurance covering the provision of services under the	9549
programs by physicians and other health care professionals, and to	9550
pay health insurance premiums on behalf of medically handicapped	9551
children participating in the program for medically handicapped	9552
children when the department determines, in accordance with	9553
criteria set forth in rules adopted under division (A)(9) of	9554
section 3701.021 of the Revised Code, that payment of the premiums	9555
is cost effective.	9556

In determining eligibility for services provided with funds	9557
received from the "Maternal and Child Health Block Grant," the	9558
department may use the application form established under section	9559
~~5111.013~~5162.15 of the Revised Code. The department may require	9560
applicants to furnish their social security numbers.	9561

Sec. 3701.043. If authorized by federal statute or	9562
regulation, the director of health may establish and collect fees	9563
for conducting the initial certification of any person or entity	9564
as a provider of health services for purposes of the medicare	9565
program ~~established under Title XVIII of the Social Security Act,~~	9566
~~49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended~~. The fee	9567
established for conducting an initial medicare certification shall	9568
not exceed the actual and necessary costs incurred by the	9569
department of health in conducting the certification.	9570

All fees collected under this section shall be deposited into	9571
the state treasury to the credit of the medicare initial	9572
certification fund, which is hereby created. Money credited to the	9573
fund shall be used solely to pay the costs of conducting initial	9574
medicare certifications.	9575

Sec. 3701.132. The department of health is hereby designated	9576
as the state agency to administer the "special supplemental	9577
nutrition program for women, infants, and children" established	9578
under the "Child Nutrition Act of 1966," 80 Stat. 885, 42 U.S.C.	9579
1786, as amended. The public health council may adopt rules	9580
pursuant to Chapter 119. of the Revised Code as necessary for	9581
administering the program. The rules may include civil money	9582
penalties for violations of the rules.	9583

In determining eligibility for services provided under the	9584
program, the department may use the application form established	9585
under section ~~5111.013~~5162.15 of the Revised Code for the healthy	9586
start program. The department may require applicants to furnish	9587
their social security numbers.	9588

If the department determines that a vendor has committed an	9589
act with respect to the program that federal statutes or	9590
regulations or state statutes or rules prohibit, the department	9591
shall take action against the vendor in the manner required by 7	9592
C.F.R. part 246, including imposition of a civil money penalty in	9593
accordance with 7 C.F.R. 246.12, or rules adopted under this	9594
section.	9595

Sec. 3701.243. (A) Except as provided in this section or	9596
section 3701.248 of the Revised Code, no person or agency of state	9597
or local government that acquires the information while providing	9598
any health care service or while in the employ of a health care	9599
facility or health care provider shall disclose or compel another	9600
to disclose any of the following:	9601

(1) The identity of any individual on whom an HIV test is	9602
performed;	9603

(2) The results of an HIV test in a form that identifies the	9604
individual tested;	9605

(3) The identity of any individual diagnosed as having AIDS	9606
or an AIDS-related condition.	9607

(B)(1) Except as provided in divisions (B)(2), (C), (D), and	9608
(F) of this section, the results of an HIV test or the identity of	9609
an individual on whom an HIV test is performed or who is diagnosed	9610
as having AIDS or an AIDS-related condition may be disclosed only	9611
to the following:	9612

(a) The individual who was tested or the individual's legal	9613
guardian, and the individual's spouse or any sexual partner;	9614

(b) A person to whom disclosure is authorized by a written	9615
release, executed by the individual tested or by the individual's	9616
legal guardian and specifying to whom disclosure of the test	9617
results or diagnosis is authorized and the time period during	9618
which the release is to be effective;	9619

9620

(d) The department of health or a health commissioner to	9621
which reports are made under section 3701.24 of the Revised Code;	9622

(e) A health care facility or provider that procures,	9623
processes, distributes, or uses a human body part from a deceased	9624
individual, donated for a purpose specified in Chapter 2108. of	9625
the Revised Code, and that needs medical information about the	9626
deceased individual to ensure that the body part is medically	9627
acceptable for its intended purpose;	9628

(f) Health care facility staff committees or accreditation or	9629
oversight review organizations conducting program monitoring,	9630
program evaluation, or service reviews;	9631

(g) A health care provider, emergency medical services	9632
worker, or peace officer who sustained a significant exposure to	9633
the body fluids of another individual, if that individual was	9634
tested pursuant to division (E)(6) of section 3701.242 of the	9635
Revised Code, except that the identity of the individual tested	9636
shall not be revealed;	9637

(h) To law enforcement authorities pursuant to a search	9638
warrant or a subpoena issued by or at the request of a grand jury,	9639
a prosecuting attorney, a city director of law or similar chief	9640
legal officer of a municipal corporation, or a village solicitor,	9641
in connection with a criminal investigation or prosecution.	9642

(2) The results of an HIV test or a diagnosis of AIDS or an	9643
AIDS-related condition may be disclosed to a health care provider,	9644
or an authorized agent or employee of a health care facility or a	9645
health care provider, if the provider, agent, or employee has a	9646
medical need to know the information and is participating in the	9647
diagnosis, care, or treatment of the individual on whom the test	9648
was performed or who has been diagnosed as having AIDS or an	9649
AIDS-related condition.	9650

This division does not impose a standard of disclosure	9651
different from the standard for disclosure of all other specific	9652
information about a patient to health care providers and	9653
facilities. Disclosure may not be requested or made solely for the	9654
purpose of identifying an individual who has a positive HIV test	9655
result or has been diagnosed as having AIDS or an AIDS-related	9656
condition in order to refuse to treat the individual. Referral of	9657
an individual to another health care provider or facility based on	9658
reasonable professional judgment does not constitute refusal to	9659
treat the individual.	9660

(3) Not later than ninety days after November 1, 1989, each	9661
health care facility in this state shall establish a protocol to	9662
be followed by employees and individuals affiliated with the	9663
facility in making disclosures authorized by division (B)(2) of	9664
this section. A person employed by or affiliated with a health	9665
care facility who determines in accordance with the protocol	9666
established by the facility that a disclosure is authorized by	9667
division (B)(2) of this section is immune from liability to any	9668
person in a civil action for damages for injury, death, or loss to	9669
person or property resulting from the disclosure.	9670

(C)(1) Any person or government agency may seek access to or	9671
authority to disclose the HIV test records of an individual in	9672
accordance with the following provisions:	9673

(a) The person or government agency shall bring an action in	9674
a court of common pleas requesting disclosure of or authority to	9675
disclose the results of an HIV test of a specific individual, who	9676
shall be identified in the complaint by a pseudonym but whose name	9677
shall be communicated to the court confidentially, pursuant to a	9678
court order restricting the use of the name. The court shall	9679
provide the individual with notice and an opportunity to	9680
participate in the proceedings if the individual is not named as a	9681
party. Proceedings shall be conducted in chambers unless the	9682
individual agrees to a hearing in open court.	9683

(b) The court may issue an order granting the plaintiff	9684
access to or authority to disclose the test results only if the	9685
court finds by clear and convincing evidence that the plaintiff	9686
has demonstrated a compelling need for disclosure of the	9687
information that cannot be accommodated by other means. In	9688
assessing compelling need, the court shall weigh the need for	9689
disclosure against the privacy right of the individual tested and	9690
against any disservice to the public interest that might result	9691
from the disclosure, such as discrimination against the individual	9692
or the deterrence of others from being tested.	9693

(c) If the court issues an order, it shall guard against	9694
unauthorized disclosure by specifying the persons who may have	9695
access to the information, the purposes for which the information	9696
shall be used, and prohibitions against future disclosure.	9697

(2) A person or government agency that considers it necessary	9698
to disclose the results of an HIV test of a specific individual in	9699
an action in which it is a party may seek authority for the	9700
disclosure by filing an in camera motion with the court in which	9701
the action is being heard. In hearing the motion, the court shall	9702
employ procedures for confidentiality similar to those specified	9703
in division (C)(1) of this section. The court shall grant the	9704
motion only if it finds by clear and convincing evidence that a	9705
compelling need for the disclosure has been demonstrated.	9706

(3) Except for an order issued in a criminal prosecution or	9707
an order under division (C)(1) or (2) of this section granting	9708
disclosure of the result of an HIV test of a specific individual,	9709
a court shall not compel a blood bank, hospital blood center, or	9710
blood collection facility to disclose the result of HIV tests	9711
performed on the blood of voluntary donors in a way that reveals	9712
the identity of any donor.	9713

(4) In a civil action in which the plaintiff seeks to recover	9714
damages from an individual defendant based on an allegation that	9715
the plaintiff contracted the HIV virus as a result of actions of	9716
the defendant, the prohibitions against disclosure in this section	9717
do not bar discovery of the results of any HIV test given to the	9718
defendant or any diagnosis that the defendant suffers from AIDS or	9719
an AIDS-related condition.	9720

(D) The results of an HIV test or the identity of an	9721
individual on whom an HIV test is performed or who is diagnosed as	9722
having AIDS or an AIDS-related condition may be disclosed to a	9723
federal, state, or local government agency, or the official	9724
representative of such an agency, for purposes of the ~~medical~~	9725
~~assistance~~medicaid program ~~established under section 5111.01 of~~	9726
~~the Revised Code~~, the medicare program ~~established under Title~~	9727
~~XVIII of the "Social Security Act," 49 Stat. 620 (1935) 42~~	9728
~~U.S.C.A. 301, as amended~~, or any other public assistance program.	9729

(E) Any disclosure pursuant to this section shall be in	9730
writing and accompanied by a written statement that includes the	9731
following or substantially similar language: "This information has	9732
been disclosed to you from confidential records protected from	9733
disclosure by state law. You shall make no further disclosure of	9734
this information without the specific, written, and informed	9735
release of the individual to whom it pertains, or as otherwise	9736
permitted by state law. A general authorization for the release of	9737
medical or other information is not sufficient for the purpose of	9738
the release of HIV test results or diagnoses."	9739

(F) An individual who knows that the individual has received	9740
a positive result on an HIV test or has been diagnosed as having	9741
AIDS or an AIDS-related condition shall disclose this information	9742
to any other person with whom the individual intends to make	9743
common use of a hypodermic needle or engage in sexual conduct as	9744
defined in section 2907.01 of the Revised Code. An individual's	9745
compliance with this division does not prohibit a prosecution of	9746
the individual for a violation of division (B) of section 2903.11	9747
of the Revised Code.	9748

(G) Nothing in this section prohibits the introduction of	9749
evidence concerning an HIV test of a specific individual in a	9750
criminal proceeding.	9751

Sec. 3701.507. (A) To assist in implementing sections	9752
3701.503 to 3701.509 of the Revised Code, the medically	9753
handicapped children's medical advisory council created in section	9754
3701.025 of the Revised Code shall appoint a permanent infant	9755
hearing screening subcommittee. The subcommittee shall consist of	9756
the following members:	9757

(1) One otolaryngologist;

9758

(2) One neonatologist;

9759

(3) One pediatrician;

9760

(4) One neurologist;

9761

(5) One hospital administrator;

9762

(6) Two or more audiologists who are experienced in infant	9763
hearing screening and evaluation;	9764

(7) One speech-language pathologist licensed under section	9765
4753.07 of the Revised Code;	9766

(8) Two persons who are each a parent of a hearing-impaired	9767
child;	9768

(9) One geneticist;

9769

(10) One epidemiologist;

9770

(11) One adult who is deaf or hearing impaired;

9771

(12) One representative from an organization for the deaf or	9772
hearing impaired;	9773

(13) One family advocate;

9774

(14) One nurse from a well-baby neonatal nursery;

9775

(15) One nurse from a special care neonatal nursery;

9776

(16) One teacher of the deaf who works with infants and	9777
toddlers;	9778

(17) One representative of the health insurance industry;

9779

(18) One representative of the bureau for children with	9780
medical handicaps;	9781

(19) One representative of the department of education;

9782

(20) One representative of the ~~Ohio~~ department of ~~job and~~	9783
~~family services who has responsibilities regarding medicaid~~health	9784
care administration;	9785

(21) Any other person the advisory council appoints.

9786

(B) The infant hearing subcommittee shall:

9787

(1) Consult with the director of health regarding the	9788
administration of sections 3701.503 to 3701.509 of the Revised	9789
Code;	9790

(2) Advise and make recommendations regarding proposed rules	9791
prior to their adoption by the public health council under section	9792
3701.508 of the Revised Code;	9793

(3) Consult with the director of health and advise and make	9794
recommendations regarding program development and implementation	9795
under sections 3701.503 to 3701.509 of the Revised Code, including	9796
all of the following:	9797

(a) Establishment under section 3701.504 of the Revised Code	9798
of the statewide hearing screening, tracking, and early	9799
intervention program to identify newborn and infant hearing	9800
impairment;	9801

(b) Identification of locations where hearing evaluations may	9802
be conducted;	9803

(c) Recommendations for methods and techniques of hearing	9804
screening and hearing evaluation;	9805

(d) Referral, data recording and compilation, and procedures	9806
to encourage follow-up hearing care;	9807

(e) Maintenance of a register of newborns and infants who do	9808
not pass the hearing screening;	9809

(f) Preparation of the information required by section	9810
3701.506 of the Revised Code and any other information the public	9811
health council requires the department of health to provide.	9812

Sec. 3701.74. (A) As used in this section and section	9813
3701.741 of the Revised Code:	9814

(1) "Ambulatory care facility" means a facility that provides	9815
medical, diagnostic, or surgical treatment to patients who do not	9816
require hospitalization, including a dialysis center, ambulatory	9817
surgical facility, cardiac catheterization facility, diagnostic	9818
imaging center, extracorporeal shock wave lithotripsy center, home	9819
health agency, inpatient hospice, birthing center, radiation	9820
therapy center, emergency facility, and an urgent care center.	9821
"Ambulatory care facility" does not include the private office of	9822
a physician or dentist, whether the office is for an individual or	9823
group practice.	9824

(2) "Chiropractor" means an individual licensed under Chapter	9825
4734. of the Revised Code to practice chiropractic.	9826

(3) "Emergency facility" means a hospital emergency	9827
department or any other facility that provides emergency medical	9828
services.	9829

(4) "Health care practitioner" means all of the following:

9830

(a) A dentist or dental hygienist licensed under Chapter	9831
4715. of the Revised Code;	9832

(b) A registered or licensed practical nurse licensed under	9833
Chapter 4723. of the Revised Code;	9834

(c) An optometrist licensed under Chapter 4725. of the	9835
Revised Code;	9836

(d) A dispensing optician, spectacle dispensing optician,	9837
contact lens dispensing optician, or spectacle-contact lens	9838
dispensing optician licensed under Chapter 4725. of the Revised	9839
Code;	9840

(e) A pharmacist licensed under Chapter 4729. of the Revised	9841
Code;	9842

(f) A physician;

9843

(g) A physician assistant authorized under Chapter 4730. of	9844
the Revised Code to practice as a physician assistant;	9845

(h) A practitioner of a limited branch of medicine issued a	9846
certificate under Chapter 4731. of the Revised Code;	9847

(i) A psychologist licensed under Chapter 4732. of the	9848
Revised Code;	9849

(j) A chiropractor;

9850

(k) A hearing aid dealer or fitter licensed under Chapter	9851
4747. of the Revised Code;	9852

(l) A speech-language pathologist or audiologist licensed	9853
under Chapter 4753. of the Revised Code;	9854

(m) An occupational therapist or occupational therapy	9855
assistant licensed under Chapter 4755. of the Revised Code;	9856

(n) A physical therapist or physical therapy assistant	9857
licensed under Chapter 4755. of the Revised Code;	9858

(o) A professional clinical counselor, professional	9859
counselor, social worker, or independent social worker licensed,	9860
or a social work assistant registered, under Chapter 4757. of the	9861
Revised Code;	9862

(p) A dietitian licensed under Chapter 4759. of the Revised	9863
Code;	9864

(q) A respiratory care professional licensed under Chapter	9865
4761. of the Revised Code;	9866

(r) An emergency medical technician-basic, emergency medical	9867
technician-intermediate, or emergency medical technician-paramedic	9868
certified under Chapter 4765. of the Revised Code.	9869

(5) "Health care provider" means a hospital, ambulatory care	9870
facility, long-term care facility, pharmacy, emergency facility,	9871
or health care practitioner.	9872

(6) "Hospital" has the same meaning as in section 3727.01 of	9873
the Revised Code.	9874

(7) "Long-term care facility" means a nursing home,	9875
residential care facility, or home for the aging, as those terms	9876
are defined in section 3721.01 of the Revised Code; an adult care	9877
facility, as defined in section 3722.01 of the Revised Code; a	9878
nursing facility or intermediate care facility for the mentally	9879
retarded, as those terms are defined in section ~~5111.20~~5164.01 of	9880
the Revised Code; a facility or portion of a facility certified as	9881
a skilled nursing facility under ~~Title XVIII of~~ the ~~"Social~~	9882
~~Security Act," 49 Stat. 286 (1965), 42 U.S.C.A. 1395, as amended~~	9883
medicare program.	9884

(8) "Medical record" means data in any form that pertains to	9885
a patient's medical history, diagnosis, prognosis, or medical	9886
condition and that is generated and maintained by a health care	9887
provider in the process of the patient's health care treatment.	9888

(9) "Medical records company" means a person who stores,	9889
locates, or copies medical records for a health care provider, or	9890
is compensated for doing so by a health care provider, and charges	9891
a fee for providing medical records to a patient or patient's	9892
representative.	9893

(10) "Patient" means either of the following:

9894

(a) An individual who received health care treatment from a	9895
health care provider;	9896

(b) A guardian, as defined in section 1337.11 of the Revised	9897
Code, of an individual described in division (A)(10)(a) of this	9898
section.	9899

(11) "Patient's personal representative" means a minor	9900
patient's parent or other person acting in loco parentis, a	9901
court-appointed guardian, or a person with durable power of	9902
attorney for health care for a patient, the executor or	9903
administrator of the patient's estate, or the person responsible	9904
for the patient's estate if it is not to be probated. "Patient's	9905
personal representative" does not include an insurer authorized	9906
under Title XXXIX of the Revised Code to do the business of	9907
sickness and accident insurance in this state, a health insuring	9908
corporation holding a certificate of authority under Chapter 1751.	9909
of the Revised Code, or any other person not named in this	9910
division.	9911

(12) "Pharmacy" has the same meaning as in section 4729.01 of	9912
the Revised Code.	9913

(13) "Physician" means a person authorized under Chapter	9914
4731. of the Revised Code to practice medicine and surgery,	9915
osteopathic medicine and surgery, or podiatric medicine and	9916
surgery.	9917

(14) "Authorized person" means a person to whom a patient has	9918
given written authorization to act on the patient's behalf	9919
regarding the patient's medical record.	9920

(B) A patient, a patient's personal representative or an	9921
authorized person who wishes to examine or obtain a copy of part	9922
or all of a medical record shall submit to the health care	9923
provider a written request signed by the patient, personal	9924
representative, or authorized person dated not more than one year	9925
before the date on which it is submitted. The request shall	9926
indicate whether the copy is to be sent to the requestor,	9927
physician or chiropractor, or held for the requestor at the	9928
office of the health care provider. Within a reasonable time after	9929
receiving a request that meets the requirements of this division	9930
and includes sufficient information to identify the record	9931
requested, a health care provider that has the patient's medical	9932
records shall permit the patient to examine the record during	9933
regular business hours without charge or, on request, shall	9934
provide a copy of the record in accordance with section 3701.741	9935
of the Revised Code, except that if a physician or chiropractor	9936
who has treated the patient determines for clearly stated	9937
treatment reasons that disclosure of the requested record is	9938
likely to have an adverse effect on the patient, the health care	9939
provider shall provide the record to a physician or chiropractor	9940
designated by the patient. The health care provider shall take	9941
reasonable steps to establish the identity of the person making	9942
the request to examine or obtain a copy of the patient's record.	9943

(C) If a health care provider fails to furnish a medical	9944
record as required by division (B) of this section, the patient,	9945
personal representative, or authorized person who requested the	9946
record may bring a civil action to enforce the patient's right of	9947
access to the record.	9948

(D)(1) This section does not apply to medical records whose	9949
release is covered by section 173.20 or 3721.13 of the Revised	9950
Code, by Chapter 1347. or 5122. of the Revised Code, by 42 C.F.R.	9951
part 2, "Confidentiality of Alcohol and Drug Abuse Patient	9952
Records," or by 42 C.F.R. 483.10.	9953

(2) Nothing in this section is intended to supersede the	9954
confidentiality provisions of sections 2305.24, 2305.25, 2305.251,	9955
and 2305.252 of the Revised Code.	9956

Sec. 3701.741. (A) Each health care provider and medical	9957
records company shall provide copies of medical records in	9958
accordance with this section.	9959

(B) Except as provided in divisions (C) and (E) of this	9960
section, a health care provider or medical records company that	9961
receives a request for a copy of a patient's medical record shall	9962
charge not more than the amounts set forth in this section.	9963

(1) If the request is made by the patient or the patient's	9964
personal representative, total costs for copies and all services	9965
related to those copies shall not exceed the sum of the following:	9966

(a) Except as provided in division (B)(1)(b) of this	9967
section, with respect to data recorded on paper or electronically,	9968
the following amounts:	9969

(i) Two dollars and seventy-four cents per page for the	9970
first ten pages;	9971

(ii) Fifty-seven cents per page for pages eleven through	9972
fifty;	9973

(iii) Twenty-three cents per page for pages fifty-one and	9974
higher;	9975

(b) With respect to data resulting from an x-ray, magnetic	9976
resonance imaging (MRI), or computed axial tomography (CAT) scan	9977
and recorded on paper or film, one dollar and eighty-seven	9978
cents per page;	9979

(c) The actual cost of any related postage incurred by the	9980
health care provider or medical records company.	9981

(2) If the request is made other than by the patient or the	9982
patient's personal representative, total costs for copies and all	9983
services related to those copies shall not exceed the sum of the	9984
following:	9985

(a) An initial fee of sixteen dollars and eighty-four cents,	9986
which shall compensate for the records search;	9987

(b) Except as provided in division (B)(2)(c) of this	9988
section, with respect to data recorded on paper or electronically,	9989
the following amounts:	9990

(i) One dollar and eleven cents per page for the first ten	9991
pages;	9992

(ii) Fifty-seven cents per page for pages eleven through	9993
fifty;	9994

(iii) Twenty-three cents per page for pages fifty-one and	9995
higher.	9996

(c) With respect to data resulting from an x-ray, magnetic	9997
resonance imaging (MRI), or computed axial tomography (CAT) scan	9998
and recorded on paper or film, one dollar and eighty-seven	9999
cents per page;	10000

(d) The actual cost of any related postage incurred by the	10001
health care provider or medical records company.	10002

(C)(1) On request, a health care provider or medical records	10003
company shall provide one copy of the patient's medical record	10004
and one copy of any records regarding treatment performed	10005
subsequent to the original request, not including copies of	10006
records already provided, without charge to the following:	10007

(a) The bureau of workers' compensation, in accordance with	10008
Chapters 4121. and 4123. of the Revised Code and the rules adopted	10009
under those chapters;	10010

(b) The industrial commission, in accordance with Chapters	10011
4121. and 4123. of the Revised Code and the rules adopted under	10012
those chapters;	10013

(c) The department of job and family services or a county	10014
department of job and family services, in accordance with	10015
Chapters 5101. and 5111. of the Revised Code and the rules adopted	10016
under those chapters;	10017

(d) The attorney general, in accordance with sections 2743.51	10018
to 2743.72 of the Revised Code and any rules that may be adopted	10019
under those sections;	10020

(e) A patient, patient's personal representative, or	10021
authorized person if the medical record is necessary to support a	10022
claim under Title II ~~or Title XVI~~ of the "Social Security Act," 49	10023
Stat. 620 (1935), 42 U.S.C.A. 401 ~~and 1381~~, as amended, or the	10024
supplemental security income program and the request is	10025
accompanied by documentation that a claim has been filed.	10026

(2) Nothing in division (C)(1) of this section requires a	10027
health care provider or medical records company to provide a copy	10028
without charge to any person or entity not listed in division	10029
(C)(1) of this section.	10030

(D) Division (C) of this section shall not be construed to	10031
supersede any rule of the bureau of workers' compensation, the	10032
industrial commission, or the department of job and family	10033
services.	10034

(E) A health care provider or medical records company may	10035
enter into a contract with either of the following for the copying	10036
of medical records at a fee other than as provided in division (B)	10037
of this section:	10038

(1) A patient, a patient's personal representative, or an	10039
authorized person;	10040

(2) An insurer authorized under Title XXXIX of the Revised	10041
Code to do the business of sickness and accident insurance in this	10042
state or health insuring corporations holding a certificate of	10043
authority under Chapter 1751. of the Revised Code.	10044

(F) This section does not apply to medical records the	10045
copying of which is covered by section 173.20 of the Revised Code	10046
or by 42 C.F.R. 483.10.	10047

Sec. 3701.881. (A) As used in this section:

10048

(1) "Applicant" means both of the following:

10049

(a) A person who is under final consideration for appointment	10050
to or employment with a home health agency in a position as a	10051
person responsible for the care, custody, or control of a child;	10052

(b) A person who is under final consideration for employment	10053
with a home health agency in a full-time, part-time, or temporary	10054
position that involves providing direct care to an older adult.	10055
With regard to persons providing direct care to older adults,	10056
"applicant" does not include a person who provides direct care as	10057
a volunteer without receiving or expecting to receive any form of	10058
remuneration other than reimbursement for actual expenses.	10059

(2) "Criminal records check" and "older adult" have the same	10060
meanings as in section 109.572 of the Revised Code.	10061

(3) "Home health agency" means a person or government entity,	10062
other than a nursing home, residential care facility, or hospice	10063
care program, that has the primary function of providing any of	10064
the following services to a patient at a place of residence used	10065
as the patient's home:	10066

(a) Skilled nursing care;

10067

(b) Physical therapy;

10068

10069

(d) Occupational therapy;

10070

(e) Medical social services;

10071

(f) Home health aide services.

10072

(4) "Home health aide services" means any of the following	10073
services provided by an individual employed with or contracted for	10074
by a home health agency:	10075

(a) Hands-on bathing or assistance with a tub bath or shower;

10076

(b) Assistance with dressing, ambulation, and toileting;

10077

10078

(d) Meal preparation and feeding.

10079

(5) "Hospice care program" has the same meaning as in section	10080
3712.01 of the Revised Code.	10081

(6) "Medical social services" means services provided by a	10082
social worker under the direction of a patient's attending	10083
physician.	10084

(7) "Minor drug possession offense" has the same meaning as	10085
in section 2925.01 of the Revised Code.	10086

(8) "Nursing home," "residential care facility," and "skilled	10087
nursing care" have the same meanings as in section 3721.01 of the	10088
Revised Code.	10089

(9) "Occupational therapy" has the same meaning as in section	10090
4755.04 of the Revised Code.	10091

(10) "Physical therapy" has the same meaning as in section	10092
4755.40 of the Revised Code.	10093

(11) "Social worker" means a person licensed under Chapter	10094
4757. of the Revised Code to practice as a social worker or	10095
independent social worker.	10096

(12) "Speech-language pathology" has the same meaning as in	10097
section 4753.01 of the Revised Code.	10098

(B)(1) Except as provided in division (I) of this section,	10099
the chief administrator of a home health agency shall request the	10100
superintendent of the bureau of criminal identification and	10101
investigation to conduct a criminal records check with respect to	10102
each applicant. If the position may involve both responsibility	10103
for the care, custody, or control of a child and provision of	10104
direct care to an older adult, the chief administrator shall	10105
request that the superintendent conduct a single criminal records	10106
check for the applicant. If an applicant for whom a criminal	10107
records check request is required under this division does not	10108
present proof of having been a resident of this state for the	10109
five-year period immediately prior to the date upon which the	10110
criminal records check is requested or does not provide evidence	10111
that within that five-year period the superintendent has requested	10112
information about the applicant from the federal bureau of	10113
investigation in a criminal records check, the chief administrator	10114
shall request that the superintendent obtain information from the	10115
federal bureau of investigation as a part of the criminal records	10116
check for the applicant. Even if an applicant for whom a criminal	10117
records check request is required under this division presents	10118
proof that the applicant has been a resident of this state for	10119
that five-year period, the chief administrator may request that	10120
the superintendent include information from the federal bureau of	10121
investigation in the criminal records check.	10122

(2) Any person required by division (B)(1) of this section to	10123
request a criminal records check shall provide to each applicant	10124
for whom a criminal records check request is required under that	10125
division a copy of the form prescribed pursuant to division (C)(1)	10126
of section 109.572 of the Revised Code and a standard impression	10127
sheet prescribed pursuant to division (C)(2) of section 109.572 of	10128
the Revised Code, obtain the completed form and impression sheet	10129
from each applicant, and forward the completed form and impression	10130
sheet to the superintendent of the bureau of criminal	10131
identification and investigation at the time the chief	10132
administrator requests a criminal records check pursuant to	10133
division (B)(1) of this section.	10134

(3) An applicant who receives pursuant to division (B)(2) of	10135
this section a copy of the form prescribed pursuant to division	10136
(C)(1) of section 109.572 of the Revised Code and a copy of an	10137
impression sheet prescribed pursuant to division (C)(2) of that	10138
section and who is requested to complete the form and provide a	10139
set of fingerprint impressions shall complete the form or provide	10140
all the information necessary to complete the form and shall	10141
provide the impression sheets with the impressions of the	10142
applicant's fingerprints. If an applicant, upon request, fails to	10143
provide the information necessary to complete the form or fails to	10144
provide fingerprint impressions, the home health agency shall not	10145
employ that applicant for any position for which a criminal	10146
records check is required by division (B)(1) of this section.	10147

(C)(1) Except as provided in rules adopted by the department	10148
of health in accordance with division (F) of this section and	10149
subject to division (C)(3) of this section, no home health agency	10150
shall employ a person as a person responsible for the care,	10151
custody, or control of a child if the person previously has been	10152
convicted of or pleaded guilty to any of the following:	10153

(a) A violation of section 2903.01, 2903.02, 2903.03,	10154
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34,	10155
2905.01, 2905.02, 2905.05, 2907.02, 2907.03, 2907.04, 2907.05,	10156
2907.06, 2907.07, 2907.08, 2907.09, 2907.21, 2907.22, 2907.23,	10157
2907.25, 2907.31, 2907.32, 2907.321, 2907.322, 2907.323, 2911.01,	10158
2911.02, 2911.11, 2911.12, 2919.12, 2919.22, 2919.24, 2919.25,	10159
2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.04, 2925.05,	10160
2925.06, or 3716.11 of the Revised Code, a violation of section	10161
2905.04 of the Revised Code as it existed prior to July 1, 1996, a	10162
violation of section 2919.23 of the Revised Code that would have	10163
been a violation of section 2905.04 of the Revised Code as it	10164
existed prior to July 1, 1996, had the violation been committed	10165
prior to that date, a violation of section 2925.11 of the Revised	10166
Code that is not a minor drug possession offense, or felonious	10167
sexual penetration in violation of former section 2907.12 of the	10168
Revised Code;	10169

(b) A violation of an existing or former law of this state,	10170
any other state, or the United States that is substantially	10171
equivalent to any of the offenses listed in division (C)(1)(a) of	10172
this section.	10173

(2) Except as provided in rules adopted by the department of	10174
health in accordance with division (F) of this section and subject	10175
to division (C)(3) of this section, no home health agency shall	10176
employ a person in a position that involves providing direct care	10177
to an older adult if the person previously has been convicted of	10178
or pleaded guilty to any of the following:	10179

(a) A violation of section 2903.01, 2903.02, 2903.03,	10180
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34,	10181
2905.01, 2905.02, 2905.11, 2905.12, 2907.02, 2907.03, 2907.05,	10182
2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 2907.25, 2907.31,	10183
2907.32, 2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11,	10184
2911.12, 2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21,	10185
2913.31, 2913.40, 2913.43, 2913.47, 2913.51, 2919.25, 2921.36,	10186
2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.11, 2925.13,	10187
2925.22, 2925.23, or 3716.11 of the Revised Code.	10188

(b) A violation of an existing or former law of this state,	10189
any other state, or the United States that is substantially	10190
equivalent to any of the offenses listed in division (C)(2)(a) of	10191
this section.	10192

(3)(a) A home health agency may employ conditionally an	10193
applicant for whom a criminal records check request is required	10194
under division (B) of this section as a person responsible for the	10195
care, custody, or control of a child until the criminal records	10196
check regarding the applicant required by this section is	10197
completed and the agency receives the results of the criminal	10198
records check. If the results of the criminal records check	10199
indicate that, pursuant to division (C)(1) of this section, the	10200
applicant does not qualify for employment, the agency shall	10201
release the applicant from employment unless the agency chooses to	10202
employ the applicant pursuant to division (F) of this section.	10203

(b)(i) A home health agency may employ conditionally an	10204
applicant for whom a criminal records check request is required	10205
under division (B) of this section in a position that involves	10206
providing direct care to an older adult or in a position that	10207
involves both responsibility for the care, custody, and control of	10208
a child and the provision of direct care to older adults prior to	10209
obtaining the results of a criminal records check regarding the	10210
individual, provided that the agency shall request a criminal	10211
records check regarding the individual in accordance with division	10212
(B)(1) of this section not later than five business days after the	10213
individual begins conditional employment. In the circumstances	10214
described in division (I)(2) of this section, a home health agency	10215
may employ conditionally in a position that involves providing	10216
direct care to an older adult an applicant who has been referred	10217
to the home health agency by an employment service that supplies	10218
full-time, part-time, or temporary staff for positions involving	10219
the direct care of older adults and for whom, pursuant to that	10220
division, a criminal records check is not required under division	10221
(B) of this section. In the circumstances described in division	10222
(I)(4) of this section, a home health agency may employ	10223
conditionally in a position that involves both responsibility for	10224
the care, custody, and control of a child and the provision of	10225
direct care to older adults an applicant who has been referred to	10226
the home health agency by an employment service that supplies	10227
full-time, part-time, or temporary staff for positions involving	10228
both responsibility for the care, custody, and control of a child	10229
and the provision of direct care to older adults and for whom,	10230
pursuant to that division, a criminal records check is not	10231
required under division (B) of this section.	10232

(ii) A home health agency that employs an individual	10233
conditionally under authority of division (C)(3)(b)(i) of this	10234
section shall terminate the individual's employment if the results	10235
of the criminal records check requested under division (B)(1) of	10236
this section or described in division (I)(2) or (4) of this	10237
section, other than the results of any request for information	10238
from the federal bureau of investigation, are not obtained within	10239
the period ending thirty days after the date the request is made.	10240
Regardless of when the results of the criminal records check are	10241
obtained, if the individual was employed conditionally in a	10242
position that involves the provision of direct care to older	10243
adults and the results indicate that the individual has been	10244
convicted of or pleaded guilty to any of the offenses listed or	10245
described in division (C)(2) of this section, or if the individual	10246
was employed conditionally in a position that involves both	10247
responsibility for the care, custody, and control of a child and	10248
the provision of direct care to older adults and the results	10249
indicate that the individual has been convicted of or pleaded	10250
guilty to any of the offenses listed or described in division	10251
(C)(1) or (2) of this section, the agency shall terminate the	10252
individual's employment unless the agency chooses to employ the	10253
individual pursuant to division (F) of this section. Termination	10254
of employment under this division shall be considered just cause	10255
for discharge for purposes of division (D)(2) of section 4141.29	10256
of the Revised Code if the individual makes any attempt to deceive	10257
the agency about the individual's criminal record.	10258

(D)(1) Each home health agency shall pay to the bureau of	10259
criminal identification and investigation the fee prescribed	10260
pursuant to division (C)(3) of section 109.572 of the Revised Code	10261
for each criminal records check conducted in accordance with that	10262
section upon the request pursuant to division (B)(1) of this	10263
section of the chief administrator of the home health agency.	10264

(2) A home health agency may charge an applicant a fee for	10265
the costs it incurs in obtaining a criminal records check under	10266
this section, unless the ~~medical assistance~~medicaid program	10267
~~established under Chapter 5111. of the Revised Code~~ reimburses the	10268
agency for the costs. A fee charged under division (D)(2) of this	10269
section shall not exceed the amount of fees the agency pays under	10270
division (D)(1) of this section. If a fee is charged under	10271
division (D)(2) of this section, the agency shall notify the	10272
applicant at the time of the applicant's initial application for	10273
employment of the amount of the fee and that, unless the fee is	10274
paid, the agency will not consider the applicant for employment.	10275

(E) The report of any criminal records check conducted by the	10276
bureau of criminal identification and investigation in accordance	10277
with section 109.572 of the Revised Code and pursuant to a request	10278
made under division (B)(1) of this section is not a public record	10279
for the purposes of section 149.43 of the Revised Code and shall	10280
not be made available to any person other than the following:	10281

(1) The individual who is the subject of the criminal records	10282
check or the individual's representative;	10283

(2) The home health agency requesting the criminal records	10284
check or its representative;	10285

(3) The administrator of any other facility, agency, or	10286
program that provides direct care to older adults that is owned or	10287
operated by the same entity that owns or operates the home health	10288
agency;	10289

(4) Any court, hearing officer, or other necessary individual	10290
involved in a case dealing with a denial of employment of the	10291
applicant or dealing with employment or unemployment benefits of	10292
the applicant;	10293

(5) Any person to whom the report is provided pursuant to,	10294
and in accordance with, division (I)(1), (2), (3), or (4) of this	10295
section.	10296

(F) The department of health shall adopt rules in accordance	10297
with Chapter 119. of the Revised Code to implement this section.	10298
The rules shall specify circumstances under which the home health	10299
agency may employ a person who has been convicted of or pleaded	10300
guilty to an offense listed or described in division (C)(1) of	10301
this section but who meets standards in regard to rehabilitation	10302
set by the department or employ a person who has been convicted of	10303
or pleaded guilty to an offense listed or described in division	10304
(C)(2) of this section but meets personal character standards set	10305
by the department.	10306

(G) Any person required by division (B)(1) of this section to	10307
request a criminal records check shall inform each person, at the	10308
time of initial application for employment that the person is	10309
required to provide a set of fingerprint impressions and that a	10310
criminal records check is required to be conducted and	10311
satisfactorily completed in accordance with section 109.572 of the	10312
Revised Code if the person comes under final consideration for	10313
appointment or employment as a precondition to employment for that	10314
position.	10315

(H) In a tort or other civil action for damages that is	10316
brought as the result of an injury, death, or loss to person or	10317
property caused by an individual who a home health agency employs	10318
in a position that involves providing direct care to older adults,	10319
all of the following shall apply:	10320

(1) If the agency employed the individual in good faith and	10321
reasonable reliance on the report of a criminal records check	10322
requested under this section, the agency shall not be found	10323
negligent solely because of its reliance on the report, even if	10324
the information in the report is determined later to have been	10325
incomplete or inaccurate;	10326

(2) If the agency employed the individual in good faith on a	10327
conditional basis pursuant to division (C)(3)(b) of this section,	10328
the agency shall not be found negligent solely because it employed	10329
the individual prior to receiving the report of a criminal records	10330
check requested under this section;	10331

(3) If the agency in good faith employed the individual	10332
according to the personal character standards established in rules	10333
adopted under division (F) of this section, the agency shall not	10334
be found negligent solely because the individual prior to being	10335
employed had been convicted of or pleaded guilty to an offense	10336
listed or described in division (C)(1) or (2) of this section.	10337

(I)(1) The chief administrator of a home health agency is not	10338
required to request that the superintendent of the bureau of	10339
criminal identification and investigation conduct a criminal	10340
records check of an applicant for a position that involves the	10341
provision of direct care to older adults if the applicant has been	10342
referred to the agency by an employment service that supplies	10343
full-time, part-time, or temporary staff for positions involving	10344
the direct care of older adults and both of the following apply:	10345

(a) The chief administrator receives from the employment	10346
service or the applicant a report of the results of a criminal	10347
records check regarding the applicant that has been conducted by	10348
the superintendent within the one-year period immediately	10349
preceding the applicant's referral;	10350

(b) The report of the criminal records check demonstrates	10351
that the person has not been convicted of or pleaded guilty to an	10352
offense listed or described in division (C)(2) of this section, or	10353
the report demonstrates that the person has been convicted of or	10354
pleaded guilty to one or more of those offenses, but the home	10355
health agency chooses to employ the individual pursuant to	10356
division (F) of this section.	10357

(2) The chief administrator of a home health agency is not	10358
required to request that the superintendent of the bureau of	10359
criminal identification and investigation conduct a criminal	10360
records check of an applicant for a position that involves	10361
providing direct care to older adults and may employ the applicant	10362
conditionally in a position of that nature as described in this	10363
division, if the applicant has been referred to the agency by an	10364
employment service that supplies full-time, part-time, or	10365
temporary staff for positions involving the direct care of older	10366
adults and if the chief administrator receives from the employment	10367
service or the applicant a letter from the employment service that	10368
is on the letterhead of the employment service, dated, and signed	10369
by a supervisor or another designated official of the employment	10370
service and that states that the employment service has requested	10371
the superintendent to conduct a criminal records check regarding	10372
the applicant, that the requested criminal records check will	10373
include a determination of whether the applicant has been	10374
convicted of or pleaded guilty to any offense listed or described	10375
in division (C)(2) of this section, that, as of the date set forth	10376
on the letter, the employment service had not received the results	10377
of the criminal records check, and that, when the employment	10378
service receives the results of the criminal records check, it	10379
promptly will send a copy of the results to the home health	10380
agency. If a home health agency employs an applicant conditionally	10381
in accordance with this division, the employment service, upon its	10382
receipt of the results of the criminal records check, promptly	10383
shall send a copy of the results to the home health agency, and	10384
division (C)(3)(b) of this section applies regarding the	10385
conditional employment.	10386

(3) The chief administrator of a home health agency is not	10387
required to request that the superintendent of the bureau of	10388
criminal identification and investigation conduct a criminal	10389
records check of an applicant for a position that involves both	10390
responsibility for the care, custody, and control of a child and	10391
the provision of direct care to older adults if the applicant has	10392
been referred to the agency by an employment service that supplies	10393
full-time, part-time, or temporary staff for positions involving	10394
both responsibility for the care, custody, and control of a child	10395
and the provision of direct care to older adults and both of the	10396
following apply:	10397

(a) The chief administrator receives from the employment	10398
service or applicant a report of a criminal records check of the	10399
type described in division (I)(1)(a) of this section;	10400

(b) The report of the criminal records check demonstrates	10401
that the person has not been convicted of or pleaded guilty to an	10402
offense listed or described in division (C)(1) or (2) of this	10403
section, or the report demonstrates that the person has been	10404
convicted of or pleaded guilty to one or more of those offenses,	10405
but the home health agency chooses to employ the individual	10406
pursuant to division (F) of this section.	10407

(4) The chief administrator of a home health agency is not	10408
required to request that the superintendent of the bureau of	10409
criminal identification and investigation conduct a criminal	10410
records check of an applicant for a position that involves both	10411
responsibility for the care, custody, and control of a child and	10412
the provision of direct care to older adults and may employ the	10413
applicant conditionally in a position of that nature as described	10414
in this division, if the applicant has been referred to the agency	10415
by an employment service that supplies full-time, part-time, or	10416
temporary staff for positions involving both responsibility for	10417
the care, custody, and control of a child and the direct care of	10418
older adults and if the chief administrator receives from the	10419
employment service or the applicant a letter from the employment	10420
service that is on the letterhead of the employment service,	10421
dated, and signed by a supervisor or another designated official	10422
of the employment service and that states that the employment	10423
service has requested the superintendent to conduct a criminal	10424
records check regarding the applicant, that the requested criminal	10425
records check will include a determination of whether the	10426
applicant has been convicted of or pleaded guilty to any offense	10427
listed or described in division (C)(1) or (2) of this section,	10428
that, as of the date set forth on the letter, the employment	10429
service had not received the results of the criminal records	10430
check, and that, when the employment service receives the results	10431
of the criminal records check, it promptly will send a copy of the	10432
results to the home health agency. If a home health agency employs	10433
an applicant conditionally in accordance with this division, the	10434
employment service, upon its receipt of the results of the	10435
criminal records check, promptly shall send a copy of the results	10436
to the home health agency, and division (C)(3)(b) of this section	10437
applies regarding the conditional employment.	10438

Sec. 3702.30. (A) As used in this section:

10439

(1) "Ambulatory surgical facility" means a facility, whether	10440
or not part of the same organization as a hospital, that is	10441
located in a building distinct from another in which inpatient	10442
care is provided, and to which any of the following apply:	10443

(a) Outpatient surgery is routinely performed in the	10444
facility, and the facility functions separately from a hospital's	10445
inpatient surgical service and from the offices of private	10446
physicians, podiatrists, and dentists.	10447

(b) Anesthesia is administered in the facility by an	10448
anesthesiologist or certified registered nurse anesthetist, and	10449
the facility functions separately from a hospital's inpatient	10450
surgical service and from the offices of private physicians,	10451
podiatrists, and dentists.	10452

(c) The facility applies to be certified by the United States	10453
centers for medicare and medicaid services as an ambulatory	10454
surgical center for purposes of reimbursement under Part B of the	10455
medicare program~~, Part B of Title XVIII of the "Social Security~~	10456
~~Act," 79 Stat. 286 (1965), 42 U.S.C.A. 1395, as amended~~.	10457

(d) The facility applies to be certified by a national	10458
accrediting body approved by the centers for medicare and medicaid	10459
services for purposes of deemed compliance with the conditions for	10460
participating in the medicare program as an ambulatory surgical	10461
center.	10462

(e) The facility bills or receives from any third-party	10463
payer, governmental health care program, or other person or	10464
government entity any ambulatory surgical facility fee that is	10465
billed or paid in addition to any fee for professional services.	10466

(f) The facility is held out to any person or government	10467
entity as an ambulatory surgical facility or similar facility by	10468
means of signage, advertising, or other promotional efforts.	10469

"Ambulatory surgical facility" does not include a hospital	10470
emergency department.	10471

(2) "Ambulatory surgical facility fee" means a fee for	10472
certain overhead costs associated with providing surgical services	10473
in an outpatient setting. A fee is an ambulatory surgical facility	10474
fee only if it directly or indirectly pays for costs associated	10475
with any of the following:	10476

(a) Use of operating and recovery rooms, preparation areas,	10477
and waiting rooms and lounges for patients and relatives;	10478

(b) Administrative functions, record keeping, housekeeping,	10479
utilities, and rent;	10480

(c) Services provided by nurses, orderlies, technical	10481
personnel, and others involved in patient care related to	10482
providing surgery.	10483

"Ambulatory surgical facility fee" does not include any	10484
additional payment in excess of a professional fee that is	10485
provided to encourage physicians, podiatrists, and dentists to	10486
perform certain surgical procedures in their office or their group	10487
practice's office rather than a health care facility, if the	10488
purpose of the additional fee is to compensate for additional cost	10489
incurred in performing office-based surgery.	10490

(3) "Governmental health care program" has the same meaning	10491
as in section 4731.65 of the Revised Code.	10492

(4) "Health care facility" means any of the following:

10493

(a) An ambulatory surgical facility;

10494

(b) A freestanding dialysis center;

10495

10496

(d) A freestanding birthing center;

10497

(e) A freestanding radiation therapy center;

10498

(f) A freestanding or mobile diagnostic imaging center.

10499

(5) "Third-party payer" has the same meaning as in section	10500
3901.38 of the Revised Code.	10501

(B) By rule adopted in accordance with sections 3702.12 and	10502
3702.13 of the Revised Code, the director of health shall	10503
establish quality standards for health care facilities. The	10504
standards may incorporate accreditation standards or other quality	10505
standards established by any entity recognized by the director.	10506

(C) Every ambulatory surgical facility shall require that	10507
each physician who practices at the facility comply with all	10508
relevant provisions in the Revised Code that relate to the	10509
obtaining of informed consent from a patient.	10510

(D) The director shall issue a license to each health care	10511
facility that makes application for a license and demonstrates to	10512
the director that it meets the quality standards established by	10513
the rules adopted under division (B) of this section and satisfies	10514
the informed consent compliance requirements specified in division	10515
(C) of this section.	10516

(E)(1) Except as provided in section 3702.301 of the Revised	10517
Code, no health care facility shall operate without a license	10518
issued under this section.	10519

(2) If the department of health finds that a physician who	10520
practices at a health care facility is not complying with any	10521
provision of the Revised Code related to the obtaining of informed	10522
consent from a patient, the department shall report its finding to	10523
the state medical board, the physician, and the health care	10524
facility.	10525

(3) This division does not create, and shall not be construed	10526
as creating, a new cause of action or substantive legal right	10527
against a health care facility and in favor of a patient who	10528
allegedly sustains harm as a result of the failure of the	10529
patient's physician to obtain informed consent from the patient	10530
prior to performing a procedure on or otherwise caring for the	10531
patient in the health care facility.	10532

(F) The rules adopted under division (B) of this section	10533
shall include all of the following:	10534

(1) Provisions governing application for, renewal,	10535
suspension, and revocation of a license under this section;	10536

(2) Provisions governing orders issued pursuant to section	10537
3702.32 of the Revised Code for a health care facility to cease	10538
its operations or to prohibit certain types of services provided	10539
by a health care facility;	10540

(3) Provisions governing the imposition under section 3702.32	10541
of the Revised Code of civil penalties for violations of this	10542
section or the rules adopted under this section, including a scale	10543
for determining the amount of the penalties.	10544

(G) An ambulatory surgical facility that performs or induces	10545
abortions shall comply with section 3701.791 of the Revised Code.	10546

Sec. 3702.31. (A) The quality monitoring and inspection fund	10547
is hereby created in the state treasury. The director of health	10548
shall use the fund to administer and enforce this section and	10549
sections 3702.11 to 3702.20, 3702.30, 3702.301, and 3702.32 of the	10550
Revised Code and rules adopted pursuant to those sections. The	10551
director shall deposit in the fund any moneys collected pursuant	10552
to this section or section 3702.32 of the Revised Code. All	10553
investment earnings of the fund shall be credited to the fund.	10554

(B) The director of health shall adopt rules pursuant to	10555
Chapter 119. of the Revised Code establishing fees for both of the	10556
following:	10557

(1) Initial and renewal license applications submitted under	10558
section 3702.30 of the Revised Code. The fees established under	10559
division (B)(1) of this section shall not exceed the actual and	10560
necessary costs of performing the activities described in division	10561
(A) of this section.	10562

(2) Inspections conducted under section 3702.15 or 3702.30 of	10563
the Revised Code. The fees established under division (B)(2) of	10564
this section shall not exceed the actual and necessary costs	10565
incurred during an inspection, including any indirect costs	10566
incurred by the department for staff, salary, or other	10567
administrative costs. The director of health shall provide to	10568
each health care facility or provider inspected pursuant to	10569
section 3702.15 or 3702.30 of the Revised Code a written statement	10570
of the fee. The statement shall itemize and total the costs	10571
incurred. Within fifteen days after receiving a statement from	10572
the director, the facility or provider shall forward the total	10573
amount of the fee to the director.	10574

(3) The fees described in divisions (B)(1) and (2) of this	10575
section shall meet both of the following requirements:	10576

(a) For each service described in section 3702.11 of the	10577
Revised Code, the fee shall not exceed one thousand seven hundred	10578
fifty dollars annually, except that the total fees charged to a	10579
health care provider under this section shall not exceed five	10580
thousand dollars annually.	10581

(b) The fee shall exclude any costs reimbursable by the	10582
United States centers for medicare and medicaid services as part	10583
of the certification process for the medicare program ~~established~~	10584
~~under Title XVIII of the "Social Security Act," 79 Stat. 286~~	10585
~~(1935), 42 U.S.C.A. 1395, as amended~~, and the medicaid program	10586
~~established under Title XIX of the "Social Security Act," 79 Stat.~~	10587
~~286 (1965), 42 U.S.C. 1396~~.	10588

(4) The director shall not establish a fee for any service	10589
for which a licensure or inspection fee is paid by the health care	10590
provider to a state agency for the same or similar licensure or	10591
inspection.	10592

Sec. 3702.51. As used in sections 3702.51 to 3702.62 of the	10593
Revised Code:	10594

(A) "Applicant" means any person that submits an application	10595
for a certificate of need and who is designated in the application	10596
as the applicant.	10597

(B) "Person" means any individual, corporation, business	10598
trust, estate, firm, partnership, association, joint stock	10599
company, insurance company, government unit, or other entity.	10600

(C) "Certificate of need" means a written approval granted by	10601
the director of health to an applicant to authorize conducting a	10602
reviewable activity.	10603

(D) "Health service area" means a geographic region	10604
designated by the director of health under section 3702.58 of the	10605
Revised Code.	10606

(E) "Health service" means a clinically related service, such	10607
as a diagnostic, treatment, rehabilitative, or preventive service.	10608

(F) "Health service agency" means an agency designated to	10609
serve a health service area in accordance with section 3702.58 of	10610
the Revised Code.	10611

(G) "Health care facility" means:

10612

(1) A hospital registered under section 3701.07 of the	10613
Revised Code;	10614

(2) A nursing home licensed under section 3721.02 of the	10615
Revised Code, or by a political subdivision certified under	10616
section 3721.09 of the Revised Code;	10617

(3) A county home or a county nursing home as defined in	10618
section 5155.31 of the Revised Code that is certified under ~~Title~~	10619
~~XVIII or XIX of~~ the ~~"Social Security Act," 49 Stat. 620 (1935), 42~~	10620
~~U.S.C.A. 301, as amended~~medicare program;	10621

(4) A freestanding dialysis center;

10622

(5) A freestanding inpatient rehabilitation facility;

10623

(6) An ambulatory surgical facility;

10624

(7) A freestanding cardiac catheterization facility;

10625

(8) A freestanding birthing center;

10626

(9) A freestanding or mobile diagnostic imaging center;

10627

(10) A freestanding radiation therapy center.

10628

A health care facility does not include the offices of	10629
private physicians and dentists whether for individual or group	10630
practice, residential facilities licensed under section 5123.19 of	10631
the Revised Code, or an institution for the sick that is operated	10632
exclusively for patients who use spiritual means for healing and	10633
for whom the acceptance of medical care is inconsistent with their	10634
religious beliefs, accredited by a national accrediting	10635
organization, exempt from federal income taxation under section	10636
501 of the Internal Revenue Code of 1986, 100 Stat. 2085, 26	10637
U.S.C.A. 1, as amended, and providing twenty-four hour nursing	10638
care pursuant to the exemption in division (E) of section 4723.32	10639
of the Revised Code from the licensing requirements of Chapter	10640
4723. of the Revised Code.	10641

(H) "Medical equipment" means a single unit of medical	10642
equipment or a single system of components with related functions	10643
that is used to provide health services.	10644

(I) "Third-party payer" means a health insuring corporation	10645
licensed under Chapter 1751. of the Revised Code, a health	10646
maintenance organization as defined in division (K) of this	10647
section, an insurance company that issues sickness and accident	10648
insurance in conformity with Chapter 3923. of the Revised Code, a	10649
state-financed health insurance program under Chapter 3701.,or	10650
4123.~~, or 5111.~~ of the Revised Code, the medicaid program, or any	10651
self-insurance plan.	10652

(J) "Government unit" means the state and any county,	10653
municipal corporation, township, or other political subdivision of	10654
the state, or any department, division, board, or other agency of	10655
the state or a political subdivision.	10656

(K) "Health maintenance organization" means a public or	10657
private organization organized under the law of any state that is	10658
qualified under section 1310(d) of Title XIII of the "Public	10659
Health Service Act," 87 Stat. 931 (1973), 42 U.S.C. 300e-9.	10660

(L) "Existing health care facility" means either of the	10661
following:	10662

(1) A health care facility that is licensed or otherwise	10663
authorized to operate in this state in accordance with applicable	10664
law, including a county home or a county nursing home that is	10665
certified as of February 1, 2008, under Title XVIII or Title XIX	10666
of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301,	10667
as amended, is staffed and equipped to provide health care	10668
services, and is actively providing health services;	10669

(2) A health care facility that is licensed or otherwise	10670
authorized to operate in this state in accordance with applicable	10671
law, including a county home or a county nursing home that is	10672
certified as of February 1, 2008, under Title XVIII or Title XIX	10673
of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301,	10674
as amended, or that has beds registered under section 3701.07 of	10675
the Revised Code as skilled nursing beds or long-term care beds	10676
and has provided services for at least three hundred sixty-five	10677
consecutive days within the twenty-four months immediately	10678
preceding the date a certificate of need application is filed with	10679
the director of health.	10680

(M) "State" means the state of Ohio, including, but not	10681
limited to, the general assembly, the supreme court, the offices	10682
of all elected state officers, and all departments, boards,	10683
offices, commissions, agencies, institutions, and other	10684
instrumentalities of the state of Ohio. "State" does not include	10685
political subdivisions.	10686

(N) "Political subdivision" means a municipal corporation,	10687
township, county, school district, and all other bodies corporate	10688
and politic responsible for governmental activities only in	10689
geographic areas smaller than that of the state to which the	10690
sovereign immunity of the state attaches.	10691

(O) "Affected person" means:

10692

(1) An applicant for a certificate of need, including an	10693
applicant whose application was reviewed comparatively with the	10694
application in question;	10695

(2) The person that requested the reviewability ruling in	10696
question;	10697

(3) Any person that resides or regularly uses health care	10698
facilities within the geographic area served or to be served by	10699
the health care services that would be provided under the	10700
certificate of need or reviewability ruling in question;	10701

(4) Any health care facility that is located in the health	10702
service area where the health care services would be provided	10703
under the certificate of need or reviewability ruling in question;	10704

(5) Third-party payers that reimburse health care facilities	10705
for services in the health service area where the health care	10706
services would be provided under the certificate of need or	10707
reviewability ruling in question;	10708

(6) Any other person who testified at a public hearing held	10709
under division (B) of section 3702.52 of the Revised Code or	10710
submitted written comments in the course of review of the	10711
certificate of need application in question.	10712

(P) "Osteopathic hospital" means a hospital registered under	10713
section 3701.07 of the Revised Code that advocates osteopathic	10714
principles and the practice and perpetuation of osteopathic	10715
medicine by doing any of the following:	10716

(1) Maintaining a department or service of osteopathic	10717
medicine or a committee on the utilization of osteopathic	10718
principles and methods, under the supervision of an osteopathic	10719
physician;	10720

(2) Maintaining an active medical staff, the majority of	10721
which is comprised of osteopathic physicians;	10722

(3) Maintaining a medical staff executive committee that has	10723
osteopathic physicians as a majority of its members.	10724

(Q) "Ambulatory surgical facility" has the same meaning as in	10725
section 3702.30 of the Revised Code.	10726

(R) Except as otherwise provided in division (T) of this	10727
section, and until the termination date specified in section	10728
3702.511 of the Revised Code, "reviewable activity" means any of	10729
the following:	10730

(1) The addition by any person of any of the following health	10731
services, regardless of the amount of operating costs or capital	10732
expenditures:	10733

(a) A heart, heart-lung, lung, liver, kidney, bowel,	10734
pancreas, or bone marrow transplantation service, a stem cell	10735
harvesting and reinfusion service, or a service for	10736
transplantation of any other organ unless transplantation of the	10737
organ is designated by public health council rule not to be a	10738
reviewable activity;	10739

(b) A cardiac catheterization service;

10740

10741

(d) Any new, experimental medical technology that is	10742
designated by rule of the public health council.	10743

(2) The acceptance of high-risk patients, as defined in rules	10744
adopted under section 3702.57 of the Revised Code, by any cardiac	10745
catheterization service that was initiated without a certificate	10746
of need pursuant to division (R)(3)(b) of the version of this	10747
section in effect immediately prior to April 20, 1995;	10748

(3)(a) The establishment, development, or construction of a	10749
new health care facility other than a new long-term care facility	10750
or a new hospital;	10751

(b) The establishment, development, or construction of a new	10752
hospital or the relocation of an existing hospital;	10753

(c) The relocation of hospital beds, other than long-term	10754
care, perinatal, or pediatric intensive care beds, into or out of	10755
a rural area.	10756

(4)(a) The replacement of an existing hospital;

10757

(b) The replacement of an existing hospital obstetric or	10758
newborn care unit or freestanding birthing center.	10759

(5)(a) The renovation of a hospital that involves a capital	10760
expenditure, obligated on or after June 30, 1995, of five million	10761
dollars or more, not including expenditures for equipment,	10762
staffing, or operational costs. For purposes of division (R)(5)(a)	10763
of this section, a capital expenditure is obligated:	10764

(i) When a contract enforceable under Ohio law is entered	10765
into for the construction, acquisition, lease, or financing of a	10766
capital asset;	10767

(ii) When the governing body of a hospital takes formal	10768
action to commit its own funds for a construction project	10769
undertaken by the hospital as its own contractor;	10770

(iii) In the case of donated property, on the date the gift	10771
is completed under applicable Ohio law.	10772

(b) The renovation of a hospital obstetric or newborn care	10773
unit or freestanding birthing center that involves a capital	10774
expenditure of five million dollars or more, not including	10775
expenditures for equipment, staffing, or operational costs.	10776

(6) Any change in the health care services, bed capacity, or	10777
site, or any other failure to conduct the reviewable activity in	10778
substantial accordance with the approved application for which a	10779
certificate of need was granted, if the change is made prior to	10780
the date the activity for which the certificate was issued ceases	10781
to be a reviewable activity;	10782

(7) Any of the following changes in perinatal bed capacity or	10783
pediatric intensive care bed capacity:	10784

(a) An increase in bed capacity;

10785

(b) A change in service or service-level designation of	10786
newborn care beds or obstetric beds in a hospital or freestanding	10787
birthing center, other than a change of service that is provided	10788
within the service-level designation of newborn care or obstetric	10789
beds as registered by the department of health;	10790

(c) A relocation of perinatal or pediatric intensive care	10791
beds from one physical facility or site to another, excluding the	10792
relocation of beds within a hospital or freestanding birthing	10793
center or the relocation of beds among buildings of a hospital or	10794
freestanding birthing center at the same site.	10795

(8) The expenditure of more than one hundred ten per cent of	10796
the maximum expenditure specified in a certificate of need;	10797

(9) Any transfer of a certificate of need issued prior to	10798
April 20, 1995, from the person to whom it was issued to another	10799
person before the project that constitutes a reviewable activity	10800
is completed, any agreement that contemplates the transfer of a	10801
certificate of need issued prior to that date upon completion of	10802
the project, and any transfer of the controlling interest in an	10803
entity that holds a certificate of need issued prior to that date.	10804
However, the transfer of a certificate of need issued prior to	10805
that date or agreement to transfer such a certificate of need from	10806
the person to whom the certificate of need was issued to an	10807
affiliated or related person does not constitute a reviewable	10808
transfer of a certificate of need for the purposes of this	10809
division, unless the transfer results in a change in the person	10810
that holds the ultimate controlling interest in the certificate of	10811
need.	10812

(10)(a) The acquisition by any person of any of the following	10813
medical equipment, regardless of the amount of operating costs or	10814
capital expenditure:	10815

(i) A cobalt radiation therapy unit;

10816

(ii) A linear accelerator;

10817

(iii) A gamma knife unit.

10818

(b) The acquisition by any person of medical equipment with a	10819
cost of two million dollars or more. The cost of acquiring medical	10820
equipment includes the sum of the following:	10821

(i) The greater of its fair market value or the cost of its	10822
lease or purchase;	10823

(ii) The cost of installation and any other activities	10824
essential to the acquisition of the equipment and its placement	10825
into service.	10826

(11) The addition of another cardiac catheterization	10827
laboratory to an existing cardiac catheterization service.	10828

(S) Except as provided in division (T) of this section,	10829
"reviewable activity" also means any of the following activities,	10830
none of which are subject to a termination date:	10831

(1) The establishment, development, or construction of a new	10832
long-term care facility;	10833

(2) The replacement of an existing long-term care facility;

10834

(3) The renovation of a long-term care facility that involves	10835
a capital expenditure of two million dollars or more, not	10836
including expenditures for equipment, staffing, or operational	10837
costs;	10838

(4) Any of the following changes in long-term care bed	10839
capacity:	10840

(a) An increase in bed capacity;

10841

(b) A relocation of beds from one physical facility or site	10842
to another, excluding the relocation of beds within a long-term	10843
care facility or among buildings of a long-term care facility at	10844
the same site;	10845

(c) A recategorization of hospital beds registered under	10846
section 3701.07 of the Revised Code from another registration	10847
category to skilled nursing beds or long-term care beds.	10848

(5) Any change in the health services, bed capacity, or site,	10849
or any other failure to conduct the reviewable activity in	10850
substantial accordance with the approved application for which a	10851
certificate of need concerning long-term care beds was granted, if	10852
the change is made within five years after the implementation of	10853
the reviewable activity for which the certificate was granted;	10854

(6) The expenditure of more than one hundred ten per cent of	10855
the maximum expenditure specified in a certificate of need	10856
concerning long-term care beds;	10857

(7) Any transfer of a certificate of need that concerns	10858
long-term care beds and was issued prior to April 20, 1995, from	10859
the person to whom it was issued to another person before the	10860
project that constitutes a reviewable activity is completed, any	10861
agreement that contemplates the transfer of such a certificate of	10862
need upon completion of the project, and any transfer of the	10863
controlling interest in an entity that holds such a certificate of	10864
need. However, the transfer of a certificate of need that concerns	10865
long-term care beds and was issued prior to April 20, 1995, or	10866
agreement to transfer such a certificate of need from the person	10867
to whom the certificate was issued to an affiliated or related	10868
person does not constitute a reviewable transfer of a certificate	10869
of need for purposes of this division, unless the transfer results	10870
in a change in the person that holds the ultimate controlling	10871
interest in the certificate of need.	10872

(T) "Reviewable activity" does not include any of the	10873
following activities:	10874

(1) Acquisition of computer hardware or software;

10875

(2) Acquisition of a telephone system;

10876

(3) Construction or acquisition of parking facilities;

10877

(4) Correction of cited deficiencies that are in violation of	10878
federal, state, or local fire, building, or safety laws and rules	10879
and that constitute an imminent threat to public health or safety;	10880

(5) Acquisition of an existing health care facility that does	10881
not involve a change in the number of the beds, by service, or in	10882
the number or type of health services;	10883

(6) Correction of cited deficiencies identified by	10884
accreditation surveys of the joint commission on accreditation of	10885
healthcare organizations or of the American osteopathic	10886
association;	10887

(7) Acquisition of medical equipment to replace the same or	10888
similar equipment for which a certificate of need has been issued	10889
if the replaced equipment is removed from service;	10890

(8) Mergers, consolidations, or other corporate	10891
reorganizations of health care facilities that do not involve a	10892
change in the number of beds, by service, or in the number or type	10893
of health services;	10894

(9) Construction, repair, or renovation of bathroom	10895
facilities;	10896

(10) Construction of laundry facilities, waste disposal	10897
facilities, dietary department projects, heating and air	10898
conditioning projects, administrative offices, and portions of	10899
medical office buildings used exclusively for physician services;	10900

(11) Acquisition of medical equipment to conduct research	10901
required by the United States food and drug administration or	10902
clinical trials sponsored by the national institute of health. Use	10903
of medical equipment that was acquired without a certificate of	10904
need under division (T)(11) of this section and for which	10905
premarket approval has been granted by the United States food and	10906
drug administration to provide services for which patients or	10907
reimbursement entities will be charged shall be a reviewable	10908
activity.	10909

(12) Removal of asbestos from a health care facility.

10910

Only that portion of a project that meets the requirements of	10911
division (T) of this section is not a reviewable activity.	10912

(U) "Small rural hospital" means a hospital that is located	10913
within a rural area, has fewer than one hundred beds, and to which	10914
fewer than four thousand persons were admitted during the most	10915
recent calendar year.	10916

(V) "Children's hospital" means any of the following:

10917

(1) A hospital registered under section 3701.07 of the	10918
Revised Code that provides general pediatric medical and surgical	10919
care, and in which at least seventy-five per cent of annual	10920
inpatient discharges for the preceding two calendar years were	10921
individuals less than eighteen years of age;	10922

(2) A distinct portion of a hospital registered under section	10923
3701.07 of the Revised Code that provides general pediatric	10924
medical and surgical care, has a total of at least one hundred	10925
fifty registered pediatric special care and pediatric acute care	10926
beds, and in which at least seventy-five per cent of annual	10927
inpatient discharges for the preceding two calendar years were	10928
individuals less than eighteen years of age;	10929

(3) A distinct portion of a hospital, if the hospital is	10930
registered under section 3701.07 of the Revised Code as a	10931
children's hospital and the children's hospital meets all the	10932
requirements of division (V)(1) of this section.	10933

(W) "Long-term care facility" means any of the following:

10934

(1) A nursing home licensed under section 3721.02 of the	10935
Revised Code or by a political subdivision certified under section	10936
3721.09 of the Revised Code;	10937

(2) The portion of any facility, including a county home or	10938
county nursing home, that is certified as a skilled nursing	10939
facility or a nursing facility under Title XVIII or XIX of the	10940
"Social Security Act";	10941

(3) The portion of any hospital that contains beds registered	10942
under section 3701.07 of the Revised Code as skilled nursing beds	10943
or long-term care beds.	10944

(X) "Long-term care bed" means a bed in a long-term care	10945
facility.	10946

(Y) "Perinatal bed" means a bed in a hospital that is	10947
registered under section 3701.07 of the Revised Code as a newborn	10948
care bed or obstetric bed, or a bed in a freestanding birthing	10949
center.	10950

(Z) "Freestanding birthing center" means any facility in	10951
which deliveries routinely occur, regardless of whether the	10952
facility is located on the campus of another health care facility,	10953
and which is not licensed under Chapter 3711. of the Revised Code	10954
as a level one, two, or three maternity unit or a limited	10955
maternity unit.	10956

(AA)(1) "Reviewability ruling" means a ruling issued by the	10957
director of health under division (A) of section 3702.52 of the	10958
Revised Code as to whether a particular proposed project is or is	10959
not a reviewable activity.	10960

(2) "Nonreviewability ruling" means a ruling issued under	10961
that division that a particular proposed project is not a	10962
reviewable activity.	10963

(BB)(1) "Metropolitan statistical area" means an area of this	10964
state designated a metropolitan statistical area or primary	10965
metropolitan statistical area in United States office of	10966
management and budget bulletin no. 93-17, June 30, 1993, and its	10967
attachments.	10968

(2) "Rural area" means any area of this state not located	10969
within a metropolitan statistical area.	10970

(CC) "County nursing home" has the same meaning as in section	10971
5155.31 of the Revised Code.	10972

Sec. 3702.522. (A) Reviews of applications for certificates	10973
of need to recategorize hospital beds to skilled nursing beds	10974
shall be conducted in accordance with this division and rules	10975
adopted by the public health council.	10976

(1) No hospital recategorizing beds shall apply for a	10977
certificate of need for more than twenty skilled nursing beds.	10978

(2) No beds for which a certificate of need is requested	10979
under this division shall be reviewed under or counted in any	10980
formula developed under public health council rules for the	10981
purpose of determining the number of long-term care beds that may	10982
be needed within the state.	10983

(3) No beds shall be approved under this division unless the	10984
hospital certifies and demonstrates in the application that the	10985
beds will be dedicated to patients with a length of stay of no	10986
more than thirty days.	10987

(4) No beds shall be approved under this division unless the	10988
hospital can satisfactorily demonstrate in the application that it	10989
is routinely unable to place the patients planned for the beds in	10990
accessible skilled nursing facilities.	10991

(5) In developing rules to implement this division, the	10992
public health council shall give special attention to the required	10993
documentation of the need for such beds, including the efforts	10994
made by the hospital to place patients in suitable skilled nursing	10995
facilities, and special attention to the appropriate size of units	10996
with such beds given the historical pattern of the applicant	10997
hospital's documented difficulty in placing skilled nursing	10998
patients.	10999

(B) To assist the director of health in monitoring the use of	11000
hospital beds recategorized as skilled nursing beds after August	11001
5, 1989, the public health council shall adopt rules specifying	11002
appropriate quarterly procedures for reporting to the department	11003
of health.	11004

(C) A patient may stay in a hospital bed that, after August	11005
5, 1989, has been recategorized as a skilled nursing bed for more	11006
than thirty days if the hospital is able to demonstrate that it	11007
made a good faith effort to place the patient in an accessible	11008
skilled nursing facility acceptable to the patient within the	11009
thirty-day period, but was unable to do so.	11010

(D) No hospital bed recategorized after August 5, 1989, as a	11011
skilled nursing bed shall be covered by a provider agreement under	11012
the ~~medical assistance~~medicaid program ~~established under Chapter~~	11013
~~5111. of the Revised Code~~.	11014

(E) Nothing in this section requires a hospital to place a	11015
patient in any nursing home if the patient does not wish to be	11016
placed in the nursing home. Nothing in this section limits the	11017
ability of a hospital to file a certificate of need application	11018
for the addition of long-term care beds that meet the definition	11019
of "home" in section 3721.01 of the Revised Code. Nothing in this	11020
section limits the ability of the director to grant certificates	11021
of need necessary for hospitals to engage in demonstration	11022
projects authorized by the federal government for the purpose of	11023
enhancing long-term quality of care and cost containment. Nothing	11024
in this section limits the ability of hospitals to develop swing	11025
bed programs in accordance with federal regulations.	11026

No hospital that is granted a certificate of need after	11027
August 5, 1989, to recategorize hospital beds as skilled nursing	11028
beds is subject to sections 3721.01 to 3721.09 of the Revised	11029
Code. If the portion of the hospital in which the recategorized	11030
beds are located is certified as a skilled nursing facility under	11031
~~Title XVIII of~~ the ~~"Social Security Act," 49 Stat. 620 (1935), 42~~	11032
~~U.S.C.A. 301, as amended~~medicare program, that portion of the	11033
hospital is subject to sections 3721.10 to 3721.17 and sections	11034
3721.21 to 3721.34 of the Revised Code. If the beds are registered	11035
pursuant to section 3701.07 of the Revised Code as long-term care	11036
beds, the beds are subject to sections ~~3721.50~~5166.20 to ~~3721.58~~	11037
5166.30 of the Revised Code.	11038

(F) The public health council shall adopt rules authorizing	11039
the creation of one or more nursing home placement clearinghouses.	11040
Any public or private agency or facility may apply to the	11041
department of health to serve as a nursing home placement	11042
clearinghouse, and the rules shall provide the procedure for	11043
application and process for designation of clearinghouses.	11044

The department may approve one or more clearinghouses, but in	11045
no event shall there be more than one nursing home placement	11046
clearinghouse in each county. Any nursing home may list with a	11047
nursing home placement clearinghouse the services it provides and	11048
the types of patients it is approved for and equipped to serve.	11049
The clearinghouse shall make reasonable efforts to update its	11050
information at least every six months.	11051

If an appropriate clearinghouse has been designated, each	11052
hospital granted a certificate of need after August 5, 1989, to	11053
recategorize hospital beds as skilled nursing beds shall, and any	11054
other hospital may, utilize the nursing home placement	11055
clearinghouse prior to admitting a patient to a skilled nursing	11056
bed within the hospital and prior to keeping a patient in a	11057
skilled nursing bed within a hospital in excess of thirty days.	11058

The department shall provide at least annually to all	11059
hospitals a list of the designated nursing home placement	11060
clearinghouses.	11061

Sec. 3702.591. As specified in former Section 11 of Am.	11062
Sub. S.B. 50 of the 121st general assembly, as amended by Am.	11063
Sub. H.B. 405 of the 124th general assembly, all of the following	11064
apply:	11065

(A) The removal of former divisions (E) and (F) of section	11066
3702.52 of the Revised Code by Sections 1 and 2 of Am. Sub. S.B.	11067
50 of the 121st general assembly does not release the holders of	11068
certificates of need issued under those divisions from complying	11069
with any conditions on which the granting of the certificates of	11070
need was based, including the requirement of former division	11071
(E)(6) of that section that the holders not enter into medicaid	11072
provider agreements ~~under Chapter 5111. of the Revised Code and~~	11073
~~Title XIX of the "Social Security Act," 49 Stat. 620 (1935), 42~~	11074
~~U.S.C. 301, as amended,~~ for at least ten years following initial	11075
licensure of the long-term care facilities for which the	11076
certificates were granted.	11077

(B) The repeal of section 3702.55 of the Revised Code by	11078
Section 2 of Am. Sub. S.B. 50 of the 121st general assembly does	11079
not release the holders of certificates of need issued under that	11080
section from complying with any conditions on which the granting	11081
of the certificates of need was based, other than the requirement	11082
of division (A)(6) of that section that the holders not seek	11083
certification under ~~Title XVIII of~~ the ~~"Social Security Act"~~	11084
medicare program for beds recategorized under the certificates.	11085
That repeal also does not eliminate the requirement that the	11086
director of health revoke the licensure of the beds under Chapter	11087
3721. of the Revised Code if a person to which their ownership is	11088
transferred fails, as required by division (A)(6) of the repealed	11089
section, to file within ten days after the transfer a sworn	11090
statement not to seek certification under ~~Title XIX of~~ the	11091
~~"Social Security Act"~~medicaid program for beds recategorized	11092
under the certificates of need.	11093

(C) The repeal of section 3702.56 of the Revised Code by	11094
Section 2 of Am. Sub. S.B. 50 of the 121st general assembly does	11095
not release the holders of certificates of need issued under that	11096
section from complying with any conditions on which the granting	11097
of the certificates of need was based.	11098

Sec. 3702.62. (A) Any action pursuant to section 140.03,	11099
140.04, 140.05, 307.091, 313.21, 339.01, 339.021, 339.03, 339.06,	11100
339.08, 339.09, 339.12, 339.14, 513.05, 513.07, 513.08, 513.081,	11101
513.12, 513.15, 513.17, 513.171, 749.02, 749.03, 749.14, 749.16,	11102
749.20, 749.25, 749.28, 749.35, 1751.06, or 3707.29 of the Revised	11103
Code shall be taken in accordance with sections 3702.51 to 3702.61	11104
of the Revised Code.	11105

(B) A nursing home certified as an intermediate care facility	11106
for the mentally retarded under ~~Title XIX of~~ the ~~"Social Security~~	11107
~~Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended~~medicaid	11108
program, that is required to apply for licensure as a residential	11109
facility under section 5123.19 of the Revised Code is not, with	11110
respect to the portion of the home certified as an intermediate	11111
care facility for the mentally retarded, subject to sections	11112
3702.51 to 3702.61 of the Revised Code.	11113

Sec. 3702.74. (A) A primary care physician who has signed a	11114
letter of intent under section 3702.73 of the Revised Code and	11115
the director of health may enter into a contract for the	11116
physician's participation in the physician loan repayment	11117
program. The physician's employer or other funding source may	11118
also be a party to the contract.	11119

(B) The contract shall include all of the following	11120
obligations:	11121

(1) The primary care physician agrees to provide primary care	11122
services in the health resource shortage area identified in the	11123
letter of intent for at least two years;	11124

(2) When providing primary care services in the health	11125
resource shortage area, the primary care physician agrees to do	11126
all of the following:	11127

(a) Provide primary care services for a minimum of forty	11128
hours per week, of which at least twenty-one hours will be spent	11129
providing patient care in an outpatient or ambulatory setting;	11130

(b) Provide primary care services without regard to a	11131
patient's ability to pay;	11132

(c) Meet the conditions ~~prescribed by the "Social Security~~	11133
~~Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended, and the~~	11134
~~department of job and family services~~ for participation in the	11135
medicaid program ~~established under Chapter 5111. of the Revised~~	11136
~~Code~~ and enter into a contract with the department of health care	11137
administration to provide primary care services to medicaid	11138
recipients ~~of the medical assistance program~~;	11139

(d) Meet the conditions established by the department of job	11140
and family services for participation in the disability medical	11141
assistance program ~~established under Chapter 5115. of the Revised~~	11142
~~Code~~ and enter into a contract with the department to provide	11143
primary care services to recipients of disability medical	11144
assistance.	11145

(3) The department of health agrees, as provided in section	11146
3702.75 of the Revised Code, to repay, so long as the primary	11147
care physician performs the service obligation agreed to under	11148
division (B)(1) of this section, all or part of the principal and	11149
interest of a government or other educational loan taken by the	11150
primary care physician for expenses described in section 3702.75	11151
of the Revised Code;	11152

(4) The primary care physician agrees to pay the department	11153
of health an amount established by rules adopted under section	11154
3702.79 of the Revised Code if the physician fails to complete	11155
the service obligation agreed to under division (B)(1) of this	11156
section.	11157

(C) The contract may include any other terms agreed upon by	11158
the parties.	11159

Sec. 3702.91. (A) An individual who has signed a letter of	11160
intent under section 3702.90 of the Revised Code may enter into a	11161
contract with the director of health for participation in the	11162
dentist loan repayment program. A lending institution may also be	11163
a party to the contract.	11164

(B) The contract shall include all of the following	11165
obligations:	11166

(1) The individual agrees to provide dental services in the	11167
dental health resource shortage area identified in the letter of	11168
intent for at least one year.	11169

(2) When providing dental services in the dental health	11170
resource shortage area, the individual agrees to do all of the	11171
following:	11172

(a) Provide dental services for a minimum of forty hours per	11173
week;	11174

(b) Provide dental services without regard to a patient's	11175
ability to pay;	11176

(c) Meet the conditions ~~prescribed by the "Social Security~~	11177
~~Act," 49 Stat. 620 (1935), 42 U.S.C. 301, as amended, and the~~	11178
~~department of job and family services~~ for participation in the	11179
medicaid program ~~established under Chapter 5111. of the Revised~~	11180
~~Code~~ and enter into a contract with the department of health care	11181
administration to provide dental services to medicaid recipients.	11182

(3) The department of health agrees, as provided in section	11183
3702.85 of the Revised Code, to repay, so long as the individual	11184
performs the service obligation agreed to under division (B)(1)	11185
of this section, all or part of the principal and interest of a	11186
government or other educational loan taken by the individual for	11187
expenses described in section 3702.85 of the Revised Code up to	11188
but not exceeding twenty thousand dollars per year of service.	11189

(4) The individual agrees to pay the department of health	11190
the following as damages if the individual fails to complete the	11191
service obligation agreed to under division (B)(1) of this	11192
section:	11193

(a) If the failure occurs during the first two years of the	11194
service obligation, three times the total amount the department	11195
has agreed to repay under division (B)(3) of this section;	11196

(b) If the failure occurs after the first two years of the	11197
service obligation, three times the amount the department is	11198
still obligated to repay under division (B)(3) of this section.	11199

(C) The contract may include any other terms agreed upon by	11200
the parties, including an assignment to the department of health	11201
of the individual's duty to pay the principal and interest of a	11202
government or other educational loan taken by the individual for	11203
expenses described in section 3702.85 of the Revised Code. If the	11204
department assumes the individual's duty to pay a loan, the	11205
contract shall set forth the total amount of principal and	11206
interest to be paid, an amortization schedule, and the amount of	11207
each payment to be made under the schedule.	11208

(D) Not later than the thirty-first day of January of each	11209
year, the department of health shall mail to each individual to	11210
whom or on whose behalf repayment is made under the dentist loan	11211
repayment program a statement showing the amount of principal and	11212
interest repaid by the department pursuant to the contract in the	11213
preceding year. The statement shall be sent by ordinary mail with	11214
address correction and forwarding requested in the manner	11215
prescribed by the United States postal service.	11216

Sec. 3712.07. (A) As used in this section, "terminal care	11217
facility for the homeless" means a facility that provides	11218
accommodations to homeless individuals who are terminally ill.	11219

(B) A person or public agency licensed under this chapter to	11220
provide a hospice care program may enter into an agreement with a	11221
terminal care facility for the homeless under which hospice care	11222
program services may be provided to individuals residing at the	11223
facility, if all of the following apply:	11224

(1) Each resident of the facility has been diagnosed by a	11225
physician as having a terminal condition and an anticipated life	11226
expectancy of six months or less;	11227

(2) No resident of the facility has a relative or other	11228
person willing or capable of providing the care necessary to cope	11229
with ~~his~~the resident's terminal illness or is financially capable	11230
of hiring a person to provide such care;	11231

(3) Each resident of the facility is under the direct care of	11232
a physician;	11233

(4) No resident of the facility requires the staff of the	11234
facility to administer medication by injection;	11235

(5) The facility does not receive any remuneration, directly	11236
or indirectly, from the residents;	11237

(6) The facility does not receive any remuneration, directly	11238
or indirectly, from the ~~medical assistance~~medicaid program	11239
~~established under section 5111.01 of the Revised Code~~ or the	11240
medicare program ~~established under Title XVIII of the "Social~~	11241
~~Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended~~;	11242

(7) The facility meets all applicable state and federal	11243
health and safety standards, including standards for fire	11244
prevention, maintenance of safe and sanitary conditions, and	11245
proper preparation and storage of foods.	11246

(C) Hospice care program services may be provided at a	11247
terminal care facility for the homeless only by the personnel of	11248
the person or public agency that has entered into an agreement	11249
with the facility under this section.	11250

(D) A terminal care facility for the homeless that has	11251
entered into an agreement under this section may assist its	11252
residents with the self-administration of medication if the	11253
medication has been prescribed by a physician and is not	11254
administered by injection. In the event that a resident has	11255
entered the final stages of dying and is no longer mentally alert,	11256
the facility may administer medication to that resident if the	11257
medication has been prescribed by a physician and is not	11258
administered by injection. Determinations of whether an individual	11259
has entered the final stages of dying and is no longer mentally	11260
alert shall be based on directions from the personnel who provide	11261
hospice care program services at the facility.	11262

Sec. 3712.09. (A) As used in this section:

11263

(1) "Applicant" means a person who is under final	11264
consideration for employment with a hospice care program in a	11265
full-time, part-time, or temporary position that involves	11266
providing direct care to an older adult. "Applicant" does not	11267
include a person who provides direct care as a volunteer without	11268
receiving or expecting to receive any form of remuneration other	11269
than reimbursement for actual expenses.	11270

(2) "Criminal records check" and "older adult" have the same	11271
meanings as in section 109.572 of the Revised Code.	11272

(B)(1) Except as provided in division (I) of this section,	11273
the chief administrator of a hospice care program shall request	11274
that the superintendent of the bureau of criminal identification	11275
and investigation conduct a criminal records check with respect to	11276
each applicant. If an applicant for whom a criminal records check	11277
request is required under this division does not present proof of	11278
having been a resident of this state for the five-year period	11279
immediately prior to the date the criminal records check is	11280
requested or provide evidence that within that five-year period	11281
the superintendent has requested information about the applicant	11282
from the federal bureau of investigation in a criminal records	11283
check, the chief administrator shall request that the	11284
superintendent obtain information from the federal bureau of	11285
investigation as part of the criminal records check of the	11286
applicant. Even if an applicant for whom a criminal records check	11287
request is required under this division presents proof of having	11288
been a resident of this state for the five-year period, the chief	11289
administrator may request that the superintendent include	11290
information from the federal bureau of investigation in the	11291
criminal records check.	11292

(2) A person required by division (B)(1) of this section to	11293
request a criminal records check shall do both of the following:	11294

(a) Provide to each applicant for whom a criminal records	11295
check request is required under that division a copy of the form	11296
prescribed pursuant to division (C)(1) of section 109.572 of the	11297
Revised Code and a standard fingerprint impression sheet	11298
prescribed pursuant to division (C)(2) of that section, and obtain	11299
the completed form and impression sheet from the applicant;	11300

(b) Forward the completed form and impression sheet to the	11301
superintendent of the bureau of criminal identification and	11302
investigation.	11303

(3) An applicant provided the form and fingerprint impression	11304
sheet under division (B)(2)(a) of this section who fails to	11305
complete the form or provide fingerprint impressions shall not be	11306
employed in any position for which a criminal records check is	11307
required by this section.	11308

(C)(1) Except as provided in rules adopted by the public	11309
health council in accordance with division (F) of this section and	11310
subject to division (C)(2) of this section, no hospice care	11311
program shall employ a person in a position that involves	11312
providing direct care to an older adult if the person has been	11313
convicted of or pleaded guilty to any of the following:	11314

(a) A violation of section 2903.01, 2903.02, 2903.03,	11315
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34,	11316
2905.01, 2905.02, 2905.11, 2905.12, 2907.02, 2907.03, 2907.05,	11317
2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 2907.25, 2907.31,	11318
2907.32, 2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11,	11319
2911.12, 2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21,	11320
2913.31, 2913.40, 2913.43, 2913.47, 2913.51, 2919.25, 2921.36,	11321
2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.11, 2925.13,	11322
2925.22, 2925.23, or 3716.11 of the Revised Code.	11323

(b) A violation of an existing or former law of this state,	11324
any other state, or the United States that is substantially	11325
equivalent to any of the offenses listed in division (C)(1)(a) of	11326
this section.	11327

(2)(a) A hospice care program may employ conditionally an	11328
applicant for whom a criminal records check request is required	11329
under division (B) of this section prior to obtaining the results	11330
of a criminal records check regarding the individual, provided	11331
that the program shall request a criminal records check regarding	11332
the individual in accordance with division (B)(1) of this section	11333
not later than five business days after the individual begins	11334
conditional employment. In the circumstances described in	11335
division (I)(2) of this section, a hospice care program may employ	11336
conditionally an applicant who has been referred to the hospice	11337
care program by an employment service that supplies full-time,	11338
part-time, or temporary staff for positions involving the direct	11339
care of older adults and for whom, pursuant to that division, a	11340
criminal records check is not required under division (B) of this	11341
section.	11342

(b) A hospice care program that employs an individual	11343
conditionally under authority of division (C)(2)(a) of this	11344
section shall terminate the individual's employment if the results	11345
of the criminal records check requested under division (B) of this	11346
section or described in division (I)(2) of this section, other	11347
than the results of any request for information from the federal	11348
bureau of investigation, are not obtained within the period ending	11349
thirty days after the date the request is made. Regardless of when	11350
the results of the criminal records check are obtained, if the	11351
results indicate that the individual has been convicted of or	11352
pleaded guilty to any of the offenses listed or described in	11353
division (C)(1) of this section, the program shall terminate the	11354
individual's employment unless the program chooses to employ the	11355
individual pursuant to division (F) of this section. Termination	11356
of employment under this division shall be considered just cause	11357
for discharge for purposes of division (D)(2) of section 4141.29	11358
of the Revised Code if the individual makes any attempt to deceive	11359
the program about the individual's criminal record.	11360

(D)(1) Each hospice care program shall pay to the bureau of	11361
criminal identification and investigation the fee prescribed	11362
pursuant to division (C)(3) of section 109.572 of the Revised Code	11363
for each criminal records check conducted pursuant to a request	11364
made under division (B) of this section.	11365

(2) A hospice care program may charge an applicant a fee not	11366
exceeding the amount the program pays under division (D)(1) of	11367
this section. A program may collect a fee only if both of the	11368
following apply:	11369

(a) The program notifies the person at the time of initial	11370
application for employment of the amount of the fee and that,	11371
unless the fee is paid, the person will not be considered for	11372
employment;	11373

(b) The ~~medical assistance~~medicaid program ~~established under~~	11374
~~Chapter 5111. of the Revised Code~~ does not reimburse the program	11375
the fee it pays under division (D)(1) of this section.	11376

(E) The report of a criminal records check conducted pursuant	11377
to a request made under this section is not a public record for	11378
the purposes of section 149.43 of the Revised Code and shall not	11379
be made available to any person other than the following:	11380

(1) The individual who is the subject of the criminal records	11381
check or the individual's representative;	11382

(2) The chief administrator of the program requesting the	11383
criminal records check or the administrator's representative;	11384

(3) The administrator of any other facility, agency, or	11385
program that provides direct care to older adults that is owned or	11386
operated by the same entity that owns or operates the hospice care	11387
program;	11388

(4) A court, hearing officer, or other necessary individual	11389
involved in a case dealing with a denial of employment of the	11390
applicant or dealing with employment or unemployment benefits of	11391
the applicant;	11392

(5) Any person to whom the report is provided pursuant to,	11393
and in accordance with, division (I)(1) or (2) of this section.	11394

(F) The public health council shall adopt rules in accordance	11395
with Chapter 119. of the Revised Code to implement this section.	11396
The rules shall specify circumstances under which a hospice care	11397
program may employ a person who has been convicted of or pleaded	11398
guilty to an offense listed or described in division (C)(1) of	11399
this section but meets personal character standards set by the	11400
council.	11401

(G) The chief administrator of a hospice care program shall	11402
inform each individual, at the time of initial application for a	11403
position that involves providing direct care to an older adult,	11404
that the individual is required to provide a set of fingerprint	11405
impressions and that a criminal records check is required to be	11406
conducted if the individual comes under final consideration for	11407
employment.	11408

(H) In a tort or other civil action for damages that is	11409
brought as the result of an injury, death, or loss to person or	11410
property caused by an individual who a hospice care program	11411
employs in a position that involves providing direct care to older	11412
adults, all of the following shall apply:	11413

(1) If the program employed the individual in good faith and	11414
reasonable reliance on the report of a criminal records check	11415
requested under this section, the program shall not be found	11416
negligent solely because of its reliance on the report, even if	11417
the information in the report is determined later to have been	11418
incomplete or inaccurate;	11419

(2) If the program employed the individual in good faith on a	11420
conditional basis pursuant to division (C)(2) of this section, the	11421
program shall not be found negligent solely because it employed	11422
the individual prior to receiving the report of a criminal records	11423
check requested under this section;	11424

(3) If the program in good faith employed the individual	11425
according to the personal character standards established in rules	11426
adopted under division (F) of this section, the program shall not	11427
be found negligent solely because the individual prior to being	11428
employed had been convicted of or pleaded guilty to an offense	11429
listed or described in division (C)(1) of this section.	11430

(I)(1) The chief administrator of a hospice care program is	11431
not required to request that the superintendent of the bureau of	11432
criminal identification and investigation conduct a criminal	11433
records check of an applicant if the applicant has been referred	11434
to the program by an employment service that supplies full-time,	11435
part-time, or temporary staff for positions involving the direct	11436
care of older adults and both of the following apply:	11437

(a) The chief administrator receives from the employment	11438
service or the applicant a report of the results of a criminal	11439
records check regarding the applicant that has been conducted by	11440
the superintendent within the one-year period immediately	11441
preceding the applicant's referral;	11442

(b) The report of the criminal records check demonstrates	11443
that the person has not been convicted of or pleaded guilty to an	11444
offense listed or described in division (C)(1) of this section, or	11445
the report demonstrates that the person has been convicted of or	11446
pleaded guilty to one or more of those offenses, but the hospice	11447
care program chooses to employ the individual pursuant to division	11448
(F) of this section.	11449

(2) The chief administrator of a hospice care program is not	11450
required to request that the superintendent of the bureau of	11451
criminal identification and investigation conduct a criminal	11452
records check of an applicant and may employ the applicant	11453
conditionally as described in this division, if the applicant has	11454
been referred to the program by an employment service that	11455
supplies full-time, part-time, or temporary staff for positions	11456
involving the direct care of older adults and if the chief	11457
administrator receives from the employment service or the	11458
applicant a letter from the employment service that is on the	11459
letterhead of the employment service, dated, and signed by a	11460
supervisor or another designated official of the employment	11461
service and that states that the employment service has requested	11462
the superintendent to conduct a criminal records check regarding	11463
the applicant, that the requested criminal records check will	11464
include a determination of whether the applicant has been	11465
convicted of or pleaded guilty to any offense listed or described	11466
in division (C)(1) of this section, that, as of the date set forth	11467
on the letter, the employment service had not received the results	11468
of the criminal records check, and that, when the employment	11469
service receives the results of the criminal records check, it	11470
promptly will send a copy of the results to the hospice care	11471
program. If a hospice care program employs an applicant	11472
conditionally in accordance with this division, the employment	11473
service, upon its receipt of the results of the criminal records	11474
check, promptly shall send a copy of the results to the hospice	11475
care program, and division (C)(2)(b) of this section applies	11476
regarding the conditional employment.	11477

Sec. 3721.01. (A) As used in sections 3721.01 to 3721.09 and	11478
3721.99 of the Revised Code:	11479

(1)(a) "Home" means an institution, residence, or facility	11480
that provides, for a period of more than twenty-four hours,	11481
whether for a consideration or not, accommodations to three or	11482
more unrelated individuals who are dependent upon the services of	11483
others, including a nursing home, residential care facility, home	11484
for the aging, and a veterans' home operated under Chapter 5907.	11485
of the Revised Code.	11486

(b) "Home" also means both of the following:

11487

(i) Any facility that a person, as defined in section 3702.51	11488
of the Revised Code, proposes for certification as a skilled	11489
nursing facility ~~or nursing facility~~ under ~~Title XVIII or XIX of~~	11490
the ~~"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301,~~	11491
~~as amended~~medicare program, or as a nursing facility under the	11492
medicaid program and for which a certificate of need, other than a	11493
certificate to recategorize hospital beds as described in section	11494
3702.522 of the Revised Code or division (R)(7)(d) of the version	11495
of section 3702.51 of the Revised Code in effect immediately prior	11496
to April 20, 1995, has been granted to the person under sections	11497
3702.51 to 3702.62 of the Revised Code after August 5, 1989;	11498

(ii) A county home or district home that is or has been	11499
licensed as a residential care facility.	11500

11501

(i) Except as provided in division (A)(1)(b) of this section,	11502
a public hospital or hospital as defined in section 3701.01 or	11503
5122.01 of the Revised Code;	11504

(ii) A residential facility for mentally ill persons as	11505
defined under section 5119.22 of the Revised Code;	11506

(iii) A residential facility as defined in section 5123.19 of	11507
the Revised Code;	11508

(iv) A community alternative home as defined in section	11509
3724.01 of the Revised Code;	11510

(v) An adult care facility as defined in section 3722.01 of	11511
the Revised Code;	11512

(vi) An alcohol or drug addiction program as defined in	11513
section 3793.01 of the Revised Code;	11514

(vii) A facility licensed to provide methadone treatment	11515
under section 3793.11 of the Revised Code;	11516

(viii) A facility providing services under contract with the	11517
department of mental retardation and developmental disabilities	11518
under section 5123.18 of the Revised Code;	11519

(ix) A facility operated by a hospice care program licensed	11520
under section 3712.04 of the Revised Code that is used exclusively	11521
for care of hospice patients;	11522

(x) A facility, infirmary, or other entity that is operated	11523
by a religious order, provides care exclusively to members of	11524
religious orders who take vows of celibacy and live by virtue of	11525
their vows within the orders as if related, and does not	11526
participate in the medicare program ~~established under Title XVIII~~	11527
~~of the "Social Security Act"~~ or the ~~medical assistance~~medicaid	11528
program ~~established under Chapter 5111. of the Revised Code and~~	11529
~~Title XIX of the "Social Security Act,"~~ if on January 1, 1994, the	11530
facility, infirmary, or entity was providing care exclusively to	11531
members of the religious order;	11532

(xi) A county home or district home that has never been	11533
licensed as a residential care facility.	11534

(2) "Unrelated individual" means one who is not related to	11535
the owner or operator of a home or to the spouse of the owner or	11536
operator as a parent, grandparent, child, grandchild, brother,	11537
sister, niece, nephew, aunt, uncle, or as the child of an aunt or	11538
uncle.	11539

(3) "Mental impairment" does not mean mental illness as	11540
defined in section 5122.01 of the Revised Code or mental	11541
retardation as defined in section 5123.01 of the Revised Code.	11542

(4) "Skilled nursing care" means procedures that require	11543
technical skills and knowledge beyond those the untrained person	11544
possesses and that are commonly employed in providing for the	11545
physical, mental, and emotional needs of the ill or otherwise	11546
incapacitated. "Skilled nursing care" includes, but is not limited	11547
to, the following:	11548

(a) Irrigations, catheterizations, application of dressings,	11549
and supervision of special diets;	11550

(b) Objective observation of changes in the patient's	11551
condition as a means of analyzing and determining the nursing care	11552
required and the need for further medical diagnosis and treatment;	11553

11554

(d) Administration of medication by any method ordered by a	11555
physician, such as hypodermically, rectally, or orally, including	11556
observation of the patient after receipt of the medication;	11557

(e) Carrying out other treatments prescribed by the physician	11558
that involve a similar level of complexity and skill in	11559
administration.	11560

(5)(a) "Personal care services" means services including, but	11561
not limited to, the following:	11562

(i) Assisting residents with activities of daily living;

11563

(ii) Assisting residents with self-administration of	11564
medication, in accordance with rules adopted under section 3721.04	11565
of the Revised Code;	11566

(iii) Preparing special diets, other than complex therapeutic	11567
diets, for residents pursuant to the instructions of a physician	11568
or a licensed dietitian, in accordance with rules adopted under	11569
section 3721.04 of the Revised Code.	11570

(b) "Personal care services" does not include "skilled	11571
nursing care" as defined in division (A)(4) of this section. A	11572
facility need not provide more than one of the services listed in	11573
division (A)(5)(a) of this section to be considered to be	11574
providing personal care services.	11575

(6) "Nursing home" means a home used for the reception and	11576
care of individuals who by reason of illness or physical or mental	11577
impairment require skilled nursing care and of individuals who	11578
require personal care services but not skilled nursing care. A	11579
nursing home is licensed to provide personal care services and	11580
skilled nursing care.	11581

(7) "Residential care facility" means a home that provides	11582
either of the following:	11583

(a) Accommodations for seventeen or more unrelated	11584
individuals and supervision and personal care services for three	11585
or more of those individuals who are dependent on the services of	11586
others by reason of age or physical or mental impairment;	11587

(b) Accommodations for three or more unrelated individuals,	11588
supervision and personal care services for at least three of those	11589
individuals who are dependent on the services of others by reason	11590
of age or physical or mental impairment, and, to at least one of	11591
those individuals, any of the skilled nursing care authorized by	11592
section 3721.011 of the Revised Code.	11593

(8) "Home for the aging" means a home that provides services	11594
as a residential care facility and a nursing home, except that the	11595
home provides its services only to individuals who are dependent	11596
on the services of others by reason of both age and physical or	11597
mental impairment.	11598

The part or unit of a home for the aging that provides	11599
services only as a residential care facility is licensed as a	11600
residential care facility. The part or unit that may provide	11601
skilled nursing care beyond the extent authorized by section	11602
3721.011 of the Revised Code is licensed as a nursing home.	11603

(9) "County home" and "district home" mean a county home or	11604
district home operated under Chapter 5155. of the Revised Code.	11605

(B) The public health council may further classify homes. For	11606
the purposes of this chapter, any residence, institution, hotel,	11607
congregate housing project, or similar facility that meets the	11608
definition of a home under this section is such a home regardless	11609
of how the facility holds itself out to the public.	11610

(C) For purposes of this chapter, personal care services or	11611
skilled nursing care shall be considered to be provided by a	11612
facility if they are provided by a person employed by or	11613
associated with the facility or by another person pursuant to an	11614
agreement to which neither the resident who receives the services	11615
nor the resident's sponsor is a party.	11616

(D) Nothing in division (A)(4) of this section shall be	11617
construed to permit skilled nursing care to be imposed on an	11618
individual who does not require skilled nursing care.	11619

Nothing in division (A)(5) of this section shall be construed	11620
to permit personal care services to be imposed on an individual	11621
who is capable of performing the activity in question without	11622
assistance.	11623

(E) Division (A)(1)(c)(x) of this section does not prohibit a	11624
facility, infirmary, or other entity described in that division	11625
from seeking licensure under sections 3721.01 to 3721.09 of the	11626
Revised Code or certification under Title XVIII or XIX of the	11627
"Social Security Act." However, such a facility, infirmary, or	11628
entity that applies for licensure or certification must meet the	11629
requirements of those sections or titles and the rules adopted	11630
under them and obtain a certificate of need from the director of	11631
health under section 3702.52 of the Revised Code.	11632

(F) Nothing in this chapter, or rules adopted pursuant to it,	11633
shall be construed as authorizing the supervision, regulation, or	11634
control of the spiritual care or treatment of residents or	11635
patients in any home who rely upon treatment by prayer or	11636
spiritual means in accordance with the creed or tenets of any	11637
recognized church or religious denomination.	11638

Sec. 3721.011. (A) In addition to providing accommodations,	11639
supervision, and personal care services to its residents, a	11640
residential care facility may provide skilled nursing care to its	11641
residents as follows:	11642

(1) Supervision of special diets;

11643

(2) Application of dressings, in accordance with rules	11644
adopted under section 3721.04 of the Revised Code;	11645

(3) Subject to division (B)(1) of this section,	11646
administration of medication;	11647

(4) Subject to division (C) of this section, other skilled	11648
nursing care provided on a part-time, intermittent basis for not	11649
more than a total of one hundred twenty days in a twelve-month	11650
period;	11651

(5) Subject to division (D) of this section, skilled nursing	11652
care provided for more than one hundred twenty days in a	11653
twelve-month period to a hospice patient, as defined in section	11654
3712.01 of the Revised Code.	11655

A residential care facility may not admit or retain an	11656
individual requiring skilled nursing care that is not authorized	11657
by this section. A residential care facility may not provide	11658
skilled nursing care beyond the limits established by this	11659
section.	11660

(B)(1) A residential care facility may admit or retain an	11661
individual requiring medication, including biologicals, only if	11662
the individual's personal physician has determined in writing that	11663
the individual is capable of self-administering the medication or	11664
the facility provides for the medication to be administered to the	11665
individual by a home health agency certified under ~~Title XVIII of~~	11666
the ~~"Social Security Act," 79 Stat. 620 (1965), 42 U.S.C.A. 1395,~~	11667
~~as amended~~medicare program; a hospice care program licensed under	11668
Chapter 3712. of the Revised Code; or a member of the staff of the	11669
residential care facility who is qualified to perform medication	11670
administration. Medication may be administered in a residential	11671
care facility only by the following persons authorized by law to	11672
administer medication:	11673

(a) A registered nurse licensed under Chapter 4723. of the	11674
Revised Code;	11675

(b) A licensed practical nurse licensed under Chapter 4723.	11676
of the Revised Code who holds proof of successful completion of a	11677
course in medication administration approved by the board of	11678
nursing and who administers the medication only at the direction	11679
of a registered nurse or a physician authorized under Chapter	11680
4731. of the Revised Code to practice medicine and surgery or	11681
osteopathic medicine and surgery;	11682

(c) A medication aide certified under Chapter 4723. of the	11683
Revised Code;	11684

(d) A physician authorized under Chapter 4731. of the Revised	11685
Code to practice medicine and surgery or osteopathic medicine and	11686
surgery.	11687

(2) In assisting a resident with self-administration of	11688
medication, any member of the staff of a residential care facility	11689
may do the following:	11690

(a) Remind a resident when to take medication and watch to	11691
ensure that the resident follows the directions on the container;	11692

(b) Assist a resident by taking the medication from the	11693
locked area where it is stored, in accordance with rules adopted	11694
pursuant to section 3721.04 of the Revised Code, and handing it to	11695
the resident. If the resident is physically unable to open the	11696
container, a staff member may open the container for the resident.	11697

(c) Assist a physically impaired but mentally alert resident,	11698
such as a resident with arthritis, cerebral palsy, or Parkinson's	11699
disease, in removing oral or topical medication from containers	11700
and in consuming or applying the medication, upon request by or	11701
with the consent of the resident. If a resident is physically	11702
unable to place a dose of medicine to the resident's mouth without	11703
spilling it, a staff member may place the dose in a container and	11704
place the container to the mouth of the resident.	11705

(C) A residential care facility may admit or retain	11706
individuals who require skilled nursing care beyond the	11707
supervision of special diets, application of dressings, or	11708
administration of medication, only if the care will be provided on	11709
a part-time, intermittent basis for not more than a total of one	11710
hundred twenty days in any twelve-month period. In accordance with	11711
Chapter 119. of the Revised Code, the public health council shall	11712
adopt rules specifying what constitutes the need for skilled	11713
nursing care on a part-time, intermittent basis. The council shall	11714
adopt rules that are consistent with rules pertaining to home	11715
health care adopted by the director of ~~job and family services~~	11716
health care administration for the ~~medical assistance~~medicaid	11717
program ~~established under Chapter 5111. of the Revised Code~~.	11718
Skilled nursing care provided pursuant to this division may be	11719
provided by a home health agency certified under ~~Title XVIII of~~	11720
the ~~"Social Security Act,"~~medicare program, a hospice care	11721
program licensed under Chapter 3712. of the Revised Code, or a	11722
member of the staff of a residential care facility who is	11723
qualified to perform skilled nursing care.	11724

A residential care facility that provides skilled nursing	11725
care pursuant to this division shall do both of the following:	11726

(1) Evaluate each resident receiving the skilled nursing care	11727
at least once every seven days to determine whether the resident	11728
should be transferred to a nursing home;	11729

(2) Meet the skilled nursing care needs of each resident	11730
receiving the care.	11731

(D) A residential care facility may admit or retain a hospice	11732
patient who requires skilled nursing care for more than one	11733
hundred twenty days in any twelve-month period only if the	11734
facility has entered into a written agreement with a hospice care	11735
program licensed under Chapter 3712. of the Revised Code. The	11736
agreement between the residential care facility and hospice	11737
program shall include all of the following provisions:	11738

(1) That the hospice patient will be provided skilled nursing	11739
care in the facility only if a determination has been made that	11740
the patient's needs can be met at the facility;	11741

(2) That the hospice patient will be retained in the facility	11742
only if periodic redeterminations are made that the patient's	11743
needs are being met at the facility;	11744

(3) That the redeterminations will be made according to a	11745
schedule specified in the agreement;	11746

(4) That the hospice patient has been given an opportunity to	11747
choose the hospice care program that best meets the patient's	11748
needs.	11749

(E) Notwithstanding any other provision of this chapter, a	11750
residential care facility in which residents receive skilled	11751
nursing care pursuant to this section is not a nursing home.	11752

Sec. 3721.021. Every person who operates a home, as defined	11753
in section 3721.01 of the Revised Code, and each county home and	11754
district home licensed as a residential care facility shall have	11755
available in the home for review by prospective patients and	11756
residents, their guardians, or other persons assisting in their	11757
placement, each inspection report completed pursuant to section	11758
3721.02 of the Revised Code and each statement of deficiencies and	11759
plan of correction completed and made available to the public	11760
under ~~Titles XVIII and XIX of~~ the ~~"Social Security Act," 49 Stat.~~	11761
~~620 (1935), 42 U.S.C. 301, as amended~~medicare program and	11762
medicaid program, and any rules promulgated under ~~Titles XVIII and~~	11763
~~XIX~~those programs, including such reports that result from life	11764
safety code and health inspections during the preceding three	11765
years, and shall post prominently within the home a notice of this	11766
requirement.	11767

Sec. 3721.022. (A) As used in this section:

11768

(1) "Nursing facility" has the same meaning as in section	11769
~~5111.20~~5164.01 of the Revised Code.	11770

(2) "Deficiency" and "survey" have the same meanings as in	11771
section ~~5111.35~~5164.50 of the Revised Code.	11772

(B) The department of health is hereby designated the state	11773
agency responsible for establishing and maintaining health	11774
standards and serving as the state survey agency for the purposes	11775
of ~~Titles XVIII and XIX of the "Social Security Act," 49 Stat. 620~~	11776
~~(1935), 42 U.S.C.A. 301, as amended~~the medicare and medicaid	11777
programs. The department shall carry out these functions in	11778
accordance with the regulations, guidelines, and procedures issued	11779
~~under Titles XVIII and XIX~~for the medicare and medicaid programs	11780
by the United States secretary of health and human services and	11781
with sections ~~5111.35~~5164.50 to ~~5111.62~~5164.78 of the Revised	11782
Code. The director of health shall enter into agreements with	11783
regard to these functions with the department of ~~job and family~~	11784
~~services~~health care administration and the United States	11785
department of health and human services. The director may also	11786
enter into agreements with the department of ~~job and family~~	11787
~~services~~health care administration under which the department of	11788
health is designated to perform functions under sections ~~5111.35~~	11789
5164.50 to ~~5111.62~~5164.78 of the Revised Code.	11790

The director, in accordance with Chapter 119. of the Revised	11791
Code, shall adopt rules necessary to implement the survey and	11792
certification requirements for skilled nursing facilities and	11793
nursing facilities established by the United States secretary of	11794
health and human services ~~under Titles XVIII and XIX of the~~	11795
~~"Social Security Act,"~~for the medicare and medicaid programs and	11796
the survey requirements established under sections ~~5111.35~~5164.50	11797
to ~~5111.62~~5164.78 of the Revised Code. The rules shall include an	11798
informal process by which a facility may obtain a review of	11799
deficiencies that have been cited on a statement of deficiencies	11800
made by the department of health under section ~~5111.42~~5164.58 of	11801
the Revised Code. The review shall be conducted by an employee of	11802
the department who did not participate in and was not otherwise	11803
involved in any way with the survey. If the employee conducting	11804
the review determines that any deficiency citation is unjustified,	11805
that determination shall be reflected clearly in all records	11806
relating to the survey.	11807

The director need not adopt as rules any of the regulations,	11808
guidelines, or procedures issued ~~under Titles XVIII and XIX of the~~	11809
~~"Social Security Act"~~for the medicare or medicaid programs by the	11810
United States secretary of health and human services.	11811

Sec. 3721.024. As used in this section, "nursing facility"	11812
has the same meaning as in section ~~5111.20~~5164.01 of the Revised	11813
Code.	11814

The department of health may establish a program of	11815
recognition of nursing facilities that provide the highest quality	11816
care to residents who are medicaid recipients ~~of medical~~	11817
~~assistance under Chapter 5111. of the Revised Code~~. The program	11818
may be funded with public funds appropriated by the general	11819
assembly for the purpose of the program or any funds appropriated	11820
for nursing home licensure.	11821

Sec. 3721.026. (A) As used in this section and section	11822
3721.027 of the Revised Code, "nursing facility" and "survey" have	11823
the same meanings as in section ~~5111.35~~5164.50 of the Revised	11824
Code.	11825

(B) The director of health shall establish a unit within the	11826
department of health to provide advice and technical assistance	11827
and to conduct on-site visits to nursing facilities for the	11828
purpose of improving resident outcomes. The director shall assign	11829
to the unit employees who have training or experience in	11830
conducting or supervising surveys, but employees assigned to the	11831
unit shall not conduct surveys. The director shall adopt rules in	11832
accordance with Chapter 119. of the Revised Code to implement this	11833
section and shall consult with interested parties in developing	11834
the rules. Technical assistance reports are not public records	11835
under section 149.43 of the Revised Code and shall not be	11836
distributed to any person outside the unit except:	11837

(1) The nursing facility that is provided with the technical	11838
assistance;	11839

(2) Persons charged with inspecting nursing facilities under	11840
section 3721.02 of the Revised Code or with conducting surveys or	11841
reviews of nursing facilities under section 3721.022 of the	11842
Revised Code whenever any such person finds that there is serious	11843
harm to resident health or safety that is more than isolated at	11844
the nursing facility.	11845

The provisions of this section and rules adopted under this	11846
section do not affect the department's authority to administer and	11847
enforce other sections of this chapter.	11848

(C) On or before the last day of December each year, the	11849
director shall submit a report to the governor and the general	11850
assembly describing the unit's activities that year and its	11851
effectiveness in improving resident outcomes.	11852

Sec. 3721.042. The director of health may not deny a nursing	11853
home license to a facility seeking a license under this chapter as	11854
a nursing home on the grounds that the facility does not satisfy a	11855
requirement established in rules adopted under section 3721.04 of	11856
the Revised Code regarding the toilet rooms and dining and	11857
recreational areas of nursing homes if all of the following	11858
requirements are met:	11859

(A) The facility seeks a license under this chapter because	11860
it is a county home or district home being sold under section	11861
5155.31 of the Revised Code to a person who may not operate the	11862
facility without a nursing home license under this chapter.	11863

(B) The requirement would not have applied to the facility	11864
had the facility been a nursing home first licensed under this	11865
chapter before October 20, 2001.	11866

(C) The facility was a nursing facility, as defined in	11867
section ~~5111.20~~5164.01 of the Revised Code, on the date	11868
immediately preceding the date the facility is sold to the person	11869
seeking the license.	11870

Sec. 3721.071. The buildings in which a home is housed shall	11871
be equipped with both an automatic fire extinguishing system and	11872
fire alarm system. Such systems shall conform to standards set	11873
forth in the regulations of the board of building standards and	11874
the state fire marshal.	11875

The time for compliance with the requirements imposed by this	11876
section shall be January 1, 1975, except that the date for	11877
compliance with the automatic fire extinguishing requirements is	11878
extended to January 1, 1976, provided the buildings of the home	11879
are otherwise in compliance with fire safety laws and regulations	11880
and:	11881

(A) The home within thirty days after August 4, 1975, files a	11882
written plan with the state fire marshal's office that:	11883

(1) Outlines the interim safety procedures which shall be	11884
carried out to reduce the possibility of a fire;	11885

(2) Provides evidence that the home has entered into an	11886
agreement for a fire safety inspection to be conducted not less	11887
than monthly by a qualified independent safety engineer consultant	11888
or a township, municipal, or other legally constituted fire	11889
department, or by a township or municipal fire prevention officer;	11890

(3) Provides verification that the home has entered into a	11891
valid contract for the installation of an automatic fire	11892
extinguishing system or fire alarm system, or both, as required to	11893
comply with this section;	11894

(4) Includes a statement regarding the expected date for the	11895
completion of the fire extinguishing system or fire alarm system,	11896
or both.	11897

(B) Inspections by a qualified independent safety engineer	11898
consultant or a township, municipal, or other legally constituted	11899
fire department, or by a township or municipal fire prevention	11900
officer are initiated no later than sixty days after August 4,	11901
1975, and are conducted no less than monthly thereafter, and	11902
reports of the consultant, fire department, or fire prevention	11903
officer identifying existing hazards and recommended corrective	11904
actions are submitted to the state fire marshal, the division of	11905
industrial compliance in the department of commerce, and the	11906
department of health.	11907

It is the express intent of the general assembly that the	11908
department of ~~job and family services~~health care administration	11909
shall terminate medicaid payments ~~under Title XIX of the "Social~~	11910
~~Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, as amended,~~ to	11911
those homes which do not comply with the requirements of this	11912
section for the submission of a written fire safety plan and the	11913
deadline for entering into contracts for the installation of	11914
systems.	11915

Sec. 3721.08. (A) As used in this section, "real and present	11916
danger" means imminent danger of serious physical or	11917
life-threatening harm to one or more occupants of a home.	11918

(B) The director of health may petition the court of common	11919
pleas of the county in which the home is located for an order	11920
enjoining any person from operating a home without a license or	11921
enjoining a county home or district home that has had its license	11922
revoked from continuing to operate. The court shall have	11923
jurisdiction to grant such injunctive relief upon a showing that	11924
the respondent named in the petition is operating a home without a	11925
license or that the county home or district home named in the	11926
petition is operating despite the revocation of its license. The	11927
court shall have jurisdiction to grant such injunctive relief	11928
against the operation of a home without a valid license regardless	11929
of whether the home meets essential licensing requirements.	11930

(C) Unless the department of ~~job and family services~~health	11931
care administration or contracting agency has taken action under	11932
section ~~5111.51~~5164.67 of the Revised Code to appoint a temporary	11933
manager or seek injunctive relief, if, in the judgment of the	11934
director of health, real and present danger exists at any home,	11935
the director may petition the court of common pleas of the county	11936
in which the home is located for such injunctive relief as is	11937
necessary to close the home, transfer one or more occupants to	11938
other homes or other appropriate care settings, or otherwise	11939
eliminate the real and present danger. The court shall have the	11940
jurisdiction to grant such injunctive relief upon a showing that	11941
there is real and present danger.	11942

(D)(1) If the director determines that real and present	11943
danger exists at a home and elects not to immediately seek	11944
injunctive relief under division (C) of this section, the director	11945
may give written notice of proposed action to the home. The notice	11946
shall specify all of the following:	11947

(a) The nature of the conditions giving rise to the real and	11948
present danger;	11949

(b) The measures that the director determines the home must	11950
take to respond to the conditions;	11951

(c) The date on which the director intends to seek injunctive	11952
relief under division (C) of this section if the director	11953
determines that real and present danger exists at the home.	11954

(2) If the home notifies the director, within the time	11955
specified pursuant to division (D)(1)(c) of this section, that it	11956
believes the conditions giving rise to the real and present danger	11957
have been substantially corrected, the director shall conduct an	11958
inspection to determine whether real and present danger exists. If	11959
the director determines on the basis of the inspection that real	11960
and present danger exists, the director may petition under	11961
division (C) of this section for injunctive relief.	11962

(E)(1) If in the judgment of the director of health	11963
conditions exist at a home that will give rise to real and present	11964
danger if not corrected, the director shall give written notice of	11965
proposed action to the home. The notice shall specify all of the	11966
following:	11967

(a) The nature of the conditions giving rise to the	11968
director's judgment;	11969

(b) The measures that the director determines the home must	11970
take to respond to the conditions;	11971

(c) The date, which shall be no less than ten days after the	11972
notice is delivered, on which the director intends to seek	11973
injunctive relief under division (C) of this section if the	11974
conditions are not substantially corrected and the director	11975
determines that a real and present danger exists.	11976

(2) If the home notifies the director, within the period of	11977
time specified pursuant to division (E)(1)(c) of this section,	11978
that the conditions giving rise to the director's determination	11979
have been substantially corrected, the director shall conduct an	11980
inspection. If the director determines on the basis of the	11981
inspection that the conditions have not been corrected and a real	11982
and present danger exists, the director may petition under	11983
division (C) of this section for injunctive relief.	11984

(F)(1) A court that grants injunctive relief under division	11985
(C) of this section may also appoint a special master who, subject	11986
to division (F)(2) of this section, shall have such powers and	11987
authority over the home and length of appointment as the court	11988
considers necessary. Subject to division (F)(2) of this section,	11989
the salary of a special master and any costs incurred by a special	11990
master shall be the obligation of the home.	11991

(2) No special master shall enter into any employment	11992
contract on behalf of a home, or purchase with the home's funds	11993
any capital goods totaling more than ten thousand dollars, unless	11994
the special master has obtained approval for the contract or	11995
purchase from the home's operator or the court.	11996

(G) If the director takes action under division (C), (D), or	11997
(E) of this section, the director may also appoint employees of	11998
the department of health to conduct on-site monitoring of the	11999
home. Appointment of monitors is not subject to appeal under	12000
Chapter 119. or any other section of the Revised Code. No employee	12001
of a home for which monitors are appointed, no person employed by	12002
the home within the previous two years, and no person who	12003
currently has a consulting contract with the department or a home,	12004
shall be appointed under this division. Every monitor shall have	12005
the professional qualifications necessary to monitor correction of	12006
the conditions that give rise to or, in the director's judgment,	12007
will give rise to real and present danger. The number of monitors	12008
present at a home at any given time shall not exceed one for every	12009
fifty residents, or fraction thereof.	12010

(H) On finding that the real and present danger for which	12011
injunctive relief was granted under division (C) of this section	12012
has been eliminated and that the home's operator has demonstrated	12013
the capacity to prevent the real and present danger from	12014
recurring, the court shall terminate its jurisdiction over the	12015
home and return control and management of the home to the	12016
operator. If the real and present danger cannot be eliminated	12017
practicably within a reasonable time following appointment of a	12018
special master, the court may order the special master to close	12019
the home and transfer all residents to other homes or other	12020
appropriate care settings.	12021

(I) The director of health shall give notice of proposed	12022
action under divisions (D) and (E) of this section to both of the	12023
following:	12024

(1) The home's administrator;

12025

(2) If the home is operated by an organization described in	12026
subsection 501(c)(3) and tax exempt under subsection 501(a) of the	12027
"Internal Revenue Code of 1986," 100 Stat. 2085, 26 U.S.C.A. 1, as	12028
amended, the board of trustees of the organization; or, if the	12029
home is not operated by such an organization, the owner of the	12030
home.	12031

Notices shall be delivered by certified mail or hand	12032
delivery. If notices are mailed, they shall be addressed to the	12033
persons specified in divisions (I)(1) and (2) of this section, as	12034
indicated in the department of health's records. If they are hand	12035
delivered, they shall be delivered to persons who would reasonably	12036
appear to the average prudent person to have authority to accept	12037
them.	12038

(J) If ownership of a home is assigned or transferred to a	12039
different person, the new owner is responsible and liable for	12040
compliance with any notice of proposed action or order issued	12041
under this section prior to the effective date of the assignment	12042
or transfer.	12043

Sec. 3721.10. As used in sections 3721.10 to 3721.18 of the	12044
Revised Code:	12045

(A) "Home" means all of the following:

12046

(1) A home as defined in section 3721.01 of the Revised Code;

12047

(2) Any facility or part of a facility not defined as a home	12048
under section 3721.01 of the Revised Code that is certified as a	12049
skilled nursing facility ~~under Title XVIII of the "Social Security~~	12050
~~Act," 79 Stat. 286 (1965), 42 U.S.C.A. 1395 and 1396, as amended,~~	12051
for the medicare program or as a nursing facility ~~as defined in~~	12052
~~section 5111.20 of the Revised Code~~for the medicaid program;	12053

(3) A county home or district home operated pursuant to	12054
Chapter 5155. of the Revised Code.	12055

(B) "Resident" means a resident or a patient of a home.

12056

12057

(1) With respect to a home as defined in section 3721.01 of	12058
the Revised Code, a nursing home administrator as defined in	12059
section 4751.01 of the Revised Code;	12060

(2) With respect to a facility or part of a facility not	12061
defined as a home in section 3721.01 of the Revised Code that is	12062
authorized to provide skilled nursing facility or nursing facility	12063
services, the administrator of the facility or part of a facility;	12064

(3) With respect to a county home or district home, the	12065
superintendent appointed under Chapter 5155. of the Revised Code.	12066

(D) "Sponsor" means an adult relative, friend, or guardian of	12067
a resident who has an interest or responsibility in the resident's	12068
welfare.	12069

(E) "Residents' rights advocate" means:

12070

(1) An employee or representative of any state or local	12071
government entity that has a responsibility regarding residents	12072
and that has registered with the department of health under	12073
division (B) of section 3701.07 of the Revised Code;	12074

(2) An employee or representative of any private nonprofit	12075
corporation or association that qualifies for tax-exempt status	12076
under section 501(a) of the "Internal Revenue Code of 1986," 100	12077
Stat. 2085, 26 U.S.C.A. 1, as amended, and that has registered	12078
with the department of health under division (B) of section	12079
3701.07 of the Revised Code and whose purposes include educating	12080
and counseling residents, assisting residents in resolving	12081
problems and complaints concerning their care and treatment, and	12082
assisting them in securing adequate services to meet their needs;	12083

(3) A member of the general assembly.

12084

(F) "Physical restraint" means, but is not limited to, any	12085
article, device, or garment that interferes with the free movement	12086
of the resident and that the resident is unable to remove easily,	12087
a geriatric chair, or a locked room door.	12088

(G) "Chemical restraint" means any medication bearing the	12089
American hospital formulary service therapeutic class 4.00,	12090
28:16:08, 28:24:08, or 28:24:92 that alters the functioning of the	12091
central nervous system in a manner that limits physical and	12092
cognitive functioning to the degree that the resident cannot	12093
attain the resident's highest practicable physical, mental, and	12094
psychosocial well-being.	12095

(H) "Ancillary service" means, but is not limited to,	12096
podiatry, dental, hearing, vision, physical therapy, occupational	12097
therapy, speech therapy, and psychological and social services.	12098

(I) "Facility" means a facility, or part of a facility,	12099
certified as a nursing facility or skilled nursing facility under	12100
~~Title XVIII or Title XIX of~~ the ~~"Social Security Act."~~medicare or	12101
medicaid programs. "Facility" does not include an intermediate	12102
care facility for the mentally retarded, as defined in section	12103
~~5111.20~~5164.01 of the Revised Code.	12104

~~(J) "Medicare" means the program established by Title XVIII~~	12105
~~of the "Social Security Act."~~	12106

~~(K) "Medicaid" means the program established by Title XIX of~~	12107
~~the "Social Security Act" and Chapter 5111. of the Revised Code.~~	12108

Sec. 3721.12. (A) The administrator of a home shall:

12109

(1) With the advice of residents, their sponsors, or both,	12110
establish and review at least annually, written policies regarding	12111
the applicability and implementation of residents' rights under	12112
sections 3721.10 to 3721.17 of the Revised Code, the	12113
responsibilities of residents regarding the rights, and the home's	12114
grievance procedure established under division (A)(2) of this	12115
section. The administrator is responsible for the development of,	12116
and adherence to, procedures implementing the policies.	12117

(2) Establish a grievance committee for review of complaints	12118
by residents. The grievance committee shall be comprised of the	12119
home's staff and residents, sponsors, or outside representatives	12120
in a ratio of not more than one staff member to every two	12121
residents, sponsors, or outside representatives.	12122

(3) Furnish to each resident and sponsor prior to or at the	12123
time of admission, and to each member of the home's staff, at	12124
least one of each of the following:	12125

(a) A copy of the rights established under sections 3721.10	12126
to 3721.17 of the Revised Code;	12127

(b) A written explanation of the provisions of sections	12128
3721.16 to 3721.162 of the Revised Code;	12129

(c) A copy of the home's policies and procedures established	12130
under this section;	12131

(d) A copy of the home's rules;

12132

(e) A copy of the addresses and telephone numbers of the	12133
board of health of the health district of the county in which the	12134
home is located, the county department of job and family services	12135
of the county in which the home is located, the state departments	12136
of health and job and family services, the state and local offices	12137
of the department of aging, and any Ohio nursing home ombudsperson	12138
program.	12139

(B) Written acknowledgment of the receipt of copies of the	12140
materials listed in this section shall be made part of the	12141
resident's record and the staff member's personnel record.	12142

(C) The administrator shall post all of the following	12143
prominently within the home:	12144

(1) A copy of the rights of residents as listed in division	12145
(A) of section 3721.13 of the Revised Code;	12146

(2) A copy of the home's rules and its policies and	12147
procedures regarding the rights and responsibilities of residents;	12148

(3) A notice that a copy of this chapter, rules of the	12149
department of health applicable to the home, and federal	12150
regulations adopted under the medicare and medicaid programs, and	12151
the materials required to be available in the home under section	12152
3721.021 of the Revised Code, are available for inspection in the	12153
home at reasonable hours;	12154

(4) A list of residents' rights advocates;

12155

(5) A notice that the following are available in a place	12156
readily accessible to residents:	12157

(a) If the home is licensed under section 3721.02 of the	12158
Revised Code, a copy of the most recent licensure inspection	12159
report prepared for the home under that section;	12160

(b) If the home is a facility, a copy of the most recent	12161
statement of deficiencies issued to the home under section ~~5111.42~~	12162
5164.58 of the Revised Code.	12163

(D) The administrator of a home may, with the advice of	12164
residents, their sponsors, or both, establish written policies	12165
regarding the applicability and administration of any additional	12166
residents' rights beyond those set forth in sections 3721.10 to	12167
3721.17 of the Revised Code, and the responsibilities of residents	12168
regarding the rights. Policies established under this division	12169
shall be reviewed, and procedures developed and adhered to as in	12170
division (A)(1) of this section.	12171

Sec. 3721.121. (A) As used in this section:

12172

(1) "Adult day-care program" means a program operated	12173
pursuant to rules adopted by the public health council under	12174
section 3721.04 of the Revised Code and provided by and on the	12175
same site as homes licensed under this chapter.	12176

(2) "Applicant" means a person who is under final	12177
consideration for employment with a home or adult day-care program	12178
in a full-time, part-time, or temporary position that involves	12179
providing direct care to an older adult. "Applicant" does not	12180
include a person who provides direct care as a volunteer without	12181
receiving or expecting to receive any form of remuneration other	12182
than reimbursement for actual expenses.	12183

(3) "Criminal records check" and "older adult" have the same	12184
meanings as in section 109.572 of the Revised Code.	12185

(4) "Home" means a home as defined in section 3721.10 of the	12186
Revised Code.	12187

(B)(1) Except as provided in division (I) of this section,	12188
the chief administrator of a home or adult day-care program shall	12189
request that the superintendent of the bureau of criminal	12190
identification and investigation conduct a criminal records check	12191
with respect to each applicant. If an applicant for whom a	12192
criminal records check request is required under this division	12193
does not present proof of having been a resident of this state for	12194
the five-year period immediately prior to the date the criminal	12195
records check is requested or provide evidence that within that	12196
five-year period the superintendent has requested information	12197
about the applicant from the federal bureau of investigation in a	12198
criminal records check, the chief administrator shall request that	12199
the superintendent obtain information from the federal bureau of	12200
investigation as part of the criminal records check of the	12201
applicant. Even if an applicant for whom a criminal records check	12202
request is required under this division presents proof of having	12203
been a resident of this state for the five-year period, the chief	12204
administrator may request that the superintendent include	12205
information from the federal bureau of investigation in the	12206
criminal records check.	12207

(2) A person required by division (B)(1) of this section to	12208
request a criminal records check shall do both of the following:	12209

(a) Provide to each applicant for whom a criminal records	12210
check request is required under that division a copy of the form	12211
prescribed pursuant to division (C)(1) of section 109.572 of the	12212
Revised Code and a standard fingerprint impression sheet	12213
prescribed pursuant to division (C)(2) of that section, and obtain	12214
the completed form and impression sheet from the applicant;	12215

(b) Forward the completed form and impression sheet to the	12216
superintendent of the bureau of criminal identification and	12217
investigation.	12218

(3) An applicant provided the form and fingerprint impression	12219
sheet under division (B)(2)(a) of this section who fails to	12220
complete the form or provide fingerprint impressions shall not be	12221
employed in any position for which a criminal records check is	12222
required by this section.	12223

(C)(1) Except as provided in rules adopted by the director of	12224
health in accordance with division (F) of this section and subject	12225
to division (C)(2) of this section, no home or adult day-care	12226
program shall employ a person in a position that involves	12227
providing direct care to an older adult if the person has been	12228
convicted of or pleaded guilty to any of the following:	12229

(a) A violation of section 2903.01, 2903.02, 2903.03,	12230
2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34,	12231
2905.01, 2905.02, 2905.11, 2905.12, 2907.02, 2907.03, 2907.05,	12232
2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 2907.25, 2907.31,	12233
2907.32, 2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11,	12234
2911.12, 2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21,	12235
2913.31, 2913.40, 2913.43, 2913.47, 2913.51, 2919.25, 2921.36,	12236
2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.11, 2925.13,	12237
2925.22, 2925.23, or 3716.11 of the Revised Code.	12238

(b) A violation of an existing or former law of this state,	12239
any other state, or the United States that is substantially	12240
equivalent to any of the offenses listed in division (C)(1)(a) of	12241
this section.	12242

(2)(a) A home or an adult day-care program may employ	12243
conditionally an applicant for whom a criminal records check	12244
request is required under division (B) of this section prior to	12245
obtaining the results of a criminal records check regarding the	12246
individual, provided that the home or program shall request a	12247
criminal records check regarding the individual in accordance with	12248
division (B)(1) of this section not later than five business days	12249
after the individual begins conditional employment. In the	12250
circumstances described in division (I)(2) of this section, a home	12251
or adult day-care program may employ conditionally an applicant	12252
who has been referred to the home or adult day-care program by an	12253
employment service that supplies full-time, part-time, or	12254
temporary staff for positions involving the direct care of older	12255
adults and for whom, pursuant to that division, a criminal records	12256
check is not required under division (B) of this section.	12257

(b) A home or adult day-care program that employs an	12258
individual conditionally under authority of division (C)(2)(a) of	12259
this section shall terminate the individual's employment if the	12260
results of the criminal records check requested under division (B)	12261
of this section or described in division (I)(2) of this section,	12262
other than the results of any request for information from the	12263
federal bureau of investigation, are not obtained within the	12264
period ending thirty days after the date the request is made.	12265
Regardless of when the results of the criminal records check are	12266
obtained, if the results indicate that the individual has been	12267
convicted of or pleaded guilty to any of the offenses listed or	12268
described in division (C)(1) of this section, the home or program	12269
shall terminate the individual's employment unless the home or	12270
program chooses to employ the individual pursuant to division (F)	12271
of this section. Termination of employment under this division	12272
shall be considered just cause for discharge for purposes of	12273
division (D)(2) of section 4141.29 of the Revised Code if the	12274
individual makes any attempt to deceive the home or program about	12275
the individual's criminal record.	12276

(D)(1) Each home or adult day-care program shall pay to the	12277
bureau of criminal identification and investigation the fee	12278
prescribed pursuant to division (C)(3) of section 109.572 of the	12279
Revised Code for each criminal records check conducted pursuant to	12280
a request made under division (B) of this section.	12281

(2) A home or adult day-care program may charge an applicant	12282
a fee not exceeding the amount the home or program pays under	12283
division (D)(1) of this section. A home or program may collect a	12284
fee only if both of the following apply:	12285

(a) The home or program notifies the person at the time of	12286
initial application for employment of the amount of the fee and	12287
that, unless the fee is paid, the person will not be considered	12288
for employment;	12289

(b) The ~~medical assistance~~medicaid program ~~established under~~	12290
~~Chapter 5111. of the Revised Code~~ does not reimburse the home or	12291
program the fee it pays under division (D)(1) of this section.	12292

(E) The report of any criminal records check conducted	12293
pursuant to a request made under this section is not a public	12294
record for the purposes of section 149.43 of the Revised Code and	12295
shall not be made available to any person other than the	12296
following:	12297

(1) The individual who is the subject of the criminal records	12298
check or the individual's representative;	12299

(2) The chief administrator of the home or program requesting	12300
the criminal records check or the administrator's representative;	12301

(3) The administrator of any other facility, agency, or	12302
program that provides direct care to older adults that is owned or	12303
operated by the same entity that owns or operates the home or	12304
program;	12305

(4) A court, hearing officer, or other necessary individual	12306
involved in a case dealing with a denial of employment of the	12307
applicant or dealing with employment or unemployment benefits of	12308
the applicant;	12309

(5) Any person to whom the report is provided pursuant to,	12310
and in accordance with, division (I)(1) or (2) of this section;	12311

(6) The board of nursing for purposes of accepting and	12312
processing an application for a medication aide certificate issued	12313
under Chapter 4723. of the Revised Code.	12314

(F) In accordance with section 3721.11 of the Revised Code,	12315
the director of health shall adopt rules to implement this	12316
section. The rules shall specify circumstances under which a home	12317
or adult day-care program may employ a person who has been	12318
convicted of or pleaded guilty to an offense listed or described	12319
in division (C)(1) of this section but meets personal character	12320
standards set by the director.	12321

(G) The chief administrator of a home or adult day-care	12322
program shall inform each individual, at the time of initial	12323
application for a position that involves providing direct care to	12324
an older adult, that the individual is required to provide a set	12325
of fingerprint impressions and that a criminal records check is	12326
required to be conducted if the individual comes under final	12327
consideration for employment.	12328

(H) In a tort or other civil action for damages that is	12329
brought as the result of an injury, death, or loss to person or	12330
property caused by an individual who a home or adult day-care	12331
program employs in a position that involves providing direct care	12332
to older adults, all of the following shall apply:	12333

(1) If the home or program employed the individual in good	12334
faith and reasonable reliance on the report of a criminal records	12335
check requested under this section, the home or program shall not	12336
be found negligent solely because of its reliance on the report,	12337
even if the information in the report is determined later to have	12338
been incomplete or inaccurate;	12339

(2) If the home or program employed the individual in good	12340
faith on a conditional basis pursuant to division (C)(2) of this	12341
section, the home or program shall not be found negligent solely	12342
because it employed the individual prior to receiving the report	12343
of a criminal records check requested under this section;	12344

(3) If the home or program in good faith employed the	12345
individual according to the personal character standards	12346
established in rules adopted under division (F) of this section,	12347
the home or program shall not be found negligent solely because	12348
the individual prior to being employed had been convicted of or	12349
pleaded guilty to an offense listed or described in division	12350
(C)(1) of this section.	12351

(I)(1) The chief administrator of a home or adult day-care	12352
program is not required to request that the superintendent of the	12353
bureau of criminal identification and investigation conduct a	12354
criminal records check of an applicant if the applicant has been	12355
referred to the home or program by an employment service that	12356
supplies full-time, part-time, or temporary staff for positions	12357
involving the direct care of older adults and both of the	12358
following apply:	12359

(a) The chief administrator receives from the employment	12360
service or the applicant a report of the results of a criminal	12361
records check regarding the applicant that has been conducted by	12362
the superintendent within the one-year period immediately	12363
preceding the applicant's referral;	12364

(b) The report of the criminal records check demonstrates	12365
that the person has not been convicted of or pleaded guilty to an	12366
offense listed or described in division (C)(1) of this section, or	12367
the report demonstrates that the person has been convicted of or	12368
pleaded guilty to one or more of those offenses, but the home or	12369
adult day-care program chooses to employ the individual pursuant	12370
to division (F) of this section.	12371

(2) The chief administrator of a home or adult day-care	12372
program is not required to request that the superintendent of the	12373
bureau of criminal identification and investigation conduct a	12374
criminal records check of an applicant and may employ the	12375
applicant conditionally as described in this division, if the	12376
applicant has been referred to the home or program by an	12377
employment service that supplies full-time, part-time, or	12378
temporary staff for positions involving the direct care of older	12379
adults and if the chief administrator receives from the employment	12380
service or the applicant a letter from the employment service that	12381
is on the letterhead of the employment service, dated, and signed	12382
by a supervisor or another designated official of the employment	12383
service and that states that the employment service has requested	12384
the superintendent to conduct a criminal records check regarding	12385
the applicant, that the requested criminal records check will	12386
include a determination of whether the applicant has been	12387
convicted of or pleaded guilty to any offense listed or described	12388
in division (C)(1) of this section, that, as of the date set forth	12389
on the letter, the employment service had not received the results	12390
of the criminal records check, and that, when the employment	12391
service receives the results of the criminal records check, it	12392
promptly will send a copy of the results to the home or adult	12393
day-care program. If a home or adult day-care program employs an	12394
applicant conditionally in accordance with this division, the	12395
employment service, upon its receipt of the results of the	12396
criminal records check, promptly shall send a copy of the results	12397
to the home or adult day-care program, and division (C)(2)(b) of	12398
this section applies regarding the conditional employment.	12399

Sec. 3721.13. (A) The rights of residents of a home shall	12400
include, but are not limited to, the following:	12401

(1) The right to a safe and clean living environment pursuant	12402
to the medicare and medicaid programs and applicable state laws	12403
and regulations prescribed by the public health council;	12404

(2) The right to be free from physical, verbal, mental, and	12405
emotional abuse and to be treated at all times with courtesy,	12406
respect, and full recognition of dignity and individuality;	12407

(3) Upon admission and thereafter, the right to adequate and	12408
appropriate medical treatment and nursing care and to other	12409
ancillary services that comprise necessary and appropriate care	12410
consistent with the program for which the resident contracted.	12411
This care shall be provided without regard to considerations such	12412
as race, color, religion, national origin, age, or source of	12413
payment for care.	12414

(4) The right to have all reasonable requests and inquiries	12415
responded to promptly;	12416

(5) The right to have clothes and bed sheets changed as the	12417
need arises, to ensure the resident's comfort or sanitation;	12418

(6) The right to obtain from the home, upon request, the name	12419
and any specialty of any physician or other person responsible for	12420
the resident's care or for the coordination of care;	12421

(7) The right, upon request, to be assigned, within the	12422
capacity of the home to make the assignment, to the staff	12423
physician of the resident's choice, and the right, in accordance	12424
with the rules and written policies and procedures of the home, to	12425
select as the attending physician a physician who is not on the	12426
staff of the home. If the cost of a physician's services is to be	12427
met under a federally supported program, the physician shall meet	12428
the federal laws and regulations governing such services.	12429

(8) The right to participate in decisions that affect the	12430
resident's life, including the right to communicate with the	12431
physician and employees of the home in planning the resident's	12432
treatment or care and to obtain from the attending physician	12433
complete and current information concerning medical condition,	12434
prognosis, and treatment plan, in terms the resident can	12435
reasonably be expected to understand; the right of access to all	12436
information in the resident's medical record; and the right to	12437
give or withhold informed consent for treatment after the	12438
consequences of that choice have been carefully explained. When	12439
the attending physician finds that it is not medically advisable	12440
to give the information to the resident, the information shall be	12441
made available to the resident's sponsor on the resident's behalf,	12442
if the sponsor has a legal interest or is authorized by the	12443
resident to receive the information. The home is not liable for a	12444
violation of this division if the violation is found to be the	12445
result of an act or omission on the part of a physician selected	12446
by the resident who is not otherwise affiliated with the home.	12447

(9) The right to withhold payment for physician visitation if	12448
the physician did not visit the resident;	12449

(10) The right to confidential treatment of personal and	12450
medical records, and the right to approve or refuse the release of	12451
these records to any individual outside the home, except in case	12452
of transfer to another home, hospital, or health care system, as	12453
required by law or rule, or as required by a third-party payment	12454
contract;	12455

(11) The right to privacy during medical examination or	12456
treatment and in the care of personal or bodily needs;	12457

(12) The right to refuse, without jeopardizing access to	12458
appropriate medical care, to serve as a medical research subject;	12459

(13) The right to be free from physical or chemical	12460
restraints or prolonged isolation except to the minimum extent	12461
necessary to protect the resident from injury to self, others, or	12462
to property and except as authorized in writing by the attending	12463
physician for a specified and limited period of time and	12464
documented in the resident's medical record. Prior to authorizing	12465
the use of a physical or chemical restraint on any resident, the	12466
attending physician shall make a personal examination of the	12467
resident and an individualized determination of the need to use	12468
the restraint on that resident.	12469

Physical or chemical restraints or isolation may be used in	12470
an emergency situation without authorization of the attending	12471
physician only to protect the resident from injury to self or	12472
others. Use of the physical or chemical restraints or isolation	12473
shall not be continued for more than twelve hours after the onset	12474
of the emergency without personal examination and authorization by	12475
the attending physician. The attending physician or a staff	12476
physician may authorize continued use of physical or chemical	12477
restraints for a period not to exceed thirty days, and at the end	12478
of this period and any subsequent period may extend the	12479
authorization for an additional period of not more than thirty	12480
days. The use of physical or chemical restraints shall not be	12481
continued without a personal examination of the resident and the	12482
written authorization of the attending physician stating the	12483
reasons for continuing the restraint.	12484

If physical or chemical restraints are used under this	12485
division, the home shall ensure that the restrained resident	12486
receives a proper diet. In no event shall physical or chemical	12487
restraints or isolation be used for punishment, incentive, or	12488
convenience.	12489

(14) The right to the pharmacist of the resident's choice and	12490
the right to receive pharmaceutical supplies and services at	12491
reasonable prices not exceeding applicable and normally accepted	12492
prices for comparably packaged pharmaceutical supplies and	12493
services within the community;	12494

(15) The right to exercise all civil rights, unless the	12495
resident has been adjudicated incompetent pursuant to Chapter	12496
2111. of the Revised Code and has not been restored to legal	12497
capacity, as well as the right to the cooperation of the home's	12498
administrator in making arrangements for the exercise of the right	12499
to vote;	12500

(16) The right of access to opportunities that enable the	12501
resident, at the resident's own expense or at the expense of a	12502
third-party payer, to achieve the resident's fullest potential,	12503
including educational, vocational, social, recreational, and	12504
habilitation programs;	12505

(17) The right to consume a reasonable amount of alcoholic	12506
beverages at the resident's own expense, unless not medically	12507
advisable as documented in the resident's medical record by the	12508
attending physician or unless contradictory to written admission	12509
policies;	12510

(18) The right to use tobacco at the resident's own expense	12511
under the home's safety rules and under applicable laws and rules	12512
of the state, unless not medically advisable as documented in the	12513
resident's medical record by the attending physician or unless	12514
contradictory to written admission policies;	12515

(19) The right to retire and rise in accordance with the	12516
resident's reasonable requests, if the resident does not disturb	12517
others or the posted meal schedules and upon the home's request	12518
remains in a supervised area, unless not medically advisable as	12519
documented by the attending physician;	12520

(20) The right to observe religious obligations and	12521
participate in religious activities; the right to maintain	12522
individual and cultural identity; and the right to meet with and	12523
participate in activities of social and community groups at the	12524
resident's or the group's initiative;	12525

(21) The right upon reasonable request to private and	12526
unrestricted communications with the resident's family, social	12527
worker, and any other person, unless not medically advisable as	12528
documented in the resident's medical record by the attending	12529
physician, except that communications with public officials or	12530
with the resident's attorney or physician shall not be restricted.	12531
Private and unrestricted communications shall include, but are not	12532
limited to, the right to:	12533

(a) Receive, send, and mail sealed, unopened correspondence;

12534

(b) Reasonable access to a telephone for private	12535
communications;	12536

12537

(22) The right to assured privacy for visits by the spouse,	12538
or if both are residents of the same home, the right to share a	12539
room within the capacity of the home, unless not medically	12540
advisable as documented in the resident's medical record by the	12541
attending physician;	12542

(23) The right upon reasonable request to have room doors	12543
closed and to have them not opened without knocking, except in the	12544
case of an emergency or unless not medically advisable as	12545
documented in the resident's medical record by the attending	12546
physician;	12547

(24) The right to retain and use personal clothing and a	12548
reasonable amount of possessions, in a reasonably secure manner,	12549
unless to do so would infringe on the rights of other residents or	12550
would not be medically advisable as documented in the resident's	12551
medical record by the attending physician;	12552

(25) The right to be fully informed, prior to or at the time	12553
of admission and during the resident's stay, in writing, of the	12554
basic rate charged by the home, of services available in the home,	12555
and of any additional charges related to such services, including	12556
charges for services not covered under the medicare or medicaid	12557
program. The basic rate shall not be changed unless thirty days	12558
notice is given to the resident or, if the resident is unable to	12559
understand this information, to the resident's sponsor.	12560

(26) The right of the resident and person paying for the care	12561
to examine and receive a bill at least monthly for the resident's	12562
care from the home that itemizes charges not included in the basic	12563
rates;	12564

(27)(a) The right to be free from financial exploitation;

12565

(b) The right to manage the resident's own personal financial	12566
affairs, or, if the resident has delegated this responsibility in	12567
writing to the home, to receive upon written request at least a	12568
quarterly accounting statement of financial transactions made on	12569
the resident's behalf. The statement shall include:	12570

(i) A complete record of all funds, personal property, or	12571
possessions of a resident from any source whatsoever, that have	12572
been deposited for safekeeping with the home for use by the	12573
resident or the resident's sponsor;	12574

(ii) A listing of all deposits and withdrawals transacted,	12575
which shall be substantiated by receipts which shall be available	12576
for inspection and copying by the resident or sponsor.	12577

(28) The right of the resident to be allowed unrestricted	12578
access to the resident's property on deposit at reasonable hours,	12579
unless requests for access to property on deposit are so	12580
persistent, continuous, and unreasonable that they constitute a	12581
nuisance;	12582

(29) The right to receive reasonable notice before the	12583
resident's room or roommate is changed, including an explanation	12584
of the reason for either change.	12585

(30) The right not to be transferred or discharged from the	12586
home unless the transfer is necessary because of one of the	12587
following:	12588

(a) The welfare and needs of the resident cannot be met in	12589
the home.	12590

(b) The resident's health has improved sufficiently so that	12591
the resident no longer needs the services provided by the home.	12592

12593

(d) The health of individuals in the home would otherwise be	12594
endangered.	12595

(e) The resident has failed, after reasonable and appropriate	12596
notice, to pay or to have the medicare or medicaid program pay on	12597
the resident's behalf, for the care provided by the home. A	12598
resident shall not be considered to have failed to have the	12599
resident's care paid for if the resident has applied for medicaid,	12600
unless both of the following are the case:	12601

(i) The resident's application, or a substantially similar	12602
previous application, has been denied by the county department of	12603
job and family services.	12604

(ii) If the resident appealed the denial pursuant to division	12605
(C) of section ~~5101.35~~5160.34 of the Revised Code, the director	12606
of job and family services has upheld the denial.	12607

(f) The home's license has been revoked, the home is being	12608
closed pursuant to section 3721.08, sections ~~5111.35~~5164.50 to	12609
~~5111.62~~5164.78, or section 5155.31 of the Revised Code, or the	12610
home otherwise ceases to operate.	12611

(g) The resident is a recipient of medicaid, and the home's	12612
participation in the medicaid program is involuntarily terminated	12613
or denied.	12614

(h) The resident is a beneficiary under the medicare program,	12615
and the home's participation in the medicare program is	12616
involuntarily terminated or denied.	12617

(31) The right to voice grievances and recommend changes in	12618
policies and services to the home's staff, to employees of the	12619
department of health, or to other persons not associated with the	12620
operation of the home, of the resident's choice, free from	12621
restraint, interference, coercion, discrimination, or reprisal.	12622
This right includes access to a residents' rights advocate, and	12623
the right to be a member of, to be active in, and to associate	12624
with persons who are active in organizations of relatives and	12625
friends of nursing home residents and other organizations engaged	12626
in assisting residents.	12627

(32) The right to have any significant change in the	12628
resident's health status reported to the resident's sponsor. As	12629
soon as such a change is known to the home's staff, the home shall	12630
make a reasonable effort to notify the sponsor within twelve	12631
hours.	12632

(B) A sponsor may act on a resident's behalf to assure that	12633
the home does not deny the residents' rights under sections	12634
3721.10 to 3721.17 of the Revised Code.	12635

(C) Any attempted waiver of the rights listed in division (A)	12636
of this section is void.	12637

Sec. 3721.15. (A) Authorization from a resident or a sponsor	12638
with a power of attorney for a home to manage the resident's	12639
financial affairs shall be in writing and shall be attested to by	12640
a witness who is not connected in any manner whatsoever with the	12641
home or its administrator. The home shall maintain accounts	12642
pursuant to division (A)(27) of section 3721.13 of the Revised	12643
Code. Upon the resident's transfer, discharge, or death, the	12644
account shall be closed and a final accounting made. All remaining	12645
funds shall be returned to the resident or resident's sponsor,	12646
except in the case of death, when all remaining funds shall be	12647
transferred or used in accordance with section ~~5111.113~~5162.37 of	12648
the Revised Code.	12649

(B) A home that manages a resident's financial affairs shall	12650
deposit the resident's funds in excess of one hundred dollars, and	12651
may deposit the resident's funds that are one hundred dollars or	12652
less, in an interest-bearing account separate from any of the	12653
home's operating accounts. Interest earned on the resident's funds	12654
shall be credited to the resident's account. A resident's funds	12655
that are one hundred dollars or less and have not been deposited	12656
in an interest-bearing account may be deposited in a	12657
noninterest-bearing account or petty cash fund.	12658

(C) Each resident whose financial affairs are managed by a	12659
home shall be promptly notified by the home when the total of the	12660
amount of funds in the resident's accounts and the petty cash fund	12661
plus other nonexempt resources reaches two hundred dollars less	12662
than the maximum amount permitted a recipient of medicaid. The	12663
notice shall include an explanation of the potential effect on the	12664
resident's eligibility for medicaid if the amount in the	12665
resident's accounts and the petty cash fund, plus the value of	12666
other nonexempt resources, exceeds the maximum assets a medicaid	12667
recipient may retain.	12668

(D) Each home that manages the financial affairs of residents	12669
shall purchase a surety bond or otherwise provide assurance	12670
satisfactory to the director of health, or, in the case of a home	12671
that participates in the medicaid program, to the director of ~~job~~	12672
~~and family services~~health care administration, to assure the	12673
security of all residents' funds managed by the home.	12674

Sec. 3721.16. For each resident of a home, notice of a	12675
proposed transfer or discharge shall be in accordance with this	12676
section.	12677

(A)(1) The administrator of a home shall notify a resident in	12678
writing, and the resident's sponsor in writing by certified mail,	12679
return receipt requested, in advance of any proposed transfer or	12680
discharge from the home. The administrator shall send a copy of	12681
the notice to the state department of health. The notice shall be	12682
provided at least thirty days in advance of the proposed transfer	12683
or discharge, unless any of the following applies:	12684

(a) The resident's health has improved sufficiently to allow	12685
a more immediate discharge or transfer to a less skilled level of	12686
care;	12687

(b) The resident has resided in the home less than thirty	12688
days;	12689

(c) An emergency arises in which the safety of individuals in	12690
the home is endangered;	12691

(d) An emergency arises in which the health of individuals in	12692
the home would otherwise be endangered;	12693

(e) An emergency arises in which the resident's urgent	12694
medical needs necessitate a more immediate transfer or discharge.	12695

In any of the circumstances described in divisions (A)(1)(a)	12696
to (e) of this section, the notice shall be provided as many days	12697
in advance of the proposed transfer or discharge as is	12698
practicable.	12699

(2) The notice required under division (A)(1) of this section	12700
shall include all of the following:	12701

(a) The reasons for the proposed transfer or discharge;

12702

(b) The proposed date the resident is to be transferred or	12703
discharged;	12704

(c) The proposed location to which the resident is to be	12705
transferred or discharged;	12706

(d) Notice of the right of the resident and the resident's	12707
sponsor to an impartial hearing at the home on the proposed	12708
transfer or discharge, and of the manner in which and the time	12709
within which the resident or sponsor may request a hearing	12710
pursuant to section 3721.161 of the Revised Code;	12711

(e) A statement that the resident will not be transferred or	12712
discharged before the date specified in the notice unless the home	12713
and the resident or, if the resident is not competent to make a	12714
decision, the home and the resident's sponsor, agree to an earlier	12715
date;	12716

(f) The address of the legal services office of the	12717
department of health;	12718

(g) The name, address, and telephone number of a	12719
representative of the state long-term care ombudsperson program	12720
and, if the resident or patient has a developmental disability or	12721
mental illness, the name, address, and telephone number of the	12722
Ohio legal rights service.	12723

(B) No home shall transfer or discharge a resident before the	12724
date specified in the notice required by division (A) of this	12725
section unless the home and the resident or, if the resident is	12726
not competent to make a decision, the home and the resident's	12727
sponsor, agree to an earlier date.	12728

(C) Transfer or discharge actions shall be documented in the	12729
resident's medical record by the home if there is a medical basis	12730
for the action.	12731

(D) A resident or resident's sponsor may challenge a transfer	12732
or discharge by requesting an impartial hearing pursuant to	12733
section 3721.161 of the Revised Code, unless the transfer or	12734
discharge is required because of one of the following reasons:	12735

(1) The home's license has been revoked under this chapter;

12736

(2) The home is being closed pursuant to section 3721.08,	12737
~~sections 5111.35 to 5111.62,~~ or ~~section~~ 5155.31, or sections	12738
5164.50 to 5164.78 of the Revised Code;	12739

(3) The resident is a recipient of medicaid and the home's	12740
participation in the medicaid program has been involuntarily	12741
terminated or denied by the federal government;	12742

(4) The resident is a beneficiary under the medicare program	12743
and the home's certification under the medicare program has been	12744
involuntarily terminated or denied by the federal government.	12745

(E) If a resident is transferred or discharged pursuant to	12746
this section, the home from which the resident is being	12747
transferred or discharged shall provide the resident with adequate	12748
preparation prior to the transfer or discharge to ensure a safe	12749
and orderly transfer or discharge from the home, and the home or	12750
alternative setting to which the resident is to be transferred or	12751
discharged shall have accepted the resident for transfer or	12752
discharge.	12753

(F) At the time of a transfer or discharge of a resident who	12754
is a recipient of medicaid from a home to a hospital or for	12755
therapeutic leave, the home shall provide notice in writing to the	12756
resident and in writing by certified mail, return receipt	12757
requested, to the resident's sponsor, specifying the number of	12758
days, if any, during which the resident will be permitted under	12759
the medicaid program to return and resume residence in the home	12760
and specifying the medicaid program's coverage of the days during	12761
which the resident is absent from the home. An individual who is	12762
absent from a home for more than the number of days specified in	12763
the notice and continues to require the services provided by the	12764
facility shall be given priority for the first available bed in a	12765
semi-private room.	12766

Sec. 3721.17. (A) Any resident who believes that the	12767
resident's rights under sections 3721.10 to 3721.17 of the Revised	12768
Code have been violated may file a grievance under procedures	12769
adopted pursuant to division (A)(2) of section 3721.12 of the	12770
Revised Code.	12771

When the grievance committee determines a violation of	12772
sections 3721.10 to 3721.17 of the Revised Code has occurred, it	12773
shall notify the administrator of the home. If the violation	12774
cannot be corrected within ten days, or if ten days have elapsed	12775
without correction of the violation, the grievance committee shall	12776
refer the matter to the department of health.	12777

(B) Any person who believes that a resident's rights under	12778
sections 3721.10 to 3721.17 of the Revised Code have been violated	12779
may report or cause reports to be made of the information directly	12780
to the department of health. No person who files a report is	12781
liable for civil damages resulting from the report.	12782

(C)(1) Within thirty days of receiving a complaint under this	12783
section, the department of health shall investigate any complaint	12784
referred to it by a home's grievance committee and any complaint	12785
from any source that alleges that the home provided substantially	12786
less than adequate care or treatment, or substantially unsafe	12787
conditions, or, within seven days of receiving a complaint, refer	12788
it to the attorney general, if the attorney general agrees to	12789
investigate within thirty days.	12790

(2) Within thirty days of receiving a complaint under this	12791
section, the department of health may investigate any alleged	12792
violation of sections 3721.10 to 3721.17 of the Revised Code, or	12793
of rules, policies, or procedures adopted pursuant to those	12794
sections, not covered by division (C)(1) of this section, or it	12795
may, within seven days of receiving a complaint, refer the	12796
complaint to the grievance committee at the home where the alleged	12797
violation occurred, or to the attorney general if the attorney	12798
general agrees to investigate within thirty days.	12799

(D) If, after an investigation, the department of health	12800
finds probable cause to believe that a violation of sections	12801
3721.10 to 3721.17 of the Revised Code, or of rules, policies, or	12802
procedures adopted pursuant to those sections, has occurred at a	12803
home that is certified under the medicare or medicaid program, it	12804
shall cite one or more findings or deficiencies under sections	12805
~~5111.35~~5164.50 to ~~5111.62~~5164.78 of the Revised Code. If the	12806
home is not so certified, the department shall hold an	12807
adjudicative hearing within thirty days under Chapter 119. of the	12808
Revised Code.	12809

(E) Upon a finding at an adjudicative hearing under division	12810
(D) of this section that a violation of sections 3721.10 to	12811
3721.17 of the Revised Code, or of rules, policies, or procedures	12812
adopted pursuant thereto, has occurred, the department of health	12813
shall make an order for compliance, set a reasonable time for	12814
compliance, and assess a fine pursuant to division (F) of this	12815
section. The fine shall be paid to the general revenue fund only	12816
if compliance with the order is not shown to have been made within	12817
the reasonable time set in the order. The department of health may	12818
issue an order prohibiting the continuation of any violation of	12819
sections 3721.10 to 3721.17 of the Revised Code.	12820

Findings at the hearings conducted under this section may be	12821
appealed pursuant to Chapter 119. of the Revised Code, except that	12822
an appeal may be made to the court of common pleas of the county	12823
in which the home is located.	12824

The department of health shall initiate proceedings in court	12825
to collect any fine assessed under this section that is unpaid	12826
thirty days after the violator's final appeal is exhausted.	12827

(F) Any home found, pursuant to an adjudication hearing under	12828
division (D) of this section, to have violated sections 3721.10 to	12829
3721.17 of the Revised Code, or rules, policies, or procedures	12830
adopted pursuant to those sections may be fined not less than one	12831
hundred nor more than five hundred dollars for a first offense.	12832
For each subsequent offense, the home may be fined not less than	12833
two hundred nor more than one thousand dollars.	12834

A violation of sections 3721.10 to 3721.17 of the Revised	12835
Code is a separate offense for each day of the violation and for	12836
each resident who claims the violation.	12837

(G) No home or employee of a home shall retaliate against any	12838
person who:	12839

(1) Exercises any right set forth in sections 3721.10 to	12840
3721.17 of the Revised Code, including, but not limited to, filing	12841
a complaint with the home's grievance committee or reporting an	12842
alleged violation to the department of health;	12843

(2) Appears as a witness in any hearing conducted under this	12844
section or section 3721.162 of the Revised Code;	12845

(3) Files a civil action alleging a violation of sections	12846
3721.10 to 3721.17 of the Revised Code, or notifies a county	12847
prosecuting attorney or the attorney general of a possible	12848
violation of sections 3721.10 to 3721.17 of the Revised Code.	12849

If, under the procedures outlined in this section, a home or	12850
its employee is found to have retaliated, the violator may be	12851
fined up to one thousand dollars.	12852

(H) When legal action is indicated, any evidence of criminal	12853
activity found in an investigation under division (C) of this	12854
section shall be given to the prosecuting attorney in the county	12855
in which the home is located for investigation.	12856

(I)(1)(a) Any resident whose rights under sections 3721.10 to	12857
3721.17 of the Revised Code are violated has a cause of action	12858
against any person or home committing the violation.	12859

(b) An action under division (I)(1)(a) of this section may be	12860
commenced by the resident or by the resident's legal guardian or	12861
other legally authorized representative on behalf of the resident	12862
or the resident's estate. If the resident or the resident's legal	12863
guardian or other legally authorized representative is unable to	12864
commence an action under that division on behalf of the resident,	12865
the following persons in the following order of priority have the	12866
right to and may commence an action under that division on behalf	12867
of the resident or the resident's estate:	12868

(i) The resident's spouse;

12869

(ii) The resident's parent or adult child;

12870

(iii) The resident's guardian if the resident is a minor	12871
child;	12872

(iv) The resident's brother or sister;

12873

(v) The resident's niece, nephew, aunt, or uncle.

12874

(c) Notwithstanding any law as to priority of persons	12875
entitled to commence an action, if more than one eligible person	12876
within the same level of priority seeks to commence an action on	12877
behalf of a resident or the resident's estate, the court shall	12878
determine, in the best interest of the resident or the resident's	12879
estate, the individual to commence the action. A court's	12880
determination under this division as to the person to commence an	12881
action on behalf of a resident or the resident's estate shall bar	12882
another person from commencing the action on behalf of the	12883
resident or the resident's estate.	12884

(d) The result of an action commenced pursuant to division	12885
(I)(1)(a) of this section by a person authorized under division	12886
(I)(1)(b) of this section shall bind the resident or the	12887
resident's estate that is the subject of the action.	12888

(e) A cause of action under division (I)(1)(a) of this	12889
section shall accrue, and the statute of limitations applicable to	12890
that cause of action shall begin to run, based upon the violation	12891
of a resident's rights under sections 3721.10 to 3721.17 of the	12892
Revised Code, regardless of the party commencing the action on	12893
behalf of the resident or the resident's estate as authorized	12894
under divisions (I)(1)(b) and (c) of this section.	12895

(2)(a) The plaintiff in an action filed under division (I)(1)	12896
of this section may obtain injunctive relief against the violation	12897
of the resident's rights. The plaintiff also may recover	12898
compensatory damages based upon a showing, by a preponderance of	12899
the evidence, that the violation of the resident's rights resulted	12900
from a negligent act or omission of the person or home and that	12901
the violation was the proximate cause of the resident's injury,	12902
death, or loss to person or property.	12903

(b) If compensatory damages are awarded for a violation of	12904
the resident's rights, section 2315.21 of the Revised Code shall	12905
apply to an award of punitive or exemplary damages for the	12906
violation.	12907

(c) The court, in a case in which only injunctive relief is	12908
granted, may award to the prevailing party reasonable attorney's	12909
fees limited to the work reasonably performed.	12910

(3) Division (I)(2) (b) of this section shall be considered	12911
to be purely remedial in operation and shall be applied in a	12912
remedial manner in any civil action in which this section is	12913
relevant, whether the action is pending in court or commenced on	12914
or after July 9, 1998.	12915

(4) Within thirty days after the filing of a complaint in an	12916
action for damages brought against a home under division (I)(1)(a)	12917
of this section by or on behalf of a resident or former resident	12918
of the home, the plaintiff or plaintiff's counsel shall send	12919
written notice of the filing of the complaint to the department of	12920
job and family services if the department has a right of recovery	12921
under section ~~5101.58~~5160.38 of the Revised Code against the	12922
liability of the home for the cost of medical services and care	12923
arising out of injury, disease, or disability of the resident or	12924
former resident.	12925

Sec. 3721.19. (A) As used in this section:

12926

(1) "Home" and "residential care facility" have the same	12927
meanings as in section 3721.01 of the Revised Code;	12928

(2) "Sponsor" and "residents' rights advocate" have the same	12929
meanings as in section 3721.10 of the Revised Code.	12930

A home licensed under this chapter that is not a party to a	12931
provider agreement, as defined in section ~~5111.20~~5164.01 of the	12932
Revised Code, shall provide each prospective resident, before	12933
admission, with the following information, orally and in a	12934
separate written notice on which is printed in a conspicuous	12935
manner: "This home is not a participant in the ~~medical assistance~~	12936
medicaid program administered by the Ohio department of ~~job and~~	12937
~~family services~~health care administration. Consequently, you may	12938
be discharged from this home if you are unable to pay for the	12939
services provided by this home."	12940

If the prospective resident has a sponsor whose identity is	12941
made known to the home, the home shall also inform the sponsor,	12942
before admission of the resident, of the home's status relative to	12943
the ~~medical assistance~~medicaid program. Written ~~acknowledgement~~	12944
acknowledgment of the receipt of the information shall be provided	12945
by the resident and, if the prospective resident has a sponsor who	12946
has been identified to the home, by the sponsor. The written	12947
~~acknowledgement~~acknowledgment shall be made part of the	12948
resident's record by the home.	12949

No home shall terminate its status as a provider under the	12950
medicaid program unless it has complied with section ~~5111.66~~	12951
5164.83 of the Revised Code and, at least ninety days prior to	12952
such termination, provided written notice to the residents of the	12953
home and their sponsors of such action. This requirement shall not	12954
apply in cases where the department of ~~job and family services~~	12955
health care administration terminates a home's provider agreement	12956
or provider status.	12957

(B) A home licensed under this chapter as a residential care	12958
facility shall provide notice to each prospective resident or the	12959
individual's sponsor of the services offered by the facility and	12960
the types of skilled nursing care that the facility may provide. A	12961
residential care facility that, pursuant to section 3721.012 of	12962
the Revised Code, has a policy of entering into risk agreements	12963
with residents or their sponsors shall provide each prospective	12964
resident or the individual's sponsor a written explanation of the	12965
policy and the provisions that may be contained in a risk	12966
agreement. At the time the information is provided, the facility	12967
shall obtain a statement signed by the individual receiving the	12968
information acknowledging that the individual received the	12969
information. The facility shall maintain on file the individual's	12970
signed statement.	12971

(C) A resident has a cause of action against a home for	12972
breach of any duty imposed by this section. The action may be	12973
commenced by the resident, or on the resident's behalf by the	12974
resident's sponsor or a residents' rights advocate, by the filing	12975
of a civil action in the court of common pleas of the county in	12976
which the home is located, or in the court of common pleas of	12977
Franklin county.	12978

If the court finds that a breach of any duty imposed by this	12979
section has occurred, the court shall enjoin the home from	12980
discharging the resident from the home until arrangements	12981
satisfactory to the court are made for the orderly transfer of the	12982
resident to another mode of health care including, but not limited	12983
to, another home, and may award the resident and a person or	12984
public agency that brings an action on behalf of a resident	12985
reasonable attorney's fees. If a home discharges a resident to	12986
whom or to whose sponsor information concerning its status	12987
relative to the ~~medical assistance~~medicaid program was not	12988
provided as required under this section, the court shall grant any	12989
appropriate relief including, but not limited to, actual damages,	12990
reasonable attorney's fees, and costs.	12991

Sec. 3721.21. As used in sections 3721.21 to 3721.34 of the	12992
Revised Code:	12993

(A) "Long-term care facility" means either of the following:

12994

(1) A nursing home as defined in section 3721.01 of the	12995
Revised Code, other than a nursing home or part of a nursing home	12996
certified as an intermediate care facility for the mentally	12997
retarded under ~~Title XIX of~~ the ~~"Social Security Act," 49 Stat.~~	12998
~~620 (1935), 42 U.S.C.A. 301, as amended~~medicaid program;	12999

(2) A facility or part of a facility that is certified as a	13000
skilled nursing facility or a nursing facility under ~~Title XVIII~~	13001
~~or XIX of~~ the ~~"Social Security Act~~medicare program and medicaid	13002
program."	13003

(B) "Residential care facility" has the same meaning as in	13004
section 3721.01 of the Revised Code.	13005

(C) "Abuse" means knowingly causing physical harm or	13006
recklessly causing serious physical harm to a resident by physical	13007
contact with the resident or by use of physical or chemical	13008
restraint, medication, or isolation as punishment, for staff	13009
convenience, excessively, as a substitute for treatment, or in	13010
amounts that preclude habilitation and treatment.	13011

(D) "Neglect" means recklessly failing to provide a resident	13012
with any treatment, care, goods, or service necessary to maintain	13013
the health or safety of the resident when the failure results in	13014
serious physical harm to the resident. "Neglect" does not include	13015
allowing a resident, at the resident's option, to receive only	13016
treatment by spiritual means through prayer in accordance with the	13017
tenets of a recognized religious denomination.	13018

(E) "Misappropriation" means depriving, defrauding, or	13019
otherwise obtaining the real or personal property of a resident by	13020
any means prohibited by the Revised Code, including violations of	13021
Chapter 2911. or 2913. of the Revised Code.	13022

(F) "Resident" includes a resident, patient, former resident	13023
or patient, or deceased resident or patient of a long-term care	13024
facility or a residential care facility.	13025

(G) "Physical restraint" has the same meaning as in section	13026
3721.10 of the Revised Code.	13027

(H) "Chemical restraint" has the same meaning as in section	13028
3721.10 of the Revised Code.	13029

(I) "Nursing and nursing-related services" means the personal	13030
care services and other services not constituting skilled nursing	13031
care that are specified in rules the public health council shall	13032
adopt in accordance with Chapter 119. of the Revised Code.	13033

(J) "Personal care services" has the same meaning as in	13034
section 3721.01 of the Revised Code.	13035

(K)(1) Except as provided in division (K)(2) of this section,	13036
"nurse aide" means an individual who provides nursing and	13037
nursing-related services to residents in a long-term care	13038
facility, either as a member of the staff of the facility for	13039
monetary compensation or as a volunteer without monetary	13040
compensation.	13041

(2) "Nurse aide" does not include either of the following:

13042

(a) A licensed health professional practicing within the	13043
scope of the professional's license;	13044

(b) An individual providing nursing and nursing-related	13045
services in a religious nonmedical health care institution, if the	13046
individual has been trained in the principles of nonmedical care	13047
and is recognized by the institution as being competent in the	13048
administration of care within the religious tenets practiced by	13049
the residents of the institution.	13050

(L) "Licensed health professional" means all of the	13051
following:	13052

(1) An occupational therapist or occupational therapy	13053
assistant licensed under Chapter 4755. of the Revised Code;	13054

(2) A physical therapist or physical therapy assistant	13055
licensed under Chapter 4755. of the Revised Code;	13056

(3) A physician authorized under Chapter 4731. of the Revised	13057
Code to practice medicine and surgery, osteopathic medicine and	13058
surgery, or podiatry;	13059

(4) A physician assistant authorized under Chapter 4730. of	13060
the Revised Code to practice as a physician assistant;	13061

(5) A registered nurse or licensed practical nurse licensed	13062
under Chapter 4723. of the Revised Code;	13063

(6) A social worker or independent social worker licensed	13064
under Chapter 4757. of the Revised Code or a social work assistant	13065
registered under that chapter;	13066

(7) A speech-language pathologist or audiologist licensed	13067
under Chapter 4753. of the Revised Code;	13068

(8) A dentist or dental hygienist licensed under Chapter	13069
4715. of the Revised Code;	13070

(9) An optometrist licensed under Chapter 4725. of the	13071
Revised Code;	13072

(10) A pharmacist licensed under Chapter 4729. of the Revised	13073
Code;	13074

(11) A psychologist licensed under Chapter 4732. of the	13075
Revised Code;	13076

(12) A chiropractor licensed under Chapter 4734. of the	13077
Revised Code;	13078

(13) A nursing home administrator licensed or temporarily	13079
licensed under Chapter 4751. of the Revised Code;	13080

(14) A professional counselor or professional clinical	13081
counselor licensed under Chapter 4757. of the Revised Code.	13082

(M) "Religious nonmedical health care institution" means an	13083
institution that meets or exceeds the conditions to receive	13084
payment under the medicare program ~~established under Title XVIII~~	13085
~~of the "Social Security Act"~~ for inpatient hospital services or	13086
post-hospital extended care services furnished to an individual in	13087
a religious nonmedical health care institution, as defined in	13088
section 1861(ss)(1) of the "Social Security Act," 79 Stat. 286	13089
(1965), 42 U.S.C. 1395x(ss)(1), as amended.	13090

(N) "Competency evaluation program" means a program through	13091
which the competency of a nurse aide to provide nursing and	13092
nursing-related services is evaluated.	13093

(O) "Training and competency evaluation program" means a	13094
program of nurse aide training and evaluation of competency to	13095
provide nursing and nursing-related services.	13096

Sec. 3721.28. (A)(1) Each nurse aide used by a long-term	13097
care facility on a full-time, temporary, per diem, or other basis	13098
on July 1, 1989, shall be provided by the facility a competency	13099
evaluation program approved by the director of health under	13100
division (A) of section 3721.31 of the Revised Code or conducted	13101
by ~~him~~the director under division (C) of that section. Each	13102
long-term care facility using a nurse aide on July 1, 1989, shall	13103
provide the nurse aide the preparation necessary to complete the	13104
competency evaluation program by January 1, 1990.	13105

(2) Each nurse aide used by a long-term care facility on a	13106
full-time, temporary, per diem, or other basis on January 1, 1990,	13107
who either was not used by the facility on July 1, 1989, or was	13108
used by the facility on July 1, 1989, but had not successfully	13109
completed a competency evaluation program by January 1, 1990,	13110
shall be provided by the facility a competency evaluation program	13111
approved by the director under division (A) of section 3721.31 of	13112
the Revised Code or conducted by ~~him~~the director under division	13113
(C) of that section. Each long-term care facility using a nurse	13114
aide described in division (A)(2) of this section shall provide	13115
the nurse aide the preparation necessary to complete the	13116
competency evaluation program by October 1, 1990, and shall assist	13117
the nurse aide in registering for the program.	13118

(B) Effective June 1, 1990, no long-term care facility shall	13119
use an individual as a nurse aide for more than four months unless	13120
the individual is competent to provide the services hethe	13121
individual is to provide, the facility has received from the nurse	13122
aide registry established under section 3721.32 of the Revised	13123
Code the information concerning the individual provided through	13124
the registry, and one of the following is the case:	13125

(1) The individual was used by a facility as a nurse aide on	13126
a full-time, temporary, per diem, or other basis at any time	13127
during the period commencing July 1, 1989, and ending January 1,	13128
1990, and successfully completed, not later than October 1, 1990,	13129
a competency evaluation program approved by the director under	13130
division (A) of section 3721.31 of the Revised Code or conducted	13131
by ~~him~~the director under division (C) of that section.	13132

(2) The individual has successfully completed a training and	13133
competency evaluation program approved by the director under	13134
division (A) of section 3721.31 of the Revised Code or conducted	13135
by ~~him~~the director under division (C) of that section or has met	13136
the conditions specified in division (F) of this section and, in	13137
addition, if the training and competency evaluation program or the	13138
training, instruction, or education the individual completed in	13139
meeting the conditions specified in division (F) of this section	13140
was conducted by or in a long-term care facility, or if the	13141
director pursuant to division (E) of section 3721.31 of the	13142
Revised Code so requires, the individual has successfully	13143
completed a competency evaluation program conducted by the	13144
director.	13145

(3) Prior to July 1, 1989, if the long-term care facility is	13146
certified as a skilled nursing facility or a nursing facility	13147
under ~~Title XVIII or XIX of~~ the ~~"Social Security Act," 49 Stat.~~	13148
~~620 (1935), 42 U.S.C.A. 301, as amended~~medicare program or	13149
medicaid program, or prior to January 1, 1990, if the facility is	13150
not so certified, the individual completed a program that the	13151
director determines included a competency evaluation component no	13152
less stringent than the competency evaluation programs approved by	13153
~~him~~the director under division (A) of section 3721.31 of the	13154
Revised Code or conducted by ~~him~~the director under division (C)	13155
of that section, and was otherwise comparable to the training and	13156
competency evaluation programs being approved by the director	13157
under division (A) of that section.	13158

(4) The individual is listed in a nurse aide registry	13159
maintained by another state and that state certifies that its	13160
program for training and evaluation of competency of nurse aides	13161
complies with ~~Titles XVIII and XIX of~~ the ~~"Social Security Act"~~	13162
medicare program and medicaid program and regulations adopted	13163
thereunder.	13164

(5) Prior to July 1, 1989, the individual was found competent	13165
to serve as a nurse aide after the completion of a course of nurse	13166
aide training of at least one hundred hours' duration.	13167

(6) The individual is enrolled in a prelicensure program of	13168
nursing education approved by the board of nursing or by an agency	13169
of another state that regulates nursing education, has provided	13170
the long-term care facility with a certificate from the program	13171
indicating that the individual has successfully completed the	13172
courses that teach basic nursing skills including infection	13173
control, safety and emergency procedures, and personal care, and	13174
has successfully completed a competency evaluation program	13175
conducted by the director under division (C) of section 3721.31 of	13176
the Revised Code.	13177

(7) The individual has the equivalent of twelve months or	13178
more of full-time employment in the preceding five years as a	13179
hospital aide or orderly and has successfully completed a	13180
competency evaluation program conducted by the director under	13181
division (C) of section 3721.31 of the Revised Code.	13182

(C) Effective June 1, 1990, no long-term care facility shall	13183
continue for longer than four months to use as a nurse aide an	13184
individual who previously met the requirements of division (B) of	13185
this section but since most recently doing so has not performed	13186
nursing and nursing-related services for monetary compensation for	13187
twenty-four consecutive months, unless the individual successfully	13188
completes additional training and competency evaluation by	13189
complying with divisions (C)(1) and (2) of this section:	13190

(1) Doing one of the following:

13191

(a) Successfully completing a training and competency	13192
evaluation program approved by the director under division (A) of	13193
section 3721.31 of the Revised Code or conducted by ~~him~~the	13194
director under division (C) of that section;	13195

(b) Successfully completing a training and competency	13196
evaluation program described in division (B)(4) of this section;	13197

(c) Meeting the requirements specified in division (B)(6) or	13198
(7) of this section.	13199

(2) If the training and competency evaluation program	13200
completed under division (C)(1)(a) of this section was conducted	13201
by or in a long-term care facility, or if the director pursuant to	13202
division (E) of section 3721.31 of the Revised Code so requires,	13203
successfully completing a competency evaluation program conducted	13204
by the director.	13205

(D)(1) The four-month periods provided for in divisions (B)	13206
and (C) of this section include any time, on or after June 1,	13207
1990, that an individual is used as a nurse aide on a full-time,	13208
temporary, per diem, or any other basis by the facility or any	13209
other long-term care facility.	13210

(2) During the four-month period provided for in division (B)	13211
of this section, during which a long-term care facility may,	13212
subject to division (E) of this section, use as a nurse aide an	13213
individual who does not have the qualifications specified in	13214
divisions (B)(1) to (7) of this section, a facility shall require	13215
the individual to comply with divisions (D)(2)(a) and (b) of this	13216
section:	13217

(a) Participate in one of the following:

13218

(i) If the individual has successfully completed a training	13219
and competency evaluation program approved by the director under	13220
division (A) of section 3721.31 of the Revised Code, and the	13221
program was conducted by or in a long-term care facility, or the	13222
director pursuant to division (E) of section 3721.31 of the	13223
Revised Code so requires, a competency evaluation program	13224
conducted by the director;	13225

(ii) If the individual is enrolled in a prelicensure program	13226
of nursing education described in division (B)(6) of this section	13227
and has completed or is working toward completion of the courses	13228
described in that division, or the individual has the experience	13229
described in division (B)(7) of this section, a competency	13230
evaluation program conducted by the director;	13231

(iii) A training and competency evaluation program approved	13232
by the director under division (A) of section 3721.31 of the	13233
Revised Code or conducted by ~~him~~the director under division (C)	13234
of that section.	13235

(b) If the individual participates in or has successfully	13236
completed a training and competency evaluation program under	13237
division (D)(2)(a)(iii) of this section that is conducted by or in	13238
a long-term care facility, or the director pursuant to division	13239
(E) of section 3721.31 of the Revised Code so requires, ~~paticipate~~	13240
participate in a competency evaluation program conducted by the	13241
director.	13242

(3) During the four-month period provided for in division (C)	13243
of this section, during which a long-term care facility may,	13244
subject to division (E) of this section, use as a nurse aide an	13245
individual who does not have the qualifications specified in	13246
divisions (C)(1) and (2) of this section, a facility shall require	13247
the individual to comply with divisions (D)(3)(a) and (b) of this	13248
section:	13249

(a) Participate in one of the following:

13250

(i) If the individual has successfully completed a training	13251
and competency evaluation program approved by the director, and	13252
the program was conducted by or in a long-term care facility, or	13253
the director pursuant to division (E) of section 3721.31 of the	13254
Revised Code so requires, a competency evaluation program	13255
conducted by the director;	13256

(ii) If the individual is enrolled in a prelicensure program	13257
of nursing education described in division (B)(6) of this section	13258
and has completed or is working toward completion of the courses	13259
described in that division, or the individual has the experience	13260
described in division (B)(7) of this section, a competency	13261
evaluation program conducted by the director;	13262

(iii) A training and competency evaluation program approved	13263
or conducted by the director.	13264

(b) If the individual participates in or has successfully	13265
completed a training and competency evaluation program under	13266
division (D)(3)(a)(iii) of this section that is conducted by or in	13267
a long-term care facility, or the director pursuant to division	13268
(E) of section 3721.31 of the Revised Code so requires,	13269
participate in a competency evaluation program conducted by the	13270
director.	13271

(E) A long-term care facility shall not permit an individual	13272
used by the facility as a nurse aide while participating in a	13273
training and competency evaluation program to provide nursing and	13274
nursing-related services unless both of the following are the	13275
case:	13276

(1) The individual has completed the number of hours of	13277
training that he must ~~complete~~be completed prior to providing	13278
services to residents as prescribed by rules that shall be adopted	13279
by the director in accordance with Chapter 119. of the Revised	13280
Code;	13281

(2) The individual is under the personal supervision of a	13282
registered or licensed practical nurse licensed under Chapter	13283
4723. of the Revised Code.	13284

(F) An individual shall be considered to have satisfied the	13285
requirement, under division (B)(2) of this section, of having	13286
successfully completed a training and competency evaluation	13287
program conducted or approved by the director, if the individual	13288
meets both of the following conditions:	13289

(1) The individual, as of July 1, 1989, completed at least	13290
sixty hours divided between skills training and classroom	13291
instruction in the topic areas described in divisions (B)(1) to	13292
(8) of section 3721.30 of the Revised Code;	13293

(2) The individual received, as of that date, at least the	13294
difference between seventy-five hours and the number of hours	13295
actually spent in training and competency evaluation in supervised	13296
practical nurse aide training or regular in-service nurse aide	13297
education.	13298

(G) The public health council shall adopt rules in accordance	13299
with Chapter 119. of the Revised Code specifying persons, in	13300
addition to the director, who may establish competence of nurse	13301
aides under division (B)(5) of this section, and establishing	13302
criteria for determining whether an individual meets the	13303
conditions specified in division (F) of this section.	13304

(H) The rules adopted pursuant to divisions (E)(1) and (G) of	13305
this section shall be no less stringent than the requirements,	13306
guidelines, and procedures established by the United States	13307
secretary of health and human services under sections 1819 and	13308
1919 of the "Social Security Act."	13309

Sec. 3721.32. (A) The director of health shall establish a	13310
state nurse aide registry listing all individuals who have done	13311
any of the following:	13312

(1) Were used by a long-term care facility as nurse aides on	13313
a full-time, temporary, per diem, or other basis at any time	13314
during the period commencing July 1, 1989, and ending January 1,	13315
1990, and successfully completed, not later than October 1, 1990,	13316
a competency evaluation program approved by the director under	13317
division (A) of section 3721.31 of the Revised Code or conducted	13318
by the director under division (C) of that section;	13319

(2) Successfully completed a training and competency	13320
evaluation program approved by the director under division (A) of	13321
section 3721.31 of the Revised Code or met the conditions	13322
specified in division (F) of section 3721.28 of the Revised Code,	13323
and, if the training and competency evaluation program or the	13324
training, instruction, or education the individual completed in	13325
meeting the conditions specified in division (F) of section	13326
3721.28 of the Revised Code was conducted in or by a long-term	13327
care facility, or if the director so required pursuant to division	13328
(E) of section 3721.31 of the Revised Code, has successfully	13329
completed a competency evaluation program conducted by the	13330
director;	13331

(3) Successfully completed a training and competency	13332
evaluation program conducted by the director under division (C) of	13333
section 3721.31 of the Revised Code;	13334

(4) Successfully completed, prior to July 1, 1989, a program	13335
that the director has determined under division (B)(3) of section	13336
3721.28 of the Revised Code included a competency evaluation	13337
component no less stringent than the competency evaluation	13338
programs approved or conducted by the director under section	13339
3721.31 of the Revised Code, and was otherwise comparable to the	13340
training and competency evaluation program being approved by the	13341
director under section 3721.31 of the Revised Code;	13342

(5) Are listed in a nurse aide registry maintained by another	13343
state that certifies that its program for training and evaluation	13344
of competency of nurse aides complies with ~~Titles XVIII and XIX of~~	13345
the ~~"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301,~~	13346
~~as amended~~medicare program and medicaid program, or regulations	13347
adopted thereunder;	13348

(6) Were found competent, as provided in division (B)(5) of	13349
section 3721.28 of the Revised Code, prior to July 1, 1989, after	13350
the completion of a course of nurse aide training of at least one	13351
hundred hours' duration;	13352

(7) Are enrolled in a prelicensure program of nursing	13353
education approved by the board of nursing or by an agency of	13354
another state that regulates nursing education, have provided the	13355
long-term care facility with a certificate from the program	13356
indicating that the individual has successfully completed the	13357
courses that teach basic nursing skills including infection	13358
control, safety and emergency procedures, and personal care, and	13359
have successfully completed a competency evaluation program	13360
conducted by the director under division (A) of section 3721.31 of	13361
the Revised Code;	13362

(8) Have the equivalent of twelve months or more of full-time	13363
employment in the five years preceding listing in the registry as	13364
a hospital aide or orderly and have successfully completed a	13365
competency evaluation program conducted by the director under	13366
division (C) of section 3721.31 of the Revised Code.	13367

(B) The registry shall include both of the following:

13368

(1) The statement required by section 3721.23 of the Revised	13369
Code detailing findings by the director under that section	13370
regarding alleged abuse or neglect of a resident or	13371
misappropriation of resident property;	13372

(2) Any statement provided by an individual under section	13373
3721.23 of the Revised Code disputing the director's findings.	13374

Whenever an inquiry is received as to the information	13375
contained in the registry concerning an individual about whom a	13376
statement required by section 3721.23 of the Revised Code is	13377
included in the registry, the director shall disclose the	13378
statement or a summary of the statement together with any	13379
statement provided by the individual under section 3721.23 or a	13380
clear and accurate summary of that statement.	13381

(C) The director may by rule specify additional information	13382
that must be provided the registry by long-term care facilities	13383
and persons or government agencies conducting approved competency	13384
evaluation programs and training and competency evaluation	13385
programs.	13386

(D) Information contained in the registry is a public record	13387
for the purposes of section 149.43 of the Revised Code, and is	13388
subject to inspection and copying under section 1347.08 of the	13389
Revised Code.	13390

Sec. 3722.10. (A) The public health council shall have the	13391
exclusive authority to adopt and shall adopt rules in accordance	13392
with Chapter 119. of the Revised Code governing the licensing and	13393
operation of adult care facilities. The rules shall specify:	13394

(1) Procedures for the issuance, renewal, and revocation of	13395
licenses and temporary licenses, for the granting and denial of	13396
waivers, and for the issuance and termination of orders of	13397
suspension of admission pursuant to section 3722.07 of the Revised	13398
Code;	13399

(2) The qualifications required for owners, managers, and	13400
employees of adult care facilities, including character, training,	13401
education, experience, and financial resources and the number of	13402
staff members required in a facility;	13403

(3) Adequate space, equipment, safety, and sanitation	13404
standards for the premises of adult care facilities, and fire	13405
protection standards for adult family homes as required by section	13406
3722.041 of the Revised Code;	13407

(4) The personal, social, dietary, and recreational services	13408
to be provided to each resident of adult care facilities;	13409

(5) Rights of residents of adult care facilities, in addition	13410
to the rights enumerated under section 3722.12 of the Revised	13411
Code, and procedures to protect and enforce the rights of these	13412
residents;	13413

(6) Provisions for keeping records of residents and for	13414
maintaining the confidentiality of the records as required by	13415
division (B) of section 3722.12 of the Revised Code. The	13416
provisions for maintaining the confidentiality of records shall,	13417
at the minimum, meet the requirements for maintaining the	13418
confidentiality of records under ~~Title XIX of~~ the ~~Social Security~~	13419
~~Act, 49 Stat. 620, 42 U.S.C. 301, as amended~~medicaid program, and	13420
regulations promulgated thereunder.	13421

(7) Measures to be taken by adult care facilities relative to	13422
residents' medication, including policies and procedures	13423
concerning medication, storage of medication in a locked area, and	13424
disposal of medication and assistance with self-administration of	13425
medication, if the facility provides assistance;	13426

(8) Requirements for initial and periodic health assessments	13427
of prospective and current adult care facility residents by	13428
physicians or other health professionals to ensure that they do	13429
not require a level of care beyond that which is provided by the	13430
adult care facility, including assessment of their capacity to	13431
self-administer the medications prescribed for them;	13432

(9) Requirements relating to preparation of special diets;

13433

(10) The amount of the fees for new and renewal license	13434
applications made pursuant to sections 3722.02 and 3722.04 of the	13435
Revised Code;	13436

(11) Measures to be taken by any employee of the state or any	13437
political subdivision of the state authorized by this chapter to	13438
enter an adult care facility to inspect the facility or for any	13439
other purpose, to ensure that the employee respects the privacy	13440
and dignity of residents of the facility, cooperates with	13441
residents of the facility and behaves in a congenial manner toward	13442
them, and protects the rights of residents;	13443

(12) How an owner or manager of an adult care facility is to	13444
comply with section 3722.18 of the Revised Code. The rules shall	13445
do at least both of the following:	13446

(a) Establish the procedures an owner or manager is to follow	13447
under division (A)(2) of section 3722.18 of the Revised Code	13448
regarding referrals to the facility of prospective residents with	13449
mental illness or severe mental disability and effective	13450
arrangements for ongoing mental health services for such	13451
prospective residents. The procedures may provide for any of the	13452
following:	13453

(i) That the owner or manager sign written agreements with	13454
the mental health agencies and boards of alcohol, drug addiction,	13455
and mental health services that refer such prospective residents	13456
to the facility. Each agreement shall cover all such prospective	13457
residents referred by the agency or board with which the owner or	13458
manager enters into the agreement.	13459

(ii) That the owner or manager and the mental health agencies	13460
and boards of alcohol, drug addiction, and mental health services	13461
that refer such prospective residents to the facility develop and	13462
sign a plan for services for each such prospective resident;	13463

(iii) Any other process regarding referrals and effective	13464
arrangements for ongoing mental health services.	13465

(b) Specify the date an owner or manager must begin to follow	13466
the procedures established by division (A)(12)(a) of this section.	13467

(13) Any other rules necessary for the administration and	13468
enforcement of this chapter.	13469

(B) After consulting with relevant constituencies, the	13470
director of mental health shall prepare and submit to the director	13471
of health recommendations for the content of rules to be adopted	13472
under division (A)(12) of this section. The public health council	13473
shall adopt the rules required by division (A)(12) of this section	13474
no later than July 1, 2000.	13475

(C) The director of health shall advise adult care facilities	13476
regarding compliance with the requirements of this chapter and	13477
with the rules adopted pursuant to this chapter.	13478

(D) Any duty or responsibility imposed upon the director of	13479
health by this chapter may be carried out by an employee of the	13480
department of health.	13481

(E) Employees of the department of health may enter, for the	13482
purposes of investigation, any institution, residence, facility,	13483
or other structure which has been reported to the department as,	13484
or that the department has reasonable cause to believe is,	13485
operating as an adult care facility without a valid license.	13486

Sec. 3722.16. (A) No person shall:

13487

(1) Operate an adult care facility unless the facility is	13488
validly licensed by the director of health under section 3722.04	13489
of the Revised Code;	13490

(2) Admit to an adult care facility more residents than the	13491
number authorized in the facility's license;	13492

(3) Admit a resident to an adult care facility after the	13493
director has issued an order pursuant to section 3722.07 of the	13494
Revised Code suspending admissions to the facility. Violation of	13495
division (A)(3) of this section is cause for revocation of the	13496
facility's license.	13497

(4) Interfere with any authorized inspection of an adult care	13498
facility conducted pursuant to section 3722.02 or 3722.04 of the	13499
Revised Code;	13500

(5) Violate any of the provisions of this chapter or any of	13501
the rules adopted pursuant to it.	13502

(B) No adult care facility shall provide, or admit or retain	13503
any resident in need of, skilled nursing care unless all of the	13504
following are the case:	13505

(1) The care will be provided on a part-time, intermittent	13506
basis for not more than a total of one hundred twenty days in any	13507
twelve-month period by one or more of the following:	13508

(a) A home health agency certified under ~~Title XVIII of~~ the	13509
~~"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as~~	13510
~~amended:~~medicare program;	13511

(b) A hospice care program licensed under Chapter 3712. of	13512
the Revised Code;	13513

(c) A nursing home licensed under Chapter 3721. of the	13514
Revised Code and owned and operated by the same person and located	13515
on the same site as the adult care facility;	13516

(d) A mental health agency or, pursuant to division (A)(8)(b)	13517
of section 340.03 of the Revised Code, a board of alcohol, drug	13518
addiction, and mental health services.	13519

(2) The staff of the home health agency, hospice care	13520
program, nursing home, mental health agency, or board of alcohol,	13521
drug addiction, and mental health services does not train facility	13522
staff to provide the skilled nursing care;	13523

(3) The individual to whom the skilled nursing care is	13524
provided is suffering from a short-term illness;	13525

(4) If the skilled nursing care is to be provided by the	13526
nursing staff of a nursing home, all of the following are the	13527
case:	13528

(a) The adult care facility evaluates the individual	13529
receiving the skilled nursing care at least once every seven days	13530
to determine whether the individual should be transferred to a	13531
nursing home;	13532

(b) The adult care facility meets at all times staffing	13533
requirements established by rules adopted under section 3722.10 of	13534
the Revised Code;	13535

(c) The nursing home does not include the cost of providing	13536
skilled nursing care to the adult care facility residents in a	13537
cost report filed under section ~~5111.26~~5164.37 of the Revised	13538
Code;	13539

(d) The nursing home meets at all times the nursing home	13540
licensure staffing ratios established by rules adopted under	13541
section 3721.04 of the Revised Code;	13542

(e) The nursing home staff providing skilled nursing care to	13543
adult care facility residents are registered nurses or licensed	13544
practical nurses licensed under Chapter 4723. of the Revised Code	13545
and meet the personnel qualifications for nursing home staff	13546
established by rules adopted under section 3721.04 of the Revised	13547
Code;	13548

(f) The skilled nursing care is provided in accordance with	13549
rules established for nursing homes under section 3721.04 of the	13550
Revised Code;	13551

(g) The nursing home meets the skilled nursing care needs of	13552
the adult care facility residents;	13553

(h) Using the nursing home's nursing staff does not prevent	13554
the nursing home or adult care facility from meeting the needs of	13555
the nursing home and adult care facility residents in a quality	13556
and timely manner.	13557

Notwithstanding section 3721.01 of the Revised Code, an adult	13558
care facility in which residents receive skilled nursing care as	13559
described in division (B) of this section is not a nursing home.	13560
No adult care facility shall provide skilled nursing care.	13561

(C) A home health agency or hospice care program that	13562
provides skilled nursing care pursuant to division (B) of this	13563
section may not be associated with the adult care facility unless	13564
the facility is part of a home for the aged as defined in section	13565
5701.13 of the Revised Code or the adult care facility is owned	13566
and operated by the same person and located on the same site as a	13567
nursing home licensed under Chapter 3721. of the Revised Code that	13568
is associated with the home health agency or hospice care program.	13569
In addition, the following requirements shall be met:	13570

(1) The adult care facility shall evaluate the individual	13571
receiving the skilled nursing care not less than once every seven	13572
days to determine whether the individual should be transferred to	13573
a nursing home;	13574

(2) If the costs of providing the skilled nursing care are	13575
included in a cost report filed pursuant to section ~~5111.26~~	13576
5164.37 of the Revised Code by the nursing home that is part of	13577
the same home for the aged, the home health agency or hospice care	13578
program shall not seek reimbursement for the care under the	13579
~~medical assistance~~medicaid program ~~established under Chapter~~	13580
~~5111. of the Revised Code~~.	13581

(D)(1) No person knowingly shall place or recommend placement	13582
of any person in an adult care facility that is operating without	13583
a license.	13584

(2) No employee of a unit of local or state government, board	13585
of alcohol, drug addiction, and mental health services, mental	13586
health agency, or PASSPORT administrative agency shall place or	13587
recommend placement of any person in an adult care facility if the	13588
employee knows that the facility cannot meet the needs of the	13589
potential resident.	13590

(3) No person who has reason to believe that an adult care	13591
facility is operating without a license shall fail to report this	13592
information to the director of health.	13593

(E) In accordance with Chapter 119. of the Revised Code, the	13594
public health council shall adopt rules that define a short-term	13595
illness for purposes of division (B)(3) of this section and	13596
specify, consistent with rules pertaining to home health care	13597
adopted by the director of ~~job and family services~~health care	13598
administration under the ~~medical assistance~~medicaid program	13599
~~established under Chapter 5111. of the Revised Code and Title XIX~~	13600
~~of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301,~~	13601
~~as amended~~, what constitutes a part-time, intermittent basis for	13602
purposes of division (B)(1) of this section.	13603

Sec. 3727.02. (A) No person and no political subdivision,	13604
agency, or instrumentality of this state shall operate a hospital	13605
unless it is certified ~~under Title XVIII of~~for the ~~"Social~~	13606
~~Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, as amended,~~	13607
medicare program or is accredited by the joint commission or the	13608
American osteopathic association.	13609

(B) No person and no political subdivision, agency, or	13610
instrumentality of this state shall hold out as a hospital any	13611
health facility that is not certified or accredited as required in	13612
division (A) of this section.	13613

Sec. 3742.30. Each child at risk of lead poisoning shall	13614
undergo a blood lead screening test to determine whether the child	13615
has lead poisoning. The at-risk children shall undergo the test at	13616
times determined by rules the public health council shall adopt in	13617
accordance with Chapter 119. of the Revised Code that are	13618
consistent with the guidelines established by the centers for	13619
disease control and prevention in the public health service of the	13620
United States department of health and human services. The rules	13621
shall specify which children are at risk of lead poisoning.	13622

Neither this section nor the rules adopted under it affect	13623
the coverage of blood lead screening tests by any publicly funded	13624
health program, including the medicaid program ~~established by~~	13625
~~Chapter 5111. of the Revised Code~~. Neither this section nor the	13626
rules adopted under it apply to a child if a parent of the child	13627
objects to the test on the grounds that the test conflicts with	13628
the parent's religious tenets and practices.	13629

Sec. 3742.51. (A) There is hereby created in the state	13630
treasury the lead poisoning prevention fund. The fund shall	13631
include all moneys appropriated to the department of health for	13632
the administration and enforcement of sections 3742.31 to 3742.50	13633
of the Revised Code and the rules adopted under those sections.	13634
Any grants, contributions, or other moneys collected by the	13635
department for purposes of preventing lead poisoning shall be	13636
deposited in the state treasury to the credit of the fund.	13637

(B) Moneys in the fund shall be used solely for the purposes	13638
of the child lead poisoning prevention program established under	13639
section 3742.31 of the Revised Code, including providing financial	13640
assistance to individuals who are unable to pay for the following:	13641

(1) Costs associated with obtaining lead tests and lead	13642
poisoning treatment for children under six years of age who are	13643
not covered by private medical insurance or are underinsured, are	13644
not eligible for the medicaid program ~~established under Chapter~~	13645
~~5111. of the Revised Code~~ or any other government health program,	13646
and do not have access to another source of funds to cover the	13647
cost of lead tests and any indicated treatments;	13648

(2) Costs associated with having lead abatement performed or	13649
having the preventive treatments specified in section 3742.41 of	13650
the Revised Code performed.	13651

Sec. 3793.07. ~~(A) As used in this section:~~

13652

~~(1) "Medicare program" means the program established under~~	13653
~~Title XVIII of the "Social Security Act," 49 Stat. 620 (1935), 42~~	13654
~~U.S.C. 301, as amended;~~	13655

~~(2) "Medicaid program" means the program established under~~	13656
~~Title XIX of the "Social Security Act."~~	13657

~~(B)~~(A) Except as provided in division ~~(D)~~(C) of this section,	13658
the department of alcohol and drug addiction services shall	13659
establish and administer a process for the certification or	13660
credentialing of chemical dependency counselors and alcohol and	13661
other drug prevention specialists for the purpose of qualifying	13662
their services for reimbursement under the medicare or medicaid	13663
program. The process shall be made available to any individual who	13664
is a member of the profession of drug abuse counseling or chemical	13665
dependency counseling or any individual who is an alcohol and	13666
other drug prevention specialist. Nothing in this section shall be	13667
construed as requiring such certification or credentials for	13668
services that are not reimbursed by medicare or medicaid.	13669

The department shall cease to administer its process for the	13670
certification or credentialing of chemical dependency counselors	13671
and alcohol and other drug prevention specialists under this	13672
section at the earlier of the following:	13673

(1) The date, which shall be specified in an agreement	13674
between the department and chemical dependency professionals	13675
board, on which the board is to assume, under Chapter 4758. of the	13676
Revised Code, the department's certification duties;	13677

(2) Two years after ~~the effective date of this amendment~~	13678
December 23, 2002.	13679

~~(C)~~(B) The department shall adopt rules in accordance with	13680
Chapter 119. of the Revised Code establishing standards and	13681
procedures for the certification or credentialing process. The	13682
rules shall include the following:	13683

(1) Eligibility requirements;

13684

(2) Application procedures;

13685

(3) Minimum educational and clinical training requirements	13686
that must be met for initial certification or credentialing;	13687

(4) Continuing education and training requirements for	13688
certified or credentialed individuals;	13689

(5) Application and renewal fees that do not exceed the cost	13690
incurred by the department in implementing and administering the	13691
process;	13692

(6) Administration or approval of examinations;

13693

(7) Investigation of complaints and alleged violations of	13694
this section;	13695

(8) Maintenance of the confidentiality of the department's	13696
investigative records;	13697

(9) Disciplinary actions, including application denial and	13698
suspension or revocation of certification or credentials;	13699

(10) Any other rules the department considers necessary to	13700
establish or administer the certification or credentialing	13701
process.	13702

~~(D)~~(C)(1) Except as provided in division ~~(D)~~(C)(2) of this	13703
section, the department shall not issue an initial certificate or	13704
credential to practice as a chemical dependency counselor I, but	13705
may renew such a certificate or credential issued prior to ~~the~~	13706
~~effective date of this amendment~~December 23, 2002, or pursuant to	13707
division ~~(D)~~(C)(2) of this section until the department ceases to	13708
administer the certification and credentialing process under this	13709
section.	13710

(2) The department may issue an initial certificate or	13711
credential to practice as a chemical dependency counselor I to an	13712
individual if the individual submitted the application for	13713
certification or credentials to the department prior to ~~the~~	13714
~~effective date of this amendment~~December 23, 2002.	13715

~~(E)~~(D) The department shall investigate alleged violations of	13716
this section or the rules adopted under it. As part of its	13717
investigation, the department may issue subpoenas, examine	13718
witnesses, and administer oaths. The department shall ensure that	13719
all records it holds pertaining to an investigation remain	13720
confidential.	13721

~~(F)~~(E) With respect to hearings conducted by the department	13722
as part of the certification or credentialing process, both of the	13723
following apply:	13724

(1) An individual whose application for certification or	13725
credentials issued under this section has been denied by the	13726
department may request a hearing in accordance with Chapter 119.	13727
of the Revised Code and the rules adopted under this section.	13728

(2) The department may appoint a referee or hearing examiner	13729
to conduct the proceedings and make recommendations to the	13730
department as appropriate.	13731

~~(G)~~(F) The department shall maintain a record of all fees	13732
collected under this section. All fees collected shall be paid	13733
into the state treasury to the credit of the credentialing fund,	13734
which is hereby created. Money credited to the fund shall be used	13735
solely to pay the costs of establishing and administering the	13736
process for certification or credentialing of chemical dependency	13737
professionals under this section.	13738

Money credited to the credentialing fund under this section	13739
shall be transferred to the occupational licensing and regulatory	13740
fund created under section 4743.05 of the Revised Code at the	13741
earlier of the following:	13742

(1) The date, which shall be specified in an agreement	13743
between the department and chemical dependency professionals	13744
board, on which the board is to assume, under Chapter 4758. of the	13745
Revised Code, the department's certification duties;	13746

(2) Two years after ~~the effective date of this amendment~~	13747
December 23, 2002.	13748

~~(H)~~(G) Certifications made and credentials issued by the Ohio	13749
credentialing board for chemical dependency professionals prior to	13750
the date the department establishes its certification or	13751
credentialing process under this section shall continue to be	13752
accepted by the department until, with respect to any particular	13753
individual, one of the following occurs:	13754

(1) The individual's certification or credentials from the	13755
board have expired.	13756

(2) The individual's certification or credentials from the	13757
board would be suspended or revoked by the department if the	13758
certification or credentials had been issued by the department	13759
under this section.	13760

Sec. 3901.3814. Sections 3901.38 and 3901.381 to 3901.3813 of	13761
the Revised Code do not apply to the following:	13762

(A) Policies offering coverage that is regulated under	13763
Chapters 3935. and 3937. of the Revised Code;	13764

(B) An employer's self-insurance plan and any of its	13765
administrators, as defined in section 3959.01 of the Revised Code,	13766
to the extent that federal law supersedes, preempts, prohibits, or	13767
otherwise precludes the application of any provisions of those	13768
sections to the plan and its administrators;	13769

(C) A third-party payer for coverage provided under the	13770
medicare advantage program operated under ~~Title XVIII of~~ the	13771
~~"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as~~	13772
~~amended~~medicare program;	13773

(D) A third-party payer for coverage provided under the	13774
medicaid program ~~operated under Title XIX of the "Social Security~~	13775
~~Act~~," except that if a federal waiver applied for under section	13776
~~5111.178~~5165.16 of the Revised Code is granted or the director of	13777
~~job and family services~~health care administration determines	13778
that this provision can be implemented without a waiver, sections	13779
3901.38 and 3901.381 to 3901.3813 of the Revised Code apply to	13780
claims submitted electronically or non-electronically that are	13781
made with respect to coverage of medicaid recipients by health	13782
insuring corporations licensed under Chapter 1751. of the Revised	13783
Code, instead of the prompt payment requirements of 42 C.F.R.	13784
447.46;	13785

(E) A third-party payer for coverage provided under the	13786
tricare program offered by the United States department of	13787
defense.	13788

(F) A third-party payer for coverage provided under the	13789
children's buy-in program ~~established under sections 5101.5211 to~~	13790
~~5101.5216 of the Revised Code~~.	13791

Sec. 3903.14. (A) The superintendent of insurance as	13792
rehabilitator may appoint one or more special deputies, who shall	13793
have all the powers and responsibilities of the rehabilitator	13794
granted under this section, and the superintendent may employ such	13795
clerks and assistants as considered necessary. The compensation of	13796
the special deputies, clerks, and assistants and all expenses of	13797
taking possession of the insurer and of conducting the proceedings	13798
shall be fixed by the superintendent, with the approval of the	13799
court and shall be paid out of the funds or assets of the insurer.	13800
The persons appointed under this section shall serve at the	13801
pleasure of the superintendent. In the event that the property of	13802
the insurer does not contain sufficient cash or liquid assets to	13803
defray the costs incurred, the superintendent may advance the	13804
costs so incurred out of any appropriation for the maintenance of	13805
the department of insurance. Any amounts so advanced for expenses	13806
of administration shall be repaid to the superintendent for the	13807
use of the department out of the first available money of the	13808
insurer.	13809

(B) The rehabilitator may take such action as the	13810
rehabilitator considers necessary or appropriate to reform and	13811
revitalize the insurer. The rehabilitator shall have all the	13812
powers of the directors, officers, and managers, whose authority	13813
shall be suspended, except as they are redelegated by the	13814
rehabilitator. The rehabilitator shall have full power to direct	13815
and manage, to hire and discharge employees subject to any	13816
contract rights they may have, and to deal with the property and	13817
business of the insurer.	13818

(C) If it appears to the rehabilitator that there has been	13819
criminal or tortious conduct, or breach of any contractual or	13820
fiduciary obligation detrimental to the insurer by any officer,	13821
manager, agent, director, trustee, broker, employee, or other	13822
person, the rehabilitator may pursue all appropriate legal	13823
remedies on behalf of the insurer.	13824

(D) If the rehabilitator determines that reorganization,	13825
consolidation, conversion, reinsurance, merger, or other	13826
transformation of the insurer is appropriate, the rehabilitator	13827
shall prepare a plan to effect such changes. Upon application of	13828
the rehabilitator for approval of the plan, and after such notice	13829
and hearings as the court may prescribe, the court may either	13830
approve or disapprove the plan proposed, or may modify it and	13831
approve it as modified. Any plan approved under this section shall	13832
be, in the judgment of the court, fair and equitable to all	13833
parties concerned. If the plan is approved, the rehabilitator	13834
shall carry out the plan. In the case of a life insurer, the plan	13835
proposed may include the imposition of liens upon the policies of	13836
the company, if all rights of shareholders are first relinquished.	13837
A plan for a life insurer may also propose imposition of a	13838
moratorium upon loan and cash surrender rights under policies, for	13839
such period and to such an extent as may be necessary.	13840

(E) In the case of a medicaid health insuring corporation	13841
that has posted a bond or deposited securities in accordance with	13842
section 1751.271 of the Revised Code, the plan proposed under	13843
division (D) of this section may include the use of the proceeds	13844
of the bond or securities to first pay the claims of contracted	13845
providers for covered health care services provided to medicaid	13846
recipients, then next to pay other claimants with any remaining	13847
funds, consistent with the priorities set forth in sections	13848
3903.421 and 3903.42 of the Revised Code.	13849

(F) The rehabilitator shall have the power under sections	13850
3903.26 and 3903.27 of the Revised Code to avoid fraudulent	13851
transfers.	13852

(G) As used in this section:

13853

(1) "Contracted provider" means a provider with a contract	13854
with a medicaid health insuring corporation to provide covered	13855
health care services to medicaid recipients.	13856

(2) "Medicaid recipient" means a person eligible for	13857
~~assistance under~~ the medicaid program ~~operated pursuant to Chapter~~	13858
~~5111. of the Revised Code~~.	13859

Sec. 3916.06. (A)(1) With each application for a viatical	13860
settlement, a viatical settlement provider or viatical settlement	13861
broker shall disclose at least the following to a viator no later	13862
than the time all parties sign the application for the viatical	13863
settlement contract:	13864

(a) That there are possible alternatives to viatical	13865
settlement contracts, including any accelerated death benefits	13866
offered under the viator's policy;	13867

(b) That some or all of the proceeds of the viatical	13868
settlement may be subject to federal income taxation and state	13869
franchise and income taxation, and that assistance should be	13870
sought from a professional tax advisor;	13871

(c) That the proceeds of the viatical settlement could be	13872
subject to the claims of creditors;	13873

(d) That receipt of the proceeds of the viatical settlement	13874
may adversely affect the viator's eligibility for ~~medical~~	13875
~~assistance under Chapter 5111. of the Revised Code~~the medicaid	13876
program or other government benefits or entitlements, and that	13877
advice should be obtained from the appropriate government	13878
agencies;	13879

(e) That the viator has a right to rescind the viatical	13880
settlement contract for at least fifteen calendar days after the	13881
viator receives the viatical settlement proceeds, as provided in	13882
section 3916.08 of the Revised Code. If the insured dies during	13883
the rescission period, the viatical settlement contract shall be	13884
deemed to have been rescinded, subject to repayment of all	13885
viatical settlement proceeds to the viatical settlement company.	13886

(f) That funds will be sent to the viator within three	13887
business days after the viatical settlement provider has received	13888
written acknowledgment from the insurer or group administrator	13889
that ownership of the policy or interest in the certificate has	13890
been transferred and that the beneficiary has been designated	13891
pursuant to the viatical settlement contract;	13892

(g) That entering into a viatical settlement contract may	13893
cause other rights or benefits, including conversion rights and	13894
waiver of premium benefits that may exist under the policy, to be	13895
forfeited by the viator and that assistance should be sought from	13896
a financial advisor.	13897

(h) That following execution of the viatical settlement	13898
contract, the viatical settlement provider or the authorized	13899
representative of the viatical settlement provider may contact	13900
the insured for the purpose of determining the insured's health	13901
status and to confirm the insured's residential or business	13902
address and telephone number or for other purposes permitted by	13903
law. Any such contact shall be limited to once in any	13904
three-month period if the insured has a life expectancy of more	13905
than one year or to once per month if the insured has a life	13906
expectancy of one year or less.	13907

(2) The viatical settlement provider or viatical settlement	13908
broker shall provide the disclosures under division (A)(1) of	13909
this section in a separate document that is signed by the viator	13910
and the viatical settlement provider or viatical settlement	13911
broker.	13912

(3) Disclosure to a viator under division (A)(1) of this	13913
section shall include distribution of a brochure describing the	13914
process of viatical settlements. The viatical settlement provider	13915
or viatical settlement broker shall use the NAIC's form for the	13916
brochure unless another form is developed or approved by the	13917
superintendent.	13918

(4) The disclosure document under division (A)(1) of this	13919
section shall contain the following language:	13920

"All medical, financial, or personal information solicited or	13921
obtained by a viatical settlement provider or viatical settlement	13922
broker about an insured, including the insured's identity or the	13923
identity of family members, a spouse, or a significant other may	13924
be disclosed as necessary to effect the viatical settlement	13925
between the viator and the viatical settlement provider. If you	13926
are asked to provide this information, you will be asked to	13927
consent to the disclosure. The information may be provided to	13928
someone who buys the policy or provides funds for the purchase.	13929
You may be asked to renew your permission to share information	13930
every two years."	13931

(B)(1) A viatical settlement provider shall disclose at	13932
least the following to a viator prior to the date the viatical	13933
settlement contract is signed by all the necessary parties:	13934

(a) The affiliation, if any, between the viatical settlement	13935
provider and the issuer of the policy to be viaticated;	13936

(b) The name, business address, and telephone number of the	13937
viatical settlement provider;	13938

(c) Regarding a viatical settlement broker, the amount and	13939
method of calculating the broker's compensation. As used in this	13940
division, "compensation" includes anything of value paid or given	13941
to a viatical settlement broker for the placement of a policy or	13942
certificate.	13943

(d) Any affiliations or contractual arrangements between the	13944
viatical settlement provider and the viatical settlement broker;	13945

(e) If a policy to be viaticated has been issued as a joint	13946
policy or involves family riders or any coverage of a life other	13947
than the insured under the policy to be viaticated, the possible	13948
loss of coverage on the other lives under the policy and that	13949
advice should be sought from the viator's insurance agent or the	13950
company issuing the policy;	13951

(f) The dollar amount of the current death benefit payable to	13952
the viatical settlement provider under the policy, and, if known,	13953
the availability of any additional guaranteed insurance benefits,	13954
the dollar amount of any accidental death and dismemberment	13955
benefits under the policy, and the extent to which the viator's	13956
interest in those benefits will be transferred as a result of	13957
the viatical settlement contract.	13958

(g) That an escrow agent shall provide escrow services to	13959
the parties pursuant to a written agreement, signed by the	13960
viatical settlement provider, the viatical settlement broker, and	13961
the viator. At the close of escrow, the escrow agent will	13962
distribute the proceeds of the sale to the viator, minus any	13963
compensation to be paid to any other persons who provided	13964
services and to whom the viator has agreed to compensate out of	13965
the gross amount offered by the viatical settlement purchaser.	13966
All persons receiving any form of compensation under the escrow	13967
agreement shall be clearly identified, including name, business	13968
address, telephone number, and tax identification number.	13969

(2) The viatical settlement broker shall disclose at least	13970
the following to a viator prior to the execution of the viatical	13971
settlement contract:	13972

(a) The name, business address, and telephone number of the	13973
viatical settlement broker;	13974

(b) A full, complete, and accurate description of all offers,	13975
counteroffers, acceptances, and rejections relating to the	13976
proposed viatical settlement contract;	13977

(c) Any affiliations or contractual agreements between the	13978
viatical settlement broker and any person making an offer in	13979
connection with the proposed viatical settlement contract;	13980

(d) The amount and method of calculating the viatical	13981
settlement broker's compensation and, if any portion of the	13982
viatical settlement broker's compensation is taken from the	13983
viatical settlement offer, the total amount of the viatical	13984
settlement offer and the viatical settlement broker's	13985
compensation as a percentage of that total. As used in this	13986
division, "compensation" includes anything of value paid or given	13987
to a viatical settlement broker related to the settlement of a	13988
policy.	13989

(3) The viatical settlement provider or viatical settlement	13990
broker shall conspicuously display the disclosures required	13991
under divisions (B)(1) and (2) of this section in the viatical	13992
settlement contract or in a separate document signed by the	13993
viator and the viatical settlement provider or viatical	13994
settlement broker, as appropriate.	13995

(C) If the viatical settlement provider transfers ownership	13996
or changes the beneficiary of the policy, the viatical	13997
settlement provider shall communicate in writing the change in	13998
ownership or beneficiary to the insured within twenty days after	13999
the change.	14000

Sec. 3923.122. (A) Every policy of group sickness and	14001
accident insurance providing hospital, surgical, or medical	14002
expense coverage for other than specific diseases or accidents	14003
only, and delivered, issued for delivery, or renewed in this state	14004
on or after January 1, 1976, shall include a provision giving each	14005
insured the option to convert to the following:	14006

(1) In the case of an individual who is not a federally	14007
eligible individual, any of the individual policies of hospital,	14008
surgical, or medical expense insurance then being issued by the	14009
insurer with benefit limits not to exceed those in effect under	14010
the group policy;	14011

(2) In the case of a federally eligible individual, a basic	14012
or standard plan established by the board of directors of the Ohio	14013
health reinsurance program or plans substantially similar to the	14014
basic and standard plan in benefit design and scope of covered	14015
services. For purposes of division (A)(2) of this section, the	14016
superintendent of insurance shall determine whether a plan is	14017
substantially similar to the basic or standard plan in benefit	14018
design and scope of covered services.	14019

(B) An option for conversion to an individual policy shall be	14020
available without evidence of insurability to every insured,	14021
including any person eligible under division (D) of this section,	14022
who terminates employment or membership in the group holding the	14023
policy after having been continuously insured thereunder for at	14024
least one year.	14025

Upon receipt of the insured's written application and upon	14026
payment of at least the first quarterly premium not later than	14027
thirty-one days after the termination of coverage under the group	14028
policy, the insurer shall issue a converted policy on a form then	14029
available for conversion. The premium shall be in accordance with	14030
the insurer's table of premium rates in effect on the later of the	14031
following dates:	14032

(1) The effective date of the converted policy;

14033

(2) The date of application therefor; and shall be applicable	14034
to the class of risk to which each person covered belongs and to	14035
the form and amount of the policy at the person's then attained	14036
age. However, premiums charged federally eligible individuals may	14037
not exceed an amount that is two times the midpoint of the	14038
standard rate charged any other individual of a group to which the	14039
insurer is currently accepting new business and for which similar	14040
copayments and deductibles are applied.	14041

At the election of the insurer, a separate converted policy	14042
may be issued to cover any dependent of an employee or member of	14043
the group.	14044

Except as provided in division (H) of this section, any	14045
converted policy shall become effective as of the day following	14046
the date of termination of insurance under the group policy.	14047

Any probationary or waiting period set forth in the converted	14048
policy is deemed to commence on the effective date of the	14049
insured's coverage under the group policy.	14050

(C) No insurer shall be required to issue a converted policy	14051
to any person who is, or is eligible to be, covered for benefits	14052
at least comparable to the group policy under:	14053

(1) ~~Title XVIII of the Social Security Act, as amended or~~	14054
~~superseded~~The medicare program;	14055

(2) Any act of congress or law under this or any other state	14056
of the United States that duplicates coverage offered under	14057
division (C)(1) of this section;	14058

(3) Any policy that duplicates coverage offered under	14059
division (C)(1) of this section;	14060

(4) Any other group sickness and accident insurance providing	14061
hospital, surgical, or medical expense coverage for other than	14062
specific diseases or accidents only.	14063

(D) The option for conversion shall be available:

14064

(1) Upon the death of the employee or member, to the	14065
surviving spouse with respect to such of the spouse and dependents	14066
as are then covered by the group policy;	14067

(2) To a child solely with respect to the child upon	14068
attaining the limiting age of coverage under the group policy	14069
while covered as a dependent thereunder;	14070

(3) Upon the divorce, dissolution, or annulment of the	14071
marriage of the employee or member, to the divorced spouse, or	14072
former spouse in the event of annulment, of such employee or	14073
member, or upon the legal separation of the spouse from such	14074
employee or member, to the spouse.	14075

Persons possessing the option for conversion pursuant to this	14076
division shall be considered members for the purposes of division	14077
(H) of this section.	14078

(E) If coverage is continued under a group policy on an	14079
employee following retirement prior to the time the employee is,	14080
or is eligible to be, covered by ~~Title XVIII of~~ the ~~Social~~	14081
~~Security Act~~medicare program, the employee may elect, in lieu of	14082
the continuance of group insurance, to have the same conversion	14083
rights as would apply had the employee's insurance terminated at	14084
retirement by reason of termination of employment.	14085

(F) If the insurer and the group policyholder agree upon one	14086
or more additional plans of benefits to be available for converted	14087
policies, the applicant for the converted policy may elect such a	14088
plan in lieu of a converted policy.	14089

(G) The converted policy may contain provisions for avoiding	14090
duplication of benefits provided pursuant to divisions (C)(1),	14091
(2), (3), and (4) of this section or provided under any other	14092
insured or noninsured plan or program.	14093

(H) If an employee or member becomes entitled to obtain a	14094
converted policy pursuant to this section, and if the employee or	14095
member has not received notice of the conversion privilege at	14096
least fifteen days prior to the expiration of the thirty-one-day	14097
conversion period provided in division (B) of this section, then	14098
the employee or member has an additional period within which to	14099
exercise the privilege. This additional period shall expire	14100
fifteen days after the employee or member receives notice, but in	14101
no event shall the period extend beyond sixty days after the	14102
expiration of the thirty-one-day conversion period.	14103

Written notice presented to the employee or member, or mailed	14104
by the policyholder to the last known address of the employee or	14105
member as indicated on its records, constitutes notice for the	14106
purpose of this division. In the case of a person who is eligible	14107
for a converted policy under division (D)(2) or (D)(3) of this	14108
section, a policyholder shall not be responsible for presenting or	14109
mailing such notice, unless such policyholder has actual knowledge	14110
of the person's eligibility for a converted policy.	14111

If an additional period is allowed by an employee or member	14112
for the exercise of a conversion privilege, and if written	14113
application for the converted policy, accompanied by at least the	14114
first quarterly premium, is made after the expiration of the	14115
thirty-one-day conversion period, but within the additional period	14116
allowed an employee or member in accordance with this division,	14117
the effective date of the converted policy shall be the date of	14118
application.	14119

(I) The converted policy may provide that any hospital,	14120
surgical, or medical expense benefits otherwise payable with	14121
respect to any person may be reduced by the amount of any such	14122
benefits payable under the group policy for the same loss after	14123
termination of coverage.	14124

(J) The converted policy may contain:

14125

(1) Any exclusion, reduction, or limitation contained in the	14126
group policy or customarily used in individual policies issued by	14127
the insurer;	14128

(2) Any provision permitted in this section;

14129

(3) Any other provision not prohibited by law.

14130

Any provision required or permitted in this section may be	14131
made a part of any converted policy by means of an endorsement or	14132
rider.	14133

(K) The time limit specified in a converted policy for	14134
certain defenses with respect to any person who was covered by a	14135
group policy shall commence on the effective date of such person's	14136
coverage under the group policy.	14137

(L) No insurer shall use deterioration of health as the basis	14138
for refusing to renew a converted policy.	14139

(M) No insurer shall use age as the basis for refusing to	14140
renew a converted policy.	14141

(N) A converted policy made available pursuant to this	14142
section shall, if delivery of the policy is to be made in this	14143
state, comply with this section. If delivery of a converted policy	14144
is to be made in another state, it may be on a form offered by the	14145
insurer in the jurisdiction where the delivery is to be made and	14146
which provides benefits substantially in compliance with those	14147
required in a policy delivered in this state.	14148

(O) As used in this section, "federally eligible individual"	14149
means an eligible individual as defined in 45 C.F.R. 148.103.	14150

Sec. 3923.27. No policy of sickness and accident insurance	14151
delivered, issued for delivery, or renewed in this state after	14152
August 26, 1976, including both individual and group policies,	14153
that provides hospitalization coverage for mental illness shall	14154
exclude such coverage for the reason that the insured is	14155
hospitalized in an institution or facility receiving tax support	14156
from the state, any municipal corporation, county, or joint county	14157
board, whether such institution or facility is deemed charitable	14158
or otherwise, provided the institution or facility or portion	14159
thereof is fully accredited by the joint commission on	14160
accreditation of hospitals or certified under ~~Titles XVIII and XIX~~	14161
of the ~~"Social Security Act of 1935," 79 Stat. 291, 42 U.S.C.A.~~	14162
~~1395, as amended~~medicare program and medicaid program. The	14163
insurance coverage shall provide payment amounting to the lesser	14164
of either the full amount of the statutory charge for the cost of	14165
the services pursuant to section 5121.33 of the Revised Code or	14166
the benefits payable for the services under the applicable	14167
insurance policy. Insurance benefits for the coverage shall be	14168
paid so long as patients and their liable relatives retain their	14169
statutory liability pursuant to section 5121.33 of the Revised	14170
Code. Only that portion or per cent of the benefits shall be	14171
payable that has been assigned, or ordered to be paid, to the	14172
state or other appropriate provider for services rendered by the	14173
institution or facility.	14174

Sec. 3923.281. (A) As used in this section:

14175

(1) "Biologically based mental illness" means schizophrenia,	14176
schizoaffective disorder, major depressive disorder, bipolar	14177
disorder, paranoia and other psychotic disorders,	14178
obsessive-compulsive disorder, and panic disorder, as these terms	14179
are defined in the most recent edition of the diagnostic and	14180
statistical manual of mental disorders published by the American	14181
psychiatric association.	14182

(2) "Policy of sickness and accident insurance" has the same	14183
meaning as in section 3923.01 of the Revised Code, but excludes	14184
any hospital indemnity, medicare supplement, long-term care,	14185
disability income, one-time-limited-duration policy of not longer	14186
than six months, supplemental benefit, or other policy that	14187
provides coverage for specific diseases or accidents only; any	14188
policy that provides coverage for workers' compensation claims	14189
compensable pursuant to Chapters 4121. and 4123. of the Revised	14190
Code; any policy that provides coverage to beneficiaries enrolled	14191
in ~~Title XIX of~~ the ~~"Social Security Act," 49 Stat. 620 (1935),~~	14192
~~42 U.S.C.A. 301, as amended, known as the medical assistance~~	14193
~~program or~~ medicaid~~, as provided by the Ohio department of job~~	14194
~~and family services under Chapter 5111. of the Revised Code~~	14195
program; and any policy that provides coverage to beneficiaries	14196
enrolled in the children's buy-in program ~~established under~~	14197
~~sections 5101.5211 to 5101.5216 of the Revised Code~~.	14198

(B) Notwithstanding section 3901.71 of the Revised Code, and	14199
subject to division (E) of this section, every policy of	14200
sickness and accident insurance shall provide benefits for the	14201
diagnosis and treatment of biologically based mental illnesses on	14202
the same terms and conditions as, and shall provide benefits no	14203
less extensive than, those provided under the policy of sickness	14204
and accident insurance for the treatment and diagnosis of all	14205
other physical diseases and disorders, if both of the following	14206
apply:	14207

(1) The biologically based mental illness is clinically	14208
diagnosed by a physician authorized under Chapter 4731. of the	14209
Revised Code to practice medicine and surgery or osteopathic	14210
medicine and surgery; a psychologist licensed under Chapter 4732.	14211
of the Revised Code; a professional clinical counselor,	14212
professional counselor, or independent social worker licensed	14213
under Chapter 4757. of the Revised Code; or a clinical nurse	14214
specialist licensed under Chapter 4723. of the Revised Code whose	14215
nursing specialty is mental health.	14216

(2) The prescribed treatment is not experimental or	14217
investigational, having proven its clinical effectiveness in	14218
accordance with generally accepted medical standards.	14219

(C) Division (B) of this section applies to all coverages and	14220
terms and conditions of the policy of sickness and accident	14221
insurance, including, but not limited to, coverage of inpatient	14222
hospital services, outpatient services, and medication; maximum	14223
lifetime benefits; copayments; and individual and family	14224
deductibles.	14225

(D) Nothing in this section shall be construed as prohibiting	14226
a sickness and accident insurance company from taking any of the	14227
following actions:	14228

(1) Negotiating separately with mental health care providers	14229
with regard to reimbursement rates and the delivery of health care	14230
services;	14231

(2) Offering policies that provide benefits solely for the	14232
diagnosis and treatment of biologically based mental illnesses;	14233

(3) Managing the provision of benefits for the diagnosis or	14234
treatment of biologically based mental illnesses through the use	14235
of pre-admission screening, by requiring beneficiaries to obtain	14236
authorization prior to treatment, or through the use of any other	14237
mechanism designed to limit coverage to that treatment determined	14238
to be necessary;	14239

(4) Enforcing the terms and conditions of a policy of	14240
sickness and accident insurance.	14241

(E) An insurer that offers any policy of sickness and	14242
accident insurance is not required to provide benefits for the	14243
diagnosis and treatment of biologically based mental illnesses	14244
pursuant to division (B) of this section if all of the following	14245
apply:	14246

(1) The insurer submits documentation certified by an	14247
independent member of the American academy of actuaries to the	14248
superintendent of insurance showing that incurred claims for	14249
diagnostic and treatment services for biologically based mental	14250
illnesses for a period of at least six months independently caused	14251
the insurer's costs for claims and administrative expenses for the	14252
coverage of all other physical diseases and disorders to increase	14253
by more than one per cent per year.	14254

(2) The insurer submits a signed letter from an independent	14255
member of the American academy of actuaries to the superintendent	14256
of insurance opining that the increase described in division	14257
(E)(1) of this section could reasonably justify an increase of	14258
more than one per cent in the annual premiums or rates charged by	14259
the insurer for the coverage of all other physical diseases and	14260
disorders.	14261

(3) The superintendent of insurance makes the following	14262
determinations from the documentation and opinion submitted	14263
pursuant to divisions (E)(1) and (2) of this section:	14264

(a) Incurred claims for diagnostic and treatment services for	14265
biologically based mental illnesses for a period of at least six	14266
months independently caused the insurer's costs for claims and	14267
administrative expenses for the coverage of all other physical	14268
diseases and disorders to increase by more than one per cent per	14269
year.	14270

(b) The increase in costs reasonably justifies an increase of	14271
more than one per cent in the annual premiums or rates charged by	14272
the insurer for the coverage of all other physical diseases and	14273
disorders.	14274

Any determination made by the superintendent under this	14275
division is subject to Chapter 119. of the Revised Code.	14276

Sec. 3923.33. As used in section 3923.33 and sections	14277
3923.331 to 3923.339 of the Revised Code:	14278

(A) "Applicant" means:

14279

(1) In the case of an individual medicare supplement policy,	14280
the person who seeks to contract for insurance benefits; and	14281

(2) In the case of a group medicare supplement policy, the	14282
proposed certificate holder.	14283

(B) "Certificate" means, for purposes of section 3923.33 and	14284
sections 3923.331 to 3923.339 of the Revised Code, any certificate	14285
delivered or issued for delivery in this state under a group	14286
medicare supplement policy.	14287

(C) "Certificate form" means the form on which the	14288
certificate is delivered or issued for delivery by the issuer.	14289

(D) "Direct response insurance policy" means a medicare	14290
supplement policy or certificate marketed without the direct	14291
involvement of an insurance agent.	14292

(E) "Issuer" includes insurance companies, fraternal benefit	14293
societies, health insuring corporations, and any other entities	14294
delivering or issuing for delivery in this state medicare	14295
supplement policies or certificates.	14296

(F) ~~"Medicare" means the "Health Insurance for the Aged Act,"~~	14297
~~Title XVIII of the Social Security Amendments of 1965, 79 Stat.~~	14298
~~291, 42 U.S.C.A. 1395, as then constituted or later amended.~~	14299

~~(G)~~ "Medicare supplement policy" means a group or individual	14300
policy of sickness and accident insurance or a subscriber contract	14301
of health insuring corporations or any other issuers, other than a	14302
policy issued pursuant to a contract under section 1876 of the	14303
"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A., 1395mm,	14304
as amended, or an issued policy under any demonstration project	14305
specified in 42 U.S.C.A. 1395ss(g)(1), which is advertised,	14306
marketed, or designed primarily as a supplement to reimbursements	14307
under medicare for the hospital, medical, or surgical expenses of	14308
persons eligible for medicare.	14309

~~(H)~~(G) "Policy form" means the form on which the policy is	14310
delivered or issued for delivery by the issuer.	14311

Sec. 3923.38. (A) As used in this section:

14312

(1) "Group policy" includes any group sickness and accident	14313
policy or contract delivered, issued for delivery, or renewed in	14314
this state on or after June 28, 1984, and any private or public	14315
employer self-insurance plan or other plan that provides, or	14316
provides payment for, health care benefits for employees resident	14317
in this state other than through an insurer or health insuring	14318
corporation, to which both of the following apply:	14319

(a) The policy insures employees for hospital, surgical, or	14320
major medical insurance on an expense incurred or service basis,	14321
other than for specified diseases or for accidental injuries only.	14322

(b) The policy is in effect and covers an eligible employee	14323
at the time the employee's employment is terminated.	14324

(2) "Eligible employee" includes only an employee to whom all	14325
of the following apply:	14326

(a) The employee has been continuously insured under a group	14327
policy or under the policy and any prior similar group coverage	14328
replaced by the policy, during the entire three-month period	14329
preceding the termination of the employee's employment.	14330

(b) The employee is entitled, at the time of the termination	14331
of the employee's employment, to unemployment compensation	14332
benefits under Chapter 4141. of the Revised Code.	14333

(c) The employee is not, and does not become, covered by or	14334
eligible for coverage by medicare ~~under Title XVIII of the Social~~	14335
~~Security Act, as amended~~.	14336

(d) The employee is not, and does not become, covered by or	14337
eligible for coverage by any other insured or uninsured	14338
arrangement that provides hospital, surgical, or medical coverage	14339
for individuals in a group and under which the person was not	14340
covered immediately prior to such termination. A person eligible	14341
for continuation of coverage under this section, who is also	14342
eligible for coverage under section 3923.123 of the Revised Code,	14343
may elect either coverage, but not both. A person who elects	14344
continuation of coverage may elect any coverage available under	14345
section 3923.123 of the Revised Code upon the termination of the	14346
continuation of coverage.	14347

(3) "Group rate" means, in the case of an employer	14348
self-insurance or other health benefits plan, the average monthly	14349
cost per employee, over a period of at least twelve months, of the	14350
operation of the plan that would represent a group insurance rate	14351
if the same coverage had been provided under a group sickness and	14352
accident insurance policy.	14353

(B) A group policy shall provide that any eligible employee	14354
may continue the employee's hospital, surgical, and medical	14355
insurance under the policy, for the employee and the employee's	14356
eligible dependents, for a period of six months after the date	14357
that the insurance coverage would otherwise terminate by reason of	14358
the termination of the employee's employment. Each certificate of	14359
coverage, or other notice of coverage, issued to employees under	14360
the policy shall include a notice of the employee's privilege of	14361
continuation.	14362

(C) All of the following apply to the continuation of	14363
coverage required under division (B) of this section:	14364

(1) Continuation need not include dental, vision care,	14365
prescription drug benefits, or any other benefits provided under	14366
the policy in addition to its hospital, surgical, or major medical	14367
benefits.	14368

(2) The employer shall notify the employee of the right of	14369
continuation at the time the employer notifies the employee of the	14370
termination of employment. The notice shall inform the employee of	14371
the amount of contribution required by the employer under division	14372
(C)(4) of this section.	14373

(3) The employee shall file a written election of	14374
continuation with the employer and pay the employer the first	14375
contribution required under division (C)(4) of this section. The	14376
request and payment must be received by the employer no later than	14377
the earlier of any of the following dates:	14378

(a) Thirty-one days after the date on which the employee's	14379
coverage would otherwise terminate;	14380

(b) Ten days after the date on which the employee's coverage	14381
would otherwise terminate, if the employer has notified the	14382
employee of the right of continuation prior to such date;	14383

(c) Ten days after the employer notifies the employee of the	14384
right of continuation, if the notice is given after the date on	14385
which the employee's coverage would otherwise terminate.	14386

(4) The employee must pay to the employer, on a monthly	14387
basis, in advance, the amount of contribution required by the	14388
employer. The amount required shall not exceed the group rate for	14389
the insurance being continued under the policy on the due date of	14390
each payment.	14391

(5) The employee's privilege to continue coverage and the	14392
coverage under any continuation ceases if any of the following	14393
occurs:	14394

(a) The employee ceases to be an eligible employee under	14395
division (A)(2)(c) or (d) of this section;	14396

(b) A period of six months expires after the date that the	14397
employee's insurance under the policy would otherwise have	14398
terminated because of the termination of employment;	14399

(c) The employee fails to make a timely payment of a required	14400
contribution, in which event the coverage shall cease at the end	14401
of the coverage for which contributions were made;	14402

(d) The policy is terminated, or the employer terminates	14403
participation under the policy, unless the employer replaces the	14404
coverage by similar coverage under another group policy or other	14405
group health arrangement.	14406

If the employer replaces the policy with similar group health	14407
coverage, all of the following apply:	14408

(i) The member shall be covered under the replacement	14409
coverage, for the balance of the period that the member would have	14410
remained covered under the terminated coverage if it had not been	14411
terminated.	14412

(ii) The minimum level of benefits under the replacement	14413
coverage shall be the applicable level of benefits of the policy	14414
replaced reduced by any benefits payable under the policy	14415
replaced.	14416

(iii) The policy replaced shall continue to provide benefits	14417
to the extent of its accrued liabilities and extensions of	14418
benefits as if the replacement had not occurred.	14419

(D) This section does not apply to an employer's	14420
self-insurance plan if federal law supersedes, preempts,	14421
prohibits, or otherwise precludes its application to such plans.	14422

Sec. 3923.49. The department of insurance shall establish an	14423
outreach program to educate consumers about the following:	14424

(A) The need for long-term care insurance;

14425

(B) Mechanisms for financing long-term care;

14426

14427

(D) The resource protection provided by the Ohio long-term	14428
care insurance program under section ~~5111.18~~5162.43 of the	14429
Revised Code;	14430

(E) That a consumer who purchased a long-term care insurance	14431
policy that does not meet the requirements of section 3923.50 of	14432
the Revised Code may purchase a policy that meets those	14433
requirements.	14434

The department shall develop and make available to consumers	14435
information to assist them in choosing long-term care insurance	14436
coverage.	14437

Sec. 3923.50. For the purposes of the Ohio long-term care	14438
insurance program established under section ~~5111.18~~5162.43 of the	14439
Revised Code, the department of insurance shall notify the	14440
department of ~~job and family services~~health care administration	14441
of all long-term care insurance policies that meet all of the	14442
following requirements:	14443

(A) Comply with sections 3923.41 to 3923.48 of the Revised	14444
Code and the rules adopted under section 3923.47 of the Revised	14445
Code;	14446

(B) Provide benefits for home and community-based services in	14447
addition to nursing home care;	14448

(C) Include case management services in its coverage of home	14449
and community-based services;	14450

(D) Provide five per cent inflation protection compounded	14451
annually;	14452

(E) Provide for the keeping of records and	14453
explanation-of-benefit reports on insurance payments that count	14454
toward resource exclusion for the ~~medical assistance~~medicaid	14455
program;	14456

(F) Provide the information the director of ~~job and family~~	14457
~~services~~health care administration determines is necessary to	14458
document the extent of resource exclusion and to evaluate the Ohio	14459
long-term care insurance program;	14460

(G) Comply with other requirements established in rules	14461
adopted under this section.	14462

The superintendent of insurance shall adopt rules in	14463
accordance with Chapter 119. of the Revised Code establishing	14464
requirements under division (G) of this section that policies must	14465
meet to qualify under the Ohio long-term care insurance program.	14466
The superintendent shall consult with the departments of aging and	14467
~~job and family services~~health care administration in adopting	14468
those rules.	14469

Sec. 3923.58. (A) As used in sections 3923.58 and 3923.59 of	14470
the Revised Code:	14471

(1) "Health benefit plan" and "MEWA" have the same meanings	14472
as in section 3924.01 of the Revised Code.	14473

(2) "Insurer" means any sickness and accident insurance	14474
company authorized to do business in this state, or MEWA	14475
authorized to issue insured health benefit plans in this state.	14476
"Insurer" does not include any health insuring corporation that is	14477
owned or operated by an insurer.	14478

(3) "Pre-existing conditions provision" means a policy	14479
provision that excludes or limits coverage for charges or expenses	14480
incurred during a specified period following the insured's	14481
effective date of coverage as to a condition which, during a	14482
specified period immediately preceding the effective date of	14483
coverage, had manifested itself in such a manner as would cause an	14484
ordinarily prudent person to seek medical advice, diagnosis, care,	14485
or treatment or for which medical advice, diagnosis, care, or	14486
treatment was recommended or received, or a pregnancy existing on	14487
the effective date of coverage.	14488

(B) Beginning in January of each year, insurers in the	14489
business of issuing individual policies of sickness and accident	14490
insurance as contemplated by section 3923.021 of the Revised Code,	14491
except individual policies issued pursuant to section 3923.122 of	14492
the Revised Code, shall accept applicants for open enrollment	14493
coverage, as set forth in this division, in the order in which	14494
they apply for coverage and subject to the limitation set forth in	14495
division (G) of this section. Insurers shall accept for coverage	14496
pursuant to this section individuals to whom both of the following	14497
conditions apply:	14498

(1) The individual is not applying for coverage as an	14499
employee of an employer, as a member of an association, or as a	14500
member of any other group.	14501

(2) The individual is not covered, and is not eligible for	14502
coverage, under any other private or public health benefits	14503
arrangement, including the medicare program ~~established under~~	14504
~~Title XVIII of the "Social Security Act," 49 Stat. 620 (1935), 42~~	14505
~~U.S.C.A. 301, as amended~~, or any other act of congress or law of	14506
this or any other state of the United States that provides	14507
benefits comparable to the benefits provided under this section,	14508
any medicare supplement policy, or any continuation of coverage	14509
policy under state or federal law.	14510

(C) An insurer shall offer to any individual accepted under	14511
this section the Ohio health care basic and standard plans	14512
established by the board of directors of the Ohio health	14513
reinsurance program under division (A) of section 3924.10 of the	14514
Revised Code or health benefit plans that are substantially	14515
similar to the Ohio health care basic and standard plans in	14516
benefit plan design and scope of covered services.	14517

An insurer may offer other health benefit plans in addition	14518
to, but not in lieu of, the plans required to be offered under	14519
this division. A basic health benefit plan shall provide, at a	14520
minimum, the coverage provided by the Ohio health care basic plan	14521
or any health benefit plan that is substantially similar to the	14522
Ohio health care basic plan in benefit plan design and scope of	14523
covered services. A standard health benefit plan shall provide, at	14524
a minimum, the coverage provided by the Ohio health care standard	14525
plan or any health benefit plan that is substantially similar to	14526
the Ohio health care standard plan in benefit plan design and	14527
scope of covered services.	14528

For purposes of this division, the superintendent of	14529
insurance shall determine whether a health benefit plan is	14530
substantially similar to the Ohio health care basic and standard	14531
plans in benefit plan design and scope of covered services.	14532

(D) Health benefit plans issued under this section may	14533
establish pre-existing conditions provisions that exclude or limit	14534
coverage for a period of up to twelve months following the	14535
individual's effective date of coverage and that may relate only	14536
to conditions during the six months immediately preceding the	14537
effective date of coverage.	14538

(E) Premiums charged to individuals under this section may	14539
not exceed an amount that is two and one-half times the highest	14540
rate charged any other individual to which the insurer is	14541
currently accepting new business, and for which similar copayments	14542
and deductibles are applied.	14543

(F) In offering health benefit plans under this section, an	14544
insurer may require the purchase of health benefit plans that	14545
condition the reimbursement of health services upon the use of a	14546
specific network of providers.	14547

(G)(1) In no event shall an insurer be required to accept	14548
annually under this section individuals who, in the aggregate,	14549
would cause the insurer to have a total number of new insureds	14550
that is more than one-half per cent of its total number of insured	14551
individuals in this state per year, as contemplated by section	14552
3923.021 of the Revised Code, calculated as of the immediately	14553
preceding thirty-first day of December and excluding the insurer's	14554
medicare supplement policies and conversion or continuation of	14555
coverage policies under state or federal law and any policies	14556
described in division (L) of this section.	14557

(2) An officer of the insurer shall certify to the department	14558
of insurance when it has met the enrollment limit set forth in	14559
division (G)(1) of this section. Upon providing such	14560
certification, the insurer shall be relieved of its open	14561
enrollment requirement under this section for the remainder of the	14562
calendar year.	14563

(H) An insurer shall not be required to accept under this	14564
section applicants who, at the time of enrollment, are confined to	14565
a health care facility because of chronic illness, permanent	14566
injury, or other infirmity that would cause economic impairment to	14567
the insurer if the applicants were accepted, or to make the	14568
effective date of benefits for individuals accepted under this	14569
section earlier than ninety days after the date of acceptance.	14570

(I) The requirements of this section do not apply to any	14571
insurer that is currently in a state of supervision, insolvency,	14572
or liquidation. If an insurer demonstrates to the satisfaction of	14573
the superintendent that the requirements of this section would	14574
place the insurer in a state of supervision, insolvency, or	14575
liquidation, the superintendent may waive or modify the	14576
requirements of division (B) or (G) of this section. The actions	14577
of the superintendent under this division shall be effective for a	14578
period of not more than one year. At the expiration of such time,	14579
a new showing of need for a waiver or modification by the insurer	14580
shall be made before a new waiver or modification is issued or	14581
imposed.	14582

(J) No hospital, health care facility, or health care	14583
practitioner, and no person who employs any health care	14584
practitioner, shall balance bill any individual or dependent of an	14585
individual for any health care supplies or services provided to	14586
the individual or dependent who is insured under a policy issued	14587
under this section. The hospital, health care facility, or health	14588
care practitioner, or any person that employs the health care	14589
practitioner, shall accept payments made to it by the insurer	14590
under the terms of the policy or contract insuring or covering	14591
such individual as payment in full for such health care supplies	14592
or services.	14593

As used in this division, "hospital" has the same meaning as	14594
in section 3727.01 of the Revised Code; "health care practitioner"	14595
has the same meaning as in section 4769.01 of the Revised Code;	14596
and "balance bill" means charging or collecting an amount in	14597
excess of the amount reimbursable or payable under the policy or	14598
health care service contract issued to an individual under this	14599
section for such health care supply or service. "Balance bill"	14600
does not include charging for or collecting copayments or	14601
deductibles required by the policy or contract.	14602

(K) An insurer shall pay an agent a commission in the amount	14603
of five per cent of the premium charged for initial placement or	14604
for otherwise securing the issuance of a policy or contract issued	14605
to an individual under this section, and four per cent of the	14606
premium charged for the renewal of such a policy or contract. The	14607
superintendent may adopt, in accordance with Chapter 119. of the	14608
Revised Code, such rules as are necessary to enforce this	14609
division.	14610

(L) This section does not apply to any policy that provides	14611
coverage for specific diseases or accidents only, or to any	14612
hospital indemnity, medicare supplement, long-term care,	14613
disability income, one-time-limited-duration policy of no longer	14614
than six months, or other policy that offers only supplemental	14615
benefits.	14616

Sec. 3923.601. (A)(1) This section applies to both of the	14617
following:	14618

(a) A sickness and accident insurer that issues or requires	14619
the use of a standardized identification card or an electronic	14620
technology for submission and routing of prescription drug claims	14621
pursuant to a policy, contract, or agreement for health care	14622
services;	14623

(b) A person that a sickness and accident insurer contracts	14624
with to issue a standardized identification card or an electronic	14625
technology described in division (A)(1)(a) of this section.	14626

(2) Notwithstanding division (A)(1) of this section, this	14627
section does not apply to the issuance or required use of a	14628
standardized identification card or an electronic technology for	14629
the submission and routing of prescription drug claims in	14630
connection with any of the following:	14631

(a) Any individual or group policy of sickness and accident	14632
insurance covering only accident, credit, dental, disability	14633
income, long-term care, hospital indemnity, medicare supplement,	14634
medicare, tricare, specified disease, or vision care; coverage	14635
under a one-time-limited-duration policy of not longer than six	14636
months; coverage issued as a supplement to liability insurance;	14637
insurance arising out of workers' compensation or similar law;	14638
automobile medical payment insurance; or insurance under which	14639
benefits are payable with or without regard to fault and which is	14640
statutorily required to be contained in any liability insurance	14641
policy or equivalent self-insurance.	14642

(b) Coverage provided under the medicaid~~, as defined in~~	14643
~~section 5111.01 of the Revised Code~~program.	14644

(c) Coverage provided under an employer's self-insurance plan	14645
or by any of its administrators, as defined in section 3959.01 of	14646
the Revised Code, to the extent that federal law supersedes,	14647
preempts, prohibits, or otherwise precludes the application of	14648
this section to the plan and its administrators.	14649

(B) A standardized identification card or an electronic	14650
technology issued or required to be used as provided in division	14651
(A)(1) of this section shall contain uniform prescription drug	14652
information in accordance with either division (B)(1) or (2) of	14653
this section.	14654

(1) The standardized identification card or the electronic	14655
technology shall be in a format and contain information fields	14656
approved by the national council for prescription drug programs or	14657
a successor organization, as specified in the council's or	14658
successor organization's pharmacy identification card	14659
implementation guide in effect on the first day of October most	14660
immediately preceding the issuance or required use of the	14661
standardized identification card or the electronic technology.	14662

(2) If the insurer or person under contract with the insurer	14663
to issue a standardized identification card or an electronic	14664
technology requires the information for the submission and routing	14665
of a claim, the standardized identification card or the electronic	14666
technology shall contain any of the following information:	14667

(a) The insurer's name;

14668

(b) The insured's name, group number, and identification	14669
number;	14670

(c) A telephone number to inquire about pharmacy-related	14671
issues;	14672

(d) The issuer's international identification number, labeled	14673
as "ANSI BIN" or "RxBIN";	14674

(e) The processor's control number, labeled as "RxPCN";

14675

(f) The insured's pharmacy benefits group number if different	14676
from the insured's medical group number, labeled as "RxGrp."	14677

(C) If the standardized identification card or the electronic	14678
technology issued or required to be used as provided in division	14679
(A)(1) of this section is also used for submission and routing of	14680
nonpharmacy claims, the designation "Rx" is required to be	14681
included as part of the labels identified in divisions (B)(2)(d)	14682
and (e) of this section if the issuer's international	14683
identification number or the processor's control number is	14684
different for medical and pharmacy claims.	14685

(D) Each sickness and accident insurer described in division	14686
(A) of this section shall annually file a certificate with the	14687
superintendent of insurance certifying that it or any person it	14688
contracts with to issue a standardized identification card or	14689
electronic technology for submission and routing of prescription	14690
drug claims complies with this section.	14691

(E)(1) Except as provided in division (E)(2) of this section,	14692
if there is a change in the information contained in the	14693
standardized identification card or the electronic technology	14694
issued to an insured, the insurer or person under contract with	14695
the insurer to issue a standardized identification card or an	14696
electronic technology shall issue a new card or electronic	14697
technology to the insured.	14698

(2) An insurer or person under contract with the insurer is	14699
not required under division (E)(1) of this section to issue a new	14700
card or electronic technology to an insured more than once during	14701
a twelve-month period.	14702

(F) Nothing in this section shall be construed as requiring	14703
an insurer to produce more than one standardized identification	14704
card or one electronic technology for use by insureds accessing	14705
health care benefits provided under a policy of sickness and	14706
accident insurance.	14707

Sec. 3923.70. Consistent with the Rules of Evidence, a	14708
written decision or opinion prepared by an independent review	14709
organization under section 3923.67 or 3923.68 of the Revised Code	14710
shall be admissible in any civil action related to the coverage	14711
decision that was the subject of the decision or opinion. The	14712
independent review organization's decision or opinion shall be	14713
presumed to be a scientifically valid and accurate description of	14714
the state of medical knowledge at the time it was written.	14715

Consistent with the Rules of Evidence, any party to a civil	14716
action related to an insurer's decision involving an	14717
investigational or experimental drug, device, or treatment may	14718
introduce into evidence any applicable medicare reimbursement	14719
standards established under ~~Title XVIII of~~ the ~~"Social Security~~	14720
~~Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended~~medicare	14721
program.	14722

Sec. 3923.79. Consistent with the Rules of Evidence, a	14723
written decision or opinion prepared by an independent review	14724
organization under section 3923.76 or 3923.77 of the Revised Code	14725
shall be admissible in any civil action related to the coverage	14726
decision that was the subject of the decision or opinion. The	14727
independent review organization's decision or opinion shall be	14728
presumed to be a scientifically valid and accurate description of	14729
the state of medical knowledge at the time it was written.	14730

Consistent with the Rules of Evidence, any party to a civil	14731
action related to a plan's decision involving an investigational	14732
or experimental drug, device, or treatment may introduce into	14733
evidence any applicable medicare reimbursement standards	14734
established under ~~Title XVIII of~~ the ~~"Social Security Act," 49~~	14735
~~Stat. 620 (1935), 42 U.S.C.A. 301, as amended~~medicare program.	14736

Sec. 3923.83. (A)(1) This section applies to both of the	14737
following:	14738

(a) A public employee benefit plan that issues or requires	14739
the use of a standardized identification card or an electronic	14740
technology for submission and routing of prescription drug claims	14741
pursuant to a policy, contract, or agreement for health care	14742
services;	14743

(b) A person or entity that a public employee benefit plan	14744
contracts with to issue a standardized identification card or an	14745
electronic technology described in division (A)(1)(a) of this	14746
section.	14747

(2) Notwithstanding division (A)(1) of this section, this	14748
section does not apply to the issuance or required use of a	14749
standardized identification card or an electronic technology for	14750
the submission and routing of prescription drug claims in	14751
connection with either of the following:	14752

(a) Any individual or group policy of insurance covering only	14753
accident, credit, dental, disability income, long-term care,	14754
hospital indemnity, medicare supplement, medicare, tricare,	14755
specified disease, or vision care; coverage under a	14756
one-time-limited-duration policy of not longer than six months;	14757
coverage issued as a supplement to liability insurance; insurance	14758
arising out of workers' compensation or similar law; automobile	14759
medical payment insurance; or insurance under which benefits are	14760
payable with or without regard to fault and which is statutorily	14761
required to be contained in any liability insurance policy or	14762
equivalent self-insurance.	14763

(b) Coverage provided under the medicaid~~, as defined in~~	14764
~~section 5111.01 of the Revised Code~~program.	14765

(B) A standardized identification card or an electronic	14766
technology issued or required to be used as provided in division	14767
(A)(1) of this section shall contain uniform prescription drug	14768
information in accordance with either division (B)(1) or (2) of	14769
this section.	14770

(1) The standardized identification card or the electronic	14771
technology shall be in a format and contain information fields	14772
approved by the national council for prescription drug programs or	14773
a successor organization, as specified in the council's or	14774
successor organization's pharmacy identification card	14775
implementation guide in effect on the first day of October most	14776
immediately preceding the issuance or required use of the	14777
standardized identification card or the electronic technology.	14778

(2) If the public employee benefit plan or person under	14779
contract with the plan to issue a standardized identification card	14780
or an electronic technology requires the information for the	14781
submission and routing of a claim, the standardized identification	14782
card or the electronic technology shall contain any of the	14783
following information:	14784

(a) The plan's name;

14785

(b) The insured's name, group number, and identification	14786
number;	14787

(c) A telephone number to inquire about pharmacy-related	14788
issues;	14789

(d) The issuer's international identification number, labeled	14790
as "ANSI BIN" or "RxBIN";	14791

(e) The processor's control number, labeled as "RxPCN";

14792

(f) The insured's pharmacy benefits group number if different	14793
from the insured's medical group number, labeled as "RxGrp."	14794

(C) If the standardized identification card or the electronic	14795
technology issued or required to be used as provided in division	14796
(A)(1) of this section is also used for submission and routing of	14797
nonpharmacy claims, the designation "Rx" is required to be	14798
included as part of the labels identified in divisions (B)(2)(d)	14799
and (e) of this section if the issuer's international	14800
identification number or the processor's control number is	14801
different for medical and pharmacy claims.	14802

(D)(1) Except as provided in division (D)(2) of this section,	14803
if there is a change in the information contained in the	14804
standardized identification card or the electronic technology	14805
issued to an insured, the public employee benefit plan or person	14806
under contract with the plan to issue a standardized	14807
identification card or electronic technology shall issue a new	14808
card or electronic technology to the insured.	14809

(2) A public employee benefit plan or person under contract	14810
with the plan is not required under division (D)(1) of this	14811
section to issue a new card or electronic technology to an insured	14812
more than once during a twelve-month period.	14813

~~(F)~~(E) Nothing in this section shall be construed as	14814
requiring a public employee benefit plan to produce more than one	14815
standardized identification card or one electronic technology for	14816
use by insureds accessing health care benefits provided under a	14817
health benefit plan.	14818

Sec. 3924.41. (A) As used in sections 3924.41 and 3924.42 of	14819
the Revised Code, "health insurer" means any sickness and accident	14820
insurer or health insuring corporation. "Health insurer" also	14821
includes any group health plan as defined in section 607 of the	14822
federal "Employee Retirement Income Security Act of 1974," 88	14823
Stat. 832, 29 U.S.C.A. 1167.	14824

(B) Notwithstanding any other provision of the Revised Code,	14825
no health insurer shall take into consideration the availability	14826
of, or eligibility for, ~~medical assistance~~the medicaid program in	14827
this state ~~under Chapter 5111. of the Revised Code~~ or in any other	14828
state ~~pursuant to Title XIX of the "Social Security Act," 49 Stat.~~	14829
~~620 (1935), 42 U.S.C.A. 301, as amended,~~ when determining an	14830
individual's eligibility for coverage or when making payments to	14831
or on behalf of an enrollee, subscriber, policyholder, or	14832
certificate holder.	14833

Sec. 3924.42. No health insurer shall impose requirements on	14834
the department of ~~job and family services~~health care	14835
administration, when it has been assigned the rights of an	14836
individual who is eligible for ~~medical assistance under Chapter~~	14837
~~5111. of the Revised Code~~the medicaid program and who is covered	14838
under a health care policy, contract, or plan issued by the health	14839
insurer, that are different from the requirements applicable to an	14840
agent or assignee of any other individual so covered.	14841

Sec. 3963.01. As used in this chapter:

14842

(A) "Affiliate" means any person or entity that has ownership	14843
or control of a contracting entity, is owned or controlled by a	14844
contracting entity, or is under common ownership or control with a	14845
contracting entity.	14846

(B) "Basic health care services" has the same meaning as in	14847
division (A) of section 1751.01 of the Revised Code, except that	14848
it does not include any services listed in that division that are	14849
provided by a pharmacist or nursing home.	14850

(C) "Contracting entity" means any person that has a primary	14851
business purpose of contracting with participating providers for	14852
the delivery of health care services.	14853

(D) "Credentialing" means the process of assessing and	14854
validating the qualifications of a provider applying to be	14855
approved by a contracting entity to provide basic health care	14856
services, specialty health care services, or supplemental health	14857
care services to enrollees.	14858

(E) "Edit" means adjusting one or more procedure codes billed	14859
by a participating provider on a claim for payment or a practice	14860
that results in any of the following:	14861

(1) Payment for some, but not all of the procedure codes	14862
originally billed by a participating provider;	14863

(2) Payment for a different procedure code than the procedure	14864
code originally billed by a participating provider;	14865

(3) A reduced payment as a result of services provided to an	14866
enrollee that are claimed under more than one procedure code on	14867
the same service date.	14868

(F) "Electronic claims transport" means to accept and	14869
digitize claims or to accept claims already digitized, to place	14870
those claims into a format that complies with the electronic	14871
transaction standards issued by the United States department of	14872
health and human services pursuant to the "Health Insurance	14873
Portability and Accountability Act of 1996," 110 Stat. 1955, 42	14874
U.S.C. 1320d, et seq., as those electronic standards are	14875
applicable to the parties and as those electronic standards are	14876
updated from time to time, and to electronically transmit those	14877
claims to the appropriate contracting entity, payer, or	14878
third-party administrator.	14879

(G) "Enrollee" means any person eligible for health care	14880
benefits under a health benefit plan, including an eligible	14881
recipient of medicaid ~~under Chapter 5111. of the Revised Code~~, and	14882
includes all of the following terms:	14883

(1) "Enrollee" and "subscriber" as defined by section 1751.01	14884
of the Revised Code;	14885

(2) "Member" as defined by section 1739.01 of the Revised	14886
Code;	14887

(3) "Insured" and "plan member" pursuant to Chapter 3923. of	14888
the Revised Code;	14889

(4) "Beneficiary" as defined by section 3901.38 of the	14890
Revised Code.	14891

(H) "Health care contract" means a contract entered into,	14892
materially amended, or renewed between a contracting entity and	14893
a participating provider for the delivery of basic health care	14894
services, specialty health care services, or supplemental health	14895
care services to enrollees.	14896

(I) "Health care services" means basic health care services,	14897
specialty health care services, and supplemental health care	14898
services.	14899

(J) "Material amendment" means an amendment to a health care	14900
contract that decreases the participating provider's payment or	14901
compensation, changes the administrative procedures in a way that	14902
may reasonably be expected to significantly increase the	14903
provider's administrative expenses, or adds a new product. A	14904
material amendment does not include any of the following:	14905

(1) A decrease in payment or compensation resulting solely	14906
from a change in a published fee schedule upon which the payment	14907
or compensation is based and the date of applicability is clearly	14908
identified in the contract;	14909

(2) A decrease in payment or compensation that was	14910
anticipated under the terms of the contract, if the amount and	14911
date of applicability of the decrease is clearly identified in the	14912
contract;	14913

(3) An administrative change that may significantly increase	14914
the provider's administrative expense, the specific applicability	14915
of which is clearly identified in the contract;	14916

(4) Changes to an existing prior authorization,	14917
precertification, notification, or referral program that do not	14918
substantially increase the provider's administrative expense;	14919

(5) Changes to an edit program or to specific edits if the	14920
participating provider is provided notice of the changes pursuant	14921
to division (A)(1) of section 3963.04 of the Revised Code and the	14922
notice includes information sufficient for the provider to	14923
determine the effect of the change;	14924

(6) Changes to a health care contract described in division	14925
(B) of section 3963.04 of the Revised Code.	14926

(K) "Participating provider" means a provider that has a	14927
health care contract with a contracting entity and is entitled to	14928
reimbursement for health care services rendered to an enrollee	14929
under the health care contract.	14930

(L) "Payer" means any person that assumes the financial risk	14931
for the payment of claims under a health care contract or the	14932
reimbursement for health care services provided to enrollees by	14933
participating providers pursuant to a health care contract.	14934

(M) "Primary enrollee" means a person who is responsible for	14935
making payments for participation in a health care plan or an	14936
enrollee whose employment or other status is the basis of	14937
eligibility for enrollment in a health care plan.	14938

(N) "Procedure codes" includes the American medical	14939
association's current procedural terminology code, the American	14940
dental association's current dental terminology, and the centers	14941
for medicare and medicaid services health care common procedure	14942
coding system.	14943

(O) "Product" means one of the following types of categories	14944
of coverage for which a participating provider may be obligated	14945
to provide health care services pursuant to a health care	14946
contract:	14947

(1) A health maintenance organization or other product	14948
provided by a health insuring corporation;	14949

(2) A preferred provider organization;

14950

(3) Medicare;

14951

(4) Medicaid or the children's buy-in program ~~established~~	14952
~~under section 5101.5211 to 5101.5216 of the Revised Code~~;	14953

(5) Workers' compensation.

14954

(P) "Provider" means a physician, podiatrist, dentist,	14955
chiropractor, optometrist, psychologist, physician assistant,	14956
advanced practice nurse, occupational therapist, massage	14957
therapist, physical therapist, professional counselor,	14958
professional clinical counselor, hearing aid dealer, orthotist,	14959
prosthetist, home health agency, hospice care program, or	14960
hospital, or a provider organization or physician-hospital	14961
organization that is acting exclusively as an administrator on	14962
behalf of a provider to facilitate the provider's participation in	14963
health care contracts. "Provider" does not mean a pharmacist,	14964
pharmacy, nursing home, or a provider organization or	14965
physician-hospital organization that leases the provider	14966
organization's or physician-hospital organization's network to a	14967
third party or contracts directly with employers or health and	14968
welfare funds.	14969

(Q) "Specialty health care services" has the same meaning as	14970
in section 1751.01 of the Revised Code, except that it does not	14971
include any services listed in division (B) of section 1751.01 of	14972
the Revised Code that are provided by a pharmacist or a nursing	14973
home.	14974

(R) "Supplemental health care services" has the same meaning	14975
as in division (B) of section 1751.01 of the Revised Code, except	14976
that it does not include any services listed in that division that	14977
are provided by a pharmacist or nursing home.	14978

Sec. 4123.27. Information contained in the annual statement	14979
provided for in section 4123.26 of the Revised Code, and such	14980
other information as may be furnished to the bureau of workers'	14981
compensation by employers in pursuance of that section, is for the	14982
exclusive use and information of the bureau in the discharge of	14983
its official duties, and shall not be open to the public nor be	14984
used in any court in any action or proceeding pending therein	14985
unless the bureau is a party to the action or proceeding; but the	14986
information contained in the statement may be tabulated and	14987
published by the bureau in statistical form for the use and	14988
information of other state departments and the public. No person	14989
in the employ of the bureau, except those who are authorized by	14990
the administrator of workers' compensation, shall divulge any	14991
information secured by the person while in the employ of the	14992
bureau in respect to the transactions, property, claim files,	14993
records, or papers of the bureau or in respect to the business or	14994
mechanical, chemical, or other industrial process of any company,	14995
firm, corporation, person, association, partnership, or public	14996
utility to any person other than the administrator or to the	14997
superior of such employee of the bureau.	14998

Notwithstanding the restrictions imposed by this section, the	14999
governor, select or standing committees of the general assembly,	15000
the auditor of state, the attorney general, or their designees,	15001
pursuant to the authority granted in this chapter and Chapter	15002
4121. of the Revised Code, may examine any records, claim files,	15003
or papers in possession of the industrial commission or the	15004
bureau. They also are bound by the privilege that attaches to	15005
these papers.	15006

The administrator shall report to the director of job and	15007
family services or to the county director of job and family	15008
services the name, address, and social security number or other	15009
identification number of any person receiving workers'	15010
compensation whose name or social security number or other	15011
identification number is the same as that of a person required by	15012
a court or child support enforcement agency to provide support	15013
payments to a recipient or participant of public assistance, and	15014
whose name is submitted to the administrator by the director under	15015
section 5101.36 of the Revised Code. The administrator shall	15016
report to the director of health care administration or to the	15017
county director of job and family services the name, address, and	15018
social security number or other identification number of any	15019
person receiving workers' compensation whose name or social	15020
security number or other identification number is the same as that	15021
of a person required by a court or child support enforcement	15022
agency to provide support payments to a public medical assistance	15023
program recipient, and whose name is submitted to the	15024
administrator by the director under section 5160.42 of the Revised	15025
Code. The administrator also shall inform the appropriate director	15026
of the amount of workers' compensation paid to the person during	15027
such period as the director specifies.	15028

Within fourteen days after receiving ~~from the director of job~~	15029
~~and family services~~ a list of the names and social security	15030
numbers of recipients or participants of public assistance	15031
pursuant to section 5101.181 of the Revised Code or a list of the	15032
names and social security numbers of public medical assistance	15033
program recipients pursuant to section 5160.43 of the Revised	15034
Code, the administrator shall inform the auditor of state of the	15035
name, current or most recent address, and social security number	15036
of each person receiving workers' compensation pursuant to this	15037
chapter whose name and social security number are the same as that	15038
of a person whose name or social security number ~~was submitted by~~	15039
~~the director~~is included in the list. The administrator also shall	15040
inform the auditor of state of the amount of workers' compensation	15041
paid to the person during such period as the director specifies.	15042

The bureau and its employees, except for purposes of	15043
furnishing the auditor of state with information required by this	15044
section, shall preserve the confidentiality of recipients or	15045
participants of public assistance in compliance with ~~division (A)~~	15046
of section 5101.181 of the Revised Code and preserve the	15047
confidentiality of public medical assistance program recipients in	15048
compliance with section 5160.43 of the Revised Code.	15049

For the purposes of this section, "public assistance" means	15050
~~medical assistance provided through the medical assistance program~~	15051
~~established under section 5111.01 of the Revised Code,~~ Ohio works	15052
first provided under Chapter 5107. of the Revised Code,	15053
prevention, retention, and contingency benefits and services	15054
provided under Chapter 5108. of the Revised Code, disability	15055
financial assistance provided under Chapter 5115. of the Revised	15056
Code, or the disability medical assistance ~~provided under Chapter~~	15057
~~5115. of the Revised Code~~program.	15058

Sec. 4141.162. (A) The director of job and family services,	15059
in collaboration with the director of health care administration,	15060
shall establish an income and eligibility verification system that	15061
complies with section 1137 of the "Social Security Act." The	15062
programs included in the system are all of the following:	15063

(1) Unemployment compensation pursuant to section 3304 of the	15064
"Internal Revenue Code of 1954";	15065

(2) The state programs funded in part under part A of Title	15066
IV of the "Social Security Act" and administered under Chapters	15067
5107. and 5108. of the Revised Code;	15068

(3) Medicaid ~~pursuant to Title XIX of the "Social Security~~	15069
~~Act"~~;	15070

(4) Food stamps pursuant to the "Food Stamp Act of 1977," 91	15071
Stat. 958, 7 U.S.C.A. 2011, as amended;	15072

(5) Any Ohio program under a plan approved under Title I, X,	15073
XIV, or XVI of the "Social Security Act."	15074

Wage information provided by employers to the director shall	15075
be furnished to the income and eligibility verification system.	15076
Such information shall be used by the director to determine	15077
eligibility of individuals for unemployment compensation benefits	15078
and the amount of those benefits and used by the agencies that	15079
administer the programs identified in divisions (A)(2) to (5) of	15080
this section to determine or verify eligibility for or the amount	15081
of benefits under those programs.	15082

The director shall fully implement the use of wage	15083
information to determine eligibility for and the amount of	15084
unemployment compensation benefits by September 30, 1988.	15085

Information furnished under the system shall also be made	15086
available to the appropriate state or local child support	15087
enforcement agency for the purposes of an approved plan under	15088
Title IV-D of the "Social Security Act" and to the appropriate	15089
federal agency for the purposes of Titles II and XVI of the	15090
"Social Security Act."	15091

(B) The director shall adopt rules as necessary under which	15092
the department of job and family services and other state agencies	15093
that the director determines must participate in order to ensure	15094
compliance with section 1137 of the "Social Security Act" exchange	15095
information with each other or authorized federal agencies about	15096
individuals who are applicants for or recipients of benefits under	15097
any of the programs enumerated in division (A) of this section.	15098
The rules shall extend to all of the following:	15099

(1) A requirement for standardized formats and procedures for	15100
a participating agency to request and receive information about an	15101
individual, which information shall include the individual's	15102
social security number;	15103

(2) A requirement that all applicants for and recipients of	15104
benefits under any program enumerated in division (A) of this	15105
section be notified at the time of application, and periodically	15106
thereafter, that information available through the system may be	15107
shared with agencies that administer other benefit programs and	15108
utilized in establishing or verifying eligibility or benefit	15109
amounts under the other programs enumerated in division (A) of	15110
this section;	15111

(3) A requirement that information is made available only to	15112
the extent necessary to assist in the valid administrative needs	15113
of the program receiving the information and is targeted for use	15114
in ways which are most likely to be productive in identifying and	15115
preventing ineligibility and incorrect payments;	15116

(4) A requirement that information is adequately protected	15117
against unauthorized disclosures for purposes other than to	15118
establish or verify eligibility or benefit amounts under the	15119
programs enumerated in division (A) of this section;	15120

(5) A requirement that a program providing information is	15121
reimbursed by the program using the information for the actual	15122
costs of furnishing the information and that the director be	15123
reimbursed by the participating programs for any actual costs	15124
incurred in operating the system;	15125

(6) Requirements for any other matters necessary to ensure	15126
the effective, efficient, and timely exchange of necessary	15127
information or that the director determines must be addressed in	15128
order to ensure compliance with the requirements of section 1137	15129
of the "Social Security Act."	15130

(C) Each participating agency shall furnish to the income and	15131
eligibility verification system established in division (A) of	15132
this section that information, which the director, by rule,	15133
determines is necessary in order to comply with section 1137 of	15134
the "Social Security Act."	15135

(D) Notwithstanding the information disclosure requirements	15136
of this section and section 4141.21 and division (A) of section	15137
4141.284 of the Revised Code, the director shall administer those	15138
provisions of law so as to comply with section 1137 of the "Social	15139
Security Act."	15140

(E) Requirements in section 4141.21 of the Revised Code with	15141
respect to confidentiality of information obtained in the	15142
administration of Chapter 4141. of the Revised Code and any	15143
sanctions imposed for improper disclosure of such information	15144
shall apply to the redisclosure of information disclosed under	15145
this section.	15146

Sec. 4719.01. (A) As used in sections 4719.01 to 4719.18 of	15147
the Revised Code:	15148

(1) "Affiliate" means a business entity that is owned by,	15149
operated by, controlled by, or under common control with another	15150
business entity.	15151

(2) "Communication" means a written or oral notification or	15152
advertisement that meets both of the following criteria, as	15153
applicable:	15154

(a) The notification or advertisement is transmitted by or on	15155
behalf of the seller of goods or services and by or through any	15156
printed, audio, video, cinematic, telephonic, or electronic means.	15157

(b) In the case of a notification or advertisement other than	15158
by telephone, either of the following conditions is met:	15159

(i) The notification or advertisement is followed by a	15160
telephone call from a telephone solicitor or salesperson.	15161

(ii) The notification or advertisement invites a response by	15162
telephone, and, during the course of that response, a telephone	15163
solicitor or salesperson attempts to make or makes a sale of goods	15164
or services. As used in division (A)(2)(b)(ii) of this section,	15165
"invites a response by telephone" excludes the mere listing or	15166
inclusion of a telephone number in a notification or	15167
advertisement.	15168

(3) "Gift, award, or prize" means anything of value that is	15169
offered or purportedly offered, or given or purportedly given by	15170
chance, at no cost to the receiver and with no obligation to	15171
purchase goods or services. As used in this division, "chance"	15172
includes a situation in which a person is guaranteed to receive an	15173
item and, at the time of the offer or purported offer, the	15174
telephone solicitor does not identify the specific item that the	15175
person will receive.	15176

(4) "Goods or services" means any real property or any	15177
tangible or intangible personal property, or services of any kind	15178
provided or offered to a person. "Goods or services" includes, but	15179
is not limited to, advertising; labor performed for the benefit of	15180
a person; personal property intended to be attached to or	15181
installed in any real property, regardless of whether it is so	15182
attached or installed; timeshare estates or licenses; and extended	15183
service contracts.	15184

(5) "Purchaser" means a person that is solicited to become or	15185
does become financially obligated as a result of a telephone	15186
solicitation.	15187

(6) "Salesperson" means an individual who is employed,	15188
appointed, or authorized by a telephone solicitor to make	15189
telephone solicitations but does not mean any of the following:	15190

(a) An individual who comes within one of the exemptions in	15191
division (B) of this section;	15192

(b) An individual employed, appointed, or authorized by a	15193
person who comes within one of the exemptions in division (B) of	15194
this section;	15195

(c) An individual under a written contract with a person who	15196
comes within one of the exemptions in division (B) of this	15197
section, if liability for all transactions with purchasers is	15198
assumed by the person so exempted.	15199

(7) "Telephone solicitation" means a communication to a	15200
person that meets both of the following criteria:	15201

(a) The communication is initiated by or on behalf of a	15202
telephone solicitor or by a salesperson.	15203

(b) The communication either represents a price or the	15204
quality or availability of goods or services or is used to induce	15205
the person to purchase goods or services, including, but not	15206
limited to, inducement through the offering of a gift, award, or	15207
prize.	15208

(8) "Telephone solicitor" means a person that engages in	15209
telephone solicitation directly or through one or more	15210
salespersons either from a location in this state, or from a	15211
location outside this state to persons in this state. "Telephone	15212
solicitor" includes, but is not limited to, any such person that	15213
is an owner, operator, officer, or director of, partner in, or	15214
other individual engaged in the management activities of, a	15215
business.	15216

(B) A telephone solicitor is exempt from the provisions of	15217
sections 4719.02 to 4719.18 and section 4719.99 of the Revised	15218
Code if the telephone solicitor is any one of the following:	15219

(1) A person engaging in a telephone solicitation that is a	15220
one-time or infrequent transaction not done in the course of a	15221
pattern of repeated transactions of a like nature;	15222

(2) A person engaged in telephone solicitation solely for	15223
religious or political purposes; a charitable organization,	15224
fund-raising counsel, or professional solicitor in compliance with	15225
the registration and reporting requirements of Chapter 1716. of	15226
the Revised Code; or any person or other entity exempt under	15227
section 1716.03 of the Revised Code from filing a registration	15228
statement under section 1716.02 of the Revised Code;	15229

(3) A person, making a telephone solicitation involving a	15230
home solicitation sale as defined in section 1345.21 of the	15231
Revised Code, that makes the sales presentation and completes the	15232
sale at a later, face-to-face meeting between the seller and the	15233
purchaser rather than during the telephone solicitation. However,	15234
if the person, following the telephone solicitation, causes	15235
another person to collect the payment of any money, this exemption	15236
does not apply.	15237

(4) A licensed securities, commodities, or investment broker,	15238
dealer, investment advisor, or associated person when making a	15239
telephone solicitation within the scope of the person's license.	15240
As used in division (B)(4) of this section, "licensed securities,	15241
commodities, or investment broker, dealer, investment advisor, or	15242
associated person" means a person subject to licensure or	15243
registration as such by the securities and exchange commission;	15244
the National Association of Securities Dealers or other	15245
self-regulatory organization, as defined by 15 U.S.C.A. 78c; by	15246
the division of securities under Chapter 1707. of the Revised	15247
Code; or by an official or agency of any other state of the United	15248
States.	15249

(5)(a) A person primarily engaged in soliciting the sale of a	15250
newspaper of general circulation;	15251

(b) As used in division (B)(5)(a) of this section, "newspaper	15252
of general circulation" includes, but is not limited to, both of	15253
the following:	15254

(i) A newspaper that is a daily law journal designated as an	15255
official publisher of court calendars pursuant to section 2701.09	15256
of the Revised Code;	15257

(ii) A newspaper or publication that has at least twenty-five	15258
per cent editorial, non-advertising content, exclusive of inserts,	15259
measured relative to total publication space, and an audited	15260
circulation to at least fifty per cent of the households in the	15261
newspaper's retail trade zone as defined by the audit.	15262

(6)(a) An issuer, or its subsidiary, that has a class of	15263
securities to which all of the following apply:	15264

(i) The class of securities is subject to section 12 of the	15265
"Securities Exchange Act of 1934," 15 U.S.C.A. 78l, and is	15266
registered or is exempt from registration under 15 U.S.C.A.	15267
78l(g)(2)(A), (B), (C), (E), (F), (G), or (H);	15268

(ii) The class of securities is listed on the New York stock	15269
exchange, the American stock exchange, or the NASDAQ national	15270
market system;	15271

(iii) The class of securities is a reported security as	15272
defined in 17 C.F.R. 240.11Aa3-1(a)(4).	15273

(b) An issuer, or its subsidiary, that formerly had a class	15274
of securities that met the criteria set forth in division	15275
(B)(6)(a) of this section if the issuer, or its subsidiary, has a	15276
net worth in excess of one hundred million dollars, files or its	15277
parent files with the securities and exchange commission an S.E.C.	15278
form 10-K, and has continued in substantially the same business	15279
since it had a class of securities that met the criteria in	15280
division (B)(6)(a) of this section. As used in division (B)(6)(b)	15281
of this section, "issuer" and "subsidiary" include the successor	15282
to an issuer or subsidiary.	15283

(7) A person soliciting a transaction regulated by the	15284
commodity futures trading commission, if the person is registered	15285
or temporarily registered for that activity with the commission	15286
under 7 U.S.C.A. 1 et. seq. and the registration or temporary	15287
registration has not expired or been suspended or revoked;	15288

(8) A person soliciting the sale of any book, record, audio	15289
tape, compact disc, or video, if the person allows the purchaser	15290
to review the merchandise for at least seven days and provides a	15291
full refund within thirty days to a purchaser who returns the	15292
merchandise or if the person solicits the sale on behalf of a	15293
membership club operating in compliance with regulations adopted	15294
by the federal trade commission in 16 C.F.R. 425;	15295

(9) A supervised financial institution or its subsidiary. As	15296
used in division (B)(9) of this section, "supervised financial	15297
institution" means a bank, trust company, savings and loan	15298
association, savings bank, credit union, industrial loan company,	15299
consumer finance lender, commercial finance lender, or institution	15300
described in section 2(c)(2)(F) of the "Bank Holding Company Act	15301
of 1956," 12 U.S.C.A. 1841(c)(2)(F), as amended, supervised by an	15302
official or agency of the United States, this state, or any other	15303
state of the United States; or a licensee or registrant under	15304
sections 1321.01 to 1321.19, 1321.51 to 1321.60, or 1321.71 to	15305
1321.83 of the Revised Code.	15306

(10)(a) An insurance company, association, or other	15307
organization that is licensed or authorized to conduct business in	15308
this state by the superintendent of insurance pursuant to Title	15309
XXXIX of the Revised Code or Chapter 1751. of the Revised Code,	15310
when soliciting within the scope of its license or authorization.	15311

(b) A licensed insurance broker, agent, or solicitor when	15312
soliciting within the scope of the person's license. As used in	15313
division (B)(10)(b) of this section, "licensed insurance broker,	15314
agent, or solicitor" means any person licensed as an insurance	15315
broker, agent, or solicitor by the superintendent of insurance	15316
pursuant to Title XXXIX of the Revised Code.	15317

(11) A person soliciting the sale of services provided by a	15318
cable television system operating under authority of a	15319
governmental franchise or permit;	15320

(12) A person soliciting a business-to-business sale under	15321
which any of the following conditions are met:	15322

(a) The telephone solicitor has been operating continuously	15323
for at least three years under the same business name under which	15324
it solicits purchasers, and at least fifty-one per cent of its	15325
gross dollar volume of sales consists of repeat sales to existing	15326
customers to whom it has made sales under the same business name.	15327

(b) The purchaser business intends to resell the goods	15328
purchased.	15329

(c) The purchaser business intends to use the goods or	15330
services purchased in a recycling, reuse, manufacturing, or	15331
remanufacturing process.	15332

(d) The telephone solicitor is a publisher of a periodical or	15333
of magazines distributed as controlled circulation publications as	15334
defined in division (CC) of section 5739.01 of the Revised Code	15335
and is soliciting sales of advertising, subscriptions, reprints,	15336
lists, information databases, conference participation or	15337
sponsorships, trade shows or media products related to the	15338
periodical or magazine, or other publishing services provided by	15339
the controlled circulation publication.	15340

(13) A person that, not less often than once each year,	15341
publishes and delivers to potential purchasers a catalog that	15342
complies with both of the following:	15343

(a) It includes all of the following:

15344

(i) The business address of the seller;

15345

(ii) A written description or illustration of each good or	15346
service offered for sale;	15347

(iii) A clear and conspicuous disclosure of the sale price of	15348
each good or service; shipping, handling, and other charges; and	15349
return policy;	15350

(b) One of the following applies:

15351

(i) The catalog includes at least twenty-four pages of	15352
written material and illustrations, is distributed in more than	15353
one state, and has an annual postage-paid mail circulation of not	15354
less than two hundred fifty thousand households;	15355

(ii) The catalog includes at least ten pages of written	15356
material or an equivalent amount of material in electronic form on	15357
the internet or an on-line computer service, the person does not	15358
solicit customers by telephone but solely receives telephone calls	15359
made in response to the catalog, and during the calls the person	15360
takes orders but does not engage in further solicitation of the	15361
purchaser. As used in division (B)(13)(b)(ii) of this section,	15362
"further solicitation" does not include providing the purchaser	15363
with information about, or attempting to sell, any other item in	15364
the catalog that prompted the purchaser's call or in a	15365
substantially similar catalog issued by the seller.	15366

(14) A political subdivision or instrumentality of the United	15367
States, this state, or any state of the United States;	15368

(15) A college or university or any other public or private	15369
institution of higher education in this state;	15370

(16) A public utility as defined in section 4905.02 of the	15371
Revised Code or a retail natural gas supplier as defined in	15372
section 4929.01 of the Revised Code, if the utility or supplier is	15373
subject to regulation by the public utilities commission, or the	15374
affiliate of the utility or supplier;	15375

(17) A person that solicits sales through a television	15376
program or advertisement that is presented in the same market area	15377
no fewer than twenty days per month or offers for sale no fewer	15378
than ten distinct items of goods or services; and offers to the	15379
purchaser an unconditional right to return any good or service	15380
purchased within a period of at least seven days and to receive a	15381
full refund within thirty days after the purchaser returns the	15382
good or cancels the service;	15383

(18)(a) A person that, for at least one year, has been	15384
operating a retail business under the same name as that used in	15385
connection with telephone solicitation and both of the following	15386
occur on a continuing basis:	15387

(i) The person either displays goods and offers them for	15388
retail sale at the person's business premises or offers services	15389
for sale and provides them at the person's business premises.	15390

(ii) At least fifty-one per cent of the person's gross dollar	15391
volume of retail sales involves purchases of goods or services at	15392
the person's business premises.	15393

(b) An affiliate of a person that meets the requirements in	15394
division (B)(18)(a) of this section if the affiliate meets all of	15395
the following requirements:	15396

(i) The affiliate has operated a retail business for a period	15397
of less than one year;	15398

(ii) The affiliate either displays goods and offers them for	15399
retail sale at the affiliate's business premises or offers	15400
services for sale and provides them at the affiliate's business	15401
premises;	15402

(iii) At least fifty-one per cent of the affiliate's gross	15403
dollar volume of retail sales involves purchases of goods or	15404
services at the affiliate's business premises.	15405

(c) A person that, for a period of less than one year, has	15406
been operating a retail business in this state under the same name	15407
as that used in connection with telephone solicitation, as long as	15408
all of the following requirements are met:	15409

(i) The person either displays goods and offers them for	15410
retail sale at the person's business premises or offers services	15411
for sale and provides them at the person's business premises;	15412

(ii) The goods or services that are the subject of telephone	15413
solicitation are sold at the person's business premises, and at	15414
least sixty-five per cent of the person's gross dollar volume of	15415
retail sales involves purchases of goods or services at the	15416
person's business premises;	15417

(iii) The person conducts all telephone solicitation	15418
activities according to sections 310.3, 310.4, and 310.5 of the	15419
telemarketing sales rule adopted by the federal trade commission	15420
in 16 C.F.R. part 310.	15421

(19) A person who performs telephone solicitation sales	15422
services on behalf of other persons and to whom one of the	15423
following applies:	15424

(a) The person has operated under the same ownership,	15425
control, and business name for at least five years, and the person	15426
receives at least seventy-five per cent of its gross revenues from	15427
written telephone solicitation contracts with persons who come	15428
within one of the exemptions in division (B) of this section.	15429

(b) The person is an affiliate of one or more exempt persons	15430
and makes telephone solicitations on behalf of only the exempt	15431
persons of which it is an affiliate.	15432

(c) The person makes telephone solicitations on behalf of	15433
only exempt persons, the person and each exempt person on whose	15434
behalf telephone solicitations are made have entered into a	15435
written contract that specifies the manner in which the telephone	15436
solicitations are to be conducted and that at a minimum requires	15437
compliance with the telemarketing sales rule adopted by the	15438
federal trade commission in 16 C.F.R. part 310, and the person	15439
conducts the telephone solicitations in the manner specified in	15440
the written contract.	15441

(d) The person performs telephone solicitation for religious	15442
or political purposes, a charitable organization, a fund-raising	15443
council, or a professional solicitor in compliance with the	15444
registration and reporting requirements of Chapter 1716. of the	15445
Revised Code; and meets all of the following requirements:	15446

(i) The person has operated under the same ownership,	15447
control, and business name for at least five years, and the person	15448
receives at least fifty-one per cent of its gross revenues from	15449
written telephone solicitation contracts with persons who come	15450
within the exemption in division (B)(2) of this section;	15451

(ii) The person does not conduct a prize promotion or offer	15452
the sale of an investment opportunity;	15453

(iii) The person conducts all telephone solicitation	15454
activities according to sections 310.3, 310.4, and 310.5 of the	15455
telemarketing sales rules adopted by the federal trade commission	15456
in 16 C.F.R. part 310.	15457

(20) A person that is a licensed real estate salesperson or	15458
broker under Chapter 4735. of the Revised Code when soliciting	15459
within the scope of the person's license;	15460

(21)(a) Either of the following:

15461

(i) A publisher that solicits the sale of the publisher's	15462
periodical or magazine of general, paid circulation, or a person	15463
that solicits a sale of that nature on behalf of a publisher under	15464
a written agreement directly between the publisher and the person.	15465

(ii) A publisher that solicits the sale of the publisher's	15466
periodical or magazine of general, paid circulation, or a person	15467
that solicits a sale of that nature as authorized by a publisher	15468
under a written agreement directly with a publisher's	15469
clearinghouse provided the person is a resident of Ohio for more	15470
than three years and initiates all telephone solicitations from	15471
Ohio and the person conducts the solicitation and sale in	15472
compliance with 16 C.F.R. part 310, as adopted by the federal	15473
trade commission.	15474

(b) As used in division (B)(21) of this section, "periodical	15475
or magazine of general, paid circulation" excludes a periodical or	15476
magazine circulated only as part of a membership package or given	15477
as a free gift or prize from the publisher or person.	15478

(22) A person that solicits the sale of food, as defined in	15479
section 3715.01 of the Revised Code, or the sale of products of	15480
horticulture, as defined in section 5739.01 of the Revised Code,	15481
if the person does not intend the solicitation to result in, or	15482
the solicitation actually does not result in, a sale that costs	15483
the purchaser an amount greater than five hundred dollars.	15484

(23) A funeral director licensed pursuant to Chapter 4717. of	15485
the Revised Code when soliciting within the scope of that license,	15486
if both of the following apply:	15487

(a) The solicitation and sale are conducted in compliance	15488
with 16 C.F.R. part 453, as adopted by the federal trade	15489
commission, and with sections 1107.33 and 1345.21 to 1345.28 of	15490
the Revised Code;	15491

(b) The person provides to the purchaser of any preneed	15492
funeral contract a notice that clearly and conspicuously sets	15493
forth the cancellation rights specified in division (G) of section	15494
1107.33 of the Revised Code, and retains a copy of the notice	15495
signed by the purchaser.	15496

(24) A person, or affiliate thereof, licensed to sell or	15497
issue Ohio instruments designated as travelers checks pursuant to	15498
sections 1315.01 to 1315.18 of the Revised Code.	15499

(25) A person that solicits sales from its previous	15500
purchasers and meets all of the following requirements:	15501

(a) The solicitation is made under the same business name	15502
that was previously used to sell goods or services to the	15503
purchaser;	15504

(b) The person has, for a period of not less than three	15505
years, operated a business under the same business name as that	15506
used in connection with telephone solicitation;	15507

(c) The person does not conduct a prize promotion or offer	15508
the sale of an investment opportunity;	15509

(d) The person conducts all telephone solicitation activities	15510
according to sections 310.3, 310.4, and 310.5 of the telemarketing	15511
sales rules adopted by the federal trade commission in 16 C.F.R.	15512
part 310;	15513

(e) Neither the person nor any of its principals has been	15514
convicted of, pleaded guilty to, or has entered a plea of no	15515
contest for a felony or a theft offense as defined in sections	15516
2901.02 and 2913.01 of the Revised Code or similar law of another	15517
state or of the United States;	15518

(f) Neither the person nor any of its principals has had	15519
entered against them an injunction or a final judgment or order,	15520
including an agreed judgment or order, an assurance of voluntary	15521
compliance, or any similar instrument, in any civil or	15522
administrative action involving engaging in a pattern of corrupt	15523
practices, fraud, theft, embezzlement, fraudulent conversion, or	15524
misappropriation of property; the use of any untrue, deceptive, or	15525
misleading representation; or the use of any unfair, unlawful,	15526
deceptive, or unconscionable trade act or practice.	15527

(26) An institution defined as a home health agency in	15528
section 3701.881 of the Revised Code, that conducts all telephone	15529
solicitation activities according to sections 310.3, 310.4, and	15530
310.5 of the telemarketing sales rules adopted by the federal	15531
trade commission in 16 C.F.R. part 310, and engages in telephone	15532
solicitation only within the scope of the institution's	15533
certification, accreditation, contract with the department of	15534
aging, or status as a home health agency; and that meets one of	15535
the following requirements:	15536

(a) The institution is certified as a provider of home health	15537
services under ~~Title XVIII of~~ the ~~Social Security Act, 49 Stat.~~	15538
~~620, 42 U.S.C. 301, as amended~~medicare program;	15539

(b) The institution is accredited by either the joint	15540
commission on accreditation of health care organizations or the	15541
community health accreditation program;	15542

(c) The institution is providing passport services under the	15543
direction of the Ohio department of aging under section 173.40 of	15544
the Revised Code;	15545

(d) An affiliate of an institution that meets the	15546
requirements of division (B)(26)(a), (b), or (c) of this section	15547
when offering for sale substantially the same goods and services	15548
as those that are offered by the institution that meets the	15549
requirements of division (B)(26)(a), (b), or (c) of this section.	15550

(27) A person licensed to provide a hospice care program by	15551
the department of health pursuant to section 3712.04 of the	15552
Revised Code when conducting telephone solicitations within the	15553
scope of the person's license and according to sections 310.3,	15554
310.4, and 310.5 of the telemarketing sales rules adopted by the	15555
federal trade commission in 16 C.F.R. part 310.	15556

Sec. 4723.063. (A) As used in this section:

15557

(1) "Health care facility" means:

15558

(a) A hospital registered under section 3701.07 of the	15559
Revised Code;	15560

(b) A nursing home licensed under section 3721.02 of the	15561
Revised Code, or by a political subdivision certified under	15562
section 3721.09 of the Revised Code;	15563

(c) A county home or a county nursing home as defined in	15564
section 5155.31 of the Revised Code that is certified under ~~Title~~	15565
~~XVIII or XIX of~~ the ~~"Social Security Act," 49 Stat. 620 (1935), 42~~	15566
~~U.S.C. 301, amended~~medicare program or medicaid program;	15567

(d) A freestanding dialysis center;

15568

(e) A freestanding inpatient rehabilitation facility;

15569

(f) An ambulatory surgical facility;

15570

(g) A freestanding cardiac catheterization facility;

15571

(h) A freestanding birthing center;

15572

(i) A freestanding or mobile diagnostic imaging center;

15573

(j) A freestanding radiation therapy center.

15574

(2) "Nurse education program" means a prelicensure nurse	15575
education program approved by the board of nursing under section	15576
4723.06 of the Revised Code or a postlicensure nurse education	15577
program approved by the board of regents under section 3333.04 of	15578
the Revised Code.	15579

(B) The state board of nursing shall establish and administer	15580
the nurse education grant program. Under the program, the board	15581
shall award grants to nurse education programs that have	15582
partnerships with other education programs, community health	15583
agencies, or health care facilities. Grant recipients shall use	15584
the money to fund partnerships to increase the nurse education	15585
program's enrollment capacity. Methods of increasing a program's	15586
enrollment capacity may include hiring faculty and preceptors,	15587
purchasing educational equipment and materials, and other actions	15588
acceptable to the board. Grant money shall not be used to	15589
construct or renovate buildings. Partnerships may be developed	15590
between one or more nurse education programs and one or more	15591
health care facilities.	15592

In awarding grants, the board shall give preference to	15593
partnerships between nurse education programs and hospitals,	15594
nursing homes, and county homes or county nursing homes, but may	15595
also award grants to fund partnerships between nurse education	15596
programs and other health care facilities.	15597

(C) The board shall adopt rules in accordance with Chapter	15598
119. of the Revised Code establishing the following:	15599

(1) Eligibility requirements for receipt of a grant;

15600

(2) Grant application forms and procedures;

15601

(3) The amounts in which grants may be made and the total	15602
amount that may be awarded to a nurse education program that has a	15603
partnership with other education programs, a community health	15604
agency, or a health care facility;	15605

(4) A method whereby the board may evaluate the effectiveness	15606
of a partnership between joint recipients in increasing the nurse	15607
education program's enrollment capacity;	15608

(5) The percentage of the money in the fund that must remain	15609
in the fund at all times to maintain a fiscally responsible fund	15610
balance;	15611

(6) The percentage of available grants to be awarded to	15612
licensed practical nurse education programs, registered nurse	15613
education programs, and graduate programs;	15614

(7) Any other matters incidental to the operation of the	15615
program.	15616

(D) From January 1, 2004, until December 31, 2013, the ten	15617
dollars of each biennial nursing license renewal fee collected	15618
under section 4723.08 of the Revised Code shall be dedicated to	15619
the nurse education grant program fund, which is hereby created in	15620
the state treasury. The board shall use money in the fund for	15621
grants awarded under division (A) of this section and for expenses	15622
of administering the grant program. The amount used for	15623
administrative expenses in any year shall not exceed ten per cent	15624
of the amount transferred to the fund in that year.	15625

(E) Each quarter, for the purposes of transferring funds to	15626
the nurse education grant program, the board of nursing shall	15627
certify to the director of budget and management the number of	15628
biennial licenses renewed under this chapter during the preceding	15629
quarter and the amount equal to that number times ten dollars.	15630

(F) Notwithstanding the requirements of section 4743.05 of	15631
the Revised Code, from January 1, 2004, until December 31, 2013,	15632
at the end of each quarter, the director of budget and management	15633
shall transfer from the occupational licensing and regulatory fund	15634
to the nurse education grant program fund the amount certified	15635
under division (E) of this section.	15636

Sec. 4723.17. (A) The board of nursing may authorize a	15637
licensed practical nurse to administer to an adult intravenous	15638
therapy authorized by an individual who is authorized to practice	15639
in this state and is acting within the course of the individual's	15640
professional practice, if the licensed practical nurse has a	15641
current, valid license issued under this chapter that includes	15642
authorization to administer medications and one of the following	15643
is the case:	15644

(1) The nurse has successfully completed, within a practical	15645
nurse prelicensure education program approved by the board or by	15646
another jurisdiction's agency that regulates the practice of	15647
nursing, a course of study that prepares the nurse to safely	15648
perform the intravenous therapy procedures the board may authorize	15649
under this section. To meet this requirement, the course of study	15650
must include all of the following:	15651

(a) Both didactic and clinical components;

15652

(b) Curriculum requirements established in rules the board of	15653
nursing shall adopt in accordance with Chapter 119. of the Revised	15654
Code;	15655

(c) Standards that require the nurse to perform a successful	15656
demonstration of the intravenous procedures, including all skills	15657
needed to perform them safely.	15658

(2) The nurse has successfully completed a minimum of forty	15659
hours of training that includes all of the following:	15660

(a) The curriculum established by rules adopted by the board	15661
and in effect on January 1, 1999;	15662

(b) Training in the anatomy and physiology of the	15663
cardiovascular system, signs and symptoms of local and systemic	15664
complications in the administration of fluids and antibiotic	15665
additives, and guidelines for management of these complications;	15666

(c) Any other training or instruction the board considers	15667
appropriate.	15668

(d) A testing component that requires the nurse to perform a	15669
successful demonstration of the intravenous procedures, including	15670
all skills needed to perform them safely.	15671

(B) Except as provided in section 4723.171 of the Revised	15672
Code, a licensed practical nurse may perform intravenous therapy	15673
only if authorized by the board pursuant to division (A) of this	15674
section and only if it is performed in accordance with this	15675
section.	15676

A licensed practical nurse authorized by the board to perform	15677
intravenous therapy may perform an intravenous therapy procedure	15678
only at the direction of one of the following:	15679

(1) A licensed physician, dentist, optometrist, or podiatrist	15680
who, except as provided in division (C)(2) of this section, is	15681
present and readily available at the facility where the	15682
intravenous therapy procedure is performed;	15683

(2) A registered nurse in accordance with division (C) of	15684
this section.	15685

(C)(1) Except as provided in division (C)(2) of this section	15686
and section 4723.171 of the Revised Code, when a licensed	15687
practical nurse authorized by the board to perform intravenous	15688
therapy performs an intravenous therapy procedure at the direction	15689
of a registered nurse, the registered nurse or another registered	15690
nurse shall be readily available at the site where the intravenous	15691
therapy is performed, and before the licensed practical nurse	15692
initiates the intravenous therapy, the registered nurse shall	15693
personally perform an on-site assessment of the individual who is	15694
to receive the intravenous therapy.	15695

(2) When a licensed practical nurse authorized by the board	15696
to perform intravenous therapy performs an intravenous therapy	15697
procedure in a home as defined in section 3721.10 of the Revised	15698
Code, or in an intermediate care facility for the mentally	15699
retarded as defined in section ~~5111.20~~5164.01 of the Revised	15700
Code, at the direction of a registered nurse or licensed	15701
physician, dentist, optometrist, or podiatrist, a registered nurse	15702
shall be on the premises of the home or facility or accessible by	15703
some form of telecommunication.	15704

(D) No licensed practical nurse shall perform any of the	15705
following intravenous therapy procedures:	15706

(1) Initiating or maintaining any of the following:

15707

(a) Blood or blood components;

15708

(b) Solutions for total parenteral nutrition;

15709

(c) Any cancer therapeutic medication including, but not	15710
limited to, cancer chemotherapy or an anti-neoplastic agent;	15711

(d) Solutions administered through any central venous line or	15712
arterial line or any other line that does not terminate in a	15713
peripheral vein, except that a licensed practical nurse authorized	15714
by the board to perform intravenous therapy may maintain the	15715
solutions specified in division (D)(6)(a) of this section that are	15716
being administered through a central venous line or peripherally	15717
inserted central catheter;	15718

(e) Any investigational or experimental medication.

15719

(2) Initiating intravenous therapy in any vein, except that a	15720
licensed practical nurse authorized by the board to perform	15721
intravenous therapy may initiate intravenous therapy in accordance	15722
with this section in a vein of the hand, forearm, or antecubital	15723
fossa;	15724

(3) Discontinuing a central venous, arterial, or any other	15725
line that does not terminate in a peripheral vein;	15726

(4) Initiating or discontinuing a peripherally inserted	15727
central catheter;	15728

(5) Mixing, preparing, or reconstituting any medication for	15729
intravenous therapy, except that a licensed practical nurse	15730
authorized by the board to perform intravenous therapy may prepare	15731
or reconstitute an antibiotic additive;	15732

(6) Administering medication via the intravenous route,	15733
including all of the following activities:	15734

(a) Adding medication to an intravenous solution or to an	15735
existing infusion, except that a licensed practical nurse	15736
authorized by the board to perform intravenous therapy may do	15737
either of the following:	15738

(i) Initiate an intravenous infusion containing one or more	15739
of the following elements: dextrose 5%; normal saline; lactated	15740
ringers; sodium chloride .45%; sodium chloride 0.2%; sterile	15741
water.	15742

(ii) Hang subsequent containers of the intravenous solutions	15743
specified in division (D)(6)(a) of this section that contain	15744
vitamins or electrolytes, if a registered nurse initiated the	15745
infusion of that same intravenous solution.	15746

(b) Initiating or maintaining an intravenous piggyback	15747
infusion, except that a licensed practical nurse authorized by the	15748
board to perform intravenous therapy may initiate or maintain an	15749
intravenous piggyback infusion containing an antibiotic additive;	15750

(c) Injecting medication via a direct intravenous route,	15751
except that a licensed practical nurse authorized by the board to	15752
perform intravenous therapy may inject heparin or normal saline to	15753
flush an intermittent infusion device or heparin lock including,	15754
but not limited to, bolus or push.	15755

(7) Aspirating any intravenous line to maintain patency;

15756

(8) Changing tubing on any line including, but not limited	15757
to, an arterial line or a central venous line, except that a	15758
licensed practical nurse authorized by the board to perform	15759
intravenous therapy may change tubing on an intravenous line that	15760
terminates in a peripheral vein;	15761

(9) Programming or setting any function of a patient	15762
controlled infusion pump.	15763

(E) Notwithstanding division (D) of this section, at the	15764
direction of a physician or a registered nurse, a licensed	15765
practical nurse authorized by the board to perform intravenous	15766
therapy may perform the following activities for the purpose of	15767
performing dialysis:	15768

(1) The routine administration and regulation of saline	15769
solution for the purpose of maintaining an established fluid plan;	15770

(2) The administration of a heparin dose intravenously;

15771

(3) The administration of a heparin dose peripherally via a	15772
fistula needle;	15773

(4) The loading and activation of a constant infusion pump or	15774
the intermittent injection of a dose of medication prescribed by a	15775
licensed physician for dialysis.	15776

(F) No person shall employ or direct a licensed practical	15777
nurse to perform an intravenous therapy procedure without first	15778
verifying that the licensed practical nurse is authorized by the	15779
board to perform intravenous therapy.	15780

(G) The board shall issue an intravenous therapy card to the	15781
licensed practical nurses authorized pursuant to division (A) of	15782
this section to perform intravenous therapy. A fee for issuing the	15783
card shall not be charged under section 4723.08 of the Revised	15784
Code if the licensed practical nurse receives the card by meeting	15785
the requirements of division (A)(1) of this section. The board	15786
shall maintain a registry of the names of licensed practical	15787
nurses who hold intravenous therapy cards.	15788

Sec. 4723.63. (A) In consultation with the medication aide	15789
advisory council established under section 4723.62 of the Revised	15790
Code, the board of nursing shall conduct a pilot program for the	15791
use of medication aides in nursing homes and residential care	15792
facilities. The board shall conduct the pilot program in a manner	15793
consistent with human protection and other ethical concerns	15794
typically associated with research studies involving live	15795
subjects. The pilot program shall be commenced not later than May	15796
1, 2006, and shall end on the thirty-first day after the report	15797
required by division (F)(2) of this section is submitted in	15798
accordance with that division.	15799

During the period the pilot program is conducted, a nursing	15800
home or residential care facility participating in the pilot	15801
program may use one or more medication aides to administer	15802
prescription medications to its residents, subject to all of the	15803
following conditions:	15804

(1) Each individual used as a medication aide must hold a	15805
current, valid medication aide certificate issued by the board of	15806
nursing under this chapter.	15807

(2) The nursing home or residential care facility shall	15808
ensure that the requirements of section 4723.67 of the Revised	15809
Code are met.	15810

(3) The nursing home or residential care facility shall	15811
submit to the board, not later than the thirty-first day after the	15812
day the board makes its request under division (F)(1)(a) of this	15813
section, the data required by division (F)(1)(a) of this section.	15814

(B) The board, in consultation with the medication aide	15815
advisory council, shall do all of the following not later than	15816
February 1, 2006:	15817

(1) Design the pilot program;

15818

(2) Establish standards to govern medication aides and the	15819
nursing homes and residential care facilities participating in the	15820
pilot program, including standards for the training of medication	15821
aides and the staff of participating nursing homes and residential	15822
care facilities;	15823

(3) Establish standards to protect the health and safety of	15824
the residents of the nursing homes and residential care facilities	15825
participating in the program;	15826

(4) Implement a process for selecting the nursing homes and	15827
residential care facilities to participate in the program.	15828

(C)(1) A nursing home or residential care facility may	15829
volunteer to participate in the pilot program by submitting an	15830
application to the board on a form prescribed and provided by the	15831
board. From among the applicants, the board shall select eighty	15832
nursing homes and forty residential care facilities to participate	15833
in the pilot program. When the board denies an application, it	15834
shall notify, in writing, the president and minority leader of the	15835
senate and the speaker and minority leader of the house of	15836
representatives of the denial and the reasons for the denial.	15837

(2) To be eligible to participate, a nursing home or	15838
residential care facility shall agree to observe the standards	15839
established by the board for the use of medication aides. A	15840
nursing home is eligible to participate only if the department of	15841
health has found in the most recent survey or inspection of the	15842
home that the home is free from deficiencies related to the	15843
administration of medication. A residential care facility is	15844
eligible to participate only if the department has found that the	15845
facility is free from deficiencies related to the provision of	15846
skilled nursing care or the administration of medication.	15847

(D) As a condition of participation in the pilot program, a	15848
nursing home and residential care facility selected by the board	15849
shall pay the participation fee established in rules adopted under	15850
section 4723.69 of the Revised Code. The participation fee is not	15851
reimbursable under the medicaid program ~~established under Chapter~~	15852
~~5111. of the Revised Code~~.	15853

(E) On receipt of evidence found credible by the board that	15854
continued participation by a nursing home or residential care	15855
facility poses an imminent danger, risk of serious harm, or	15856
jeopardy to a resident of the home or facility, the board may	15857
terminate the authority of the home or facility to participate in	15858
the pilot program.	15859

(F)(1) With the assistance of the medication aide advisory	15860
council, the board shall conduct an evaluation of the pilot	15861
program. In conducting the evaluation, the board shall do all of	15862
the following:	15863

(a) Request from each nursing home and residential care	15864
facility participating in the pilot program, on the ninety-first	15865
day after the day the board issues a medication aide certificate	15866
under section 4723.651 of the Revised Code to the seventy-fifth	15867
individual, the data the board requires participating nursing	15868
homes and residential care facilities to report under rules the	15869
board adopts under section 4723.69 of the Revised Code.	15870

(b) Assess whether medication aides are able to administer	15871
prescription medications safely to nursing home and residential	15872
care facility residents;	15873

(c) Determine the financial implications of using medication	15874
aides in nursing homes and residential care facilities;	15875

(d) Consider any other issue the board or council considers	15876
relevant to the evaluation.	15877

(2) Not later than the one hundred eighty-first day after	15878
the day the board issues a medication aide certificate under	15879
section 4723.651 of the Revised Code to the seventy-fifth	15880
individual, the board shall prepare a report of its findings and	15881
recommendations derived from the evaluation of the pilot program.	15882
The board shall submit the report to the governor, president and	15883
minority leader of the senate, speaker and minority leader of the	15884
house of representatives, and director of health.	15885

(G) The board shall, on the day it issues a medication aide	15886
certificate to the seventy-fifth individual, post a notice on its	15887
web site indicating the date on which any nursing home or	15888
residential care facility may use medication aides in accordance	15889
with section 4723.64 of the Revised Code.	15890

Sec. 4731.151. (A) Naprapaths who received a certificate to	15891
practice from the board prior to March 2, 1992, may continue to	15892
practice naprapathy, as defined in rules adopted by the board.	15893
Such naprapaths shall practice in accordance with rules adopted by	15894
the board.	15895

(B)(1) As used in this division:

15896

(a) "Mechanotherapy" means all of the following:

15897

(i) Examining patients by verbal inquiry;

15898

(ii) Examination of the musculoskeletal system by hand;

15899

(iii) Visual inspection and observation;

15900

(iv) Diagnosing a patient's condition only as to whether the	15901
patient has a disorder of the musculoskeletal system;	15902

(v) In the treatment of patients, employing the techniques of	15903
advised or supervised exercise; electrical neuromuscular	15904
stimulation; massage or manipulation; or air, water, heat, cold,	15905
sound, or infrared ray therapy only to those disorders of the	15906
musculoskeletal system that are amenable to treatment by such	15907
techniques and that are identifiable by examination performed in	15908
accordance with division (B)(1)(a)(i) of this section and	15909
diagnosable in accordance with division (B)(1)(a)(ii) of this	15910
section.	15911

(b) "Educational requirements" means the completion of a	15912
course of study appropriate for certification to practice	15913
mechanotherapy on or before November 3, 1985, as determined by	15914
rules adopted under this chapter.	15915

(2) Mechanotherapists who received a certificate to practice	15916
from the board prior to March 2, 1992, may continue to practice	15917
mechanotherapy, as defined in rules adopted by the board. Such	15918
mechanotherapists shall practice in accordance with rules adopted	15919
by the board.	15920

A person authorized by this division to practice as a	15921
mechanotherapist may examine, diagnose, and assume responsibility	15922
for the care of patients with due regard for first aid and the	15923
hygienic and nutritional care of the patients. Roentgen rays shall	15924
be used by a mechanotherapist only for diagnostic purposes.	15925

(3) A person who holds a certificate to practice	15926
mechanotherapy and completed educational requirements in	15927
mechanotherapy on or before November 3, 1985, is entitled to use	15928
the title "doctor of mechanotherapy" and is a "physician" who	15929
performs "medical services" for the purposes of Chapters 4121. and	15930
4123. of the Revised Code and the medicaid program ~~established~~	15931
~~under section 5111.01 of the Revised Code~~, and shall receive	15932
payment or reimbursement as provided under those chapters and that	15933
~~section~~program.	15934

Sec. 4731.65. As used in sections 4731.65 to 4731.71 of the	15935
Revised Code:	15936

(A)(1) "Clinical laboratory services" means either of the	15937
following:	15938

(a) Any examination of materials derived from the human body	15939
for the purpose of providing information for the diagnosis,	15940
prevention, or treatment of any disease or impairment or for the	15941
assessment of health;	15942

(b) Procedures to determine, measure, or otherwise describe	15943
the presence or absence of various substances or organisms in the	15944
body.	15945

(2) "Clinical laboratory services" does not include the mere	15946
collection or preparation of specimens.	15947

(B) "Designated health services" means any of the following:

15948

(1) Clinical laboratory services;

15949

(2) Home health care services;

15950

(3) Outpatient prescription drugs.

15951

(C) "Fair market value" means the value in arms-length	15952
transactions, consistent with general market value and:	15953

(1) With respect to rentals or leases, the value of rental	15954
property for general commercial purposes, not taking into account	15955
its intended use;	15956

(2) With respect to a lease of space, not adjusted to reflect	15957
the additional value the prospective lessee or lessor would	15958
attribute to the proximity or convenience to the lessor if the	15959
lessor is a potential source of referrals to the lessee.	15960

(D) "Governmental health care program" means any program	15961
providing health care benefits that is administered by the federal	15962
government, this state, or a political subdivision of this state,	15963
including the medicare program ~~established under Title XVIII of~~	15964
~~the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301,~~	15965
~~as amended~~, health care coverage for public employees, health care	15966
benefits administered by the bureau of workers' compensation, the	15967
medicaid program ~~established under Chapter 5111. of the Revised~~	15968
~~Code~~, the disability medical assistance program ~~established~~	15969
~~under Chapter 5115. of the Revised Code~~, and the children's	15970
buy-in program ~~established under sections 5101.5211 to 5101.5216~~	15971
~~of the Revised Code~~.	15972

(E)(1) "Group practice" means a group of two or more holders	15973
of certificates under this chapter legally organized as a	15974
partnership, professional corporation or association, limited	15975
liability company, foundation, nonprofit corporation, faculty	15976
practice plan, or similar group practice entity, including an	15977
organization comprised of a nonprofit medical clinic that	15978
contracts with a professional corporation or association of	15979
physicians to provide medical services exclusively to patients of	15980
the clinic in order to comply with section 1701.03 of the Revised	15981
Code and including a corporation, limited liability company,	15982
partnership, or professional association described in division (B)	15983
of section 4731.226 of the Revised Code formed for the purpose of	15984
providing a combination of the professional services of	15985
optometrists who are licensed, certificated, or otherwise legally	15986
authorized to practice optometry under Chapter 4725. of the	15987
Revised Code, chiropractors who are licensed, certificated, or	15988
otherwise legally authorized to practice chiropractic or	15989
acupuncture under Chapter 4734. of the Revised Code, psychologists	15990
who are licensed, certificated, or otherwise legally authorized to	15991
practice psychology under Chapter 4732. of the Revised Code,	15992
registered or licensed practical nurses who are licensed,	15993
certificated, or otherwise legally authorized to practice nursing	15994
under Chapter 4723. of the Revised Code, pharmacists who are	15995
licensed, certificated, or otherwise legally authorized to	15996
practice pharmacy under Chapter 4729. of the Revised Code,	15997
physical therapists who are licensed, certificated, or otherwise	15998
legally authorized to practice physical therapy under sections	15999
4755.40 to 4755.56 of the Revised Code, occupational therapists	16000
who are licensed, certificated, or otherwise legally authorized to	16001
practice occupational therapy under sections 4755.04 to 4755.13 of	16002
the Revised Code, mechanotherapists who are licensed,	16003
certificated, or otherwise legally authorized to practice	16004
mechanotherapy under section 4731.151 of the Revised Code, and	16005
doctors of medicine and surgery, osteopathic medicine and surgery,	16006
or podiatric medicine and surgery who are licensed, certificated,	16007
or otherwise legally authorized for their respective practices	16008
under this chapter, to which all of the following apply:	16009

(a) Each physician who is a member of the group practice	16010
provides substantially the full range of services that the	16011
physician routinely provides, including medical care,	16012
consultation, diagnosis, or treatment, through the joint use of	16013
shared office space, facilities, equipment, and personnel.	16014

(b) Substantially all of the services of the members of the	16015
group are provided through the group and are billed in the name of	16016
the group and amounts so received are treated as receipts of the	16017
group.	16018

(c) The overhead expenses of and the income from the practice	16019
are distributed in accordance with methods previously determined	16020
by members of the group.	16021

(d) The group practice meets any other requirements that the	16022
state medical board applies in rules adopted under section 4731.70	16023
of the Revised Code.	16024

(2) In the case of a faculty practice plan associated with a	16025
hospital with a medical residency training program in which	16026
physician members may provide a variety of specialty services and	16027
provide professional services both within and outside the group,	16028
as well as perform other tasks such as research, the criteria in	16029
division (E)(1) of this section apply only with respect to	16030
services rendered within the faculty practice plan.	16031

(F) "Home health care services" and "immediate family" have	16032
the same meanings as in the rules adopted under section 4731.70 of	16033
the Revised Code.	16034

(G) "Hospital" has the same meaning as in section 3727.01 of	16035
the Revised Code.	16036

(H) A "referral" includes both of the following:

16037

(1) A request by a holder of a certificate under this chapter	16038
for an item or service, including a request for a consultation	16039
with another physician and any test or procedure ordered by or to	16040
be performed by or under the supervision of the other physician;	16041

(2) A request for or establishment of a plan of care by a	16042
certificate holder that includes the provision of designated	16043
health services.	16044

(I) "Third-party payer" has the same meaning as in section	16045
3901.38 of the Revised Code.	16046

Sec. 4731.71. The auditor of state may implement procedures	16047
to detect violations of section 4731.66 or 4731.69 of the Revised	16048
Code within governmental health care programs administered by the	16049
state. The auditor of state shall report any violation of either	16050
section to the state medical board and shall certify to the	16051
attorney general in accordance with section 131.02 of the Revised	16052
Code the amount of any refund owed to a state-administered	16053
governmental health care program under section 4731.69 of the	16054
Revised Code as a result of a violation. If a refund is owed to	16055
the medicaid program ~~established under Chapter 5111. of the~~	16056
~~Revised Code~~, the disability medical assistance program	16057
~~established under Chapter 5115. of the Revised Code~~, or the	16058
children's buy-in program ~~established under sections 5101.5211 to~~	16059
~~5101.5216 of the Revised Code~~, the auditor of state also shall	16060
report the amount to the department of ~~job and family services~~	16061
health care administration.	16062

The state medical board also may implement procedures to	16063
detect violations of section 4731.66 or 4731.69 of the Revised	16064
Code.	16065

Sec. 4752.02. (A) Except as provided in division (B) of this	16066
section, no person shall provide home medical equipment services	16067
or claim to the public to be a home medical equipment services	16068
provider unless either of the following is the case:	16069

(1) The person holds a valid license issued under this	16070
chapter;	16071

(2) The person holds a valid certificate of registration	16072
issued under this chapter.	16073

(B) Division (A) of this section does not apply to any of the	16074
following:	16075

(1) A health care practitioner, as defined in section 4769.01	16076
of the Revised Code, who does not sell or rent home medical	16077
equipment;	16078

(2) A hospital that provides home medical equipment services	16079
only as an integral part of patient care and does not provide the	16080
services through a separate entity that has its own medicare or	16081
medicaid provider number;	16082

(3) A manufacturer or wholesale distributor of home medical	16083
equipment that does not sell directly to the public;	16084

(4) A hospice care program, as defined by section 3712.01 of	16085
the Revised Code, that does not sell or rent home medical	16086
equipment;	16087

(5) A home, as defined by section 3721.01 of the Revised	16088
Code;	16089

(6) A home health agency that is certified under ~~Title XVIII~~	16090
of the ~~"Social Security Act," 79 Stat. 286 (1965), 42 U.S.C. 1395,~~	16091
medicare program as a provider of home health services and does	16092
not sell or rent home medical equipment;	16093

(7) An individual who holds a current, valid license issued	16094
under Chapter 4741. of the Revised Code to practice veterinary	16095
medicine;	16096

(8) An individual who holds a current, valid license issued	16097
under Chapter 4779. of the Revised Code to practice orthotics,	16098
prosthetics, or pedorthics;	16099

(9) A pharmacy licensed under Chapter 4729. of the Revised	16100
Code that either does not sell or rent home medical equipment or	16101
receives total payments of less than ten thousand dollars per year	16102
from selling or renting home medical equipment;	16103

(10) A home dialysis equipment provider regulated by federal	16104
law.	16105

Sec. 4752.09. (A) The Ohio respiratory care board may, in	16106
accordance with Chapter 119. of the Revised Code, suspend or	16107
revoke a license issued under this chapter or discipline a license	16108
holder by imposing a fine of not more than five thousand dollars	16109
or taking other disciplinary action on any of the following	16110
grounds:	16111

(1) Violation of any provision of this chapter or an order or	16112
rule of the board, as those provisions, orders, or rules are	16113
applicable to persons licensed under this chapter;	16114

(2) A plea of guilty to or a judicial finding of guilt of a	16115
felony or a misdemeanor that involves dishonesty or is directly	16116
related to the provision of home medical equipment services;	16117

(3) Making a material misstatement in furnishing information	16118
to the board;	16119

(4) Professional incompetence;

16120

(5) Being guilty of negligence or gross misconduct in	16121
providing home medical equipment services;	16122

(6) Aiding, assisting, or willfully permitting another person	16123
to violate any provision of this chapter or an order or rule of	16124
the board, as those provisions, orders, or rules are applicable to	16125
persons licensed under this chapter;	16126

(7) Failing, within sixty days, to provide information in	16127
response to a written request by the board;	16128

(8) Engaging in conduct likely to deceive, defraud, or harm	16129
the public;	16130

(9) Denial, revocation, suspension, or restriction of a	16131
license to provide home medical equipment services, for any reason	16132
other than failure to renew, in another state or jurisdiction;	16133

(10) Directly or indirectly giving to or receiving from any	16134
person a fee, commission, rebate, or other form of compensation	16135
for services not rendered;	16136

(11) Knowingly making or filing false records, reports, or	16137
billings in the course of providing home medical equipment	16138
services, including false records, reports, or billings prepared	16139
for or submitted to state and federal agencies or departments;	16140

(12) Failing to comply with federal rules issued pursuant to	16141
the medicare program ~~established under Title XVIII of the "Social~~	16142
~~Security Act," 49 Stat. 620(1935), 42 U.S.C. 1395, as amended~~,	16143
relating to operations, financial transactions, and general	16144
business practices of home medical services providers.	16145

(B) The respiratory care board immediately may suspend a	16146
license without a hearing if it determines that there is evidence	16147
that the license holder is subject to actions under this section	16148
and that there is clear and convincing evidence that continued	16149
operation by the license holder presents an immediate and serious	16150
harm to the public. The president and executive director of the	16151
board shall make a preliminary determination and describe, by	16152
telephone conference or any other method of communication, the	16153
evidence on which they made their determination to the other	16154
members of the board. The board may by resolution designate	16155
another board member to act in place of the president of the board	16156
or another employee to act in the place of the executive director,	16157
in the event that the board president or executive director is	16158
unavailable or unable to act. On review of the evidence, the board	16159
may by a vote of not less than seven of its members, suspend a	16160
license without a prior hearing. The board may vote on the	16161
suspension by way of a telephone conference call.	16162

Immediately following the decision to suspend a license under	16163
this division, the board shall issue a written order of suspension	16164
and cause it to be delivered in accordance with section 119.07 of	16165
the Revised Code. The order shall not be subject to suspension by	16166
the court during the pendency of any appeal filed under section	16167
119.12 of the Revised Code. If the license holder requests an	16168
adjudication hearing, the date set for the hearing shall be within	16169
fifteen days but not earlier than seven days after the license	16170
holder requests the hearing, unless another date is agreed to by	16171
the license holder and the board. The suspension shall remain in	16172
effect, unless reversed by the board, until a final adjudication	16173
order issued by the board pursuant to this section and Chapter	16174
119. of the Revised Code becomes effective. The board shall issue	16175
its final adjudication order not later than ninety days after	16176
completion of the hearing. The board's failure to issue the order	16177
by that day shall cause the summary suspension to end, but shall	16178
not affect the validity of any subsequent final adjudication	16179
order.	16180

Sec. 4753.071. A person who is required to meet the	16181
supervised professional experience requirement of division (F) of	16182
section 4753.06 of the Revised Code shall submit to the board of	16183
speech-language pathology and audiology an application for a	16184
conditional license. The application shall include a plan for the	16185
content of the supervised professional experience on a form the	16186
board shall prescribe. The board shall issue the conditional	16187
license to the applicant if the applicant meets the requirements	16188
of section 4753.06 of the Revised Code, other than the requirement	16189
to have obtained the supervised professional experience, and pays	16190
to the board the appropriate fee for a conditional license. An	16191
applicant may not begin employment until the conditional license	16192
has been issued.	16193

A conditional license authorizes an individual to practice	16194
speech-language pathology or audiology while completing the	16195
supervised professional experience as required by division (F) of	16196
section 4753.06 of the Revised Code. A person holding a	16197
conditional license may practice speech-language pathology or	16198
audiology while working under the supervision of a person fully	16199
licensed in accordance with this chapter. A conditional license is	16200
valid for eighteen months unless suspended or revoked pursuant to	16201
section 3123.47 or 4753.10 of the Revised Code.	16202

A person holding a conditional license may perform services	16203
for which reimbursement will be sought under the medicare program	16204
~~established under Title XVIII of the "Social Security Act," 79~~	16205
~~Stat. 286 (1965), 42 U.S.C. 1395, as amended~~, or the medicaid	16206
program ~~established under Chapter 5111. of the Revised Code~~ but	16207
all requests for reimbursement for such services shall be made by	16208
the person who supervises the person performing the services.	16209

Sec. 4755.481. (A) If a physical therapist evaluates and	16210
treats a patient without the prescription of, or the referral of	16211
the patient by, a person who is licensed to practice medicine and	16212
surgery, chiropractic, dentistry, osteopathic medicine and	16213
surgery, podiatric medicine and surgery, or nursing as a certified	16214
registered nurse anesthetist, clinical nurse specialist, certified	16215
nurse-midwife, or certified nurse practitioner, all of the	16216
following apply:	16217

(1) The physical therapist shall, upon consent of the	16218
patient, inform the patient's physician, chiropractor, dentist,	16219
podiatrist, certified registered nurse anesthetist, clinical nurse	16220
specialist, certified nurse-midwife, or certified nurse	16221
practitioner of the evaluation not later than five business days	16222
after the evaluation is made.	16223

(2) If the physical therapist determines, based on reasonable	16224
evidence, that no substantial progress has been made with respect	16225
to that patient during the thirty-day period immediately following	16226
the date of the patient's initial visit with the physical	16227
therapist, the physical therapist shall consult with or refer the	16228
patient to a licensed physician, chiropractor, dentist,	16229
podiatrist, certified registered nurse anesthetist, clinical nurse	16230
specialist, certified nurse-midwife, or certified nurse	16231
practitioner, unless either of the following applies:	16232

(a) The evaluation, treatment, or services are being provided	16233
for fitness, wellness, or prevention purposes.	16234

(b) The patient previously was diagnosed with chronic,	16235
neuromuscular, or developmental conditions and the evaluation,	16236
treatment, or services are being provided for problems or symptoms	16237
associated with one or more of those previously diagnosed	16238
conditions.	16239

(3) If the physical therapist determines that orthotic	16240
devices are necessary to treat the patient, the physical therapist	16241
shall be limited to the application of the following orthotic	16242
devices:	16243

(a) Upper extremity adaptive equipment used to facilitate the	16244
activities of daily living;	16245

(b) Finger splints;

16246

16247

(d) Prefabricated elastic or fabric abdominal supports with	16248
or without metal or plastic reinforcing stays and other	16249
prefabricated soft goods requiring minimal fitting;	16250

(e) Nontherapeutic accommodative inlays;

16251

(f) Shoes that are not manufactured or modified for a	16252
particular individual;	16253

(g) Prefabricated foot care products;

16254

(h) Custom foot orthotics;

16255

(i) Durable medical equipment.

16256

(4) If, at any time, the physical therapist has reason to	16257
believe that the patient has symptoms or conditions that require	16258
treatment or services beyond the scope of practice of a physical	16259
therapist, the physical therapist shall refer the patient to a	16260
licensed health care practitioner acting within the practitioner's	16261
scope of practice.	16262

(B) Nothing in sections 4755.40 to 4755.56 of the Revised	16263
Code shall be construed to require reimbursement under any health	16264
insuring corporation policy, contract, or agreement, any sickness	16265
and accident insurance policy, the ~~medical assistance~~medicaid	16266
program ~~as defined in section 5111.01 of the Revised Code~~, or the	16267
health partnership program or qualified health plans established	16268
pursuant to sections 4121.44 to 4121.442 of the Revised Code, for	16269
any physical therapy service rendered without the prescription of,	16270
or the referral of the patient by, a licensed physician,	16271
chiropractor, dentist, podiatrist, certified registered nurse	16272
anesthetist, clinical nurse specialist, certified nurse-midwife,	16273
or certified nurse practitioner.	16274

(C) For purposes of this section, "business day" means any	16275
calendar day that is not a Saturday, Sunday, or legal holiday.	16276
"Legal holiday" has the same meaning as in section 1.14 of the	16277
Revised Code.	16278

Sec. 4758.02. (A) Effective two years after the date the	16279
department of alcohol and drug addiction services ceases to	16280
administer its certification and credentialing process under	16281
section 3793.07 of the Revised Code as specified in division	16282
~~(B)~~(A) of that section and except as provided in sections 4758.03	16283
and 4758.04 of the Revised Code, no person shall do any of the	16284
following:	16285

(1) Engage in or represent to the public that the person	16286
engages in chemical dependency counseling for a fee, salary, or	16287
other consideration unless the person holds a valid independent	16288
chemical dependency counselor license, chemical dependency	16289
counselor III license, chemical dependency counselor II license,	16290
chemical dependency counselor I certificate, or chemical	16291
dependency counselor assistant certificate issued under this	16292
chapter;	16293

(2) Use the title "licensed independent chemical dependency	16294
counselor," "LICDC," "licensed chemical dependency counselor III,"	16295
"LCDC III," "licensed chemical dependency counselor II," "LCDC	16296
II," "certified chemical dependency counselor I," "CCDC I,"	16297
"chemical dependency counselor assistant," "CDCA," or any other	16298
title or description incorporating the word "chemical dependency	16299
counselor" or any other initials used to identify persons acting	16300
in those capacities unless currently authorized under this chapter	16301
to act in the capacity indicated by the title or initials;	16302

(3) Represent to the public that the person is a registered	16303
applicant unless the person holds a valid registered applicant	16304
certificate issued under this chapter;	16305

(4) Use the title "certified prevention specialist II," "CPS	16306
II," "certified prevention specialist I," "CPS I," "registered	16307
applicant," or any other title, description, or initials used to	16308
identify persons acting in those capacities unless currently	16309
authorized under this chapter to act in the capacity indicated by	16310
the title or initials.	16311

(B) Effective six years after ~~the effective date of this~~	16312
~~section~~December 23, 2002, no person shall engage in or represent	16313
to the public that the person engages in chemical dependency	16314
counseling as a chemical dependency counselor I.	16315

Sec. 4758.04. After the date the department of alcohol and	16316
drug addiction services ceases to administer its certification and	16317
credentialing process under section 3793.07 of the Revised Code as	16318
specified in division ~~(B)~~(A) of that section, an individual who	16319
holds, on ~~the effective date of this section~~December 23, 2002, a	16320
valid certificate or credentials that are accepted under section	16321
3793.07 of the Revised Code as authority to practice as a chemical	16322
dependency counselor or alcohol and other drug prevention	16323
specialist may apply to the chemical dependency professionals	16324
board for the board to delay the expiration date of the	16325
individual's certificate or credentials. If the board determines	16326
that there is good cause for delaying the expiration date, the	16327
board may delay the expiration date until a date the board	16328
specifies. The date the board specifies shall not be later than	16329
the date that is three years after the effective date of the	16330
board's initial rules adopted under section 4758.20 of the Revised	16331
Code.	16332

An individual who has the expiration date of the individual's	16333
certificate or credentials delayed under this section may perform	16334
services within the scope, standards, and ethics of the	16335
certificate or credentials until the date of the delayed	16336
expiration date.	16337

Sec. 4761.01. As used in this chapter:

16338

(A) "Respiratory care" means rendering or offering to render	16339
to individuals, groups, organizations, or the public any service	16340
involving the evaluation of cardiopulmonary function, the	16341
treatment of cardiopulmonary impairment, the assessment of	16342
treatment effectiveness, and the care of patients with	16343
deficiencies and abnormalities associated with the cardiopulmonary	16344
system. The practice of respiratory care includes:	16345

(1) Obtaining, analyzing, testing, measuring, and monitoring	16346
blood and gas samples in the determination of cardiopulmonary	16347
parameters and related physiologic data, including flows,	16348
pressures, and volumes, and the use of equipment employed for this	16349
purpose;	16350

(2) Administering, monitoring, recording the results of, and	16351
instructing in the use of medical gases, aerosols, and	16352
bronchopulmonary hygiene techniques, including drainage,	16353
aspiration, and sampling, and applying, maintaining, and	16354
instructing in the use of artificial airways, ventilators, and	16355
other life support equipment employed in the treatment of	16356
cardiopulmonary impairment and provided in collaboration with	16357
other licensed health care professionals responsible for providing	16358
care;	16359

(3) Performing cardiopulmonary resuscitation and respiratory	16360
rehabilitation techniques;	16361

(4) Administering medications for the testing or treatment of	16362
cardiopulmonary impairment.	16363

(B) "Respiratory care professional" means a person who is	16364
licensed under this chapter to practice the full range of	16365
respiratory care services as defined in division (A) of this	16366
section.	16367

(C) "Physician" means an individual authorized under Chapter	16368
4731. of the Revised Code to practice medicine and surgery or	16369
osteopathic medicine and surgery.	16370

(D) "Registered nurse" means an individual licensed under	16371
Chapter 4723. of the Revised Code to engage in the practice of	16372
nursing as a registered nurse.	16373

(E) "Hospital" means a facility that meets the operating	16374
standards of section 3727.02 of the Revised Code.	16375

(F) "Nursing facility" has the same meaning as in section	16376
~~5111.20~~5164.01 of the Revised Code.	16377

Sec. 4761.03. The Ohio respiratory care board shall regulate	16378
the practice of respiratory care in this state and the persons to	16379
whom the board issues licenses and limited permits under this	16380
chapter and shall license and register home medical equipment	16381
services providers under Chapter 4752. of the Revised Code. Rules	16382
adopted under this chapter that deal with the provision of	16383
respiratory care in a hospital, other than rules regulating the	16384
issuance of licenses or limited permits, shall be consistent with	16385
the conditions for participation under medicare~~, Title XVIII of~~	16386
~~the "Social Security Act," 79 Stat. 286 (1965), 42 U.S.C.A. 1395,~~	16387
~~as amended,~~ and with the respiratory care accreditation standards	16388
of the joint commission on accreditation of healthcare	16389
organizations or the American osteopathic association.	16390

The board shall:

16391

(A) Adopt, and may rescind or amend, rules in accordance with	16392
Chapter 119. of the Revised Code to carry out the purposes of this	16393
chapter, including rules prescribing:	16394

(1) The form and manner for filing applications for licensure	16395
and renewal, limited permits, and limited permit extensions under	16396
sections 4761.05 and 4761.06 of the Revised Code;	16397

(2) The form, scoring, and scheduling of examinations and	16398
reexaminations for licensure and license renewal;	16399

(3) Standards for the approval of educational programs	16400
required to qualify for licensure and continuing education	16401
programs required for license renewal;	16402

(4) Continuing education courses and the number of hour	16403
requirements necessary for license renewal, in accordance with	16404
section 4761.06 of the Revised Code;	16405

(5) Procedures for the issuance and renewal of licenses and	16406
limited permits, including the duties that may be fulfilled by the	16407
board's executive director and other board employees;	16408

(6) Procedures for the denial, suspension, permanent	16409
revocation, refusal to renew, and reinstatement of licenses and	16410
limited permits, the conduct of hearings, and the imposition of	16411
fines for engaging in conduct that is grounds for such action and	16412
hearings under section 4761.09 of the Revised Code;	16413

(7) Standards of ethical conduct for the practice of	16414
respiratory care;	16415

(8) Conditions under which the license renewal fee and	16416
continuing education requirements may be waived at the request of	16417
a licensee who is not in active practice;	16418

(9) The respiratory care tasks that may be performed by an	16419
individual practicing as a polysomnographic technologist pursuant	16420
to division (B)(3) of section 4761.10 of the Revised Code;	16421

(10) Procedures for registering out-of-state respiratory care	16422
providers authorized to practice in this state under division	16423
(A)(4) of section 4761.11 of the Revised Code;	16424

(11) Requirements for criminal records checks of applicants	16425
under section 4776.03 of the Revised Code.	16426

(B) Determine the sufficiency of an applicant's	16427
qualifications for admission to the licensing examination or a	16428
reexamination, and for the issuance or renewal of a license or	16429
limited permit;	16430

(C) Determine the respiratory care educational programs that	16431
are acceptable for fulfilling the requirements of division (A) of	16432
section 4761.04 of the Revised Code;	16433

(D) Schedule, administer, and score the licensing examination	16434
or any reexamination for license renewal or reinstatement. The	16435
board shall administer the licensing examinations at least twice a	16436
year and notify applicants of the time and place of the	16437
examinations.	16438

(E) Investigate complaints concerning alleged violations of	16439
section 4761.10 of the Revised Code or grounds for the suspension,	16440
permanent revocation, or refusal to issue licenses or limited	16441
permits under section 3123.47 or 4761.09 of the Revised Code. The	16442
board shall employ investigators who shall, under the direction of	16443
the executive director of the board, investigate complaints and	16444
make inspections and other inquiries as, in the judgment of the	16445
board, are appropriate to enforce sections 3123.41 to 3123.50,	16446
4761.09, and 4761.10 of the Revised Code. Pursuant to an	16447
investigation and inspection, the investigators may review and	16448
audit records during normal business hours at the place of	16449
business of a licensee or person who is the subject of a complaint	16450
filed with the board or at any place where the records are kept.	16451

Except when required by court order, the board and its	16452
employees shall not disclose confidential information obtained	16453
during an investigation or identifying information about any	16454
person who files a complaint with the board.	16455

The board may hear testimony in matters relating to the	16456
duties imposed upon it and issue subpoenas pursuant to an	16457
investigation. The president and secretary of the board may	16458
administer oaths.	16459

(F) Conduct hearings, keep records of its proceedings, and do	16460
other things as are necessary and proper to carry out and enforce	16461
the provisions of this chapter;	16462

(G) Maintain, publish, and make available upon request, for a	16463
fee not to exceed the actual cost of printing and mailing:	16464

(1) The requirements for the issuance of licenses and limited	16465
permits under this chapter and rules adopted by the board;	16466

(2) A current register of every person licensed to practice	16467
respiratory care in this state, to include the addresses of the	16468
person's last known place of business and residence, the effective	16469
date and identification number of the license, the name and	16470
location of the institution that granted the person's degree or	16471
certificate of completion of respiratory care educational	16472
requirements, and the date the degree or certificate was issued;	16473

(3) A list of the names and locations of the institutions	16474
that each year granted degrees or certificates of completion in	16475
respiratory care;	16476

(4) After the administration of each examination, a list of	16477
persons who passed the examination.	16478

(H) Submit to the governor and to the general assembly each	16479
year a report of all of its official actions during the preceding	16480
year, together with any findings and recommendations with regard	16481
to the improvement of the profession of respiratory care;	16482

(I) Administer and enforce Chapter 4752. of the Revised Code.

16483

Sec. 4769.01. As used in this chapter:

16484

(A) ~~"Medicare" means the program established by Title XVIII~~	16485
~~of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A.~~	16486
~~301, as amended.~~	16487

~~(B)~~ "Balance billing" means charging or collecting from a	16488
medicare beneficiary an amount in excess of the medicare	16489
reimbursement rate for medicare-covered services or supplies	16490
provided to a medicare beneficiary, except when medicare is the	16491
secondary insurer. When medicare is the secondary insurer, the	16492
health care practitioner may pursue full reimbursement under the	16493
terms and conditions of the primary coverage and, if applicable,	16494
the charge allowed under the terms and conditions of the	16495
appropriate provider contract, from the primary insurer, but the	16496
medicare beneficiary cannot be balance billed above the medicare	16497
reimbursement rate for a medicare-covered service or supply.	16498
"Balance billing" does not include charging or collecting	16499
deductibles or coinsurance required by the program.	16500

~~(C)~~(B) "Health care practitioner" means all of the following:

16501

(1) A dentist or dental hygienist licensed under Chapter	16502
4715. of the Revised Code;	16503

(2) A registered or licensed practical nurse licensed under	16504
Chapter 4723. of the Revised Code;	16505

(3) An optometrist licensed under Chapter 4725. of the	16506
Revised Code;	16507

(4) A dispensing optician, spectacle dispensing optician,	16508
contact lens dispensing optician, or spectacle-contact lens	16509
dispensing optician licensed under Chapter 4725. of the Revised	16510
Code;	16511

(5) A pharmacist licensed under Chapter 4729. of the Revised	16512
Code;	16513

(6) A physician authorized under Chapter 4731. of the Revised	16514
Code to practice medicine and surgery, osteopathic medicine and	16515
surgery, or podiatry;	16516

(7) A physician assistant authorized under Chapter 4730. of	16517
the Revised Code to practice as a physician assistant;	16518

(8) A practitioner of a limited branch of medicine issued a	16519
certificate under Chapter 4731. of the Revised Code;	16520

(9) A psychologist licensed under Chapter 4732. of the	16521
Revised Code;	16522

(10) A chiropractor licensed under Chapter 4734. of the	16523
Revised Code;	16524

(11) A hearing aid dealer or fitter licensed under Chapter	16525
4747. of the Revised Code;	16526

(12) A speech-language pathologist or audiologist licensed	16527
under Chapter 4753. of the Revised Code;	16528

(13) An occupational therapist or occupational therapy	16529
assistant licensed under Chapter 4755. of the Revised Code;	16530

(14) A physical therapist or physical therapy assistant	16531
licensed under Chapter 4755. of the Revised Code;	16532

(15) A professional clinical counselor, professional	16533
counselor, social worker, or independent social worker licensed,	16534
or a social work assistant registered, under Chapter 4757. of the	16535
Revised Code;	16536

(16) A dietitian licensed under Chapter 4759. of the Revised	16537
Code;	16538

(17) A respiratory care professional licensed under Chapter	16539
4761. of the Revised Code;	16540

(18) An emergency medical technician-basic, emergency medical	16541
technician-intermediate, or emergency medical technician-paramedic	16542
certified under Chapter 4765. of the Revised Code.	16543

Sec. 5101.07. There is hereby created in the state treasury	16544
the ODJFS support services federal operating fund. The fund shall	16545
consist of federal funds the department of job and family services	16546
receives and that the director of job and family services	16547
determines are appropriate for deposit into the fund. Money in the	16548
fund shall be used to pay the federal share of both of the	16549
following:	16550

(A) The department's costs for computer projects;

16551

(B) The operating costs of the parts of the department that	16552
provide general support services for the department's work units	16553
established under section 5101.06 of the Revised Code.	16554

Sec. 5101.071. There is hereby created in the state treasury	16555
the ODJFS support services state operating fund. The fund shall	16556
consist of payments made to the fund from other appropriation	16557
items by intrastate transfer voucher. Money in the fund shall be	16558
used to pay for both of the following:	16559

(A) The department of job and family services' costs for	16560
computer projects;	16561

(B) The operating costs of the parts of the department that	16562
provide general support services for the department's work units	16563
established under section 5101.06 of the Revised Code.	16564

Sec. 5101.11. ~~This section does not apply to contracts~~	16565
~~entered into under section 5111.90 or 5111.91 of the Revised Code.~~	16566

(A) As used in this section:

16567

(1) "Entity" includes an agency, board, commission, or	16568
department of the state or a political subdivision of the state; a	16569
private, nonprofit entity; a school district; a private school; or	16570
a public or private institution of higher education.	16571

(2) "Federal financial participation" means the federal	16572
government's share of expenditures made by an entity in	16573
implementing a program administered by the department of job and	16574
family services.	16575

(B) At the request of any public entity having authority to	16576
implement a program administered by the department of job and	16577
family services or any private entity under contract with a public	16578
entity to implement a program administered by the department, the	16579
department may seek to obtain federal financial participation for	16580
costs incurred by the entity. Federal financial participation may	16581
be sought from programs operated pursuant to Title IV-A,and Title	16582
IV-E~~, and Title XIX~~ of the "Social Security Act," 49 Stat. 620	16583
(1935), 42 U.S.C. 301, as amended; the "Food Stamp Act of 1964,"	16584
78 Stat. 703, 7 U.S.C. 2011, as amended; and any other statute or	16585
regulation under which federal financial participation may be	16586
available, except that federal financial participation may be	16587
sought only for expenditures made with funds for which federal	16588
financial participation is available under federal law.	16589

(C) All funds collected by the department of job and family	16590
services pursuant to division (B) of this section shall be	16591
distributed to the entities that incurred the costs, except for	16592
any amounts retained by the department pursuant to division (D)(3)	16593
of this section.	16594

(D) In distributing federal financial participation pursuant	16595
to this section, the department may either enter into an agreement	16596
with the entity that is to receive the funds or distribute the	16597
funds in accordance with rules adopted under division (F) of this	16598
section. If the department decides to enter into an agreement to	16599
distribute the funds, the agreement may include terms that do any	16600
of the following:	16601

(1) Provide for the whole or partial reimbursement of any	16602
cost incurred by the entity in implementing the program;	16603

(2) In the event that federal financial participation is	16604
disallowed or otherwise unavailable for any expenditure, require	16605
the department of job and family services or the entity, whichever	16606
party caused the disallowance or unavailability of federal	16607
financial participation, to assume responsibility for the	16608
expenditures;	16609

(3) Permit the department to retain not more than five per	16610
cent of the amount of the federal financial participation to be	16611
distributed to the entity;	16612

(4) Require the public entity to certify the availability of	16613
sufficient unencumbered funds to match the federal financial	16614
participation it receives under this section;	16615

(5) Establish the length of the agreement, which may be for a	16616
fixed or a continuing period of time;	16617

(6) Establish any other requirements determined by the	16618
department to be necessary for the efficient administration of the	16619
agreement.	16620

(E) An entity that receives federal financial participation	16621
pursuant to this section for a program aiding children and their	16622
families shall establish a process for collaborative planning with	16623
the department of job and family services for the use of the funds	16624
to improve and expand the program.	16625

(F) The director of job and family services shall adopt rules	16626
as necessary to implement this section, including rules for the	16627
distribution of federal financial participation pursuant to this	16628
section. The rules shall be adopted in accordance with Chapter	16629
119. of the Revised Code. The director may adopt or amend any	16630
statewide plan required by the federal government for a program	16631
administered by the department, as necessary to implement this	16632
section.	16633

(G) Federal financial participation received pursuant to this	16634
section shall not be included in any calculation made under	16635
section 5101.16 or 5101.161 of the Revised Code.	16636

Sec. 5101.16. (A) As used in this section and sections	16637
5101.161 and 5101.162 of the Revised Code:	16638

(1) "Disability financial assistance" means the financial	16639
assistance program established under Chapter 5115. of the Revised	16640
Code.	16641

(2) ~~"Disability medical assistance" means the medical~~	16642
~~assistance program established under Chapter 5115. of the Revised~~	16643
~~Code.~~	16644

~~(3)~~ "Food stamps" means the program administered by the	16645
department of job and family services pursuant to section 5101.54	16646
of the Revised Code.	16647

~~(4) "Medicaid" means the medical assistance program~~	16648
~~established by Chapter 5111. of the Revised Code, excluding~~	16649
~~transportation services provided under that chapter.~~	16650

~~(5)~~(3) "Ohio works first" means the program established by	16651
Chapter 5107. of the Revised Code.	16652

~~(6)~~(4) "Prevention, retention, and contingency" means the	16653
program established by Chapter 5108. of the Revised Code.	16654

~~(7)~~(5) "Public assistance expenditures" means expenditures	16655
for all of the following:	16656

(a) Ohio works first;

16657

(b) County administration of Ohio works first;

16658

16659

(d) County administration of prevention, retention, and	16660
contingency;	16661

(e) Disability financial assistance;

16662

(f) ~~Disability medical assistance;~~

16663

~~(g)~~ County administration of disability financial assistance;

16664

~~(h) County administration of disability medical assistance;~~

16665

~~(i)~~(g) County administration of food stamps;

16666

~~(j) County administration of medicaid~~.

16667

~~(8)~~(6) "Public medical assistance expenditures" has the same	16668
meaning as in section 5160.26 of the Revised Code.	16669

(7) "Title IV-A program" has the same meaning as in section	16670
5101.80 of the Revised Code.	16671

(B) Each board of county commissioners shall pay the county	16672
share of public assistance expenditures in accordance with section	16673
5101.161 of the Revised Code. Except as provided in division (C)	16674
of this section, a county's share of public assistance	16675
expenditures is the sum of all of the following for state fiscal	16676
year 1998 and each state fiscal year thereafter:	16677

(1) The amount that is twenty-five per cent of the county's	16678
total expenditures for disability financial assistance ~~and~~	16679
~~disability medical assistance~~ and county administration of ~~those~~	16680
~~programs~~disability financial assistance during the state fiscal	16681
year ending in the previous calendar year that the department of	16682
job and family services determines are allowable.	16683

(2) The amount that is ten per cent, or other percentage	16684
determined under division (D) of this section, of the county's	16685
total expenditures for county administration of food stamps ~~and~~	16686
~~medicaid~~ during the state fiscal year ending in the previous	16687
calendar year that the department determines are allowable, less	16688
the amount of federal reimbursement credited to the county under	16689
division (E) of this section for the state fiscal year ending in	16690
the previous calendar year;	16691

(3) A percentage of the actual amount of the county share of	16692
program and administrative expenditures during federal fiscal year	16693
1994 for assistance and services, other than child care, provided	16694
under ~~Titles~~former Title IV-A ~~and IV-F~~ of the "Social Security	16695
Act," 49 Stat. ~~620~~627 (1935), 42 U.S.C. ~~301~~601, and former Title	16696
IV-F of the "Social Security Act," 102 Stat. 2360 (1988), 42	16697
U.S.C. 681, as those titles existed prior to the enactment of the	16698
"Personal Responsibility and Work Opportunity Reconciliation Act	16699
of 1996," 110 Stat. 2105. The department of job and family	16700
services shall determine the actual amount of the county share	16701
from expenditure reports submitted to the United States department	16702
of health and human services. The percentage shall be the	16703
percentage established in rules adopted under division (F) of this	16704
section.	16705

(C)(1) If a county's share of public assistance expenditures	16706
determined under division (B) of this section and the county's	16707
share of public medical assistance expenditures determined under	16708
division (B) of section 5160.26 of the Revised Code for a state	16709
fiscal year exceeds one hundred ten per cent of the county's share	16710
for those expenditures for the immediately preceding state fiscal	16711
year, the department of job and family services shall reduce the	16712
county's share for expenditures under divisions (B)(1) and (2) of	16713
this section so that the total of the county's share for public	16714
assistance expenditures ~~under division (B) of this section~~and	16715
public medical assistance expenditures equals one hundred ten per	16716
cent of the county's share of those expenditures for the	16717
immediately preceding state fiscal year. The department of job and	16718
family services shall cooperate with the department of health care	16719
administration for the purpose of making reductions under division	16720
(C)(1) of this section.	16721

(2) A county's share of public assistance expenditures	16722
determined under division (B) of this section may be increased	16723
pursuant to section 5101.163 of the Revised Code and a sanction	16724
under section 5101.24 of the Revised Code. An increase made	16725
pursuant to section 5101.163 of the Revised Code may cause the	16726
county's share to exceed the limit established by division (C)(1)	16727
of this section.	16728

(D)(1) If the per capita tax duplicate of a county is less	16729
than the per capita tax duplicate of the state as a whole and	16730
division (D)(2) of this section does not apply to the county, the	16731
percentage to be used for the purpose of division (B)(2) of this	16732
section is the product of ten multiplied by a fraction of which	16733
the numerator is the per capita tax duplicate of the county and	16734
the denominator is the per capita tax duplicate of the state as a	16735
whole. The department of job and family services shall compute the	16736
per capita tax duplicate for the state and for each county by	16737
dividing the tax duplicate for the most recent available year by	16738
the current estimate of population prepared by the department of	16739
development.	16740

(2) If the percentage of families in a county with an annual	16741
income of less than three thousand dollars is greater than the	16742
percentage of such families in the state and division (D)(1) of	16743
this section does not apply to the county, the percentage to be	16744
used for the purpose of division (B)(2) of this section is the	16745
product of ten multiplied by a fraction of which the numerator is	16746
the percentage of families in the state with an annual income of	16747
less than three thousand dollars a year and the denominator is the	16748
percentage of such families in the county. The department of job	16749
and family services shall compute the percentage of families with	16750
an annual income of less than three thousand dollars for the state	16751
and for each county by multiplying the most recent estimate of	16752
such families published by the department of development, by a	16753
fraction, the numerator of which is the estimate of average annual	16754
personal income published by the bureau of economic analysis of	16755
the United States department of commerce for the year on which the	16756
census estimate is based and the denominator of which is the most	16757
recent such estimate published by the bureau.	16758

(3) If the per capita tax duplicate of a county is less than	16759
the per capita tax duplicate of the state as a whole and the	16760
percentage of families in the county with an annual income of less	16761
than three thousand dollars is greater than the percentage of such	16762
families in the state, the percentage to be used for the purpose	16763
of division (B)(2) of this section shall be determined as follows:	16764

(a) Multiply ten by the fraction determined under division	16765
(D)(1) of this section;	16766

(b) Multiply the product determined under division (D)(3)(a)	16767
of this section by the fraction determined under division (D)(2)	16768
of this section.	16769

(4) The department of job and family services shall	16770
determine, for each county, the percentage to be used for the	16771
purpose of division (B)(2) of this section not later than the	16772
first day of July of the year preceding the state fiscal year for	16773
which the percentage is used.	16774

(E) The department of job and family services shall credit to	16775
a county the amount of federal reimbursement the department	16776
receives from the United States ~~departments~~department of	16777
agriculture ~~and health and human services~~ for the county's	16778
expenditures for administration of food stamps ~~and medicaid~~ that	16779
the department determines are allowable administrative	16780
expenditures.	16781

(F)(1) The director of job and family services shall adopt	16782
rules in accordance with section 111.15 of the Revised Code to	16783
establish all of the following:	16784

(a) The method the department is to use to change a county's	16785
share of public assistance expenditures determined under division	16786
(B) of this section as provided in division (C) of this section;	16787

(b) The allocation methodology and formula the department	16788
will use to determine the amount of funds to credit to a county	16789
under this section;	16790

(c) The method the department will use to change the payment	16791
of the county share of public assistance expenditures from a	16792
calendar-year basis to a state fiscal year basis;	16793

(d) The percentage to be used for the purpose of division	16794
(B)(3) of this section, which shall, except as provided in section	16795
5101.163 of the Revised Code, meet both of the following	16796
requirements:	16797

(i) The percentage shall not be less than seventy-five per	16798
cent nor more than eighty-two per cent;	16799

(ii) The percentage shall not exceed the percentage that the	16800
state's qualified state expenditures is of the state's historic	16801
state expenditures as those terms are defined in 42 U.S.C.	16802
609(a)(7).	16803

(e) Other procedures and requirements necessary to implement	16804
this section.	16805

(2) The director of job and family services may amend the	16806
rule adopted under division (F)(1)(d) of this section to modify	16807
the percentage on determination that the amount the general	16808
assembly appropriates for Title IV-A programs makes the	16809
modification necessary. The rule shall be adopted and amended as	16810
if an internal management rule and in consultation with the	16811
director of budget and management.	16812

Sec. 5101.162. Subject to available federal funds and	16813
appropriations made by the general assembly, the department of job	16814
and family services may, at its sole discretion, use available	16815
federal funds to reimburse county expenditures for county	16816
administration of food stamps ~~or medicaid~~ even though the county	16817
expenditures meet or exceed the maximum allowable reimbursement	16818
amount established by rules adopted under section 5101.161 of the	16819
Revised Code. The director may adopt internal management rules in	16820
accordance with section 111.15 of the Revised Code to implement	16821
this section.	16822

Sec. 5101.18. ~~(A)~~ When the director of job and family	16823
services adopts rules under section 5107.05 regarding income	16824
requirements for the Ohio works first program and under section	16825
5115.03 of the Revised Code regarding income and resource	16826
requirements for the disability financial assistance program, the	16827
director shall determine what payments shall be regarded or	16828
disregarded. In making this determination, the director shall	16829
consider:	16830

~~(1)~~(A) The source of the payment;

16831

~~(2)~~(B) The amount of the payment;

16832

~~(3)~~(C) The purpose for which the payment was made;

16833

~~(4)~~(D) Whether regarding the payment as income would be in	16834
the public interest;	16835

~~(5)~~(E) Whether treating the payment as income would be	16836
detrimental to any of the programs administered in whole or in	16837
part by the department of job and family services or department of	16838
health care administration and whether such determination would	16839
jeopardize the receipt of any federal grant or payment by the	16840
state or any receipt of aid under Chapter 5107. of the Revised	16841
Code.	16842

~~(B) Any recipient of aid under Title XVI of the "Social~~	16843
~~Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, as amended,~~	16844
~~whose money payment is discontinued as the result of a general~~	16845
~~increase in old-age, survivors, and disability insurance benefits~~	16846
~~under such act, shall remain a recipient for the purpose of~~	16847
~~receiving medical assistance through the medical assistance~~	16848
~~program established under section 5111.01 of the Revised Code.~~	16849

Sec. 5101.181. ~~(A) As used in this section and section~~	16850
~~5101.182 of the Revised Code, "public assistance" includes, in~~	16851
~~addition to Ohio works first, all of the following:~~	16852

~~(1) Prevention, retention, and contingency;~~

16853

~~(2) Medicaid;~~

16854

~~(3) Disability financial assistance;~~

16855

~~(4) Disability medical assistance;~~

16856

~~(5) General assistance provided prior to July 17, 1995, under~~	16857
~~former Chapter 5113. of the Revised Code.~~	16858

~~(B)~~ As part of the procedure for the determination of	16859
overpayment to a recipient of public assistance under Chapter	16860
5107., 5108., ~~5111.,~~ or 5115. of the Revised Code, the director of	16861
job and family services shall furnish quarterly the name and	16862
social security number of each individual who receives public	16863
assistance to the director of administrative services, the	16864
administrator of the bureau of workers' compensation, and each of	16865
the state's retirement boards. Within fourteen days after	16866
receiving the name and social security number of an individual who	16867
receives public assistance, the director of administrative	16868
services, administrator, or board shall inform the auditor of	16869
state as to whether such individual is receiving wages or	16870
benefits, the amount of any wages or benefits being received, the	16871
social security number, and the address of the individual. The	16872
director of administrative services, administrator, boards, and	16873
any agent or employee of those officials and boards shall comply	16874
with the rules ~~of the director of job and family services~~adopted	16875
under section 5101.30 of the Revised Code restricting the	16876
disclosure of information regarding recipients of public	16877
assistance. Any person who violates this provision shall	16878
thereafter be disqualified from acting as an agent or employee or	16879
in any other capacity under appointment or employment of any state	16880
board, commission, or agency.	16881

~~(C) The auditor of state may enter into a reciprocal~~	16882
~~agreement with the director of job and family services or~~	16883
~~comparable officer of any other state for the exchange of names,~~	16884
~~current or most recent addresses, or social security numbers of~~	16885
~~persons receiving public assistance under Title IV-A or under~~	16886
~~Title XIX of the "Social Security Act," 49 Stat. 620 (1935), 42~~	16887
~~U.S.C. 301, as amended.~~	16888

~~(D)(1) The auditor of state shall retain, for not less than~~	16889
~~two years, at least one copy of all information received under~~	16890
~~this section and sections 145.27, 742.41, 3307.20, 3309.22,~~	16891
~~4123.27, 5101.182, and 5505.04 of the Revised Code. The auditor~~	16892
~~shall review the information to determine whether overpayments~~	16893
~~were made to recipients of public assistance under Chapters 5107.,~~	16894
~~5108., 5111., and 5115. of the Revised Code. The auditor of state~~	16895
~~shall initiate action leading to prosecution, where warranted, of~~	16896
~~recipients who received overpayments by forwarding the name of~~	16897
~~each recipient who received overpayment, together with other~~	16898
~~pertinent information, to the director of job and family services~~	16899
~~and the attorney general, to the district director of job and~~	16900
~~family services of the district through which public assistance~~	16901
~~was received, and to the county director of job and family~~	16902
~~services and county prosecutor of the county through which public~~	16903
~~assistance was received.~~	16904

~~(2) The auditor of state and the attorney general or their~~	16905
~~designees may examine any records, whether in computer or printed~~	16906
~~format, in the possession of the director of job and family~~	16907
~~services or any county director of job and family services. They~~	16908
~~shall provide safeguards which restrict access to such records to~~	16909
~~purposes directly connected with an audit or investigation,~~	16910
~~prosecution, or criminal or civil proceeding conducted in~~	16911
~~connection with the administration of the programs and shall~~	16912
~~comply with the rules of the director of job and family services~~	16913
~~restricting the disclosure of information regarding recipients of~~	16914
~~public assistance. Any person who violates this provision shall~~	16915
~~thereafter be disqualified from acting as an agent or employee or~~	16916
~~in any other capacity under appointment or employment of any state~~	16917
~~board, commission, or agency.~~	16918

~~(3) Costs incurred by the auditor of state in carrying out~~	16919
~~the auditor of state's duties under this division shall be borne~~	16920
~~by the auditor of state.~~	16921

Sec. 5101.182. As part of the procedure for the	16922
determination of overpayment to a recipient of public assistance	16923
under Chapter 5107.~~, 5111.,~~ or 5115. of the Revised Code, the	16924
director of job and family services shall semiannually, at times	16925
determined jointly by the auditor of state and the tax	16926
commissioner, furnish to the tax commissioner in computer format	16927
the name and social security number of each individual who	16928
receives public assistance. Within sixty days after receiving the	16929
name and social security number of a recipient of public	16930
assistance, the commissioner shall inform the auditor of state	16931
whether the individual filed an Ohio individual income tax return,	16932
separate or joint, as provided by section 5747.08 of the Revised	16933
Code, for either or both of the two taxable years preceding the	16934
year in which the director furnished the names and social security	16935
numbers to the commissioner. If the individual did so file, at the	16936
same time the commissioner shall also inform the auditor of state	16937
of the amount of the federal adjusted gross income as reported on	16938
such returns and of the addresses on such returns. The	16939
commissioner shall also advise the auditor of state whether such	16940
returns were filed on a joint basis, as provided in section	16941
5747.08 of the Revised Code, in which case the federal adjusted	16942
gross income as reported may be that of the individual or the	16943
individual's spouse.	16944

If the auditor of state determines that further investigation	16945
is needed, the auditor of state may request the commissioner to	16946
determine whether the individual filed income tax returns for any	16947
previous taxable years in which the individual received public	16948
assistance and for which the tax department retains income tax	16949
returns. Within fourteen days of receipt of the request, the	16950
commissioner shall inform the auditor of state whether the	16951
individual filed an individual income tax return for the taxable	16952
years in question, of the amount of the federal adjusted gross	16953
income as reported on such returns, of the addresses on such	16954
returns, and whether the returns were filed on a joint or separate	16955
basis.	16956

If the auditor of state determines that further investigation	16957
is needed of a recipient of public assistance who filed an Ohio	16958
individual income tax return, the auditor of state may request a	16959
certified copy of the Ohio individual income tax return or returns	16960
of that person for the taxable years described above, together	16961
with any other documents the commissioner has concerning the	16962
return or returns. Within fourteen days of receipt of such a	16963
request in writing, the commissioner shall forward the returns and	16964
documents to the auditor of state.	16965

The director of job and family services, district director of	16966
job and family services, county director of job and family	16967
services, county prosecutor, attorney general, auditor of state,	16968
or any agent or employee of those officials having access to any	16969
information or documents furnished by the commissioner pursuant to	16970
this section shall not divulge or use any such information except	16971
for the purpose of determining overpayment of public assistance,	16972
or for an audit, investigation, or prosecution, or in accordance	16973
with a proper judicial order. Any person who violates this	16974
provision shall thereafter be disqualified from acting as an agent	16975
or employee or in any other capacity under appointment or	16976
employment of any state or county board, commission, or agency.	16977

Sec. 5101.184. (A) The director of job and family services	16978
shall work with the tax commissioner to collect overpayments of	16979
assistance under Chapter 5107.~~, 5111.,~~ or 5115., former Chapter	16980
5113., or section 5101.54 of the Revised Code from refunds of	16981
state income taxes for taxable year 1992 and thereafter that are	16982
payable to the recipients of such overpayments.	16983

Any overpayment of assistance, whether obtained by fraud or	16984
misrepresentation, as the result of an error by the recipient or	16985
by the agency making the payment, or in any other manner, may be	16986
collected under this section. Any reduction under section 5747.12	16987
or 5747.121 of the Revised Code to an income tax refund shall be	16988
made before a reduction under this section. No reduction shall be	16989
made under this section if the amount of the refund is less than	16990
twenty-five dollars after any reduction under section 5747.12 of	16991
the Revised Code. A reduction under this section shall be made	16992
before any part of the refund is contributed under section	16993
5747.113 of the Revised Code, or is credited under section 5747.12	16994
of the Revised Code against tax due in any subsequent year.	16995

The director and the tax commissioner, by rules adopted in	16996
accordance with Chapter 119. of the Revised Code, shall establish	16997
procedures to implement this division. The procedures shall	16998
provide for notice to a recipient of assistance and an opportunity	16999
for the recipient to be heard before the recipient's income tax	17000
refund is reduced.	17001

(B) The director of job and family services may enter into	17002
agreements with the federal government to collect overpayments of	17003
assistance from refunds of federal income taxes that are payable	17004
to recipients of the overpayments.	17005

Sec. 5101.21. (A) As used in sections 5101.21 to ~~5101.212~~	17006
5101.25 of the Revised Code:	17007

(1) "County grantee" means all of the following:

17008

(a) A board of county commissioners;

17009

(b) A county children services board appointed under section	17010
5153.03 of the Revised Code;	17011

(c) A county elected official that is a child support	17012
enforcement agency.	17013

(2) "County subgrant" means a grant that a county grantee	17014
awards to another entity.	17015

(3) "County subgrant agreement" means an agreement between a	17016
county grantee and another entity under which the county grantee	17017
awards the other entity one or more county subgrants.	17018

(4) "Fiscal biennial period" means a two-year period	17019
beginning on the first day of July of an odd-numbered year and	17020
ending on the last day of June of the next odd-numbered year.	17021

(5) "Grant" means an award for one or more ODJFS family	17022
services duties of federal financial assistance that a federal	17023
agency provides in the form of money, or property in lieu of	17024
money, to the department of job and family services and that the	17025
department awards to a county grantee. "Grant" may include state	17026
funds the department awards to a county grantee to match the	17027
federal financial assistance. "Grant" does not mean either of the	17028
following:	17029

(a) Technical assistance that provides services instead of	17030
money;	17031

(b) Other assistance provided in the form of revenue sharing,	17032
loans, loan guarantees, interest subsidies, or insurance.	17033

(6) "Grant agreement" means an agreement between the	17034
department of job and family services and a county grantee under	17035
which the department awards the county grantee one or more grants.	17036

(7) "ODJFS family services duty" means a family services duty	17037
associated with a program that the department of job and family	17038
services supervises the administration of on the state level.	17039

(B) Effective July 1, 2008, the director of job and family	17040
services may award grants to counties only through grant	17041
agreements entered into under this section.	17042

(C) The director shall enter into one or more written grant	17043
agreements with the county grantees of each county. If a county	17044
has multiple county grantees, the director shall jointly enter	17045
into the grant agreement with all of the county grantees. The	17046
initial grant agreement shall be entered into not later than	17047
January 31, 2008, and shall be in effect for fiscal year 2009.	17048
Except as provided in rules adopted under this section,	17049
subsequent grant agreements shall be entered into before the	17050
first day of each successive fiscal biennial period and shall be	17051
in effect for that fiscal biennial period or, in the case of a	17052
grant agreement entered into after the first day of a fiscal	17053
biennial period and except as provided by section 5101.211 of the	17054
Revised Code, for the remainder of the fiscal biennial period. A	17055
grant agreement shall do all of the following:	17056

(1) Comply with all of the conditions, requirements, and	17057
restrictions applicable to the ODJFS family services duties for	17058
which the grants included in the agreement are awarded, including	17059
the conditions, requirements, and restrictions established by the	17060
department, federal or state law, state plans for receipt of	17061
federal financial participation, agreements between the department	17062
and a federal agency, and executive orders issued by the governor;	17063

(2) Establish terms and conditions governing the	17064
accountability for and use of the grants included in the grant	17065
agreement;	17066

(3) Specify both of the following:

17067

(a) The ODJFS family services duties for which the grants	17068
included in the agreement are awarded;	17069

(b) The private and government entities designated under	17070
section 307.981 of the Revised Code to serve as the county family	17071
services agencies performing the ODJFS family services duties;	17072

(4) Provide for the department of job and family services to	17073
award the grants included in the agreement in accordance with a	17074
methodology for determining the amount of the award established	17075
by rules adopted under this section;	17076

(5) Specify the form of the grants which may be a cash draw,	17077
reimbursement, property, advance, working capital advance, or	17078
other forms specified in rules adopted under this section;	17079

(6) Provide that the grants are subject to the availability	17080
of federal funds and appropriations made by the general assembly;	17081

(7) Specify annual financial, administrative, or other	17082
incentive awards, if any, to be provided in accordance with	17083
section 5101.23 of the Revised Code;	17084

(8) Include the assurance of each county grantee that the	17085
county grantee will do all of the following:	17086

(a) Ensure that the grants included in the agreement are	17087
used, and the ODJFS family services duties for which the grants	17088
are awarded are performed, in accordance with conditions,	17089
requirements, and restrictions applicable to the duties	17090
established by the department, a federal or state law, state	17091
plans for receipt of federal financial participation, agreements	17092
between the department and a federal agency, and executive orders	17093
issued by the governor;	17094

(b) Utilize a financial management system and other	17095
accountability mechanisms for the grants awarded under the	17096
agreement that meet requirements the department establishes;	17097

(c) Do all of the following with regard to a county	17098
subgrant:	17099

(i) Award the subgrant through a written county subgrant	17100
agreement that requires the entity awarded the county subgrant to	17101
comply with all conditions, requirements, and restrictions	17102
applicable to the county grantee regarding the grant that the	17103
county grantee subgrants to the entity, including the conditions,	17104
requirements, and restrictions of this section;	17105

(ii) Monitor the entity that is awarded the subgrant to	17106
ensure that the entity uses the subgrant in accordance with	17107
conditions, requirements, and restrictions applicable to the	17108
ODJFS family services duties for which the subgrant is awarded;	17109

(iii) Take action to recover subgrants that are not used in	17110
accordance with the conditions, requirements, or restrictions	17111
applicable to the ODJFS family services duties for which the	17112
subgrant is awarded.	17113

(d) Promptly reimburse the department the amount that	17114
represents the amount the county grantee is responsible for,	17115
pursuant to action the department takes under division (C) of	17116
section 5101.24 of the Revised Code, of funds the department pays	17117
to any entity because of an adverse audit finding, adverse	17118
quality control finding, final disallowance of federal financial	17119
participation, or other sanction or penalty;	17120

(e) Take prompt corrective action, including paying amounts	17121
resulting from an adverse finding, sanction, or penalty, if the	17122
department, auditor of state, federal agency, or other entity	17123
authorized by federal or state law to determine compliance with	17124
the conditions, requirements, and restrictions applicable to a	17125
an ODJFS family services duty for which a grant included in the	17126
agreement is awarded determines compliance has not been	17127
achieved;	17128

(f) Ensure that any matching funds, regardless of the source,	17129
that the county grantee manages are clearly identified and used in	17130
accordance with federal and state laws and the agreement.	17131

(9) Provide for the department taking action pursuant to	17132
division (C) of section 5101.24 of the Revised Code if authorized	17133
by division (B)(1), (2), (3), or (4) of that section;	17134

(10) Provide for timely audits required by federal and	17135
state law and require prompt release of audit findings and prompt	17136
action to correct problems identified in an audit;	17137

(11) Provide for administrative review procedures in	17138
accordance with section 5101.24 of the Revised Code;	17139

(12) Establish the method of amending or terminating the	17140
agreement and an expedited process for correcting terms or	17141
conditions of the agreement that the director and each county	17142
grantee agree are erroneous.	17143

(D) A grant agreement does not have to be amended for a	17144
county grantee to be required to comply with a new or amended	17145
condition, requirement, or restriction for aan ODJFS family	17146
services duty established by federal or state law, state plan for	17147
receipt of federal financial participation, agreement between the	17148
department and a federal agency, or executive order issued by the	17149
governor.	17150

(E) The department shall make payments authorized by a grant	17151
agreement on vouchers it prepares and may include any funds	17152
appropriated or allocated to it for carrying out ODJFS family	17153
services duties for which a grant included in the agreement is	17154
awarded, including funds for personal services and maintenance.	17155

(F)(1) The director shall adopt rules in accordance with	17156
section 111.15 of the Revised Code governing grant agreements.	17157
The director shall adopt the rules as if they were internal	17158
management rules. Before adopting the rules, the director shall	17159
give the public an opportunity to review and comment on the	17160
proposed rules. The rules shall establish methodologies to be used	17161
to determine the amount of the grants included in the agreements.	17162
The rules also shall establish terms and conditions under which	17163
an agreement may be entered into after the first day of a fiscal	17164
biennial period. The rules may do any or all of the following:	17165

(a) Govern the award of grants included in grant agreements,	17166
including the establishment of, and restrictions on, the form of	17167
the grants and the distribution of the grants;	17168

(b) Specify allowable uses of the grants included in the	17169
agreements;	17170

(c) Establish reporting, cash management, audit, and other	17171
requirements the director determines are necessary to provide	17172
accountability for the use of the grants included in the	17173
agreements and determine compliance with conditions,	17174
requirements, and restrictions established by the department, a	17175
federal or state law, state plans for receipt of federal	17176
financial participation, agreements between the department and a	17177
federal agency, and executive orders issued by the governor.	17178

(2) A requirement of a grant agreement established by a rule	17179
adopted under this division is applicable to a grant agreement	17180
without having to be restated in the grant agreement. A	17181
requirement established by a grant agreement is applicable to the	17182
grant agreement without having to be restated in a rule.	17183

Sec. 5101.212. The department of job and family services	17184
shall publish in a manner accessible to the public all of the	17185
following that concern ODJFS family services duties for which	17186
grants included in grant agreements entered into under section	17187
5101.21 of the Revised Code are awarded: state plans for receipt	17188
of federal financial participation, agreements between the	17189
department and a federal agency, and executive orders issued by	17190
the governor. The department may publish the materials	17191
electronically or otherwise.	17192

Sec. 5101.214. The director of job and family services may	17193
enter into a written agreement with one or more state agencies, as	17194
defined in section 117.01 of the Revised Code, and state	17195
universities and colleges to assist in the coordination,	17196
provision, or enhancement of the ODJFS family services duties of a	17197
county family services agency or the workforce development	17198
activities of a workforce development agency. The director also	17199
may enter into written agreements or contracts with, or issue	17200
grants to, private and government entities under which funds are	17201
provided for the enhancement or innovation of ODJFS family	17202
services duties or workforce development activities on the state	17203
or local level.	17204

The director may adopt internal management rules in	17205
accordance with section 111.15 of the Revised Code to implement	17206
this section.	17207

Sec. 5101.216. The director of job and family services may	17208
enter into one or more written operational agreements with boards	17209
of county commissioners to do one or more of the following	17210
regarding ODJFS family services duties:	17211

(A) Provide for the director to amend or rescind a rule the	17212
director previously adopted;	17213

(B) Provide for the director to modify procedures or	17214
establish alternative procedures to accommodate special	17215
circumstances in a county;	17216

(C) Provide for the director and board to jointly identify	17217
operational problems of mutual concern and develop a joint plan to	17218
address the problems;	17219

(D) Establish a framework for the director and board to	17220
modify the use of existing resources in a manner that is	17221
beneficial to the department of job and family services and the	17222
county that the board serves and improves ODJFS family services	17223
duties for the recipients of the services.	17224

Sec. 5101.22. The department of job and family services may	17225
establish performance and other administrative standards for the	17226
administration and outcomes of ODJFS family services duties and	17227
determine at intervals the department decides the degree to which	17228
a county family services agency complies with a performance or	17229
other administrative standard. The department may use statistical	17230
sampling, performance audits, case reviews, or other methods it	17231
determines necessary and appropriate to determine compliance with	17232
performance and administrative standards.	17233

Sec. 5101.221. (A) Except as provided by division (C) of	17234
this section, if the department of job and family services	17235
determines that a county family services agency has failed to	17236
comply with a performance or other administrative standard	17237
established under section 5101.22 of the Revised Code or by	17238
federal law for the administration or outcome of aan ODJFS family	17239
services duty, the department shall require the agency to develop,	17240
submit to the department for approval, and comply with a	17241
corrective action plan.	17242

(B) If a county family services agency fails to develop,	17243
submit to the department, or comply with a corrective action plan	17244
under division (A) of this section, or the department disapproves	17245
the agency's corrective action plan, the department may require	17246
the agency to develop, submit to the department for approval, and	17247
comply with a corrective action plan that requires the agency to	17248
commit existing resources to the plan.	17249

(C) The department may not require a county family services	17250
agency to take action under this section for failure to comply	17251
with a performance or other administrative standard established	17252
for an incentive awarded by the department. Instead, the	17253
department may require a county family services agency that fails	17254
to comply with that kind of performance or other administrative	17255
standard to take action in accordance with rules adopted by the	17256
department governing the standard.	17257

(D) At the request of a county family services agency, the	17258
department shall assist the agency with the development of a	17259
corrective action plan under this section and provide the agency	17260
technical assistance in the implementation of the plan.	17261

Sec. 5101.23. Subject to the availability of funds, the	17262
department of job and family services may provide annual	17263
financial, administrative, or other incentive awards to county	17264
family services agencies and workforce development agencies. A	17265
county family services agency or workforce development agency may	17266
spend funds provided as a financial incentive award only for the	17267
purpose for which the funds are appropriated. The department may	17268
adopt internal management rules in accordance with section 111.15	17269
of the Revised Code to establish the amounts of awards,	17270
methodology for distributing the awards, types of awards, and	17271
standards for administration by the department.	17272

There is hereby created in the state treasury the social	17273
services incentive fund. The director of job and family services	17274
may request that the director of budget and management transfer	17275
funds in the Title IV-A reserve fund created under section 5101.82	17276
of the Revised Code and other funds appropriated for ODJFS family	17277
services duties or workforce investment activities into the fund.	17278
If the director of budget and management determines that the funds	17279
identified by the director of job and family services are	17280
available and appropriate for transfer, the director of budget and	17281
management shall make the transfer. Money in the fund shall be	17282
used to provide incentive awards under this section.	17283

Sec. 5101.24. (A) As used in this section, "responsible	17284
county grantee" means whichever county grantee, as defined in	17285
section 5101.21 of the Revised Code, the director of job and	17286
family services determines is appropriate to take action against	17287
under division (C) of this section.	17288

(B) Regardless of whether aan ODJFS family services duty is	17289
performed by a county family services agency, private or	17290
government entity pursuant to a contract entered into under	17291
section 307.982 of the Revised Code or division (C)(2) of section	17292
5153.16 of the Revised Code, or private or government provider of	17293
aan ODJFS family service duty, the department of job and family	17294
services may take action under division (C) of this section	17295
against the responsible county grantee if the department	17296
determines any of the following are the case:	17297

(1) A requirement of a grant agreement entered into under	17298
section 5101.21 of the Revised Code that includes a grant for the	17299
ODJFS family services duty, including a requirement for grant	17300
agreements established by rules adopted under that section, is	17301
not complied with;	17302

(2) A county family services agency fails to develop, submit	17303
to the department, or comply with a corrective action plan under	17304
division (B) of section 5101.221 of the Revised Code, or the	17305
department disapproves the agency's corrective action plan	17306
developed under division (B) of section 5101.221 of the Revised	17307
Code;	17308

(3) A requirement for the ODJFS family services duty	17309
established by the department or any of the following is not	17310
complied with: a federal or state law, state plan for receipt of	17311
federal financial participation, grant agreement between the	17312
department and a federal agency, or executive order issued by the	17313
governor;	17314

(4) The responsible county grantee is solely or partially	17315
responsible, as determined by the director of job and family	17316
services, for an adverse audit finding, adverse quality control	17317
finding, final disallowance of federal financial participation,	17318
or other sanction or penalty regarding the ODJFS family services	17319
duty.	17320

(C) The department may take one or more of the following	17321
actions against the responsible county grantee when authorized by	17322
division (B)(1), (2), (3), or (4) of this section:	17323

(1) Require the responsible county grantee to comply with a	17324
corrective action plan pursuant to a time schedule specified by	17325
the department. The corrective action plan shall be established	17326
or approved by the department and shall not require a county	17327
grantee to commit resources to the plan.	17328

(2) Require the responsible county grantee to comply with a	17329
corrective action plan pursuant to a time schedule specified by	17330
the department. The corrective action plan shall be established	17331
or approved by the department and require a county grantee to	17332
commit to the plan existing resources identified by the agency.	17333

(3) Require the responsible county grantee to do one of the	17334
following:	17335

(a) Share with the department a final disallowance of federal	17336
financial participation or other sanction or penalty;	17337

(b) Reimburse the department the final amount the department	17338
pays to the federal government or another entity that represents	17339
the amount the responsible county grantee is responsible for of	17340
an adverse audit finding, adverse quality control finding, final	17341
disallowance of federal financial participation, or other	17342
sanction or penalty issued by the federal government, auditor of	17343
state, or other entity;	17344

(c) Pay the federal government or another entity the final	17345
amount that represents the amount the responsible county grantee	17346
is responsible for of an adverse audit finding, adverse quality	17347
control finding, final disallowance of federal financial	17348
participation, or other sanction or penalty issued by the federal	17349
government, auditor of state, or other entity;	17350

(d) Pay the department the final amount that represents the	17351
amount the responsible county grantee is responsible for of an	17352
adverse audit finding or adverse quality control finding.	17353

(4) Impose an administrative sanction issued by the	17354
department against the responsible county grantee. A sanction may	17355
be increased if the department has previously taken action	17356
against the responsible entity under this division.	17357

(5) Perform, or contract with a government or private entity	17358
for the entity to perform, the ODJFS family services duty until	17359
the department is satisfied that the responsible county grantee	17360
ensures that the duty will be performed satisfactorily. If the	17361
department performs or contracts with an entity to perform aan	17362
ODJFS family services duty under division (C)(5) of this section,	17363
the department may do either or both of the following:	17364

(a) Spend funds in the county treasury appropriated by the	17365
board of county commissioners for the duty;	17366

(b) Withhold funds allocated or reimbursements due to the	17367
responsible county grantee for the duty and spend the funds for	17368
the duty.	17369

(6) Request that the attorney general bring mandamus	17370
proceedings to compel the responsible county grantee to take or	17371
cease the action that causes division (B)(1), (2), (3), or (4) of	17372
this section to apply. The attorney general shall bring mandamus	17373
proceedings in the Franklin county court of appeals at the	17374
department's request.	17375

(7) If the department takes action under this division	17376
because of division (B)(3) of this section, temporarily withhold	17377
funds allocated or reimbursement due to the responsible county	17378
grantee until the department determines that the responsible	17379
county grantee is in compliance with the requirement. The	17380
department shall release the funds when the department determines	17381
that compliance has been achieved.	17382

(D) If the department proposes to take action against the	17383
responsible county grantee under division (C) of this section, the	17384
department shall notify the responsible county grantee, director	17385
of the appropriate county family services agency, and county	17386
auditor. The notice shall be in writing and specify the action	17387
the department proposes to take. The department shall send the	17388
notice by regular United States mail.	17389

Except as provided by division (E) of this section, the	17390
responsible county grantee may request an administrative review	17391
of a proposed action in accordance with administrative review	17392
procedures the department shall establish. The administrative	17393
review procedures shall comply with all of the following:	17394

(1) A request for an administrative review shall state	17395
specifically all of the following:	17396

(a) The proposed action specified in the notice from the	17397
department for which the review is requested;	17398

(b) The reason why the responsible county grantee believes	17399
the proposed action is inappropriate;	17400

(c) All facts and legal arguments that the responsible	17401
county grantee wants the department to consider;	17402

(d) The name of the person who will serve as the responsible	17403
county grantee's representative in the review.	17404

(2) If the department's notice specifies more than one	17405
proposed action and the responsible county grantee does not	17406
specify all of the proposed actions in its request pursuant to	17407
division (D)(1)(a) of this section, the proposed actions not	17408
specified in the request shall not be subject to administrative	17409
review and the parts of the notice regarding those proposed	17410
actions shall be final and binding on the responsible county	17411
grantee.	17412

(3) In the case of a proposed action under division (C)(1) of	17413
this section, the responsible county grantee shall have fifteen	17414
calendar days after the department mails the notice to the	17415
responsible county grantee to send a written request to the	17416
department for an administrative review. If it receives such a	17417
request within the required time, the department shall postpone	17418
taking action under division (C)(1) of this section for fifteen	17419
calendar days following the day it receives the request or	17420
extended period of time provided for in division (D)(5) of this	17421
section to allow a representative of the department and a	17422
representative of the responsible county grantee an informal	17423
opportunity to resolve any dispute during that fifteen-day or	17424
extended period.	17425

(4) In the case of a proposed action under division (C)(2),	17426
(3), (4), (5), or (7) of this section, the responsible county	17427
grantee shall have thirty calendar days after the department	17428
mails the notice to the responsible county grantee to send a	17429
written request to the department for an administrative review.	17430
If it receives such a request within the required time, the	17431
department shall postpone taking action under division (C)(2),	17432
(3), (4), (5), or (7) of this section for thirty calendar days	17433
following the day it receives the request or extended period of	17434
time provided for in division (D)(5) of this section to allow a	17435
representative of the department and a representative of the	17436
responsible county grantee an informal opportunity to resolve	17437
any dispute during that thirty-day or extended period.	17438

(5) If the informal opportunity provided in division (D)(3)	17439
or (4) of this section does not result in a written resolution to	17440
the dispute within the fifteen- or thirty-day period, the director	17441
of job and family services and representative of the responsible	17442
county grantee may enter into a written agreement extending the	17443
time period for attempting an informal resolution of the dispute	17444
under division (D)(3) or (4) of this section.	17445

(6) In the case of a proposed action under division (C)(3) of	17446
this section, the responsible county grantee may not include in	17447
its request disputes over a finding, final disallowance of	17448
federal financial participation, or other sanction or penalty	17449
issued by the federal government, auditor of state, or entity	17450
other than the department.	17451

(7) If the responsible county grantee fails to request an	17452
administrative review within the required time, the responsible	17453
county grantee loses the right to request an administrative	17454
review of the proposed actions specified in the notice and the	17455
notice becomes final and binding on the responsible county	17456
grantee.	17457

(8) If the informal opportunity provided in division (D)(3)	17458
or (4) of this section does not result in a written resolution to	17459
the dispute within the time provided by division (D)(3), (4), or	17460
(5) of this section, the director shall appoint an administrative	17461
review panel to conduct the administrative review. The review	17462
panel shall consist of department employees and one director or	17463
other representative of the type of county family services agency	17464
that is responsible for the kind of ODJFS family services duty	17465
that is the subject of the dispute and serves a different county	17466
than the county served by the responsible county grantee. No	17467
individual involved in the department's proposal to take action	17468
against the responsible county grantee may serve on the review	17469
panel. The review panel shall review the responsible county	17470
grantee's request. The review panel may require that the	17471
department or responsible county grantee submit additional	17472
information and schedule and conduct an informal hearing to	17473
obtain testimony or additional evidence. A review of a proposal	17474
to take action under division (C)(3) of this section shall be	17475
limited solely to the issue of the amount the responsible county	17476
grantee shall share with the department, reimburse the	17477
department, or pay to the federal government, department, or	17478
other entity under division (C)(3) of this section. The review	17479
panel is not required to make a stenographic record of its	17480
hearing or other proceedings.	17481

(9) After finishing an administrative review, an	17482
administrative review panel appointed under division (D)(8) of	17483
this section shall submit a written report to the director setting	17484
forth its findings of fact, conclusions of law, and	17485
recommendations for action. The director may approve, modify, or	17486
disapprove the recommendations. If the director modifies or	17487
disapproves the recommendations, the director shall state the	17488
reasons for the modification or disapproval and the actions to be	17489
taken against the responsible county grantee.	17490

(10) The director's approval, modification, or disapproval	17491
under division (D)(9) of this section shall be final and binding	17492
on the responsible county grantee and shall not be subject to	17493
further departmental review.	17494

(E) The responsible county grantee is not entitled to an	17495
administrative review under division (D) of this section for any	17496
of the following:	17497

(1) An action taken under division (C)(6) of this section;

17498

(2) An action taken under section 5101.242 of the Revised	17499
Code;	17500

(3) An action taken under division (C)(3) of this section if	17501
the federal government, auditor of state, or entity other than the	17502
department has identified the responsible county grantee as being	17503
solely or partially responsible for an adverse audit finding,	17504
adverse quality control finding, final disallowance of federal	17505
financial participation, or other sanction or penalty;	17506

(4) An adjustment to an allocation, cash draw, advance, or	17507
reimbursement to a responsible county grantee that the department	17508
determines necessary for budgetary reasons;	17509

(5) Withholding of a cash draw or reimbursement due to	17510
noncompliance with a reporting requirement established in rules	17511
adopted under section 5101.243 of the Revised Code.	17512

(F) This section does not apply to other actions the	17513
department takes against the responsible county grantee pursuant	17514
to authority granted by another state law unless the other state	17515
law requires the department to take the action in accordance with	17516
this section.	17517

(G) The director of job and family services may adopt rules	17518
in accordance with Chapter 119. of the Revised Code as necessary	17519
to implement this section.	17520

Sec. 5101.243. The director of job and family services may	17521
adopt rules in accordance with section 111.15 of the Revised Code	17522
establishing reporting requirements for ODJFS family services	17523
duties and workforce development activities. If the director	17524
adopts the rules, the director shall adopt the rules as if they	17525
were internal management rules and, before adopting the rules,	17526
give the public an opportunity to review and comment on the	17527
proposed rules.	17528

Sec. 5101.25. The department of ~~human~~job and family	17529
services, in consultation with county representatives, shall	17530
develop annual training goals and model training curriculum	17531
regarding ODJFS family services duties for employees of county	17532
family services agencies and identify a variety of state funded	17533
training opportunities to meet the proposed goals.	17534

Sec. 5101.26. As used in this section and in sections	17535
5101.27 to 5101.30 of the Revised Code:	17536

(A) "County agency" means a county department of job and	17537
family services or a public children services agency.	17538

(B) "Fugitive felon" means an individual who is fleeing to	17539
avoid prosecution, or custody or confinement after conviction,	17540
under the laws of the place from which the individual is fleeing,	17541
for a crime or an attempt to commit a crime that is a felony under	17542
the laws of the place from which the individual is fleeing or, in	17543
the case of New Jersey, a high misdemeanor, regardless of whether	17544
the individual has departed from the individual's usual place of	17545
residence.	17546

(C) "Information" means records as defined in section 149.011	17547
of the Revised Code, any other documents in any format, and data	17548
derived from records and documents that are generated, acquired,	17549
or maintained by the department of job and family services, a	17550
county agency, or an entity performing duties on behalf of the	17551
department or a county agency.	17552

(D) "Law enforcement agency" means the state highway patrol,	17553
an agency that employs peace officers as defined in section 109.71	17554
of the Revised Code, the adult parole authority, a county	17555
department of probation, a prosecuting attorney, the attorney	17556
general, similar agencies of other states, federal law enforcement	17557
agencies, and postal inspectors. "Law enforcement agency" includes	17558
the peace officers and other law enforcement officers employed by	17559
the agency.	17560

(E) "Medical assistance provided under a public assistance	17561
program" means medical assistance provided under the programs	17562
established under ~~sections~~section 5101.49~~, 5101.50 to 5101.503,~~	17563
~~5101.51 to 5101.5110, 5101.52 to 5101.529, and 5101.5211 to~~	17564
~~5101.5216, Chapters 5111. and 5115.,~~ or any other provision of	17565
the Revised Code that the department of job and family services	17566
administers.	17567

(F) "Public assistance" means financial assistance, medical	17568
assistance, or social services provided under a program	17569
administered by the department of job and family services or a	17570
county agency pursuant to Chapter 329., 5101., 5104., 5107.,	17571
5108., ~~5111.,~~ or 5115. of the Revised Code or an executive order	17572
issued under section 107.17 of the Revised Code.	17573

(G) "Public assistance recipient" means an applicant for or	17574
recipient or former recipient of public assistance.	17575

Sec. 5101.35. (A) As used in this section:

17576

(1) "Agency" means the following entities that administer a	17577
family services program:	17578

(a) The department of job and family services;

17579

(b) A county department of job and family services;

17580

17581

(d) A private or government entity administering, in whole or	17582
in part, a family services program for or on behalf of the	17583
department of job and family services or a county department of	17584
job and family services or public children services agency.	17585

(2) "Appellant" means an applicant, participant, former	17586
participant, recipient, or former recipient of a family services	17587
program who is entitled by federal or state law to a hearing	17588
regarding a decision or order of the agency that administers the	17589
program.	17590

(3) "Family services program" means assistance provided under	17591
a Title IV-A program as defined in section 5101.80 of the Revised	17592
Code or under Chapter 5104.~~, 5111.,~~ or 5115. or section ~~173.35~~	17593
5160.80, 5101.141, 5101.46, 5101.461, 5101.54, 5153.163, or	17594
5153.165 of the Revised Code, other than assistance provided under	17595
section 5101.46 of the Revised Code by the department of mental	17596
health, the department of mental retardation and developmental	17597
disabilities, a board of alcohol, drug addiction, and mental	17598
health services, or a county board of mental retardation and	17599
developmental disabilities.	17600

(B) Except as provided by ~~divisions~~division (G) ~~and (H)~~ of	17601
this section, an appellant who appeals under federal or state law	17602
a decision or order of an agency administering a family services	17603
program shall, at the appellant's request, be granted a state	17604
hearing by the department of job and family services. This state	17605
hearing shall be conducted in accordance with rules adopted under	17606
this section. The state hearing shall be recorded, but neither the	17607
recording nor a transcript of the recording shall be part of the	17608
official record of the proceeding. A state hearing decision is	17609
binding upon the agency and department, unless it is reversed or	17610
modified on appeal to the director of job and family services or a	17611
court of common pleas.	17612

(C) Except as provided by division (G) of this section, an	17613
appellant who disagrees with a state hearing decision may make an	17614
administrative appeal to the director of job and family services	17615
in accordance with rules adopted under this section. This	17616
administrative appeal does not require a hearing, but the director	17617
or the director's designee shall review the state hearing decision	17618
and previous administrative action and may affirm, modify, remand,	17619
or reverse the state hearing decision. Any person designated to	17620
make an administrative appeal decision on behalf of the director	17621
shall have been admitted to the practice of law in this state. An	17622
administrative appeal decision is the final decision of the	17623
department and is binding upon the department and agency, unless	17624
it is reversed or modified on appeal to the court of common pleas.	17625

(D) An agency shall comply with a decision issued pursuant to	17626
division (B) or (C) of this section within the time limits	17627
established by rules adopted under this section. If a county	17628
department of job and family services or a public children	17629
services agency fails to comply within these time limits, the	17630
department may take action pursuant to section 5101.24 of the	17631
Revised Code. If another agency fails to comply within the time	17632
limits, the department may force compliance by withholding funds	17633
due the agency or imposing another sanction established by rules	17634
adopted under this section.	17635

(E) An appellant who disagrees with an administrative appeal	17636
decision of the director of job and family services or the	17637
director's designee issued under division (C) of this section may	17638
appeal from the decision to the court of common pleas pursuant to	17639
section 119.12 of the Revised Code. The appeal shall be governed	17640
by section 119.12 of the Revised Code except that:	17641

(1) The person may appeal to the court of common pleas of the	17642
county in which the person resides, or to the court of common	17643
pleas of Franklin county if the person does not reside in this	17644
state.	17645

(2) The person may apply to the court for designation as an	17646
indigent and, if the court grants this application, the appellant	17647
shall not be required to furnish the costs of the appeal.	17648

(3) The appellant shall mail the notice of appeal to the	17649
department of job and family services and file notice of appeal	17650
with the court within thirty days after the department mails the	17651
administrative appeal decision to the appellant. For good cause	17652
shown, the court may extend the time for mailing and filing notice	17653
of appeal, but such time shall not exceed six months from the date	17654
the department mails the administrative appeal decision. Filing	17655
notice of appeal with the court shall be the only act necessary to	17656
vest jurisdiction in the court.	17657

(4) The department shall be required to file a transcript of	17658
the testimony of the state hearing with the court only if the	17659
court orders the department to file the transcript. The court	17660
shall make such an order only if it finds that the department and	17661
the appellant are unable to stipulate to the facts of the case and	17662
that the transcript is essential to a determination of the appeal.	17663
The department shall file the transcript not later than thirty	17664
days after the day such an order is issued.	17665

(F) The department of job and family services shall adopt	17666
rules in accordance with Chapter 119. of the Revised Code to	17667
implement this section, including rules governing the following:	17668

(1) State hearings under division (B) of this section. The	17669
rules shall include provisions regarding notice of eligibility	17670
termination and the opportunity of an appellant appealing a	17671
decision or order of a county department of job and family	17672
services to request a county conference with the county department	17673
before the state hearing is held.	17674

(2) Administrative appeals under division (C) of this	17675
section;	17676

(3) Time limits for complying with a decision issued under	17677
division (B) or (C) of this section;	17678

(4) Sanctions that may be applied against an agency under	17679
division (D) of this section.	17680

(G) The department of job and family services may adopt rules	17681
in accordance with Chapter 119. of the Revised Code establishing	17682
an appeals process for an appellant who appeals a decision or	17683
order regarding a Title IV-A program identified under division	17684
(A)(4)(c), (d), (e), or (f) of section 5101.80 of the Revised Code	17685
that is different from the appeals process established by this	17686
section. The different appeals process may include having a state	17687
agency that administers the Title IV-A program pursuant to an	17688
interagency agreement entered into under section 5101.801 of the	17689
Revised Code administer the appeals process.	17690

(H) ~~If an appellant receiving medicaid through a health~~	17691
~~insuring corporation that holds a certificate of authority under~~	17692
~~Chapter 1751. of the Revised Code is appealing a denial of~~	17693
~~medicaid services based on lack of medical necessity or other~~	17694
~~clinical issues regarding coverage by the health insuring~~	17695
~~corporation, the person hearing the appeal may order an~~	17696
~~independent medical review if that person determines that a review~~	17697
~~is necessary. The review shall be performed by a health care~~	17698
~~professional with appropriate clinical expertise in treating the~~	17699
~~recipient's condition or disease. The department shall pay the~~	17700
~~costs associated with the review.~~	17701

~~A review ordered under this division shall be part of the~~	17702
~~record of the hearing and shall be given appropriate evidentiary~~	17703
~~consideration by the person hearing the appeal.~~	17704

~~(I)~~ The requirements of Chapter 119. of the Revised Code	17705
apply to a state hearing or administrative appeal under this	17706
section only to the extent, if any, specifically provided by rules	17707
adopted under this section.	17708

Sec. 5101.36. Any application for public assistance gives a	17709
right of subrogation to the department of job and family services	17710
for any workers' compensation benefits payable to a person who is	17711
subject to a support order, as defined in section 3119.01 of the	17712
Revised Code, on behalf of the applicant, to the extent of any	17713
public assistance payments made on the applicant's behalf. If the	17714
director of job and family services, in consultation with a child	17715
support enforcement agency and the administrator of the bureau of	17716
workers' compensation, determines that a person responsible for	17717
support payments to a recipient of public assistance is receiving	17718
workers' compensation, the director shall notify the administrator	17719
of the amount of the benefit to be paid to the department of job	17720
and family services.	17721

For purposes of this section, "public assistance" means	17722
~~medical assistance provided through the medical assistance program~~	17723
~~established under section 5111.01 of the Revised Code;~~ Ohio works	17724
first provided under Chapter 5107. of the Revised Code;	17725
prevention, retention, and contingency benefits and services	17726
provided under Chapter 5108. of the Revised Code; or disability	17727
financial assistance provided under Chapter 5115. of the Revised	17728
Code~~; or disability medical assistance provided under Chapter~~	17729
~~5115. of the Revised Code~~.	17730

Sec. 5101.47. (A) Except as provided in division (B) of	17731
this section, the director of job and family services may accept	17732
applications, determine eligibility, redetermine eligibility, and	17733
perform related administrative activities for one or more of the	17734
following:	17735

(1) ~~The medicaid program established by Chapter 5111. of the~~	17736
~~Revised Code;~~	17737

~~(2) The children's health insurance program parts I, II, and~~	17738
~~III provided for under sections 5101.50, 5101.51, and 5101.52 of~~	17739
~~the Revised Code;~~	17740

~~(3)~~ Publicly funded child care provided under Chapter 5104.	17741
of the Revised Code;	17742

~~(4)~~(2) The food stamp program administered by the department	17743
of job and family services pursuant to section 5101.54 of the	17744
Revised Code;	17745

~~(5)~~(3) Other programs the director determines are supportive	17746
of children, adults, or families;	17747

~~(6)~~(4) Other programs regarding which the director determines	17748
administrative cost savings and efficiency may be achieved through	17749
the department accepting applications, determining eligibility,	17750
redetermining eligibility, or performing related administrative	17751
activities.	17752

(B) If federal law requires a face-to-face interview to	17753
complete an eligibility determination for a program specified in	17754
or pursuant to division (A) of this section, the face-to-face	17755
interview shall not be conducted by the department of job and	17756
family services.	17757

(C) Subject to division (B) of this section, if the director	17758
elects to accept applications, determine eligibility, redetermine	17759
eligibility, and perform related administrative activities for a	17760
program specified in or pursuant to division (A) of this section,	17761
both of the following apply:	17762

(1) An individual seeking services under the program may	17763
apply for the program to the director or to the entity that state	17764
law governing the program authorizes to accept applications for	17765
the program.	17766

(2) The director is subject to federal statutes and	17767
regulations and state statutes and rules that require, permit, or	17768
prohibit an action regarding accepting applications, determining	17769
or redetermining eligibility, and performing related	17770
administrative activities for the program.	17771

(D) The director may adopt rules as necessary to implement	17772
this section.	17773

Sec. 5101.97. (A)(1) Not later than the last day of each	17774
July and January, the department of job and family services shall	17775
complete a report on the characteristics of the individuals who	17776
participate in or receive services through the programs operated	17777
by the department and the outcomes of the individuals'	17778
participation in or receipt of services through the programs. The	17779
reports shall be for the six-month periods ending on the last days	17780
of June and December and shall include information on the	17781
following:	17782

(a) Work activities, developmental activities, and	17783
alternative work activities established under sections 5107.40 to	17784
5107.69 of the Revised Code;	17785

(b) Programs of publicly funded child care, as defined in	17786
section 5104.01 of the Revised Code;	17787

17788

~~(d) Births to recipients of the medical assistance program~~	17789
~~established under Chapter 5111. of the Revised Code~~.	17790

(2) The department shall submit the reports required under	17791
division (A)(1) of this section to the speaker and minority leader	17792
of the house of representatives, the president and minority leader	17793
of the senate, the legislative budget officer, the director of	17794
budget and management, and each board of county commissioners. The	17795
department shall provide copies of the reports to any person or	17796
government entity on request.	17797

In designing the format for the reports, the department shall	17798
consult with individuals, organizations, and government entities	17799
interested in the programs operated by the department, so that the	17800
reports are designed to enable the general assembly and the public	17801
to evaluate the effectiveness of the programs and identify any	17802
needs that the programs are not meeting.	17803

(B) Whenever the federal government requires that the	17804
department submit a report on a program that is operated by the	17805
department or is otherwise under the department's jurisdiction,	17806
the department shall prepare and submit the report in accordance	17807
with the federal requirements applicable to that report. To the	17808
extent possible, the department may coordinate the preparation and	17809
submission of a particular report with any other report, plan, or	17810
other document required to be submitted to the federal government,	17811
as well as with any report required to be submitted to the general	17812
assembly. The reports required by the Personal Responsibility and	17813
Work Opportunity Reconciliation Act of 1996 (P.L. 104-193) may be	17814
submitted as an annual summary.	17815

Sec. 5103.02. As used in sections 5103.03 to 5103.17 of the	17816
Revised Code:	17817

(A) "Association" or "institution" includes any incorporated	17818
or unincorporated organization, society, association, or agency,	17819
public or private, that receives or cares for children for two or	17820
more consecutive weeks; any individual, including the operator of	17821
a foster home, who, for hire, gain, or reward, receives or cares	17822
for children for two or more consecutive weeks, unless the	17823
individual is related to them by blood or marriage; and any	17824
individual not in the regular employ of a court, or of an	17825
institution or association certified in accordance with section	17826
5103.03 of the Revised Code, who in any manner becomes a party to	17827
the placing of children in foster homes, unless the individual is	17828
related to such children by blood or marriage, or is the appointed	17829
guardian of such children; provided, that any organization,	17830
society, association, school, agency, child guidance center,	17831
detention or rehabilitation facility, or children's clinic	17832
licensed, regulated, approved, operated under the direction of, or	17833
otherwise certified by the department of education, a local board	17834
of education, the department of youth services, the department of	17835
mental health, or the department of mental retardation and	17836
developmental disabilities, or any individual who provides care	17837
for only a single-family group, placed there by their parents or	17838
other relative having custody, shall not be considered as being	17839
within the purview of these sections.	17840

(B) "Family foster home" means a foster home that is not a	17841
specialized foster home.	17842

(C) "Foster caregiver" means a person holding a valid foster	17843
home certificate issued under section 5103.03 of the Revised Code.	17844

(D) "Foster home" means a private residence in which children	17845
are received apart from their parents, guardian, or legal	17846
custodian, by an individual reimbursed for providing the children	17847
nonsecure care, supervision, or training twenty-four hours a day.	17848
"Foster home" does not include care provided for a child in the	17849
home of a person other than the child's parent, guardian, or legal	17850
custodian while the parent, guardian, or legal custodian is	17851
temporarily away. Family foster homes and specialized foster homes	17852
are types of foster homes.	17853

(E) "Medically fragile foster home" means a foster home that	17854
provides specialized medical services designed to meet the needs	17855
of children with intensive health care needs who meet all of the	17856
following criteria:	17857

(1) Under rules adopted by the ~~department~~director of ~~job and~~	17858
~~family services~~health care administration governing payment under	17859
~~Chapter 5111. of the Revised Code~~the medicaid program for	17860
long-term care services, the children require a skilled level of	17861
care.	17862

(2) The children require the services of a doctor of medicine	17863
or osteopathic medicine at least once a week due to the	17864
instability of their medical conditions.	17865

(3) The children require the services of a registered nurse	17866
on a daily basis.	17867

(4) The children are at risk of institutionalization in a	17868
hospital, skilled nursing facility, or intermediate care facility	17869
for the mentally retarded.	17870

(F) "Recommending agency" means a public children services	17871
agency, private child placing agency, or private noncustodial	17872
agency that recommends that the department of job and family	17873
services take any of the following actions under section 5103.03	17874
of the Revised Code regarding a foster home:	17875

(1) Issue a certificate;

17876

(2) Deny a certificate;

17877

(3) Renew a certificate;

17878

(4) Deny renewal of a certificate;

17879

(5) Revoke a certificate.

17880

(G) "Specialized foster home" means a medically fragile	17881
foster home or a treatment foster home.	17882

(H) "Treatment foster home" means a foster home that	17883
incorporates special rehabilitative services designed to treat the	17884
specific needs of the children received in the foster home and	17885
that receives and cares for children who are emotionally or	17886
behaviorally disturbed, chemically dependent, mentally retarded,	17887
developmentally disabled, or who otherwise have exceptional needs.	17888

Sec. 5107.10. (A) As used in this section:

17889

(1) "Countable income," "gross earned income," and "gross	17890
unearned income" have the meanings established in rules adopted	17891
under section 5107.05 of the Revised Code.	17892

(2) "Federal poverty guidelines" has the same meaning as in	17893
section 5101.46 of the Revised Code, except that references to a	17894
person's family in the definition shall be deemed to be references	17895
to the person's assistance group.	17896

(3) "Gross income" means gross earned income and gross	17897
unearned income.	17898

(4) "Strike" means continuous concerted action in failing to	17899
report to duty; willful absence from one's position; or stoppage	17900
of work in whole from the full, faithful, and proper performance	17901
of the duties of employment, for the purpose of inducing,	17902
influencing, or coercing a change in wages, hours, terms, and	17903
other conditions of employment. "Strike" does not include a	17904
stoppage of work by employees in good faith because of dangerous	17905
or unhealthful working conditions at the place of employment that	17906
are abnormal to the place of employment.	17907

(B) Under the Ohio works first program, an assistance group	17908
shall receive, except as otherwise provided by this chapter,	17909
time-limited cash assistance. In the case of an assistance group	17910
that includes a minor head of household or adult, assistance shall	17911
be provided in accordance with the self-sufficiency contract	17912
entered into under section 5107.14 of the Revised Code.	17913

(C) To be eligible to participate in Ohio works first, an	17914
assistance group must meet all of the following requirements:	17915

(1) The assistance group, except as provided in division (E)	17916
of this section, must include at least one of the following:	17917

(a) A minor child who, except as provided in section 5107.24	17918
of the Revised Code, resides with a parent, or specified relative	17919
caring for the child, or, to the extent permitted by Title IV-A	17920
and federal regulations adopted until Title IV-A, resides with a	17921
guardian or custodian caring for the child;	17922

(b) A parent residing with and caring for the parent's minor	17923
child who receives benefits under the supplemental security income	17924
~~under Title XVI of the "Social Security Act," 86 Stat. 1475~~	17925
~~(1972), 42 U.S.C.A. 1383, as amended,~~program or federal, state,	17926
or local adoption assistance;	17927

(c) A specified relative residing with and caring for a minor	17928
child who is related to the specified relative in a manner that	17929
makes the specified relative a specified relative and receives	17930
supplemental security income or federal, state, or local foster	17931
care or adoption assistance;	17932

(d) A woman at least six months pregnant.

17933

(2) The assistance group must meet the income requirements	17934
established by division (D) of this section.	17935

(3) No member of the assistance group may be involved in a	17936
strike.	17937

(4) The assistance group must satisfy the requirements for	17938
Ohio works first established by this chapter and sections ~~5101.58,~~	17939
~~5101.59, and~~ 5101.83, 5160.37, and 5160.38 of the Revised Code.	17940

(5) The assistance group must meet requirements for Ohio	17941
works first established by rules adopted under section 5107.05 of	17942
the Revised Code.	17943

(D)(1) Except as provided in division (D)(4) of this section,	17944
to determine whether an assistance group is initially eligible to	17945
participate in Ohio works first, a county department of job and	17946
family services shall do the following:	17947

(a) Determine whether the assistance group's gross income	17948
exceeds fifty per cent of the federal poverty guidelines. In	17949
making this determination, the county department shall disregard	17950
amounts that federal statutes or regulations and sections 5101.17	17951
and 5117.10 of the Revised Code require be disregarded. The	17952
assistance group is ineligible to participate in Ohio works first	17953
if the assistance group's gross income, less the amounts	17954
disregarded, exceeds fifty per cent of the federal poverty	17955
guidelines.	17956

(b) If the assistance group's gross income, less the amounts	17957
disregarded pursuant to division (D)(1)(a) of this section, does	17958
not exceed fifty per cent of the federal poverty guidelines,	17959
determine whether the assistance group's countable income is less	17960
than the payment standard. The assistance group is ineligible to	17961
participate in Ohio works first if the assistance group's	17962
countable income equals or exceeds the payment standard.	17963

(2) For the purpose of determining whether an assistance	17964
group meets the income requirement established by division	17965
(D)(1)(a) of this section, the annual revision that the United	17966
States department of health and human services makes to the	17967
federal poverty guidelines shall go into effect on the first day	17968
of July of the year for which the revision is made.	17969

(3) To determine whether an assistance group participating in	17970
Ohio works first continues to be eligible to participate, a county	17971
department of job and family services shall determine whether the	17972
assistance group's countable income continues to be less than the	17973
payment standard. In making this determination, the county	17974
department shall disregard the first two hundred fifty dollars and	17975
fifty per cent of the remainder of the assistance group's gross	17976
earned income. No amounts shall be disregarded from the assistance	17977
group's gross unearned income. The assistance group ceases to be	17978
eligible to participate in Ohio works first if its countable	17979
income, less the amounts disregarded, equals or exceeds the	17980
payment standard.	17981

(4) If an assistance group reapplies to participate in Ohio	17982
works first not more than four months after ceasing to	17983
participate, a county department of job and family services shall	17984
use the income requirement established by division (D)(3) of this	17985
section to determine eligibility for resumed participation rather	17986
than the income requirement established by division (D)(1) of this	17987
section.	17988

(E)(1) An assistance group may continue to participate in	17989
Ohio works first even though a public children services agency	17990
removes the assistance group's minor children from the assistance	17991
group's home due to abuse, neglect, or dependency if the agency	17992
does both of the following:	17993

(a) Notifies the county department of job and family services	17994
at the time the agency removes the children that it believes the	17995
children will be able to return to the assistance group within six	17996
months;	17997

(b) Informs the county department at the end of each of the	17998
first five months after the agency removes the children that the	17999
parent, guardian, custodian, or specified relative of the children	18000
is cooperating with the case plans prepared for the children under	18001
section 2151.412 of the Revised Code and that the agency is making	18002
reasonable efforts to return the children to the assistance group.	18003

(2) An assistance group may continue to participate in Ohio	18004
works first pursuant to division (E)(1) of this section for not	18005
more than six payment months. This division does not affect the	18006
eligibility of an assistance group that includes a woman at least	18007
six months pregnant.	18008

Sec. 5107.14. (A) An assistance group is ineligible to	18009
participate in Ohio works first unless the following enter into a	18010
written self-sufficiency contract with the county department of	18011
job and family services not later than thirty days after the	18012
assistance group applies for or undergoes a redetermination of	18013
eligibility for the program:	18014

(1) Each adult member of the assistance group;

18015

(2) The assistance group's minor head of household unless the	18016
minor head of household is participating in the LEAP program.	18017

(B) A self-sufficiency contract shall set forth the rights	18018
and responsibilities of the assistance group as applicants for and	18019
participants of Ohio works first. Each self-sufficiency contract	18020
shall include, based on appraisals conducted under section	18021
5107.41 of the Revised Code and assessments conducted under	18022
section 5107.70 of the Revised Code, the following:	18023

(1) The assistance group's plan, developed under section	18024
5107.41 of the Revised Code, to achieve the goal of self	18025
sufficiency and personal responsibility through unsubsidized	18026
employment within the time limit for participating in Ohio works	18027
first established by section 5107.18 of the Revised Code;	18028

(2) Work activities, developmental activities, and	18029
alternative work activities to which members of the assistance	18030
group are assigned under sections 5107.40 to 5107.69 of the	18031
Revised Code;	18032

(3) The responsibility of a caretaker member of the	18033
assistance group to cooperate in establishing a minor child's	18034
paternity and establishing, modifying, and enforcing a support	18035
order for the child in accordance with section 5107.22 of the	18036
Revised Code;	18037

(4) Other responsibilities that members of the assistance	18038
group must satisfy to participate in Ohio works first and the	18039
consequences for failure or refusal to satisfy the	18040
responsibilities;	18041

(5) An agreement that, except as otherwise provided in a	18042
waiver issued under section 5107.714 of the Revised Code, the	18043
assistance group will comply with the conditions of participating	18044
in Ohio works first established by this chapter and sections	18045
~~5101.58, 5101.59, and~~ 5101.83, 5160.37 and 5160.38 of the Revised	18046
Code;	18047

(6) Assistance and services the county department will	18048
provide to the assistance group;	18049

(7) Assistance and services the child support enforcement	18050
agency and public children services agency will provide to the	18051
assistance group pursuant to a plan of cooperation entered into	18052
under section 307.983 of the Revised Code;	18053

(8) Other provisions designed to assist the assistance group	18054
in achieving self sufficiency and personal responsibility;	18055

(9) Procedures for assessing whether responsibilities are	18056
being satisfied and whether the contract should be amended;	18057

(10) Procedures for amending the contract.

18058

(C) No self-sufficiency contract shall include provisions	18059
regarding the LEAP program.	18060

(D) The county department shall provide without charge a copy	18061
of the self-sufficiency contract to each assistance group member	18062
who signs it.	18063

Sec. 5107.16. (A) If a member of an assistance group fails	18064
or refuses, without good cause, to comply in full with a provision	18065
of a self-sufficiency contract entered into under section 5107.14	18066
of the Revised Code, a county department of job and family	18067
services shall sanction the assistance group as follows:	18068

(1) For a first failure or refusal, the county department	18069
shall deny or terminate the assistance group's eligibility to	18070
participate in Ohio works first for one payment month;	18071

(2) For a second failure or refusal, the county department	18072
shall deny or terminate the assistance group's eligibility to	18073
participate in Ohio works first for three payment months;	18074

(3) For a third or subsequent failure or refusal, the county	18075
department shall deny or terminate the assistance group's	18076
eligibility to participate in Ohio works first for six payment	18077
months.	18078

(B) The director of job and family services shall establish	18079
standards for the determination of good cause for failure or	18080
refusal to comply in full with a provision of a self-sufficiency	18081
contract in rules adopted under section 5107.05 of the Revised	18082
Code.	18083

(C) After sanctioning an assistance group under division (A)	18084
of this section, a county department of job and family services	18085
shall continue to work with the assistance group.	18086

(D) An adult eligible for the medicaid program pursuant to	18087
division (A)~~(1)(a)~~ of section ~~5111.01~~5162.01 of the Revised Code	18088
who is sanctioned under division (A)(3) of this section for a	18089
failure or refusal, without good cause, to comply in full with a	18090
provision of a self-sufficiency contract related to work	18091
responsibilities under sections 5107.40 to 5107.69 of the Revised	18092
Code loses eligibility for the medicaid program unless the adult	18093
is otherwise eligible for the medicaid program pursuant to	18094
another division of section ~~5111.01~~5162.01 of the Revised Code.	18095

An assistance group that would be participating in Ohio	18096
works first if not for a sanction under this section shall	18097
continue to be eligible for all of the following:	18098

(1) Publicly funded child care in accordance with division	18099
(A)(3) of section 5104.30 of the Revised Code;	18100

(2) Support services in accordance with section 5107.66 of	18101
the Revised Code;	18102

(3) To the extent permitted by the "Fair Labor Standards Act	18103
of 1938," 52 Stat. 1060, 29 U.S.C. 201, as amended, to	18104
participate in work activities, developmental activities, and	18105
alternative work activities in accordance with sections 5107.40 to	18106
5107.69 of the Revised Code.	18107

Sec. 5107.20. As used in this section, "support" means	18108
child support, spousal support, and support for a spouse or a	18109
former spouse.	18110

Participation in Ohio works first constitutes an assignment	18111
to the department of job and family services of any rights members	18112
of an assistance group have to support from any other person,	18113
excluding medical support assigned pursuant to section ~~5101.59~~	18114
5160.37 of the Revised Code. The rights to support assigned to the	18115
department pursuant to this section constitute an obligation of	18116
the person who is responsible for providing the support to the	18117
state for the amount of cash assistance provided to the assistance	18118
group.	18119

The office of child support in the department of job and	18120
family services shall collect and distribute support payments owed	18121
to Ohio works first participants, whether assigned to the	18122
department or unassigned, in accordance with 42 U.S.C. 654 B and	18123
657 and regulations adopted under those statutes, state statutes,	18124
and rules adopted under section 5107.05 of the Revised Code.	18125

Upon implementation of centralized collection and	18126
disbursement under Chapter 3121. of the Revised Code, in	18127
accordance with 42 U.S.C. 654 B and 657 and regulations adopted	18128
under those statutes, the department shall deposit support	18129
payments it receives pursuant to this section into the state	18130
treasury to the credit of the child support collections fund or	18131
the child support administrative fund, both of which are hereby	18132
created. Money credited to the funds shall be used to make cash	18133
assistance payments under Ohio works first.	18134

Sec. 5107.26. (A) As used in this section:

18135

(1) "Transitional child care" means publicly funded child	18136
care provided under division (A)(3) of section 5104.34 of the	18137
Revised Code.	18138

(2) "Transitional medicaid" means the medical assistance	18139
provided under the medicaid program pursuant to section ~~5111.0115~~	18140
5162.09 of the Revised Code.	18141

(B) Except as provided in division (C) of this section, each	18142
member of an assistance group participating in Ohio works first is	18143
ineligible to participate in the program for six payment months if	18144
a county department of job and family services determines that a	18145
member of the assistance group terminated the member's employment	18146
and each person who, on the day prior to the day a recipient	18147
begins to receive transitional child care or transitional	18148
medicaid, was a member of the recipient's assistance group is	18149
ineligible to participate in Ohio works first for six payment	18150
months if a county department determines that the recipient	18151
terminated the recipient's employment.	18152

(C) No assistance group member shall lose or be denied	18153
eligibility to participate in Ohio works first pursuant to	18154
division (B) of this section if the termination of employment was	18155
because an assistance group member or recipient of transitional	18156
child care or transitional medicaid secured comparable or better	18157
employment or the county department of job and family services	18158
certifies that the member or recipient terminated the employment	18159
with just cause.	18160

Just cause includes the following:

18161

(1) Discrimination by an employer based on age, race, sex,	18162
color, handicap, religious beliefs, or national origin;	18163

(2) Work demands or conditions that render continued	18164
employment unreasonable, such as working without being paid on	18165
schedule;	18166

(3) Employment that has become unsuitable due to any of the	18167
following:	18168

(a) The wage is less than the federal minimum wage;

18169

(b) The work is at a site subject to a strike or lockout,	18170
unless the strike has been enjoined under section 208 of the	18171
"Labor-Management Relations Act," 61 Stat. 155 (1947), 29 U.S.C.A.	18172
178, as amended, an injunction has been issued under section 10 of	18173
the "Railway Labor Act," 44 Stat. 586 (1926), 45 U.S.C.A. 160, as	18174
amended, or an injunction has been issued under section 4117.16 of	18175
the Revised Code;	18176

(c) The documented degree of risk to the member or	18177
recipient's health and safety is unreasonable;	18178

(d) The member or recipient is physically or mentally unfit	18179
to perform the employment, as documented by medical evidence or by	18180
reliable information from other sources.	18181

(4) Documented illness of the member or recipient or of	18182
another assistance group member of the member or recipient	18183
requiring the presence of the member or recipient;	18184

(5) A documented household emergency;

18185

(6) Lack of adequate child care for children of the member or	18186
recipient who are under six years of age.	18187

Sec. 5115.02. (A) An individual is not eligible for	18188
disability financial assistance under this chapter if any of the	18189
following apply:	18190

(1) The individual is eligible to participate in the Ohio	18191
works first program established under Chapter 5107. of the Revised	18192
Code; eligible ~~to receive~~for the supplemental security income	18193
~~provided pursuant to Title XVI of the "Social Security Act," 86~~	18194
~~Stat. 1475 (1972), 42 U.S.C. 1383, as amended~~program; or eligible	18195
to participate in or receive assistance through another state or	18196
federal program that provides financial assistance similar to	18197
disability financial assistance, as determined by the director of	18198
job and family services;	18199

(2) The individual is ineligible to participate in the Ohio	18200
works first program because of any of the following:	18201

(a) The time limit established by section 5107.18 of the	18202
Revised Code;	18203

(b) Failure to comply with an application or verification	18204
procedure;	18205

(c) The fraud control provisions of section 5101.83 of the	18206
Revised Code or the fraud control program established pursuant to	18207
45 C.F.R. 235.112, as in effect July 1, 1996;	18208

(d) The self-sufficiency contract provisions of sections	18209
5107.14 and 5107.16 of the Revised Code;	18210

(e) The minor parent provisions of section 5107.24 of the	18211
Revised Code;	18212

(f) The provisions of section 5107.26 of the Revised Code	18213
regarding termination of employment without just cause.	18214

(3) The individual, or any of the other individuals included	18215
in determining the individual's eligibility, is involved in a	18216
strike, as defined in section 5107.10 of the Revised Code;	18217

(4) For the purpose of avoiding consideration of property in	18218
determinations of the individual's eligibility for disability	18219
financial assistance or a greater amount of assistance, the	18220
individual has transferred property during the two years preceding	18221
application for or most recent redetermination of eligibility for	18222
disability assistance;	18223

(5) The individual is a child and does not live with the	18224
child's parents, guardians, or other persons standing in place of	18225
parents, unless the child is emancipated by being married, by	18226
serving in the armed forces, or by court order;	18227

(6) The individual ~~reside~~resides in a county home, city	18228
infirmary, jail, or public institution;	18229

(7) The individual is a fugitive felon as defined in section	18230
5101.26 of the Revised Code;	18231

(8) The individual is violating a condition of probation, a	18232
community control sanction, parole, or a post-release control	18233
sanction imposed under federal or state law.	18234

(B)(1) As used in division (B)(2) of this section,	18235
"assistance group" has the same meaning as in section 5107.02 of	18236
the Revised Code.	18237

(2) Ineligibility under division (A)(2)(c) or (d) of this	18238
section applies as follows:	18239

(a) In the case of an individual who is under eighteen years	18240
of age, the individual is ineligible only if the individual caused	18241
the assistance group to be ineligible to participate in the Ohio	18242
works first program or resides with an individual eighteen years	18243
of age or older who was a member of the same ineligible assistance	18244
group.	18245

(b) In the case of an individual who is eighteen years of age	18246
or older, the individual is ineligible regardless of whether the	18247
individual caused the assistance group to be ineligible to	18248
participate in the Ohio works first program.	18249

Sec. 5115.20. (A) The department of job and family services	18250
shall establish a disability advocacy program and each county	18251
department of job and family services shall establish a disability	18252
advocacy program unit or join with other county departments of job	18253
and family services to establish a joint county disability	18254
advocacy program unit. Through the program the department and	18255
county departments shall cooperate in efforts to assist applicants	18256
for and recipients of assistance under the disability financial	18257
assistance program and the disability medical assistance program,	18258
who might be eligible for benefits under the supplemental security	18259
income ~~benefits under Title XVI of the "Social Security Act," 86~~	18260
~~Stat. 1475 (1972), 42 U.S.C.A. 1383, as amended~~program, in	18261
applying for those benefits. The department of health care	18262
administration shall assist the department of job and family	18263
services and county departments with the program.	18264

As part of their disability advocacy programs, the state	18265
department and county departments may enter into contracts for the	18266
services of persons and government entities that in the judgment	18267
of the department or county department have demonstrated expertise	18268
in representing persons seeking supplemental security income	18269
benefits. Each contract shall require the person or entity with	18270
which a department contracts to assess each person referred to it	18271
by the department to determine whether the person appears to be	18272
eligible for supplemental security income benefits, and, if the	18273
person appears to be eligible, assist the person in applying and	18274
represent the person in any proceeding of the social security	18275
administration, including any appeal or reconsideration of a	18276
denial of benefits. The department or county department shall	18277
provide to the person or entity with which it contracts all	18278
records in its possession relevant to the application for	18279
supplemental security income benefits. The department shall	18280
require a county department with relevant records to submit them	18281
to the person or entity.	18282

(B) Each applicant for or recipient of disability financial	18283
assistance ~~or disability medical assistance~~ who, in the judgment	18284
of the department of job and family services or a county	18285
department of job and family services might be eligible for	18286
supplemental security benefits, shall, as a condition of	18287
eligibility for assistance, apply for such benefits if directed to	18288
do so by the department or county department.	18289

(C) ~~With regard to applicants for and recipients of~~	18290
~~disability financial assistance or disability medical assistance,~~	18291
~~each county department of job and family services shall do all of~~	18292
~~the following:~~	18293

~~(1) Identify applicants and recipients who might be eligible~~	18294
~~for supplemental security income benefits;~~	18295

~~(2) Assist applicants and recipients in securing~~	18296
~~documentation of disabling conditions or refer them for such~~	18297
~~assistance to a person or government entity with which the~~	18298
~~department or county department has contracted under division (A)~~	18299
~~of this section;~~	18300

~~(3) Inform applicants and recipients of available sources of~~	18301
~~representation, which may include a person or government entity~~	18302
~~with which the department or county department has contracted~~	18303
~~under division (A) of this section, and of their right to~~	18304
~~represent themselves in reconsiderations and appeals of social~~	18305
~~security administration decisions that deny them supplemental~~	18306
~~security income benefits. The county department may require the~~	18307
~~applicants and recipients, as a condition of eligibility for~~	18308
~~assistance, to pursue reconsiderations and appeals of social~~	18309
~~security administration decisions that deny them supplemental~~	18310
~~security income benefits, and shall assist applicants and~~	18311
~~recipients as necessary to obtain such benefits or refer them to a~~	18312
~~person or government entity with which the department or county~~	18313
~~department has contracted under division (A) of this section~~.	18314

~~(4) Require applicants and recipients who, in the judgment~~	18315
~~of the county department, are or may be aged, blind, or disabled,~~	18316
~~to apply for medical assistance under Chapter 5111. of the Revised~~	18317
~~Code, make determinations when appropriate as to eligibility for~~	18318
~~medical assistance, and refer their applications when necessary to~~	18319
~~the disability determination unit established in accordance with~~	18320
~~division (F) of this section for expedited review;~~	18321

~~(5) Require each applicant and recipient who in the judgment~~	18322
~~of the department or the county department might be eligible for~~	18323
~~supplemental security income benefits, as a condition of~~	18324
~~eligibility for disability financial assistance or disability~~	18325
~~medical assistance, to execute a written authorization for the~~	18326
~~secretary of health and human services to withhold benefits due~~	18327
~~that individual and pay to the director of job and family services~~	18328
~~or the director's designee an amount sufficient to reimburse the~~	18329
~~state and county shares of interim assistance furnished to the~~	18330
~~individual. For the purposes of division (C)(5) of this section,~~	18331
~~"benefits" and "interim assistance" have the meanings given in~~	18332
~~Title XVI of the "Social Security Act."~~	18333

~~(D)~~ The director of job and family services shall adopt rules	18334
in accordance with section 111.15 of the Revised Code for the	18335
effective administration of the disability advocacy program. The	18336
rules shall include all of the following:	18337

(1) Methods to be used in collecting information from and	18338
disseminating it to county departments, including the following:	18339

(a) The number of individuals in the county who are disabled	18340
recipients of disability financial assistance or disability	18341
medical assistance;	18342

(b) The final decision made either by the social security	18343
administration or by a court for each application or	18344
reconsideration in which an individual was assisted pursuant to	18345
this section.	18346

(2) The type and process of training to be provided by the	18347
department of job and family services to the employees of the	18348
county department of job and family services who perform duties	18349
under this section and section 329.043 of the Revised Code;	18350

(3) Requirements for the written authorization required by	18351
division ~~(C)(5)~~(E) of ~~this~~ section 329.043 of the Revised Code.	18352

~~(E)~~(D) The department of job and family services shall	18353
provide basic and continuing training to employees of the county	18354
department of job and family services who perform duties under	18355
this section and section 329.043 of the Revised Code. Training	18356
shall include but not be limited to all processes necessary to	18357
obtain federal disability benefits, and methods of advocacy.	18358

~~(F) The department shall establish a disability determination~~	18359
~~unit and develop guidelines for expediting reviews of applications~~	18360
~~for medical assistance under Chapter 5111. of the Revised Code for~~	18361
~~persons who have been referred to the unit under division (C)(4)~~	18362
~~of this section. The department shall make determinations of~~	18363
~~eligibility for medical assistance for any such person within the~~	18364
~~time prescribed by federal regulations.~~	18365

~~(G)~~(E) The department of job and family services may, under	18366
rules the director of job and family services adopts in accordance	18367
with section 111.15 of the Revised Code, pay a portion of the	18368
federal reimbursement described in division ~~(C)(5)~~(E) of ~~this~~	18369
section 329.043 of the Revised Code to persons or government	18370
entities that assist or represent assistance recipients in	18371
reconsiderations and appeals of social security administration	18372
decisions denying them supplemental security income benefits.	18373

~~(H)~~(F) The director of job and family services shall conduct	18374
investigations to determine whether disability advocacy programs	18375
are being administered in compliance with the Revised Code and the	18376
rules adopted by the director pursuant to this section.	18377

Sec. 5115.22. (A) If a recipient of disability financial	18378
assistance ~~or disability medical assistance~~, or an individual	18379
whose income and resources are included in determining the	18380
recipient's eligibility for the assistance, becomes possessed of	18381
resources or income in excess of the amount allowed to retain	18382
eligibility, or if other changes occur that affect the recipient's	18383
eligibility or need for assistance, the recipient shall notify the	18384
state or county department of job and family services within the	18385
time limits specified in rules adopted by the director of job and	18386
family services in accordance with section 111.15 of the Revised	18387
Code. Failure of a recipient to report possession of excess	18388
resources or income or a change affecting eligibility or need	18389
within those time limits shall be considered prima-facie evidence	18390
of intent to defraud under section 5115.23 of the Revised Code.	18391

(B) As a condition of eligibility for disability financial	18392
assistance ~~or disability medical assistance~~, and as a means of	18393
preventing or reducing the provision of assistance at public	18394
expense, each applicant for or recipient of the assistance shall	18395
make reasonable efforts to secure support from persons responsible	18396
for the applicant's or recipient's support, and from other	18397
sources, including any federal program designed to provide	18398
assistance to individuals with disabilities. The state or county	18399
department of job and family services may provide assistance to	18400
the applicant or recipient in securing other forms of financial	18401
assistance.	18402

Sec. 5115.23. As used in this section, "erroneous payments"	18403
means disability financial assistance payments ~~or disability~~	18404
~~medical assistance payments~~ made to persons who are not entitled	18405
to receive them, including payments made as a result of	18406
misrepresentation or fraud, and payments made due to an error by	18407
the recipient or by the county department of job and family	18408
services that made the payment.	18409

The department of job and family services shall adopt rules	18410
in accordance with section 111.15 of the Revised Code specifying	18411
the circumstances under which action is to be taken under this	18412
section to recover erroneous payments. The department, or a county	18413
department of job and family services at the request of the	18414
department, shall take action to recover erroneous payments in the	18415
circumstances specified in the rules. The department or county	18416
department may institute a civil action to recover erroneous	18417
payments.	18418

Whenever disability financial assistance ~~or disability~~	18419
~~medical assistance~~ has been furnished to a recipient for whose	18420
support another person is responsible, the other person shall, in	18421
addition to the liability otherwise imposed, as a consequence of	18422
failure to support the recipient, be liable for all assistance	18423
furnished the recipient. The value of the assistance so furnished	18424
may be recovered in a civil action brought by the county	18425
department of job and family services.	18426

Each county department of job and family services shall	18427
retain fifty per cent of the erroneous payments it recovers under	18428
this section. The department of job and family services shall	18429
receive the remaining fifty per cent.	18430

Sec. 5117.10. (A) On or before the fifteenth day of January,	18431
the director of development shall pay each applicant determined	18432
eligible for a payment under divisions (A) and (B) of section	18433
5117.07 of the Revised Code one hundred twenty-five dollars.	18434

(B) The director may withhold from any payment to which a	18435
person would otherwise be entitled under division (A) of this	18436
section any amount that the director determines was erroneously	18437
received by such person in a preceding year under this or the	18438
program established under Am. Sub. H.B. 230, as amended by Am.	18439
H.B. 937, Am. Sub. H.B. 1073, Am. Sub. S.B. 493, and Am. Sub. S.B.	18440
523 of the 112th general assembly, provided the director has	18441
employed all other legal methods reasonably available to obtain	18442
reimbursement for the erroneous payment or credit prior to the	18443
commencement of the current program year.	18444

(C) Payments made under this section and credits granted	18445
under section 5117.09 of the Revised Code shall not be considered	18446
income for the purpose of determining eligibility or the level of	18447
benefits or assistance under section 329.042 or Chapters 5107.,	18448
~~5111.,~~ and 5115. of the Revised Code; the medicaid program; the	18449
disability medical assistance program; supplemental security	18450
income payments ~~under Title XVI of the "Social Security Act," 49~~	18451
~~Stat. 620 (1935), 42 U.S.C. 301, as amended~~; or any other program	18452
under which eligibility or the level of benefits or assistance is	18453
based upon need measured by income.	18454

Sec. 5119.04. The department of mental health and any	18455
institutions under its supervision or jurisdiction shall, where	18456
applicable, be in substantial compliance with standards set forth	18457
for psychiatric facilities by the joint commission on	18458
accreditation of healthcare organizations or ~~medical assistance~~	18459
medicaid standards ~~under Title XIX of the "Social Security Act,"~~	18460
~~49 Stat. 620 (1935), 42 U.S.C. 301, as amended~~, or other	18461
applicable standards, except that the department and any	18462
institution under its supervision or jurisdiction shall be in	18463
substantial compliance with standards for physical facilities and	18464
equipment by July 1, 1989. The requirements of this section do not	18465
apply to any facility designated by the director of mental health	18466
for use as a psychiatric rehabilitation center.	18467

The requirements of this section are in addition to any other	18468
requirements established by the Revised Code and nothing in this	18469
section shall be construed to limit any rights, privileges,	18470
protections, or immunities which may exist under the constitution	18471
and laws of the United States or this state.	18472

Sec. 5119.061. (A) As used in this section, "mentally ill	18473
individual" and "specialized services" have the same meanings as	18474
in section ~~5111.202~~5119.061 of the Revised Code.	18475

(B)(1) Except as provided in division (B)(2) of this section	18476
and rules adopted under division (E)(3) of this section, for	18477
purposes of section ~~5111.202~~5119.061 of the Revised Code, the	18478
department of mental health shall determine in accordance with	18479
~~section 1919(e)(7) of the "Social Security Act," 49 Stat. 620~~	18480
~~(1935),~~ 42 U.S.C.~~A. 301, as amended,~~1396r(e)(7) and regulations	18481
adopted under ~~section 1919(f)(8)(A) of that act~~42 U.S.C.	18482
1396r(f)(8)(A) whether, because of the individual's physical and	18483
mental condition, a mentally ill individual seeking admission to a	18484
nursing facility requires the level of services provided by a	18485
nursing facility and, if the individual requires that level of	18486
services, whether the individual requires specialized services for	18487
mental illness. The determination required by this division shall	18488
be based on an independent physical and mental evaluation	18489
performed by a person or entity other than the department.	18490

(2) A determination under this division is not required for	18491
any of the following:	18492

(a) An individual seeking readmission to a nursing facility	18493
after having been transferred from a nursing facility to a	18494
hospital for care;	18495

(b) An individual who meets all of the following conditions:

18496

(i) The individual is admitted to the nursing facility	18497
directly from a hospital after receiving inpatient care at the	18498
hospital;	18499

(ii) The individual requires nursing facility services for	18500
the condition for which care in the hospital was received;	18501

(iii) The individual's attending physician has certified,	18502
before admission to the nursing facility, that the individual is	18503
likely to require less than thirty days of nursing facility	18504
services.	18505

(c) An individual transferred from one nursing facility to	18506
another nursing facility, with or without an intervening hospital	18507
stay.	18508

(C) Except as provided in rules adopted under division (F)(3)	18509
of this section, the department of mental health shall review and	18510
determine for each resident of a nursing facility who is mentally	18511
ill, whether the resident, because of the resident's physical and	18512
mental condition, requires the level of services provided by a	18513
nursing facility and whether the resident requires specialized	18514
services for mental illness. The review and determination shall be	18515
conducted in accordance with section 1919(e)(7) of the "Social	18516
Security Act" and the regulations adopted under section	18517
1919(f)(8)(A) of the act and based on an independent physical and	18518
mental evaluation performed by a person or entity other than the	18519
department. The review and determination shall be completed	18520
promptly after a nursing facility has notified the department that	18521
there has been a significant change in the resident's mental or	18522
physical condition.	18523

(D)(1) In the case of a nursing facility resident who has	18524
continuously resided in a nursing facility for at least thirty	18525
months before the date of a review and determination under	18526
division (C) of this section, if the resident is determined not to	18527
require the level of services provided by a nursing facility, but	18528
is determined to require specialized services for mental illness,	18529
the department, in consultation with the resident's family or	18530
legal representative and care givers, shall do all of the	18531
following:	18532

(a) Inform the resident of the institutional and	18533
noninstitutional alternatives covered under the state medicaid	18534
plan ~~for medical assistance~~;	18535

(b) Offer the resident the choice of remaining in the nursing	18536
facility or receiving covered services in an alternative	18537
institutional or noninstitutional setting;	18538

(c) Clarify the effect on eligibility for services under the	18539
state medicaid plan ~~for medical assistance~~ if the resident chooses	18540
to leave the facility, including its effect on readmission to the	18541
facility;	18542

(d) Provide for or arrange for the provision of specialized	18543
services for the resident's mental illness in the setting chosen	18544
by the resident.	18545

(2) In the case of a nursing facility resident who has	18546
continuously resided in a nursing facility for less than thirty	18547
months before the date of the review and determination under	18548
division (C) of this section, if the resident is determined not to	18549
require the level of services provided by a nursing facility, but	18550
is determined to require specialized services for mental illness,	18551
or if the resident is determined to require neither the level of	18552
services provided by a nursing facility nor specialized services	18553
for mental illness, the department shall act in accordance with	18554
its alternative disposition plan approved by the United States	18555
department of health and human services under section	18556
1919(e)(7)(E) of the "Social Security Act."	18557

(3) In the case of an individual who is determined under	18558
division (B) or (C) of this section to require both the level of	18559
services provided by a nursing facility and specialized services	18560
for mental illness, the department of mental health shall provide	18561
or arrange for the provision of the specialized services needed by	18562
the individual or resident while residing in a nursing facility.	18563

(E) The department of mental health shall adopt rules in	18564
accordance with Chapter 119. of the Revised Code that do all of	18565
the following:	18566

(1) Establish criteria to be used in making the	18567
determinations required by divisions (B) and (C) of this section.	18568
The criteria shall not exceed the criteria established by	18569
regulations adopted by the United States department of health and	18570
human services under section 1919(f)(8)(A) of the "Social Security	18571
Act."	18572

(2) Specify information to be provided by the individual or	18573
nursing facility resident being assessed;	18574

(3) Specify any circumstances, in addition to circumstances	18575
listed in division (B) of this section, under which determinations	18576
under divisions (B) and (C) of this section are not required to be	18577
made.	18578

Sec. 5119.16. As used in this section, "free clinic" has the	18579
same meaning as in section 2305.2341 of the Revised Code.	18580

(A) The department of mental health is hereby designated to	18581
provide certain goods and services for the department of mental	18582
health, the department of mental retardation and developmental	18583
disabilities, the department of rehabilitation and correction, the	18584
department of youth services, and other state, county, or	18585
municipal agencies requesting ~~such~~those goods and services when	18586
the department of mental health determines that it is in the	18587
public interest, and considers it advisable, to provide ~~these~~	18588
those goods and services. The department of mental health also may	18589
provide goods and services to agencies operated by the United	18590
States government and to public or private nonprofit agencies,	18591
other than free clinics, that are funded in whole or in part by	18592
the state if the public or private nonprofit agencies are	18593
designated for participation in this program by the director of	18594
mental health for community mental health agencies, the director	18595
of mental retardation and developmental disabilities for community	18596
mental retardation and developmental disabilities agencies, the	18597
director of rehabilitation and correction for community	18598
rehabilitation and correction agencies, or the director of youth	18599
services for community youth services agencies.	18600

Designated community agencies shall receive goods and	18601
services through the department of mental health only in those	18602
cases where the designating state agency certifies that providing	18603
~~such~~the goods and services to the agency will conserve public	18604
resources to the benefit of the public and where the provision of	18605
~~such~~the goods and services is considered feasible by the	18606
department of mental health.	18607

(B) The department of mental health may permit free clinics	18608
to purchase certain goods and services to the extent the purchases	18609
fall within the exemption to the Robinson-Patman Act, 15 U.S.C. 13	18610
et seq., applicable to ~~non-profit~~nonprofit institutions, in 15	18611
U.S.C. 13c, as amended.	18612

(C) The goods and services to be provided by the department	18613
of mental health under divisions (A) and (B) of this section may	18614
include all of the following:	18615

(1) Procurement, storage, processing, and distribution of	18616
food and professional consultation on food operations;	18617

(2) Procurement, storage, and distribution of medical and	18618
laboratory supplies, dental supplies, medical records, forms,	18619
optical supplies, and sundries, subject to section 5120.135 of the	18620
Revised Code;	18621

(3) Procurement, storage, repackaging, distribution, and	18622
dispensing of drugs, the provision of professional pharmacy	18623
consultation, and drug information services;	18624

(4) Other goods and services as may be agreed to.

18625

(D) ~~The~~Subject to section 5160.75 of the Revised Code, the	18626
department of mental health shall provide the goods and services	18627
designated in division (C) of this section to its institutions and	18628
to state-operated community-based mental health services.	18629

(E) After consultation with and advice from the director of	18630
mental retardation and developmental disabilities, the director of	18631
rehabilitation and correction, and the director of youth services	18632
and subject to section 5160.75 of the Revised Code, the department	18633
of mental health shall provide the goods and services designated	18634
in division (C) of this section to the department of mental	18635
retardation and developmental disabilities, the department of	18636
rehabilitation and correction, and the department of youth	18637
services.	18638

(F) The cost of administration of this section shall be	18639
determined by the department of mental health and paid by the	18640
agencies or free clinics receiving the goods and services to the	18641
department for deposit in the state treasury to the credit of the	18642
mental health fund, which is hereby created. The fund shall be	18643
used to pay the cost of administration of this section to the	18644
department.	18645

(G) If the goods or services designated in division (C) of	18646
this section are not provided in a satisfactory manner by the	18647
department of mental health to the agencies described in division	18648
(A) of this section, the director of mental retardation and	18649
developmental disabilities, the director of rehabilitation and	18650
correction, the director of youth services, or the managing	18651
officer of a department of mental health institution shall attempt	18652
to resolve unsatisfactory service with the director of mental	18653
health. If, after ~~such~~the attempt, the provision of goods or	18654
services continues to be unsatisfactory, the director or officer	18655
shall notify the director of mental health. If, within thirty days	18656
of ~~such~~that notice the department of mental health does not	18657
provide the specified goods and services in a satisfactory manner,	18658
the director of mental retardation and developmental disabilities,	18659
the director of rehabilitation and correction, the director of	18660
youth services, or the managing officer of the department of	18661
mental health institution shall notify the director of mental	18662
health of the director's or managing officer's intent to cease	18663
purchasing goods and services from the department. Following a	18664
sixty-day cancellation period from the date of ~~such~~that notice	18665
and subject to section 5160.75 of the Revised Code, the department	18666
of mental retardation, department of rehabilitation and	18667
correction, department of youth services, or the department of	18668
mental health institution may obtain the goods and services from a	18669
source other than the department of mental health, if the	18670
department certifies to the department of administrative services	18671
that the requirements of this division have been met.	18672

(H) Whenever a state agency fails to make a payment for goods	18673
and services provided under this section within thirty-one days	18674
after the date the payment was due, the office of budget and	18675
management may transfer moneys from the state agency to the	18676
department of mental health. The amount transferred shall not	18677
exceed the amount of overdue payments. Prior to making a transfer	18678
under this division, the office of budget and management shall	18679
apply any credits the state agency has accumulated in payments for	18680
goods and services provided under this section.	18681

(I) Purchases of goods and services under this section are	18682
not subject to section 307.86 of the Revised Code.	18683

(J) The department shall not perform any acts described in	18684
division (A)(3) of this section for state departments or other	18685
state agencies covered by the operation of section 5160.75 of the	18686
Revised Code.	18687

Sec. 5119.351. The department of mental health may pay an	18688
amount for personal use to each individual residing in a state	18689
institution as described in section 5119.02 of the Revised Code	18690
who would be eligible for supplemental security income benefits at	18691
the reduced rate established by ~~Title XVI of the "Social Security~~	18692
~~Act," 49 Stat. 620 (1935), 42 U.S.C.A. 1382, as amended~~the	18693
supplemental security income program, if the state medicaid plan	18694
~~for providing medical assistance under section 5111.01 of the~~	18695
~~Revised Code~~ included reimbursement of services provided in such	18696
institutions. The amount paid by the department shall not exceed	18697
the reduced supplemental security income benefit rate established	18698
by ~~Title XVI of the "Social Security Act~~the program."	18699

Sec. 5119.61. Any provision in this chapter that refers to a	18700
board of alcohol, drug addiction, and mental health services also	18701
refers to the community mental health board in an alcohol, drug	18702
addiction, and mental health service district that has a community	18703
mental health board.	18704

The director of mental health with respect to all facilities	18705
and programs established and operated under Chapter 340. of the	18706
Revised Code for mentally ill and emotionally disturbed persons,	18707
shall do all of the following:	18708

(A) Adopt rules pursuant to Chapter 119. of the Revised Code	18709
that may be necessary to carry out the purposes of Chapter 340.	18710
and sections 5119.61 to 5119.63 of the Revised Code.	18711

(1) The rules shall include all of the following:

18712

(a) Rules governing a community mental health agency's	18713
services under section 340.091 of the Revised Code to an	18714
individual referred to the agency under division (C)(2) of section	18715
~~173.35~~5160.80 of the Revised Code;	18716

(b) For the purpose of division (A)(16) of section 340.03 of	18717
the Revised Code, rules governing the duties of mental health	18718
agencies and boards of alcohol, drug addiction, and mental health	18719
services under section 3722.18 of the Revised Code regarding	18720
referrals of individuals with mental illness or severe mental	18721
disability to adult care facilities and effective arrangements for	18722
ongoing mental health services for the individuals. The rules	18723
shall do at least the following:	18724

(i) Provide for agencies and boards to participate fully in	18725
the procedures owners and managers of adult care facilities must	18726
follow under division (A)(2) of section 3722.18 of the Revised	18727
Code;	18728

(ii) Specify the manner in which boards are accountable for	18729
ensuring that ongoing mental health services are effectively	18730
arranged for individuals with mental illness or severe mental	18731
disability who are referred by the board or mental health agency	18732
under contract with the board to an adult care facility.	18733

(c) Rules governing a board of alcohol, drug addiction, and	18734
mental health services when making a report to the director of	18735
health under section 3722.17 of the Revised Code regarding the	18736
quality of care and services provided by an adult care facility to	18737
a person with mental illness or a severe mental disability.	18738

(2) Rules may be adopted to govern the method of paying a	18739
community mental health facility, as defined in section ~~5111.023~~	18740
5163.20 of the Revised Code, for providing services listed in	18741
division (B) of that section. Such rules must be consistent with	18742
the contract entered into between the departments of ~~job and~~	18743
~~family services~~health care administration and mental health under	18744
section ~~5111.91~~5161.05 of the Revised Code and include	18745
requirements ensuring appropriate service utilization.	18746

(B) Review and evaluate, and, taking into account the	18747
findings and recommendations of the board of alcohol, drug	18748
addiction, and mental health services of the district served by	18749
the program and the requirements and priorities of the state	18750
mental health plan, including the needs of residents of the	18751
district now residing in state mental institutions, approve and	18752
allocate funds to support community programs, and make	18753
recommendations for needed improvements to boards of alcohol, drug	18754
addiction, and mental health services;	18755

(C) Withhold state and federal funds for any program, in	18756
whole or in part, from a board of alcohol, drug addiction, and	18757
mental health services in the event of failure of that program to	18758
comply with Chapter 340. or section 5119.61, 5119.611, 5119.612,	18759
or 5119.62 of the Revised Code or rules of the department of	18760
mental health. The director shall identify the areas of	18761
noncompliance and the action necessary to achieve compliance. The	18762
director shall offer technical assistance to the board to achieve	18763
compliance. The director shall give the board a reasonable time	18764
within which to comply or to present its position that it is in	18765
compliance. Before withholding funds, a hearing shall be conducted	18766
to determine if there are continuing violations and that either	18767
assistance is rejected or the board is unable to achieve	18768
compliance. Subsequent to the hearing process, if it is determined	18769
that compliance has not been achieved, the director may allocate	18770
all or part of the withheld funds to a public or private agency to	18771
provide the services not in compliance until the time that there	18772
is compliance. The director shall establish rules pursuant to	18773
Chapter 119. of the Revised Code to implement this division.	18774

(D) Withhold state or federal funds from a board of alcohol,	18775
drug addiction, and mental health services that denies available	18776
service on the basis of religion, race, color, creed, sex,	18777
national origin, age, disability as defined in section 4112.01 of	18778
the Revised Code, developmental disability, or the inability to	18779
pay;	18780

(E) Provide consultative services to community mental health	18781
agencies with the knowledge and cooperation of the board of	18782
alcohol, drug addiction, and mental health services;	18783

(F) Provide to boards of alcohol, drug addiction, and mental	18784
health services state or federal funds, in addition to those	18785
allocated under section 5119.62 of the Revised Code, for special	18786
programs or projects the director considers necessary but for	18787
which local funds are not available;	18788

(G) Establish criteria by which a board of alcohol, drug	18789
addiction, and mental health services reviews and evaluates the	18790
quality, effectiveness, and efficiency of services provided	18791
through its community mental health plan. The criteria shall	18792
include requirements ensuring appropriate service utilization. The	18793
department shall assess a board's evaluation of services and the	18794
compliance of each board with this section, Chapter 340. or	18795
section 5119.62 of the Revised Code, and other state or federal	18796
law and regulations. The department, in cooperation with the	18797
board, periodically shall review and evaluate the quality,	18798
effectiveness, and efficiency of services provided through each	18799
board. The department shall collect information that is necessary	18800
to perform these functions.	18801

(H) Develop and operate a community mental health information	18802
system.	18803

Boards of alcohol, drug abuse, and mental health services	18804
shall submit information requested by the department in the form	18805
and manner prescribed by the department. Information collected by	18806
the department shall include, but not be limited to, all of the	18807
following:	18808

(1) Information regarding units of services provided in whole	18809
or in part under contract with a board, including diagnosis and	18810
special needs, demographic information, the number of units of	18811
service provided, past treatment, financial status, and service	18812
dates in accordance with rules adopted by the department in	18813
accordance with Chapter 119. of the Revised Code;	18814

(2) Financial information other than price or price-related	18815
data regarding expenditures of boards and community mental health	18816
agencies, including units of service provided, budgeted and actual	18817
expenses by type, and sources of funds.	18818

Boards shall submit the information specified in division	18819
(H)(1) of this section no less frequently than annually for each	18820
client, and each time the client's case is opened or closed. The	18821
department shall not collect any information for the purpose of	18822
identifying by name any person who receives a service through a	18823
board of alcohol, drug addiction, and mental health services,	18824
except as required by state or federal law to validate appropriate	18825
reimbursement. For the purposes of division (H)(1) of this	18826
section, the department shall use an identification system that is	18827
consistent with applicable nationally recognized standards.	18828

(I) Review each board's community mental health plan	18829
submitted pursuant to section 340.03 of the Revised Code and	18830
approve or disapprove it in whole or in part. Periodically, in	18831
consultation with representatives of boards and after considering	18832
the recommendations of the medical director, the director shall	18833
issue criteria for determining when a plan is complete, criteria	18834
for plan approval or disapproval, and provisions for conditional	18835
approval. The factors that the director considers may include, but	18836
are not limited to, the following:	18837

(1) The mental health needs of all persons residing within	18838
the board's service district, especially severely mentally	18839
disabled children, adolescents, and adults;	18840

(2) The demonstrated quality, effectiveness, efficiency, and	18841
cultural relevance of the services provided in each service	18842
district, the extent to which any services are duplicative of	18843
other available services, and whether the services meet the needs	18844
identified above;	18845

(3) The adequacy of the board's accounting for the	18846
expenditure of funds.	18847

If the director disapproves all or part of any plan, the	18848
director shall provide the board an opportunity to present its	18849
position. The director shall inform the board of the reasons for	18850
the disapproval and of the criteria that must be met before the	18851
plan may be approved. The director shall give the board a	18852
reasonable time within which to meet the criteria, and shall offer	18853
technical assistance to the board to help it meet the criteria.	18854

If the approval of a plan remains in dispute thirty days	18855
prior to the conclusion of the fiscal year in which the board's	18856
current plan is scheduled to expire, the board or the director may	18857
request that the dispute be submitted to a mutually agreed upon	18858
third-party mediator with the cost to be shared by the board and	18859
the department. The mediator shall issue to the board and the	18860
department recommendations for resolution of the dispute. Prior to	18861
the conclusion of the fiscal year in which the current plan is	18862
scheduled to expire, the director, taking into consideration the	18863
recommendations of the mediator, shall make a final determination	18864
and approve or disapprove the plan, in whole or in part.	18865

Sec. 5120.65. (A) The department of rehabilitation and	18866
correction may establish in one or more of the institutions for	18867
women operated by the department a prison nursery program under	18868
which eligible inmates and children born to them while in the	18869
custody of the department may reside together in the institution.	18870
If the department establishes a prison nursery program in one or	18871
more institutions under this section, sections 5120.651 to	18872
5120.657 of the Revised Code apply regarding the program. If the	18873
department establishes a prison nursery program and an inmate	18874
participates in the program, neither the inmate's participation in	18875
the program nor any provision of sections 5120.65 to 5120.657 of	18876
the Revised Code affects, modifies, or interferes with the	18877
inmate's custodial rights of the child or establishes legal	18878
custody of the child with the department.	18879

(B) As used in sections 5120.651 to 5120.657 of the Revised	18880
Code:	18881

(1) "Prison nursery program" means the prison nursery program	18882
established by the department of rehabilitation and correction	18883
under this section, if one is so established.	18884

(2) "Public assistance" ~~has the same meaning as in section~~	18885
~~5101.58 of the Revised Code~~means all of the following:	18886

(a) Medicaid;

18887

(b) Disability medical assistance;

18888

(c) The Ohio works first program established under Chapter	18889
5107. of the Revised Code;	18890

(d) Disability financial assistance established under Chapter	18891
5115. of the Revised Code.	18892

(3) "Support" means amounts to be paid under a support order.

18893

(4) "Support order" has the same meaning as in section	18894
3119.01 of the Revised Code.	18895

Sec. 5120.652. To participate in the prison nursery program,	18896
each eligible inmate selected by the department shall do all the	18897
following:	18898

(A) Agree in writing to do all the following:

18899

(1) Comply with any program, educational, counseling, and	18900
other requirements established for the program by the department	18901
of rehabilitation and correction;	18902

(2) If eligible, have the child participate in the medicaid	18903
program or a health insurance program;	18904

(3) Accept the normal risks of childrearing;

18905

(4) Abide by any court decisions regarding the allocation of	18906
parental rights and responsibilities with respect to the child.	18907

(B) Assign to the department any rights to support from any	18908
other person, excluding support assigned pursuant to section	18909
5107.20 of the Revised Code and medical support assigned pursuant	18910
to section ~~5101.59~~5160.37 of the Revised Code;	18911

(C) Specify with whom the child is to be placed in the event	18912
the inmate's participation in the program is terminated for a	18913
reason other than release from imprisonment.	18914

Sec. 5121.04. (A) The department of mental retardation and	18915
developmental disabilities shall investigate the financial	18916
condition of the residents in institutions, residents whose care	18917
or treatment is being paid for in a private facility or home under	18918
the control of the department, and of the relatives named in	18919
section 5121.06 of the Revised Code as liable for the support of	18920
such residents, in order to determine the ability of any resident	18921
or liable relatives to pay for the support of the resident and to	18922
provide suitable clothing as required by the superintendent of the	18923
institution.	18924

(B) The department shall follow the provisions of this	18925
division in determining the ability to pay of a resident or the	18926
resident's liable relatives and the amount to be charged such	18927
resident or liable relatives.	18928

(1) Subject to divisions (B)(10) and (11) of this section, a	18929
resident without dependents shall be liable for the full	18930
applicable cost. A resident without dependents who has a gross	18931
annual income equal to or exceeding the sum of the full applicable	18932
cost, plus fifty dollars per month, regardless of the source of	18933
such income, shall pay currently the full amount of the applicable	18934
cost; if the resident's gross annual income is less than such sum,	18935
not more than fifty dollars per month shall be kept for personal	18936
use by or on behalf of the resident, except as permitted in the	18937
state medicaid plan ~~for providing medical assistance under Title~~	18938
~~XIX of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.~~	18939
~~301, as amended~~, and the balance shall be paid currently on the	18940
resident's support. Subject to divisions (B)(10) and (11) of this	18941
section, the estate of a resident without dependents shall pay	18942
currently any remaining difference between the applicable cost and	18943
the amounts prescribed in this section, or shall execute an	18944
agreement with the department for payment to be made at some	18945
future date under terms suitable to the department. However, no	18946
security interest, mortgage, or lien shall be taken, granted, or	18947
charged against any principal residence of a resident without	18948
dependents under an agreement or otherwise to secure support	18949
payments, and no foreclosure actions shall be taken on security	18950
interests, mortgages, or liens taken, granted, or charged against	18951
principal residences of residents prior to October 7, 1977.	18952

(2) The ability to pay of a resident with dependents, or of a	18953
liable relative of a resident either with or without dependents,	18954
shall be determined in accordance with the resident's or liable	18955
relative's income or other assets, the needs of others who are	18956
dependent on such income and other assets for support, and, if	18957
applicable, divisions (B)(10) and (11) of this section.	18958

For the first thirty days of care and treatment of each	18959
admission, but in no event for more than thirty days in any	18960
calendar year, the resident with dependents or the liable	18961
relative of a resident either with or without dependents shall be	18962
charged an amount equal to the percentage of the average	18963
applicable cost determined in accordance with the schedule of	18964
adjusted gross annual income contained after this paragraph. After	18965
such first thirty days of care and treatment, such resident or	18966
such liable relative shall be charged an amount equal to the	18967
percentage of a base support rate of four dollars per day for	18968
residents, as determined in accordance with the schedule of gross	18969
annual income contained after this paragraph, or in accordance	18970
with division (B)(5) of this section. Beginning January 1, 1978,	18971
the department shall increase the base rate when the consumer	18972
price index average is more than 4.0 for the preceding calendar	18973
year by not more than the average for such calendar year.	18974

Adjusted Gross Annual		18975
Income of Resident		18976
or Liable Relative (FN a)	Number of Dependents (FN b)	18977

								8 or	18978
	1	2	3	4	5	6	7	more	18979
	Rate of Support (In Percentages)								18980
$15,000 or less	--	--	--	--	--	--	--	--	18981
15,001 to 17,500	20	--	--	--	--	--	--	--	18982
17,501 to 20,000	25	20	--	--	--	--	--	--	18983
20,001 to 21,000	30	25	20	--	--	--	--	--	18984
21,001 to 22,000	35	30	25	20	--	--	--	--	18985
22,001 to 23,000	40	35	30	25	20	--	--	--	18986
23,001 to 24,000	45	40	35	30	25	20	--	--	18987
24,001 to 25,000	50	45	40	35	30	25	20	--	18988
25,001 to 26,000	55	50	45	40	35	30	25	20	18989
26,001 to 27,000	60	55	50	45	40	35	30	25	18990
27,001 to 28,000	70	60	55	50	45	40	35	30	18991
28,001 to 30,000	80	70	60	55	50	45	40	35	18992
30,001 to 40,000	90	80	70	60	55	50	45	40	18993
40,001 and over	100	90	80	70	60	55	50	45	18994

Footnote a. The resident or relative shall furnish a copy of	18995
the resident's or relative's federal income tax return as evidence	18996
of gross annual income.	18997

Footnote b. The number of dependents includes the liable	18998
relative but excludes a resident in an institution. "Dependent"	18999
includes any person who receives more than half the person's	19000
support from the resident or the resident's liable relative.	19001

(3) A resident or liable relative having medical, funeral, or	19002
related expenses in excess of four per cent of the adjusted gross	19003
annual income, which expenses were not covered by insurance, may	19004
adjust such gross annual income by reducing the adjusted gross	19005
annual income by the full amount of such expenses. Proof of such	19006
expenses satisfactory to the department must be furnished.	19007

(4) Additional dependencies may be claimed if:

19008

(a) The liable relative is blind;

19009

(b) The liable relative is over sixty-five;

19010

(c) A child is a college student with expenses in excess of	19011
fifty dollars per month;	19012

(d) The services of a housekeeper, costing in excess of fifty	19013
dollars per month, are required if the person who normally keeps	19014
house for minor children is the resident.	19015

(5) If with respect to any resident with dependents there is	19016
chargeable under division (B)(2) of this section less than fifty	19017
per cent of the applicable cost or, if the base support rate was	19018
used, less than fifty per cent of the amount determined by use of	19019
the base support rate, and if with respect to such resident there	19020
is a liable relative who has an estate having a value in excess of	19021
fifteen thousand dollars or if such resident has a dependent and	19022
an estate having a value in excess of fifteen thousand dollars,	19023
there shall be paid with respect to such resident a total of fifty	19024
per cent of the applicable cost or the base support rate amount,	19025
as the case may be, on a current basis or there shall be executed	19026
with respect to such resident an agreement with the department for	19027
payment to be made at some future date under terms suitable to the	19028
department.	19029

(6) When a person has been a resident for fifteen years and	19030
the support charges for which a relative is liable have been paid	19031
for the fifteen-year period, the liable relative shall be relieved	19032
of any further support charges.	19033

(7) The department shall accept voluntary payments from	19034
residents or liable relatives whose incomes are below the minimum	19035
shown in the schedule set forth in this division. The department	19036
also shall accept voluntary payments in excess of required amounts	19037
from both liable and nonliable relatives.	19038

(8) If a resident is covered by an insurance policy, or other	19039
contract that provides for payment of expenses for care and	19040
treatment for mental retardation or other developmental disability	19041
at or from an institution or facility (including a community	19042
service unit under the jurisdiction of the department), the other	19043
provisions of this section, except divisions (B)(8), (10), and	19044
(11) of this section, and of section 5121.01 of the Revised Code	19045
shall be suspended to the extent that such insurance policy or	19046
other contract is in force, and such resident shall be charged the	19047
full amount of the applicable cost. Any insurance carrier or other	19048
third party payor providing coverage for such care and treatment	19049
shall pay for this support obligation in an amount equal to the	19050
lesser of either the applicable cost or the benefits provided	19051
under the policy or other contract. Whether or not an insured,	19052
owner of, or other person having an interest in such policy or	19053
other contract is liable for support payments under other	19054
provisions of this chapter, the insured, policy owner, or other	19055
person shall assign payment directly to the department of all	19056
assignable benefits under the policy or other contract and shall	19057
pay over to the department, within ten days of receipt, all	19058
insurance or other benefits received as reimbursement or payment	19059
for expenses incurred by the resident or for any other reason. If	19060
the insured, policy owner, or other person refuses to assign such	19061
payment to the department or refuses to pay such received	19062
reimbursements or payments over to the department within ten days	19063
of receipt, the insured's, policy owners', or other person's total	19064
liability for the services equals the applicable statutory	19065
liability for payment for the services as determined under other	19066
provisions of this chapter, plus the amounts payable under the	19067
terms of the policy or other contract. In no event shall this	19068
total liability exceed the full amount of the applicable cost.	19069
Upon its request, the department is entitled to a court order that	19070
compels the insured, owner of, or other person having an interest	19071
in the policy or other contract to comply with the assignment	19072
requirements of this division or that itself serves as a legally	19073
sufficient assignment in compliance with such requirements.	19074
Notwithstanding section 5123.89 of the Revised Code and any other	19075
law relating to confidentiality of records, the managing officer	19076
of the institution or facility where a person is or has been a	19077
resident shall disclose pertinent medical information concerning	19078
the resident to the insurance carrier or other third party payor	19079
in question, in order to effect collection from the carrier or	19080
payor of the state's claim for care and treatment under this	19081
division. For such disclosure, the managing officer is not subject	19082
to any civil or criminal liability.	19083

(9) The rate to be charged for pre-admission care,	19084
after-care, day-care, or routine consultation and treatment	19085
services shall be based upon the ability of the resident or the	19086
resident's liable relatives to pay. When it is determined by the	19087
department that a charge shall be made, such charge shall be	19088
computed as provided in divisions (B)(1) and (2) of this section.	19089

(10) If a resident with or without dependents is the	19090
beneficiary of a trust created pursuant to section 1339.51 of the	19091
Revised Code, then, notwithstanding any contrary provision of this	19092
chapter or of a rule adopted pursuant to this chapter, divisions	19093
(C) and (D) of that section shall apply in determining the assets	19094
or resources of the resident, the resident's estate, the settlor,	19095
or the settlor's estate and to claims arising under this chapter	19096
against the resident, the resident's estate, the settlor, or the	19097
settlor's estate.	19098

(11) If the department waives the liability of an individual	19099
and the individual's liable relatives pursuant to section 5123.194	19100
of the Revised Code, the liability of the individual and relative	19101
ceases in accordance with the waiver's terms.	19102

(C) The department may enter into agreements with a resident	19103
or a liable relative for support payments to be made in the	19104
future. However, no security interest, mortgage, or lien shall be	19105
taken, granted, or charged against any principal family residence	19106
of a resident with dependents or a liable relative under an	19107
agreement or otherwise to secure support payments, and no	19108
foreclosure actions shall be taken on security interests,	19109
mortgages or liens taken, granted, or charged against principal	19110
residences of residents or liable relatives prior to October 7,	19111
1977.	19112

(D) The department shall make all investigations and	19113
determinations required by this section within ninety days after a	19114
resident is admitted to an institution under the department's	19115
control and immediately shall notify by mail the persons liable of	19116
the amount to be charged.	19117

(E) All actions to enforce the collection of payments agreed	19118
upon or charged by the department shall be commenced within six	19119
years after the date of default of an agreement to pay support	19120
charges or the date such payment becomes delinquent. If a payment	19121
is made pursuant to an agreement which is in default, a new	19122
six-year period for actions to enforce the collection of payments	19123
under such agreement shall be computed from the date of such	19124
payment. For purposes of this division an agreement is in default	19125
or a payment is delinquent if a payment is not made within thirty	19126
days after it is incurred or a payment, pursuant to an agreement,	19127
is not made within thirty days after the date specified for such	19128
payment. In all actions to enforce the collection of payment for	19129
the liability for support, every court of record shall receive	19130
into evidence the proof of claim made by the state together with	19131
all debts and credits, and it shall be prima-facie evidence of the	19132
facts contained in it.	19133

Sec. 5123.01. As used in this chapter:

19134

(A) "Chief medical officer" means the licensed physician	19135
appointed by the managing officer of an institution for the	19136
mentally retarded with the approval of the director of mental	19137
retardation and developmental disabilities to provide medical	19138
treatment for residents of the institution.	19139

(B) "Chief program director" means a person with special	19140
training and experience in the diagnosis and management of the	19141
mentally retarded, certified according to division (C) of this	19142
section in at least one of the designated fields, and appointed by	19143
the managing officer of an institution for the mentally retarded	19144
with the approval of the director to provide habilitation and care	19145
for residents of the institution.	19146

(C) "Comprehensive evaluation" means a study, including a	19147
sequence of observations and examinations, of a person leading to	19148
conclusions and recommendations formulated jointly, with	19149
dissenting opinions if any, by a group of persons with special	19150
training and experience in the diagnosis and management of persons	19151
with mental retardation or a developmental disability, which group	19152
shall include individuals who are professionally qualified in the	19153
fields of medicine, psychology, and social work, together with	19154
such other specialists as the individual case may require.	19155

(D) "Education" means the process of formal training and	19156
instruction to facilitate the intellectual and emotional	19157
development of residents.	19158

(E) "Habilitation" means the process by which the staff of	19159
the institution assists the resident in acquiring and maintaining	19160
those life skills that enable the resident to cope more	19161
effectively with the demands of the resident's own person and of	19162
the resident's environment and in raising the level of the	19163
resident's physical, mental, social, and vocational efficiency.	19164
Habilitation includes but is not limited to programs of formal,	19165
structured education and training.	19166

(F) "Health officer" means any public health physician,	19167
public health nurse, or other person authorized or designated by a	19168
city or general health district.	19169

(G) "Home and community-based services" means medicaid-funded	19170
home and community-based services specified in division (B)(1) of	19171
section ~~5111.87~~5163.65 of the Revised Code provided under the	19172
medicaid waiver components the department of mental retardation	19173
and developmental disabilities administers pursuant to section	19174
~~5111.871~~5163.651 of the Revised Code.	19175

(H) "Indigent person" means a person who is unable, without	19176
substantial financial hardship, to provide for the payment of an	19177
attorney and for other necessary expenses of legal representation,	19178
including expert testimony.	19179

(I) "Institution" means a public or private facility, or a	19180
part of a public or private facility, that is licensed by the	19181
appropriate state department and is equipped to provide	19182
residential habilitation, care, and treatment for the mentally	19183
retarded.	19184

(J) "Licensed physician" means a person who holds a valid	19185
certificate issued under Chapter 4731. of the Revised Code	19186
authorizing the person to practice medicine and surgery or	19187
osteopathic medicine and surgery, or a medical officer of the	19188
government of the United States while in the performance of the	19189
officer's official duties.	19190

(K) "Managing officer" means a person who is appointed by the	19191
director of mental retardation and developmental disabilities to	19192
be in executive control of an institution for the mentally	19193
retarded under the jurisdiction of the department.	19194

(L) ~~"Medicaid" has the same meaning as in section 5111.01 of~~	19195
~~the Revised Code.~~	19196

~~(M)~~ "Medicaid case management services" means case management	19197
services provided to an individual with mental retardation or	19198
other developmental disability that the state medicaid plan	19199
requires.	19200

~~(N)~~(M) "Mentally retarded person" means a person having	19201
significantly subaverage general intellectual functioning existing	19202
concurrently with deficiencies in adaptive behavior, manifested	19203
during the developmental period.	19204

~~(O)~~(N) "Mentally retarded person subject to	19205
institutionalization by court order" means a person eighteen years	19206
of age or older who is at least moderately mentally retarded and	19207
in relation to whom, because of the person's retardation, either	19208
of the following conditions exist:	19209

(1) The person represents a very substantial risk of physical	19210
impairment or injury to self as manifested by evidence that the	19211
person is unable to provide for and is not providing for the	19212
person's most basic physical needs and that provision for those	19213
needs is not available in the community;	19214

(2) The person needs and is susceptible to significant	19215
habilitation in an institution.	19216

~~(P)~~(O) "A person who is at least moderately mentally	19217
retarded" means a person who is found, following a comprehensive	19218
evaluation, to be impaired in adaptive behavior to a moderate	19219
degree and to be functioning at the moderate level of intellectual	19220
functioning in accordance with standard measurements as recorded	19221
in the most current revision of the manual of terminology and	19222
classification in mental retardation published by the American	19223
association on mental retardation.	19224

~~(Q)~~(P) As used in this division, "substantial functional	19225
limitation," "developmental delay," and "established risk" have	19226
the meanings established pursuant to section 5123.011 of the	19227
Revised Code.	19228

"Developmental disability" means a severe, chronic disability	19229
that is characterized by all of the following:	19230

(1) It is attributable to a mental or physical impairment or	19231
a combination of mental and physical impairments, other than a	19232
mental or physical impairment solely caused by mental illness as	19233
defined in division (A) of section 5122.01 of the Revised Code.	19234

(2) It is manifested before age twenty-two.

19235

(3) It is likely to continue indefinitely.

19236

(4) It results in one of the following:

19237

(a) In the case of a person under three years of age, at	19238
least one developmental delay or an established risk;	19239

(b) In the case of a person at least three years of age but	19240
under six years of age, at least two developmental delays or an	19241
established risk;	19242

(c) In the case of a person six years of age or older, a	19243
substantial functional limitation in at least three of the	19244
following areas of major life activity, as appropriate for the	19245
person's age: self-care, receptive and expressive language,	19246
learning, mobility, self-direction, capacity for independent	19247
living, and, if the person is at least sixteen years of age,	19248
capacity for economic self-sufficiency.	19249

(5) It causes the person to need a combination and sequence	19250
of special, interdisciplinary, or other type of care, treatment,	19251
or provision of services for an extended period of time that is	19252
individually planned and coordinated for the person.	19253

~~(R)~~(Q) "Developmentally disabled person" means a person with	19254
a developmental disability.	19255

~~(S)~~(R) "State institution" means an institution that is	19256
tax-supported and under the jurisdiction of the department.	19257

~~(T)~~(S) "Residence" and "legal residence" have the same	19258
meaning as "legal settlement," which is acquired by residing in	19259
Ohio for a period of one year without receiving general assistance	19260
prior to July 17, 1995, under former Chapter 5113. of the Revised	19261
Code, financial assistance under Chapter 5115. of the Revised	19262
Code, or assistance from a private agency that maintains records	19263
of assistance given. A person having a legal settlement in the	19264
state shall be considered as having legal settlement in the	19265
assistance area in which the person resides. No adult person	19266
coming into this state and having a spouse or minor children	19267
residing in another state shall obtain a legal settlement in this	19268
state as long as the spouse or minor children are receiving	19269
public assistance, care, or support at the expense of the other	19270
state or its subdivisions. For the purpose of determining the	19271
legal settlement of a person who is living in a public or private	19272
institution or in a home subject to licensing by the department	19273
of job and family services, the department of mental health, or	19274
the department of mental retardation and developmental	19275
disabilities, the residence of the person shall be considered as	19276
though the person were residing in the county in which the person	19277
was living prior to the person's entrance into the institution or	19278
home. Settlement once acquired shall continue until a person has	19279
been continuously absent from Ohio for a period of one year or	19280
has acquired a legal residence in another state. A woman who	19281
marries a man with legal settlement in any county immediately	19282
acquires the settlement of her husband. The legal settlement of a	19283
minor is that of the parents, surviving parent, sole parent,	19284
parent who is designated the residential parent and legal	19285
custodian by a court, other adult having permanent custody	19286
awarded by a court, or guardian of the person of the minor,	19287
provided that:	19288

(1) A minor female who marries shall be considered to have	19289
the legal settlement of her husband and, in the case of death of	19290
her husband or divorce, she shall not thereby lose her legal	19291
settlement obtained by the marriage.	19292

(2) A minor male who marries, establishes a home, and who has	19293
resided in this state for one year without receiving general	19294
assistance prior to July 17, 1995, under former Chapter 5113. of	19295
the Revised Code, financial assistance under Chapter 5115. of the	19296
Revised Code, or assistance from a private agency that maintains	19297
records of assistance given shall be considered to have obtained a	19298
legal settlement in this state.	19299

(3) The legal settlement of a child under eighteen years of	19300
age who is in the care or custody of a public or private child	19301
caring agency shall not change if the legal settlement of the	19302
parent changes until after the child has been in the home of the	19303
parent for a period of one year.	19304

No person, adult or minor, may establish a legal settlement	19305
in this state for the purpose of gaining admission to any state	19306
institution.	19307

~~(U)~~(T)(1) "Resident" means, subject to division (R)(2) of	19308
this section, a person who is admitted either voluntarily or	19309
involuntarily to an institution or other facility pursuant to	19310
section 2945.39, 2945.40, 2945.401, or 2945.402 of the Revised	19311
Code subsequent to a finding of not guilty by reason of insanity	19312
or incompetence to stand trial or under this chapter who is under	19313
observation or receiving habilitation and care in an institution.	19314

(2) "Resident" does not include a person admitted to an	19315
institution or other facility under section 2945.39, 2945.40,	19316
2945.401, or 2945.402 of the Revised Code to the extent that the	19317
reference in this chapter to resident, or the context in which the	19318
reference occurs, is in conflict with any provision of sections	19319
2945.37 to 2945.402 of the Revised Code.	19320

~~(V)~~(U) "Respondent" means the person whose detention,	19321
commitment, or continued commitment is being sought in any	19322
proceeding under this chapter.	19323

~~(W)~~(V) "Working day" and "court day" mean Monday, Tuesday,	19324
Wednesday, Thursday, and Friday, except when such day is a legal	19325
holiday.	19326

~~(X)~~(W) "Prosecutor" means the prosecuting attorney, village	19327
solicitor, city director of law, or similar chief legal officer	19328
who prosecuted a criminal case in which a person was found not	19329
guilty by reason of insanity, who would have had the authority to	19330
prosecute a criminal case against a person if the person had not	19331
been found incompetent to stand trial, or who prosecuted a case in	19332
which a person was found guilty.	19333

~~(Y)~~(X) "Court" means the probate division of the court of	19334
common pleas.	19335

~~(Z)~~(Y) "Supported living" has the same meaning as in section	19336
5126.01 of the Revised Code.	19337

Sec. 5123.021. (A) As used in this section, "mentally	19338
retarded individual" and "specialized services" have the same	19339
meanings as in section ~~5111.202~~5164.45 of the Revised Code.	19340

(B)(1) Except as provided in division (B)(2) of this section	19341
and rules adopted under division (E)(3) of this section, for	19342
purposes of section ~~5111.202~~5164.41 of the Revised Code, the	19343
department of mental retardation and developmental disabilities	19344
shall determine in accordance with ~~section 1919(e)(7) of the~~	19345
~~"Social Security Act," 49 Stat. 620 (1935),~~ 42 U.S.C.~~A. 301, as~~	19346
~~amended,~~1396r(e)(7) and regulations adopted under ~~section~~	19347
~~1919(f)(8)(A) of that act~~42 U.S.C. 1396r(f)(8)(A) whether,	19348
because of the individual's physical and mental condition, a	19349
mentally retarded individual seeking admission to a nursing	19350
facility requires the level of services provided by a nursing	19351
facility and, if the individual requires that level of services,	19352
whether the individual requires specialized services for mental	19353
retardation.	19354

(2) A determination under this division is not required for	19355
any of the following:	19356

(a) An individual seeking readmission to a nursing facility	19357
after having been transferred from a nursing facility to a	19358
hospital for care;	19359

(b) An individual who meets all of the following conditions:

19360

(i) The individual is admitted to the nursing facility	19361
directly from a hospital after receiving inpatient care at the	19362
hospital;	19363

(ii) The individual requires nursing facility services for	19364
the condition for which the individual received care in the	19365
hospital;	19366

(iii) The individual's attending physician has certified,	19367
before admission to the nursing facility, that the individual is	19368
likely to require less than thirty days of nursing facility	19369
services.	19370

(c) An individual transferred from one nursing facility to	19371
another nursing facility, with or without an intervening hospital	19372
stay.	19373

(C) Except as provided in rules adopted under division (F)(3)	19374
of this section, the department of mental retardation and	19375
developmental disabilities shall review and determine, for each	19376
resident of a nursing facility who is mentally retarded, whether	19377
the resident, because of the resident's physical and mental	19378
condition, requires the level of services provided by a nursing	19379
facility and whether the resident requires specialized services	19380
for mental retardation. The review and determination shall be	19381
conducted in accordance with section 1919(e)(7) of the "Social	19382
Security Act" and the regulations adopted under section	19383
1919(f)(8)(A) of the act. The review and determination shall be	19384
completed promptly after a nursing facility has notified the	19385
department that there has been a significant change in the	19386
resident's mental or physical condition.	19387

(D)(1) In the case of a nursing facility resident who has	19388
continuously resided in a nursing facility for at least thirty	19389
months before the date of a review and determination under	19390
division (C) of this section, if the resident is determined not to	19391
require the level of services provided by a nursing facility, but	19392
is determined to require specialized services for mental	19393
retardation, the department, in consultation with the resident's	19394
family or legal representative and care givers, shall do all of	19395
the following:	19396

(a) Inform the resident of the institutional and	19397
noninstitutional alternatives covered under the state medicaid	19398
plan ~~for medical assistance~~;	19399

(b) Offer the resident the choice of remaining in the nursing	19400
facility or receiving covered services in an alternative	19401
institutional or noninstitutional setting;	19402

(c) Clarify the effect on eligibility for services under the	19403
state medicaid plan ~~for medical assistance~~ if the resident chooses	19404
to leave the facility, including its effect on readmission to the	19405
facility;	19406

(d) Provide for or arrange for the provision of specialized	19407
services for the resident's mental retardation in the setting	19408
chosen by the resident.	19409

(2) In the case of a nursing facility resident who has	19410
continuously resided in a nursing facility for less than thirty	19411
months before the date of the review and determination under	19412
division (C) of this section, if the resident is determined not to	19413
require the level of services provided by a nursing facility, but	19414
is determined to require specialized services for mental	19415
retardation, or if the resident is determined to require neither	19416
the level of services provided by a nursing facility nor	19417
specialized services for mental retardation, the department shall	19418
act in accordance with its alternative disposition plan approved	19419
by the United States department of health and human services under	19420
section 1919(e)(7)(E) of the "Social Security Act."	19421

(3) In the case of an individual who is determined under	19422
division (B) or (C) of this section to require both the level of	19423
services provided by a nursing facility and specialized services	19424
for mental retardation, the department of mental retardation and	19425
developmental disabilities shall provide or arrange for the	19426
provision of the specialized services needed by the individual or	19427
resident while residing in a nursing facility.	19428

(E) The department of mental retardation and developmental	19429
disabilities shall adopt rules in accordance with Chapter 119. of	19430
the Revised Code that do all of the following:	19431

(1) Establish criteria to be used in making the	19432
determinations required by divisions (B) and (C) of this section.	19433
The criteria shall not exceed the criteria established by	19434
regulations adopted by the United States department of health and	19435
human services under section 1919(f)(8)(A) of the "Social Security	19436
Act."	19437

(2) Specify information to be provided by the individual or	19438
nursing facility resident being assessed;	19439

(3) Specify any circumstances, in addition to circumstances	19440
listed in division (B) of this section, under which determinations	19441
under divisions (B) and (C) of this section are not required to be	19442
made.	19443

Sec. 5123.0412. (A) The department of mental retardation and	19444
developmental disabilities shall charge each county board of	19445
mental retardation and developmental disabilities an annual fee	19446
equal to one and one-half per cent of the total value of all	19447
medicaid paid claims for home and community-based services	19448
provided during the year to an individual eligible for services	19449
from the county board. No county board shall pass the cost of a	19450
fee charged to the county board under this section on to another	19451
provider of these services.	19452

(B) The fees collected under this section shall be deposited	19453
into the ODMR/DD administration and oversight fund and the ~~ODJFS~~	19454
ODHCA administration and oversight fund, both of which are hereby	19455
created in the state treasury. The portion of the fees to be	19456
deposited into the ODMR/DD administration and oversight fund and	19457
the portion of the fees to be deposited into the ~~ODJFS~~ODHCA	19458
administration and oversight fund shall be the portion specified	19459
in an interagency agreement entered into under division (C) of	19460
this section. The department of mental retardation and	19461
developmental disabilities shall use the money in the ODMR/DD	19462
administration and oversight fund and the department of ~~job and~~	19463
~~family services~~health care administration shall use the money in	19464
the ~~ODJFS~~ODHCA administration and oversight fund for both of the	19465
following purposes:	19466

(1) The administrative and oversight costs of medicaid case	19467
management services and home and community-based services. The	19468
administrative and oversight costs shall include costs for staff,	19469
systems, and other resources the departments need and dedicate	19470
solely to the following duties associated with the services:	19471

(a) Eligibility determinations;

19472

(b) Training;

19473

19474

(d) Claims processing;

19475

(e) Quality assurance oversight;

19476

(f) Other duties the departments identify.

19477

(2) Providing technical support to county boards' local	19478
administrative authority under section 5126.055 of the Revised	19479
Code for the services.	19480

(C) The departments of mental retardation and developmental	19481
disabilities and ~~job and family services~~health care	19482
administration shall enter into an interagency agreement to do	19483
both of the following:	19484

(1) Specify which portion of the fees collected under this	19485
section is to be deposited into the ODMR/DD administration and	19486
oversight fund and which portion is to be deposited into the ~~ODJFS~~	19487
ODHCA administration and oversight fund;	19488

(2) Provide for the departments to coordinate the staff whose	19489
costs are paid for with money in the ODMR/DD administration and	19490
oversight fund and the ~~ODJFS~~ODHCA administration and oversight	19491
fund.	19492

(D) The departments shall submit an annual report to the	19493
director of budget and management certifying how the departments	19494
spent the money in the ODMR/DD administration and oversight fund	19495
and the ~~ODJFS~~ODHCA administration and oversight fund for the	19496
purposes specified in division (B) of this section.	19497

Sec. 5123.0417. (A) Using funds available under section	19498
~~5112.371~~5166.481 of the Revised Code, the director of mental	19499
retardation and developmental disabilities shall establish one or	19500
more programs for individuals under twenty-one years of age who	19501
have intensive behavioral needs, including such individuals with	19502
a primary diagnosis of autism spectrum disorder. The programs may	19503
include one or more medicaid waiver components that the director	19504
administers pursuant to section ~~5111.871~~5163.651 of the Revised	19505
Code. The programs may do one or more of the following:	19506

(1) Establish models that incorporate elements common to	19507
effective intervention programs and evidence-based practices in	19508
services for children with intensive behavioral needs;	19509

(2) Design a template for individualized education plans and	19510
individual service plans that provide consistent intervention	19511
programs and evidence-based practices for the care and treatment	19512
of children with intensive behavioral needs;	19513

(3) Disseminate best practice guidelines for use by families	19514
of children with intensive behavioral needs and professionals	19515
working with such families;	19516

(4) Develop a transition planning model for effectively	19517
mainstreaming school-age children with intensive behavioral needs	19518
to their public school district;	19519

(5) Contribute to the field of early and effective	19520
identification and intervention programs for children with	19521
intensive behavioral needs by providing financial support for	19522
scholarly research and publication of clinical findings.	19523

(B) The director of mental retardation and developmental	19524
disabilities shall collaborate with the director of ~~job and family~~	19525
~~services~~health care administration and consult with the executive	19526
director of the Ohio center for autism and low incidence and	19527
university-based programs that specialize in services for	19528
individuals with developmental disabilities when establishing	19529
programs under this section.	19530

Sec. 5123.171. As used in this section, "respite care" means	19531
appropriate, short-term, temporary care provided to a mentally	19532
retarded or developmentally disabled person to sustain the family	19533
structure or to meet planned or emergency needs of the family.	19534

The department of mental retardation and developmental	19535
disabilities shall provide respite care services to persons with	19536
mental retardation or a developmental disability for the purpose	19537
of promoting self-sufficiency and normalization, preventing or	19538
reducing inappropriate institutional care, and furthering the	19539
unity of the family by enabling the family to meet the special	19540
needs of a mentally retarded or developmentally disabled person.	19541

In order to be eligible for respite care services under this	19542
section, the mentally retarded or developmentally disabled person	19543
must be in need of habilitation services as defined in section	19544
5126.01 of the Revised Code.	19545

Respite care may be provided in a facility licensed under	19546
section 5123.19 of the Revised Code or certified as an	19547
intermediate care facility for the mentally retarded under ~~Title~~	19548
~~XIX of~~ the ~~"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.~~	19549
~~301, as amended,~~medicaid program or certified as a respite care	19550
home under section 5126.05 of the Revised Code.	19551

The department shall develop a system for locating vacant	19552
beds that are available for respite care and for making	19553
information on vacant beds available to users of respite care	19554
services. Facilities certified as intermediate care facilities for	19555
the mentally retarded and facilities holding contracts with the	19556
department for the provision of residential services under section	19557
5123.18 of the Revised Code shall report vacant beds to the	19558
department but shall not be required to accept respite care	19559
clients.	19560

The director of mental retardation and developmental	19561
disabilities shall adopt, and may amend or rescind, rules in	19562
accordance with Chapter 119. of the Revised Code for both of the	19563
following:	19564

(A) Certification by county boards of mental retardation and	19565
developmental disabilities of respite care homes;	19566

(B) Provision of respite care services authorized by this	19567
section. Rules adopted under this division shall establish all of	19568
the following:	19569

(1) A formula for distributing funds appropriated for respite	19570
care services;	19571

(2) Standards for supervision, training and quality control	19572
in the provision of respite care services;	19573

(3) Eligibility criteria for emergency respite care services.

19574

Sec. 5123.181. The director of mental retardation and	19575
developmental disabilities and the director of ~~job and family~~	19576
~~services~~health care administration shall, in concert with each	19577
other, eliminate all double billings and double payments for	19578
services on behalf of persons with mental retardation or another	19579
developmental disability in intermediate care facilities. The	19580
department of mental retardation and developmental disabilities	19581
may enter into contracts with providers of services for the	19582
purpose of making payments to the providers for services rendered	19583
to eligible clients who are persons with mental retardation or a	19584
developmental disability over and above the services authorized	19585
and paid under ~~Chapter 5111. of~~ the ~~Revised Code~~medicaid program.	19586
Payments authorized under this section and section 5123.18 of the	19587
Revised Code shall not be subject to audit findings ~~pursuant to~~	19588
~~Chapter 5111. of~~under the ~~Revised Code~~medicaid program, unless	19589
an audit determines that payment was made to the provider for	19590
services that were not rendered in accordance with the provisions	19591
of the provider agreement entered into with the department of ~~job~~	19592
~~and family services~~health care administration or the department	19593
of mental retardation and developmental disabilities pursuant to	19594
this section.	19595

Sec. 5123.19. (A) As used in this section and in sections	19596
5123.191, 5123.194, 5123.196, 5123.198, and 5123.20 of the Revised	19597
Code:	19598

(1)(a) "Residential facility" means a home or facility in	19599
which a mentally retarded or developmentally disabled person	19600
resides, except the home of a relative or legal guardian in which	19601
a mentally retarded or developmentally disabled person resides, a	19602
respite care home certified under section 5126.05 of the Revised	19603
Code, a county home or district home operated pursuant to Chapter	19604
5155. of the Revised Code, or a dwelling in which the only	19605
mentally retarded or developmentally disabled residents are in an	19606
independent living arrangement or are being provided supported	19607
living.	19608

(b) "Intermediate care facility for the mentally retarded"	19609
means a residential facility that is considered an intermediate	19610
care facility for the mentally retarded for the purposes of	19611
~~Chapter 5111. of~~ the ~~Revised Code~~medicaid program.	19612

(2) "Political subdivision" means a municipal corporation,	19613
county, or township.	19614

(3) "Independent living arrangement" means an arrangement in	19615
which a mentally retarded or developmentally disabled person	19616
resides in an individualized setting chosen by the person or the	19617
person's guardian, which is not dedicated principally to the	19618
provision of residential services for mentally retarded or	19619
developmentally disabled persons, and for which no financial	19620
support is received for rendering such service from any	19621
governmental agency by a provider of residential services.	19622

(4) "Licensee" means the person or government agency that has	19623
applied for a license to operate a residential facility and to	19624
which the license was issued under this section.	19625

(5) "Related party" has the same meaning as in section	19626
5123.16 of the Revised Code except that "provider" as used in the	19627
definition of "related party" means a person or government entity	19628
that held or applied for a license to operate a residential	19629
facility, rather than a person or government entity certified to	19630
provide supported living.	19631

(B) Every person or government agency desiring to operate a	19632
residential facility shall apply for licensure of the facility to	19633
the director of mental retardation and developmental disabilities	19634
unless the residential facility is subject to section 3721.02,	19635
3722.04, 5103.03, or 5119.20 of the Revised Code. Notwithstanding	19636
Chapter 3721. of the Revised Code, a nursing home that is	19637
certified as an intermediate care facility for the mentally	19638
retarded ~~under Title XIX of~~for the ~~"Social Security Act," 79~~	19639
~~Stat. 286 (1965), 42 U.S.C.A. 1396, as amended,~~medicaid program	19640
shall apply for licensure of the portion of the home that is	19641
certified as an intermediate care facility for the mentally	19642
retarded.	19643

(C) Subject to section 5123.196 of the Revised Code, the	19644
director of mental retardation and developmental disabilities	19645
shall license the operation of residential facilities. An initial	19646
license shall be issued for a period that does not exceed one	19647
year, unless the director denies the license under division (D) of	19648
this section. A license shall be renewed for a period that does	19649
not exceed three years, unless the director refuses to renew the	19650
license under division (D) of this section. The director, when	19651
issuing or renewing a license, shall specify the period for which	19652
the license is being issued or renewed. A license remains valid	19653
for the length of the licensing period specified by the director,	19654
unless the license is terminated, revoked, or voluntarily	19655
surrendered.	19656

(D) If it is determined that an applicant or licensee is not	19657
in compliance with a provision of this chapter that applies to	19658
residential facilities or the rules adopted under such a	19659
provision, the director may deny issuance of a license, refuse to	19660
renew a license, terminate a license, revoke a license, issue an	19661
order for the suspension of admissions to a facility, issue an	19662
order for the placement of a monitor at a facility, issue an order	19663
for the immediate removal of residents, or take any other action	19664
the director considers necessary consistent with the director's	19665
authority under this chapter regarding residential facilities. In	19666
the director's selection and administration of the sanction to be	19667
imposed, all of the following apply:	19668

(1) The director may deny, refuse to renew, or revoke a	19669
license, if the director determines that the applicant or licensee	19670
has demonstrated a pattern of serious noncompliance or that a	19671
violation creates a substantial risk to the health and safety of	19672
residents of a residential facility.	19673

(2) The director may terminate a license if more than twelve	19674
consecutive months have elapsed since the residential facility was	19675
last occupied by a resident or a notice required by division (K)	19676
of this section is not given.	19677

(3) The director may issue an order for the suspension of	19678
admissions to a facility for any violation that may result in	19679
sanctions under division (D)(1) of this section and for any other	19680
violation specified in rules adopted under division (H)(2) of	19681
this section. If the suspension of admissions is imposed for a	19682
violation that may result in sanctions under division (D)(1) of	19683
this section, the director may impose the suspension before	19684
providing an opportunity for an adjudication under Chapter 119. of	19685
the Revised Code. The director shall lift an order for the	19686
suspension of admissions when the director determines that the	19687
violation that formed the basis for the order has been corrected.	19688

(4) The director may order the placement of a monitor at a	19689
residential facility for any violation specified in rules adopted	19690
under division (H)(2) of this section. The director shall lift the	19691
order when the director determines that the violation that formed	19692
the basis for the order has been corrected.	19693

(5) If the director determines that two or more residential	19694
facilities owned or operated by the same person or government	19695
entity are not being operated in compliance with a provision of	19696
this chapter that applies to residential facilities or the rules	19697
adopted under such a provision, and the director's findings are	19698
based on the same or a substantially similar action, practice,	19699
circumstance, or incident that creates a substantial risk to the	19700
health and safety of the residents, the director shall conduct a	19701
survey as soon as practicable at each residential facility owned	19702
or operated by that person or government entity. The director may	19703
take any action authorized by this section with respect to any	19704
facility found to be operating in violation of a provision of this	19705
chapter that applies to residential facilities or the rules	19706
adopted under such a provision.	19707

(6) When the director initiates license revocation	19708
proceedings, no opportunity for submitting a plan of correction	19709
shall be given. The director shall notify the licensee by letter	19710
of the initiation of the proceedings. The letter shall list the	19711
deficiencies of the residential facility and inform the licensee	19712
that no plan of correction will be accepted. The director shall	19713
also send a copy of the letter to the county board of mental	19714
retardation and developmental disabilities. The county board shall	19715
send a copy of the letter to each of the following:	19716

(a) Each resident who receives services from the licensee;

19717

(b) The guardian of each resident who receives services from	19718
the licensee if the resident has a guardian;	19719

(c) The parent or guardian of each resident who receives	19720
services from the licensee if the resident is a minor.	19721

(7) Pursuant to rules which shall be adopted in accordance	19722
with Chapter 119. of the Revised Code, the director may order the	19723
immediate removal of residents from a residential facility	19724
whenever conditions at the facility present an immediate danger of	19725
physical or psychological harm to the residents.	19726

(8) In determining whether a residential facility is being	19727
operated in compliance with a provision of this chapter that	19728
applies to residential facilities or the rules adopted under such	19729
a provision, or whether conditions at a residential facility	19730
present an immediate danger of physical or psychological harm to	19731
the residents, the director may rely on information obtained by a	19732
county board of mental retardation and developmental disabilities	19733
or other governmental agencies.	19734

(9) In proceedings initiated to deny, refuse to renew, or	19735
revoke licenses, the director may deny, refuse to renew, or revoke	19736
a license regardless of whether some or all of the deficiencies	19737
that prompted the proceedings have been corrected at the time of	19738
the hearing.	19739

(E) The director shall establish a program under which public	19740
notification may be made when the director has initiated license	19741
revocation proceedings or has issued an order for the suspension	19742
of admissions, placement of a monitor, or removal of residents.	19743
The director shall adopt rules in accordance with Chapter 119. of	19744
the Revised Code to implement this division. The rules shall	19745
establish the procedures by which the public notification will be	19746
made and specify the circumstances for which the notification must	19747
be made. The rules shall require that public notification be made	19748
if the director has taken action against the facility in the	19749
eighteen-month period immediately preceding the director's latest	19750
action against the facility and the latest action is being taken	19751
for the same or a substantially similar violation of a provision	19752
of this chapter that applies to residential facilities or the	19753
rules adopted under such a provision. The rules shall specify a	19754
method for removing or amending the public notification if the	19755
director's action is found to have been unjustified or the	19756
violation at the residential facility has been corrected.	19757

(F)(1) Except as provided in division (F)(2) of this section,	19758
appeals from proceedings initiated to impose a sanction under	19759
division (D) of this section shall be conducted in accordance with	19760
Chapter 119. of the Revised Code.	19761

(2) Appeals from proceedings initiated to order the	19762
suspension of admissions to a facility shall be conducted in	19763
accordance with Chapter 119. of the Revised Code, unless the order	19764
was issued before providing an opportunity for an adjudication, in	19765
which case all of the following apply:	19766

(a) The licensee may request a hearing not later than ten	19767
days after receiving the notice specified in section 119.07 of the	19768
Revised Code.	19769

(b) If a timely request for a hearing that includes the	19770
licensee's current address is made, the hearing shall commence not	19771
later than thirty days after the department receives the request.	19772

(c) After commencing, the hearing shall continue	19773
uninterrupted, except for Saturdays, Sundays, and legal holidays,	19774
unless other interruptions are agreed to by the licensee and the	19775
director.	19776

(d) If the hearing is conducted by a hearing examiner, the	19777
hearing examiner shall file a report and recommendations not later	19778
than ten days after the last of the following:	19779

(i) The close of the hearing;

19780

(ii) If a transcript of the proceedings is ordered, the	19781
hearing examiner receives the transcript;	19782

(iii) If post-hearing briefs are timely filed, the hearing	19783
examiner receives the briefs.	19784

(e) A copy of the written report and recommendation of the	19785
hearing examiner shall be sent, by certified mail, to the licensee	19786
and the licensee's attorney, if applicable, not later than five	19787
days after the report is filed.	19788

(f) Not later than five days after the hearing examiner files	19789
the report and recommendations, the licensee may file objections	19790
to the report and recommendations.	19791

(g) Not later than fifteen days after the hearing examiner	19792
files the report and recommendations, the director shall issue an	19793
order approving, modifying, or disapproving the report and	19794
recommendations.	19795

(h) Notwithstanding the pendency of the hearing, the director	19796
shall lift the order for the suspension of admissions when the	19797
director determines that the violation that formed the basis for	19798
the order has been corrected.	19799

(G) Neither a person or government agency whose application	19800
for a license to operate a residential facility is denied nor a	19801
related party of the person or government agency may apply for a	19802
license to operate a residential facility before the date that is	19803
one year after the date of the denial. Neither a licensee whose	19804
residential facility license is revoked nor a related party of the	19805
licensee may apply for a residential facility license before the	19806
date that is five years after the date of the revocation.	19807

(H) In accordance with Chapter 119. of the Revised Code, the	19808
director shall adopt and may amend and rescind rules for licensing	19809
and regulating the operation of residential facilities, including	19810
intermediate care facilities for the mentally retarded. The rules	19811
for intermediate care facilities for the mentally retarded may	19812
differ from those for other residential facilities. The rules	19813
shall establish and specify the following:	19814

(1) Procedures and criteria for issuing and renewing	19815
licenses, including procedures and criteria for determining the	19816
length of the licensing period that the director must specify for	19817
each license when it is issued or renewed;	19818

(2) Procedures and criteria for denying, refusing to renew,	19819
terminating, and revoking licenses and for ordering the suspension	19820
of admissions to a facility, placement of a monitor at a facility,	19821
and the immediate removal of residents from a facility;	19822

(3) Fees for issuing and renewing licenses, which shall be	19823
deposited into the program fee fund created under section 5123.033	19824
of the Revised Code;	19825

(4) Procedures for surveying residential facilities;

19826

(5) Requirements for the training of residential facility	19827
personnel;	19828

(6) Classifications for the various types of residential	19829
facilities;	19830

(7) Certification procedures for licensees and management	19831
contractors that the director determines are necessary to ensure	19832
that they have the skills and qualifications to properly operate	19833
or manage residential facilities;	19834

(8) The maximum number of persons who may be served in a	19835
particular type of residential facility;	19836

(9) Uniform procedures for admission of persons to and	19837
transfers and discharges of persons from residential facilities;	19838

(10) Other standards for the operation of residential	19839
facilities and the services provided at residential facilities;	19840

(11) Procedures for waiving any provision of any rule adopted	19841
under this section.	19842

(I) Before issuing a license, the director of the department	19843
or the director's designee shall conduct a survey of the	19844
residential facility for which application is made. The director	19845
or the director's designee shall conduct a survey of each	19846
licensed residential facility at least once during the period the	19847
license is valid and may conduct additional inspections as needed.	19848
A survey includes but is not limited to an on-site examination and	19849
evaluation of the residential facility, its personnel, and the	19850
services provided there.	19851

In conducting surveys, the director or the director's	19852
designee shall be given access to the residential facility; all	19853
records, accounts, and any other documents related to the	19854
operation of the facility; the licensee; the residents of the	19855
facility; and all persons acting on behalf of, under the control	19856
of, or in connection with the licensee. The licensee and all	19857
persons on behalf of, under the control of, or in connection with	19858
the licensee shall cooperate with the director or the director's	19859
designee in conducting the survey.	19860

Following each survey, unless the director initiates a	19861
license revocation proceeding, the director or the director's	19862
designee shall provide the licensee with a report listing any	19863
deficiencies, specifying a timetable within which the licensee	19864
shall submit a plan of correction describing how the deficiencies	19865
will be corrected, and, when appropriate, specifying a timetable	19866
within which the licensee must correct the deficiencies. After a	19867
plan of correction is submitted, the director or the director's	19868
designee shall approve or disapprove the plan. A copy of the	19869
report and any approved plan of correction shall be provided to	19870
any person who requests it.	19871

The director shall initiate disciplinary action against any	19872
department employee who notifies or causes the notification to any	19873
unauthorized person of an unannounced survey of a residential	19874
facility by an authorized representative of the department.	19875

(J) In addition to any other information which may be	19876
required of applicants for a license pursuant to this section, the	19877
director shall require each applicant to provide a copy of an	19878
approved plan for a proposed residential facility pursuant to	19879
section 5123.042 of the Revised Code. This division does not apply	19880
to renewal of a license.	19881

(K) A licensee shall notify the owner of the building in	19882
which the licensee's residential facility is located of any	19883
significant change in the identity of the licensee or management	19884
contractor before the effective date of the change if the licensee	19885
is not the owner of the building.	19886

Pursuant to rules which shall be adopted in accordance with	19887
Chapter 119. of the Revised Code, the director may require	19888
notification to the department of any significant change in the	19889
ownership of a residential facility or in the identity of the	19890
licensee or management contractor. If the director determines that	19891
a significant change of ownership is proposed, the director shall	19892
consider the proposed change to be an application for development	19893
by a new operator pursuant to section 5123.042 of the Revised Code	19894
and shall advise the applicant within sixty days of the	19895
notification that the current license shall continue in effect or	19896
a new license will be required pursuant to this section. If the	19897
director requires a new license, the director shall permit the	19898
facility to continue to operate under the current license until	19899
the new license is issued, unless the current license is revoked,	19900
refused to be renewed, or terminated in accordance with Chapter	19901
119. of the Revised Code.	19902

(L) A county board of mental retardation and developmental	19903
disabilities, the legal rights service, and any interested person	19904
may file complaints alleging violations of statute or department	19905
rule relating to residential facilities with the department. All	19906
complaints shall be in writing and shall state the facts	19907
constituting the basis of the allegation. The department shall not	19908
reveal the source of any complaint unless the complainant agrees	19909
in writing to waive the right to confidentiality or until so	19910
ordered by a court of competent jurisdiction.	19911

The department shall adopt rules in accordance with Chapter	19912
119. of the Revised Code establishing procedures for the receipt,	19913
referral, investigation, and disposition of complaints filed with	19914
the department under this division.	19915

(M) The department shall establish procedures for the	19916
notification of interested parties of the transfer or interim care	19917
of residents from residential facilities that are closing or are	19918
losing their license.	19919

(N) Before issuing a license under this section to a	19920
residential facility that will accommodate at any time more than	19921
one mentally retarded or developmentally disabled individual, the	19922
director shall, by first class mail, notify the following:	19923

(1) If the facility will be located in a municipal	19924
corporation, the clerk of the legislative authority of the	19925
municipal corporation;	19926

(2) If the facility will be located in unincorporated	19927
territory, the clerk of the appropriate board of county	19928
commissioners and the fiscal officer of the appropriate board of	19929
township trustees.	19930

The director shall not issue the license for ten days after	19931
mailing the notice, excluding Saturdays, Sundays, and legal	19932
holidays, in order to give the notified local officials time in	19933
which to comment on the proposed issuance.	19934

Any legislative authority of a municipal corporation, board	19935
of county commissioners, or board of township trustees that	19936
receives notice under this division of the proposed issuance of a	19937
license for a residential facility may comment on it in writing to	19938
the director within ten days after the director mailed the notice,	19939
excluding Saturdays, Sundays, and legal holidays. If the director	19940
receives written comments from any notified officials within the	19941
specified time, the director shall make written findings	19942
concerning the comments and the director's decision on the	19943
issuance of the license. If the director does not receive written	19944
comments from any notified local officials within the specified	19945
time, the director shall continue the process for issuance of the	19946
license.	19947

(O) Any person may operate a licensed residential facility	19948
that provides room and board, personal care, habilitation	19949
services, and supervision in a family setting for at least six but	19950
not more than eight persons with mental retardation or a	19951
developmental disability as a permitted use in any residential	19952
district or zone, including any single-family residential district	19953
or zone, of any political subdivision. These residential	19954
facilities may be required to comply with area, height, yard, and	19955
architectural compatibility requirements that are uniformly	19956
imposed upon all single-family residences within the district or	19957
zone.	19958

(P) Any person may operate a licensed residential facility	19959
that provides room and board, personal care, habilitation	19960
services, and supervision in a family setting for at least nine	19961
but not more than sixteen persons with mental retardation or a	19962
developmental disability as a permitted use in any multiple-family	19963
residential district or zone of any political subdivision, except	19964
that a political subdivision that has enacted a zoning ordinance	19965
or resolution establishing planned unit development districts may	19966
exclude these residential facilities from those districts, and a	19967
political subdivision that has enacted a zoning ordinance or	19968
resolution may regulate these residential facilities in	19969
multiple-family residential districts or zones as a conditionally	19970
permitted use or special exception, in either case, under	19971
reasonable and specific standards and conditions set out in the	19972
zoning ordinance or resolution to:	19973

(1) Require the architectural design and site layout of the	19974
residential facility and the location, nature, and height of any	19975
walls, screens, and fences to be compatible with adjoining land	19976
uses and the residential character of the neighborhood;	19977

(2) Require compliance with yard, parking, and sign	19978
regulation;	19979

(3) Limit excessive concentration of these residential	19980
facilities.	19981

(Q) This section does not prohibit a political subdivision	19982
from applying to residential facilities nondiscriminatory	19983
regulations requiring compliance with health, fire, and safety	19984
regulations and building standards and regulations.	19985

(R) Divisions (O) and (P) of this section are not applicable	19986
to municipal corporations that had in effect on June 15, 1977, an	19987
ordinance specifically permitting in residential zones licensed	19988
residential facilities by means of permitted uses, conditional	19989
uses, or special exception, so long as such ordinance remains in	19990
effect without any substantive modification.	19991

(S)(1) The director may issue an interim license to operate a	19992
residential facility to an applicant for a license under this	19993
section if either of the following is the case:	19994

(a) The director determines that an emergency exists	19995
requiring immediate placement of persons in a residential	19996
facility, that insufficient licensed beds are available, and that	19997
the residential facility is likely to receive a permanent license	19998
under this section within thirty days after issuance of the	19999
interim license.	20000

(b) The director determines that the issuance of an interim	20001
license is necessary to meet a temporary need for a residential	20002
facility.	20003

(2) To be eligible to receive an interim license, an	20004
applicant must meet the same criteria that must be met to receive	20005
a permanent license under this section, except for any differing	20006
procedures and time frames that may apply to issuance of a	20007
permanent license.	20008

(3) An interim license shall be valid for thirty days and may	20009
be renewed by the director for a period not to exceed one hundred	20010
fifty days.	20011

(4) The director shall adopt rules in accordance with Chapter	20012
119. of the Revised Code as the director considers necessary to	20013
administer the issuance of interim licenses.	20014

(T) Notwithstanding rules adopted pursuant to this section	20015
establishing the maximum number of persons who may be served in a	20016
particular type of residential facility, a residential facility	20017
shall be permitted to serve the same number of persons being	20018
served by the facility on the effective date of the rules or the	20019
number of persons for which the facility is authorized pursuant to	20020
a current application for a certificate of need with a letter of	20021
support from the department of mental retardation and	20022
developmental disabilities and which is in the review process	20023
prior to April 4, 1986.	20024

(U) The director or the director's designee may enter at any	20025
time, for purposes of investigation, any home, facility, or other	20026
structure that has been reported to the director or that the	20027
director has reasonable cause to believe is being operated as a	20028
residential facility without a license issued under this section.	20029

The director may petition the court of common pleas of the	20030
county in which an unlicensed residential facility is located for	20031
an order enjoining the person or governmental agency operating the	20032
facility from continuing to operate without a license. The court	20033
may grant the injunction on a showing that the person or	20034
governmental agency named in the petition is operating a	20035
residential facility without a license. The court may grant the	20036
injunction, regardless of whether the residential facility meets	20037
the requirements for receiving a license under this section.	20038

Sec. 5123.192. Notwithstanding section 5123.19 of the	20039
Revised Code, any nursing home that on June 30, 1987, contained	20040
beds that the department of health had certified prior to June 30,	20041
1987, as intermediate care facility for the mentally retarded beds	20042
under ~~Title XIX of~~ the ~~"Social Security Act," 49 Stat. 620 (1935),~~	20043
~~42 U.S.C. 301, as amended,~~medicaid program or any nursing home	20044
that on June 30, 1987, had an application pending before the	20045
department to convert intermediate care facility beds to	20046
intermediate care facility for the mentally retarded beds, shall	20047
not be required to apply for licensure under section 5123.19 of	20048
the Revised Code, shall be subject to the requirements for	20049
licensure as a nursing home and all other requirements of Chapter	20050
3721. of the Revised Code and any rules adopted under that	20051
chapter, and shall be subject to sections 3702.51 to 3702.62 of	20052
the Revised Code and any rules adopted under those sections,	20053
unless either of the following applies:	20054

(A) The nursing home's certification or provider agreement as	20055
an intermediate care facility for the mentally retarded is subject	20056
to a final order of nonrenewal or termination with respect to	20057
which all appeal rights have been exhausted and the facility	20058
intends to apply for recertification;	20059

(B) The nursing home intends to increase its number of beds	20060
certified as intermediate care facility for the mentally retarded	20061
beds. In such a case, the nursing home shall be required to apply	20062
for licensure of the additional beds under section 5123.19 of the	20063
Revised Code.	20064

Sec. 5123.198. (A) As used in this section, "date of the	20065
commitment" means the date that an individual specified in	20066
division (B) of this section begins to reside in a state-operated	20067
intermediate care facility for the mentally retarded after being	20068
committed to the facility pursuant to sections 5123.71 to 5123.76	20069
of the Revised Code.	20070

(B) Except as provided in division (C) of this section,	20071
whenever a resident of a residential facility is committed to a	20072
state-operated intermediate care facility for the mentally	20073
retarded pursuant to sections 5123.71 to 5123.76 of the Revised	20074
Code, the department of mental retardation and developmental	20075
disabilities, pursuant to an adjudication order issued in	20076
accordance with Chapter 119. of the Revised Code, shall reduce by	20077
one the number of residents for which the facility in which the	20078
resident resided is licensed.	20079

(C) The department shall not reduce under division (B) of	20080
this section the number of residents for which a residential	20081
facility is licensed if any of the following are the case:	20082

(1) The resident of the residential facility who is committed	20083
to a state-operated intermediate care facility for the mentally	20084
retarded resided in the residential facility because of the	20085
closure, on or after June 26, 2003, of another state-operated	20086
intermediate care facility for the mentally retarded;	20087

(2) The residential facility admits within ninety days of the	20088
date of the commitment an individual who resides on the date of	20089
the commitment in a state-operated intermediate care facility for	20090
the mentally retarded or another residential facility;	20091

(3) The department fails to do either of the following within	20092
ninety days of the date of the commitment:	20093

(a) Identify an individual to whom all of the following	20094
applies:	20095

(i) Resides on the date of the commitment in a state-operated	20096
intermediate care facility for the mentally retarded or another	20097
residential facility;	20098

(ii) Has indicated to the department an interest in	20099
relocating to the residential facility or has a parent or guardian	20100
who has indicated to the department an interest for the individual	20101
to relocate to the residential facility;	20102

(iii) The department determines the individual has needs that	20103
the residential facility can meet.	20104

(b) Provide the residential facility with information about	20105
the individual identified under division (C)(2)(a) of this section	20106
that the residential facility needs in order to determine whether	20107
the facility can meet the individual's needs.	20108

(4) If the department completes the actions specified in	20109
divisions (C)(3)(a) and (b) of this section not later than ninety	20110
days after the date of the commitment and except as provided in	20111
division (D) of this section, the residential facility does all of	20112
the following not later than ninety days after the date of the	20113
commitment:	20114

(a) Evaluates the information provided by the department;

20115

(b) Assesses the identified individual's needs;

20116

(c) Determines that the residential facility cannot meet the	20117
identified individual's needs.	20118

(5) If the department completes the actions specified in	20119
divisions (C)(3)(a) and (b) of this section not later than ninety	20120
days after the date of the commitment and the residential facility	20121
determines that the residential facility can meet the identified	20122
individual's needs, the individual, or a parent or guardian of the	20123
individual, refuses placement in the residential facility.	20124

(D) The department may reduce under division (B) of this	20125
section the number of residents for which a residential facility	20126
is licensed even though the residential facility completes the	20127
actions specified in division (C)(4) of this section not later	20128
than ninety days after the date of the commitment if all of the	20129
following are the case:	20130

(1) The department disagrees with the residential facility's	20131
determination that the residential facility cannot meet the	20132
identified individual's needs.	20133

(2) The department issues a written decision pursuant to the	20134
uniform procedures for admissions, transfers, and discharges	20135
established by rules adopted under division (H)(9) of section	20136
5123.19 of the Revised Code that the residential facility should	20137
admit the identified individual.	20138

(3) After the department issues the written decision	20139
specified in division (D)(2) of this section, the residential	20140
facility refuses to admit the identified individual.	20141

(E) A residential facility that admits, refuses to admit,	20142
transfers, or discharges a resident under this section shall	20143
comply with the uniform procedures for admissions, transfers, and	20144
discharges established by rules adopted under division (H)(9) of	20145
section 5123.19 of the Revised Code.	20146

(F) The department of mental retardation and developmental	20147
disabilities may notify the department of ~~job and family services~~	20148
health care administration of any reduction under this section in	20149
the number of residents for which a residential facility that is	20150
an intermediate care facility for the mentally retarded is	20151
licensed. On receiving the notice, the department of ~~job and~~	20152
~~family services~~health care administration may transfer to the	20153
department of mental retardation and developmental disabilities	20154
the savings in the nonfederal share of medicaid expenditures for	20155
each fiscal year after the year of the commitment to be used for	20156
costs of the resident's care in the state-operated intermediate	20157
care facility for the mentally retarded. In determining the amount	20158
saved, the department of ~~job and family services~~health care	20159
administration shall consider medicaid payments for the remaining	20160
residents of the facility in which the resident resided.	20161

Sec. 5123.211. (A) As used in this section, "residential	20162
services" has the same meaning as in section 5126.01 of the	20163
Revised Code.	20164

(B) The department of mental retardation and developmental	20165
disabilities shall provide or arrange provision of residential	20166
services for each person who, on or after July 1, 1989, ceases to	20167
be a resident of a state institution because of closure of the	20168
institution or a reduction in the institution's population by	20169
forty per cent or more within a period of one year. The services	20170
shall be provided in the county in which the person chooses to	20171
reside and shall consist of one of the following as determined	20172
appropriate by the department in consultation with the county	20173
board of mental retardation and developmental disabilities of the	20174
county in which the services are to be provided:	20175

(1) Residential services provided pursuant to section 5123.18	20176
of the Revised Code;	20177

(2) Residential services for which reimbursement is made	20178
under the ~~medical assistance~~medicaid program ~~established under~~	20179
~~section 5111.01 of the Revised Code~~;	20180

(3) Residential services provided in a manner or setting	20181
approved by the director of mental retardation and developmental	20182
disabilities.	20183

(C) Not less than six months prior to closing a state	20184
institution or reducing a state institution's population by forty	20185
per cent or more within a period of one year, the department shall	20186
identify those counties in which individuals leaving the	20187
institution have chosen to reside and notify the county boards of	20188
mental retardation and developmental disabilities in those	20189
counties of the need to develop the services specified in division	20190
(B) of this section. The notice shall specify the number of	20191
individuals requiring services who plan to reside in the county	20192
and indicate the amount of funds the department will use to	20193
provide or arrange services for those individuals.	20194

(D) In each county in which one or more persons receive	20195
residential services pursuant to division (B) of this section, the	20196
department shall provide or arrange provision of residential	20197
services, or shall distribute moneys to the county board of mental	20198
retardation and developmental disabilities to provide or arrange	20199
provision of residential services, for an equal number of persons	20200
with mental retardation or developmental disabilities in that	20201
county who the county board has determined need residential	20202
services but are not receiving them.	20203

Sec. 5123.71. (A)(1) Proceedings for the involuntary	20204
institutionalization of a person pursuant to sections 5123.71 to	20205
5123.76 of the Revised Code shall be commenced by the filing of an	20206
affidavit with the probate division of the court of common pleas	20207
of the county where the person resides or where the person is	20208
institutionalized, in the manner and form prescribed by the	20209
department of mental retardation and developmental disabilities	20210
either on information or actual knowledge, whichever is determined	20211
to be proper by the court. The affidavit may be filed only by a	20212
person who has custody of the individual as a parent, guardian, or	20213
service provider or by a person acting on behalf of the department	20214
or a county board of mental retardation and developmental	20215
disabilities. This section does not apply regarding the	20216
institutionalization of a person pursuant to section 2945.39,	20217
2945.40, 2945.401, or 2945.402 of the Revised Code.	20218

The affidavit shall contain an allegation setting forth the	20219
specific category or categories under division ~~(O)~~(N) of section	20220
5123.01 of the Revised Code upon which the commencement of	20221
proceedings is based and a statement of the factual ground for the	20222
belief that the person is a mentally retarded person subject to	20223
institutionalization by court order. Except as provided in	20224
division (A)(2) of this section, the affidavit shall be	20225
accompanied by both of the following:	20226

(a) A comprehensive evaluation report prepared by the	20227
person's evaluation team that includes a statement by the members	20228
of the team certifying that they have performed a comprehensive	20229
evaluation of the person and that they are of the opinion that the	20230
person is a mentally retarded person subject to	20231
institutionalization by court order;	20232

(b) An assessment report prepared by the county board of	20233
mental retardation and developmental disabilities under section	20234
5123.711 of the Revised Code specifying that the individual is in	20235
need of services on an emergency or priority basis.	20236

(2) In lieu of the comprehensive evaluation report, the	20237
affidavit may be accompanied by a written and sworn statement that	20238
the person or the guardian of a person adjudicated incompetent has	20239
refused to allow a comprehensive evaluation and county board	20240
assessment and assessment reports. Immediately after accepting an	20241
affidavit that is not accompanied by the reports of a	20242
comprehensive evaluation and county board assessment, the court	20243
shall cause a comprehensive evaluation and county board assessment	20244
of the person named in the affidavit to be performed. The	20245
evaluation shall be conducted in the least restrictive environment	20246
possible and the assessment shall be conducted in the same manner	20247
as assessments conducted under section 5123.711 of the Revised	20248
Code. The evaluation and assessment must be completed before a	20249
probable cause hearing or full hearing may be held under section	20250
5123.75 or 5123.76 of the Revised Code.	20251

A written report of the evaluation team's findings and the	20252
county board's assessment shall be filed with the court. The	20253
reports shall, consistent with the rules of evidence, be accepted	20254
as probative evidence in any proceeding under section 5123.75 or	20255
5123.76 of the Revised Code. If the counsel for the person who is	20256
evaluated or assessed is known, the court shall send to the	20257
counsel a copy of the reports as soon as possible after they are	20258
filed and prior to any proceedings under section 5123.75 or	20259
5123.76 of the Revised Code.	20260

(B) Any person who is involuntarily detained in an	20261
institution or otherwise is in custody under this chapter shall be	20262
informed of the right to do the following:	20263

(1) Immediately make a reasonable number of telephone calls	20264
or use other reasonable means to contact an attorney, a physician,	20265
or both, to contact any other person or persons to secure	20266
representation by counsel, or to obtain medical assistance, and be	20267
provided assistance in making calls if the assistance is needed	20268
and requested;	20269

(2) Retain counsel and have independent expert evaluation	20270
and, if the person is an indigent person, be represented by	20271
court-appointed counsel and have independent expert evaluation at	20272
court expense;	20273

(3) Upon request, have a hearing to determine whether there	20274
is probable cause to believe that the person is a mentally	20275
retarded person subject to institutionalization by court order.	20276

(C) No person who is being treated by spiritual means through	20277
prayer alone in accordance with a recognized religious method of	20278
healing may be ordered detained or involuntarily committed unless	20279
the court has determined that the person represents a very	20280
substantial risk of self-impairment, self-injury, or impairment or	20281
injury to others.	20282

Sec. 5123.76. (A) The full hearing shall be conducted in a	20283
manner consistent with the procedures outlined in this chapter and	20284
with due process of law. The hearing shall be held by a judge of	20285
the probate division or, upon transfer by the judge of the probate	20286
division, by another judge of the court of common pleas, or a	20287
referee designated by the judge of the probate division. Any	20288
referee designated by the judge of the probate division must be an	20289
attorney.	20290

(1) The following shall be made available to counsel for the	20291
respondent:	20292

(a) All relevant documents, information, and evidence in the	20293
custody or control of the state or prosecutor;	20294

(b) All relevant documents, information, and evidence in the	20295
custody or control of the institution, facility, or program in	20296
which the respondent currently is held or in which the respondent	20297
has been held pursuant to these proceedings;	20298

(c) With the consent of the respondent, all relevant	20299
documents, information, and evidence in the custody or control of	20300
any institution or person other than the state.	20301

(2) The respondent has the right to be represented by counsel	20302
of the respondent's choice and has the right to attend the hearing	20303
except if unusual circumstances of compelling medical necessity	20304
exist that render the respondent unable to attend and the	20305
respondent has not expressed a desire to attend.	20306

(3) If the respondent is not represented by counsel and the	20307
court determines that the conditions specified in division (A)(2)	20308
of this section justify the respondent's absence and the right to	20309
counsel has not been validly waived, the court shall appoint	20310
counsel forthwith to represent the respondent at the hearing,	20311
reserving the right to tax costs of appointed counsel to the	20312
respondent unless it is shown that the respondent is indigent. If	20313
the court appoints counsel, or if the court determines that the	20314
evidence relevant to the respondent's absence does not justify the	20315
absence, the court shall continue the case.	20316

(4) The respondent shall be informed of the right to retain	20317
counsel, to have independent expert evaluation, and, if an	20318
indigent person, to be represented by court appointed counsel and	20319
have expert independent evaluation at court expense.	20320

(5) The hearing may be closed to the public unless counsel	20321
for the respondent requests that the hearing be open to the	20322
public.	20323

(6) Unless objected to by the respondent, the respondent's	20324
counsel, or the designee of the director of mental retardation and	20325
developmental disabilities, the court, for good cause shown, may	20326
admit persons having a legitimate interest in the proceedings.	20327

(7) The affiant under section 5123.71 of the Revised Code	20328
shall be subject to subpoena by either party.	20329

(8) The court shall examine the sufficiency of all documents	20330
filed and shall inform the respondent, if present, and the	20331
respondent's counsel of the nature of the content of the documents	20332
and the reason for which the respondent is being held or for which	20333
the respondent's placement is being sought.	20334

(9) The court shall receive only relevant, competent, and	20335
material evidence.	20336

(10) The designee of the director shall present the evidence	20337
for the state. In proceedings under this chapter, the attorney	20338
general shall present the comprehensive evaluation, assessment,	20339
diagnosis, prognosis, record of habilitation and care, if any, and	20340
less restrictive habilitation plans, if any. The attorney general	20341
does not have a similar presentation responsibility in connection	20342
with a person who has been found not guilty by reason of insanity	20343
and who is the subject of a hearing under section 2945.40 of the	20344
Revised Code to determine whether the person is a mentally	20345
retarded person subject to institutionalization by court order.	20346

(11) The respondent has the right to testify and the	20347
respondent or the respondent's counsel has the right to subpoena	20348
witnesses and documents and to present and cross-examine	20349
witnesses.	20350

(12) The respondent shall not be compelled to testify and	20351
shall be so advised by the court.	20352

(13) On motion of the respondent or the respondent's counsel	20353
for good cause shown, or upon the court's own motion, the court	20354
may order a continuance of the hearing.	20355

(14) To an extent not inconsistent with this chapter, the	20356
Rules of Civil Procedure shall be applicable.	20357

(B) Unless, upon completion of the hearing, the court finds	20358
by clear and convincing evidence that the respondent named in the	20359
affidavit is a mentally retarded person subject to	20360
institutionalization by court order, it shall order the	20361
respondent's discharge forthwith.	20362

(C) If, upon completion of the hearing, the court finds by	20363
clear and convincing evidence that the respondent is a mentally	20364
retarded person subject to institutionalization by court order,	20365
the court may order the respondent's discharge or order the	20366
respondent, for a period not to exceed ninety days, to any of the	20367
following:	20368

(1) A public institution, provided that commitment of the	20369
respondent to the institution will not cause the institution to	20370
exceed its licensed capacity determined in accordance with section	20371
5123.19 of the Revised Code and provided that such a placement is	20372
indicated by the comprehensive evaluation report filed pursuant to	20373
section 5123.71 of the Revised Code;	20374

(2) A private institution;

20375

(3) A county mental retardation program;

20376

(4) Receive private habilitation and care;

20377

(5) Any other suitable facility, program, or the care of any	20378
person consistent with the comprehensive evaluation, assessment,	20379
diagnosis, prognosis, and habilitation needs of the respondent.	20380

(D) Any order made pursuant to division (C)(2), (4), or (5)	20381
of this section shall be conditional upon the receipt by the court	20382
of consent by the facility, program, or person to accept the	20383
respondent.	20384

(E) In determining the place to which, or the person with	20385
whom, the respondent is to be committed, the court shall consider	20386
the comprehensive evaluation, assessment, diagnosis, and projected	20387
habilitation plan for the respondent, and shall order the	20388
implementation of the least restrictive alternative available and	20389
consistent with habilitation goals.	20390

(F) If, at any time it is determined by the director of the	20391
facility or program to which, or the person to whom, the	20392
respondent is committed that the respondent could be equally well	20393
habilitated in a less restrictive environment that is available,	20394
the following shall occur:	20395

(1) The respondent shall be released by the director of the	20396
facility or program or by the person forthwith and referred to the	20397
court together with a report of the findings and recommendations	20398
of the facility, program, or person.	20399

(2) The director of the facility or program or the person	20400
shall notify the respondent's counsel and the designee of the	20401
director of mental retardation and developmental disabilities.	20402

(3) The court shall dismiss the case or order placement in	20403
the less restrictive environment.	20404

(G)(1) Except as provided in divisions (G)(2) and (3) of this	20405
section, any person who has been committed under this section may	20406
apply at any time during the ninety-day period for voluntary	20407
admission to an institution under section 5123.69 of the Revised	20408
Code. Upon admission of a voluntary resident, the managing officer	20409
immediately shall notify the court, the respondent's counsel, and	20410
the designee of the director in writing of that fact by mail or	20411
otherwise, and, upon receipt of the notice, the court shall	20412
dismiss the case.	20413

(2) A person who is found incompetent to stand trial or not	20414
guilty by reason of insanity and who is committed pursuant to	20415
section 2945.39, 2945.40, 2945.401, or 2945.402 of the Revised	20416
Code shall not be voluntarily admitted to an institution pursuant	20417
to division (G)(1) of this section until after the termination of	20418
the commitment, as described in division (J) of section 2945.401	20419
of the Revised Code.	20420

(H) If, at the end of any commitment period, the respondent	20421
has not already been discharged or has not requested voluntary	20422
admission status, the director of the facility or program, or the	20423
person to whose care the respondent has been committed, shall	20424
discharge the respondent forthwith, unless at least ten days	20425
before the expiration of that period the designee of the director	20426
of mental retardation and developmental disabilities or the	20427
prosecutor files an application with the court requesting	20428
continued commitment.	20429

(1) An application for continued commitment shall include a	20430
written report containing a current comprehensive evaluation and	20431
assessment, a diagnosis, a prognosis, an account of progress and	20432
past habilitation, and a description of alternative habilitation	20433
settings and plans, including a habilitation setting that is the	20434
least restrictive setting consistent with the need for	20435
habilitation. A copy of the application shall be provided to	20436
respondent's counsel. The requirements for notice under section	20437
5123.73 of the Revised Code and the provisions of divisions (A) to	20438
(E) of this section apply to all hearings on such applications.	20439

(2) A hearing on the first application for continued	20440
commitment shall be held at the expiration of the first ninety-day	20441
period. The hearing shall be mandatory and may not be waived.	20442

(3) Subsequent periods of commitment not to exceed one	20443
hundred eighty days each may be ordered by the court if the	20444
designee of the director of mental retardation and developmental	20445
disabilities files an application for continued commitment, after	20446
a hearing is held on the application or without a hearing if no	20447
hearing is requested and no hearing required under division (H)(4)	20448
of this section is waived. Upon the application of a person	20449
involuntarily committed under this section, supported by an	20450
affidavit of a licensed physician alleging that the person is no	20451
longer a mentally retarded person subject to institutionalization	20452
by court order, the court for good cause shown may hold a full	20453
hearing on the person's continued commitment prior to the	20454
expiration of any subsequent period of commitment set by the	20455
court.	20456

(4) A mandatory hearing shall be held at least every two	20457
years after the initial commitment.	20458

(5) If the court, after a hearing upon a request to continue	20459
commitment, finds that the respondent is a mentally retarded	20460
person subject to institutionalization by court order, the court	20461
may make an order pursuant to divisions (C), (D), and (E) of this	20462
section.	20463

(I) Notwithstanding the provisions of division (H) of this	20464
section, no person who is found to be a mentally retarded person	20465
subject to institutionalization by court order pursuant to	20466
division ~~(O)~~(N)(2) of section 5123.01 of the Revised Code shall be	20467
held under involuntary commitment for more than five years.	20468

(J) The managing officer admitting a person pursuant to a	20469
judicial proceeding, within ten working days of the admission,	20470
shall make a report of the admission to the department.	20471

Sec. 5126.01. As used in this chapter:

20472

(A) As used in this division, "adult" means an individual who	20473
is eighteen years of age or over and not enrolled in a program or	20474
service under Chapter 3323. of the Revised Code and an individual	20475
sixteen or seventeen years of age who is eligible for adult	20476
services under rules adopted by the director of mental retardation	20477
and developmental disabilities pursuant to Chapter 119. of the	20478
Revised Code.	20479

(1) "Adult services" means services provided to an adult	20480
outside the home, except when they are provided within the home	20481
according to an individual's assessed needs and identified in an	20482
individual service plan, that support learning and assistance in	20483
the area of self-care, sensory and motor development,	20484
socialization, daily living skills, communication, community	20485
living, social skills, or vocational skills.	20486

(2) "Adult services" includes all of the following:

20487

(a) Adult day habilitation services;

20488

(b) Adult day care;

20489

20490

(d) Sheltered employment;

20491

(e) Educational experiences and training obtained through	20492
entities and activities that are not expressly intended for	20493
individuals with mental retardation and developmental	20494
disabilities, including trade schools, vocational or technical	20495
schools, adult education, job exploration and sampling, unpaid	20496
work experience in the community, volunteer activities, and	20497
spectator sports;	20498

(f) Community employment services and supported employment	20499
services.	20500

(B)(1) "Adult day habilitation services" means adult services	20501
that do the following:	20502

(a) Provide access to and participation in typical activities	20503
and functions of community life that are desired and chosen by the	20504
general population, including such activities and functions as	20505
opportunities to experience and participate in community	20506
exploration, companionship with friends and peers, leisure	20507
activities, hobbies, maintaining family contacts, community	20508
events, and activities where individuals without disabilities are	20509
involved;	20510

(b) Provide supports or a combination of training and	20511
supports that afford an individual a wide variety of opportunities	20512
to facilitate and build relationships and social supports in the	20513
community.	20514

(2) "Adult day habilitation services" includes all of the	20515
following:	20516

(a) Personal care services needed to ensure an individual's	20517
ability to experience and participate in vocational services,	20518
educational services, community activities, and any other adult	20519
day habilitation services;	20520

(b) Skilled services provided while receiving adult day	20521
habilitation services, including such skilled services as behavior	20522
management intervention, occupational therapy, speech and language	20523
therapy, physical therapy, and nursing services;	20524

(c) Training and education in self-determination designed to	20525
help the individual do one or more of the following: develop	20526
self-advocacy skills, exercise the individual's civil rights,	20527
acquire skills that enable the individual to exercise control and	20528
responsibility over the services received, and acquire skills that	20529
enable the individual to become more independent, integrated, or	20530
productive in the community;	20531

(d) Recreational and leisure activities identified in the	20532
individual's service plan as therapeutic in nature or assistive in	20533
developing or maintaining social supports;	20534

(e) Counseling and assistance provided to obtain housing,	20535
including such counseling as identifying options for either rental	20536
or purchase, identifying financial resources, assessing needs for	20537
environmental modifications, locating housing, and planning for	20538
ongoing management and maintenance of the housing selected;	20539

(f) Transportation necessary to access adult day habilitation	20540
services;	20541

(g) Habilitation management, as described in section 5126.14	20542
of the Revised Code.	20543

(3) "Adult day habilitation services" does not include	20544
activities that are components of the provision of residential	20545
services, family support services, or supported living services.	20546

20547

(1) In the case of a member of a county board of mental	20548
retardation and developmental disabilities appointed by, or to be	20549
appointed by, a board of county commissioners, the board of county	20550
commissioners;	20551

(2) In the case of a member of a county board appointed by,	20552
or to be appointed by, a senior probate judge, the senior probate	20553
judge.	20554

(D) "Community employment services" or "supported employment	20555
services" means job training and other services related to	20556
employment outside a sheltered workshop. "Community employment	20557
services" or "supported employment services" include all of the	20558
following:	20559

(1) Job training resulting in the attainment of competitive	20560
work, supported work in a typical work environment, or	20561
self-employment;	20562

(2) Supervised work experience through an employer paid to	20563
provide the supervised work experience;	20564

(3) Ongoing work in a competitive work environment at a wage	20565
commensurate with workers without disabilities;	20566

(4) Ongoing supervision by an employer paid to provide the	20567
supervision.	20568

(E) As used in this division, "substantial functional	20569
limitation," "developmental delay," and "established risk" have	20570
the meanings established pursuant to section 5123.011 of the	20571
Revised Code.	20572

"Developmental disability" means a severe, chronic disability	20573
that is characterized by all of the following:	20574

(1) It is attributable to a mental or physical impairment or	20575
a combination of mental and physical impairments, other than a	20576
mental or physical impairment solely caused by mental illness as	20577
defined in division (A) of section 5122.01 of the Revised Code;	20578

(2) It is manifested before age twenty-two;

20579

(3) It is likely to continue indefinitely;

20580

(4) It results in one of the following:

20581

(a) In the case of a person under age three, at least one	20582
developmental delay or an established risk;	20583

(b) In the case of a person at least age three but under age	20584
six, at least two developmental delays or an established risk;	20585

(c) In the case of a person age six or older, a substantial	20586
functional limitation in at least three of the following areas of	20587
major life activity, as appropriate for the person's age:	20588
self-care, receptive and expressive language, learning, mobility,	20589
self-direction, capacity for independent living, and, if the	20590
person is at least age sixteen, capacity for economic	20591
self-sufficiency.	20592

(5) It causes the person to need a combination and sequence	20593
of special, interdisciplinary, or other type of care, treatment,	20594
or provision of services for an extended period of time that is	20595
individually planned and coordinated for the person.	20596

(F) "Early childhood services" means a planned program of	20597
habilitation designed to meet the needs of individuals with mental	20598
retardation or other developmental disabilities who have not	20599
attained compulsory school age.	20600

(G)(1) "Environmental modifications" means the physical	20601
adaptations to an individual's home, specified in the individual's	20602
service plan, that are necessary to ensure the individual's	20603
health, safety, and welfare or that enable the individual to	20604
function with greater independence in the home, and without which	20605
the individual would require institutionalization.	20606

(2) "Environmental modifications" includes such adaptations	20607
as installation of ramps and grab-bars, widening of doorways,	20608
modification of bathroom facilities, and installation of	20609
specialized electric and plumbing systems necessary to accommodate	20610
the individual's medical equipment and supplies.	20611

(3) "Environmental modifications" does not include physical	20612
adaptations or improvements to the home that are of general	20613
utility or not of direct medical or remedial benefit to the	20614
individual, including such adaptations or improvements as	20615
carpeting, roof repair, and central air conditioning.	20616

(H) "Family support services" means the services provided	20617
under a family support services program operated under section	20618
5126.11 of the Revised Code.	20619

(I) "Habilitation" means the process by which the staff of	20620
the facility or agency assists an individual with mental	20621
retardation or other developmental disability in acquiring and	20622
maintaining those life skills that enable the individual to cope	20623
more effectively with the demands of the individual's own person	20624
and environment, and in raising the level of the individual's	20625
personal, physical, mental, social, and vocational efficiency.	20626
Habilitation includes, but is not limited to, programs of formal,	20627
structured education and training.	20628

(J) "Home and community-based services" means medicaid-funded	20629
home and community-based services specified in division (B)(1) of	20630
section ~~5111.87~~5163.65 of the Revised Code and provided under the	20631
medicaid waiver components the department of mental retardation	20632
and developmental disabilities administers pursuant to section	20633
~~5111.871~~5163.651 of the Revised Code.	20634

(K) "Immediate family" means parents, grandparents, brothers,	20635
sisters, spouses, sons, daughters, aunts, uncles, mothers-in-law,	20636
fathers-in-law, brothers-in-law, sisters-in-law, sons-in-law, and	20637
daughters-in-law.	20638

(L) ~~"Medicaid" has the same meaning as in section 5111.01 of~~	20639
~~the Revised Code.~~	20640

~~(M)~~ "Medicaid case management services" means case management	20641
services provided to an individual with mental retardation or	20642
other developmental disability that the state medicaid plan	20643
requires.	20644

~~(N)~~(M) "Mental retardation" means a mental impairment	20645
manifested during the developmental period characterized by	20646
significantly subaverage general intellectual functioning existing	20647
concurrently with deficiencies in the effectiveness or degree with	20648
which an individual meets the standards of personal independence	20649
and social responsibility expected of the individual's age and	20650
cultural group.	20651

~~(O)~~(N) "Residential services" means services to individuals	20652
with mental retardation or other developmental disabilities to	20653
provide housing, food, clothing, habilitation, staff support, and	20654
related support services necessary for the health, safety, and	20655
welfare of the individuals and the advancement of their quality of	20656
life. "Residential services" includes program management, as	20657
described in section 5126.14 of the Revised Code.	20658

~~(P)~~(O) "Resources" means available capital and other assets,	20659
including moneys received from the federal, state, and local	20660
governments, private grants, and donations; appropriately	20661
qualified personnel; and appropriate capital facilities and	20662
equipment.	20663

~~(Q)~~(P) "Senior probate judge" means the current probate judge	20664
of a county who has served as probate judge of that county longer	20665
than any of the other current probate judges of that county. If a	20666
county has only one probate judge, "senior probate judge" means	20667
that probate judge.	20668

~~(R)~~(Q) "Service and support administration" means the duties	20669
performed by a service and support administrator pursuant to	20670
section 5126.15 of the Revised Code.	20671

~~(S)~~(R)(1) "Specialized medical, adaptive, and assistive	20672
equipment, supplies, and supports" means equipment, supplies, and	20673
supports that enable an individual to increase the ability to	20674
perform activities of daily living or to perceive, control, or	20675
communicate within the environment.	20676

(2) "Specialized medical, adaptive, and assistive equipment,	20677
supplies, and supports" includes the following:	20678

(a) Eating utensils, adaptive feeding dishes, plate guards,	20679
mylatex straps, hand splints, reaches, feeder seats, adjustable	20680
pointer sticks, interpreter services, telecommunication devices	20681
for the deaf, computerized communications boards, other	20682
communication devices, support animals, veterinary care for	20683
support animals, adaptive beds, supine boards, prone boards,	20684
wedges, sand bags, sidelayers, bolsters, adaptive electrical	20685
switches, hand-held shower heads, air conditioners, humidifiers,	20686
emergency response systems, folding shopping carts, vehicle lifts,	20687
vehicle hand controls, other adaptations of vehicles for	20688
accessibility, and repair of the equipment received.	20689

(b) Nondisposable items not covered by medicaid that are	20690
intended to assist an individual in activities of daily living or	20691
instrumental activities of daily living.	20692

~~(T)~~(S) "Supportive home services" means a range of services	20693
to families of individuals with mental retardation or other	20694
developmental disabilities to develop and maintain increased	20695
acceptance and understanding of such persons, increased ability of	20696
family members to teach the person, better coordination between	20697
school and home, skills in performing specific therapeutic and	20698
management techniques, and ability to cope with specific	20699
situations.	20700

~~(U)~~(T)(1) "Supported living" means services provided for as	20701
long as twenty-four hours a day to an individual with mental	20702
retardation or other developmental disability through any public	20703
or private resources, including moneys from the individual, that	20704
enhance the individual's reputation in community life and advance	20705
the individual's quality of life by doing the following:	20706

(a) Providing the support necessary to enable an individual	20707
to live in a residence of the individual's choice, with any number	20708
of individuals who are not disabled, or with not more than three	20709
individuals with mental retardation and developmental disabilities	20710
unless the individuals are related by blood or marriage;	20711

(b) Encouraging the individual's participation in the	20712
community;	20713

20714

(d) Assisting the individual in acquiring, retaining, and	20715
improving the skills and competence necessary to live successfully	20716
in the individual's residence.	20717

(2) "Supported living" includes the provision of all of the	20718
following:	20719

(a) Housing, food, clothing, habilitation, staff support,	20720
professional services, and any related support services necessary	20721
to ensure the health, safety, and welfare of the individual	20722
receiving the services;	20723

(b) A combination of lifelong or extended-duration	20724
supervision, training, and other services essential to daily	20725
living, including assessment and evaluation and assistance with	20726
the cost of training materials, transportation, fees, and	20727
supplies;	20728

20729

(d) Household maintenance that does not include modifications	20730
to the physical structure of the residence;	20731

(e) Respite care services;

20732

(f) Program management, as described in section 5126.14 of	20733
the Revised Code.	20734

Sec. 5126.042. (A) As used in this section:

20735

(1) "Emergency" means any situation that creates for an	20736
individual with mental retardation or developmental disabilities	20737
a risk of substantial self-harm or substantial harm to others if	20738
action is not taken within thirty days. An "emergency" may include	20739
one or more of the following situations:	20740

(a) Loss of present residence for any reason, including legal	20741
action;	20742

(b) Loss of present caretaker for any reason, including	20743
serious illness of the caretaker, change in the caretaker's	20744
status, or inability of the caretaker to perform effectively for	20745
the individual;	20746

20747

(d) Health and safety conditions that pose a serious risk to	20748
the individual or others of immediate harm or death;	20749

(e) Change in the emotional or physical condition of the	20750
individual that necessitates substantial accommodation that cannot	20751
be reasonably provided by the individual's existing caretaker.	20752

(2) "Service substitution list" means a service substitution	20753
list established by a county board of mental retardation and	20754
developmental disabilities before ~~the effective date of this~~	20755
~~amendment~~September 1, 2008, pursuant to division (B) of this	20756
section as this section existed on the day immediately before ~~the~~	20757
~~effective date of this amendment~~September 1, 2008.	20758

(B) If a county board of mental retardation and developmental	20759
disabilities determines that available resources are not	20760
sufficient to meet the needs of all individuals who request	20761
programs and services and may be offered the programs and	20762
services, it shall establish waiting lists for services. The board	20763
may establish priorities for making placements on its waiting	20764
lists according to an individual's emergency status and shall	20765
establish priorities in accordance with divisions (D) and (E) of	20766
this section.	20767

The individuals who may be placed on a waiting list include	20768
individuals with a need for services on an emergency basis and	20769
individuals who have requested services for which resources are	20770
not available.	20771

An individual placed on a county board's service substitution	20772
list before ~~the effective date of this amendment~~September 1,	20773
2008, for the purpose of obtaining home and community-based	20774
services shall be deemed to have been placed on the county	20775
board's waiting list for home and community-based services on the	20776
date the individual made a request to the county board that the	20777
individual receive home and community-based services instead of	20778
the services the individual received at the time the request for	20779
home and community-based services was made to the county board.	20780

(C) A county board shall establish a separate waiting list	20781
for each of the following categories of services, and may	20782
establish separate waiting lists within the waiting lists:	20783

(1) Early childhood services;

20784

(2) Educational programs for preschool and school age	20785
children;	20786

(3) Adult services;

20787

(4) Service and support administration;

20788

(5) Residential services and supported living;

20789

(6) Transportation services;

20790

(7) Other services determined necessary and appropriate for	20791
persons with mental retardation or a developmental disability	20792
according to their individual habilitation or service plans;	20793

(8) Family support services provided under section 5126.11 of	20794
the Revised Code.	20795

(D) Except as provided in division (G) of this section, a	20796
county board shall do, as priorities, all of the following in	20797
accordance with the assessment component, approved under section	20798
5123.046 of the Revised Code, of the county board's plan developed	20799
under section 5126.054 of the Revised Code:	20800

(1) For the purpose of obtaining additional federal medicaid	20801
funds for home and community-based services and medicaid case	20802
management services, do both of the following:	20803

(a) Give an individual who is eligible for home and	20804
community-based services and meets both of the following	20805
requirements priority over any other individual on a waiting list	20806
established under division (C) of this section for home and	20807
community-based services that include supported living,	20808
residential services, or family support services:	20809

(i) Is twenty-two years of age or older;

20810

(ii) Receives supported living or family support services.

20811

(b) Give an individual who is eligible for home and	20812
community-based services and meets both of the following	20813
requirements priority over any other individual on a waiting list	20814
established under division (C) of this section for home and	20815
community-based services that include adult services:	20816

(i) Resides in the individual's own home or the home of the	20817
individual's family and will continue to reside in that home after	20818
enrollment in home and community-based services;	20819

(ii) Receives adult services from the county board.

20820

(2) As federal medicaid funds become available pursuant to	20821
division (D)(1) of this section, give an individual who is	20822
eligible for home and community-based services and meets any of	20823
the following requirements priority for such services over any	20824
other individual on a waiting list established under division (C)	20825
of this section:	20826

(a) Does not receive residential services or supported	20827
living, either needs services in the individual's current living	20828
arrangement or will need services in a new living arrangement, and	20829
has a primary caregiver who is sixty years of age or older;	20830

(b) Is less than twenty-two years of age and has at least one	20831
of the following service needs that are unusual in scope or	20832
intensity:	20833

(i) Severe behavior problems for which a behavior support	20834
plan is needed;	20835

(ii) An emotional disorder for which anti-psychotic	20836
medication is needed;	20837

(iii) A medical condition that leaves the individual	20838
dependent on life-support medical technology;	20839

(iv) A condition affecting multiple body systems for which a	20840
combination of specialized medical, psychological, educational, or	20841
habilitation services are needed;	20842

(v) A condition the county board determines to be comparable	20843
in severity to any condition described in divisions (D)(2)(b)(i)	20844
to (iv) of this section and places the individual at significant	20845
risk of institutionalization.	20846

(c) Is twenty-two years of age or older, does not receive	20847
residential services or supported living, and is determined by the	20848
county board to have intensive needs for home and community-based	20849
services on an in-home or out-of-home basis.	20850

(E) Except as provided in division (G) of this section and	20851
for a number of years and beginning on a date specified in rules	20852
adopted under division (K) of this section, a county board shall	20853
give an individual who is eligible for home and community-based	20854
services, resides in a nursing facility, and chooses to move to	20855
another setting with the help of home and community-based	20856
services, priority over any other individual on a waiting list	20857
established under division (C) of this section for home and	20858
community-based services who does not meet these criteria.	20859

(F) If two or more individuals on a waiting list established	20860
under division (C) of this section for home and community-based	20861
services have priority for the services pursuant to division	20862
(D)(1) or (2) or (E) of this section, a county board may use	20863
criteria specified in rules adopted under division (K)(2) of this	20864
section in determining the order in which the individuals with	20865
priority will be offered the services. Otherwise, the county board	20866
shall offer the home and community-based services to such	20867
individuals in the order they are placed on the waiting list.	20868

(G) No individual may receive priority for services pursuant	20869
to division (D) or (E) of this section over an individual placed	20870
on a waiting list established under division (C) of this section	20871
on an emergency status.	20872

(H) Prior to establishing any waiting list under this	20873
section, a county board shall develop and implement a policy for	20874
waiting lists that complies with this section and rules adopted	20875
under division (K) of this section.	20876

Prior to placing an individual on a waiting list, the county	20877
board shall assess the service needs of the individual in	20878
accordance with all applicable state and federal laws. The county	20879
board shall place the individual on the appropriate waiting list	20880
and may place the individual on more than one waiting list. The	20881
county board shall notify the individual of the individual's	20882
placement and position on each waiting list on which the	20883
individual is placed.	20884

At least annually, the county board shall reassess the	20885
service needs of each individual on a waiting list. If it	20886
determines that an individual no longer needs a program or	20887
service, the county board shall remove the individual from the	20888
waiting list. If it determines that an individual needs a program	20889
or service other than the one for which the individual is on the	20890
waiting list, the county board shall provide the program or	20891
service to the individual or place the individual on a waiting	20892
list for the program or service in accordance with the board's	20893
policy for waiting lists.	20894

When a program or service for which there is a waiting list	20895
becomes available, the county board shall reassess the service	20896
needs of the individual next scheduled on the waiting list to	20897
receive that program or service. If the reassessment demonstrates	20898
that the individual continues to need the program or service, the	20899
board shall offer the program or service to the individual. If it	20900
determines that an individual no longer needs a program or	20901
service, the county board shall remove the individual from the	20902
waiting list. If it determines that an individual needs a program	20903
or service other than the one for which the individual is on the	20904
waiting list, the county board shall provide the program or	20905
service to the individual or place the individual on a waiting	20906
list for the program or service in accordance with the board's	20907
policy for waiting lists. The county board shall notify the	20908
individual of the individual's placement and position on the	20909
waiting list on which the individual is placed.	20910

(I) A child subject to a determination made pursuant to	20911
section 121.38 of the Revised Code who requires the home and	20912
community-based services provided through a medicaid component	20913
that the department of mental retardation and developmental	20914
disabilities administers under section ~~5111.871~~5163.651 of the	20915
Revised Code shall receive services through that medicaid	20916
component. For all other services, a child subject to a	20917
determination made pursuant to section 121.38 of the Revised Code	20918
shall be treated as an emergency by the county boards and shall	20919
not be subject to a waiting list.	20920

(J) Not later than the fifteenth day of March of each	20921
even-numbered year, each county board shall prepare and submit to	20922
the director of mental retardation and developmental disabilities	20923
its recommendations for the funding of services for individuals	20924
with mental retardation and developmental disabilities and its	20925
proposals for reducing the waiting lists for services.	20926

(K)(1) The department of mental retardation and developmental	20927
disabilities shall adopt rules in accordance with Chapter 119. of	20928
the Revised Code governing waiting lists established under this	20929
section. The rules shall include procedures to be followed to	20930
ensure that the due process rights of individuals placed on	20931
waiting lists are not violated.	20932

(2) As part of the rules adopted under this division, the	20933
department shall adopt rules establishing criteria a county board	20934
may use under division (F) of this section in determining the	20935
order in which individuals with priority for home and	20936
community-based services will be offered the services. The rules	20937
shall also specify conditions under which a county board, when	20938
there is no individual with priority for home and community-based	20939
services pursuant to division (D)(1) or (2) or (E) of this section	20940
available and appropriate for the services, may offer the services	20941
to an individual on a waiting list for the services but not given	20942
such priority for the services.	20943

(3) As part of the rules adopted under this division, the	20944
department shall adopt rules specifying both of the following for	20945
the priority category established under division (E) of this	20946
section:	20947

(a) The number of years, which shall not exceed five, that	20948
the priority category will be in effect;	20949

(b) The date that the priority category is to go into effect.

20950

(L) The following shall take precedence over the applicable	20951
provisions of this section:	20952

(1) Medicaid rules and regulations;

20953

(2) Any specific requirements that may be contained within a	20954
medicaid state plan amendment or waiver program that a county	20955
board has authority to administer or with respect to which it has	20956
authority to provide services, programs, or supports.	20957

Sec. 5126.046. (A) Each county board of mental retardation	20958
and developmental disabilities that has medicaid local	20959
administrative authority under division (A) of section 5126.055 of	20960
the Revised Code for habilitation, vocational, or community	20961
employment services provided as part of home and community-based	20962
services shall create a list of all persons and government	20963
entities eligible to provide such habilitation, vocational, or	20964
community employment services. If the county board chooses and is	20965
eligible to provide such habilitation, vocational, or community	20966
employment services, the county board shall include itself on the	20967
list. The county board shall make the list available to each	20968
individual with mental retardation or other developmental	20969
disability who resides in the county and is eligible for such	20970
habilitation, vocational, or community employment services. The	20971
county board shall also make the list available to such	20972
individuals' families.	20973

An individual with mental retardation or other developmental	20974
disability who is eligible for habilitation, vocational, or	20975
community employment services may choose the provider of the	20976
services.	20977

(B) Each month, the department of mental retardation and	20978
developmental disabilities shall create a list of all persons and	20979
government entities eligible to provide residential services and	20980
supported living. The department shall include on the list all	20981
residential facilities licensed under section 5123.19 of the	20982
Revised Code and all supported living providers certified under	20983
section 5123.161 of the Revised Code. The department shall	20984
distribute the monthly lists to county boards that have local	20985
administrative authority under division (A) of section 5126.055	20986
of the Revised Code for residential services and supported living	20987
provided as part of home and community-based services. A county	20988
board that receives a list shall make it available to each	20989
individual with mental retardation or other developmental	20990
disability who resides in the county and is eligible for such	20991
residential services or supported living. The county board shall	20992
also make the list available to the families of those	20993
individuals.	20994

An individual who is eligible for residential services or	20995
supported living may choose the provider of the residential	20996
services or supported living.	20997

(C) If a county board that has medicaid local administrative	20998
authority under division (A) of section 5126.055 of the Revised	20999
Code for home and community-based services violates the right	21000
established by this section of an individual to choose a provider	21001
that is qualified and willing to provide services to the	21002
individual, the individual shall receive timely notice that the	21003
individual may request a hearing under section ~~5101.35~~5160.34 of	21004
the Revised Code.	21005

(D) The departments of mental retardation and developmental	21006
disabilities and ~~job and family services~~health care	21007
administration shall adopt rules in accordance with Chapter 119.	21008
of the Revised Code governing the implementation of this section.	21009
The rules shall include procedures for individuals to choose	21010
their service providers. The rules shall not be limited by a	21011
provider selection system established under section 5126.42 of	21012
the Revised Code, including any pool of providers created	21013
pursuant to a provider selection system.	21014

Sec. 5126.054. (A) Each county board of mental retardation	21015
and developmental disabilities shall, by resolution, develop a	21016
three-calendar year plan that includes the following three	21017
components:	21018

(1) An assessment component that includes all of the	21019
following:	21020

(a) The number of individuals with mental retardation or	21021
other developmental disability residing in the county who need the	21022
level of care provided by an intermediate care facility for the	21023
mentally retarded, may seek home and community-based services, are	21024
given priority for the services pursuant to division (D) of	21025
section 5126.042 of the Revised Code; the service needs of those	21026
individuals; and the projected annualized cost for services;	21027

(b) The source of funds available to the county board to pay	21028
the nonfederal share of medicaid expenditures that the county	21029
board is required by sections 5126.059 and 5126.0510 of the	21030
Revised Code to pay;	21031

(c) Any other applicable information or conditions that the	21032
department of mental retardation and developmental disabilities	21033
requires as a condition of approving the component under section	21034
5123.046 of the Revised Code.	21035

(2) (A preliminary implementation component that specifies	21036
the number of individuals to be provided, during the first year	21037
that the plan is in effect, home and community-based services	21038
pursuant to the priority given to them under divisions (D)(1) and	21039
(2) of section 5126.042 of the Revised Code and the types of home	21040
and community-based services the individuals are to receive;	21041

(3) A component that provides for the implementation of	21042
medicaid case management services and home and community-based	21043
services for individuals who begin to receive the services on or	21044
after the date the plan is approved under section 5123.046 of the	21045
Revised Code. A county board shall include all of the following in	21046
the component:	21047

(a) If the department of mental retardation and developmental	21048
disabilities or department of ~~job and family services~~health care	21049
administration requires, an agreement to pay the nonfederal share	21050
of medicaid expenditures that the county board is required by	21051
sections 5126.059 and 5126.0510 of the Revised Code to pay;	21052

(b) How the services are to be phased in over the period the	21053
plan covers, including how the county board will serve individuals	21054
on a waiting list established under division (C) of section	21055
5126.042 who are given priority status under division (D)(1) of	21056
that section;	21057

(c) Any agreement or commitment regarding the county board's	21058
funding of home and community-based services that the county board	21059
has with the department at the time the county board develops the	21060
component;	21061

(d) Assurances adequate to the department that the county	21062
board will comply with all of the following requirements:	21063

(i) To provide the types of home and community-based services	21064
specified in the preliminary implementation component required by	21065
division (A)(2) of this section to at least the number of	21066
individuals specified in that component;	21067

(ii) To use any additional funds the county board receives	21068
for the services to improve the county board's resource	21069
capabilities for supporting such services available in the county	21070
at the time the component is developed and to expand the services	21071
to accommodate the unmet need for those services in the county;	21072

(iii) To employ a business manager who is either a new	21073
employee who has earned at least a bachelor's degree in business	21074
administration or a current employee who has the equivalent	21075
experience of a bachelor's degree in business administration. If	21076
the county board will employ a new employee, the county board	21077
shall include in the component a timeline for employing the	21078
employee.	21079

(iv) To employ or contract with a medicaid services manager	21080
who is either a new employee who has earned at least a bachelor's	21081
degree or a current employee who has the equivalent experience of	21082
a bachelor's degree. If the county board will employ a new	21083
employee, the county board shall include in the component a	21084
timeline for employing the employee. Two or three county boards	21085
that have a combined total enrollment in county board services not	21086
exceeding one thousand individuals as determined pursuant to	21087
certifications made under division (B) of section 5126.12 of the	21088
Revised Code may satisfy this requirement by sharing the services	21089
of a medicaid services manager or using the services of a medicaid	21090
services manager employed by or under contract with a regional	21091
council that the county boards establish under section 5126.13 of	21092
the Revised Code.	21093

(e) Programmatic and financial accountability measures and	21094
projected outcomes expected from the implementation of the plan;	21095

(f) Any other applicable information or conditions that the	21096
department requires as a condition of approving the component	21097
under section 5123.046 of the Revised Code.	21098

(B) A county board whose plan developed under division (A) of	21099
this section is approved by the department under section 5123.046	21100
of the Revised Code shall update and renew the plan in accordance	21101
with a schedule the department shall develop.	21102

Sec. 5126.055. (A) Except as provided in section 5126.056	21103
of the Revised Code, a county board of mental retardation and	21104
developmental disabilities has medicaid local administrative	21105
authority to, and shall, do all of the following for an individual	21106
with mental retardation or other developmental disability who	21107
resides in the county that the county board serves and seeks or	21108
receives home and community-based services:	21109

(1) Perform assessments and evaluations of the individual. As	21110
part of the assessment and evaluation process, the county board	21111
shall do all of the following:	21112

(a) Make a recommendation to the department of mental	21113
retardation and developmental disabilities on whether the	21114
department should approve or deny the individual's application for	21115
the services, including on the basis of whether the individual	21116
needs the level of care an intermediate care facility for the	21117
mentally retarded provides;	21118

(b) If the individual's application is denied because of the	21119
county board's recommendation and the individual requests a	21120
hearing under section ~~5101.35~~5160.34 of the Revised Code,	21121
present, with the department of mental retardation and	21122
developmental disabilities or department of ~~job and family~~	21123
~~services~~health care administration, whichever denies the	21124
application, the reasons for the recommendation and denial at the	21125
hearing;	21126

(c) If the individual's application is approved, recommend to	21127
the departments of mental retardation and developmental	21128
disabilities and ~~job and family services~~health care	21129
administration the services that should be included in the	21130
individual's individualized service plan and, if either department	21131
approves, reduces, denies, or terminates a service included in the	21132
individual's individualized service plan under section ~~5111.871~~	21133
5163.651 of the Revised Code because of the county board's	21134
recommendation, present, with the department that made the	21135
approval, reduction, denial, or termination, the reasons for the	21136
recommendation and approval, reduction, denial, or termination at	21137
a hearing under section ~~5101.35~~5160.34 of the Revised Code.	21138

(2) In accordance with the rules adopted under section	21139
5126.046 of the Revised Code, perform the county board's duties	21140
under that section regarding assisting the individual's right to	21141
choose a qualified and willing provider of the services and, at a	21142
hearing under section 5101.35 of the Revised Code, present	21143
evidence of the process for appropriate assistance in choosing	21144
providers;	21145

(3) If the county board is certified under section 5123.161	21146
of the Revised Code to provide the services and agrees to	21147
provide the services to the individual and the individual	21148
chooses the county board to provide the services, furnish, in	21149
accordance with the county board's medicaid provider agreement	21150
and for the authorized reimbursement rate, the services the	21151
individual requires;	21152

(4) Monitor the services provided to the individual and	21153
ensure the individual's health, safety, and welfare. The	21154
monitoring shall include quality assurance activities. If the	21155
county board provides the services, the department of mental	21156
retardation and developmental disabilities shall also monitor the	21157
services.	21158

(5) Develop, with the individual and the provider of the	21159
individual's services, an effective individualized service plan	21160
that includes coordination of services, recommend that the	21161
departments of mental retardation and developmental disabilities	21162
and ~~job and family services~~health care administration approve the	21163
plan, and implement the plan unless either department disapproves	21164
it;	21165

(6) Have an investigative agent conduct investigations under	21166
section 5126.313 of the Revised Code that concern the individual;	21167

(7) Have a service and support administrator perform the	21168
duties under division (B)(9) of section 5126.15 of the Revised	21169
Code that concern the individual.	21170

(B) A county board shall perform its medicaid local	21171
administrative authority under this section in accordance with all	21172
of the following:	21173

(1) The county board's plan that the department of mental	21174
retardation and developmental disabilities approves under section	21175
5123.046 of the Revised Code;	21176

(2) All applicable federal and state laws;

21177

(3) All applicable policies of the departments of mental	21178
retardation and developmental disabilities and ~~job and family~~	21179
~~services~~health care administration and the United States	21180
department of health and human services;	21181

(4) The department of ~~job and family services'~~health care	21182
administration's supervision under its authority under section	21183
~~5111.01~~5161.01 of the Revised Code to act as the single state	21184
medicaid agency;	21185

(5) The department of mental retardation and developmental	21186
disabilities' oversight.	21187

(C) The departments of mental retardation and developmental	21188
disabilities and ~~job and family services~~health care	21189
administration shall communicate with and provide training to	21190
county boards regarding medicaid local administrative authority	21191
granted by this section. The communication and training shall	21192
include issues regarding audit protocols and other standards	21193
established by the United States department of health and human	21194
services that the departments determine appropriate for	21195
communication and training. County boards shall participate in the	21196
training. The departments shall assess the county board's	21197
compliance against uniform standards that the departments shall	21198
establish.	21199

(D) A county board may not delegate its medicaid local	21200
administrative authority granted under this section but may	21201
contract with a person or government entity, including a council	21202
of governments, for assistance with its medicaid local	21203
administrative authority. A county board that enters into such a	21204
contract shall notify the director of mental retardation and	21205
developmental disabilities. The notice shall include the tasks and	21206
responsibilities that the contract gives to the person or	21207
government entity. The person or government entity shall comply in	21208
full with all requirements to which the county board is subject	21209
regarding the person or government entity's tasks and	21210
responsibilities under the contract. The county board remains	21211
ultimately responsible for the tasks and responsibilities.	21212

(E) A county board that has medicaid local administrative	21213
authority under this section shall, through the departments of	21214
mental retardation and developmental disabilities and ~~job and~~	21215
~~family services~~health care administration, reply to, and	21216
cooperate in arranging compliance with, a program or fiscal audit	21217
or program violation exception that a state or federal audit or	21218
review discovers. The department of ~~job and family services~~health	21219
care administration shall timely notify the department of mental	21220
retardation and developmental disabilities and the county board of	21221
any adverse findings. After receiving the notice, the county	21222
board, in conjunction with the department of mental retardation	21223
and developmental disabilities, shall cooperate fully with the	21224
department of ~~job and family services~~health care administration	21225
and timely prepare and send to the department a written plan of	21226
correction or response to the adverse findings. The county board	21227
is liable for any adverse findings that result from an action it	21228
takes or fails to take in its implementation of medicaid local	21229
administrative authority.	21230

(F) If the department of mental retardation and developmental	21231
disabilities or department of ~~job and family services~~health care	21232
administration determines that a county board's implementation of	21233
its medicaid local administrative authority under this section is	21234
deficient, the department that makes the determination shall	21235
require that county board do the following:	21236

(1) If the deficiency affects the health, safety, or welfare	21237
of an individual with mental retardation or other developmental	21238
disability, correct the deficiency within twenty-four hours;	21239

(2) If the deficiency does not affect the health, safety, or	21240
welfare of an individual with mental retardation or other	21241
developmental disability, receive technical assistance from the	21242
department or submit a plan of correction to the department that	21243
is acceptable to the department within sixty days and correct the	21244
deficiency within the time required by the plan of correction.	21245

Sec. 5126.0512. (A) As used in this section, "medicaid	21246
waiver component" means a medicaid waiver component as defined in	21247
section ~~5111.85~~5163.50 of the Revised Code under which home and	21248
community-based services are provided.	21249

(B) Effective July 1, 2007, each county board of mental	21250
retardation and developmental disabilities shall ensure, for each	21251
medicaid waiver component, that the number of individuals eligible	21252
under section 5126.041 of the Revised Code for services from the	21253
county board who are enrolled in a medicaid waiver component is no	21254
less than the sum of the following:	21255

(1) The number of individuals eligible for services from the	21256
county board who are enrolled in the medicaid waiver component on	21257
June 30, 2007;	21258

(2) The number of medicaid waiver component slots the county	21259
board requested before July 1, 2007, that were assigned to the	21260
county board before that date but in which no individual was	21261
enrolled before that date.	21262

(C) An individual enrolled in a medicaid waiver component	21263
after March 1, 2007, due to an emergency reserve capacity waiver	21264
assignment shall not be counted in determining the number of	21265
individuals a county board must ensure under division (B) of this	21266
section are enrolled in a medicaid waiver component.	21267

(D) An individual who is enrolled in a medicaid waiver	21268
component to comply with the terms of the consent order filed	21269
March 5, 2007, in Martin v. Strickland, Case No. 89-CV-00362, in	21270
the United States district court for the southern district of	21271
Ohio, eastern division, shall be excluded in determining whether a	21272
county board has complied with division (B) of this section.	21273

(E) A county board shall make as many requests for	21274
individuals to be enrolled in a medicaid waiver component as	21275
necessary for the county board to comply with division (B) of this	21276
section.	21277

Sec. 5126.082. (A) In addition to the rules adopted under	21278
division (A)(2) of section 5126.08 of the Revised Code	21279
establishing standards to be followed by county boards of mental	21280
retardation and developmental disabilities in administering,	21281
providing, arranging, and operating programs and services and in	21282
addition to the board accreditation system established under	21283
section 5126.081 of the Revised Code, the director of mental	21284
retardation and developmental disabilities shall adopt rules in	21285
accordance with Chapter 119. of the Revised Code establishing	21286
standards for promoting and advancing the quality of life of	21287
individuals with mental retardation and developmental disabilities	21288
receiving any of the following:	21289

(1) Early childhood services pursuant to section 5126.05 of	21290
the Revised Code for children under age three;	21291

(2) Adult services pursuant to section 5126.05 and division	21292
(B) of section 5126.051 of the Revised Code for individuals age	21293
sixteen or older;	21294

(3) Family support services pursuant to section 5126.11 of	21295
the Revised Code.	21296

(B) The rules adopted under this section shall specify the	21297
actions county boards of mental retardation and developmental	21298
disabilities and the agencies with which they contract should take	21299
to do the following:	21300

(1) Offer individuals with mental retardation and	21301
developmental disabilities, and their families when appropriate,	21302
choices in programs and services that are centered on the needs	21303
and desires of those individuals;	21304

(2) Maintain infants with their families whenever possible by	21305
collaborating with other agencies that provide services to infants	21306
and their families and taking other appropriate actions;	21307

(3) Provide families that have children with mental	21308
retardation and developmental disabilities under age eighteen	21309
residing in their homes the resources necessary to allow the	21310
children to remain in their homes;	21311

(4) Create and implement community employment services based	21312
on the needs and desires of adults with mental retardation and	21313
developmental disabilities;	21314

(5) Create, in collaboration with other agencies,	21315
transportation systems that provide safe and accessible	21316
transportation within the county to individuals with disabilities;	21317

(6) Provide services that allow individuals with disabilities	21318
to be integrated into the community by engaging in educational,	21319
vocational, and recreational activities with individuals who do	21320
not have disabilities;	21321

(7) Provide age-appropriate retirement services for	21322
individuals age sixty-five and older with mental retardation and	21323
developmental disabilities;	21324

(8) Establish residential services and supported living for	21325
individuals with mental retardation and developmental disabilities	21326
in accordance with their needs.	21327

(C) To assist in funding programs and services that meet the	21328
standards established under this section, each county board of	21329
mental retardation and developmental disabilities shall make a	21330
good faith effort to acquire available federal funds, including	21331
reimbursements under ~~Title XIX of~~ the ~~"Social Security Act," 79~~	21332
~~Stat. 286 (1965), 42 U.S.C.A. 1396, as amended~~medicaid program.	21333

(D) Each county board of mental retardation and developmental	21334
disabilities shall work toward full compliance with the standards	21335
established under this section, based on its available resources.	21336
Funds received under this chapter shall be used to comply with the	21337
standards. Annually, each board shall conduct a self audit to	21338
evaluate the board's progress in complying fully with the	21339
standards.	21340

(E) The department shall complete a program quality review of	21341
each county board of mental retardation and developmental	21342
disabilities to determine the extent to which the board has	21343
complied with the standards. The review shall be conducted in	21344
conjunction with the comprehensive accreditation review of the	21345
board that is conducted under section 5126.081 of the Revised	21346
Code.	21347

Notwithstanding any provision of this chapter or Chapter	21348
5123. of the Revised Code requiring the department to distribute	21349
funds to county boards of mental retardation and developmental	21350
disabilities, the department may withhold funds from a board if it	21351
finds that the board is not in substantial compliance with the	21352
standards established under this section.	21353

(F) When the standards for accreditation from the commission	21354
on accreditation of rehabilitation facilities, or another	21355
accrediting agency, meet or exceed the standards established under	21356
this section, the director may accept accreditation from the	21357
commission or other agency as evidence that the board is in	21358
compliance with all or part of the standards established under	21359
this section. Programs and services accredited by the commission	21360
or agency are exempt from the program quality reviews required by	21361
division (E) of this section.	21362

Sec. 5126.12. (A) As used in this section:

21363

(1) "Approved school age class" means a class operated by a	21364
county board of mental retardation and developmental disabilities	21365
and funded by the department of education under section 3317.20 of	21366
the Revised Code.	21367

(2) "Approved preschool unit" means a class or unit operated	21368
by a county board of mental retardation and developmental	21369
disabilities and approved under division (B) of section 3317.05 of	21370
the Revised Code.	21371

(3) "Active treatment" means a continuous treatment program,	21372
which includes aggressive, consistent implementation of a program	21373
of specialized and generic training, treatment, health services,	21374
and related services, that is directed toward the acquisition of	21375
behaviors necessary for an individual with mental retardation or	21376
other developmental disability to function with as much	21377
self-determination and independence as possible and toward the	21378
prevention of deceleration, regression, or loss of current optimal	21379
functional status.	21380

(4) "Eligible for active treatment" means that an individual	21381
with mental retardation or other developmental disability resides	21382
in an intermediate care facility for the mentally retarded	21383
certified ~~under Title XIX of the "Social Security Act," 79 Stat.~~	21384
~~286 (1965), 42 U.S.C. 1396, as amended~~for the medicaid program;	21385
resides in a state institution operated by the department of	21386
mental retardation and developmental disabilities; or is enrolled	21387
in home and community-based services.	21388

(5) "Traditional adult services" means vocational and	21389
nonvocational activities conducted within a sheltered workshop or	21390
adult activity center or supportive home services.	21391

(B) Each county board of mental retardation and developmental	21392
disabilities shall certify to the director of mental retardation	21393
and developmental disabilities all of the following:	21394

(1) On or before the fifteenth day of October, the average	21395
daily membership for the first full week of programs and services	21396
during October receiving:	21397

(a) Early childhood services provided pursuant to section	21398
5126.05 of the Revised Code for children who are less than three	21399
years of age on the thirtieth day of September of the academic	21400
year;	21401

(b) Special education for children with disabilities in	21402
approved school age classes;	21403

(c) Adult services for persons sixteen years of age and older	21404
operated pursuant to section 5126.05 and division (B) of section	21405
5126.051 of the Revised Code. Separate counts shall be made for	21406
the following:	21407

(i) Persons enrolled in traditional adult services who are	21408
eligible for but not enrolled in active treatment;	21409

(ii) Persons enrolled in traditional adult services who are	21410
eligible for and enrolled in active treatment;	21411

(iii) Persons enrolled in traditional adult services but who	21412
are not eligible for active treatment;	21413

(iv) Persons participating in community employment services.	21414
To be counted as participating in community employment services, a	21415
person must have spent an average of no less than ten hours per	21416
week in that employment during the preceding six months.	21417

(d) Other programs in the county for individuals with mental	21418
retardation and developmental disabilities that have been approved	21419
for payment of subsidy by the department of mental retardation and	21420
developmental disabilities.	21421

The membership in each such program and service in the county	21422
shall be reported on forms prescribed by the department of mental	21423
retardation and developmental disabilities.	21424

The department of mental retardation and developmental	21425
disabilities shall adopt rules defining full-time equivalent	21426
enrollees and for determining the average daily membership	21427
therefrom, except that certification of average daily membership	21428
in approved school age classes shall be in accordance with rules	21429
adopted by the state board of education. The average daily	21430
membership figure shall be determined by dividing the amount	21431
representing the sum of the number of enrollees in each program or	21432
service in the week for which the certification is made by the	21433
number of days the program or service was offered in that week. No	21434
enrollee may be counted in average daily membership for more than	21435
one program or service.	21436

(2) By the fifteenth day of December, the number of children	21437
enrolled in approved preschool units on the first day of December;	21438

(3) On or before the thirtieth day of April, an itemized	21439
report of all income and operating expenditures for the	21440
immediately preceding calendar year, in the format specified by	21441
the department of mental retardation and developmental	21442
disabilities;	21443

(4) That each required certification and report is in	21444
accordance with rules established by the department of mental	21445
retardation and developmental disabilities and the state board of	21446
education for the operation and subsidization of the programs and	21447
services.	21448

Sec. 5160.01. As used in the Revised Code:

21449

"Children's buy-in program" means the program established	21450
under sections 5167.35 to 5167.40 of the Revised Code.	21451

"Children's health insurance program" means the program	21452
authorized by Title XXI of the Social Security Act of 1935 and	21453
sections 5167.01 to 5167.32 of the Revised Code.	21454

"Disability medical assistance program" and "disability	21455
medical assistance" mean the program authorized by Chapter 5168.	21456
of the Revised Code.	21457

"Medicaid program" and "medicaid" mean the medical assistance	21458
program created by Title XIX of the Social Security Act of 1935	21459
and Chapters 5161., 5162., 5163., 5164., 5165., and 5166. of the	21460
Revised Code.	21461

"Medicare program" and "medicare" mean the health insurance	21462
program created by Title XVIII of the Social Security Act of 1935.	21463

"Ohio's best Rx program" means the program established under	21464
Chapter 5169. of the Revised Code.	21465

"Supplemental security income program," "SSI program,"	21466
"supplemental security income," and "SSI" mean the program	21467
providing benefits to qualified aged, blind, and disabled	21468
individuals created by Title XVI of the Social Security Act of	21469
1935.	21470

"Residential state supplement program" means the program	21471
administered pursuant to section 5160.80 of the Revised Code.	21472

Sec. 5160.02. As used in this chapter:

21473

(A) "ODHCA family services duty" means a family services duty	21474
associated with an ODHCA program.	21475

(B) "ODHCA program" means all of the following:

21476

(1) The children's buy-in program;

21477

(2) The children's health insurance program;

21478

(3) The disability medical assistance program;

21479

(4) The medicaid program;

21480

(5) The Ohio's best Rx program;

21481

(6) The residential state supplement program;

21482

(7) Any other program that state law permits or requires the	21483
department of health care administration to administer.	21484

Sec. 5160.03. The director of health care administration	21485
shall do all of the following as necessary for the department's	21486
efficient administration:	21487

(A) Organize the department of health care administration,	21488
including creating administrative subunits;	21489

(B) Appoint employees and prescribe their titles and duties,	21490
including chiefs of administrative subunits;	21491

(C) Establish procedures for conducting the business of the	21492
department, including procedures for the custody, use, and	21493
preservation of records, papers, documents, and property.	21494

~~Sec. 5111.084.~~ Sec. 5160.04. There is hereby established the	21495
pharmacy and therapeutics committee of the department of ~~job and~~	21496
~~family services~~health care administration. The committee shall	21497
consist of ten members and shall be appointed by the director of	21498
~~job and family services~~health care administration. The	21499
membership of the committee shall include:	21500

(A) Three pharmacists licensed under Chapter 4729. of the	21501
Revised Code;	21502

(B) Two doctors of medicine and two doctors of osteopathy	21503
who hold certificates issued under Chapter 4731. of the Revised	21504
Code;	21505

(C) A registered nurse licensed under Chapter 4723. of the	21506
Revised Code;	21507

(D) A pharmacologist who has a doctoral degree;

21508

(E) A psychiatrist who holds a certificate issued under	21509
Chapter 4731. of the Revised Code and specializes in psychiatry.	21510

The committee shall elect one of its members as chairperson.

21511

Sec. 5160.05. If the director of health care administration	21512
determines that a position with the department of health care	21513
administration can best be filled in accordance with division	21514
(A)(2) of section 124.30 of the Revised Code or without regard to	21515
a residency requirement established by a rule adopted by the	21516
director of administrative services, the director of health care	21517
administration shall provide the director of administrative	21518
services certification of the determination.	21519

Sec. 5160.06. The director of health care administration may	21520
require any of the employees of the department of health care	21521
administration who may be charged with custody or control of any	21522
public money or property or who is required to give bond, to give	21523
a bond, properly conditioned, in a sum to be fixed by the director	21524
which when approved by the director, shall be filed in the office	21525
of the secretary of state. The cost of such bonds, when approved	21526
by the director, shall be paid from funds available for the	21527
department. The bonds required or authorized by this section may,	21528
in the discretion of the director, be individual, schedule, or	21529
blanket bonds.	21530

Sec. 5160.08. The director of health care administration may	21531
acquire by purchase, lease, or otherwise such real and personal	21532
property rights in the name of the state as are necessary for the	21533
purposes of the department of health care administration. The	21534
director, with the approval of the governor and the attorney	21535
general, may sell, lease, or exchange portions of real and	21536
personal property of the department when the sale, lease, or	21537
exchange is advantageous to the state. Money received from such	21538
sales, leases, or exchanges shall be credited to the general	21539
revenue fund.	21540

Sec. 5160.10. There is hereby created in the state treasury	21541
the ODHCA support services federal operating fund. The fund shall	21542
consist of federal funds the department of health care	21543
administration receives and that the director of health care	21544
administration determines are appropriate for deposit into the	21545
fund. Money in the fund shall be used to pay the federal share of	21546
both of the following:	21547

(A) The department's costs for computer projects;

21548

(B) The operating costs of the parts of the department that	21549
provide general support services for the department's	21550
administrative subunits.	21551

Sec. 5160.101. There is hereby created in the state treasury	21552
the ODHCA support services state operating fund. The fund shall	21553
consist of payments made to the fund from other appropriation	21554
items by intrastate transfer voucher. Money in the fund shall be	21555
used to pay for both of the following:	21556

(A) The department of health care administration's costs for	21557
computer projects;	21558

(B) The operating costs of the parts of the department that	21559
provide general support services for the department's	21560
administrative subunits.	21561

Sec. 5160.12. The director of health care administration may	21562
expend funds appropriated or available to the department of health	21563
care administration from any person or government entity. For	21564
purposes of this section, the director may enter into contracts	21565
with persons and government entities and make grants to persons	21566
and government entities. To the extent permitted by federal law,	21567
the director may advance funds to a grantee when necessary for the	21568
grantee to perform duties under the grant as specified by the	21569
director.	21570

Sec. 5160.13. (A) As used in this section:

21571

(1) "Entity" includes an agency, board, commission, or	21572
department of the state or a political subdivision of the state; a	21573
private, nonprofit entity; a school district; a private school; or	21574
a public or private institution of higher education.	21575

(2) "Federal financial participation" means the federal	21576
government's share of expenditures made by an entity in	21577
implementing an ODHCA program.	21578

(B) This section does not apply to contracts entered into	21579
under section 5161.05 or 5161.10 of the Revised Code.	21580

(C) At the request of any public entity having authority to	21581
implement an ODHCA program or any private entity under contract	21582
with a public entity to implement an ODHCA program, the department	21583
may seek to obtain federal financial participation for costs	21584
incurred by the entity. Federal financial participation may be	21585
sought only for expenditures made with funds for which federal	21586
financial participation is available under federal law.	21587

(D) All funds collected by the department pursuant to this	21588
section shall be distributed to the entities that incurred the	21589
costs, except for any amounts retained by the department pursuant	21590
to division (E)(3) of this section.	21591

(E) In distributing federal financial participation pursuant	21592
to this section, the department may either enter into an agreement	21593
with the entity that is to receive the funds or distribute the	21594
funds in accordance with rules adopted under division (F) of this	21595
section. If the department decides to enter into an agreement to	21596
distribute the funds, the agreement may include terms that do any	21597
of the following:	21598

(1) Provide for the whole or partial reimbursement of any	21599
cost incurred by the entity in implementing the program;	21600

(2) In the event that federal financial participation is	21601
disallowed or otherwise unavailable for any expenditure, require	21602
the department or the entity, whichever party caused the	21603
disallowance or unavailability of federal financial participation,	21604
to assume responsibility for the expenditures;	21605

(3) Permit the department to retain not more than five per	21606
cent of the amount of the federal financial participation to be	21607
distributed to the entity;	21608

(4) Require the public entity to certify the availability of	21609
sufficient unencumbered funds to match the federal financial	21610
participation it receives under this section;	21611

(5) Establish the length of the agreement, which may be for a	21612
fixed or a continuing period of time;	21613

(6) Establish any other requirements determined by the	21614
department to be necessary for the efficient administration of the	21615
agreement.	21616

(F) The director of health care administration shall adopt	21617
rules as necessary to implement this section, including rules for	21618
the distribution of federal financial participation pursuant to	21619
this section. The rules shall be adopted in accordance with	21620
Chapter 119. of the Revised Code. The director may amend the state	21621
medicaid plan or state child health plan as necessary to implement	21622
this section.	21623

(G) Federal financial participation received pursuant to this	21624
section shall not be included in any calculation made under	21625
sections 5160.26 and 5160.261 of the Revised Code.	21626

Sec. 5160.15. (A) As used in sections 5160.15 to 5160.152 of	21627
the Revised Code:	21628

(1) "County subgrant" means a grant that a board of county	21629
commissioners awards to another entity.	21630

(2) "County subgrant agreement" means an agreement between a	21631
board of county commissioners and another entity under which the	21632
board awards the other entity one or more county subgrants.	21633

(3) "Fiscal biennial period" means a two-year period	21634
beginning on the first day of July of an odd-numbered year and	21635
ending on the last day of June of the next odd-numbered year.	21636

(4) "Grant" means an award for one or more ODHCA family	21637
services duties of federal financial assistance that a federal	21638
agency provides in the form of money, or property in lieu of	21639
money, to the department of health care administration and that	21640
the department awards to a board of county commissioners. "Grant"	21641
may include state funds the department awards to a board of county	21642
commissioners to match the federal financial assistance. "Grant"	21643
does not mean either of the following:	21644

(a) Technical assistance that provides services instead of	21645
money;	21646

(b) Other assistance provided in the form of revenue sharing,	21647
loans, loan guarantees, interest subsidies, or insurance.	21648

(5) "Grant agreement" means an agreement between the	21649
department of health care administration and a board of county	21650
commissioners under which the department awards the board one or	21651
more grants.	21652

(B) Effective July 1, 2009, the director of health care	21653
administration may award grants to counties only through grant	21654
agreements entered into under this section.	21655

(C) The director shall enter into one or more written grant	21656
agreements with the board of county commissioners of each county.	21657
Except as provided in rules adopted under this section, grant	21658
agreements shall be entered into before the first day of each	21659
fiscal biennial period and shall be in effect for that fiscal	21660
biennial period or, in the case of a grant agreement entered into	21661
after the first day of a fiscal biennial period and except as	21662
provided by section 5160.151 of the Revised Code, for the	21663
remainder of the fiscal biennial period. A grant agreement shall	21664
do all of the following:	21665

(1) Comply with all of the conditions, requirements, and	21666
restrictions applicable to the ODHCA family services duties for	21667
which the grants included in the agreement are awarded, including	21668
the conditions, requirements, and restrictions established by the	21669
department, federal or state law, state plans for receipt of	21670
federal financial participation, agreements between the department	21671
and a federal agency, and executive orders issued by the governor;	21672

(2) Establish terms and conditions governing the	21673
accountability for and use of the grants included in the grant	21674
agreement;	21675

(3) Specify both of the following:

21676

(a) The ODHCA family services duties for which the grants	21677
included in the agreement are awarded;	21678

(b) The private and government entities designated under	21679
section 307.981 of the Revised Code to serve as the county family	21680
services agencies performing the ODHCA family services duties.	21681

(4) Provide for the department of health care administration	21682
to award the grants included in the agreement in accordance with a	21683
methodology for determining the amount of the award established by	21684
rules adopted under this section;	21685

(5) Specify the form of the grants which may be a cash draw,	21686
reimbursement, property, advance, working capital advance, or	21687
other forms specified in rules adopted under this section;	21688

(6) Provide that the grants are subject to the availability	21689
of federal funds and appropriations made by the general assembly;	21690

(7) Specify annual financial, administrative, or other	21691
incentive awards, if any, to be provided in accordance with	21692
section 5160.20 of the Revised Code;	21693

(8) Include the assurance of each board of county	21694
commissioners that the board will do all of the following:	21695

(a) Ensure that the grants included in the agreement are	21696
used, and the ODHCA family services duties for which the grants	21697
are awarded are performed, in accordance with conditions,	21698
requirements, and restrictions applicable to the duties	21699
established by the department, a federal or state law, state plans	21700
for receipt of federal financial participation, agreements between	21701
the department and a federal agency, and executive orders issued	21702
by the governor;	21703

(b) Utilize a financial management system and other	21704
accountability mechanisms for the grants awarded under the	21705
agreement that meet requirements the department establishes;	21706

21707

(i) Award the subgrant through a written county subgrant	21708
agreement that requires the entity awarded the county subgrant to	21709
comply with all conditions, requirements, and restrictions	21710
applicable to the board of county commissioners regarding the	21711
grant that the board subgrants to the entity, including the	21712
conditions, requirements, and restrictions of this section;	21713

(ii) Monitor the entity that is awarded the subgrant to	21714
ensure that the entity uses the subgrant in accordance with	21715
conditions, requirements, and restrictions applicable to the ODHCA	21716
family services duties for which the subgrant is awarded;	21717

(iii) Take action to recover subgrants that are not used in	21718
accordance with the conditions, requirements, or restrictions	21719
applicable to the ODHCA family services duties for which the	21720
subgrant is awarded.	21721

(d) Promptly reimburse the department the amount that	21722
represents the amount the board of county commissioners is	21723
responsible for, pursuant to action the department takes under	21724
division (B) of section 5160.21 of the Revised Code, of funds the	21725
department pays to any entity because of an adverse audit finding,	21726
adverse quality control finding, final disallowance of federal	21727
financial participation, or other sanction or penalty;	21728

(e) Take prompt corrective action, including paying amounts	21729
resulting from an adverse finding, sanction, or penalty, if the	21730
department, auditor of state, federal agency, or other entity	21731
authorized by federal or state law to determine compliance with	21732
the conditions, requirements, and restrictions applicable to an	21733
ODHCA family services duty for which a grant included in the	21734
agreement is awarded determines compliance has not been achieved;	21735

(f) Ensure that any matching funds, regardless of the source,	21736
that the board of county commissioners manages are clearly	21737
identified and used in accordance with federal and state laws and	21738
the agreement.	21739

(9) Provide for the department taking action pursuant to	21740
division (B) of section 5160.21 of the Revised Code if authorized	21741
by division (A)(1), (2), (3), or (4) of that section;	21742

(10) Provide for timely audits required by federal and state	21743
law and require prompt release of audit findings and prompt action	21744
to correct problems identified in an audit;	21745

(11) Provide for administrative review procedures in	21746
accordance with section 5160.21 of the Revised Code;	21747

(12) Establish the method of amending or terminating the	21748
agreement and an expedited process for correcting terms or	21749
conditions of the agreement that the director and the board of	21750
county commissioners agree are erroneous.	21751

(D) A grant agreement does not have to be amended for a board	21752
of county commissioners to be required to comply with a new or	21753
amended condition, requirement, or restriction for an ODHCA family	21754
services duty established by federal or state law, state plan for	21755
receipt of federal financial participation, agreement between the	21756
department and a federal agency, or executive order issued by the	21757
governor.	21758

(E) The department shall make payments authorized by a grant	21759
agreement on vouchers it prepares and may include any funds	21760
appropriated or allocated to it for carrying out ODHCA family	21761
services duties for which a grant included in the agreement is	21762
awarded, including funds for personal services and maintenance.	21763

(F)(1) The director shall adopt rules in accordance with	21764
section 111.15 of the Revised Code governing grant agreements. The	21765
director shall adopt the rules as if they were internal management	21766
rules. Before adopting the rules, the director shall give the	21767
public an opportunity to review and comment on the proposed rules.	21768
The rules shall establish methodologies to be used to determine	21769
the amount of the grants included in the agreements. The rules	21770
also shall establish terms and conditions under which an agreement	21771
may be entered into after the first day of a fiscal biennial	21772
period. The rules may do any or all of the following:	21773

(a) Govern the award of grants included in grant agreements,	21774
including the establishment of, and restrictions on, the form of	21775
the grants and the distribution of the grants;	21776

(b) Specify allowable uses of the grants included in the	21777
agreements;	21778

(c) Establish reporting, cash management, audit, and other	21779
requirements the director determines are necessary to provide	21780
accountability for the use of the grants included in the	21781
agreements and determine compliance with conditions, requirements,	21782
and restrictions established by the department, a federal or state	21783
law, state plans for receipt of federal financial participation,	21784
agreements between the department and a federal agency, and	21785
executive orders issued by the governor.	21786

(2) A requirement of a grant agreement established by a rule	21787
adopted under this division is applicable to a grant agreement	21788
without having to be restated in the grant agreement. A	21789
requirement established by a grant agreement is applicable to the	21790
grant agreement without having to be restated in a rule.	21791

Sec. 5160.151. The director of health care administration	21792
may provide for a grant agreement entered into under section	21793
5160.15 of the Revised Code to have a retroactive effective date	21794
of the first day of July of an odd-numbered year if both of the	21795
following are the case:	21796

(A) The agreement is entered into after that date and before	21797
the last day of that July.	21798

(B) The board of county commissioners requests the	21799
retroactive effective date and provides the director good cause	21800
satisfactory to the director for the reason the agreement was not	21801
entered into on or before the first day of that July.	21802

Sec. 5160.152. The department of health care administration	21803
shall publish in a manner accessible to the public all of the	21804
following that concern ODHCA family services duties for which	21805
grants included in grant agreements entered into under section	21806
5160.15 of the Revised Code are awarded: state plans for receipt	21807
of federal financial participation, agreements between the	21808
department and a federal agency, and executive orders issued by	21809
the governor. The department may publish the materials	21810
electronically or otherwise.	21811

Sec. 5160.17. The director of health care administration may	21812
enter into a written agreement with one or more state agencies, as	21813
defined in section 117.01 of the Revised Code, and state	21814
universities and colleges to assist in the coordination,	21815
provision, or enhancement of ODHCA family services duties. The	21816
director also may enter into written agreements or contracts with,	21817
or issue grants to, private and government entities under which	21818
funds are provided for the enhancement or innovation of ODHCA	21819
family services duties on the state or local level.	21820

The director may adopt internal management rules in	21821
accordance with section 111.15 of the Revised Code to implement	21822
this section.	21823

Sec. 5160.18. The director of health care administration may	21824
enter into one or more written operational agreements with boards	21825
of county commissioners to do one or more of the following	21826
regarding ODHCA family services duties:	21827

(A) Provide for the director to amend or rescind a rule the	21828
director previously adopted;	21829

(B) Provide for the director to modify procedures or	21830
establish alternative procedures to accommodate special	21831
circumstances in a county;	21832

(C) Provide for the director and board to jointly identify	21833
operational problems of mutual concern and develop a joint plan to	21834
address the problems;	21835

(D) Establish a framework for the director and board to	21836
modify the use of existing resources in a manner that is	21837
beneficial to the department of health care administration and the	21838
county that the board serves and improves ODHCA family services	21839
duties for the recipients of the services.	21840

Sec. 5160.19. The department of health care administration	21841
may establish performance and other administrative standards for	21842
the administration and outcomes of ODHCA family services duties	21843
and determine at intervals the department decides the degree to	21844
which a county department of job and family services complies with	21845
a performance or other administrative standard. The department may	21846
use statistical sampling, performance audits, case reviews, or	21847
other methods it determines necessary and appropriate to determine	21848
compliance with performance and administrative standards.	21849

Sec. 5160.191. (A) Except as provided by division (C) of this	21850
section, if the department of health care administration	21851
determines that a county department of job and family services has	21852
failed to comply with a performance or other administrative	21853
standard established under section 5160.19 of the Revised Code or	21854
by federal law for the administration or outcome of an ODHCA	21855
family services duty, the department shall require the county	21856
department to develop, submit to the department for approval, and	21857
comply with a corrective action plan.	21858

(B) If a county department fails to develop, submit to the	21859
department, or comply with a corrective action plan under division	21860
(A) of this section, or the department disapproves the county	21861
department's corrective action plan, the department may require	21862
the county department to develop, submit to the department for	21863
approval, and comply with a corrective action plan that requires	21864
the county department to commit existing resources to the plan.	21865

(C) The department may not require a county department to	21866
take action under this section for failure to comply with a	21867
performance or other administrative standard established for an	21868
incentive awarded by the department. Instead, the department may	21869
require a county department that fails to comply with that kind of	21870
performance or other administrative standard to take action in	21871
accordance with rules adopted by the department governing the	21872
standard.	21873

(D) At the request of a county department, the department	21874
shall assist the county department with the development of a	21875
corrective action plan under this section and provide the county	21876
department technical assistance in the implementation of the plan.	21877

Sec. 5160.192. The director of health care administration may	21878
adopt rules in accordance with section 111.15 of the Revised Code	21879
to implement sections 5160.19 to 5160.192 of the Revised Code. If	21880
the director adopts the rules, the director shall adopt the rules	21881
as if they were internal management rules.	21882

Sec. 5160.20. Subject to the availability of funds, the	21883
department of health care administration may provide annual	21884
financial, administrative, or other incentive awards to county	21885
departments of job and family services. A county department may	21886
spend funds provided as a financial incentive award only for the	21887
purpose for which the funds are appropriated. The department may	21888
adopt internal management rules in accordance with section 111.15	21889
of the Revised Code to establish the amounts of awards,	21890
methodology for distributing the awards, types of awards, and	21891
standards for administration by the department.	21892

There is hereby created in the state treasury the medicaid	21893
local incentive fund. The director of health care administration	21894
may request that the director of budget and management transfer	21895
funds appropriated for ODHCA family services duties into the fund.	21896
If the director of budget and management determines that the funds	21897
identified by the director of health care administration are	21898
available and appropriate for transfer, the director of budget and	21899
management shall make the transfer. Money in the fund shall be	21900
used to provide incentive awards under this section.	21901

Sec. 5160.21. (A) Regardless of whether an ODHCA family	21902
services duty is performed by a county department of job and	21903
family services, private or government entity pursuant to a	21904
contract entered into under section 307.982 of the Revised Code,	21905
or private or government provider of an ODHCA family service duty,	21906
the department of health care administration may take action under	21907
division (B) of this section against a board of county	21908
commissioners if the department determines any of the following	21909
are the case:	21910

(1) A requirement of a grant agreement entered into under	21911
section 5160.15 of the Revised Code that includes a grant for the	21912
ODHCA family services duty, including a requirement for grant	21913
agreements established by rules adopted under that section, is not	21914
complied with;	21915

(2) A county department fails to develop, submit to the	21916
department, or comply with a corrective action plan under division	21917
(B) of section 5160.191 of the Revised Code, or the department	21918
disapproves the county department's corrective action plan	21919
developed under division (B) of section 5160.191 of the Revised	21920
Code;	21921

(3) A requirement for the ODHCA family services duty	21922
established by the department or any of the following is not	21923
complied with: a federal or state law, state plan for receipt of	21924
federal financial participation, grant agreement between the	21925
department and a federal agency, or executive order issued by the	21926
governor;	21927

(4) The board of county commissioners is solely or partially	21928
responsible, as determined by the director of health care	21929
administration, for an adverse audit finding, adverse quality	21930
control finding, final disallowance of federal financial	21931
participation, or other sanction or penalty regarding the ODHCA	21932
family services duty.	21933

(B) The department may take one or more of the following	21934
actions against a board of county commissioners when authorized by	21935
division (A)(1), (2), (3), or (4) of this section:	21936

(1) Require the board to comply with a corrective action plan	21937
pursuant to a time schedule specified by the department. The	21938
corrective action plan shall be established or approved by the	21939
department and shall not require the board to commit resources to	21940
the plan.	21941

(2) Require the board to comply with a corrective action plan	21942
pursuant to a time schedule specified by the department. The	21943
corrective action plan shall be established or approved by the	21944
department and require the board to commit to the plan existing	21945
resources identified by the agency.	21946

(3) Require the board to do one of the following:

21947

(a) Share with the department a final disallowance of federal	21948
financial participation or other sanction or penalty;	21949

(b) Reimburse the department the final amount the department	21950
pays to the federal government or another entity that represents	21951
the amount the board is responsible for of an adverse audit	21952
finding, adverse quality control finding, final disallowance of	21953
federal financial participation, or other sanction or penalty	21954
issued by the federal government, auditor of state, or other	21955
entity;	21956

(c) Pay the federal government or another entity the final	21957
amount that represents the amount the board is responsible for of	21958
an adverse audit finding, adverse quality control finding, final	21959
disallowance of federal financial participation, or other sanction	21960
or penalty issued by the federal government, auditor of state, or	21961
other entity;	21962

(d) Pay the department the final amount that represents the	21963
amount the board is responsible for of an adverse audit finding or	21964
adverse quality control finding.	21965

(4) Impose an administrative sanction issued by the	21966
department against the board. A sanction may be increased if the	21967
department has previously taken action against the board under	21968
this division.	21969

(5) Perform, or contract with a government or private entity	21970
for the entity to perform, the ODHCA family services duty until	21971
the department is satisfied that the board ensures that the duty	21972
will be performed satisfactorily. If the department performs or	21973
contracts with an entity to perform an ODHCA family services duty	21974
under division (B)(5) of this section, the department may do	21975
either or both of the following:	21976

(a) Spend funds in the county treasury appropriated by the	21977
board for the duty;	21978

(b) Withhold funds allocated or reimbursements due to the	21979
board for the duty and spend the funds for the duty.	21980

(6) Request that the attorney general bring mandamus	21981
proceedings to compel the board to take or cease the action that	21982
causes division (A)(1), (2), (3), or (4) of this section to apply.	21983
The attorney general shall bring mandamus proceedings in the	21984
Franklin county court of appeals at the department's request.	21985

(7) If the department takes action under this division	21986
because of division (A)(3) of this section, temporarily withhold	21987
funds allocated or reimbursement due to the board until the	21988
department determines that the board is in compliance with the	21989
requirement. The department shall release the funds when the	21990
department determines that compliance has been achieved.	21991

(C) If the department proposes to take action against a board	21992
of county commissioners under division (B) of this section, the	21993
department shall notify the board, director of the county	21994
department of job and family services, and county auditor. The	21995
notice shall be in writing and specify the action the department	21996
proposes to take. The department shall send the notice by regular	21997
United States mail.	21998

Except as provided in division (D) of this section, the board	21999
may request an administrative review of a proposed action in	22000
accordance with administrative review procedures the department	22001
shall establish. The administrative review procedures shall comply	22002
with all of the following:	22003

(1) A request for an administrative review shall state	22004
specifically all of the following:	22005

(a) The proposed action specified in the notice from the	22006
department for which the review is requested;	22007

(b) The reason why the board believes the proposed action is	22008
inappropriate;	22009

(c) All facts and legal arguments that the board wants the	22010
department to consider;	22011

(d) The name of the person who will serve as the board's	22012
representative in the review.	22013

(2) If the department's notice specifies more than one	22014
proposed action and the board does not specify all of the proposed	22015
actions in its request pursuant to division (C)(1)(a) of this	22016
section, the proposed actions not specified in the request shall	22017
not be subject to administrative review and the parts of the	22018
notice regarding those proposed actions shall be final and binding	22019
on the board.	22020

(3) In the case of a proposed action under division (B)(1) of	22021
this section, the board shall have fifteen calendar days after the	22022
department mails the notice to the board to send a written request	22023
to the department for an administrative review. If it receives	22024
such a request within the required time, the department shall	22025
postpone taking action under division (B)(1) of this section for	22026
fifteen calendar days following the day it receives the request or	22027
for the extended period of time provided for in division (C)(5)	22028
of this section to allow a representative of the department and a	22029
representative of the board an informal opportunity to resolve any	22030
dispute during that fifteen-day or extended period.	22031

(4) In the case of a proposed action under division (B)(2),	22032
(3), (4), (5), or (7) of this section, the board shall have thirty	22033
calendar days after the department mails the notice to the board	22034
to send a written request to the department for an administrative	22035
review. If it receives such a request within the required time,	22036
the department shall postpone taking action under division (B)(2),	22037
(3), (4), (5), or (7) of this section for thirty calendar days	22038
following the day it receives the request or for the extended	22039
period of time provided for in division (C)(5) of this section to	22040
allow a representative of the department and a representative of	22041
the board an informal opportunity to resolve any dispute during	22042
that thirty-day or extended period.	22043

(5) If the informal opportunity provided in division (C)(3)	22044
or (4) of this section does not result in a written resolution to	22045
the dispute within the fifteen- or thirty-day period, the director	22046
of health care administration and representative of the board may	22047
enter into a written agreement extending the time period for	22048
attempting an informal resolution of the dispute under division	22049
(C)(3) or (4) of this section.	22050

(6) In the case of a proposed action under division (B)(3) of	22051
this section, the board may not include in its request disputes	22052
over a finding, final disallowance of federal financial	22053
participation, or other sanction or penalty issued by the federal	22054
government, auditor of state, or entity other than the department.	22055

(7) If the board fails to request an administrative review	22056
within the required time, the board loses the right to request an	22057
administrative review of the proposed actions specified in the	22058
notice and the notice becomes final and binding on the board.	22059

(8) If the informal opportunity provided in division (C)(3)	22060
or (4) of this section does not result in a written resolution to	22061
the dispute within the time provided by division (C)(3), (4), or	22062
(5) of this section, the director shall appoint an administrative	22063
review panel to conduct the administrative review. The review	22064
panel shall consist of department employees and one county	22065
director of job and family services or other representative of a	22066
county department of job and family services from a different	22067
county than the county served by the board. No individual involved	22068
in the department's proposal to take action against the board may	22069
serve on the review panel. The review panel shall review the	22070
board's request. The review panel may require that the department	22071
or board submit additional information and schedule and conduct an	22072
informal hearing to obtain testimony or additional evidence. A	22073
review of a proposal to take action under division (B)(3) of this	22074
section shall be limited solely to the issue of the amount the	22075
board shall share with the department, reimburse the department,	22076
or pay to the federal government, department, or other entity	22077
under division (B)(3) of this section. The review panel is not	22078
required to make a stenographic record of its hearing or other	22079
proceedings.	22080

(9) After finishing an administrative review, an	22081
administrative review panel appointed under division (C)(8) of	22082
this section shall submit a written report to the director setting	22083
forth its findings of fact, conclusions of law, and	22084
recommendations for action. The director may approve, modify, or	22085
disapprove the recommendations. If the director modifies or	22086
disapproves the recommendations, the director shall state the	22087
reasons for the modification or disapproval and the actions to be	22088
taken against the board.	22089

(10) The director's approval, modification, or disapproval	22090
under division (C)(9) of this section shall be final and binding	22091
on the board and shall not be subject to further departmental	22092
review.	22093

(D) A board of county commissioners is not entitled to an	22094
administrative review under division (C) of this section for any	22095
of the following:	22096

(1) An action taken under division (B)(6) of this section;

22097

(2) An action taken under section 5160.211 of the Revised	22098
Code;	22099

(3) An action taken under division (B)(3) of this section if	22100
the federal government, auditor of state, or entity other than the	22101
department has identified the board as being solely or partially	22102
responsible for an adverse audit finding, adverse quality control	22103
finding, final disallowance of federal financial participation, or	22104
other sanction or penalty;	22105

(4) An adjustment to an allocation, cash draw, advance, or	22106
reimbursement to the board that the department determines	22107
necessary for budgetary reasons;	22108

(5) Withholding of a cash draw or reimbursement due to	22109
noncompliance with a reporting requirement established in rules	22110
adopted under section 5160.22 of the Revised Code.	22111

(E) This section does not apply to other actions the	22112
department takes against a board of county commissioners pursuant	22113
to authority granted by another state law unless the other state	22114
law requires the department to take the action in accordance with	22115
this section.	22116

(F) The director of health care administration may adopt	22117
rules in accordance with Chapter 119. of the Revised Code as	22118
necessary to implement this section.	22119

Sec. 5160.211. The department of health care administration	22120
may certify a claim to the attorney general under section 131.02	22121
of the Revised Code for the attorney general to take action under	22122
that section against a board of county commissioners to recover	22123
any funds that the department determines the board owes the	22124
department for actions taken under division (B)(2), (3), (4), or	22125
(5) of section 5160.21 of the Revised Code.	22126

Sec. 5160.22. The director of health care administration may	22127
adopt rules in accordance with section 111.15 of the Revised Code	22128
establishing reporting requirements for ODHCA family services	22129
duties. If the director adopts the rules, the director shall adopt	22130
the rules as if they were internal management rules and, before	22131
adopting the rules, give the public an opportunity to review and	22132
comment on the proposed rules.	22133

Sec. 5160.23. If the department of health care administration	22134
determines that a grant awarded to a board of county commissioners	22135
in a grant agreement entered into under section 5160.15 of the	22136
Revised Code, an allocation, advance, or reimbursement the	22137
department makes to a county department of job and family	22138
services, or a cash draw a county department of job and family	22139
services makes exceeds the allowable amount for the grant,	22140
allocation, advance, reimbursement, or cash draw, the department	22141
may adjust, offset, withhold, or reduce an allocation, cash draw,	22142
advance, reimbursement, or other financial assistance to the board	22143
or county department as necessary to recover the amount of the	22144
excess grant, allocation, advance, reimbursement, or cash draw.	22145
The department is not required to make the adjustment, offset,	22146
withholding, or reduction in accordance with section 5160.21 of	22147
the Revised Code.	22148

The director of health care administration may adopt rules	22149
under section 111.15 of the Revised Code as necessary to implement	22150
this section. The director shall adopt the rules as if they were	22151
internal management rules.	22152

Sec. 5160.24. The department of health care administration,	22153
in consultation with county representatives, shall develop annual	22154
training goals and model training curriculum regarding ODHCA	22155
family services duties for employees of county departments of job	22156
and family services and identify a variety of state funded	22157
training opportunities to meet the proposed goals.	22158

Sec. 5160.26. (A) As used in sections 5160.26 to 5160.262 of	22159
the Revised Code:	22160

"Disability medical assistance expenditures" means	22161
expenditures for the disability medical assistance program and	22162
county administration of the disability medical assistance	22163
program.	22164

"Medicaid expenditures" means expenditures for county	22165
administration of the medicaid program. "Medicaid expenditures"	22166
does not include expenditures for transportation services provided	22167
under the medicaid program.	22168

"Public assistance expenditures" has the same meaning as in	22169
section 5101.16 of the Revised Code.	22170

"Public medical assistance expenditures" means disability	22171
medical assistance expenditures and medicaid expenditures.	22172

(B) Except as provided in division (C) of this section, a	22173
county's share of public medical assistance expenditures is the	22174
sum of the following for each state fiscal year:	22175

(1) The amount that is twenty-five per cent of the county's	22176
total disability medical assistance expenditures during the state	22177
fiscal year ending in the previous calendar year that the	22178
department of health care administration determines are allowable;	22179

(2) The amount that is ten per cent, or other percentage	22180
determined under division (D) of this section, of the county's	22181
total medicaid expenditures during the state fiscal year ending in	22182
the previous calendar year that the department of health care	22183
administration determines are allowable, less the amount of	22184
federal reimbursement credited to the county under division (E) of	22185
this section for the state fiscal year ending in the previous	22186
calendar year.	22187

(C)(1) If a county's share of public medical assistance	22188
expenditures determined under division (B) of this section and the	22189
county's share of public assistance expenditures determined under	22190
division (B) of section 5101.16 of the Revised Code for a state	22191
fiscal year exceeds one hundred ten per cent of the county's share	22192
for those expenditures for the immediately preceding state fiscal	22193
year, the department of health care administration shall reduce	22194
the county's share for public medical assistance expenditures so	22195
that the total of the county's share for public medical assistance	22196
expenditures and public assistance expenditures equals one hundred	22197
ten per cent of the county's share of those expenditures for the	22198
immediately preceding state fiscal year. The department of health	22199
care administration shall cooperate with the department of job and	22200
family services for the purpose of making reductions under	22201
division (C)(1) of this section.	22202

(2) A county's share of public medical assistance	22203
expenditures determined under division (B) of this section may be	22204
increased pursuant to a sanction under section 5160.21 of the	22205
Revised Code.	22206

(D)(1) If the per capita tax duplicate of a county is less	22207
than the per capita tax duplicate of the state as a whole and	22208
division (D)(2) of this section does not apply to the county, the	22209
percentage to be used for the purpose of division (B)(2) of this	22210
section is the product of ten multiplied by a fraction of which	22211
the numerator is the per capita tax duplicate of the county and	22212
the denominator is the per capita tax duplicate of the state as a	22213
whole. The department of health care administration shall compute	22214
the per capita tax duplicate for the state and for each county by	22215
dividing the tax duplicate for the most recent available year by	22216
the current estimate of population prepared by the department of	22217
development.	22218

(2) If the percentage of families in a county with an annual	22219
income of less than three thousand dollars is greater than the	22220
percentage of such families in the state and division (D)(1) of	22221
this section does not apply to the county, the percentage to be	22222
used for the purpose of division (B)(2) of this section is the	22223
product of ten multiplied by a fraction of which the numerator is	22224
the percentage of families in the state with an annual income of	22225
less than three thousand dollars a year and the denominator is the	22226
percentage of such families in the county. The department of	22227
health care administration shall compute the percentage of	22228
families with an annual income of less than three thousand dollars	22229
for the state and for each county by multiplying the most recent	22230
estimate of such families published by the department of	22231
development, by a fraction, the numerator of which is the estimate	22232
of average annual personal income published by the bureau of	22233
economic analysis of the United States department of commerce for	22234
the year on which the census estimate is based and the denominator	22235
of which is the most recent such estimate published by the bureau.	22236

(3) If the per capita tax duplicate of a county is less than	22237
the per capita tax duplicate of the state as a whole and the	22238
percentage of families in the county with an annual income of less	22239
than three thousand dollars is greater than the percentage of such	22240
families in the state, the percentage to be used for the purpose	22241
of division (B)(2) of this section shall be determined as follows:	22242

(a) Multiply ten by the fraction determined under division	22243
(D)(1) of this section;	22244

(b) Multiply the product determined under division (D)(3)(a)	22245
of this section by the fraction determined under division (D)(2)	22246
of this section.	22247

(4) The department of health care administration shall	22248
determine, for each county, the percentage to be used for the	22249
purpose of division (B)(2) of this section not later than the	22250
first day of July of the year preceding the state fiscal year for	22251
which the percentage is used.	22252

(E) The department of health care administration shall credit	22253
to a county the amount of federal reimbursement the department	22254
receives from the United States department of health and human	22255
services for the county's medicaid expenditures that the	22256
department determines are allowable administrative expenditures.	22257

(F) The director of health care administration shall adopt	22258
rules in accordance with section 111.15 of the Revised Code to	22259
establish all of the following:	22260

(1) The method the department of health care administration	22261
is to use to change a county's share of public medical assistance	22262
expenditures determined under division (B) of this section as	22263
provided in division (C) of this section;	22264

(2) The allocation methodology and formula the department	22265
will use to determine the amount of funds to credit to a county	22266
under this section;	22267

(3) The method the department will use to change the payment	22268
of the county share of public medical assistance expenditures from	22269
a calendar-year basis to a state fiscal year basis;	22270

(4) Other procedures and requirements necessary to implement	22271
this section.	22272

Sec. 5160.261. Prior to the sixteenth day of May annually,	22273
the department of health care administration shall certify to the	22274
board of county commissioners of each county the amount estimated	22275
by the department to be needed in the following state fiscal year	22276
to meet the county share, as determined under section 5160.26 of	22277
the Revised Code, of public medical assistance expenditures. Each	22278
January, the board shall appropriate the amount certified by the	22279
department and an additional five per cent of that amount. Each	22280
June, the board may reappropriate, for any purpose the board	22281
determines to be appropriate, the amount appropriated in January	22282
that exceeds the total of the amount certified by the department	22283
for the last six months of the current state fiscal year and the	22284
first six months of the following state fiscal year.	22285

Before the fifteenth day of each payment period the director	22286
of health care administration establishes by rule, the department	22287
of health care administration shall pay a county the estimated	22288
state and federal share of the county's public medical assistance	22289
expenditures for that payment period increased or decreased by the	22290
amount the department underpaid or overpaid the county for the	22291
most recent payment period that the department knows an	22292
underpayment or overpayment was made.	22293

If the department establishes a maximum amount that it will	22294
reimburse a county for public medical assistance expenditures and	22295
a county spends more for public medical assistance expenditures	22296
than is reimbursable, the department shall not pay the county a	22297
state or, except as provided in section 5160.262 of the Revised	22298
Code, a federal share for the amount of the expenditure that	22299
exceeds the maximum allowable reimbursement amount. County	22300
expenditures that exceed the maximum allowable reimbursement	22301
amount shall not be credited to a county's share of public medical	22302
assistance expenditures under section 5160.26 of the Revised Code.	22303
The department also shall not pay a county a state or, except as	22304
provided in section 5160.262 of the Revised Code, a federal share	22305
for an administrative expenditure that is not allowed by the	22306
department.	22307

A county shall deposit all funds appropriated by a board of	22308
county commissioners and received from the department under this	22309
section in a special fund in the county treasury known as the	22310
public assistance fund. A county shall make payments for public	22311
medical assistance expenditures from the public assistance fund.	22312

The attorney general shall bring mandamus proceedings in the	22313
Franklin county court of appeals against any board of county	22314
commissioners that fails to make appropriations or deposits into	22315
the public assistance fund required by this section.	22316

The director shall adopt internal management rules in	22317
accordance with section 111.15 of the Revised Code to do all of	22318
the following:	22319

(A) Establish the method by which the department is to make	22320
payments to counties under this section;	22321

(B) Establish procedures for payment by counties of the	22322
county share of public medical assistance expenditures;	22323

(C) Establish payment periods for paying a county its	22324
estimated state and federal share of public medical assistance	22325
expenditures;	22326

(D) Allow county departments of job and family services to	22327
use the public assistance fund for other purposes and programs	22328
similar to the disability medical assistance program and medicaid	22329
program.	22330

The director may adopt internal management rules in	22331
accordance with section 111.15 of the Revised Code to establish a	22332
maximum amount that it will reimburse a county for public medical	22333
assistance expenditures.	22334

Sec. 5160.262. Subject to available federal funds and	22335
appropriations made by the general assembly, the department of	22336
health care administration may, at its sole discretion, use	22337
available federal funds to reimburse a county for medicaid	22338
expenditures even though the county's medicaid expenditures meet	22339
or exceed the maximum allowable reimbursement amount established	22340
by rules adopted under section 5160.261 of the Revised Code. The	22341
director may adopt internal management rules in accordance with	22342
section 111.15 of the Revised Code to implement this section.	22343

Sec. 5160.28. The department of health care administration	22344
may make any investigations that are necessary in the performance	22345
of its duties, and to that end the department shall have the same	22346
power as a judge of a county court to administer oaths and to	22347
enforce the attendance and testimony of witnesses and the	22348
production of books or papers.	22349

The department shall keep a record of its investigations	22350
stating the time, place, charges or subject, witnesses summoned	22351
and examined, and their conclusions.	22352

Witnesses shall be paid the fees and mileage provided for	22353
under section 119.094 of the Revised Code.	22354

Sec. 5160.29. Any judge of any division of the court of	22355
common pleas, upon application of the department of health care	22356
administration, may compel the attendance of witnesses, the	22357
production of books or papers, and the giving of testimony before	22358
the department, by a judgment for contempt or otherwise, in the	22359
same manner as in cases before those courts.	22360

Sec. 5160.30. The department of health care administration	22361
may appoint and commission any competent officer, employee,	22362
agency, or person to serve as a special agent, investigator, or	22363
representative to perform a designated duty for and in behalf of	22364
the department. Specific credentials shall be given by the	22365
department to each person so designated, and each credential shall	22366
state:	22367

(A) The person's name;

22368

(B) Agency with which such person is connected;

22369

22370

(D) Date of expiration of appointment, if appropriate;

22371

(E) Such information as the department considers proper.

22372

Sec. 5160.32. (A) Subject to division (B) of this section,	22373
the director of health care administration may accept	22374
applications, determine eligibility, redetermine eligibility, and	22375
perform related administrative activities for one or more of the	22376
following:	22377

(1) The medicaid program;

22378

(2) The children's health insurance program;

22379

(3) The children's buy-in program;

22380

(4) Other programs regarding which the director determines	22381
administrative cost savings and efficiency may be achieved through	22382
the department accepting applications, determining eligibility,	22383
redetermining eligibility, or performing related administrative	22384
activities.	22385

(B) If federal law requires a face-to-face interview to	22386
complete an eligibility determination for a program, the	22387
face-to-face interview shall not be conducted by the department of	22388
health care administration.	22389

(C) Subject to division (B) of this section, if the director	22390
elects to accept applications, determine eligibility, redetermine	22391
eligibility, and perform related administrative activities for a	22392
program under this section, both of the following apply:	22393

(1) An individual seeking services under the program may	22394
apply for the program to the director or to the entity that state	22395
law governing the program authorizes to accept applications for	22396
the program.	22397

(2) The director is subject to federal statutes and	22398
regulations and state statutes and rules that require, permit, or	22399
prohibit an action regarding accepting applications, determining	22400
or redetermining eligibility, and performing related	22401
administrative activities for the program.	22402

(D) The director may adopt rules as necessary to implement	22403
this section.	22404

Sec. 5160.34. (A) As used in this section:

22405

(1) "Agency" means the following entities that administer an	22406
ODHCA program:	22407

(a) The department of health care administration;

22408

(b) A county department of job and family services;

22409

(c) A private or government entity administering, in whole or	22410
in part, an ODHCA program for or on behalf of the department of	22411
health care administration or a county department of job and	22412
family services.	22413

(2) "Appellant" means an applicant, participant, former	22414
participant, recipient, or former recipient of an ODHCA program	22415
who is entitled by federal or state law to a hearing regarding a	22416
decision or order of the agency that administers the program.	22417

(3) "ODHCA program" means the disability medical assistance	22418
program, the medicaid program, and residential state supplement	22419
program.	22420

(B) Except as provided by division (F) of this section, an	22421
appellant who appeals under federal or state law a decision or	22422
order of an agency administering an ODHCA program shall, at the	22423
appellant's request, be granted a state hearing by the department	22424
of health care administration. This state hearing shall be	22425
conducted in accordance with rules adopted under this section. The	22426
state hearing shall be recorded, but neither the recording nor a	22427
transcript of the recording shall be part of the official record	22428
of the proceeding. A state hearing decision is binding upon the	22429
agency and department, unless it is reversed or modified on appeal	22430
to the director of health care administration or a court of common	22431
pleas.	22432

(C) An appellant who disagrees with a state hearing decision	22433
may make an administrative appeal to the director of health care	22434
administration in accordance with rules adopted under this	22435
section. This administrative appeal does not require a hearing,	22436
but the director or the director's designee shall review the state	22437
hearing decision and previous administrative action and may	22438
affirm, modify, remand, or reverse the state hearing decision. Any	22439
person designated to make an administrative appeal decision on	22440
behalf of the director shall have been admitted to the practice of	22441
law in this state. An administrative appeal decision is the final	22442
decision of the department and is binding upon the department and	22443
agency, unless it is reversed or modified on appeal to the court	22444
of common pleas.	22445

(D) An agency shall comply with a decision issued pursuant to	22446
division (B) or (C) of this section within the time limits	22447
established by rules adopted under this section. If a county	22448
department of job and family services fails to comply within these	22449
time limits, the department may take action pursuant to section	22450
5160.21 of the Revised Code. If another agency fails to comply	22451
within the time limits, the department may force compliance by	22452
withholding funds due the agency or imposing another sanction	22453
established by rules adopted under this section.	22454

(E) An appellant who disagrees with an administrative appeal	22455
decision of the director of health care administration or the	22456
director's designee issued under division (C) of this section may	22457
appeal from the decision to the court of common pleas pursuant to	22458
section 119.12 of the Revised Code. The appeal shall be governed	22459
by section 119.12 of the Revised Code except that:	22460

(1) The person may appeal to the court of common pleas of the	22461
county in which the person resides, or to the court of common	22462
pleas of Franklin county if the person does not reside in this	22463
state.	22464

(2) The person may apply to the court for designation as an	22465
indigent and, if the court grants this application, the appellant	22466
shall not be required to furnish the costs of the appeal.	22467

(3) The appellant shall mail the notice of appeal to the	22468
department of health care administration and file notice of appeal	22469
with the court within thirty days after the department mails the	22470
administrative appeal decision to the appellant. For good cause	22471
shown, the court may extend the time for mailing and filing notice	22472
of appeal, but such time shall not exceed six months from the date	22473
the department mails the administrative appeal decision. Filing	22474
notice of appeal with the court shall be the only act necessary to	22475
vest jurisdiction in the court.	22476

(4) The department shall be required to file a transcript of	22477
the testimony of the state hearing with the court only if the	22478
court orders the department to file the transcript. The court	22479
shall make such an order only if it finds that the department and	22480
the appellant are unable to stipulate to the facts of the case and	22481
that the transcript is essential to a determination of the appeal.	22482
The department shall file the transcript not later than thirty	22483
days after the day such an order is issued.	22484

(F) If an appellant receiving medicaid through a health	22485
insuring corporation that holds a certificate of authority under	22486
Chapter 1751. of the Revised Code is appealing a denial of	22487
medicaid services based on lack of medical necessity or other	22488
clinical issues regarding coverage by the health insuring	22489
corporation, the person hearing the appeal may order an	22490
independent medical review if that person determines that a review	22491
is necessary. The review shall be performed by a health care	22492
professional with appropriate clinical expertise in treating the	22493
recipient's condition or disease. The department shall pay the	22494
costs associated with the review.	22495

A review ordered under this division shall be part of the	22496
record of the hearing and shall be given appropriate evidentiary	22497
consideration by the person hearing the appeal.	22498

(G) The director of health care administration shall adopt	22499
rules in accordance with Chapter 119. of the Revised Code to	22500
implement this section, including rules governing the following:	22501

(1) State hearings under division (B) of this section. The	22502
rules shall include provisions regarding notice of eligibility	22503
termination and the opportunity of an appellant appealing a	22504
decision or order of a county department of job and family	22505
services to request a county conference with the county department	22506
before the state hearing is held.	22507

(2) Administrative appeals under division (C) of this	22508
section;	22509

(3) Time limits for complying with a decision issued under	22510
division (B) or (C) of this section;	22511

(4) Sanctions that may be applied against an agency under	22512
division (D) of this section.	22513

(H) The requirements of Chapter 119. of the Revised Code	22514
apply to a state hearing or administrative appeal under this	22515
section only to the extent, if any, specifically provided by rules	22516
adopted under this section.	22517

Sec. 5160.341. The department of health care administration	22518
may employ or contract with hearing officers to draft and	22519
recommend state hearing decisions under division (B) of section	22520
5160.34 of the Revised Code. The department may employ or contract	22521
with hearing authorities to issue state hearing decisions under	22522
division (B) of section 5160.34 of the Revised Code. Except in the	22523
case of an individual who was employed by or under contract with	22524
the department of job and family services to perform the duties of	22525
a hearing authority under division (B) of section 5101.35 of the	22526
Revised Code before July 1, 2000, an individual performing the	22527
duties of a hearing authority shall have been admitted to the	22528
practice of law in this state.	22529

~~Sec. 5101.571.~~ Sec. 5160.36. As used in sections ~~5101.571~~5160.36	22530
to ~~5101.591~~5160.41 of the Revised Code:	22531

(A) "Information" means all of the following:

22532

(1) An individual's name, address, date of birth, and social	22533
security number;	22534

(2) The group or plan number, or other identifier, assigned	22535
by a third party to a policy held by an individual or a plan in	22536
which the individual participates and the nature of the coverage;	22537

(3) Any other data the director of ~~job and family services~~	22538
health care administration specifies in rules adopted under	22539
section ~~5101.591~~5160.41 of the Revised Code.	22540

(B) "Medical assistance" means medical items or services	22541
provided under any of the following:	22542

(1) Medicaid~~, as defined in section 5111.01 of the Revised~~	22543
~~Code~~;	22544

(2) The children's health insurance program ~~part I, part II,~~	22545
~~and part III established under sections 5101.50 to 5101.529 of the~~	22546
~~Revised Code~~;	22547

(3) The disability medical assistance program ~~established~~	22548
~~under Chapter 5115. of the Revised Code~~;	22549

(4) The children's buy-in program ~~established under sections~~	22550
~~5101.5211 to 5101.5216 of the Revised Code~~.	22551

(C) "Medical support" means support specified as support for	22552
the purpose of medical care by order of a court or administrative	22553
agency.	22554

(D) "Public assistance" means medical assistance or	22555
assistance under the Ohio works first program established under	22556
Chapter 5107. of the Revised Code.	22557

(E)(1) Subject to division (E)(2) of this section, and except	22558
as provided in division (E)(3) of this section, "third party"	22559
means all of the following:	22560

(a) A person authorized to engage in the business of sickness	22561
and accident insurance under Title XXXIX of the Revised Code;	22562

(b) A person or governmental entity providing coverage for	22563
medical services or items to individuals on a self-insurance	22564
basis;	22565

(c) A health insuring corporation as defined in section	22566
1751.01 of the Revised Code;	22567

(d) A group health plan as defined in 29 U.S.C. 1167;

22568

(e) A service benefit plan as referenced in 42 U.S.C.	22569
1396a(a)(25);	22570

(f) A managed care organization;

22571

(g) A pharmacy benefit manager;

22572

(h) A third party administrator;

22573

(i) Any other person or governmental entity that is, by law,	22574
contract, or agreement, responsible for the payment or processing	22575
of a claim for a medical item or service for a public assistance	22576
recipient or participant.	22577

(2) Except when otherwise provided by 42 U.S.C. 1395y(b), a	22578
person or governmental entity listed in division (E)(1) of this	22579
section is a third party even if the person or governmental entity	22580
limits or excludes payments for a medical item or service in the	22581
case of a public assistance recipient.	22582

(3) "Third party" does not include the program for medically	22583
handicapped children established under section 3701.023 of the	22584
Revised Code.	22585

~~Sec. 5101.59.~~ Sec. 5160.37. (A) The application for, or acceptance	22586
of, public assistance constitutes an automatic assignment of	22587
certain rights to the department of ~~job and family services~~	22588
health care administration. This assignment includes the rights	22589
of the applicant, recipient, or participant and also the rights of	22590
any other member of the assistance group for whom the applicant,	22591
recipient, or participant can legally make an assignment.	22592

(B) Pursuant to this section, the applicant, recipient, or	22593
participant assigns to the department any rights to medical	22594
support available to the applicant, recipient, or participant or	22595
for other members of the assistance group under an order of a	22596
court or administrative agency, and any rights to payments by a	22597
liable third party for the cost of medical assistance paid on	22598
behalf of a public assistance recipient or participant. The	22599
recipient or participant shall cooperate with the department in	22600
obtaining such payments.	22601

Medicare benefits shall not be assigned pursuant to this	22602
section. Benefits assigned to the department by operation of this	22603
section are directly reimbursable to the department by liable	22604
third parties.	22605

(C) Refusal by the applicant, recipient, or participant to	22606
cooperate in obtaining medical assistance paid for self or any	22607
other member of the assistance group renders the applicant,	22608
recipient, or participant ineligible for public assistance, unless	22609
cooperation is waived by the department. Eligibility shall	22610
continue for any individual who cannot legally assign the	22611
individual's own rights and who would have been eligible for	22612
public assistance but for the refusal to assign the individual's	22613
rights or to cooperate as required by this section by another	22614
person legally able to assign the individual's rights.	22615

(D) If the applicant, recipient, or participant or any member	22616
of the assistance group becomes ineligible for public assistance,	22617
the department shall restore to the applicant, recipient,	22618
participant, or member of the assistance group any future rights	22619
to benefits assigned under this section.	22620

(E) The rights of assignment given to the department under	22621
this section do not include rights to support assigned under	22622
section 5107.20 or 5115.07 of the Revised Code.	22623

~~Sec. 5101.58.~~ Sec. 5160.38. (A) The acceptance of public assistance	22624
gives an automatic right of recovery to the department of ~~job~~	22625
~~and family services~~health care administration and a county	22626
department of job and family services against the liability of a	22627
third party for the cost of medical assistance paid on behalf of	22628
the public assistance recipient or participant. When an action	22629
or claim is brought against a third party by a public assistance	22630
recipient or participant, any payment, settlement or compromise	22631
of the action or claim, or any court award or judgment, is	22632
subject to the recovery right of the department of ~~job and family~~	22633
~~services~~health care administration or county department of job	22634
and family services. Except in the case of a recipient or	22635
participant who receives medical assistance through a managed	22636
care organization, the department's or county department's claim	22637
shall not exceed the amount of medical assistance paid by a	22638
department on behalf of the recipient or participant. A payment,	22639
settlement, compromise, judgment, or award that excludes the	22640
cost of medical assistance paid for by a department shall not	22641
preclude a department from enforcing its rights under this	22642
section.	22643

(B) In the case of a recipient or participant who receives	22644
medical assistance through a managed care organization, the	22645
amount of the department's or county department's claim shall be	22646
the amount the managed care organization pays for medical	22647
assistance rendered to the recipient or participant, even if that	22648
amount is more than the amount a department pays to the managed	22649
care organization for the recipient's or participant's medical	22650
assistance.	22651

(C) A recipient or participant, and the recipient's or	22652
participant's attorney, if any, shall cooperate with the	22653
departments. In furtherance of this requirement, the recipient or	22654
participant, or the recipient's or participant's attorney, if	22655
any, shall, not later than thirty days after initiating informal	22656
recovery activity or filing a legal recovery action against a	22657
third party, provide written notice of the activity or action to	22658
the appropriate department or departments as follows:	22659

(1) To only the department of ~~job and family services~~health	22660
care administration when medical assistance under medicaid or the	22661
children's buy-in program has been paid;	22662

(2) To the department of ~~job and family services~~health care	22663
administration and the appropriate county department of job and	22664
family services when medical assistance under the disability	22665
medical assistance program has been paid.	22666

(D) The written notice that must be given under division (C)	22667
of this section shall disclose the identity and address of any	22668
third party against whom the recipient or participant has or may	22669
have a right of recovery.	22670

(E) No settlement, compromise, judgment, or award or any	22671
recovery in any action or claim by a recipient or participant	22672
where the departments have a right of recovery shall be made final	22673
without first giving the appropriate departments written notice as	22674
described in division (C) of this section and a reasonable	22675
opportunity to perfect their rights of recovery. If the	22676
departments are not given the appropriate written notice, the	22677
recipient or participant and, if there is one, the recipient's or	22678
participant's attorney, are liable to reimburse the departments	22679
for the recovery received to the extent of medical payments made	22680
by the departments.	22681

(F) The departments shall be permitted to enforce their	22682
recovery rights against the third party even though they accepted	22683
prior payments in discharge of their rights under this section if,	22684
at the time the departments received such payments, they were not	22685
aware that additional medical expenses had been incurred but had	22686
not yet been paid by the departments. The third party becomes	22687
liable to the department of ~~job and family services~~health care	22688
administration or county department of job and family services as	22689
soon as the third party is notified in writing of the valid	22690
claims for recovery under this section.	22691

(G)(1) Subject to division (G)(2) of this section, the right	22692
of recovery of a department does not apply to that portion of any	22693
judgment, award, settlement, or compromise of a claim, to the	22694
extent of attorneys' fees, costs, or other expenses incurred by a	22695
recipient or participant in securing the judgment, award,	22696
settlement, or compromise, or to the extent of medical, surgical,	22697
and hospital expenses paid by such recipient or participant from	22698
the recipient's or participant's own resources.	22699

(2) Reasonable attorneys' fees, not to exceed one-third of	22700
the total judgment, award, settlement, or compromise, plus costs	22701
and other expenses incurred by the recipient or participant in	22702
securing the judgment, award, settlement, or compromise, shall	22703
first be deducted from the total judgment, award, settlement, or	22704
compromise. After fees, costs, and other expenses are deducted	22705
from the total judgment, award, settlement, or compromise, the	22706
department of ~~job and family services~~health care administration	22707
or appropriate county department of job and family services shall	22708
receive no less than one-half of the remaining amount, or the	22709
actual amount of medical assistance paid, whichever is less.	22710

(H) A right of recovery created by this section may be	22711
enforced separately or jointly by the department of ~~job and family~~	22712
~~services~~health care administration or the appropriate county	22713
department of job and family services. To enforce their recovery	22714
rights, the departments may do any of the following:	22715

(1) Intervene or join in any action or proceeding brought by	22716
the recipient or participant or on the recipient's or	22717
participant's behalf against any third party who may be liable for	22718
the cost of medical assistance paid;	22719

(2) Institute and pursue legal proceedings against any third	22720
party who may be liable for the cost of medical assistance paid;	22721

(3) Initiate legal proceedings in conjunction with any	22722
injured, diseased, or disabled recipient or participant or the	22723
recipient's or participant's attorney or representative.	22724

(I) A recipient or participant shall not assess attorney	22725
fees, costs, or other expenses against the department of ~~job and~~	22726
~~family services~~health care administration or a county department	22727
of job and family services when the department or county	22728
department enforces its right of recovery created by this	22729
section.	22730

(J) The right of recovery given to the department under this	22731
section does not include rights to support from any other person	22732
assigned to the state under sections 5107.20 and 5115.07 of the	22733
Revised Code, but includes payments made by a third party under	22734
contract with a person having a duty to support.	22735

~~Sec. 5111.121.~~ Sec. 5160.39. (A) ~~As used in this section, "third~~	22736
~~party" has the same meaning as in section 5101.571 of the Revised~~	22737
~~Code.~~	22738

~~(B)~~ In addition to the authority granted under section	22739
~~5101.59~~5160.37 of the Revised Code, the department of ~~job and~~	22740
~~family services~~health care administration may, to the extent	22741
necessary to reimburse its costs, garnish the wages, salary, or	22742
other employment income of, and withhold amounts from state tax	22743
refunds to, any person to whom both of the following apply:	22744

(1) The person is required by a court or administrative order	22745
to provide coverage of the cost of health care services to a child	22746
eligible for ~~medical assistance under this chapter~~the medicaid	22747
program.	22748

(2) The person has received payment from a third party for	22749
the costs of such services but has not used the payment to	22750
reimburse either the other parent or guardian of the child or the	22751
provider of the services.	22752

~~(C)~~(B) Claims for current and past due child support shall	22753
take priority over claims under division ~~(B)~~(A) of this section.	22754

~~Sec. 5101.572.~~ Sec. 5160.40. (A) A third party shall cooperate	22755
with the department of ~~job and family services~~health care	22756
administration in identifying individuals for the purpose of	22757
establishing third party liability ~~pursuant to Title XIX of the~~	22758
~~Social Security Act, as amended~~for the medicaid program.	22759

(B) In furtherance of the requirement in division (A) of this	22760
section and to allow the department to determine any period that	22761
the individual or the individual's spouse or dependent may have	22762
been covered by the third party and the nature of the coverage, a	22763
third party shall provide, as the department so chooses,	22764
information or access to information, or both, in the third	22765
party's electronic data system on the department's request and in	22766
accordance with division (C) of this section.	22767

(C)(1) If the department chooses to receive information	22768
directly, the third party shall provide the information under all	22769
of the following circumstances:	22770

(a) In a medium, format, and manner prescribed by the	22771
director of ~~job and family services~~health care administration in	22772
rules adopted under section ~~5101.591~~5160.41 of the Revised Code;	22773

(b) Free of charge;

22774

(c) Not later than the end of the thirtieth day after the	22775
department makes its request, unless a different time is agreed to	22776
by the director in writing.	22777

(2) If the department chooses to receive access to	22778
information, the third party shall provide access by a method	22779
prescribed by the director of ~~job and family services~~health care	22780
administration in rules adopted under section ~~5101.591~~5160.41 of	22781
the Revised Code. In facilitating access, the department may	22782
enter into a trading partner agreement with the third party to	22783
permit the exchange of information via "ASC X 12N 270/271 Health	22784
Care Eligibility Benefit Inquiry and Response" transactions.	22785

(D) All of the following apply with respect to information	22786
provided by a third party to the department under this section:	22787

(1) The information is confidential and not a public record	22788
under section 149.43 of the Revised Code.	22789

(2) The release of information to the department is not to be	22790
considered a violation of any right of confidentiality or contract	22791
that the third party may have with covered persons including, but	22792
not limited to, contractees, beneficiaries, heirs, assignees, and	22793
subscribers.	22794

(3) The third party is immune from any liability that it may	22795
otherwise incur through its release of information to the	22796
department.	22797

The department of ~~job and family services~~health care	22798
administration shall limit its use of information gained from	22799
third parties to purposes directly connected with the	22800
administration of the medicaid program and the child support	22801
program authorized by Title IV-D of the "Social Security Act."	22802

(E) No third party shall disclose to other parties or make	22803
use of any information regarding recipients of aid under Chapter	22804
5107. ~~or 5111.~~ of the Revised Code or the medicaid program that it	22805
obtains from the department, except in the manner provided for	22806
by the director of ~~job and family services~~health care	22807
administration in administrative rules.	22808

(F) The department of health care administration may enter	22809
into an interagency agreement with the department of job and	22810
family services as necessary to implement this section as regards	22811
recipients of assistance under Chapter 5107. of the Revised Code	22812
and the child support program authorized by Title IV-D of the	22813
"Social Security Act."	22814

~~Sec. 5101.573.~~ Sec. 5160.401. (A) Subject to divisions (B) and (C)	22815
of this section, a third party shall do all of the following:	22816

(1) Accept the department of ~~job and family services'~~health	22817
care administration's right of recovery under section ~~5101.58~~	22818
5160.38 of the Revised Code and the assignment of rights to the	22819
department that are described in section ~~5101.59~~5160.38 of the	22820
Revised Code.	22821

(2) Respond to an inquiry by the department regarding a claim	22822
for payment of a medical item or service that was submitted to the	22823
third party not later than three years after the date of the	22824
provision of such medical item or service;	22825

(3) Pay a claim described in division (A)(2) of this section;

22826

(4) Not deny a claim submitted by the department solely on	22827
the basis of the date of submission of the claim, type or format	22828
of the claim form, or a failure by the medical assistance	22829
recipient who is the subject of the claim to present proper	22830
documentation of coverage at the time of service, if both of the	22831
following are true:	22832

(a) The claim was submitted by the department not later than	22833
three years after the date of the provision of the medical item or	22834
service;	22835

(b) An action by the department to enforce its right of	22836
recovery under section ~~5101.58~~5160.38 of the Revised Code on the	22837
claim was commenced not later than six years after the	22838
department's submission of the claim.	22839

(B) For purposes of the requirements in division (A) of this	22840
section, a third party shall treat a managed care organization as	22841
the department for a claim in which both of the following are	22842
true:	22843

(1) The individual who is the subject of the claim received a	22844
medical item or service through a managed care organization that	22845
has entered into a contract with the department of ~~job and family~~	22846
~~services~~health care administration under section ~~5111.16~~5165.03	22847
of the Revised Code;	22848

(2) The department has assigned its right of recovery for the	22849
claim to the managed care organization.	22850

(C) The time limitations associated with the requirements in	22851
divisions (A)(2) and (A)(4) of this section apply only to	22852
submissions of claims to, and payments of claims by, a health	22853
insurer to which 42 U.S.C. 1396a(a)(25)(I) applies.	22854

~~Sec. 5101.574.~~ Sec. 5160.402. No third party shall consider	22855
whether an individual is eligible for or receives medical	22856
assistance when either of the following applies:	22857

(A) The individual seeks to obtain a policy or enroll in a	22858
plan or program operated or administered by the third party;	22859

(B) The individual, or a person or governmental entity on the	22860
individual's behalf, seeks payment for a medical item or service	22861
provided to the individual.	22862

~~Sec. 5101.575.~~ Sec. 5160.403. (A) If a third party violates section	22863
~~5101.572~~5160.40, ~~5101.573~~5160.401, or ~~5101.574~~5160.402 of the	22864
Revised Code, a governmental entity that is responsible for	22865
issuing a license, certificate of authority, registration, or	22866
approval that authorizes the third party to do business in this	22867
state may impose a fine against the third party or deny, revoke,	22868
or terminate the third party's license, certificate,	22869
registration, or approval to do business in this state. The	22870
governmental entity shall determine which sanction is to be	22871
imposed. All actions to impose the sanction shall be taken in	22872
accordance with Chapter 119. of the Revised Code.	22873

(B) In addition to the sanctions that may be imposed under	22874
division (A) of this section for a violation of section ~~5101.572~~	22875
5160.40, ~~5101.573~~5160.401, or ~~5101.574~~5160.402 of the Revised	22876
Code, the attorney general may petition a court of common pleas	22877
to enjoin the violation.	22878

~~Sec. 5101.591.~~ Sec. 5160.41. (A) Except as provided in division (B)	22879
of this section, the director of ~~job and family services~~health	22880
care administration may adopt rules in accordance with Chapter	22881
119. of the Revised Code to implement sections ~~5101.571~~5160.36	22882
to ~~5101.59~~5160.41 of the Revised Code, including rules that	22883
specify what constitutes cooperating with efforts to obtain	22884
support or payments, or medical assistance payments, and when	22885
cooperation may be waived.	22886

(B) The department shall adopt rules in accordance with	22887
Chapter 119. of the Revised Code to do all of the following:	22888

(1) For purposes of the definition of "information" in	22889
division (A) of section ~~5101.571~~5160.36 of the Revised Code, any	22890
data other than the data specified in that division that should	22891
be included in the definition.	22892

(2) For purposes of division (C)(1)(a) of section ~~5101.572~~	22893
5160.40 of the Revised Code, the medium, format, and manner in	22894
which a third party must provide information to the department.	22895

(3) For purposes of division (C)(2) of section ~~5101.572~~	22896
5160.40 of the Revised Code, the method by which a third party	22897
must provide the department with access to information.	22898

Sec. 5160.42. Any application for the medicaid program or	22899
disability medical assistance program gives a right of subrogation	22900
to the department of health care administration for any workers'	22901
compensation benefits payable to a person who is subject to a	22902
support order, as defined in section 3119.01 of the Revised Code,	22903
on behalf of the applicant, to the extent of any payments made on	22904
the applicant's behalf under the medicaid program or disability	22905
medical assistance program. If the director of health care	22906
administration, in consultation with a child support enforcement	22907
agency and the administrator of the bureau of workers'	22908
compensation, determines that a person responsible for support	22909
payments to a medicaid recipient or disability medical assistance	22910
recipient is receiving workers' compensation, the director shall	22911
notify the administrator of the amount of the benefit to be paid	22912
to the department of health care administration.	22913

Sec. 5160.43. As used in sections 5160.43 to 5160.46 of the	22914
Revised Code, "public medical assistance program" means the	22915
disability medical assistance program and medicaid program.	22916

As part of the procedure for the determination of whether	22917
benefits were incorrectly paid on behalf of public medical	22918
assistance program recipients, the director of health care	22919
administration shall furnish quarterly the name and social	22920
security number of each public medical assistance program	22921
recipient to the director of administrative services, the	22922
administrator of the bureau of workers' compensation, and each of	22923
the state's retirement boards. Within fourteen days after	22924
receiving the name and social security number of a public medical	22925
assistance program recipient, the director of administrative	22926
services, administrator, or board shall inform the auditor of	22927
state as to whether the recipient is receiving wages or benefits,	22928
the amount of any wages or benefits being received, the social	22929
security number, and the address of the recipient. The director of	22930
administrative services, administrator, boards, and any agent or	22931
employee of those officials and boards shall comply with the rules	22932
adopted under section 5160.65 of the Revised Code restricting the	22933
disclosure of information regarding public medical assistance	22934
program recipients. Any person who violates this provision shall	22935
thereafter be disqualified from acting as an agent or employee or	22936
in any other capacity under appointment or employment of any state	22937
board, commission, or agency.	22938

Sec. 5160.44. As part of the procedure for the determination	22939
of whether benefits were incorrectly paid on behalf of a public	22940
medical assistance program recipient, the director of health care	22941
administration shall semiannually, at times determined jointly by	22942
the auditor of state and the tax commissioner, furnish to the tax	22943
commissioner in computer format the name and social security	22944
number of each public medical assistance program recipient. Within	22945
sixty days after receiving the name and social security number of	22946
a public medical assistance program recipient, the commissioner	22947
shall inform the auditor of state whether the recipient filed an	22948
Ohio individual income tax return, separate or joint, as provided	22949
by section 5747.08 of the Revised Code, for either or both of the	22950
two taxable years preceding the year in which the director	22951
furnished the names and social security numbers to the	22952
commissioner. If the recipient did so file, at the same time the	22953
commissioner shall also inform the auditor of state of the amount	22954
of the federal adjusted gross income as reported on such returns	22955
and of the addresses on such returns. The commissioner shall also	22956
advise the auditor of state whether such returns were filed on a	22957
joint basis, as provided in section 5747.08 of the Revised Code,	22958
in which case the federal adjusted gross income as reported may be	22959
that of the recipient or the recipient's spouse.	22960

If the auditor of state determines that further investigation	22961
is needed, the auditor of state may ask the commissioner to	22962
determine whether the public medical assistance program recipient	22963
filed income tax returns for any previous taxable years in which	22964
the recipient received medical assistance under a public medical	22965
assistance program and for which the tax department retains income	22966
tax returns. Within fourteen days of receipt of the request, the	22967
commissioner shall inform the auditor of state whether the	22968
recipient filed an individual income tax return for the taxable	22969
years in question, of the amount of the federal adjusted gross	22970
income as reported on such returns, of the addresses on such	22971
returns, and whether the returns were filed on a joint or separate	22972
basis.	22973

If the auditor of state determines that further investigation	22974
is needed of a public medical assistance program recipient who	22975
filed an Ohio individual income tax return, the auditor of state	22976
may request a certified copy of the Ohio individual income tax	22977
return or returns of that person for the taxable years described	22978
above, together with any other documents the commissioner has	22979
concerning the return or returns. Within fourteen days of receipt	22980
of such a request in writing, the commissioner shall forward the	22981
returns and documents to the auditor of state.	22982

The director of health care administration, county director	22983
of job and family services, county prosecutor, attorney general,	22984
auditor of state, or any agent or employee of those officials	22985
having access to any information or documents furnished by the	22986
commissioner pursuant to this section shall not divulge or use any	22987
such information except for the purpose of determining whether	22988
benefits were incorrectly paid on behalf of a public medical	22989
assistance program recipient, or for an audit, investigation, or	22990
prosecution, or in accordance with a proper judicial order. Any	22991
person who violates this provision shall thereafter be	22992
disqualified from acting as an agent or employee or in any other	22993
capacity under appointment or employment of any state or county	22994
board, commission, or agency.	22995

Sec. 5160.45. The director of health care administration	22996
shall work with the tax commissioner to recover benefits	22997
incorrectly paid on behalf of public medical assistance program	22998
recipients from refunds of state income taxes that are payable to	22999
the recipients. Any benefit incorrectly paid, because of fraud or	23000
misrepresentation, as the result of an error by the recipient or	23001
by the agency making the payment, or for any other reason, may be	23002
collected under this section. Any reduction under section 5747.12	23003
or 5747.121 of the Revised Code to an income tax refund shall be	23004
made before a reduction under this section. No reduction shall be	23005
made under this section if the amount of the refund is less than	23006
twenty-five dollars after any reduction under section 5747.12 of	23007
the Revised Code. A reduction under this section shall be made	23008
before any part of the refund is contributed under section	23009
5747.113 of the Revised Code or is credited under section 5747.12	23010
of the Revised Code against tax due in any subsequent year.	23011

The director and the tax commissioner, by rules adopted in	23012
accordance with Chapter 119. of the Revised Code, shall establish	23013
procedures to implement this section. The procedures shall provide	23014
for notice to a public medical assistance program recipient and an	23015
opportunity for the recipient to be heard before the recipient's	23016
income tax refund is reduced.	23017

Sec. 5160.46. The director of health care administration may	23018
enter into agreements with the federal government to recover	23019
benefits incorrectly paid on behalf of public medical assistance	23020
program recipients from refunds of federal income taxes that are	23021
payable to the recipients.	23022

Sec. 5160.50. As used in sections 5160.50 to 5160.65 of the	23023
Revised Code:	23024

"Community control sanction" has the same meaning as in	23025
section 2929.01 of the Revised Code.	23026

"Fugitive felon" means an individual who is fleeing to avoid	23027
prosecution, or custody or confinement after conviction, under the	23028
laws of the place from which the individual is fleeing, for a	23029
crime or an attempt to commit a crime that is a felony under the	23030
laws of the place from which the individual is fleeing or, in the	23031
case of New Jersey, a high misdemeanor, regardless of whether the	23032
individual has departed from the individual's usual place of	23033
residence.	23034

"Information" means records as defined in section 149.011 of	23035
the Revised Code, any other documents in any format, and data	23036
derived from records and documents that are generated, acquired,	23037
or maintained by the department of health care administration, a	23038
county department of job and family services, or an entity	23039
performing duties on behalf of the department or a county	23040
department.	23041

"Law enforcement agency" means the state highway patrol, an	23042
agency that employs peace officers as defined in section 109.71 of	23043
the Revised Code, the adult parole authority, a county department	23044
of probation, a prosecuting attorney, the attorney general,	23045
similar agencies of other states, federal law enforcement	23046
agencies, and postal inspectors. "Law enforcement agency" includes	23047
the peace officers and other law enforcement officers employed by	23048
the agency.	23049

"Medical assistance provided under a government-funded	23050
program" means medical assistance provided under the medicaid	23051
program, children's health insurance program, children's buy-in	23052
program, disability medical assistance program, or any other	23053
program established under the Revised Code that the department of	23054
health care administration administers.	23055

"Post-release control sanction" has the same meaning as in	23056
section 2967.01 of the Revised Code.	23057

"Public medical assistance program" means the children's	23058
health insurance program, children's buy-in program, disability	23059
medical assistance program, and medicaid program.	23060

"Public medical assistance program recipient" means an	23061
applicant for, or recipient or former recipient of, a public	23062
medical assistance program.	23063

Sec. 5160.51. Except as permitted by sections 5160.52 to	23064
5160.64 of the Revised Code or the rules adopted under section	23065
5160.65 of the Revised Code or required by federal law, no person	23066
or government entity shall solicit, disclose, receive, use, or	23067
knowingly permit, or participate in the use of any information	23068
regarding a public medical assistance program recipient for any	23069
purpose not directly connected with the administration of the	23070
public medical assistance program.	23071

Sec. 5160.52. To the extent permitted by federal law, the	23072
department of health care administration and county departments of	23073
job and family services shall release information regarding a	23074
public medical assistance program recipient for purposes directly	23075
connected to the administration of the public medical assistance	23076
program to a government entity responsible for administering the	23077
public medical assistance program.	23078

Sec. 5160.53. To the extent permitted by federal law, the	23079
department of health care administration and county departments of	23080
job and family services shall provide information regarding a	23081
public medical assistance program recipient to a law enforcement	23082
agency for the purpose of any investigation, prosecution, or	23083
criminal or civil proceeding relating to the administration of the	23084
public medical assistance program.	23085

Sec. 5160.54. (A) To the extent permitted by federal law and	23086
section 1347.08 of the Revised Code, the department of health care	23087
administration and county departments of job and family services	23088
shall provide access to information regarding a public medical	23089
assistance program recipient to all of the following:	23090

(1) The recipient;

23091

(2) The authorized representative;

23092

(3) The legal guardian of the recipient;

23093

(4) The attorney of the recipient, if the attorney has	23094
written authorization that complies with section 5160.57 of the	23095
Revised Code from the recipient.	23096

(B) The director of health care administration may adopt	23097
rules defining "authorized representative" for the purpose of this	23098
section.	23099

Sec. 5160.55. (A) To the extent permitted by federal law and	23100
subject to division (C) of this section, the department of health	23101
care administration and county departments of job and family	23102
services may release information regarding a public medical	23103
assistance program recipient as follows:	23104

(1) For purposes directly connected to the administration of	23105
a state, federal, or federally assisted program that provides cash	23106
or in-kind assistance or services directly to individuals, to a	23107
government entity responsible for administering the program;	23108

(2) For the purpose of protecting children, to a government	23109
entity responsible for administering a children's protective	23110
services program;	23111

(3) Subject to division (B) of this section, to any person or	23112
government entity to whom the recipient authorizes to receive the	23113
information by providing the department or county department	23114
voluntary, written authorization that complies with section	23115
5160.57 of the Revised Code.	23116

(B) The department and a county department shall release	23117
information pursuant to division (A)(3) of this section only in	23118
accordance with the public medical assistance program recipient's	23119
authorization. The department or county department shall provide,	23120
at no cost, a copy of each written authorization to the individual	23121
who signed it.	23122

(C) Neither the department nor a county department may	23123
release information under this section concerning a public medical	23124
assistance program recipient's receipt of medical assistance	23125
provided under a government-funded program unless all of the	23126
following conditions are met:	23127

(1) The release of information is for purposes directly	23128
connected to the administration of or provision of medical	23129
assistance provided under a government-funded program;	23130

(2) The information is released to persons or government	23131
entities that are subject to standards of confidentiality and	23132
safeguarding information substantially comparable to those	23133
established for medical assistance provided under a	23134
government-funded program;	23135

(3) The department or county department has obtained an	23136
authorization consistent with section 5160.57 of the Revised Code.	23137

Sec. 5160.56. Information concerning the receipt of medical	23138
assistance provided under a government-funded program may be	23139
released only if the release complies with the more restrictive of	23140
the following:	23141

(A) Sections 5160.52 to 5160.55 of the Revised Code and rules	23142
adopted under section 5160.65 of the Revised Code;	23143

(B) The Health Insurance Portability and Accountability Act	23144
of 1996, 110 Stat. 1955, 42 U.S.C. 1320d, et seq., as amended, and	23145
regulations adopted by the United States department of health and	23146
human services to implement the act.	23147

Sec. 5160.57. (A) For the purposes of sections 5160.54 and	23148
5160.55 of the Revised Code, an authorization shall be made on a	23149
form that uses language understandable to the average person and	23150
contains all of the following:	23151

(1) A description of the information to be used or disclosed	23152
that identifies the information in a specific and meaningful	23153
fashion;	23154

(2) The name or other specific identification of the person	23155
or class of persons authorized to make the requested use or	23156
disclosure;	23157

(3) The name or other specific identification of the person	23158
or governmental entity to which the information may be released;	23159

(4) A description of each purpose of the requested use or	23160
disclosure of the information;	23161

(5) The date on which the authorization expires or an event	23162
related either to the individual who is the subject of the request	23163
or to the purposes of the requested use or disclosure, the	23164
occurrence of which will cause the authorization to expire;	23165

(6) A statement that the information used or disclosed	23166
pursuant to the authorization may be disclosed by the recipient of	23167
the information and may no longer be protected from disclosure;	23168

(7) The signature of the individual or the individual's	23169
authorized representative and the date on which the authorization	23170
was signed;	23171

(8) If signed by an authorized representative, a description	23172
of the representative's authority to act for the individual;	23173

(9) A statement of the individual or authorized	23174
representative's right to prospectively revoke the written	23175
authorization in writing, along with one of the following:	23176

(a) A description of how the individual or authorized	23177
representative may revoke the authorization;	23178

(b) If the department of health care administration's privacy	23179
notice contains a description of how the individual or authorized	23180
representative may revoke the authorization, a reference to that	23181
privacy notice.	23182

(10) A statement that treatment, payment, enrollment, or	23183
eligibility for a public medical assistance program cannot be	23184
conditioned on signing the authorization unless the authorization	23185
is necessary for determining eligibility for the program.	23186

(B) When an individual requests information pursuant to	23187
section 5160.54 or 5160.55 of the Revised Code regarding the	23188
individual's receipt of a public medical assistance program and	23189
does not wish to provide a statement of purpose, the statement "at	23190
request of the individual" is a sufficient description for	23191
purposes of division (A)(4) of this section.	23192

Sec. 5160.58. If cost savings are indicated in the report	23193
that the director of job and family services submitted to the	23194
general assembly under section 5101.272 of the Revised Code, the	23195
department of health care administration shall enter into any	23196
necessary agreements with the United States department of health	23197
and human services and neighboring states to join and participate	23198
as an active member in the public assistance reporting information	23199
system. The department may disclose information regarding a public	23200
medical assistance program recipient to the extent necessary to	23201
participate as an active member in the public assistance reporting	23202
information system.	23203

Sec. 5160.59. On request of the department of health care	23204
administration or a county department of job and family services,	23205
a law enforcement agency shall provide information regarding	23206
public medical assistance program recipients to enable the	23207
department or county department to determine, for eligibility	23208
purposes, whether a recipient or a member of a recipient's	23209
assistance group is a fugitive felon or violating a condition of	23210
probation, a community control sanction, parole, or a post-release	23211
control sanction imposed under state or federal law.	23212

A county department may enter into a written agreement with a	23213
local law enforcement agency establishing procedures concerning	23214
access to information and providing for compliance with this	23215
section.	23216

The auditor of state shall prepare an annual report on the	23217
outcome of the agreements required by this section. The report	23218
shall include the number of fugitive felons, probation and parole	23219
violators, and violators of community control sanctions and	23220
post-release control sanctions apprehended during the immediately	23221
preceding year as a result of the exchange of information pursuant	23222
to this section. The auditor of state shall file the report with	23223
the governor, the president and minority leader of the senate, and	23224
the speaker and minority leader of the house of representatives.	23225
The department, county departments, and law enforcement agencies	23226
shall cooperate with the auditor of state's office in gathering	23227
the information needed for the report.	23228

Sec. 5160.60. To the extent permitted by federal law, the	23229
department of health care administration and county departments of	23230
job and family services shall provide information, except	23231
information directly related to the receipt of medical assistance	23232
or medical services, regarding disability medical assistance	23233
program recipients to law enforcement agencies on request for the	23234
purposes of investigations, prosecutions, and criminal and civil	23235
proceedings that are within the scope of the law enforcement	23236
agencies' official duties.	23237

Sec. 5160.61. Information about a public medical assistance	23238
program recipient shall be exchanged, obtained, or shared under	23239
sections 5160.59 and 5160.60 of the Revised Code only if the	23240
department of health care administration, county department of job	23241
and family services, or law enforcement agency requesting the	23242
information gives sufficient information to specifically identify	23243
the recipient. In addition to the recipient's name, identifying	23244
information may include the recipient's current or last known	23245
address, social security number, other identifying number, age,	23246
gender, physical characteristics, any information specified in an	23247
agreement entered into under section 5160.59 of the Revised Code,	23248
or any information considered appropriate by the department or	23249
county department.	23250

Sec. 5160.62. The department of health care administration	23251
and its officers and employees are not liable in damages in a	23252
civil action for any injury, death, or loss to person or property	23253
that allegedly arises from the release of information in	23254
accordance with sections 5160.59 and 5160.60 of the Revised Code.	23255
This section does not affect any immunity or defense that the	23256
department and its officers and employees may be entitled to under	23257
another section of the Revised Code or the common law of this	23258
state, including section 9.86 of the Revised Code.	23259

Sec. 5160.63. As used in this section, "employee" has the	23260
same meaning as in division (B) of section 2744.01 of the Revised	23261
Code.	23262

County departments of job and family services and their	23263
employees are not liable in damages in a civil action for any	23264
injury, death, or loss to person or property that allegedly arises	23265
from the release of information in accordance with sections	23266
5160.59 and 5160.60 of the Revised Code. This section does not	23267
affect any immunity or defense that the county departments and	23268
their employees may be entitled to under another section of the	23269
Revised Code or the common law of this state, including section	23270
2744.02 and division (A)(6) of section 2744.03 of the Revised	23271
Code.	23272

Sec. 5160.64. To the extent permitted by federal law, the	23273
department of health care administration and county departments of	23274
job and family services shall provide access to information to the	23275
auditor of state acting pursuant to Chapter 117. or sections	23276
117.54, 117.55, 117.56, 5160.43, and 5160.44 of the Revised Code	23277
and to any other government entity authorized by federal law to	23278
conduct an audit of or similar activity involving a public medical	23279
assistance program.	23280

Sec. 5160.65. The director of health care administration	23281
shall adopt rules in accordance with Chapter 119. of the Revised	23282
Code implementing sections 5160.50 to 5160.64 of the Revised Code	23283
and governing the custody, use, and preservation of the	23284
information generated or received by the department of health care	23285
administration, county departments of job and family services,	23286
other state and county entities, contractors, grantees, private	23287
entities, or officials participating in the administration of a	23288
public medical assistance program. The rules shall specify	23289
conditions and procedures for the release of information. The	23290
rules shall comply with applicable federal statutes and	23291
regulations. To the extent permitted by federal law:	23292

(A) The rules may permit providers of services or assistance	23293
under a public medical assistance program limited access to	23294
information that is essential for the providers to render services	23295
or assistance or to bill for services or assistance rendered. The	23296
department of aging, when investigating a complaint under section	23297
173.20 of the Revised Code, shall be granted any limited access	23298
permitted in the rules pursuant to division (A) of this section.	23299

(B) The rules may permit a contractor, grantee, or other	23300
state or county entity limited access to information that is	23301
essential for the contractor, grantee, or entity to perform	23302
administrative or other duties on behalf of the department or	23303
county department. A contractor, grantee, or entity given access	23304
to information pursuant to division (B) of this section is bound	23305
by the director's rules, and disclosure of the information by the	23306
contractor, grantee, or entity in a manner not authorized by the	23307
rules is a violation of section 5160.51 of the Revised Code.	23308

Sec. 5160.66. Whenever names, addresses, or other information	23309
relating to public medical assistance program recipients is held	23310
by any agency other than the department of health care	23311
administration or a county department of job and family services,	23312
that other agency shall adopt rules consistent with sections	23313
5160.50 to 5160.65 of the Revised Code to prevent the publication	23314
or disclosure of names, lists, or other information concerning	23315
those recipients.	23316

~~Sec. 5101.31.~~ Sec. 5160.67. Any record, data, pricing information,	23317
or other information regarding a drug rebate agreement or a	23318
supplemental drug rebate agreement for the medicaid program	23319
~~established under Chapter 5111. of the Revised Code~~ or the	23320
disability medical assistance program ~~established under section~~	23321
~~5115.10 of the Revised Code~~ that the department of ~~job and family~~	23322
~~services~~health care administration receives from a pharmaceutical	23323
manufacturer or creates pursuant to negotiation of the agreement	23324
is not a public record under section 149.43 of the Revised Code	23325
and shall be treated by the department as confidential	23326
information.	23327

Sec. 5160.70. Not later than the last day of each July and	23328
January, the department of health care administration shall	23329
complete a report on the characteristics of the individuals who	23330
receive services through the programs operated by the department	23331
and the outcomes of the individuals' receipt of the services. The	23332
reports shall be for the six-month periods ending on the last days	23333
of June and December and shall include information regarding	23334
births to medicaid recipients.	23335

The department shall submit the reports to the speaker and	23336
minority leader of the house of representatives, the president and	23337
minority leader of the senate, the legislative budget officer, the	23338
director of budget and management, and each board of county	23339
commissioners. The department shall provide copies of the reports	23340
to any person or government entity on request.	23341

In designing the format for the reports, the department shall	23342
consult with individuals, organizations, and government entities	23343
interested in the programs operated by the department, so that the	23344
reports are designed to enable the general assembly and the public	23345
to evaluate the effectiveness of the programs and identify any	23346
needs that the programs are not meeting.	23347

Sec. 5160.71. Whenever the federal government requires that	23348
the department of health care administration submit a report on a	23349
program that is operated by the department or is otherwise under	23350
the department's jurisdiction, the department shall prepare and	23351
submit the report in accordance with the federal requirements	23352
applicable to that report. To the extent possible, the department	23353
may coordinate the preparation and submission of a particular	23354
report with any other report, plan, or other document required to	23355
be submitted to the federal government, as well as with any report	23356
required to be submitted to the general assembly.	23357

Sec. 5160.75. The department of health care administration	23358
shall create within the department the central pharmaceutical	23359
purchasing office. The office shall purchase, store, repackage,	23360
distribute, and dispense all drugs, pharmaceutical products, and	23361
related items needed by the departments of health, job and family	23362
services, mental health, mental retardation and developmental	23363
disabilities, rehabilitation and correction, and youth services	23364
and other state agencies for which the department of	23365
administrative services purchases supplies under section 125.05 of	23366
the Revised Code. The office also shall provide professional	23367
pharmacy consultation and drug information services to those	23368
departments and other state agencies.	23369

Notwithstanding section 125.05 of the Revised Code, purchases	23370
of drugs, pharmaceutical products, and related items under this	23371
section need not be purchased through the department of	23372
administrative services.	23373

~~Sec. 173.35.~~ Sec. 5160.80. (A) As used in this section, "PASSPORT	23374
administrative agency" means an entity under contract with the	23375
department of aging to provide administrative services regarding	23376
the PASSPORT program created under section 173.40 of the Revised	23377
Code.	23378

(B) The department of ~~aging~~health care administration shall	23379
administer the residential state supplement program under which	23380
the state supplements the ~~supplemental security income~~ payments	23381
received by aged, blind, or disabled adults under ~~Title XVI of the~~	23382
~~"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A., as~~	23383
~~amended~~the supplemental security income program. Residential	23384
state supplement payments shall be used for the provision of	23385
accommodations, supervision, and personal care services to	23386
supplemental security income recipients who the department	23387
determines are at risk of needing institutional care.	23388

(C) For an individual to be eligible for residential state	23389
supplement payments, all of the following must be the case:	23390

(1) Except as provided by division (G) of this section, the	23391
individual must reside in one of the following:	23392

(a) An adult foster home certified under section 173.36 of	23393
the Revised Code;	23394

(b) A home or facility, other than a nursing home or nursing	23395
home unit of a home for the aging, licensed by the department of	23396
health under Chapter 3721. or 3722. of the Revised Code and	23397
certified in accordance with standards established by the director	23398
of aging under division (D)(2) of this section;	23399

(c) A community alternative home licensed under section	23400
3724.03 of the Revised Code and certified in accordance with	23401
standards established by the director of aging under division	23402
(D)(2) of this section;	23403

(d) A residential facility as defined in division	23404
(A)(1)(d)(ii) of section 5119.22 of the Revised Code licensed by	23405
the department of mental health and certified in accordance with	23406
standards established by the director of aging under division	23407
(D)(2) of this section;	23408

(e) An apartment or room used to provide community mental	23409
health housing services certified by the department of mental	23410
health under section 5119.611 of the Revised Code and approved by	23411
a board of alcohol, drug addiction, and mental health services	23412
under division (A)(14) of section 340.03 of the Revised Code and	23413
certified in accordance with standards established by the director	23414
of aging under division (D)(2) of this section.	23415

(2) Effective July 1, 2000, a PASSPORT administrative agency	23416
must have determined that the environment in which the individual	23417
will be living while receiving the payments is appropriate for the	23418
individual's needs. If the individual is eligible for supplemental	23419
security income payments or social security disability insurance	23420
benefits because of a mental disability, the PASSPORT	23421
administrative agency shall refer the individual to a community	23422
mental health agency for the community mental health agency to	23423
issue in accordance with section 340.091 of the Revised Code a	23424
recommendation on whether the PASSPORT administrative agency	23425
should determine that the environment in which the individual will	23426
be living while receiving the payments is appropriate for the	23427
individual's needs. Division (C)(2) of this section does not apply	23428
to an individual receiving residential state supplement payments	23429
on June 30, 2000, until the individual's first eligibility	23430
redetermination after that date.	23431

(3) The individual satisfies all eligibility requirements	23432
established by rules adopted under division (D) of this section.	23433

(D)(1) The ~~directors~~director of ~~aging and job and family~~	23434
~~services~~health care administration shall adopt rules in	23435
accordance with section 111.15 of the Revised Code as necessary	23436
to implement the residential state supplement program.	23437

To the extent permitted by Title XVI of the "Social Security	23438
Act,of 1935" and any other provision of federal law, the director	23439
of ~~job and family services~~health care administration shall adopt	23440
rules establishing standards for adjusting the eligibility	23441
requirements concerning the level of impairment a person must have	23442
so that the amount appropriated for the program by the general	23443
assembly is adequate for the number of eligible individuals. The	23444
rules shall not limit the eligibility of disabled persons solely	23445
on a basis classifying disabilities as physical or mental. The	23446
director of ~~job and family services~~health care administration	23447
also shall adopt rules that establish eligibility standards for	23448
aged, blind, or disabled individuals who reside in one of the	23449
homes or facilities specified in division (C)(1) of this section	23450
but who, because of their income, do not receive supplemental	23451
security income payments. The rules may provide that these	23452
individuals may include individuals who receive other types of	23453
benefits, including, social security disability insurance benefits	23454
provided under Title II of the "Social Security Act,of 1935" 49	23455
~~Stat. 620 (1935), 42 U.S.C.A. 401, as amended~~. Notwithstanding	23456
division (B) of this section, such payments may be made if funds	23457
are available for them.	23458

The director of ~~aging~~health care administration shall adopt	23459
rules establishing the method to be used to determine the amount	23460
an eligible individual will receive under the program. The amount	23461
the general assembly appropriates for the program shall be a	23462
factor included in the method that department establishes.	23463

(2) The director of aging shall adopt rules in accordance	23464
with Chapter 119. of the Revised Code establishing standards for	23465
certification of living facilities described in division (C)(1) of	23466
this section.	23467

The directors of aging and mental health shall enter into an	23468
agreement to certify facilities that apply for certification and	23469
meet the standards established by the director of aging under this	23470
division.	23471

(E) The county department of job and family services of the	23472
county in which an applicant for the residential state supplement	23473
program resides shall determine whether the applicant meets income	23474
and resource requirements for the program.	23475

(F) The department of ~~aging~~health care administration shall	23476
maintain a waiting list of any individuals eligible for payments	23477
under this section but not receiving them because moneys	23478
appropriated to the department for the purposes of this section	23479
are insufficient to make payments to all eligible individuals. An	23480
individual may apply to be placed on the waiting list even though	23481
the individual does not reside in one of the homes or facilities	23482
specified in division (C)(1) of this section at the time of	23483
application. The director of ~~aging~~health care administration, by	23484
rules adopted in accordance with Chapter 119. of the Revised	23485
Code, shall specify procedures and requirements for placing an	23486
individual on the waiting list and priorities for the order in	23487
which individuals placed on the waiting list are to begin to	23488
receive residential state supplement payments. The rules	23489
specifying priorities may give priority to individuals placed on	23490
the waiting list on or after July 1, 2006, who receive	23491
supplemental security income benefits ~~under Title XVI of the~~	23492
~~"Social Security Act," 86 Stat. 1475 (1972), 42 U.S.C. 1381, as~~	23493
~~amended~~. The rules shall not affect the place on the waiting list	23494
of any person who was on the list on July 1, 2006. The rules	23495
specifying priorities may also set additional priorities based on	23496
living arrangement, such as whether an individual resides in a	23497
facility listed in division (C)(1) of this section or has been	23498
admitted to a nursing facility.	23499

(G) An individual in a licensed or certified living	23500
arrangement receiving state supplementation on November 15, 1990,	23501
under former section 5101.531 of the Revised Code shall not become	23502
ineligible for payments under this section solely by reason of the	23503
individual's living arrangement as long as the individual remains	23504
in the living arrangement in which the individual resided on	23505
November 15, 1990.	23506

(H) The department of ~~aging~~health care administration shall	23507
notify each person denied approval for payments under this section	23508
of the person's right to a hearing. On request, the hearing shall	23509
be provided ~~by the department of job and family services~~ in	23510
accordance with section ~~5101.35~~5160.34 of the Revised Code.	23511

~~Sec. 173.351.~~ Sec. 5160.81. (A) As used in this section:

23512

"Area agency on aging" has the same meaning as in section	23513
173.14 of the Revised Code.	23514

"Long-term care consultation program" means the program the	23515
department of aging is required to develop under section 173.42 of	23516
the Revised Code.	23517

"Long-term care consultation program administrator" or	23518
"administrator" means the department of aging or, if the	23519
department contracts with an area agency on aging or other entity	23520
to administer the long-term care consultation program for a	23521
particular area, that agency or entity.	23522

"Nursing facility" has the same meaning as in section ~~5111.20~~	23523
5164.01 of the Revised Code.	23524

~~"Residential state supplement program" means the program~~	23525
~~administered pursuant to section 173.35 of the Revised Code.~~	23526

(B) Each month, each area agency on aging shall determine	23527
whether individuals who reside in the area that the area agency on	23528
aging serves and are on a waiting list for the residential state	23529
supplement program have been admitted to a nursing facility. If an	23530
area agency on aging determines that such an individual has been	23531
admitted to a nursing facility, the agency shall notify the	23532
long-term care consultation program administrator serving the area	23533
in which the individual resides about the determination. The	23534
administrator shall determine whether the residential state	23535
supplement program is appropriate for the individual and whether	23536
the individual would rather participate in the program than	23537
continue residing in the nursing facility. If the administrator	23538
determines that the residential state supplement program is	23539
appropriate for the individual and the individual would rather	23540
participate in the program than continue residing in the nursing	23541
facility, the administrator shall so notify the department of	23542
~~aging~~health care administration. On receipt of the notice from	23543
the administrator, the department of ~~aging~~health care	23544
administration shall approve the individual's enrollment in the	23545
residential state supplement program in accordance with the	23546
priorities specified in rules adopted under division (F) of	23547
section ~~173.35~~5160.80 of the Revised Code. Each quarter, the	23548
department of ~~aging~~health care administration shall certify to	23549
the director of budget and management the estimated increase in	23550
costs of the residential state supplement program resulting from	23551
enrollment of individuals in the program pursuant to this	23552
section.	23553

(C) Not later than the last day of each calendar year, the	23554
director of ~~aging~~health care administration shall submit to the	23555
general assembly a report regarding the number of individuals	23556
enrolled in the residential state supplement program pursuant to	23557
this section and the costs incurred and savings achieved as a	23558
result of the enrollments.	23559

Sec. 5160.99. Whoever violates section 5160.51 of the Revised	23560
Code is guilty of a misdemeanor of the first degree.	23561

Sec. 5161.01. The department of health care administration	23562
shall act as the single state agency to supervise the	23563
administration of the medicaid program. As the single state	23564
agency, the department shall comply with 42 C.F.R. 431.10(e). The	23565
department's rules governing medicaid are binding on other	23566
agencies that administer components of the medicaid program. No	23567
agency may establish, by rule or otherwise, a policy governing	23568
medicaid that is inconsistent with a medicaid policy established,	23569
in rule or otherwise, by the director of health care	23570
administration.	23571

~~Sec. 5111.102.~~ Sec. 5161.011. As used in this section, "state	23572
agency" has the same meaning as in section 9.23 of the Revised	23573
Code.	23574

No provision of Title LI of the Revised Code or any other law	23575
of this state that incorporates any provision of federal ~~Medicaid~~	23576
medicaid law, Title XIX of the Social Security Act, 79 Stat. 286	23577
(1965), 42 U.S.C. 1396, or that may be construed as requiring the	23578
state, a state agency, or any state official or employee to	23579
comply with that federal provision, shall be construed as	23580
creating a cause of action to enforce such state law beyond the	23581
causes of action available under federal law for enforcement of	23582
the provision of federal law.	23583

~~Sec. 5111.98.~~ Sec. 5161.02. (A) The director of ~~job and family~~	23584
~~services~~health care administration may do all of the following as	23585
necessary for the department of ~~job and family services~~health	23586
care administration to fulfill the duties it has, as the single	23587
state agency for the medicaid program, under the "Medicare	23588
Prescription Drug, Improvement, and Modernization Act of 2003"	23589
Pub. L. No. 108-173, 117 Stat. 2066:	23590

(1) Adopt rules;

23591

(2) Assign duties to county departments of job and family	23592
services;	23593

(3) Make payments to the United States department of health	23594
and human services from appropriations made to the department of	23595
~~job and family services~~health care administration for this	23596
purpose.	23597

(B) Rules adopted under division (A)(1) of this section shall	23598
be adopted as follows:	23599

(1) If the rules concern the department's duties regarding	23600
service providers, in accordance with Chapter 119. of the Revised	23601
Code;	23602

(2) If the rules concern the department's duties concerning	23603
individuals' eligibility for services, in accordance with section	23604
111.15 of the Revised Code;	23605

(3) If the rules concern the department's duties concerning	23606
financial and operational matters between the department and	23607
county departments of job and family services, in accordance with	23608
section 111.15 of the Revised Code as if the rules were internal	23609
management rules.	23610

Sec. 5161.03. The director of health care administration	23611
shall prepare and submit to the United States secretary of health	23612
and human services both of the following as necessary to	23613
accomplish the requirements of state law governing the medicaid	23614
program:	23615

(A) A state medicaid plan.

23616

(B) Amendments to the state medicaid plan.

23617

~~Sec. 5111.91.~~ Sec. 5161.05. The department of ~~job and family~~	23618
~~services~~health care administration may enter into contracts with	23619
one or more other state agencies or political subdivisions to have	23620
the state agency or political subdivision administer one or more	23621
components of the medicaid program, or one or more aspects of a	23622
component, under the department's supervision. A state agency or	23623
political subdivision that enters into such a contract shall	23624
comply with the terms of the contract and any rules the director	23625
of ~~job and family services~~health care administration has adopted	23626
governing the component, or aspect of the component, that the	23627
state agency or political subdivision is to administer, including	23628
any rules establishing review, audit, and corrective action plan	23629
requirements. A contract with a state agency shall be in the form	23630
of an interagency agreement. The interagency agreement shall	23631
include a requirement for the state agency to submit an annual	23632
financing plan to the department.	23633

A state agency or political subdivision that enters into a	23634
contract with the department under this section shall reimburse	23635
the department for the nonfederal share of the cost to the	23636
department of performing, or contracting for the performance of, a	23637
fiscal audit of the component of the medicaid program, or aspect	23638
of the component, that the state agency or political subdivision	23639
administers if rules governing the component, or aspect of the	23640
component, require that a fiscal audit be conducted.	23641

There is hereby created in the state treasury the medicaid	23642
administrative reimbursement fund. The department shall use money	23643
in the fund to pay for the nonfederal share of the cost of a	23644
fiscal audit for which a state agency or political subdivision is	23645
required by this section to reimburse the department. The	23646
department shall deposit the reimbursements into the fund.	23647

~~Sec. 5111.911.~~ Sec. 5161.06. Any contract the department of ~~job and~~	23648
~~family services~~health care administration enters into with the	23649
department of mental health or department of alcohol and drug	23650
addiction services under section ~~5111.91~~5161.05 of the Revised	23651
Code is subject to the approval of the director of budget and	23652
management and shall require or specify all of the following:	23653

(A) In the case of a contract with the department of mental	23654
health, that section ~~5111.912~~5161.07 of the Revised Code be	23655
complied with;	23656

(B) In the case of a contract with the department of alcohol	23657
and drug addiction services, that section ~~5111.913~~5161.08 of the	23658
Revised Code be complied with;	23659

23660

(D) The department of mental health's or department of	23661
alcohol and drug addiction services' responsibilities for	23662
reimbursing providers, including program oversight and quality	23663
assurance.	23664

~~Sec. 5111.912.~~ Sec. 5161.07. If the department of ~~job and family~~	23665
~~services~~health care administration enters into a contract with	23666
the department of mental health under section ~~5111.91~~5161.05 of	23667
the Revised Code, the department of mental health and boards of	23668
alcohol, drug addiction, and mental health services shall pay the	23669
nonfederal share of any medicaid payment to a provider for	23670
services under the component, or aspect of the component, the	23671
department of mental health administers.	23672

~~Sec. 5111.913.~~ Sec. 5161.08. If the department of ~~job and family~~	23673
~~services~~health care administration enters into a contract with	23674
the department of alcohol and drug addiction services under	23675
section ~~5111.91~~5161.05 of the Revised Code, the department of	23676
alcohol and drug addiction services and boards of alcohol, drug	23677
addiction, and mental health services shall pay the nonfederal	23678
share of any medicaid payment to a provider for services under the	23679
component, or aspect of the component, the department of alcohol	23680
and drug addiction services administers.	23681

~~Sec. 5111.90.~~ Sec. 5161.10. (A) As used in sections ~~5111.90~~	23682
5161.10 to ~~5111.93~~5161.13 of the Revised Code:	23683

(1) "Political subdivision" means a municipal corporation,	23684
township, county, school district, or other body corporate and	23685
politic responsible for governmental activities only in a	23686
geographical area smaller than that of the state.	23687

(2) "State agency" means every organized body, office, or	23688
agency, other than the department of ~~job and family services~~	23689
health care administration, established by the laws of the state	23690
for the exercise of any function of state government.	23691

(B) To the extent permitted by Title XIX of the "Social	23692
Security Act,of 1935" ~~79 Stat. 286 (1965), 42 U.S.C.A. 1396, as~~	23693
~~amended,~~ and regulations adopted under that title, the department	23694
of ~~job and family services~~health care administration may enter	23695
into contracts with political subdivisions to use funds of the	23696
political subdivision to pay the nonfederal share of expenditures	23697
under the medicaid program. The determination and provision of	23698
federal financial reimbursement to a subdivision entering into a	23699
contract under this section shall be determined by the department,	23700
subject to section ~~5111.92~~5161.12 of the Revised Code, approval	23701
by the United States secretary of health and human services, and	23702
the availability of federal financial participation.	23703

~~Sec. 5111.92.~~ Sec. 5161.12. (A)(1) Except as provided in division	23704
(B) of this section, if a state agency or political subdivision	23705
administers one or more components of the medicaid program that	23706
the United States department of health and human services	23707
approved, and for which federal financial participation was	23708
initially obtained, prior to January 1, 2002, or administers one	23709
or more aspects of such a component, the department of ~~job and~~	23710
~~family services~~health care administration may retain or collect	23711
not more than ten per cent of the federal financial participation	23712
the state agency or political subdivision obtains through an	23713
approved, administrative claim regarding the component or aspect	23714
of the component. If the department retains or collects a	23715
percentage of such federal financial participation, the percentage	23716
the department retains or collects shall be specified in a	23717
contract the department enters into with the state agency or	23718
political subdivision under section ~~5111.91~~5161.05 of the Revised	23719
Code.	23720

(2) Except as provided in division (B) of this section, if a	23721
state agency or political subdivision administers one or more	23722
components of the medicaid program that the United States	23723
department of health and human services approved on or after	23724
January 1, 2002, or administers one or more aspects of such a	23725
component, the department of ~~job and family services~~health care	23726
administration shall retain or collect not less than three and not	23727
more than ten per cent of the federal financial participation the	23728
state agency or political subdivision obtains through an approved,	23729
administrative claim regarding the component or aspect of the	23730
component. The percentage the department retains or collects shall	23731
be specified in a contract the department enters into with the	23732
state agency or political subdivision under section ~~5111.91~~	23733
5161.05 of the Revised Code.	23734

(B) The department of ~~job and family services~~health care	23735
administration may retain or collect a percentage of federal	23736
financial participation under divisions (A)(1) and (2) of this	23737
section only to the extent permitted by federal statutes and	23738
regulations.	23739

(C) All amounts the department retains or collects under this	23740
section shall be deposited into the health care services	23741
administration fund created under section ~~5111.94~~5161.15 of the	23742
Revised Code.	23743

~~Sec. 5111.93.~~ Sec. 5161.13. The department of ~~job and family~~	23744
~~services~~health care administration may retain or collect a	23745
percentage of the federal financial participation included in a	23746
supplemental medicaid payment to one or more medicaid providers	23747
owned or operated by a state agency or political subdivision that	23748
brings the payment to such provider or providers to the upper	23749
payment limit established by 42 C.F.R. 447.272. If the department	23750
retains or collects a percentage of that federal financial	23751
participation, the department shall adopt a rule under Chapter	23752
119. of the Revised Code specifying the percentage the department	23753
is to retain or collect. All amounts the department retains or	23754
collects under this section shall be deposited into the health	23755
care services administration fund created under section ~~5111.94~~	23756
5161.15 of the Revised Code.	23757

~~Sec. 5111.94.~~ Sec. 5161.15. (A) As used in this section, "vendor	23758
offset" means a reduction of a medicaid payment to a medicaid	23759
provider to correct a previous, incorrect medicaid payment to	23760
that provider.	23761

(B) There is hereby created in the state treasury the health	23762
care services administration fund. Except as provided in division	23763
(C) of this section, all the following shall be deposited into the	23764
fund:	23765

(1) Amounts deposited into the fund pursuant to sections	23766
~~5111.92~~5161.12 and ~~5111.93~~5161.13 of the Revised Code;	23767

(2) The amount of the state share of all money the department	23768
of ~~job and family services~~health care administration, in fiscal	23769
year 2003 and each fiscal year thereafter, recovers pursuant to a	23770
tort action under the department's right of recovery under	23771
section ~~5101.58~~5160.38 of the Revised Code that exceeds the	23772
state share of all money the department, in fiscal year 2002,	23773
recovers pursuant to a tort action under that right of recovery;	23774

(3) Subject to division (D) of this section, the amount of	23775
the state share of all money the department of ~~job and family~~	23776
~~services~~health care administration, in fiscal year 2003 and each	23777
fiscal year thereafter, recovers through audits of medicaid	23778
providers that exceeds the state share of all money the	23779
department, in fiscal year 2002, recovers through such audits;	23780

(4) Amounts from assessments on hospitals under section	23781
~~5112.06~~5166.05 of the Revised Code and intergovernmental	23782
transfers by governmental hospitals under section ~~5112.07~~5166.06	23783
of the Revised Code that are deposited into the fund in	23784
accordance with the law;	23785

(5) Amounts that the department of education pays to the	23786
department of ~~job and family services~~health care administration,	23787
if any, pursuant to an interagency agreement entered into under	23788
section ~~5111.713~~5163.303 of the Revised Code.	23789

(C) No funds shall be deposited into the health care services	23790
administration fund in violation of federal statutes or	23791
regulations.	23792

(D) In determining under division (B)(3) of this section the	23793
amount of money the department, in a fiscal year, recovers through	23794
audits of medicaid providers, the amount recovered in the form of	23795
vendor offset shall be excluded.	23796

(E) The director of ~~job and family services~~health care	23797
administration shall use funds available in the health care	23798
services administration fund to pay for costs associated with the	23799
administration of the medicaid program.	23800

~~Sec. 5111.941.~~ Sec. 5161.16. (A) The medicaid revenue and	23801
collections fund is hereby created in the state treasury. Except	23802
as otherwise provided by statute or as authorized by the	23803
controlling board, both of the following shall be credited to the	23804
fund:	23805

(1) The nonfederal share of all medicaid-related revenues,	23806
collections, and recoveries;	23807

(2) The monthly premiums charged under the children's buy-in	23808
program pursuant to section ~~5101.5213~~5167.37 of the Revised Code.	23809

(B) The department of ~~job and family services~~health care	23810
administration shall use money credited to the medicaid revenue	23811
and collections fund to pay for medicaid services and contracts	23812
and the children's buy-in program ~~established under sections~~	23813
~~5101.5211 to 5101.5216 of the Revised Code~~.	23814

~~Sec. 5111.942.~~ Sec. 5161.17. (A) The prescription drug rebates fund	23815
is hereby created in the state treasury. Both of the following	23816
shall be credited to the fund:	23817

(1) The ~~non-federal~~nonfederal share of all rebates paid by	23818
drug manufacturers to the department of ~~job and family services~~	23819
health care administration in accordance with a rebate agreement	23820
required by 42 U.S.C.A. 1396r-8;	23821

(2) The ~~non-federal~~nonfederal share of all supplemental	23822
rebates paid by drug manufacturers to the department of ~~job and~~	23823
~~family services~~health care administration in accordance with the	23824
supplemental drug rebate program established under section	23825
~~5111.081~~5163.26 of the Revised Code.	23826

(B) The department of ~~job and family services~~health care	23827
administration shall use money credited to the prescription drug	23828
rebates fund to pay for medicaid services and contracts.	23829

~~Sec. 5111.943.~~ Sec. 5161.18. (A) The health care - federal fund is	23830
hereby created in the state treasury. All of the following shall	23831
be credited to the fund:	23832

(1) Funds that division (B) of section ~~5112.18~~5166.12 of the	23833
Revised Code requires be credited to the fund;	23834

(2) The federal share of all rebates paid by drug	23835
manufacturers to the department of ~~job and family services~~health	23836
care administration in accordance with a rebate agreement required	23837
by 42 U.S.C. 1396r-8;	23838

(3) The federal share of all supplemental rebates paid by	23839
drug manufacturers to the department of ~~job and family services~~	23840
health care administration in accordance with the supplemental	23841
drug rebate program established under section ~~5111.081~~5163.26 of	23842
the Revised Code;	23843

(4) Except as otherwise provided by statute or as authorized	23844
by the controlling board, the federal share of all other	23845
medicaid-related revenues, collections, and recoveries.	23846

(B) All money credited to the health care - federal fund	23847
pursuant to division (B) of section ~~5112.18~~5166.12 of the Revised	23848
Code shall be used solely for distributing funds to hospitals	23849
under section ~~5112.08~~5166.07 of the Revised Code. The department	23850
of ~~job and family services~~health care administration shall use	23851
all other money credited to the fund to pay for other medicaid	23852
services and contracts.	23853

~~Sec. 5111.915.~~ Sec. 5161.25. (A) The department of ~~job and family~~	23854
~~services~~health care administration shall enter into an agreement	23855
with the department of administrative services for the department	23856
of administrative services to contract through competitive	23857
selection pursuant to section 125.07 of the Revised Code with a	23858
vendor to perform an assessment of the data collection and data	23859
warehouse functions of the medicaid data warehouse system,	23860
including the ability to link the data sets of all agencies	23861
serving medicaid recipients.	23862

The assessment of the data system shall include functions	23863
related to fraud and abuse detection, program management and	23864
budgeting, and performance measurement capabilities of all	23865
agencies serving medicaid recipients, including the departments of	23866
aging, alcohol and drug addiction services, health, ~~job and family~~	23867
~~services~~health care administration, mental health, and mental	23868
retardation and developmental disabilities.	23869

The department of administrative services shall enter into	23870
this contract within thirty days after ~~the effective date of this~~	23871
~~section~~September 29, 2005. The contract shall require the vendor	23872
to complete the assessment within ninety days after ~~the effective~~	23873
~~date of this section~~September 29, 2005.	23874

A qualified vendor with whom the department of administrative	23875
services contracts to assess the data system shall also assist the	23876
medicaid agencies in the definition of the requirements for an	23877
enhanced data system or a new data system and assist the	23878
department of administrative services in the preparation of a	23879
request for proposal to enhance or develop a data system.	23880

(B) Based on the assessment performed pursuant to division	23881
(A) of this section, the department of administrative services	23882
shall seek a qualified vendor through competitive selection	23883
pursuant to section 125.07 of the Revised Code to develop or	23884
enhance a data collection and data warehouse system for the	23885
department of ~~job and family services~~health care administration	23886
and all agencies serving medicaid recipients.	23887

Within ninety days after ~~the effective date of this section~~	23888
September 29, 2005, the department of ~~job and family services~~	23889
health care administration shall seek enhanced federal funding for	23890
ninety per cent of the funds required to establish or enhance the	23891
data system. The department of administrative services shall not	23892
award a contract for establishing or enhancing the data system	23893
until the department of ~~job and family services~~health care	23894
administration receives approval from the secretary of the United	23895
States department of health and human services for the ninety per	23896
cent federal match.	23897

~~Sec. 5111.10.~~ Sec. 5161.30. The director of ~~job and family~~	23898
~~services~~health care administration may conduct reviews of the	23899
medicaid program. The reviews may include physical inspections of	23900
records and sites where medicaid-funded services are provided and	23901
interviews of providers and recipients of the services. If the	23902
director determines pursuant to a review that a person or	23903
government entity has violated a rule governing the medicaid	23904
program, the director may establish a corrective action plan for	23905
the violator and impose fiscal, administrative, or both types of	23906
sanctions on the violator in accordance with rules governing the	23907
medicaid program.	23908

~~Sec. 5111.09.~~ Sec. 5161.32. On or before the first day of January	23909
of each year, the department of ~~job and family services~~health	23910
care administration shall submit to the speaker and minority	23911
leader of the house of representatives and the president and	23912
minority leader of the senate, and shall make available to the	23913
public, a report on the effectiveness of ~~the Ohio works first~~	23914
~~program established under Chapter 5107. of the Revised Code and~~	23915
the ~~medical assistance~~medicaid program ~~established under this~~	23916
~~chapter~~ in meeting the health care needs of low-income pregnant	23917
women, infants, and children. The report shall include: the	23918
estimated number of persons eligible for health care services to	23919
pregnant women, infants, and children under the programs; the	23920
actual number of eligible persons served; the number of prenatal,	23921
postpartum, and child health visits; a report on birth outcomes,	23922
including a comparison of low-birthweight births and infant	23923
mortality rates of program participants with the general female	23924
child-bearing and infant population in this state; and a	23925
comparison of the prenatal, delivery, and child health costs of	23926
the programs with such costs of similar programs in other states,	23927
where available.	23928

~~Sec. 5111.091.~~ Sec. 5161.33. Not later than the first day of each	23929
calendar quarter, the director of ~~job and family services~~health	23930
care administration shall submit a report to the president and	23931
minority leader of the senate, speaker and minority leader of	23932
the house of representatives, and the chairpersons of the	23933
committees of the senate and house of representatives that hear	23934
bills making biennial appropriations on the establishment and	23935
implementation of programs designed to control the increase of	23936
the cost of the medicaid program, increase the efficiency of the	23937
medicaid program, and promote better health outcomes.	23938

The report shall include information regarding all of the	23939
following:	23940

(A) Provider network management;

23941

(B) Electronic claims submission and payment systems;

23942

(C) Limited provider contracts and payments based on	23943
performance;	23944

(D) Efforts to enforce third party liability;

23945

(E) Implementation of the medicaid information technology	23946
system;	23947

(F) Expansion of the medicaid data warehouse and decision	23948
support system;	23949

(G) Development of infrastructure policies for electronic	23950
health records and e-prescribing.	23951

~~Sec. 5111.01.~~ Sec. 5162.01. ~~As used in this chapter, "medical~~	23952
~~assistance program" or "medicaid" means the program that is~~	23953
~~authorized by this chapter and provided by the department of job~~	23954
~~and family services under this chapter, Title XIX of the "Social~~	23955
~~Security Act," 79 Stat. 286 (1965), 42 U.S.C.A. 1396, as amended,~~	23956
~~and the waivers of Title XIX requirements granted to the~~	23957
~~department by the centers for medicare and medicaid services of~~	23958
~~the United States department of health and human services.~~	23959

~~The department of job and family services shall act as the~~	23960
~~single state agency to supervise the administration of the~~	23961
~~medicaid program. As the single state agency, the department shall~~	23962
~~comply with 42 C.F.R. 431.10(e). The department's rules governing~~	23963
~~medicaid are binding on other agencies that administer components~~	23964
~~of the medicaid program. No agency may establish, by rule or~~	23965
~~otherwise, a policy governing medicaid that is inconsistent with a~~	23966
~~medicaid policy established, in rule or otherwise, by the director~~	23967
~~of job and family services.~~	23968

~~(A)~~ The department of ~~job and family services~~health care	23969
administration may provide medical assistance under the medicaid	23970
program as long as federal funds are provided for such	23971
assistance, to the following:	23972

~~(1)~~(A) Families with children that meet ~~either of the~~	23973
~~following conditions:~~	23974

~~(a) The family meets~~ the income, resource, and family	23975
composition requirements in effect on July 16, 1996, for the	23976
former aid to dependent children program as those requirements	23977
were established by Chapter 5107. of the Revised Code, federal	23978
waivers granted pursuant to requests made under former section	23979
5101.09 of the Revised Code, and rules adopted ~~by the department~~	23980
for that former program or any changes the department makes to	23981
those requirements in accordance with ~~paragraph (a)(2) of section~~	23982
~~114 of the "Personal Responsibility and Work Opportunity~~	23983
~~Reconciliation Act of 1996," 110 Stat. 2177,~~ 42 U.S.C.A. 1396u-1,	23984
for the purpose of implementing section ~~5111.019~~5126.05 of the	23985
Revised Code. An adult loses eligibility for medicaid under	23986
division (A)~~(1)(a)~~ of this section pursuant to division (D) of	23987
section 5107.16 of the Revised Code.	23988

~~(b) The family does not meet the requirements specified in~~	23989
~~division (A)(1)(a) of this section but is eligible for medicaid~~	23990
~~pursuant to section 5101.18 of the Revised Code.~~	23991

~~(2)~~(B) Aged, blind, and disabled persons who meet either of	23992
the following conditions:	23993

~~(a)~~(1) Receive federal ~~aid~~benefits under ~~Title XVI of the~~	23994
~~"Social Security Act,"~~the supplemental security income program or	23995
are eligible for but are not receiving ~~such aid~~SSI benefits,	23996
provided that the income from all other sources for individuals	23997
with independent living arrangements shall not exceed one hundred	23998
seventy-five dollars per month. The income standards hereby	23999
established shall be adjusted annually at the rate that is used by	24000
the United States department of health and human services to	24001
adjust the amounts payable under ~~Title XVI~~the SSI program.	24002

~~(b)~~(2) Do not receive ~~aid under Title XVI~~supplemental	24003
security income benefits, but meet any of the following criteria:	24004

~~(i)~~(a) Would be eligible ~~to receive such aid~~for SSI	24005
benefits, except that their income, other than that excluded from	24006
consideration as income ~~under Title XVI~~for the SSI program,	24007
exceeds the maximum under division ~~(A)(2)(a)~~(B)(1) of this	24008
section, and incurred expenses for medical care, as determined	24009
under federal regulations applicable to section 209(b) of the	24010
"Social Security Amendments of 1972," 86 Stat. 1381, 42 U.S.C.A.	24011
1396a(f), as amended, equal or exceed the amount by which their	24012
income exceeds the maximum under division ~~(A)(2)(a)~~(B)(1) of this	24013
section;	24014

~~(ii)~~(b) Received aid for the aged, aid to the blind, or aid	24015
for the permanently and totally disabled prior to January 1, 1974,	24016
and continue to meet all the same eligibility requirements;	24017

~~(iii) Are eligible for medicaid pursuant to section 5101.18~~	24018
~~of the Revised Code~~(c) Lost eligibility for SSI benefits due to a	24019
general increase in old-age, survivors, and disability insurance	24020
benefits under Title II of the Social Security Act of 1935.	24021

~~(3)~~(C) Persons to whom federal law requires, as a condition	24022
of state participation in the medicaid program, that medicaid be	24023
provided;	24024

~~(4)~~(D) Persons under age twenty-one who meet the income	24025
requirements for the Ohio works first program established under	24026
Chapter 5107. of the Revised Code but do not meet other	24027
eligibility requirements for the program. The director shall	24028
adopt rules in accordance with Chapter 119. of the Revised Code	24029
specifying which Ohio works first requirements shall be waived for	24030
the purpose of providing medicaid eligibility under division	24031
(A)(4) of this section.	24032

~~(B) If sufficient funds are appropriated for the medicaid~~	24033
~~program, the department may provide medical assistance under the~~	24034
~~medicaid program to persons in groups designated by federal law~~	24035
~~as groups to which a state, at its option, may provide medical~~	24036
~~assistance under the medicaid program.~~	24037

~~(C) The department may expand eligibility for the medicaid~~	24038
~~program to include individuals under age nineteen with family~~	24039
~~incomes at or below one hundred fifty per cent of the federal~~	24040
~~poverty guidelines, except that the eligibility expansion shall~~	24041
~~not occur unless the department receives the approval of the~~	24042
~~federal government. The department may implement the eligibility~~	24043
~~expansion authorized under this division on any date selected by~~	24044
~~the department, but not sooner than January 1, 1998.~~	24045

~~(D) In addition to any other authority or requirement to~~	24046
~~adopt rules under this chapter, the director may adopt rules in~~	24047
~~accordance with section 111.15 of the Revised Code as the director~~	24048
~~considers necessary to establish standards, procedures, and other~~	24049
~~requirements regarding the provision of medical assistance under~~	24050
~~the medicaid program. The rules may establish requirements to be~~	24051
~~followed in applying for medicaid, making determinations of~~	24052
~~eligibility for medicaid, and verifying eligibility for medicaid.~~	24053
~~The rules may include special conditions as the department~~	24054
~~determines appropriate for making applications, determining~~	24055
~~eligibility, and verifying eligibility for any medical assistance~~	24056
~~that the department may provide under the medicaid program~~	24057
~~pursuant to division (C) of this section and section 5111.014 or~~	24058
~~5111.019 of the Revised Code.~~	24059

Sec. 5162.02. If funds are appropriated for such purpose by	24060
the general assembly, the department of health care administration	24061
may expand eligibility for the medicaid program to persons in	24062
groups designated by federal law as groups to which a state, at	24063
its option, may provide medical assistance under the medicaid	24064
program.	24065

Sec. 5162.03. The department of health care administration	24066
may expand eligibility for the medicaid program to individuals	24067
under nineteen years of age with family incomes at or below one	24068
hundred fifty per cent of the federal poverty guidelines, except	24069
that the eligibility expansion shall not occur unless the	24070
department receives the approval of the United States department	24071
of health and human services. The department may implement the	24072
eligibility expansion authorized by this section on any date	24073
selected by the department.	24074

~~Sec. 5111.014.~~ Sec. 5162.04. (A) The director of ~~job and family~~	24075
~~services~~health care administration shall submit to the United	24076
States secretary of health and human services an amendment to the	24077
state medicaid plan to make an individual who meets all of the	24078
following requirements eligible for medicaid:	24079

(1) The individual is pregnant;

24080

(2) The individual's family income does not exceed two	24081
hundred per cent of the federal poverty guidelines;	24082

(3) The individual satisfies all relevant requirements	24083
established by rules adopted under ~~division (D) of~~ section ~~5111.01~~	24084
5162.20 of the Revised Code.	24085

(B) If approved by the United States secretary of health and	24086
human services, the director of ~~job and family services~~health	24087
care administration shall implement the medicaid plan amendment	24088
submitted under division (A) of this section as soon as possible	24089
after receipt of notice of the approval, but not sooner than	24090
January 1, 2008.	24091

~~Sec. 5111.019.~~ Sec. 5162.05. The director of ~~job and family~~	24092
~~services~~health care administration shall submit to the United	24093
States secretary of health and human services an amendment to the	24094
state medicaid plan to make an individual eligible for medicaid	24095
who meets all of the following requirements:	24096

(A) The individual is the parent of a child under nineteen	24097
years of age and resides with the child;	24098

(B) The individual's family income does not exceed ninety	24099
per cent of the federal poverty guidelines;	24100

24101

(D) The individual satisfies all relevant requirements	24102
established by rules adopted under ~~division (D) of~~ section ~~5111.01~~	24103
5162.20 of the Revised Code.	24104

~~Sec. 5111.0111.~~ Sec. 5162.06. (A) The director of ~~job and family~~	24105
~~services~~health care administration shall submit to the United	24106
States secretary of health and human services an amendment to the	24107
state medicaid plan to implement 42 U.S.C. 1396a	24108
(a)(10)(A)(ii)(XVII) to make an individual who meets all of the	24109
following requirements eligible for medicaid:	24110

(1) The individual is under twenty-one years of age;

24111

(2) The individual was in foster care under the	24112
responsibility of the state on the individual's eighteenth	24113
birthday;	24114

(3) Foster care maintenance payments or independent living	24115
services were furnished under a program funded under Title IV-E	24116
of the Social Security Act of 1935 on the individual's behalf	24117
before the individual attained eighteen years of age;	24118

(4) The individual meets all other applicable eligibility	24119
requirements established in rules adopted under section ~~5111.011~~	24120
5162.20 of the Revised Code.	24121

(B) If approved by the United States secretary of health and	24122
human services, the director of ~~job and family services~~health	24123
care administration shall implement the medicaid plan amendment	24124
submitted under this section beginning January 1, 2008.	24125

~~Sec. 5111.0113.~~ Sec. 5162.07. Children who are in the temporary or	24126
permanent custody of a certified public or private nonprofit	24127
agency or institution or in adoptions subsidized under division	24128
(B) of section 5153.163 of the Revised Code are eligible for	24129
~~medical assistance through~~ the medicaid program ~~established under~~	24130
~~section 5111.01 of the Revised Code~~.	24131

~~Sec. 5111.0110.~~ Sec. 5162.08. (A) The director of ~~job and family~~	24132
~~services~~health care administration shall submit to the United	24133
States secretary of health and human services an amendment to the	24134
state medicaid plan to implement the "Breast and Cervical Cancer	24135
Prevention and Treatment Act of 2000," 114 Stat. 1381, 42 U.S.C.A.	24136
1396a, as amended, to provide medical assistance to women who meet	24137
all of the following requirements:	24138

(1) Are under age sixty-five;

24139

(2) Are not otherwise eligible for medicaid;

24140

(3) Have been screened for breast and cervical cancer under	24141
the centers for disease control and prevention breast and cervical	24142
cancer early detection program established under 42 U.S.C.A. 300k	24143
in accordance with 42 U.S.C.A. 300n;	24144

(4) Need treatment for breast or cervical cancer;

24145

(5) Are not otherwise covered under creditable coverage, as	24146
defined in 42 U.S.C.A. 300gg(c).	24147

(B) If the United States secretary of health and human	24148
services approves the state medicaid plan amendment submitted	24149
under division (A) of this section, the director of ~~job and family~~	24150
~~services~~health care administration shall implement the amendment.	24151
The medical assistance provided under the amendment shall be	24152
limited to medical assistance provided during the period in which	24153
a woman who meets the requirements of division (A) of this section	24154
requires treatment for breast or cervical cancer.	24155

~~Sec. 5111.0115.~~ Sec. 5162.09. (A) The department of ~~job and family~~	24156
~~services~~health care administration may provide medical assistance	24157
under the medicaid program, as long as federal funds are provided	24158
for such assistance, to each former participant of the Ohio works	24159
first program established under Chapter 5107. of the Revised Code	24160
who meets all of the following requirements:	24161

(1) Is ineligible to participate in Ohio works first solely	24162
as a result of increased income due to employment;	24163

(2) Is not covered by, and does not have access to, medical	24164
insurance coverage through the employer with benefits comparable	24165
to those provided under this section, as determined in accordance	24166
with rules adopted by the director of ~~job and family services~~	24167
health care administration under division (B) of this section;	24168

(3) Meets any other requirement established by rule adopted	24169
under division (B) of this section.	24170

(B) The director of ~~job and family services~~health care	24171
administration shall adopt such rules under Chapter 119. of the	24172
Revised Code as are necessary to implement and administer the	24173
~~medical assistance~~medicaid program under this section.	24174

(C) A person seeking to participate in ~~a program of medical~~	24175
~~assistance under~~the medicaid program pursuant to this section	24176
shall apply to the county department of job and family services in	24177
the county in which the applicant resides. The application shall	24178
be made on a form prescribed by the department of ~~job and family~~	24179
~~services~~health care administration and furnished by the county	24180
department.	24181

(D) If the county department of job and family services	24182
determines that a person is eligible to receive ~~medical assistance~~	24183
medicaid under this section, the department shall provide	24184
assistance, to the same extent and in the same manner as ~~medical~~	24185
~~assistance~~medicaid is provided to a person eligible for ~~medical~~	24186
~~assistance~~medicaid pursuant to division (A)~~(1)(a)~~ of section	24187
~~5111.01~~5162.01 of the Revised Code, for no longer than twelve	24188
months, beginning the month after the date the participant's	24189
eligibility for Ohio works first is terminated.	24190

~~Sec. 5111.70.~~ Sec. 5162.10. (A) As used in sections ~~5111.70~~	24191
5162.10 to ~~5111.7011~~5162.1011 of the Revised Code:	24192

"Applicant" means an individual who applies to participate	24193
in the medicaid buy-in for workers with disabilities program.	24194

"Earned income" has the meaning established by rules adopted	24195
under section ~~5111.708~~5162.108 of the Revised Code.	24196

"Employed individual with a medically improved disability"	24197
has the same meaning as in 42 U.S.C. 1396d(v).	24198

"Family" means an applicant or participant and the spouse	24199
and dependent children of the applicant or participant. If an	24200
applicant or participant is under eighteen years of age, "family"	24201
also means the parents of the applicant or participant.	24202

"Federal poverty guidelines" has the same meaning as in	24203
section 5101.46 of the Revised Code.	24204

"Health insurance" has the meaning established by rules	24205
adopted under section ~~5111.708~~5162.108 of the Revised Code.	24206

"Income" means earned income and unearned income.

24207

"Participant" means an individual who has been determined	24208
eligible for the medicaid buy-in for workers with disabilities	24209
program and is participating in the program.	24210

"Resources" has the meaning established by rules adopted	24211
under section ~~5111.708~~5162.108 of the Revised Code.	24212

"Spouse" has the meaning established in rules adopted under	24213
section ~~5111.708~~5162.108 of the Revised Code.	24214

~~"Supplemental security income program" means the program~~	24215
~~established under Title XVI of the "Social Security Act," 86 Stat.~~	24216
~~1329 (1972), 42 U.S.C. 1381, as amended.~~	24217

"Medicaid buy-in for workers with disabilities program"	24218
means the component of the medicaid program established under	24219
sections ~~5111.70~~5162.10 to ~~5111.7011~~5162.1011 of the Revised	24220
Code.	24221

"Unearned income" has the meaning established by rules	24222
adopted under section ~~5111.708~~5162.108 of the Revised Code.	24223

(B) Not later than one hundred eighty days after ~~the~~	24224
~~effective date of this section~~September 29, 2007, the director	24225
of ~~job and family services~~health care administration shall	24226
submit to the United States secretary of health and human	24227
services an amendment to the state medicaid plan and any	24228
federal waiver necessary to establish the medicaid buy-in for	24229
workers with disabilities program in accordance with 42 U.S.C.	24230
1396a(a) (10)(A)(ii)(XV) and (XVI) and sections ~~5111.70~~5162.10	24231
to ~~5111.7011~~5162.1011 of the Revised Code. The director shall	24232
implement sections ~~5111.701~~5162.101 to ~~5111.7011~~5162.1011 of	24233
the Revised Code if the amendment and, if needed, federal	24234
waiver are approved.	24235

~~Sec. 5111.701.~~ Sec. 5162.101. Under the medicaid buy-in for	24236
workers with disabilities program, an individual who does all of	24237
the following in accordance with rules adopted under section	24238
~~5111.708~~5162.108 of the Revised Code qualifies for medical	24239
assistance under the medicaid program:	24240

(A) Applies for the medicaid buy-in for workers with	24241
disabilities program;	24242

(B) Provides satisfactory evidence of all of the following:

24243

(1) That the individual is at least sixteen years of age and	24244
under sixty-five years of age;	24245

(2) Except as provided in section ~~5111.706~~5162.106 of the	24246
Revised Code, that one of the following applies to the	24247
individual:	24248

(a) The individual is considered disabled for the purpose of	24249
the supplemental security income program, regardless of whether	24250
the individual receives supplemental security income benefits, and	24251
the individual has earnings from employment.	24252

(b) The individual is an employed individual with a medically	24253
improved disability.	24254

(3) That the value of the individual's resources, less	24255
amounts disregarded pursuant to rules adopted under section	24256
~~5111.708~~5162.108 of the Revised Code, does not exceed the amount	24257
provided for by section ~~5111.702~~5162.102 of the Revised Code;	24258

(4) That the individual's income, less amounts disregarded	24259
pursuant to section ~~5111.703~~5162.103 of the Revised Code, does	24260
not exceed two hundred fifty per cent of the federal poverty	24261
guidelines;	24262

(5) That the individual meets the additional eligibility	24263
requirements for the medicaid buy-in for workers with disabilities	24264
program that ~~the director of job and family services establishes~~	24265
are established in rules adopted under section ~~5111.708~~5162.108	24266
of the Revised Code.	24267

(C) To the extent required by section ~~5111.704~~5162.104 of	24268
the Revised Code, pays the premium established under that	24269
section.	24270

~~Sec. 5111.702.~~ Sec. 5162.102. (A) Except as provided in division	24271
(B) of this section, the maximum value of resources, less amounts	24272
disregarded pursuant to rules adopted under section ~~5111.708~~	24273
5162.108 of the Revised Code, that an individual may have	24274
without the individual exceeding the resource eligibility limit	24275
for the medicaid buy-in for workers with disabilities program	24276
shall not exceed ten thousand dollars.	24277

(B) Each calendar year, the director of ~~job and family~~	24278
~~services~~health care administration shall adjust the resource	24279
eligibility limit specified in division (A) of this section by	24280
the change in the consumer price index for all items for all	24281
urban consumers for the previous calendar year, as published by	24282
the United States bureau of labor statistics. The annual	24283
adjustment shall go into effect on the earliest date possible.	24284

~~Sec. 5111.703.~~ Sec. 5162.103. For the purpose of determining	24285
whether an individual is within the income eligibility limit for	24286
the medicaid buy-in for workers with disabilities program, all	24287
of the following apply:	24288

(A) Twenty thousand dollars of the individual's earned	24289
income shall be disregarded.	24290

(B) No amount that the individual's employer pays to obtain	24291
health insurance for one or more members of the individual's	24292
family, including any amount of a premium established under	24293
section ~~5111.704~~5162.104 of the Revised Code that the employer	24294
pays, shall be treated as the individual's income.	24295

(C) Any other amounts, if any, specified in rules adopted	24296
under section ~~5111.708~~5162.108 of the Revised Code shall be	24297
disregarded from the individual's earned income, unearned	24298
income, or both.	24299

~~Sec. 5111.704.~~ Sec. 5162.104. An individual whose income exceeds	24300
one hundred fifty per cent of the federal poverty guidelines	24301
shall pay an annual premium as a condition of qualifying for the	24302
medicaid buy-in for workers with disabilities program. The amount	24303
of the premium shall be determined as follows:	24304

(A) Subtract one hundred fifty per cent of the federal	24305
poverty guidelines, as applicable for a family size equal to the	24306
size of the individual's family, from the amount of the income of	24307
the individual's family;	24308

(B) Subtract an amount specified in rules adopted under	24309
section ~~5111.708~~5162.108 of the Revised Code from the difference	24310
determined under division (A) of this section;	24311

(C) Multiply the difference determined under division (B) of	24312
this section by one tenth.	24313

~~Sec. 5111.705.~~ Sec. 5162.105. No individual shall be denied	24314
eligibility for the medicaid buy-in for workers with disabilities	24315
program on the basis that the individual receives services under	24316
a home and community-based services medicaid waiver component as	24317
defined in section ~~5111.851~~5163.51 of the Revised Code.	24318

~~Sec. 5111.706.~~ Sec. 5162.106. An individual participating in the	24319
medicaid buy-in for workers with disabilities program may	24320
continue to participate in the program for up to six months even	24321
though the individual ceases to have earnings from employment or	24322
to be an employed individual with a medically improved disability	24323
due to ceasing to be employed if the individual continues to meet	24324
all other eligibility requirements for the program.	24325

~~Sec. 5111.707.~~ Sec. 5162.107. If the United States secretary of	24326
health and human services requires that a provision in the	24327
amendment to the state medicaid plan or the federal waiver	24328
request submitted under section ~~5111.70~~5162.10 of the Revised	24329
Code be changed or removed in order for the secretary to approve	24330
the amendment or waiver or to avoid an extended delay in the	24331
secretary's approval, the director of ~~job and family services~~	24332
health care administration shall make the change or removal. The	24333
change or removal may cause the medicaid buy-in for workers with	24334
disabilities program to include a provision that is inconsistent	24335
with sections ~~5111.70~~5162.10 to ~~5111.706~~5162.106 of the Revised	24336
Code. Such a change or removal shall be made only to the extent	24337
necessary to obtain the United States secretary's approval or	24338
avoid an extended delay in the secretary's approval and shall be	24339
reflected in rules adopted under section ~~5111.708~~5162.108 of the	24340
Revised Code.	24341

~~Sec. 5111.708.~~ Sec. 5162.108. (A) The director of ~~job and family~~	24342
~~services~~health care administration, after consulting with the	24343
medicaid buy-in advisory council, shall adopt rules in accordance	24344
with Chapter 119. of the Revised Code as necessary to implement	24345
the medicaid buy-in for workers with disabilities program. The	24346
rules shall do all of the following:	24347

(1) Specify assets, asset values, and amounts to be	24348
disregarded in determining asset and income eligibility limits for	24349
the program;	24350

(2) Establish meanings for the terms "earned income," "health	24351
insurance," "resources," "spouse," and "unearned income";	24352

(3) Establish additional eligibility requirements for the	24353
program that must be established for the United States secretary	24354
of health and human services to approve the program;	24355

(4) For the purpose of division (B) of section ~~5111.704~~	24356
5162.104 of the Revised Code, specify an amount to be subtracted	24357
from the difference determined under division (A) of that	24358
section.	24359

(B) The director, after consulting with the medicaid buy-in	24360
advisory council, may adopt rules in accordance with Chapter 119.	24361
of the Revised Code to specify amounts to be disregarded from an	24362
individual's earned income, unearned income, or both under	24363
division (C) of section ~~5111.703~~5162.103 of the Revised Code for	24364
the purpose of determining whether the individual is within the	24365
income eligibility limit for the medicaid buy-in for workers with	24366
disabilities program.	24367

~~Sec. 5111.709.~~ Sec. 5162.109. (A) There is hereby created the	24368
medicaid buy-in advisory council. The council shall consist of	24369
all of the following:	24370

(1) The following voting members:

24371

(a) The executive director of assistive technology of Ohio or	24372
the executive director's designee;	24373

(b) The director of the axis center for public awareness of	24374
people with disabilities or the director's designee;	24375

(c) The executive director of the cerebral palsy association	24376
of Ohio or the executive director's designee;	24377

(d) The chief executive officer of Ohio advocates for mental	24378
health or the chief executive officer's designee;	24379

(e) The state director of the Ohio chapter of AARP or the	24380
state director's designee;	24381

(f) The director of the Ohio developmental disabilities	24382
council created under section 5123.35 of the Revised Code or the	24383
director's designee;	24384

(g) The executive director of the governor's council on	24385
people with disabilities created under section 3303.41 of the	24386
Revised Code or the executive director's designee;	24387

(h) The administrator of the legal rights service created	24388
under section 5123.60 of the Revised Code or the administrator's	24389
designee;	24390

(i) The chairperson of the Ohio Olmstead task force or the	24391
chairperson's designee;	24392

(j) The executive director of the Ohio statewide independent	24393
living council or the executive director's designee;	24394

(k) The president of the Ohio chapter of the national	24395
multiple sclerosis society or the president's designee;	24396

(l) The executive director of the arc of Ohio or the	24397
executive director's designee;	24398

(m) The executive director of the commission on minority	24399
health or the executive director's designee;	24400

(n) The executive director of the brain injury association of	24401
Ohio or the executive director's designee;	24402

(o) The executive officer of any other advocacy organization	24403
who volunteers to serve on the council, or such an executive	24404
officer's designee, if the other voting members, at a meeting	24405
called by the chairperson elected under division (C) of this	24406
section, determine it is appropriate for the advocacy organization	24407
to be represented on the council;	24408

(p) One or more participants who volunteer to serve on the	24409
council and are selected by the other voting members at a meeting	24410
the chairperson calls after the medicaid buy-in for workers with	24411
disabilities program is implemented.	24412

(2) The following non-voting members:

24413

(a) The director of ~~job and family services~~health care	24414
administration or the director's designee;	24415

(b) The administrator of the rehabilitation services	24416
commission or the administrator's designee;	24417

(c) The director of alcohol and drug addiction services or	24418
the director's designee;	24419

(d) The director of mental retardation and developmental	24420
disabilities or the director's designee;	24421

(e) The director of mental health or the director's designee;

24422

(f) The executive officer of any other government entity, or	24423
the executive officer's designee, if the voting members, at a	24424
meeting called by the chairperson, determine it is appropriate for	24425
the government entity to be represented on the council.	24426

(B) All members of the medicaid buy-in advisory council shall	24427
serve without compensation or reimbursement, except as serving on	24428
the council is considered part of their usual job duties.	24429

(C) The voting members of the medicaid buy-in advisory	24430
council shall elect one of the members of the council to serve as	24431
the council's chairperson for a two-year term. The chairperson	24432
may be re-elected to successive terms.	24433

(D) The department of ~~job and family services~~health care	24434
administration shall provide the Ohio medicaid buy-in advisory	24435
council with accommodations for the council to hold its meetings	24436
and shall provide the council with other administrative	24437
assistance the council needs to perform its duties.	24438

~~Sec. 5111.7010.~~ Sec. 5162.1010. The director of ~~job and family~~	24439
~~services~~health care administration or the director's designee	24440
shall consult with the medicaid buy-in advisory council before	24441
adopting, amending, or rescinding any rules under section	24442
~~5111.708~~5162.108 of the Revised Code governing the medicaid	24443
buy-in for workers with disabilities program.	24444

The director or designee shall meet at least quarterly with	24445
the council to discuss the program. At the meetings, the council	24446
may provide the director or designee with suggestions for	24447
improving the program and the director or designee shall provide	24448
the council with all of the following information:	24449

(A) The number of individuals who participated in the program	24450
the previous calendar quarter;	24451

(B) The cost of the program the previous calendar quarter;

24452

(C) The amount of revenue generated the previous quarter by	24453
premiums that participants pay under section ~~5111.704~~5162.104 of	24454
the Revised Code;	24455

(D) The average amount of earned income of participants'	24456
families;	24457

(E) The average amount of time participants have participated	24458
in the program;	24459

(F) The types of other health insurance participants have	24460
been able to obtain.	24461

~~Sec. 5111.7011.~~ Sec. 5162.1011. Not less than once each year, the	24462
director of ~~job and family services~~health care administration	24463
shall submit a report on the medicaid buy-in for workers with	24464
disabilities program to the governor, speaker and minority leader	24465
of the house of representatives, president and minority leader of	24466
the senate, and chairpersons of the house and senate committees	24467
to which the biennial operating budget bill is referred. The	24468
report shall include all of the following information:	24469

(A) The number of individuals who participated in the	24470
medicaid buy-in for workers with disabilities program;	24471

(B) The cost of the program;

24472

(C) The amount of revenue generated by premiums that	24473
participants pay under section ~~5111.704~~5162.104 of the Revised	24474
Code;	24475

(D) The average amount of earned income of participants'	24476
families;	24477

(E) The average amount of time participants have participated	24478
in the program;	24479

(F) The types of other health insurance participants have	24480
been able to obtain.	24481

~~Sec. 5111.013.~~ Sec. 5162.15. (A) The provision of ~~medical~~	24482
~~assistance~~medicaid to pregnant women and young children who are	24483
eligible for ~~medical assistance~~medicaid under division ~~(A)(3)~~(C)	24484
of section ~~5111.01~~5162.01 of the Revised Code, but who are not	24485
otherwise eligible for ~~medical assistance~~medicaid under that	24486
section, shall be known as the healthy start program.	24487

(B) The department of ~~job and family services~~health care	24488
administration shall do all of the following with regard to the	24489
application procedures for the healthy start program:	24490

(1) Establish a short application form for the program that	24491
requires the applicant to provide no more information than is	24492
necessary for making determinations of eligibility for the healthy	24493
start program, except that the form may require applicants to	24494
provide their social security numbers. The form shall include a	24495
statement, which must be signed by the applicant, indicating that	24496
she does not choose at the time of making application for the	24497
program to apply for assistance provided under any other program	24498
administered by the department and that she understands that she	24499
is permitted at any other time to apply at the county department	24500
of job and family services of the county in which she resides for	24501
any other assistance administered by the department or department	24502
of job and family services.	24503

(2) To the extent permitted by federal law, do one or both of	24504
the following:	24505

(a) Distribute the application form for the program to each	24506
public or private entity that serves as a women, infants, and	24507
children clinic or as a child and family health clinic and to each	24508
administrative body for such clinics and train employees of each	24509
such agency or entity to provide applicants assistance in	24510
completing the form;	24511

(b) In cooperation with the department of health, develop	24512
arrangements under which employees of county departments of job	24513
and family services are stationed at public or private agencies or	24514
entities selected by the department of ~~job and family services~~	24515
health care administration that serve as women, infants, and	24516
children clinics; child and family health clinics; or	24517
administrative bodies for such clinics for the purpose both of	24518
assisting applicants for the program in completing the application	24519
form and of making determinations at that location of eligibility	24520
for the program.	24521

(3) Establish performance standards by which a county	24522
department of job and family services' level of enrollment of	24523
persons potentially eligible for the program can be measured, and	24524
establish acceptable levels of enrollment for each county	24525
department.	24526

(4) Direct any county department of job and family services	24527
whose rate of enrollment of potentially eligible enrollees in the	24528
program is below acceptable levels established under division	24529
(B)(3) of this section to implement corrective action. Corrective	24530
action may include but is not limited to any one or more of the	24531
following to the extent permitted by federal law:	24532

(a) Establishing formal referral and outreach methods with	24533
local health departments and local entities receiving funding	24534
through the bureau of maternal and child health;	24535

(b) Designating a specialized intake unit within the county	24536
department for healthy start applicants;	24537

(c) Establishing abbreviated timeliness requirements to	24538
shorten the time between receipt of an application and the	24539
scheduling of an initial application interview;	24540

(d) Establishing a system for telephone scheduling of intake	24541
interviews for applicants;	24542

(e) Establishing procedures to minimize the time an applicant	24543
must spend in completing the application and eligibility	24544
determination process, including permitting applicants to complete	24545
the process at times other than the regular business hours of the	24546
county department and at locations other than the offices of the	24547
county department.	24548

(C) To the extent permitted by federal law, local funds,	24549
whether from public or private sources, expended by a county	24550
department for administration of the healthy start program shall	24551
be considered to have been expended by the state for the purpose	24552
of determining the extent to which the state has complied with any	24553
federal requirement that the state provide funds to match federal	24554
funds for ~~medical assistance~~medicaid, except that this division	24555
shall not affect the amount of funds the county is entitled to	24556
receive under section ~~5101.16, 5101.161,~~5160.26 or ~~5111.012~~	24557
5160.261 of the Revised Code.	24558

(D) The director of ~~job and family services~~health care	24559
administration shall do one or both of the following:	24560

(1) To the extent that federal funds are provided for such	24561
assistance, adopt a plan for granting presumptive eligibility for	24562
pregnant women applying for healthy start;	24563

(2) To the extent permitted by federal medicaid regulations,	24564
adopt a plan for making same-day determinations of eligibility for	24565
pregnant women applying for healthy start.	24566

(E) A county department of job and family services that	24567
maintains offices at more than one location shall accept	24568
applications for the healthy start program at all of those	24569
locations.	24570

(F) The director of ~~job and family services~~health care	24571
administration shall adopt rules in accordance with section 111.15	24572
of the Revised Code as necessary to implement this section.	24573

~~Sec. 5111.016.~~ Sec. 5162.16. (A) As used in this section,	24574
"healthcheck" has the same meaning as in section 3313.714 of the	24575
Revised Code.	24576

(B) The department of ~~job and family services~~health care	24577
administration shall adopt rules in accordance with Chapter 119.	24578
of the Revised Code establishing a combination of written and	24579
oral methods designed to provide information about healthcheck	24580
to all persons eligible for the program or their parents or	24581
guardians. The department shall ensure that its methods of	24582
providing information are effective. The methods shall comply	24583
with federal law and regulations.	24584

Each county department of job and family services or other	24585
entity that distributes or accepts applications for ~~medical~~	24586
~~assistance~~medicaid shall prominently display a notice that	24587
complies with the rules adopted under this division.	24588

Sec. 5162.17. The department of health care administration	24589
shall establish a disability determination unit and develop	24590
guidelines for expediting reviews of applications for the medicaid	24591
program for persons who have been referred to the unit under	24592
division (D) of section 329.043 of the Revised Code. The	24593
department shall make determinations of eligibility for medicaid	24594
for any such person within the time prescribed by federal	24595
regulations.	24596

~~Sec. 5111.0119.~~ Sec. 5162.18. (A)(1) As used in this section,	24597
subject to division (A)(2) of this section, "state or local	24598
correctional facility" means any of the following:	24599

(a) A "state correctional institution," as defined in section	24600
2967.01 of the Revised Code;	24601

(b) A "local correctional facility," as defined in section	24602
2903.13 of the Revised Code;	24603

(c) A correctional facility that is privately operated and	24604
managed pursuant to section 9.06 of the Revised Code.	24605

(2) "State or local correctional facility" does not include	24606
any facility operated directly by or at the direction of the	24607
department of youth services.	24608

(B) If a person who is confined in a state or local	24609
correctional facility was a medicaid recipient immediately prior	24610
to being confined in the facility, all of the following apply:	24611

(1) The person's eligibility for medicaid while so confined	24612
shall be suspended due to the confinement.	24613

(2) No medicaid payment shall be made for any care,	24614
services, or supplies provided to the person during the	24615
suspension described in division (B)(1) of this section.	24616

(3) The suspension described in division (B)(1) of this	24617
section shall end upon the release of the person from the	24618
confinement.	24619

(4) Except as provided in division (C) of this section, the	24620
person shall not be required to reapply or undergo a	24621
redetermination of eligibility for medicaid when the suspension	24622
described in division (B)(1) of this section ends.	24623

(C) A person may be disenrolled from medicaid any time after	24624
the suspension described in division (B)(1) of this section ends	24625
if the person is no longer eligible for medicaid. A person may be	24626
required to undergo a redetermination of eligibility for medicaid	24627
any time after the suspension described in division (B)(1) of this	24628
section ends if it is time or past time for the person's	24629
eligibility redetermination or the person's circumstances have	24630
changed in a manner warranting a redetermination.	24631

(D) The department of ~~job and family services~~health care	24632
administration shall take the steps necessary to begin	24633
implementation of this section not later than September 1, 2009.	24634

~~Sec. 5111.011.~~ Sec. 5162.20. (A) The director of ~~job and family~~	24635
~~services~~health care administration shall adopt rules establishing	24636
eligibility requirements for the medicaid program. The rules shall	24637
be adopted pursuant to section 111.15 of the Revised Code and	24638
shall be consistent with federal and state law. The rules shall	24639
include rules that do all of the following:	24640

(1) Establish requirements to be followed in applying for	24641
medicaid, making determinations of eligibility for medicaid, and	24642
verifying eligibility for medicaid;	24643

(2) Establish standards consistent with federal law for	24644
allocating income and resources as income and resources of the	24645
spouse, children, parents, or stepparents of a recipient of or	24646
applicant for medicaid;	24647

~~(2)~~(3) Define the term "resources" as used in division	24648
(A)~~(1)~~(2) of this section;	24649

~~(3)~~(4) Specify the number of months that is to be used for	24650
the purpose of the term "look-back date" used in section ~~5111.0116~~	24651
5162.21 of the Revised Code;	24652

~~(4)~~(5) Establish processes to be used to determine both of	24653
the following:	24654

(a) The date an institutionalized individual's ineligibility	24655
for services under section ~~5111.0116~~5162.21 of the Revised Code	24656
is to begin;	24657

(b) The number of months an institutionalized individual's	24658
ineligibility for such services is to continue.	24659

~~(5)~~(6) Establish exceptions to the period of ineligibility	24660
that an institutionalized individual would otherwise be subject to	24661
under section ~~5111.0116~~5162.21 of the Revised Code;	24662

~~(6)~~(7) Define the term "other medicaid-funded long-term care	24663
services" as used in sections ~~5111.0117~~5162.22 and ~~5111.0118~~	24664
5162.23 of the Revised Code;	24665

~~(7)~~(8) For the purpose of division (C)(2)(c) of section	24666
~~5111.0117~~5162.22 of the Revised Code, establish the process to	24667
determine whether the child of an aged, blind, or disabled	24668
individual is financially dependent on the individual for housing.	24669

(B) Notwithstanding any provision of state law, including	24670
statutes, administrative rules, common law, and court rules,	24671
regarding real or personal property or domestic relations, the	24672
standards established under rules adopted under division (A)~~(1)~~(2)	24673
of this section shall be used to determine eligibility for	24674
medicaid.	24675

~~Sec. 5111.0116.~~ Sec. 5162.21. (A) As used in this section:

24676

(1) "Assets" include all of an individual's income and	24677
resources and those of the individual's spouse, including any	24678
income or resources the individual or spouse is entitled to but	24679
does not receive because of action by any of the following:	24680

(a) The individual or spouse;

24681

(b) A person or government entity, including a court or	24682
administrative agency, with legal authority to act in place of or	24683
on behalf of the individual or spouse;	24684

(c) A person or government entity, including a court or	24685
administrative agency, acting at the direction or on the request	24686
of the individual or spouse.	24687

(2) "Home and community-based services" means home and	24688
community-based services furnished under a medicaid waiver granted	24689
by the United States secretary of health and human services under	24690
42 U.S.C. 1396n(c) or (d).	24691

(3) "Institutionalized individual" means a resident of a	24692
nursing facility, an inpatient in a medical institution for whom a	24693
payment is made based on a level of care provided in a nursing	24694
facility, or an individual described in 42 U.S.C.	24695
1396a(a)(10)(A)(ii)(VI).	24696

(4) "Look-back date" means the date that is a number of	24697
months specified in rules adopted under section ~~5111.011~~5162.20	24698
of the Revised Code immediately before either of the following:	24699

(a) The date an individual becomes an institutionalized	24700
individual if the individual is eligible for medicaid on that	24701
date;	24702

(b) The date an individual applies for medicaid while an	24703
institutionalized individual.	24704

(5) "Nursing facility" has the same meaning as in section	24705
~~5111.20~~5164.01 of the Revised Code.	24706

(6) "Nursing facility equivalent services" means services	24707
that are covered by the medicaid program, equivalent to nursing	24708
facility services, provided by an institution that provides the	24709
same level of care as a nursing facility, and provided to an	24710
inpatient of the institution who is a medicaid recipient eligible	24711
for medicaid-covered nursing facility equivalent services.	24712

(7) "Nursing facility services" means nursing facility	24713
services covered by the medicaid program that a nursing facility	24714
provides to a resident of the nursing facility who is a medicaid	24715
recipient eligible for medicaid-covered nursing facility services.	24716

(B) Except as provided in rules adopted under section	24717
~~5111.011~~5162.20 of the Revised Code, an institutionalized	24718
individual is ineligible for nursing facility services, nursing	24719
facility equivalent services, and home and community-based	24720
services if the individual or individual's spouse disposes of	24721
assets for less than fair market value on or after the look-back	24722
date. The institutionalized individual's ineligibility shall begin	24723
on a date determined in accordance with rules adopted under	24724
section ~~5111.011~~5162.20 of the Revised Code and shall continue	24725
for a number of months determined in accordance with such rules.	24726

(C) To secure compliance with this section, the director of	24727
~~job and family services~~health care administration may require an	24728
individual, as a condition of initial or continued eligibility for	24729
medicaid, to provide documentation of the individual's assets up	24730
to five years before the date the individual becomes an	24731
institutionalized individual if the individual is eligible for	24732
medicaid on that date or the date the individual applies for	24733
medicaid while an institutionalized individual. Documentation may	24734
include tax returns, records from financial institutions, and real	24735
property records.	24736

~~Sec. 5111.0117.~~ Sec. 5162.22. (A) As used in this section and	24737
section ~~5111.0118~~5162.23 of the Revised Code:	24738

(1) "ICF/MR services" means intermediate care facility for	24739
the mentally retarded services covered by the medicaid program	24740
that an intermediate care facility for the mentally retarded	24741
provides to a resident of the facility who is a medicaid recipient	24742
eligible for medicaid-covered intermediate care facility for the	24743
mentally retarded services.	24744

(2) "Intermediate care facility for the mentally retarded"	24745
has the same meaning as in section ~~5111.20~~5164.01 of the Revised	24746
Code.	24747

(3) "Nursing facility" has the same meaning as in section	24748
~~5111.20~~5164.01 of the Revised Code.	24749

(4) "Nursing facility services" means nursing facility	24750
services covered by the medicaid program that a nursing facility	24751
provides to a resident of the nursing facility who is a medicaid	24752
recipient eligible for medicaid-covered nursing facility services.	24753

(5) "Other medicaid-funded long-term care services" has the	24754
meaning specified in rules adopted under section ~~5111.011~~5162.20	24755
of the Revised Code.	24756

(B) Except as provided by division (C) of this section and	24757
for the purpose of determining whether an aged, blind, or disabled	24758
individual is eligible for nursing facility services, ICF/MR	24759
services, or other medicaid-funded long-term care services, the	24760
director of ~~job and family services~~health care administration may	24761
consider an aged, blind, or disabled individual's real property to	24762
not be the individual's homestead or principal place of residence	24763
once the individual has resided in a nursing facility,	24764
intermediate care facility for the mentally retarded, or other	24765
medical institution for at least thirteen months.	24766

(C) Division (B) of this section does not apply to an	24767
individual if any of the following reside in the individual's real	24768
property that, because of this division, continues to be	24769
considered the individual's homestead or principal place of	24770
residence:	24771

(1) The individual's spouse;

24772

(2) The individual's child if any of the following apply:

24773

(a) The child is under twenty-one years of age.

24774

(b) The child is considered blind or disabled under 42 U.S.C.	24775
1382c.	24776

(c) The child is financially dependent on the individual for	24777
housing as determined in accordance with rules adopted under	24778
section ~~5111.011~~5162.20 of the Revised Code.	24779

(3) The individual's sibling if the sibling has a verified	24780
equity interest in the real property and resided in the real	24781
property for at least one year immediately before the date the	24782
individual was admitted to the nursing facility, intermediate care	24783
facility for the mentally retarded, or other medical institution.	24784

~~Sec. 5111.0118.~~ Sec. 5162.23. (A) Except as otherwise provided by	24785
this section, no individual shall qualify for nursing facility	24786
services or other medicaid-funded long-term care services if the	24787
individual's equity interest in the individual's home exceeds five	24788
hundred thousand dollars. The director of ~~job and family services~~	24789
health care administration shall increase this amount effective	24790
January 1, 2011, and the first day of each year thereafter, by the	24791
percentage increase in the consumer price index for all urban	24792
consumers (all items; United States city average), rounded to the	24793
nearest one thousand dollars.	24794

(B) This section does not apply to an individual if either of	24795
the following applies:	24796

(1) Either of the following lawfully reside in the	24797
individual's home:	24798

(a) The individual's spouse;

24799

(b) The individual's child if the child is under twenty-one	24800
years of age or, under 42 U.S.C. 1382c, considered blind or	24801
disabled.	24802

(2) The individual qualifies, pursuant to the process	24803
established under division (C) of this section, for a waiver of	24804
this section due to a demonstrated hardship.	24805

(C) The director shall establish a process by which	24806
individuals may obtain a waiver of this section due to a	24807
demonstrated hardship. The process shall be consistent with the	24808
process for such waivers established by the United States	24809
secretary of health and human services under 42 U.S.C.	24810
1396p(f)(4).	24811

(D) Nothing in this section shall be construed as preventing	24812
an individual from using a reverse mortgage or home equity loan to	24813
reduce the individual's total equity interest in the home.	24814

~~Sec. 5111.015.~~ Sec. 5162.24. (A) If the United States secretary of	24815
health and human services grants a waiver of any contrary federal	24816
requirements governing the ~~medical assistance~~medicaid program or	24817
the director of ~~job and family services~~health care administration	24818
determines that there are no contrary federal requirements,	24819
divisions (A)(1) and (2) of this section apply to determinations	24820
of eligibility under this chapter:	24821

(1) In determining the eligibility of an assistance group for	24822
assistance under this chapter, the department of ~~job and family~~	24823
~~services~~health care administration shall exclude from the income	24824
and resources applicable to the assistance group the value of any	24825
tuition payment contract entered into under section 3334.09 of the	24826
Revised Code or any scholarship awarded under section 3334.18 of	24827
the Revised Code and the amount of payments made by the Ohio	24828
tuition trust authority under section 3334.09 of the Revised Code	24829
pursuant to the contract or scholarship.	24830

(2) The department shall not require any person to terminate	24831
a tuition payment contract entered into under Chapter 3334. of the	24832
Revised Code as a condition of an assistance group's eligibility	24833
for ~~assistance under this chapter~~medicaid.	24834

(B) To the extent required by federal law, the department	24835
shall include as income any refund paid under section 3334.10 of	24836
the Revised Code to a member of the assistance group.	24837

(C) Not later than sixty days after July 1, 1994, the	24838
department shall apply to the United States department of health	24839
and human services for a waiver of any federal requirements that	24840
otherwise would be violated by implementation of division (A) of	24841
this section.	24842

~~Sec. 5111.15.~~ Sec. 5162.25. If a medicaid recipient ~~of medical~~	24843
~~assistance~~ is the beneficiary of a trust created pursuant to	24844
section 5815.28 of the Revised Code, then, notwithstanding any	24845
contrary provision of this chapter or of a rule adopted pursuant	24846
to this chapter, divisions (C) and (D) of that section shall apply	24847
in determining the assets or resources of the recipient, the	24848
recipient's estate, the settlor, or the settlor's estate and to	24849
claims arising under this chapter against the recipient, the	24850
recipient's estate, the settlor, or the settlor's estate.	24851

~~Sec. 5111.151.~~ Sec. 5162.26. (A) This section applies to	24852
eligibility determinations for all cases involving ~~medicaid~~	24853
medical assistance provided ~~pursuant to this chapter~~under the	24854
medicaid program, qualified medicare beneficiaries, specified	24855
low-income medicare beneficiaries, qualifying individuals-1,	24856
qualifying individuals-2, and ~~medical assistance~~medicaid for	24857
covered families and children.	24858

(B) As used in this section:

24859

(1) "Trust" means any arrangement in which a grantor	24860
transfers real or personal property to a trust with the intention	24861
that it be held, managed, or administered by at least one trustee	24862
for the benefit of the grantor or beneficiaries. "Trust" includes	24863
any legal instrument or device similar to a trust.	24864

(2) "Legal instrument or device similar to a trust" includes,	24865
but is not limited to, escrow accounts, investment accounts,	24866
partnerships, contracts, and other similar arrangements that are	24867
not called trusts under state law but are similar to a trust and	24868
to which all of the following apply:	24869

(a) The property in the trust is held, managed, retained, or	24870
administered by a trustee.	24871

(b) The trustee has an equitable, legal, or fiduciary duty to	24872
hold, manage, retain, or administer the property for the benefit	24873
of the beneficiary.	24874

(c) The trustee holds identifiable property for the	24875
beneficiary.	24876

(3) "Grantor" is a person who creates a trust, including all	24877
of the following:	24878

(a) An individual;

24879

(b) An individual's spouse;

24880

(c) A person, including a court or administrative body, with	24881
legal authority to act in place of or on behalf of an individual	24882
or an individual's spouse;	24883

(d) A person, including a court or administrative body, that	24884
acts at the direction or on request of an individual or the	24885
individual's spouse.	24886

(4) "Beneficiary" is a person or persons, including a	24887
grantor, who benefits in some way from a trust.	24888

(5) "Trustee" is a person who manages a trust's principal and	24889
income for the benefit of the beneficiaries.	24890

(6) "Person" has the same meaning as in section 1.59 of the	24891
Revised Code and includes an individual, corporation, business	24892
trust, estate, trust, partnership, and association.	24893

(7) "Applicant" is an individual who applies for medicaid or	24894
the individual's spouse.	24895

(8) "Recipient" is an individual who receives medicaid or the	24896
individual's spouse.	24897

(9) "Revocable trust" is a trust that can be revoked by the	24898
grantor or the beneficiary, including all of the following, even	24899
if the terms of the trust state that it is irrevocable:	24900

(a) A trust that provides that the trust can be terminated	24901
only by a court;	24902

(b) A trust that terminates on the happening of an event, but	24903
only if the event occurs at the direction or control of the	24904
grantor, beneficiary, or trustee.	24905

(10) "Irrevocable trust" is a trust that cannot be revoked by	24906
the grantor or terminated by a court and that terminates only on	24907
the occurrence of an event outside of the control or direction of	24908
the beneficiary or grantor.	24909

(11) "Payment" is any disbursal from the principal or income	24910
of the trust, including actual cash, noncash or property	24911
disbursements, or the right to use and occupy real property.	24912

(12) "Payments to or for the benefit of the applicant or	24913
recipient" is a payment to any person resulting in a direct or	24914
indirect benefit to the applicant or recipient.	24915

(13) "Testamentary trust" is a trust that is established by a	24916
will and does not take effect until after the death of the person	24917
who created the trust.	24918

(C) If an applicant or recipient is a beneficiary of a trust,	24919
the county department of job and family services shall determine	24920
what type of trust it is and shall treat the trust in accordance	24921
with the appropriate provisions of this section and rules adopted	24922
by the department of ~~job and family services~~health care	24923
administration governing trusts. The county department of job and	24924
family services may determine that the trust or portion of the	24925
trust is one of the following:	24926

(1) A countable resource;

24927

(2) Countable income;

24928

(3) A countable resource and countable income;

24929

(4) Not a countable resource or countable income.

24930

(D)(1) A trust or legal instrument or device similar to a	24931
trust shall be considered a medicaid qualifying trust if all of	24932
the following apply:	24933

(a) The trust was established on or prior to August 10, 1993.

24934

(b) The trust was not established by a will.

24935

24936

(d) The applicant or recipient is or may become the	24937
beneficiary of all or part of the trust.	24938

(e) Payment from the trust is determined by one or more	24939
trustees who are permitted to exercise any discretion with respect	24940
to the distribution to the applicant or recipient.	24941

(2) If a trust meets the requirement of division (D)(1) of	24942
this section, the amount of the trust that is considered by the	24943
county department of job and family services as an available	24944
resource to the applicant or recipient shall be the maximum amount	24945
of payments permitted under the terms of the trust to be	24946
distributed to the applicant or recipient, assuming the full	24947
exercise of discretion by the trustee or trustees. The maximum	24948
amount shall include only amounts that are permitted to be	24949
distributed but are not distributed from either the income or	24950
principal of the trust.	24951

(3) Amounts that are actually distributed from a medicaid	24952
qualifying trust to a beneficiary for any purpose shall be treated	24953
in accordance with rules adopted by the department of ~~job and~~	24954
~~family services~~health care administration governing income.	24955

(4) Availability of a medicaid qualifying trust shall be	24956
considered without regard to any of the following:	24957

(a) Whether or not the trust is irrevocable or was	24958
established for purposes other than to enable a grantor to qualify	24959
for medicaid, ~~medical assistance~~medicaid for covered families and	24960
children, or as a qualified medicare beneficiary, specified	24961
low-income medicare beneficiary, qualifying individual-1, or	24962
qualifying individual-2;	24963

(b) Whether or not the trustee actually exercises discretion.

24964

(5) If any real or personal property is transferred to a	24965
medicaid qualifying trust that is not distributable to the	24966
applicant or recipient, the transfer shall be considered an	24967
improper disposition of assets and shall be subject to section	24968
~~5111.0116~~5162.21 of the Revised Code and rules to implement that	24969
section adopted under section ~~5111.011~~5162.20 of the Revised	24970
Code.	24971

(6) The baseline date for the look-back period for	24972
disposition of assets involving a medicaid qualifying trust shall	24973
be the date on which the applicant or recipient is both	24974
institutionalized and first applies for medicaid.	24975

(E)(1) A trust or legal instrument or device similar to a	24976
trust shall be considered a self-settled trust if all of the	24977
following apply:	24978

(a) The trust was established on or after August 11, 1993.

24979

(b) The trust was not established by a will.

24980

(c) The trust was established by an applicant or recipient,	24981
spouse of an applicant or recipient, or a person, including a	24982
court or administrative body, with legal authority to act in place	24983
of or on behalf of an applicant, recipient, or spouse, or acting	24984
at the direction or on request of an applicant, recipient, or	24985
spouse.	24986

(2) A trust that meets the requirements of division (E)(1) of	24987
this section and is a revocable trust shall be treated by the	24988
county department of job and family services as follows:	24989

(a) The corpus of the trust shall be considered a resource	24990
available to the applicant or recipient.	24991

(b) Payments from the trust to or for the benefit of the	24992
applicant or recipient shall be considered unearned income of the	24993
applicant or recipient.	24994

(c) Any other payments from the trust shall be considered an	24995
improper disposition of assets and shall be subject to section	24996
~~5111.0116~~5162.21 of the Revised Code and rules to implement that	24997
section adopted under section ~~5111.011~~5162.20 of the Revised	24998
Code.	24999

(3) A trust that meets the requirements of division (E)(1) of	25000
this section and is an irrevocable trust shall be treated by the	25001
county department of job and family services as follows:	25002

(a) If there are any circumstances under which payment from	25003
the trust could be made to or for the benefit of the applicant or	25004
recipient, including a payment that can be made only in the	25005
future, the portion from which payments could be made shall be	25006
considered a resource available to the applicant or recipient. The	25007
county department of job and family services shall not take into	25008
account when payments can be made.	25009

(b) Any payment that is actually made to or for the benefit	25010
of the applicant or recipient from either the corpus or income	25011
shall be considered unearned income.	25012

(c) If a payment is made to someone other than to the	25013
applicant or recipient and the payment is not for the benefit of	25014
the applicant or recipient, the payment shall be considered an	25015
improper disposition of assets and shall be subject to section	25016
~~5111.0116~~5162.21 of the Revised Code and rules to implement that	25017
section adopted under section ~~5111.011~~5162.20 of the Revised	25018
Code.	25019

(d) The date of the disposition shall be the later of the	25020
date of establishment of the trust or the date of the occurrence	25021
of the event.	25022

(e) When determining the value of the disposed asset under	25023
this provision, the value of the trust shall be its value on the	25024
date payment to the applicant or recipient was foreclosed.	25025

(f) Any income earned or other resources added subsequent to	25026
the foreclosure date shall be added to the total value of the	25027
trust.	25028

(g) Any payments to or for the benefit of the applicant or	25029
recipient after the foreclosure date but prior to the application	25030
date shall be subtracted from the total value. Any other payments	25031
shall not be subtracted from the value.	25032

(h) Any addition of assets after the foreclosure date shall	25033
be considered a separate disposition.	25034

(4) If a trust is funded with assets of another person or	25035
persons in addition to assets of the applicant or recipient, the	25036
applicable provisions of this section and rules adopted by the	25037
department of ~~job and family services~~health care administration	25038
governing trusts shall apply only to the portion of the trust	25039
attributable to the applicant or recipient.	25040

(5) The availability of a self-settled trust shall be	25041
considered without regard to any of the following:	25042

(a) The purpose for which the trust is established;

25043

(b) Whether the trustees have exercised or may exercise	25044
discretion under the trust;	25045

(c) Any restrictions on when or whether distributions may be	25046
made from the trust;	25047

(d) Any restrictions on the use of distributions from the	25048
trust.	25049

(6) The baseline date for the look-back period for	25050
dispositions of assets involving a self-settled trust shall be the	25051
date on which the applicant or recipient is both institutionalized	25052
and first applies for medicaid.	25053

(F) The principal or income from any of the following shall	25054
be exempt from being counted as a resource by a county department	25055
of job and family services:	25056

(1)(a) A special needs trust that meets all of the following	25057
requirements:	25058

(i) The trust contains assets of an applicant or recipient	25059
under sixty-five years of age and may contain the assets of other	25060
individuals.	25061

(ii) The applicant or recipient is disabled as defined in	25062
rules adopted by the department of ~~job and family services~~health	25063
care administration.	25064

(iii) The trust is established for the benefit of the	25065
applicant or recipient by a parent, grandparent, legal guardian,	25066
or a court.	25067

(iv) The trust requires that on the death of the applicant or	25068
recipient the state will receive all amounts remaining in the	25069
trust up to an amount equal to the total amount of medicaid paid	25070
on behalf of the applicant or recipient.	25071

(b) If a special needs trust meets the requirements of	25072
division (F)(1)(a) of this section and has been established for a	25073
disabled applicant or recipient under sixty-five years of age, the	25074
exemption for the trust granted pursuant to division (F) of this	25075
section shall continue after the disabled applicant or recipient	25076
becomes sixty-five years of age if the applicant or recipient	25077
continues to be disabled as defined in rules adopted by the	25078
department of ~~job and family services~~health care administration.	25079
Except for income earned by the trust, the grantor shall not add	25080
to or otherwise augment the trust after the applicant or recipient	25081
attains sixty-five years of age. An addition or augmentation of	25082
the trust by the applicant or recipient with the applicant's own	25083
assets after the applicant or recipient attains sixty-five years	25084
of age shall be treated as an improper disposition of assets.	25085

(c) Cash distributions to the applicant or recipient shall be	25086
counted as unearned income. All other distributions from the trust	25087
shall be treated as provided in rules adopted by the department of	25088
~~job and family services~~health care administration governing	25089
in-kind income.	25090

(d) Transfers of assets to a special needs trust shall not be	25091
treated as an improper transfer of resources. Assets held prior to	25092
the transfer to the trust shall be considered as countable assets	25093
or countable income or countable assets and income.	25094

(2)(a) A qualifying income trust that meets all of the	25095
following requirements:	25096

(i) The trust is composed only of pension, social security,	25097
and other income to the applicant or recipient, including	25098
accumulated interest in the trust.	25099

(ii) The income is received by the individual and the right	25100
to receive the income is not assigned or transferred to the trust.	25101

(iii) The trust requires that on the death of the applicant	25102
or recipient the state will receive all amounts remaining in the	25103
trust up to an amount equal to the total amount of medicaid paid	25104
on behalf of the applicant or recipient.	25105

(b) No resources shall be used to establish or augment the	25106
trust.	25107

(c) If an applicant or recipient has irrevocably transferred	25108
or assigned the applicant's or recipient's right to receive income	25109
to the trust, the trust shall not be considered a qualifying	25110
income trust by the county department of job and family services.	25111

(d) Income placed in a qualifying income trust shall not be	25112
counted in determining an applicant's or recipient's eligibility	25113
for medicaid. The recipient of the funds may place any income	25114
directly into a qualifying income trust without those funds	25115
adversely affecting the applicant's or recipient's eligibility for	25116
medicaid. Income generated by the trust that remains in the trust	25117
shall not be considered as income to the applicant or recipient.	25118

(e) All income placed in a qualifying income trust shall be	25119
combined with any countable income not placed in the trust to	25120
arrive at a base income figure to be used for spend down	25121
calculations.	25122

(f) The base income figure shall be used for post-eligibility	25123
deductions, including personal needs allowance, monthly income	25124
allowance, family allowance, and medical expenses not subject to	25125
third party payment. Any income remaining shall be used toward	25126
payment of patient liability. Payments made from a qualifying	25127
income trust shall not be combined with the base income figure for	25128
post-eligibility calculations.	25129

(g) The base income figure shall be used when determining the	25130
spend down budget for the applicant or recipient. Any income	25131
remaining after allowable deductions are permitted as provided	25132
under rules adopted by the department of ~~job and family services~~	25133
health care administration shall be considered the applicant's or	25134
recipient's spend down liability.	25135

(3)(a) A pooled trust that meets all of the following	25136
requirements:	25137

(i) The trust contains the assets of the applicant or	25138
recipient of any age who is disabled as defined in rules adopted	25139
by the department of ~~job and family services~~health care	25140
administration.	25141

(ii) The trust is established and managed by a nonprofit	25142
association.	25143

(iii) A separate account is maintained for each beneficiary	25144
of the trust but, for purposes of investment and management of	25145
funds, the trust pools the funds in these accounts.	25146

(iv) Accounts in the trust are established by the applicant	25147
or recipient, the applicant's or recipient's parent, grandparent,	25148
or legal guardian, or a court solely for the benefit of	25149
individuals who are disabled.	25150

(v) The trust requires that, to the extent that any amounts	25151
remaining in the beneficiary's account on the death of the	25152
beneficiary are not retained by the trust, the trust pay to the	25153
state the amounts remaining in the trust up to an amount equal to	25154
the total amount of medicaid paid on behalf of the beneficiary.	25155

(b) Cash distributions to the applicant or recipient shall be	25156
counted as unearned income. All other distributions from the trust	25157
shall be treated as provided in rules adopted by the department of	25158
~~job and family services~~health care administration governing	25159
in-kind income.	25160

(c) Transfers of assets to a pooled trust shall not be	25161
treated as an improper disposition of assets. Assets held prior to	25162
the transfer to the trust shall be considered as countable assets,	25163
countable income, or countable assets and income.	25164

(4) A supplemental services trust that meets the requirements	25165
of section 5815.28 of the Revised Code and to which all of the	25166
following apply:	25167

(a) A person may establish a supplemental services trust	25168
pursuant to section 5815.28 of the Revised Code only for another	25169
person who is eligible to receive services through one of the	25170
following agencies:	25171

(i) The department of mental retardation and developmental	25172
disabilities;	25173

(ii) A county board of mental retardation and developmental	25174
disabilities;	25175

(iii) The department of mental health;

25176

(iv) A board of alcohol, drug addiction, and mental health	25177
services.	25178

(b) A county department of job and family services shall not	25179
determine eligibility for another agency's program. An applicant	25180
or recipient shall do one of the following:	25181

(i) Provide documentation from one of the agencies listed in	25182
division (F)(4)(a) of this section that establishes that the	25183
applicant or recipient was determined to be eligible for services	25184
from the agency at the time of the creation of the trust;	25185

(ii) Provide an order from a court of competent jurisdiction	25186
that states that the applicant or recipient was eligible for	25187
services from one of the agencies listed in division (F)(4)(a) of	25188
this section at the time of the creation of the trust.	25189

(c) At the time the trust is created, the trust principal	25190
does not exceed the maximum amount permitted. The maximum amount	25191
permitted in calendar year 2006 is two hundred twenty-two thousand	25192
dollars. Each year thereafter, the maximum amount permitted is the	25193
prior year's amount plus two thousand dollars.	25194

(d) A county department of job and family services shall	25195
review the trust to determine whether it complies with the	25196
provisions of section 5815.28 of the Revised Code.	25197

(e) Payments from supplemental services trusts shall be	25198
exempt as long as the payments are for supplemental services as	25199
defined in rules adopted by the department of ~~job and family~~	25200
~~services~~health care administration. All supplemental services	25201
shall be purchased by the trustee and shall not be purchased	25202
through direct cash payments to the beneficiary.	25203

(f) If a trust is represented as a supplemental services	25204
trust and a county department of job and family services	25205
determines that the trust does not meet the requirements provided	25206
in division (F)(4) of this section and section 5815.28 of the	25207
Revised Code, the county department of job and family services	25208
shall not consider it an exempt trust.	25209

(G)(1) A trust or legal instrument or device similar to a	25210
trust shall be considered a trust established by an individual for	25211
the benefit of the applicant or recipient if all of the following	25212
apply:	25213

(a) The trust is created by a person other than the applicant	25214
or recipient.	25215

(b) The trust names the applicant or recipient as a	25216
beneficiary.	25217

(c) The trust is funded with assets or property in which the	25218
applicant or recipient has never held an ownership interest prior	25219
to the establishment of the trust.	25220

(2) Any portion of a trust that meets the requirements of	25221
division (G)(1) of this section shall be an available resource	25222
only if the trust permits the trustee to expend principal, corpus,	25223
or assets of the trust for the applicant's or recipient's medical	25224
care, care, comfort, maintenance, health, welfare, general well	25225
being, or any combination of these purposes.	25226

(3) A trust that meets the requirements of division (G)(1) of	25227
this section shall be considered an available resource even if the	25228
trust contains any of the following types of provisions:	25229

(a) A provision that prohibits the trustee from making	25230
payments that would supplant or replace medicaid or other public	25231
assistance;	25232

(b) A provision that prohibits the trustee from making	25233
payments that would impact or have an effect on the applicant's or	25234
recipient's right, ability, or opportunity to receive medicaid or	25235
other public assistance;	25236

(c) A provision that attempts to prevent the trust or its	25237
corpus or principal from being counted as an available resource.	25238

(4) A trust that meets the requirements of division (G)(1) of	25239
this section shall not be counted as an available resource if at	25240
least one of the following circumstances applies:	25241

(a) If a trust contains a clear statement requiring the	25242
trustee to preserve a portion of the trust for another beneficiary	25243
or remainderman, that portion of the trust shall not be counted as	25244
an available resource. Terms of a trust that grant discretion to	25245
preserve a portion of the trust shall not qualify as a clear	25246
statement requiring the trustee to preserve a portion of the	25247
trust.	25248

(b) If a trust contains a clear statement requiring the	25249
trustee to use a portion of the trust for a purpose other than	25250
medical care, care, comfort, maintenance, welfare, or general well	25251
being of the applicant or recipient, that portion of the trust	25252
shall not be counted as an available resource. Terms of a trust	25253
that grant discretion to limit the use of a portion of the trust	25254
shall not qualify as a clear statement requiring the trustee to	25255
use a portion of the trust for a particular purpose.	25256

(c) If a trust contains a clear statement limiting the	25257
trustee to making fixed periodic payments, the trust shall not be	25258
counted as an available resource and payments shall be treated in	25259
accordance with rules adopted by the department of ~~job and family~~	25260
~~services~~health care administration governing income. Terms of a	25261
trust that grant discretion to limit payments shall not qualify as	25262
a clear statement requiring the trustee to make fixed periodic	25263
payments.	25264

(d) If a trust contains a clear statement that requires the	25265
trustee to terminate the trust if it is counted as an available	25266
resource, the trust shall not be counted as an available resource.	25267
Terms of a trust that grant discretion to terminate the trust do	25268
not qualify as a clear statement requiring the trustee to	25269
terminate the trust.	25270

(e) If a person obtains a judgment from a court of competent	25271
jurisdiction that expressly prevents the trustee from using part	25272
or all of the trust for the medical care, care, comfort,	25273
maintenance, welfare, or general well being of the applicant or	25274
recipient, the trust or that portion of the trust subject to the	25275
court order shall not be counted as a resource.	25276

(f) If a trust is specifically exempt from being counted as	25277
an available resource by a provision of the Revised Code, rules,	25278
or federal law, the trust shall not be counted as a resource.	25279

(g) If an applicant or recipient presents a final judgment	25280
from a court demonstrating that the applicant or recipient was	25281
unsuccessful in a civil action against the trustee to compel	25282
payments from the trust, the trust shall not be counted as an	25283
available resource.	25284

(h) If an applicant or recipient presents a final judgment	25285
from a court demonstrating that in a civil action against the	25286
trustee the applicant or recipient was only able to compel limited	25287
or periodic payments, the trust shall not be counted as an	25288
available resource and payments shall be treated in accordance	25289
with rules adopted by the department of ~~job and family services~~	25290
health care administration governing income.	25291

(i) If an applicant or recipient provides written	25292
documentation showing that the cost of a civil action brought to	25293
compel payments from the trust would be cost prohibitive, the	25294
trust shall not be counted as an available resource.	25295

(5) Any actual payments to the applicant or recipient from a	25296
trust that meet the requirements of division (G)(1) of this	25297
section, including trusts that are not counted as an available	25298
resource, shall be treated as provided in rules adopted by the	25299
department of ~~job and family services~~health care administration	25300
governing income. Payments to any person other than the applicant	25301
or recipient shall not be considered income to the applicant or	25302
recipient. Payments from the trust to a person other than the	25303
applicant or recipient shall not be considered an improper	25304
disposition of assets.	25305

~~Sec. 5111.181.~~ Sec. 5162.30. (A) The general assembly hereby finds	25306
that the state has an insurable interest in ~~medical assistance~~	25307
medicaid recipients because of the state's statutory right to	25308
recover from the estate of a recipient state funds used to provide	25309
the recipient with medical care and services.	25310

(B) As used in this section:

25311

(1) "Beneficiary" means the person or entity designated in a	25312
life insurance policy to receive the proceeds of the policy on the	25313
death of the insured or maturity of the policy.	25314

(2) "Owner" means the person who has the right to designate	25315
the beneficiary of a life insurance policy and to change the	25316
designation.	25317

(C) Notwithstanding section ~~5111.011~~5162.20 of the Revised	25318
Code, the value of a life insurance policy that would otherwise be	25319
considered a resource in determining eligibility for the ~~medical~~	25320
~~assistance~~medicaid program shall be excluded from any	25321
determination of a person's eligibility for the ~~medical assistance~~	25322
medicaid program if the owner designates the department of ~~job and~~	25323
~~family services~~health care administration as beneficiary of the	25324
policy. The department may pay premiums to keep the policy in	25325
force. Premiums paid by the department are ~~medical assistance~~	25326
medicaid payments correctly paid on behalf of a ~~medical assistance~~	25327
medicaid recipient and subject to recovery under section ~~5111.11~~	25328
5162.40 of the Revised Code.	25329

(D) The director of ~~job and family services~~health care	25330
administration shall deposit the proceeds of a life insurance	25331
policy that do not exceed the amount the department may recover	25332
against the property and estate of the owner under section ~~5111.11~~	25333
5162.40 of the Revised Code into the general revenue fund. The	25334
director shall pay any remaining proceeds to the person designated	25335
by the owner. If the owner failed to designate a person, the	25336
director shall pay the remaining proceeds to the surviving spouse,	25337
or, if there is no surviving spouse, to the estate of the owner.	25338

(E) If the owner designates the department of ~~job and family~~	25339
~~services~~health care administration as the policy's beneficiary,	25340
the department shall notify the owner that the owner may designate	25341
a person to receive proceeds of the policy that exceed the amount	25342
the department may recover against the owner's property and estate	25343
under section ~~5111.11~~5162.40 of the Revised Code. The designation	25344
shall be made on a form provided by the department.	25345

(F) The department of ~~job and family services~~health care	25346
administration shall not implement this section if implementation	25347
would violate any federal requirement unless the department	25348
receives a waiver of the requirement from the United States	25349
department of health and human services.	25350

~~Sec. 5111.0112.~~ Sec. 5162.35. (A) The director of ~~job and family~~	25351
~~services~~health care administration shall institute a	25352
cost-sharing program under the medicaid program. In instituting	25353
the cost-sharing program, the director shall comply with federal	25354
law. In the case of an individual participating in the	25355
children's buy-in program ~~established under sections 5101.5211~~	25356
~~to 5101.5216 of the Revised Code~~, the cost-sharing program	25357
shall be consistent with sections ~~5101.5213~~5167.37 and	25358
~~5101.5214~~5167.38 of the Revised Code if the children's buy-in	25359
program is a component of the medicaid program. The cost-sharing	25360
program shall establish a copayment requirement for at least	25361
dental services, vision services, nonemergency emergency	25362
department services, and prescription drugs, other than generic	25363
drugs. The cost-sharing program shall establish requirements	25364
regarding premiums, enrollment fees, deductions, and similar	25365
charges. The director shall adopt rules under section ~~5111.02~~	25366
5162.20 of the Revised Code governing the cost-sharing program.	25367

(B) The cost-sharing program shall, to the extent permitted	25368
by federal law, provide for all of the following with regard to	25369
any providers participating in the medicaid program:	25370

(1) No provider shall refuse to provide a service to a	25371
medicaid recipient who is unable to pay a required copayment for	25372
the service.	25373

(2) Division (B)(1) of this section shall not be considered	25374
to do either of the following with regard to a medicaid recipient	25375
who is unable to pay a required copayment:	25376

(a) Relieve the medicaid recipient from the obligation to pay	25377
a copayment;	25378

(b) Prohibit the provider from attempting to collect an	25379
unpaid copayment.	25380

(3) Except as provided in division (C) of this section, no	25381
provider shall waive a medicaid recipient's obligation to pay the	25382
provider a copayment.	25383

(4) No provider or drug manufacturer, including the	25384
manufacturer's representative, employee, independent contractor,	25385
or agent, shall pay any copayment on behalf of a medicaid	25386
recipient.	25387

(5) If it is the routine business practice of the provider to	25388
refuse service to any individual who owes an outstanding debt to	25389
the provider, the provider may consider an unpaid copayment	25390
imposed by the cost-sharing program as an outstanding debt and	25391
may refuse service to a medicaid recipient who owes the provider	25392
an outstanding debt. If the provider intends to refuse service to	25393
a medicaid recipient who owes the provider an outstanding debt,	25394
the provider shall notify the individual of the provider's intent	25395
to refuse services.	25396

(C) In the case of a provider that is a hospital, the	25397
cost-sharing program shall permit the hospital to take action to	25398
collect a copayment by providing, at the time services are	25399
rendered to a medicaid recipient, notice that a copayment may be	25400
owed. If the hospital provides the notice and chooses not to take	25401
any further action to pursue collection of the copayment, the	25402
prohibition against waiving copayments specified in division	25403
(B)(3) of this section does not apply.	25404

(D) The department of ~~job and family services~~health care	25405
administration may work with a state agency that is	25406
administering, pursuant to a contract entered into under section	25407
~~5111.91~~5161.05 of the Revised Code, one or more components of	25408
the medicaid program or one or more aspects of a component as	25409
necessary for the state agency to apply the cost-sharing program	25410
to the components or aspects of the medicaid program that the	25411
state agency administers.	25412

~~Sec. 5111.114.~~ Sec. 5162.36. As used in this section, "nursing	25413
facility" and "intermediate care facility for the mentally	25414
retarded" have the same meanings as in section ~~5111.20~~5164.01 of	25415
the Revised Code.	25416

In determining the amount of income that a medicaid recipient	25417
~~of medical assistance~~ must apply monthly toward payment of the	25418
cost of care in a nursing facility or intermediate care facility	25419
for the mentally retarded, the county department of job and family	25420
services shall deduct from the recipient's monthly income a	25421
monthly personal needs allowance in accordance with ~~section 1902~~	25422
~~of the "Social Security Act," 49 Stat. 620 (1935),~~ 42 U.S.C.A.	25423
~~1396a, as amended~~1396a(q).	25424

For a resident of a nursing facility, the monthly personal	25425
needs allowance shall be not less than forty dollars for an	25426
individual resident and not less than eighty dollars for a married	25427
couple if both spouses are residents of a nursing facility.	25428

For a resident of an intermediate care facility for the	25429
mentally retarded, the monthly personal needs allowance shall be	25430
forty dollars unless the resident has earned income, in which case	25431
the monthly personal needs allowance shall be determined by the	25432
~~state~~ department of ~~job and family services~~health care	25433
administration but shall not exceed one hundred five dollars.	25434

~~Sec. 5111.113.~~ Sec. 5162.37. (A) As used in this section:

25435

(1) "Adult care facility" has the same meaning as in section	25436
3722.01 of the Revised Code.	25437

(2) "Commissioner" means a person appointed by a probate	25438
court under division (B) of section 2113.03 of the Revised Code to	25439
act as a commissioner.	25440

(3) "Home" has the same meaning as in section 3721.10 of the	25441
Revised Code.	25442

(4) "Personal needs allowance account" means an account or	25443
petty cash fund that holds the money of a resident of an adult	25444
care facility or home and that the facility or home manages for	25445
the resident.	25446

(B) Except as provided in divisions (C) and (D) of this	25447
section, the owner or operator of an adult care facility or home	25448
shall transfer to the department of ~~job and family services~~health	25449
care administration the money in the personal needs allowance	25450
account of a resident of the facility or home who was a medicaid	25451
recipient ~~of the medical assistance program~~ no earlier than sixty	25452
days but not later than ninety days after the resident dies. The	25453
adult care facility or home shall transfer the money even though	25454
the owner or operator of the facility or home has not been issued	25455
letters testamentary or letters of administration concerning the	25456
resident's estate.	25457

(C) If funeral or burial expenses for a resident of an adult	25458
care facility or home who has died have not been paid and the only	25459
resource the resident had that could be used to pay for the	25460
expenses is the money in the resident's personal needs allowance	25461
account, or all other resources of the resident are inadequate to	25462
pay the full cost of the expenses, the money in the resident's	25463
personal needs allowance account shall be used to pay for the	25464
expenses rather than being transferred to the department of ~~job~~	25465
~~and family services~~health care administration pursuant to	25466
division (B) of this section.	25467

(D) If, not later than sixty days after a resident of an	25468
adult care facility or home dies, letters testamentary or letters	25469
of administration are issued, or an application for release from	25470
administration is filed under section 2113.03 of the Revised Code,	25471
concerning the resident's estate, the owner or operator of the	25472
facility or home shall transfer the money in the resident's	25473
personal needs allowance account to the administrator, executor,	25474
commissioner, or person who filed the application for release from	25475
administration.	25476

(E) The transfer or use of money in a resident's personal	25477
needs allowance account in accordance with division (B), (C), or	25478
(D) of this section discharges and releases the adult care	25479
facility or home, and the owner or operator of the facility or	25480
home, from any claim for the money from any source.	25481

(F) If, sixty-one or more days after a resident of an adult	25482
care facility or home dies, letters testamentary or letters of	25483
administration are issued, or an application for release from	25484
administration under section 2113.03 of the Revised Code is filed,	25485
concerning the resident's estate, the department of ~~job and family~~	25486
~~services~~health care administration shall transfer the funds to	25487
the administrator, executor, commissioner, or person who filed	25488
the application, unless the department is entitled to recover the	25489
money under the medicaid estate recovery program instituted under	25490
section ~~5111.11~~5162.40 of the Revised Code.	25491

~~Sec. 5111.11.~~ Sec. 5162.40. (A) As used in this section and	25492
section 5111.111 of the Revised Code:	25493

(1) "Estate" includes both of the following:

25494

(a) All real and personal property and other assets to be	25495
administered under Title XXI of the Revised Code and property that	25496
would be administered under that title if not for section 2113.03	25497
or 2113.031 of the Revised Code;	25498

(b) Any other real and personal property and other assets in	25499
which an individual had any legal title or interest at the time of	25500
death (to the extent of the interest), including assets conveyed	25501
to a survivor, heir, or assign of the individual through joint	25502
tenancy, tenancy in common, survivorship, life estate, living	25503
trust, or other arrangement.	25504

(2) "Institution" means a nursing facility, intermediate care	25505
facility for the mentally retarded, or a medical institution.	25506

(3) "Intermediate care facility for the mentally retarded"	25507
and "nursing facility" have the same meanings as in section	25508
~~5111.20~~5164.01 of the Revised Code.	25509

(4) "Permanently institutionalized individual" means an	25510
individual to whom all of the following apply:	25511

(a) Is an inpatient in an institution;

25512

(b) Is required, as a condition of the medicaid program	25513
paying for the individual's services in the institution, to spend	25514
for costs of medical or nursing care all of the individual's	25515
income except for an amount for personal needs specified by the	25516
department of ~~job and family services~~health care administration;	25517

(c) Cannot reasonably be expected to be discharged from the	25518
institution and return home as determined by the department of ~~job~~	25519
~~and family services~~health care administration.	25520

(5) "Qualified state long-term care insurance partnership	25521
program" means the program established under section ~~5111.18~~	25522
5162.43 of the Revised Code.	25523

(6) "Time of death" shall not be construed to mean a time	25524
after which a legal title or interest in real or personal property	25525
or other asset may pass by survivorship or other operation of law	25526
due to the death of the decedent or terminate by reason of the	25527
decedent's death.	25528

(B) To the extent permitted by federal law, the department of	25529
~~job and family services~~health care administration shall institute	25530
a medicaid estate recovery program under which the department	25531
shall, except as provided in divisions (C) and (E) of this	25532
section, and subject to division (D) of this section, do all of	25533
the following:	25534

(1) For the costs of medicaid services the medicaid program	25535
correctly paid or will pay on behalf of a permanently	25536
institutionalized individual of any age, seek adjustment or	25537
recovery from the individual's estate or on the sale of property	25538
of the individual or spouse that is subject to a lien imposed	25539
under section ~~5111.111~~5162.41 of the Revised Code;	25540

(2) For the costs of medicaid services the medicaid program	25541
correctly paid or will pay on behalf of an individual fifty-five	25542
years of age or older who is not a permanently institutionalized	25543
individual, seek adjustment or recovery from the individual's	25544
estate;	25545

(3) Seek adjustment or recovery from the estate of other	25546
individuals as permitted by federal law.	25547

(C)(1) No adjustment or recovery may be made under division	25548
(B)(1) of this section from a permanently institutionalized	25549
individual's estate or on the sale of property of a permanently	25550
institutionalized individual that is subject to a lien imposed	25551
under section ~~5111.111~~5162.41 of the Revised Code or under	25552
division (B)(2) or (3) of this section from an individual's	25553
estate while either of the following are alive:	25554

(a) The spouse of the permanently institutionalized	25555
individual or individual;	25556

(b) The son or daughter of a permanently institutionalized	25557
individual or individual if the son or daughter is under age	25558
twenty-one or, under 42 U.S.C. 1382c, is considered blind or	25559
disabled.	25560

(2) No adjustment or recovery may be made under division	25561
(B)(1) of this section from a permanently institutionalized	25562
individual's home that is subject to a lien imposed under section	25563
~~5111.111~~5162.41 of the Revised Code while either of the following	25564
lawfully reside in the home:	25565

(a) The permanently institutionalized individual's sibling	25566
who resided in the home for at least one year immediately before	25567
the date of the permanently institutionalized individual's	25568
admission to the institution and on a continuous basis since that	25569
time;	25570

(b) The permanently institutionalized individual's son or	25571
daughter who provided care to the permanently institutionalized	25572
individual that delayed the permanently institutionalized	25573
individual's institutionalization and resided in the home for at	25574
least two years immediately before the date of the permanently	25575
institutionalized individual's admission to the institution and on	25576
a continuous basis since that time.	25577

(D) In the case of a participant of the qualified state	25578
long-term care insurance partnership program, adjustment or	25579
recovery required by this section may be reduced in accordance	25580
with rules adopted under division (G) of this section.	25581

(E) The department shall, in accordance with procedures and	25582
criteria established in rules adopted under division (G) of this	25583
section, waive seeking an adjustment or recovery otherwise	25584
required by this section if the director of ~~job and family~~	25585
~~services~~health care administration determines that adjustment or	25586
recovery would work an undue hardship. The department may limit	25587
the duration of the waiver to the period during which the undue	25588
hardship exists.	25589

(F) For the purpose of determining whether an individual	25590
meets the definition of "permanently institutionalized individual"	25591
established for this section, a rebuttable presumption exists that	25592
the individual cannot reasonably be expected to be discharged from	25593
an institution and return home if either of the following is the	25594
case:	25595

(1) The individual declares that he or she does not intend to	25596
return home.	25597

(2) The individual has been an inpatient in an institution	25598
for at least six months.	25599

(G) The director of ~~job and family services~~health care	25600
administration shall adopt rules in accordance with Chapter 119.	25601
of the Revised Code regarding the medicaid estate recovery	25602
program, including rules that do both of the following:	25603

(1) For the purpose of division (D) of this section and	25604
consistent with 42 U.S.C. 1396p(b)(1)(C), provide for reducing an	25605
adjustment or recovery in the case of a participant of the	25606
qualified state long-term care insurance partnership program;	25607

(2) For the purpose of division (E) of this section and	25608
consistent with the standards specified by the United States	25609
secretary of health and human services under 42 U.S.C.	25610
1396p(b)(3), establish procedures and criteria for waiving	25611
adjustment or recovery due to an undue hardship.	25612

~~Sec. 5111.111.~~ Sec. 5162.41. (A) Except as provided in division	25613
(B) of this section and section ~~5111.12~~5162.45 of the Revised	25614
Code, no lien may be imposed against the property of an individual	25615
before the individual's death on account of medicaid services	25616
correctly paid or to be paid on the individual's behalf.	25617

(B) Except as provided in division (C) of this section, the	25618
department of ~~job and family services~~health care administration	25619
may impose a lien against the real property of a medicaid	25620
recipient who is a permanently institutionalized individual and	25621
against the real property of the recipient's spouse, including any	25622
real property that is jointly held by the recipient and spouse.	25623
The lien may be imposed on account of medicaid paid or to be paid	25624
on the recipient's behalf.	25625

(C) No lien may be imposed under division (B) of this section	25626
against the home of a medicaid recipient if any of the following	25627
lawfully resides in the home:	25628

(1) The recipient's spouse;

25629

(2) The recipient's son or daughter who is under twenty-one	25630
years of age or, under 42 U.S.C. 1382c, considered to be blind or	25631
disabled;	25632

(3) The recipient's sibling who has an equity interest in the	25633
home and resided in the home for at least one year immediately	25634
before the date of the recipient's admission to the institution.	25635

(D) The director of ~~job and family services~~health care	25636
administration or a person designated by the director shall sign a	25637
certificate to effectuate a lien required to be imposed under this	25638
section. The county department of job and family services shall	25639
file for recording and indexing the certificate, or a certified	25640
copy, in the real estate mortgage records in the office of the	25641
county recorder in every county in which real property of the	25642
recipient or spouse is situated. From the time of filing the	25643
certificate in the office of the county recorder, the lien	25644
attaches to all real property of the recipient or spouse described	25645
in the certificate for all amounts for which adjustment or	25646
recovery may be made under section ~~5111.11~~5162.40 of the Revised	25647
Code and, except as provided in division (E) of this section,	25648
shall remain a lien until satisfied.	25649

Upon filing the certificate in the office of the recorder,	25650
all persons are charged with notice of the lien and the rights of	25651
the department of ~~job and family services~~health care	25652
administration thereunder.	25653

The county recorder shall keep a record of every certificate	25654
filed showing its date, the time of filing, the name and residence	25655
of the recipient or spouse, and any release, waivers, or	25656
satisfaction of the lien.	25657

The priority of the lien shall be established in accordance	25658
with state and federal law.	25659

The department may waive the priority of its lien to provide	25660
for the costs of the last illness as determined by the department,	25661
administration, attorney fees, administrator fees, a sum for the	25662
payment of the costs of burial, which shall be computed by	25663
deducting from five hundred dollars whatever amount is available	25664
for the same purpose from all other sources, and a similar sum for	25665
the spouse of the decedent.	25666

(E) A lien imposed with respect to a medicaid recipient under	25667
this section shall dissolve on the recipient's discharge from the	25668
institution and return home.	25669

~~Sec. 5111.112.~~ Sec. 5162.42. The department of ~~job and family~~	25670
~~services~~health care administration shall certify amounts due	25671
under the medicaid estate recovery program instituted under	25672
section ~~5111.11~~5162.40 of the Revised Code to the attorney	25673
general pursuant to section 131.02 of the Revised Code. The	25674
attorney general may enter into a contract with any person or	25675
government entity to collect the amounts due on behalf of the	25676
attorney general.	25677

The attorney general, in entering into a contract under this	25678
section, shall comply with all of the requirements that must be	25679
met for the state to receive federal financial participation for	25680
the costs incurred in entering into the contract and carrying out	25681
actions under the contract. The contract may provide for the	25682
person or government entity with which the attorney general	25683
contracts to be compensated from the property recovered under the	25684
medicaid estate recovery program or may provide for another manner	25685
of compensation agreed to by the parties to the contract.	25686

Regardless of whether the attorney general collects the	25687
amounts due under the medicaid estate recovery program or	25688
contracts with a person or government entity to collect the	25689
amounts due on behalf of the attorney general, the amounts due	25690
shall be collected in accordance with applicable requirements of	25691
federal statutes and regulations and state statutes and rules.	25692

~~Sec. 5111.18.~~ Sec. 5162.43. Not later than September 1, 2007, the	25693
director of ~~job and family services~~health care administration	25694
shall establish a qualified state long-term care insurance	25695
partnership program consistent with the definition of that term in	25696
42 U.S.C. 1396p(b)(1)(C)(iii). An individual participating in the	25697
program who is subject to the medicaid estate recovery program	25698
instituted under section ~~5111.11~~5162.40 of the Revised Code shall	25699
be eligible for the reduced adjustment or recovery under division	25700
(D) of that section.	25701

The director of ~~job and family services~~health care	25702
administration may adopt rules in accordance with Chapter 119. of	25703
the Revised Code as necessary to implement this section.	25704

~~Sec. 5111.12.~~ Sec. 5162.45. (A) The director of ~~job and family~~	25705
~~services~~health care administration shall establish rules under	25706
which county departments of job and family services may take	25707
action to recover benefits incorrectly paid on behalf of medicaid	25708
recipients ~~of medical assistance~~. The rules shall provide for	25709
recovery by the following methods:	25710

(1) Soliciting voluntary payments from recipients or from	25711
persons holding property in which a recipient has a legal or	25712
equitable interest;	25713

(2) Obtaining a lien on property pursuant to division (B) of	25714
this section.	25715

(B) A county department of job and family services may bring	25716
a civil action in a court of common pleas against a medicaid	25717
recipient ~~of medical assistance~~ for the recovery of any ~~medical~~	25718
~~assistance~~medicaid benefits determined by the court to have been	25719
paid incorrectly on behalf of the recipient. All persons holding	25720
property in which the recipient has a legal or equitable interest	25721
may be joined as parties. The court may issue pre-judgment orders,	25722
including injunctive relief or attachment under Chapter 2715. of	25723
the Revised Code, for the preservation of real or personal	25724
property in which the recipient may have a legal or equitable	25725
interest. If the court determines that benefits were paid	25726
incorrectly and issues a judgment to that effect, the county	25727
department may obtain a lien upon property of the recipient in	25728
accordance with Chapter 2329. of the Revised Code.	25729

(C) The county department of job and family services shall	25730
retain fifty per cent of the balance remaining after deduction	25731
from the recovery of the amount required to be returned to the	25732
federal government and shall pay the other fifty per cent of the	25733
balance to the department of ~~job and family services~~health care	25734
administration.	25735

(D) Recovery of ~~medical assistance~~medicaid benefits	25736
incorrectly paid to a recipient may not be accomplished by	25737
reducing the amount of benefits the recipient is entitled to	25738
receive under another government assistance program.	25739

(E) The remedies provided pursuant to this section do not	25740
affect any other remedies county departments of job and family	25741
services may have to recover benefits incorrectly paid on behalf	25742
of medicaid recipients ~~of medical assistance~~.	25743

~~Sec. 5111.06.~~ Sec. 5163.01. (A)(1) As used in this section and in	25744
sections ~~5111.061~~5163.07 and ~~5111.062~~5163.09 of the Revised	25745
Code:	25746

(a) "Provider" means any person, institution, or entity that	25747
furnishes medicaid services under a medicaid provider agreement	25748
with the department of ~~job and family services pursuant to Title~~	25749
~~XIX of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A.~~	25750
~~301, as amended~~health care administration.	25751

(b) "Party" has the same meaning as in division (G) of	25752
section 119.01 of the Revised Code.	25753

(c) "Adjudication" has the same meaning as in division (D) of	25754
section 119.01 of the Revised Code.	25755

(2) This section does not apply to any action taken by the	25756
department of ~~job and family services~~health care administration	25757
under sections ~~5111.35~~5164.50 to ~~5111.62~~5164.78 of the Revised	25758
Code.	25759

(B) Except as provided in division (D) of this section and	25760
section ~~5111.914~~5163.06 of the Revised Code, the department shall	25761
do either of the following by issuing an order pursuant to an	25762
adjudication conducted in accordance with Chapter 119. of the	25763
Revised Code:	25764

(1) Enter into or refuse to enter into a medicaid provider	25765
agreement with a provider, or suspend, terminate, renew, or refuse	25766
to renew an existing medicaid provider agreement with a provider;	25767

(2) Take any action based upon a final fiscal audit of a	25768
provider.	25769

(C) Any party who is adversely affected by the issuance of an	25770
adjudication order under division (B) of this section may appeal	25771
to the court of common pleas of Franklin county in accordance with	25772
section 119.12 of the Revised Code.	25773

(D) The department is not required to comply with division	25774
(B)(1) of this section whenever any of the following occur:	25775

(1) The terms of a medicaid provider agreement require the	25776
provider to hold a license, permit, or certificate or maintain a	25777
certification issued by an official, board, commission,	25778
department, division, bureau, or other agency of state or federal	25779
government other than the department of ~~job and family services~~	25780
health care administration, and the license, permit, certificate,	25781
or certification has been denied, revoked, not renewed,	25782
suspended, or otherwise limited.	25783

(2) The terms of a medicaid provider agreement require the	25784
provider to hold a license, permit, or certificate or maintain	25785
certification issued by an official, board, commission,	25786
department, division, bureau, or other agency of state or federal	25787
government other than the department of ~~job and family services~~	25788
health care administration, and the provider has not obtained the	25789
license, permit, certificate, or certification.	25790

(3) The medicaid provider agreement is denied, terminated, or	25791
not renewed due to the termination, refusal to renew, or denial	25792
of a license, permit, certificate, or certification by an	25793
official, board, commission, department, division, bureau, or	25794
other agency of this state other than the department of ~~job and~~	25795
~~family services~~health care administration, notwithstanding the	25796
fact that the provider may hold a license, permit, certificate,	25797
or certification from an official, board, commission, department,	25798
division, bureau, or other agency of another state.	25799

(4) The medicaid provider agreement is denied, terminated, or	25800
not renewed pursuant to division (C) or (F) of section ~~5111.03~~	25801
5163.03 of the Revised Code;	25802

(5) The medicaid provider agreement is denied, terminated, or	25803
not renewed due to the provider's termination, suspension, or	25804
exclusion from the medicare program ~~established under Title XVIII~~	25805
~~of the "Social Security Act,"~~ and the termination, suspension, or	25806
exclusion is binding on the provider's participation in the	25807
medicaid program;	25808

(6) The medicaid provider agreement is denied, terminated, or	25809
not renewed due to the provider's pleading guilty to or being	25810
convicted of a criminal activity materially related to either the	25811
medicare or medicaid program;	25812

(7) The medicaid provider agreement is denied, terminated, or	25813
suspended as a result of action by the United States department of	25814
health and human services and that action is binding on the	25815
provider's participation in the medicaid program;	25816

(8) The medicaid provider agreement is suspended pursuant to	25817
section ~~5111.031~~5163.031 of the Revised Code pending indictment	25818
of the provider.	25819

(9) The medicaid provider agreement is denied, terminated, or	25820
not renewed because the provider has been convicted of one of the	25821
offenses that caused the provider agreement to be suspended	25822
pursuant to section ~~5111.031~~5163.031 of the Revised Code.	25823

(10) The medicaid provider agreement is converted under	25824
section ~~5111.028~~5163.011 of the Revised Code from a provider	25825
agreement that is not time-limited to a provider agreement that	25826
is time-limited.	25827

(11) The medicaid provider agreement is terminated or an	25828
application for re-enrollment is denied because the provider has	25829
failed to apply for re-enrollment within the time or in the	25830
manner specified for re-enrollment pursuant to section ~~5111.028~~	25831
5163.011 of the Revised Code.	25832

(12) The medicaid provider agreement is terminated or not	25833
renewed because the provider has not billed or otherwise	25834
submitted a medicaid claim to the department for two years or	25835
longer, and the department has determined that the provider has	25836
moved from the address on record with the department without	25837
leaving an active forwarding address with the department.	25838

In the case of a provider described in division (D)(12) of	25839
this section, the department may terminate or not renew the	25840
medicaid provider agreement by sending a notice explaining the	25841
department's proposed action to the address on record with the	25842
department. The notice may be sent by regular mail.	25843

(E) The department may withhold payments for services	25844
rendered by a medicaid provider under the ~~medical assistance~~	25845
medicaid program during the pendency of proceedings initiated	25846
under division (B)(1) of this section. If the proceedings are	25847
initiated under division (B)(2) of this section, the department	25848
may withhold payments only to the extent that they equal amounts	25849
determined in a final fiscal audit as being due the state. This	25850
division does not apply if the department fails to comply with	25851
section 119.07 of the Revised Code, requests a continuance of the	25852
hearing, or does not issue a decision within thirty days after the	25853
hearing is completed. This division does not apply to nursing	25854
facilities and intermediate care facilities for the mentally	25855
retarded as defined in section ~~5111.20~~5164.01 of the Revised	25856
Code.	25857

~~Sec. 5111.028.~~ Sec. 5163.011. (A) Pursuant to section ~~5111.02~~	25858
5163.15 of the Revised Code, the director of ~~job and family~~	25859
~~services~~health care administration shall adopt rules	25860
establishing procedures for the use of time-limited provider	25861
agreements under the medicaid program. Except as provided in	25862
division (E) of this section, all provider agreements shall be	25863
time-limited in accordance with the procedures established in the	25864
rules.	25865

The department of ~~job and family services~~health care	25866
administration shall phase-in the use of time-limited provider	25867
agreements pursuant to this section during a period commencing	25868
not later than January 1, 2008, and ending January 1, 2011.	25869

(B) In the use of time-limited provider agreements pursuant	25870
to this section, all of the following apply:	25871

(1) Each provider agreement shall expire not later than	25872
three years from the effective date of the agreement.	25873

(2) During the phase-in period specified in division (A) of	25874
this section, the department may provide for the conversion of a	25875
provider agreement without a time limit to a provider agreement	25876
with a time limit. The department may take an action to convert	25877
the provider agreement by sending a notice by regular mail to the	25878
address of the provider on record with the department advising the	25879
provider of the conversion.	25880

(3) The department may make the effective date of a provider	25881
agreement retroactive for a period not to exceed one year from the	25882
date of the provider's application for the agreement, as long as	25883
the provider met all medicaid program requirements during that	25884
period.	25885

(C) The rules for use of time-limited provider agreements	25886
pursuant to this section shall include a process for re-enrollment	25887
of providers. All of the following apply to the re-enrollment	25888
process:	25889

(1) The department of ~~job and family services~~health care	25890
administration may terminate a time-limited provider agreement	25891
or deny re-enrollment when a provider fails to file an	25892
application for re-enrollment within the time and in the manner	25893
required under the re-enrollment process.	25894

(2) If a provider files an application for re-enrollment	25895
within the time and in the manner required under the re-enrollment	25896
process, but the provider agreement expires before the department	25897
acts on the application or before the effective date of the	25898
department's decision on the application, the provider may	25899
continue operating under the terms of the expired provider	25900
agreement until the effective date of the department's decision.	25901

(3) A decision by the department to approve an application	25902
for re-enrollment becomes effective on the date of the	25903
department's decision. A decision by the department to deny	25904
re-enrollment shall take effect not sooner than thirty days after	25905
the date the department mails written notice of the decision to	25906
the provider. The department shall specify in the notice the date	25907
on which the provider is required to cease operating under the	25908
provider agreement.	25909

(D) Pursuant to section ~~5111.06~~5163.01 of the Revised Code,	25910
the department is not required to take the actions specified in	25911
division (C)(1) of this section by issuing an order pursuant to an	25912
adjudication conducted in accordance with Chapter 119. of the	25913
Revised Code.	25914

(E) The use of time-limited provider agreements pursuant to	25915
this section does not apply to provider agreements issued to the	25916
following, including any provider agreements issued to the	25917
following that are otherwise time-limited under the medicaid	25918
program:	25919

(1) A managed care organization under contract with the	25920
department pursuant to section ~~5111.17~~5165.05 of the Revised	25921
Code;	25922

(2) A nursing facility, as defined in section ~~5111.20~~5164.01	25923
of the Revised Code;	25924

(3) An intermediate care facility for the mentally retarded,	25925
as defined in section ~~5111.20~~5164.01 of the Revised Code.	25926

~~Sec. 5111.05.~~ Sec. 5163.02. (A) The department of ~~job and family~~	25927
~~services~~health care administration may contract with any person	25928
or persons as a fiscal agent for the examination, processing, and	25929
determination of ~~medical assistance~~medicaid claims ~~under this~~	25930
~~chapter~~. The contracting party may provide any of the following	25931
services, as required by the contract:	25932

(1) Design and operate medicaid management information	25933
systems, including the provision of data processing services;	25934

(2) Determine the amounts of payments to be made upon claims	25935
for ~~medical assistance~~medicaid;	25936

(3) Prepare and furnish to the department lists and computer	25937
tapes of such claims for payment;	25938

(4) In addition to audits which may be conducted by the	25939
department and by the auditor of state, make audits of providers	25940
and the claims of medicaid providers ~~of medical assistance~~	25941
according to the standards set forth in the contract;	25942

(5) Assist medicaid providers ~~of medical assistance~~ in the	25943
development of procedures relating to utilization practices, make	25944
studies of the effectiveness of such procedures and methods for	25945
their improvement, implement and enforce standards of medical	25946
policy, and assist in the application of safeguards against	25947
unnecessary utilization;	25948

(6) Assist any institution, facility, or agency to qualify as	25949
a medicaid provider ~~of medical assistance~~;	25950

(7) Establish and maintain fiscal records for the ~~medical~~	25951
~~assistance~~medicaid program;	25952

(8) Perform statistical and research studies;

25953

(9) Develop and implement programs for ~~medical assistance~~	25954
medicaid cost containment;	25955

(10) Perform such other duties as are necessary to carry out	25956
the ~~medical assistance~~medicaid program.	25957

(B) The department of ~~job and family services~~health care	25958
administration may contract with any person or persons as an	25959
insuring agent for the examination, processing, and determination	25960
of ~~medical assistance~~medicaid claims, as provided in division (A)	25961
of this section, and for the payment of ~~medical assistance~~	25962
medicaid claims through an underwritten program in which the state	25963
pays the insuring agent a monthly premium and the insuring agent	25964
pays for medical services authorized under the state's ~~medical~~	25965
~~assistance~~medicaid program. The person with whom the department	25966
contracts, with respect to the awarding, provisions, and	25967
performance of such contract, shall not be subject to the	25968
provisions of Title XXXIX of the Revised Code or to regulation by	25969
the department of insurance, nor to taxation as an insurance	25970
company pursuant to section 5725.18 or 5729.03 of the Revised	25971
Code. A contract with an insuring agent shall specify the	25972
qualifications, including capital and surplus requirements, and	25973
other conditions with which the insuring agent must comply.	25974

(C) In entering into a contract under this section, the	25975
department, in cooperation with the director of budget and	25976
management, shall determine that the contracting party is	25977
qualified to perform the required services and shall follow	25978
applicable procedures required of the department of administrative	25979
services in sections 125.07 to 125.11 of the Revised Code. A	25980
contract shall be awarded to the bidder who, with due	25981
consideration to the bidder's experience and financial capability,	25982
offers the lowest and best bid to the state for control of the	25983
costs of the ~~medical assistance~~medicaid program consistent with	25984
meeting the obligations under that program for fair and equitable	25985
treatment of recipients and providers of medical services. Any	25986
arrangement whereby funds are paid to an insuring or fiscal agent	25987
for administrative functions under this section shall, for the	25988
purposes of section 125.081 of the Revised Code, be deemed to be a	25989
contract or purchase by the department of administrative services;	25990
however, money to be used by an insuring agent to pay for medical	25991
services authorized under the state's ~~medical assistance~~medicaid	25992
program shall not be deemed a contract or purchase within the	25993
meaning of such section.	25994

~~Sec. 5111.03.~~ Sec. 5163.03. (A) No provider of services or goods	25995
contracting with the department of ~~job and family services~~health	25996
care administration pursuant to the medicaid program shall, by	25997
deception, obtain or attempt to obtain payments under this	25998
chapter to which the provider is not entitled pursuant to the	25999
provider agreement, or the rules of the federal government or the	26000
department of ~~job and family services~~health care administration	26001
relating to the program. No provider shall willfully receive	26002
payments to which the provider is not entitled, or willfully	26003
receive payments in a greater amount than that to which the	26004
provider is entitled; nor shall any provider falsify any report	26005
or document required by state or federal law, rule, or provider	26006
agreement relating to medicaid payments. As used in this section,	26007
a provider engages in "deception" when the provider, acting with	26008
actual knowledge of the representation or information involved,	26009
acting in deliberate ignorance of the truth or falsity of the	26010
representation or information involved, or acting in reckless	26011
disregard of the truth or falsity of the representation or	26012
information involved, deceives another or causes another to be	26013
deceived by any false or misleading representation, by withholding	26014
information, by preventing another from acquiring information, or	26015
by any other conduct, act, or omission that creates, confirms, or	26016
perpetuates a false impression in another, including a false	26017
impression as to law, value, state of mind, or other objective or	26018
subjective fact. No proof of specific intent to defraud is	26019
required to show, for purposes of this section, that a provider	26020
has engaged in deception.	26021

(B) Any provider who violates division (A) of this section	26022
shall be liable, in addition to any other penalties provided by	26023
law, for all of the following civil penalties:	26024

(1) Payment of interest on the amount of the excess payments	26025
at the maximum interest rate allowable for real estate mortgages	26026
under section 1343.01 of the Revised Code on the date the payment	26027
was made to the provider for the period from the date upon which	26028
payment was made, to the date upon which repayment is made to the	26029
state;	26030

(2) Payment of an amount equal to three times the amount of	26031
any excess payments;	26032

(3) Payment of a sum of not less than five thousand dollars	26033
and not more than ten thousand dollars for each deceptive claim or	26034
falsification;	26035

(4) All reasonable expenses which the court determines have	26036
been necessarily incurred by the state in the enforcement of this	26037
section.	26038

(C) As used in this division, "intermediate care facility for	26039
the mentally retarded" and "nursing facility" have the same	26040
meanings given in section ~~5111.20~~5164.01 of the Revised Code.	26041

In addition to the civil penalties provided in division (B)	26042
of this section, the director of ~~job and family services~~health	26043
care administration, upon the conviction of, or the entry of a	26044
judgment in either a criminal or civil action against, a medicaid	26045
provider or its owner, officer, authorized agent, associate,	26046
manager, or employee in an action brought pursuant to section	26047
109.85 of the Revised Code, shall terminate the provider	26048
agreement between the department and the provider and stop	26049
reimbursement to the provider for services rendered from the	26050
date of conviction or entry of judgment. As used in this	26051
division, "owner" means any person having at least five per cent	26052
ownership in the medicaid provider. No such provider, owner,	26053
officer, authorized agent, associate, manager, or employee shall	26054
own or provide services to any other medicaid provider or risk	26055
contractor or arrange for, render, or order services for	26056
medicaid recipients, nor shall such provider, owner, officer,	26057
authorized agent, associate, manager, or employee receive	26058
reimbursement in the form of direct payments from the department	26059
or indirect payments of medicaid funds in the form of salary,	26060
shared fees, contracts, kickbacks, or rebates from or through any	26061
participating provider or risk contractor. The provider agreement	26062
shall not be terminated or reimbursement terminated if the	26063
provider or owner can demonstrate that the provider or owner did	26064
not directly or indirectly sanction the action of its authorized	26065
agent, associate, manager, or employee that resulted in the	26066
conviction or entry of a judgment in a criminal or civil action	26067
brought pursuant to section 109.85 of the Revised Code. Nothing in	26068
this division prohibits any owner, officer, authorized agent,	26069
associate, manager, or employee of a medicaid provider from	26070
entering into a medicaid provider agreement if the person can	26071
demonstrate that the person had no knowledge of an action of the	26072
medicaid provider the person was formerly associated with that	26073
resulted in the conviction or entry of a judgment in a criminal	26074
or civil action brought pursuant to section 109.85 of the Revised	26075
Code.	26076

Nursing facility or intermediate care facility for the	26077
mentally retarded providers whose agreements are terminated	26078
pursuant to this section may continue to receive reimbursement for	26079
up to thirty days after the effective date of the termination if	26080
the provider makes reasonable efforts to transfer recipients to	26081
another facility or to alternate care and if federal funds are	26082
provided for such reimbursement.	26083

(D) For any reason permitted or required by federal law, the	26084
director of ~~job and family services~~health care administration may	26085
deny a provider agreement or terminate a provider agreement.	26086

For any reason permitted or required by federal law, the	26087
director may exclude an individual, provider of services or goods,	26088
or other entity from participation in the medicaid program. No	26089
individual, provider, or entity excluded under this division shall	26090
own or provide services to any other medicaid provider or risk	26091
contractor or arrange for, render, or order services for medicaid	26092
recipients during the period of exclusion, nor, during the period	26093
of exclusion, shall such individual, provider, or entity receive	26094
reimbursement in the form of direct payments from the department	26095
or indirect payments of medicaid funds in the form of salary,	26096
shared fees, contracts, kickbacks, or rebates from or through any	26097
participating provider or risk contractor. An excluded individual,	26098
provider, or entity may request a reconsideration of the	26099
exclusion. The director shall adopt rules in accordance with	26100
Chapter 119. of the Revised Code governing the process for	26101
requesting a reconsideration.	26102

Nothing in this division limits the applicability of section	26103
5111.06 of the Revised Code to a medicaid provider.	26104

(E) Any provider of services or goods contracting with the	26105
department of ~~job and family services pursuant to Title XIX of~~	26106
health care administration under the ~~"Social Security Act,"~~	26107
medicaid program who, without intent, obtains payments under this	26108
chapter in excess of the amount to which the provider is entitled,	26109
thereby becomes liable for payment of interest on the amount of	26110
the excess payments at the maximum real estate mortgage rate on	26111
the date the payment was made to the provider for the period from	26112
the date upon which payment was made to the date upon which	26113
repayment is made to the state.	26114

(F) The attorney general on behalf of the state may commence	26115
proceedings to enforce this section in any court of competent	26116
jurisdiction; and the attorney general may settle or compromise	26117
any case brought under this section with the approval of the	26118
department of ~~job and family services~~health care administration.	26119
Notwithstanding any other provision of law providing a shorter	26120
period of limitations, the attorney general may commence a	26121
proceeding to enforce this section at any time within six years	26122
after the conduct in violation of this section terminates.	26123

(G) The authority, under state and federal law, of the	26124
department of ~~job and family services~~health care administration	26125
or a county department of job and family services to recover	26126
excess payments made to a provider is not limited by the	26127
availability of remedies under sections ~~5111.11~~5162.40 and	26128
~~5111.12~~5162.45 of the Revised Code for recovering benefits paid	26129
on behalf of medicaid recipients ~~of medical assistance~~.	26130

The penalties under this chapter apply to any overpayment,	26131
billing, or falsification occurring on and after April 24, 1978.	26132
All moneys collected by the state pursuant to this section shall	26133
be deposited in the state treasury to the credit of the general	26134
revenue fund.	26135

~~Sec. 5111.031.~~ Sec. 5163.031. (A) As used in this section:

26136

(1) "Independent provider" has the same meaning as in section	26137
~~5111.034~~5163.034 of the Revised Code.	26138

(2) "Intermediate care facility for the mentally retarded"	26139
and "nursing facility" have the same meanings as in section	26140
~~5111.20~~5164.01 of the Revised Code.	26141

(3) "Noninstitutional medicaid provider" means any person or	26142
entity with a medicaid provider agreement other than a hospital,	26143
nursing facility, or intermediate care facility for the mentally	26144
retarded.	26145

(4) "Owner" means any person having at least five per cent	26146
ownership in a noninstitutional medicaid provider.	26147

(B) Notwithstanding any provision of this chapter to the	26148
contrary, the department of ~~job and family services~~health care	26149
administration shall take action under this section against a	26150
noninstitutional medicaid provider or its owner, officer,	26151
authorized agent, associate, manager, or employee.	26152

(C) Except as provided in division (D) of this section and in	26153
rules adopted by the department under division (H) of this	26154
section, on receiving notice and a copy of an indictment that is	26155
issued on or after ~~the effective date of this section~~September	26156
29, 2007, and charges a noninstitutional medicaid provider or its	26157
owner, officer, authorized agent, associate, manager, or employee	26158
with committing an offense specified in division (E) of this	26159
section, the department shall suspend the provider agreement held	26160
by the noninstitutional medicaid provider. Subject to division	26161
(D) of this section, the department shall also terminate medicaid	26162
reimbursement to the provider for services rendered.	26163

The suspension shall continue in effect until the proceedings	26164
in the criminal case are completed through conviction, dismissal	26165
of the indictment, plea, or finding of not guilty. If the	26166
department commences a process to terminate the suspended provider	26167
agreement, the suspension shall continue in effect until the	26168
termination process is concluded. Pursuant to section ~~5111.06~~	26169
5163.01 of the Revised Code, the department is not required to	26170
take action under this division by issuing an order pursuant to	26171
an adjudication conducted in accordance with Chapter 119. of the	26172
Revised Code.	26173

When subject to a suspension under this division, a provider,	26174
owner, officer, authorized agent, associate, manager, or employee	26175
shall not own or provide services to any other medicaid provider	26176
or risk contractor or arrange for, render, or order services for	26177
medicaid recipients during the period of suspension. During the	26178
period of suspension, the provider, owner, officer, authorized	26179
agent, associate, manager, or employee shall not receive	26180
reimbursement in the form of direct payments from the department	26181
or indirect payments of medicaid funds in the form of salary,	26182
shared fees, contracts, kickbacks, or rebates from or through any	26183
participating provider or risk contractor.	26184

(D)(1) The department shall not suspend a provider agreement	26185
or terminate medicaid reimbursement under division (C) of this	26186
section if the provider or owner can demonstrate that the provider	26187
or owner did not directly or indirectly sanction the action of its	26188
authorized agent, associate, manager, or employee that resulted in	26189
the indictment.	26190

(2) The termination of medicaid reimbursement applies only to	26191
payments for medicaid services rendered subsequent to the date on	26192
which the notice required under division (F) of this section is	26193
sent. Claims for reimbursement for medicaid services rendered by	26194
the provider prior to the issuance of the notice may be subject to	26195
prepayment review procedures whereby the department reviews claims	26196
to determine whether they are supported by sufficient	26197
documentation, are in compliance with state and federal statutes	26198
and rules, and are otherwise complete.	26199

(E)(1) In the case of a noninstitutional medicaid provider	26200
that is not an independent provider, the suspension of a provider	26201
agreement under division (C) of this section applies when an	26202
indictment charges a person with committing an act that would be a	26203
felony or misdemeanor under the laws of this state and the act	26204
relates to or results from either of the following:	26205

(a) Furnishing or billing for medical care, services, or	26206
supplies under the medicaid program;	26207

(b) Participating in the performance of management or	26208
administrative services relating to furnishing medical care,	26209
services, or supplies under the medicaid program.	26210

(2) In the case of a noninstitutional medicaid provider that	26211
is an independent provider, the suspension of a provider agreement	26212
under division (C) of this section applies when an indictment	26213
charges a person with committing an act that would constitute one	26214
of the offenses specified in division (D) of section ~~5111.034~~	26215
5163.034 of the Revised Code.	26216

(F) Not later than five days after suspending a provider	26217
agreement under division (C) of this section, the department shall	26218
send notice of the suspension to the affected provider or owner.	26219
In providing the notice, the department shall do all of the	26220
following:	26221

(1) Describe the indictment that was the cause of the	26222
suspension, without necessarily disclosing specific information	26223
concerning any ongoing civil or criminal investigation;	26224

(2) State that the suspension will continue in effect until	26225
the proceedings in the criminal case are completed through	26226
conviction, dismissal of the indictment, plea, or finding of not	26227
guilty and, if the department commences a process to terminate the	26228
suspended provider agreement, until the termination process is	26229
concluded;	26230

(3) Inform the provider or owner of the opportunity to submit	26231
to the department, not later than thirty days after receiving the	26232
notice, a request for a reconsideration pursuant to division (G)	26233
of this section.	26234

(G)(1) A noninstitutional medicaid provider or owner subject	26235
to a suspension under this section may request a reconsideration.	26236
The request shall be made not later than thirty days after receipt	26237
of the notice provided under division (F) of this section. The	26238
reconsideration is not subject to an adjudication hearing pursuant	26239
to Chapter 119. of the Revised Code.	26240

(2) In requesting a reconsideration, the provider or owner	26241
shall submit written information and documents to the department.	26242
The information and documents may pertain to any of the following	26243
issues:	26244

(a) Whether the determination to suspend the provider	26245
agreement was based on a mistake of fact, other than the validity	26246
of the indictment;	26247

(b) Whether any offense charged in the indictment resulted	26248
from an offense specified in division (E) of this section;	26249

(c) Whether the provider or owner can demonstrate that the	26250
provider or owner did not directly or indirectly sanction the	26251
action of its authorized agent, associate, manager, or employee	26252
that resulted in the indictment.	26253

(3) The department shall review the information and documents	26254
submitted in a request for reconsideration. After the review, the	26255
suspension may be affirmed, reversed, or modified, in whole or in	26256
part. The department shall notify the affected provider or owner	26257
of the results of the review. The review and notification of its	26258
results shall be completed not later than forty-five days after	26259
receiving the information and documents submitted in a request for	26260
reconsideration.	26261

(H) The department may adopt rules in accordance with Chapter	26262
119. of the Revised Code to implement this section. The rules may	26263
specify circumstances under which the department would not suspend	26264
a provider agreement pursuant to this section.	26265

~~Sec. 5111.032.~~ Sec. 5163.032. (A) As used in this section:

26266

(1) "Criminal records check" has the same meaning as in	26267
section 109.572 of the Revised Code.	26268

(2) "Department" includes a designee of the department of ~~job~~	26269
~~and family services~~health care administration.	26270

(3) "Owner" means a person who has an ownership interest in a	26271
provider in an amount designated by the department of ~~job and~~	26272
~~family services~~health care administration in rules adopted under	26273
this section.	26274

(4) "Provider" means a person, institution, or entity that	26275
has a medicaid provider agreement with the department of ~~job and~~	26276
~~family services pursuant to Title XIX of the "Social Security~~	26277
~~Act," 49 State. 620 (1965), 42 U.S.C. 1396, as amended~~health	26278
care administration.	26279

(B)(1) Except as provided in division (B)(2) of this section,	26280
the department of ~~job and family services~~health care	26281
administration may require that any provider, applicant to be a	26282
provider, employee or prospective employee of a provider, owner	26283
or prospective owner of a provider, officer or prospective	26284
officer of a provider, or board member or prospective board	26285
member of a provider submit to a criminal records check as a	26286
condition of obtaining a provider agreement, continuing to hold a	26287
provider agreement, being employed by a provider, having an	26288
ownership interest in a provider, or being an officer or board	26289
member of a provider. The department may designate the categories	26290
of persons who are subject to the criminal records check	26291
requirement. The department shall designate the times at which	26292
the criminal records checks must be conducted.	26293

(2) The section does not apply to providers, applicants to be	26294
providers, employees of a provider, or prospective employees of a	26295
provider who are subject to criminal records checks under section	26296
~~5111.033~~5163.033 or ~~5111.034~~5163.034 of the Revised Code.	26297

(C)(1) The department shall inform each provider or applicant	26298
to be a provider whether the provider or applicant is subject to a	26299
criminal records check requirement under division (B) of this	26300
section. For providers, the information shall be given at times	26301
designated in rules adopted under this section. For applicants to	26302
be providers, the information shall be given at the time of	26303
initial application. When the information is given, the department	26304
shall specify which of the provider's or applicant's employees or	26305
prospective employees, owners or prospective owners, officers or	26306
prospective officers, or board members or prospective board	26307
members are subject to the criminal records check requirement.	26308

(2) At times designated in rules adopted under this section,	26309
a provider that is subject to the criminal records check	26310
requirement shall inform each person specified by the department	26311
under division (C)(1) of this section that the person is required,	26312
as applicable, to submit to a criminal records check for final	26313
consideration for employment in a full-time, part-time, or	26314
temporary position; as a condition of continued employment; or as	26315
a condition of becoming or continuing to be an officer, board	26316
member or owner of a provider.	26317

(D)(1) If a provider or applicant to be a provider is subject	26318
to a criminal records check under this section, the department	26319
shall require the conduct of a criminal records check by the	26320
superintendent of the bureau of criminal identification and	26321
investigation. If a provider or applicant to be a provider for	26322
whom a criminal records check is required does not present proof	26323
of having been a resident of this state for the five-year period	26324
immediately prior to the date the criminal records check is	26325
requested or provide evidence that within that five-year period	26326
the superintendent has requested information about the individual	26327
from the federal bureau of investigation in a criminal records	26328
check, the department shall require the provider or applicant to	26329
request that the superintendent obtain information from the	26330
federal bureau of investigation as part of the criminal records	26331
check of the provider or applicant. Even if a provider or	26332
applicant for whom a criminal records check request is required	26333
presents proof of having been a resident of this state for the	26334
five-year period, the department may require that the provider or	26335
applicant request that the superintendent obtain information from	26336
the federal bureau of investigation and include it in the criminal	26337
records check of the provider or applicant.	26338

(2) A provider shall require the conduct of a criminal	26339
records check by the superintendent with respect to each of the	26340
persons specified by the department under division (C)(1) of this	26341
section. If the person for whom a criminal records check is	26342
required does not present proof of having been a resident of this	26343
state for the five-year period immediately prior to the date the	26344
criminal records check is requested or provide evidence that	26345
within that five-year period the superintendent of the bureau of	26346
criminal identification and investigation has requested	26347
information about the individual from the federal bureau of	26348
investigation in a criminal records check, the individual shall	26349
request that the superintendent obtain information from the	26350
federal bureau of investigation as part of the criminal records	26351
check of the individual. Even if an individual for whom a criminal	26352
records check request is required presents proof of having been a	26353
resident of this state for the five-year period, the department	26354
may require the provider to request that the superintendent obtain	26355
information from the federal bureau of investigation and include	26356
it in the criminal records check of the person.	26357

(E)(1) Criminal records checks required under this section	26358
for providers or applicants to be providers shall be obtained as	26359
follows:	26360

(a) The department shall provide each provider or applicant	26361
information about accessing and completing the form prescribed	26362
pursuant to division (C)(1) of section 109.572 of the Revised Code	26363
and the standard fingerprint impression sheet prescribed pursuant	26364
to division (C)(2) of that section.	26365

(b) The provider or applicant shall submit the required form	26366
and one complete set of fingerprint impressions directly to the	26367
superintendent for purposes of conducting the criminal records	26368
check using the applicable methods prescribed by division (C) of	26369
section 109.572 of the Revised Code. The applicant or provider	26370
shall pay all fees associated with obtaining the criminal records	26371
check.	26372

(c) The superintendent shall conduct the criminal records	26373
check in accordance with section 109.572 of the Revised Code. The	26374
provider or applicant shall instruct the superintendent to submit	26375
the report of the criminal records check directly to the director	26376
of job and family services.	26377

(2) Criminal records checks required under this section for	26378
persons specified by the department under division (C)(1) of this	26379
section shall be obtained as follows:	26380

(a) The provider shall give to each person subject to	26381
criminal records check requirement information about accessing and	26382
completing the form prescribed pursuant to division (C)(1) of	26383
section 109.572 of the Revised Code and the standard fingerprint	26384
impression sheet prescribed pursuant to division (C)(2) of that	26385
section.	26386

(b) The person shall submit the required form and one	26387
complete set of fingerprint impressions directly to the	26388
superintendent for purposes of conducting the criminal records	26389
check using the applicable methods prescribed by division (C) of	26390
section 109.572 of the Revised Code. The person shall pay all fees	26391
associated with obtaining the criminal records check.	26392

(c) The superintendent shall conduct the criminal records	26393
check in accordance with section 109.572 of the Revised Code. The	26394
person subject to the criminal records check shall instruct the	26395
superintendent to submit the report of the criminal records check	26396
directly to the provider. The department may require the provider	26397
to submit the report to the department.	26398

(F) If a provider or applicant to be a provider is given the	26399
information specified in division (E)(1)(a) of this section but	26400
fails to obtain a criminal records check, the department shall, as	26401
applicable, terminate the provider agreement or deny the	26402
application to be a provider.	26403

If a person is given the information specified in division	26404
(E)(2)(a) of this section but fails to obtain a criminal records	26405
check, the provider shall not, as applicable, permit the person to	26406
be an employee, owner, officer, or board member of the provider.	26407

(G) Except as provided in rules adopted under division (J) of	26408
this section, the department shall terminate the provider	26409
agreement of a provider or the department shall not issue a	26410
provider agreement to an applicant if the provider or applicant is	26411
subject to a criminal records check under this section and the	26412
provider or applicant has been convicted of, has pleaded guilty	26413
to, or has been found eligible for intervention in lieu of	26414
conviction for any of the following:	26415

(1) A violation of section 2903.01, 2903.02, 2903.03,	26416
2903.04, 2903.041, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21,	26417
2903.34, 2905.01, 2905.02, 2905.05, 2905.11, 2905.12, 2907.02,	26418
2907.03, 2907.04, 2907.05, 2907.06, 2907.07, 2907.08, 2907.09,	26419
2907.21, 2907.22, 2907.23, 2907.24, 2907.25, 2907.31, 2907.32,	26420
2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 2911.12,	26421
2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21, 2913.31,	26422
2913.40, 2913.43, 2913.47, 2913.48, 2913.49, 2913.51, 2917.11,	26423
2919.12, 2919.22, 2919.24, 2919.25, 2921.13, 2921.36, 2923.02,	26424
2923.12, 2923.13, 2923.161, 2923.32, 2925.02, 2925.03, 2925.04,	26425
2925.05, 2925.06, 2925.11, 2925.13, 2925.14, 2925.22, 2925.23, or	26426
3716.11 of the Revised Code, felonious sexual penetration in	26427
violation of former section 2907.12 of the Revised Code, a	26428
violation of section 2905.04 of the Revised Code as it existed	26429
prior to July 1, 1996, a violation of section 2919.23 of the	26430
Revised Code that would have been a violation of section 2905.04	26431
of the Revised Code as it existed prior to July 1, 1996, had the	26432
violation been committed prior to that date;	26433

(2) An existing or former law of this state, any other state,	26434
or the United States that is substantially equivalent to any of	26435
the offenses listed in division (G)(1) of this section.	26436

(H)(1)(a) Except as provided in rules adopted under division	26437
(J) of this section and subject to division (H)(2) of this	26438
section, no provider shall permit a person to be an employee,	26439
owner, officer, or board member of the provider if the person is	26440
subject to a criminal records check under this section and the	26441
person has been convicted of, has pleaded guilty to, or has been	26442
found eligible for intervention in lieu of conviction for any of	26443
the offenses specified in division (G)(1) or (2) of this section.	26444

(b) No provider shall employ a person who has been excluded	26445
from participating in the medicaid program, the medicare program	26446
~~operated pursuant to Title XVIII of the "Social Security Act~~," or	26447
any other federal health care program.	26448

(2)(a) A provider may employ conditionally a person for whom	26449
a criminal records check is required under this section prior to	26450
obtaining the results of a criminal records check regarding the	26451
person, but only if the person submits a request for a criminal	26452
records check not later than five business days after the	26453
individual begins conditional employment.	26454

(b) A provider that employs a person conditionally under	26455
authority of division (H)(2)(a) of this section shall terminate	26456
the person's employment if the results of the criminal records	26457
check request are not obtained within the period ending sixty days	26458
after the date the request is made. Regardless of when the results	26459
of the criminal records check are obtained, if the results	26460
indicate that the individual has been convicted of, has pleaded	26461
guilty to, or has been found eligible for intervention in lieu of	26462
conviction for any of the offenses specified in division (G)(1) or	26463
(2) of this section, the provider shall terminate the person's	26464
employment unless the provider chooses to employ the individual	26465
pursuant to division (J) of this section.	26466

(I) The report of a criminal records check conducted pursuant	26467
to this section is not a public record for the purposes of section	26468
149.43 of the Revised Code and shall not be made available to any	26469
person other than the following:	26470

(1) The person who is the subject of the criminal records	26471
check or the person's representative;	26472

(2) The director of ~~job and family services~~health care	26473
administration and the staff of the department in the	26474
administration of the medicaid program;	26475

(3) A court, hearing officer, or other necessary individual	26476
involved in a case dealing with the denial or termination of a	26477
provider agreement;	26478

(4) A court, hearing officer, or other necessary individual	26479
involved in a case dealing with a person's denial of employment,	26480
termination of employment, or employment or unemployment benefits.	26481

(J) The department may adopt rules in accordance with Chapter	26482
119. of the Revised Code to implement this section. The rules may	26483
specify circumstances under which the department may continue a	26484
provider agreement or issue a provider agreement to an applicant	26485
when the provider or applicant has been convicted of, has pleaded	26486
guilty to, or has been found eligible for intervention in lieu of	26487
conviction for any of the offenses specified in division (G)(1) or	26488
(2) of this section. The rules may also specify circumstances	26489
under which a provider may permit a person to be an employee,	26490
owner, officer, or board member of the provider, when the person	26491
has been convicted of, has pleaded guilty to, or has been found	26492
eligible for intervention in lieu of conviction for any of the	26493
offenses specified in division (G)(1) or (2) of this section.	26494

~~Sec. 5111.033.~~ Sec. 5163.033. (A) As used in this section:

26495

(1) "Applicant" means a person who is under final	26496
consideration for employment or, after September 26, 2003, an	26497
existing employee with a waiver agency in a full-time, part-time,	26498
or temporary position that involves providing home and	26499
community-based waiver services to a person with disabilities.	26500
"Applicant" also means an existing employee with a waiver agency	26501
in a full-time, part-time, or temporary position that involves	26502
providing home and community-based waiver services to a person	26503
with disabilities after September 26, 2003.	26504

(2) "Criminal records check" has the same meaning as in	26505
section 109.572 of the Revised Code.	26506

(3) "Waiver agency" means a person or government entity that	26507
is not certified under the medicare program and is accredited by	26508
the community health accreditation program or the joint commission	26509
on accreditation of health care organizations or a company that	26510
provides home and community-based waiver services to persons with	26511
disabilities through department of ~~job and family services~~health	26512
care administration administered home and community-based waiver	26513
programs.	26514

(4) "Home and community-based waiver services" means services	26515
furnished under the provision of 42 C.F.R. 441, subpart G, that	26516
permit individuals to live in a home setting rather than a nursing	26517
facility or hospital. Home and community-based waiver services are	26518
approved by the centers for medicare and medicaid for specific	26519
populations and are not otherwise available under the medicaid	26520
state plan.	26521

(B)(1) The chief administrator of a waiver agency shall	26522
require each applicant to request that the superintendent of the	26523
bureau of criminal identification and investigation conduct a	26524
criminal records check with respect to the applicant. If an	26525
applicant for whom a criminal records check request is required	26526
under this division does not present proof of having been a	26527
resident of this state for the five-year period immediately prior	26528
to the date the criminal records check is requested or provide	26529
evidence that within that five-year period the superintendent has	26530
requested information about the applicant from the federal bureau	26531
of investigation in a criminal records check, the chief	26532
administrator shall require the applicant to request that the	26533
superintendent obtain information from the federal bureau of	26534
investigation as part of the criminal records check of the	26535
applicant. Even if an applicant for whom a criminal records check	26536
request is required under this division presents proof of having	26537
been a resident of this state for the five-year period, the chief	26538
administrator may require the applicant to request that the	26539
superintendent include information from the federal bureau of	26540
investigation in the criminal records check.	26541

(2) The chief administrator shall provide the following to	26542
each applicant for whom a criminal records check request is	26543
required under division (B)(1) of this section:	26544

(a) Information about accessing, completing, and forwarding	26545
to the superintendent of the bureau of criminal identification and	26546
investigation the form prescribed pursuant to division (C)(1) of	26547
section 109.572 of the Revised Code and the standard fingerprint	26548
impression sheet prescribed pursuant to division (C)(2) of that	26549
section;	26550

(b) Written notification that the applicant is to instruct	26551
the superintendent to submit the completed report of the criminal	26552
records check directly to the chief administrator.	26553

(3) An applicant given information and notification under	26554
divisions (B)(2)(a) and (b) of this section who fails to access,	26555
complete, and forward to the superintendent the form or the	26556
standard fingerprint impression sheet, or who fails to instruct	26557
the superintendent to submit the completed report of the criminal	26558
records check directly to the chief administrator, shall not be	26559
employed in any position in a waiver agency for which a criminal	26560
records check is required by this section.	26561

(C)(1) Except as provided in rules adopted by the department	26562
of ~~job and family services~~health care administration in	26563
accordance with division (F) of this section and subject to	26564
division (C)(2) of this section, no waiver agency shall employ a	26565
person in a position that involves providing home and	26566
community-based waiver services to persons with disabilities if	26567
the person has been convicted of, has pleaded guilty to, or has	26568
been found eligible for intervention in lieu of conviction for	26569
any of the following:	26570

(a) A violation of section 2903.01, 2903.02, 2903.03,	26571
2903.04, 2903.041, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21,	26572
2903.34, 2905.01, 2905.02, 2905.05, 2905.11, 2905.12, 2907.02,	26573
2907.03, 2907.04, 2907.05, 2907.06, 2907.07, 2907.08, 2907.09,	26574
2907.21, 2907.22, 2907.23, 2907.24, 2907.25, 2907.31, 2907.32,	26575
2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 2911.12,	26576
2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21, 2913.31,	26577
2913.40, 2913.43, 2913.47, 2913.48, 2913.49, 2913.51, 2917.11,	26578
2919.12, 2919.22, 2919.24, 2919.25, 2921.13, 2921.36, 2923.02,	26579
2923.12, 2923.13, 2923.161, 2923.32, 2925.02, 2925.03, 2925.04,	26580
2925.05, 2925.06, 2925.11, 2925.13, 2925.14, 2925.22, 2925.23, or	26581
3716.11 of the Revised Code, felonious sexual penetration in	26582
violation of former section 2907.12 of the Revised Code, a	26583
violation of section 2905.04 of the Revised Code as it existed	26584
prior to July 1, 1996, a violation of section 2919.23 of the	26585
Revised Code that would have been a violation of section 2905.04	26586
of the Revised Code as it existed prior to July 1, 1996, had the	26587
violation been committed prior to that date;	26588

(b) An existing or former law of this state, any other state,	26589
or the United States that is substantially equivalent to any of	26590
the offenses listed in division (C)(1)(a) of this section.	26591

(2)(a) A waiver agency may employ conditionally an applicant	26592
for whom a criminal records check request is required under	26593
division (B) of this section prior to obtaining the results of a	26594
criminal records check regarding the individual, provided that the	26595
agency shall require the individual to request a criminal records	26596
check regarding the individual in accordance with division (B)(1)	26597
of this section not later than five business days after the	26598
individual begins conditional employment.	26599

(b) A waiver agency that employs an individual conditionally	26600
under authority of division (C)(2)(a) of this section shall	26601
terminate the individual's employment if the results of the	26602
criminal records check request under division (B) of this section,	26603
other than the results of any request for information from the	26604
federal bureau of investigation, are not obtained within the	26605
period ending sixty days after the date the request is made.	26606
Regardless of when the results of the criminal records check are	26607
obtained, if the results indicate that the individual has been	26608
convicted of, has pleaded guilty to, or has been found eligible	26609
for intervention in lieu of conviction for any of the offenses	26610
listed or described in division (C)(1) of this section, the agency	26611
shall terminate the individual's employment unless the agency	26612
chooses to employ the individual pursuant to division (F) of this	26613
section.	26614

(D)(1) The fee prescribed pursuant to division (C)(3) of	26615
section 109.572 of the Revised Code for each criminal records	26616
check conducted pursuant to a request made under division (B) of	26617
this section shall be paid to the bureau of criminal	26618
identification and investigation by the applicant or the waiver	26619
agency.	26620

(2) If a waiver agency pays the fee, it may charge the	26621
applicant a fee not exceeding the amount the agency pays under	26622
division (D)(1) of this section. An agency may collect a fee only	26623
if the agency notifies the person at the time of initial	26624
application for employment of the amount of the fee and that,	26625
unless the fee is paid, the person will not be considered for	26626
employment.	26627

(E) The report of any criminal records check conducted	26628
pursuant to a request made under this section is not a public	26629
record for the purposes of section 149.43 of the Revised Code and	26630
shall not be made available to any person other than the	26631
following:	26632

(1) The individual who is the subject of the criminal records	26633
check or the individual's representative;	26634

(2) The chief administrator of the agency requesting the	26635
criminal records check or the administrator's representative;	26636

(3) An administrator at the department;

26637

(4) A court, hearing officer, or other necessary individual	26638
involved in a case dealing with a denial of employment of the	26639
applicant or dealing with employment or unemployment benefits of	26640
the applicant.	26641

(F) The department shall adopt rules in accordance with	26642
Chapter 119. of the Revised Code to implement this section. The	26643
rules shall specify circumstances under which a waiver agency may	26644
employ a person who has been convicted of, has pleaded guilty to,	26645
or has been found eligible for intervention in lieu of conviction	26646
for an offense listed or described in division (C)(1) of this	26647
section.	26648

(G) The chief administrator of a waiver agency shall inform	26649
each person, at the time of initial application for a position	26650
that involves providing home and community-based waiver services	26651
to a person with a disability, that the person is required to	26652
provide a set of fingerprint impressions and that a criminal	26653
records check is required to be conducted if the person comes	26654
under final consideration for employment.	26655

(H)(1) A person who, on September 26, 2003, is an employee	26656
of a waiver agency in a full-time, part-time, or temporary	26657
position that involves providing home and community-based waiver	26658
services to a person with disabilities shall comply with this	26659
section within sixty days after September 26, 2003, unless	26660
division (H)(2) of this section applies.	26661

(2) This section shall not apply to a person to whom all of	26662
the following apply:	26663

(a) On September 26, 2003, the person is an employee of a	26664
waiver agency in a full-time, part-time, or temporary position	26665
that involves providing home and community-based waiver services	26666
to a person with disabilities.	26667

(b) The person previously had been the subject of a criminal	26668
background check relating to that position;	26669

(c) The person has been continuously employed in that	26670
position since that criminal background check had been conducted.	26671

~~Sec. 5111.034.~~ Sec. 5163.034. (A) As used in this section:

26672

(1) "Anniversary date" means the later of the effective date	26673
of the provider agreement relating to the independent provider or	26674
sixty days after September 26, 2003.	26675

(2) "Criminal records check" has the same meaning as in	26676
section 109.572 of the Revised Code.	26677

(3) "Department" includes a designee of the department of	26678
~~job and family services~~health care administration.	26679

(4) "Independent provider" means a person who is submitting	26680
an application for a provider agreement or who has a provider	26681
agreement as an independent provider in a department of ~~job and~~	26682
~~family services~~health care administration administered home and	26683
community-based services program providing home and	26684
community-based waiver services to consumers with disabilities.	26685

(5) "Home and community-based waiver services" has the same	26686
meaning as in section ~~5111.033~~5163.033 of the Revised Code.	26687

(B)(1) The department of ~~job and family services~~health care	26688
administration shall inform each independent provider, at the	26689
time of initial application for a provider agreement that	26690
involves providing home and community-based waiver services to	26691
consumers with disabilities, that the independent provider is	26692
required to provide a set of fingerprint impressions and that a	26693
criminal records check is required to be conducted if the person	26694
is to become an independent provider in a department administered	26695
home and community-based waiver program.	26696

(2) Beginning on September 26, 2003, the department shall	26697
inform each enrolled medicaid independent provider on or before	26698
time of the anniversary date of the provider agreement that	26699
involves providing home and community-based waiver services to	26700
consumers with disabilities that the independent provider is	26701
required to provide a set of fingerprint impressions and that a	26702
criminal records check is required to be conducted.	26703

(C)(1) The department shall require the independent provider	26704
to complete a criminal records check prior to entering into a	26705
provider agreement with the independent provider and at least	26706
annually thereafter. If an independent provider for whom a	26707
criminal records check is required under this division does not	26708
present proof of having been a resident of this state for the	26709
five-year period immediately prior to the date the criminal	26710
records check is requested or provide evidence that within that	26711
five-year period the superintendent of the bureau of criminal	26712
identification and investigation has requested information about	26713
the independent provider from the federal bureau of investigation	26714
in a criminal records check, the department shall request that	26715
the independent provider obtain through the superintendent a	26716
criminal records request from the federal bureau of investigation	26717
as part of the criminal records check of the independent	26718
provider. Even if an independent provider for whom a criminal	26719
records check request is required under this division presents	26720
proof of having been a resident of this state for the five-year	26721
period, the department may request that the independent provider	26722
obtain information through the superintendent from the federal	26723
bureau of investigation in the criminal records check.	26724

(2) The department shall provide the following to each	26725
independent provider for whom a criminal records check request	26726
is required under division (C)(1) of this section:	26727

(a) Information about accessing, completing, and forwarding	26728
to the superintendent of the bureau of criminal identification and	26729
investigation the form prescribed pursuant to division (C)(1) of	26730
section 109.572 of the Revised Code and the standard fingerprint	26731
impression sheet prescribed pursuant to division (C)(2) of that	26732
section;	26733

(b) Written notification that the independent provider is to	26734
instruct the superintendent to submit the completed report of the	26735
criminal records check directly to the department.	26736

(3) An independent provider given information and	26737
notification under divisions (C)(2)(a) and (b) of this section	26738
who fails to access, complete, and forward to the superintendent	26739
the form or the standard fingerprint impression sheet, or who	26740
fails to instruct the superintendent to submit the completed	26741
report of the criminal records check directly to the department,	26742
shall not be approved as an independent provider.	26743

(D) Except as provided in rules adopted by the department in	26744
accordance with division (G) of this section, the department shall	26745
not issue a new provider agreement to, and shall terminate an	26746
existing provider agreement of, an independent provider if the	26747
person has been convicted of, has pleaded guilty to, or has been	26748
found eligible for intervention in lieu of conviction for any of	26749
the following:	26750

(1) A violation of section 2903.01, 2903.02, 2903.03,	26751
2903.04, 2903.041, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21,	26752
2903.34, 2905.01, 2905.02, 2905.05, 2905.11, 2905.12, 2907.02,	26753
2907.03, 2907.04, 2907.05, 2907.06, 2907.07, 2907.08, 2907.09,	26754
2907.21, 2907.22, 2907.23, 2907.24, 2907.25, 2907.31, 2907.32,	26755
2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 2911.12,	26756
2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21, 2913.31,	26757
2913.40, 2913.43, 2913.47, 2913.48, 2913.49, 2913.51, 2917.11,	26758
2919.12, 2919.22, 2919.24, 2919.25, 2921.13, 2921.36, 2923.02,	26759
2923.12, 2923.13, 2923.161, 2923.32, 2925.02, 2925.03, 2925.04,	26760
2925.05, 2925.06, 2925.11, 2925.13, 2925.14, 2925.22, 2925.23, or	26761
3716.11 of the Revised Code, felonious sexual penetration in	26762
violation of former section 2907.12 of the Revised Code, a	26763
violation of section 2905.04 of the Revised Code as it existed	26764
prior to July 1, 1996, a violation of section 2919.23 of the	26765
Revised Code that would have been a violation of section 2905.04	26766
of the Revised Code as it existed prior to July 1, 1996, had the	26767
violation been committed prior to that date;	26768

(2) An existing or former law of this state, any other state,	26769
or the United States that is substantially equivalent to any of	26770
the offenses listed in division (D)(1) of this section.	26771

(E) Each independent provider shall pay to the bureau of	26772
criminal identification and investigation the fee prescribed	26773
pursuant to division (C)(3) of section 109.572 of the Revised Code	26774
for each criminal records check conducted pursuant to a request	26775
made under division (C) of this section.	26776

(F) The report of any criminal records check conducted by the	26777
bureau of criminal identification and investigation in accordance	26778
with section 109.572 of the Revised Code and pursuant to a request	26779
made under division (C) of this section is not a public record for	26780
the purposes of section 149.43 of the Revised Code and shall not	26781
be made available to any person other than the following:	26782

(1) The person who is the subject of the criminal records	26783
check or the person's representative;	26784

(2) An administrator at the department or the administrator's	26785
representative;	26786

(3) A court, hearing officer, or other necessary individual	26787
involved in a case dealing with a denial or termination of a	26788
provider agreement related to the criminal records check.	26789

(G) The department shall adopt rules in accordance with	26790
Chapter 119. of the Revised Code to implement this section. The	26791
rules shall specify circumstances under which the department may	26792
either issue a provider agreement to an independent provider or	26793
allow an independent provider to maintain an existing provider	26794
agreement when the independent provider has been convicted of,	26795
has pleaded guilty to, or has been found eligible for intervention	26796
in lieu of conviction for an offense listed or described in	26797
division (C)(1) of this section.	26798

Sec. 5163.04. The department of health care administration	26799
may conduct final fiscal audits under the medicaid program in	26800
accordance with the applicable requirements set forth in federal	26801
laws and regulations and determine any amounts the provider may	26802
owe the state. When conducting final fiscal audits, the department	26803
shall consider generally accepted auditing standards, which	26804
include the use of statistical sampling.	26805

~~Sec. 5111.914.~~ Sec. 5163.06. (A) As used in this section,	26806
"provider" has the same meaning as in section ~~5111.06~~5163.01 of	26807
the Revised Code.	26808

(B) If a state agency that enters into a contract with the	26809
department of ~~job and family services~~health care administration	26810
under section ~~5111.91~~5161.05 of the Revised Code identifies that	26811
a medicaid overpayment has been made to a provider, the state	26812
agency may commence actions to recover the overpayment on behalf	26813
of the department.	26814

(C) In recovering an overpayment pursuant to this section, a	26815
state agency shall comply with the following procedures:	26816

(1) The state agency shall attempt to recover the overpayment	26817
by notifying the provider of the overpayment and requesting	26818
voluntary repayment. Not later than five business days after	26819
notifying the provider, the state agency shall notify the	26820
department in writing of the overpayment. The state agency may	26821
negotiate a settlement of the overpayment and notify the	26822
department of the settlement. A settlement negotiated by the state	26823
agency is not valid and shall not be implemented until the	26824
department has given its written approval of the settlement.	26825

(2) If the state agency is unable to obtain voluntary	26826
repayment of an overpayment, the agency shall give the provider	26827
notice of an opportunity for a hearing in accordance with Chapter	26828
119. of the Revised Code. If the provider timely requests a	26829
hearing in accordance with section 119.07 of the Revised Code, the	26830
state agency shall conduct the hearing to determine the legal and	26831
factual validity of the overpayment. On completion of the hearing,	26832
the state agency shall submit its hearing officer's report and	26833
recommendation and the complete record of proceedings, including	26834
all transcripts, to the director of ~~job and family services~~health	26835
care administration for final adjudication. The director may issue	26836
a final adjudication order in accordance with Chapter 119. of the	26837
Revised Code. The state agency shall pay any attorney's fees	26838
imposed under section 119.092 of the Revised Code. The department	26839
of job and family services shall pay any attorney's fees imposed	26840
under section 2335.39 of the Revised Code.	26841

(D) In any action taken by a state agency under this section	26842
that requires the agency to give notice of an opportunity for a	26843
hearing in accordance with Chapter 119. of the Revised Code, if	26844
the agency gives notice of the opportunity for a hearing but the	26845
provider subject to the notice does not request a hearing or	26846
timely request a hearing in accordance with section 119.07 of the	26847
Revised Code, the agency is not required to hold a hearing. The	26848
agency may request that the director of ~~job and family services~~	26849
health care administration issue a final adjudication order in	26850
accordance with Chapter 119. of the Revised Code.	26851

(E) This section does not preclude the department of ~~job and~~	26852
~~family services~~health care administration from adjudicating a	26853
final fiscal audit under section ~~5111.06~~5163.01 of the Revised	26854
Code, recovering overpayments under section ~~5111.061~~5163.07 of	26855
the Revised Code, or making findings or taking other actions	26856
authorized by this chapter.	26857

~~Sec. 5111.061.~~ Sec. 5163.07. (A) The department of ~~job and family~~	26858
~~services~~health care administration may recover a medicaid payment	26859
or portion of a payment made to a provider to which the provider	26860
is not entitled if the department notifies the provider of the	26861
overpayment during the five-year period immediately following the	26862
end of the state fiscal year in which the overpayment was made.	26863

(B) Among the overpayments that may be recovered under this	26864
section are the following:	26865

(1) Payment for a service, or a day of service, not rendered;

26866

(2) Payment for a day of service at a full per diem rate that	26867
should have been paid at a percentage of the full per diem rate;	26868

(3) Payment for a service, or day of service, that was paid	26869
by, or partially paid by, a third-party, as defined in section	26870
~~5101.571~~5160.36 of the Revised Code, and the third-party's	26871
payment or partial payment was not offset against the amount paid	26872
by the medicaid program to reduce or eliminate the amount that was	26873
paid by the medicaid program;	26874

(4) Payment when a medicaid recipient's responsibility for	26875
payment was understated and resulted in an overpayment to the	26876
provider.	26877

(C) The department may recover an overpayment under this	26878
section prior to or after any of the following:	26879

(1) Adjudication of a final fiscal audit that section ~~5111.06~~	26880
5163.01 of the Revised Code requires to be conducted in accordance	26881
with Chapter 119. of the Revised Code;	26882

(2) Adjudication of a finding under any other provision of	26883
this chapter or the rules adopted under it;	26884

(3) Expiration of the time to issue a final fiscal audit that	26885
section ~~5111.06~~5163.01 of the Revised Code requires to be	26886
conducted in accordance with Chapter 119. of the Revised Code;	26887

(4) Expiration of the time to issue a finding under any other	26888
provision of this chapter or the rules adopted under it.	26889

(D)(1) Subject to division (D)(2) of this section, the	26890
recovery of an overpayment under this section does not preclude	26891
the department from subsequently doing the following:	26892

(a) Issuing a final fiscal audit in accordance with Chapter	26893
119. of the Revised Code, as required under section ~~5111.06~~	26894
5163.01 of the Revised Code;	26895

(b) Issuing a finding under any other provision of this	26896
chapter or the rules adopted under it.	26897

(2) A final fiscal audit or finding issued subsequent to the	26898
recovery of an overpayment under this section shall be reduced by	26899
the amount of the prior recovery, as appropriate.	26900

(E) Nothing in this section limits the department's authority	26901
to recover overpayments pursuant to any other provision of the	26902
Revised Code.	26903

~~Sec. 5111.022.~~ Sec. 5163.08. Under the medicaid program, any	26904
amount determined to be owed the state by a final fiscal audit	26905
conducted pursuant to ~~division (D) of~~ section ~~5111.021~~5163.04 of	26906
the Revised Code, upon the issuance of an adjudication order	26907
pursuant to Chapter 119. of the Revised Code that contains a	26908
finding that there is a preponderance of the evidence that the	26909
provider will liquidate assets or file bankruptcy in order to	26910
prevent payment of the amount determined to be owed the state,	26911
becomes a lien upon the real and personal property of the	26912
provider. Upon failure of the provider to pay the amount to the	26913
state, the director of ~~job and family services~~health care	26914
administration shall file notice of the lien, for which there	26915
shall be no charge, in the office of the county recorder of the	26916
county in which it is ascertained that the provider owns real or	26917
personal property. The director shall notify the provider by mail	26918
of the lien, but absence of proof that the notice was sent does	26919
not affect the validity of the lien. The lien is not valid as	26920
against the claim of any mortgagee, pledgee, purchaser, judgment	26921
creditor, or other lienholder of record at the time the notice is	26922
filed.	26923

If the provider acquires real or personal property after	26924
notice of the lien is filed, the lien shall not be valid as	26925
against the claim of any mortgagee, pledgee, subsequent bona fide	26926
purchaser for value, judgment creditor, or other lienholder of	26927
record to such after-acquired property unless the notice of lien	26928
is refiled after the property is acquired by the provider and	26929
before the competing lien attaches to the after-acquired property	26930
or before the conveyance to the subsequent bona fide purchaser for	26931
value.	26932

When the amount has been paid, the provider may record with	26933
the recorder notice of the payment. For recording such notice of	26934
payment, the recorder shall charge and receive from the provider a	26935
base fee of one dollar for services and a housing trust fund fee	26936
of one dollar pursuant to section 317.36 of the Revised Code.	26937

In the event of a distribution of a provider's assets	26938
pursuant to an order of any court under the law of this state	26939
including any receivership, assignment for benefit of creditors,	26940
adjudicated insolvency, or similar proceedings, amounts then or	26941
thereafter due the state under this chapter have the same priority	26942
as provided by law for the payment of taxes due the state and	26943
shall be paid out of the receivership trust fund or other such	26944
trust fund in the same manner as provided for claims for unpaid	26945
taxes due the state.	26946

If the attorney general finds after investigation that any	26947
amount due the state under this chapter is uncollectable, in whole	26948
or in part, the attorney general shall recommend to the director	26949
the cancellation of all or part of the claim. The director may	26950
thereupon effect the cancellation.	26951

~~Sec. 5111.062.~~ Sec. 5163.09. In any action taken by the department	26952
of ~~job and family services~~health care administration under	26953
section ~~5111.06~~5163.01 or ~~5111.061~~5163.07 of the Revised Code	26954
or any other provision of ~~this chapter~~law governing the medicaid	26955
program that requires the department to give notice of an	26956
opportunity for a hearing in accordance with Chapter 119. of the	26957
Revised Code, if the department gives notice of the opportunity	26958
for a hearing but the provider or other entity subject to the	26959
notice does not request a hearing or timely request a hearing in	26960
accordance with section 119.07 of the Revised Code, the	26961
department is not required to hold a hearing. The director of ~~job~~	26962
~~and family service~~health care administration may proceed by	26963
issuing a final adjudication order in accordance with Chapter 119.	26964
of the Revised Code.	26965

~~Sec. 5111.101.~~ Sec. 5163.12. (A) As used in this section;

26966

"Agent" and "contractor" include any agent, contractor,	26967
subcontractor, or other person who, on behalf of an entity,	26968
furnishes or authorizes the furnishing of health care items or	26969
services under the medicaid program, performs billing or coding	26970
functions, or is involved in monitoring of health care that an	26971
entity provides.	26972

"Employee" includes any officer or employee (including	26973
management employees) of an entity.	26974

"Entity" includes a governmental entity or an organization,	26975
unit, corporation, partnership, or other business arrangement,	26976
including any medicaid managed care organization, irrespective of	26977
the form of business structure or arrangement by which it exists,	26978
whether for-profit or not-for-profit. "Entity" does not include a	26979
government entity that administers one or more components of the	26980
medicaid program, unless the government entity receives medicaid	26981
payments for providing items or services.	26982

"Federal health care programs" has the same meaning as in 42	26983
U.S.C. 1320a-7b(f).	26984

(B) Each entity that receives or makes in a federal fiscal	26985
year payments under the medicaid program, either through the state	26986
medicaid plan or a federal medicaid waiver, totaling at least five	26987
million dollars shall, as a condition of receiving such payments,	26988
do all of the following not later than the first day of the	26989
succeeding calendar year:	26990

(1) Establish written policies for all of the entity's	26991
employees, contractors, and agents that provide detailed	26992
information about the role of all of the following in preventing	26993
and detecting fraud, waste, and abuse in federal health care	26994
programs:	26995

(a) Federal false claims law under 31 U.S.C. 3729 to 3733;

26996

(b) Federal administrative remedies for false claims and	26997
statements available under 31 U.S.C. 3801 to 3812;	26998

(c) Sections 124.341, 2913.40, 2913.401, and 2921.13 of the	26999
Revised Code and any other state laws pertaining to civil or	27000
criminal penalties for false claims and statements;	27001

(d) Whistleblower protections under the laws specified in	27002
divisions (B)(1)(a) to (c) of this section.	27003

(2) Include as part of the written policies required by	27004
division (B)(1) of this section detailed provisions regarding the	27005
entity's policies and procedures for preventing and detecting	27006
fraud, waste, and abuse.	27007

(3) Disseminate the written policies required by division	27008
(B)(1) of this section to each of the entity's employees,	27009
contractors, and agents in a paper or electronic form and make the	27010
written policies readily available to the entity's employees,	27011
contractors, and agents.	27012

(4) If the entity has an employee handbook, include in the	27013
employee handbook a specific discussion of the laws specified in	27014
division (B)(1) of this section, the rights of employees to be	27015
protected as whistleblowers, and the entity's policies and	27016
procedures for preventing and detecting fraud, waste, and abuse.	27017

(5) Require the entity's contractors and agents to adopt the	27018
entity's written policies required by division (B)(1) of this	27019
section.	27020

(C) An entity that furnishes items or services at multiple	27021
locations or under multiple contractual or other payment	27022
arrangements is required to comply with division (B) of this	27023
section if the entity receives in a federal fiscal year medicaid	27024
payments totaling in the aggregate at least five million dollars.	27025
This applies regardless of whether the entity submits claims for	27026
medicaid payments using multiple provider identification or tax	27027
identification numbers.	27028

~~Sec. 5111.02.~~ Sec. 5163.15. The director of ~~job and family services~~	27029
health care administration shall adopt, and may amend or rescind,	27030
rules under Chapter 119. of the Revised Code establishing the	27031
amount, duration, and scope of medicaid services. The rules shall	27032
be consistent with federal and state law. The rules may be	27033
different for different medicaid services. The rules shall	27034
establish all of the following:	27035

(A) The conditions under which the medicaid program shall	27036
cover and reimburse medicaid services;	27037

(B) The method of reimbursement applicable to each medicaid	27038
service;	27039

(C) The amount of reimbursement or, in lieu of amounts,	27040
methods by which amounts are to be determined for each medicaid	27041
service;	27042

(D) Procedures for enforcing the rules adopted under this	27043
section that provide due process protections, including procedures	27044
for corrective action plans for, and imposing financial and	27045
administrative sanctions on, persons and government entities that	27046
violate the rules.	27047

~~Sec. 5111.021.~~ Sec. 5163.16. Under the medicaid program:

27048

(A) Except as otherwise permitted by federal statute or	27049
regulation and at the department's discretion, reimbursement by	27050
the department of ~~job and family services~~health care	27051
administration to a medical provider for any medical service	27052
rendered under the program shall not exceed the authorized	27053
reimbursement level for the same service under the medicare	27054
program ~~established under Title XVIII of the "Social Security~~	27055
~~Act," 79 Stat. 286 (1965), 42 U.S.C. 1395, as amended~~.	27056

(B) Reimbursement for freestanding medical laboratory charges	27057
shall not exceed the customary and usual fee for laboratory	27058
profiles.	27059

(C) The department may deduct from payments for services	27060
rendered by a medicaid provider under the medicaid program any	27061
amounts the provider owes the state as the result of incorrect	27062
medicaid payments the department has made to the provider.	27063

(D) ~~The department may conduct final fiscal audits in~~	27064
~~accordance with the applicable requirements set forth in federal~~	27065
~~laws and regulations and determine any amounts the provider may~~	27066
~~owe the state. When conducting final fiscal audits, the department~~	27067
~~shall consider generally accepted auditing standards, which~~	27068
~~include the use of statistical sampling.~~	27069

~~(E)~~ The number of days of inpatient hospital care for which	27070
reimbursement is made on behalf of a medicaid recipient to a	27071
hospital that is not paid under a diagnostic-related-group	27072
prospective payment system shall not exceed thirty days during a	27073
period beginning on the day of the recipient's admission to the	27074
hospital and ending sixty days after the termination of that	27075
hospital stay, except that the department may make exceptions to	27076
this limitation. The limitation does not apply to children	27077
participating in the program for medically handicapped children	27078
established under section 3701.023 of the Revised Code.	27079

~~(F)~~(E) The division of any reimbursement between a	27080
collaborating physician or podiatrist and a clinical nurse	27081
specialist, certified nurse-midwife, or certified nurse	27082
practitioner for services performed by the nurse shall be	27083
determined and agreed on by the nurse and collaborating physician	27084
or podiatrist. In no case shall reimbursement exceed the payment	27085
that the physician or podiatrist would have received had the	27086
physician or podiatrist provided the entire service.	27087

~~Sec. 5111.025.~~ Sec. 5163.17. (A) In rules adopted under section	27088
~~5111.02~~5163.15 of the Revised Code, the director of ~~job and~~	27089
~~family services~~health care administration shall modify the manner	27090
or establish a new manner in which the following are paid under	27091
medicaid:	27092

(1) Community mental health facilities for providing mental	27093
health services included in the state medicaid plan pursuant to	27094
section ~~5111.023~~5163.20 of the Revised Code;	27095

(2) Providers of alcohol and drug addiction services for	27096
providing alcohol and drug addiction services included in the	27097
medicaid program pursuant to rules adopted under section ~~5111.02~~	27098
5163.15 of the Revised Code.	27099

(B) The director's authority to modify the manner, or to	27100
establish a new manner, for medicaid to pay for the services	27101
specified in division (A) of this section is not limited by any	27102
rules adopted under section ~~5111.02~~5163.15 or 5119.61 of the	27103
Revised Code that are in effect on June 26, 2003, and govern the	27104
way medicaid pays for those services. This is the case regardless	27105
of what state agency adopted the rules.	27106

~~Sec. 5111.018.~~ Sec. 5163.18. (A) The ~~provision of medical~~	27107
~~assistance under this chapter~~medicaid program shall ~~include~~	27108
~~coverage of~~cover inpatient care and follow-up care for a mother	27109
and her newborn as follows:	27110

(1) The ~~medical assistance~~medicaid program shall cover a	27111
minimum of forty-eight hours of inpatient care following a normal	27112
vaginal delivery and a minimum of ninety-six hours of inpatient	27113
care following a cesarean delivery. Services covered as inpatient	27114
care shall include medical, educational, and any other services	27115
that are consistent with the inpatient care recommended in the	27116
protocols and guidelines developed by national organizations that	27117
represent pediatric, obstetric, and nursing professionals.	27118

(2) The ~~medical assistance~~medicaid program shall cover a	27119
physician-directed source of follow-up care. Services covered as	27120
follow-up care shall include physical assessment of the mother and	27121
newborn, parent education, assistance and training in breast or	27122
bottle feeding, assessment of the home support system, performance	27123
of any medically necessary and appropriate clinical tests, and any	27124
other services that are consistent with the follow-up care	27125
recommended in the protocols and guidelines developed by national	27126
organizations that represent pediatric, obstetric, and nursing	27127
professionals. The coverage shall apply to services provided in a	27128
medical setting or through home health care visits. The coverage	27129
shall apply to a home health care visit only if the health care	27130
professional who conducts the visit is knowledgeable and	27131
experienced in maternity and newborn care.	27132

When a decision is made in accordance with division (B) of	27133
this section to discharge a mother or newborn prior to the	27134
expiration of the applicable number of hours of inpatient care	27135
required to be covered, the coverage of follow-up care shall apply	27136
to all follow-up care that is provided within forty-eight hours	27137
after discharge. When a mother or newborn receives at least the	27138
number of hours of inpatient care required to be covered, the	27139
coverage of follow-up care shall apply to follow-up care that is	27140
determined to be medically necessary by the health care	27141
professionals responsible for discharging the mother or newborn.	27142

(B) Any decision to shorten the length of inpatient stay to	27143
less than that specified under division (A)(1) of this section	27144
shall be made by the physician attending the mother or newborn,	27145
except that if a nurse-midwife is attending the mother in	27146
collaboration with a physician, the decision may be made by the	27147
nurse-midwife. Decisions regarding early discharge shall be made	27148
only after conferring with the mother or a person responsible for	27149
the mother or newborn. For purposes of this division, a person	27150
responsible for the mother or newborn may include a parent,	27151
guardian, or any other person with authority to make medical	27152
decisions for the mother or newborn.	27153

(C) The department of ~~job and family services~~health care	27154
administration, in administering the ~~medical assistance~~medicaid	27155
program, may not do either of the following:	27156

(1) Terminate the participation of a health care professional	27157
or health care facility as a provider under the program solely for	27158
making recommendations for inpatient or follow-up care for a	27159
particular mother or newborn that are consistent with the care	27160
required to be covered by this section;	27161

(2) Establish or offer monetary or other financial incentives	27162
for the purpose of encouraging a person to decline the inpatient	27163
or follow-up care required to be covered by this section.	27164

(D) This section does not do any of the following:

27165

(1) Require the ~~medical assistance~~medicaid program to cover	27166
inpatient or follow-up care that is not received in accordance	27167
with the program's terms pertaining to the health care	27168
professionals and facilities from which an individual is	27169
authorized to receive health care services.	27170

(2) Require a mother or newborn to stay in a hospital or	27171
other inpatient setting for a fixed period of time following	27172
delivery;	27173

(3) Require a child to be delivered in a hospital or other	27174
inpatient setting;	27175

(4) Authorize a nurse-midwife to practice beyond the	27176
authority to practice nurse-midwifery in accordance with Chapter	27177
4723. of the Revised Code;	27178

(5) Establish minimum standards of medical diagnosis, care,	27179
or treatment for inpatient or follow-up care for a mother or	27180
newborn. A deviation from the care required to be covered under	27181
this section shall not, on the basis of this section, give rise to	27182
a medical claim or derivative medical claim, as those terms are	27183
defined in section 2305.113 of the Revised Code.	27184

~~Sec. 5111.024.~~ Sec. 5163.19. (A) As used in this section,	27185
"screening mammography" means a radiologic examination utilized to	27186
detect unsuspected breast cancer at an early stage in asymptomatic	27187
women and includes the x-ray examination of the breast using	27188
equipment that is dedicated specifically for mammography,	27189
including the x-ray tube, filter, compression device, screens,	27190
film, and cassettes, and that has an average radiation exposure	27191
delivery of less than one rad mid-breast. "Screening mammography"	27192
includes two views for each breast. The term also includes the	27193
professional interpretation of the film.	27194

"Screening mammography" does not include diagnostic	27195
mammography.	27196

(B) ~~In addition to any other services required to be included~~	27197
~~in the program or for which federal approval is received, the~~	27198
~~medical assistance~~The medicaid program shall ~~include~~cover both	27199
of the following if ~~approval for use of federal funds is granted~~	27200
~~to the department by the federal agency responsible for~~	27201
~~distributing funds under Title XIX of the "Social Security Act,"~~	27202
~~49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended~~federal financial	27203
participation is available for them:	27204

(1) ~~Effective July 1, 1993, screening~~Screening mammography	27205
to detect the presence of breast cancer in adult women;	27206

(2) ~~Effective January 1, 1993, cytologic~~Cytologic screening	27207
for the presence of cervical cancer.	27208

(C) The service provided under division (B)(1) of this	27209
section shall be provided in accordance with all of the following:	27210

(1) If a woman is at least thirty-five years of age but under	27211
forty years of age, one screening mammography;	27212

(2) If a woman is at least forty years of age but under fifty	27213
years of age, either of the following:	27214

(a) One screening mammography every two years;

27215

(b) If a licensed physician has determined that the woman has	27216
risk factors to breast cancer, one screening mammography every	27217
year.	27218

(3) If a woman is at least fifty years of age but under	27219
sixty-five years of age, one screening mammography every year.	27220

(D) The service provided under division (B)(1) of this	27221
section shall be provided only for screening mammographies that	27222
are performed in a facility or mobile mammography screening unit	27223
that is accredited under the American college of radiology	27224
mammography accreditation program or in a hospital as defined in	27225
section 3727.01 of the Revised Code.	27226

(E) The service provided under division (B)(2) of this	27227
section shall be provided only for cytologic screenings that are	27228
processed and interpreted in a laboratory certified by the college	27229
of American pathologists or in a hospital as defined in section	27230
3727.01 of the Revised Code.	27231

~~Sec. 5111.023.~~ Sec. 5163.20. (A) As used in this section:

27232

(1) "Community mental health facility" means a community	27233
mental health facility that has a quality assurance program	27234
accredited by the joint commission on accreditation of healthcare	27235
organizations or is certified by the department of mental health	27236
or department of ~~job and family services~~health care	27237
administration.	27238

(2) "Mental health professional" means a person qualified to	27239
work with mentally ill persons under the standards established by	27240
the director of mental health pursuant to section 5119.611 of the	27241
Revised Code.	27242

(B) The state medicaid plan shall include provision of the	27243
following mental health services when provided by community mental	27244
health facilities:	27245

(1) Outpatient mental health services, including, but not	27246
limited to, preventive, diagnostic, therapeutic, rehabilitative,	27247
and palliative interventions rendered to individuals in an	27248
individual or group setting by a mental health professional in	27249
accordance with a plan of treatment appropriately established,	27250
monitored, and reviewed;	27251

(2) Partial-hospitalization mental health services rendered	27252
by persons directly supervised by a mental health professional;	27253

(3) Unscheduled, emergency mental health services of a kind	27254
ordinarily provided to persons in crisis when rendered by persons	27255
supervised by a mental health professional;	27256

(4) Subject to receipt of federal approval, assertive	27257
community treatment and intensive home-based mental health	27258
services.	27259

(C) The comprehensive annual plan shall certify the	27260
availability of sufficient unencumbered community mental health	27261
state subsidy and local funds to match federal medicaid	27262
reimbursement funds earned by community mental health facilities.	27263

(D) The department of ~~job and family services~~health care	27264
administration shall enter into a separate contract with the	27265
department of mental health under section ~~5111.91~~5161.05 of the	27266
Revised Code with regard to the component of the medicaid program	27267
provided for by this section.	27268

(E) Not later than July 21, 2006, the department of ~~job and~~	27269
~~family services~~health care administration shall request federal	27270
approval to provide assertive community treatment and intensive	27271
home-based mental health services under medicaid pursuant to this	27272
section.	27273

(F) On receipt of federal approval sought under division (E)	27274
of this section, the director of ~~job and family services~~health	27275
care administration shall adopt rules in accordance with Chapter	27276
119. of the Revised Code for assertive community treatment and	27277
intensive home-based mental health services provided under	27278
medicaid pursuant to this section. The director shall consult	27279
with the department of mental health in adopting the rules.	27280

~~Sec. 5111.04.~~ Sec. 5163.21. (A) As used in this section:

27281

(1) "Outpatient health facility" means a facility that	27282
provides comprehensive primary health services by or under the	27283
direction of a physician at least five days per week on a	27284
forty-hour per week basis to outpatients, is operated by the board	27285
of health of a city or general health district or another public	27286
agency or by a nonprofit private agency or organization under the	27287
direction and control of a governing board that has no	27288
health-related responsibilities other than the direction and	27289
control of one or more such outpatient health facilities, and	27290
receives at least seventy-five per cent of its operating funds	27291
from public sources, except that it does not include an outpatient	27292
hospital facility or a federally qualified health center as	27293
defined in Sec. 1905(l) (2)(B) of the "Social Security Act," 103	27294
Stat. 2264 (1989), 42 U.S.C.A. 1396d(l)(2)(B).	27295

(2) "Comprehensive primary health services" means preventive,	27296
diagnostic, therapeutic, rehabilitative, or palliative items or	27297
services that include all of the following:	27298

(a) Services of physicians, physician assistants, and	27299
certified nurse practitioners;	27300

(b) Diagnostic laboratory and radiological services;

27301

(c) Preventive health services, such as children's eye and	27302
ear examinations, perinatal services, well child services, and	27303
family planning services;	27304

(d) Arrangements for emergency medical services;

27305

(e) Transportation services.

27306

(3) "Certified nurse practitioner" has the same meaning as in	27307
section 4723.01 of the Revised Code.	27308

(B) Outpatient health facilities are a separate category of	27309
medical care provider under the rules governing the administration	27310
of the ~~medical assistance~~medicaid program ~~established under~~	27311
~~section 5111.01 of the Revised Code~~. Rates of reimbursement for	27312
items and services provided by an outpatient health facility under	27313
this section shall be prospectively determined by the department	27314
of ~~job and family services~~health care administration not less	27315
often than once each year, shall not be subject to retroactive	27316
adjustment based on actual costs incurred, and shall not exceed	27317
the maximum fee schedule or rates of payment, limitations based on	27318
reasonable costs or customary charges, and limitations based on	27319
combined payments received for furnishing comparable services, as	27320
are applicable to outpatient hospital facilities under ~~Title XVIII~~	27321
of the ~~"Social Security Act~~medicare program." In determining	27322
rates of reimbursement prospectively, the department shall take	27323
into account the historic expenses of the facility, the operating	27324
requirements and services offered by the facility, and the	27325
geographical location of the facility, shall provide incentives	27326
for the efficient and economical utilization of the facility's	27327
resources, and shall ensure that the facility does not	27328
discriminate between classes of persons for whom or by whom	27329
payment for items and services is made.	27330

(C) A facility does not qualify for classification as an	27331
outpatient health facility under this section unless it:	27332

(1) Has health and medical care policies developed with the	27333
advice of and subject to review by an advisory committee of	27334
professional personnel, including one or more physicians, one or	27335
more dentists if dental care is provided, and one or more	27336
registered nurses;	27337

(2) Has a medical director, a dental director, if dental care	27338
is provided, and a nursing director responsible for the execution	27339
of such policies, and has physicians, dentists, nursing, and	27340
ancillary staff appropriate to the scope of services provided;	27341

(3) Requires that the care of every patient be under the	27342
supervision of a physician, provides for medical care in case of	27343
emergency, has in effect a written agreement with one or more	27344
hospitals and one or more other outpatient facilities, and has an	27345
established system for the referral of patients to other resources	27346
and a utilization review plan and program;	27347

(4) Maintains clinical records on all patients;

27348

(5) Provides nursing services and other therapeutic services	27349
in compliance with applicable laws and rules and under the	27350
supervision of a registered nurse, and has a registered nurse on	27351
duty at all times when the facility is in operation;	27352

(6) Follows approved methods and procedures for the	27353
dispensing and administration of drugs and biologicals;	27354

(7) Maintains the accounting and record-keeping system	27355
required under federal laws and regulations for the determination	27356
of reasonable and allowable costs.	27357

~~Sec. 5111.14.~~ Sec. 5163.22. The department of ~~job and family~~	27358
~~services~~health care administration may require county departments	27359
of job and family services to provide case management of	27360
nonemergency transportation services provided under the ~~medical~~	27361
~~assistance~~medicaid program. County departments shall provide the	27362
case management if required by the department in accordance with	27363
rules adopted by the director of ~~job and family services~~health	27364
care administration.	27365

The department shall determine, for the purposes of claiming	27366
federal reimbursement under the ~~medical assistance~~medicaid	27367
program, whether it will claim expenditures for nonemergency	27368
transportation services as administrative or program expenditures.	27369

~~Sec. 5111.19.~~ Sec. 5163.23. The director of ~~job and family~~	27370
~~services~~health care administration shall adopt rules governing	27371
the calculation and payment of graduate medical education costs	27372
associated with services rendered to medicaid recipients after	27373
June 30, 1994. Subject to section ~~5111.191~~5163.231 of the Revised	27374
Code, the rules shall provide for reimbursement of graduate	27375
medical education costs associated with services rendered to	27376
medicaid recipients, including recipients enrolled in a managed	27377
care organization under contract with the department under section	27378
~~5111.17~~5165.05 of the Revised Code, that the department	27379
determines are allowable and reasonable.	27380

If the department requires a managed care organization to pay	27381
a provider for graduate medical education costs associated with	27382
the delivery of services to medicaid recipients enrolled in the	27383
organization, the department shall include in its payment to the	27384
organization an amount sufficient for the organization to pay such	27385
costs. If the department does not include in its payments to the	27386
managed care organization amounts for graduate medical education	27387
costs of providers, all of the following apply:	27388

(A) Except as provided in section ~~5111.191~~5163.231 of the	27389
Revised Code, the department shall pay the provider for graduate	27390
medical education costs associated with the delivery of services	27391
to medicaid recipients enrolled in the organization;	27392

(B) No provider shall seek reimbursement from the	27393
organization for such costs;	27394

(C) The organization is not required to pay providers for	27395
such costs.	27396

~~Sec. 5111.191.~~ Sec. 5163.231. (A) Except as provided in division	27397
(B) of this section, the department of ~~job and family services~~	27398
health care administration may deny payment to a hospital for	27399
direct graduate medical education costs associated with the	27400
delivery of services to any medicaid recipient if the hospital	27401
refuses without good cause to contract with a managed care	27402
organization that serves participants in the care management	27403
system established under section ~~5111.16~~5165.03 of the Revised	27404
Code who are required to be enrolled in a managed care	27405
organization and the managed care organization serves the area in	27406
which the hospital is located.	27407

(B) A hospital is not subject to division (A) of this section	27408
if all of the following are the case:	27409

(1) The hospital is located in a county in which participants	27410
in the care management system are required before January 1, 2006,	27411
to be enrolled in a medicaid managed care organization that is a	27412
health insuring corporation.	27413

(2) The hospital has entered into a contract before January	27414
1, 2006, with at least one health insuring corporation serving the	27415
participants specified in division (B)(1) of this section.	27416

(3) The hospital remains under contract with at least one	27417
health insuring corporation serving participants in the care	27418
management system who are required to be enrolled in a health	27419
insuring corporation.	27420

(C) The director of ~~job and family services~~health care	27421
administration shall specify in the rules adopted under section	27422
~~5111.19~~5163.231 of the Revised Code what constitutes good cause	27423
for a hospital to refuse to contract with a managed care	27424
organization.	27425

~~Sec. 5111.082.~~ Sec. 5163.24. (A) As used in this section:

27426

(1) "State maximum allowable cost" means the per unit amount	27427
the department of ~~job and family services~~health care	27428
administration reimburses a terminal distributor of dangerous	27429
drugs for a prescription drug included in the state maximum	27430
allowable cost program established under division (B) of this	27431
section. "State maximum allowable cost" excludes dispensing fees	27432
and copayments, coinsurance, or other cost-sharing charges, if	27433
any.	27434

(2) "Terminal distributor of dangerous drugs" has the same	27435
meaning as in section 4729.01 of the Revised Code.	27436

(B) The director of ~~job and family services~~health care	27437
administration shall establish a state maximum allowable cost	27438
program for purposes of managing reimbursement to terminal	27439
distributors of dangerous drugs for prescription drugs identified	27440
by the director pursuant to this division. The director shall do	27441
all of the following with respect to the program:	27442

(1) Identify and create a list of prescription drugs to be	27443
included in the program.	27444

(2) Update the list of prescription drugs described in	27445
division (B)(1) of this section on a weekly basis.	27446

(3) Review the state maximum allowable cost for each drug	27447
included on the list described in division (B)(1) of this section	27448
on a weekly basis.	27449

(C) The director may adopt rules in accordance with Chapter	27450
119. of the Revised Code to implement this section.	27451

~~Sec. 5111.08.~~ Sec. 5163.241. In accordance with ~~subsection (g) of~~	27452
~~section 1927 of the "Social Security Act," 49 Stat. 320 (1935),~~ 42	27453
U.S.C.A. 1396r-8(g), ~~as amended,~~ the department of ~~job and family~~	27454
~~services~~health care administration shall establish an outpatient	27455
drug use review program to assure that prescriptions obtained by	27456
recipients of medical assistance under this chapter are	27457
appropriate, medically necessary, and unlikely to cause adverse	27458
medical results.	27459

~~Sec. 5111.027.~~ Sec. 5163.242. If the medicaid program provides	27460
prescription drug services to medicaid recipients, the program	27461
shall not provide reimbursement for prescription drugs for	27462
treatment of erectile dysfunction.	27463

~~Sec. 5111.083.~~ Sec. 5163.243. (A) As used in this section,	27464
"licensed health professional authorized to prescribe drugs" has	27465
the same meaning as in section 4729.01 of the Revised Code.	27466

(B) The director of ~~job and family services~~health care	27467
administration may establish an e-prescribing system for the	27468
medicaid program under which a medicaid provider who is a licensed	27469
health professional authorized to prescribe drugs shall use an	27470
electronic system to prescribe a drug for a medicaid recipient	27471
when required to do so by division (C) of this section. The	27472
e-prescribing system shall eliminate the need for such medicaid	27473
providers to make prescriptions for medicaid recipients by	27474
handwriting or telephone. The e-prescribing system also shall	27475
provide such medicaid providers with an up-to-date, clinically	27476
relevant drug information database and a system of electronically	27477
monitoring medicaid recipients' medical history, drug regimen	27478
compliance, and fraud and abuse.	27479

(C) If the director establishes an e-prescribing system under	27480
division (B) of this section, the director shall do all of the	27481
following:	27482

(1) Require that a medicaid provider who is a licensed health	27483
professional authorized to prescribe drugs use the e-prescribing	27484
system during a fiscal year if the medicaid provider was one of	27485
the ten medicaid providers who, during the calendar year that	27486
precedes that fiscal year, issued the most prescriptions for	27487
medicaid recipients receiving hospital services;	27488

(2) Before the beginning of each fiscal year, determine the	27489
ten medicaid providers that issued the most prescriptions for	27490
medicaid recipients receiving hospital services during the	27491
calendar year that precedes the upcoming fiscal year and notify	27492
those medicaid providers that they must use the e-prescribing	27493
system for the upcoming fiscal year;	27494

(3) Seek the most federal financial participation available	27495
for the development and implementation of the e-prescribing	27496
system.	27497

~~Sec. 5111.07.~~ Sec. 5163.25. Commencing in July, 1986, and every	27498
second July thereafter, the department of ~~job and family services~~	27499
health care administration shall initiate a private survey of	27500
retail pharmacy operations in the state as the basis for	27501
establishing a current maximum dispensing fee for licensed	27502
pharmacists who are providers of drugs under this chapter. The	27503
survey shall be conducted in conformance with the requirements set	27504
forth in 42 C.F.R. 447.331 through 447.333, as amended or	27505
superseded, and shall include operational data and direct	27506
prescription expenses, professional services and personnel costs,	27507
usual and customary overhead expenses, and profit data of the	27508
retail pharmacies surveyed. The survey shall be completed and its	27509
results published no later than the last day of October of the	27510
year in which the survey is conducted, and the survey shall	27511
compute and report dispensing fees on a basis of the usual and	27512
customary charges by retail pharmacies to their customers for	27513
dispensing drugs. The director of ~~job and family services~~health	27514
care administration shall take into account the results of the	27515
survey in establishing a dispensing fee.	27516

~~Sec. 5111.071.~~ Sec. 5163.251. Commencing in December, 1986, and	27517
every second December thereafter, the director of ~~job and family~~	27518
~~services~~health care administration shall establish a dispensing	27519
fee, effective the following January, for licensed pharmacists who	27520
are medicaid providers ~~under this chapter~~. The dispensing fee	27521
shall take into consideration the results of the survey conducted	27522
under section ~~5111.07~~5163.25 of the Revised Code.	27523

~~Sec. 5111.081.~~ Sec. 5163.26. The director of ~~job and family~~	27524
~~services~~health care administration, in rules adopted under	27525
section ~~5111.02~~5163.15 of the Revised Code, may establish and	27526
implement a supplemental drug rebate program under which drug	27527
manufacturers may be required to provide the department of ~~job and~~	27528
~~family services~~health care administration a supplemental rebate	27529
as a condition of having the drug manufacturers' drug products	27530
covered by the medicaid program without prior approval. The	27531
department may receive a supplemental rebate negotiated under the	27532
program for a drug dispensed to a medicaid recipient pursuant to a	27533
prescription or a drug purchased by a medicaid provider for	27534
administration to a medicaid recipient in the provider's primary	27535
place of business. If necessary, the director may apply to the	27536
United States secretary of health and human services for a waiver	27537
of federal statutes and regulations to establish the supplemental	27538
drug rebate program.	27539

If the director establishes a supplemental drug rebate	27540
program, the director shall consult with drug manufacturers	27541
regarding the establishment and implementation of the program.	27542

~~Sec. 5111.0114.~~ Sec. 5163.261. (A) As used in this section,	27543
"dangerous drug" and "manufacturer of dangerous drugs" have the	27544
same meaning as in section 4729.01 of the Revised Code.	27545

(B) The director of ~~job and family services~~health care	27546
administration may enter into or administer an agreement or	27547
cooperative arrangement with other states to create or join a	27548
multiple-state prescription drug purchasing program for the	27549
purpose of negotiating with manufacturers of dangerous drugs to	27550
receive discounts or rebates for dangerous drugs dispensed under	27551
the medicaid program.	27552

~~Sec. 5111.029.~~ Sec. 5163.27. The medicaid program shall cover	27553
occupational therapy services provided by an occupational	27554
therapist licensed under section 4755.08 of the Revised Code.	27555
Coverage shall not be limited to services provided in a hospital	27556
or nursing facility. Any licensed occupational therapist may	27557
enter into a medicaid provider agreement with the department of	27558
~~job and family services~~health care administration to provide	27559
occupational therapy services under the medicaid program.	27560

~~Sec. 5111.042.~~ Sec. 5163.28. The departments of mental retardation	27561
and developmental disabilities and ~~job and family services~~health	27562
care administration may approve, reduce, deny, or terminate a	27563
service included in the individualized service plan developed for	27564
a medicaid recipient with mental retardation or other	27565
developmental disability who is eligible for medicaid case	27566
management services. If either department approves, reduces,	27567
denies, or terminates a service, that department shall timely	27568
notify the medicaid recipient that the recipient may request a	27569
hearing under section ~~5101.35~~5160.34 of the Revised Code.	27570

~~Sec. 5111.71.~~ Sec. 5163.30. (A) As used in sections ~~5111.71~~5163.30	27571
to ~~5111.715~~5163.305 of the Revised Code, "qualified medicaid	27572
school provider" means the board of education of a city, local,	27573
or exempted village school district, the governing authority of a	27574
community school established under Chapter 3314. of the Revised	27575
Code, the state school for the deaf, and the state school for the	27576
blind to which both of the following apply:	27577

(1) It holds a valid medicaid provider agreement.

27578

(2) It meets all other conditions for participation in the	27579
medicaid school component of the medicaid program established in	27580
rules adopted under section ~~5111.715~~5163.305 of the Revised Code.	27581

(B) The director of ~~job and family services~~health care	27582
administration shall submit a state medicaid plan amendment to	27583
the United States secretary of health and human services for the	27584
purpose of creating, in accordance with sections ~~5111.71~~5163.30	27585
to ~~5111.715~~5163.305 of the Revised Code, the medicaid school	27586
component of the medicaid program. The director shall create the	27587
medicaid school component on receipt of the United States	27588
secretary's approval of the amendment.	27589

~~Sec. 5111.711.~~ Sec. 5163.301. A qualified medicaid school provider	27590
participating in the medicaid school component of the medicaid	27591
program may submit a claim to the department of ~~job and family~~	27592
~~services~~health care administration for federal financial	27593
participation for providing, in schools, services covered by the	27594
medicaid school component to medicaid recipients who are eligible	27595
for the services. No qualified medicaid school provider may	27596
submit such a claim before the provider incurs the cost of	27597
providing the service.	27598

The claim shall include certification of the qualified	27599
medicaid school provider's expenditures for the service. The	27600
certification shall show that the money the qualified medicaid	27601
school provider used for the expenditures was nonfederal money the	27602
provider may legally use for providing the service and that the	27603
amount of the expenditures was sufficient to pay the full cost of	27604
the service.	27605

Except as otherwise provided in sections ~~5111.71~~5163.30 to	27606
~~5111.715~~5163.305 of the Revised Code and rules adopted under	27607
sections ~~5111.713~~5163.303 and ~~5111.715~~5163.305 of the Revised	27608
Code, a qualified medicaid school provider is subject to all	27609
conditions of participation in the medicaid program that	27610
generally apply to providers of goods and services under the	27611
medicaid program, including conditions regarding audits and	27612
recovery of overpayments.	27613

~~Sec. 5111.712.~~ Sec. 5163.302. The department of ~~job and family~~	27614
~~services~~health care administration shall seek federal financial	27615
participation for each claim a qualified medicaid school provider	27616
properly submits to the department under section ~~5111.711~~	27617
5163.301 of the Revised Code. The department shall disburse the	27618
federal financial participation the department receives from the	27619
federal government for such a claim to the qualified medicaid	27620
school provider that submitted the claim. The department may not	27621
pay the qualified medicaid school provider the nonfederal share	27622
of the cost of the services for which the claim was submitted.	27623

~~Sec. 5111.713.~~ Sec. 5163.303. The department of ~~job and family~~	27624
~~services~~health care administration shall enter into an	27625
interagency agreement with the department of education under	27626
section ~~5111.91~~5161.05 of the Revised Code that provides for the	27627
department of education to administer the medicaid school	27628
component of the medicaid program other than the aspects of the	27629
component that sections ~~5111.71~~5163.30 to ~~5111.715~~5163.305 of	27630
the Revised Code require the department of ~~job and family~~	27631
~~services~~health care administration to administer. The	27632
interagency agreement may include a provision that provides for	27633
the department of education to pay to the department of ~~job and~~	27634
~~family services~~health care administration the nonfederal share of	27635
a portion of the administrative expenses the department of ~~job~~	27636
~~and family services~~health care administration incurs in	27637
administering the aspects of the component that the department of	27638
~~job and family services~~health care administration administers.	27639

The department of education shall establish, in rules adopted	27640
under Chapter 119. of the Revised Code, a process by which	27641
qualified medicaid school providers participating in the medicaid	27642
school component pay to the department of education the nonfederal	27643
share of the department's expenses incurred in administering the	27644
component.	27645

~~Sec. 5111.714.~~ Sec. 5163.304. (A) There is hereby created in the	27646
state treasury the medicaid school program administrative fund.	27647

(B) Both of the following shall be deposited into the	27648
medicaid school program administrative fund:	27649

(1) The federal funds the department of education receives	27650
for the expenses the department incurs in administering the	27651
medicaid school component of the medicaid program;	27652

(2) The money the department collects from qualified medicaid	27653
school providers in the process established in rules adopted	27654
under section ~~5111.713~~5163.303 of the Revised Code.	27655

(C) No funds shall be deposited into the medicaid school	27656
program administrative fund in violation of federal statutes or	27657
regulations.	27658

(D) The department of education shall use money in the	27659
medicaid school program administrative fund for both of the	27660
following purposes:	27661

(1) Paying for the expenses the department incurs in	27662
administering the medicaid school component of the medicaid	27663
program;	27664

(2) Paying a qualified medicaid school provider a refund for	27665
any overpayment the provider makes to the department under the	27666
process established in rules adopted under section ~~5111.713~~	27667
5163.303 of the Revised Code if the process results in an	27668
overpayment.	27669

~~Sec. 5111.715.~~ Sec. 5163.305. The director of ~~job and family~~	27670
~~services~~health care administration shall adopt rules under	27671
Chapter 119. of the Revised Code as necessary to implement the	27672
medicaid school component of the medicaid program, including	27673
rules that establish or specify all of the following:	27674

(A) Conditions a board of education of a city, local, or	27675
exempted school district, governing authority of a community	27676
school established under Chapter 3314. of the Revised Code, the	27677
state school for the deaf, and the state school for the blind must	27678
meet to participate in the component;	27679

(B) Services the component covers;

27680

(C) Reimbursement rates for the services the component	27681
covers.	27682

~~Sec. 5111.85.~~ Sec. 5163.50. (A) As used in this section and	27683
sections ~~5111.851~~5163.51 to ~~5111.856~~5163.56 of the Revised Code,	27684
"medicaid waiver component" means a component of the medicaid	27685
program authorized by a waiver granted by the United States	27686
department of health and human services under ~~section 1115 or 1915~~	27687
~~of the "Social Security Act," 49 Stat. 620 (1935),~~ 42 U.S.C.A.	27688
1315 or 1396n. "Medicaid waiver component" does not include a	27689
care management system established under section ~~5111.16~~5165.03	27690
of the Revised Code.	27691

(B) The director of ~~job and family services~~health care	27692
administration may adopt rules under Chapter 119. of the Revised	27693
Code governing medicaid waiver components that establish all of	27694
the following:	27695

(1) Eligibility requirements for the medicaid waiver	27696
components;	27697

(2) The type, amount, duration, and scope of services the	27698
medicaid waiver components provide;	27699

(3) The conditions under which the medicaid waiver components	27700
cover services;	27701

(4) The amount the medicaid waiver components pay for	27702
services or the method by which the amount is determined;	27703

(5) The manner in which the medicaid waiver components pay	27704
for services;	27705

(6) Safeguards for the health and welfare of medicaid	27706
recipients receiving services under a medicaid waiver component;	27707

(7) Procedures for enforcing the rules, including	27708
establishing corrective action plans for, and imposing financial	27709
and administrative sanctions on, persons and government entities	27710
that violate the rules. Sanctions shall include terminating	27711
medicaid provider agreements. The procedures shall include due	27712
process protections.	27713

(8) Other policies necessary for the efficient administration	27714
of the medicaid waiver components.	27715

(C) The director of ~~job and family services~~health care	27716
administration may adopt different rules for the different	27717
medicaid waiver components. The rules shall be consistent with the	27718
terms of the waiver authorizing the medicaid waiver component.	27719

~~Sec. 5111.84.~~ Sec. 5163.501. The director of ~~job and family~~	27720
~~services~~health care administration may not submit a request to	27721
the United States secretary of health and human services for a	27722
medicaid waiver under ~~section 1115 of the "Social Security Act of~~	27723
~~1935,"~~ 42 U.S.C. 1315, unless the director provides the speaker	27724
of the house of representatives and president of the senate	27725
written notice of the director's intent to submit the request at	27726
least ten days before the date the director submits the request	27727
to the United States secretary. The notice shall include a	27728
detailed explanation of the medicaid waiver the director proposes	27729
to seek.	27730

~~Sec. 5111.851.~~ Sec. 5163.51. (A) As used in sections ~~5111.851~~	27731
5163.51 to ~~5111.855~~5163.55 of the Revised Code:	27732

"Administrative agency" means, with respect to a home and	27733
community-based services medicaid waiver component, the department	27734
of ~~job and family services~~health care administration or, if a	27735
state agency or political subdivision contracts with the	27736
department under section ~~5111.91~~5161.05 of the Revised Code to	27737
administer the component, that state agency or political	27738
subdivision.	27739

"Home and community-based services medicaid waiver component"	27740
means a medicaid waiver component under which home and	27741
community-based services are provided as an alternative to	27742
hospital, nursing facility, or intermediate care facility for the	27743
mentally retarded services.	27744

"Hospital" has the same meaning as in section 3727.01 of the	27745
Revised Code.	27746

"Intermediate care facility for the mentally retarded" has	27747
the same meaning as in section ~~5111.20~~5164.01 of the Revised	27748
Code.	27749

"Level of care determination" means a determination of	27750
whether an individual needs the level of care provided by a	27751
hospital, nursing facility, or intermediate care facility for the	27752
mentally retarded and whether the individual, if determined to	27753
need that level of care, would receive hospital, nursing facility,	27754
or intermediate care facility for the mentally retarded services	27755
if not for a home and community-based services medicaid waiver	27756
component.	27757

"Medicaid buy-in for workers with disabilities program" means	27758
the component of the medicaid program established under sections	27759
~~5111.70~~5162.10 to ~~5111.7011~~5162.1011 of the Revised Code.	27760

"Nursing facility" has the same meaning as in section ~~5111.20~~	27761
5164.01 of the Revised Code.	27762

"Skilled nursing facility" means a facility certified as a	27763
skilled nursing facility ~~under Title XVIII of the "Social Security~~	27764
~~Act," 79 Stat. 286 (1965), 42 U.S.C. 1395, as amended~~for the	27765
medicare program.	27766

(B) The following requirements apply to each home and	27767
community-based services medicaid waiver component:	27768

(1) Only an individual who qualifies for a component shall	27769
receive that component's services.	27770

(2) A level of care determination shall be made as part of	27771
the process of determining whether an individual qualifies for a	27772
component and shall be made each year after the initial	27773
determination if, during such a subsequent year, the	27774
administrative agency determines there is a reasonable indication	27775
that the individual's needs have changed.	27776

(3) A written plan of care or individual service plan based	27777
on an individual assessment of the services that an individual	27778
needs to avoid needing admission to a hospital, nursing facility,	27779
or intermediate care facility for the mentally retarded shall be	27780
created for each individual determined eligible for a component.	27781

(4) Each individual determined eligible for a component shall	27782
receive that component's services in accordance with the	27783
individual's level of care determination and written plan of care	27784
or individual service plan.	27785

(5) No individual may receive services under a component	27786
while the individual is a hospital inpatient or resident of a	27787
skilled nursing facility, nursing facility, or intermediate care	27788
facility for the mentally retarded.	27789

(6) No individual may receive prevocational, educational, or	27790
supported employment services under a component if the individual	27791
is eligible for such services that are funded with federal funds	27792
provided under 29 U.S.C. 730 or the "Individuals with Disabilities	27793
Education Act," 111 Stat. 37 (1997), 20 U.S.C. 1400, as amended.	27794

(7) Safeguards shall be taken to protect the health and	27795
welfare of individuals receiving services under a component,	27796
including safeguards established in rules adopted under section	27797
~~5111.85~~5163.50 of the Revised Code and safeguards established by	27798
licensing and certification requirements that are applicable to	27799
the providers of that component's services.	27800

(8) No services may be provided under a component by a	27801
provider that is subject to standards that 42 U.S.C. 1382e(e)(1)	27802
requires be established if the provider fails to comply with the	27803
standards applicable to the provider.	27804

(9) Individuals determined to be eligible for a component, or	27805
such individuals' representatives, shall be informed of that	27806
component's services, including any choices that the individual or	27807
representative may make regarding the component's services, and	27808
given the choice of either receiving services under that component	27809
or, as appropriate, hospital, nursing facility, or intermediate	27810
care facility for the mentally retarded services.	27811

(10) No individual shall lose eligibility for services under	27812
a component, or have the services reduced or otherwise disrupted,	27813
on the basis that the individual also receives services under the	27814
medicaid buy-in for workers with disabilities program.	27815

(11) No individual shall lose eligibility for services under	27816
a component, or have the services reduced or otherwise disrupted,	27817
on the basis that the individual's income or resources increase to	27818
an amount above the eligibility limit for the component if the	27819
individual is participating in the medicaid buy-in for workers	27820
with disabilities program and the amount of the individual's	27821
income or resources does not exceed the eligibility limit for the	27822
medicaid buy-in for workers with disabilities program.	27823

(12) No individual receiving services under a component shall	27824
be required to pay any cost sharing expenses for the services for	27825
any period during which the individual also participates in the	27826
medicaid buy-in for workers with disabilities program.	27827

~~Sec. 5111.852.~~ Sec. 5163.52. The department of ~~job and family~~	27828
~~services~~health care administration may review and approve,	27829
modify, or deny written plans of care and individual service plans	27830
that section ~~5111.851~~5163.51 of the Revised Code requires be	27831
created for individuals determined eligible for a home and	27832
community-based services medicaid waiver component. If a state	27833
agency or political subdivision contracts with the department	27834
under section ~~5111.91~~5161.05 of the Revised Code to administer a	27835
home and community-based services medicaid waiver component and	27836
approves, modifies, or denies a written plan of care or individual	27837
service plan pursuant to the agency's or subdivision's	27838
administration of the component, the department may review the	27839
agency's or subdivision's approval, modification, or denial and	27840
order the agency or subdivision to reverse or modify the approval,	27841
modification, or denial. The state agency or political subdivision	27842
shall comply with the department's order.	27843

The department of ~~job and family services~~health care	27844
administration shall be granted full and immediate access to any	27845
records the department needs to implement its duties under this	27846
section.	27847

~~Sec. 5111.853.~~ Sec. 5163.53. Each administrative agency shall	27848
maintain, for a period of time the department of ~~job and family~~	27849
~~services~~health care administration shall specify, financial	27850
records documenting the costs of services provided under the home	27851
and community-based services medicaid waiver components that the	27852
agency administers, including records of independent audits. The	27853
administrative agency shall make the financial records available	27854
on request to the United States secretary of health and human	27855
services, United States comptroller general, and their designees.	27856

~~Sec. 5111.854.~~ Sec. 5163.54. Each administrative agency is	27857
financially accountable for funds expended for services provided	27858
under the home and community-based services medicaid waiver	27859
components that the agency administers.	27860

~~Sec. 5111.855.~~ Sec. 5163.55. Each state agency and political	27861
subdivision that enters into a contract with the department of ~~job~~	27862
~~and family services~~health care administration under section	27863
~~5111.91~~5161.05 of the Revised Code to administer a home and	27864
community-based services medicaid waiver component, or one or more	27865
aspects of such a component, shall provide the department a	27866
written assurance that the agency or subdivision will not violate	27867
any of the requirements of sections ~~5111.85~~5163.50 to ~~5111.854~~	27868
5163.54 of the Revised Code.	27869

~~Sec. 5111.856.~~ Sec. 5163.56. To the extent necessary for the	27870
efficient and economical administration of medicaid waiver	27871
components, the department of ~~job and family services~~health care	27872
administration may transfer an individual enrolled in a medicaid	27873
waiver component administered by the department to another	27874
medicaid waiver component the department administers if the	27875
individual is eligible for the medicaid waiver component and the	27876
transfer does not jeopardize the individual's health or safety.	27877

~~Sec. 5111.86.~~ Sec. 5163.60. (A) As used in this section:

27878

(1) "Hospital" has the same meaning as in section 3727.01 of	27879
the Revised Code.	27880

(2) "Medicaid waiver component" has the same meaning as in	27881
section ~~5111.85~~5163.50 of the Revised Code.	27882

(3) "Nursing facility" has the same meaning as in section	27883
~~5111.20~~5164.01 of the Revised Code.	27884

(4) "Ohio home care program" means the program the department	27885
of ~~job and family services~~health care administration administers	27886
that provides state plan services and medicaid waiver component	27887
services pursuant to rules adopted under sections ~~5111.01~~5162.20	27888
and ~~5111.02~~5163.15 of the Revised Code and a medicaid waiver that	27889
went into effect July 1, 1998.	27890

(B) The director of ~~job and family services~~health care	27891
administration may submit requests to the United States secretary	27892
of health and human services pursuant to ~~section 1915 of the~~	27893
~~"Social Security Act," 79 Stat. 286 (1965),~~ 42 U.S.C. 1396n~~, as~~	27894
~~amended,~~ to obtain waivers of federal medicaid requirements that	27895
would otherwise be violated in the creation and implementation of	27896
two or more medicaid waiver components under which home and	27897
community-based services are provided to eligible individuals who	27898
need the level of care provided by a nursing facility or hospital.	27899
In the requests, the director may specify the following:	27900

(1) The maximum number of individuals who may be enrolled in	27901
each of the medicaid waiver components included in the requests;	27902

(2) The maximum amount the medicaid program may expend each	27903
year for each individual enrolled in the medicaid waiver	27904
components;	27905

(3) The maximum amount the medicaid program may expend each	27906
year for all individuals enrolled in the medicaid waiver	27907
components;	27908

(4) Any other requirements the director selects for the	27909
medicaid waiver components.	27910

(C) If the secretary approves the medicaid waivers requested	27911
under this section, the director may create and implement the	27912
medicaid waiver components in accordance with the provisions of	27913
the approved waivers. The department of ~~job and family services~~	27914
health care administration shall administer the medicaid waiver	27915
components.	27916

After the first of any medicaid waiver components created	27917
under this section begins to enroll eligible individuals, the	27918
director may submit to the United States secretary of health and	27919
human services an amendment to a medicaid waiver component of the	27920
Ohio home care program authorizing the department to cease	27921
enrolling additional individuals in that medicaid waiver component	27922
of the Ohio home care program. If the secretary approves the	27923
amendment, the director may cease to enroll additional individuals	27924
in that medicaid waiver component of the Ohio home care program.	27925

~~Sec. 5111.87.~~ Sec. 5163.65. (A) As used in this section and section	27926
~~5111.871~~5163.651 of the Revised Code:	27927

(1) "Intermediate care facility for the mentally retarded"	27928
has the same meaning as in section ~~5111.20~~5164.01 of the Revised	27929
Code.	27930

(2) "Medicaid waiver component" has the same meaning as in	27931
section ~~5111.85~~5163.50 of the Revised Code.	27932

(B) The director of ~~job and family services~~health care	27933
administration may apply to the United States secretary of health	27934
and human services for both of the following:	27935

(1) One or more medicaid waiver components under which home	27936
and community-based services are provided to individuals with	27937
mental retardation or other developmental disability as an	27938
alternative to placement in an intermediate care facility for the	27939
mentally retarded;	27940

(2) One or more medicaid waiver components under which home	27941
and community-based services are provided in the form of any of	27942
the following:	27943

(a) Early intervention and supportive services for children	27944
under three years of age who have developmental delays or	27945
disabilities the director determines are significant;	27946

(b) Therapeutic services for children who have autism;

27947

(c) Specialized habilitative services for individuals who are	27948
eighteen years of age or older and have autism.	27949

(C) No medicaid waiver component authorized by division	27950
(B)(2)(b) or (c) of this section shall provide services that are	27951
available under another medicaid waiver component. No medicaid	27952
waiver component authorized by division (B)(2)(b) of this section	27953
shall provide services to an individual that the individual is	27954
eligible to receive through an individualized education program as	27955
defined in section 3323.01 of the Revised Code.	27956

(D) The director of mental retardation and developmental	27957
disabilities or director of health may request that the director	27958
of ~~job and family services~~health care administration apply for	27959
one or more medicaid waivers under this section.	27960

(E) Before applying for a waiver under this section, the	27961
director of ~~job and family services~~health care administration	27962
shall seek, accept, and consider public comments.	27963

~~Sec. 5111.871.~~ Sec. 5163.651. The department of ~~job and family~~	27964
~~services~~health care administration shall enter into a contract	27965
with the department of mental retardation and developmental	27966
disabilities under section ~~5111.91~~5161.05 of the Revised Code	27967
with regard to one or more of the components of the medicaid	27968
program established by the department of ~~job and family services~~	27969
health care administration under one or more of the medicaid	27970
waivers sought under section ~~5111.87~~5163.65 of the Revised Code.	27971
The contract shall provide for the department of mental	27972
retardation and developmental disabilities to administer the	27973
components in accordance with the terms of the waivers. The	27974
directors of ~~job and family services~~health care administration	27975
and mental retardation and developmental disabilities shall adopt	27976
rules in accordance with Chapter 119. of the Revised Code	27977
governing the components.	27978

If the department of mental retardation and developmental	27979
disabilities or the department of ~~job and family services~~health	27980
care administration denies an individual's application for home	27981
and community-based services provided under any of these medicaid	27982
components, the department that denied the services shall give	27983
timely notice to the individual that the individual may request a	27984
hearing under section ~~5101.35~~5160.34 of the Revised Code.	27985

The departments of mental retardation and developmental	27986
disabilities and ~~job and family services~~health care	27987
administration may approve, reduce, deny, or terminate a service	27988
included in the individualized service plan developed for a	27989
medicaid recipient eligible for home and community-based services	27990
provided under any of these medicaid components. The departments	27991
shall consider the recommendations a county board of mental	27992
retardation and developmental disabilities makes under division	27993
(A)(1)(c) of section 5126.055 of the Revised Code. If either	27994
department approves, reduces, denies, or terminates a service,	27995
that department shall give timely notice to the medicaid recipient	27996
that the recipient may request a hearing under section 5101.35 of	27997
the Revised Code.	27998

If supported living, as defined in section 5126.01 of the	27999
Revised Code, is to be provided as a service under any of these	28000
components, any person or government entity with a current, valid	28001
medicaid provider agreement and a current, valid certificate	28002
under section 5123.161 of the Revised Code may provide the	28003
service.	28004

If a service is to be provided under any of these components	28005
by a residential facility, as defined in section 5123.19 of the	28006
Revised Code, any person or government entity with a current,	28007
valid medicaid provider agreement and a current, valid license	28008
under section 5123.19 of the Revised Code may provide the service.	28009

~~Sec. 5111.872.~~ Sec. 5163.652. When the department of mental	28010
retardation and developmental disabilities allocates enrollment	28011
numbers to a county board of mental retardation and developmental	28012
disabilities for home and community-based services specified in	28013
division (B)(1) of section ~~5111.87~~5163.65 of the Revised Code	28014
and provided under any of the components of the medicaid program	28015
that the department administers under section ~~5111.871~~5163.651	28016
of the Revised Code, the department shall consider all of the	28017
following:	28018

(A) The number of individuals with mental retardation or	28019
other developmental disability who are on a waiting list the	28020
county board establishes under division (C) of section 5126.042 of	28021
the Revised Code for those services and are given priority on the	28022
waiting list pursuant to division (D) or (E) of that section;	28023

(B) The implementation component required by division (A)(3)	28024
of section 5126.054 of the Revised Code of the county board's plan	28025
approved under section 5123.046 of the Revised Code;	28026

(C) Anything else the department considers necessary to	28027
enable county boards to provide those services to individuals in	28028
accordance with the priority requirements of divisions (D) and (E)	28029
of section 5126.042 of the Revised Code.	28030

~~Sec. 5111.873.~~ Sec. 5163.653. (A) Not later than the effective date	28031
of the first of any medicaid waivers the United States secretary	28032
of health and human services grants pursuant to a request made	28033
under section ~~5111.87~~5163.65 of the Revised Code, the director of	28034
~~job and family services~~health care administration shall adopt	28035
rules in accordance with Chapter 119. of the Revised Code	28036
establishing statewide fee schedules for home and community-based	28037
services specified in division (B)(1) of section ~~5111.87~~5163.65	28038
of the Revised Code and provided under the components of the	28039
medicaid program that the department of mental retardation and	28040
developmental disabilities administers under section ~~5111.871~~	28041
5163.651 of the Revised Code. The rules shall provide for all of	28042
the following:	28043

(1) The department of mental retardation and developmental	28044
disabilities arranging for the initial and ongoing collection of	28045
cost information from a comprehensive, statistically valid sample	28046
of persons and government entities providing the services at the	28047
time the information is obtained;	28048

(2) The collection of consumer-specific information through	28049
an assessment instrument the department of mental retardation and	28050
developmental disabilities shall provide to the department of ~~job~~	28051
~~and family services~~health care administration;	28052

(3) With the information collected pursuant to divisions	28053
(A)(1) and (2) of this section, an analysis of that information,	28054
and other information the director determines relevant, methods	28055
and standards for calculating the fee schedules that do all of the	28056
following:	28057

(a) Assure that the fees are consistent with efficiency,	28058
economy, and quality of care;	28059

(b) Consider the intensity of consumer resource need;

28060

(c) Recognize variations in different geographic areas	28061
regarding the resources necessary to assure the health and welfare	28062
of consumers;	28063

(d) Recognize variations in environmental supports available	28064
to consumers.	28065

(B) As part of the process of adopting rules under this	28066
section, the director shall consult with the director of mental	28067
retardation and developmental disabilities, representatives of	28068
county boards of mental retardation and developmental	28069
disabilities, persons who provide the home and community-based	28070
services, and other persons and government entities the director	28071
identifies.	28072

(C) The directors of ~~job and family services~~health care	28073
administration and mental retardation and developmental	28074
disabilities shall review the rules adopted under this section at	28075
times they determine to ensure that the methods and standards	28076
established by the rules for calculating the fee schedules	28077
continue to do everything that division (A)(3) of this section	28078
requires.	28079

~~Sec. 5111.874.~~ Sec. 5163.66. (A) As used in sections ~~5111.874~~	28080
5163.66 to ~~5111.8710~~5163.666 of the Revised Code:	28081

"Home and community-based services" has the same meaning as	28082
in section 5123.01 of the Revised Code.	28083

"ICF/MR services" means intermediate care facility for the	28084
mentally retarded services covered by the medicaid program that an	28085
intermediate care facility for the mentally retarded provides to a	28086
resident of the facility who is a medicaid recipient eligible for	28087
medicaid-covered intermediate care facility for the mentally	28088
retarded services.	28089

"Intermediate care facility for the mentally retarded" means	28090
an intermediate care facility for the mentally retarded that is	28091
certified as in compliance with applicable standards for the	28092
medicaid program by the director of health in accordance with	28093
Title XIX of the "Social Security Act," 79 Stat. 286 (1965), 42	28094
U.S.C. 1396, as amended, and licensed as a residential facility	28095
under section 5123.19 of the Revised Code.	28096

"Residential facility" has the same meaning as in section	28097
5123.19 of the Revised Code.	28098

(B) For the purpose of increasing the number of slots	28099
available for home and community-based services and subject to	28100
sections ~~5111.877~~5163.663 and ~~5111.878~~5163.664 of the Revised	28101
Code, the operator of an intermediate care facility for the	28102
mentally retarded may convert all of the beds in the facility	28103
from providing ICF/MR services to providing home and	28104
community-based services if all of the following requirements	28105
are met:	28106

(1) The operator provides the directors of health, ~~job and~~	28107
~~family services~~health care administration, and mental	28108
retardation and developmental disabilities at least ninety days'	28109
notice of the operator's intent to relinquish the facility's	28110
certification as an intermediate care facility for the mentally	28111
retarded and to begin providing home and community-based	28112
services.	28113

(2) The operator complies with the requirements of sections	28114
~~5111.65~~5164.82 to ~~5111.688~~5164.858 of the Revised Code regarding	28115
a voluntary termination as defined in section ~~5111.65~~5164.82 of	28116
the Revised Code if those requirements are applicable.	28117

(3) The operator notifies each of the facility's residents	28118
that the facility is to cease providing ICF/MR services and inform	28119
each resident that the resident may do either of the following:	28120

(a) Continue to receive ICF/MR services by transferring to	28121
another facility that is an intermediate care facility for the	28122
mentally retarded willing and able to accept the resident if the	28123
resident continues to qualify for ICF/MR services;	28124

(b) Begin to receive home and community-based services	28125
instead of ICF/MR services from any provider of home and	28126
community-based services that is willing and able to provide the	28127
services to the resident if the resident is eligible for the	28128
services and a slot for the services is available to the resident.	28129

(4) The operator meets the requirements for providing home	28130
and community-based services, including the following:	28131

(a) Such requirements applicable to a residential facility if	28132
the operator maintains the facility's license as a residential	28133
facility;	28134

(b) Such requirements applicable to a facility that is not	28135
licensed as a residential facility if the operator surrenders the	28136
facility's residential facility license under section 5123.19 of	28137
the Revised Code.	28138

(5) The director of mental retardation and developmental	28139
disabilities approves the conversion.	28140

(C) The notice to the director of mental retardation and	28141
developmental disabilities under division (B)(1) of this section	28142
shall specify whether the operator wishes to surrender the	28143
facility's license as a residential facility under section 5123.19	28144
of the Revised Code.	28145

(D) If the director of mental retardation and developmental	28146
disabilities approves a conversion under division (B) of this	28147
section, the director of health shall terminate the certification	28148
of the intermediate care facility for the mentally retarded to be	28149
converted. The director of health shall notify the director of	28150
~~job and family services~~health care administration of the	28151
termination. On receipt of the director of health's notice, the	28152
director of ~~job and family services~~health care administration	28153
shall terminate the operator's medicaid provider agreement that	28154
authorizes the operator to provide ICF/MR services at the	28155
facility. The operator is not entitled to notice or a hearing	28156
under Chapter 119. of the Revised Code before the director of ~~job~~	28157
~~and family services~~health care administration terminates the	28158
medicaid provider agreement.	28159

~~Sec. 5111.875.~~ Sec. 5163.661. (A) For the purpose of increasing the	28160
number of slots available for home and community-based services	28161
and subject to sections ~~5111.877~~5163.663 and ~~5111.878~~5163.664	28162
of the Revised Code, a person who acquires, through a request	28163
for proposals issued by the director of mental retardation and	28164
developmental disabilities, a residential facility that is an	28165
intermediate care facility for the mentally retarded and for	28166
which the license as a residential facility was previously	28167
surrendered or revoked may convert some or all of the facility's	28168
beds from providing ICF/MR services to providing home and	28169
community-based services if all of the following requirements	28170
are met:	28171

(1) The person provides the directors of health, ~~job and~~	28172
~~family services~~health care administration, and mental retardation	28173
and developmental disabilities at least ninety days' notice of	28174
the person's intent to make the conversion.	28175

(2) The person complies with the requirements of sections	28176
~~5111.65~~5164.82 to ~~5111.688~~5164.858 of the Revised Code regarding	28177
a voluntary termination as defined in section ~~5111.65~~5164.82 of	28178
the Revised Code if those requirements are applicable.	28179

(3) If the person intends to convert all of the facility's	28180
beds, the person notifies each of the facility's residents that	28181
the facility is to cease providing ICF/MR services and informs	28182
each resident that the resident may do either of the following:	28183

(a) Continue to receive ICF/MR services by transferring to	28184
another facility that is an intermediate care facility for the	28185
mentally retarded willing and able to accept the resident if the	28186
resident continues to qualify for ICF/MR services;	28187

(b) Begin to receive home and community-based services	28188
instead of ICF/MR services from any provider of home and	28189
community-based services that is willing and able to provide the	28190
services to the resident if the resident is eligible for the	28191
services and a slot for the services is available to the resident.	28192

(4) If the person intends to convert some but not all of the	28193
facility's beds, the person notifies each of the facility's	28194
residents that the facility is to convert some of its beds from	28195
providing ICF/MR services to providing home and community-based	28196
services and inform each resident that the resident may do either	28197
of the following:	28198

(a) Continue to receive ICF/MR services from any provider of	28199
ICF/MR services that is willing and able to provide the services	28200
to the resident if the resident continues to qualify for ICF/MR	28201
services;	28202

(b) Begin to receive home and community-based services	28203
instead of ICF/MR services from any provider of home and	28204
community-based services that is willing and able to provide the	28205
services to the resident if the resident is eligible for the	28206
services and a slot for the services is available to the resident.	28207

(5) The person meets the requirements for providing home and	28208
community-based services at a residential facility.	28209

(B) The notice provided to the directors under division	28210
(A)(1) of this section shall specify whether some or all of the	28211
facility's beds are to be converted. If some but not all of the	28212
beds are to be converted, the notice shall specify how many of	28213
the facility's beds are to be converted and how many of the beds	28214
are to continue to provide ICF/MR services.	28215

(C) On receipt of a notice under division (A)(1) of this	28216
section, the director of health shall do the following:	28217

(1) Terminate the certification of the intermediate care	28218
facility for the mentally retarded if the notice specifies that	28219
all of the facility's beds are to be converted;	28220

(2) Reduce the facility's certified capacity by the number of	28221
beds being converted if the notice specifies that some but not all	28222
of the beds are to be converted.	28223

(D) The director of health shall notify the director of ~~job~~	28224
~~and family services~~health care administration of the termination	28225
or reduction under division (C) of this section. On receipt of	28226
the director of health's notice, the director of ~~job and family~~	28227
~~services~~health care administration shall do the following:	28228

(1) Terminate the person's medicaid provider agreement that	28229
authorizes the person to provide ICF/MR services at the facility	28230
if the facility's certification was terminated;	28231

(2) Amend the person's medicaid provider agreement to reflect	28232
the facility's reduced certified capacity if the facility's	28233
certified capacity is reduced.	28234

The person is not entitled to notice or a hearing under	28235
Chapter 119. of the Revised Code before the director of ~~job and~~	28236
~~family services~~health care administration terminates or amends	28237
the medicaid provider agreement.	28238

~~Sec. 5111.876.~~ Sec. 5163.662. Subject to section ~~5111.877~~5163.663	28239
of the Revised Code, the director of mental retardation and	28240
developmental disabilities may request that the director of ~~job~~	28241
~~and family services~~health care administration seek the approval	28242
of the United States secretary of health and human services to	28243
increase the number of slots available for home and	28244
community-based services by a number not exceeding the number of	28245
beds that were part of the licensed capacity of a residential	28246
facility that had its license revoked or surrendered under	28247
section 5123.19 of the Revised Code if the residential facility	28248
was an intermediate care facility for the mentally retarded at	28249
the time of the license revocation or surrender. The revocation	28250
or surrender may have occurred before, or may occur on or after,	28251
~~the effective date of this section~~June 24, 2008. The request	28252
may include beds the director removed from such a residential	28253
facility's licensed capacity before transferring ownership or	28254
operation of the residential facility pursuant to a request for	28255
proposals.	28256

~~Sec. 5111.877.~~ Sec. 5163.663. The director of ~~job and family~~	28257
~~services~~health care administration may seek approval from the	28258
United States secretary of health and human services for not more	28259
than a total of one hundred slots for home and community-based	28260
services for the purposes of sections ~~5111.874~~5163.66, ~~5111.875~~	28261
5163.661, and ~~5111.876~~5163.662 of the Revised Code.	28262

~~Sec. 5111.878.~~ Sec. 5163.664. Not more than a total of one hundred	28263
beds may be converted from providing ICF/MR services to providing	28264
home and community-based services under sections ~~5111.874~~5163.66	28265
and ~~5111.875~~5163.661 of the Revised Code.	28266

~~Sec. 5111.879.~~ Sec. 5163.665. No person or government entity may	28267
reconvert a bed to be used for ICF/MR services if the bed was	28268
converted to use for home and community-based services under	28269
section ~~5111.874~~5163.66 or ~~5111.875~~5163.661 of the Revised	28270
Code. This prohibition applies regardless of either of the	28271
following:	28272

(A) The bed is part of the licensed capacity of a residential	28273
facility.	28274

(B) The bed has been sold, leased, or otherwise transferred	28275
to another person or government entity.	28276

~~Sec. 5111.8710.~~ Sec. 5163.666. The directors of ~~job and family~~	28277
~~services~~health care administration and mental retardation and	28278
developmental disabilities may adopt rules in accordance with	28279
Chapter 119. of the Revised Code as necessary to implement	28280
sections ~~5111.874~~5163.66 to ~~5111.8710~~5163.666 of the Revised	28281
Code.	28282

~~Sec. 5111.89.~~ Sec. 5163.68. (A) As used in sections ~~5111.89~~	28283
5163.68 to ~~5111.894~~5163.684 of the Revised Code:	28284

"Area agency on aging" has the same meaning as in section	28285
173.14 of the Revised Code.	28286

"Assisted living program" means the medicaid waiver component	28287
for which the director of ~~job and family services~~health care	28288
administration is authorized by this section to request a	28289
medicaid waiver.	28290

"Assisted living services" means the following home and	28291
community-based services: personal care, homemaker, chore,	28292
attendant care, companion, medication oversight, and therapeutic	28293
social and recreational programming.	28294

"County or district home" means a county or district home	28295
operated under Chapter 5155. of the Revised Code.	28296

"Long-term care consultation program" means the program the	28297
department of aging is required to develop under section 173.42 of	28298
the Revised Code.	28299

"Long-term care consultation program administrator" or	28300
"administrator" means the department of aging or, if the	28301
department contracts with an area agency on aging or other entity	28302
to administer the long-term care consultation program for a	28303
particular area, that agency or entity.	28304

"Medicaid waiver component" has the same meaning as in	28305
section ~~5111.85~~5163.50 of the Revised Code.	28306

"Nursing facility" has the same meaning as in section ~~5111.20~~	28307
5164.01 of the Revised Code.	28308

"Residential care facility" has the same meaning as in	28309
section 3721.01 of the Revised Code.	28310

"State administrative agency" means the department of ~~job and~~	28311
~~family services~~health care administration if the department of	28312
~~job and family services~~health care administration administers	28313
the assisted living program or the department of aging if the	28314
department of aging administers the assisted living program.	28315

(B) The director of ~~job and family services~~health care	28316
administration may submit a request to the United States	28317
secretary of health and human services under 42 U.S.C. 1396n to	28318
obtain a waiver of federal medicaid requirements that would	28319
otherwise be violated in the creation and implementation of a	28320
program under which assisted living services are provided to not	28321
more than one thousand eight hundred individuals who meet the	28322
program's eligibility requirements established under section	28323
~~5111.891~~5163.681 of the Revised Code.	28324

If the secretary approves the medicaid waiver requested under	28325
this section and the director of budget and management approves	28326
the contract, the department of ~~job and family services~~health	28327
care administration shall enter into a contract with the	28328
department of aging under section ~~5111.91~~5161.05 of the Revised	28329
Code that provides for the department of aging to administer the	28330
assisted living program. The contract shall include an estimate	28331
of the program's costs.	28332

The director of ~~job and family services~~health care	28333
administration may adopt rules under section ~~5111.85~~5163.50 of	28334
the Revised Code regarding the assisted living program. The	28335
director of aging may adopt rules under Chapter 119. of the	28336
Revised Code regarding the program that the rules adopted by the	28337
director of ~~job and family services~~health care administration	28338
authorize the director of aging to adopt.	28339

~~Sec. 5111.891.~~ Sec. 5163.681. To be eligible for the assisted	28340
living program, an individual must meet all of the following	28341
requirements:	28342

(A) Need an intermediate level of care as determined under	28343
rule 5101:3-3-06 of the Administrative Code;	28344

(B) At the time the individual applies for the assisted	28345
living program, be one of the following:	28346

(1) A nursing facility resident who is seeking to move to a	28347
residential care facility and would remain in a nursing facility	28348
for long term care if not for the assisted living program;	28349

(2) A participant of any of the following medicaid waiver	28350
components who would move to a nursing facility if not for the	28351
assisted living program:	28352

(a) The PASSPORT program created under section 173.40 of the	28353
Revised Code;	28354

(b) The medicaid waiver component called the choices program	28355
that the department of aging administers;	28356

(c) A medicaid waiver component that the department of ~~job~~	28357
~~and family services~~health care administration administers.	28358

(3) A resident of a residential care facility who has resided	28359
in a residential care facility for at least six months immediately	28360
before the date the individual applies for the assisted living	28361
program.	28362

(C) At the time the individual receives assisted living	28363
services under the assisted living program, reside in a	28364
residential care facility that is authorized by a valid medicaid	28365
provider agreement to participate in the assisted living program,	28366
including both of the following:	28367

(1) A residential care facility that is owned or operated by	28368
a metropolitan housing authority that has a contract with the	28369
United States department of housing and urban development to	28370
receive an operating subsidy or rental assistance for the	28371
residents of the facility;	28372

(2) A county or district home licensed as a residential care	28373
facility.	28374

(D) Meet all other eligibility requirements for the assisted	28375
living program established in rules adopted under section ~~5111.85~~	28376
5163.50 of the Revised Code.	28377

~~Sec. 5111.892.~~ Sec. 5163.682. A residential care facility	28378
providing services covered by the assisted living program to an	28379
individual enrolled in the program shall have staff on-site	28380
twenty-four hours each day who are able to do all of the	28381
following:	28382

(A) Meet the scheduled and unpredicted needs of the	28383
individuals enrolled in the assisted living program in a manner	28384
that promotes the individuals' dignity and independence;	28385

(B) Provide supervision services for those individuals;

28386

28387

~~Sec. 5111.893.~~ Sec. 5163.683. If the United States secretary of	28388
health and human services approves a medicaid waiver authorizing	28389
the assisted living program, the director of aging shall contract	28390
with a person or government entity to evaluate the program's cost	28391
effectiveness. The director shall provide the results of the	28392
evaluation to the governor, president and minority leader of the	28393
senate, and speaker and minority leader of the house of	28394
representatives not later than June 30, 2007.	28395

~~Sec. 5111.894.~~ Sec. 5163.684. The state administrative agency may	28396
establish one or more waiting lists for the assisted living	28397
program. Only individuals eligible for the medicaid program may be	28398
placed on a waiting list.	28399

Each month, each area agency on aging shall determine	28400
whether any individual who resides in the area that the area	28401
agency on aging serves and is on a waiting list for the assisted	28402
living program has been admitted to a nursing facility. If an	28403
area agency on aging determines that such an individual has been	28404
admitted to a nursing facility and that there is a vacancy in a	28405
residential care facility participating in the assisted living	28406
program that is acceptable to the individual, the agency shall	28407
notify the long-term care consultation program administrator	28408
serving the area in which the individual resides about the	28409
determination. The administrator shall determine whether the	28410
assisted living program is appropriate for the individual and	28411
whether the individual would rather participate in the assisted	28412
living program than continue residing in the nursing facility.	28413
If the administrator determines that the assisted living	28414
program is appropriate for the individual and the individual	28415
would rather participate in the assisted living program than	28416
continue residing in the nursing facility, the administrator	28417
shall so notify the state administrative agency.	28418

On receipt of the notice from the administrator, the state	28419
administrative agency shall approve the individual's enrollment in	28420
the assisted living program regardless of any waiting list for the	28421
assisted living program, unless the enrollment would cause the	28422
assisted living program to exceed the limit on the number of	28423
individuals who may participate in the program as set by section	28424
~~5111.89~~5163.68 of the Revised Code. Each quarter, the state	28425
administrative agency shall certify to the director of budget	28426
and management the estimated increase in costs of the assisted	28427
living program resulting from enrollment of individuals in the	28428
assisted living program pursuant to this section.	28429

Not later than the last day of each calendar year, the	28430
director of ~~job and family services~~health care administration	28431
shall submit to the general assembly a report regarding the	28432
number of individuals enrolled in the assisted living program	28433
pursuant to this section and the costs incurred and savings	28434
achieved as a result of the enrollments.	28435

~~Sec. 5111.971.~~ Sec. 5163.69. (A) As used in this section,	28436
"long-term care medicaid waiver component" means any of the	28437
following:	28438

(1) The PASSPORT program created under section 173.40 of the	28439
Revised Code;	28440

(2) The medicaid waiver component called the choices program	28441
that the department of aging administers;	28442

(3) A medicaid waiver component that the department of ~~job~~	28443
~~and family services~~health care administration administers.	28444

(B) The director of ~~job and family services~~health care	28445
administration shall submit a request to the United States	28446
secretary of health and human services for a waiver of federal	28447
medicaid requirements that would be otherwise violated in the	28448
creation of a pilot program under which not more than two hundred	28449
individuals who meet the pilot program's eligibility requirements	28450
specified in division (D) of this section receive a spending	28451
authorization to pay for the cost of medically necessary home and	28452
community-based services that the pilot program covers. The	28453
spending authorization shall be in an amount not exceeding seventy	28454
per cent of the average cost under the medicaid program for	28455
providing nursing facility services to an individual. An	28456
individual participating in the pilot program shall also receive	28457
necessary support services, including fiscal intermediary and	28458
other case management services, that the pilot program covers.	28459

(C) If the United States secretary of health and human	28460
services approves the waiver submitted under division (B) of this	28461
section, the department of ~~job and family services~~health care	28462
administration shall enter into a contract with the department of	28463
aging under section ~~5111.91~~5161.05 of the Revised Code that	28464
provides for the department of aging to administer the pilot	28465
program that the waiver authorizes.	28466

(D) To be eligible to participate in the pilot program	28467
created under division (B) of this section, an individual must	28468
meet all of the following requirements:	28469

(1) Need an intermediate level of care as determined under	28470
rule 5101:3-3-06 of the Administrative Code or a skilled level of	28471
care as determined under rule 5101:3-3-05 of the Administrative	28472
Code;	28473

(2) At the time the individual applies to participate in the	28474
pilot program, be one of the following:	28475

(a) A nursing facility resident who would remain in a nursing	28476
facility if not for the pilot program;	28477

(b) A participant of any long-term care medicaid waiver	28478
component who would move to a nursing facility if not for the	28479
pilot program.	28480

(3) Meet all other eligibility requirements for the pilot	28481
program established in rules adopted under section ~~5111.85~~5163.50	28482
of the Revised Code.	28483

(E) The director of ~~job and family services~~health care	28484
administration may adopt rules under section ~~5111.85~~5163.50 of	28485
the Revised Code as the director considers necessary to implement	28486
the pilot program created under division (B) of this section. The	28487
director of aging may adopt rules under Chapter 119. of the	28488
Revised Code as the director considers necessary for the pilot	28489
program's implementation. The rules may establish a list of	28490
medicaid-covered services not covered by the pilot program that an	28491
individual participating in the pilot program may not receive if	28492
the individual also receives medicaid-covered services outside of	28493
the pilot program.	28494

~~Sec. 5111.97.~~ Sec. 5163.73. (A) As used in this section and in	28495
section ~~5111.971~~5163.69 of the Revised Code, "nursing facility"	28496
has the same meaning as in section ~~5111.20~~5164.01 of the Revised	28497
Code.	28498

(B) To the extent funds are available, the director of ~~job~~	28499
~~and family services~~health care administration may establish the	28500
Ohio access success project to help medicaid recipients make the	28501
transition from residing in a nursing facility to residing in a	28502
community setting. The program may be established as a separate	28503
~~non-medicaid~~nonmedicaid program or integrated into a new or	28504
existing program of medicaid-funded home and community-based	28505
services authorized by a waiver approved by the United States	28506
department of health and human services. The director shall permit	28507
any recipient of medicaid-funded nursing facility services to	28508
apply for participation in the program, but may limit the number	28509
of program participants. If an application is received before the	28510
applicant has been a recipient of medicaid-funded nursing facility	28511
services for six months, the director shall ensure that an	28512
assessment is conducted as soon as practicable to determine	28513
whether the applicant is eligible for participation in the	28514
program. To the maximum extent possible, the assessment and	28515
eligibility determination shall be completed not later than the	28516
date that occurs six months after the applicant became a recipient	28517
of medicaid-funded nursing facility services.	28518

(C) To be eligible for benefits under the project, a medicaid	28519
recipient must satisfy all of the following requirements:	28520

(1) Be a recipient of medicaid-funded nursing facility	28521
services, at the time of applying for the benefits;	28522

(2) Need the level of care provided by nursing facilities;

28523

(3) For participation in a ~~non-medicaid~~nonmedicaid program,	28524
receive services to remain in the community with a projected cost	28525
not exceeding eighty per cent of the average monthly medicaid cost	28526
of a medicaid recipient in a nursing facility;	28527

(4) For participation in a program established as part of a	28528
medicaid-funded home and community-based services waiver program,	28529
meet waiver enrollment criteria.	28530

(D) If the director establishes the Ohio access success	28531
project, the benefits provided under the project may include	28532
payment of all of the following:	28533

(1) The first month's rent in a community setting;

28534

(2) Rental deposits;

28535

(3) Utility deposits;

28536

(4) Moving expenses;

28537

(5) Other expenses not covered by the medicaid program that	28538
facilitate a medicaid recipient's move from a nursing facility to	28539
a community setting.	28540

(E) If the project is established as a ~~non-medicaid~~	28541
nonmedicaid program, no participant may receive more than two	28542
thousand dollars worth of benefits under the project.	28543

(F) The director may submit a request to the United States	28544
secretary of health and human services pursuant to ~~section 1915 of~~	28545
~~the "Social Security Act," 79 Stat. 286 (1965),~~ 42 U.S.C. 1396n,	28546
~~as amended,~~ to create a medicaid home and community-based services	28547
waiver program to serve individuals who meet the criteria for	28548
participation in the Ohio access success project. The director may	28549
adopt rules under Chapter 119. of the Revised Code for the	28550
administration and operation of the program.	28551

~~Sec. 5111.20.~~ Sec. 5164.01. As used in sections ~~5111.20~~5164.01 to	28552
~~5111.34~~5164.47 of the Revised Code:	28553

(A) "Allowable costs" are those costs determined by the	28554
department of ~~job and family services~~health care administration	28555
to be reasonable and do not include fines paid under sections	28556
~~5111.35~~5164.50 to ~~5111.61~~5164.78 and section ~~5111.99~~5164.99 of	28557
the Revised Code.	28558

(B) "Ancillary and support costs" means all reasonable costs	28559
incurred by a nursing facility other than direct care costs or	28560
capital costs. "Ancillary and support costs" includes, but is not	28561
limited to, costs of activities, social services, pharmacy	28562
consultants, habilitation supervisors, qualified mental	28563
retardation professionals, program directors, medical and	28564
habilitation records, program supplies, incontinence supplies,	28565
food, enterals, dietary supplies and personnel, laundry,	28566
housekeeping, security, administration, medical equipment,	28567
utilities, liability insurance, bookkeeping, purchasing	28568
department, human resources, communications, travel, dues, license	28569
fees, subscriptions, home office costs not otherwise allocated,	28570
legal services, accounting services, minor equipment, maintenance	28571
and repairs, help-wanted advertising, informational advertising,	28572
start-up costs, organizational expenses, other interest, property	28573
insurance, employee training and staff development, employee	28574
benefits, payroll taxes, and workers' compensation premiums or	28575
costs for self-insurance claims and related costs as specified in	28576
rules adopted ~~by the director of job and family services~~ under	28577
section ~~5111.02~~5163.15 of the Revised Code, for personnel listed	28578
in this division. "Ancillary and support costs" also means the	28579
cost of equipment, including vehicles, acquired by operating	28580
lease executed before December 1, 1992, if the costs are reported	28581
as administrative and general costs on the facility's cost report	28582
for the cost reporting period ending December 31, 1992.	28583

(C) "Capital costs" means costs of ownership and, in the case	28584
of an intermediate care facility for the mentally retarded, costs	28585
of nonextensive renovation.	28586

(1) "Cost of ownership" means the actual expense incurred for	28587
all of the following:	28588

(a) Depreciation and interest on any capital assets that cost	28589
five hundred dollars or more per item, including the following:	28590

(i) Buildings;

28591

(ii) Building improvements that are not approved as	28592
nonextensive renovations under section ~~5111.251~~5164.08 of the	28593
Revised Code;	28594

(iii) Except as provided in division (B) of this section,	28595
equipment;	28596

(iv) In the case of an intermediate care facility for the	28597
mentally retarded, extensive renovations;	28598

(v) Transportation equipment.

28599

(b) Amortization and interest on land improvements and	28600
leasehold improvements;	28601

28602

(d) Except as provided in division (K) of this section, lease	28603
and rent of land, building, and equipment.	28604

The costs of capital assets of less than five hundred dollars	28605
per item may be considered capital costs in accordance with a	28606
provider's practice.	28607

(2) "Costs of nonextensive renovation" means the actual	28608
expense incurred by an intermediate care facility for the mentally	28609
retarded for depreciation or amortization and interest on	28610
renovations that are not extensive renovations.	28611

(D) "Capital lease" and "operating lease" shall be construed	28612
in accordance with generally accepted accounting principles.	28613

(E) "Case-mix score" means the measure determined under	28614
section 5164.051 of the Revised Code of the relative direct-care	28615
resources needed to provide care and habilitation to a resident of	28616
an intermediate care facility for the mentally retarded and the	28617
measure determined under section ~~5111.232~~5164.191 of the Revised	28618
Code of the relative direct-care resources needed to provide care	28619
and habilitation to a resident of a nursing facility or	28620
~~intermediate care facility for the mentally retarded~~.	28621

(F)(1) "Date of licensure," for a facility originally	28622
licensed as a nursing home under Chapter 3721. of the Revised	28623
Code, means the date specific beds were originally licensed as	28624
nursing home beds under that chapter, regardless of whether they	28625
were subsequently licensed as residential facility beds under	28626
section 5123.19 of the Revised Code. For a facility originally	28627
licensed as a residential facility under section 5123.19 of the	28628
Revised Code, "date of licensure" means the date specific beds	28629
were originally licensed as residential facility beds under that	28630
section.	28631

If nursing home beds licensed under Chapter 3721. of the	28632
Revised Code or residential facility beds licensed under section	28633
5123.19 of the Revised Code were not required by law to be	28634
licensed when they were originally used to provide nursing home or	28635
residential facility services, "date of licensure" means the date	28636
the beds first were used to provide nursing home or residential	28637
facility services, regardless of the date the present provider	28638
obtained licensure.	28639

If a facility adds nursing home beds or residential facility	28640
beds or extensively renovates all or part of the facility after	28641
its original date of licensure, it will have a different date of	28642
licensure for the additional beds or extensively renovated portion	28643
of the facility, unless the beds are added in a space that was	28644
constructed at the same time as the previously licensed beds but	28645
was not licensed under Chapter 3721. or section 5123.19 of the	28646
Revised Code at that time.	28647

(2) The definition of "date of licensure" in this section	28648
applies in determinations of the medicaid reimbursement rate for a	28649
nursing facility or intermediate care facility for the mentally	28650
retarded but does not apply in determinations of the franchise	28651
permit fee for a nursing facility or intermediate care facility	28652
for the mentally retarded.	28653

(G) "Desk-reviewed" means that costs as reported on a cost	28654
report submitted under section ~~5111.26~~5164.37 of the Revised Code	28655
have been subjected to a desk review under division (A) of section	28656
~~5111.27~~5164.38 of the Revised Code and preliminarily determined	28657
to be allowable costs.	28658

(H) "Direct care costs" means all of the following:

28659

(1)(a) Costs for registered nurses, licensed practical	28660
nurses, and nurse aides employed by the facility;	28661

(b) Costs for direct care staff, administrative nursing	28662
staff, medical directors, respiratory therapists, and except as	28663
provided in division (H)(2) of this section, other persons holding	28664
degrees qualifying them to provide therapy;	28665

28666

(d) Costs of quality assurance;

28667

(e) Costs of training and staff development, employee	28668
benefits, payroll taxes, and workers' compensation premiums or	28669
costs for self-insurance claims and related costs as specified in	28670
rules adopted ~~by the director of job and family services in~~	28671
~~accordance with Chapter 119.~~under section 5163.15 of the Revised	28672
Code, for personnel listed in divisions (H)(1)(a), (b), and (d) of	28673
this section;	28674

(f) Costs of consulting and management fees related to direct	28675
care;	28676

(g) Allocated direct care home office costs.

28677

(2) In addition to the costs specified in division (H)(1) of	28678
this section, for nursing facilities only, direct care costs	28679
include costs of habilitation staff (other than habilitation	28680
supervisors), medical supplies, emergency oxygen, habilitation	28681
supplies, and universal precautions supplies.	28682

(3) In addition to the costs specified in division (H)(1) of	28683
this section, for intermediate care facilities for the mentally	28684
retarded only, direct care costs include both of the following:	28685

(a) Costs for physical therapists and physical therapy	28686
assistants, occupational therapists and occupational therapy	28687
assistants, speech therapists, audiologists, habilitation staff	28688
(including habilitation supervisors), qualified mental retardation	28689
professionals, program directors, social services staff,	28690
activities staff, off-site day programming, psychologists and	28691
psychology assistants, and social workers and counselors;	28692

(b) Costs of training and staff development, employee	28693
benefits, payroll taxes, and workers' compensation premiums or	28694
costs for self-insurance claims and related costs as specified in	28695
rules adopted under section ~~5111.02~~5163.15 of the Revised Code,	28696
for personnel listed in division (H)(3)(a) of this section.	28697

(4) Costs of other direct-care resources that are specified	28698
as direct care costs in rules adopted under section ~~5111.02~~	28699
5163.15 of the Revised Code.	28700

(I) "Fiscal year" means the fiscal year of this state, as	28701
specified in section 9.34 of the Revised Code.	28702

(J) "Franchise permit fee" means the following:

28703

(1) In the context of nursing facilities, the fee imposed by	28704
sections ~~3721.50~~5166.20 to ~~3721.58~~5166.30 of the Revised Code;	28705

(2) In the context of intermediate care facilities for the	28706
mentally retarded, the fee imposed by sections ~~5112.30~~5166.40 to	28707
~~5112.39~~5166.50 of the Revised Code.	28708

(K) "Indirect care costs" means all reasonable costs incurred	28709
by an intermediate care facility for the mentally retarded other	28710
than direct care costs, other protected costs, or capital costs.	28711
"Indirect care costs" includes but is not limited to costs of	28712
habilitation supplies, pharmacy consultants, medical and	28713
habilitation records, program supplies, incontinence supplies,	28714
food, enterals, dietary supplies and personnel, laundry,	28715
housekeeping, security, administration, liability insurance,	28716
bookkeeping, purchasing department, human resources,	28717
communications, travel, dues, license fees, subscriptions, home	28718
office costs not otherwise allocated, legal services, accounting	28719
services, minor equipment, maintenance and repairs, help-wanted	28720
advertising, informational advertising, start-up costs,	28721
organizational expenses, other interest, property insurance,	28722
employee training and staff development, employee benefits,	28723
payroll taxes, and workers' compensation premiums or costs for	28724
self-insurance claims and related costs as specified in rules	28725
adopted under section ~~5111.02~~5163.15 of the Revised Code, for	28726
personnel listed in this division. Notwithstanding division (C)(1)	28727
of this section, "indirect care costs" also means the cost of	28728
equipment, including vehicles, acquired by operating lease	28729
executed before December 1, 1992, if the costs are reported as	28730
administrative and general costs on the facility's cost report for	28731
the cost reporting period ending December 31, 1992.	28732

(L) "Inpatient days" means all days during which a resident,	28733
regardless of payment source, occupies a bed in a nursing facility	28734
or intermediate care facility for the mentally retarded that is	28735
included in the facility's certified capacity under Title XIX.	28736
Therapeutic or hospital leave days for which payment is made under	28737
section ~~5111.33~~5164.35 of the Revised Code are considered	28738
inpatient days proportionate to the percentage of the facility's	28739
per resident per day rate paid for those days.	28740

(M) "Intermediate care facility for the mentally retarded"	28741
means an intermediate care facility for the mentally retarded	28742
certified as in compliance with applicable standards for the	28743
medicaid program by the director of health in accordance with	28744
Title XIX.	28745

(N) "Maintenance and repair expenses" means, except as	28746
provided in division (BB)(2) of this section, expenditures that	28747
are necessary and proper to maintain an asset in a normally	28748
efficient working condition and that do not extend the useful life	28749
of the asset two years or more. "Maintenance and repair expenses"	28750
includes but is not limited to the cost of ordinary repairs such	28751
as painting and wallpapering.	28752

(O) "Medicaid days" means all days during which a resident	28753
who is a Medicaid recipient eligible for nursing facility services	28754
occupies a bed in a nursing facility that is included in the	28755
nursing facility's certified capacity under Title XIX. Therapeutic	28756
or hospital leave days for which payment is made under section	28757
~~5111.33~~5164.35 of the Revised Code are considered Medicaid days	28758
proportionate to the percentage of the nursing facility's per	28759
resident per day rate paid for those days.	28760

(P) "Nursing facility" means a facility, or a distinct part	28761
of a facility, that is certified as a nursing facility by the	28762
director of health ~~in accordance with Title XIX~~for the medicaid	28763
program and is not an intermediate care facility for the mentally	28764
retarded. "Nursing facility" includes a facility, or a distinct	28765
part of a facility, that is certified as a nursing facility by	28766
the director of health ~~in accordance with Title XIX~~for the	28767
medicaid program and is certified as a skilled nursing facility by	28768
the director ~~in accordance with Title XVIII~~for the medicare	28769
program.	28770

(Q) "Operator" means the person or government entity	28771
responsible for the daily operating and management decisions for a	28772
nursing facility or intermediate care facility for the mentally	28773
retarded.	28774

(R) "Other protected costs" means costs incurred by an	28775
intermediate care facility for the mentally retarded for medical	28776
supplies; real estate, franchise, and property taxes; natural gas,	28777
fuel oil, water, electricity, sewage, and refuse and hazardous	28778
medical waste collection; allocated other protected home office	28779
costs; and any additional costs defined as other protected costs	28780
in rules adopted under section ~~5111.02~~5163.15 of the Revised	28781
Code.	28782

(S)(1) "Owner" means any person or government entity that has	28783
at least five per cent ownership or interest, either directly,	28784
indirectly, or in any combination, in any of the following	28785
regarding a nursing facility or intermediate care facility for the	28786
mentally retarded:	28787

(a) The land on which the facility is located;

28788

(b) The structure in which the facility is located;

28789

(c) Any mortgage, contract for deed, or other obligation	28790
secured in whole or in part by the land or structure on or in	28791
which the facility is located;	28792

(d) Any lease or sublease of the land or structure on or in	28793
which the facility is located.	28794

(2) "Owner" does not mean a holder of a debenture or bond	28795
related to the nursing facility or intermediate care facility for	28796
the mentally retarded and purchased at public issue or a regulated	28797
lender that has made a loan related to the facility unless the	28798
holder or lender operates the facility directly or through a	28799
subsidiary.	28800

(T) "Patient" includes "resident."

28801

(U) Except as provided in divisions (U)(1) and (2) of this	28802
section, "per diem" means a nursing facility's or intermediate	28803
care facility for the mentally retarded's actual, allowable costs	28804
in a given cost center in a cost reporting period, divided by the	28805
facility's inpatient days for that cost reporting period.	28806

(1) When calculating indirect care costs for the purpose of	28807
establishing rates under section ~~5111.241~~5164.07 of the Revised	28808
Code, "per diem" means an intermediate care facility for the	28809
mentally retarded's actual, allowable indirect care costs in a	28810
cost reporting period divided by the greater of the facility's	28811
inpatient days for that period or the number of inpatient days the	28812
facility would have had during that period if its occupancy rate	28813
had been eighty-five per cent.	28814

(2) When calculating capital costs for the purpose of	28815
establishing rates under section ~~5111.251~~5164.08 of the Revised	28816
Code, "per diem" means a facility's actual, allowable capital	28817
costs in a cost reporting period divided by the greater of the	28818
facility's inpatient days for that period or the number of	28819
inpatient days the facility would have had during that period if	28820
its occupancy rate had been ninety-five per cent.	28821

(V) "Provider" means an operator with a provider agreement.

28822

(W) "Provider agreement" means a contract between the	28823
department of ~~job and family services~~health care administration	28824
and the operator of a nursing facility or intermediate care	28825
facility for the mentally retarded for the provision of nursing	28826
facility services or intermediate care facility services for the	28827
mentally retarded under the medicaid program.	28828

(X) "Purchased nursing services" means services that are	28829
provided in a nursing facility by registered nurses, licensed	28830
practical nurses, or nurse aides who are not employees of the	28831
facility.	28832

(Y) "Reasonable" means that a cost is an actual cost that is	28833
appropriate and helpful to develop and maintain the operation of	28834
patient care facilities and activities, including normal standby	28835
costs, and that does not exceed what a prudent buyer pays for a	28836
given item or services. Reasonable costs may vary from provider to	28837
provider and from time to time for the same provider.	28838

(Z) "Related party" means an individual or organization that,	28839
to a significant extent, has common ownership with, is associated	28840
or affiliated with, has control of, or is controlled by, the	28841
provider.	28842

(1) An individual who is a relative of an owner is a related	28843
party.	28844

(2) Common ownership exists when an individual or individuals	28845
possess significant ownership or equity in both the provider and	28846
the other organization. Significant ownership or equity exists	28847
when an individual or individuals possess five per cent ownership	28848
or equity in both the provider and a supplier. Significant	28849
ownership or equity is presumed to exist when an individual or	28850
individuals possess ten per cent ownership or equity in both the	28851
provider and another organization from which the provider	28852
purchases or leases real property.	28853

(3) Control exists when an individual or organization has the	28854
power, directly or indirectly, to significantly influence or	28855
direct the actions or policies of an organization.	28856

(4) An individual or organization that supplies goods or	28857
services to a provider shall not be considered a related party if	28858
all of the following conditions are met:	28859

(a) The supplier is a separate bona fide organization.

28860

(b) A substantial part of the supplier's business activity of	28861
the type carried on with the provider is transacted with others	28862
than the provider and there is an open, competitive market for the	28863
types of goods or services the supplier furnishes.	28864

(c) The types of goods or services are commonly obtained by	28865
other nursing facilities or intermediate care facilities for the	28866
mentally retarded from outside organizations and are not a basic	28867
element of patient care ordinarily furnished directly to patients	28868
by the facilities.	28869

(d) The charge to the provider is in line with the charge for	28870
the goods or services in the open market and no more than the	28871
charge made under comparable circumstances to others by the	28872
supplier.	28873

(AA) "Relative of owner" means an individual who is related	28874
to an owner of a nursing facility or intermediate care facility	28875
for the mentally retarded by one of the following relationships:	28876

(1) Spouse;

28877

(2) Natural parent, child, or sibling;

28878

(3) Adopted parent, child, or sibling;

28879

(4) Stepparent, stepchild, stepbrother, or stepsister;

28880

(5) Father-in-law, mother-in-law, son-in-law,	28881
daughter-in-law, brother-in-law, or sister-in-law;	28882

(6) Grandparent or grandchild;

28883

(7) Foster caregiver, foster child, foster brother, or foster	28884
sister.	28885

(BB) "Renovation" and "extensive renovation" mean:

28886

(1) Any betterment, improvement, or restoration of an	28887
intermediate care facility for the mentally retarded started	28888
before July 1, 1993, that meets the definition of a renovation or	28889
extensive renovation established in rules ~~adopted by the director~~	28890
~~of job and family services~~ in effect on December 22, 1992.	28891

(2) In the case of betterments, improvements, and	28892
restorations of intermediate care facilities for the mentally	28893
retarded started on or after July 1, 1993:	28894

(a) "Renovation" means the betterment, improvement, or	28895
restoration of an intermediate care facility for the mentally	28896
retarded beyond its current functional capacity through a	28897
structural change that costs at least five hundred dollars per	28898
bed. A renovation may include betterment, improvement,	28899
restoration, or replacement of assets that are affixed to the	28900
building and have a useful life of at least five years. A	28901
renovation may include costs that otherwise would be considered	28902
maintenance and repair expenses if they are an integral part of	28903
the structural change that makes up the renovation project.	28904
"Renovation" does not mean construction of additional space for	28905
beds that will be added to a facility's licensed or certified	28906
capacity.	28907

(b) "Extensive renovation" means a renovation that costs more	28908
than sixty-five per cent and no more than eighty-five per cent of	28909
the cost of constructing a new bed and that extends the useful	28910
life of the assets for at least ten years.	28911

For the purposes of division (BB)(2) of this section, the	28912
cost of constructing a new bed shall be considered to be forty	28913
thousand dollars, adjusted for the estimated rate of inflation	28914
from January 1, 1993, to the end of the calendar year during which	28915
the renovation is completed, using the consumer price index for	28916
shelter costs for all urban consumers for the north central	28917
region, as published by the United States bureau of labor	28918
statistics.	28919

The department of ~~job and family services~~health care	28920
administration may treat a renovation that costs more than	28921
eighty-five per cent of the cost of constructing new beds as an	28922
extensive renovation if the department determines that the	28923
renovation is more prudent than construction of new beds.	28924

(CC) "Title XIX" means Title XIX of the "Social Security	28925
Act," 79 Stat. 286 (1965), 42 U.S.C. 1396, as amended.	28926

(DD) "Title XVIII" means Title XVIII of the "Social Security	28927
Act," 79 Stat. 286 (1965), 42 U.S.C. 1395, as amended.	28928

~~Sec. 5111.201.~~ Sec. 5164.011. Whenever "skilled nursing facility,"	28929
"intermediate care facility," or "dual skilled nursing and	28930
intermediate care facility" is referred to or designated in any	28931
statute, rule, contract, provider agreement, or other document	28932
pertaining to the ~~medical assistance~~medicaid program, the	28933
reference or designation is deemed to refer to a nursing facility,	28934
except that a reference to or designation of an "intermediate care	28935
facility for the mentally retarded" is not deemed to refer to a	28936
nursing facility.	28937

~~Sec. 5111.21.~~ Sec. 5164.02. (A) In order to be eligible for	28938
medicaid payments, the operator of a nursing facility or	28939
intermediate care facility for the mentally retarded shall do all	28940
of the following:	28941

(1) Enter into a provider agreement with the department of	28942
health care administration as provided in section ~~5111.22~~5164.03,	28943
~~5111.671~~5164.841, or ~~5111.672~~5164.842 of the Revised Code;	28944

(2) Apply for and maintain a valid license to operate if so	28945
required by law;	28946

(3) Comply with all applicable state and federal laws and	28947
rules.	28948

(B)(1) Except as provided in division (B)(2) of this section,	28949
the operator of a nursing facility that elects to obtain and	28950
maintain eligibility for payments under the medicaid program shall	28951
qualify all of the facility's medicaid-certified beds in the	28952
medicare program ~~established by Title XVIII~~. The director of ~~job~~	28953
~~and family services~~health care administration may adopt rules	28954
under section ~~5111.02~~5163.15 of the Revised Code to establish the	28955
time frame in which a nursing facility must comply with this	28956
requirement.	28957

(2) The Ohio veteran's home agency is not required to qualify	28958
all of the medicaid-certified beds in a nursing facility the	28959
agency maintains and operates under section 5907.01 of the Revised	28960
Code in the medicare program.	28961

~~Sec. 5111.22.~~ Sec. 5164.03. A provider agreement between the	28962
department of ~~job and family services~~health care administration	28963
and the provider of a nursing facility or intermediate care	28964
facility for the mentally retarded shall contain the following	28965
provisions:	28966

(A) The department agrees to make payments to the provider,	28967
as provided in sections ~~5111.20~~5164.01 to ~~5111.33~~5164.47 of the	28968
Revised Code, for medicaid-covered services the facility provides	28969
to a resident of the facility who is a medicaid recipient. No	28970
payment shall be made for the day a medicaid recipient is	28971
discharged from the facility.	28972

(B) The provider agrees to:

28973

(1) Maintain eligibility as provided in section ~~5111.21~~	28974
5164.02 of the Revised Code;	28975

(2) Keep records relating to a cost reporting period for the	28976
greater of seven years after the cost report is filed or, if the	28977
department issues an audit report in accordance with division (B)	28978
of section ~~5111.27~~5164.38 of the Revised Code, six years after	28979
all appeal rights relating to the audit report are exhausted;	28980

(3) File reports as required by the department;

28981

(4) Open all records relating to the costs of its services	28982
for inspection and audit by the department;	28983

(5) Open its premises for inspection by the department, the	28984
department of health, and any other state or local authority	28985
having authority to inspect;	28986

(6) Supply to the department such information as it requires	28987
concerning the facility's services to residents who are or are	28988
eligible to be medicaid recipients;	28989

(7) Comply with section ~~5111.31~~5164.033 of the Revised Code.

28990

The provider agreement may contain other provisions that are	28991
consistent with law and considered necessary by the department.	28992

A provider agreement shall be effective for no longer than	28993
twelve months, except that if federal statute or regulations	28994
authorize a longer term, it may be effective for a longer term so	28995
authorized. A provider agreement may be renewed only if the	28996
facility is certified by the department of health for	28997
participation in the medicaid program.	28998

The department of ~~job and family services~~health care	28999
administration, in accordance with rules adopted under section	29000
~~5111.02~~5163.15 of the Revised Code, may elect not to enter into,	29001
not to renew, or to terminate a provider agreement when the	29002
department determines that such an agreement would not be in the	29003
best interests of medicaid recipients or of the state.	29004

~~Sec. 5111.223.~~ Sec. 5164.031. The operator of a nursing facility or	29005
intermediate care facility for the mentally retarded may enter	29006
into provider agreements for more than one nursing facility or	29007
intermediate care facility for the mentally retarded.	29008

~~Sec. 5111.30.~~ Sec. 5164.032. The department of ~~job and family~~	29009
~~services~~health care administration shall terminate the provider	29010
agreement with a provider that does not comply with the	29011
requirements of section 3721.071 of the Revised Code for the	29012
installation of fire extinguishing and fire alarm systems.	29013

~~Sec. 5111.31.~~ Sec. 5164.033. (A) Every provider agreement with the	29014
provider of a nursing facility or intermediate care facility for	29015
the mentally retarded shall:	29016

(1) Prohibit the provider from failing or refusing to retain	29017
as a patient any person because the person is, becomes, or may, as	29018
a patient in the facility, become a medicaid recipient. For the	29019
purposes of this division, a medicaid recipient who is a patient	29020
in a facility shall be considered a patient in the facility during	29021
any hospital stays totaling less than twenty-five days during any	29022
twelve-month period. Recipients who have been identified by the	29023
department of ~~job and family services~~health care administration	29024
or its designee as requiring the level of care of an intermediate	29025
care facility for the mentally retarded shall not be subject to a	29026
maximum period of absences during which they are considered	29027
patients if prior authorization of the department for visits with	29028
relatives and friends and participation in therapeutic programs	29029
is obtained under rules adopted under section ~~5111.02~~5163.15 of	29030
the Revised Code.	29031

(2) Except as provided by division (B)(1) of this section,	29032
include any part of the facility that meets standards for	29033
certification of compliance with federal and state laws and rules	29034
for participation in the medicaid program.	29035

(3) Prohibit the provider from discriminating against any	29036
patient on the basis of race, color, sex, creed, or national	29037
origin.	29038

(4) Except as otherwise prohibited under section ~~5111.55~~	29039
5164.71 of the Revised Code, prohibit the provider from failing	29040
or refusing to accept a patient because the patient is, becomes,	29041
or may, as a patient in the facility, become a medicaid recipient	29042
if less than eighty per cent of the patients in the facility are	29043
medicaid recipients.	29044

(B)(1) Except as provided by division (B)(2) of this section,	29045
the following are not required to be included in a provider	29046
agreement unless otherwise required by federal law:	29047

(a) Beds added during the period beginning July 1, 1987, and	29048
ending July 1, 1993, to a nursing home licensed under Chapter	29049
3721. of the Revised Code;	29050

(b) Beds in an intermediate care facility for the mentally	29051
retarded that are designated for respite care under a medicaid	29052
waiver component operated pursuant to a waiver sought under	29053
section ~~5111.87~~5163.65 of the Revised Code.	29054

(2) If a provider chooses to include a bed specified in	29055
division (B)(1)(a) of this section in a provider agreement, the	29056
bed may not be removed from the provider agreement unless the	29057
provider withdraws the facility in which the bed is located from	29058
the medicaid program.	29059

(C) Nothing in this section shall bar a provider that is a	29060
religious organization operating a religious or denominational	29061
nursing facility or intermediate care facility for the mentally	29062
retarded from giving preference to persons of the same religion or	29063
denomination. Nothing in this section shall bar any provider from	29064
giving preference to persons with whom the provider has	29065
contracted to provide continuing care.	29066

(D) Nothing in this section shall bar the provider of a	29067
county home organized under Chapter 5155. of the Revised Code from	29068
admitting residents exclusively from the county in which the	29069
county home is located.	29070

(E) No provider of a nursing facility or intermediate care	29071
facility for the mentally retarded for which a provider agreement	29072
is in effect shall violate the provider contract obligations	29073
imposed under this section.	29074

(F) Nothing in divisions (A) and (C) of this section shall	29075
bar a provider from retaining patients who have resided in the	29076
provider's facility for not less than one year as private pay	29077
patients and who subsequently become medicaid recipients, but	29078
refusing to accept as a patient any person who is or may, as a	29079
patient in the facility, become a medicaid recipient, if all of	29080
the following apply:	29081

(1) The provider does not refuse to retain any patient who	29082
has resided in the provider's facility for not less than one year	29083
as a private pay patient because the patient becomes a medicaid	29084
recipient, except as necessary to comply with division (F)(2) of	29085
this section;	29086

(2) The number of medicaid recipients retained under this	29087
division does not at any time exceed ten per cent of all the	29088
patients in the facility;	29089

(3) On July 1, 1980, all the patients in the facility were	29090
private pay patients.	29091

~~Sec. 5111.32.~~ Sec. 5164.034. Any patient has a cause of action	29092
against the provider of a nursing facility or intermediate care	29093
facility for the mentally retarded for breach of the provider	29094
agreement obligations or other duties imposed by section ~~5111.31~~	29095
5164.033 of the Revised Code. The action may be commenced by the	29096
patient, or on the patient's behalf by the patient's sponsor or a	29097
residents' rights advocate, as either is defined under section	29098
3721.10 of the Revised Code, by the filing of a civil action in	29099
the court of common pleas of the county in which the facility is	29100
located, or in the court of common pleas of Franklin county.	29101

If the court finds that a breach of the provider agreement	29102
obligations imposed by section ~~5111.31~~5164.033 of the Revised	29103
Code has occurred, the court may enjoin the provider from engaging	29104
in the practice, order such affirmative relief as may be	29105
necessary, and award to the patient and a person or public agency	29106
that brings an action on behalf of a patient actual damages,	29107
costs, and reasonable attorney's fees.	29108

~~Sec. 5111.23.~~ Sec. 5164.05. (A) The department of ~~job and family~~	29109
~~services~~health care administration shall pay a provider for each	29110
of the provider's eligible intermediate care facilities for the	29111
mentally retarded a per resident per day rate for direct care	29112
costs established prospectively for each facility. The department	29113
shall establish each facility's rate for direct care costs	29114
quarterly.	29115

(B) Each facility's rate for direct care costs shall be based	29116
on the facility's cost per case-mix unit, subject to the maximum	29117
costs per case-mix unit established under division (B)(2) of this	29118
section, from the calendar year preceding the fiscal year in which	29119
the rate is paid. To determine the rate, the department shall do	29120
all of the following:	29121

(1) Determine each facility's cost per case-mix unit for the	29122
calendar year preceding the fiscal year in which the rate will be	29123
paid by dividing the facility's desk-reviewed, actual, allowable,	29124
per diem direct care costs for that year by its average case-mix	29125
score determined under section ~~5111.232~~5164.051 of the Revised	29126
Code for the same calendar year.	29127

(2)(a) Set the maximum cost per case-mix unit for each peer	29128
group of intermediate care facilities for the mentally retarded	29129
with more than eight beds specified in rules adopted under	29130
division (E) of this section at a percentage above the cost per	29131
case-mix unit of the facility in the group that has the group's	29132
median medicaid inpatient day for the calendar year preceding the	29133
fiscal year in which the rate will be paid, as calculated under	29134
division (B)(1) of this section, that is no less than the	29135
percentage calculated under division (D)(2) of this section.	29136

(b) Set the maximum cost per case-mix unit for each peer	29137
group of intermediate care facilities for the mentally retarded	29138
with eight or fewer beds specified in rules adopted under division	29139
(E) of this section at a percentage above the cost per case-mix	29140
unit of the facility in the group that has the group's median	29141
medicaid inpatient day for the calendar year preceding the fiscal	29142
year in which the rate will be paid, as calculated under division	29143
(B)(1) of this section, that is no less than the percentage	29144
calculated under division (D)(3) of this section.	29145

(c) In calculating the maximum cost per case-mix unit under	29146
divisions (B)(2)(a) toand (b) of this section for each peer	29147
group, the department shall exclude from its calculations the cost	29148
per case-mix unit of any facility in the group that participated	29149
in the medicaid program under the same operator for less than	29150
twelve months during the calendar year preceding the fiscal year	29151
in which the rate will be paid.	29152

(3) Estimate the rate of inflation for the eighteen-month	29153
period beginning on the first day of July of the calendar year	29154
preceding the fiscal year in which the rate will be paid and	29155
ending on the thirty-first day of December of the fiscal year in	29156
which the rate will be paid, using the employment cost index for	29157
total compensation, health services component, published by the	29158
United States bureau of labor statistics. If the estimated	29159
inflation rate for the eighteen-month period is different from the	29160
actual inflation rate for that period, as measured using the same	29161
index, the difference shall be added to or subtracted from the	29162
inflation rate estimated under division (B)(3) of this section for	29163
the following fiscal year.	29164

(4) The department shall not recalculate a maximum cost per	29165
case-mix unit under division (B)(2) of this section or a	29166
percentage under division (D) of this section based on additional	29167
information that it receives after the maximum costs per case-mix	29168
unit or percentages are set. The department shall recalculate a	29169
maximum cost per case-mix units or percentage only if it made an	29170
error in computing the maximum cost per case-mix unit or	29171
percentage based on information available at the time of the	29172
original calculation.	29173

(C) Each facility's rate for direct care costs shall be	29174
determined as follows for each calendar quarter within a fiscal	29175
year:	29176

(1) Multiply the lesser of the following by the facility's	29177
average case-mix score determined under section ~~5111.232~~5164.051	29178
of the Revised Code for the calendar quarter that preceded the	29179
immediately preceding calendar quarter:	29180

(a) The facility's cost per case-mix unit for the calendar	29181
year preceding the fiscal year in which the rate will be paid, as	29182
determined under division (B)(1) of this section;	29183

(b) The maximum cost per case-mix unit established for the	29184
fiscal year in which the rate will be paid for the facility's peer	29185
group under division (B)(2) of this section;	29186

(2) Adjust the product determined under division (C)(1) of	29187
this section by the inflation rate estimated under division (B)(3)	29188
of this section.	29189

(D)(1) The department shall calculate the percentage above	29190
the median cost per case-mix unit determined under division (B)(1)	29191
of this section for the facility that has the median medicaid	29192
inpatient day for calendar year 1992 for all intermediate care	29193
facilities for the mentally retarded with more than eight beds	29194
that would result in payment of all desk-reviewed, actual,	29195
allowable direct care costs for eighty and one-half per cent of	29196
the medicaid inpatient days for such facilities for calendar year	29197
1992.	29198

(2) The department shall calculate the percentage above the	29199
median cost per case-mix unit determined under division (B)(1) of	29200
this section for the facility that has the median medicaid	29201
inpatient day for calendar year 1992 for all intermediate care	29202
facilities for the mentally retarded with eight or fewer beds that	29203
would result in payment of all desk-reviewed, actual, allowable	29204
direct care costs for eighty and one-half per cent of the medicaid	29205
inpatient days for such facilities for calendar year 1992.	29206

(E) The director of ~~job and family services~~health care	29207
administration shall adopt rules under section ~~5111.02~~5163.15 of	29208
the Revised Code that specify peer groups of intermediate care	29209
facilities for the mentally retarded with more than eight beds and	29210
intermediate care facilities for the mentally retarded with eight	29211
or fewer beds, based on findings of significant per diem direct	29212
care cost differences due to geography and facility bed-size. The	29213
rules also may specify peer groups based on findings of	29214
significant per diem direct care cost differences due to other	29215
factors which may include case-mix.	29216

(F) The department, in accordance with division ~~(D)~~(C) of	29217
section ~~5111.232~~5164.051 of the Revised Code and rules adopted	29218
under division ~~(E)~~(D) of that section, may assign case-mix scores	29219
or costs per case-mix unit if a provider fails to submit	29220
assessment data necessary to calculate an intermediate care	29221
facility for the mentally retarded's case-mix score in accordance	29222
with that section.	29223

Sec. 5164.051. (A) The department of health care	29224
administration shall determine case-mix scores for intermediate	29225
care facilities for the mentally retarded using data for each	29226
resident, regardless of payment source, from a resident assessment	29227
instrument and grouper methodology prescribed in rules adopted	29228
under section 5163.15 of the Revised Code and expressed in	29229
case-mix values established by the department in those rules.	29230

(B) Each calendar quarter, each provider of an intermediate	29231
care facility for the mentally retarded shall compile complete	29232
assessment data, from the resident assessment instrument specified	29233
in rules authorized by division (A) of this section, for each	29234
resident of each of the provider's intermediate care facilities	29235
for the mentally retarded, regardless of payment source, who was	29236
in the facility or on hospital or therapeutic leave from the	29237
facility on the last day of the quarter. Providers shall submit	29238
the data to the department of health care administration. The data	29239
shall be submitted not later than fifteen days after the end of	29240
the calendar quarter for which the data is compiled.	29241

Except as provided in division (C) of this section, the	29242
department, after the end of each calendar year, shall calculate	29243
an annual average case-mix score for each intermediate care	29244
facility for the mentally retarded using the facility's quarterly	29245
case-mix scores for that calendar year. The department shall make	29246
the calculations pursuant to procedures specified in rules adopted	29247
under section 5163.15 of the Revised Code.	29248

(C)(1) If a provider of an intermediate care facility for the	29249
mentally retarded does not timely submit information for a	29250
calendar quarter necessary to calculate the facility's case-mix	29251
score, or submits incomplete or inaccurate information for a	29252
calendar quarter, the department may assign the facility a	29253
quarterly average case-mix score that is five per cent less than	29254
the facility's quarterly average case-mix score for the preceding	29255
calendar quarter. If the facility was subject to an exception	29256
review under division (C) of section 5164.38 of the Revised Code	29257
for the preceding calendar quarter, the department may assign a	29258
quarterly average case-mix score that is five per cent less than	29259
the score determined by the exception review. If the facility was	29260
assigned a quarterly average case-mix score for the preceding	29261
quarter, the department may assign a quarterly average case-mix	29262
score that is five per cent less than that score assigned for the	29263
preceding quarter.	29264

The department may use a quarterly average case-mix score	29265
assigned under division (C)(1) of this section, instead of a	29266
quarterly average case-mix score calculated based on the	29267
provider's submitted information, to calculate the facility's rate	29268
for direct care costs being established under section 5164.05 of	29269
the Revised Code for one or more months, as specified in rules	29270
authorized by division (D) of this section, of the quarter for	29271
which the rate established under section 5164.05 of the Revised	29272
Code will be paid.	29273

Before taking action under division (C)(1) of this section,	29274
the department shall permit the provider a reasonable period of	29275
time, specified in rules authorized by division (D) of this	29276
section, to correct the information. The department shall not	29277
assign a quarterly average case-mix score due to late submission	29278
of corrections to assessment information unless the provider fails	29279
to submit corrected information prior to the eighty-first day	29280
after the end of the calendar quarter to which the information	29281
pertains.	29282

(2) If a provider is paid a rate for an intermediate care	29283
facility for the mentally retarded calculated using a quarterly	29284
average case-mix score assigned under division (C)(1) of this	29285
section for more than six months in a calendar year, the	29286
department may assign the facility a cost per case-mix unit that	29287
is five per cent less than the facility's actual or assigned cost	29288
per case-mix unit for the preceding calendar year. The department	29289
may use the assigned cost per case-mix unit, instead of	29290
calculating the facility's actual cost per case-mix unit in	29291
accordance with section 5164.05 of the Revised Code, to establish	29292
the facility's rate for direct care costs for the following fiscal	29293
year.	29294

(3) The department shall take action under division (C)(1) or	29295
(2) of this section only in accordance with rules authorized by	29296
division (D) of this section. The department shall not take an	29297
action that affects rates for prior payment periods except in	29298
accordance with sections 5164.38 and 5164.39 of the Revised Code.	29299

(D) The director shall adopt rules under section 5163.15 of	29300
the Revised Code that do all of the following:	29301

(1) Specify the medium or media through which the completed	29302
assessment data shall be submitted;	29303

(2) Establish procedures under which the assessment data	29304
shall be reviewed for accuracy and providers shall be notified of	29305
any data that requires correction;	29306

(3) Establish procedures for providers to correct assessment	29307
data and specify a reasonable period of time by which providers	29308
shall submit the corrections;	29309

(4) Specify when and how the department will assign case-mix	29310
scores or costs per case-mix unit under division (C) of this	29311
section if information necessary to calculate the facility's	29312
case-mix score is not provided or corrected in accordance with the	29313
procedures established by the rules. Notwithstanding any other	29314
provision of sections 5164.01 to 5164.47 of the Revised Code, the	29315
rules also may provide for excluding case-mix scores assigned	29316
under division (C) of this section from calculation of an	29317
intermediate care facility for the mentally retarded's annual	29318
average case-mix score and the maximum cost per case-mix unit for	29319
the facility's peer group.	29320

~~Sec. 5111.235.~~ Sec. 5164.06. The department of ~~job and family~~	29321
~~services~~health care administration shall pay a provider for each	29322
of the provider's eligible intermediate care facilities for the	29323
mentally retarded a per resident per day rate for other protected	29324
costs established prospectively each fiscal year for each	29325
facility. The rate for each facility shall be the facility's	29326
desk-reviewed, actual, allowable, per diem other protected costs	29327
from the calendar year preceding the fiscal year in which the rate	29328
will be paid, all adjusted for the estimated inflation rate for	29329
the eighteen-month period beginning on the first day of July of	29330
the calendar year preceding the fiscal year in which the rate will	29331
be paid and ending on the thirty-first day of December of that	29332
fiscal year. The department shall estimate inflation using the	29333
consumer price index for all urban consumers for nonprescription	29334
drugs and medical supplies, as published by the United States	29335
bureau of labor statistics. If the estimated inflation rate for	29336
the eighteen-month period is different from the actual inflation	29337
rate for that period, the difference shall be added to or	29338
subtracted from the inflation rate estimated for the following	29339
year.	29340

~~Sec. 5111.241.~~ Sec. 5164.07. (A) The department of ~~job and family~~	29341
~~services~~health care administration shall pay a provider for each	29342
of the provider's eligible intermediate care facilities for the	29343
mentally retarded a per resident per day rate for indirect care	29344
costs established prospectively each fiscal year for each	29345
facility. The rate for each intermediate care facility for the	29346
mentally retarded shall be the sum of the following, but shall not	29347
exceed the maximum rate established for the facility's peer group	29348
under division (B) of this section:	29349

(1) The facility's desk-reviewed, actual, allowable, per diem	29350
indirect care costs from the calendar year preceding the fiscal	29351
year in which the rate will be paid, adjusted for the inflation	29352
rate estimated under division (C)(1) of this section;	29353

(2) An efficiency incentive in the following amount:

29354

(a) For fiscal years ending in even-numbered calendar years:

29355

(i) In the case of intermediate care facilities for the	29356
mentally retarded with more than eight beds, seven and one-tenth	29357
per cent of the maximum rate established for the facility's peer	29358
group under division (B) of this section;	29359

(ii) In the case of intermediate care facilities for the	29360
mentally retarded with eight or fewer beds, seven per cent of the	29361
maximum rate established for the facility's peer group under	29362
division (B) of this section;	29363

(b) For fiscal years ending in odd-numbered calendar years,	29364
the amount calculated for the preceding fiscal year under division	29365
(A)(2)(a) of this section.	29366

(B)(1) The maximum rate for indirect care costs for each peer	29367
group of intermediate care facilities for the mentally retarded	29368
with more than eight beds specified in rules adopted under	29369
division (D) of this section shall be determined as follows:	29370

(a) For fiscal years ending in even-numbered calendar years,	29371
the maximum rate for each peer group shall be the rate that is no	29372
less than twelve and four-tenths per cent above the median	29373
desk-reviewed, actual, allowable, per diem indirect care cost for	29374
all intermediate care facilities for the mentally retarded with	29375
more than eight beds in the group, excluding facilities in the	29376
group whose indirect care costs for that period are more than	29377
three standard deviations from the mean desk-reviewed, actual,	29378
allowable, per diem indirect care cost for all intermediate care	29379
facilities for the mentally retarded with more than eight beds,	29380
for the calendar year preceding the fiscal year in which the rate	29381
will be paid, adjusted by the inflation rate estimated under	29382
division (C)(1) of this section.	29383

(b) For fiscal years ending in odd-numbered calendar years,	29384
the maximum rate for each peer group is the group's maximum rate	29385
for the previous fiscal year, adjusted for the inflation rate	29386
estimated under division (C)(2) of this section.	29387

(2) The maximum rate for indirect care costs for each peer	29388
group of intermediate care facilities for the mentally retarded	29389
with eight or fewer beds specified in rules adopted under division	29390
(D) of this section shall be determined as follows:	29391

(a) For fiscal years ending in even-numbered calendar years,	29392
the maximum rate for each peer group shall be the rate that is no	29393
less than ten and three-tenths per cent above the median	29394
desk-reviewed, actual, allowable, per diem indirect care cost for	29395
all intermediate care facilities for the mentally retarded with	29396
eight or fewer beds in the group, excluding facilities in the	29397
group whose indirect care costs are more than three standard	29398
deviations from the mean desk-reviewed, actual, allowable, per	29399
diem indirect care cost for all intermediate care facilities for	29400
the mentally retarded with eight or fewer beds, for the calendar	29401
year preceding the fiscal year in which the rate will be paid,	29402
adjusted by the inflation rate estimated under division (C)(1) of	29403
this section.	29404

(b) For fiscal years that end in odd-numbered calendar years,	29405
the maximum rate for each peer group is the group's maximum rate	29406
for the previous fiscal year, adjusted for the inflation rate	29407
estimated under division (C)(2) of this section.	29408

(3) The department shall not recalculate a maximum rate for	29409
indirect care costs under division (B)(1) or (2) of this section	29410
based on additional information that it receives after the maximum	29411
rate is set. The department shall recalculate the maximum rate for	29412
indirect care costs only if it made an error in computing the	29413
maximum rate based on the information available at the time of the	29414
original calculation.	29415

(C)(1) When adjusting rates for inflation under divisions	29416
(A)(1), (B)(1)(a), and (B)(2)(a) of this section, the department	29417
shall estimate the rate of inflation for the eighteen-month period	29418
beginning on the first day of July of the calendar year preceding	29419
the fiscal year in which the rate will be paid and ending on the	29420
thirty-first day of December of the fiscal year in which the rate	29421
will be paid, using the consumer price index for all items for all	29422
urban consumers for the north central region, published by the	29423
United States bureau of labor statistics.	29424

(2) When adjusting rates for inflation under divisions	29425
(B)(1)(b) and (B)(2)(b) of this section, the department shall	29426
estimate the rate of inflation for the twelve-month period	29427
beginning on the first day of January of the fiscal year preceding	29428
the fiscal year in which the rate will be paid and ending on the	29429
thirty-first day of December of the fiscal year in which the rate	29430
will be paid, using the consumer price index for all items for all	29431
urban consumers for the north central region, published by the	29432
United States bureau of labor statistics.	29433

(3) If an inflation rate estimated under division (C)(1) or	29434
(2) of this section is different from the actual inflation rate	29435
for the relevant time period, as measured using the same index,	29436
the difference shall be added to or subtracted from the inflation	29437
rate estimated pursuant to this division for the following fiscal	29438
year.	29439

(D) The director of ~~job and family services~~health care	29440
administration shall adopt rules under section ~~5111.02~~5163.15 of	29441
the Revised Code that specify peer groups of intermediate care	29442
facilities for the mentally retarded with more than eight beds,	29443
and peer groups of intermediate care facilities for the mentally	29444
retarded with eight or fewer beds, based on findings of	29445
significant per diem indirect care cost differences due to	29446
geography and facility bed-size. The rules also may specify peer	29447
groups based on findings of significant per diem indirect care	29448
cost differences due to other factors, including case-mix.	29449

~~Sec. 5111.251.~~ Sec. 5164.08. (A) The department of ~~job and family~~	29450
~~services~~health care administration shall pay a provider for each	29451
of the provider's eligible intermediate care facilities for the	29452
mentally retarded for its reasonable capital costs, a per resident	29453
per day rate established prospectively each fiscal year for each	29454
intermediate care facility for the mentally retarded. Except as	29455
otherwise provided in sections ~~5111.20~~5164.01 to ~~5111.33~~5164.41	29456
of the Revised Code, the rate shall be based on the facility's	29457
capital costs for the calendar year preceding the fiscal year in	29458
which the rate will be paid. The rate shall equal the sum of the	29459
following:	29460

(1) The facility's desk-reviewed, actual, allowable, per diem	29461
cost of ownership for the preceding cost reporting period, limited	29462
as provided in divisions (C) and (F) of this section;	29463

(2) Any efficiency incentive determined under division (B) of	29464
this section;	29465

(3) Any amounts for renovations determined under division (D)	29466
of this section;	29467

(4) Any amounts for return on equity determined under	29468
division (I) of this section.	29469

Buildings shall be depreciated using the straight line method	29470
over forty years or over a different period approved by the	29471
department. Components and equipment shall be depreciated using	29472
the straight line method over a period designated by the director	29473
of ~~job and family services~~health care administration in rules	29474
adopted under section ~~5111.02~~5163.15 of the Revised Code,	29475
consistent with the guidelines of the American hospital	29476
association, or over a different period approved by the department	29477
of ~~job and family services~~health care administration. Any rules	29478
authorized by this division that specify useful lives of	29479
buildings, components, or equipment apply only to assets acquired	29480
on or after July 1, 1993. Depreciation for costs paid or	29481
reimbursed by any government agency shall not be included in costs	29482
of ownership or renovation unless that part of the payment under	29483
sections ~~5111.20~~5164.01 to ~~5111.33~~5164.41 of the Revised Code is	29484
used to reimburse the government agency.	29485

(B) The department of ~~job and family services~~health care	29486
administration shall pay to a provider for each of the provider's	29487
eligible intermediate care facilities for the mentally retarded an	29488
efficiency incentive equal to fifty per cent of the difference	29489
between any desk-reviewed, actual, allowable cost of ownership and	29490
the applicable limit on cost of ownership payments under division	29491
(C) of this section. For purposes of computing the efficiency	29492
incentive, depreciation for costs paid or reimbursed by any	29493
government agency shall be considered as a cost of ownership, and	29494
the applicable limit under division (C) of this section shall	29495
apply both to facilities with more than eight beds and facilities	29496
with eight or fewer beds. The efficiency incentive paid to a	29497
provider for a facility with eight or fewer beds shall not exceed	29498
three dollars per patient day, adjusted annually for the inflation	29499
rate for the twelve-month period beginning on the first day of	29500
July of the calendar year preceding the calendar year that	29501
precedes the fiscal year for which the efficiency incentive is	29502
determined and ending on the thirtieth day of the following June,	29503
using the consumer price index for shelter costs for all urban	29504
consumers for the north central region, as published by the United	29505
States bureau of labor statistics.	29506

(C) Cost of ownership payments for intermediate care	29507
facilities for the mentally retarded with more than eight beds	29508
shall not exceed the following limits:	29509

(1) For facilities with dates of licensure prior to January	29510
1, l958, not exceeding two dollars and fifty cents per patient	29511
day;	29512

(2) For facilities with dates of licensure after December 31,	29513
l957, but prior to January 1, l968, not exceeding:	29514

(a) Three dollars and fifty cents per patient day if the cost	29515
of construction was three thousand five hundred dollars or more	29516
per bed;	29517

(b) Two dollars and fifty cents per patient day if the cost	29518
of construction was less than three thousand five hundred dollars	29519
per bed.	29520

(3) For facilities with dates of licensure after December 31,	29521
l967, but prior to January 1, l976, not exceeding:	29522

(a) Four dollars and fifty cents per patient day if the cost	29523
of construction was five thousand one hundred fifty dollars or	29524
more per bed;	29525

(b) Three dollars and fifty cents per patient day if the cost	29526
of construction was less than five thousand one hundred fifty	29527
dollars per bed, but exceeds three thousand five hundred dollars	29528
per bed;	29529

(c) Two dollars and fifty cents per patient day if the cost	29530
of construction was three thousand five hundred dollars or less	29531
per bed.	29532

(4) For facilities with dates of licensure after December 31,	29533
l975, but prior to January 1, l979, not exceeding:	29534

(a) Five dollars and fifty cents per patient day if the cost	29535
of construction was six thousand eight hundred dollars or more per	29536
bed;	29537

(b) Four dollars and fifty cents per patient day if the cost	29538
of construction was less than six thousand eight hundred dollars	29539
per bed but exceeds five thousand one hundred fifty dollars per	29540
bed;	29541

(c) Three dollars and fifty cents per patient day if the cost	29542
of construction was five thousand one hundred fifty dollars or	29543
less per bed, but exceeds three thousand five hundred dollars per	29544
bed;	29545

(d) Two dollars and fifty cents per patient day if the cost	29546
of construction was three thousand five hundred dollars or less	29547
per bed.	29548

(5) For facilities with dates of licensure after December 31,	29549
l978, but prior to January 1, l980, not exceeding:	29550

(a) Six dollars per patient day if the cost of construction	29551
was seven thousand six hundred twenty-five dollars or more per	29552
bed;	29553

(b) Five dollars and fifty cents per patient day if the cost	29554
of construction was less than seven thousand six hundred	29555
twenty-five dollars per bed but exceeds six thousand eight hundred	29556
dollars per bed;	29557

(c) Four dollars and fifty cents per patient day if the cost	29558
of construction was six thousand eight hundred dollars or less per	29559
bed but exceeds five thousand one hundred fifty dollars per bed;	29560

(d) Three dollars and fifty cents per patient day if the cost	29561
of construction was five thousand one hundred fifty dollars or	29562
less but exceeds three thousand five hundred dollars per bed;	29563

(e) Two dollars and fifty cents per patient day if the cost	29564
of construction was three thousand five hundred dollars or less	29565
per bed.	29566

(6) For facilities with dates of licensure after December 31,	29567
1979, but prior to January 1, 1981, not exceeding:	29568

(a) Twelve dollars per patient day if the beds were	29569
originally licensed as residential facility beds by the department	29570
of mental retardation and developmental disabilities;	29571

(b) Six dollars per patient day if the beds were originally	29572
licensed as nursing home beds by the department of health.	29573

(7) For facilities with dates of licensure after December 31,	29574
1980, but prior to January 1, 1982, not exceeding:	29575

(a) Twelve dollars per patient day if the beds were	29576
originally licensed as residential facility beds by the department	29577
of mental retardation and developmental disabilities;	29578

(b) Six dollars and forty-five cents per patient day if the	29579
beds were originally licensed as nursing home beds by the	29580
department of health.	29581

(8) For facilities with dates of licensure after December 31,	29582
1981, but prior to January 1, 1983, not exceeding:	29583

(a) Twelve dollars per patient day if the beds were	29584
originally licensed as residential facility beds by the department	29585
of mental retardation and developmental disabilities;	29586

(b) Six dollars and seventy-nine cents per patient day if the	29587
beds were originally licensed as nursing home beds by the	29588
department of health.	29589

(9) For facilities with dates of licensure after December 31,	29590
1982, but prior to January 1, 1984, not exceeding:	29591

(a) Twelve dollars per patient day if the beds were	29592
originally licensed as residential facility beds by the department	29593
of mental retardation and developmental disabilities;	29594

(b) Seven dollars and nine cents per patient day if the beds	29595
were originally licensed as nursing home beds by the department of	29596
health.	29597

(10) For facilities with dates of licensure after December	29598
31, 1983, but prior to January 1, 1985, not exceeding:	29599

(a) Twelve dollars and twenty-four cents per patient day if	29600
the beds were originally licensed as residential facility beds by	29601
the department of mental retardation and developmental	29602
disabilities;	29603

(b) Seven dollars and twenty-three cents per patient day if	29604
the beds were originally licensed as nursing home beds by the	29605
department of health.	29606

(11) For facilities with dates of licensure after December	29607
31, 1984, but prior to January 1, 1986, not exceeding:	29608

(a) Twelve dollars and fifty-three cents per patient day if	29609
the beds were originally licensed as residential facility beds by	29610
the department of mental retardation and developmental	29611
disabilities;	29612

(b) Seven dollars and forty cents per patient day if the beds	29613
were originally licensed as nursing home beds by the department of	29614
health.	29615

(12) For facilities with dates of licensure after December	29616
31, 1985, but prior to January 1, 1987, not exceeding:	29617

(a) Twelve dollars and seventy cents per patient day if the	29618
beds were originally licensed as residential facility beds by the	29619
department of mental retardation and developmental disabilities;	29620

(b) Seven dollars and fifty cents per patient day if the beds	29621
were originally licensed as nursing home beds by the department of	29622
health.	29623

(13) For facilities with dates of licensure after December	29624
31, 1986, but prior to January 1, 1988, not exceeding:	29625

(a) Twelve dollars and ninety-nine cents per patient day if	29626
the beds were originally licensed as residential facility beds by	29627
the department of mental retardation and developmental	29628
disabilities;	29629

(b) Seven dollars and sixty-seven cents per patient day if	29630
the beds were originally licensed as nursing home beds by the	29631
department of health.	29632

(14) For facilities with dates of licensure after December	29633
31, 1987, but prior to January 1, 1989, not exceeding thirteen	29634
dollars and twenty-six cents per patient day;	29635

(15) For facilities with dates of licensure after December	29636
31, 1988, but prior to January 1, 1990, not exceeding thirteen	29637
dollars and forty-six cents per patient day;	29638

(16) For facilities with dates of licensure after December	29639
31, 1989, but prior to January 1, 1991, not exceeding thirteen	29640
dollars and sixty cents per patient day;	29641

(17) For facilities with dates of licensure after December	29642
31, 1990, but prior to January 1, 1992, not exceeding thirteen	29643
dollars and forty-nine cents per patient day;	29644

(18) For facilities with dates of licensure after December	29645
31, 1991, but prior to January 1, 1993, not exceeding thirteen	29646
dollars and sixty-seven cents per patient day;	29647

(19) For facilities with dates of licensure after December	29648
31, 1992, not exceeding fourteen dollars and twenty-eight cents	29649
per patient day.	29650

(D) Beginning January 1, 1981, regardless of the original	29651
date of licensure, the department of ~~job and family services~~	29652
health care administration shall pay a rate for the per diem	29653
capitalized costs of renovations to intermediate care facilities	29654
for the mentally retarded made after January 1, l981, not	29655
exceeding six dollars per patient day using 1980 as the base year	29656
and adjusting the amount annually until June 30, 1993, for	29657
fluctuations in construction costs calculated by the department	29658
using the "Dodge building cost indexes, northeastern and north	29659
central states," published by Marshall and Swift. The payment	29660
provided for in this division is the only payment that shall be	29661
made for the capitalized costs of a nonextensive renovation of an	29662
intermediate care facility for the mentally retarded.	29663
Nonextensive renovation costs shall not be included in cost of	29664
ownership, and a nonextensive renovation shall not affect the date	29665
of licensure for purposes of division (C) of this section. This	29666
division applies to nonextensive renovations regardless of whether	29667
they are made by an owner or a lessee. If the tenancy of a lessee	29668
that has made renovations ends before the depreciation expense for	29669
the renovation costs has been fully reported, the former lessee	29670
shall not report the undepreciated balance as an expense.	29671

For a nonextensive renovation to qualify for payment under	29672
this division, both of the following conditions must be met:	29673

(1) At least five years have elapsed since the date of	29674
licensure or date of an extensive renovation of the portion of the	29675
facility that is proposed to be renovated, except that this	29676
condition does not apply if the renovation is necessary to meet	29677
the requirements of federal, state, or local statutes, ordinances,	29678
rules, or policies.	29679

(2) The provider has obtained prior approval from the	29680
department of ~~job and family services~~health care administration.	29681
The provider shall submit a plan that describes in detail the	29682
changes in capital assets to be accomplished by means of the	29683
renovation and the timetable for completing the project. The time	29684
for completion of the project shall be no more than eighteen	29685
months after the renovation begins. The director of ~~job and family~~	29686
~~services~~health care administration shall adopt rules under	29687
section ~~5111.02~~5163.15 of the Revised Code that specify criteria	29688
and procedures for prior approval of renovation projects. No	29689
provider shall separate a project with the intent to evade the	29690
characterization of the project as a renovation or as an extensive	29691
renovation. No provider shall increase the scope of a project	29692
after it is approved by the department of ~~job and family services~~	29693
health care administration unless the increase in scope is	29694
approved by the department.	29695

(E) The amounts specified in divisions (C) and (D) of this	29696
section shall be adjusted beginning July 1, 1993, for the	29697
estimated inflation for the twelve-month period beginning on the	29698
first day of July of the calendar year preceding the calendar year	29699
that precedes the fiscal year for which rate will be paid and	29700
ending on the thirtieth day of the following June, using the	29701
consumer price index for shelter costs for all urban consumers for	29702
the north central region, as published by the United States bureau	29703
of labor statistics.	29704

(F)(1) For facilities of eight or fewer beds that have dates	29705
of licensure or have been granted project authorization by the	29706
department of mental retardation and developmental disabilities	29707
before July 1, 1993, and for facilities of eight or fewer beds	29708
that have dates of licensure or have been granted project	29709
authorization after that date if the providers of the facilities	29710
demonstrate that they made substantial commitments of funds on or	29711
before that date, cost of ownership shall not exceed eighteen	29712
dollars and thirty cents per resident per day. The eighteen-dollar	29713
and thirty-cent amount shall be increased by the change in the	29714
"Dodge building cost indexes, northeastern and north central	29715
states," published by Marshall and Swift, during the period	29716
beginning June 30, 1990, and ending July 1, 1993, and by the	29717
change in the consumer price index for shelter costs for all urban	29718
consumers for the north central region, as published by the United	29719
States bureau of labor statistics, annually thereafter.	29720

(2) For facilities with eight or fewer beds that have dates	29721
of licensure or have been granted project authorization by the	29722
department of mental retardation and developmental disabilities on	29723
or after July 1, 1993, for which substantial commitments of funds	29724
were not made before that date, cost of ownership payments shall	29725
not exceed the applicable amount calculated under division (F)(1)	29726
of this section, if the department of ~~job and family services~~	29727
health care administration gives prior approval for construction	29728
of the facility. If the department does not give prior approval,	29729
cost of ownership payments shall not exceed the amount specified	29730
in division (C) of this section.	29731

(3) Notwithstanding divisions (D) and (F)(1) and (2) of this	29732
section, the total payment for cost of ownership, cost of	29733
ownership efficiency incentive, and capitalized costs of	29734
renovations for an intermediate care facility for the mentally	29735
retarded with eight or fewer beds shall not exceed the sum of the	29736
limitations specified in divisions (C) and (D) of this section.	29737

(G) Notwithstanding any provision of this section or section	29738
~~5111.241~~5164.07 of the Revised Code, the director of ~~job and~~	29739
~~family services~~health care administration may adopt rules under	29740
section ~~5111.02~~5163.15 of the Revised Code that provide for a	29741
calculation of a combined maximum payment limit for indirect care	29742
costs and cost of ownership for intermediate care facilities for	29743
the mentally retarded with eight or fewer beds.	29744

(H) After the date on which a transaction of sale is closed,	29745
the provider shall refund to the department the amount of excess	29746
depreciation paid to the provider for the facility by the	29747
department for each year the provider has operated the facility	29748
under a provider agreement and prorated according to the number of	29749
medicaid patient days for which the provider has received payment	29750
for the facility. For the purposes of this division,	29751
"depreciation paid to the provider for the facility" means the	29752
amount paid to the provider for the intermediate care facility for	29753
the mentally retarded for cost of ownership pursuant to this	29754
section less any amount paid for interest costs. For the purposes	29755
of this division, "excess depreciation" is the intermediate care	29756
facility for the mentally retarded's depreciated basis, which is	29757
the provider's cost less accumulated depreciation, subtracted from	29758
the purchase price but not exceeding the amount of depreciation	29759
paid to the provider for the facility.	29760

(I) The department of ~~job and family services~~health care	29761
administration shall pay a provider for each of the provider's	29762
eligible proprietary intermediate care facilities for the mentally	29763
retarded a return on the facility's net equity computed at the	29764
rate of one and one-half times the average of interest rates on	29765
special issues of public debt obligations issued to the federal	29766
hospital insurance trust fund for the cost reporting period. No	29767
facility's return on net equity paid under this division shall	29768
exceed one dollar per patient day.	29769

In calculating the rate for return on net equity, the	29770
department shall use the greater of the facility's inpatient days	29771
during the applicable cost reporting period or the number of	29772
inpatient days the facility would have had during that period if	29773
its occupancy rate had been ninety-five per cent.	29774

(J)(1) Except as provided in division (J)(2) of this section,	29775
if a provider leases or transfers an interest in a facility to	29776
another provider who is a related party, the related party's	29777
allowable cost of ownership shall include the lesser of the	29778
following:	29779

(a) The annual lease expense or actual cost of ownership,	29780
whichever is applicable;	29781

(b) The reasonable cost to the lessor or provider making the	29782
transfer.	29783

(2) If a provider leases or transfers an interest in a	29784
facility to another provider who is a related party, regardless of	29785
the date of the lease or transfer, the related party's allowable	29786
cost of ownership shall include the annual lease expense or actual	29787
cost of ownership, whichever is applicable, subject to the	29788
limitations specified in divisions (B) to (I) of this section, if	29789
all of the following conditions are met:	29790

(a) The related party is a relative of owner;

29791

(b) In the case of a lease, if the lessor retains any	29792
ownership interest, it is, except as provided in division	29793
(J)(2)(d)(ii) of this section, in only the real property and any	29794
improvements on the real property;	29795

(c) In the case of a transfer, the provider making the	29796
transfer retains, except as provided in division (J)(2)(d)(iv) of	29797
this section, no ownership interest in the facility;	29798

(d) The department of ~~job and family services~~health care	29799
administration determines that the lease or transfer is an arm's	29800
length transaction pursuant to rules adopted under section ~~5111.02~~	29801
5163.15 of the Revised Code. The rules shall provide that a lease	29802
or transfer is an arm's length transaction if all of the	29803
following, as applicable, apply:	29804

(i) In the case of a lease, once the lease goes into effect,	29805
the lessor has no direct or indirect interest in the lessee or,	29806
except as provided in division (J)(2)(b) of this section, the	29807
facility itself, including interest as an owner, officer,	29808
director, employee, independent contractor, or consultant, but	29809
excluding interest as a lessor.	29810

(ii) In the case of a lease, the lessor does not reacquire an	29811
interest in the facility except through the exercise of a lessor's	29812
rights in the event of a default. If the lessor reacquires an	29813
interest in the facility in this manner, the department shall	29814
treat the facility as if the lease never occurred when the	29815
department calculates its reimbursement rates for capital costs.	29816

(iii) In the case of a transfer, once the transfer goes into	29817
effect, the provider that made the transfer has no direct or	29818
indirect interest in the provider that acquires the facility or	29819
the facility itself, including interest as an owner, officer,	29820
director, employee, independent contractor, or consultant, but	29821
excluding interest as a creditor.	29822

(iv) In the case of a transfer, the provider that made the	29823
transfer does not reacquire an interest in the facility except	29824
through the exercise of a creditor's rights in the event of a	29825
default. If the provider reacquires an interest in the facility in	29826
this manner, the department shall treat the facility as if the	29827
transfer never occurred when the department calculates its	29828
reimbursement rates for capital costs.	29829

(v) The lease or transfer satisfies any other criteria	29830
specified in the rules.	29831

(e) Except in the case of hardship caused by a catastrophic	29832
event, as determined by the department, or in the case of a lessor	29833
or provider making the transfer who is at least sixty-five years	29834
of age, not less than twenty years have elapsed since, for the	29835
same facility, allowable cost of ownership was determined most	29836
recently under this division.	29837

~~Sec. 5111.261.~~ Sec. 5164.10. Except as otherwise provided in	29838
section ~~5111.264~~5164.372 of the Revised Code, the department of	29839
~~job and family services~~health care administration, in determining	29840
whether an intermediate care facility for the mentally retarded's	29841
direct care costs and indirect care costs are allowable, shall	29842
place no limit on specific categories of reasonable costs other	29843
than compensation of owners, compensation of relatives of owners,	29844
compensation of administrators and costs for resident meals that	29845
are prepared and consumed outside the facility.	29846

Compensation cost limits for owners and relatives of owners	29847
shall be based on compensation costs for individuals who hold	29848
comparable positions but who are not owners or relatives of	29849
owners, as reported on facility cost reports. As used in this	29850
section, "comparable position" means the position that is held by	29851
the owner or the owner's relative, if that position is listed	29852
separately on the cost report form, or if the position is not	29853
listed separately, the group of positions that is listed on the	29854
cost report form and that includes the position held by the owner	29855
or the owner's relative. In the case of an owner or owner's	29856
relative who serves the facility in a capacity such as corporate	29857
officer, proprietor, or partner for which no comparable position	29858
or group of positions is listed on the cost report form, the	29859
compensation cost limit shall be based on civil service	29860
equivalents and shall be specified in rules adopted under section	29861
~~5111.02~~5163.15 of the Revised Code.	29862

Compensation cost limits for administrators shall be based on	29863
compensation costs for administrators who are not owners or	29864
relatives of owners, as reported on facility cost reports.	29865
Compensation cost limits for administrators of four or more	29866
intermediate care facilities for the mentally retarded shall be	29867
the same as the limits for administrators of intermediate care	29868
facilities for the mentally retarded with one hundred fifty or	29869
more beds.	29870

~~Sec. 5111.255.~~ Sec. 5164.12. (A) The department of ~~job and family~~	29871
~~services~~health care administration shall establish initial rates	29872
for an intermediate care facility for the mentally retarded with a	29873
first date of licensure that is on or after January 1, 1993,	29874
including a facility that replaces one or more existing	29875
facilities, or for an intermediate care facility for the mentally	29876
retarded with a first date of licensure before that date that was	29877
initially certified for the medicaid program on or after that	29878
date, in the following manner:	29879

(1) The rate for direct care costs shall be determined as	29880
follows:	29881

(a) If there are no cost or resident assessment data as	29882
necessary to calculate a rate under section ~~5111.23~~5164.05 of the	29883
Revised Code, the rate shall be the median cost per case-mix unit	29884
calculated under division (B)(1) of that section for the relevant	29885
peer group for the calendar year preceding the fiscal year in	29886
which the rate will be paid, multiplied by the median annual	29887
average case-mix score for the peer group for that period and by	29888
the rate of inflation estimated under division (B)(3) of that	29889
section. This rate shall be recalculated to reflect the	29890
facility's actual quarterly average case-mix score, in accordance	29891
with that section, after it submits its first quarterly assessment	29892
data that qualifies for use in calculating a case-mix score in	29893
accordance with rules authorized by division ~~(E)~~(D) of section	29894
~~5111.232~~5164.051 of the Revised Code. If the facility's first two	29895
quarterly submissions do not contain assessment data that	29896
qualifies for use in calculating a case-mix score, the department	29897
shall continue to calculate the rate using the median annual	29898
case-mix score for the peer group in lieu of an assigned quarterly	29899
case-mix score. The department shall assign a case-mix score or,	29900
if necessary, a cost per case-mix unit under division ~~(D)~~(C) of	29901
section ~~5111.232~~5164.051 of the Revised Code for any subsequent	29902
submissions that do not contain assessment data that qualifies for	29903
use in calculating a case-mix score.	29904

(b) If the facility is a replacement facility and the	29905
facility or facilities that are being replaced are in operation	29906
immediately before the replacement facility opens, the rate shall	29907
be the same as the rate for the replaced facility or facilities,	29908
proportionate to the number of beds in each replaced facility. If	29909
one or more of the replaced facilities is not in operation	29910
immediately before the replacement facility opens, its proportion	29911
shall be determined under division (A)(1)(a) of this section.	29912

(2) The rate for other protected costs shall be one hundred	29913
fifteen per cent of the median rate for intermediate care	29914
facilities for the mentally retarded calculated for the fiscal	29915
year under section ~~5111.235~~5164.06 of the Revised Code.	29916

(3) The rate for indirect care costs shall be the applicable	29917
maximum rate for the facility's peer group as specified in	29918
division (B) of section ~~5111.241~~5164.07 of the Revised Code.	29919

(4) The rate for capital costs shall be determined under	29920
section ~~5111.251~~5164.08 of the Revised Code using the greater of	29921
actual inpatient days or an imputed occupancy rate of eighty per	29922
cent.	29923

(B) The department shall adjust the rates established under	29924
division (A) of this section at both of the following times:	29925

(1) Effective the first day of July, to reflect new rate	29926
calculations for all facilities under sections ~~5111.20~~5164.01 to	29927
~~5111.33~~5164.41 of the Revised Code;	29928

(2) Following the provider's submission of the facility's	29929
cost report under division (A)(1)(b) of section ~~5111.26~~5164.37 of	29930
the Revised Code.	29931

The department shall pay the rate adjusted based on the cost	29932
report beginning the first day of the calendar quarter that begins	29933
more than ninety days after the department receives the cost	29934
report.	29935

~~Sec. 5111.291.~~ Sec. 5164.13. Notwithstanding sections ~~5111.20~~	29936
5164.01 to ~~5111.33~~5164.41 of the Revised Code, the department of	29937
~~job and family services~~health care administration may compute the	29938
rate for intermediate care facilities for the mentally retarded	29939
operated by the department of mental retardation and developmental	29940
disabilities or the department of mental health according to the	29941
reasonable cost principles of ~~Title XVIII~~the medicare program.	29942

~~Sec. 5111.211.~~ Sec. 5164.14. (A) The department of mental	29943
retardation and developmental disabilities is responsible for the	29944
nonfederal share of claims submitted for services that are covered	29945
by the medicaid program and provided to an eligible medicaid	29946
recipient by an intermediate care facility for the mentally	29947
retarded if all of the following are the case:	29948

(1) The services are provided on or after July 1, 2003;

29949

(2) The facility receives initial certification by the	29950
director of health as an intermediate care facility for the	29951
mentally retarded on or after June 1, 2003;	29952

(3) The facility, or a portion of the facility, is licensed	29953
by the director of mental retardation and developmental	29954
disabilities as a residential facility under section 5123.19 of	29955
the Revised Code;	29956

(4) There is a valid provider agreement for the facility.

29957

(B) Each month, the department of ~~job and family services~~	29958
health care administration shall invoice the department of mental	29959
retardation and developmental disabilities by interagency transfer	29960
voucher for the claims for which the department of mental	29961
retardation and developmental disabilities is responsible pursuant	29962
to this section.	29963

~~Sec. 5111.222.~~ Sec. 5164.18. (A) Except as otherwise provided by	29964
sections ~~5111.20~~5164.01 to ~~5111.33~~5164.41 of the Revised Code	29965
and by division (B) of this section, the payments that the	29966
department of ~~job and family services~~health care administration	29967
shall agree to make to the provider of a nursing facility pursuant	29968
to a provider agreement shall equal the sum of all of the	29969
following:	29970

(1) The rate for direct care costs determined for the nursing	29971
facility under section ~~5111.231~~5164.19 of the Revised Code;	29972

(2) The rate for ancillary and support costs determined for	29973
the nursing facility's ancillary and support cost peer group under	29974
section ~~5111.24~~5164.20 of the Revised Code;	29975

(3) The rate for tax costs determined for the nursing	29976
facility under section ~~5111.242~~5164.21 of the Revised Code;	29977

(4) The rate for franchise permit fees determined for the	29978
nursing facility under section ~~5111.243~~5164.22 of the Revised	29979
Code;	29980

(5) The quality incentive payment paid to the nursing	29981
facility under section ~~5111.244~~5164.23 of the Revised Code;	29982

(6) The median rate for capital costs for the nursing	29983
facilities in the nursing facility's capital costs peer group as	29984
determined under section ~~5111.25~~5164.24 of the Revised Code.	29985

(B) The department shall adjust the rates otherwise	29986
determined under divisions (A)(1), (2), (3), and (6) of this	29987
section as directed by the general assembly through the enactment	29988
of law governing medicaid payments to providers of nursing	29989
facilities, including any law that does either of the following:	29990

(1) Establishes factors by which the rates are to be	29991
adjusted;	29992

(2) Establishes a methodology for phasing in the rates	29993
determined for fiscal year 2006 under uncodified law the general	29994
assembly enacts to rates determined for subsequent fiscal years	29995
under sections ~~5111.20~~5164.01 to ~~5111.33~~5164.41 of the Revised	29996
Code.	29997

~~Sec. 5111.231.~~ Sec. 5164.19. (A) As used in this section,	29998
"applicable calendar year" means the following:	29999

(1) For the purpose of the department of ~~job and family~~	30000
~~services'~~health care administration's initial determination under	30001
division (D) of this section of each peer group's cost per	30002
case-mix unit, calendar year 2003;	30003

(2) For the purpose of the department's subsequent	30004
determinations under division (D) of this section of each peer	30005
group's cost per case-mix unit, the calendar year the department	30006
selects.	30007

(B) The department of ~~job and family services~~health care	30008
administration shall pay a provider for each of the provider's	30009
eligible nursing facilities a per resident per day rate for direct	30010
care costs determined semiannually by multiplying the cost per	30011
case-mix unit determined under division (D) of this section for	30012
the facility's peer group by the facility's semiannual case-mix	30013
score determined under section ~~5111.232~~5164.191 of the Revised	30014
Code.	30015

(C) For the purpose of determining nursing facilities' rate	30016
for direct care costs, the department shall establish three peer	30017
groups.	30018

Each nursing facility located in any of the following	30019
counties shall be placed in peer group one: Brown, Butler,	30020
Clermont, Clinton, Hamilton, and Warren.	30021

Each nursing facility located in any of the following	30022
counties shall be placed in peer group two: Ashtabula, Champaign,	30023
Clark, Cuyahoga, Darke, Delaware, Fairfield, Fayette, Franklin,	30024
Fulton, Geauga, Greene, Hancock, Knox, Lake, Licking, Lorain,	30025
Lucas, Madison, Marion, Medina, Miami, Montgomery, Morrow, Ottawa,	30026
Pickaway, Portage, Preble, Ross, Sandusky, Seneca, Summit, Union,	30027
and Wood.	30028

Each nursing facility located in any of the following	30029
counties shall be placed in peer group three: Adams, Allen,	30030
Ashland, Athens, Auglaize, Belmont, Carroll, Columbiana,	30031
Coshocton, Crawford, Defiance, Erie, Gallia, Guernsey, Hardin,	30032
Harrison, Henry, Highland, Hocking, Holmes, Huron, Jackson,	30033
Jefferson, Lawrence, Logan, Mahoning, Meigs, Mercer, Monroe,	30034
Morgan, Muskingum, Noble, Paulding, Perry, Pike, Putnam, Richland,	30035
Scioto, Shelby, Stark, Trumbull, Tuscarawas, Van Wert, Vinton,	30036
Washington, Wayne, Williams, and Wyandot.	30037

(D)(1) At least once every ten years, the department shall	30038
determine a cost per case-mix unit for each peer group established	30039
under division (C) of this section. A cost per case-mix unit	30040
determined under this division for a peer group shall be used for	30041
subsequent years until the department redetermines it. To	30042
determine a peer group's cost per case-mix unit, the department	30043
shall do all of the following:	30044

(a) Determine the cost per case-mix unit for each nursing	30045
facility in the peer group for the applicable calendar year by	30046
dividing each facility's desk-reviewed, actual, allowable, per	30047
diem direct care costs for the applicable calendar year by the	30048
facility's annual average case-mix score determined under section	30049
~~5111.232~~5164.191 of the Revised Code for the applicable calendar	30050
year.	30051

(b) Subject to division (D)(2) of this section, identify	30052
which nursing facility in the peer group is at the twenty-fifth	30053
percentile of the cost per case-mix units determined under	30054
division (D)(1)(a) of this section.	30055

(c) Calculate the amount that is seven per cent above the	30056
cost per case-mix unit determined under division (D)(1)(a) of this	30057
section for the nursing facility identified under division	30058
(D)(1)(b) of this section.	30059

(d) Multiply the amount calculated under division (D)(1)(c)	30060
of this section by the rate of inflation for the eighteen-month	30061
period beginning on the first day of July of the applicable	30062
calendar year and ending the last day of December of the calendar	30063
year immediately following the applicable calendar year using the	30064
employment cost index for total compensation, health services	30065
component, published by the United States bureau of labor	30066
statistics.	30067

(2) In making the identification under division (D)(1)(b) of	30068
this section, the department shall exclude both of the following:	30069

(a) Nursing facilities that participated in the medicaid	30070
program under the same provider for less than twelve months in the	30071
applicable calendar year;	30072

(b) Nursing facilities whose cost per case-mix unit is more	30073
than one standard deviation from the mean cost per case-mix unit	30074
for all nursing facilities in the nursing facility's peer group	30075
for the applicable calendar year.	30076

(3) The department shall not redetermine a peer group's cost	30077
per case-mix unit under this division based on additional	30078
information that it receives after the peer group's per case-mix	30079
unit is determined. The department shall redetermine a peer	30080
group's cost per case-mix unit only if it made an error in	30081
determining the peer group's cost per case-mix unit based on	30082
information available to the department at the time of the	30083
original determination.	30084

~~Sec. 5111.232.~~ Sec. 5164.191. (A)(1) The department of ~~job and~~	30085
~~family services~~health care administration shall determine	30086
semiannual and annual average case-mix scores for nursing	30087
facilities by using all of the following:	30088

(a) Data from a resident assessment instrument specified in	30089
rules adopted under section ~~5111.02~~5163.15 of the Revised Code	30090
pursuant to ~~section 1919(e)(5) of the "Social Security Act," 49~~	30091
~~Stat. 620 (1935),~~ 42 U.S.C.A. 1396r(e)(5)~~, as amended,~~ for the	30092
following residents:	30093

(i) When determining ~~semi-annual~~semiannual case-mix scores,	30094
each resident who is a medicaid recipient;	30095

(ii) When determining annual average case-mix scores, each	30096
resident regardless of payment source.	30097

(b) Except as provided in rules authorized by ~~division~~	30098
divisions (A)(2)(a) and (b) of this section, the case-mix values	30099
established by the United States department of health and human	30100
services;	30101

(c) Except as modified in rules authorized by division	30102
(A)(2)(c) of this section, the grouper methodology used on June	30103
30, 1999, by the United States department of health and human	30104
services for prospective payment of skilled nursing facilities	30105
under the medicare program ~~established by Title XVIII~~.	30106

(2) The director of ~~job and family services~~health care	30107
administration may adopt rules under section ~~5111.02~~5163.15 of	30108
the Revised Code that do any of the following:	30109

(a) Adjust the case-mix values specified in division	30110
(A)(1)(b) of this section to reflect changes in relative wage	30111
differentials that are specific to this state;	30112

(b) Express all of those case-mix values in numeric terms	30113
that are different from the terms specified by the United States	30114
department of health and human services but that do not alter the	30115
relationship of the case-mix values to one another;	30116

(c) Modify the grouper methodology specified in division	30117
(A)(1)(c) of this section as follows:	30118

(i) Establish a different hierarchy for assigning residents	30119
to case-mix categories under the methodology;	30120

(ii) Prohibit the use of the index maximizer element of the	30121
methodology;	30122

(iii) Incorporate changes to the methodology the United	30123
States department of health and human services makes after June	30124
30, 1999;	30125

(iv) Make other changes the department determines are	30126
necessary.	30127

(B) ~~The department shall determine case-mix scores for~~	30128
~~intermediate care facilities for the mentally retarded using data~~	30129
~~for each resident, regardless of payment source, from a resident~~	30130
~~assessment instrument and grouper methodology prescribed in rules~~	30131
~~adopted under section 5111.02 of the Revised Code and expressed in~~	30132
~~case-mix values established by the department in those rules.~~	30133

~~(C)~~ Each calendar quarter, each provider of a nursing	30134
facility shall compile complete assessment data, from the resident	30135
assessment instrument specified in rules authorized by division	30136
(A) ~~or (B)~~ of this section, for each resident of each of the	30137
provider's nursing facilities, regardless of payment source, who	30138
was in the facility or on hospital or therapeutic leave from the	30139
facility on the last day of the quarter. Providers ~~of a nursing~~	30140
~~facility~~ shall submit the data to the department of health and, if	30141
required by rules, the department of ~~job and family services~~	30142
health care administration. ~~Providers of an intermediate care~~	30143
~~facility for the mentally retarded shall submit the data to the~~	30144
~~department of job and family services.~~ The data shall be submitted	30145
not later than fifteen days after the end of the calendar quarter	30146
for which the data is compiled.	30147

Except as provided in division ~~(D)~~(C) of this section, the	30148
department, every six months and after the end of each calendar	30149
year, shall calculate a semiannual and annual average case-mix	30150
score for each nursing facility using the facility's quarterly	30151
case-mix scores for that six-month period or calendar year. ~~Also~~	30152
~~except as provided in division (D) of this section, the~~	30153
~~department, after the end of each calendar year, shall calculate~~	30154
~~an annual average case-mix score for each intermediate care~~	30155
~~facility for the mentally retarded using the facility's quarterly~~	30156
~~case-mix scores for that calendar year.~~ The department shall make	30157
the calculations pursuant to procedures specified in rules adopted	30158
under section ~~5111.02~~5163.15 of the Revised Code.	30159

~~(D)~~(C)(1) If a provider of a nursing facility does not timely	30160
submit information for a calendar quarter necessary to calculate a	30161
facility's case-mix score, or submits incomplete or inaccurate	30162
information for a calendar quarter, the department may assign the	30163
facility a quarterly average case-mix score that is five per cent	30164
less than the facility's quarterly average case-mix score for the	30165
preceding calendar quarter. If the facility was subject to an	30166
exception review under division (C) of section ~~5111.27~~5164.38 of	30167
the Revised Code for the preceding calendar quarter, the	30168
department may assign a quarterly average case-mix score that is	30169
five per cent less than the score determined by the exception	30170
review. If the facility was assigned a quarterly average case-mix	30171
score for the preceding quarter, the department may assign a	30172
quarterly average case-mix score that is five per cent less than	30173
that score assigned for the preceding quarter.	30174

The department may use a quarterly average case-mix score	30175
assigned under division ~~(D)~~(C)(1) of this section, instead of a	30176
quarterly average case-mix score calculated based on the	30177
provider's submitted information, to calculate the facility's rate	30178
for direct care costs being established under section ~~5111.23 or~~	30179
~~5111.231~~5164.19 of the Revised Code for one or more months, as	30180
specified in rules authorized by division ~~(E)~~(D) of this section,	30181
of the quarter for which the rate established under section	30182
~~5111.23 or 5111.231~~5164.19 of the Revised Code will be paid.	30183

Before taking action under division ~~(D)~~(C)(1) of this	30184
section, the department shall permit the provider a reasonable	30185
period of time, specified in rules authorized by division ~~(E)~~(D)	30186
of this section, to correct the information. ~~In the case of an~~	30187
~~intermediate care facility for the mentally retarded, the~~	30188
~~department shall not assign a quarterly average case-mix score due~~	30189
~~to late submission of corrections to assessment information unless~~	30190
~~the provider fails to submit corrected information prior to the~~	30191
~~eighty-first day after the end of the calendar quarter to which~~	30192
~~the information pertains. In the case of a nursing facility, the~~	30193
The department shall not assign a quarterly average case-mix score	30194
due to late submission of corrections to assessment information	30195
unless the provider fails to submit corrected information prior to	30196
the earlier of the eighty-first day after the end of the calendar	30197
quarter to which the information pertains or the deadline for	30198
submission of such corrections established by regulations adopted	30199
by the United States department of health and human services under	30200
Titles XVIII and XIX.	30201

(2) If a provider is paid a rate for a nursing facility	30202
calculated using a quarterly average case-mix score assigned under	30203
division ~~(D)~~(C)(1) of this section for more than six months in a	30204
calendar year, the department may assign the facility a cost per	30205
case-mix unit that is five per cent less than the facility's	30206
actual or assigned cost per case-mix unit for the preceding	30207
calendar year. The department may use the assigned cost per	30208
case-mix unit, instead of calculating the facility's actual cost	30209
per case-mix unit in accordance with section ~~5111.23 or 5111.231~~	30210
5164.19 of the Revised Code, to establish the facility's rate for	30211
direct care costs for the following fiscal year.	30212

(3) The department shall take action under division ~~(D)~~(C)(1)	30213
or (2) of this section only in accordance with rules authorized by	30214
division ~~(E)~~(D) of this section. The department shall not take an	30215
action that affects rates for prior payment periods except in	30216
accordance with sections ~~5111.27~~5164.38 and ~~5111.28~~5164.39 of	30217
the Revised Code.	30218

~~(E)~~(D) The director shall adopt rules under section ~~5111.02~~	30219
5163.15 of the Revised Code that do all of the following:	30220

(1) Specify whether providers of a nursing facility must	30221
submit the assessment data to the department of ~~job and family~~	30222
~~services~~health care administration;	30223

(2) Specify the medium or media through which the completed	30224
assessment data shall be submitted;	30225

(3) Establish procedures under which the assessment data	30226
shall be reviewed for accuracy and providers shall be notified of	30227
any data that requires correction;	30228

(4) Establish procedures for providers to correct assessment	30229
data and specify a reasonable period of time by which providers	30230
shall submit the corrections. The procedures may limit the content	30231
of corrections by providers of nursing facilities in the manner	30232
required by regulations adopted by the United States department of	30233
health and human services under Titles XVIII and XIX.	30234

(5) Specify when and how the department will assign case-mix	30235
scores or costs per case-mix unit under division ~~(D)~~(C) of this	30236
section if information necessary to calculate the facility's	30237
case-mix score is not provided or corrected in accordance with the	30238
procedures established by the rules. Notwithstanding any other	30239
provision of sections ~~5111.20~~5164.01 to ~~5111.33~~5164.41 of the	30240
Revised Code, the rules also may provide for ~~the following:~~	30241

~~(a) Exclusion of case-mix scores assigned under division (D)~~	30242
~~of this section from calculation of an intermediate care facility~~	30243
~~for the mentally retarded's annual average case-mix score and the~~	30244
~~maximum cost per case-mix unit for the facility's peer group;~~	30245

~~(b) Exclusion of~~excluding case-mix scores assigned under	30246
division ~~(D)~~(C) of this section from calculation of a nursing	30247
facility's semiannual or annual average case-mix score and the	30248
cost per case-mix unit for the facility's peer group.	30249

~~Sec. 5111.24.~~ Sec. 5164.20. (A) As used in this section,	30250
"applicable calendar year" means the following:	30251

(1) For the purpose of the department of ~~job and family~~	30252
~~services'~~health care administration's initial determination under	30253
division (D) of this section of each peer group's rate for	30254
ancillary and support costs, calendar year 2003;	30255

(2) For the purpose of the department's subsequent	30256
determinations under division (D) of this section of each peer	30257
group's rate for ancillary and support costs, the calendar year	30258
the department selects.	30259

(B) The department of ~~job and family services~~health care	30260
administration shall pay a provider for each of the provider's	30261
eligible nursing facilities a per resident per day rate for	30262
ancillary and support costs determined for the nursing facility's	30263
peer group under division (D) of this section.	30264

(C) For the purpose of determining nursing facilities' rate	30265
for ancillary and support costs, the department shall establish	30266
six peer groups.	30267

Each nursing facility located in any of the following	30268
counties shall be placed in peer group one or two: Brown, Butler,	30269
Clermont, Clinton, Hamilton, and Warren. Each nursing facility	30270
located in any of those counties that has fewer than one hundred	30271
beds shall be placed in peer group one. Each nursing facility	30272
located in any of those counties that has one hundred or more beds	30273
shall be placed in peer group two.	30274

Each nursing facility located in any of the following	30275
counties shall be placed in peer group three or four: Ashtabula,	30276
Champaign, Clark, Cuyahoga, Darke, Delaware, Fairfield, Fayette,	30277
Franklin, Fulton, Geauga, Greene, Hancock, Knox, Lake, Licking,	30278
Lorain, Lucas, Madison, Marion, Medina, Miami, Montgomery, Morrow,	30279
Ottawa, Pickaway, Portage, Preble, Ross, Sandusky, Seneca, Summit,	30280
Union, and Wood. Each nursing facility located in any of those	30281
counties that has fewer than one hundred beds shall be placed in	30282
peer group three. Each nursing facility located in any of those	30283
counties that has one hundred or more beds shall be placed in peer	30284
group four.	30285

Each nursing facility located in any of the following	30286
counties shall be placed in peer group five or six: Adams, Allen,	30287
Ashland, Athens, Auglaize, Belmont, Carroll, Columbiana,	30288
Coshocton, Crawford, Defiance, Erie, Gallia, Guernsey, Hardin,	30289
Harrison, Henry, Highland, Hocking, Holmes, Huron, Jackson,	30290
Jefferson, Lawrence, Logan, Mahoning, Meigs, Mercer, Monroe,	30291
Morgan, Muskingum, Noble, Paulding, Perry, Pike, Putnam, Richland,	30292
Scioto, Shelby, Stark, Trumbull, Tuscarawas, Van Wert, Vinton,	30293
Washington, Wayne, Williams, and Wyandot. Each nursing facility	30294
located in any of those counties that has fewer than one hundred	30295
beds shall be placed in peer group five. Each nursing facility	30296
located in any of those counties that has one hundred or more beds	30297
shall be placed in peer group six.	30298

(D)(1) At least once every ten years, the department shall	30299
determine the rate for ancillary and support costs for each peer	30300
group established under division (C) of this section. The rate for	30301
ancillary and support costs determined under this division for a	30302
peer group shall be used for subsequent years until the department	30303
redetermines it. To determine a peer group's rate for ancillary	30304
and support costs, the department shall do all of the following:	30305

(a) Determine the rate for ancillary and support costs for	30306
each nursing facility in the peer group for the applicable	30307
calendar year by using the greater of the nursing facility's	30308
actual inpatient days for the applicable calendar year or the	30309
inpatient days the nursing facility would have had for the	30310
applicable calendar year if its occupancy rate had been ninety per	30311
cent. For the purpose of determining a nursing facility's	30312
occupancy rate under division (D)(1)(a) of this section, the	30313
department shall include any beds that the nursing facility	30314
removes from its medicaid-certified capacity unless the nursing	30315
facility also removes the beds from its licensed bed capacity.	30316

(b) Subject to division (D)(2) of this section, identify	30317
which nursing facility in the peer group is at the twenty-fifth	30318
percentile of the rate for ancillary and support costs for the	30319
applicable calendar year determined under division (D)(1)(a) of	30320
this section.	30321

(c) Calculate the amount that is three per cent above the	30322
rate for ancillary and support costs determined under division	30323
(D)(1)(a) of this section for the nursing facility identified	30324
under division (D)(1)(b) of this section.	30325

(d) Multiply the amount calculated under division (D)(1)(c)	30326
of this section by the rate of inflation for the eighteen-month	30327
period beginning on the first day of July of the applicable	30328
calendar year and ending the last day of December of the calendar	30329
year immediately following the applicable calendar year using the	30330
consumer price index for all items for all urban consumers for the	30331
north central region, published by the United States bureau of	30332
labor statistics.	30333

(2) In making the identification under division (D)(1)(b) of	30334
this section, the department shall exclude both of the following:	30335

(a) Nursing facilities that participated in the medicaid	30336
program under the same provider for less than twelve months in the	30337
applicable calendar year;	30338

(b) Nursing facilities whose ancillary and support costs are	30339
more than one standard deviation from the mean desk-reviewed,	30340
actual, allowable, per diem ancillary and support cost for all	30341
nursing facilities in the nursing facility's peer group for the	30342
applicable calendar year.	30343

(3) The department shall not redetermine a peer group's rate	30344
for ancillary and support costs under this division based on	30345
additional information that it receives after the rate is	30346
determined. The department shall redetermine a peer group's rate	30347
for ancillary and support costs only if it made an error in	30348
determining the rate based on information available to the	30349
department at the time of the original determination.	30350

~~Sec. 5111.242.~~ Sec. 5164.21. (A) As used in this section:

30351

(1) "Applicable calendar year" means the following:

30352

(a) For the purpose of the department of ~~job and family~~	30353
~~services'~~health care administration's initial determination under	30354
this section of nursing facilities' rate for tax costs, calendar	30355
year 2003;	30356

(b) For the purpose of the department's subsequent	30357
determinations under division (D) of this section of nursing	30358
facilities' rate for tax costs, the calendar year the department	30359
selects.	30360

(2) "Tax costs" means the costs of taxes imposed under	30361
Chapter 5751. of the Revised Code, real estate taxes, personal	30362
property taxes, and corporate franchise taxes.	30363

(B) The department of ~~job and family services~~health care	30364
administration shall pay a provider for each of the provider's	30365
eligible nursing facilities a per resident per day rate for tax	30366
costs determined under division (C) of this section.	30367

(C) At least once every ten years, the department shall	30368
determine the rate for tax costs for each nursing facility. The	30369
rate for tax costs determined under this division for a nursing	30370
facility shall be used for subsequent years until the department	30371
redetermines it. To determine a nursing facility's rate for tax	30372
costs, the department shall divide the nursing facility's	30373
desk-reviewed, actual, allowable tax costs paid for the applicable	30374
calendar year by the number of inpatient days the nursing facility	30375
would have had if its occupancy rate had been one hundred per cent	30376
during the applicable calendar year.	30377

~~Sec. 5111.243.~~ Sec. 5164.22. The department of ~~job and family~~	30378
~~services~~health care administration shall pay a provider for each	30379
of the provider's eligible nursing facilities a per resident per	30380
day rate for the franchise permit fees paid for the nursing	30381
facility. The rate shall be equal to the franchise permit fee for	30382
the fiscal year for which the rate is paid.	30383

~~Sec. 5111.244.~~ Sec. 5164.23. (A) As used in this section,	30384
"deficiency" and "standard survey" have the same meanings as in	30385
section ~~5111.35~~5164.50 of the Revised Code.	30386

(B) Each fiscal year, the department of ~~job and family~~	30387
~~services~~health care administration shall pay the provider of each	30388
nursing facility a quality incentive payment. The amount of a	30389
quality incentive payment paid to a provider for a fiscal year	30390
shall be based on the number of points the provider's nursing	30391
facility is awarded under division (C) of this section for that	30392
fiscal year. The amount of a quality incentive payment paid to a	30393
provider of a nursing facility that is awarded no points may be	30394
zero. The mean payment for fiscal year 2007, weighted by medicaid	30395
days, shall be three dollars per medicaid day. The department	30396
shall adjust the mean payment for subsequent fiscal years by the	30397
same adjustment factors the department uses to adjust, pursuant to	30398
division (B) of section ~~5111.222~~5164.18 of the Revised Code,	30399
nursing facilities' rates otherwise determined under divisions	30400
(A)(1), (2), (3), and (6) of that section.	30401

(C)(1) Except as provided by division (C)(2) of this section,	30402
the department shall annually award each nursing facility	30403
participating in the medicaid program one point for each of the	30404
following accountability measures the facility meets:	30405

(a) The facility had no health deficiencies on the facility's	30406
most recent standard survey.	30407

(b) The facility had no health deficiencies with a scope and	30408
severity level greater than E, as determined under nursing	30409
facility certification standards established under Title XIX, on	30410
the facility's most recent standard survey.	30411

(c) The facility's resident satisfaction is above the	30412
statewide average.	30413

(d) The facility's family satisfaction is above the statewide	30414
average.	30415

(e) The number of hours the facility employs nurses is above	30416
the statewide average.	30417

(f) The facility's employee retention rate is above the	30418
average for the facility's peer group established in division (C)	30419
of section ~~5111.231~~5164.19 of the Revised Code.	30420

(g) The facility's occupancy rate is above the statewide	30421
average.	30422

(h) The facility's medicaid utilization rate is above the	30423
statewide average.	30424

(i) The facility's case-mix score is above the statewide	30425
average.	30426

(2) The department shall award points pursuant to division	30427
(C)(1)(c) or (d) of this section only for a fiscal year	30428
immediately following a calendar year for which a survey of	30429
resident or family satisfaction has been conducted under section	30430
173.47 of the Revised Code.	30431

(D) The director of ~~job and family services~~health care	30432
administration shall adopt rules under section ~~5111.02~~5163.15 of	30433
the Revised Code as necessary to implement this section. The rules	30434
shall include rules establishing the system for awarding points	30435
under division (C) of this section.	30436

~~Sec. 5111.25.~~ Sec. 5164.24. (A) As used in this section,	30437
"applicable calendar year" means the following:	30438

(1) For the purpose of the department of ~~job and family~~	30439
~~services'~~health care administration's initial determination under	30440
division (D) of this section of each peer group's median rate for	30441
capital costs, calendar year 2003;	30442

(2) For the purpose of the department's subsequent	30443
determinations under division (D) of this section of each peer	30444
group's median rate for capital costs, the calendar year the	30445
department selects.	30446

(B) The department of ~~job and family services~~health care	30447
administration shall pay a provider for each of the provider's	30448
eligible nursing facilities a per resident per day rate for	30449
capital costs. A nursing facility's rate for capital costs shall	30450
be the median rate for capital costs for the nursing facilities in	30451
the nursing facility's peer group as determined under division (D)	30452
of this section.	30453

(C) For the purpose of determining nursing facilities' rate	30454
for capital costs, the department shall establish six peer groups.	30455

Each nursing facility located in any of the following	30456
counties shall be placed in peer group one or two: Brown, Butler,	30457
Clermont, Clinton, Hamilton, and Warren. Each nursing facility	30458
located in any of those counties that has fewer than one hundred	30459
beds shall be placed in peer group one. Each nursing facility	30460
located in any of those counties that has one hundred or more beds	30461
shall be placed in peer group two.	30462

Each nursing facility located in any of the following	30463
counties shall be placed in peer group three or four: Ashtabula,	30464
Champaign, Clark, Cuyahoga, Darke, Delaware, Fairfield, Fayette,	30465
Franklin, Fulton, Geauga, Greene, Hancock, Knox, Lake, Licking,	30466
Lorain, Lucas, Madison, Marion, Medina, Miami, Montgomery, Morrow,	30467
Ottawa, Pickaway, Portage, Preble, Ross, Sandusky, Seneca, Summit,	30468
Union, and Wood. Each nursing facility located in any of those	30469
counties that has fewer than one hundred beds shall be placed in	30470
peer group three. Each nursing facility located in any of those	30471
counties that has one hundred or more beds shall be placed in peer	30472
group four.	30473

Each nursing facility located in any of the following	30474
counties shall be placed in peer group five or six: Adams, Allen,	30475
Ashland, Athens, Auglaize, Belmont, Carroll, Columbiana,	30476
Coshocton, Crawford, Defiance, Erie, Gallia, Guernsey, Hardin,	30477
Harrison, Henry, Highland, Hocking, Holmes, Huron, Jackson,	30478
Jefferson, Lawrence, Logan, Mahoning, Meigs, Mercer, Monroe,	30479
Morgan, Muskingum, Noble, Paulding, Perry, Pike, Putnam, Richland,	30480
Scioto, Shelby, Stark, Trumbull, Tuscarawas, Van Wert, Vinton,	30481
Washington, Wayne, Williams, and Wyandot. Each nursing facility	30482
located in any of those counties that has fewer than one hundred	30483
beds shall be placed in peer group five. Each nursing facility	30484
located in any of those counties that has one hundred or more beds	30485
shall be placed in peer group six.	30486

(D)(1) At least once every ten years, the department shall	30487
determine the median rate for capital costs for each peer group	30488
established under division (C) of this section. The median rate	30489
for capital costs determined under this division for a peer group	30490
shall be used for subsequent years until the department	30491
redetermines it. To determine a peer group's median rate for	30492
capital costs, the department shall do both of the following:	30493

(a) Subject to division (D)(2) of this section, use the	30494
greater of each nursing facility's actual inpatient days for the	30495
applicable calendar year or the inpatient days the nursing	30496
facility would have had for the applicable calendar year if its	30497
occupancy rate had been one hundred per cent.	30498

(b) Exclude both of the following:

30499

(i) Nursing facilities that participated in the medicaid	30500
program under the same provider for less than twelve months in the	30501
applicable calendar year;	30502

(ii) Nursing facilities whose capital costs are more than one	30503
standard deviation from the mean desk-reviewed, actual, allowable,	30504
per diem capital cost for all nursing facilities in the nursing	30505
facility's peer group for the applicable calendar year.	30506

(2) For the purpose of determining a nursing facility's	30507
occupancy rate under division (D)(1)(a) of this section, the	30508
department shall include any beds that the nursing facility	30509
removes from its medicaid-certified capacity after June 30, 2005,	30510
unless the nursing facility also removes the beds from its	30511
licensed bed capacity.	30512

(E) Buildings shall be depreciated using the straight line	30513
method over forty years or over a different period approved by the	30514
department. Components and equipment shall be depreciated using	30515
the straight-line method over a period designated in rules adopted	30516
under section ~~5111.02~~5163.15 of the Revised Code, consistent with	30517
the guidelines of the American hospital association, or over a	30518
different period approved by the department. Any rules authorized	30519
by this division that specify useful lives of buildings,	30520
components, or equipment apply only to assets acquired on or after	30521
July 1, 1993. Depreciation for costs paid or reimbursed by any	30522
government agency shall not be included in capital costs unless	30523
that part of the payment under sections ~~5111.20~~5164.01 to ~~5111.33~~	30524
5164.41 of the Revised Code is used to reimburse the government	30525
agency.	30526

(F) The capital cost basis of nursing facility assets shall	30527
be determined in the following manner:	30528

(1) Except as provided in division (F)(3) of this section,	30529
for purposes of calculating the rates to be paid for facilities	30530
with dates of licensure on or before June 30, 1993, the capital	30531
cost basis of each asset shall be equal to the desk-reviewed,	30532
actual, allowable, capital cost basis that is listed on the	30533
facility's cost report for the calendar year preceding the fiscal	30534
year during which the rate will be paid.	30535

(2) For facilities with dates of licensure after June 30,	30536
1993, the capital cost basis shall be determined in accordance	30537
with the principles of the medicare program established under	30538
Title XVIII, except as otherwise provided in sections ~~5111.20~~	30539
5164.01 to ~~5111.33~~5164.41 of the Revised Code.	30540

(3) Except as provided in division (F)(4) of this section, if	30541
a provider transfers an interest in a facility to another provider	30542
after June 30, 1993, there shall be no increase in the capital	30543
cost basis of the asset if the providers are related parties or	30544
the provider to which the interest is transferred authorizes the	30545
provider that transferred the interest to continue to operate the	30546
facility under a lease, management agreement, or other	30547
arrangement. If the previous sentence does not prohibit the	30548
adjustment of the capital cost basis under this division, the	30549
basis of the asset shall be adjusted by the lesser of the	30550
following:	30551

(a) One-half of the change in construction costs during the	30552
time that the transferor held the asset, as calculated by the	30553
department of ~~job and family services~~health care administration	30554
using the "Dodge building cost indexes, northeastern and north	30555
central states," published by Marshall and Swift;	30556

(b) One-half of the change in the consumer price index for	30557
all items for all urban consumers, as published by the United	30558
States bureau of labor statistics, during the time that the	30559
transferor held the asset.	30560

(4) If a provider transfers an interest in a facility to	30561
another provider who is a related party, the capital cost basis of	30562
the asset shall be adjusted as specified in division (F)(3) of	30563
this section if all of the following conditions are met:	30564

(a) The related party is a relative of owner;

30565

(b) Except as provided in division (F)(4)(c)(ii) of this	30566
section, the provider making the transfer retains no ownership	30567
interest in the facility;	30568

(c) The department of ~~job and family services~~health care	30569
administration determines that the transfer is an arm's length	30570
transaction pursuant to rules adopted under section ~~5111.02~~	30571
5163.15 of the Revised Code. The rules shall provide that a	30572
transfer is an arm's length transaction if all of the following	30573
apply:	30574

(i) Once the transfer goes into effect, the provider that	30575
made the transfer has no direct or indirect interest in the	30576
provider that acquires the facility or the facility itself,	30577
including interest as an owner, officer, director, employee,	30578
independent contractor, or consultant, but excluding interest as a	30579
creditor.	30580

(ii) The provider that made the transfer does not reacquire	30581
an interest in the facility except through the exercise of a	30582
creditor's rights in the event of a default. If the provider	30583
reacquires an interest in the facility in this manner, the	30584
department shall treat the facility as if the transfer never	30585
occurred when the department calculates its reimbursement rates	30586
for capital costs.	30587

(iii) The transfer satisfies any other criteria specified in	30588
the rules.	30589

(d) Except in the case of hardship caused by a catastrophic	30590
event, as determined by the department, or in the case of a	30591
provider making the transfer who is at least sixty-five years of	30592
age, not less than twenty years have elapsed since, for the same	30593
facility, the capital cost basis was adjusted most recently under	30594
division (F)(4) of this section or actual, allowable cost of	30595
ownership was determined most recently under division (G)(9) of	30596
this section.	30597

(G) As used in this division:

30598

"Imputed interest" means the lesser of the prime rate plus	30599
two per cent or ten per cent.	30600

"Lease expense" means lease payments in the case of an	30601
operating lease and depreciation expense and interest expense in	30602
the case of a capital lease.	30603

"New lease" means a lease, to a different lessee, of a	30604
nursing facility that previously was operated under a lease.	30605

(1) Subject to division (B) of this section, for a lease of a	30606
facility that was effective on May 27, 1992, the entire lease	30607
expense is an actual, allowable capital cost during the term of	30608
the existing lease. The entire lease expense also is an actual,	30609
allowable capital cost if a lease in existence on May 27, 1992, is	30610
renewed under either of the following circumstances:	30611

(a) The renewal is pursuant to a renewal option that was in	30612
existence on May 27, 1992;	30613

(b) The renewal is for the same lease payment amount and	30614
between the same parties as the lease in existence on May 27,	30615
1992.	30616

(2) Subject to division (B) of this section, for a lease of a	30617
facility that was in existence but not operated under a lease on	30618
May 27, 1992, actual, allowable capital costs shall include the	30619
lesser of the annual lease expense or the annual depreciation	30620
expense and imputed interest expense that would be calculated at	30621
the inception of the lease using the lessor's entire historical	30622
capital asset cost basis, adjusted by the lesser of the following	30623
amounts:	30624

(a) One-half of the change in construction costs during the	30625
time the lessor held each asset until the beginning of the lease,	30626
as calculated by the department using the "Dodge building cost	30627
indexes, northeastern and north central states," published by	30628
Marshall and Swift;	30629

(b) One-half of the change in the consumer price index for	30630
all items for all urban consumers, as published by the United	30631
States bureau of labor statistics, during the time the lessor held	30632
each asset until the beginning of the lease.	30633

(3) Subject to division (B) of this section, for a lease of a	30634
facility with a date of licensure on or after May 27, 1992, that	30635
is initially operated under a lease, actual, allowable capital	30636
costs shall include the annual lease expense if there was a	30637
substantial commitment of money for construction of the facility	30638
after December 22, 1992, and before July 1, 1993. If there was not	30639
a substantial commitment of money after December 22, 1992, and	30640
before July 1, 1993, actual, allowable capital costs shall include	30641
the lesser of the annual lease expense or the sum of the	30642
following:	30643

(a) The annual depreciation expense that would be calculated	30644
at the inception of the lease using the lessor's entire historical	30645
capital asset cost basis;	30646

(b) The greater of the lessor's actual annual amortization of	30647
financing costs and interest expense at the inception of the lease	30648
or the imputed interest expense calculated at the inception of the	30649
lease using seventy per cent of the lessor's historical capital	30650
asset cost basis.	30651

(4) Subject to division (B) of this section, for a lease of a	30652
facility with a date of licensure on or after May 27, 1992, that	30653
was not initially operated under a lease and has been in existence	30654
for ten years, actual, allowable capital costs shall include the	30655
lesser of the annual lease expense or the annual depreciation	30656
expense and imputed interest expense that would be calculated at	30657
the inception of the lease using the entire historical capital	30658
asset cost basis of the lessor, adjusted by the lesser of the	30659
following:	30660

(a) One-half of the change in construction costs during the	30661
time the lessor held each asset until the beginning of the lease,	30662
as calculated by the department using the "Dodge building cost	30663
indexes, northeastern and north central states," published by	30664
Marshall and Swift;	30665

(b) One-half of the change in the consumer price index for	30666
all items for all urban consumers, as published by the United	30667
States bureau of labor statistics, during the time the lessor held	30668
each asset until the beginning of the lease.	30669

(5) Subject to division (B) of this section, for a new lease	30670
of a facility that was operated under a lease on May 27, 1992,	30671
actual, allowable capital costs shall include the lesser of the	30672
annual new lease expense or the annual old lease payment. If the	30673
old lease was in effect for ten years or longer, the old lease	30674
payment from the beginning of the old lease shall be adjusted by	30675
the lesser of the following:	30676

(a) One-half of the change in construction costs from the	30677
beginning of the old lease to the beginning of the new lease, as	30678
calculated by the department using the "Dodge building cost	30679
indexes, northeastern and north central states," published by	30680
Marshall and Swift;	30681

(b) One-half of the change in the consumer price index for	30682
all items for all urban consumers, as published by the United	30683
States bureau of labor statistics, from the beginning of the old	30684
lease to the beginning of the new lease.	30685

(6) Subject to division (B) of this section, for a new lease	30686
of a facility that was not in existence or that was in existence	30687
but not operated under a lease on May 27, 1992, actual, allowable	30688
capital costs shall include the lesser of annual new lease expense	30689
or the annual amount calculated for the old lease under division	30690
(G)(2), (3), (4), or (6) of this section, as applicable. If the	30691
old lease was in effect for ten years or longer, the lessor's	30692
historical capital asset cost basis shall be adjusted by the	30693
lesser of the following for purposes of calculating the annual	30694
amount under division (G)(2), (3), (4), or (6) of this section:	30695

(a) One-half of the change in construction costs from the	30696
beginning of the old lease to the beginning of the new lease, as	30697
calculated by the department using the "Dodge building cost	30698
indexes, northeastern and north central states," published by	30699
Marshall and Swift;	30700

(b) One-half of the change in the consumer price index for	30701
all items for all urban consumers, as published by the United	30702
States bureau of labor statistics, from the beginning of the old	30703
lease to the beginning of the new lease.	30704

In the case of a lease under division (G)(3) of this section	30705
of a facility for which a substantial commitment of money was made	30706
after December 22, 1992, and before July 1, 1993, the old lease	30707
payment shall be adjusted for the purpose of determining the	30708
annual amount.	30709

(7) For any revision of a lease described in division (G)(1),	30710
(2), (3), (4), (5), or (6) of this section, or for any subsequent	30711
lease of a facility operated under such a lease, other than	30712
execution of a new lease, the portion of actual, allowable capital	30713
costs attributable to the lease shall be the same as before the	30714
revision or subsequent lease.	30715

(8) Except as provided in division (G)(9) of this section, if	30716
a provider leases an interest in a facility to another provider	30717
who is a related party or previously operated the facility, the	30718
related party's or previous operator's actual, allowable capital	30719
costs shall include the lesser of the annual lease expense or the	30720
reasonable cost to the lessor.	30721

(9) If a provider leases an interest in a facility to another	30722
provider who is a related party, regardless of the date of the	30723
lease, the related party's actual, allowable capital costs shall	30724
include the annual lease expense, subject to the limitations	30725
specified in divisions (G)(1) to (7) of this section, if all of	30726
the following conditions are met:	30727

(a) The related party is a relative of owner;

30728

(b) If the lessor retains an ownership interest, it is,	30729
except as provided in division (G)(9)(c)(ii) of this section, in	30730
only the real property and any improvements on the real property;	30731

(c) The department of ~~job and family services~~health care	30732
administration determines that the lease is an arm's length	30733
transaction pursuant to rules adopted under section ~~5111.02~~	30734
5163.15 of the Revised Code. The rules shall provide that a lease	30735
is an arm's length transaction if all of the following apply:	30736

(i) Once the lease goes into effect, the lessor has no direct	30737
or indirect interest in the lessee or, except as provided in	30738
division (G)(9)(b) of this section, the facility itself, including	30739
interest as an owner, officer, director, employee, independent	30740
contractor, or consultant, but excluding interest as a lessor.	30741

(ii) The lessor does not reacquire an interest in the	30742
facility except through the exercise of a lessor's rights in the	30743
event of a default. If the lessor reacquires an interest in the	30744
facility in this manner, the department shall treat the facility	30745
as if the lease never occurred when the department calculates its	30746
reimbursement rates for capital costs.	30747

(iii) The lease satisfies any other criteria specified in the	30748
rules.	30749

(d) Except in the case of hardship caused by a catastrophic	30750
event, as determined by the department, or in the case of a lessor	30751
who is at least sixty-five years of age, not less than twenty	30752
years have elapsed since, for the same facility, the capital cost	30753
basis was adjusted most recently under division (F)(4) of this	30754
section or actual, allowable capital costs were determined most	30755
recently under division (G)(9) of this section.	30756

(10) This division does not apply to leases of specific items	30757
of equipment.	30758

(H) After the date on which a transaction of sale is closed,	30759
the provider shall refund to the department the amount of excess	30760
depreciation paid to the provider for the facility by the	30761
department for each year the provider has operated the facility	30762
under a provider agreement and prorated according to the number of	30763
medicaid patient days for which the provider has received payment	30764
for the facility. The provider of a facility that is sold or that	30765
voluntarily terminates participation in the medicaid program also	30766
shall refund any other amount that the department properly finds	30767
to be due after the audit conducted under this division. For the	30768
purposes of this division, "depreciation paid to the provider for	30769
the facility" means the amount paid to the provider for the	30770
nursing facility for capital costs pursuant to this section less	30771
any amount paid for interest costs, amortization of financing	30772
costs, and lease expenses. For the purposes of this division,	30773
"excess depreciation" is the nursing facility's depreciated basis,	30774
which is the provider's cost less accumulated depreciation,	30775
subtracted from the purchase price net of selling costs but not	30776
exceeding the amount of depreciation paid to the provider for the	30777
facility.	30778

~~Sec. 5111.263.~~ Sec. 5164.26. (A) As used in this section, "covered	30779
therapy services" means physical therapy, occupational therapy,	30780
audiology, and speech therapy services that are provided by	30781
appropriately licensed therapists or therapy assistants and that	30782
are covered for nursing facility residents either by the medicare	30783
program ~~established under Title XVIII~~ or the medicaid program as	30784
specified in rules adopted by the director of ~~job and family~~	30785
~~services~~health care administration under section ~~5111.02~~5163.15	30786
of the Revised Code.	30787

(B) Except as provided in division (G) of this section, the	30788
costs of therapy are not allowable costs for nursing facilities	30789
for the purpose of determining rates under sections ~~5111.20~~	30790
5164.01 to ~~5111.33~~5164.41 of the Revised Code.	30791

(C) The department of ~~job and family services~~health care	30792
administration shall process no claims for payment under the	30793
medicaid program for covered therapy services rendered to a	30794
resident of a nursing facility other than such claims submitted,	30795
in accordance with this section, by a nursing facility that has a	30796
valid provider agreement with the department.	30797

(D) Providers of nursing facilities may bill the department	30798
of ~~job and family services~~health care administration for covered	30799
therapy services the nursing facilities provide to residents of	30800
any nursing facility who are medicaid recipients and not eligible	30801
for the medicare program.	30802

(E) The department shall not process any claim for a covered	30803
therapy service provided to a nursing facility resident who is	30804
eligible for the medicare program unless the claim is for a	30805
copayment or deductible or the conditions in division (E)(1) or	30806
(2) of this section apply:	30807

(1) The covered therapy service provided is, under the	30808
federal statutes, regulations, or policies governing the medicare	30809
program, not covered by the medicare program and the service is,	30810
under the provisions of this chapter or the rules adopted under	30811
this chapter, covered by the medicaid program.	30812

(2) All of the following apply:

30813

(a) The individual or entity who provided the covered therapy	30814
service was eligible to bill the medicare program for the service.	30815

(b) A complete, accurate, and timely claim was submitted to	30816
the medicare program and the program denied payment for the	30817
service as not medically necessary for the resident. For the	30818
purposes of division (E)(2)(b) of this section, a claim is not	30819
considered to have been denied by the medicare program until	30820
either a denial has been issued following a medicare fair hearing	30821
or six months have elapsed since the request for a fair hearing	30822
was filed.	30823

(c) The facility is required to provide or arrange for the	30824
provision of the service by a licensed therapist or therapy	30825
assistant to be in compliance with federal or state nursing	30826
facility certification requirements for the medicaid program.	30827

(d) The claim for payment for the services under the medicaid	30828
program is accompanied by documentation that divisions (E)(2)(b)	30829
and (c) of this section apply to the service.	30830

(F) The reimbursement allowed by the department for covered	30831
therapy services provided to nursing facility residents and billed	30832
under division (D) or (E) of this section shall be fifteen per	30833
cent less than the fees it pays for the same services rendered to	30834
hospital outpatients. The director may adopt rules under section	30835
~~5111.02~~5163.15 of the Revised Code establishing comparable fees	30836
for covered therapy services that are not included in its schedule	30837
of fees paid for services rendered to hospital outpatients.	30838

(G) A nursing facility's reasonable costs for rehabilitative,	30839
restorative, or maintenance therapy services rendered to facility	30840
residents by nurses or nurse aides, and the facility's overhead	30841
costs to support provision of therapy services provided to nursing	30842
facility residents, are allowable costs for the purposes of	30843
establishing rates under sections ~~5111.20~~5164.01 to ~~5111.33~~	30844
5164.41 of the Revised Code.	30845

~~Sec. 5111.257.~~ Sec. 5164.27. If a provider of a nursing facility	30846
adds or replaces one or more medicaid certified beds to or at the	30847
nursing facility, or renovates one or more of the nursing	30848
facility's beds, the rate for the added, replaced, or renovated	30849
beds shall be the same as the rate for the nursing facility's	30850
existing beds.	30851

~~Sec. 5111.265.~~ Sec. 5164.28. If one or more medicaid-certified	30852
beds are relocated from one nursing facility to another nursing	30853
facility owned by a different person or government entity and the	30854
application for the certificate of need authorizing the relocation	30855
is filed with the director of health on or after ~~the effective~~	30856
~~date of this section~~July 1, 2005, amortization of the cost of	30857
acquiring operating rights for the relocated beds is not an	30858
allowable cost for the purpose of determining the nursing	30859
facility's medicaid reimbursement rate.	30860

~~Sec. 5111.34.~~ Sec. 5164.30. The director of ~~job and family~~	30861
~~services~~health care administration shall prepare an annual report	30862
containing recommendations on the methodology that should be used	30863
to transition paying providers of nursing facilities the rate	30864
determined for nursing facilities for one fiscal year to the	30865
immediately succeeding fiscal year. The director shall submit a	30866
copy of the annual report to the governor, the president and	30867
minority leader of the senate, and the speaker and minority leader	30868
of the house of representatives not later than the first day of	30869
each October.	30870

~~Sec. 5111.254.~~ Sec. 5164.32. (A) The department of ~~job and family~~	30871
~~services~~health care administration shall establish initial rates	30872
for a nursing facility with a first date of licensure that is on	30873
or after July 1, 2006, including a facility that replaces one or	30874
more existing facilities, or for a nursing facility with a first	30875
date of licensure before that date that was initially certified	30876
for the medicaid program on or after that date, in the following	30877
manner:	30878

(1) The rate for direct care costs shall be the product of	30879
the cost per case-mix unit determined under division (D) of	30880
section ~~5111.231~~5164.19 of the Revised Code for the facility's	30881
peer group and the nursing facility's case-mix score. For the	30882
purpose of division (A)(1) of this section, the nursing facility's	30883
case-mix score shall be the following:	30884

(a) Unless the nursing facility replaces an existing nursing	30885
facility that participated in the medicaid program immediately	30886
before the replacement nursing facility begins participating in	30887
the medicaid program, the median annual average case-mix score for	30888
the nursing facility's peer group;	30889

(b) If the nursing facility replaces an existing nursing	30890
facility that participated in the medicaid program immediately	30891
before the replacement nursing facility begins participating in	30892
the medicaid program, the semiannual case-mix score most recently	30893
determined under section ~~5111.232~~5164.191 of the Revised Code for	30894
the replaced nursing facility as adjusted, if necessary, to	30895
reflect any difference in the number of beds in the replaced and	30896
replacement nursing facilities.	30897

(2) The rate for ancillary and support costs shall be the	30898
rate for the facility's peer group determined under division (D)	30899
of section ~~5111.24~~5164.20 of the Revised Code.	30900

(3) The rate for capital costs shall be the median rate for	30901
the facility's peer group determined under division (D) of section	30902
~~5111.25~~5164.24 of the Revised Code.	30903

(4) The rate for tax costs as defined in section ~~5111.242~~	30904
5164.21 of the Revised Code shall be the median rate for tax costs	30905
for the facility's peer group in which the facility is placed	30906
under division (C) of section ~~5111.24~~5164.20 of the Revised Code.	30907

(5) The quality incentive payment shall be the mean payment	30908
specified in division (B) of section ~~5111.244~~5164.23 of the	30909
Revised Code.	30910

(B) Subject to division (C) of this section, the department	30911
shall adjust the rates established under division (A) of this	30912
section effective the first day of July, to reflect new rate	30913
calculations for all nursing facilities under sections ~~5111.20~~	30914
5164.01 to ~~5111.33~~5164.41 of the Revised Code.	30915

(C) If a rate for direct care costs is determined under this	30916
section for a nursing facility using the median annual average	30917
case-mix score for the nursing facility's peer group, the rate	30918
shall be redetermined to reflect the replacement nursing	30919
facility's actual semiannual case-mix score determined under	30920
section ~~5111.232~~5164.191 of the Revised Code after the nursing	30921
facility submits its first two quarterly assessment data that	30922
qualify for use in calculating a case-mix score in accordance with	30923
rules authorized by division ~~(E)~~(D) of section ~~5111.232~~5164.191	30924
of the Revised Code. If the nursing facility's quarterly	30925
submissions do not qualify for use in calculating a case-mix	30926
score, the department shall continue to use the median annual	30927
average case-mix score for the nursing facility's peer group in	30928
lieu of the nursing facility's semiannual case-mix score until	30929
the nursing facility submits two consecutive quarterly assessment	30930
data that qualify for use in calculating a case-mix score.	30931

~~Sec. 5111.258.~~ Sec. 5164.34. (A) Notwithstanding sections ~~5111.20~~	30932
5164.01 to ~~5111.33~~5164.41 of the Revised Code, the director of	30933
~~job and family services~~health care administration shall adopt	30934
rules under section ~~5111.02~~5163.15 of the Revised Code that	30935
establish a methodology for calculating the prospective rates that	30936
will be paid each fiscal year to a provider for each of the	30937
provider's eligible nursing facilities and intermediate care	30938
facilities for the mentally retarded, and discrete units of the	30939
provider's nursing facilities or intermediate care facilities for	30940
the mentally retarded, that serve residents who have diagnoses or	30941
special care needs that require direct care resources that are not	30942
measured adequately by the applicable assessment instrument	30943
specified in rules authorized by section ~~5111.232~~5164.051 or	30944
5164.191 of the Revised Code, or who have diagnoses or special	30945
care needs specified in the rules as otherwise qualifying for	30946
consideration under this section. The facilities and units of	30947
facilities whose rates are established under this division may	30948
include, but shall not be limited to, any of the following:	30949

(1) In the case of nursing facilities, facilities and units	30950
of facilities that serve medically fragile pediatric residents,	30951
residents who are dependent on ventilators, or residents who have	30952
severe traumatic brain injury, end-stage Alzheimer's disease, or	30953
end-stage acquired immunodeficiency syndrome;	30954

(2) In the case of intermediate care facilities for the	30955
mentally retarded, facilities and units of facilities that serve	30956
residents who have complex medical conditions or severe behavioral	30957
problems.	30958

The department shall use the methodology established under	30959
this division to pay for services rendered by such facilities and	30960
units after June 30, 1993.	30961

The rules authorized by this division shall specify the	30962
criteria and procedures the department will apply when designating	30963
facilities and units that qualify for calculation of rates under	30964
this division. The criteria shall include consideration of whether	30965
all of the allowable costs of the facility or unit would be paid	30966
by rates established under sections ~~5111.20~~5164.01 to ~~5111.33~~	30967
5164.41 of the Revised Code, and shall establish a minimum bed	30968
size for a facility or unit to qualify to have its rates	30969
established under this division. The criteria shall not be	30970
designed to require that residents be served only in facilities	30971
located in large cities. The methodology established by the rules	30972
shall consider the historical costs of providing care to the	30973
residents of the facilities or units.	30974

The rules may require that a facility designated under this	30975
division or containing a unit designated under this division	30976
receive authorization from the department to admit or retain a	30977
resident to the facility or unit and shall specify the criteria	30978
and procedures the department will apply when granting that	30979
authorization.	30980

Notwithstanding any other provision of sections ~~5111.20~~	30981
5164.01 to ~~5111.33~~5164.41 of the Revised Code, the costs incurred	30982
by facilities or units whose rates are established under this	30983
division shall not be considered in establishing payment rates for	30984
other facilities or units.	30985

(B) The director may adopt rules under section ~~5111.02~~	30986
5163.15 of the Revised Code under which the department,	30987
notwithstanding any other provision of sections ~~5111.20~~5164.01 to	30988
~~5111.33~~5164.41 of the Revised Code, may adjust the rates	30989
determined under sections ~~5111.20~~5164.01 to ~~5111.33~~5164.41 of	30990
the Revised Code for a facility that serves a resident who has a	30991
diagnosis or special care need that, in the rules authorized by	30992
division (A) of this section, would qualify a facility or unit of	30993
a facility to have its rate determined under that division, but	30994
who is not in such a unit. The rules may require that a facility	30995
that qualifies for a rate adjustment under this division receive	30996
authorization from the department to admit or retain a resident	30997
who qualifies the facility for the rate adjustment and shall	30998
specify the criteria and procedures the department will apply when	30999
granting that authorization.	31000

~~Sec. 5111.33.~~ Sec. 5164.35. Reimbursement to a provider under	31001
sections ~~5111.20~~5164.01 to ~~5111.32~~5164.41 of the Revised Code	31002
shall include payments to the provider, at a rate equal to the	31003
percentage of the per resident per day rates that the department	31004
of ~~job and family services~~health care administration has	31005
established for the provider's nursing facility or intermediate	31006
care facility for the mentally retarded under sections ~~5111.20~~	31007
5164.01 to ~~5111.33~~5164.41 of the Revised Code for the fiscal year	31008
for which the cost of services is reimbursed, to reserve a bed for	31009
a recipient during a temporary absence under conditions prescribed	31010
by the department, to include hospitalization for an acute	31011
condition, visits with relatives and friends, and participation in	31012
therapeutic programs outside the facility, when the resident's	31013
plan of care provides for such absence and federal participation	31014
in the payments is available. The maximum period during which	31015
payments may be made to reserve a bed shall not exceed the maximum	31016
period specified under federal regulations, and shall not be more	31017
than thirty days during any calendar year for hospital stays,	31018
visits with relatives and friends, and participation in	31019
therapeutic programs. Recipients who have been identified by the	31020
department as requiring the level of care of an intermediate care	31021
facility for the mentally retarded shall not be subject to a	31022
maximum period during which payments may be made to reserve a bed	31023
if prior authorization of the department is obtained for hospital	31024
stays, visits with relatives and friends, and participation in	31025
therapeutic programs. The director of ~~job and family services~~	31026
health care administration shall adopt rules under section ~~5111.02~~	31027
5163.15 of the Revised Code establishing conditions under which	31028
prior authorization may be obtained.	31029

~~Sec. 5111.26.~~ Sec. 5164.37. (A)(1)(a) Except as provided in	31030
division (A)(1)(b) of this section, each provider shall file with	31031
the department of ~~job and family services~~health care	31032
administration an annual cost report for each of the provider's	31033
nursing facilities and intermediate care facilities for the	31034
mentally retarded that participate in the medicaid program. A	31035
provider shall prepare the reports in accordance with guidelines	31036
established by the department. A report shall cover a calendar	31037
year or the portion of a calendar year during which the facility	31038
participated in the medicaid program. A provider shall file the	31039
reports within ninety days after the end of the calendar year. The	31040
department, for good cause, may grant a fourteen-day extension of	31041
the time for filing cost reports upon written request from a	31042
provider. The director of ~~job and family services~~health care	31043
administration shall prescribe, in rules adopted under section	31044
~~5111.02~~5163.15 of the Revised Code, the cost reporting form and a	31045
uniform chart of accounts for the purpose of cost reporting, and	31046
shall distribute cost reporting forms or computer software for	31047
electronic submission of the cost report to each provider at least	31048
sixty days before the reporting date.	31049

(b) If rates for a provider's nursing facility or	31050
intermediate care facility for the mentally retarded were most	31051
recently established under section ~~5111.254~~5164.32 or ~~5111.255~~	31052
5164.12 of the Revised Code, the provider shall submit a cost	31053
report for that facility no later than ninety days after the end	31054
of the facility's first three full calendar months of operation.	31055
If a nursing facility or intermediate care facility for the	31056
mentally retarded undergoes a change of provider that the	31057
department determines, in accordance with rules adopted under	31058
section ~~5111.02~~5163.15 of the Revised Code, is an arm's length	31059
transaction, the new provider shall submit a cost report for that	31060
facility not later than ninety days after the end of the	31061
facility's first three full calendar months of operation under the	31062
new provider. The provider of a facility that opens or undergoes a	31063
change of provider that is an arm's length transaction after the	31064
first day of October in any calendar year is not required to file	31065
a cost report for that calendar year.	31066

(c) If a nursing facility undergoes a change of provider that	31067
the department determines, in accordance with rules adopted under	31068
section ~~5111.02~~5163.15 of the Revised Code, is not an ~~arms~~arm's	31069
length transaction, the new provider shall file a cost report	31070
under division (A)(1)(a) of this section for the facility. The	31071
cost report shall cover the portion of the calendar year during	31072
which the new provider operated the nursing facility and the	31073
portion of the calendar year during which the previous provider	31074
operated the nursing facility.	31075

(2) If a provider required to submit a cost report for a	31076
nursing facility or intermediate care facility for the mentally	31077
retarded does not file the report within the required time period	31078
or within fourteen days thereafter if an extension is granted	31079
under division (A)(1)(a) of this section, or files an incomplete	31080
or inadequate report for the facility, the department shall	31081
provide immediate written notice to the provider that the provider	31082
agreement for the facility will be terminated in thirty days	31083
unless the provider submits a complete and adequate cost report	31084
for the facility within thirty days. During the thirty-day	31085
termination period or any additional time allowed for an appeal of	31086
the proposed termination of a provider agreement, the provider	31087
shall be paid the facility's then current per resident per day	31088
rate, minus two dollars. On July 1, 1994, the department shall	31089
adjust the two-dollar reduction to reflect the rate of inflation	31090
during the preceding twelve months, as shown in the consumer price	31091
index for all items for all urban consumers for the north central	31092
region, published by the United States bureau of labor statistics.	31093
On July 1, 1995, and the first day of July of each year	31094
thereafter, the department shall adjust the amount of the	31095
reduction in effect during the previous twelve months to reflect	31096
the rate of inflation during the preceding twelve months, as shown	31097
in the same index.	31098

(B) No provider shall report fines paid under sections	31099
~~5111.35~~5164.50 to ~~5111.62~~5164.78 or section ~~5111.99~~5164.99 of	31100
the Revised Code in any cost report filed under this section.	31101

(C) The department shall develop an addendum to the cost	31102
report form that a provider may use to set forth costs that the	31103
provider believes may be disputed by the department. Any costs	31104
reported by the provider on the addendum may be considered by the	31105
department in setting the facility's rate. If the department does	31106
not consider the costs listed on the addendum in setting the	31107
facility's rate, the provider may seek reconsideration of that	31108
determination under section ~~5111.29~~5164.41 of the Revised Code.	31109
If the department subsequently includes the costs listed in the	31110
addendum in the facility's rate, the department shall pay the	31111
provider interest at a reasonable rate established in rules	31112
adopted under section ~~5111.02~~5163.15 of the Revised Code for the	31113
time that the rate paid excluded the costs.	31114

~~Sec. 5111.266.~~ Sec. 5164.371. A provider of a nursing facility	31115
filing the facility's cost report with the department of ~~job and~~	31116
~~family services~~health care administration under section ~~5111.26~~	31117
5164.37 of the Revised Code shall report as a nonreimbursable	31118
expense the cost of the nursing facility's franchise permit fee.	31119

~~Sec. 5111.264.~~ Sec. 5164.372. Except as provided in section	31120
~~5111.25~~5164.24 or ~~5111.251~~5164.08 of the Revised Code, the costs	31121
of goods, services, and facilities, furnished to a provider by a	31122
related party are includable in the allowable costs of the	31123
provider at the reasonable cost to the related party.	31124

~~Sec. 5111.27.~~ Sec. 5164.38. (A) The department of ~~job and family~~	31125
~~services~~health care administration shall conduct a desk review of	31126
each cost report it receives under section ~~5111.26~~5164.37 of the	31127
Revised Code. Based on the desk review, the department shall make	31128
a preliminary determination of whether the reported costs are	31129
allowable costs. The department shall notify each provider of	31130
whether any of the reported costs are preliminarily determined not	31131
to be allowable, the rate calculation under sections ~~5111.20~~	31132
5164.01 to ~~5111.33~~5164.41 of the Revised Code that results from	31133
that determination, and the reasons for the determination and	31134
resulting rate. The department shall allow the provider to verify	31135
the calculation and submit additional information.	31136

(B) The department may conduct an audit, as defined by rule	31137
adopted under section ~~5111.02~~5163.15 of the Revised Code, of any	31138
cost report and shall notify the provider of its findings.	31139

Audits shall be conducted by auditors under contract with or	31140
employed by the department. The decision whether to conduct an	31141
audit and the scope of the audit, which may be a desk or field	31142
audit, shall be determined based on prior performance of the	31143
provider and may be based on a risk analysis or other evidence	31144
that gives the department reason to believe that the provider has	31145
reported costs improperly. A desk or field audit may be performed	31146
annually, but is required whenever a provider does not pass the	31147
risk analysis tolerance factors. The department shall issue the	31148
audit report no later than three years after the cost report is	31149
filed, or upon the completion of a desk or field audit on the	31150
report or a report for a subsequent cost reporting period,	31151
whichever is earlier. During the time within which the department	31152
may issue an audit report, the provider may amend the cost report	31153
upon discovery of a material error or material additional	31154
information. The department shall review the amended cost report	31155
for accuracy and notify the provider of its determination.	31156

The department may establish a contract for the auditing of	31157
facilities by outside firms. Each contract entered into by bidding	31158
shall be effective for one to two years. The department shall	31159
establish an audit manual and program which shall require that all	31160
field audits, conducted either pursuant to a contract or by	31161
department employees:	31162

(1) Comply with the applicable rules prescribed pursuant to	31163
Titles XVIII and XIX;	31164

(2) Consider generally accepted auditing standards prescribed	31165
by the American institute of certified public accountants;	31166

(3) Include a written summary as to whether the costs	31167
included in the report examined during the audit are allowable and	31168
are presented fairly in accordance with generally accepted	31169
accounting principles and department rules, and whether, in all	31170
material respects, allowable costs are documented, reasonable, and	31171
related to patient care;	31172

(4) Are conducted by accounting firms or auditors who, during	31173
the period of the auditors' professional engagement or employment	31174
and during the period covered by the cost reports, do not have nor	31175
are committed to acquire any direct or indirect financial interest	31176
in the ownership, financing, or operation of a nursing facility or	31177
intermediate care facility for the mentally retarded in this	31178
state;	31179

(5) Are conducted by accounting firms or auditors who, as a	31180
condition of the contract or employment, shall not audit any	31181
facility that has been a client of the firm or auditor;	31182

(6) Are conducted by auditors who are otherwise independent	31183
as determined by the standards of independence established by the	31184
American institute of certified public accountants;	31185

(7) Are completed within the time period specified by the	31186
department;	31187

(8) Provide to the provider complete written interpretations	31188
that explain in detail the application of all relevant contract	31189
provisions, regulations, auditing standards, rate formulae, and	31190
departmental policies, with explanations and examples, that are	31191
sufficient to permit the provider to calculate with reasonable	31192
certainty those costs that are allowable and the rate to which the	31193
provider's facility is entitled.	31194

For the purposes of division (B)(4) of this section,	31195
employment of a member of an auditor's family by a nursing	31196
facility or intermediate care facility for the mentally retarded	31197
that the auditor does not review does not constitute a direct or	31198
indirect financial interest in the ownership, financing, or	31199
operation of the facility.	31200

(C) The department, pursuant to rules adopted under section	31201
~~5111.02~~5163.15 of the Revised Code, may conduct an exception	31202
review of assessment data submitted under section ~~5111.232~~	31203
5164.051 or 5164.191 of the Revised Code. The department may	31204
conduct an exception review based on the findings of a	31205
certification survey conducted by the department of health, a risk	31206
analysis, or prior performance of the provider.	31207

Exception reviews shall be conducted at the facility by	31208
appropriate health professionals under contract with or employed	31209
by the department of ~~job and family services~~health care	31210
administration. The professionals may review resident assessment	31211
forms and supporting documentation, conduct interviews, and	31212
observe residents to identify any patterns or trends of inaccurate	31213
assessments and resulting inaccurate case-mix scores.	31214

The rules shall establish an exception review program that	31215
requires that exception reviews do all of the following:	31216

(1) Comply with Titles XVIII and XIX;

31217

(2) Provide a written summary that states whether the	31218
resident assessment forms have been completed accurately;	31219

(3) Are conducted by health professionals who, during the	31220
period of their professional engagement or employment with the	31221
department, neither have nor are committed to acquire any direct	31222
or indirect financial interest in the ownership, financing, or	31223
operation of a nursing facility or intermediate care facility for	31224
the mentally retarded in this state;	31225

(4) Are conducted by health professionals who, as a condition	31226
of their engagement or employment with the department, shall not	31227
review any provider that has been a client of the professional.	31228

For the purposes of division (C)(3) of this section,	31229
employment of a member of a health professional's family by a	31230
nursing facility or intermediate care facility for the mentally	31231
retarded that the professional does not review does not constitute	31232
a direct or indirect financial interest in the ownership,	31233
financing, or operation of the facility.	31234

If an exception review is conducted before the effective date	31235
of the rate that is based on the case-mix data subject to the	31236
review and the review results in findings that exceed tolerance	31237
levels specified in the rules adopted under this division, the	31238
department, in accordance with those rules, may use the findings	31239
to recalculate individual resident case-mix scores, quarterly	31240
average facility case-mix scores, and annual average facility	31241
case-mix scores. The department may use the recalculated quarterly	31242
and annual facility average case-mix scores to calculate the	31243
facility's rate for direct care costs for the appropriate calendar	31244
quarter or quarters.	31245

(D) The department shall prepare a written summary of any	31246
audit disallowance or exception review finding that is made after	31247
the effective date of the rate that is based on the cost or	31248
case-mix data. Where the provider is pursuing judicial or	31249
administrative remedies in good faith regarding the disallowance	31250
or finding, the department shall not withhold from the provider's	31251
current payments any amounts the department claims to be due from	31252
the provider pursuant to section ~~5111.28~~5164.39 of the Revised	31253
Code.	31254

(E) The department shall not reduce rates calculated under	31255
sections ~~5111.20~~5164.01 to ~~5111.33~~5164.41 of the Revised Code on	31256
the basis that the provider charges a lower rate to any resident	31257
who is not eligible for the medicaid program.	31258

(F) The department shall adjust the rates calculated under	31259
sections ~~5111.20~~5164.01 to ~~5111.33~~5164.41 of the Revised Code to	31260
account for reasonable additional costs that must be incurred by	31261
intermediate care facilities for the mentally retarded to comply	31262
with requirements of federal or state statutes, rules, or policies	31263
enacted or amended after January 1, 1992, or with orders issued by	31264
state or local fire authorities.	31265

~~Sec. 5111.28.~~ Sec. 5164.39. (A) If a provider properly amends its	31266
cost report under section ~~5111.27~~5164.38 of the Revised Code and	31267
the amended report shows that the provider received a lower rate	31268
under the original cost report than it was entitled to receive,	31269
the department of ~~job and family services~~health care	31270
administration shall adjust the provider's rate prospectively to	31271
reflect the corrected information. The department shall pay the	31272
adjusted rate beginning two months after the first day of the	31273
month after the provider files the amended cost report. If the	31274
department finds, from an exception review of resident assessment	31275
information conducted after the effective date of the rate for	31276
direct care costs that is based on the assessment information,	31277
that inaccurate assessment information resulted in the provider	31278
receiving a lower rate than it was entitled to receive, the	31279
department prospectively shall adjust the provider's rate	31280
accordingly and shall make payments using the adjusted rate for	31281
the remainder of the calendar quarter for which the assessment	31282
information is used to determine the rate, beginning one month	31283
after the first day of the month after the exception review is	31284
completed.	31285

(B) If the provider properly amends its cost report under	31286
section ~~5111.27~~5164.38 of the Revised Code, the department makes	31287
a finding based on an audit under that section, or the department	31288
makes a finding based on an exception review of resident	31289
assessment information conducted under that section after the	31290
effective date of the rate for direct care costs that is based on	31291
the assessment information, any of which results in a	31292
determination that the provider has received a higher rate than it	31293
was entitled to receive, the department shall recalculate the	31294
provider's rate using the revised information. The department	31295
shall apply the recalculated rate to the periods when the provider	31296
received the incorrect rate to determine the amount of the	31297
overpayment. The provider shall refund the amount of the	31298
overpayment.	31299

In addition to requiring a refund under this division, the	31300
department may charge the provider interest at the applicable rate	31301
specified in this division from the time the overpayment was made.	31302

(1) If the overpayment resulted from costs reported for	31303
calendar year 1993, the interest shall be no greater than one and	31304
one-half times the average bank prime rate.	31305

(2) If the overpayment resulted from costs reported for	31306
subsequent calendar years:	31307

(a) The interest shall be no greater than two times the	31308
average bank prime rate if the overpayment was equal to or less	31309
than one per cent of the total medicaid payments to the provider	31310
for the fiscal year for which the incorrect information was used	31311
to establish a rate.	31312

(b) The interest shall be no greater than two and one-half	31313
times the current average bank prime rate if the overpayment was	31314
greater than one per cent of the total medicaid payments to the	31315
provider for the fiscal year for which the incorrect information	31316
was used to establish a rate.	31317

31318

(1) If a provider does not furnish invoices or other	31319
documentation that the department requests during an audit within	31320
sixty days after the request, no more than the greater of one	31321
thousand dollars per audit or twenty-five per cent of the	31322
cumulative amount by which the costs for which documentation was	31323
not furnished increased the total medicaid payments to the	31324
provider during the fiscal year for which the costs were used to	31325
establish a rate;	31326

(2) If an exiting operator or owner fails to provide notice	31327
of a facility closure, voluntary termination, or voluntary	31328
withdrawal of participation in the medicaid program as required by	31329
section ~~5111.66~~5164.83 of the Revised Code, or an exiting	31330
operator or owner and entering operator fail to provide notice of	31331
a change of operator as required by section ~~5111.67~~5164.84 of the	31332
Revised Code, no more than the current average bank prime rate	31333
plus four per cent of the last two monthly payments.	31334

(D) If the provider continues to participate in the medicaid	31335
program, the department shall deduct any amount that the provider	31336
is required to refund under this section, and the amount of any	31337
interest charged or penalty imposed under this section, from the	31338
next available payment from the department to the provider. The	31339
department and the provider may enter into an agreement under	31340
which the amount, together with interest, is deducted in	31341
installments from payments from the department to the provider.	31342

(E) The department shall transmit refunds and penalties to	31343
the treasurer of state for deposit in the general revenue fund.	31344

(F) For the purpose of this section, the department shall	31345
determine the average bank prime rate using statistical release	31346
H.15, "selected interest rates," a weekly publication of the	31347
federal reserve board, or any successor publication. If	31348
statistical release H.15, or its successor, ceases to contain the	31349
bank prime rate information or ceases to be published, the	31350
department shall request a written statement of the average bank	31351
prime rate from the federal reserve bank of Cleveland or the	31352
federal reserve board.	31353

~~Sec. 5111.221.~~ Sec. 5164.40. The department of ~~job and family~~	31354
~~services~~health care administration shall make its best efforts	31355
each year to calculate rates under sections ~~5111.20~~5164.01 to	31356
~~5111.33~~5164.41 of the Revised Code in time to use them to make	31357
the payments due to providers by the fifteenth day of August. If	31358
the department is unable to calculate the rates so that they can	31359
be paid by that date, the department shall pay each provider the	31360
rate calculated for the provider's nursing facilities and	31361
intermediate care facilities for the mentally retarded under those	31362
sections at the end of the previous fiscal year. If the department	31363
also is unable to calculate the rates to make the payments due by	31364
the fifteenth day of September and the fifteenth day of October,	31365
the department shall pay the previous fiscal year's rate to make	31366
those payments. The department may increase by five per cent the	31367
previous fiscal year's rate paid for any facility pursuant to this	31368
section at the request of the provider. The department shall use	31369
rates calculated for the current fiscal year to make the payments	31370
due by the fifteenth day of November.	31371

If the rate paid to a provider for a facility pursuant to	31372
this section is lower than the rate calculated for the facility	31373
for the current fiscal year, the department shall pay the provider	31374
the difference between the two rates for the number of days for	31375
which the provider was paid for the facility pursuant to this	31376
section. If the rate paid for a facility pursuant to this section	31377
is higher than the rate calculated for it for the current fiscal	31378
year, the provider shall refund to the department the difference	31379
between the two rates for the number of days for which the	31380
provider was paid for the facility pursuant to this section.	31381

~~Sec. 5111.29.~~ Sec. 5164.41. (A) The director of ~~job and family~~	31382
~~services~~health care administration shall adopt rules under	31383
section ~~5111.02~~5163.15 of the Revised Code that establish a	31384
process under which a provider, or a group or association of	31385
providers, may seek reconsideration of rates established under	31386
sections ~~5111.20~~5164.01 to ~~5111.33~~5164.41 of the Revised Code,	31387
including a rate for direct care costs recalculated before the	31388
effective date of the rate as a result of an exception review of	31389
resident assessment information conducted under section ~~5111.27~~	31390
5164.38 of the Revised Code.	31391

(1) Except as provided in divisions (A)(2) to (4) of this	31392
section, the only issue that a provider, group, or association may	31393
raise in the rate reconsideration shall be whether the rate was	31394
calculated in accordance with sections ~~5111.20~~5164.01 to ~~5111.33~~	31395
5164.41 of the Revised Code and the rules adopted under section	31396
~~5111.02~~5163.15 of the Revised Code. The rules shall permit a	31397
provider, group, or association to submit written arguments or	31398
other materials that support its position. The rules shall specify	31399
time frames within which the provider, group, or association and	31400
the department must act. If the department determines, as a result	31401
of the rate reconsideration, that the rate established for one or	31402
more facilities of a provider is less than the rate to which the	31403
facility is entitled, the department shall increase the rate. If	31404
the department has paid the incorrect rate for a period of time,	31405
the department shall pay the provider the difference between the	31406
amount the provider was paid for that period for the facility and	31407
the amount the provider should have been paid for the facility.	31408

(2) The rules shall provide that during a fiscal year, the	31409
department, by means of the rate reconsideration process, may	31410
increase the rate determined for an intermediate care facility for	31411
the mentally retarded as calculated under sections ~~5111.20~~	31412
5164.01 to ~~5111.33~~5164.41 of the Revised Code if the provider of	31413
the facility demonstrates that the facility's actual, allowable	31414
costs have increased because of extreme circumstances. A facility	31415
may qualify for a rate increase only if the facility's per diem,	31416
actual, allowable costs have increased to a level that exceeds its	31417
total rate. The rules shall specify the circumstances that would	31418
justify a rate increase under division (A)(2) of this section. The	31419
rules shall provide that the extreme circumstances include natural	31420
disasters, renovations approved under division (D) of section	31421
~~5111.251~~5164.08 of the Revised Code, an increase in workers'	31422
compensation experience rating of greater than five per cent for a	31423
facility that has an appropriate claims management program,	31424
increased security costs for an inner-city facility, and a change	31425
of ownership that results from bankruptcy, foreclosure, or	31426
findings of violations of certification requirements by the	31427
department of health. An increase under division (A)(2) of this	31428
section is subject to any rate limitations or maximum rates	31429
established by sections ~~5111.20~~5164.01 to ~~5111.33~~5164.41 of the	31430
Revised Code for specific cost centers. Any rate increase granted	31431
under division (A)(2) of this section shall take effect on the	31432
first day of the first month after the department receives the	31433
request.	31434

(3) The rules shall provide that the department, through the	31435
rate reconsideration process, may increase an intermediate care	31436
facility for the mentally retarded's rate as calculated under	31437
sections ~~5111.20~~5164.01 to ~~5111.33~~5164.41 of the Revised Code if	31438
the department, in the department's sole discretion, determines	31439
that the rate as calculated under those sections works an extreme	31440
hardship on the facility.	31441

(4) The rules shall provide that when beds certified for the	31442
medicaid program are added to an existing intermediate care	31443
facility for the mentally retarded or replaced at the same site,	31444
the department, through the rate reconsideration process, shall	31445
increase the intermediate care facility for the mentally	31446
retarded's rate for capital costs proportionately, as limited by	31447
any applicable limitation under section ~~5111.251~~5164.08 of the	31448
Revised Code, to account for the costs of the beds that are added	31449
or replaced. The department shall make this increase one month	31450
after the first day of the month after the department receives	31451
sufficient documentation of the costs. Any rate increase granted	31452
under division (A)(4) of this section after June 30, 1993, shall	31453
remain in effect until the effective date of a rate calculated	31454
under section ~~5111.251~~5164.08 of the Revised Code that includes	31455
costs incurred for a full calendar year for the bed addition or	31456
bed replacement. The facility shall report double accumulated	31457
depreciation in an amount equal to the depreciation included in	31458
the rate adjustment on its cost report for the first year of	31459
operation. During the term of any loan used to finance a project	31460
for which a rate adjustment is granted under division (A)(4) of	31461
this section, if the facility is operated by the same provider,	31462
the provider shall subtract from the interest costs it reports on	31463
its cost report an amount equal to the difference between the	31464
following:	31465

(a) The actual, allowable interest costs for the loan during	31466
the calendar year for which the costs are being reported;	31467

(b) The actual, allowable interest costs attributable to the	31468
loan that were used to calculate the rates paid to the provider	31469
for the facility during the same calendar year.	31470

(5) The department's decision at the conclusion of the	31471
reconsideration process shall not be subject to any administrative	31472
proceedings under Chapter 119. or any other provision of the	31473
Revised Code.	31474

(B) All of the following are subject to an adjudication	31475
conducted in accordance with Chapter 119. of the Revised Code:	31476

(1) Any audit disallowance that the department makes as the	31477
result of an audit under section ~~5111.27~~5164.38 of the Revised	31478
Code;	31479

(2) Any adverse finding that results from an exception review	31480
of resident assessment information conducted under section ~~5111.27~~	31481
5164.38 of the Revised Code after the effective date of the	31482
facility's rate that is based on the assessment information;	31483

(3) Any medicaid payment deemed an overpayment under section	31484
~~5111.683~~5164.853 of the Revised Code;	31485

(4) Any penalty the department imposes under division (C) of	31486
section ~~5111.28~~5164.39 of the Revised Code or section ~~5111.683~~	31487
5164.853 of the Revised Code.	31488

~~Sec. 5111.202.~~ Sec. 5164.45. (A) As used in this section:

31489

(1) "Dementia" includes Alzheimer's disease or a related	31490
disorder.	31491

(2) "Serious mental illness" means "serious mental illness,"	31492
as defined by the United States department of health and human	31493
services in regulations adopted under ~~section 1919(e)(7)(G)(i) of~~	31494
~~the "Social Security Act," 49 Stat. 620 (1935),~~ 42 U.S.C.~~A. 301,~~	31495
~~as amended~~1396r(e)(7)(G)(i).	31496

(3) "Mentally ill individual" means an individual who has a	31497
serious mental illness other than either of the following:	31498

(a) A primary diagnosis of dementia;

31499

(b) A primary diagnosis that is not a primary diagnosis of	31500
dementia and a primary diagnosis of something other than a serious	31501
mental illness.	31502

(4) "Mentally retarded individual" means an individual who is	31503
mentally retarded or has a related condition, as described in	31504
~~section 1905(d) of the "Social Security Act~~42 U.S.C. 1396d(d)."	31505

(5) "Specialized services" means the services specified by	31506
the United States department of health and human services in	31507
regulations adopted under ~~section 1919(e)(7)(G)(iii) of the~~	31508
~~"Social Security Act~~42 U.S.C. 1396r(e)(7)(G)(iii)."	31509

(B)(1) Except as provided in division (D) of this section, no	31510
nursing facility shall admit as a resident any mentally ill	31511
individual unless the facility has received evidence that the	31512
department of mental health has determined both of the following	31513
under section 5119.061 of the Revised Code:	31514

(a) That the individual requires the level of services	31515
provided by a nursing facility because of the individual's	31516
physical and mental condition;	31517

(b) Whether the individual requires specialized services for	31518
mental illness.	31519

(2) Except as provided in division (D) of this section, no	31520
nursing facility shall admit as a resident any mentally retarded	31521
individual unless the facility has received evidence that the	31522
department of mental retardation and developmental disabilities	31523
has determined both of the following under section 5123.021 of the	31524
Revised Code:	31525

(a) That the individual requires the level of services	31526
provided by a nursing facility because of the individual's	31527
physical and mental condition;	31528

(b) Whether the individual requires specialized services for	31529
mental retardation.	31530

(C) The department of ~~job and family services~~health care	31531
administration shall not make payments under the ~~medical~~	31532
~~assistance~~medicaid program to a nursing facility on behalf of any	31533
individual who is admitted to the facility in violation of	31534
division (B) of this section for the period beginning on the date	31535
of admission and ending on the date the requirements of division	31536
(B) of this section are met.	31537

(D) A determination under division (B) of this section is not	31538
required for any individual who is exempted from the requirement	31539
that a determination be made by division (B)(2) of section	31540
5119.061 of the Revised Code or rules adopted by the department of	31541
mental health under division (E)(3) of that section, or by	31542
division (B)(2) of section 5123.021 of the Revised Code or rules	31543
adopted by the department of mental retardation and developmental	31544
disabilities under division (E)(3) of that section.	31545

~~Sec. 5111.203.~~ Sec. 5164.46. Regardless of whether or not an	31546
applicant for admission to a nursing facility or resident of a	31547
nursing facility is an applicant for or recipient of ~~medical~~	31548
~~assistance~~medicaid, the department of ~~job and family services~~	31549
health care administration shall provide notice and an opportunity	31550
for a hearing to any applicant for admission to a nursing facility	31551
or resident of a nursing facility who is adversely affected by a	31552
determination made by the department of mental health under	31553
section 5119.061 of the Revised Code or by the department of	31554
mental retardation and developmental disabilities under section	31555
5123.021 of the Revised Code. The hearing shall be conducted in	31556
the same manner as hearings conducted under section ~~5101.35~~	31557
5160.34 of the Revised Code. Any decision made by the department	31558
of ~~job and family services~~health care administration on the basis	31559
of the hearing is binding on the department of mental health and	31560
the department of mental retardation and developmental	31561
disabilities.	31562

~~Sec. 5111.204.~~ Sec. 5164.47. (A) As used in this section,	31563
"representative" means a person acting on behalf of an applicant	31564
for or recipient of medicaid. A representative may be a family	31565
member, attorney, hospital social worker, or any other person	31566
chosen to act on behalf of an applicant or recipient.	31567

(B) The department of ~~job and family services~~health care	31568
administration may require each applicant for or recipient of	31569
medicaid who applies or intends to apply for admission to a	31570
nursing facility or resides in a nursing facility to undergo an	31571
assessment to determine whether the applicant or recipient needs	31572
the level of care provided by a nursing facility. The assessment	31573
may be performed concurrently with a long-term care consultation	31574
provided under section 173.42 of the Revised Code.	31575

To the maximum extent possible, the assessment shall be based	31576
on information from the resident assessment instrument specified	31577
in rules adopted by the director of ~~job and family services~~health	31578
care administration under division ~~(E)~~(D) of section ~~5111.232~~	31579
5164.191 of the Revised Code. The assessment shall also be based	31580
on criteria and procedures established in rules adopted under	31581
division (F) of this section and information provided by the	31582
person being assessed or the person's representative.	31583

The department of ~~job and family services~~health care	31584
administration, or if the assessment is performed by an agency	31585
under contract with the department pursuant to division (G) of	31586
this section, the agency, shall, not later than the time the level	31587
of care determination based on the assessment is required to be	31588
provided under division (C) of this section, give written notice	31589
of its conclusions and the basis for them to the person assessed	31590
and, if the department of ~~job and family services~~health care	31591
administration or agency under contract with the department has	31592
been informed that the person has a representative, to the	31593
representative.	31594

(C) The department of ~~job and family services~~health care	31595
administration or agency under contract with the department,	31596
whichever performs the assessment, shall provide a level of care	31597
determination based on the assessment as follows:	31598

(1) In the case of a person applying or intending to apply	31599
for admission to a nursing facility while hospitalized, not later	31600
than one of the following:	31601

(a) One working day after the person or the person's	31602
representative submits the application or notifies the department	31603
of the person's intention to apply and submits all information	31604
required for providing the level of care determination, as	31605
specified in rules adopted under division (F)(2) of this section;	31606

(b) A later date requested by the person or the person's	31607
representative.	31608

(2) In the case of a person applying or intending to apply	31609
for admission to a nursing facility who is not hospitalized, not	31610
later than one of the following:	31611

(a) Five calendar days after the person or the person's	31612
representative submits the application or notifies the department	31613
of the person's intention to apply and submits all information	31614
required for providing the level of care determination, as	31615
specified in rules adopted under division (F)(2) of this section;	31616

(b) A later date requested by the person or the person's	31617
representative.	31618

(3) In the case of a person who resides in a nursing	31619
facility, not later than one of the following:	31620

(a) Five calendar days after the person or the person's	31621
representative submits an application for ~~medical assistance~~	31622
medicaid and submits all information required for providing the	31623
level of care determination, as specified in rules adopted under	31624
division (F)(2) of this section;	31625

(b) A later date requested by the person or the person's	31626
representative.	31627

(4) In the case of an emergency, as specified in rules	31628
adopted under division (F)(4) of this section, within the number	31629
of days specified in the rules.	31630

(D) A person assessed under this section or the person's	31631
representative may request a state hearing to dispute the	31632
conclusions reached by the department of ~~job and family services~~	31633
health care administration or agency under contract with the	31634
department on the basis of the assessment. The request for a	31635
state hearing shall be made in accordance with section ~~5101.35~~	31636
5160.34 of the Revised Code. The department of ~~job and family~~	31637
~~services~~health care administration or agency under contract with	31638
the department shall provide to the person or the person's	31639
representative and the nursing facility written notice of the	31640
person's right to request a state hearing. The notice shall	31641
include an explanation of the procedure for requesting a state	31642
hearing. If a state hearing is requested, the state shall be	31643
represented in the hearing by the department of ~~job and family~~	31644
~~services~~health care administration or the agency under contract	31645
with the department, whichever performed the assessment.	31646

(E) A nursing facility that admits or retains a person	31647
determined pursuant to an assessment required under this section	31648
not to need the level of care provided by the nursing facility	31649
shall not be reimbursed under the medicaid program for the	31650
person's care.	31651

(F) The director of ~~job and family services~~health care	31652
administration shall adopt rules in accordance with Chapter 119.	31653
of the Revised Code to implement and administer this section. The	31654
rules shall include all of the following:	31655

(1) Criteria and procedures to be used in determining whether	31656
admission to a nursing facility or continued stay in a nursing	31657
facility is appropriate for the person being assessed;	31658

(2) Information the person being assessed or the person's	31659
representative must provide to the department or agency under	31660
contract with the department for purposes of the assessment and	31661
providing a level of care determination based on the assessment;	31662

(3) Circumstances under which a person is not required to be	31663
assessed;	31664

(4) Circumstances that constitute an emergency for purposes	31665
of division (C)(4) of this section and the number of days within	31666
which a level of care determination must be provided in the case	31667
of an emergency.	31668

(G) Pursuant to section ~~5111.91~~5161.05 of the Revised Code,	31669
the department of ~~job and family services~~health care	31670
administration may enter into contracts in the form of interagency	31671
agreements with one or more other state agencies to perform the	31672
assessments required under this section. The interagency	31673
agreements shall specify the responsibilities of each agency in	31674
the performance of the assessments.	31675

~~Sec. 5111.35.~~ Sec. 5164.50. As used in this section "a resident's	31676
rights" means the rights of a nursing facility resident under	31677
sections 3721.10 to 3721.17 of the Revised Code and subsection (c)	31678
of section 1819 or 1919 of the "Social Security Act," 49 Stat. 620	31679
(1935), 42 U.S.C.A. 301, as amended, and regulations issued under	31680
those subsections.	31681

As used in sections ~~5111.35~~5164.50 to ~~5111.62~~5164.78 of the	31682
Revised Code:	31683

(A) "Certification requirements" means the requirements for	31684
nursing facilities established under sections 1819 and 1919 of the	31685
"Social Security Act."	31686

(B) "Compliance" means substantially meeting all applicable	31687
certification requirements.	31688

(C) "Contracting agency" means a state agency that has	31689
entered into a contract with the department of ~~job and family~~	31690
~~services~~health care administration under section ~~5111.38~~5164.53	31691
of the Revised Code.	31692

(D)(1) "Deficiency" means a finding cited by the department	31693
of health during a survey, on the basis of one or more actions,	31694
practices, situations, or incidents occurring at a nursing	31695
facility, that constitutes a severity level three finding,	31696
severity level four finding, scope level three finding, or scope	31697
level four finding. Whenever the finding is a repeat finding,	31698
"deficiency" also includes any finding that is a severity level	31699
two and scope level one finding, a severity level two and scope	31700
level two finding, or a severity level one and scope level two	31701
finding.	31702

(2) "Cluster of deficiencies" means deficiencies that result	31703
from noncompliance with two or more certification requirements and	31704
are causing or resulting from the same action, practice,	31705
situation, or incident.	31706

(E) "Emergency" means either of the following:

31707

(1) A deficiency or cluster of deficiencies that creates a	31708
condition of immediate jeopardy;	31709

(2) An unexpected situation or sudden occurrence of a serious	31710
or urgent nature that creates a substantial likelihood that one or	31711
more residents of a nursing facility may be seriously harmed if	31712
allowed to remain in the facility, including the following:	31713

(a) A flood or other natural disaster, civil disaster, or	31714
similar event;	31715

(b) A labor strike that suddenly causes the number of staff	31716
members in a nursing facility to be below that necessary for	31717
resident care.	31718

(F) "Finding" means a finding of noncompliance with	31719
certification requirements determined by the department of health	31720
under section ~~5111.41~~5164.56 of the Revised Code.	31721

(G) "Immediate jeopardy" means that one or more residents of	31722
a nursing facility are in imminent danger of serious physical or	31723
life-threatening harm.	31724

(H) "Medicaid eligible resident" means a person who is a	31725
resident of a nursing facility, or is applying for admission to a	31726
nursing facility, and is eligible to receive financial assistance	31727
under the ~~medical assistance~~medicaid program for the care the	31728
person receives in such a facility.	31729

(I) "Noncompliance" means failure to substantially meet all	31730
applicable certification requirements.	31731

(J) "Nursing facility" has the same meaning as in section	31732
~~5111.20~~5164.01 of the Revised Code.	31733

(K) "Provider" means a person, institution, or entity that	31734
furnishes nursing facility services under a ~~medical assistance~~	31735
~~program~~medicaid provider agreement.	31736

(L) "Repeat finding" or "repeat deficiency" means a finding	31737
or deficiency cited pursuant to a survey, to which both of the	31738
following apply:	31739

(1) The finding or deficiency involves noncompliance with the	31740
same certification requirement, and the same kind of actions,	31741
practices, situations, or incidents caused by or resulting from	31742
the noncompliance, as were cited in the immediately preceding	31743
standard survey or another survey conducted subsequent to the	31744
immediately preceding standard survey of the facility. For	31745
purposes of this division, actions, practices, situations, or	31746
incidents may be of the same kind even though they involve	31747
different residents, staff, or parts of the facility.	31748

(2) The finding or deficiency is cited subsequent to a	31749
determination by the department of health that the finding or	31750
deficiency cited on the immediately preceding standard survey, or	31751
another survey conducted subsequent to the immediately preceding	31752
standard survey, had been corrected.	31753

(M)(1) "Scope level one finding" means a finding of	31754
noncompliance by a nursing facility in which the actions,	31755
situations, practices, or incidents causing or resulting from the	31756
noncompliance affect one or a very limited number of facility	31757
residents and involve one or a very limited number of facility	31758
staff members.	31759

(2) "Scope level two finding" means a finding of	31760
noncompliance by a nursing facility in which the actions,	31761
situations, practices, or incidents causing or resulting from the	31762
noncompliance affect more than a limited number of facility	31763
residents or involve more than a limited number of facility staff	31764
members, but the number or percentage of facility residents	31765
affected or staff members involved and the number or frequency of	31766
the actions, situations, practices, or incidents in short	31767
succession does not establish any reasonable degree of	31768
predictability of similar actions, situations, practices, or	31769
incidents occurring in the future.	31770

(3) "Scope level three finding" means a finding of	31771
noncompliance by a nursing facility in which the actions,	31772
situations, practices, or incidents causing or resulting from the	31773
noncompliance affect more than a limited number of facility	31774
residents or involve more than a limited number of facility staff	31775
members, and the number or percentage of facility residents	31776
affected or staff members involved or the number or frequency of	31777
the actions, situations, practices, or incidents in short	31778
succession establishes a reasonable degree of predictability of	31779
similar actions, situations, practices, or incidents occurring in	31780
the future.	31781

(4) "Scope level four finding" means a finding of	31782
noncompliance by a nursing facility causing or resulting from	31783
actions, situations, practices, or incidents that involve a	31784
sufficient number or percentage of facility residents or staff	31785
members or occur with sufficient regularity over time that the	31786
noncompliance can be considered systemic or pervasive in the	31787
facility.	31788

(N)(1) "Severity level one finding" means a finding of	31789
noncompliance by a nursing facility that has not caused and, if	31790
continued, is unlikely to cause physical harm to a facility	31791
resident, mental or emotional harm to a resident, or a violation	31792
of a resident's rights that results in physical, mental, or	31793
emotional harm to the resident.	31794

(2) "Severity level two finding" means a finding of	31795
noncompliance by a nursing facility that, if continued over time,	31796
will cause, or is likely to cause, physical harm to a facility	31797
resident, mental or emotional harm to a resident, or a violation	31798
of a resident's rights that results in physical, mental, or	31799
emotional harm to the resident.	31800

(3) "Severity level three finding" means a finding of	31801
noncompliance by a nursing facility that has caused physical harm	31802
to a facility resident, mental or emotional harm to a resident, or	31803
a violation of a resident's rights that results in physical,	31804
mental, or emotional harm to the resident.	31805

(4) "Severity level four finding" means a finding of	31806
noncompliance by a nursing facility that has caused	31807
life-threatening harm to a facility resident or caused a	31808
resident's death.	31809

(O) "State agency" has the same meaning as in section 1.60 of	31810
the Revised Code.	31811

(P) "Substandard care" means care furnished in a facility in	31812
which the department of health has cited a deficiency or	31813
deficiencies that constitute one of the following:	31814

(1) A severity level four finding, regardless of scope;

31815

(2) A severity level three and scope level four finding, in	31816
the quality of care provided to residents;	31817

(3) A severity level three and scope level three finding, in	31818
the quality of care provided to residents.	31819

(Q)(1) "Survey" means a survey of a nursing facility	31820
conducted under section ~~5111.39~~5164.54 of the Revised Code.	31821

(2) "Standard survey" means a survey conducted by the	31822
department of health under division (A) of section ~~5111.39~~5164.54	31823
of the Revised Code and includes an extended survey.	31824

(3) "Follow-up survey" means a survey conducted by the	31825
department of health to determine whether a nursing facility has	31826
substantially corrected deficiencies cited in a previous survey.	31827

~~Sec. 5111.36.~~ Sec. 5164.51. The director of ~~job and family~~	31828
~~services~~health care administration may adopt rules under Chapter	31829
119. of the Revised Code that are consistent with regulations,	31830
guidelines, and procedures issued by the United States secretary	31831
of health and human services under ~~sections 1819 and 1919 of the~~	31832
~~"Social Security Act," 49 Stat. 620 (1935),~~ 42 U.S.C.~~A. 301, as~~	31833
~~amended,~~1395i-3 and 1396r and necessary for administration and	31834
enforcement of sections ~~5111.35~~5164.50 to ~~5111.62~~5164.78 of the	31835
Revised Code. If the secretary does not issue appropriate	31836
regulations for enforcement of ~~sections 1819 and 1919 of the~~	31837
~~"Social Security Act"~~42 U.S.C. 1395i-3 and 1396r on or before	31838
December 13, 1990, the director of ~~job and family services~~health	31839
care administration may adopt, under Chapter 119. of the Revised	31840
Code, rules that are consistent with those sections and with	31841
sections ~~5111.35~~5164.50 to ~~5111.62~~5164.78 of the Revised Code.	31842

~~Sec. 5111.37.~~ Sec. 5164.52. The department of ~~job and family~~	31843
~~services~~health care administration is hereby authorized to	31844
enforce sections ~~5111.35~~5164.50 to ~~5111.62~~5164.78 of the Revised	31845
Code. The department may enforce the sections directly or through	31846
contracting agencies. The department and agencies shall enforce	31847
the sections in accordance with the requirements of ~~sections 1819~~	31848
~~and 1919 of the "Social Security Act," 49 Stat. 620 (1935),~~ 42	31849
U.S.C.~~A. 301, as amended,~~1395i-3 and 1396r that apply to nursing	31850
facilities; with regulations, guidelines, and procedures adopted	31851
by the United States secretary of health and human services for	31852
the enforcement of ~~sections 1819 and 1919 of the "Social Security~~	31853
~~Act"~~42 U.S.C. 1395i-3 and 1396r; and with the rules adopted under	31854
section ~~5111.36~~5164.51 of the Revised Code. The department and	31855
agencies shall enforce sections ~~5111.35~~5164.50 to ~~5111.62~~5164.78	31856
of the Revised Code for purposes of the medicare program~~, Title~~	31857
~~XVIII of the "Social Security Act,"~~ only to the extent prescribed	31858
by the regulations, guidelines, and procedures issued by the	31859
secretary under ~~section 1819 of that act~~42 U.S.C. 1395i-3.	31860

~~Sec. 5111.38.~~ Sec. 5164.53. The department of ~~job and family~~	31861
~~services~~health care administration may enter into contracts with	31862
other state agencies that authorize the agencies to perform all or	31863
part of the duties assigned to the department of ~~job and family~~	31864
~~services~~health care administration under sections ~~5111.35~~5164.50	31865
to ~~5111.62~~5164.78 of the Revised Code. Each contract shall	31866
specify the duties the agency is authorized to perform and the	31867
sections of the Revised Code under which the agency is authorized	31868
to perform those duties.	31869

~~Sec. 5111.39.~~ Sec. 5164.54. (A) The department of health shall	31870
conduct a survey, titled a standard survey, of every nursing	31871
facility in this state on a statewide average of not more than	31872
once every twelve months. Each nursing facility shall undergo a	31873
standard survey at least once every fifteen months as a condition	31874
of meeting certification requirements. The department may extend a	31875
standard survey; such a survey is titled an extended survey.	31876

(B) The department may conduct surveys in addition to	31877
standard surveys when it considers them necessary.	31878

(C) The department shall conduct surveys in accordance with	31879
the regulations, guidelines, and procedures issued by the United	31880
States secretary of health and human services ~~under Titles XVIII~~	31881
~~and XIX of the "Social Security Act," 49 Stat. 620 (1935), 42~~	31882
~~U.S.C.A. 301, as amended~~for the medicare and medicaid programs,	31883
sections ~~5111.40~~5164.55 to ~~5111.42~~5164.58 of the Revised Code,	31884
and rules adopted under section 3721.022 of the Revised Code.	31885

~~Sec. 5111.40.~~ Sec. 5164.55. (A) At the conclusion of each survey,	31886
the department of health survey team shall conduct an exit	31887
interview with the administrator or other person in charge of the	31888
nursing facility and any other facility staff members designated	31889
by the administrator or person in charge of the facility. During	31890
the exit interview, at the request of the administrator or other	31891
person in charge of the facility, the survey team shall provide	31892
one of the following, as selected by the survey team:	31893

(1) Copies of all survey notes and any other written	31894
materials created during the survey;	31895

(2) A written summary of the survey team's recommendations	31896
regarding findings of noncompliance with certification	31897
requirements;	31898

(3) An audio or audiovisual recording of the interview. If	31899
the survey team selects this option, at least two copies of the	31900
recording shall be made and the survey team shall select one copy	31901
to be kept by the survey team for use by the department of health.	31902

(B) All expenses of copying under division (A)(1) of this	31903
section or recording under division (A)(3) of this section,	31904
including the cost of the copy of the recording kept by the survey	31905
team, shall be paid by the facility.	31906

~~Sec. 5111.41.~~ Sec. 5164.56. (A) Except as provided in section	31907
3721.17 of the Revised Code, a finding shall be cited only on the	31908
basis of a survey and a determination that one or more actions,	31909
practices, situations, or incidents at a nursing facility caused	31910
or resulted from the facility's failure to comply with one or more	31911
certification requirements. The department of health shall	31912
determine whether the actions, practices, situations, or incidents	31913
can be justified by either of the following:	31914

(1) The actions, practices, situations, or incidents resulted	31915
from a resident exercising the resident's rights guaranteed under	31916
the laws of the United States or of this state;	31917

(2) The actions, practices, situations, or incidents resulted	31918
from a facility following the orders of a person licensed under	31919
Chapter 4731. of the Revised Code to practice medicine or surgery	31920
or osteopathic medicine and surgery.	31921

(B) If the department of health determines both that the	31922
actions, practices, situations, or incidents cannot be justified	31923
by the factors identified in division (A) of this section and that	31924
one or more of the following are applicable, the department shall	31925
declare that the actions, practices, situations, or incidents	31926
constitute a finding:	31927

(1) The actions, practices, situations, or incidents could	31928
have been prevented by one or more persons involved in the	31929
facility's operation;	31930

(2) No person involved in the facility's operation identified	31931
the actions, practices, situations, or incidents prior to the	31932
survey;	31933

(3) Prior to the survey, no person involved in the facility's	31934
operation initiated action to correct the noncompliance caused by	31935
or resulting in the actions, practices, situations, or incidents;	31936

(4) The facility does not have in effect, if needed, a	31937
contingency plan that is reasonably calculated to prevent	31938
physical, mental, or emotional harm to residents while permanent	31939
corrective action is being taken.	31940

(C) The department of health shall determine the severity	31941
level and scope level of each finding.	31942

(D) A deficiency that is substantially corrected within the	31943
time limits specified in sections ~~5111.52~~5164.68 to ~~5111.56~~	31944
5164.72 of the Revised Code and for which no remedy is imposed,	31945
shall be counted as a deficiency for the purpose of determining	31946
whether a deficiency is a repeat deficiency.	31947

(E) Whenever the department of health determines that during	31948
the period between two surveys a finding existed at the facility,	31949
but the facility substantially corrected it prior to the second	31950
survey, the department shall cite it. However, the department of	31951
~~job and family services~~health care administration or a	31952
contracting agency shall impose a remedy only as provided in	31953
division (C) of section ~~5111.46~~5164.62 of the Revised Code.	31954

(F) Immediately upon determining the severity and scope of a	31955
finding at a nursing facility, the department of health shall	31956
notify the department of ~~job and family services~~health care	31957
administration and any contracting agency of the finding, the	31958
severity and scope of the finding, and whether the finding creates	31959
immediate jeopardy. Immediately upon determining that an emergency	31960
exists at a facility that does not result from a deficiency that	31961
creates immediate jeopardy, the department of health shall notify	31962
the department of ~~job and family services~~health care	31963
administration and any contracting agency.	31964

~~Sec. 5111.411.~~ Sec. 5164.57. The results of a survey of a nursing	31965
facility that is conducted under section ~~5111.39~~5164.54 of the	31966
Revised Code, including any statement of deficiencies and all	31967
findings and deficiencies cited in the statement on the basis of	31968
the survey, shall be used solely to determine the nursing	31969
facility's compliance with certification requirements or with this	31970
chapter or another chapter of the Revised Code. Those results of a	31971
survey, that statement of deficiencies, and the findings and	31972
deficiencies cited in that statement shall not be used in any	31973
court or in any action or proceeding that is pending in any court	31974
and are not admissible in evidence in any action or proceeding	31975
unless that action or proceeding is an appeal of an administrative	31976
action by the department of ~~job and family services~~health care	31977
administration or contracting agency under this chapter or is an	31978
action by any department or agency of the state to enforce this	31979
chapter or another chapter of the Revised Code.	31980

Nothing in this section prohibits the results of a survey, a	31981
statement of deficiencies, or the findings and deficiencies cited	31982
in that statement on the basis of the survey under this section	31983
from being used in a criminal investigation or prosecution.	31984

~~Sec. 5111.42.~~ Sec. 5164.58. (A) Not later than ten days after an	31985
exit interview, the department of health shall deliver to the	31986
nursing facility a detailed statement, titled a statement of	31987
deficiencies, setting forth all findings and deficiencies cited on	31988
the basis of the survey, including any finding cited pursuant to	31989
division (E) of section ~~5111.41~~5164.56 of the Revised Code. The	31990
statement shall indicate the severity and scope level of each	31991
finding and fully describe the incidents or other facts that form	31992
the basis of the department's determination of the existence of	31993
each finding and deficiency. A failure by the survey team to	31994
completely disclose in the exit interview every finding that may	31995
result from the survey does not affect the validity of any finding	31996
or deficiency cited in the statement of deficiencies. On request	31997
of the facility, the department shall provide a copy of any	31998
written worksheet or other document produced by the survey team in	31999
making recommendations regarding scope and severity levels of	32000
findings and deficiencies.	32001

(B) At the same time the department of health delivers a	32002
statement of deficiencies, it also shall deliver to the facility a	32003
separate written notice that states all of the following:	32004

(1) That the department of ~~job and family services~~health	32005
care administration or a contracting agency will issue an order	32006
under section ~~5111.57~~5164.73 of the Revised Code denying payment	32007
for any medicaid eligible residents admitted on and after the	32008
effective date of the order if the facility does not substantially	32009
correct, within ninety days after the exit interview, the	32010
deficiency or deficiencies cited in the statement of deficiencies	32011
in accordance with the plan of correction it submitted under	32012
section ~~5111.43~~5164.59 of the Revised Code;	32013

(2) If a condition of substandard care has been cited on the	32014
basis of a standard survey and a condition of substandard care was	32015
also cited on the immediately preceding standard survey, that the	32016
department of ~~job and family services~~health care administration	32017
or a contracting agency will issue an order under section ~~5111.57~~	32018
5164.73 of the Revised Code denying payment for any medicaid	32019
eligible residents admitted on and after the effective date of the	32020
order if a condition of substandard care is cited on the basis of	32021
the next standard survey;	32022

(3) That the department of ~~job and family services~~health	32023
care administration or a contracting agency will issue an order	32024
under section ~~5111.58~~5164.74 of the Revised Code terminating the	32025
facility's participation in the ~~medical assistance~~medicaid	32026
program if either of the following applies:	32027

(a) The facility does not substantially correct the	32028
deficiency or deficiencies in accordance with the plan of	32029
correction it submitted under section ~~5111.43~~5164.59 of the	32030
Revised Code within six months after the exit interview.	32031

(b) The facility substantially corrects the deficiency or	32032
deficiencies within the six-month period, but after correcting it,	32033
the department of health, based on a follow-up survey conducted	32034
during the remainder of the six-month period, determines that the	32035
facility has failed to maintain compliance with certification	32036
requirements.	32037

~~Sec. 5111.43.~~ Sec. 5164.59. Whenever a nursing facility receives a	32038
statement of deficiencies under section ~~5111.42~~5164.58 of the	32039
Revised Code, the facility shall submit to the department of	32040
health for its approval a plan of correction for each finding	32041
cited in the statement. The plan shall describe the actions the	32042
facility will take to correct each finding and specify the date by	32043
which each finding will be corrected. In the case of a finding	32044
cited pursuant to division (E) of section ~~5111.41~~5164.56 of the	32045
Revised Code, the plan shall describe the actions the facility	32046
took to correct the finding and the date on which it was	32047
corrected.	32048

The department shall approve any plan that conforms to the	32049
requirements for approval of plans of corrections established in	32050
the regulations, guidelines, and procedures issued by the United	32051
States secretary of health and human services ~~under Titles XVIII~~	32052
~~and XIX of the "Social Security Act," 49 Stat. 620 (1935), 42~~	32053
~~U.S.C.A. 301, as amended~~for the medicare and medicaid programs.	32054
The department also shall approve any modification of an existing	32055
plan submitted by a facility, if the plan as modified conforms to	32056
those regulations, guidelines, and procedures. The department	32057
shall not reject a facility's plan of correction or modification	32058
on the ground that the facility disputes the finding, if the plan	32059
is reasonably calculated to correct the finding.	32060

A facility that complies with this section shall not be	32061
considered to have admitted the existence of a finding cited by	32062
the department.	32063

~~Sec. 5111.44.~~ Sec. 5164.60. The department of health may appoint	32064
employees of the department to conduct on-site monitoring of a	32065
nursing facility whenever a finding is cited, including any	32066
finding cited pursuant to division (E) of section ~~5111.41~~5164.56	32067
of the Revised Code, or an emergency is found to exist.	32068
Appointment of monitors under this section is not subject to	32069
appeal under section ~~5111.60~~5164.76 or any other section of the	32070
Revised Code. No employee of a facility for which monitors are	32071
appointed, no person employed by the facility within the previous	32072
two years, and no person who currently has a consulting or other	32073
contract with the department or the facility, shall be appointed	32074
as a monitor under this section. Every monitor appointed under	32075
this section shall have the professional qualifications necessary	32076
to monitor correction of the finding or elimination of the	32077
emergency.	32078

~~Sec. 5111.45.~~ Sec. 5164.61. (A) If the department of health cites	32079
a deficiency or deficiencies that was not substantially corrected	32080
before a survey and that does not constitute a severity level four	32081
finding or create immediate jeopardy, the department of ~~job and~~	32082
~~family services~~health care administration or a contracting agency	32083
shall permit the nursing facility to continue participating in the	32084
~~medical assistance~~medicaid program for up to six months after the	32085
exit interview, if all of the following apply:	32086

(1) The facility meets the requirements, established in	32087
regulations issued by the United States secretary of health and	32088
human services under ~~Title XIX of the "Social Security Act," 49~~	32089
~~Stat. 620 (1935), 42 U.S.C.A. 301, as amended,~~the medicaid	32090
program for certification of nursing facilities that have a	32091
deficiency.	32092

(2) The department of health has approved a plan of	32093
correction submitted by the facility under section ~~5111.43~~5164.59	32094
of the Revised Code for each deficiency.	32095

(3) The provider agrees to repay the department of ~~job and~~	32096
~~family services~~health care administration, in accordance with	32097
section ~~5111.58~~5164.74 of the Revised Code, the federal share of	32098
all payments made by the department to the facility during the	32099
six-month period following the exit interview if the facility does	32100
not within the six-month period substantially correct the	32101
deficiency or deficiencies in accordance with the plan of	32102
correction submitted under section ~~5111.43~~5164.59 of the Revised	32103
Code.	32104

(B) If any of the conditions in divisions (A)(1) to (3) of	32105
this section do not apply, the department of ~~job and family~~	32106
~~services~~health care administration or contracting agency shall	32107
issue an order terminating the facility's participation in the	32108
~~medical assistance~~medicaid program. An order issued under this	32109
division is subject to appeal under Chapter 119. of the Revised	32110
Code. The order shall not take effect prior to the later of the	32111
thirtieth day after it is delivered to the facility or, if the	32112
order is appealed, the date on which a final adjudication order	32113
upholding the termination becomes effective pursuant to Chapter	32114
119. of the Revised Code.	32115

(C) At the time the department of ~~job and family services~~	32116
health care administration or contracting agency issues an order	32117
under division (B) of this section terminating a nursing	32118
facility's participation in the ~~medical assistance~~medicaid	32119
program, it may also impose, subject to section ~~5111.50~~5164.66 of	32120
the Revised Code, other remedies under sections ~~5111.46~~5164.62 to	32121
~~5111.48~~5164.64 of the Revised Code.	32122

~~Sec. 5111.46.~~ Sec. 5164.62. (A) If the department of health cites	32123
a deficiency, or cluster of deficiencies, that was not	32124
substantially corrected before a survey and constitutes a severity	32125
level four finding, the department of ~~job and family services~~	32126
health care administration or contracting agency shall, subject to	32127
sections ~~5111.52~~5164.68 to ~~5111.56~~5164.72 of the Revised Code,	32128
impose a remedy for the deficiency or cluster of deficiencies. The	32129
department or agency may act under either division (A)(1) or (2)	32130
of this section:	32131

(1) The department or agency may impose one or more of the	32132
following remedies:	32133

(a) Issue an order terminating the nursing facility's	32134
participation in the ~~medical assistance~~medicaid program.	32135

(b) Do either of the following:

32136

(i) Regardless of whether the provider consents, appoint a	32137
temporary manager of the facility.	32138

(ii) Apply to the common pleas court of the county in which	32139
the facility is located for such injunctive or other equitable	32140
relief as is necessary for the appointment of a special master	32141
with such powers and authority over the facility and length of	32142
appointment as the court considers necessary.	32143

32144

(i) Issue an order denying payment to the facility under the	32145
~~medical assistance~~medicaid program for all medicaid eligible	32146
residents admitted after the effective date of the order;	32147

(ii) Impose a fine.

32148

(d) Issue an order denying payment to the facility under the	32149
~~medical assistance~~medicaid program for medicaid eligible	32150
residents admitted after the effective date of the order who have	32151
certain diagnoses or special care needs specified by the	32152
department or agency.	32153

(2) The department or agency may impose one or more of the	32154
following remedies:	32155

(a) Appoint, subject to the continuing consent of the	32156
provider, a temporary manager of the facility;	32157

(b) Do either of the following:

32158

(i) Regardless of whether the provider consents, appoint a	32159
temporary manager of the facility;	32160

(ii) Apply to the common pleas court of the county in which	32161
the facility is located for such injunctive or other equitable	32162
relief as is necessary for the appointment of a special master	32163
with such powers and authority over the facility and length of	32164
appointment as the court considers necessary.	32165

32166

(i) Issue an order denying payment to the facility under the	32167
~~medical assistance~~medicaid program for all medicaid eligible	32168
residents admitted after the effective date of the order;	32169

(ii) Impose a fine.

32170

(d) Issue an order denying payment to the facility under the	32171
~~medical assistance~~medicaid program for medicaid eligible	32172
residents admitted after the effective date of the order who have	32173
certain diagnoses or special care needs specified by the	32174
department or agency;	32175

(e) Issue an order requiring the facility to correct the	32176
deficiency or cluster of deficiencies under the plan of correction	32177
submitted by the facility and approved by the department of health	32178
under section ~~5111.43~~5164.59 of the Revised Code.	32179

(B) The department of ~~job and family services~~health care	32180
administration or contracting agency shall deliver a written order	32181
issued under division (A)(1) of this section terminating a nursing	32182
facility's participation in the ~~medical assistance~~medicaid	32183
program to the facility within five days after the exit interview.	32184
If the facility alleges, at any time prior to the later of the	32185
twentieth day after the exit interview or the fifteenth day after	32186
it receives the order, that the deficiency or cluster of	32187
deficiencies for which the order was issued has been substantially	32188
corrected, the department of health shall conduct a follow-up	32189
survey to determine whether the deficiency or cluster of	32190
deficiencies has been substantially corrected. The order shall	32191
take effect and the facility's participation shall terminate on	32192
the twentieth day after the exit interview, unless the facility	32193
has substantially corrected the deficiency or cluster of	32194
deficiencies that constituted a severity level four finding or did	32195
not receive notice from the department of ~~job and family services~~	32196
health care administration or contracting agency within five days	32197
after the exit interview. In the latter case, the order shall take	32198
effect and the facility's participation shall terminate on the	32199
fifteenth day after the facility received the order.	32200

(C) If the department of health cites a deficiency or cluster	32201
of deficiencies pursuant to division (E) of section ~~5111.41~~	32202
5164.56 of the Revised Code that constituted a severity level four	32203
finding, the department of ~~job and family services~~health care	32204
administration or a contracting agency shall, subject to section	32205
~~5111.56~~5164.72 of the Revised Code, impose a fine. The fine shall	32206
be in effect for a period equal to the number of days the	32207
deficiency or cluster of deficiencies existed at the facility.	32208

~~Sec. 5111.47.~~ Sec. 5164.63. If the department of health cites a	32209
deficiency, or cluster of deficiencies, that was not substantially	32210
corrected before a survey and constitutes a severity level three	32211
and scope level three or four finding, the department of ~~job and~~	32212
~~family services~~health care administration or a contracting agency	32213
may, subject to sections ~~5111.55~~5164.71 and ~~5111.56~~5164.72 of	32214
the Revised Code, impose one or more of the following remedies:	32215

(A) Do either of the following:

32216

(1) Issue an order denying payment to the facility under the	32217
~~medical assistance~~medicaid program for all medicaid eligible	32218
residents admitted after the effective date of the order;	32219

(2) Impose a fine.

32220

(B) Issue an order denying payment to the facility under the	32221
~~medical assistance~~medicaid program for medicaid eligible	32222
residents admitted after the effective date of the order who have	32223
certain diagnoses or special care needs specified by the	32224
department or agency;	32225

(C) Issue an order requiring the facility to correct the	32226
deficiency or cluster of deficiencies under the plan of correction	32227
submitted by the facility and approved by the department of health	32228
under section ~~5111.43~~5164.59 of the Revised Code.	32229

~~Sec. 5111.48.~~ Sec. 5164.64. (A) If the department of health cites	32230
a deficiency, or cluster of deficiencies, that was not	32231
substantially corrected before a survey and constitutes a severity	32232
level three and scope level two finding, the department of ~~job and~~	32233
~~family services~~health care administration or a contracting agency	32234
may, subject to sections ~~5111.55~~5164.71 and ~~5111.56~~5164.72 of	32235
the Revised Code, impose one or more of the following remedies:	32236

(1) Do either of the following:

32237

(a) Issue an order denying payment to the facility under the	32238
~~medical assistance~~medicaid program for all medicaid eligible	32239
residents admitted after the effective date of the order;	32240

(b) Impose a fine.

32241

(2) Issue an order denying payment to the facility under the	32242
~~medical assistance~~medicaid program for medicaid eligible	32243
residents admitted after the effective date of the order who have	32244
certain diagnoses or special care needs specified by the	32245
department or agency;	32246

(3) Issue an order requiring the facility to correct the	32247
deficiency or cluster of deficiencies under the plan of correction	32248
proposed by the facility and approved by the department of health	32249
under section ~~5111.43~~5164.59 of the Revised Code.	32250

(B) If the department of health cites a deficiency, or	32251
cluster of deficiencies, that was not substantially corrected	32252
before a survey and constitutes a severity level three and scope	32253
level one finding, the department of ~~job and family services~~	32254
health care administration or a contracting agency may, subject to	32255
sections ~~5111.55~~5164.71 and ~~5111.56~~5164.72 of the Revised Code,	32256
impose one or more of the following remedies:	32257

(1) Impose a fine;

32258

(2) Issue an order denying payment to the facility under the	32259
~~medical assistance~~medicaid program for medicaid eligible	32260
residents admitted after the effective date of the order who have	32261
certain diagnoses or special care needs specified by the	32262
department or agency;	32263

(3) Issue an order requiring the facility to correct the	32264
deficiency or cluster of deficiencies under the plan of correction	32265
proposed by the facility and approved by the department of health	32266
under section ~~5111.43~~5164.59 of the Revised Code.	32267

(C) If the department of health cites a deficiency, or	32268
cluster of deficiencies, that was not substantially corrected	32269
before a survey and constitutes a severity level two and a scope	32270
level three or four finding, the department of ~~job and family~~	32271
~~services~~health care administration or a contracting agency may,	32272
subject to sections ~~5111.55~~5164.71 and ~~5111.56~~5164.72 of the	32273
Revised Code, impose one or more of the following remedies:	32274

(1) Impose a fine;

32275

(2) Issue an order denying payment to the facility under the	32276
~~medical assistance~~medicaid program for medicaid eligible	32277
residents admitted after the effective date of the order who have	32278
certain diagnoses or special care needs specified by the	32279
department or agency;	32280

(3) Issue an order requiring the facility to correct the	32281
deficiency or cluster of deficiencies under the plan of correction	32282
submitted by the facility and approved by the department of health	32283
under section ~~5111.43~~5164.59 of the Revised Code.	32284

(D) If the department of health cites a deficiency, or	32285
cluster of deficiencies, that was not substantially corrected	32286
before a survey, constitutes a severity level two and scope level	32287
one or two finding, and is a repeat finding, the department of ~~job~~	32288
~~and family services~~health care administration or a contracting	32289
agency may issue an order requiring the facility to correct the	32290
deficiency or cluster of deficiencies under the plan of correction	32291
submitted by the facility and approved by the department of health	32292
under section ~~5111.43~~5164.59 of the Revised Code.	32293

(E) If the department of health cites a deficiency, or	32294
cluster of deficiencies, that was not substantially corrected	32295
before a survey and constitutes a severity level one and scope	32296
level three or four finding, the department of ~~job and family~~	32297
~~services~~health care administration or a contracting agency may	32298
issue an order requiring the facility to correct the deficiency or	32299
cluster of deficiencies under the plan of correction submitted by	32300
the facility and approved by the department of health under	32301
section ~~5111.43~~5164.59 of the Revised Code.	32302

(F) If the department of health cites a deficiency, or	32303
cluster of deficiencies, that was not substantially corrected	32304
before a survey, constitutes a severity level one and scope level	32305
two finding, and is a repeat finding, the department of ~~job and~~	32306
~~family services~~health care administration or a contracting agency	32307
may issue an order requiring the facility to correct the	32308
deficiency or cluster of deficiencies under the plan of correction	32309
submitted by the facility and approved by the department of health	32310
under section ~~5111.43~~5164.59 of the Revised Code.	32311

~~Sec. 5111.49.~~ Sec. 5164.65. (A) In determining which remedies to	32312
impose under section ~~5111.46~~5164.62, ~~5111.47~~5164.63, or ~~5111.48~~	32313
5164.64 of the Revised Code, including whether a fine should be	32314
imposed, the department of ~~job and family services~~health care	32315
administration or a contracting agency shall do both of the	32316
following:	32317

(1) Impose the remedies that are most likely to achieve	32318
correction of deficiencies, encourage sustained compliance with	32319
certification requirements, and protect the health, safety, and	32320
rights of facility residents, but that are not directed at	32321
punishment of the facility;	32322

(2) Consider all of the following:

32323

(a) The presence or absence of immediate jeopardy;

32324

(b) The relationships of groups of deficiencies to each	32325
other;	32326

(c) The facility's history of compliance with certification	32327
requirements generally and in the specific area of the deficiency	32328
or deficiencies;	32329

(d) Whether the deficiency or deficiencies are directly	32330
related to resident care;	32331

(e) The corrective, long-term compliance, resident	32332
protective, and nonpunitive outcomes sought by the department or	32333
agency;	32334

(f) The nature, scope, and duration of the noncompliance with	32335
certification requirements;	32336

(g) The existence of repeat deficiencies;

32337

(h) The category of certification requirements with which the	32338
facility is out of compliance;	32339

(i) Any period of noncompliance with certification	32340
requirements that occurred between two certifications by the	32341
department of health that the facility was in compliance with	32342
certification requirements;	32343

(j) The facility's degree of culpability;

32344

(k) The accuracy, extent, and availability of facility	32345
records;	32346

(l) The facility's financial condition, exclusive of any	32347
moneys donated to a facility that is an organization described in	32348
subsection 501(c)(3) and is tax exempt under subsection 501(a) of	32349
the "Internal Revenue Code of 1986," 100 Stat. 2085, 26 U.S.C.A.	32350
1;	32351

(m) Any adverse effect that the action or fine would have on	32352
the health and safety of facility residents;	32353

(n) If the noncompliance that resulted in the citation of a	32354
deficiency or cluster of deficiencies existed before a change in	32355
ownership of the facility, whether the new owner or owners have	32356
had sufficient time to correct the noncompliance.	32357

(B) Whenever the department or agency imposes remedies under	32358
section ~~5111.46~~5164.62, ~~5111.47~~5164.63, or ~~5111.48~~5164.64 of	32359
the Revised Code, it shall provide a written statement to the	32360
nursing facility that specifies all of the following:	32361

(1) The effective date of each remedy;

32362

(2) The deficiency or cluster of deficiencies for which each	32363
remedy is imposed;	32364

(3) The severity and scope of the deficiency or cluster of	32365
deficiencies;	32366

(4) The rationale, including all applicable factors specified	32367
in division (A) of this section, for imposing the remedies.	32368

~~Sec. 5111.50.~~ Sec. 5164.66. At the time the department of ~~job and~~	32369
~~family services~~health care administration or a contracting	32370
agency, under section ~~5111.45~~5164.61, ~~5111.46~~5164.62, or ~~5111.51~~	32371
5164.67 of the Revised Code, issues an order terminating a nursing	32372
facility's participation in the ~~medical assistance~~medicaid	32373
program, the department or agency may also impose a fine, in	32374
accordance with sections ~~5111.46~~5164.62 to ~~5111.48~~5164.64 and	32375
~~5111.56~~5164.72 of the Revised Code, to be collected in the event	32376
the termination order does not take effect. The department or	32377
agency shall not collect this fine if the termination order takes	32378
effect.	32379

~~Sec. 5111.51.~~ Sec. 5164.67. (A) If the department of health finds	32380
during a survey that an emergency exists at a nursing facility, as	32381
the result of a deficiency or cluster of deficiencies that creates	32382
immediate jeopardy, the department of ~~job and family services~~	32383
health care administration or a contracting agency shall impose	32384
one or more of the remedies described in division (A)(1) of this	32385
section and, in addition, may take one or both of the actions	32386
described in division (A)(2) of this section.	32387

(1) The department or agency shall impose one or more of the	32388
following remedies:	32389

(a) Appoint, subject to the continuing consent of the	32390
provider, a temporary manager of the facility;	32391

(b) Apply to the common pleas court of the county in which	32392
the facility is located for a temporary restraining order,	32393
preliminary injunction, or such other injunctive or equitable	32394
relief as is necessary to close the facility, transfer one or more	32395
residents to other nursing facilities or other appropriate care	32396
settings, or otherwise eliminate the condition of immediate	32397
jeopardy. If the court grants such an order, injunction, or	32398
relief, it may appoint a special master empowered to implement the	32399
court's judgment under the court's direct supervision.	32400

(c) Issue an order terminating the facility's participation	32401
in the medical assistance program;	32402

(d) Regardless of whether the provider consents, appoint a	32403
temporary manager of the facility.	32404

(2) The department or agency may do one or both of the	32405
following:	32406

(a) Issue an order denying payment to the facility for all	32407
medicaid eligible residents admitted after the effective date of	32408
the order;	32409

(b) Impose remedies under sections ~~5111.46~~5164.62 to ~~5111.48~~	32410
5164.64 of the Revised Code appropriate to the severity and scope	32411
of the deficiency or cluster of deficiencies, except that the	32412
department or agency shall not impose a fine for the same	32413
deficiency for which the department or agency has issued an order	32414
under division (A)(2)(a) of this section.	32415

(B) If the department of health, department of ~~job and family~~	32416
~~services~~health care administration, or a contracting agency finds	32417
on the basis of a survey or other visit to the facility by	32418
representatives of that department or agency that an emergency	32419
exists at a facility that is not the result of a deficiency or	32420
cluster of deficiencies that constitutes immediate jeopardy, the	32421
department of ~~job and family services~~health care administration	32422
or contracting agency may do either of the following:	32423

(1) Appoint, subject to the continuing consent of the	32424
provider, a temporary manager of the facility;	32425

(2) Apply to the common pleas court of the county in which	32426
the facility is located for a temporary restraining order,	32427
preliminary injunction, or such other injunctive or equitable	32428
relief as is necessary to close the facility, transfer one or more	32429
residents to other nursing facilities or other appropriate care	32430
settings, or otherwise eliminate the emergency. If the court	32431
grants such an order, injunction, or relief, it may appoint a	32432
special master empowered to implement the court's judgment under	32433
the court's direct supervision.	32434

(C)(1) Prior to acting under division (A)(1)(b), (c), (d), or	32435
(2), or (B)(2) of this section, the department of ~~job and family~~	32436
~~services~~health care administration or contracting agency shall	32437
give written notice to the facility specifying all of the	32438
following:	32439

(a) The nature of the emergency, including the nature of any	32440
deficiency or deficiencies that caused the emergency;	32441

(b) The nature of the action the department or agency intends	32442
to take unless the department of health determines that the	32443
facility, in the absence of state intervention, possesses the	32444
capacity to eliminate the emergency;	32445

32446

(2) If the department of health determines that the facility	32447
does not possess the capacity to eliminate the emergency in the	32448
absence of state intervention, the department of ~~job and family~~	32449
~~services~~health care administration or contracting agency may	32450
immediately take action under division (A) or (B) of this section.	32451
If the department of health determines that the facility possesses	32452
the capacity to eliminate the emergency, the department of ~~job and~~	32453
~~family services~~health care administration or contracting agency	32454
shall direct the facility to eliminate the emergency within five	32455
days after the facility's receipt of the notice. At the end of the	32456
five-day period, the department of health shall conduct a	32457
follow-up survey that focuses on the emergency. If the department	32458
of health determines that the facility has eliminated the	32459
emergency within the time period, the department of ~~job and family~~	32460
~~services~~health care administration or contracting agency shall	32461
not act under division (A)(1)(b), (c), (d), or (2)(a), or (B)(2)	32462
of this section. If the department of health determines that the	32463
facility has failed to eliminate the emergency within the five-day	32464
period, the department of job and family services or contracting	32465
agency shall take appropriate action under division (A)(1)(b),	32466
(c), (d), or (2), or (B)(2) of this section.	32467

(3) Until the written notice required by division (C)(1) of	32468
this section is actually delivered, no action taken by the	32469
department of ~~job and family services~~health care administration	32470
or contracting agency under division (A)(1)(b), (c), (d), or (2),	32471
or (B)(2) of this section shall have any legal effect. In addition	32472
to the written notice, the department of health survey team shall	32473
give oral notice to the facility, at the time of the survey,	32474
concerning any recommendations the survey team intends to make	32475
that could form the basis of a determination that an emergency	32476
exists.	32477

(D) The department of ~~job and family services~~health care	32478
administration or contracting agency shall deliver a written order	32479
issued under division (A)(1) of this section terminating a nursing	32480
facility's participation in the ~~medical assistance~~medicaid	32481
program to the facility within five days after the exit interview.	32482
If the facility alleges, at any time prior to the later of the	32483
twentieth day after the exit interview or the fifteenth day after	32484
it receives the order, that the condition of immediate jeopardy	32485
for which the order was issued has been eliminated, the department	32486
of health shall conduct a follow-up survey to determine whether	32487
the immediate jeopardy has been eliminated. The order shall take	32488
effect and the facility's participation shall terminate on the	32489
twentieth day after the exit interview, unless the facility has	32490
eliminated the immediate jeopardy or did not receive notice from	32491
the department of ~~job and family services~~health care	32492
administration or contracting agency within five days after the	32493
exit interview. In the latter case, the order shall take effect	32494
and the facility's participation shall terminate on the fifteenth	32495
day after the facility received the order.	32496

(E) Any action taken by the department of ~~job and family~~	32497
~~services~~health care administration or a contracting agency under	32498
division (A)(1)(c), (d), or (2)(a) of this section is subject to	32499
appeal under Chapter 119. of the Revised Code, except that the	32500
department or agency may take such action prior to and during the	32501
pendency of any proceeding under that chapter. No action taken by	32502
a facility under division (C) of this section to eliminate an	32503
emergency cited by the department of health shall be considered an	32504
admission by the facility of the existence of an emergency.	32505

~~Sec. 5111.52.~~ Sec. 5164.68. (A) As used in this section:

32506

(1) "Provider agreement" means a contract between the	32507
department of ~~job and family services~~health care administration	32508
and a nursing facility for the provision of nursing facility	32509
services under the ~~medical assistance~~medicaid program.	32510

(2) "Terminating" includes not renewing.

32511

(B) A nursing facility's participation in the ~~medical~~	32512
~~assistance~~medicaid program shall be terminated under sections	32513
~~5111.35~~5164.50 to ~~5111.62~~5164.78 of the Revised Code as follows:	32514

(1) If the department of ~~job and family services~~health care	32515
administration is terminating the facility's participation, it	32516
shall issue an order terminating the facility's provider	32517
agreement.	32518

(2) If the department of health, acting as a contracting	32519
agency, is terminating the facility's participation, it shall	32520
issue an order terminating certification of the facility's	32521
compliance with certification requirements. When the department of	32522
health terminates certification, the department of ~~job and family~~	32523
~~services~~health care administration shall terminate the facility's	32524
provider agreement. The department of ~~job and family services~~	32525
health care administration is not required to provide an	32526
adjudication hearing when it terminates a provider agreement	32527
following termination of certification by the department of	32528
health.	32529

(3) If a state agency other than the department of health,	32530
acting as a contracting agency, is terminating the facility's	32531
participation, it shall notify the department of ~~job and family~~	32532
~~services~~health care administration, and the department of ~~job and~~	32533
~~family services~~health care administration shall issue an order	32534
terminating the facility's provider agreement. The contracting	32535
agency shall conduct any administrative proceedings concerning the	32536
order.	32537

(C) If the following conditions are met, the department of	32538
~~job and family services~~health care administration may make	32539
~~medical assistance~~medicaid payments to a nursing facility for a	32540
period not exceeding thirty days after the effective date of	32541
termination under sections ~~5111.35~~5164.50 to ~~5111.62~~5164.78 of	32542
the Revised Code of the facility's participation in the ~~medical~~	32543
~~assistance~~medicaid program:	32544

(1) The payments are for medicaid eligible residents admitted	32545
to the facility prior to the effective date of the termination;	32546

(2) The provider is making reasonable efforts to transfer	32547
medicaid eligible residents to other care settings.	32548

The period during which payments may be made under this	32549
division begins on the later of the effective date of the	32550
termination or, if the facility has appealed a termination order,	32551
the date of issuance of the adjudication order upholding	32552
termination.	32553

~~Sec. 5111.53.~~ Sec. 5164.69. (A) Whenever a nursing facility is	32554
closed under sections ~~5111.35~~5164.50 to ~~5111.62~~5164.78 of the	32555
Revised Code, the department of ~~job and family services~~health	32556
care administration or contracting agency shall arrange for the	32557
safe and orderly transfer of all residents, including residents	32558
who are not medicaid eligible residents, to other appropriate care	32559
settings. Whenever a facility's participation in the ~~medical~~	32560
~~assistance~~medicaid program is terminated under sections ~~5111.35~~	32561
5164.50 to ~~5111.62~~5164.78 of the Revised Code, the department or	32562
agency shall arrange for the safe and orderly transfer of all	32563
medicaid eligible residents or, if the termination results in the	32564
closure of the facility, of all residents. The provider and all	32565
persons involved in the facility's operation shall cooperate with	32566
and assist in the transfer of residents.	32567

(B) After a nursing facility's participation in the ~~medical~~	32568
~~assistance~~medicaid program is terminated under section ~~5111.45~~	32569
5164.61, ~~5111.46~~5164.62, ~~5111.51~~5164.67, or ~~5111.58~~5164.74 of	32570
the Revised Code, the department of ~~job and family services~~health	32571
care administration or contracting agency may appoint a temporary	32572
manager subject to the continuing consent of the provider, or may	32573
apply to the common pleas court of the county in which the	32574
facility is located for such injunctive relief as is necessary for	32575
the appointment of a special master, to ensure the transfer of	32576
medicaid eligible residents to other appropriate care settings	32577
and, if applicable, the orderly closure of the facility.	32578

~~Sec. 5111.54.~~ Sec. 5164.70. (A) A temporary manager of a nursing	32579
facility appointed by the department of ~~job and family services~~	32580
health care administration or a contracting agency under sections	32581
~~5111.35~~5164.50 to ~~5111.62~~5164.78 of the Revised Code shall meet	32582
all of the following qualifications:	32583

(1) Be licensed as a nursing home administrator under Chapter	32584
4751. of the Revised Code;	32585

(2) Have demonstrated competence as a nursing home	32586
administrator;	32587

(3) Have had no disciplinary action taken against the	32588
temporary manager by any licensing board or professional society	32589
in this state.	32590

(B) The salary of a temporary manager or special master	32591
appointed under sections ~~5111.35~~5164.50 to ~~5111.62~~5164.78 of the	32592
Revised Code shall be paid by the facility and set by the	32593
department of ~~job and family services~~health care administration	32594
or contracting agency, in the case of a temporary manager, or by	32595
the court, in the case of a special master, at a rate not to	32596
exceed the maximum allowable compensation for an administrator	32597
under the ~~medical assistance~~medicaid program. The extent to which	32598
this compensation is allowable under the ~~medical assistance~~	32599
medicaid program is subject to and limited by this chapter and	32600
rules of the department.	32601

Subject to division (C) of this section, any costs incurred	32602
on behalf of a nursing facility by a temporary manager or special	32603
master appointed under sections ~~5111.35~~5164.50 to ~~5111.62~~5164.78	32604
of the Revised Code shall be paid by the facility. The	32605
allowability of these costs under the ~~medical assistance~~medicaid	32606
program shall be subject to and governed by this chapter and the	32607
rules of the department. This division does not prohibit a	32608
facility from applying for or receiving any waiver of cost	32609
ceilings available under rules of the department.	32610

(C) No temporary manager or special master appointed under	32611
sections ~~5111.35~~5164.50 to ~~5111.62~~5164.78 of the Revised Code	32612
shall enter into any employment contract on behalf of a facility,	32613
or purchase any capital goods using facility funds totaling more	32614
than ten thousand dollars, unless the temporary manager or special	32615
master has obtained prior approval for the contract or purchase	32616
from either the provider or the court.	32617

(D)(1) A temporary manager appointed for a nursing facility	32618
under section ~~5111.46~~5164.62 of the Revised Code is hereby	32619
vested, subject to division (C) of this section, with the legal	32620
authority necessary to correct any deficiency or cluster of	32621
deficiencies at a facility, bring the facility into compliance	32622
with certification requirements, and otherwise ensure the health	32623
and safety of the residents.	32624

(2) A temporary manager appointed under section ~~5111.51~~	32625
5164.67 of the Revised Code is hereby vested, subject to division	32626
(C) of this section, with the authority necessary to eliminate the	32627
emergency, bring the facility into compliance with certification	32628
requirements, and otherwise ensure the health and safety of the	32629
residents.	32630

(3) A temporary manager appointed under section ~~5111.53~~	32631
5164.69 of the Revised Code is hereby vested, subject to division	32632
(C) of this section, with the authority necessary to ensure the	32633
transfer of medicaid eligible residents to other appropriate care	32634
settings and, if applicable, the orderly closure of the facility,	32635
and to otherwise ensure the health and safety of the residents.	32636

(E) Prior to acting under division (A)(1)(b) or (2)(b) of	32637
section ~~5111.46~~5164.62 of the Revised Code to appoint a temporary	32638
manager or apply for a special master, the department of ~~job and~~	32639
~~family services~~health care administration or contracting agency	32640
shall order the facility to substantially correct the deficiency	32641
or deficiencies within five days after receiving the statement and	32642
inform the facility, in the statement it provides pursuant to	32643
division (B) of section ~~5111.49~~5164.65 of the Revised Code, of	32644
the order and that it will not take that action unless the	32645
facility fails to substantially correct the deficiency or	32646
deficiencies within that five-day period. At the end of the	32647
five-day period, the department of health shall conduct a	32648
follow-up survey that focuses on the deficiency or deficiencies.	32649
If the department of health determines that the facility has	32650
substantially corrected the deficiency or deficiencies within that	32651
time, the department of ~~job and family services~~health care	32652
administration or contracting agency shall not appoint a temporary	32653
manager or apply for a special master. If the department of health	32654
determines that the facility has failed to substantially correct	32655
the deficiency or deficiencies within that time, the department of	32656
~~job and family services~~health care administration or contracting	32657
agency may proceed with appointment of the temporary manager or	32658
application for a special master. Until the statement required	32659
under division (B) of section ~~5111.49~~5164.65 of the Revised Code	32660
is actually delivered, no action taken by the department or agency	32661
to appoint a temporary manager or apply for a temporary manager	32662
under division (A)(1)(b) or (2)(b) of section ~~5111.46~~5164.62 of	32663
the Revised Code shall have any legal effect. No action taken by a	32664
facility under this division to substantially correct a deficiency	32665
or deficiencies shall be considered an admission by the facility	32666
of the existence of a deficiency or deficiencies.	32667

(F) Appointment of a temporary manager under division	32668
(A)(1)(b) or (2)(b) of section ~~5111.46~~5164.62 or division	32669
(A)(1)(d) of section ~~5111.51~~5164.67 of the Revised Code shall	32670
expire at the end of the seventh day following the appointment. If	32671
the department of ~~job and family services~~health care	32672
administration or contracting agency finds that the deficiency or	32673
deficiencies that prompted the appointment under division	32674
(A)(1)(b) or (2)(b) of section ~~5111.46~~5164.62 of the Revised Code	32675
cannot be substantially corrected, or the condition of immediate	32676
jeopardy that prompted the appointment under division (A)(1)(d) of	32677
section ~~5111.51~~5164.67 of the Revised Code cannot be eliminated,	32678
prior to the expiration of the appointment, it may take one of the	32679
following actions:	32680

(1) Appoint, subject to the continuing consent of the	32681
provider, a temporary manager for the facility;	32682

(2) Apply to the common pleas court of the county in which	32683
the facility is located for an order appointing a special master	32684
who, under the authority and direct supervision of the court and	32685
subject to divisions (B) and (C) of this section, may take such	32686
additional actions as are necessary to correct the deficiency or	32687
deficiencies or eliminate the condition of immediate jeopardy and	32688
bring the facility into compliance with certification	32689
requirements.	32690

(G) The court, on finding that the deficiency or deficiencies	32691
for which a special master was appointed under division (F)(2) of	32692
this section or division (A)(1)(b) or (2)(b) of section ~~5111.46~~	32693
5164.62 of the Revised Code has been substantially corrected, or	32694
the emergency for which a special master was appointed under	32695
division (F)(2) of this section or division (A)(1)(b) or (B)(2) of	32696
section ~~5111.51~~5164.67 of the Revised Code has been eliminated,	32697
that the facility has been brought into compliance with	32698
certification requirements, and that the provider has established	32699
the management capability to ensure continued compliance with the	32700
certification requirements, shall immediately terminate its	32701
jurisdiction over the facility and return control and management	32702
of the facility to the provider. If the deficiency or deficiencies	32703
cannot be substantially corrected, or the emergency cannot be	32704
eliminated practicably within a reasonable time following	32705
appointment of the special master, the court may order the special	32706
master to close the facility and transfer all residents to other	32707
nursing facilities or other appropriate care settings.	32708

~~Sec. 5111.55.~~ Sec. 5164.71. (A) An order issued under section	32709
~~5111.46~~5164.62, ~~5111.47~~5164.63, ~~5111.48~~5164.64, ~~5111.51~~	32710
5164.67, or ~~5111.57~~5164.73 of the Revised Code denying payment to	32711
a nursing facility for all medicaid eligible residents admitted	32712
after its effective date, or an order issued under section ~~5111.46~~	32713
5164.62, ~~5111.47~~5164.63, or ~~5111.48~~5164.64 of the Revised Code	32714
denying payment to a nursing facility for medicaid eligible	32715
residents admitted after the effective date of the order who have	32716
specified diagnoses or special care needs, shall also apply to	32717
individuals admitted to the facility on and after the effective	32718
date of the order who are not medicaid eligible residents but	32719
become medicaid eligible residents after admission. Such an order	32720
shall not apply to any of the following:	32721

(1) An individual who was a medicaid eligible resident of the	32722
facility on the day immediately preceding the effective date of	32723
the order and continues to be a medicaid eligible resident on and	32724
after that date;	32725

(2) An individual who was a resident of the facility on the	32726
day immediately preceding the effective date of the order,	32727
continues to be a resident on and after that date, and becomes	32728
medicaid eligible on or after that date;	32729

(3) An individual who was a medicaid eligible resident of the	32730
facility prior to the effective date of the order, is temporarily	32731
absent from the facility on that or a subsequent date due to	32732
hospitalization or participation in therapeutic programs outside	32733
the facility, and chooses to return to the facility;	32734

(4) An individual who was a resident of the facility prior to	32735
the effective date of the order, is temporarily absent from the	32736
facility on that or a subsequent date due to hospitalization or	32737
participation in therapeutic programs outside the facility,	32738
becomes medicaid eligible on or after that date, and chooses to	32739
return to the facility.	32740

(B) An order issued under section ~~5111.46~~5164.62 of the	32741
Revised Code denying payment to a nursing facility for all	32742
medicaid eligible residents admitted after its effective date, or	32743
denying payment to a facility for medicaid eligible residents	32744
admitted after the effective date of the order who have specified	32745
diagnoses or special care needs shall not take effect prior to the	32746
fifth day after the order is delivered to the facility. Such an	32747
order issued under section ~~5111.47~~5164.63 or ~~5111.48~~5164.64 of	32748
the Revised Code shall not take effect prior to the twentieth day	32749
after it is delivered to the facility.	32750

(C) No nursing facility that has received an order under	32751
section ~~5111.46~~5164.62, ~~5111.47~~5164.63, ~~5111.48~~5164.64, ~~5111.51~~	32752
5164.67, or ~~5111.57~~5164.73 of the Revised Code denying payment	32753
for all new admissions of medicaid eligible residents shall admit	32754
a medicaid eligible resident on or after the effective date of the	32755
order, unless the resident is described in division (A)(3) or (4)	32756
of this section, until the order is terminated pursuant to this	32757
section. No nursing facility that has received an order under	32758
section ~~5111.46~~5164.62, ~~5111.47~~5164.63, or ~~5111.48~~5164.64 of	32759
the Revised Code denying payment to a nursing facility for new	32760
admissions of medicaid eligible residents with specified diagnoses	32761
or special care needs shall admit such a resident on or after the	32762
effective date of the order, unless the resident is described in	32763
division (A)(3) or (4) of this section, until the order is	32764
terminated pursuant to this section.	32765

(D) In the case of an order imposed under division (B) of	32766
section ~~5111.57~~5164.73 of the Revised Code, the department of	32767
health care administration or contracting agency shall appoint	32768
monitors in accordance with section ~~5111.44~~5164.60 of the Revised	32769
Code to conduct on-site monitoring.	32770

(E)(1) A facility may give written notice to the department	32771
of health whenever any of the following apply:	32772

(a) With respect to an order denying payment issued under	32773
section ~~5111.46~~5164.62, ~~5111.47~~5164.63, or ~~5111.48~~5164.64 of	32774
the Revised Code, either of the following is the case:	32775

(i) The facility has completed implementation of the plan of	32776
correction it submitted under section ~~5111.43~~5164.59 of the	32777
Revised Code and substantially corrected all deficiencies for	32778
which the order was issued.	32779

(ii) The facility has reduced the severity or scope of all of	32780
the deficiencies to a level at which sections ~~5111.46~~5164.62 to	32781
~~5111.48~~5164.64 of the Revised Code do not authorize the order.	32782

(b) With respect to an order denying payment issued under	32783
section ~~5111.51~~5164.67 of the Revised Code, the facility has	32784
eliminated the immediate jeopardy.	32785

(c) With respect to an order denying payment issued under	32786
division (A) of section ~~5111.57~~5164.73 of the Revised Code, the	32787
facility has completed implementation of the plan of correction it	32788
submitted under section ~~5111.43~~5164.59 of the Revised Code and	32789
substantially corrected all deficiencies for which the order was	32790
issued.	32791

(d) With respect to an order denying payment issued under	32792
division (B) of section ~~5111.57~~5164.73 of the Revised Code, both	32793
of the following are the case:	32794

(i) The facility has completed implementation of the plan of	32795
correction it submitted under section ~~5111.43~~5164.59 of the	32796
Revised Code and substantially corrected all deficiencies for	32797
which the order was issued.	32798

(ii) The facility is in compliance with certification	32799
requirements and has provided adequate assurance that it will	32800
remain in compliance with them.	32801

(2) Within ten working days after it receives the notice	32802
under division (E)(1) of this section, the department of health	32803
shall conduct a follow-up survey that focuses on the cited	32804
deficiency or deficiencies, unless the department is able to	32805
determine, on the basis of documentation provided by the facility,	32806
that the facility has completed the applicable action described in	32807
divisions (E)(1)(a) to (d) of this section. If the department of	32808
health makes that determination on the basis of the documentation,	32809
the department of ~~job and family services~~health care	32810
administration or contracting agency shall terminate the order	32811
denying payment as of the date the facility completed the	32812
applicable action, as subsequently verified by the department of	32813
health. If the department of health conducts a follow-up survey,	32814
the department of ~~job and family services~~health care	32815
administration or contracting agency shall terminate the order	32816
denying payment as of the date the department of health makes the	32817
determination that the facility completed the applicable action.	32818

(F) The department of ~~job and family services~~health care	32819
administration or contracting agency shall provide public notice	32820
implementing an order under section ~~5111.46~~5164.62, ~~5111.47~~	32821
5164.63, ~~5111.48~~5164.64, ~~5111.51~~5164.67, or ~~5111.57~~5164.73 of	32822
the Revised Code denying payment to a nursing facility under the	32823
~~medical assistance~~medicaid program for all medicaid eligible	32824
residents by publishing in a newspaper of general circulation in	32825
the county in which the facility is located an announcement	32826
stating: "By order of the (Ohio Department of ~~Job and Family~~	32827
~~Services~~Health Care Administration or name of contracting	32828
agency), effective on and after (effective date of order), (name	32829
of facility) is no longer authorized to admit Medicaid eligible	32830
residents." Immediately following termination of any such order,	32831
the department or agency shall publish in a newspaper of general	32832
circulation in the county in which the facility is located an	32833
announcement stating: "By order of the (Ohio Department of ~~Job and~~	32834
~~Family Services~~Health Care Administration or name of contracting	32835
agency), effective on and after (effective date of termination),	32836
(name of facility) is hereby authorized to admit Medicaid eligible	32837
residents." Neither the department nor the contracting agency	32838
shall issue public notice of an order under section ~~5111.46~~	32839
5164.62, ~~5111.47~~5164.63, or ~~5111.48~~5164.64 of the Revised Code	32840
denying payment to a nursing facility for medicaid eligible	32841
residents with specified diagnoses or special care needs; public	32842
notice is not required for such an order to take effect.	32843

(G) A facility that complies with division (E) of this	32844
section shall not be considered to have admitted to the existence	32845
of the deficiency that constitutes the basis of the department's	32846
or agency's order.	32847

~~Sec. 5111.56.~~ Sec. 5164.72. (A) As used in this section,	32848
"certified beds" means beds certified under ~~Title XVIII or XIX of~~	32849
~~the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301,~~	32850
~~as amended~~the medicare or medicaid program.	32851

(B) If the department of ~~job and family services~~health care	32852
administration or a contracting agency imposes a fine on a nursing	32853
facility under section ~~5111.46~~5164.62, ~~5111.47~~5164.63, or	32854
~~5111.48~~5164.64 of the Revised Code, it may impose one or more of	32855
the following:	32856

(1) One hundred sixty per cent of the amount calculated under	32857
division (C) of this section for any deficiency or cluster of	32858
deficiencies that constitutes a severity level four and scope	32859
level four finding;	32860

(2) One hundred forty per cent of the amount calculated under	32861
division (C) of this section for any deficiency or cluster of	32862
deficiencies that constitutes a severity level four and scope	32863
level three finding;	32864

(3) One hundred twenty per cent of the amount calculated	32865
under division (C) of this section for any deficiency or cluster	32866
of deficiencies that constitutes a severity level four and scope	32867
level two finding;	32868

(4) The amount calculated under division (C) of this section	32869
for any deficiency or cluster of deficiencies that constitutes a	32870
severity level four and scope level one finding or any deficiency	32871
or cluster of deficiencies that constitutes a severity level three	32872
and scope level four finding;	32873

(5) Ninety per cent of the amount calculated under division	32874
(C) of this section for any deficiency or cluster of deficiencies	32875
that constitutes a severity level three and scope level three	32876
finding;	32877

(6) Eighty per cent of the amount calculated under division	32878
(C) of this section for any deficiency or cluster of deficiencies	32879
that constitutes a severity level three and scope level two	32880
finding;	32881

(7) Seventy per cent of the amount calculated under division	32882
(C) of this section for any deficiency or cluster of deficiencies	32883
that constitutes a severity level three and scope level one	32884
finding;	32885

(8) Fifty per cent of the amount calculated under division	32886
(C) of this section for any deficiency or cluster of deficiencies	32887
that constitutes a severity level two and scope level four	32888
finding;	32889

(9) Forty per cent of the amount calculated under division	32890
(C) of this section for any deficiency or cluster of deficiencies	32891
that constitutes a severity level two and scope level three	32892
finding.	32893

(C) The amount subject to division (B) of this section shall	32894
be the product of multiplying two dollars and fifty cents for each	32895
day the fine is in effect by the total number of licensed nursing	32896
home beds or certified beds, whichever is greater, in the facility	32897
as of the date the deficiency or cluster of deficiencies that is	32898
the reason for the fine was cited.	32899

(D)(1) The department of ~~job and family services~~health care	32900
administration or contracting agency shall not impose on a	32901
facility, at any one time, more than four fines as a result of any	32902
one survey.	32903

(2) The department of ~~job and family services~~health care	32904
administration or contracting agency shall not impose more than	32905
one fine based on a deficiency or cluster of deficiencies.	32906
However, if the department of health, in a follow-up or other	32907
subsequent survey, finds a change in the scope or severity of the	32908
deficiency or cluster of deficiencies, the department of ~~job and~~	32909
~~family services~~health care administration or contracting agency	32910
may increase or decrease the fine in accordance with division (B)	32911
of this section to reflect the change in scope or severity. The	32912
department or agency shall give the facility written notice of the	32913
change in the amount of the fine. The change shall take effect on	32914
the date the follow-up or other subsequent survey is completed.	32915

If the department of health finds that a deficiency is a	32916
repeat deficiency, the department of ~~job and family services~~	32917
health care administration or contracting agency may impose a fine	32918
that is one hundred per cent greater than the fine specified in	32919
division (B) of this section for the deficiency.	32920

(E) The total amount of fines the department of ~~job and~~	32921
~~family services~~health care administration or contracting agency	32922
may impose on a facility in a single calendar year shall not	32923
exceed five hundred dollars for each licensed nursing home bed or	32924
certified bed, whichever is greater in number, in the facility.	32925

(F)(1) Except as provided in division (F)(2) of this section,	32926
the department of ~~job and family services~~health care	32927
administration or contracting agency shall not impose a fine under	32928
section ~~5111.46~~5164.62, ~~5111.47~~5164.63, or ~~5111.48~~5164.64 of	32929
the Revised Code if the deficiency or cluster of deficiencies is	32930
substantially corrected within twenty days after the nursing	32931
facility receives the statement provided under division (B) of	32932
section ~~5111.49~~5164.65 of the Revised Code. The department or	32933
agency shall inform the nursing facility in that statement that	32934
the fine will not be imposed if the deficiency or cluster of	32935
deficiencies is substantially corrected within the twenty-day	32936
period.	32937

(2) If a nursing facility has substantially corrected a	32938
deficiency or cluster of deficiencies within six months after the	32939
exit interview of a survey that was the basis for citing a	32940
deficiency or cluster of deficiencies, but after correcting it has	32941
been cited for the same deficiency or cluster of deficiencies by	32942
the department of health on the basis of a subsequent survey	32943
conducted during the remainder of the six-month period, the	32944
department of ~~job and family services~~health care administration	32945
or contracting agency may impose a fine beginning on the date of	32946
the exit interview of the subsequent survey.	32947

(G) Whenever a facility believes that it has completed	32948
implementation of the plan of correction it submitted under	32949
section ~~5111.43~~5164.59 of the Revised Code and substantially	32950
corrected the cited deficiency or cluster of deficiencies that is	32951
the basis for a fine, it may give written notice to that effect to	32952
the department of health. After receiving the notice, the	32953
department shall conduct a follow-up survey of the facility that	32954
focuses on the deficiency or cluster, unless the department is	32955
able to determine, on the basis of documentation provided by the	32956
facility, that the facility has substantially corrected the	32957
deficiency or cluster. If, based on the follow-up survey, the	32958
department establishes that the facility had not completed	32959
implementation of the plan of correction at the time the	32960
department received the notice, any fine based on the deficiency	32961
or cluster shall be doubled effective from the date the department	32962
received the notice. A facility that complies with this division	32963
shall not be considered to have admitted the existence of the	32964
deficiency or cluster that is the basis for the fine.	32965

(H) Except for a fine imposed under division (C) of section	32966
~~5111.46~~5164.62 of the Revised Code and as provided in division	32967
(F)(2) of this section, the department of ~~job and family services~~	32968
health care administration or contracting agency shall impose a	32969
fine only if the facility fails to give notice under division (G)	32970
of this section within twenty days after it receives the statement	32971
required by division (B) of section ~~5111.49~~5164.65 of the Revised	32972
Code or if the department of health determines, based on a	32973
follow-up survey, that the deficiency or cluster of deficiencies	32974
for which the fine is proposed has not been substantially	32975
corrected within the twenty-day period. The fine shall be imposed	32976
effective on the twenty-first day after the facility receives the	32977
statement under division (B) of section ~~5111.49~~5164.65 of the	32978
Revised Code. The fine shall remain in effect until the earliest	32979
of the following:	32980

(1) The date the department of health receives notice under	32981
division (G) of this section, unless the department determines, on	32982
the basis of a follow-up survey, that the deficiency or cluster of	32983
deficiencies that is the basis for the fine has not been	32984
substantially corrected as of that date;	32985

(2) The date on which the department of health makes a	32986
determination, on the basis of a follow-up survey, that the	32987
deficiency or cluster of deficiencies has been substantially	32988
corrected;	32989

(3) The date the facility substantially corrected the	32990
deficiency or cluster, as subsequently determined by the	32991
department of health on the basis of documentation provided by the	32992
facility.	32993

(I) Any fine imposed by the department of ~~job and family~~	32994
~~services~~health care administration or contracting agency under	32995
this section is subject to appeal under Chapter 119. of the	32996
Revised Code. If the facility does not request a hearing under	32997
Chapter 119. of the Revised Code and either pays or agrees in	32998
writing to pay the fine when payment becomes due under division	32999
(J) of this section, the department or agency shall reduce the	33000
fine by fifty per cent. The department or agency may compromise	33001
any claim for payment of a fine under sections ~~5111.35~~5164.50 to	33002
~~5111.62~~5164.78 of the Revised Code.	33003

(J) The department of ~~job and family services~~health care	33004
administration or contracting agency shall collect interest on	33005
fines, at the rate per calendar month that equals one-twelfth of	33006
the rate per year prescribed by section 5703.47 of the Revised	33007
Code for the calendar year that includes the month for which the	33008
interest charge accrues. Payment of a fine is due, and interest	33009
begins to accrue on the unpaid fine or balance, on the	33010
thirty-first day after the department or agency issues a final	33011
adjudication order imposing the fine. If the deficiency or	33012
deficiencies on which the fine is based have not been corrected	33013
when the final adjudication order is issued, the payment is due,	33014
and interest begins to accrue on the unpaid fine or balance, on	33015
the thirty-first day after the deficiency or deficiencies are	33016
corrected and the department or agency mails a notice specifying	33017
the amount of the fine to the facility.	33018

(K) The department of ~~job and family services~~health care	33019
administration or contracting agency shall collect fines and	33020
interest imposed under this section through one of the following	33021
means:	33022

(1) A lump sum payment from the provider;

33023

(2) Periodic payments for a period not to exceed twelve	33024
months, in accordance with a schedule approved by the department	33025
or agency;	33026

(3) Appropriately reducing the amounts of payments made to	33027
the facility for care provided to medicaid eligible residents for	33028
a period not to exceed twelve months following the date on which	33029
payment of the fine becomes due under division (J) of this	33030
section. An amount equal to the amount by which each payment is	33031
reduced shall be deposited to the credit of the residents	33032
protection fund in accordance with section ~~5111.62~~5164.78 of the	33033
Revised Code.	33034

~~Sec. 5111.57.~~ Sec. 5164.73. (A) The department of ~~job and family~~	33035
~~services~~health care administration or a contracting agency shall	33036
issue an order denying payment to a nursing facility for all	33037
medicaid eligible residents admitted to the facility on or after	33038
the effective date of the order, if the facility has failed to	33039
substantially correct within ninety days after the exit interview	33040
a deficiency or cluster of deficiencies in accordance with the	33041
plan of correction it submitted under section ~~5111.43~~5164.59 of	33042
the Revised Code, as determined by the department of health on the	33043
basis of a follow-up survey.	33044

(B) The department of ~~job and family services~~health care	33045
administration or contracting agency shall issue an order denying	33046
payment to a nursing facility for all medicaid eligible residents	33047
admitted to the facility on or after the effective date of the	33048
order, if during three consecutive standard surveys conducted	33049
after December 13, 1990, the department of health has found a	33050
condition of substandard care in a facility.	33051

(C) An order issued under division (A) or (B) of this section	33052
shall take effect on the later of the date the facility receives	33053
the order or the date the public notice required under division	33054
(F) of section ~~5111.55~~5164.71 of the Revised Code is published.	33055
The order is subject to appeal under Chapter 119. of the Revised	33056
Code; however the order may take effect prior to or during the	33057
pendency of any hearing under that chapter. In that case, the	33058
department or agency shall provide the facility an opportunity for	33059
a hearing in accordance with section ~~5111.60~~5164.76 of the	33060
Revised Code.	33061

~~Sec. 5111.58.~~ Sec. 5164.74. (A) If a nursing facility notifies the	33062
department of ~~job and family services~~health care administration	33063
or a contracting agency, at any time during the six-month period	33064
following the exit interview of a survey that was the basis for	33065
citing a deficiency or deficiencies, that the deficiency or	33066
deficiencies have been substantially corrected in accordance with	33067
the plan of correction submitted and approved under section	33068
~~5111.43~~5164.59 of the Revised Code, the department of health	33069
shall conduct a follow-up survey to determine whether the	33070
deficiency or deficiencies have been substantially corrected in	33071
accordance with the plan.	33072

(B) The department of ~~job and family services~~health care	33073
administration or a contracting agency shall terminate a nursing	33074
facility's participation in the ~~medical assistance~~medicaid	33075
program whenever the facility has not substantially corrected,	33076
within six months after the exit interview of the survey on the	33077
basis of which it was cited, a deficiency or deficiencies in	33078
accordance with the plan of correction submitted under section	33079
~~5111.43~~5164.59 of the Revised Code, as determined by the	33080
department of health on the basis of a follow-up survey.	33081

(C) Unless the facility has substantially corrected the	33082
deficiency or deficiencies in accordance with the plan of	33083
correction, as determined by the department of health on the basis	33084
of a follow-up survey, the department of ~~job and family services~~	33085
health care administration or contracting agency shall deliver to	33086
the facility, at least thirty days prior to the day that is six	33087
months after the exit interview, a written order terminating the	33088
facility's participation in the ~~medical assistance~~medicaid	33089
program. The order shall take effect and the facility's	33090
participation shall terminate on the day that is six months after	33091
the exit interview. The order shall not take effect if, after it	33092
is delivered to the facility and prior to the effective date of	33093
the order, the department of health determines on the basis of a	33094
follow-up survey that the facility has corrected the deficiency or	33095
deficiencies.	33096

An order issued under this section is subject to appeal under	33097
Chapter 119. of the Revised Code; however, the order may take	33098
effect prior to or during the pendency of any hearing under that	33099
chapter. In that case, the department of ~~job and family services~~	33100
health care administration or contracting agency shall provide the	33101
facility an opportunity for a hearing in accordance with section	33102
~~5111.60~~5164.76 of the Revised Code.	33103

(D) Except as provided in division (E) of this section,	33104
whenever the department of ~~job and family services~~health care	33105
administration or a contracting agency terminates a facility's	33106
participation in the ~~medical assistance~~medicaid program pursuant	33107
to this section, the provider shall repay the department the	33108
federal share of all payments made by the department to the	33109
facility under the ~~medical assistance~~medicaid program during the	33110
six-month period following the exit interview of the survey that	33111
was the basis for citing the deficiency or cluster of	33112
deficiencies. The provider shall repay the department within	33113
thirty days after the department repays to the federal government	33114
the federal share of payments made to the facility during that	33115
six-month period.	33116

(E) A provider is not required to repay the department of ~~job~~	33117
~~and family services~~health care administration if either of the	33118
following is the case:	33119

(1) The facility has brought an appeal under Chapter 119. of	33120
the Revised Code of termination of its participation in the	33121
~~medical assistance~~medicaid program, except that the provider	33122
shall repay the department of ~~job and family services~~health care	33123
administration within thirty days after the facility exhausts its	33124
right to appeal under that chapter.	33125

(2) The facility complied with the plan of correction	33126
approved by the department of health and the obligation to repay	33127
resulted from the department's failure to provide timely	33128
verification to the United States department of health and human	33129
services of the facility's compliance with the plan of correction.	33130

(F) If a provider's obligation to repay the department of ~~job~~	33131
~~and family services~~health care administration under division (D)	33132
of this section results from disallowance of federal financial	33133
participation by the United States department of health and human	33134
services, the provider shall not be required to repay the	33135
department of ~~job and family services~~health care administration	33136
until the federal disallowance becomes final.	33137

(G) Any fines paid under sections ~~5111.35~~5164.50 to ~~5111.62~~	33138
5164.78 of the Revised Code during any period for which the	33139
facility is required to repay the department of ~~job and family~~	33140
~~services~~health care administration under division (D) of this	33141
section shall be offset against the amount the provider is	33142
required to repay the department for that period.	33143

(H) Prior to a change of ownership of a facility for which a	33144
provider has an obligation to repay the department of ~~job and~~	33145
~~family services~~health care administration under division (D) of	33146
this section that has not become final, or has become final but	33147
not been paid, the department may do one or more of the following:	33148

(1) Require the provider to place money in escrow, or obtain	33149
a bond, in sufficient amount to indemnify the state against the	33150
provider's failure to repay the department after the change of	33151
ownership occurs;	33152

(2) Place a lien on the facility's real property;

33153

(3) Use any method to recover the payments that is available	33154
to the attorney general to recover payments on behalf of the	33155
department of ~~job and family services~~health care administration.	33156

~~Sec. 5111.59.~~ Sec. 5164.75. The department of ~~job and family~~	33157
~~services~~health care administration, the department of health, and	33158
any contracting agency shall deliver a written notice, statement,	33159
or order to a nursing facility under sections ~~5111.35~~5164.50 to	33160
~~5111.41~~5164.56 and ~~5111.43~~5164.59 to ~~5111.62~~5164.78 of the	33161
Revised Code by certified mail or hand delivery. If the notice,	33162
statement, or order is mailed, it shall be addressed to the	33163
administrator of the facility as indicated in the department's or	33164
agency's records. If it is hand delivered, it shall be delivered	33165
to a person at the facility who would appear to the average	33166
prudent person to have authority to accept it.	33167

Delivery of written notice by a nursing facility to the	33168
department of health, the department of ~~job and family services~~	33169
health care administration, or a contracting agency under sections	33170
~~5111.35~~5164.50 to ~~5111.62~~5164.78 of the Revised Code shall be by	33171
certified mail or hand delivery to the appropriate department or	33172
the agency.	33173

~~Sec. 5111.60.~~ Sec. 5164.76. (A) Except as provided in division (B)	33174
of this section, the following remedies are subject to appeal	33175
under Chapter 119. of the Revised Code:	33176

(1) An order issued under section ~~5111.45~~5164.61, ~~5111.46~~	33177
5164.62, ~~5111.51~~5164.67, or ~~5111.58~~5164.74 of the Revised Code	33178
terminating a nursing facility's participation in the ~~medical~~	33179
~~assistance~~medicaid program;	33180

(2) Appointment of a temporary manager of a facility under	33181
division (A)(1)(b) or (2)(b) of section ~~5111.46~~5164.62, or	33182
division (A)(1)(d) of section ~~5111.51~~5164.67 of the Revised Code;	33183

(3) An order issued under section ~~5111.46~~5164.62, ~~5111.47~~	33184
5164.63, ~~5111.48~~5164.64, ~~5111.51~~5164.67, or ~~5111.57~~5164.73 of	33185
the Revised Code denying payment to a facility under the ~~medical~~	33186
~~assistance~~medicaid program for all medicaid eligible residents	33187
admitted after the effective date of the order;	33188

(4) An order issued under section ~~5111.46~~5164.62, ~~5111.47~~	33189
5164.63, or ~~5111.48~~5164.64 of the Revised Code denying payment to	33190
a facility under the ~~medical assistance~~medicaid program for	33191
medicaid eligible residents admitted after the effective date of	33192
the order who have certain diagnoses or special care needs	33193
specified by the department or agency;	33194

(5) A fine imposed under section ~~5111.46~~5164.62, ~~5111.47~~	33195
5164.63, or ~~5111.48~~5164.64 of the Revised Code.	33196

(B) The department of ~~job and family services~~health care	33197
administration or contracting agency may do any of the following	33198
prior to or during the pendency of any proceeding under Chapter	33199
119. of the Revised Code:	33200

(1) Issue and execute an order under section ~~5111.46~~5164.62,	33201
~~5111.51~~5164.67, or ~~5111.58~~5164.74 of the Revised Code	33202
terminating a nursing facility's participation in the ~~medical~~	33203
~~assistance~~medicaid program;	33204

(2) Appoint a temporary manager under division (A)(1)(b) or	33205
(2)(b) of section ~~5111.46~~5164.62 or division (A)(1)(d) of section	33206
~~5111.51~~5164.67 of the Revised Code;	33207

(3) Issue and execute an order under section ~~5111.46~~5164.62,	33208
~~5111.47~~5164.63, ~~5111.51~~5164.67, or ~~5111.57~~5164.73 of the	33209
Revised Code denying payment to a facility for all medicaid	33210
eligible residents admitted after the effective date of the order;	33211

(4) Issue and execute an order under section ~~5111.46~~5164.62	33212
or ~~5111.47~~5164.63 or division (A), (B), or (C) of section ~~5111.48~~	33213
5164.64 of the Revised Code denying payment to a facility for	33214
medicaid eligible residents admitted after the effective date of	33215
the order who have specified diagnoses or special care needs.	33216

(C) Whenever the department or agency imposes a remedy listed	33217
in division (B) of this section prior to or during the pendency of	33218
a proceeding, all of the following apply:	33219

(1) The provider against whom the action is taken shall have	33220
ten days after the date the facility actually receives the notice	33221
specified in section 119.07 of the Revised Code to request a	33222
hearing.	33223

(2) The hearing shall commence within thirty days after the	33224
date the department or agency receives the provider's request for	33225
a hearing.	33226

(3) The hearing shall continue uninterrupted from day to day,	33227
except for Saturdays, Sundays, and legal holidays, unless other	33228
interruptions are agreed to by the provider and the department or	33229
agency.	33230

(4) If the hearing is conducted by a hearing examiner, the	33231
hearing examiner shall file a report and recommendations within	33232
ten days after the close of the hearing.	33233

(5) The provider shall have five days after the date the	33234
hearing officer files the report and recommendations within which	33235
to file objections to the report and recommendations.	33236

(6) Not later than fifteen days after the date the hearing	33237
officer files the report and recommendations, the director of ~~job~~	33238
~~and family services~~health care administration or the director of	33239
the contracting agency shall issue an order approving, modifying,	33240
or disapproving the report and recommendations of the hearing	33241
examiner.	33242

(D) If the department or agency imposes more than one remedy	33243
as the result of deficiencies cited in a single survey, the	33244
proceedings for all of the remedies shall be consolidated. If any	33245
of the remedies are imposed during the pendency of a hearing, as	33246
permitted by division (B) of this section, the consolidated	33247
hearing shall be conducted in accordance with division (C) of this	33248
section. The consolidation of the remedies for purposes of a	33249
hearing does not affect the effective dates prescribed in sections	33250
~~5111.35~~5164.50 to ~~5111.58~~5164.74 of the Revised Code.	33251

(E) If a contracting agency conducts administrative	33252
proceedings pertaining to remedies imposed under sections ~~5111.35~~	33253
5164.50 to ~~5111.62~~5164.78 of the Revised Code, the department of	33254
~~job and family services~~health care administration shall not be	33255
considered a party to the proceedings.	33256

~~Sec. 5111.61.~~ Sec. 5164.77. (A)(1) Except as required by court	33257
order, as necessary for the administration or enforcement of any	33258
statute relating to nursing facilities, or as provided in division	33259
(C) of this section, the department of ~~job and family services~~	33260
health care administration and any contracting agency shall not	33261
release any of the following information without the permission of	33262
the individual or the individual's legal representative:	33263

(a) The identity of any resident of a nursing facility;

33264

(b) The identity of any individual who submits a complaint	33265
about a nursing facility;	33266

(c) The identity of any individual who provides the	33267
department or agency with information about a nursing facility and	33268
has requested confidentiality;	33269

(d) Any information that reasonably would tend to disclose	33270
the identity of any individual described in division (A)(1)(a) to	33271
(c) of this section.	33272

(2) An agency or individual to whom the department or	33273
contracting agency is required, by court order or for the	33274
administration or enforcement of a statute relating to nursing	33275
facilities, to release information described in division (A)(1) of	33276
this section shall not release the information without the	33277
permission of the individual who would be or would reasonably tend	33278
to be identified, or of the individual's legal representative,	33279
unless the agency or individual is required to release it by	33280
division (C) of this section, by court order, or for the	33281
administration or enforcement of a statute relating to nursing	33282
facilities.	33283

(B) Except as provided in division (C) of this section, any	33284
record that identifies an individual described in division (A)(1)	33285
of this section or that reasonably would tend to identify such an	33286
individual is not a public record for the purposes of section	33287
149.43 of the Revised Code, and is not subject to inspection and	33288
copying under section 1347.08 of the Revised Code.	33289

(C) If the department or a contracting agency, or an agency	33290
or individual to whom the department or contracting agency was	33291
required by court order or for administration or enforcement of a	33292
statute relating to nursing facilities to release information	33293
described in division (A)(1) of this section, uses information in	33294
any administrative or judicial proceeding against a facility that	33295
reasonably would tend to identify an individual described in	33296
division (A)(1) of this section, the department, agency, or	33297
individual shall disclose that information to the facility.	33298
However, the department, agency, or individual shall not disclose	33299
information that directly identifies an individual described in	33300
divisions (A)(1)(a) to (c) of this section, unless the individual	33301
is to testify in the proceedings.	33302

(D) No person shall knowingly register a false complaint	33303
about a nursing facility with the department or a contracting	33304
agency, or knowingly swear or affirm the truth of a false	33305
complaint, when the allegation is made for the purpose of	33306
incriminating another.	33307

~~Sec. 5111.62.~~ Sec. 5164.78. The proceeds of all fines, including	33308
interest, collected under sections ~~5111.35~~5164.50 to ~~5111.62~~	33309
5164.78 of the Revised Code shall be deposited in the state	33310
treasury to the credit of the residents protection fund, which is	33311
hereby created. The proceeds of all fines, including interest,	33312
collected under section 173.42 of the Revised Code shall be	33313
deposited in the state treasury to the credit of the residents	33314
protection fund.	33315

Moneys in the fund shall be used for the protection of the	33316
health or property of residents of nursing facilities in which the	33317
department of health finds deficiencies, including payment for the	33318
costs of relocation of residents to other facilities, maintenance	33319
of operation of a facility pending correction of deficiencies or	33320
closure, and reimbursement of residents for the loss of money	33321
managed by the facility under section 3721.15 of the Revised Code.	33322

The fund shall be maintained and administered by the	33323
department of ~~job and family services~~health care administration	33324
under rules developed in consultation with the departments of	33325
health and aging and adopted by the director of ~~job and family~~	33326
~~services~~health care administration under Chapter 119. of the	33327
Revised Code.	33328

~~Sec. 5111.63.~~ Sec. 5164.79. For the purposes of this section,	33329
"facility," ~~"medicare," and "medicaid" have~~has the same ~~meanings~~	33330
meaning as in section 3721.10 of the Revised Code.	33331

The department of health shall be the designee of the	33332
department of ~~job and family services~~health care administration	33333
for the purpose of conducting a hearing pursuant to section	33334
3721.162 of the Revised Code concerning a facility's decision to	33335
transfer or discharge a resident if the resident is a medicaid	33336
recipient or medicare beneficiary.	33337

~~Sec. 5111.65.~~ Sec. 5164.82. As used in sections ~~5111.65~~5164.82 to	33338
~~5111.688~~5164.858 of the Revised Code:	33339

(A) "Change of operator" means an entering operator becoming	33340
the operator of a nursing facility or intermediate care facility	33341
for the mentally retarded in the place of the exiting operator.	33342

(1) Actions that constitute a change of operator include the	33343
following:	33344

(a) A change in an exiting operator's form of legal	33345
organization, including the formation of a partnership or	33346
corporation from a sole proprietorship;	33347

(b) A transfer of all the exiting operator's ownership	33348
interest in the operation of the facility to the entering	33349
operator, regardless of whether ownership of any or all of the	33350
real property or personal property associated with the facility is	33351
also transferred;	33352

(c) A lease of the facility to the entering operator or the	33353
exiting operator's termination of the exiting operator's lease;	33354

(d) If the exiting operator is a partnership, dissolution of	33355
the partnership;	33356

(e) If the exiting operator is a partnership, a change in	33357
composition of the partnership unless both of the following apply:	33358

(i) The change in composition does not cause the	33359
partnership's dissolution under state law.	33360

(ii) The partners agree that the change in composition does	33361
not constitute a change in operator.	33362

(f) If the operator is a corporation, dissolution of the	33363
corporation, a merger of the corporation into another corporation	33364
that is the survivor of the merger, or a consolidation of one or	33365
more other corporations to form a new corporation.	33366

(2) The following, alone, do not constitute a change of	33367
operator:	33368

(a) A contract for an entity to manage a nursing facility or	33369
intermediate care facility for the mentally retarded as the	33370
operator's agent, subject to the operator's approval of daily	33371
operating and management decisions;	33372

(b) A change of ownership, lease, or termination of a lease	33373
of real property or personal property associated with a nursing	33374
facility or intermediate care facility for the mentally retarded	33375
if an entering operator does not become the operator in place of	33376
an exiting operator;	33377

(c) If the operator is a corporation, a change of one or more	33378
members of the corporation's governing body or transfer of	33379
ownership of one or more shares of the corporation's stock, if the	33380
same corporation continues to be the operator.	33381

(B) "Effective date of a change of operator" means the day	33382
the entering operator becomes the operator of the nursing facility	33383
or intermediate care facility for the mentally retarded.	33384

(C) "Effective date of a facility closure" means the last day	33385
that the last of the residents of the nursing facility or	33386
intermediate care facility for the mentally retarded resides in	33387
the facility.	33388

(D) "Effective date of a voluntary termination" means the	33389
day the intermediate care facility for the mentally retarded	33390
ceases to accept medicaid patients.	33391

(E) "Effective date of a voluntary withdrawal of	33392
participation" means the day the nursing facility ceases to accept	33393
new medicaid patients other than the individuals who reside in the	33394
nursing facility on the day before the effective date of the	33395
voluntary withdrawal of participation.	33396

(F) "Entering operator" means the person or government entity	33397
that will become the operator of a nursing facility or	33398
intermediate care facility for the mentally retarded when a change	33399
of operator occurs.	33400

(G) "Exiting operator" means any of the following:

33401

(1) An operator that will cease to be the operator of a	33402
nursing facility or intermediate care facility for the mentally	33403
retarded on the effective date of a change of operator;	33404

(2) An operator that will cease to be the operator of a	33405
nursing facility or intermediate care facility for the mentally	33406
retarded on the effective date of a facility closure;	33407

(3) An operator of an intermediate care facility for the	33408
mentally retarded that is undergoing or has undergone a voluntary	33409
termination;	33410

(4) An operator of a nursing facility that is undergoing or	33411
has undergone a voluntary withdrawal of participation.	33412

(H)(1) "Facility closure" means discontinuance of the use of	33413
the building, or part of the building, that houses the facility as	33414
a nursing facility or intermediate care facility for the mentally	33415
retarded that results in the relocation of all of the facility's	33416
residents. A facility closure occurs regardless of any of the	33417
following:	33418

(a) The operator completely or partially replacing the	33419
facility by constructing a new facility or transferring the	33420
facility's license to another facility;	33421

(b) The facility's residents relocating to another of the	33422
operator's facilities;	33423

(c) Any action the department of health takes regarding the	33424
facility's certification ~~under Title XIX of the "Social Security~~	33425
~~Act," 79 Stat. 286 (1965), 42 U.S.C. 1396, as amended,~~for	33426
participation in the medicaid program that may result in the	33427
transfer of part of the facility's survey findings to another of	33428
the operator's facilities;	33429

(d) Any action the department of health takes regarding the	33430
facility's license under Chapter 3721. of the Revised Code;	33431

(e) Any action the department of mental retardation and	33432
developmental disabilities takes regarding the facility's license	33433
under section 5123.19 of the Revised Code.	33434

(2) A facility closure does not occur if all of the	33435
facility's residents are relocated due to an emergency evacuation	33436
and one or more of the residents return to a medicaid-certified	33437
bed in the facility not later than thirty days after the	33438
evacuation occurs.	33439

(I) "Fiscal year," "intermediate care facility for the	33440
mentally retarded," "nursing facility," "operator," "owner," and	33441
"provider agreement" have the same meanings as in section ~~5111.20~~	33442
5164.01 of the Revised Code.	33443

(J) "Voluntary termination" means an operator's voluntary	33444
election to terminate the participation of an intermediate care	33445
facility for the mentally retarded in the medicaid program but to	33446
continue to provide service of the type provided by a residential	33447
facility as defined in section 5123.19 of the Revised Code.	33448

(K) "Voluntary withdrawal of participation" means an	33449
operator's voluntary election to terminate the participation of a	33450
nursing facility in the medicaid program but to continue to	33451
provide service of the type provided by a nursing facility.	33452

~~Sec. 5111.651.~~ Sec. 5164.821. Sections ~~5111.65~~5164.82 to ~~5111.688~~	33453
5164.858 of the Revised Code do not apply to a nursing facility or	33454
intermediate care facility for the mentally retarded that	33455
undergoes a facility closure, voluntary termination, voluntary	33456
withdrawal of participation, or change of operator on or before	33457
September 30, 2005, if the exiting operator provided written	33458
notice of the facility closure, voluntary termination, voluntary	33459
withdrawal of participation, or change of operator to the	33460
department of job and family services on or before June 30, 2005.	33461

~~Sec. 5111.66.~~ Sec. 5164.83. An exiting operator or owner of a	33462
nursing facility or intermediate care facility for the mentally	33463
retarded participating in the medicaid program shall provide the	33464
department of ~~job and family services~~health care administration	33465
written notice of a facility closure, voluntary termination, or	33466
voluntary withdrawal of participation not less than ninety days	33467
before the effective date of the facility closure, voluntary	33468
termination, or voluntary withdrawal of participation. The written	33469
notice shall include all of the following:	33470

(A) The name of the exiting operator and, if any, the exiting	33471
operator's authorized agent;	33472

(B) The name of the nursing facility or intermediate care	33473
facility for the mentally retarded that is the subject of the	33474
written notice;	33475

(C) The exiting operator's medicaid provider agreement number	33476
for the facility that is the subject of the written notice;	33477

(D) The effective date of the facility closure, voluntary	33478
termination, or voluntary withdrawal of participation;	33479

(E) The signature of the exiting operator's or owner's	33480
representative.	33481

~~Sec. 5111.67.~~ Sec. 5164.84. (A) An exiting operator or owner and	33482
entering operator shall provide the department of ~~job and family~~	33483
~~services~~health care administration written notice of a change of	33484
operator if the nursing facility or intermediate care facility for	33485
the mentally retarded participates in the medicaid program and the	33486
entering operator seeks to continue the facility's participation.	33487
The written notice shall be provided to the department not later	33488
than forty-five days before the effective date of the change of	33489
operator if the change of operator does not entail the relocation	33490
of residents. The written notice shall be provided to the	33491
department not later than ninety days before the effective date of	33492
the change of operator if the change of operator entails the	33493
relocation of residents. The written notice shall include all of	33494
the following:	33495

(1) The name of the exiting operator and, if any, the exiting	33496
operator's authorized agent;	33497

(2) The name of the nursing facility or intermediate care	33498
facility for the mentally retarded that is the subject of the	33499
change of operator;	33500

(3) The exiting operator's medicaid provider agreement number	33501
for the facility that is the subject of the change of operator;	33502

(4) The name of the entering operator;

33503

(5) The effective date of the change of operator;

33504

(6) The manner in which the entering operator becomes the	33505
facility's operator, including through sale, lease, merger, or	33506
other action;	33507

(7) If the manner in which the entering operator becomes the	33508
facility's operator involves more than one step, a description of	33509
each step;	33510

(8) Written authorization from the exiting operator or owner	33511
and entering operator for the department to process a provider	33512
agreement for the entering operator;	33513

(9) The signature of the exiting operator's or owner's	33514
representative.	33515

(B) The entering operator shall include a completed	33516
application for a provider agreement with the written notice to	33517
the department. The entering operator shall attach to the	33518
application the following:	33519

(1) If the written notice is provided to the department	33520
before the date the exiting operator or owner and entering	33521
operator complete the transaction for the change of operator, all	33522
the proposed leases, management agreements, merger agreements and	33523
supporting documents, and sales contracts and supporting documents	33524
relating to the facility's change of operator;	33525

(2) If the written notice is provided to the department on or	33526
after the date the exiting operator or owner and entering operator	33527
complete the transaction for the change of operator, copies of all	33528
the executed leases, management agreements, merger agreements and	33529
supporting documents, and sales contracts and supporting documents	33530
relating to the facility's change of operator.	33531

~~Sec. 5111.671.~~ Sec. 5164.841. The department of ~~job and family~~	33532
~~services~~health care administration may enter into a provider	33533
agreement with an entering operator that goes into effect at 12:01	33534
a.m. on the effective date of the change of operator if all of the	33535
following requirements are met:	33536

(A) The department receives a properly completed written	33537
notice required by section ~~5111.67~~5164.84 of the Revised Code on	33538
or before the date required by that section.	33539

(B) The entering operator furnishes to the department copies	33540
of all the fully executed leases, management agreements, merger	33541
agreements and supporting documents, and sales contracts and	33542
supporting documents relating to the change of operator not later	33543
than ten days after the effective date of the change of operator.	33544

(C) The entering operator is eligible for medicaid payments	33545
as provided in section ~~5111.21~~5164.02 of the Revised Code.	33546

~~Sec. 5111.672.~~ Sec. 5164.842. (A) The department of ~~job and family~~	33547
~~services~~health care administration may enter into a provider	33548
agreement with an entering operator that goes into effect at 12:01	33549
a.m. on the date determined under division (B) of this section if	33550
all of the following are the case:	33551

(1) The department receives a properly completed written	33552
notice required by section ~~5111.67~~5164.84 of the Revised Code.	33553

(2) The entering operator furnishes to the department copies	33554
of all the fully executed leases, management agreements, merger	33555
agreements and supporting documents, and sales contracts and	33556
supporting documents relating to the change of operator.	33557

(3) The requirement of division (A)(1) of this section is met	33558
after the time required by section ~~5111.67~~5164.84 of the Revised	33559
Code, the requirement of division (A)(2) of this section is met	33560
more than ten days after the effective date of the change of	33561
operator, or both.	33562

(4) The entering operator is eligible for medicaid payments	33563
as provided in section ~~5111.21~~5164.02 of the Revised Code.	33564

(B) The department shall determine the date a provider	33565
agreement entered into under this section is to go into effect as	33566
follows:	33567

(1) The effective date shall give the department sufficient	33568
time to process the change of operator, assure no duplicate	33569
payments are made, make the withholding required by section	33570
~~5111.681~~5164.851 of the Revised Code, and withhold the final	33571
payment to the exiting operator until one hundred eighty days	33572
after either of the following:	33573

(a) The date that the exiting operator submits to the	33574
department a properly completed cost report under section ~~5111.682~~	33575
5164.852 of the Revised Code;	33576

(b) The date that the department waives the cost report	33577
requirement of section ~~5111.682~~5164.852 of the Revised Code.	33578

(2) The effective date shall be not earlier than the later of	33579
the effective date of the change of operator or the date that the	33580
exiting operator or owner and entering operator comply with	33581
section ~~5111.67~~5164.84 of the Revised Code.	33582

(3) The effective date shall be not later than the following	33583
after the later of the dates specified in division (B)(2) of this	33584
section:	33585

(a) Forty-five days if the change of operator does not entail	33586
the relocation of residents;	33587

(b) Ninety days if the change of operator entails the	33588
relocation of residents.	33589

~~Sec. 5111.673.~~ Sec. 5164.843. A provider that enters into a	33590
provider agreement with the department of ~~job and family services~~	33591
health care administration under section ~~5111.671~~5164.841 or	33592
~~5111.672~~5164.842 of the Revised Code shall do all of the	33593
following:	33594

(A) Comply with all applicable federal statutes and	33595
regulations;	33596

(B) Comply with section ~~5111.22~~5164.03 of the Revised Code	33597
and all other applicable state statutes and rules;	33598

(C) Comply with all the terms and conditions of the exiting	33599
operator's provider agreement, including, but not limited to, all	33600
of the following:	33601

(1) Any plan of correction;

33602

(2) Compliance with health and safety standards;

33603

(3) Compliance with the ownership and financial interest	33604
disclosure requirements of 42 C.F.R. 455.104, 455.105, and 1002.3;	33605

(4) Compliance with the civil rights requirements of 45	33606
C.F.R. parts 80, 84, and 90;	33607

(5) Compliance with additional requirements imposed by the	33608
department;	33609

(6) Any sanctions relating to remedies for violation of the	33610
provider agreement, including deficiencies, compliance periods,	33611
accountability periods, monetary penalties, notification for	33612
correction of contract violations, and history of deficiencies.	33613

~~Sec. 5111.674.~~ Sec. 5164.844. In the case of a change of operator,	33614
the exiting operator shall be considered to be the operator of the	33615
nursing facility or intermediate care facility for the mentally	33616
retarded for purposes of the medicaid program, including medicaid	33617
payments, until the effective date of the entering operator's	33618
provider agreement if the provider agreement is entered into under	33619
section ~~5111.671~~5164.841 or ~~5111.672~~5164.842 of the Revised	33620
Code.	33621

~~Sec. 5111.675.~~ Sec. 5164.845. The department of ~~job and family~~	33622
~~services~~health care administration may enter into a provider	33623
agreement as provided in section ~~5111.22~~5164.03 of the Revised	33624
Code, rather than section ~~5111.671~~5164.841 or ~~5111.672~~5164.842	33625
of the Revised Code, with an entering operator if the entering	33626
operator does not agree to a provider agreement that satisfies the	33627
requirements of division (C) of section ~~5111.673~~5164.843 of the	33628
Revised Code. The department may not enter into the provider	33629
agreement unless the department of health certifies the nursing	33630
facility or intermediate care facility for the mentally retarded	33631
~~under Title XIX of the "Social Security Act," 79 Stat. 286 (1965),~~	33632
~~42 U.S.C. 1396, as amended~~for participation in the medicaid	33633
program. The effective date of the provider agreement shall not	33634
precede any of the following:	33635

(A) The date that the department of health certifies the	33636
facility;	33637

(B) The effective date of the change of operator;

33638

(C) The date the requirement of section ~~5111.67~~5164.84 of	33639
the Revised Code is satisfied.	33640

~~Sec. 5111.676.~~ Sec. 5164.846. The director of ~~job and family~~	33641
~~services~~health care administration may adopt rules in accordance	33642
with Chapter 119. of the Revised Code governing adjustments to the	33643
medicaid reimbursement rate for a nursing facility or intermediate	33644
care facility for the mentally retarded that undergoes a change of	33645
operator. No rate adjustment resulting from a change of operator	33646
shall be effective before the effective date of the entering	33647
operator's provider agreement. This is the case regardless of	33648
whether the provider agreement is entered into under section	33649
~~5111.671~~5164.841, section ~~5111.672~~5164.842, or, pursuant to	33650
section ~~5111.675~~5164.845, section ~~5111.22~~5164.03 of the Revised	33651
Code.	33652

~~Sec. 5111.677.~~ Sec. 5164.847. Neither of the following shall affect	33653
the department of ~~job and family services'~~health care	33654
administration's determination of whether or when a change of	33655
operator occurs or the effective date of an entering operator's	33656
provider agreement under section ~~5111.671~~5164.841, section	33657
~~5111.672~~5164.842, or, pursuant to section ~~5111.675~~5164.845,	33658
section ~~5111.22~~5164.03 of the Revised Code:	33659

(A) The department of health's determination that a change of	33660
operator has or has not occurred for purposes of licensure under	33661
Chapter 3721. of the Revised Code;	33662

(B) The department of mental retardation and developmental	33663
disabilities' determination that a change of operator has or has	33664
not occurred for purposes of licensure under section 5123.19 of	33665
the Revised Code.	33666

~~Sec. 5111.68.~~ Sec. 5164.85. (A) On receipt of a written notice	33667
under section ~~5111.66~~5164.83 of the Revised Code of a facility	33668
closure, voluntary termination, or voluntary withdrawal of	33669
participation or a written notice under section ~~5111.67~~5164.84 of	33670
the Revised Code of a change of operator, the department of ~~job~~	33671
~~and family services~~health care administration shall determine the	33672
amount of any overpayments made under the medicaid program to the	33673
exiting operator, including overpayments the exiting operator	33674
disputes, and other actual and potential debts the exiting	33675
operator owes or may owe to the department and United States	33676
centers for medicare and medicaid services under the medicaid	33677
program. In determining the exiting operator's other actual and	33678
potential debts to the department under the medicaid program, the	33679
department shall include all of the following that the department	33680
determines is applicable:	33681

(1) Refunds due the department under section ~~5111.27~~5164.38	33682
of the Revised Code;	33683

(2) Interest owed to the department and United States centers	33684
for medicare and medicaid services;	33685

(3) Final civil monetary and other penalties for which all	33686
right of appeal has been exhausted;	33687

(4) Money owed the department and United States centers for	33688
medicare and medicaid services from any outstanding final fiscal	33689
audit, including a final fiscal audit for the last fiscal year or	33690
portion thereof in which the exiting operator participated in the	33691
medicaid program.	33692

(B) If the department is unable to determine the amount of	33693
the overpayments and other debts for any period before the	33694
effective date of the entering operator's provider agreement or	33695
the effective date of the facility closure, voluntary termination,	33696
or voluntary withdrawal of participation, the department shall	33697
make a reasonable estimate of the overpayments and other debts for	33698
the period. The department shall make the estimate using	33699
information available to the department, including prior	33700
determinations of overpayments and other debts.	33701

~~Sec. 5111.681.~~ Sec. 5164.851. (A) Except as provided in division	33702
(B) of this section, the department of ~~job and family services~~	33703
health care administration shall withhold the greater of the	33704
following from payment due an exiting operator under the medicaid	33705
program:	33706

(1) The total amount of any overpayments made under the	33707
medicaid program to the exiting operator, including overpayments	33708
the exiting operator disputes, and other actual and potential	33709
debts, including any unpaid penalties, the exiting operator owes	33710
or may owe to the department and United States centers for	33711
medicare and medicaid services under the medicaid program;	33712

(2) An amount equal to the average amount of monthly payments	33713
to the exiting operator under the medicaid program for the	33714
twelve-month period immediately preceding the month that includes	33715
the last day the exiting operator's provider agreement is in	33716
effect or, in the case of a voluntary withdrawal of participation,	33717
the effective date of the voluntary withdrawal of participation.	33718

(B) The department may choose not to make the withholding	33719
under division (A) of this section if an entering operator does	33720
both of the following:	33721

(1) Enters into a nontransferable, unconditional, written	33722
agreement with the department to pay the department any debt the	33723
exiting operator owes the department under the medicaid program;	33724

(2) Provides the department a copy of the entering operator's	33725
balance sheet that assists the department in determining whether	33726
to make the withholding under division (A) of this section.	33727

~~Sec. 5111.682.~~ Sec. 5164.852. (A) Except as provided in division	33728
(B) of this section, an exiting operator shall file with the	33729
department of ~~job and family services~~health care administration a	33730
cost report not later than ninety days after the last day the	33731
exiting operator's provider agreement is in effect or, in the case	33732
of a voluntary withdrawal of participation, the effective date of	33733
the voluntary withdrawal of participation. The cost report shall	33734
cover the period that begins with the day after the last day	33735
covered by the operator's most recent previous cost report	33736
required by section ~~5111.26~~5164.37 of the Revised Code and ends	33737
on the last day the exiting operator's provider agreement is in	33738
effect or, in the case of a voluntary withdrawal of participation,	33739
the effective date of the voluntary withdrawal of participation.	33740
The cost report shall include, as applicable, all of the	33741
following:	33742

(1) The sale price of the nursing facility or intermediate	33743
care facility for the mentally retarded;	33744

(2) A final depreciation schedule that shows which assets are	33745
transferred to the buyer and which assets are not transferred to	33746
the buyer;	33747

(3) Any other information the department requires.

33748

(B) The department, at its sole discretion, may waive the	33749
requirement that an exiting operator file a cost report in	33750
accordance with division (A) of this section.	33751

~~Sec. 5111.683.~~ Sec. 5164.853. If an exiting operator required by	33752
section ~~5111.682~~5164.852 of the Revised Code to file a cost	33753
report with the department of ~~job and family services~~health care	33754
administration fails to file the cost report in accordance with	33755
that section, all payments under the medicaid program for the	33756
period the cost report is required to cover are deemed	33757
overpayments until the date the department receives the properly	33758
completed cost report. The department may impose on the exiting	33759
operator a penalty of one hundred dollars for each calendar day	33760
the properly completed cost report is late.	33761

~~Sec. 5111.684.~~ Sec. 5164.854. The department of ~~job and family~~	33762
~~services~~health care administration may not provide an exiting	33763
operator final payment under the medicaid program until the	33764
department receives all properly completed cost reports the	33765
exiting operator is required to file under sections ~~5111.26~~	33766
5164.37 and ~~5111.682~~5164.852 of the Revised Code.	33767

~~Sec. 5111.685.~~ Sec. 5164.855. The department of ~~job and family~~	33768
~~services~~health care administration shall determine the actual	33769
amount of debt an exiting operator owes the department under the	33770
medicaid program by completing all final fiscal audits not already	33771
completed and performing all other appropriate actions the	33772
department determines to be necessary. The department shall issue	33773
a debt summary report on this matter not later than ninety days	33774
after the date the exiting operator files the properly completed	33775
cost report required by section ~~5111.682~~5164.852 of the Revised	33776
Code with the department or, if the department waives the cost	33777
report requirement for the exiting operator, ninety days after the	33778
date the department waives the cost report requirement. The report	33779
shall include the department's findings and the amount of debt the	33780
department determines the exiting operator owes the department and	33781
United States centers for medicare and medicaid services under the	33782
medicaid program. Only the parts of the report that are subject to	33783
an adjudication as specified in section ~~5111.30~~5164.032 of the	33784
Revised Code are subject to an adjudication conducted in	33785
accordance with Chapter 119. of the Revised Code.	33786

~~Sec. 5111.686.~~ Sec. 5164.856. The department of ~~job and family~~	33787
~~services~~health care administration shall release the actual	33788
amount withheld under division (A) of section ~~5111.681~~5164.851 of	33789
the Revised Code, less any amount the exiting operator owes the	33790
department and United States centers for medicare and medicaid	33791
services under the medicaid program, as follows:	33792

(A) Ninety-one days after the date the exiting operator files	33793
a properly completed cost report required by section ~~5111.682~~	33794
5164.852 of the Revised Code unless the department issues the	33795
report required by section ~~5111.685~~5164.855 of the Revised Code	33796
not later than ninety days after the date the exiting operator	33797
files the properly completed cost report;	33798

(B) Not later than thirty days after the exiting operator	33799
agrees to a final fiscal audit resulting from the report required	33800
by section ~~5111.685~~5164.855 of the Revised Code if the department	33801
issues the report not later than ninety days after the date the	33802
exiting operator files a properly completed cost report required	33803
by section ~~5111.682~~5164.852 of the Revised Code;	33804

(C) Ninety-one days after the date the department waives the	33805
cost report requirement of section ~~5111.682~~5164.852 of the	33806
Revised Code unless the department issues the report required by	33807
section ~~5111.685~~5164.855 of the Revised Code not later than	33808
ninety days after the date the department waives the cost report	33809
requirement;	33810

(D) Not later than thirty days after the exiting operator	33811
agrees to a final fiscal audit resulting from the report required	33812
by section ~~5111.685~~5164.855 of the Revised Code if the department	33813
issues the report not later than ninety days after the date the	33814
department waives the cost report requirement of section ~~5111.682~~	33815
5164.852 of the Revised Code.	33816

~~Sec. 5111.687.~~ Sec. 5164.857. The department of ~~job and family~~	33817
~~services~~health care administration, at its sole discretion, may	33818
release the amount withheld under division (A) of section ~~5111.681~~	33819
5164.851 of the Revised Code if the exiting operator submits to	33820
the department written notice of a postponement of a change of	33821
operator, facility closure, voluntary termination, or voluntary	33822
withdrawal of participation and the transactions leading to the	33823
change of operator, facility closure, voluntary termination, or	33824
voluntary withdrawal of participation are postponed for at least	33825
thirty days but less than ninety days after the date originally	33826
proposed for the change of operator, facility closure, voluntary	33827
termination, or voluntary withdrawal of participation as reported	33828
in the written notice required by section ~~5111.66~~5164.83 or	33829
~~5111.67~~5164.84 of the Revised Code. The department shall release	33830
the amount withheld if the exiting operator submits to the	33831
department written notice of a cancellation or postponement of a	33832
change of operator, facility closure, voluntary termination, or	33833
voluntary withdrawal of participation and the transactions leading	33834
to the change of operator, facility closure, voluntary	33835
termination, or voluntary withdrawal of participation are canceled	33836
or postponed for more than ninety days after the date originally	33837
proposed for the change of operator, facility closure, voluntary	33838
termination, or voluntary withdrawal of participation as reported	33839
in the written notice required by section ~~5111.66~~5164.83 or	33840
~~5111.67~~5164.84 of the Revised Code.	33841

After the department receives a written notice regarding a	33842
cancellation or postponement of a facility closure, voluntary	33843
termination, or voluntary withdrawal of participation, the exiting	33844
operator or owner shall provide new written notice to the	33845
department under section ~~5111.66~~5164.83 of the Revised Code	33846
regarding any transactions leading to a facility closure,	33847
voluntary termination, or voluntary withdrawal of participation at	33848
a future time. After the department receives a written notice	33849
regarding a cancellation or postponement of a change of operator,	33850
the exiting operator or owner and entering operator shall provide	33851
new written notice to the department under section ~~5111.67~~5164.84	33852
of the Revised Code regarding any transactions leading to a change	33853
of operator at a future time.	33854

~~Sec. 5111.688.~~ Sec. 5164.858. The director of ~~job and family~~	33855
~~services~~health care administration may adopt rules under section	33856
~~5111.02~~5163.15 of the Revised Code to implement sections ~~5111.65~~	33857
5164.82 to ~~5111.688~~5164.858 of the Revised Code, including rules	33858
applicable to an exiting operator that provides written	33859
notification under section ~~5111.66~~5164.83 of the Revised Code of	33860
a voluntary withdrawal of participation. Rules adopted under this	33861
section shall comply with ~~section 1919(c)(2)(F) of the "Social~~	33862
~~Security Act," 79 Stat. 286 (1965),~~ 42 U.S.C. 1396r(c)(2)(F),	33863
regarding restrictions on transfers or discharges of nursing	33864
facility residents in the case of a voluntary withdrawal of	33865
participation. The rules may prescribe a medicaid reimbursement	33866
methodology and other procedures that are applicable after the	33867
effective date of a voluntary withdrawal of participation that	33868
differ from the reimbursement methodology and other procedures	33869
that would otherwise apply.	33870

~~Sec. 5111.99.~~ Sec. 5164.99. (A) Whoever violates division (B) of	33871
section ~~5111.26~~5164.37 or division (E) of section ~~5111.31~~	33872
5164.033 of the Revised Code shall be fined not less than five	33873
hundred dollars nor more than one thousand dollars for the first	33874
offense and not less than one thousand dollars nor more than five	33875
thousand dollars for each subsequent offense. Fines paid under	33876
this section shall be deposited in the state treasury to the	33877
credit of the general revenue fund.	33878

(B) Whoever violates division (D) of section ~~5111.61~~5164.77	33879
of the Revised Code is guilty of registering a false complaint, a	33880
misdemeanor of the first degree.	33881

Sec. 5165.01. As used in this chapter:

33882

"Care management system" means the medicaid managed care	33883
program established under section 5165.02 of the Revised Code.	33884

"Emergency services" has the same meaning as in 42 U.S.C.	33885
1396u-2(b)(2).	33886

"Medicaid managed care organization" means a managed care	33887
organization that has entered into a contract with the department	33888
of health care administration under section 5165.05 of the Revised	33889
Code.	33890

"Provider" has the same meaning as in section 5163.01 of the	33891
Revised Code.	33892

Sec. 5165.02. The department of health care administration	33893
shall establish a care management system as part of the medicaid	33894
program. The department shall submit, if necessary, applications	33895
to the United States department of health and human services for	33896
waivers of federal medicaid requirements that would otherwise be	33897
violated in the implementation of the system.	33898

~~Sec. 5111.16.~~ Sec. 5165.03. ~~(A) As part of the medicaid program,~~	33899
~~the department of job and family services shall establish a care~~	33900
~~management system. The department shall submit, if necessary,~~	33901
~~applications to the United States department of health and human~~	33902
~~services for waivers of federal medicaid requirements that would~~	33903
~~otherwise be violated in the implementation of the system.~~	33904

~~(B)~~ The department of health care administration shall	33905
implement the care management system in some or all counties and	33906
shall designate the medicaid recipients who are required or	33907
permitted to participate in the system. In the department's	33908
implementation of the system and designation of participants, all	33909
of the following apply:	33910

~~(1)~~(A) In the case of individuals who receive medicaid on the	33911
basis of being included in the category identified by the	33912
department as covered families and children, the department shall	33913
implement the care management system in all counties. All	33914
individuals included in the category shall be designated for	33915
participation, except for ~~indivduals~~individuals included in one	33916
or more of the medicaid recipient groups specified in 42 C.F.R.	33917
438.50(d). The department shall designate the participants not	33918
later than January 1, 2006. Beginning not later than December 31,	33919
2006, the department shall ensure that all participants are	33920
enrolled in health insuring corporations under contract with the	33921
department pursuant to section ~~5111.17~~5165.05 of the Revised	33922
Code.	33923

~~(2)~~(B) In the case of individuals who receive medicaid on the	33924
basis of being aged, blind, or disabled, as specified in division	33925
~~(A)(2)~~(B) of section ~~5111.01~~5162.01 of the Revised Code, the	33926
department shall implement the care management system in all	33927
counties. All individuals included in the category shall be	33928
designated for participation, except for the individuals specified	33929
in divisions (B)~~(2)(a) to (e)~~ of this section. Beginning not later	33930
than December 31, 2006, the department shall ensure that all	33931
participants are enrolled in health insuring corporations under	33932
contract with the department pursuant to section ~~5111.17~~5165.05	33933
of the Revised Code.	33934

In designating participants who receive medicaid on the basis	33935
of being aged, blind, or disabled, the department shall not	33936
include any of the following:	33937

~~(a)~~(1) Individuals who are under twenty-one years of age;

33938

~~(b)~~(2) Individuals who are institutionalized;

33939

~~(c)~~(3) Individuals who become eligible for medicaid by	33940
spending down their income or resources to a level that meets the	33941
medicaid program's financial eligibility requirements;	33942

~~(d)~~(4) Individuals who are dually eligible under the medicaid	33943
program and the medicare program ~~established under Title XVIII of~~	33944
~~the "Social Security Act," 79 Stat. 286 (1965), 42 U.S.C. 1395, as~~	33945
~~amended~~;	33946

~~(e)~~(5) Individuals to the extent that they are receiving	33947
medicaid services through a medicaid waiver component, as defined	33948
in section ~~5111.85~~5163.50 of the Revised Code.	33949

~~(3)~~(C) Alcohol, drug addiction, and mental health services	33950
covered by medicaid shall not be included in any component of the	33951
care management system when the nonfederal share of the cost of	33952
those services is provided by a board of alcohol, drug ~~adiction~~	33953
addiction, and mental health services or a state agency other than	33954
the department of ~~job and family services~~health care	33955
administration, but the recipients of those services may otherwise	33956
be designated for participation in the system.	33957

~~(C) Subject to division (B) of this section, the department~~	33958
~~may do both of the following under the care management system:~~	33959

~~(1) Require or permit participants in the system to obtain~~	33960
~~health care services from providers designated by the department;~~	33961

~~(2) Require or permit participants in the system to obtain~~	33962
~~health care services through managed care organizations under~~	33963
~~contract with the department pursuant to section 5111.17 of the~~	33964
~~Revised Code.~~	33965

~~(D)(1) The department shall prepare an annual report on the~~	33966
~~care management system. The report shall address the department's~~	33967
~~ability to implement the system, including all of the following~~	33968
~~components:~~	33969

~~(a) The required designation of participants included in the~~	33970
~~category identified by the department as covered families and~~	33971
~~children;~~	33972

~~(b) The required designation of participants included in the~~	33973
~~aged, blind, or disabled category of medicaid recipients;~~	33974

~~(c) The conduct of the pilot program for chronically ill~~	33975
~~children established under section 5111.163 of the Revised Code;~~	33976

~~(d) The use of any programs for enhanced care management.~~

33977

~~(2) The department shall submit each annual report to the~~	33978
~~general assembly. The first report shall be submitted not later~~	33979
~~than October 1, 2007.~~	33980

~~(E) The director of job and family services may adopt rules~~	33981
~~in accordance with Chapter 119. of the Revised Code to implement~~	33982
~~this section.~~	33983

Sec. 5165.04. Subject to section 5165.03 of the Revised	33984
Code, the department of health care administration may do both of	33985
the following under the care management system:	33986

(A) Require or permit participants in the system to obtain	33987
health care services from providers designated by the department;	33988

(B) Require or permit participants in the system to obtain	33989
health care services through managed care organizations under	33990
contract with the department pursuant to section 5165.05 of the	33991
Revised Code.	33992

~~Sec. 5111.17.~~ Sec. 5165.05. ~~(A)~~ The department of ~~job and family~~	33993
~~services~~health care administration may enter into contracts with	33994
managed care organizations, including health insuring	33995
corporations, under which the organizations are authorized to	33996
provide, or arrange for the provision of, health care services to	33997
~~medical assistance~~medicaid recipients who are required or	33998
permitted to obtain health care services through managed care	33999
organizations as part of the care management system ~~established~~	34000
~~under section 5111.16 of the Revised Code~~.	34001

~~(B) The director of job and family services may adopt rules~~	34002
~~in accordance with Chapter 119. of the Revised Code to implement~~	34003
~~this section.~~	34004

~~(C)~~ The department of ~~job and family services~~health care	34005
administration shall allow managed care plans to use providers	34006
to render care upon completion of the managed care plan's	34007
credentialing process.	34008

Sec. 5165.06. The department of health care administration	34009
shall develop and implement a financial incentive program to	34010
improve and reward positive health outcomes through the managed	34011
care organization contracts entered into under section 5165.05 of	34012
the Revised Code. In developing and implementing the program, the	34013
department may take into consideration the recommendations	34014
regarding the program made by the medicaid care management working	34015
group created under section 5165.19 of the Revised Code.	34016

~~Sec. 5111.171.~~ Sec. 5165.07. ~~(A)~~ The department of ~~job and family~~	34017
~~services~~health care administration may provide financial	34018
incentive awards to medicaid managed care organizations ~~under~~	34019
~~contract with the department pursuant to section 5111.17 of the~~	34020
~~Revised Code~~ that meet or exceed performance standards specified	34021
in provider agreements or rules adopted ~~by the department~~under	34022
section 5165.18 of the Revised Code. The department may specify in	34023
a contract with a managed care organization the amounts of	34024
financial incentive awards, methodology for distributing awards,	34025
types of awards, and standards for administration by the	34026
department.	34027

~~(B) There is hereby created in the state treasury the health~~	34028
~~care compliance fund. The fund shall consist of all fines imposed~~	34029
~~on and collected from managed care organizations for failure to~~	34030
~~meet performance standards or other requirements specified in~~	34031
~~provider agreements or rules adopted by the department. All~~	34032
~~investment earnings of the fund shall be credited to the fund.~~	34033
~~Moneys credited to the fund shall be used solely for the following~~	34034
~~purposes:~~	34035

~~(1) To reimburse managed care organizations that have paid~~	34036
~~fines for failures to meet performance standards or other~~	34037
~~requirements and that have come into compliance by meeting~~	34038
~~requirements as specified by the department;~~	34039

~~(2) To provide financial incentive awards established~~	34040
~~pursuant to division (A) of this section and specified in~~	34041
~~contracts between managed care organizations and the department.~~	34042

Sec. 5165.08. There is hereby created in the state treasury	34043
the health care compliance fund. The fund shall consist of all	34044
fines imposed on and collected from medicaid managed care	34045
organizations for failure to meet performance standards or other	34046
requirements specified in provider agreements or rules under	34047
section 5165.18 of the Revised Code. All investment earnings of	34048
the fund shall be credited to the fund. Moneys credited to the	34049
fund shall be used solely for the following purposes:	34050

(A) To reimburse medicaid managed care organizations that	34051
have paid fines for failures to meet performance standards or	34052
other requirements and that have come into compliance by meeting	34053
requirements as specified by the department;	34054

(B) To provide financial incentive awards established	34055
pursuant to section 5165.06 of the Revised Code and specified in	34056
contracts between medicaid managed care organizations and the	34057
department.	34058

~~Sec. 5111.172.~~ Sec. 5165.09. (A) When contracting under section	34059
~~5111.17~~5165.05 of the Revised Code with a managed care	34060
organization that is a health insuring corporation, the	34061
department of ~~job and family services~~health care administration	34062
may require the health insuring corporation to provide coverage of	34063
prescription drugs for medicaid recipients enrolled in the health	34064
insuring corporation. In providing the required coverage, the	34065
health insuring corporation may, subject to the department's	34066
approval, use strategies for the management of drug utilization.	34067

(B) As used in this division, "controlled substance" has the	34068
same meaning as in section 3719.01 of the Revised Code.	34069

If a health insuring corporation is required under this	34070
section to provide coverage of prescription drugs, the department	34071
shall permit the health insuring corporation to develop and	34072
implement a pharmacy utilization management program under which	34073
prior authorization through the program is established as a	34074
condition of obtaining a controlled substance pursuant to a	34075
prescription. The program may include processes for requiring	34076
medicaid recipients at high risk for fraud or abuse involving	34077
controlled substances to have their prescriptions for controlled	34078
substances filled by a pharmacy, medical provider, or health care	34079
facility designated by the program.	34080

~~Sec. 5111.173.~~ Sec. 5165.10. The department of ~~job and family~~	34081
~~services~~health care administration shall appoint a temporary	34082
manager for a medicaid managed care organization ~~under contract~~	34083
~~with the department pursuant to section 5111.17 of the Revised~~	34084
~~Code~~ if the department determines that the medicaid managed care	34085
organization has repeatedly failed to meet substantive	34086
requirements specified in ~~section 1903(m) of the "Social Security~~	34087
~~Act," 79 Stat. 286 (1965),~~ 42 U.S.C. 1396b(m), ~~as amended; section~~	34088
~~1932 of the Social Security Act,~~ 42 U.S.C. 1396u-2, ~~as amended;~~ or	34089
42 C.F.R. 438 Part I. The appointment of a temporary manager does	34090
not preclude the department from imposing other sanctions	34091
available to the department against the medicaid managed care	34092
organization.	34093

The medicaid managed care organization shall pay all costs of	34094
having the temporary manager perform the temporary manager's	34095
duties, including all costs the temporary manager incurs in	34096
performing those duties. If the temporary manager incurs costs or	34097
liabilities on behalf of the medicaid managed care organization,	34098
the medicaid managed care organization shall pay those costs and	34099
be responsible for those liabilities.	34100

The appointment of a temporary manager is not subject to	34101
Chapter 119. of the Revised Code, but the medicaid managed care	34102
organization may request a reconsideration of the appointment.	34103
Reconsiderations shall be requested and conducted in accordance	34104
with rules ~~the director of job and family services shall adopt in~~	34105
~~accordance with Chapter 119.~~adopted under section 5165.18 of the	34106
Revised Code.	34107

The appointment of a temporary manager does not cause the	34108
medicaid managed care organization to lose the right to appeal, in	34109
accordance with Chapter 119. of the Revised Code, any proposed	34110
termination or any decision not to renew the medicaid managed care	34111
organization's medicaid provider agreement or the right to	34112
initiate the sale of the medicaid managed care organization or its	34113
assets.	34114

~~In addition to the rules required to be adopted under this~~	34115
~~section, the director may adopt any other rules necessary to~~	34116
~~implement this section. The rules shall be adopted in accordance~~	34117
~~with Chapter 119. of the Revised Code.~~	34118

~~Sec. 5111.177.~~ Sec. 5165.11. When contracting under section	34119
~~5111.17~~5165.05 of the Revised Code with a health insuring	34120
corporation that holds a certificate of authority under Chapter	34121
1751. of the Revised Code, the department of ~~job and family~~	34122
~~services~~health care administration shall require the health	34123
insuring corporation to provide a grievance process for medicaid	34124
recipients in accordance with 42 C.F.R. 438, subpart F.	34125

~~Sec. 5111.174.~~ Sec. 5165.12. The department of ~~job and family~~	34126
~~services~~health care administration may disenroll some or all	34127
medicaid recipients enrolled in a medicaid managed care	34128
organization ~~under contract with the department pursuant to~~	34129
~~section 5111.17 of the Revised Code~~ if the department proposes to	34130
terminate or not to renew the contract and determines that the	34131
recipients' access to medically necessary services is jeopardized	34132
by the proposal to terminate or not to renew the contract. The	34133
disenrollment is not subject to Chapter 119. of the Revised Code,	34134
but the medicaid managed care organization may request a	34135
reconsideration of the disenrollment. Reconsiderations shall be	34136
requested and conducted in accordance with rules ~~the director of~~	34137
~~job and family services shall adopt in accordance with Chapter~~	34138
~~119.~~adopted under section 5165.18 of the Revised Code. The	34139
request for, or conduct of, a reconsideration regarding a proposed	34140
disenrollment shall not delay the disenrollment.	34141

~~In addition to the rules required to be adopted under this~~	34142
~~section, the director may adopt any other rules necessary to~~	34143
~~implement this section. The rules shall be adopted in accordance~~	34144
~~with Chapter 119. of the Revised Code.~~	34145

~~Sec. 5111.175.~~ Sec. 5165.13. For the purpose of determining the	34146
amount the department of ~~job and family services~~health care	34147
administration pays hospitals under section ~~5112.08~~5166.07 of the	34148
Revised Code and the amount of disproportionate share hospital	34149
payments paid by the medicare program ~~established under Title~~	34150
~~XVIII of the "Social Security Act," 79 Stat. 286 (1965), 42 U.S.C.~~	34151
~~1396n, as amended~~, a medicaid managed care organization ~~under~~	34152
~~contract with the department pursuant to section 5111.17 of the~~	34153
~~Revised Code authorizing the organization~~authorized to provide,	34154
or arrange for the provision of, hospital services to medicaid	34155
recipients shall keep detailed records for each hospital with	34156
which it contracts about the cost to the hospital of providing the	34157
services, payments made by the organization to the hospital for	34158
the services, utilization of hospital services by medicaid	34159
recipients enrolled in the organization, and other utilization	34160
data required by the department.	34161

~~Sec. 5111.162.~~ Sec. 5165.14. (A) ~~As used in this section:~~

34162

~~(1) "Emergency services" has the same meaning as in section~~	34163
~~1932(b)(2) of the "Social Security Act," 79 Stat. 286 (1965), 42~~	34164
~~U.S.C. 1396u-2(b)(2), as amended.~~	34165

~~(2) "Medicaid managed care organization" means a managed care~~	34166
~~organization that has entered into a contract with the department~~	34167
~~of job and family services pursuant to section 5111.17 of the~~	34168
~~Revised Code.~~	34169

~~(B)~~ Except as provided in division ~~(C)~~(B) of this section,	34170
when a participant in the care management system ~~established under~~	34171
~~section 5111.16 of the Revised Code~~ is enrolled in a medicaid	34172
managed care organization and the organization refers the	34173
participant to receive services, other than emergency services	34174
provided on or after January 1, 2007, at a hospital that	34175
participates in the medicaid program but is not under contract	34176
with the organization, the hospital shall provide the service for	34177
which the referral was made and shall accept from the	34178
organization, as payment in full, the amount derived from the	34179
reimbursement rate used by the department to reimburse other	34180
hospitals of the same type for providing the same service to a	34181
medicaid recipient who is not enrolled in a medicaid managed care	34182
organization.	34183

~~(C)~~(B) A hospital is not subject to division ~~(B)~~(A) of this	34184
section if all of the following are the case:	34185

(1) The hospital is located in a county in which participants	34186
in the care management system are required before January 1, 2006,	34187
to be enrolled in a medicaid managed care organization that is a	34188
health insuring corporation;	34189

(2) The hospital has entered into a contract before January	34190
1, 2006, with at least one health insuring corporation serving the	34191
participants specified in division ~~(C)~~(B)(1) of this section;	34192

(3) The hospital remains under contract with at least one	34193
health insuring corporation serving participants in the care	34194
management system who are required to be enrolled in a health	34195
insuring corporation.	34196

~~(D) The director of job and family services shall adopt rules~~	34197
~~specifying the circumstances under which a medicaid managed care~~	34198
~~organization is permitted to refer a participant in the care~~	34199
~~management system to a hospital that is not under contract with~~	34200
~~the organization. The director may adopt any other rules necessary~~	34201
~~to implement this section. All rules adopted under this section~~	34202
~~shall be adopted in accordance with Chapter 119. of the Revised~~	34203
~~Code.~~	34204

~~Sec. 5111.163.~~ Sec. 5165.15. ~~(A) As used in this section:~~

34205

~~(1) "Emergency services" has the same meaning as in section~~	34206
~~1932(b)(2) of the "Social Security Act," 79 Stat. 286 (1965), 42~~	34207
~~U.S.C. 1396u-2(b)(2), as amended.~~	34208

~~(2) "Medicaid managed care organization" has the same meaning~~	34209
~~as in section 5111.162 of the Revised Code.~~	34210

~~(3) "Provider" means any person, institution, or entity that~~	34211
~~furnishes emergency services to a medicaid recipient enrolled in a~~	34212
~~medicaid managed care organization, regardless of whether the~~	34213
~~person, institution, or entity has a provider agreement with the~~	34214
~~department of job and family services pursuant to Title XIX of the~~	34215
~~"Social Security Act."~~	34216

~~(B)~~ When a participant in the care management system	34217
~~established under section 5111.16 of the Revised Code~~ is enrolled	34218
in a medicaid managed care organization and receives emergency	34219
services on or after January 1, 2007, from a provider that is not	34220
under contract with the organization, the provider shall accept	34221
from the organization, as payment in full, not more than the	34222
amounts (less any payments for indirect costs of medical education	34223
and direct costs of graduate medical education) that the provider	34224
could collect if the participant received medicaid other than	34225
through enrollment in a managed care organization.	34226

~~Sec. 5111.178.~~ Sec. 5165.16. (A) The director of ~~job and family~~	34227
~~services~~health care administration shall determine whether a	34228
waiver of federal medicaid requirements is necessary to fulfill	34229
the requirements of section 3901.3814 of the Revised Code. If the	34230
director determines a waiver is necessary, the department of ~~job~~	34231
~~and family services~~health care administration shall apply to the	34232
United States secretary of health and human services for the	34233
waiver.	34234

(B)(1) If the director determines that section 3901.3814 of	34235
the Revised Code can be implemented without a waiver or a waiver	34236
is granted, the department shall notify the department of	34237
insurance that the section can be implemented. Implementation of	34238
the section shall be effective eighteen months after the notice is	34239
sent.	34240

(2) At the time the notice is given under division (B)(1) of	34241
this section, the department shall also give notice to each health	34242
insuring corporation that provides coverage to medicaid	34243
recipients. The notice shall inform the corporation that sections	34244
3901.38 and 3901.381 to 3901.3814 of the Revised Code apply to	34245
claims for services rendered to recipients on the date determined	34246
under division (B)(1) of this section, instead of the prompt	34247
payment requirements of 42 C.F.R. 447.46. That date shall be	34248
specified in the notice.	34249

Sec. 5165.17. (A) The department of health care	34250
administration shall prepare an annual report on the care	34251
management system. The report shall address the department's	34252
ability to implement the system, including all of the following	34253
components:	34254

(1) The required designation of participants included in the	34255
category identified by the department as covered families and	34256
children;	34257

(2) The required designation of participants included in the	34258
aged, blind, or disabled category of medicaid recipients;	34259

(3) The use of any programs for enhanced care management.

34260

(B) The department shall submit each annual report to the	34261
general assembly. The first report shall be submitted not later	34262
than October 1, 2007.	34263

Sec. 5165.18. The director of health care administration	34264
shall adopt rules in accordance with Chapter 119. of the Revised	34265
Code to implement care management system, including rules that do	34266
all of the following:	34267

(A) Specify the circumstances under which a medicaid managed	34268
care organization is permitted to refer a participant in the care	34269
management system to a hospital that is not under contract with	34270
the organization;	34271

(B) Specify performance standards for medicaid managed care	34272
organizations;	34273

(C) The method by which a medicaid managed care organization	34274
may request a reconsideration of the appointment of a temporary	34275
manager under section 5165.10 of the Revised Code and the method	34276
by which the reconsideration is to be conducted;	34277

(D) The method by which a medicaid managed care organization	34278
may request a reconsideration of a disenrollment under section	34279
5165.12 of the Revised Code and the method by which the	34280
reconsideration is to be conducted.	34281

~~Sec. 5111.13.~~ Sec. 5165.30. (A) As used in this section,	34282
"cost-effective" and "group health plan" have the same meanings as	34283
in ~~section 1906 of the "Social Security Act," 49 Stat. 620 (1935),~~	34284
42 U.S.C.A. 1396e~~, as amended,~~ and any regulations adopted under	34285
that section.	34286

(B) The department of ~~job and family services~~health care	34287
administration, pursuant to guidelines issued by the United States	34288
secretary of health and human services, shall identify cases in	34289
which enrollment of an individual otherwise eligible for ~~medical~~	34290
~~assistance under this chapter~~the medicaid program in a group	34291
health plan in which the individual is eligible to enroll and	34292
payment of the individual's premiums, deductibles, coinsurance,	34293
and other cost-sharing expenses is cost effective.	34294

The department shall require, as a condition of eligibility	34295
for ~~medical assistance~~the medicaid program, individuals	34296
identified under this division, or in the case of a child, the	34297
child's parent, to apply for enrollment in the group health plan,	34298
except that the failure of a parent to enroll self or the parent's	34299
child in a group health plan does not affect the child's	34300
eligibility under the ~~medical assistance~~medicaid program.	34301

The department shall pay enrollee premiums and deductibles,	34302
coinsurance, and other cost-sharing obligations for services and	34303
items otherwise covered under the ~~medical assistance~~medicaid	34304
program. The department shall treat coverage under the group	34305
health plan in the same manner as any other third-party liability	34306
under the program. If not all members of a family are eligible for	34307
~~medical assistance~~the medicaid program and enrollment of the	34308
eligible members in a group health plan is not possible without	34309
also enrolling the members who are ineligible for ~~medical~~	34310
~~assistance~~the medicaid program, the department shall pay the	34311
premiums for the ineligible members if the payments are cost	34312
effective. The department shall not pay deductibles, coinsurance,	34313
or other cost-sharing obligations of enrolled members who are not	34314
eligible for ~~medical assistance~~the medicaid program.	34315

The department may make payments under this section to	34316
employers, insurers, or other entities. The department may make	34317
the payments without entering into a contract with employers,	34318
insurers, or other entities.	34319

(C) To the extent permitted by federal law and regulations,	34320
the department of ~~job and family services~~health care	34321
administration shall coordinate the ~~medical assistance~~medicaid	34322
program with group health plans in such a manner that the ~~medical~~	34323
~~assistance~~medicaid program serves as a supplement to the group	34324
health plans. In its coordination efforts, the department shall	34325
consider cost-effectiveness and quality of care. The department	34326
may enter into agreements with group health plans as necessary to	34327
implement this division.	34328

(D) The director of ~~job and family services~~health care	34329
administration shall adopt rules in accordance with Chapter 119.	34330
of the Revised Code to implement this section.	34331

~~Sec. 5112.01.~~ Sec. 5166.01. As used in sections ~~5112.03~~5166.02 to	34332
~~5112.21~~5166.14 of the Revised Code:	34333

(A)(1) "Hospital" means a nonfederal hospital to which either	34334
of the following applies:	34335

(a) The hospital is registered under section 3701.07 of the	34336
Revised Code as a general medical and surgical hospital or a	34337
pediatric general hospital, and provides inpatient hospital	34338
services, as defined in 42 C.F.R. 440.10;	34339

(b) The hospital is recognized under the medicare program	34340
~~established by Title XVIII of the "Social Security Act," 49 Stat.~~	34341
~~620 (1935), 42 U.S.C.A. 301, as amended,~~ as a cancer hospital and	34342
is exempt from the medicare prospective payment system.	34343

"Hospital" does not include a hospital operated by a health	34344
insuring corporation that has been issued a certificate of	34345
authority under section 1751.05 of the Revised Code or a hospital	34346
that does not charge patients for services.	34347

(2) "Disproportionate share hospital" means a hospital that	34348
meets the definition of a disproportionate share hospital in rules	34349
adopted under section ~~5112.03~~5166.02 of the Revised Code.	34350

(B) "Bad debt," "charity care," "courtesy care," and	34351
"contractual allowances" have the same meanings given these terms	34352
in regulations ~~adopted under Title XVIII of the "Social Security~~	34353
~~Act~~governing the medicare program."	34354

(C) "Cost reporting period" means the twelve-month period	34355
used by a hospital in reporting costs for purposes of ~~Title XVIII~~	34356
~~of the "Social Security Act~~the medicare program."	34357

(D) "Governmental hospital" means a county hospital with more	34358
than five hundred registered beds or a state-owned and -operated	34359
hospital with more than five hundred registered beds.	34360

(E) "Indigent care pool" means the sum of the following:

34361

(1) The total of assessments to be paid in a program year by	34362
all hospitals under section ~~5112.06~~5166.05 of the Revised Code,	34363
less the assessments deposited into the legislative budget	34364
services fund under section ~~5112.19~~5166.13 of the Revised Code	34365
and into the health care services administration fund created	34366
under section ~~5111.94~~5161.15 of the Revised Code;	34367

(2) The total amount of intergovernmental transfers required	34368
to be made in the same program year by governmental hospitals	34369
under section ~~5112.07~~5166.06 of the Revised Code, less the amount	34370
of transfers deposited into the legislative budget services fund	34371
under section ~~5112.19~~5166.13 of the Revised Code and into the	34372
health care services administration fund created under section	34373
~~5111.94~~5161.15 of the Revised Code;	34374

(3) The total amount of federal matching funds that will be	34375
made available in the same program year as a result of funds	34376
distributed by the department of ~~job and family services~~health	34377
care administration to hospitals under section ~~5112.08~~5166.07 of	34378
the Revised Code.	34379

(F) "Intergovernmental transfer" means any transfer of money	34380
by a governmental hospital under section ~~5112.07~~5166.06 of the	34381
Revised Code.	34382

(G) ~~"Medical assistance program" means the program of medical~~	34383
~~assistance established under section 5111.01 of the Revised Code~~	34384
~~and Title XIX of the "Social Security Act."~~	34385

~~(H)~~ "Program year" means a period beginning the first day of	34386
October, or a later date designated in rules adopted under section	34387
~~5112.03~~5166.02 of the Revised Code, and ending the thirtieth day	34388
of September, or an earlier date designated in rules adopted under	34389
that section.	34390

~~(I)~~(H) "Registered beds" means the total number of hospital	34391
beds registered with the department of health, as reported in the	34392
most recent "directory of registered hospitals" published by the	34393
department of health.	34394

~~(J)~~(I) "Total facility costs" means the total costs for all	34395
services rendered to all patients, including the direct, indirect,	34396
and overhead cost to the hospital of all services, supplies,	34397
equipment, and capital related to the care of patients, regardless	34398
of whether patients are enrolled in a health insuring corporation,	34399
excluding costs associated with providing skilled nursing services	34400
in distinct-part nursing facility units, as shown on the	34401
hospital's cost report filed under section ~~5112.04~~5166.03 of the	34402
Revised Code. Effective October 1, 1993, if rules adopted under	34403
section ~~5112.03~~5166.02 of the Revised Code so provide, "total	34404
facility costs" may exclude costs associated with providing care	34405
to recipients of any of the governmental programs listed in	34406
division (B) of that section.	34407

~~(K)~~(J) "Uncompensated care" means bad debt and charity care.

34408

~~Sec. 5112.03.~~ Sec. 5166.02. (A) The director of ~~job and family~~	34409
~~services~~health care administration shall adopt, and may amend and	34410
rescind, rules in accordance with Chapter 119. of the Revised Code	34411
for the purpose of administering sections ~~5112.01~~5166.01 to	34412
~~5112.21~~5166.14 of the Revised Code, including rules that do all	34413
of the following:	34414

(1) Define as a "disproportionate share hospital" any	34415
hospital included under subsection (b) of section 1923 of the	34416
"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A.	34417
1396r-4(b), as amended, and any other hospital the director	34418
determines appropriate;	34419

(2) Prescribe the form for submission of cost reports under	34420
section ~~5112.04~~5166.03 of the Revised Code;	34421

(3) Establish, in accordance with division (A) of section	34422
~~5112.06~~5166.05 of the Revised Code, the assessment rate or rates	34423
to be applied to hospitals under that section;	34424

(4) Establish schedules for hospitals to pay installments on	34425
their assessments under section ~~5112.06~~5166.05 of the Revised	34426
Code and for governmental hospitals to pay installments on their	34427
intergovernmental transfers under section ~~5112.07~~5166.06 of the	34428
Revised Code;	34429

(5) Establish procedures to notify hospitals of adjustments	34430
made under division (B)(2)(b) of section ~~5112.06~~5166.05 of the	34431
Revised Code in the amount of installments on their assessment;	34432

(6) Establish procedures to notify hospitals of adjustments	34433
made under division (D) of section ~~5112.09~~5166.08 of the Revised	34434
Code in the total amount of their assessment and to adjust for the	34435
remainder of the program year the amount of the installments on	34436
the assessments;	34437

(7) Establish, in accordance with section ~~5112.08~~5166.07 of	34438
the Revised Code, the methodology for paying hospitals under that	34439
section.	34440

The director shall consult with hospitals when adopting the	34441
rules required by divisions (A)(4) and (5) of this section in	34442
order to minimize hospitals' cash flow difficulties.	34443

(B) Rules adopted under this section may provide that "total	34444
facility costs" excludes costs associated with any of the	34445
following:	34446

(1) Recipients of the ~~medical assistance~~medicaid program;

34447

(2) Recipients of financial assistance provided under Chapter	34448
5115. of the Revised Code;	34449

(3) Recipients of the disability medical assistance ~~provided~~	34450
~~under Chapter 5115. of the Revised Code~~program;	34451

(4) Recipients of the program for medically handicapped	34452
children established under section 3701.023 of the Revised Code;	34453

(5) Recipients of the medicare program ~~established under~~	34454
~~Title XVIII of the "Social Security Act," 49 Stat. 620 (1935), 42~~	34455
~~U.S.C.A. 301, as amended:~~;	34456

(6) Recipients of Title V of the "Social Security Act of	34457
1935";	34458

(7) Any other category of costs deemed appropriate by the	34459
director in accordance with ~~Title XIX of the "Social Security Act"~~	34460
~~and the rules adopted under that title~~federal law, including	34461
administrative regulations, governing the medicaid program.	34462

~~Sec. 5112.04.~~ Sec. 5166.03. (A) Except as provided in division (C)	34463
of this section, each hospital, on or before the first day of July	34464
of each year or at a later date approved by the director of ~~job~~	34465
~~and family services~~health care administration, shall submit to	34466
the department of ~~job and family services~~health care	34467
administration a financial statement for the preceding calendar	34468
year that accurately reflects the income, expenses, assets,	34469
liabilities, and net worth of the hospital, and accompanying	34470
notes. A hospital that has a fiscal year different from the	34471
calendar year shall file its financial statement within one	34472
hundred eighty days of the end of its fiscal year or at a later	34473
date approved by the director of ~~job and family services~~health	34474
care administration. The financial statement shall be prepared by	34475
an independent certified public accountant and reflect an official	34476
audit report prepared in a manner consistent with generally	34477
accepted accounting principles. The financial statement shall, to	34478
the extent that the hospital has sufficient financial records,	34479
show bad debt and charity care separately from courtesy care and	34480
contractual allowances.	34481

(B) Except as provided in division (C) of this section, each	34482
hospital, within one hundred eighty days after the end of the	34483
hospital's cost reporting period, shall submit to the department a	34484
cost report in a format prescribed in rules adopted ~~by the~~	34485
~~director of job and family services~~ under section ~~5112.03~~5166.02	34486
of the Revised Code. The department shall grant a hospital an	34487
extension of the one hundred eighty day period if the health care	34488
financing administration of the United States department of health	34489
and human services extends the date by which the hospital must	34490
submit its cost report for the hospital's cost reporting period.	34491

(C) The director of ~~job and family services~~health care	34492
administration may adopt rules under section ~~5112.03~~5166.02 of	34493
the Revised Code specifying financial information that must be	34494
submitted by hospitals for which no financial statement or cost	34495
report is available. The rules shall specify deadlines for	34496
submitting the information. Each such hospital shall submit the	34497
information specified in the rules not later than the deadline	34498
specified in the rules.	34499

~~Sec. 5112.05.~~ Sec. 5166.04. The requirements of sections ~~5112.06~~	34500
5166.05 to ~~5112.09~~5166.08 of the Revised Code apply only as long	34501
as the United States ~~health care financing administration~~	34502
department of health and human services determines that the	34503
assessment imposed under section ~~5112.06~~5166.05 of the Revised	34504
Code is a permissible health care-related tax pursuant to ~~section~~	34505
~~1903(w) of the "Social Security Act," 49 Stat. 620 (1935),~~ 42	34506
U.S.C.A. 1396b(w)~~, as amended~~. Whenever the department of ~~job and~~	34507
~~family services~~health care administration is informed that the	34508
assessment is an impermissible health care-related tax, the	34509
department shall promptly refund to each hospital the amount of	34510
money currently in the hospital care assurance program fund	34511
created by section ~~5112.18~~5166.12 of the Revised Code that has	34512
been paid by the hospital under section ~~5112.06~~5166.05 or ~~5112.07~~	34513
5166.06 of the Revised Code, plus any investment earnings on that	34514
amount.	34515

~~Sec. 5112.06.~~ Sec. 5166.05. (A) For the purpose of distributing	34516
funds to hospitals under the ~~medical assistance~~medicaid program	34517
pursuant to sections ~~5112.01~~5166.01 to ~~5112.21~~5166.14 of the	34518
Revised Code and depositing funds into the legislative budget	34519
services fund under section ~~5112.19~~5166.13 of the Revised Code	34520
and into the health care services administration fund created	34521
under section ~~5111.94~~5161.15 of the Revised Code, there is hereby	34522
imposed an assessment on all hospitals. Each hospital's assessment	34523
shall be based on total facility costs. All hospitals shall be	34524
assessed according to the rate or rates established each program	34525
year by the department of ~~job and family services~~health care	34526
administration in rules adopted under section ~~5112.03~~5166.02 of	34527
the Revised Code. The department shall assess all hospitals	34528
uniformly and in a manner consistent with federal statutes and	34529
regulations. During any program year, the department shall not	34530
assess any hospital more than two per cent of the hospital's total	34531
facility costs.	34532

The department shall establish an assessment rate or rates	34533
each program year that will do both of the following:	34534

(1) Yield funds that, when combined with intergovernmental	34535
transfers and federal matching funds, will produce a program of	34536
sufficient size to pay a substantial portion of the indigent care	34537
provided by hospitals;	34538

(2) Yield funds that, when combined with intergovernmental	34539
transfers and federal matching funds, will produce amounts for	34540
distribution to disproportionate share hospitals that do not	34541
exceed, in the aggregate, the limits prescribed by the United	34542
States ~~health care financing administration~~department of health	34543
and human services under ~~subsection (f) of section 1923 of the~~	34544
~~"Social Security Act," 49 Stat. 620 (1935),~~ 42 U.S.C.A.	34545
1396r-4(f)~~, as amended~~.	34546

(B)(1) Except as provided in division (B)(3) of this section,	34547
each hospital shall pay its assessment in periodic installments in	34548
accordance with a schedule established by the director of ~~job and~~	34549
~~family services~~health care administration in rules adopted under	34550
section ~~5112.03~~5166.02 of the Revised Code.	34551

(2) The installments shall be equal in amount, unless either	34552
of the following applies:	34553

(a) The department makes adjustments during a program year	34554
under division (D) of section ~~5112.09~~5166.08 of the Revised Code	34555
in the total amount of hospitals' assessments;	34556

(b) The director of ~~job and family services~~health care	34557
administration determines that adjustments in the amounts of	34558
installments are necessary for the administration of sections	34559
~~5112.01~~5166.01 to ~~5112.21~~5166.14 of the Revised Code and that	34560
unequal installments will not create cash flow difficulties for	34561
hospitals.	34562

(3) The director may adopt rules under section ~~5112.03~~	34563
5166.02 of the Revised Code establishing alternate schedules for	34564
hospitals to pay assessments under this section in order to reduce	34565
hospitals' cash flow difficulties.	34566

~~Sec. 5112.07.~~ Sec. 5166.06. (A) The department of ~~job and family~~	34567
~~services~~health care administration may require governmental	34568
hospitals to make intergovernmental transfers each program year	34569
for the purpose of distributing funds to hospitals under the	34570
~~medical assistance~~medicaid program pursuant to sections ~~5112.01~~	34571
5166.01 to ~~5112.21~~5166.14 of the Revised Code and depositing	34572
funds into the legislative budget services fund under section	34573
~~5112.19~~5166.13 of the Revised Code and into the health care	34574
services administration fund created under section ~~5111.94~~5161.15	34575
of the Revised Code. The department shall not require transfers in	34576
an amount that, when combined with hospital assessments paid under	34577
section ~~5112.06~~5166.05 of the Revised Code and federal matching	34578
funds, produce amounts for distribution to disproportionate share	34579
hospitals that, in the aggregate, exceed limits prescribed by the	34580
United States ~~health care financing administration~~department of	34581
health and human services under ~~subsection (f) of section 1923 of~~	34582
~~the "Social Security Act," 49 Stat. 620 (1935),~~ 42 U.S.C.A.	34583
1396r-4(f)~~, as amended~~.	34584

(B) Before or during each program year, the department shall	34585
notify each governmental hospital of the amount of the	34586
intergovernmental transfer it is required to make during the	34587
program year. Each governmental hospital shall make	34588
intergovernmental transfers as required by the department under	34589
this section in periodic installments, executed by electronic fund	34590
transfer, in accordance with a schedule established in rules	34591
adopted under section ~~5112.03~~5166.02 of the Revised Code.	34592

~~Sec. 5112.08.~~ Sec. 5166.07. The director of ~~job and family~~	34593
~~services~~health care administration shall adopt rules under	34594
section ~~5112.03~~5166.02 of the Revised Code establishing a	34595
methodology to pay hospitals that is sufficient to expend all	34596
money in the indigent care pool. Under the rules:	34597

(A) The department of ~~job and family services~~health care	34598
administration may classify similar hospitals into groups and	34599
allocate funds for distribution within each group.	34600

(B) The department shall establish a method of allocating	34601
funds to hospitals, taking into consideration the relative amount	34602
of indigent care provided by each hospital or group of hospitals.	34603
The amount to be allocated shall be based on any combination of	34604
the following indicators of indigent care that the director	34605
considers appropriate:	34606

(1) Total costs, volume, or proportion of services to	34607
medicaid recipients ~~of the medical assistance program~~, including	34608
recipients enrolled in health insuring corporations;	34609

(2) Total costs, volume, or proportion of services to	34610
low-income patients in addition to medicaid recipients ~~of the~~	34611
~~medical assistance program~~, which may include recipients of Title	34612
V of the "Social Security Act of 1935," ~~49 Stat. 620 (1935), 42~~	34613
~~U.S.C.A. 301, as amended, and~~ recipients of financial ~~or medical~~	34614
assistance provided under Chapter 5115. of the Revised Code, and	34615
recipients of the disability medical assistance program;	34616

(3) The amount of uncompensated care provided by the hospital	34617
or group of hospitals;	34618

(4) Other factors that the director considers to be	34619
appropriate indicators of indigent care.	34620

(C) The department shall distribute funds to each hospital or	34621
group of hospitals in a manner that first may provide for an	34622
additional distribution to individual hospitals that provide a	34623
high proportion of indigent care in relation to the total care	34624
provided by the hospital or in relation to other hospitals. The	34625
department shall establish a formula to distribute the remainder	34626
of the funds. The formula shall be consistent with ~~section 1923 of~~	34627
~~the "Social Security Act,"~~ 42 U.S.C.A. 1396r-4~~, as amended, shall~~	34628
beand based on any combination of the indicators of indigent care	34629
listed in division (B) of this section that the director considers	34630
appropriate.	34631

(D) The department shall distribute funds to each hospital in	34632
installments not later than ten working days after the deadline	34633
established in rules for each hospital to pay an installment on	34634
its assessment under section ~~5112.06~~5166.05 of the Revised Code.	34635
In the case of a governmental hospital that makes	34636
intergovernmental transfers, the department shall pay an	34637
installment under this section not later than ten working days	34638
after the earlier of that deadline or the deadline established in	34639
rules for the governmental hospital to pay an installment on its	34640
intergovernmental transfer. If the amount in the hospital care	34641
assurance program fund created under section ~~5112.18~~5166.12 of	34642
the Revised Code and the portion of the health care - federal fund	34643
created under section ~~5111.943~~5161.18 of the Revised Code that is	34644
credited to that fund pursuant to division (B) of section ~~5112.18~~	34645
5166.12 of the Revised Code are insufficient to make the total	34646
distributions for which hospitals are eligible to receive in any	34647
period, the department shall reduce the amount of each	34648
distribution by the percentage by which the amount and portion are	34649
insufficient. The department shall distribute to hospitals any	34650
amounts not distributed in the period in which they are due as	34651
soon as moneys are available in the funds.	34652

~~Sec. 5112.09.~~ Sec. 5166.08. (A) Before or during each program	34653
year, the department of ~~job and family services~~health care	34654
administration shall mail to each hospital by certified mail,	34655
return receipt requested, the preliminary determination of the	34656
amount that the hospital is assessed under section ~~5112.06~~5166.05	34657
of the Revised Code during the program year. The preliminary	34658
determination of a hospital's assessment shall be calculated for a	34659
cost-reporting period that is specified in rules adopted under	34660
section ~~5112.03~~5166.02 of the Revised Code.	34661

The department shall consult with hospitals each year when	34662
determining the date on which it will mail the preliminary	34663
determinations in order to minimize hospitals' cash flow	34664
difficulties.	34665

If no hospital submits a request for reconsideration under	34666
division (B) of this section, the preliminary determination	34667
constitutes the final reconciliation of each hospital's assessment	34668
under section ~~5112.06~~5166.05 of the Revised Code. The final	34669
reconciliation is subject to adjustments under division (D) of	34670
this section.	34671

(B) Not later than fourteen days after the preliminary	34672
determinations are mailed, any hospital may submit to the	34673
department a written request to reconsider the preliminary	34674
determinations. The request shall be accompanied by written	34675
materials setting forth the basis for the reconsideration. If one	34676
or more hospitals submit a request, the department shall hold a	34677
public hearing not later than thirty days after the preliminary	34678
determinations are mailed to reconsider the preliminary	34679
determinations. The department shall mail to each hospital a	34680
written notice of the date, time, and place of the hearing at	34681
least ten days prior to the hearing. On the basis of the evidence	34682
submitted to the department or presented at the public hearing,	34683
the department shall reconsider and may adjust the preliminary	34684
determinations. The result of the reconsideration is the final	34685
reconciliation of the hospital's assessment under section ~~5112.06~~	34686
5166.05 of the Revised Code. The final reconciliation is subject	34687
to adjustments under division (D) of this section.	34688

(C) The department shall mail to each hospital a written	34689
notice of its assessment for the program year under the final	34690
reconciliation. A hospital may appeal the final reconciliation of	34691
its assessment to the court of common pleas of Franklin county.	34692
While a judicial appeal is pending, the hospital shall pay, in	34693
accordance with the schedules required by division (B) of section	34694
~~5112.06~~5166.05 of the Revised Code, any amount of its assessment	34695
that is not in dispute into the hospital care assurance program	34696
fund created in section ~~5112.18~~5166.12 of the Revised Code.	34697

(D) In the course of any program year, the department may	34698
adjust the assessment rate or rates established in rules pursuant	34699
to section ~~5112.06~~5166.05 of the Revised Code or adjust the	34700
amounts of intergovernmental transfers required under section	34701
~~5112.07~~5166.06 of the Revised Code and, as a result of the	34702
adjustment, adjust each hospital's assessment and	34703
intergovernmental transfer, to reflect refinements made by the	34704
United States ~~health care financing administration~~department of	34705
health and human services during that program year to the limits	34706
it prescribed under ~~subsection (f) of section 1923 of the "Social~~	34707
~~Security Act," 49 Stat. 620 (1935),~~ 42 U.S.C.A. 1396r-4(f)~~, as~~	34708
~~amended~~. When adjusted, the assessment rate or rates must comply	34709
with division (A) of section ~~5112.06~~5166.05 of the Revised Code.	34710
An adjusted intergovernmental transfer must comply with division	34711
(A) of section ~~5112.07~~5166.06 of the Revised Code. The department	34712
shall notify hospitals of adjustments made under this division and	34713
adjust for the remainder of the program year the installments paid	34714
by hospitals under sections ~~5112.06~~5166.05 and ~~5112.07~~5166.06 of	34715
the Revised Code in accordance with rules adopted under section	34716
~~5112.03~~5166.02 of the Revised Code.	34717

~~Sec. 5112.10.~~ Sec. 5166.09. The department of ~~job and family~~	34718
~~services~~health care administration shall operate the hospital	34719
care assurance program established by sections ~~5112.01~~5166.01 to	34720
~~5112.21~~5166.14 of the Revised Code on a program year basis. The	34721
department shall complete all program requirements on or before	34722
the thirtieth day of September each year.	34723

~~Sec. 5112.11.~~ Sec. 5166.10. Except for moneys deposited into the	34724
legislative budget services fund under section ~~5112.19~~5166.13 of	34725
the Revised Code and the health care services administration fund	34726
created under section ~~5111.94~~5161.15 of the Revised Code, the	34727
department of ~~job and family services~~health care administration	34728
shall not use money paid to the department under sections ~~5112.06~~	34729
5166.05 and ~~5112.07~~5166.06 of the Revised Code or money that the	34730
department pays to hospitals under section ~~5112.08~~5166.07 of the	34731
Revised Code to replace any funds appropriated by the general	34732
assembly for the ~~medical assistance~~medicaid program.	34733

~~Sec. 5112.17.~~ Sec. 5166.11. (A) As used in this section:

34734

(1) "Federal poverty guideline" means the official poverty	34735
guideline as revised annually by the United States secretary of	34736
health and human services in accordance with section 673 of the	34737
"Community Service Block Grant Act," 95 Stat. 511 (1981), 42	34738
U.S.C.A. 9902, as amended, for a family size equal to the size of	34739
the family of the person whose income is being determined.	34740

(2) "Third-party payer" means any private or public entity or	34741
program that may be liable by law or contract to make payment to	34742
or on behalf of an individual for health care services.	34743
"Third-party payer" does not include a hospital.	34744

(B) Each hospital that receives funds distributed under	34745
sections ~~5112.01~~5166.01 to ~~5112.21~~5166.14 of the Revised Code	34746
shall provide, without charge to the individual, basic, medically	34747
necessary hospital-level services to individuals who are residents	34748
of this state, are not recipients of the ~~medical assistance~~	34749
medicaid program, and whose income is at or below the federal	34750
poverty guideline. Recipients of disability financial assistance	34751
~~and recipients of disability medical assistance~~ provided under	34752
Chapter 5115. of the Revised Code and recipients of the disability	34753
medical assistance program qualify for services under this	34754
section. The director of ~~job and family services~~health care	34755
administration shall adopt rules under section ~~5112.03~~5166.02 of	34756
the Revised Code specifying the hospital services to be provided	34757
under this section.	34758

(C) Nothing in this section shall be construed to prevent a	34759
hospital from requiring an individual to apply for eligibility	34760
under the ~~medical assistance~~medicaid program before the hospital	34761
processes an application under this section. Hospitals may bill	34762
any third-party payer for services rendered under this section.	34763
Hospitals may bill the ~~medical assistance~~medicaid program, in	34764
accordance with Chapter ~~5111.~~5163. of the Revised Code and the	34765
rules adopted under ~~that chapter~~section 5163.15 of the Revised	34766
Code, for services rendered under this section if the individual	34767
becomes a recipient of the program. Hospitals may bill individuals	34768
for services under this section if all of the following apply:	34769

(1) The hospital has an established post-billing procedure	34770
for determining the individual's income and canceling the charges	34771
if the individual is found to qualify for services under this	34772
section.	34773

(2) The initial bill, and at least the first follow-up bill,	34774
is accompanied by a written statement that does all of the	34775
following:	34776

(a) Explains that individuals with income at or below the	34777
federal poverty guideline are eligible for services without	34778
charge;	34779

(b) Specifies the federal poverty guideline for individuals	34780
and families of various sizes at the time the bill is sent;	34781

(c) Describes the procedure required by division (C)(1) of	34782
this section.	34783

(3) The hospital complies with any additional rules the	34784
department adopts under section ~~5112.03~~5166.02 of the Revised	34785
Code.	34786

Notwithstanding division (B) of this section, a hospital	34787
providing care to an individual under this section is subrogated	34788
to the rights of any individual to receive compensation or	34789
benefits from any person or governmental entity for the hospital	34790
goods and services rendered.	34791

(D) Each hospital shall collect and report to the department,	34792
in the form and manner prescribed by the department, information	34793
on the number and identity of patients served pursuant to this	34794
section.	34795

(E) This section applies beginning May 22, 1992, regardless	34796
of whether the department has adopted rules specifying the	34797
services to be provided. Nothing in this section alters the scope	34798
or limits the obligation of any governmental entity or program,	34799
including the program awarding reparations to victims of crime	34800
under sections 2743.51 to 2743.72 of the Revised Code and the	34801
program for medically handicapped children established under	34802
section 3701.023 of the Revised Code, to pay for hospital services	34803
in accordance with state or local law.	34804

~~Sec. 5112.18.~~ Sec. 5166.12. (A) Except as provided in section	34805
~~5112.19~~5166.13 of the Revised Code, all payments of assessments	34806
by hospitals under section ~~5112.06~~5166.05 of the Revised Code and	34807
all intergovernmental transfers under section ~~5112.07~~5166.06 of	34808
the Revised Code shall be deposited in the state treasury to the	34809
credit of the hospital care assurance program fund, hereby	34810
created. All investment earnings of the hospital care assurance	34811
program fund shall be credited to the fund. The department of ~~job~~	34812
~~and family services~~health care administration shall maintain	34813
records that show the amount of money in the hospital care	34814
assurance program fund at any time that has been paid by each	34815
hospital and the amount of any investment earnings on that amount.	34816
All moneys credited to the hospital care assurance program fund	34817
shall be used solely to make payments to hospitals under division	34818
(D) of this section and section ~~5112.08~~5166.07 of the Revised	34819
Code.	34820

(B) All federal matching funds received as a result of the	34821
department distributing funds from the hospital care assurance	34822
program fund to hospitals under section ~~5112.08~~5166.07 of the	34823
Revised Code shall be credited to the health care - federal fund	34824
created under section ~~5111.943~~5161.18 of the Revised Code.	34825

(C) All distributions of funds to hospitals under section	34826
~~5112.08~~5166.07 of the Revised Code are conditional on:	34827

(1) Expiration of the time for appeals under section ~~5112.09~~	34828
5166.08 of the Revised Code without the filing of an appeal, or on	34829
court determinations, in the event of appeals, that the hospital	34830
is entitled to the funds;	34831

(2) The sum of the following being sufficient to distribute	34832
the funds after the final determination of any appeals:	34833

(a) The available money in the hospital care assurance	34834
program fund;	34835

(b) The available portion of the money in the health care -	34836
federal fund that is credited to that fund pursuant to division	34837
(B) of this section.	34838

(3) The hospital's compliance with section ~~5112.17~~5166.11 of	34839
the Revised Code.	34840

(D) If an audit conducted by the department of the amounts of	34841
payments made and funds received by hospitals under sections	34842
~~5112.06, 5112.07, and 5112.08~~5166.05, 5166.06, and 5166.07 of the	34843
Revised Code identifies amounts that, due to errors by the	34844
department, a hospital should not have been required to pay but	34845
did pay, should have been required to pay but did not pay, should	34846
not have received but did receive, or should have received but did	34847
not receive, the department shall:	34848

(1) Make payments to any hospital that the audit reveals paid	34849
amounts it should not have been required to pay or did not receive	34850
amounts it should have received;	34851

(2) Take action to recover from a hospital any amounts that	34852
the audit reveals it should have been required to pay but did not	34853
pay or that it should not have received but did receive.	34854

Payments made under division (D)(1) of this section shall be	34855
made from the hospital care assurance program fund. Amounts	34856
recovered under division (D)(2) of this section shall be deposited	34857
to the credit of that fund. Any hospital may appeal the amount the	34858
hospital is to be paid under division (D)(1) or the amount that is	34859
to be recovered from the hospital under division (D)(2) of this	34860
section to the court of common pleas of Franklin county.	34861

~~Sec. 5112.19.~~ Sec. 5166.13. From the first installment of	34862
assessments paid under section ~~5112.06~~5166.05 of the Revised Code	34863
and intergovernmental transfers made under section ~~5112.07~~5166.06	34864
of the Revised Code during each program year beginning in an	34865
odd-numbered calendar year, the department of ~~job and family~~	34866
~~services~~health care administration shall deposit into the state	34867
treasury to the credit of the legislative budget services fund,	34868
which is hereby created, a total amount equal to the amount by	34869
which the biennial appropriation from that fund exceeds the amount	34870
of unexpended, unencumbered moneys in that fund. All investment	34871
earnings of the legislative budget services fund shall be credited	34872
to that fund. Money in the legislative budget services fund shall	34873
be used solely to pay the expenses of the legislative budget	34874
office of the legislative service commission.	34875

~~Sec. 5112.21.~~ Sec. 5166.14. Except as specifically required by	34876
sections ~~5112.01~~5166.01 to ~~5112.19~~5166.13 of the Revised Code,	34877
information filed under those sections shall not include any	34878
patient-identifying material. Information that includes	34879
patient-identifying material is not a public record under section	34880
149.43 of the Revised Code, and no patient-identifying material	34881
shall be released publicly by the department of ~~job and family~~	34882
~~services~~health care administration or by any person under	34883
contract with the department who has access to such information.	34884

~~Sec. 3721.50.~~ Sec. 5166.20. As used in sections ~~3721.50~~5166.20 to	34885
~~3721.58~~5166.30 of the Revised Code:	34886

(A) "Hospital" has the same meaning as in section 3727.01 of	34887
the Revised Code.	34888

(B) "Inpatient days" means all days during which a resident	34889
of a nursing facility, regardless of payment source, occupies a	34890
bed in the nursing facility that is included in the facility's	34891
certified capacity under ~~Title XIX~~the medicaid program.	34892
Therapeutic or hospital leave days for which payment is made under	34893
section ~~5111.26~~5164.37 of the Revised Code are considered	34894
inpatient days proportionate to the percentage of the facility's	34895
per resident per day rate paid for those days.	34896

(C) ~~"Medicaid" has the same meaning as in section 5111.01 of~~	34897
~~the Revised Code.~~	34898

~~(D)~~ "Medicaid day" means all days during which a resident who	34899
is a medicaid recipient occupies a bed in a nursing facility that	34900
is included in the facility's certified capacity under ~~Title XIX~~	34901
the medicaid program. Therapeutic or hospital leave days for which	34902
payment is made under section ~~5111.26~~5164.37 of the Revised Code	34903
are considered medicaid days proportionate to the percentage of	34904
the nursing facility's per resident per day rate for those days.	34905

~~(E)~~(D) "Nursing facility" has the same meaning as in section	34906
~~5111.20~~5164.01 of the Revised Code.	34907

~~(F)~~(E)(1) "Nursing home" means all of the following:

34908

(a) A nursing home licensed under section 3721.02 or 3721.09	34909
of the Revised Code, including any part of a home for the aging	34910
licensed as a nursing home;	34911

(b) A facility or part of a facility, other than a hospital,	34912
that is certified as a skilled nursing facility under ~~Title XVIII~~	34913
the medicare program;	34914

(c) A nursing facility, other than a portion of a hospital	34915
certified as a nursing facility.	34916

(2) "Nursing home" does not include any of the following:

34917

(a) A county home, county nursing home, or district home	34918
operated pursuant to Chapter 5155. of the Revised Code;	34919

(b) A nursing home maintained and operated by the Ohio	34920
veterans' home agency under section 5907.01 of the Revised Code;	34921

(c) A nursing home or part of a nursing home licensed under	34922
section 3721.02 or 3721.09 of the Revised Code that is certified	34923
as an intermediate care facility for the mentally retarded under	34924
~~Title XIX~~the medicaid program.	34925

~~(G) "Title XIX" means Title XIX of the "Social Security Act,"~~	34926
~~79 Stat. 286 (1965), 42 U.S.C. 1396, as amended.~~	34927

~~(H) "Title XVIII" means Title XVIII of the "Social Security~~	34928
~~Act," 79 Stat. 286 (1965), 42 U.S.C. 1395, as amended.~~	34929

~~Sec. 3721.51.~~ Sec. 5166.21. The department of ~~job and family~~	34930
~~services~~health care administration shall do all of the following:	34931

(A) Subject to division (C) of this section and for the	34932
purposes specified in sections ~~3721.56~~5166.27 and ~~3721.561~~	34933
5166.28 of the Revised Code, determine an annual franchise permit	34934
fee on each nursing home in an amount equal to six dollars and	34935
twenty-five cents, multiplied by the product of the following:	34936

(1) The number of beds licensed as nursing home beds, plus	34937
any other beds certified as skilled nursing facility beds under	34938
~~Title XVIII~~the medicare program or nursing facility beds under	34939
~~Title XIX~~the medicaid program on the first day of May of the	34940
calendar year in which the fee is determined pursuant to division	34941
(A) of section ~~3721.53~~5166.23 of the Revised Code;	34942

(2) The number of days in the fiscal year beginning on the	34943
first day of July of the calendar year in which the fee is	34944
determined pursuant to division (A) of section ~~3721.53~~5166.23 of	34945
the Revised Code.	34946

(B) Subject to division (C) of this section and for the	34947
purposes specified in sections ~~3721.56~~5166.27 and ~~3721.561~~	34948
5166.28 of the Revised Code, determine an annual franchise	34949
permit fee on each hospital in an amount equal to six dollars	34950
and twenty-five cents, multiplied by the product of the	34951
following:	34952

(1) The number of beds registered pursuant to section 3701.07	34953
of the Revised Code as skilled nursing facility beds or long-term	34954
care beds, plus any other beds licensed as nursing home beds under	34955
section 3721.02 or 3721.09 of the Revised Code, on the first day	34956
of May of the calendar year in which the fee is determined	34957
pursuant to division (A) of section ~~3721.53~~5166.23 of the Revised	34958
Code;	34959

(2) The number of days in the fiscal year beginning on the	34960
first day of July of the calendar year in which the fee is	34961
determined pursuant to division (A) of section ~~3721.53~~5166.23 of	34962
the Revised Code.	34963

(C) If the United States centers for medicare and medicaid	34964
services determines that the franchise permit fee established by	34965
sections ~~3721.50~~5166.20 to ~~3721.58~~5166.30 of the Revised Code is	34966
an impermissible health care-related tax under ~~section 1903(w) of~~	34967
~~the "Social Security Act," 49 Stat. 620 (1935),~~ 42 U.S.C.	34968
1396b(w), ~~as amended,~~ take all necessary actions to cease	34969
implementation of sections ~~3721.50~~5166.20 to ~~3721.58~~5166.30 of	34970
the Revised Code in accordance with rules adopted under section	34971
~~3721.58~~5166.30 of the Revised Code.	34972

~~Sec. 3721.52.~~ Sec. 5166.22. (A) For the purpose of the fee under	34973
division (A) of section ~~3721.51~~5166.21 of the Revised Code, the	34974
department of health shall, not later than the first day of each	34975
June, report to the department of ~~job and family services~~health	34976
care administration the number of beds in each nursing home	34977
licensed on the preceding first day of May under section 3721.02	34978
or 3721.09 of the Revised Code or certified on that date under	34979
~~Title XVIII or XIX~~the medicare or medicaid program.	34980

(B) For the purpose of the fee under division (B) of section	34981
~~3721.51~~5166.21 of the Revised Code, the department of health	34982
shall, not later than the first day of each June, report to the	34983
department of ~~job and family services~~health care administration	34984
the number of beds in each hospital registered on the preceding	34985
first day of May pursuant to section 3701.07 of the Revised Code	34986
as skilled nursing facility or long-term care beds or licensed on	34987
that date under section 3721.02 or 3721.09 of the Revised Code as	34988
nursing home beds.	34989

~~Sec. 3721.53.~~ Sec. 5166.23. (A) Not later than the fifteenth day	34990
of August of each year, the department of ~~job and family services~~	34991
health care administration shall determine the annual franchise	34992
permit fee for each nursing home in accordance with division (A)	34993
of section ~~3721.51~~5166.21 of the Revised Code and the annual	34994
franchise permit fee for each hospital in accordance with division	34995
(B) of that section.	34996

(B) Not later than the first day of September of each year,	34997
the department shall mail to each nursing home and hospital notice	34998
of the amount of the franchise permit fee that has been determined	34999
for the nursing home or hospital.	35000

(C) Each nursing home and hospital shall pay its fee under	35001
section ~~3721.51~~5166.21 of the Revised Code to the department in	35002
quarterly installment payments not later than forty-five days	35003
after the last day of each September, December, March, and June.	35004

(D) No nursing home or hospital shall directly bill its	35005
residents for the fee paid under this section, or otherwise	35006
directly pass the fee through to its residents.	35007

~~Sec. 3721.54.~~ Sec. 5166.24. If a nursing home or hospital fails to	35008
pay the full amount of a franchise permit fee installment when	35009
due, the department of ~~job and family services~~health care	35010
administration may assess a five per cent penalty on the amount	35011
due for each month or fraction thereof the installment is overdue.	35012

~~Sec. 3721.541.~~ Sec. 5166.25. (A) In addition to assessing a	35013
penalty pursuant to section ~~3721.54~~5166.24 of the Revised Code,	35014
the department of ~~job and family services~~health care	35015
administration may do any of the following if a nursing facility	35016
or hospital fails to pay the full amount of a franchise permit	35017
fee installment when due:	35018

(1) Withhold an amount less than or equal to the installment	35019
and penalty assessed under section ~~3721.54~~5166.24 of the Revised	35020
Code from a medicaid payment due the nursing facility or hospital	35021
until the nursing facility or hospital pays the installment and	35022
penalty;	35023

(2) Offset an amount less than or equal to the installment	35024
and penalty assessed under section ~~3721.54~~5166.24 of the Revised	35025
Code from a ~~Medicaid~~medicaid payment due the nursing facility or	35026
hospital;	35027

(3) Terminate the nursing facility or hospital's medicaid	35028
provider agreement.	35029

(B) The department may offset a medicaid payment under	35030
division (A) of this section without providing notice to the	35031
nursing facility or hospital and without conducting an	35032
adjudication under Chapter 119. of the Revised Code.	35033

~~Sec. 3721.55.~~ Sec. 5166.26. (A) A nursing home or hospital may	35034
appeal the fee imposed under section ~~3721.51~~5166.21 of the	35035
Revised Code solely on the grounds that the department of ~~job and~~	35036
~~family services~~health care administration committed a material	35037
error in determining the amount of the fee. A request for an	35038
appeal must be received by the department not later than fifteen	35039
days after the date the department mails the notice of the fee and	35040
must include written materials setting forth the basis for the	35041
appeal.	35042

(B) If a nursing home or hospital submits a request for an	35043
appeal within the time required under division (A) of this	35044
section, the department of ~~job and family services~~health care	35045
administration shall hold a public hearing in Columbus not later	35046
than thirty days after the date the department receives the	35047
request for an appeal. The department shall, not later than ten	35048
days before the date of the hearing, mail a notice of the date,	35049
time, and place of the hearing to the nursing home or hospital.	35050
The department may hear all the requested appeals in one public	35051
hearing.	35052

(C) On the basis of the evidence presented at the hearing or	35053
any other evidence submitted by the nursing home or hospital, the	35054
department may adjust a fee. The department's decision is final.	35055

~~Sec. 3721.56.~~ Sec. 5166.27. There is hereby created in the state	35056
treasury the home- and community-based services for the aged	35057
fund. Sixteen per cent of all payments and penalties paid by	35058
nursing homes and hospitals under sections ~~3721.53~~5166.23 and	35059
~~3721.54~~5166.24 of the Revised Code shall be deposited into the	35060
fund. The departments of ~~job and family services~~health care	35061
administration and aging shall use the moneys in the fund to	35062
fund the following in accordance with rules adopted under section	35063
~~3721.58~~5166.30 of the Revised Code:	35064

(A) The medicaid program ~~established under Chapter 5111. of~~	35065
~~the Revised Code~~, including the PASSPORT program established under	35066
section 173.40 of the Revised Code;	35067

(B) The residential state supplement program established	35068
under section ~~173.35~~5160.80 of the Revised Code.	35069

~~Sec. 3721.561.~~ Sec. 5166.28. (A) There is hereby created in the	35070
state treasury the nursing facility stabilization fund. All	35071
payments and penalties paid by nursing homes and hospitals under	35072
sections ~~3721.53~~5166.23 and ~~3721.54~~5166.24 of the Revised Code	35073
that are not deposited into the home and community-based services	35074
for the aged fund shall be deposited into the fund. The department	35075
of ~~job and family services~~health care administration shall use	35076
the money in the fund to make medicaid payments to nursing	35077
facilities.	35078

(B) Any money remaining in the nursing facility stabilization	35079
fund after payments specified in division (A) of this section are	35080
made shall be retained in the fund. Any interest or other	35081
investment proceeds earned on money in the fund shall be credited	35082
to the fund and used to make medicaid payments in accordance with	35083
division (A) of this section.	35084

~~Sec. 3721.57.~~ Sec. 5166.29. The department of ~~job and family~~	35085
~~services~~health care administration may make any investigation it	35086
considers appropriate to obtain information necessary to fulfill	35087
its duties under sections ~~3721.50~~5166.20 to ~~3721.58~~5166.30 of	35088
the Revised Code. At the request of the department, the attorney	35089
general shall aid in any such investigations. The attorney general	35090
shall institute and prosecute all necessary actions for the	35091
enforcement of sections ~~3721.50~~5166.20 to ~~3721.58~~5166.30 of the	35092
Revised Code, except that at the request of the attorney general,	35093
the county prosecutor of the county in which a nursing home or	35094
hospital that has failed to comply with sections ~~3721.50~~5166.20	35095
to ~~3721.58~~5166.30 of the Revised Code is located shall institute	35096
and prosecute any necessary action against the nursing home or	35097
hospital.	35098

~~Sec. 3721.58.~~ Sec. 5166.30. The director of ~~job and family~~	35099
~~services~~health care administration shall adopt rules in	35100
accordance with Chapter 119. of the Revised Code to do all of the	35101
following:	35102

(A) Prescribe the actions the department of ~~job and family~~	35103
~~services~~health care administration will take to cease	35104
implementation of sections ~~3721.50~~5166.20 through ~~3721.57~~5166.29	35105
of the Revised Code if the United States centers for medicare and	35106
medicaid services determines that the franchise permit fee	35107
established by those sections is an impermissible health-care	35108
related tax under ~~section 1903(w) of the "Social Security Act," 49~~	35109
~~Stat. 620 (1935),~~ 42 U.S.C. 1396b(w)~~, as amended~~;	35110

(B) Establish the method of distributing moneys in the home	35111
and community-based services for the aged fund created under	35112
section ~~3721.56~~5166.27 of the Revised Code;	35113

(C) Establish any requirements or procedures the director	35114
considers necessary to implement sections ~~3721.50~~5166.20 to	35115
~~3721.58~~5166.30 of the Revised Code.	35116

~~Sec. 5112.30.~~ Sec. 5166.40. As used in sections ~~5112.30~~5166.40 to	35117
~~5112.39~~5166.50 of the Revised Code:	35118

~~(A) "Intermediate~~, "intermediate care facility for the	35119
mentally retarded" has the same meaning as in section ~~5111.20~~	35120
5164.01 of the Revised Code, except that it does not include any	35121
such facility operated by the department of mental retardation and	35122
developmental disabilities.	35123

~~(B) "Medicaid" has the same meaning as in section 5111.01 of~~	35124
~~the Revised Code.~~	35125

~~Sec. 5112.31.~~ Sec. 5166.41. The department of ~~job and family~~	35126
~~services~~health care administration shall do all of the	35127
following:	35128

(A) For the purposes specified in sections ~~5112.37~~5166.48	35129
and ~~5112.371~~5166.481 of the Revised Code, annually assess each	35130
intermediate care facility for the mentally retarded a franchise	35131
permit fee equal to eleven dollars and ninety-eight cents	35132
multiplied by the product of the following:	35133

(1) The number of beds certified ~~under Title XIX of the~~	35134
~~"Social Security Act"~~for the medicaid program on the first day of	35135
May of the calendar year in which the assessment is determined	35136
pursuant to division (A) of section ~~5112.33~~5166.44 of the	35137
Revised Code;	35138

(2) The number of days in the fiscal year beginning on the	35139
first day of July of the same calendar year.	35140

(B) Beginning July 1, 2009, and the first day of each July	35141
thereafter, adjust fees determined under division (A) of this	35142
section in accordance with the composite inflation factor	35143
established in rules adopted under section ~~5112.39~~5166.50 of the	35144
Revised Code.	35145

(C) If the United States secretary of health and human	35146
services determines that the franchise permit fee established by	35147
sections ~~5112.30~~5166.40 to ~~5112.39~~5166.50 of the Revised Code	35148
would be an impermissible health care-related tax under ~~section~~	35149
~~1903(w) of the "Social Security Act,"~~ 42 U.S.C.A. 1396b(w), as	35150
~~amended,~~ take all necessary actions to cease implementation of	35151
those sections in accordance with rules adopted under section	35152
~~5112.39~~5166.50 of the Revised Code.	35153

~~Sec. 5112.32.~~ Sec. 5166.43. For the purpose of the franchise	35154
permit fee imposed under section ~~5112.31~~5166.41 of the Revised	35155
Code, the department of mental retardation and developmental	35156
disabilities shall:	35157

(A) Not later than August 1, 1993, report to the department	35158
of ~~job and family services~~health care administration the number	35159
of beds in each intermediate care facility for the mentally	35160
retarded certified on July 1, 1993, ~~under Title XIX of the "Social~~	35161
~~Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended~~	35162
for the medicaid program;	35163

(B) Not later than June 1, 1994, and the first day of each	35164
June thereafter, report to the department of ~~job and family~~	35165
~~services~~health care administration the number of beds in each	35166
such facility certified on the preceding first day of May under	35167
that title.	35168

~~Sec. 5112.33.~~ Sec. 5166.44. (A) Not later than the fifteenth day	35169
of August of each year, the department of ~~job and family services~~	35170
health care administration shall determine the annual franchise	35171
permit fee for each intermediate care facility for the mentally	35172
retarded in accordance with section ~~5112.31~~5166.41 of the Revised	35173
Code.	35174

(B) Not later than the first day of September of each year,	35175
the department shall mail to each intermediate care facility for	35176
the mentally retarded notice of the amount of the franchise permit	35177
fee the facility has been assessed under section ~~5112.31~~5166.41	35178
of the Revised Code.	35179

(C) Each intermediate care facility for the mentally retarded	35180
shall pay its fee under section ~~5112.31~~5166.41 of the Revised	35181
Code to the department in quarterly installment payments not later	35182
than forty-five days after the last day of each September,	35183
December, March, and June.	35184

~~Sec. 5112.34.~~ Sec. 5166.45. If an intermediate care facility for	35185
the mentally retarded fails to pay the full amount of an	35186
installment when due, the department of ~~job and family services~~	35187
health care administration may assess a five per cent penalty on	35188
the amount due for each month or fraction thereof the installment	35189
is overdue.	35190

~~Sec. 5112.341.~~ Sec. 5166.46. (A) In addition to assessing a	35191
penalty pursuant to section ~~5112.34~~5166.45 of the Revised Code,	35192
the department of ~~job and family services~~health care	35193
administration may do any of the following if an intermediate	35194
care facility for the mentally retarded fails to pay the full	35195
amount of a franchise permit fee installment when due:	35196

(1) Withhold an amount less than or equal to the installment	35197
and penalty assessed under section ~~5112.34~~5166.45 of the Revised	35198
Code from a medicaid payment due the facility until the facility	35199
pays the installment and penalty;	35200

(2) Offset an amount less than or equal to the installment	35201
and penalty assessed under section ~~5112.34~~5166.45 of the Revised	35202
Code from a ~~Medicaid~~medicaid payment due the nursing facility or	35203
hospital;	35204

(3) Terminate the facility's medicaid provider agreement.

35205

(B) The department may offset a medicaid payment under	35206
division (A) of this section without providing notice to the	35207
intermediate care facility for the mentally retarded and without	35208
conducting an adjudication under Chapter 119. of the Revised	35209
Code.	35210

~~Sec. 5112.35.~~ Sec. 5166.47. (A) An intermediate care facility for	35211
the mentally retarded may appeal the franchise permit fee imposed	35212
under section ~~5112.31~~5166.41 of the Revised Code solely on the	35213
grounds that the department of ~~job and family services~~health care	35214
administration committed a material error in determining the	35215
amount of the fee. A request for an appeal must be received by the	35216
department not later than fifteen days after the date the	35217
department mails the notice of the fee and must include written	35218
materials setting forth the basis for the appeal.	35219

(B) If an intermediate care facility for the mentally	35220
retarded submits a request for an appeal within the time required	35221
under division (A) of this section, the department shall hold a	35222
public hearing in Columbus not later than thirty days after the	35223
date the department receives the request for an appeal. The	35224
department shall, not later than ten days before the date of the	35225
hearing, mail a notice of the date, time, and place of the hearing	35226
to the facility. The department may hear all requested appeals in	35227
one public hearing.	35228

(C) On the basis of the evidence presented at the hearing or	35229
any other evidence submitted by the intermediate care facility for	35230
the mentally retarded, the department may adjust a fee. The	35231
department's decision is final.	35232

~~Sec. 5112.37.~~ Sec. 5166.48. There is hereby created in the state	35233
treasury the home and community-based services for the mentally	35234
retarded and developmentally disabled fund. Ninety-four and	35235
twenty-eight hundredths per cent of all installment payments and	35236
penalties paid by an intermediate care facility for the mentally	35237
retarded under sections ~~5112.33~~5166.44 and ~~5112.34~~5166.45 of	35238
the Revised Code shall be deposited into the fund. The	35239
department of ~~job and family services~~health care administration	35240
shall distribute the money in the fund in accordance with rules	35241
adopted under section ~~5112.39~~5166.50 of the Revised Code. The	35242
departments of ~~job and family services~~health care administration	35243
and mental retardation and developmental disabilities shall use	35244
the money for the medicaid program ~~established under Chapter~~	35245
~~5111. of the Revised Code and~~, including home and community-based	35246
services to ~~mentally retarded and developmentally disabled~~	35247
persons with mental retardation or a developmental disability.	35248

~~Sec. 5112.371.~~ Sec. 5166.481. There is hereby created in the state	35249
treasury the children with intensive behavioral needs programs	35250
fund. Five and seventy-two hundredths per cent of all installment	35251
payments and penalties paid by an intermediate care facility for	35252
the mentally retarded under sections ~~5112.33~~5166.44 and ~~5112.34~~	35253
5166.45 of the Revised Code shall be deposited in the fund. The	35254
money in the fund shall be used for the programs the director of	35255
mental retardation and developmental disabilities establishes	35256
under section 5123.0417 of the Revised Code.	35257

~~Sec. 5112.38.~~ Sec. 5166.49. The department of ~~job and family~~	35258
~~services~~health care administration may make any investigation it	35259
considers appropriate to obtain information necessary to fulfill	35260
its duties under sections ~~5112.30~~5166.40 to ~~5112.39~~5166.50 of	35261
the Revised Code. At the request of the department, the attorney	35262
general shall aid in any such investigations. The attorney general	35263
shall institute and prosecute all necessary actions for the	35264
enforcement of sections ~~5112.30~~5166.40 to ~~5112.39~~5166.50 of the	35265
Revised Code, except that at the request of the attorney general,	35266
the county prosecutor of the county in which an intermediate care	35267
facility for the mentally retarded that has failed to comply with	35268
those sections is located shall institute and prosecute any	35269
necessary action against the facility.	35270

~~Sec. 5112.39.~~ Sec. 5166.50. The director of ~~job and family~~	35271
~~services~~health care administration shall adopt rules in	35272
accordance with Chapter 119. of the Revised Code to do all of the	35273
following:	35274

(A) Establish a composite inflation factor with which to	35275
adjust franchise permit fees under section ~~5112.31~~5166.41 of the	35276
Revised Code;	35277

(B) Prescribe the actions the department will take to cease	35278
implementation of sections ~~5112.30~~5166.40 to ~~5112.39~~5166.50 of	35279
the Revised Code if the United States secretary of health and	35280
human services determines that the franchise permit fee imposed	35281
under section ~~5112.31~~5166.41 of the Revised Code is an	35282
impermissible health care-related tax under ~~section 1903(w) of the~~	35283
~~"Social Security Act," 49 Stat. 620 (1935),~~ 42 U.S.C.A. 1396b(w),	35284
~~as amended~~;	35285

(C) Establish the method of distributing the money in the	35286
home and community-based services for the mentally retarded and	35287
developmentally disabled fund created by section ~~5112.37~~5166.48	35288
of the Revised Code;	35289

(D) Establish any other requirements or procedures the	35290
director considers necessary to implement sections ~~5112.30~~5166.40	35291
to ~~5112.39~~5166.50 of the Revised Code.	35292

~~Sec. 5111.176.~~ Sec. 5166.60. (A) As used in this section:

35293

(1) "Medicaid health insuring corporation" means a health	35294
insuring corporation that holds a certificate of authority under	35295
Chapter 1751. of the Revised Code and has entered into a contract	35296
with the department of ~~job and family services~~health care	35297
administration pursuant to section ~~5111.17~~5165.05 of the Revised	35298
Code.	35299

(2) "Managed care premium" means any premium payment,	35300
capitation payment, or other payment a medicaid health insuring	35301
corporation receives for providing, or arranging for the provision	35302
of, health care services to its members or enrollees residing in	35303
this state.	35304

(B) Except as provided in division (C) of this section, all	35305
of the following apply:	35306

(1) Each medicaid health insuring corporation shall pay to	35307
the department of ~~job and family services~~health care	35308
administration a franchise permit fee for the period December 1,	35309
2005, through December 31, 2005, and each calendar quarter	35310
occurring thereafter.	35311

(2) The fee to be paid is an amount that is equal to a	35312
percentage of the managed care premiums the medicaid health	35313
insuring corporation received in the period December 1, 2005,	35314
through December 31, 2005, and in the subsequent quarter to which	35315
the fee applies, excluding the amount of any managed care premiums	35316
the corporation returned or refunded to enrollees, members, or	35317
premium payers during the period December 1, 2005, through	35318
December 31, 2005, or the subsequent quarter to which the fee	35319
applies.	35320

(3) The percentage to be used in calculating the fee shall be	35321
four and one-half per cent, unless the department adopts rules	35322
under division (L) of this section decreasing the percentage below	35323
four and one-half per cent or increasing the percentage to not	35324
more than six per cent.	35325

(C) The department shall reduce the franchise permit fee	35326
imposed under this section or terminate its collection of the fee	35327
if the department determines either of the following:	35328

(1) That the reduction or termination is required to comply	35329
with federal statutes or regulations;	35330

(2) That the fee does not qualify as a state share of	35331
medicaid expenditures eligible for federal financial	35332
participation.	35333

(D) The franchise permit fee shall be paid on or before the	35334
thirtieth day following the end of the period December 1, 2005,	35335
through December 31, 2005, or the calendar quarter to which the	35336
fee applies. At the time the fee is submitted, the medicaid health	35337
insuring corporation shall file with the department a report on a	35338
form prescribed by the department. The corporation shall provide	35339
on the form all information required by the department and shall	35340
include with the form any necessary supporting documentation.	35341

(E) The department may audit the records of any medicaid	35342
health insuring corporation to determine whether the corporation	35343
is in compliance with this section. The department may audit the	35344
records that pertain to the period December 1, 2005, through	35345
December 31, 2005, or a particular calendar quarter, at any time	35346
during the five years following the date the franchise permit fee	35347
payment for that period or quarter was due.	35348

(F)(1) A medicaid health insuring corporation that does not	35349
pay the franchise permit fee in full by the date the payment is	35350
due is subject to any or all of the following:	35351

(a) A monetary penalty in the amount of five hundred dollars	35352
for each day any part of the fee remains unpaid, except that the	35353
penalty shall not exceed an amount equal to five per cent of the	35354
total fee that was due;	35355

(b) Withholdings from future managed care premiums pursuant	35356
to division (G) of this section;	35357

(c) Termination of the corporation's medicaid provider	35358
agreement pursuant to division (H) of this section.	35359

(2) Penalties imposed under division (F)(1)(a) of this	35360
section are in addition to and not in lieu of the franchise permit	35361
fee.	35362

(G) If a medicaid health insuring corporation fails to pay	35363
the full amount of its franchise permit fee when due, or the full	35364
amount of a penalty imposed under division (F)(1)(a) of this	35365
section, the department may withhold an amount equal to the	35366
remaining amount due from any future managed care premiums to be	35367
paid to the corporation under the medicaid program. The department	35368
may withhold amounts under this division without providing notice	35369
to the corporation. The amounts may be withheld until the amount	35370
due has been paid.	35371

(H) The department may commence actions to terminate a	35372
medicaid health insuring corporation's medicaid provider	35373
agreement, and may terminate the agreement subject to division (I)	35374
of this section, if the corporation does any of the following:	35375

(1) Fails to pay its franchise permit fee or fails to pay the	35376
fee promptly;	35377

(2) Fails to pay a penalty imposed under division (F)(1)(a)	35378
of this section or fails to pay the penalty promptly;	35379

(3) Fails to cooperate with an audit conducted under division	35380
(E) of this section.	35381

(I) At the request of a medicaid health insuring corporation,	35382
the department shall grant the corporation a hearing in accordance	35383
with Chapter 119. of the Revised Code, if either of the following	35384
is the case:	35385

(1) The department has determined that the corporation owes	35386
an additional franchise permit fee or penalty as the result of an	35387
audit conducted under division (E) of this section.	35388

(2) The department is proposing to terminate the	35389
corporation's medicaid provider agreement and the provisions of	35390
section ~~5111.06~~5163.01 of the Revised Code requiring an	35391
adjudication in accordance with Chapter 119. of the Revised Code	35392
are applicable.	35393

(J)(1) At the request of a medicaid corporation, the	35394
department shall grant the corporation a reconsideration of any	35395
issue that arises out of the provisions of this section and is not	35396
subject to division (I) of this section. The department's decision	35397
at the conclusion of the reconsideration is not subject to appeal	35398
under Chapter 119. of the Revised Code or any other provision of	35399
the Revised Code.	35400

(2) In conducting a reconsideration, the department shall do	35401
at least the following:	35402

(a) Specify the time frames within which a corporation must	35403
act in order to exercise its opportunity for a reconsideration;	35404

(b) Permit the corporation to present written arguments or	35405
other materials that support the corporation's position.	35406

(K) There is hereby created in the state treasury the managed	35407
care assessment fund. Money collected from the franchise permit	35408
fees and penalties imposed under this section shall be credited to	35409
the fund. The department shall use the money in the fund to pay	35410
for medicaid services, the department's administrative costs, and	35411
contracts with medicaid health insuring corporations.	35412

(L) The director of ~~job and family services~~health care	35413
administration may adopt rules to implement and administer this	35414
section. The rules shall be adopted in accordance with Chapter	35415
119. of the Revised Code.	35416

~~Sec. 5112.99.~~ Sec. 5166.99. (A) The director of ~~job and family~~	35417
~~services~~health care administration shall impose a penalty for	35418
each day that a hospital fails to report the information required	35419
under section ~~5112.04~~5166.03 of the Revised Code on or before the	35420
dates specified in that section. The amount of the penalty shall	35421
be established by the director in rules adopted under section	35422
~~5112.03~~5166.02 of the Revised Code.	35423

(B) In addition to any other remedy available to the	35424
department of ~~job and family services~~health care administration	35425
under law to collect unpaid assessments and transfers, the	35426
director shall impose a penalty of ten per cent of the amount due	35427
on any hospital that fails to pay assessments or make	35428
intergovernmental transfers by the dates required by rules adopted	35429
under section ~~5112.03~~5166.02 of the Revised Code.	35430

(C) The director shall waive the penalties provided for in	35431
divisions (A) and (B) of this section for good cause shown by the	35432
hospital.	35433

(D) All penalties imposed under this section shall be	35434
deposited into the health care administration fund created by	35435
section ~~5111.94~~5161.15 of the Revised Code.	35436

Sec. 5167.01. As used in this chapter, "federal poverty	35437
guidelines" has the same meaning as in section 5101.46 of the	35438
Revised Code.	35439

~~Sec. 5101.50.~~ Sec. 5167.05. (A) ~~As used in sections 5101.50 to~~	35440
~~5101.529 of the Revised Code:~~	35441

~~(1) "Children's health insurance program" means the program~~	35442
~~authorized by Title XXI of the "Social Security Act," 111 Stat.~~	35443
~~552 (1997), 42 U.S.C.A. 1397aa.~~	35444

~~(2) "Federal poverty guidelines" has the same meaning as in~~	35445
~~section 5101.46 of the Revised Code.~~	35446

~~(B)~~ The director of ~~job and family services~~health care	35447
administration may continue to operate the children's health	35448
insurance program initially authorized by an executive order	35449
issued under section 107.17 of the Revised Code as long as federal	35450
financial participation is available for the program. If operated,	35451
the program shall provide health assistance to uninsured	35452
individuals under nineteen years of age with family incomes not	35453
exceeding one hundred fifty per cent of the federal poverty	35454
guidelines. In accordance with 42 U.S.C.A. 1397aa, the director	35455
may provide for the health assistance to meet the requirements of	35456
42 U.S.C.A. 1397cc, to be provided under the medicaid program	35457
~~established under Chapter 5111. of the Revised Code~~, or to be a	35458
combination of both.	35459

~~Sec. 5101.501.~~ Sec. 5167.06. Health assistance provided under	35460
section ~~5101.50~~5167.05 of the Revised Code shall be known as the	35461
children's health insurance program part I.	35462

~~Sec. 5101.502.~~ Sec. 5167.07. The director of ~~job and family~~	35463
~~services~~health care administration may adopt rules in accordance	35464
with Chapter 119. of the Revised Code as necessary for the	35465
efficient administration of the children's health insurance	35466
program part I, including rules that establish all of the	35467
following:	35468

(A) The conditions under which health assistance services	35469
will be reimbursed;	35470

(B) The method of reimbursement applicable to services	35471
reimbursable under the program;	35472

(C) The amount of reimbursement, or the method by which the	35473
amount is to be determined, for each reimbursable service.	35474

~~Sec. 5101.503.~~ Sec. 5167.08. A completed application for ~~medical~~	35475
~~assistance under Chapter 5111. of the Revised Code~~the medicaid	35476
program shall be treated as an application for health assistance	35477
under the children's health insurance program part I if the	35478
application is for an assistance group that includes a child under	35479
nineteen years of age and is denied.	35480

~~Sec. 5101.51.~~ Sec. 5167.10. In accordance with federal law	35481
governing the children's health insurance program, the director of	35482
~~job and family services~~health care administration may submit a	35483
state child health plan to the United States secretary of health	35484
and human services to provide, except as provided in section	35485
~~5101.516~~5167.16 of the Revised Code, health assistance to	35486
uninsured individuals under nineteen years of age with family	35487
incomes above one hundred fifty per cent of the federal poverty	35488
guidelines but not exceeding two hundred per cent of the federal	35489
poverty guidelines. If the director submits the plan, the director	35490
shall include both of the following in the plan:	35491

(A) The health assistance will not begin before January 1,	35492
2000.	35493

(B) The health assistance will be available only while	35494
federal financial participation is available for it.	35495

~~Sec. 5101.511.~~ Sec. 5167.11. Health assistance provided under	35496
section ~~5101.51~~5167.10 of the Revised Code shall be known as the	35497
children's health insurance program part II.	35498

~~Sec. 5101.512.~~ Sec. 5167.12. If the director of ~~job and family~~	35499
~~services~~health care administration submits a state child health	35500
plan to the United States secretary of health and human services	35501
under section ~~5101.51~~5167.10 of the Revised Code and the	35502
secretary approves the plan, the director shall implement the	35503
children's health insurance program part II in accordance with the	35504
plan. The director may adopt rules in accordance with Chapter 119.	35505
of the Revised Code as necessary for the efficient administration	35506
of the program, including rules that establish all of the	35507
following:	35508

(A) The conditions under which health assistance services	35509
will be reimbursed;	35510

(B) The method of reimbursement applicable to services	35511
reimbursable under the program;	35512

(C) The amount of reimbursement, or the method by which the	35513
amount is to be determined, for each reimbursable service.	35514

~~Sec. 5101.513.~~ Sec. 5167.13. The director of ~~job and family~~	35515
~~services~~health care administration may contract with a government	35516
entity or person to perform the director's administrative duties	35517
regarding the children's health insurance program part II, other	35518
than the duty to submit a state child health plan to the United	35519
States secretary of health and human services under section	35520
~~5101.51~~5167.10 of the Revised Code and the duty to adopt rules	35521
under section ~~5101.512~~5167.12 of the Revised Code.	35522

~~Sec. 5101.514.~~ Sec. 5167.14. In accordance with 42 U.S.C.A.	35523
1397aa, the director of health care administration may provide for	35524
health assistance under the children's health insurance program	35525
part II to meet the requirements of 42 U.S.C.A. 1397cc, to be	35526
provided under the medicaid program ~~established under Chapter~~	35527
~~5111. of the Revised Code~~, or to be a combination of both.	35528

~~Sec. 5101.515.~~ Sec. 5167.15. The director of ~~job and family~~	35529
~~services~~health care administration may determine applicants'	35530
eligibility for the children's health insurance program part II by	35531
any of the following means:	35532

(A) Using employees of the department of ~~job and family~~	35533
~~services~~health care administration;	35534

(B) Assigning the duty to county departments of job and	35535
family services;	35536

35537

~~Sec. 5101.516.~~ Sec. 5167.16. If the director of ~~job and family~~	35538
~~services~~health care administration determines that federal	35539
financial participation for the children's health insurance	35540
program part II is insufficient to provide health assistance to	35541
all the individuals the director anticipates are eligible for the	35542
program, the director may refuse to accept new applications for	35543
the program or may make the program's eligibility requirements	35544
more restrictive.	35545

~~Sec. 5101.517.~~ Sec. 5167.17. To the extent permitted by 42	35546
U.S.C.A. 1397cc(e), the director of ~~job and family services~~health	35547
care administration may require an individual receiving health	35548
assistance under the children's health insurance program part II	35549
to pay a premium, deductible, coinsurance payment, or other	35550
cost-sharing expense.	35551

~~Sec. 5101.518.~~ Sec. 5167.18. The director of ~~job and family~~	35552
~~services~~health care administration shall establish an appeal	35553
process for individuals aggrieved by a decision made regarding	35554
eligibility for the children's health insurance program part II.	35555
The process may be identical to, similar to, or different from the	35556
appeal process established by section ~~5101.35~~5160.34 of the	35557
Revised Code.	35558

~~Sec. 5101.519.~~ Sec. 5167.19. A completed application for ~~medical~~	35559
~~assistance under Chapter 5111. of the Revised Code~~the medicaid	35560
program shall be treated as an application for health assistance	35561
under the children's health insurance program part II if the	35562
application is for an assistance group that includes a child under	35563
nineteen years of age and is denied.	35564

~~Sec. 5101.52.~~ Sec. 5167.21. In accordance with federal law	35565
governing the children's health insurance program, the director	35566
of ~~job and family services~~health care administration may submit	35567
a request for a federal waiver to the United States secretary of	35568
health and human services to provide, except as provided in	35569
section ~~5101.526~~5167.27 of the Revised Code, health assistance	35570
to individuals under nineteen years of age with family incomes	35571
above two hundred per cent of the federal poverty guidelines but	35572
not exceeding three hundred per cent of the federal poverty	35573
guidelines. If the director submits the plan, the director shall	35574
stipulate in the plan that the health assistance will be	35575
available only while federal financial participation is available	35576
for it and that health assistance shall not begin before January	35577
1, 2008.	35578

~~Sec. 5101.521.~~ Sec. 5167.22. Health assistance provided under	35579
section ~~5101.52~~5167.21 of the Revised Code shall be known as the	35580
children's health insurance program part III.	35581

~~Sec. 5101.522.~~ Sec. 5167.23. If the director of ~~job and family~~	35582
~~services~~health care administration submits a waiver request to	35583
the United States secretary of health and human services under	35584
section ~~5101.52~~5167.21 of the Revised Code and the secretary	35585
grants the waiver, the director shall implement the children's	35586
health insurance program part III in accordance with the waiver.	35587
The director may adopt rules in accordance with Chapter 119. of	35588
the Revised Code as necessary for the efficient administration of	35589
the program, including rules that establish all of the following:	35590

(A) The conditions under which health assistance services	35591
will be reimbursed;	35592

(B) The method of reimbursement applicable to services	35593
reimbursable under the program;	35594

(C) The amount of reimbursement, or the method by which the	35595
amount is to be determined, for each reimbursable service.	35596

~~Sec. 5101.523.~~ Sec. 5167.24. The director of ~~job and family~~	35597
~~services~~health care administration may contract with a	35598
government entity or person to perform the director's	35599
administrative duties regarding the children's health insurance	35600
program part III, other than the duty to submit a waiver request	35601
to the United States secretary of health and human services under	35602
section ~~5101.52~~5167.21 of the Revised Code and the duty to adopt	35603
rules under section ~~5101.522~~5167.23 of the Revised Code.	35604

~~Sec. 5101.524.~~ Sec. 5167.25. In accordance with 42 U.S.C. 1397aa,	35605
the director of ~~job and family services~~health care	35606
administration shall provide for health assistance under the	35607
children's health insurance program part III to meet the	35608
requirements of 42 U.S.C. 1397cc, to be provided under the	35609
medicaid program ~~established under Chapter 5111. of the Revised~~	35610
~~Code~~, or to be a combination of both.	35611

~~Sec. 5101.525.~~ Sec. 5167.26. The director of ~~job and family~~	35612
~~services~~health care administration may determine applicants'	35613
eligibility for the children's health insurance program part III	35614
by any of the following means:	35615

(A) Using employees of the department of ~~job and family~~	35616
~~services~~health care administration;	35617

(B) Assigning the duty to county departments of job and	35618
family services;	35619

35620

~~Sec. 5101.526.~~ Sec. 5167.27. If the director of ~~job and family~~	35621
~~services~~health care administration determines that federal	35622
financial participation for the children's health insurance	35623
program part III is insufficient to provide health assistance to	35624
all the individuals the director anticipates are eligible for the	35625
program, the director may refuse to accept new applications for	35626
the program or may make the program's eligibility requirements	35627
more restrictive.	35628

~~Sec. 5101.527.~~ Sec. 5167.28. To the extent permitted by 42 U.S.C.	35629
1397cc(e), the director of ~~job and family services~~health care	35630
administration shall require an individual receiving health	35631
assistance under the children's health insurance program part III	35632
to pay the following as a term of participation in the program:	35633

(A) A premium of not less than forty dollars per month for a	35634
family with one individual receiving health assistance under the	35635
program;	35636

(B) A premium of not less than eighty dollars per month for a	35637
family with two individuals receiving health assistance under the	35638
program;	35639

(C) A premium of not less than one hundred twenty dollars per	35640
month for a family with three or more individuals receiving health	35641
assistance under the program.	35642

~~Sec. 5101.528.~~ Sec. 5167.29. If the children's health insurance	35643
program part III is not provided under the medicaid program	35644
~~established under Chapter 5111. of the Revised Code~~, the director	35645
of ~~job and family services~~health care administration shall	35646
establish an appeal process for individuals aggrieved by a	35647
decision made regarding eligibility for the children's health	35648
insurance program part III. The process may be identical to,	35649
similar to, or different from the appeal process established by	35650
section ~~5101.35~~5160.34 of the Revised Code.	35651

~~Sec. 5101.529.~~ Sec. 5167.30. A completed application for the	35652
medicaid program ~~under Chapter 5111. of the Revised Code~~ shall be	35653
treated as an application for health assistance under the	35654
children's health insurance program part III.	35655

~~Sec. 5101.5110.~~ Sec. 5167.32. (A) The director of ~~job and family~~	35656
~~services~~health care administration may submit a waiver request to	35657
the United States secretary of health and human services to	35658
provide health assistance to any individual who meets all of the	35659
following requirements:	35660

(1) Is the parent of a child under nineteen years of age who	35661
resides with the parent and is eligible for health assistance	35662
under the children's health insurance program part I or II or the	35663
medicaid program ~~established under Chapter 5111. of the Revised~~	35664
~~Code~~;	35665

(2) Is uninsured;

35666

(3) Has a family income that does not exceed one hundred per	35667
cent of the federal poverty guidelines.	35668

(B) A waiver request the director submits under division (A)	35669
of this section may seek federal funds allotted to the state under	35670
~~Title XXI of the "Social Security Act," 111 Stat. 558 (1997),~~ 42	35671
U.S.C.A. 1397dd~~, as amended,~~ that are not otherwise used to fund	35672
the children's health insurance program parts I and II.	35673

(C) If a waiver request the director submits under division	35674
(A) of this section is granted, the director may adopt rules in	35675
accordance with Chapter 119. of the Revised Code as necessary for	35676
the efficient administration of the program authorization by the	35677
waiver.	35678

~~Sec. 5101.5211.~~ Sec. 5167.35. (A) As used in sections ~~5101.5211~~	35679
5167.35 to ~~5101.5216~~5167.40 of the Revised Code:	35680

~~"Children's buy-in program" means the program established~~	35681
~~under sections 5101.5211 to 5101.5216 of the Revised Code.~~	35682

"Countable family income" has the meaning established in	35683
rules adopted under section ~~5101.5215~~5167.39 of the Revised	35684
Code.	35685

"Creditable coverage" has the same meaning as in 42 U.S.C.	35686
300gg(c)(1), except that it does not mean medical assistance	35687
available under the children's buy-in program or the program for	35688
medically handicapped children.	35689

"Family" has the meaning established in rules adopted under	35690
section ~~5101.5215~~5167.39 of the Revised Code.	35691

"Federal poverty guidelines" has the same meaning as in	35692
section 5101.46 of the Revised Code.	35693

"Program for medically handicapped children" means the	35694
program established under sections 3701.021 to 3701.0210 of the	35695
Revised Code.	35696

(B) The director of ~~job and family services~~health care	35697
administration shall establish the children's buy-in program in	35698
accordance with sections ~~5101.5211~~5167.35 to ~~5101.5216~~5167.40	35699
of the Revised Code. The director shall submit to the United	35700
States secretary of health and human services an amendment to	35701
the state medicaid plan, an amendment to the state child health	35702
plan, one or more requests for a federal waiver, or such an	35703
amendment and waiver requests as necessary to seek federal	35704
matching funds for the children's buy-in program. The director	35705
shall not begin implementation of the program until after	35706
submitting the amendment, waiver request, or both. The director	35707
may begin implementation of the program before receiving approval	35708
of the amendment, waiver request, or both using state funds only.	35709
The director shall implement the program regardless of whether	35710
the amendment, waiver request, or both are denied. The program	35711
shall be funded with state funds only if the United States	35712
secretary denies federal matching funds for the program. If the	35713
United States secretary approves federal matching funds for the	35714
program and if permitted under the terms of the approval, the	35715
program shall be operated as part of the medicaid program, the	35716
children's health insurance program, or both.	35717

~~Sec. 5101.5212.~~ Sec. 5167.36. Under the children's buy-in program	35718
and subject to section ~~5101.5213~~5167.37 of the Revised Code, an	35719
individual who does both of the following in accordance with	35720
rules adopted under section ~~5101.5215~~5167.39 of the Revised	35721
Code qualifies for medical assistance under the program, unless	35722
the director of ~~job and family services~~health care	35723
administration has adopted rules under division (B) of section	35724
~~5101.5215~~5167.39 of the Revised Code to limit the number of	35725
individuals who may participate in the program at one time and the	35726
program is serving the maximum number of individuals specified in	35727
the rules:	35728

(A) Applies for the children's buy-in program;

35729

(B) Provides satisfactory evidence of all of the following:

35730

(1) That the individual is under nineteen years of age;

35731

(2) That the individual's countable family income exceeds	35732
two hundred fifty per cent of the federal poverty guidelines;	35733

(3) That the individual has not had creditable coverage for	35734
at least six months before enrolling in the children's buy-in	35735
program, unless the individual lost the only creditable coverage	35736
available to the individual because the individual exhausted a	35737
lifetime benefit limitation;	35738

(4) That one or more of the following apply to the	35739
individual:	35740

(a) The individual is unable to obtain creditable coverage	35741
due to a pre-existing condition of the individual;	35742

(b) The individual lost the only creditable coverage	35743
available to the individual because the individual has exhausted	35744
a lifetime benefit limitation;	35745

(c) The premium for the only creditable coverage available to	35746
the individual is greater than two hundred per cent of the premium	35747
applicable to the individual under the children's buy-in program;	35748

(d) The individual participates in the program for medically	35749
handicapped children.	35750

(5) That the individual meets the additional eligibility	35751
requirements for the children's buy-in program established in	35752
rules adopted under section ~~5101.5215~~5167.39 of the Revised	35753
Code.	35754

~~Sec. 5101.5213.~~ Sec. 5167.37. (A) An individual participating in	35755
the children's buy-in program shall be charged a monthly	35756
premium established by rules adopted under section ~~5101.5215~~	35757
5167.39 of the Revised Code. The amount of the monthly premium	35758
shall not be less than the following:	35759

(1) In the case of an individual with countable family income	35760
exceeding two hundred fifty per cent but not exceeding four	35761
hundred per cent of the federal poverty guidelines, the	35762
following amount:	35763

(a) If no other member of the individual's family receives	35764
medical assistance under the program with the individual, one	35765
hundred dollars;	35766

(b) If one or more members of the individual's family receive	35767
medical assistance under the program with the individual, one	35768
hundred fifty dollars.	35769

(2) In the case of an individual with countable family income	35770
exceeding four hundred per cent but not exceeding five hundred	35771
per cent of the federal poverty guidelines, the following	35772
amount:	35773

(a) If no other member of the individual's family receives	35774
medical assistance under the program with the individual, one	35775
hundred twenty-five dollars;	35776

(b) If one or more members of the individual's family receive	35777
medical assistance under the program with the individual, one	35778
hundred seventy-five dollars.	35779

(3) In the case of an individual with countable family	35780
income exceeding five hundred per cent of the federal poverty	35781
guidelines, the full amount of the actuarially determined cost	35782
of the premium.	35783

(B) If the premium for the children's buy-in program is not	35784
paid for two consecutive months, the individual shall lose	35785
eligibility for the program. The individual may not resume	35786
participation in the program until the unpaid premiums that	35787
accrued before the individual lost eligibility are paid.	35788

~~Sec. 5101.5214.~~ Sec. 5167.38. (A) An individual participating in	35789
the children's buy-in program shall be charged co-payments	35790
established by rules adopted under section ~~5101.5215~~5167.39 of	35791
the Revised Code.	35792

(B) Notwithstanding division (B) of section ~~5111.0112~~5162.35	35793
of the Revised Code, if applicable, and to the extent permitted	35794
by federal law, a provider may refuse to provide a service to an	35795
individual if a co-payment required by this section is not	35796
paid.	35797

~~Sec. 5101.5215.~~ Sec. 5167.39. (A) The director of ~~job and family~~	35798
~~services~~health care administration shall adopt rules in	35799
accordance with Chapter 119. of the Revised Code as necessary to	35800
implement the children's buy-in program, including rules that do	35801
all of the following:	35802

(1) Establish the meaning of "countable family income" and	35803
"family";	35804

(2) For the purpose of section ~~5101.5212~~5167.36 of the	35805
Revised Code, establish additional eligibility requirements for	35806
the program;	35807

(3) For the purpose of section ~~5101.5213~~5167.37 of the	35808
Revised Code, establish monthly premiums for the children's	35809
buy-in program;	35810

(4) For the purpose of section ~~5101.5214~~5167.38 of the	35811
Revised Code, establish copayment requirements for the children's	35812
buy-in program.	35813

(B) The director may adopt rules in accordance with Chapter	35814
119. of the Revised Code to limit the number of individuals who	35815
may participate in the children's buy-in program at one time.	35816

~~Sec. 5101.5216.~~ Sec. 5167.40. The director of ~~job and family~~	35817
~~services~~health care administration shall prepare a report on the	35818
children's buy-in program that examines the program's	35819
effectiveness and includes the number of individuals	35820
participating in the program and the costs of the program. The	35821
director shall submit the report to the governor and general	35822
assembly not later than December 31, 2008.	35823

~~Sec. 5115.10.~~ Sec. 5168.01. (A) The director of ~~job and family~~	35824
~~services~~health care administration shall establish a disability	35825
medical assistance program.	35826

(B) Subject to all other eligibility requirements established	35827
by this chapter and the rules adopted under it for the disability	35828
medical assistance program, a person may be eligible for	35829
disability medical assistance only if the person is medication	35830
dependent, as determined by the department of ~~job and family~~	35831
~~services~~health care administration.	35832

(C) The director shall adopt rules under section 111.15 of	35833
the Revised Code for purposes of implementing division (B) of this	35834
section. The rules may specify or establish any or all of the	35835
following:	35836

(1) Standards for determining whether a person is medication	35837
dependent, including standards under which a person may qualify as	35838
being medication dependent only if it is determined that both of	35839
the following are the case:	35840

(a) The person is receiving ongoing treatment for a chronic	35841
medical condition that requires continuous prescription medication	35842
for an indefinite, long-term period of time;	35843

(b) Loss of the medication would result in a significant risk	35844
of medical emergency and loss of employability lasting at least	35845
nine months.	35846

(2) A requirement that a person's medical condition be	35847
certified by an individual authorized under Chapter 4731. of the	35848
Revised Code to practice medicine and surgery or osteopathic	35849
medicine and surgery;	35850

(3) Limitations on the chronic medical conditions and	35851
prescription medications that may qualify a person as being	35852
medication dependent.	35853

~~Sec. 5115.11.~~ Sec. 5168.02. An individual who qualifies for the	35854
~~medical assistance~~medicaid program ~~established under Chapter~~	35855
~~5111. of the Revised Code~~ shall receive medical assistance through	35856
that program rather than through the disability medical assistance	35857
program.	35858

An individual is ineligible for disability medical assistance	35859
if, for the purpose of avoiding consideration of property in	35860
determinations of the individual's eligibility for disability	35861
medical assistance or a greater amount of assistance, the person	35862
has transferred property during the two years preceding	35863
application for or most recent redetermination of eligibility for	35864
disability medical assistance.	35865

Sec. 5168.03. Each applicant for or recipient of disability	35866
medical assistance who, in the judgment of the department of	35867
health care administration or a county department of job and	35868
family services might be eligible for benefits under the	35869
supplemental security program, shall, as a condition of	35870
eligibility for assistance, apply for such benefits if directed to	35871
do so by the department or county department.	35872

Sec. 5168.04. As a condition of eligibility for disability	35873
medical assistance, and as a means of preventing or reducing the	35874
provision of assistance at public expense, each applicant for or	35875
recipient of the assistance shall make reasonable efforts to	35876
secure support from persons responsible for the applicant's or	35877
recipient's support, and from other sources, including any federal	35878
program designed to provide assistance to individuals with	35879
disabilities. The department of health care administration or	35880
county department of job and family services may provide	35881
assistance to the applicant or recipient in securing other forms	35882
of assistance.	35883

~~Sec. 5115.12.~~ Sec. 5168.05. (A) The director of ~~job and family~~	35884
~~services~~health care administration shall adopt rules in	35885
accordance with section 111.15 of the Revised Code governing the	35886
disability medical assistance program. The rules may establish or	35887
specify any or all of the following:	35888

(1) Income, resource, citizenship, age, residence, living	35889
arrangement, and other eligibility requirements;	35890

(2) Health services to be included in the program;

35891

(3) The maximum authorized amount, scope, duration, or limit	35892
of payment for services;	35893

(4) Limits on the length of time an individual may receive	35894
disability medical assistance;	35895

(5) Limits on the total number of individuals in the state	35896
who may receive disability medical assistance;	35897

(6) Limits on the number and types of providers eligible to	35898
be reimbursed for services provided to individuals enrolled in the	35899
program.	35900

(B) For purposes of limiting the cost of the disability	35901
medical assistance program, the director may do either of the	35902
following:	35903

(1) Adopt rules in accordance with section 111.15 of the	35904
Revised Code that revise the program's eligibility requirements;	35905
the maximum authorized amount, scope, duration, or limit of	35906
payment for services included in the program; or any other	35907
requirement or standard established or specified by rules adopted	35908
under division (A) of this section or under section ~~5115.10~~	35909
5168.01 of the Revised Code;	35910

(2) Suspend acceptance of applications for disability medical	35911
assistance. While a suspension is in effect, no person shall	35912
receive a determination or redetermination of eligibility for	35913
disability medical assistance unless the person was receiving the	35914
assistance during the month immediately preceding the suspension's	35915
effective date or the person submitted an application prior to the	35916
suspension's effective date and receives a determination of	35917
eligibility based on that application. The director may adopt	35918
rules in accordance with section 111.15 of the Revised Code	35919
establishing requirements and specifying procedures applicable to	35920
the suspension of acceptance of applications.	35921

~~Sec. 5115.14.~~ Sec. 5168.06. (A) The director of ~~job and family~~	35922
~~services~~health care administration shall adopt rules in	35923
accordance with section 111.15 of the Revised Code establishing	35924
application and verification procedures, reapplication procedures,	35925
and other requirements the director considers necessary in the	35926
administration of the application process for disability medical	35927
assistance.	35928

(B) Any person who applies for disability medical assistance	35929
shall receive a voter registration application under section	35930
3503.10 of the Revised Code.	35931

~~Sec. 5115.13.~~ Sec. 5168.07. (A) The department of ~~job and family~~	35932
~~services~~health care administration shall supervise and administer	35933
the disability medical program, except as follows:	35934

(1) The department may require county departments of job and	35935
family services to perform any administrative function specified	35936
in rules adopted by the director of ~~job and family services~~health	35937
care administration.	35938

(2) The director may contract with any private or public	35939
entity in this state to perform any administrative function or to	35940
administer any or all of the program.	35941

(B) If the department requires county departments to perform	35942
administrative functions, the director of ~~job and family services~~	35943
health care administration shall adopt rules in accordance with	35944
section 111.15 of the Revised Code governing the performance of	35945
the functions to be performed by county departments. County	35946
departments shall perform the functions in accordance with the	35947
rules.	35948

If the director contracts with a private or public entity to	35949
perform administrative functions or to administer any or all of	35950
the program, the director may either adopt rules in accordance	35951
with section 111.15 of the Revised Code or include provisions in	35952
the contract governing the performance of the functions by the	35953
private or public entity. Entities under contract shall perform	35954
the functions in accordance with the requirements established by	35955
the director.	35956

(C) Whenever division (A)(1) or (2) of this section is	35957
implemented, the director shall conduct investigations to	35958
determine whether disability medical assistance is being	35959
administered in compliance with the Revised Code and rules adopted	35960
by the director or in accordance with the terms of the contract.	35961

Sec. 5168.08. If a recipient of disability medical	35962
assistance, or an individual whose income and resources are	35963
included in determining the recipient's eligibility for the	35964
assistance, becomes possessed of resources or income in excess of	35965
the amount allowed to retain eligibility, or if other changes	35966
occur that affect the recipient's eligibility or need for	35967
assistance, the recipient shall notify the department of health	35968
care administration or county department of job and family	35969
services within the time limits specified in rules adopted by the	35970
director of health care administration in accordance with section	35971
111.15 of the Revised Code. Failure of a recipient to report	35972
possession of excess resources or income or a change affecting	35973
eligibility or need within those time limits shall be considered	35974
prima-facie evidence of intent to defraud under section 5168.09 of	35975
the Revised Code.	35976

Sec. 5168.09. As used in this section, "erroneous payments"	35977
means disability medical assistance payments made to persons who	35978
are not entitled to receive them, including payments made as a	35979
result of misrepresentation or fraud, and payments made due to an	35980
error by the recipient or by the county department of job and	35981
family services that made the payment.	35982

The department of health care administration shall adopt	35983
rules in accordance with section 111.15 of the Revised Code	35984
specifying the circumstances under which action is to be taken	35985
under this section to recover erroneous payments. The department,	35986
or a county department of job and family services at the request	35987
of the department, shall take action to recover erroneous payments	35988
in the circumstances specified in the rules. The department or	35989
county department may institute a civil action to recover	35990
erroneous payments.	35991

Each county department of job and family services shall	35992
retain fifty per cent of the erroneous payments it recovers under	35993
this section. The department of health care administration shall	35994
receive the remaining fifty per cent.	35995

Sec. 5168.10. Whenever disability medical assistance has been	35996
furnished to a recipient for whose support another person is	35997
responsible, the other person shall, in addition to the liability	35998
otherwise imposed, as a consequence of failure to support the	35999
recipient, be liable for all assistance furnished the recipient.	36000
The value of the assistance so furnished may be recovered in a	36001
civil action brought by the county department of job and family	36002
services.	36003

~~Sec. 173.71.~~ Sec. 5169.01. As used in ~~sections 173.71 to 173.91 of~~	36004
~~the Revised Code~~this chapter:	36005

~~(A) "Children's health insurance program" means the~~	36006
~~children's health insurance program part I, part II, and part III~~	36007
~~established under sections 5101.50 to 5101.529 of the Revised~~	36008
~~Code.~~	36009

~~(B) "Disability medical assistance program" means the program~~	36010
~~established under section 5115.10 of the Revised Code.~~	36011

~~(C) "Medicaid program" or "medicaid" means the medical~~	36012
~~assistance program established under Chapter 5111. of the Revised~~	36013
~~Code.~~	36014

~~(D)~~ "National drug code number" means the number registered	36015
for a drug pursuant to the listing system established by the	36016
United States food and drug administration under the "Drug Listing	36017
Act of 1972," 86 Stat. 559, 21 U.S.C. 360, as amended.	36018

~~(E)~~(B) "Ohio's best Rx program participant" or "participant"	36019
means an individual determined eligible for the Ohio's best Rx	36020
program and included under an Ohio's best Rx program enrollment	36021
card.	36022

~~(F)~~(C) "Participating manufacturer" means a drug manufacturer	36023
participating in the Ohio's best Rx program pursuant to a	36024
manufacturer agreement entered into under section 173.81 of the	36025
Revised Code.	36026

~~(G)~~(D) "Participating terminal distributor" means a terminal	36027
distributor of dangerous drugs participating in the Ohio's best Rx	36028
program pursuant to an agreement entered into under section 173.79	36029
of the Revised Code.	36030

~~(H)~~(E) "Political subdivision" has the same meaning as in	36031
section 9.23 of the Revised Code.	36032

~~(I)~~(F) "State agency" has the same meaning as in section 9.23	36033
of the Revised Code.	36034

~~(J)~~(G) "Terminal distributor of dangerous drugs" has the same	36035
meaning as in section 4729.01 of the Revised Code.	36036

~~(K)~~(H) "Third-party payer" has the same meaning as in section	36037
3901.38 of the Revised Code.	36038

~~(L)~~(I) "Trade secret" has the same meaning as in section	36039
1333.61 of the Revised Code.	36040

~~(M)~~(J) "Usual and customary charge" means the amount a	36041
participating terminal distributor or the drug mail order system	36042
included in the Ohio's best Rx program pursuant to section 173.78	36043
of the Revised Code charges when a drug included in the program is	36044
purchased by an individual who does not receive a discounted price	36045
for the drug pursuant to any drug discount program, including the	36046
Ohio's best Rx program or a pharmacy assistance program	36047
established by any person or government entity, and for whom no	36048
third-party payer or program funded in whole or part with state or	36049
federal funds is responsible for all or part of the cost of the	36050
drug.	36051

~~Sec. 173.72.~~ Sec. 5169.02. There is hereby established the Ohio's	36052
best Rx program for the purpose of providing outpatient	36053
prescription drug discounts to individuals residing in this state	36054
who are enrolled in the program by meeting the eligibility	36055
requirements specified in section ~~173.76~~5169.06 of the Revised	36056
Code, including eligible individuals who are sixty years of age or	36057
older, eligible individuals who have low incomes but are not	36058
eligible for medicaid, and other eligible individuals who do not	36059
have health benefits that cover outpatient drugs. The program	36060
shall include all drugs that are included in a manufacturer	36061
agreement entered into under section ~~173.81~~5169.11 of the Revised	36062
Code and all other drugs that may be dispensed only pursuant to a	36063
prescription issued by a licensed health professional authorized	36064
to prescribe drugs, as defined in section 4729.01 of the Revised	36065
Code.	36066

~~Sec. 173.721.~~ Sec. 5169.021. (A) Except as provided in division (B)	36067
of this section, the Ohio's best Rx program shall be administered	36068
by the department of ~~aging~~health care administration.	36069

(B)(1) The department may enter into a contract with any	36070
person under which the person serves as the administrator of the	36071
Ohio's best Rx program. Before entering into a contract for a	36072
program administrator, the department shall issue a request for	36073
proposals from persons seeking to be considered. The department	36074
shall develop a process to be used in issuing the request for	36075
proposals, receiving responses to the request, and evaluating the	36076
responses on a competitive basis. In accordance with that process,	36077
the department shall select the person to be awarded the contract.	36078

(2) Subject to divisions (B)(5) and (6) of this section, the	36079
department may delegate to the person awarded the contract any of	36080
the department's powers or duties specified in sections ~~173.71~~	36081
5169.01 to ~~173.91~~5169.21 of the Revised Code or any other	36082
provision of the Revised Code pertaining to the Ohio's best Rx	36083
program. The terms of the contract shall specify the extent to	36084
which the powers or duties are delegated to the program	36085
administrator.	36086

(3) In exercising powers or performing duties delegated under	36087
the contract, the program administrator is subject to the same	36088
provisions of sections ~~173.71~~5169.01 to ~~173.91~~5169.21 of the	36089
Revised Code or other provisions of the Revised Code that grant	36090
the powers or duties to the department, as well as any limitations	36091
or restrictions that are applicable to or associated with those	36092
powers or duties.	36093

(4) Wherever the department is referred to in sections ~~173.71~~	36094
5169.01 to ~~173.91~~5169.21 of the Revised Code or another provision	36095
of the Revised Code relative to a power or duty delegated to the	36096
program administrator, both of the following apply:	36097

(a) If the department has delegated the power or duty in	36098
whole to the program administrator, the reference to the	36099
department is, instead, a reference to the administrator.	36100

(b) If the department retains any part of the power or duty	36101
that is delegated to the program administrator, the reference to	36102
the department is a reference to both the department and the	36103
administrator.	36104

(5) The terms of a contract for a program administrator shall	36105
include provisions for offering the drug mail order system	36106
included in the Ohio's best Rx program pursuant to section ~~173.78~~	36107
5169.08 of the Revised Code. The terms of the contract may permit	36108
the administrator to offer the drug mail order system by	36109
contracting with another person.	36110

(6) The department shall not delegate to a program	36111
administrator the department's powers or duties to do any of the	36112
following:	36113

(a) Enter into contracts under this section other than a	36114
contract to offer a drug mail order system;	36115

(b) Receive verification of drug pricing information under	36116
section ~~173.742~~5169.042 of the Revised Code or verification of	36117
drug manufacturer payment information under section ~~173.814~~	36118
5169.114 of the Revised Code from the pharmacy benefit manager	36119
selected under section ~~173.731~~5169.031 of the Revised Code to	36120
serve as the Ohio's best Rx program's consulting pharmacy benefit	36121
manager;	36122

(c) Request the program's consulting pharmacy benefit manager	36123
to provide for an audit under section ~~173.732~~5169.032 of the	36124
Revised Code;	36125

(d) Review or use any information contained in or pertaining	36126
to an audit provided for by the program's consulting pharmacy	36127
benefit manager other than the audit's findings of whether the	36128
consulting pharmacy benefit manager provided valid information	36129
when providing drug pricing verification services or drug	36130
manufacturer payment verification services;	36131

(e) Adopt rules under section ~~173.83~~5169.13 or ~~173.84~~	36132
5169.14 of the Revised Code;	36133

(f) Employ an ombudsperson pursuant to section ~~173.723~~	36134
5169.023 of the Revised Code.	36135

~~Sec. 173.722.~~ Sec. 5169.022. The department of ~~aging~~health care	36136
administration shall undertake outreach efforts to publicize the	36137
Ohio's best Rx program and maximize participation in the program.	36138

~~Sec. 173.723.~~ Sec. 5169.023. The department of ~~aging~~health care	36139
administration shall employ an ombudsperson to assist terminal	36140
distributors of dangerous drugs with grievances regarding the	36141
Ohio's best Rx program.	36142

~~Sec. 173.724.~~ Sec. 5169.024. The department of ~~aging~~health care	36143
administration may coordinate the Ohio's best Rx program with	36144
either of the following:	36145

(A) ~~The~~In cooperation with the department of aging, the	36146
golden buckeye card program established under section 173.06 of	36147
the Revised Code. In coordinating the programs, the ~~department~~	36148
departments may establish a card that serves as both a golden	36149
buckeye card provided under section 173.06 of the Revised Code and	36150
an Ohio's best Rx program enrollment card issued under section	36151
~~173.773~~5169.073 of the Revised Code. The ~~department~~departments	36152
may identify the card by including the names of both programs on	36153
the card or by selecting a combined name for inclusion on the	36154
card.	36155

(B) Any health benefit plan offered to the employees of state	36156
agencies and the eligible dependents of those employees, for	36157
purposes of enhancing efficiency, reducing the cost of drugs, and	36158
maximizing the benefits of the Ohio's best Rx program and the	36159
health benefit plan.	36160

~~Sec. 173.73.~~ Sec. 5169.03. (A) Any entity that provides services as	36161
a pharmacy benefit manager relative to the outpatient drug	36162
coverage included in a health benefit plan offered to the	36163
employees or retirees of a state agency or political subdivision	36164
and the eligible dependents of those employees or retirees shall	36165
provide drug pricing verification services under section ~~173.742~~	36166
5169.042 of the Revised Code and drug manufacturer payment	36167
verification services under section ~~173.814~~5169.114 of the	36168
Revised Code if the entity is selected under section ~~173.731~~	36169
5169.031 of the Revised Code by the department of ~~aging~~health	36170
care administration to serve as the Ohio's best Rx program's	36171
consulting pharmacy benefit manager for purposes of providing the	36172
verification services.	36173

(B) Both of the following apply to the entity selected to	36174
serve as the Ohio's best Rx program's consulting pharmacy benefit	36175
manager:	36176

(1) The entity shall provide the drug pricing verification	36177
services and drug manufacturer payment verification services	36178
without charge, either to the Ohio's best Rx program or to the	36179
state agency or political subdivision for which it provides	36180
services as a pharmacy benefit manager.	36181

(2) The entity shall provide the verification services for	36182
the entire year for which it is selected to serve as the program's	36183
consulting pharmacy benefit manager, regardless of the duration or	36184
termination of its responsibility to the state agency or political	36185
subdivision for which it provides services as a pharmacy benefit	36186
manager.	36187

(C) If the entity selected to serve as the consulting	36188
pharmacy benefit manager fails to provide the program with drug	36189
pricing verification services or drug manufacturer payment	36190
verification services, or fails to provide for an audit when	36191
requested to do so under section ~~173.732~~5169.032 of the Revised	36192
Code, the department may ask the attorney general to bring an	36193
action for injunctive relief in any court of competent	36194
jurisdiction. On the filing of an appropriate petition in the	36195
court, the court shall conduct a hearing on the petition. If it is	36196
demonstrated in the proceedings that the pharmacy benefit manager	36197
has failed to provide the verification services or has failed to	36198
provide for the audit, the court shall grant a temporary or	36199
permanent injunction enjoining the pharmacy benefit manager from	36200
continuing to fail to provide the verification services or from	36201
continuing to fail to provide for the audit.	36202

(D) This section does not impose any duty on the state agency	36203
or political subdivision for which an entity provides services as	36204
a pharmacy benefit manager.	36205

~~Sec. 173.731.~~ Sec. 5169.031. Annually, the department of ~~aging~~	36206
health care administration shall select a pharmacy benefit	36207
manager, from among the pharmacy benefit managers subject to	36208
section ~~173.73~~5169.03 of the Revised Code, to serve as the Ohio's	36209
best Rx program's consulting pharmacy benefit manager for purposes	36210
of providing drug pricing verification services under section	36211
~~173.742~~5169.042 of the Revised Code and drug manufacturer payment	36212
verification services under section ~~173.814~~5169.114 of the	36213
Revised Code. The department shall select the pharmacy benefit	36214
manager that the department considers to be the most appropriate	36215
pharmacy benefit manager to provide the verification services for	36216
the Ohio's best Rx program. In making the selection, the	36217
department shall consider the pharmacy benefit manager that	36218
provides services relative to the outpatient drug coverage	36219
included in the health benefit plan offered to the greatest number	36220
of employees or retirees of a state agency or political	36221
subdivision and the eligible dependents of those employees or	36222
retirees.	36223

The department shall provide written notice to the pharmacy	36224
benefit manager that it has been selected to serve as the Ohio's	36225
best Rx program's consulting pharmacy benefit manager. The notice	36226
shall specify the date on which the pharmacy benefit manager is to	36227
begin serving as the program's consulting pharmacy benefit manager	36228
for the ensuing year.	36229

Before the end of the one-year period during which a pharmacy	36230
benefit manager is to serve as the program's consulting pharmacy	36231
benefit manager, the department shall make another selection in	36232
accordance with this section. In making the selection, the	36233
department may select the same pharmacy benefit manager to serve	36234
as the program's consulting pharmacy benefit manager or may select	36235
another pharmacy benefit manager.	36236

~~Sec. 173.732.~~ Sec. 5169.032. (A) To determine whether the pharmacy	36237
benefit manager selected under section ~~173.731~~5169.031 of the	36238
Revised Code to serve as the Ohio's best Rx program's consulting	36239
pharmacy benefit manager has provided valid information when	36240
providing drug pricing verification services under section ~~173.742~~	36241
5169.042 of the Revised Code or drug manufacturer payment	36242
verification services under section ~~173.814~~5169.114 of the	36243
Revised Code, the department of ~~aging~~health care administration	36244
may request that the consulting pharmacy benefit manager provide	36245
for an audit of its relevant contracts with drug manufacturers and	36246
terminal distributors of dangerous drugs.	36247

In making audit requests under this section, both of the	36248
following apply:	36249

(1) The department may request an audit on a regularly	36250
occurring basis, but not more frequently than once every three	36251
years.	36252

(2) The department may request an audit at any time it has a	36253
reasonable basis to believe that the consulting pharmacy benefit	36254
manager is not acting in good faith in providing drug pricing	36255
verification services or drug manufacturer payment verification	36256
services. Notice of the request shall be made in writing and	36257
signed by the director of ~~aging~~health care administration. The	36258
notice may specify the basis for the belief that the consulting	36259
pharmacy benefit manager is not acting in good faith. If the basis	36260
for the belief is not specified and the audit findings demonstrate	36261
that the consulting pharmacy benefit manager acted in good faith,	36262
the department shall pay the cost incurred by the consulting	36263
pharmacy benefit manager in providing for the audit.	36264

(B) An audit provided for under this section shall be	36265
performed only by an auditor that is mutually satisfactory to the	36266
department and consulting pharmacy benefit manager and independent	36267
of both the department and consulting pharmacy benefit manager.	36268

(C) If the findings of an audit provided for under this	36269
section demonstrate that the verification services provided by the	36270
consulting pharmacy benefit manager did not result in valid	36271
information, the department shall use the audit findings for	36272
purposes of confirming the validity of the one or more drug	36273
pricing formulas designated under section ~~173.741~~5169.041 of the	36274
Revised Code and entering into agreements with drug manufacturers	36275
under section ~~173.81~~5169.11 of the Revised Code.	36276

~~Sec. 173.74.~~ Sec. 5169.04. Annually, the department of ~~aging~~health	36277
care administration shall establish a base price for each drug	36278
included in the Ohio's best Rx program. In the case of drugs	36279
dispensed by a terminal distributor of dangerous drugs that has	36280
entered into an agreement under section ~~173.79~~5169.09 of the	36281
Revised Code, the base price shall be established by using the one	36282
or more formulas designated under section ~~173.741~~5169.041 of the	36283
Revised Code. In the case of the drug mail order system included	36284
in the program pursuant to section ~~173.78~~5169.08 of the Revised	36285
Code, the base price shall be established in accordance with the	36286
rules adopted under section ~~173.83~~5169.13 of the Revised Code	36287
governing the drug mail order system.	36288

~~Sec. 173.741.~~ Sec. 5169.041. Annually, the department of ~~aging~~	36289
health care administration shall designate one or more formulas	36290
for use in establishing under section ~~173.74~~5169.04 of the	36291
Revised Code the Ohio's best Rx program's base price for drugs	36292
dispensed by a terminal distributor of dangerous drugs that has	36293
entered into an agreement under section ~~173.79~~5169.09 of the	36294
Revised Code. Each formula shall include a drug pricing discount	36295
component that is expressed as a percentage discount. The formula	36296
used for generic drugs may include the maximum allowable cost	36297
limits that apply to generic drugs under the medicaid program.	36298

In designating the one or more formulas, the department shall	36299
use the best information on drug pricing that is available to the	36300
department, including information obtained through the drug	36301
pricing verification services provided under section ~~173.742~~	36302
5169.042 of the Revised Code by the Ohio's best Rx program's	36303
consulting pharmacy benefit manager selected under section ~~173.731~~	36304
5169.031 of the Revised Code. Based on the available information,	36305
the department shall modify the one or more formulas as it	36306
considers appropriate to maximize the benefits provided to Ohio's	36307
best Rx program participants.	36308

~~Sec. 173.742.~~ Sec. 5169.042. For purposes of section ~~173.741~~	36309
5169.041 of the Revised Code, the department of ~~aging~~health care	36310
administration shall obtain verification of drug pricing	36311
information from the Ohio's best Rx program's consulting pharmacy	36312
benefit manager selected under section ~~173.731~~5169.031 of the	36313
Revised Code. The information shall be obtained in accordance with	36314
the following procedures:	36315

(A) For brand name drugs, excluding generic drugs marketed	36316
under brand names, the department shall submit to the consulting	36317
pharmacy benefit manager the formula the department proposes to	36318
use to establish the program's base price for brand name drugs	36319
during the year.	36320

The consulting pharmacy benefit manager shall review the	36321
formula submitted by the department. In conducting the review, the	36322
consulting pharmacy benefit manager shall compare the drug pricing	36323
discount percentage included in the department's formula to the	36324
drug pricing discount percentage included in the formula most	36325
commonly used by the consulting pharmacy benefit manager to	36326
establish part of its payment rate for brand name drugs dispensed	36327
by terminal distributors of dangerous drugs other than drug mail	36328
order systems. If the formulas are not expressed in equivalent	36329
terms, the consulting pharmacy benefit manager shall make all	36330
accommodations necessary to make the comparison of the discount	36331
percentages.	36332

After conducting the review, the consulting pharmacy benefit	36333
manager shall provide information to the department verifying	36334
whether the discount percentage included in the department's	36335
formula is more than two percentage points below the discount	36336
percentage included in the formula used by the consulting pharmacy	36337
benefit manager. The information provided to the department shall	36338
be certified by signature of an officer of the consulting pharmacy	36339
benefit manager.	36340

(B) For generic drugs, the department shall identify the	36341
fifty generic drugs most frequently purchased by Ohio's best Rx	36342
program participants in the immediately preceding year from	36343
terminal distributors of dangerous drugs other than the drug mail	36344
order system included in the program pursuant to section ~~173.78~~	36345
5169.08 of the Revised Code. The department shall submit to the	36346
consulting pharmacy benefit manager the names of the fifty drugs,	36347
the number of prescriptions filled for each of the drugs, the	36348
formula used to compute the base price for the drugs during the	36349
year, and the weighted average base price for the drugs that	36350
resulted for the year.	36351

The consulting pharmacy benefit manager shall review the	36352
submitted information. In conducting the review, the consulting	36353
pharmacy benefit manager shall compare the department's weighted	36354
average base price to the equivalent part of the consulting	36355
pharmacy benefit manager's weighted average payment rate for the	36356
same drugs when dispensed by terminal distributors of dangerous	36357
drugs other than drug mail order systems. For purposes of the	36358
comparison, the department and consulting pharmacy benefit manager	36359
shall express the weighted average base price and payment rate in	36360
terms of a discount percentage that is taken from the drugs'	36361
average wholesale price, as identified by a national drug price	36362
reporting service selected by the department and the consulting	36363
pharmacy benefit manager.	36364

After conducting the review, the consulting pharmacy benefit	36365
manager shall provide information to the department verifying	36366
whether the discount percentage reflected in the department's	36367
weighted average base price for the drugs is more than two	36368
percentage points below the equivalent part of the consulting	36369
pharmacy benefit manager's weighted average payment rate for the	36370
same drugs. The information provided to the department shall be	36371
certified by signature of an officer of the consulting pharmacy	36372
benefit manager.	36373

~~Sec. 173.75.~~ Sec. 5169.05. (A) Subject to division (B) of this	36374
section, the amount that an Ohio's best Rx program participant is	36375
to be charged for a quantity of a drug purchased under the program	36376
shall be established in accordance with all of the following:	36377

(1) If the drug is not included in a manufacturer agreement	36378
entered into under section ~~173.81~~5169.11 of the Revised Code, the	36379
participant shall be charged an amount that is computed according	36380
to the drug's base price established under section ~~173.74~~5169.04	36381
of the Revised Code.	36382

(2) If the drug is included in a manufacturer agreement	36383
entered into under section ~~173.81~~5169.11 of the Revised Code, the	36384
participant shall be charged an amount that is computed by	36385
subtracting from the drug's base price established under section	36386
~~173.74~~5169.04 of the Revised Code the amount of the manufacturer	36387
payment that applies to the transaction, as established under	36388
section ~~173.812~~5169.112 of the Revised Code.	36389

(3) If an administrative fee is specified in rules adopted	36390
under section ~~173.83~~5169.13 of the Revised Code, the participant	36391
shall be charged the amount of the administrative fee.	36392

(4) If the drug is dispensed by a terminal distributor of	36393
dangerous drugs under an agreement entered into under section	36394
~~173.79~~5169.09 of the Revised Code, and the terminal distributor	36395
charges a professional fee pursuant to the agreement, the	36396
participant shall be charged the amount of the professional fee.	36397

(5) If the drug is dispensed through the drug mail order	36398
system included in the program pursuant to section ~~173.78~~5169.08	36399
of the Revised Code, the participant shall not be charged a	36400
professional fee.	36401

(B) When a quantity of a drug is purchased by an Ohio's best	36402
Rx program participant, the participating terminal distributor or	36403
drug mail order system dispensing the drug shall charge the lesser	36404
of the amount that applies to the transaction, as established in	36405
accordance with division (A) of this section, or the usual and	36406
customary charge that otherwise would apply to the transaction.	36407
When a drug is purchased at the usual and customary charge	36408
pursuant to this division, the transaction is not subject to	36409
sections ~~173.71~~5169.01 to ~~173.91~~5169.21 of the Revised Code as	36410
the purchase or dispensing of a drug under the program.	36411

~~Sec. 173.751.~~ Sec. 5169.051. The department of ~~aging~~health care	36412
administration shall report the following to each participating	36413
terminal distributor and the drug mail order system included in	36414
the Ohio's best Rx program pursuant to section ~~173.78~~5169.08 of	36415
the Revised Code in a manner enabling the distributor and system	36416
to comply with section ~~173.75~~5169.05 of the Revised Code:	36417

(A) For each drug included in the program, the amount to be	36418
charged under division (A)(1) or (2) of section ~~173.75~~5169.05 of	36419
the Revised Code;	36420

(B) The administrative fee, if any, specified by the	36421
department in rules adopted under section ~~173.83~~5169.13 of the	36422
Revised Code.	36423

~~Sec. 173.752.~~ Sec. 5169.052. The amount that an Ohio's best Rx	36424
program participant saves when a drug is purchased under the	36425
program shall be determined by subtracting the amount that the	36426
participant is charged in accordance with division (A) of section	36427
~~173.75~~5169.05 of the Revised Code from the usual and customary	36428
charge that otherwise would apply to the transaction.	36429

~~Sec. 173.753.~~ Sec. 5169.053. Not later than the first day of March	36430
of each year, the department of ~~aging~~health care administration	36431
shall do all of the following:	36432

(A) Create a list of the twenty-five drugs most often	36433
dispensed to Ohio's best Rx program participants under the	36434
program, using data from the most recent six-month period for	36435
which the data is available;	36436

(B) Determine the average amount that participants are	36437
charged under the program, on a date selected by the department,	36438
for each drug included on the list created under division (A) of	36439
this section;	36440

(C) Determine, for the date selected for division (B) of this	36441
section, the average usual and customary charge for each drug	36442
included on the list created under division (A) of this section;	36443

(D) By comparing the average charges determined under	36444
divisions (B) and (C) of this section, determine the average	36445
percentage savings Ohio's best Rx program participants receive for	36446
each drug included on the list created under division (A) of this	36447
section.	36448

~~Sec. 173.76.~~ Sec. 5169.06. (A) To be eligible for the Ohio's best	36449
Rx program, an individual must meet all of the following	36450
requirements at the time of application for the program:	36451

(1) The individual must be a resident of this state.

36452

(2) One of the following must be the case:

36453

(a) The individual has family income, as determined under	36454
rules adopted pursuant to section ~~173.83~~5169.13 of the Revised	36455
Code, that does not exceed three hundred per cent of the federal	36456
poverty guidelines, as revised annually by the United States	36457
department of health and human services in accordance with section	36458
673(2) of the "Omnibus Budget Reconciliation Act of 1981," 95	36459
Stat. 511, 42 U.S.C. 9902, as amended;	36460

(b) The individual is sixty years of age or older;

36461

(c) The individual is a person with a disability, as defined	36462
in section 173.06 of the Revised Code.	36463

(3) Except as provided in division (B) of this section, the	36464
individual must not have coverage for outpatient drugs paid for in	36465
whole or in part by any of the following:	36466

(a) A third-party payer, including an employer;

36467

(b) The medicaid program;

36468

36469

(d) The disability medical assistance program;

36470

(e) Another health plan or pharmacy assistance program that	36471
uses state or federal funds to pay part or all of the cost of the	36472
individual's outpatient drugs.	36473

(4) The individual must not have had coverage for outpatient	36474
drugs paid for by any of the entities or programs specified in	36475
division (A)(3) of this section during any of the four months	36476
preceding the month in which the application for the Ohio's best	36477
Rx program is made, unless any of the following applies:	36478

(a) The individual is sixty years of age or older.

36479

(b) The third-party payer, including an employer, that paid	36480
for the coverage filed for bankruptcy under federal bankruptcy	36481
laws.	36482

(c) The individual is no longer eligible for coverage	36483
provided through a retirement plan subject to protection under the	36484
"Employee Retirement Income Security Act of 1974," 88 Stat. 832,	36485
29 U.S.C. 1001, as amended.	36486

(d) The individual is no longer eligible for the medicaid	36487
program, children's health insurance program, or disability	36488
medical assistance program.	36489

(e) The individual is either temporarily or permanently	36490
discharged from employment due to a business reorganization.	36491

(B) An individual is not subject to division (A)(3) of this	36492
section if the individual has coverage for outpatient drugs paid	36493
for in whole or in part by either of the following:	36494

(1) The workers' compensation program;

36495

(2) A medicare prescription drug plan offered pursuant to the	36496
"Medicare Prescription Drug, Improvement, and Modernization Act of	36497
2003," 117 Stat. 2071, 42 U.S.C. 1395w-101, as amended, but only	36498
if all of the following are the case with respect to the	36499
particular drug being purchased through the Ohio's best Rx	36500
program:	36501

(a) The individual is responsible for the full cost of the	36502
drug.	36503

(b) The drug is not subject to a rebate from the manufacturer	36504
under the individual's medicare prescription drug plan.	36505

(c) The manufacturer of the drug has agreed to the Ohio's	36506
best Rx program's inclusion of individuals who have coverage	36507
through a medicare prescription drug plan.	36508

~~Sec. 173.77.~~ Sec. 5169.07. Application for participation in the	36509
Ohio's best Rx program shall be made in accordance with rules	36510
adopted by the department of ~~aging~~health care administration	36511
under section ~~173.83~~5169.13 of the Revised Code. When applying	36512
for participation, an individual may include application for	36513
participation by the individual's spouse and children. An	36514
individual's guardian or custodian may apply on behalf of the	36515
individual.	36516

When submitting an application, the applicant shall include	36517
the information and documentation specified in the department's	36518
rules as necessary to verify eligibility for the program. The	36519
application may be submitted on a paper form prescribed and	36520
supplied by the department or pursuant to any other application	36521
method the department makes available for the program, including	36522
methods that permit an individual to apply by telephone or through	36523
the internet.	36524

An applicant shall attest that the information and	36525
documentation the applicant submits with an application is	36526
accurate to the best knowledge and belief of the applicant. In the	36527
case of a paper application form, the applicant's signature shall	36528
be used to certify that the applicant has attested to the accuracy	36529
of the information and documentation. In the case of other	36530
application methods, the application certification process	36531
specified in the department's rules shall be used to certify that	36532
the applicant has attested to the accuracy of the information and	36533
documentation.	36534

The department shall inform each applicant that knowingly	36535
making a false statement in an application is falsification under	36536
section 2921.13 of the Revised Code, a misdemeanor of the first	36537
degree. In the case of a paper application form, the department	36538
shall provide the information by including on the form a statement	36539
printed in bold letters.	36540

~~Sec. 173.771.~~ Sec. 5169.071. The department of ~~aging~~health care	36541
administration shall provide each applicant for the Ohio's best Rx	36542
program information about the medicaid program in accordance with	36543
rules adopted under section ~~173.83~~5169.13 of the Revised Code.	36544
The information shall include general eligibility requirements,	36545
application procedures, and benefits. The information shall also	36546
explain the ways in which the medicaid program's drug benefits are	36547
better than the Ohio's best Rx program.	36548

~~Sec. 173.772.~~ Sec. 5169.072. On receipt of applications, the	36549
department of ~~aging~~health care administration shall make	36550
eligibility determinations for the Ohio's best Rx program in	36551
accordance with procedures established in rules adopted under	36552
section ~~173.83~~5169.13 of the Revised Code.	36553

An eligibility determination under this section may not be	36554
appealed under Chapter 119., section 5101.35, or any other	36555
provision of the Revised Code.	36556

~~Sec. 173.773.~~ Sec. 5169.073. (A) The department of ~~aging~~health	36557
care administration shall issue Ohio's best Rx program enrollment	36558
cards to or on behalf of individuals determined eligible to	36559
participate. One enrollment card may cover each member of a family	36560
determined eligible to participate.	36561

The department shall determine the information to be included	36562
on the card, including an identification number, and shall	36563
determine the card's size and format. If the department	36564
establishes an application method that permits individuals to	36565
apply through the internet, the department may issue the	36566
enrollment card by sending the applicant an electronic version of	36567
the card in a printable format.	36568

(B) Each time a drug is purchased under the program, the	36569
entity dispensing the drug shall confirm whether the individual	36570
for whom the drug is dispensed is enrolled in the program. If the	36571
drug is being purchased from a participating terminal distributor	36572
rather than the drug mail order system included in the program	36573
pursuant to section ~~173.78~~5169.08 of the Revised Code, and the	36574
individual's enrollment card is available for presentation at the	36575
time of the purchase, the purchaser shall present the card to the	36576
participating terminal distributor as confirmation of the	36577
individual's enrollment in the program. If the drug is being	36578
purchased through the drug mail order system and the individual's	36579
program identification number is available, the purchaser shall	36580
present the identification number as confirmation of enrollment.	36581
Otherwise, the terminal distributor or mail order system shall	36582
confirm the individual's enrollment through the department. The	36583
department shall establish the methods to be used in confirming	36584
enrollment through the department, including confirmation by	36585
telephone, through the internet, or by any other electronic means.	36586

(C) Purchasing a drug under the program by using an	36587
enrollment card or any other method shall serve as an attestation	36588
by the participant for whom the drug is dispensed that the	36589
participant meets the eligibility requirements specified in	36590
division (A)(3) of section ~~173.76~~5169.06 of the Revised Code	36591
regarding not having coverage for outpatient drugs.	36592

~~Sec. 173.78.~~ Sec. 5169.08. (A) For purposes of making drugs	36593
included in the Ohio's best Rx program available to participants	36594
by mail, the department of ~~aging~~health care administration shall	36595
include a drug mail order system within the program. Not more than	36596
one drug mail order system shall be included in the program.	36597
Subject to division (B) of this section, the program's drug mail	36598
order system shall be provided in accordance with rules adopted	36599
under section ~~173.83~~5169.13 of the Revised Code.	36600

(B) Neither the department nor the drug mail order system	36601
shall promote the purchase of drugs through the system by using	36602
information collected under the program regarding the drugs	36603
purchased by participants from participating terminal	36604
distributors. This division does not preclude the use of the	36605
information for purposes of limiting the amount that a participant	36606
may be charged for a quantity of a drug purchased through the drug	36607
mail order system to an amount that is not more than the amount	36608
that would be charged if the same quantity of the drug were	36609
purchased from a participating terminal distributor.	36610

~~Sec. 173.79.~~ Sec. 5169.09. (A) For purposes of making drugs	36611
included in the Ohio's best Rx program available to participants	36612
from terminal distributors of dangerous drugs other than the drug	36613
mail order system included in the program pursuant to section	36614
~~173.78~~5169.08 of the Revised Code, the department of ~~aging~~health	36615
care administration shall enter into agreements under this section	36616
with terminal distributors of dangerous drugs. Any terminal	36617
distributor of dangerous drugs may enter into an agreement with	36618
the department to participate in the program pursuant to this	36619
section.	36620

Before entering into an agreement with a terminal	36621
distributor, the department shall provide the terminal distributor	36622
with one of the following:	36623

(1) A formula that allows the terminal distributor to	36624
calculate for each drug included in the program the amount to be	36625
charged under division (A)(1) or (2) of section ~~173.75~~5169.05 of	36626
the Revised Code by participating terminal distributors.	36627

(2) A statistically valid sampling of drug prices that	36628
includes the amount to be charged under division (A)(1) or (2) of	36629
section ~~173.75~~5169.05 of the Revised Code by participating	36630
terminal distributors for not fewer than two brand name drugs and	36631
two generic drugs from each category of drugs included in the	36632
program.	36633

(3) The current amount to be charged under division (A)(1) or	36634
(2) of section ~~173.75~~5169.05 of the Revised Code by participating	36635
terminal distributors for each drug included in the program.	36636

(B) An agreement entered into under this section shall do all	36637
of the following:	36638

(1) Except as provided in division (B)(3) of this section, be	36639
in effect for not less than one year;	36640

(2) Specify the dates that the agreement is to begin and end;

36641

(3) Permit the terminal distributor to terminate the	36642
agreement before the date the agreement would otherwise end as	36643
specified pursuant to division (B)(2) of this section by providing	36644
the department notice of early termination at least thirty days	36645
before the effective date of the early termination;	36646

(4) Require that the terminal distributor comply with section	36647
~~173.75~~5169.05 of the Revised Code when charging for a drug	36648
purchased under the program;	36649

(5) Permit the terminal distributor to add to the amount to	36650
be charged under division (A)(1) or (2) of section ~~173.75~~5169.05	36651
of the Revised Code a professional fee in an amount not to exceed,	36652
except as provided in rules adopted under section ~~173.83~~5169.13	36653
of the Revised Code, three dollars;	36654

(6) Require the terminal distributor to disclose to each	36655
participant the amount the participant saves under the program as	36656
determined in accordance with section ~~173.752~~5169.052 of the	36657
Revised Code;	36658

(7) Require the terminal distributor to submit a claim to the	36659
department under section ~~173.80~~5169.10 of the Revised Code for	36660
each sale of a drug to a participant;	36661

(8) Permit the terminal distributor to deliver drugs to	36662
Ohio's best Rx program participants by mail, but not by using a	36663
drug mail order system operated in the same manner as the system	36664
included in the program pursuant to section ~~173.78~~5169.08 of the	36665
Revised Code.	36666

~~Sec. 173.791.~~ Sec. 5169.091. A terminal distributor of dangerous	36667
drugs shall not be prohibited from participating in any program or	36668
any network of health care providers on the basis that the	36669
terminal distributor has not entered into an agreement under	36670
section ~~173.79~~5169.09 of the Revised Code to participate in the	36671
Ohio's best Rx program.	36672

~~Sec. 173.80.~~ Sec. 5169.10. For each drug dispensed under the	36673
Ohio's best Rx program, a claim shall be submitted to the	36674
department of ~~aging~~health care administration. The participating	36675
terminal distributor or the drug mail order system included in the	36676
program pursuant to section ~~173.78~~5169.08 of the Revised Code	36677
that dispensed the drug shall submit the claim not later than	36678
thirty days after the drug is dispensed. The claim shall be	36679
submitted in accordance with the electronic method provided for in	36680
rules adopted under section ~~173.83~~5169.13 of the Revised Code.	36681

The claim shall specify all of the following:

36682

(A) The prescription number of the participant's prescription	36683
under which the drug was dispensed to the participant;	36684

(B) The name of, and national drug code number for, the drug	36685
dispensed to the participant;	36686

(C) The number of units of the drug dispensed to the	36687
participant;	36688

(D) The amount the participant was charged for the drug;

36689

(E) The date the drug was dispensed to the participant;

36690

(F) Any additional information required by rules adopted	36691
under section ~~173.83~~5169.13 of the Revised Code.	36692

~~Sec. 173.801.~~ Sec. 5169.101. (A) In accordance with rules adopted	36693
under section ~~173.83~~5169.13 of the Revised Code and subject to	36694
section ~~173.803~~5169.103 of the Revised Code, the department of	36695
~~aging~~health care administration shall make payments under the	36696
Ohio's best Rx program for complete and timely claims submitted	36697
under section ~~173.80~~5169.10 of the Revised Code for drugs	36698
included in the program that are also included in a manufacturer	36699
agreement entered into under section ~~173.81~~5169.11 of the Revised	36700
Code. The payment for a complete and timely claim shall be made by	36701
a date that is not later than two weeks after the department	36702
receives the claim from the participating terminal distributor or	36703
the drug mail order system included in the program pursuant to	36704
section ~~173.78~~5169.08 of the Revised Code.	36705

(B) Subject to division (D) of this section, the amount to be	36706
paid for a claim for a drug dispensed under the program shall be	36707
determined as follows:	36708

(1) Compute the manufacturer payment amount that applies to	36709
the transaction, based on quantity of the drug dispensed and the	36710
drug's national drug code number, in accordance with the	36711
provisions of division (B) of section ~~173.812~~5169.112 of the	36712
Revised Code;	36713

(2) If rules adopted under section ~~173.83~~5169.13 of the	36714
Revised Code require that program participants be charged an	36715
administrative fee for each transaction in which a quantity of the	36716
drug was dispensed, subtract from the amount computed under	36717
division (B)(1) of this section the administrative fee amount	36718
specified in those rules.	36719

(C) The department may combine the claims submitted by a	36720
participating terminal distributor or the program's drug mail	36721
order system to make aggregate payments under this section to the	36722
distributor or system.	36723

(D) If the total of the amounts computed under division (B)	36724
of this section for any period for which payments are due is a	36725
negative number, the participating terminal distributor or the	36726
program's drug mail order system that submitted the claims has	36727
been overpaid for the claims. When there is an overpayment, the	36728
department shall reduce future payments made under this section to	36729
the distributor or system or collect an amount from the	36730
distributor or system sufficient to reimburse the department for	36731
the overpayment.	36732

~~Sec. 173.802.~~ Sec. 5169.102. Neither a participating terminal	36733
distributor nor the drug mail order system included in the Ohio's	36734
best Rx program pursuant to section ~~173.78~~5169.08 of the Revised	36735
Code may be charged by the department of ~~aging~~health care	36736
administration for the submission of a claim under section ~~173.80~~	36737
5169.10 of the Revised Code or the processing of a claim under	36738
section ~~173.801~~5169.101 of the Revised Code.	36739

~~Sec. 173.803.~~ Sec. 5169.103. The department of ~~aging~~health care	36740
administration may not make a payment under section ~~173.801~~	36741
5169.101 of the Revised Code for a claim submitted under section	36742
~~173.80~~5169.10 of the Revised Code if any of the following are the	36743
case:	36744

(A) The claim is submitted by either a terminal distributor	36745
of dangerous drugs that is not a participating terminal	36746
distributor or a drug mail order system that is not the system	36747
included in the Ohio's best Rx program pursuant to section ~~173.78~~	36748
5169.08 of the Revised Code.	36749

(B) The claim is for a drug that is not included in the	36750
program.	36751

(C) The claim is for a drug included in the program but the	36752
drug is dispensed to an individual who is not covered by an Ohio's	36753
best Rx program enrollment card.	36754

(D) A person or government entity has paid the participating	36755
terminal distributor or the program's drug mail order system	36756
through any other prescription drug coverage program or	36757
prescription drug discount program for dispensing the drug, unless	36758
the payment is reimbursement for redeeming a coupon or is an	36759
amount directly paid by a drug manufacturer to the distributor or	36760
system for dispensing drugs to residents of a long-term care	36761
facility.	36762

~~Sec. 173.81.~~ Sec. 5169.11. For purposes of participating in the	36763
Ohio's best Rx program, any drug manufacturer may enter into an	36764
agreement with the department of ~~aging~~health care administration	36765
under which the manufacturer agrees to make payments to the	36766
department with respect to one or more of the manufacturer's drugs	36767
when the one or more drugs are dispensed under the program. The	36768
terms of the agreement shall comply with section ~~173.811~~5169.111	36769
of the Revised Code.	36770

~~Sec. 173.811.~~ Sec. 5169.111. (A) A manufacturer agreement entered	36771
into under section ~~173.81~~5169.11 of the Revised Code by a drug	36772
manufacturer and the department of ~~aging~~health care	36773
administration shall include terms that do all of the following:	36774

(1) Specify the time the agreement is to be in effect, which	36775
shall be not less than one year from the date the agreement is	36776
entered into;	36777

(2) Specify which of the manufacturer's drugs are included in	36778
the agreement;	36779

(3) Permit the department to remove a drug from the agreement	36780
in the event of a dispute over the drug's utilization;	36781

(4) Require that the manufacturer specify a per unit amount	36782
that will be paid to the department for each drug included in the	36783
agreement that is dispensed to an Ohio's best Rx program	36784
participant;	36785

(5) Require that the per unit amount specified by the	36786
manufacturer be an amount that the manufacturer believes is	36787
greater than or comparable to the per unit amount generally	36788
payable by the manufacturer for the same drug when the drug is	36789
dispensed to an individual using the outpatient drug coverage	36790
included in a health benefit plan offered in this state or another	36791
state to public employees or retirees and the eligible dependents	36792
of those employees or retirees;	36793

(6) Require the manufacturer to make payments in accordance	36794
with the amounts computed under division (A) of section ~~173.812~~	36795
5169.112 of the Revised Code;	36796

(7) Require that the manufacturer make the payments on a	36797
quarterly basis or in accordance with a schedule established by	36798
rules adopted under section ~~173.83~~5169.13 of the Revised Code.	36799

(B) For any drug included in a manufacturer agreement, the	36800
terms of the agreement may provide for the establishment of a	36801
process for referring Ohio's best Rx program applicants and	36802
participants to a patient assistance program operated or sponsored	36803
by the manufacturer. The referral process may be included only if	36804
the manufacturer agrees to refer to the Ohio's best Rx program	36805
residents of this state who apply but are found to be ineligible	36806
for the patient assistance program.	36807

~~Sec. 173.812.~~ Sec. 5169.112. When a drug included in a manufacturer	36808
agreement entered into under section ~~173.81~~5169.11 of the Revised	36809
Code is dispensed under the Ohio's best Rx program, the	36810
manufacturer payment amount that applies to the transaction shall	36811
be established in accordance with the following:	36812

(A) For purposes of the amount to be paid by the	36813
manufacturer, the manufacturer payment amount shall be computed by	36814
multiplying the per unit amount specified for the drug in the	36815
manufacturer agreement by the number of units dispensed.	36816

(B) For purposes of the amount that a participant is to be	36817
charged under section ~~173.75~~5169.05 of the Revised Code and the	36818
amount to be paid for claims under section ~~173.801~~5169.101 of the	36819
Revised Code, both of the following apply:	36820

(1) If a program administration percentage is not determined	36821
by the department of ~~aging~~health care administration in rules	36822
adopted under section ~~173.83~~5169.13 of the Revised Code, the	36823
manufacturer payment amount shall be the same as the manufacturer	36824
payment amount computed under division (A) of this section.	36825

(2) If a program administration percentage is determined by	36826
the department, the manufacturer payment amount shall be computed	36827
as follows:	36828

(a) Multiply the per unit amount specified for the drug in	36829
the agreement by the program administration percentage;	36830

(b) Subtract the product determined under division (B)(2)(a)	36831
of this section from the per unit amount specified for the drug in	36832
the agreement;	36833

(c) Multiply the per unit amount resulting from the	36834
computation under division (B)(2)(b) of this section by the number	36835
of units dispensed.	36836

~~Sec. 173.813.~~ Sec. 5169.113. In its negotiations with a drug	36837
manufacturer proposing to enter into an agreement under section	36838
~~173.81~~5169.11 of the Revised Code, the department of ~~aging~~health	36839
care administration shall use the best information on manufacturer	36840
payments that is available to the department, including	36841
information obtained from the verifications made under section	36842
~~173.814~~5169.114 of the Revised Code by the Ohio's best Rx	36843
program's consulting pharmacy benefit manager selected under	36844
section ~~173.731~~5169.031 of the Revised Code. The department shall	36845
use the information in an attempt to obtain manufacturer payments	36846
that maximize the benefits provided to Ohio's best Rx program	36847
participants.	36848

~~Sec. 173.814.~~ Sec. 5169.114. Annually, the department of ~~aging~~	36849
health care administration shall select a sample of not more than	36850
ten of the drugs that were included in the manufacturer agreements	36851
entered into under section ~~173.81~~5169.11 of the Revised Code in	36852
the immediately preceding year. The department shall submit to the	36853
program's consulting pharmacy benefit manager selected under	36854
section ~~173.731~~5169.031 of the Revised Code information that	36855
identifies the per unit amount of the manufacturer payments that	36856
applied to each of the drugs in the sample.	36857

The consulting pharmacy benefit manager shall review the	36858
submitted information. After the review, the consulting pharmacy	36859
benefit manager shall provide information to the department	36860
verifying whether any of the per unit payment amounts that applied	36861
to the selected drugs were more than two per cent lower than the	36862
per unit payment amounts negotiated by the consulting pharmacy	36863
benefit manager for the same drugs in connection with health	36864
benefit plans that generally do not use formularies to restrict	36865
the outpatient drug coverage included in the plans. The consulting	36866
pharmacy benefit manager shall specify which, if any, of the drugs	36867
in the sample were subject to the lower per unit payment amounts.	36868
The information provided to the department shall be certified by	36869
signature of an officer of the consulting pharmacy benefit	36870
manager.	36871

~~Sec. 173.815.~~ Sec. 5169.115. (A) The department of ~~aging~~health	36872
care administration shall seek from the centers for medicare and	36873
medicaid services of the United States department of health and	36874
human services written confirmation that manufacturer payments	36875
made pursuant to an agreement entered into under section ~~173.81~~	36876
5169.11 of the Revised Code are exempt from the medicaid best	36877
price computation applicable under Title XIX of the "Social	36878
Security Act," 79 Stat. 286 (1965), 42 U.S.C. 1396r-8, as	36879
amended.	36880

(B) Entering into a manufacturer agreement under section	36881
~~173.81~~5169.11 of the Revised Code does not require a drug	36882
manufacturer to make a manufacturer payment that would establish	36883
the manufacturer's medicaid best price for a drug.	36884

~~Sec. 173.82.~~ Sec. 5169.12. A drug manufacturer that enters into an	36885
agreement under section ~~173.81~~5169.11 of the Revised Code may	36886
submit a request to the department of ~~aging~~health care	36887
administration to audit claims submitted under section ~~173.80~~	36888
5169.10 of the Revised Code. On submission of a request that the	36889
department considers reasonable, the department shall permit the	36890
manufacturer to audit the claims.	36891

~~Sec. 173.83.~~ Sec. 5169.13. The department of ~~aging~~health care	36892
administration shall adopt rules in accordance with Chapter 119.	36893
of the Revised Code to implement the Ohio's best Rx program. The	36894
rules shall provide for all of the following:	36895

(A) Standards and procedures for establishing, pursuant to	36896
section ~~173.74~~5169.04 of the Revised Code, the base price for	36897
each drug included in the program;	36898

(B) Determination of family income for the purpose of	36899
division (A)(2)(a) of section ~~173.76~~5169.06 of the Revised Code;	36900

(C) For the purpose of section ~~173.77~~5169.07 of the Revised	36901
Code, the application process for the program, including the	36902
information and documentation to be submitted with applications to	36903
verify eligibility and a process to be used in certifying that an	36904
applicant has attested to the accuracy of the submitted	36905
information and documentation;	36906

(D) The method of providing information about the medicaid	36907
program to applicants under section ~~173.771~~5169.071 of the	36908
Revised Code;	36909

(E) For the purpose of section ~~173.772~~5169.072 of the	36910
Revised Code, eligibility determination procedures;	36911

(F) Standards and procedures governing the drug mail order	36912
system included in the program pursuant to section ~~173.78~~5169.08	36913
of the Revised Code;	36914

(G) Subject to section ~~173.831~~5169.131 of the Revised Code,	36915
periodically increasing the maximum professional fee that	36916
participating terminal distributors may charge Ohio's best Rx	36917
program participants pursuant to an agreement entered into under	36918
section ~~173.79~~5169.09 of the Revised Code;	36919

(H) Subject to section ~~173.832~~5169.132 of the Revised Code,	36920
the amount of the administrative fee, if any, that Ohio's best Rx	36921
program participants are to be charged under the program;	36922

(I) The electronic method for submission of claims to the	36923
department under section ~~173.80~~5169.10 of the Revised Code;	36924

(J) Additional information to be included on claims submitted	36925
under section ~~173.80~~5169.10 of the Revised Code that the	36926
department determines is necessary for the department to be able	36927
to make payments under section ~~173.801~~5169.101 of the Revised	36928
Code;	36929

(K) The method for making payments under section ~~173.801~~	36930
5169.101 of the Revised Code;	36931

(L) Subject to section ~~173.833~~5169.133 of the Revised Code,	36932
the percentage, if any, that is the program administration	36933
percentage;	36934

(M) If the department determines it is best that	36935
participating manufacturers make payments pursuant to manufacturer	36936
agreements entered into under section ~~173.81~~5169.11 of the	36937
Revised Code on a basis other than quarterly, a schedule for	36938
making the payments;	36939

(N) Procedures for making computations under sections ~~173.75~~	36940
5169.05 and ~~173.812~~5169.112 of the Revised Code;	36941

(O) Standards and procedures for the use and preservation of	36942
records regarding the Ohio's best Rx program pursuant to section	36943
~~173.91~~5169.21 of the Revised Code;	36944

(P) The efficient administration of other provisions of	36945
sections ~~173.71~~5169.01 to ~~173.91~~5169.21 of the Revised Code for	36946
which the department determines rules are necessary.	36947

~~Sec. 173.831.~~ Sec. 5169.131. As used in this section, "medicaid	36948
dispensing fee" means the dispensing fee established under section	36949
~~5111.071~~5163.251 of the Revised Code for the medicaid program.	36950

In adopting a rule under division (G) of section ~~173.83~~	36951
5169.13 of the Revised Code increasing the maximum amount of the	36952
professional fee participating terminal distributors may charge	36953
Ohio's best Rx program participants pursuant to an agreement	36954
entered into under section ~~173.79~~5169.09 of the Revised Code, the	36955
department of ~~aging~~health care administration shall review the	36956
amount of the professional fee once a year or, at the department's	36957
discretion, at more frequent intervals. The department shall not	36958
increase the professional fee to an amount exceeding the medicaid	36959
dispensing fee.	36960

A participating terminal distributor may charge a maximum	36961
three dollar professional fee regardless of whether the medicaid	36962
dispensing fee for that drug is less than that amount. The	36963
department, however, may not adopt a rule increasing the maximum	36964
professional fee for that drug until the medicaid dispensing fee	36965
for that drug exceeds that amount.	36966

~~Sec. 173.832.~~ Sec. 5169.132. (A) Once a year or, at the discretion	36967
of the department of ~~aging~~health care administration, at more	36968
frequent intervals, the department shall determine the amount, if	36969
any, that each Ohio's best Rx program participant will be charged	36970
as an administrative fee to be used in paying the administrative	36971
costs of the program. The fee, which shall not exceed one dollar	36972
per transaction, shall be specified in rules adopted under section	36973
~~173.83~~5169.13 of the Revised Code. In adopting the rules, the	36974
department shall specify a fee that results in an amount that	36975
equals or is less than the amount needed to cover the	36976
administrative costs of the Ohio's best Rx program when added to	36977
the sum of the following:	36978

(1) The amount resulting from the program administration	36979
percentage, if the department determines a program administration	36980
percentage in rules adopted under section ~~173.83~~5169.13 of the	36981
Revised Code;	36982

(2) The investment earnings of the Ohio's best Rx program	36983
fund created by section ~~173.85~~5169.15 of the Revised Code;	36984

(3) Any amounts accepted by the department as donations to	36985
the Ohio's best Rx program fund.	36986

(B) Once a year or, at the discretion of the department, at	36987
more frequent intervals, the department shall report the	36988
methodology underlying the determination of the administrative fee	36989
to the Ohio's best Rx program council.	36990

~~Sec. 173.833.~~ Sec. 5169.133. (A) At least once a year or, at the	36991
discretion of the department of ~~aging~~health care administration,	36992
at more frequent intervals, the department shall determine the	36993
percentage, if any, of each manufacturer payment made under an	36994
agreement entered into under section ~~173.81~~5169.11 of the Revised	36995
Code that will be retained by the department for use in paying the	36996
administrative costs of the Ohio's best Rx program. The	36997
percentage, which shall not exceed five per cent, shall be	36998
specified in rules adopted under section ~~173.83~~5169.13 of the	36999
Revised Code. In adopting the rules, the department shall specify	37000
a percentage that results in an amount that equals or is less than	37001
the amount needed to cover the administrative costs of the Ohio's	37002
best Rx program when added to the sum of the following:	37003

(1) The amount resulting from administrative fees, if the	37004
department determines an administrative fee in rules adopted under	37005
section ~~173.83~~5169.13 of the Revised Code;	37006

(2) The investment earnings of the Ohio's best Rx program	37007
fund created by section ~~173.85~~5169.15 of the Revised Code;	37008

(3) Any amounts accepted by the department as donations to	37009
the Ohio's best Rx program fund.	37010

(B) Once a year or, at the discretion of the department, at	37011
more frequent intervals, the department shall report the	37012
methodology underlying the determination of the program	37013
administration percentage to the Ohio's best Rx program council.	37014

~~Sec. 173.84.~~ Sec. 5169.14. Notwithstanding any conflicting	37015
provision of sections ~~173.71~~5169.01 to ~~173.91~~5169.21 of the	37016
Revised Code, the department of ~~aging~~health care administration	37017
may adopt rules in accordance with Chapter 119. of the Revised	37018
Code to make adjustments to the Ohio's best Rx program that the	37019
department considers appropriate to conform the program to, or	37020
coordinate it with, any federally funded prescription drug program	37021
created after October 1, 2003.	37022

~~Sec. 173.85.~~ Sec. 5169.15. (A) The Ohio's best Rx program fund is	37023
hereby created in the state treasury. The fund shall consist of	37024
the following:	37025

(1) Manufacturer payments made by participating manufacturers	37026
pursuant to agreements entered into under section 173.81 of the	37027
Revised Code;	37028

(2) Administrative fees, if an administrative fee is	37029
determined by the department of ~~aging~~health care administration	37030
in rules adopted under section ~~173.83~~5169.13 of the Revised	37031
Code;	37032

(3) Any amounts donated to the fund and accepted by the	37033
department;	37034

(4) The fund's investment earnings.

37035

(B) Money in the Ohio's best Rx program fund shall be used to	37036
make payments under section ~~173.801~~5169.101 of the Revised Code	37037
and to make transfers to the Ohio's best Rx administration fund	37038
in accordance with section ~~173.86~~5169.16 of the Revised Code.	37039

~~Sec. 173.86.~~ Sec. 5169.16. (A) The Ohio's best Rx administration	37040
fund is hereby created in the state treasury. The director of	37041
budget and management shall transfer from the Ohio's best Rx	37042
program fund to the Ohio's best Rx administration fund amounts	37043
equal to the following:	37044

(1) Amounts resulting from application of the program	37045
administration percentage, if a program administration percentage	37046
is determined by the department of ~~aging~~health care	37047
administration in rules adopted under section ~~173.83~~5169.13 of	37048
the Revised Code;	37049

(2) The amount of the administrative fees charged Ohio's best	37050
Rx participants, if an administrative fee is determined by the	37051
department of ~~aging~~health care administration in rules adopted	37052
under section ~~173.83~~5169.13 of the Revised Code;	37053

(3) The amount of any donations credited to the Ohio's best	37054
Rx program fund;	37055

(4) The amount of investment earnings credited to the Ohio's	37056
best Rx program fund.	37057

The director of budget and management shall make the	37058
transfers in accordance with a schedule developed by the director	37059
and the department of ~~aging~~health care administration.	37060

(B) The department of ~~aging~~health care administration shall	37061
use money in the Ohio's best Rx administration fund to pay the	37062
administrative costs of the Ohio's best Rx program, including,	37063
but not limited to, costs associated with contracted services,	37064
staff, outreach activities, computers and network services, and	37065
the Ohio's best Rx program council. If the fund includes an	37066
amount that exceeds the amount necessary to pay the	37067
administrative costs of the program, the department may use the	37068
excess amount to pay the cost of subsidies provided to Ohio's	37069
best Rx program participants under any subsidy program	37070
established pursuant to section ~~173.861~~5169.161 of the Revised	37071
Code.	37072

~~Sec. 173.861.~~ Sec. 5169.161. The department of ~~aging~~health care	37073
administration may establish a component of the Ohio's best Rx	37074
program under which subsidies are provided to participants to	37075
assist them with the cost of purchasing drugs under the program,	37076
including the cost of any professional fees charged for dispensing	37077
the drugs. The subsidies shall be provided only when the Ohio's	37078
best Rx administration fund created under section ~~173.86~~5169.16	37079
of the Revised Code includes an amount that exceeds the amount	37080
necessary to pay the administrative costs of the program.	37081

~~Sec. 173.87.~~ Sec. 5169.17. There is hereby created the Ohio's best	37082
Rx program council. The council shall advise the department of	37083
~~aging~~health care administration on the Ohio's best Rx program.	37084
With the approval of a majority of the council's appointed	37085
members, the council may initiate studies to determine whether	37086
there are more effective ways to administer the program and	37087
provide the department with suggestions for improvements.	37088

~~Sec. 173.871.~~ Sec. 5169.171. The Ohio's best Rx program council	37089
shall consist of the following members:	37090

(A) The president of the senate;

37091

(B) The speaker of the house of representatives;

37092

37093

(D) The minority leader of the house of representatives;

37094

(E) A representative of the Ohio chapter of the American	37095
federation of labor-congress of industrial organizations,	37096
appointed by the governor from a list of names submitted to the	37097
governor by that organization;	37098

(F) A representative of the Ohio chapter of the American	37099
association of retired persons, appointed by the governor from a	37100
list of names submitted to the governor by that organization;	37101

(G) A representative of a disability advocacy organization	37102
located in the state of Ohio, appointed by the governor from a	37103
list of names submitted to the governor by disability advocacy	37104
organizations located in the state of Ohio;	37105

(H) A representative of the Ohio chapter of the united way,	37106
appointed by the governor from a list of names submitted to the	37107
governor by that organization;	37108

(I) A representative of the Ohio alliance of retired	37109
Americans, appointed by the governor from a list of names	37110
submitted to the governor by that organization;	37111

(J) Three representatives of research-based drug	37112
manufacturers, appointed by the governor from a list of names	37113
submitted to the governor by the pharmaceutical research and	37114
manufacturers of America;	37115

(K) A pharmacist licensed under Chapter 4729. of the Revised	37116
Code, appointed by the governor from a list of names submitted to	37117
the governor by the Ohio pharmacists association.	37118

~~Sec. 173.872.~~ Sec. 5169.172. The governor shall make initial	37119
appointments to the Ohio's best Rx program council not later than	37120
thirty days after December 18, 2003. The members appointed by the	37121
governor shall serve at the pleasure of the governor. If an	37122
appointed member's seat becomes vacant, the governor shall fill	37123
the vacancy not later than thirty days after the vacancy occurs	37124
and in the manner provided for the initial appointment.	37125

~~Sec. 173.873.~~ Sec. 5169.173. The president of the senate and	37126
speaker of the house of representatives shall serve as co-chairs	37127
of the Ohio's best Rx program council.	37128

The president of the senate, the minority leader of the	37129
senate, the speaker of the house of representatives, and the	37130
minority leader of the house of representatives may each appoint a	37131
member of the general assembly to attend any meeting of the Ohio's	37132
best Rx program council on behalf of the president of the senate,	37133
the minority leader of the senate, the speaker of the house of	37134
representatives, or the minority leader of the house of	37135
representatives, respectively.	37136

~~Sec. 173.874.~~ Sec. 5169.174. Members of the Ohio's best Rx program	37137
council shall serve without compensation and shall not be	37138
reimbursed for any expenses associated with their duties on the	37139
council.	37140

~~Sec. 173.875.~~ Sec. 5169.175. Except for any part of records that	37141
contain a trade secret, the Ohio's best Rx program council's	37142
records are a public record for the purpose of section 149.43 of	37143
the Revised Code.	37144

~~Sec. 173.876.~~ Sec. 5169.176. Sections 101.82 to 101.87 of the	37145
Revised Code do not apply to the Ohio's best Rx program council.	37146

~~Sec. 173.88.~~ Sec. 5169.18. (A) The department of ~~aging~~health care	37147
administration shall compile both of the following lists regarding	37148
the Ohio's best Rx program:	37149

(1) A list consisting of the name of each drug manufacturer	37150
that enters into a manufacturer agreement under section ~~173.791~~	37151
5169.091 of the Revised Code and the names of the drugs included	37152
in each manufacturer agreement;	37153

(2) A list consisting of the name of each participating	37154
terminal distributor and the name of the drug mail order system	37155
included in the program pursuant to section ~~173.78~~5169.08 of the	37156
Revised Code.	37157

(B) As part of the list compiled under division (A)(1) of	37158
this section, the department may include aggregate information	37159
regarding the drugs selected under section ~~173.814~~5169.114 of the	37160
Revised Code that were verified under that section as having per	37161
unit manufacturer payment amounts that were not more than two per	37162
cent lower than the per unit payment amounts negotiated for the	37163
same drugs by the program's consulting pharmacy benefit manager	37164
selected under section ~~173.731~~5169.031 of the Revised Code. The	37165
information shall not identify a specific drug and shall be	37166
expressed only as a percentage of the sample of drugs selected	37167
under section ~~173.814~~5169.114 of the Revised Code.	37168

(C) The lists compiled under this section are public records	37169
for the purpose of section 149.43 of the Revised Code. The	37170
department shall specifically make the lists available to	37171
physicians, participating terminal distributors, and other health	37172
professionals.	37173

~~Sec. 173.89.~~ Sec. 5169.19. Information transmitted by or to any of	37174
the following for any purpose related to the Ohio's best Rx	37175
program is confidential to the extent required by federal and	37176
state law:	37177

(A) Drug manufacturers;

37178

(B) Terminal distributors of dangerous drugs;

37179

37180

(D) The program's consulting pharmacy benefit manager	37181
selected under section ~~173.731~~5169.031 of the Revised Code;	37182

(E) Ohio's best Rx program participants;

37183

(F) Any other government entity or person.

37184

~~Sec. 173.891.~~ Sec. 5169.191. (A) Except as provided by section	37185
~~173.892~~5169.192 of the Revised Code, all of the following are	37186
trade secrets, are not public records for the purposes of section	37187
149.43 of the Revised Code, and shall not be used, released,	37188
published, or disclosed in a form that reveals a specific drug or	37189
the identity of a drug manufacturer:	37190

(1) The amounts determined under section ~~173.801~~5169.101 of	37191
the Revised Code for payment of claims submitted by participating	37192
terminal distributors and the drug mail order system included in	37193
the Ohio's best Rx program pursuant to section ~~173.78~~5169.08 of	37194
the Revised Code;	37195

(2) Information disclosed in a manufacturer agreement entered	37196
into under section ~~173.81~~5169.11 of the Revised Code or in	37197
communications related to an agreement;	37198

(3) Drug pricing and drug manufacturer payment information	37199
verified under sections ~~173.742~~5169.042 and ~~173.814~~5169.114 of	37200
the Revised Code by the program's consulting pharmacy benefit	37201
manager selected under section ~~173.731~~5169.031 of the Revised	37202
Code;	37203

(4) Information contained in or pertaining to an audit	37204
provided for by the program's consulting pharmacy benefit manager	37205
under section ~~173.732~~5169.032 of the Revised Code;	37206

(5) The elements of the computations made pursuant to	37207
sections ~~173.75~~5169.05, ~~173.801~~5169.101, and ~~173.812~~5169.112 of	37208
the Revised Code and any results of those computations that reveal	37209
or could be used to reveal the manufacturer payment amounts used	37210
to make the computations.	37211

(B) No person or government entity shall use or reveal any	37212
information specified in division (A) of this section except as	37213
required for the implementation of sections ~~173.71~~5169.01 to	37214
~~173.91~~5169.21 of the Revised Code.	37215

~~Sec. 173.892.~~ Sec. 5169.192. Sections ~~173.89~~5169.19 and ~~173.891~~	37216
5169.191 of the Revised Code shall not preclude the department of	37217
~~aging~~health care administration from disclosing information	37218
necessary for the implementation of sections ~~173.71~~5169.01 to	37219
~~173.91~~5169.21 of the Revised Code, including the amount an Ohio's	37220
best Rx program participant is to be charged when the amount is	37221
disclosed under section ~~173.751~~5169.051 of the Revised Code to	37222
participating terminal distributors or the drug mail order system	37223
included in the program pursuant to section ~~173.78~~5169.08 of the	37224
Revised Code.	37225

~~Sec. 173.90.~~ Sec. 5169.20. (A) As used in this section,	37226
"identifying information" means information that identifies or	37227
could be used to identify an Ohio's best Rx program applicant or	37228
participant. "Identifying information" does not include aggregate	37229
information about applicants and participants that does not	37230
identify and could not be used to identify an individual applicant	37231
or participant.	37232

(B) Except as provided in divisions (C), (D), and (E) of this	37233
section, no person or government entity shall sell, solicit,	37234
disclose, receive, or use identifying information or knowingly	37235
permit the use of identifying information.	37236

(C)(1) The department of ~~aging~~health care administration may	37237
solicit, disclose, receive, or use identifying information or	37238
knowingly permit the use of identifying information for a purpose	37239
directly connected to the administration of the Ohio's best Rx	37240
program, including disclosing and knowingly permitting the use of	37241
identifying information included in a claim that a participating	37242
manufacturer audits pursuant to section ~~173.82~~5169.12 of the	37243
Revised Code, contacting Ohio's best Rx program applicants or	37244
participants regarding participation in the program, and notifying	37245
applicants and participants regarding participating terminal	37246
distributors and the drug mail order system included in the	37247
program pursuant to section ~~173.78~~5169.08 of the Revised Code.	37248

(2) The department may solicit, disclose, receive, or use	37249
identifying information or knowingly permit the use of identifying	37250
information to the extent required by federal law.	37251

(3) The department may disclose identifying information to	37252
the Ohio's best Rx program applicant or participant who is the	37253
subject of that information or to the parent, spouse, guardian, or	37254
custodian of that applicant or participant.	37255

(D)(1) A participating terminal distributor may solicit,	37256
disclose, receive, or use identifying information or knowingly	37257
permit the use of identifying information to the extent required	37258
or permitted by an agreement the distributor enters into under	37259
section ~~173.79~~5169.09 of the Revised Code.	37260

(2) Subject to division (B) of section ~~173.78~~5169.08 of the	37261
Revised Code, the drug mail order system included in the program	37262
pursuant to section ~~173.78~~5169.08 of the Revised Code may	37263
solicit, disclose, receive, or use identifying information or	37264
knowingly permit the use of identifying information to the extent	37265
required or permitted by the department.	37266

(E) A participating manufacturer may, for the purpose of	37267
auditing a claim pursuant to section ~~173.82~~5169.12 of the Revised	37268
Code, solicit, receive, and use identifying information included	37269
in the claim.	37270

~~Sec. 173.91.~~ Sec. 5169.21. (A) Except as provided in division (B)	37271
of this section, the department of ~~aging~~health care	37272
administration shall use and preserve records regarding the Ohio's	37273
best Rx program in accordance with rules adopted under section	37274
~~173.83~~5169.13 of the Revised Code. The department shall use and	37275
preserve the records in accordance with those rules, regardless of	37276
whether the department generated the records or received them from	37277
another government entity or any person.	37278

(B) All records received by the department under sections	37279
~~173.742~~5169.042 and ~~173.814~~5169.114 of the Revised Code from the	37280
program's consulting pharmacy benefit manager selected under	37281
section ~~173.731~~5169.031 of the Revised Code shall be destroyed	37282
promptly after the department has completed the purpose for which	37283
the information contained in the records was obtained.	37284

Sec. 5169.99. Whoever violates division (B) of section	37285
5169.20 of the Revised Code is guilty of a misdemeanor of the	37286
first degree.	37287

Sec. 5302.221. (A) As used in this section:

37288

"Estate" has the same meaning as in section ~~5111.11~~5162.40	37289
of the Revised Code.	37290

"Medicaid estate recovery program" means the program	37291
instituted under section ~~5111.11~~5162.40 of the Revised Code.	37292

(B) The administrator of the medicaid estate recovery program	37293
shall prescribe a form on which a beneficiary of a transfer on	37294
death deed as provided in section 5302.22 of the Revised Code, who	37295
survives the deceased owner of the real property or an interest in	37296
the real property or that is in existence on the date of death of	37297
the deceased owner, or such a beneficiary's representative is to	37298
indicate both of the following:	37299

(1) Whether the deceased owner was either of the following:

37300

(a) A decedent subject to the medicaid estate recovery	37301
program;	37302

(b) The spouse of a decedent subject to the medicaid estate	37303
recovery program.	37304

(2) Whether the real property or interest in the real	37305
property was part of the estate of a decedent subject to the	37306
medicaid estate recovery program.	37307

(C) A county recorder shall obtain a properly completed form	37308
prescribed under division (B) of this section from the beneficiary	37309
of a transfer on death deed or the beneficiary's representative	37310
and send a copy of the form to the administrator of the medicaid	37311
estate recovery program before recording the transfer of the real	37312
property or interest in the real property under division (C) of	37313
section 5302.22 of the Revised Code.	37314

Sec. 5309.082. (A) As used in this section:

37315

"Estate" has the same meaning as in section ~~5111.11~~5162.40	37316
of the Revised Code.	37317

"Medicaid estate recovery program" means the program	37318
instituted under section ~~5111.11~~5162.40 of the Revised Code.	37319

(B) The administrator of the medicaid estate recovery program	37320
shall prescribe a form on which a surviving tenant under a	37321
survivorship tenancy or such a surviving tenant's representative	37322
is to indicate both of the following:	37323

(1) Whether the deceased survivorship tenant was either of	37324
the following:	37325

(a) A decedent subject to the medicaid estate recovery	37326
program;	37327

(b) The spouse of a decedent subject to the medicaid estate	37328
recovery program.	37329

(2) Whether the registered land under a survivorship tenancy	37330
was part of the estate of a decedent subject to the medicaid	37331
estate recovery program.	37332

(C) A county recorder shall obtain a properly completed form	37333
prescribed under division (B) of this section from the surviving	37334
tenant under a survivorship tenancy or the surviving tenant's	37335
representative and send a copy of the form to the administrator of	37336
the medicaid estate recovery program before registering the title	37337
in the surviving tenants under section 5309.081 of the Revised	37338
Code.	37339

Sec. 5505.04. (A)(1) The general administration and	37340
management of the state highway patrol retirement system and the	37341
making effective of this chapter are hereby vested in the state	37342
highway patrol retirement board. The board may sue and be sued,	37343
plead and be impleaded, contract and be contracted with, and do	37344
all things necessary to carry out this chapter.	37345

The board shall consist of the following members:

37346

(a) The superintendent of the state highway patrol;

37347

(b) Two retirant members who reside in this state;

37348

37349

(d) One member, known as the treasurer of state's investment	37350
designee, who shall be appointed by the treasurer of state for a	37351
term of four years and who shall have the following	37352
qualifications:	37353

(i) The member is a resident of this state.

37354

(ii) Within the three years immediately preceding the	37355
appointment, the member has not been employed by the public	37356
employees retirement system, police and fire pension fund, state	37357
teachers retirement system, school employees retirement system, or	37358
state highway patrol retirement system or by any person,	37359
partnership, or corporation that has provided to one of those	37360
retirement systems services of a financial or investment nature,	37361
including the management, analysis, supervision, or investment of	37362
assets.	37363

(iii) The member has direct experience in the management,	37364
analysis, supervision, or investment of assets.	37365

(iv) The member is not currently employed by the state or a	37366
political subdivision of the state.	37367

(e) Two investment expert members, who shall be appointed to	37368
four-year terms. One investment expert member shall be appointed	37369
by the governor, and one investment expert member shall be jointly	37370
appointed by the speaker of the house of representatives and the	37371
president of the senate. Each investment expert member shall have	37372
the following qualifications:	37373

(i) Each investment expert member shall be a resident of this	37374
state.	37375

(ii) Within the three years immediately preceding the	37376
appointment, each investment expert member shall not have been	37377
employed by the public employees retirement system, police and	37378
fire pension fund, state teachers retirement system, school	37379
employees retirement system, or state highway patrol retirement	37380
system or by any person, partnership, or corporation that has	37381
provided to one of those retirement systems services of a	37382
financial or investment nature, including the management,	37383
analysis, supervision, or investment of assets.	37384

(iii) Each investment expert member shall have direct	37385
experience in the management, analysis, supervision, or investment	37386
of assets.	37387

(2) The board shall annually elect a chairperson and	37388
vice-chairperson from among its members. The vice-chairperson	37389
shall act as chairperson in the absence of the chairperson. A	37390
majority of the members of the board shall constitute a quorum and	37391
any action taken shall be approved by a majority of the members of	37392
the board. The board shall meet not less than once each year, upon	37393
sufficient notice to the members. All meetings of the board shall	37394
be open to the public except executive sessions as set forth in	37395
division (G) of section 121.22 of the Revised Code, and any	37396
portions of any sessions discussing medical records or the degree	37397
of disability of a member excluded from public inspection by this	37398
section.	37399

(3) Any investment expert member appointed to fill a vacancy	37400
occurring prior to the expiration of the term for which the	37401
member's predecessor was appointed holds office until the end of	37402
such term. The member continues in office subsequent to the	37403
expiration date of the member's term until the member's successor	37404
takes office, or until a period of sixty days has elapsed,	37405
whichever occurs first.	37406

(B) The attorney general shall prescribe procedures for the	37407
adoption of rules authorized under this chapter, consistent with	37408
the provision of section 111.15 of the Revised Code under which	37409
all rules shall be filed in order to be effective. Such procedures	37410
shall establish methods by which notice of proposed rules are	37411
given to interested parties and rules adopted by the board	37412
published and otherwise made available. When it files a rule with	37413
the joint committee on agency rule review pursuant to section	37414
111.15 of the Revised Code, the board shall submit to the Ohio	37415
retirement study council a copy of the full text of the rule, and	37416
if applicable, a copy of the rule summary and fiscal analysis	37417
required by division (B) of section 127.18 of the Revised Code.	37418

(C)(1) As used in this division, "personal history record"	37419
means information maintained by the board on an individual who is	37420
a member, former member, retirant, or beneficiary that includes	37421
the address, telephone number, social security number, record of	37422
contributions, correspondence with the system, and other	37423
information the board determines to be confidential.	37424

(2) The records of the board shall be open to public	37425
inspection, except for the following which shall be excluded: the	37426
member's, former member's, retirant's, or beneficiary's personal	37427
history record and the amount of a monthly allowance or benefit	37428
paid to a retirant, beneficiary, or survivor, except with the	37429
written authorization of the individual concerned. All medical	37430
reports and recommendations are privileged except that copies of	37431
such medical reports or recommendations shall be made available to	37432
the individual's personal physician, attorney, or authorized agent	37433
upon written release received from such individual or such	37434
individual's agent, or when necessary for the proper	37435
administration of the fund to the board-assigned physician.	37436

(D) Notwithstanding the exceptions to public inspection in	37437
division (C)(2) of this section, the board may furnish the	37438
following information:	37439

(1) If a member, former member, or retirant is subject to an	37440
order issued under section 2907.15 of the Revised Code or an order	37441
issued under division (A) or (B) of section 2929.192 of the	37442
Revised Code or is convicted of or pleads guilty to a violation of	37443
section 2921.41 of the Revised Code, on written request of a	37444
prosecutor as defined in section 2935.01 of the Revised Code, the	37445
board shall furnish to the prosecutor the information requested	37446
from the individual's personal history record.	37447

(2) Pursuant to a court order issued under Chapters 3119.,	37448
3121., and 3123. of the Revised Code, the board shall furnish to a	37449
court or child support enforcement agency the information required	37450
under those chapters.	37451

(3) At the written request of any nonprofit organization or	37452
association providing services to retirement system members,	37453
retirants, or beneficiaries, the board shall provide to the	37454
organization or association a list of the names and addresses of	37455
members, former members, retirants, or beneficiaries if the	37456
organization or association agrees to use such information solely	37457
in accordance with its stated purpose of providing services to	37458
such individuals and not for the benefit of other persons,	37459
organizations, or associations. The costs of compiling, copying,	37460
and mailing the list shall be paid by such entity.	37461

(4) Within fourteen days after receiving ~~from the director of~~	37462
~~job and family services~~ a list of the names and social security	37463
numbers of recipients of public assistance pursuant to section	37464
5101.181 of the Revised Code or a list of the names and social	37465
security numbers of public medical assistance recipients pursuant	37466
to section 5160.43 of the Revised Code, the board shall inform the	37467
auditor of state of the name, current or most recent employer	37468
address, and social security number of each member whose name and	37469
social security number are the same as those of a person whose	37470
name or social security number ~~was submitted by the director~~is	37471
included on the list. The board and its employees, except for	37472
purposes of furnishing the auditor of state with information	37473
required by this section, shall preserve the confidentiality of	37474
recipients of public assistance in compliance with ~~division (A) of~~	37475
section 5101.181 of the Revised Code and preserve the	37476
confidentiality of public medical assistance program recipients in	37477
compliance with section 5160.43 of the Revised Code.	37478

(5) The system shall comply with orders issued under section	37479
3105.87 of the Revised Code.	37480

On the written request of an alternate payee, as defined in	37481
section 3105.80 of the Revised Code, the system shall furnish to	37482
the alternate payee information on the amount and status of any	37483
amounts payable to the alternate payee under an order issued under	37484
section 3105.171 or 3105.65 of the Revised Code.	37485

(6) At the request of any person, the board shall make	37486
available to the person copies of all documents, including	37487
resumes, in the board's possession regarding filling a vacancy of	37488
an employee member or retirant member of the board. The person who	37489
made the request shall pay the cost of compiling, copying, and	37490
mailing the documents. The information described in this division	37491
is a public record.	37492

(E) A statement that contains information obtained from the	37493
system's records that is certified and signed by an officer of the	37494
retirement system and to which the system's official seal is	37495
affixed, or copies of the system's records to which the signature	37496
and seal are attached, shall be received as true copies of the	37497
system's records in any court or before any officer of this state.	37498

Sec. 5725.18. (A) An annual franchise tax on the privilege	37499
of being an insurance company is hereby levied on each domestic	37500
insurance company. In the month of May, annually, the treasurer of	37501
state shall charge for collection from each domestic insurance	37502
company a franchise tax in the amount computed in accordance with	37503
the following, as applicable:	37504

(1) With respect to a domestic insurance company that is a	37505
health insuring corporation, one per cent of all premium rate	37506
payments received, exclusive of payments received under the	37507
medicare program ~~established under Title XVIII of the "Social~~	37508
~~Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended,~~	37509
or pursuant to the ~~medical assistance~~medicaid program ~~established~~	37510
~~under Chapter 5111. of the Revised Code~~, as reflected in its	37511
annual report for the preceding calendar year;	37512

(2) With respect to a domestic insurance company that is not	37513
a health insuring corporation, one and four-tenths per cent of the	37514
gross amount of premiums received from policies covering risks	37515
within this state, exclusive of premiums received under the	37516
medicare program ~~established under Title XVIII of the "Social~~	37517
~~Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended,~~	37518
or pursuant to the ~~medical assistance~~medicaid program ~~established~~	37519
~~under Chapter 5111. of the Revised Code~~, as reflected in its	37520
annual statement for the preceding calendar year, and, if the	37521
company operates a health insuring corporation as a line of	37522
business, one per cent of all premium rate payments received from	37523
that line of business, exclusive of payments received under the	37524
medicare program ~~established under Title XVIII of the "Social~~	37525
~~Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended,~~	37526
or pursuant to the ~~medical assistance~~medicaid program ~~established~~	37527
~~under Chapter 5111. of the Revised Code~~, as reflected in its	37528
annual statement for the preceding calendar year.	37529

(B) The gross amount of premium rate payments or premiums	37530
used to compute the applicable tax in accordance with division (A)	37531
of this section is subject to the deductions prescribed by section	37532
5729.03 of the Revised Code for foreign insurance companies. The	37533
objects of such tax are those declared in section 5725.24 of the	37534
Revised Code, to which only such tax shall be applied.	37535

(C) In no case shall such tax be less than two hundred fifty	37536
dollars.	37537

Sec. 5729.03. (A) If the superintendent of insurance finds	37538
the annual statement required by section 5729.02 of the Revised	37539
Code to be correct, the superintendent shall compute the following	37540
amount, as applicable, of the balance of such gross amount, after	37541
deducting such return premiums and considerations received for	37542
reinsurance, and charge such amount to such company as a tax upon	37543
the business done by it in this state for the period covered by	37544
such annual statement:	37545

(1) If the company is a health insuring corporation, one per	37546
cent of the balance of premium rate payments received, exclusive	37547
of payments received under the medicare program ~~established under~~	37548
~~Title XVIII of the "Social Security Act," 49 Stat. 620 (1935), 42~~	37549
~~U.S.C.A. 301, as amended,~~ or pursuant to the ~~medical assistance~~	37550
medicaid program ~~established under Chapter 5111. of the Revised~~	37551
~~Code~~, as reflected in its annual report;	37552

(2) If the company is not a health insuring corporation, one	37553
and four-tenths per cent of the balance of premiums received,	37554
exclusive of premiums received under the medicare program	37555
~~established under Title XVIII of the "Social Security Act," 49~~	37556
~~Stat. 620 (1935), 42 U.S.C.A. 301, as amended,~~ or pursuant to the	37557
~~medical assistance~~medicaid program ~~established under Chapter~~	37558
~~5111. of the Revised Code~~, as reflected in its annual statement,	37559
and, if the company operates a health insuring corporation as a	37560
line of business, one per cent of the balance of premium rate	37561
payments received from that line of business, exclusive of	37562
payments received under the medicare program ~~established under~~	37563
~~Title XVIII of the "Social Security Act," 49 Stat. 620 (1935), 42~~	37564
~~U.S.C.A. 301, as amended,~~ or pursuant to the ~~medical assistance~~	37565
medicaid program ~~established under Chapter 5111. of the Revised~~	37566
~~Code~~, as reflected in its annual statement.	37567

(B) Any insurance policies that were not issued in violation	37568
of Title XXXIX of the Revised Code and that were issued prior to	37569
April 15, 1967, by a life insurance company organized and operated	37570
without profit to any private shareholder or individual,	37571
exclusively for the purpose of aiding educational or scientific	37572
institutions organized and operated without profit to any private	37573
shareholder or individual, are not subject to the tax imposed by	37574
this section. All taxes collected pursuant to this section shall	37575
be credited to the general revenue fund.	37576

(C) In no case shall the tax imposed under this section be	37577
less than two hundred fifty dollars.	37578

Sec. 5731.39. (A) No corporation organized or existing under	37579
the laws of this state shall transfer on its books or issue a new	37580
certificate for any share of its capital stock registered in the	37581
name of a decedent, or in trust for a decedent, or in the name of	37582
a decedent and another person or persons, without the written	37583
consent of the tax commissioner.	37584

(B) No safe deposit company, trust company, financial	37585
institution as defined in division (A) of section 5725.01 of the	37586
Revised Code or other corporation or person, having in possession,	37587
control, or custody a deposit standing in the name of a decedent,	37588
or in trust for a decedent, or in the name of a decedent and	37589
another person or persons, shall deliver or transfer an amount in	37590
excess of three-fourths of the total value of such deposit,	37591
including accrued interest and dividends, as of the date of	37592
decedent's death, without the written consent of the tax	37593
commissioner. The written consent of the tax commissioner need not	37594
be obtained prior to the delivery or transfer of amounts having a	37595
value of three-fourths or less of said total value.	37596

(C) No life insurance company shall pay the proceeds of an	37597
annuity or matured endowment contract, or of a life insurance	37598
contract payable to the estate of a decedent, or of any other	37599
insurance contract taxable under Chapter 5731. of the Revised	37600
Code, without the written consent of the tax commissioner. Any	37601
life insurance company may pay the proceeds of any insurance	37602
contract not specified in this division (C) without the written	37603
consent of the tax commissioner.	37604

(D) No trust company or other corporation or person shall pay	37605
the proceeds of any death benefit, retirement, pension or profit	37606
sharing plan in excess of two thousand dollars, without the	37607
written consent of the tax commissioner. Such trust company or	37608
other corporation or person, however, may pay the proceeds of any	37609
death benefit, retirement, pension, or profit-sharing plan which	37610
consists of insurance on the life of the decedent payable to a	37611
beneficiary other than the estate of the insured without the	37612
written consent of the tax commissioner.	37613

(E) No safe deposit company, trust company, financial	37614
institution as defined in division (A) of section 5725.01 of the	37615
Revised Code, or other corporation or person, having in	37616
possession, control, or custody securities, assets, or other	37617
property (including the shares of the capital stock of, or other	37618
interest in, such safe deposit company, trust company, financial	37619
institution as defined in division (A) of section 5725.01 of the	37620
Revised Code, or other corporation), standing in the name of a	37621
decedent, or in trust for a decedent, or in the name of a decedent	37622
and another person or persons, and the transfer of which is	37623
taxable under Chapter 5731. of the Revised Code, shall deliver or	37624
transfer any such securities, assets, or other property which have	37625
a value as of the date of decedent's death in excess of	37626
three-fourths of the total value thereof, without the written	37627
consent of the tax commissioner. The written consent of the tax	37628
commissioner need not be obtained prior to the delivery or	37629
transfer of any such securities, assets, or other property having	37630
a value of three-fourths or less of said total value.	37631

(F) No safe deposit company, financial institution as defined	37632
in division (A) of section 5725.01 of the Revised Code, or other	37633
corporation or person having possession or control of a safe	37634
deposit box or similar receptacle standing in the name of a	37635
decedent or in the name of the decedent and another person or	37636
persons, or to which the decedent had a right of access, except	37637
when such safe deposit box or other receptacle stands in the name	37638
of a corporation or partnership, or in the name of the decedent as	37639
guardian or executor, shall deliver any of the contents thereof	37640
unless the safe deposit box or similar receptacle has been opened	37641
and inventoried in the presence of the tax commissioner or the	37642
commissioner's agent, and a written consent to transfer issued;	37643
provided, however, that a safe deposit company, financial	37644
institution, or other corporation or person having possession or	37645
control of a safe deposit box may deliver wills, deeds to burial	37646
lots, and insurance policies to a representative of the decedent,	37647
but that a representative of the safe deposit company, financial	37648
institution, or other corporation or person must supervise the	37649
opening of the box and make a written record of the wills, deeds,	37650
and policies removed. Such written record shall be included in the	37651
tax commissioner's inventory records.	37652

(G) Notwithstanding any provision of this section:

37653

(1) The tax commissioner may authorize any delivery or	37654
transfer or waive any of the foregoing requirements under such	37655
terms and conditions as the commissioner may prescribe;	37656

(2) An adult care facility, as defined in section 3722.01 of	37657
the Revised Code, or a home, as defined in section 3721.10 of the	37658
Revised Code, may transfer or use the money in a personal needs	37659
allowance account in accordance with section ~~5111.113~~5162.37 of	37660
the Revised Code without the written consent of the tax	37661
commissioner, and without the account having been opened and	37662
inventoried in the presence of the commissioner or the	37663
commissioner's agent.	37664

Failure to comply with this section shall render such safe	37665
deposit company, trust company, life insurance company, financial	37666
institution as defined in division (A) of section 5725.01 of the	37667
Revised Code, or other corporation or person liable for the amount	37668
of the taxes and interest due under the provisions of Chapter	37669
5731. of the Revised Code on the transfer of such stock, deposit,	37670
proceeds of an annuity or matured endowment contract or of a life	37671
insurance contract payable to the estate of a decedent, or other	37672
insurance contract taxable under Chapter 5731. of the Revised	37673
Code, proceeds of any death benefit, retirement, pension, or	37674
profit sharing plan in excess of two thousand dollars, or	37675
securities, assets, or other property of any resident decedent,	37676
and in addition thereto, to a penalty of not less than five	37677
hundred or more than five thousand dollars.	37678

Sec. 5747.01. Except as otherwise expressly provided or	37679
clearly appearing from the context, any term used in this chapter	37680
that is not otherwise defined in this section has the same meaning	37681
as when used in a comparable context in the laws of the United	37682
States relating to federal income taxes or if not used in a	37683
comparable context in those laws, has the same meaning as in	37684
section 5733.40 of the Revised Code. Any reference in this chapter	37685
to the Internal Revenue Code includes other laws of the United	37686
States relating to federal income taxes.	37687

As used in this chapter:

37688

(A) "Adjusted gross income" or "Ohio adjusted gross income"	37689
means federal adjusted gross income, as defined and used in the	37690
Internal Revenue Code, adjusted as provided in this section:	37691

(1) Add interest or dividends on obligations or securities of	37692
any state or of any political subdivision or authority of any	37693
state, other than this state and its subdivisions and authorities.	37694

(2) Add interest or dividends on obligations of any	37695
authority, commission, instrumentality, territory, or possession	37696
of the United States to the extent that the interest or dividends	37697
are exempt from federal income taxes but not from state income	37698
taxes.	37699

(3) Deduct interest or dividends on obligations of the United	37700
States and its territories and possessions or of any authority,	37701
commission, or instrumentality of the United States to the extent	37702
that the interest or dividends are included in federal adjusted	37703
gross income but exempt from state income taxes under the laws of	37704
the United States.	37705

(4) Deduct disability and survivor's benefits to the extent	37706
included in federal adjusted gross income.	37707

(5) Deduct benefits under Title II of the Social Security Act	37708
and tier 1 railroad retirement benefits to the extent included in	37709
federal adjusted gross income under section 86 of the Internal	37710
Revenue Code.	37711

(6) In the case of a taxpayer who is a beneficiary of a trust	37712
that makes an accumulation distribution as defined in section 665	37713
of the Internal Revenue Code, add, for the beneficiary's taxable	37714
years beginning before 2002, the portion, if any, of such	37715
distribution that does not exceed the undistributed net income of	37716
the trust for the three taxable years preceding the taxable year	37717
in which the distribution is made to the extent that the portion	37718
was not included in the trust's taxable income for any of the	37719
trust's taxable years beginning in 2002 or thereafter.	37720
"Undistributed net income of a trust" means the taxable income of	37721
the trust increased by (a)(i) the additions to adjusted gross	37722
income required under division (A) of this section and (ii) the	37723
personal exemptions allowed to the trust pursuant to section	37724
642(b) of the Internal Revenue Code, and decreased by (b)(i) the	37725
deductions to adjusted gross income required under division (A) of	37726
this section, (ii) the amount of federal income taxes attributable	37727
to such income, and (iii) the amount of taxable income that has	37728
been included in the adjusted gross income of a beneficiary by	37729
reason of a prior accumulation distribution. Any undistributed net	37730
income included in the adjusted gross income of a beneficiary	37731
shall reduce the undistributed net income of the trust commencing	37732
with the earliest years of the accumulation period.	37733

(7) Deduct the amount of wages and salaries, if any, not	37734
otherwise allowable as a deduction but that would have been	37735
allowable as a deduction in computing federal adjusted gross	37736
income for the taxable year, had the targeted jobs credit allowed	37737
and determined under sections 38, 51, and 52 of the Internal	37738
Revenue Code not been in effect.	37739

(8) Deduct any interest or interest equivalent on public	37740
obligations and purchase obligations to the extent that the	37741
interest or interest equivalent is included in federal adjusted	37742
gross income.	37743

(9) Add any loss or deduct any gain resulting from the sale,	37744
exchange, or other disposition of public obligations to the extent	37745
that the loss has been deducted or the gain has been included in	37746
computing federal adjusted gross income.	37747

(10) Deduct or add amounts, as provided under section	37748
5747.70 of the Revised Code, related to contributions to variable	37749
college savings program accounts made or tuition units purchased	37750
pursuant to Chapter 3334. of the Revised Code.	37751

(11)(a) Deduct, to the extent not otherwise allowable as a	37752
deduction or exclusion in computing federal or Ohio adjusted gross	37753
income for the taxable year, the amount the taxpayer paid during	37754
the taxable year for medical care insurance and qualified	37755
long-term care insurance for the taxpayer, the taxpayer's spouse,	37756
and dependents. No deduction for medical care insurance under	37757
division (A)(11) of this section shall be allowed either to any	37758
taxpayer who is eligible to participate in any subsidized health	37759
plan maintained by any employer of the taxpayer or of the	37760
taxpayer's spouse, or to any taxpayer who is entitled to, or on	37761
application would be entitled to, benefits under part A of ~~Title~~	37762
~~XVIII of~~ the ~~"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.~~	37763
~~301, as amended~~medicare program. For the purposes of division	37764
(A)(11)(a) of this section, "subsidized health plan" means a	37765
health plan for which the employer pays any portion of the plan's	37766
cost. The deduction allowed under division (A)(11)(a) of this	37767
section shall be the net of any related premium refunds, related	37768
premium reimbursements, or related insurance premium dividends	37769
received during the taxable year.	37770

(b) Deduct, to the extent not otherwise deducted or excluded	37771
in computing federal or Ohio adjusted gross income during the	37772
taxable year, the amount the taxpayer paid during the taxable	37773
year, not compensated for by any insurance or otherwise, for	37774
medical care of the taxpayer, the taxpayer's spouse, and	37775
dependents, to the extent the expenses exceed seven and one-half	37776
per cent of the taxpayer's federal adjusted gross income.	37777

(c) For purposes of division (A)(11) of this section,	37778
"medical care" has the meaning given in section 213 of the	37779
Internal Revenue Code, subject to the special rules, limitations,	37780
and exclusions set forth therein, and "qualified long-term care"	37781
has the same meaning given in section 7702B(c) of the Internal	37782
Revenue Code.	37783

(12)(a) Deduct any amount included in federal adjusted gross	37784
income solely because the amount represents a reimbursement or	37785
refund of expenses that in any year the taxpayer had deducted as	37786
an itemized deduction pursuant to section 63 of the Internal	37787
Revenue Code and applicable United States department of the	37788
treasury regulations. The deduction otherwise allowed under	37789
division (A)(12)(a) of this section shall be reduced to the extent	37790
the reimbursement is attributable to an amount the taxpayer	37791
deducted under this section in any taxable year.	37792

(b) Add any amount not otherwise included in Ohio adjusted	37793
gross income for any taxable year to the extent that the amount is	37794
attributable to the recovery during the taxable year of any amount	37795
deducted or excluded in computing federal or Ohio adjusted gross	37796
income in any taxable year.	37797

(13) Deduct any portion of the deduction described in section	37798
1341(a)(2) of the Internal Revenue Code, for repaying previously	37799
reported income received under a claim of right, that meets both	37800
of the following requirements:	37801

(a) It is allowable for repayment of an item that was	37802
included in the taxpayer's adjusted gross income for a prior	37803
taxable year and did not qualify for a credit under division (A)	37804
or (B) of section 5747.05 of the Revised Code for that year;	37805

(b) It does not otherwise reduce the taxpayer's adjusted	37806
gross income for the current or any other taxable year.	37807

(14) Deduct an amount equal to the deposits made to, and net	37808
investment earnings of, a medical savings account during the	37809
taxable year, in accordance with section 3924.66 of the Revised	37810
Code. The deduction allowed by division (A)(14) of this section	37811
does not apply to medical savings account deposits and earnings	37812
otherwise deducted or excluded for the current or any other	37813
taxable year from the taxpayer's federal adjusted gross income.	37814

(15)(a) Add an amount equal to the funds withdrawn from a	37815
medical savings account during the taxable year, and the net	37816
investment earnings on those funds, when the funds withdrawn were	37817
used for any purpose other than to reimburse an account holder	37818
for, or to pay, eligible medical expenses, in accordance with	37819
section 3924.66 of the Revised Code;	37820

(b) Add the amounts distributed from a medical savings	37821
account under division (A)(2) of section 3924.68 of the Revised	37822
Code during the taxable year.	37823

(16) Add any amount claimed as a credit under section	37824
5747.059 of the Revised Code to the extent that such amount	37825
satisfies either of the following:	37826

(a) The amount was deducted or excluded from the computation	37827
of the taxpayer's federal adjusted gross income as required to be	37828
reported for the taxpayer's taxable year under the Internal	37829
Revenue Code;	37830

(b) The amount resulted in a reduction of the taxpayer's	37831
federal adjusted gross income as required to be reported for any	37832
of the taxpayer's taxable years under the Internal Revenue Code.	37833

(17) Deduct the amount contributed by the taxpayer to an	37834
individual development account program established by a county	37835
department of job and family services pursuant to sections 329.11	37836
to 329.14 of the Revised Code for the purpose of matching funds	37837
deposited by program participants. On request of the tax	37838
commissioner, the taxpayer shall provide any information that, in	37839
the tax commissioner's opinion, is necessary to establish the	37840
amount deducted under division (A)(17) of this section.	37841

(18) Beginning in taxable year 2001 but not for any taxable	37842
year beginning after December 31, 2005, if the taxpayer is married	37843
and files a joint return and the combined federal adjusted gross	37844
income of the taxpayer and the taxpayer's spouse for the taxable	37845
year does not exceed one hundred thousand dollars, or if the	37846
taxpayer is single and has a federal adjusted gross income for the	37847
taxable year not exceeding fifty thousand dollars, deduct amounts	37848
paid during the taxable year for qualified tuition and fees paid	37849
to an eligible institution for the taxpayer, the taxpayer's	37850
spouse, or any dependent of the taxpayer, who is a resident of	37851
this state and is enrolled in or attending a program that	37852
culminates in a degree or diploma at an eligible institution. The	37853
deduction may be claimed only to the extent that qualified tuition	37854
and fees are not otherwise deducted or excluded for any taxable	37855
year from federal or Ohio adjusted gross income. The deduction may	37856
not be claimed for educational expenses for which the taxpayer	37857
claims a credit under section 5747.27 of the Revised Code.	37858

(19) Add any reimbursement received during the taxable year	37859
of any amount the taxpayer deducted under division (A)(18) of this	37860
section in any previous taxable year to the extent the amount is	37861
not otherwise included in Ohio adjusted gross income.	37862

(20)(a)(i) Add five-sixths of the amount of depreciation	37863
expense allowed by subsection (k) of section 168 of the Internal	37864
Revenue Code, including the taxpayer's proportionate or	37865
distributive share of the amount of depreciation expense allowed	37866
by that subsection to a pass-through entity in which the taxpayer	37867
has a direct or indirect ownership interest.	37868

(ii) Add five-sixths of the amount of qualifying section 179	37869
depreciation expense, including a person's proportionate or	37870
distributive share of the amount of qualifying section 179	37871
depreciation expense allowed to any pass-through entity in which	37872
the person has a direct or indirect ownership. For the purposes of	37873
this division, "qualifying section 179 depreciation expense" means	37874
the difference between (I) the amount of depreciation expense	37875
directly or indirectly allowed to the taxpayer under section 179	37876
of the Internal Revenue Code, and (II) the amount of depreciation	37877
expense directly or indirectly allowed to the taxpayer under	37878
section 179 of the Internal Revenue Code as that section existed	37879
on December 31, 2002.	37880

The tax commissioner, under procedures established by the	37881
commissioner, may waive the add-backs related to a pass-through	37882
entity if the taxpayer owns, directly or indirectly, less than	37883
five per cent of the pass-through entity.	37884

(b) Nothing in division (A)(20) of this section shall be	37885
construed to adjust or modify the adjusted basis of any asset.	37886

(c) To the extent the add-back required under division	37887
(A)(20)(a) of this section is attributable to property generating	37888
nonbusiness income or loss allocated under section 5747.20 of the	37889
Revised Code, the add-back shall be sitused to the same location	37890
as the nonbusiness income or loss generated by the property for	37891
the purpose of determining the credit under division (A) of	37892
section 5747.05 of the Revised Code. Otherwise, the add-back shall	37893
be apportioned, subject to one or more of the four alternative	37894
methods of apportionment enumerated in section 5747.21 of the	37895
Revised Code.	37896

(d) For the purposes of division (A) of this section, net	37897
operating loss carryback and carryforward shall not include	37898
five-sixths of the allowance of any net operating loss deduction	37899
carryback or carryforward to the taxable year to the extent such	37900
loss resulted from depreciation allowed by section 168(k) of the	37901
Internal Revenue Code and by the qualifying section 179	37902
depreciation expense amount.	37903

(21)(a) If the taxpayer was required to add an amount under	37904
division (A)(20)(a) of this section for a taxable year, deduct	37905
one-fifth of the amount so added for each of the five succeeding	37906
taxable years.	37907

(b) If the amount deducted under division (A)(21)(a) of this	37908
section is attributable to an add-back allocated under division	37909
(A)(20)(c) of this section, the amount deducted shall be sitused	37910
to the same location. Otherwise, the add-back shall be apportioned	37911
using the apportionment factors for the taxable year in which the	37912
deduction is taken, subject to one or more of the four alternative	37913
methods of apportionment enumerated in section 5747.21 of the	37914
Revised Code.	37915

(c) No deduction is available under division (A)(21)(a) of	37916
this section with regard to any depreciation allowed by section	37917
168(k) of the Internal Revenue Code and by the qualifying section	37918
179 depreciation expense amount to the extent that such	37919
depreciation resulted in or increased a federal net operating loss	37920
carryback or carryforward to a taxable year to which division	37921
(A)(20)(d) of this section does not apply.	37922

(22) Deduct, to the extent not otherwise deducted or excluded	37923
in computing federal or Ohio adjusted gross income for the taxable	37924
year, the amount the taxpayer received during the taxable year as	37925
reimbursement for life insurance premiums under section 5919.31 of	37926
the Revised Code.	37927

(23) Deduct, to the extent not otherwise deducted or excluded	37928
in computing federal or Ohio adjusted gross income for the taxable	37929
year, the amount the taxpayer received during the taxable year as	37930
a death benefit paid by the adjutant general under section 5919.33	37931
of the Revised Code.	37932

(24) Deduct, to the extent included in federal adjusted gross	37933
income and not otherwise allowable as a deduction or exclusion in	37934
computing federal or Ohio adjusted gross income for the taxable	37935
year, military pay and allowances received by the taxpayer during	37936
the taxable year for active duty service in the United States	37937
army, air force, navy, marine corps, or coast guard or reserve	37938
components thereof or the national guard. The deduction may not be	37939
claimed for military pay and allowances received by the taxpayer	37940
while the taxpayer is stationed in this state.	37941

(25) Deduct, to the extent not otherwise allowable as a	37942
deduction or exclusion in computing federal or Ohio adjusted gross	37943
income for the taxable year and not otherwise compensated for by	37944
any other source, the amount of qualified organ donation expenses	37945
incurred by the taxpayer during the taxable year, not to exceed	37946
ten thousand dollars. A taxpayer may deduct qualified organ	37947
donation expenses only once for all taxable years beginning with	37948
taxable years beginning in 2007.	37949

For the purposes of division (A)(25) of this section:

37950

(a) "Human organ" means all or any portion of a human liver,	37951
pancreas, kidney, intestine, or lung, and any portion of human	37952
bone marrow.	37953

(b) "Qualified organ donation expenses" means travel	37954
expenses, lodging expenses, and wages and salary forgone by a	37955
taxpayer in connection with the taxpayer's donation, while living,	37956
of one or more of the taxpayer's human organs to another human	37957
being.	37958

(26) Deduct, to the extent not otherwise deducted or excluded	37959
in computing federal or Ohio adjusted gross income for the taxable	37960
year, amounts received by the taxpayer as retired military	37961
personnel pay for service in the United States army, navy, air	37962
force, coast guard, or marine corps or reserve components thereof,	37963
or the national guard, or received by the surviving spouse or	37964
former spouse of such a taxpayer under the survivor benefit plan	37965
on account of such a taxpayer's death. If the taxpayer receives	37966
income on account of retirement paid under the federal civil	37967
service retirement system or federal employees retirement system,	37968
or under any successor retirement program enacted by the congress	37969
of the United States that is established and maintained for	37970
retired employees of the United States government, and such	37971
retirement income is based, in whole or in part, on credit for	37972
the taxpayer's military service, the deduction allowed under this	37973
division shall include only that portion of such retirement	37974
income that is attributable to the taxpayer's military service,	37975
to the extent that portion of such retirement income is otherwise	37976
included in federal adjusted gross income and is not otherwise	37977
deducted under this section. Any amount deducted under division	37978
(A)(26) of this section is not included in a taxpayer's	37979
adjusted gross income for the purposes of section 5747.055 of	37980
the Revised Code. No amount may be deducted under division	37981
(A)(26) of this section on the basis of which a credit was	37982
claimed under section 5747.055 of the Revised Code.	37983

(27) Deduct, to the extent not otherwise deducted or excluded	37984
in computing federal or Ohio adjusted gross income for the taxable	37985
year, the amount the taxpayer received during the taxable year	37986
from the military injury relief fund created in section 5101.98 of	37987
the Revised Code.	37988

(B) "Business income" means income, including gain or loss,	37989
arising from transactions, activities, and sources in the regular	37990
course of a trade or business and includes income, gain, or loss	37991
from real property, tangible property, and intangible property if	37992
the acquisition, rental, management, and disposition of the	37993
property constitute integral parts of the regular course of a	37994
trade or business operation. "Business income" includes income,	37995
including gain or loss, from a partial or complete liquidation of	37996
a business, including, but not limited to, gain or loss from the	37997
sale or other disposition of goodwill.	37998

(C) "Nonbusiness income" means all income other than business	37999
income and may include, but is not limited to, compensation, rents	38000
and royalties from real or tangible personal property, capital	38001
gains, interest, dividends and distributions, patent or copyright	38002
royalties, or lottery winnings, prizes, and awards.	38003

(D) "Compensation" means any form of remuneration paid to an	38004
employee for personal services.	38005

(E) "Fiduciary" means a guardian, trustee, executor,	38006
administrator, receiver, conservator, or any other person acting	38007
in any fiduciary capacity for any individual, trust, or estate.	38008

(F) "Fiscal year" means an accounting period of twelve months	38009
ending on the last day of any month other than December.	38010

(G) "Individual" means any natural person.

38011

(H) "Internal Revenue Code" means the "Internal Revenue Code	38012
of 1986," 100 Stat. 2085, 26 U.S.C.A. 1, as amended.	38013

(I) "Resident" means any of the following, provided that	38014
division (I)(3) of this section applies only to taxable years of a	38015
trust beginning in 2002 or thereafter:	38016

(1) An individual who is domiciled in this state, subject to	38017
section 5747.24 of the Revised Code;	38018

(2) The estate of a decedent who at the time of death was	38019
domiciled in this state. The domicile tests of section 5747.24 of	38020
the Revised Code are not controlling for purposes of division	38021
(I)(2) of this section.	38022

(3) A trust that, in whole or part, resides in this state. If	38023
only part of a trust resides in this state, the trust is a	38024
resident only with respect to that part.	38025

For the purposes of division (I)(3) of this section:

38026

(a) A trust resides in this state for the trust's current	38027
taxable year to the extent, as described in division (I)(3)(d) of	38028
this section, that the trust consists directly or indirectly, in	38029
whole or in part, of assets, net of any related liabilities, that	38030
were transferred, or caused to be transferred, directly or	38031
indirectly, to the trust by any of the following:	38032

(i) A person, a court, or a governmental entity or	38033
instrumentality on account of the death of a decedent, but only if	38034
the trust is described in division (I)(3)(e)(i) or (ii) of this	38035
section;	38036

(ii) A person who was domiciled in this state for the	38037
purposes of this chapter when the person directly or indirectly	38038
transferred assets to an irrevocable trust, but only if at least	38039
one of the trust's qualifying beneficiaries is domiciled in this	38040
state for the purposes of this chapter during all or some portion	38041
of the trust's current taxable year;	38042

(iii) A person who was domiciled in this state for the	38043
purposes of this chapter when the trust document or instrument or	38044
part of the trust document or instrument became irrevocable, but	38045
only if at least one of the trust's qualifying beneficiaries is a	38046
resident domiciled in this state for the purposes of this chapter	38047
during all or some portion of the trust's current taxable year. If	38048
a trust document or instrument became irrevocable upon the death	38049
of a person who at the time of death was domiciled in this state	38050
for purposes of this chapter, that person is a person described in	38051
division (I)(3)(a)(iii) of this section.	38052

(b) A trust is irrevocable to the extent that the transferor	38053
is not considered to be the owner of the net assets of the trust	38054
under sections 671 to 678 of the Internal Revenue Code.	38055

(c) With respect to a trust other than a charitable lead	38056
trust, "qualifying beneficiary" has the same meaning as "potential	38057
current beneficiary" as defined in section 1361(e)(2) of the	38058
Internal Revenue Code, and with respect to a charitable lead trust	38059
"qualifying beneficiary" is any current, future, or contingent	38060
beneficiary, but with respect to any trust "qualifying	38061
beneficiary" excludes a person or a governmental entity or	38062
instrumentality to any of which a contribution would qualify for	38063
the charitable deduction under section 170 of the Internal Revenue	38064
Code.	38065

(d) For the purposes of division (I)(3)(a) of this section,	38066
the extent to which a trust consists directly or indirectly, in	38067
whole or in part, of assets, net of any related liabilities, that	38068
were transferred directly or indirectly, in whole or part, to the	38069
trust by any of the sources enumerated in that division shall be	38070
ascertained by multiplying the fair market value of the trust's	38071
assets, net of related liabilities, by the qualifying ratio, which	38072
shall be computed as follows:	38073

(i) The first time the trust receives assets, the numerator	38074
of the qualifying ratio is the fair market value of those assets	38075
at that time, net of any related liabilities, from sources	38076
enumerated in division (I)(3)(a) of this section. The denominator	38077
of the qualifying ratio is the fair market value of all the	38078
trust's assets at that time, net of any related liabilities.	38079

(ii) Each subsequent time the trust receives assets, a	38080
revised qualifying ratio shall be computed. The numerator of the	38081
revised qualifying ratio is the sum of (1) the fair market value	38082
of the trust's assets immediately prior to the subsequent	38083
transfer, net of any related liabilities, multiplied by the	38084
qualifying ratio last computed without regard to the subsequent	38085
transfer, and (2) the fair market value of the subsequently	38086
transferred assets at the time transferred, net of any related	38087
liabilities, from sources enumerated in division (I)(3)(a) of this	38088
section. The denominator of the revised qualifying ratio is the	38089
fair market value of all the trust's assets immediately after the	38090
subsequent transfer, net of any related liabilities.	38091

(iii) Whether a transfer to the trust is by or from any of	38092
the sources enumerated in division (I)(3)(a) of this section shall	38093
be ascertained without regard to the domicile of the trust's	38094
beneficiaries.	38095

(e) For the purposes of division (I)(3)(a)(i) of this	38096
section:	38097

(i) A trust is described in division (I)(3)(e)(i) of this	38098
section if the trust is a testamentary trust and the testator of	38099
that testamentary trust was domiciled in this state at the time of	38100
the testator's death for purposes of the taxes levied under	38101
Chapter 5731. of the Revised Code.	38102

(ii) A trust is described in division (I)(3)(e)(ii) of this	38103
section if the transfer is a qualifying transfer described in any	38104
of divisions (I)(3)(f)(i) to (vi) of this section, the trust is an	38105
irrevocable inter vivos trust, and at least one of the trust's	38106
qualifying beneficiaries is domiciled in this state for purposes	38107
of this chapter during all or some portion of the trust's current	38108
taxable year.	38109

(f) For the purposes of division (I)(3)(e)(ii) of this	38110
section, a "qualifying transfer" is a transfer of assets, net of	38111
any related liabilities, directly or indirectly to a trust, if the	38112
transfer is described in any of the following:	38113

(i) The transfer is made to a trust, created by the decedent	38114
before the decedent's death and while the decedent was domiciled	38115
in this state for the purposes of this chapter, and, prior to the	38116
death of the decedent, the trust became irrevocable while the	38117
decedent was domiciled in this state for the purposes of this	38118
chapter.	38119

(ii) The transfer is made to a trust to which the decedent,	38120
prior to the decedent's death, had directly or indirectly	38121
transferred assets, net of any related liabilities, while the	38122
decedent was domiciled in this state for the purposes of this	38123
chapter, and prior to the death of the decedent the trust became	38124
irrevocable while the decedent was domiciled in this state for the	38125
purposes of this chapter.	38126

(iii) The transfer is made on account of a contractual	38127
relationship existing directly or indirectly between the	38128
transferor and either the decedent or the estate of the decedent	38129
at any time prior to the date of the decedent's death, and the	38130
decedent was domiciled in this state at the time of death for	38131
purposes of the taxes levied under Chapter 5731. of the Revised	38132
Code.	38133

(iv) The transfer is made to a trust on account of a	38134
contractual relationship existing directly or indirectly between	38135
the transferor and another person who at the time of the	38136
decedent's death was domiciled in this state for purposes of this	38137
chapter.	38138

(v) The transfer is made to a trust on account of the will of	38139
a testator.	38140

(vi) The transfer is made to a trust created by or caused to	38141
be created by a court, and the trust was directly or indirectly	38142
created in connection with or as a result of the death of an	38143
individual who, for purposes of the taxes levied under Chapter	38144
5731. of the Revised Code, was domiciled in this state at the time	38145
of the individual's death.	38146

(g) The tax commissioner may adopt rules to ascertain the	38147
part of a trust residing in this state.	38148

(J) "Nonresident" means an individual or estate that is not a	38149
resident. An individual who is a resident for only part of a	38150
taxable year is a nonresident for the remainder of that taxable	38151
year.	38152

(K) "Pass-through entity" has the same meaning as in section	38153
5733.04 of the Revised Code.	38154

(L) "Return" means the notifications and reports required to	38155
be filed pursuant to this chapter for the purpose of reporting the	38156
tax due and includes declarations of estimated tax when so	38157
required.	38158

(M) "Taxable year" means the calendar year or the taxpayer's	38159
fiscal year ending during the calendar year, or fractional part	38160
thereof, upon which the adjusted gross income is calculated	38161
pursuant to this chapter.	38162

(N) "Taxpayer" means any person subject to the tax imposed by	38163
section 5747.02 of the Revised Code or any pass-through entity	38164
that makes the election under division (D) of section 5747.08 of	38165
the Revised Code.	38166

(O) "Dependents" means dependents as defined in the Internal	38167
Revenue Code and as claimed in the taxpayer's federal income tax	38168
return for the taxable year or which the taxpayer would have been	38169
permitted to claim had the taxpayer filed a federal income tax	38170
return.	38171

(P) "Principal county of employment" means, in the case of a	38172
nonresident, the county within the state in which a taxpayer	38173
performs services for an employer or, if those services are	38174
performed in more than one county, the county in which the major	38175
portion of the services are performed.	38176

(Q) As used in sections 5747.50 to 5747.55 of the Revised	38177
Code:	38178

(1) "Subdivision" means any county, municipal corporation,	38179
park district, or township.	38180

(2) "Essential local government purposes" includes all	38181
functions that any subdivision is required by general law to	38182
exercise, including like functions that are exercised under a	38183
charter adopted pursuant to the Ohio Constitution.	38184

(R) "Overpayment" means any amount already paid that exceeds	38185
the figure determined to be the correct amount of the tax.	38186

(S) "Taxable income" or "Ohio taxable income" applies only to	38187
estates and trusts, and means federal taxable income, as defined	38188
and used in the Internal Revenue Code, adjusted as follows:	38189

(1) Add interest or dividends, net of ordinary, necessary,	38190
and reasonable expenses not deducted in computing federal taxable	38191
income, on obligations or securities of any state or of any	38192
political subdivision or authority of any state, other than this	38193
state and its subdivisions and authorities, but only to the extent	38194
that such net amount is not otherwise includible in Ohio taxable	38195
income and is described in either division (S)(1)(a) or (b) of	38196
this section:	38197

(a) The net amount is not attributable to the S portion of an	38198
electing small business trust and has not been distributed to	38199
beneficiaries for the taxable year;	38200

(b) The net amount is attributable to the S portion of an	38201
electing small business trust for the taxable year.	38202

(2) Add interest or dividends, net of ordinary, necessary,	38203
and reasonable expenses not deducted in computing federal taxable	38204
income, on obligations of any authority, commission,	38205
instrumentality, territory, or possession of the United States to	38206
the extent that the interest or dividends are exempt from federal	38207
income taxes but not from state income taxes, but only to the	38208
extent that such net amount is not otherwise includible in Ohio	38209
taxable income and is described in either division (S)(1)(a) or	38210
(b) of this section;	38211

(3) Add the amount of personal exemption allowed to the	38212
estate pursuant to section 642(b) of the Internal Revenue Code;	38213

(4) Deduct interest or dividends, net of related expenses	38214
deducted in computing federal taxable income, on obligations of	38215
the United States and its territories and possessions or of any	38216
authority, commission, or instrumentality of the United States to	38217
the extent that the interest or dividends are exempt from state	38218
taxes under the laws of the United States, but only to the extent	38219
that such amount is included in federal taxable income and is	38220
described in either division (S)(1)(a) or (b) of this section;	38221

(5) Deduct the amount of wages and salaries, if any, not	38222
otherwise allowable as a deduction but that would have been	38223
allowable as a deduction in computing federal taxable income for	38224
the taxable year, had the targeted jobs credit allowed under	38225
sections 38, 51, and 52 of the Internal Revenue Code not been in	38226
effect, but only to the extent such amount relates either to	38227
income included in federal taxable income for the taxable year or	38228
to income of the S portion of an electing small business trust for	38229
the taxable year;	38230

(6) Deduct any interest or interest equivalent, net of	38231
related expenses deducted in computing federal taxable income, on	38232
public obligations and purchase obligations, but only to the	38233
extent that such net amount relates either to income included in	38234
federal taxable income for the taxable year or to income of the S	38235
portion of an electing small business trust for the taxable year;	38236

(7) Add any loss or deduct any gain resulting from sale,	38237
exchange, or other disposition of public obligations to the extent	38238
that such loss has been deducted or such gain has been included in	38239
computing either federal taxable income or income of the S portion	38240
of an electing small business trust for the taxable year;	38241

(8) Except in the case of the final return of an estate, add	38242
any amount deducted by the taxpayer on both its Ohio estate tax	38243
return pursuant to section 5731.14 of the Revised Code, and on its	38244
federal income tax return in determining federal taxable income;	38245

(9)(a) Deduct any amount included in federal taxable income	38246
solely because the amount represents a reimbursement or refund of	38247
expenses that in a previous year the decedent had deducted as an	38248
itemized deduction pursuant to section 63 of the Internal Revenue	38249
Code and applicable treasury regulations. The deduction otherwise	38250
allowed under division (S)(9)(a) of this section shall be reduced	38251
to the extent the reimbursement is attributable to an amount the	38252
taxpayer or decedent deducted under this section in any taxable	38253
year.	38254

(b) Add any amount not otherwise included in Ohio taxable	38255
income for any taxable year to the extent that the amount is	38256
attributable to the recovery during the taxable year of any amount	38257
deducted or excluded in computing federal or Ohio taxable income	38258
in any taxable year, but only to the extent such amount has not	38259
been distributed to beneficiaries for the taxable year.	38260

(10) Deduct any portion of the deduction described in section	38261
1341(a)(2) of the Internal Revenue Code, for repaying previously	38262
reported income received under a claim of right, that meets both	38263
of the following requirements:	38264

(a) It is allowable for repayment of an item that was	38265
included in the taxpayer's taxable income or the decedent's	38266
adjusted gross income for a prior taxable year and did not qualify	38267
for a credit under division (A) or (B) of section 5747.05 of the	38268
Revised Code for that year.	38269

(b) It does not otherwise reduce the taxpayer's taxable	38270
income or the decedent's adjusted gross income for the current or	38271
any other taxable year.	38272

(11) Add any amount claimed as a credit under section	38273
5747.059 of the Revised Code to the extent that the amount	38274
satisfies either of the following:	38275

(a) The amount was deducted or excluded from the computation	38276
of the taxpayer's federal taxable income as required to be	38277
reported for the taxpayer's taxable year under the Internal	38278
Revenue Code;	38279

(b) The amount resulted in a reduction in the taxpayer's	38280
federal taxable income as required to be reported for any of the	38281
taxpayer's taxable years under the Internal Revenue Code.	38282

(12) Deduct any amount, net of related expenses deducted in	38283
computing federal taxable income, that a trust is required to	38284
report as farm income on its federal income tax return, but only	38285
if the assets of the trust include at least ten acres of land	38286
satisfying the definition of "land devoted exclusively to	38287
agricultural use" under section 5713.30 of the Revised Code,	38288
regardless of whether the land is valued for tax purposes as such	38289
land under sections 5713.30 to 5713.38 of the Revised Code. If the	38290
trust is a pass-through entity investor, section 5747.231 of the	38291
Revised Code applies in ascertaining if the trust is eligible to	38292
claim the deduction provided by division (S)(12) of this section	38293
in connection with the pass-through entity's farm income.	38294

Except for farm income attributable to the S portion of an	38295
electing small business trust, the deduction provided by division	38296
(S)(12) of this section is allowed only to the extent that the	38297
trust has not distributed such farm income. Division (S)(12) of	38298
this section applies only to taxable years of a trust beginning in	38299
2002 or thereafter.	38300

(13) Add the net amount of income described in section 641(c)	38301
of the Internal Revenue Code to the extent that amount is not	38302
included in federal taxable income.	38303

(14) Add or deduct the amount the taxpayer would be required	38304
to add or deduct under division (A)(20) or (21) of this section if	38305
the taxpayer's Ohio taxable income were computed in the same	38306
manner as an individual's Ohio adjusted gross income is computed	38307
under this section. In the case of a trust, division (S)(14) of	38308
this section applies only to any of the trust's taxable years	38309
beginning in 2002 or thereafter.	38310

(T) "School district income" and "school district income tax"	38311
have the same meanings as in section 5748.01 of the Revised Code.	38312

(U) As used in divisions (A)(8), (A)(9), (S)(6), and (S)(7)	38313
of this section, "public obligations," "purchase obligations," and	38314
"interest or interest equivalent" have the same meanings as in	38315
section 5709.76 of the Revised Code.	38316

(V) "Limited liability company" means any limited liability	38317
company formed under Chapter 1705. of the Revised Code or under	38318
the laws of any other state.	38319

(W) "Pass-through entity investor" means any person who,	38320
during any portion of a taxable year of a pass-through entity, is	38321
a partner, member, shareholder, or equity investor in that	38322
pass-through entity.	38323

(X) "Banking day" has the same meaning as in section 1304.01	38324
of the Revised Code.	38325

(Y) "Month" means a calendar month.

38326

(Z) "Quarter" means the first three months, the second three	38327
months, the third three months, or the last three months of the	38328
taxpayer's taxable year.	38329

(AA)(1) "Eligible institution" means a state university or	38330
state institution of higher education as defined in section	38331
3345.011 of the Revised Code, or a private, nonprofit college,	38332
university, or other post-secondary institution located in this	38333
state that possesses a certificate of authorization issued by the	38334
Ohio board of regents pursuant to Chapter 1713. of the Revised	38335
Code or a certificate of registration issued by the state board of	38336
career colleges and schools under Chapter 3332. of the Revised	38337
Code.	38338

(2) "Qualified tuition and fees" means tuition and fees	38339
imposed by an eligible institution as a condition of enrollment or	38340
attendance, not exceeding two thousand five hundred dollars in	38341
each of the individual's first two years of post-secondary	38342
education. If the individual is a part-time student, "qualified	38343
tuition and fees" includes tuition and fees paid for the academic	38344
equivalent of the first two years of post-secondary education	38345
during a maximum of five taxable years, not exceeding a total of	38346
five thousand dollars. "Qualified tuition and fees" does not	38347
include:	38348

(a) Expenses for any course or activity involving sports,	38349
games, or hobbies unless the course or activity is part of the	38350
individual's degree or diploma program;	38351

(b) The cost of books, room and board, student activity fees,	38352
athletic fees, insurance expenses, or other expenses unrelated to	38353
the individual's academic course of instruction;	38354

(c) Tuition, fees, or other expenses paid or reimbursed	38355
through an employer, scholarship, grant in aid, or other	38356
educational benefit program.	38357

(BB)(1) "Modified business income" means the business income	38358
included in a trust's Ohio taxable income after such taxable	38359
income is first reduced by the qualifying trust amount, if any.	38360

(2) "Qualifying trust amount" of a trust means capital gains	38361
and losses from the sale, exchange, or other disposition of equity	38362
or ownership interests in, or debt obligations of, a qualifying	38363
investee to the extent included in the trust's Ohio taxable	38364
income, but only if the following requirements are satisfied:	38365

(a) The book value of the qualifying investee's physical	38366
assets in this state and everywhere, as of the last day of the	38367
qualifying investee's fiscal or calendar year ending immediately	38368
prior to the date on which the trust recognizes the gain or loss,	38369
is available to the trust.	38370

(b) The requirements of section 5747.011 of the Revised Code	38371
are satisfied for the trust's taxable year in which the trust	38372
recognizes the gain or loss.	38373

Any gain or loss that is not a qualifying trust amount is	38374
modified business income, qualifying investment income, or	38375
modified nonbusiness income, as the case may be.	38376

(3) "Modified nonbusiness income" means a trust's Ohio	38377
taxable income other than modified business income, other than the	38378
qualifying trust amount, and other than qualifying investment	38379
income, as defined in section 5747.012 of the Revised Code, to the	38380
extent such qualifying investment income is not otherwise part of	38381
modified business income.	38382

(4) "Modified Ohio taxable income" applies only to trusts,	38383
and means the sum of the amounts described in divisions (BB)(4)(a)	38384
to (c) of this section:	38385

(a) The fraction, calculated under section 5747.013, and	38386
applying section 5747.231 of the Revised Code, multiplied by the	38387
sum of the following amounts:	38388

(i) The trust's modified business income;

38389

(ii) The trust's qualifying investment income, as defined in	38390
section 5747.012 of the Revised Code, but only to the extent the	38391
qualifying investment income does not otherwise constitute	38392
modified business income and does not otherwise constitute a	38393
qualifying trust amount.	38394

(b) The qualifying trust amount multiplied by a fraction, the	38395
numerator of which is the sum of the book value of the qualifying	38396
investee's physical assets in this state on the last day of the	38397
qualifying investee's fiscal or calendar year ending immediately	38398
prior to the day on which the trust recognizes the qualifying	38399
trust amount, and the denominator of which is the sum of the book	38400
value of the qualifying investee's total physical assets	38401
everywhere on the last day of the qualifying investee's fiscal or	38402
calendar year ending immediately prior to the day on which the	38403
trust recognizes the qualifying trust amount. If, for a taxable	38404
year, the trust recognizes a qualifying trust amount with respect	38405
to more than one qualifying investee, the amount described in	38406
division (BB)(4)(b) of this section shall equal the sum of the	38407
products so computed for each such qualifying investee.	38408

(c)(i) With respect to a trust or portion of a trust that is	38409
a resident as ascertained in accordance with division (I)(3)(d) of	38410
this section, its modified nonbusiness income.	38411

(ii) With respect to a trust or portion of a trust that is	38412
not a resident as ascertained in accordance with division	38413
(I)(3)(d) of this section, the amount of its modified nonbusiness	38414
income satisfying the descriptions in divisions (B)(2) to (5) of	38415
section 5747.20 of the Revised Code, except as otherwise provided	38416
in division (BB)(4)(c)(ii) of this section. With respect to a	38417
trust or portion of a trust that is not a resident as ascertained	38418
in accordance with division (I)(3)(d) of this section, the trust's	38419
portion of modified nonbusiness income recognized from the sale,	38420
exchange, or other disposition of a debt interest in or equity	38421
interest in a section 5747.212 entity, as defined in section	38422
5747.212 of the Revised Code, without regard to division (A) of	38423
that section, shall not be allocated to this state in accordance	38424
with section 5747.20 of the Revised Code but shall be apportioned	38425
to this state in accordance with division (B) of section 5747.212	38426
of the Revised Code without regard to division (A) of that	38427
section.	38428

If the allocation and apportionment of a trust's income under	38429
divisions (BB)(4)(a) and (c) of this section do not fairly	38430
represent the modified Ohio taxable income of the trust in this	38431
state, the alternative methods described in division (C) of	38432
section 5747.21 of the Revised Code may be applied in the manner	38433
and to the same extent provided in that section.	38434

(5)(a) Except as set forth in division (BB)(5)(b) of this	38435
section, "qualifying investee" means a person in which a trust has	38436
an equity or ownership interest, or a person or unit of government	38437
the debt obligations of either of which are owned by a trust. For	38438
the purposes of division (BB)(2)(a) of this section and for the	38439
purpose of computing the fraction described in division (BB)(4)(b)	38440
of this section, all of the following apply:	38441

(i) If the qualifying investee is a member of a qualifying	38442
controlled group on the last day of the qualifying investee's	38443
fiscal or calendar year ending immediately prior to the date on	38444
which the trust recognizes the gain or loss, then "qualifying	38445
investee" includes all persons in the qualifying controlled group	38446
on such last day.	38447

(ii) If the qualifying investee, or if the qualifying	38448
investee and any members of the qualifying controlled group of	38449
which the qualifying investee is a member on the last day of the	38450
qualifying investee's fiscal or calendar year ending immediately	38451
prior to the date on which the trust recognizes the gain or loss,	38452
separately or cumulatively own, directly or indirectly, on the	38453
last day of the qualifying investee's fiscal or calendar year	38454
ending immediately prior to the date on which the trust recognizes	38455
the qualifying trust amount, more than fifty per cent of the	38456
equity of a pass-through entity, then the qualifying investee and	38457
the other members are deemed to own the proportionate share of the	38458
pass-through entity's physical assets which the pass-through	38459
entity directly or indirectly owns on the last day of the	38460
pass-through entity's calendar or fiscal year ending within or	38461
with the last day of the qualifying investee's fiscal or calendar	38462
year ending immediately prior to the date on which the trust	38463
recognizes the qualifying trust amount.	38464

(iii) For the purposes of division (BB)(5)(a)(iii) of this	38465
section, "upper level pass-through entity" means a pass-through	38466
entity directly or indirectly owning any equity of another	38467
pass-through entity, and "lower level pass-through entity" means	38468
that other pass-through entity.	38469

An upper level pass-through entity, whether or not it is also	38470
a qualifying investee, is deemed to own, on the last day of the	38471
upper level pass-through entity's calendar or fiscal year, the	38472
proportionate share of the lower level pass-through entity's	38473
physical assets that the lower level pass-through entity directly	38474
or indirectly owns on the last day of the lower level pass-through	38475
entity's calendar or fiscal year ending within or with the last	38476
day of the upper level pass-through entity's fiscal or calendar	38477
year. If the upper level pass-through entity directly and	38478
indirectly owns less than fifty per cent of the equity of the	38479
lower level pass-through entity on each day of the upper level	38480
pass-through entity's calendar or fiscal year in which or with	38481
which ends the calendar or fiscal year of the lower level	38482
pass-through entity and if, based upon clear and convincing	38483
evidence, complete information about the location and cost of the	38484
physical assets of the lower pass-through entity is not available	38485
to the upper level pass-through entity, then solely for purposes	38486
of ascertaining if a gain or loss constitutes a qualifying trust	38487
amount, the upper level pass-through entity shall be deemed as	38488
owning no equity of the lower level pass-through entity for each	38489
day during the upper level pass-through entity's calendar or	38490
fiscal year in which or with which ends the lower level	38491
pass-through entity's calendar or fiscal year. Nothing in division	38492
(BB)(5)(a)(iii) of this section shall be construed to provide for	38493
any deduction or exclusion in computing any trust's Ohio taxable	38494
income.	38495

(b) With respect to a trust that is not a resident for the	38496
taxable year and with respect to a part of a trust that is not a	38497
resident for the taxable year, "qualifying investee" for that	38498
taxable year does not include a C corporation if both of the	38499
following apply:	38500

(i) During the taxable year the trust or part of the trust	38501
recognizes a gain or loss from the sale, exchange, or other	38502
disposition of equity or ownership interests in, or debt	38503
obligations of, the C corporation.	38504

(ii) Such gain or loss constitutes nonbusiness income.

38505

(6) "Available" means information is such that a person is	38506
able to learn of the information by the due date plus extensions,	38507
if any, for filing the return for the taxable year in which the	38508
trust recognizes the gain or loss.	38509

(CC) "Qualifying controlled group" has the same meaning as in	38510
section 5733.04 of the Revised Code.	38511

(DD) "Related member" has the same meaning as in section	38512
5733.042 of the Revised Code.	38513

(EE)(1) For the purposes of division (EE) of this section:

38514

(a) "Qualifying person" means any person other than a	38515
qualifying corporation.	38516

(b) "Qualifying corporation" means any person classified for	38517
federal income tax purposes as an association taxable as a	38518
corporation, except either of the following:	38519

(i) A corporation that has made an election under subchapter	38520
S, chapter one, subtitle A, of the Internal Revenue Code for its	38521
taxable year ending within, or on the last day of, the investor's	38522
taxable year;	38523

(ii) A subsidiary that is wholly owned by any corporation	38524
that has made an election under subchapter S, chapter one,	38525
subtitle A of the Internal Revenue Code for its taxable year	38526
ending within, or on the last day of, the investor's taxable year.	38527

(2) For the purposes of this chapter, unless expressly stated	38528
otherwise, no qualifying person indirectly owns any asset directly	38529
or indirectly owned by any qualifying corporation.	38530

(FF) For purposes of this chapter and Chapter 5751. of the	38531
Revised Code:	38532

(1) "Trust" does not include a qualified pre-income tax	38533
trust.	38534

(2) A "qualified pre-income tax trust" is any pre-income tax	38535
trust that makes a qualifying pre-income tax trust election as	38536
described in division (FF)(3) of this section.	38537

(3) A "qualifying pre-income tax trust election" is an	38538
election by a pre-income tax trust to subject to the tax imposed	38539
by section 5751.02 of the Revised Code the pre-income tax trust	38540
and all pass-through entities of which the trust owns or	38541
controls, directly, indirectly, or constructively through related	38542
interests, five per cent or more of the ownership or equity	38543
interests. The trustee shall notify the tax commissioner in	38544
writing of the election on or before April 15, 2006. The	38545
election, if timely made, shall be effective on and after January	38546
1, 2006, and shall apply for all tax periods and tax years until	38547
revoked by the trustee of the trust.	38548

(4) A "pre-income tax trust" is a trust that satisfies all of	38549
the following requirements:	38550

(a) The document or instrument creating the trust was	38551
executed by the grantor before January 1, 1972;	38552

(b) The trust became irrevocable upon the creation of the	38553
trust; and	38554

(c) The grantor was domiciled in this state at the time the	38555
trust was created.	38556

Sec. 5747.122. (A) The tax commissioner, in accordance with	38557
section 5101.184 of the Revised Code, shall cooperate with the	38558
director of job and family services to collect overpayments of	38559
assistance under Chapter 5107.~~, 5111.,~~ or 5115., former Chapter	38560
5113., or section 5101.54 of the Revised Code from refunds of	38561
state income taxes for taxable year 1992 and thereafter that are	38562
payable to the recipients of such overpayments. The tax	38563
commissioner, in accordance with section 5160.45 of the Revised	38564
Code, shall cooperate with the director of health care	38565
administration to collect overpayments of assistance under the	38566
disability medical assistance program or medicaid program from	38567
refunds of state income taxes for taxable year 1992 and thereafter	38568
that are payable to disability medical assistance recipients or	38569
medicaid recipients.	38570

(B) At the request of the department of job and family	38571
services or department of health care administration in connection	38572
with the collection of an overpayment of assistance from a refund	38573
of state income taxes pursuant to this section and section	38574
5101.184 or 5160.45 of the Revised Code, the tax commissioner	38575
shall release to the department the home address and social	38576
security number of any recipient of assistance whose overpayment	38577
may be collected from a refund of state income taxes under those	38578
sections.	38579

(C) In the case of a joint income tax return for two people	38580
who were not married to each other at the time one of them	38581
received an overpayment of assistance, only the portion of a	38582
refund that is due to the recipient of the overpayment shall be	38583
available for collection of the overpayment under this section and	38584
section 5101.184 or 5160.45 of the Revised Code. The tax	38585
commissioner shall determine such portion. A recipient's spouse	38586
who objects to the portion as determined by the commissioner may	38587
file a complaint with the commissioner within twenty-one days	38588
after receiving notice of the collection, and the commissioner	38589
shall afford the spouse an opportunity to be heard on the	38590
complaint. The commissioner shall waive or extend the	38591
twenty-one-day period if the recipient's spouse establishes that	38592
such action is necessary to avoid unjust, unfair, or unreasonable	38593
results. After the hearing, the commissioner shall make a final	38594
determination of the portion of the refund available for	38595
collection of the overpayment.	38596

(D) The welfare overpayment intercept fund is hereby created	38597
in the state treasury. The tax commissioner shall deposit amounts	38598
collected from income tax refunds under this section to the credit	38599
of the welfare overpayment intercept fund. The director of job and	38600
family services and director of health care administration shall	38601
distribute money in the fund in accordance with appropriate	38602
federal or state laws and procedures regarding collection of	38603
welfare overpayments and disability medical assistance program and	38604
medicaid payments.	38605

Sec. 5747.18. The tax commissioner shall enforce and	38606
administer this chapter. In addition to any other powers conferred	38607
upon the commissioner by law, the commissioner may:	38608

(A) Prescribe all forms required to be filed pursuant to this	38609
chapter;	38610

(B) Adopt such rules as the commissioner finds necessary to	38611
carry out this chapter;	38612

(C) Appoint and employ such personnel as are necessary to	38613
carry out the duties imposed upon the commissioner by this	38614
chapter.	38615

Any information gained as the result of returns,	38616
investigations, hearings, or verifications required or authorized	38617
by this chapter is confidential, and no person shall disclose such	38618
information, except for official purposes, or as provided by	38619
section 3125.43, 4123.271, 4123.591, 4507.023, or 5101.182, or	38620
5160.44, division (B) of section 5703.21 of the Revised Code, or	38621
in accordance with a proper judicial order. The tax commissioner	38622
may furnish the internal revenue service with copies of returns or	38623
reports filed and may furnish the officer of a municipal	38624
corporation charged with the duty of enforcing a tax subject to	38625
Chapter 718. of the Revised Code with the names, addresses, and	38626
identification numbers of taxpayers who may be subject to such	38627
tax. A municipal corporation shall use this information for tax	38628
collection purposes only. This section does not prohibit the	38629
publication of statistics in a form which does not disclose	38630
information with respect to individual taxpayers.	38631

Sec. 5751.081. As used in this section, "debt to this state"	38632
means unpaid taxes due the state, unpaid workers' compensation	38633
premiums due under section 4123.35 of the Revised Code, unpaid	38634
unemployment compensation contributions due under section 4141.25	38635
of the Revised Code, unpaid unemployment compensation payment in	38636
lieu of contribution under section 4141.241 of the Revised Code,	38637
unpaid fee payable to the state or to the clerk of courts pursuant	38638
to section 4505.06 of the Revised Code, incorrect ~~medical~~	38639
~~assistance~~medicaid payments ~~under section 5111.02 of the Revised~~	38640
~~Code~~, or any unpaid charge, penalty, or interest arising from any	38641
of the foregoing.	38642

If a taxpayer entitled to a refund under section 5751.08 of	38643
the Revised Code owes any debt to this state, the amount	38644
refundable may be applied in satisfaction of the debt. If the	38645
amount refundable is less than the amount of the debt, it may be	38646
applied in partial satisfaction of the debt. If the amount	38647
refundable is greater than the amount of the debt, the amount	38648
remaining after satisfaction of the debt shall be refunded. This	38649
section applies only to debts that have become final. For the	38650
purposes of this section, a debt becomes final when, under the	38651
applicable law, any time provided for petition for reassessment,	38652
request for reconsideration, or other appeal of the legality or	38653
validity of the amount giving rise to the debt expires without an	38654
appeal having been filed in the manner provided by law.	38655

Sec. 5815.28. (A) As used in this section:

38656

(1) "Ascertainable standard" includes a standard in a trust	38657
instrument requiring the trustee to provide for the care, comfort,	38658
maintenance, welfare, education, or general well-being of the	38659
beneficiary.	38660

(2) "Disability" means any substantial, medically	38661
determinable impairment that can be expected to result in death or	38662
that has lasted or can be expected to last for a continuous period	38663
of at least twelve months, except that "disability" does not	38664
include an impairment that is the result of abuse of alcohol or	38665
drugs.	38666

(3) "Political subdivision" and "state" have the same	38667
meanings as in section 2744.01 of the Revised Code.	38668

(4) "Supplemental services" means services specified by rule	38669
of the department of mental health under section 5119.01 of the	38670
Revised Code or the department of mental retardation and	38671
developmental disabilities under section 5123.04 of the Revised	38672
Code that are provided to an individual with a disability in	38673
addition to services the individual is eligible to receive under	38674
programs authorized by federal or state law.	38675

(B) Any person may create a trust under this section to	38676
provide funding for supplemental services for the benefit of	38677
another individual who meets either of the following conditions:	38678

(1) The individual has a physical or mental disability and is	38679
eligible to receive services through the department of mental	38680
retardation and developmental disabilities or a county board of	38681
mental retardation and developmental disabilities;	38682

(2) The individual has a mental disability and is eligible to	38683
receive services through the department of mental health or a	38684
board of alcohol, drug addiction, and mental health services.	38685

The trust may confer discretion upon the trustee and may	38686
contain specific instructions or conditions governing the exercise	38687
of the discretion.	38688

(C) The general division of the court of common pleas and the	38689
probate court of the county in which the beneficiary of a trust	38690
authorized by division (B) of this section resides or is confined	38691
have concurrent original jurisdiction to hear and determine	38692
actions pertaining to the trust. In any action pertaining to the	38693
trust in a court of common pleas or probate court and in any	38694
appeal of the action, all of the following apply to the trial or	38695
appellate court:	38696

(1) The court shall render determinations consistent with the	38697
testator's or other settlor's intent in creating the trust, as	38698
evidenced by the terms of the trust instrument.	38699

(2) The court may order the trustee to exercise discretion	38700
that the trust instrument confers upon the trustee only if the	38701
instrument contains specific instructions or conditions governing	38702
the exercise of that discretion and the trustee has failed to	38703
comply with the instructions or conditions. In issuing an order	38704
pursuant to this division, the court shall require the trustee to	38705
exercise the trustee's discretion only in accordance with the	38706
instructions or conditions.	38707

(3) The court may order the trustee to maintain the trust and	38708
distribute assets in accordance with rules adopted by the director	38709
of mental health under section 5119.01 of the Revised Code or the	38710
director of mental retardation and developmental disabilities	38711
under section 5123.04 of the Revised Code if the trustee has	38712
failed to comply with such rules.	38713

(D) To the extent permitted by federal law and subject to the	38714
provisions of division (C)(2) of this section pertaining to the	38715
enforcement of specific instructions or conditions governing a	38716
trustee's discretion, a trust authorized by division (B) of this	38717
section that confers discretion upon the trustee shall not be	38718
considered an asset or resource of the beneficiary, the	38719
beneficiary's estate, the settlor, or the settlor's estate and	38720
shall be exempt from the claims of creditors, political	38721
subdivisions, the state, other governmental entities, and other	38722
claimants against the beneficiary, the beneficiary's estate, the	38723
settlor, or the settlor's estate, including claims based on	38724
provisions of ~~Chapters 5111.,~~Chapter 5121., or 5123. of the	38725
Revised Code or the medicaid program and claims sought to be	38726
satisfied by way of a civil action, subrogation, execution,	38727
garnishment, attachment, judicial sale, or other legal process,	38728
if all of the following apply:	38729

(1) At the time the trust is created, the trust principal	38730
does not exceed the maximum amount determined under division (E)	38731
of this section;	38732

(2) The trust instrument contains a statement of the	38733
settlor's intent, or otherwise clearly evidences the settlor's	38734
intent, that the beneficiary does not have authority to compel the	38735
trustee under any circumstances to furnish the beneficiary with	38736
minimal or other maintenance or support, to make payments from the	38737
principal of the trust or from the income derived from the	38738
principal, or to convert any portion of the principal into cash,	38739
whether pursuant to an ascertainable standard specified in the	38740
instrument or otherwise;	38741

(3) The trust instrument provides that trust assets can be	38742
used only to provide supplemental services, as defined by rule of	38743
the director of mental health under section 5119.01 of the Revised	38744
Code or the director of mental retardation and developmental	38745
disabilities under section 5123.04 of the Revised Code, to the	38746
beneficiary;	38747

(4) The trust is maintained and assets are distributed in	38748
accordance with rules adopted by the director of mental health	38749
under section 5119.01 of the Revised Code or the director of	38750
mental retardation and developmental disabilities under section	38751
5123.04 of the Revised Code;	38752

(5) The trust instrument provides that on the death of the	38753
beneficiary, a portion of the remaining assets of the trust, which	38754
shall be not less than fifty per cent of such assets, will be	38755
deposited to the credit of the services fund for individuals with	38756
mental illness created by section 5119.17 of the Revised Code or	38757
the services fund for individuals with mental retardation and	38758
developmental disabilities created by section 5123.40 of the	38759
Revised Code.	38760

(E) In 1994, the trust principal maximum amount for a trust	38761
created under this section shall be two hundred thousand dollars.	38762
The maximum amount for a trust created under this section prior to	38763
November 11, 1994, may be increased to two hundred thousand	38764
dollars.	38765

In 1995, the maximum amount for a trust created under this	38766
section shall be two hundred two thousand dollars. Each year	38767
thereafter, the maximum amount shall be the prior year's amount	38768
plus two thousand dollars.	38769

(F) This section does not limit or otherwise affect the	38770
creation, validity, interpretation, or effect of any trust that is	38771
not created under this section.	38772

(G) Once a trustee takes action on a trust created by a	38773
settlor under this section and disburses trust funds on behalf of	38774
the beneficiary of the trust, then the trust may not be terminated	38775
or otherwise revoked by a particular event or otherwise without	38776
payment into the services fund created pursuant to section 5119.17	38777
or 5123.40 of the Revised Code of an amount that is equal to the	38778
disbursements made on behalf of the beneficiary for medical care	38779
by the state from the date the trust vests but that is not more	38780
than fifty per cent of the trust corpus.	38781

Sec. 5907.04. Subject to the following paragraph, all	38782
members of the armed forces, who served in the regular or	38783
volunteer forces of the United States or the Ohio national guard	38784
or members of the naval militia during the war with Spain, the	38785
Philippine insurrection, the China relief expedition, the Indian	38786
war, the Mexican expedition, World War I, World War II, or during	38787
the period beginning June 25, 1950 and ending July 19, 1953, known	38788
as the Korean conflict, or during the period beginning August 5,	38789
1964, and ending July 1, 1973, known as the Vietnam conflict, or	38790
any person who is awarded either the armed forces expeditionary	38791
medal established by presidential executive order 10977 dated	38792
December 4, 1961, or the Vietnam service medal established by	38793
presidential executive order 11231 dated July 8, 1965, who have	38794
been honorably discharged or separated under honorable conditions	38795
therefrom, or any discharged members of the Polish and	38796
Czechoslovakian armed forces who served in armed conflict with an	38797
enemy of the United States in World War I or World War II who have	38798
been citizens of the United States for at least ten years,	38799
provided that the above-mentioned persons have been citizens of	38800
this state for five consecutive years or more at the date of	38801
making application for admission, are disabled by disease, wounds,	38802
or otherwise, and are by reason of such disability incapable of	38803
earning their living, and all members of the Ohio national guard	38804
or naval militia who have lost an arm or leg, or their sight, or	38805
become permanently disabled from any cause, while in the line and	38806
discharge of duty, and are not able to support themselves, may be	38807
admitted to a veterans' home under such rules as the director of	38808
veterans services adopts.	38809

A person who served in the armed forces of the United States	38810
as defined in division (E)(7) of section 5903.11 of the Revised	38811
Code is eligible for admission to a veterans' home under the	38812
preceding paragraph only if the person has the characteristics	38813
defined in division (B)(1) of section 5901.01 of the Revised Code.	38814

The superintendent of the Ohio veterans' home agency shall	38815
promptly and diligently pursue the establishment of the	38816
eligibility for ~~medical assistance under Chapter 5111. of~~ the	38817
~~Revised Code~~medicaid program of all persons admitted to a	38818
veterans' home and all residents of a home who appear to qualify	38819
and shall promptly and diligently pursue and maintain the	38820
certification of each home's compliance with federal laws and	38821
regulations governing participation in the ~~medical assistance~~	38822
medicaid program to include as large as possible a part of the	38823
home's bed capacity.	38824

Veterans' homes may reserve a bed during the temporary	38825
absence of a resident or patient from the home, including a	38826
nursing home within it, under conditions prescribed by the	38827
director, to include hospitalization for an acute condition,	38828
visits with relatives and friends, and participation in	38829
therapeutic programs outside the home. A home shall not reserve a	38830
bed for more than thirty days, except that absences for more than	38831
thirty days due to hospitalization may be authorized.	38832

Section 2. That existing sections 9.231, 9.239, 9.24, 101.39,	38833
101.391, 103.144, 109.572, 109.85, 117.10, 119.01, 121.02, 121.03,	38834
122.15, 124.30, 124.301, 127.16, 131.23, 145.27, 145.58, 149.431,	38835
169.02, 173.14, 173.20, 173.21, 173.26, 173.35, 173.351, 173.394,	38836
173.40, 173.401, 173.42, 173.45, 173.47, 173.50, 173.71, 173.72,	38837
173.721, 173.722, 173.723, 173.724, 173.73, 173.731, 173.732,	38838
173.74, 173.741, 173.742, 173.75, 173.751, 173.752, 173.753,	38839
173.76, 173.77, 173.771, 173.772, 173.773, 173.78, 173.79,	38840
173.791, 173.80, 173.801, 173.802, 173.803, 173.81, 173.811,	38841
173.812, 173.813, 173.814, 173.815, 173.82, 173.83, 173.831,	38842
173.832, 173.833, 173.84, 173.85, 173.86, 173.861, 173.87,	38843
173.871, 173.872, 173.873, 173.874, 173.875, 173.876, 173.88,	38844
173.89, 173.891, 173.892, 173.90, 173.91, 173.99, 317.08, 317.36,	38845
323.01, 329.04, 329.051, 329.06, 329.14, 340.03, 340.091, 340.16,	38846
341.192, 505.84, 742.41, 955.201, 1337.11, 1347.08, 1731.04,	38847
1739.061, 1751.01, 1751.11, 1751.12, 1751.18, 1751.271, 1751.31,	38848
1751.60, 1751.88, 1751.89, 1923.14, 2113.041, 2113.06, 2117.061,	38849
2117.25, 2133.01, 2151.3514, 2305.234, 2307.65, 2317.02, 2335.39,	38850
2505.02, 2705.02, 2744.05, 2903.33, 2913.40, 2913.401, 2921.01,	38851
2921.13, 2945.401, 3101.051, 3107.083, 3111.04, 3111.72, 3113.06,	38852
3119.29. 3119.54, 3121.441, 3121.898, 3125.36, 3307.20, 3309.22,	38853
3313.714, 3313.715, 3323.021, 3599.45, 3701.023, 3701.024,	38854
3701.027, 3701.043, 3701.132, 3701.243, 3701.507, 3701.74,	38855
3701.741, 3701.881, 3702.30, 3702.31, 3702.51, 3702.522, 3702.591,	38856
3702.62, 3702.74, 3702.91, 3712.07, 3712.09, 3721.01, 3721.011,	38857
3721.021, 3721.022, 3721.024, 3721.026, 3721.042, 3721.071,	38858
3721.08, 3721.10, 3721.12, 3721.121, 3721.13, 3721.15, 3721.16,	38859
3721.17, 3721.19, 3721.21, 3721.28, 3721.32, 3721.50, 3721.51,	38860
3721.52, 3721.53, 3721.54, 3721.541, 3721.55, 3721.56, 3721.561,	38861
3721.57, 3721.58, 3722.10, 3722.16, 3727.02, 3742.30, 3742.51,	38862
3793.07, 3901.3814, 3903.14, 3916.06, 3923.122, 3923.27,	38863
3923.281, 3923.33, 3923.38, 3923.49, 3923.50, 3923.58, 3923.601,	38864
3923.70, 3923.79, 3923.83, 3924.41, 3924.42, 3963.01, 4123.27,	38865
4141.162, 4719.01, 4723.063, 4723.17, 4723.63, 4731.151, 4731.65,	38866
4731.71, 4752.02, 4752.09, 4753.071, 4755.481, 4758.02, 4758.04,	38867
4761.01, 4761.03, 4769.01, 5101.07, 5101.071, 5101.11, 5101.16,	38868
5101.162, 5101.18, 5101.181, 5101.182, 5101.184, 5101.21,	38869
5101.212, 5101.214, 5101.216, 5101.22, 5101.221, 5101.23,	38870
5101.24, 5101.243, 5101.25, 5101.26, 5101.31, 5101.35, 5101.36,	38871
5101.47, 5101.50, 5101.501, 5101.502, 5101.503, 5101.51,	38872
5101.511, 5101.512, 5101.513, 5101.514, 5101.515, 5101.516,	38873
5101.517, 5101.518, 5101.519, 5101.5110, 5101.52, 5101.521,	38874
5101.522, 5101.523, 5101.524, 5101.525, 5101.526, 5101.527,	38875
5101.528, 5101.529, 5101.5211, 5101.5212, 5101.5213, 5101.5214,	38876
5101.5215, 5101.5216, 5101.571, 5101.572, 5101.573, 5101.574,	38877
5101.575, 5101.58, 5101.59, 5101.591, 5101.97, 5103.02, 5107.10,	38878
5107.14, 5107.16, 5107.20, 5107.26, 5111.01, 5111.011, 5111.013,	38879
5111.014, 5111.015, 5111.016, 5111.018, 5111.019, 5111.0110,	38880
5111.0111, 5111.0112, 5111.0113, 5111.0114, 5111.0115, 5111.0116,	38881
5111.0117, 5111.0118, 5111.0119, 5111.02, 5111.021, 5111.022,	38882
5111.023, 5111.024, 5111.025, 5111.027, 5111.028, 5111.029,	38883
5111.03, 5111.031, 5111.032, 5111.033, 5111.034, 5111.04,	38884
5111.042, 5111.05, 5111.06, 5111.061, 5111.062, 5111.07,	38885
5111.071, 5111.08, 5111.081, 5111.082, 5111.083, 5111.084,	38886
5111.09, 5111.091, 5111.10, 5111.101, 5111.102, 5111.11, 5111.111,	38887
5111.112, 5111.113, 5111.114, 5111.12, 5111.121, 5111.13, 5111.14,	38888
5111.15, 5111.151, 5111.16, 5111.162, 5111.163, 5111.17,	38889
5111.171, 5111.172, 5111.173, 5111.174, 5111.175, 5111.176,	38890
5111.177, 5111.178, 5111.18, 5111.181, 5111.19, 5111.191, 5111.20,	38891
5111.201, 5111.202, 5111.203, 5111.204, 5111.21, 5111.211,	38892
5111.22, 5111.221, 5111.222, 5111.223, 5111.23, 5111.231,	38893
5111.232, 5111.235, 5111.24, 5111.241, 5111.242, 5111.243,	38894
5111.244, 5111.25, 5111.251, 5111.254, 5111.255, 5111.257,	38895
5111.258, 5111.26, 5111.261, 5111.263, 5111.264, 5111.265,	38896
5111.266, 5111.27, 5111.28, 5111.29, 5111.291, 5111.30, 5111.31,	38897
5111.32, 5111.33, 5111.34, 5111.35, 5111.36, 5111.37, 5111.38,	38898
5111.39, 5111.40, 5111.41, 5111.411, 5111.42, 5111.43, 5111.44,	38899
5111.45, 5111.46, 5111.47, 5111.48, 5111.49, 5111.50, 5111.51,	38900
5111.52, 5111.53, 5111.54, 5111.55, 5111.56, 5111.57, 5111.58,	38901
5111.59, 5111.60, 5111.61, 5111.62, 5111.63, 5111.65, 5111.651,	38902
5111.66, 5111.67, 5111.671, 5111.672, 5111.673, 5111.674,	38903
5111.675, 5111.676, 5111.677, 5111.68, 5111.681, 5111.682,	38904
5111.683, 5111.684, 5111.685, 5111.686, 5111.687, 5111.688,	38905
5111.70, 5111.701, 5111.702, 5111.703, 5111.704, 5111.705,	38906
5111.706, 5111.707, 5111.708, 5111.709, 5111.7010, 5111.7011,	38907
5111.71, 5111.711, 5111.712, 5111.713, 5111.714, 5111.715, 5111.84	38908
5111.85, 5111.851, 5111.852, 5111.853, 5111.854, 5111.855,	38909
5111.856, 5111.86, 5111.87, 5111.871, 5111.872, 5111.873,	38910
5111.874, 5111.875, 5111.876, 5111.877, 5111.878, 5111.879,	38911
5111.8710, 5111.89, 5111.891, 5111.892, 5111.893, 5111.894,	38912
5111.90, 5111.91, 5111.911, 5111.912, 5111.913, 5111.914,	38913
5111.915, 5111.92, 5111.93, 5111.94, 5111.941, 5111.942,	38914
5111.943, 5111.97, 5111.971, 5111.98, 5111.99, 5112.01, 5112.03,	38915
5112.04, 5112.05, 5112.06, 5112.07, 5112.08, 5112.09, 5112.10,	38916
5112.11, 5112.17, 5112.18, 5112.19, 5112.21, 5112.30, 5112.31,	38917
5112.32, 5112.33, 5112.34, 5112.341, 5112.35, 5112.37, 5112.371,	38918
5112.38, 5112.39, 5112.99, 5115.02, 5115.10, 5115.11, 5115.12,	38919
5115.13, 5115.14, 5115.20, 5115.22, 5115.23, 5117.10, 5119.04,	38920
5119.061, 5119.16, 5119.351, 5119.61, 5120.65, 5120.652, 5121.04,	38921
5123.01, 5123.021, 5123.0412, 5123.0417, 5123.171, 5123.181,	38922
5123.19, 5123.192, 5123.198, 5123.211, 5123.71, 5123.76, 5126.01,	38923
5126.042, 5126.046, 5126.054, 5126.055, 5126.0512, 5126.082,	38924
5126.12, 5302.221, 5309.082, 5505.04, 5725.18, 5729.03, 5731.39,	38925
5747.01, 5747.122, 5747.18, 5751.081, 5815.28, and 5907.04 and	38926
section 5111.012 of the Revised Code are hereby repealed.	38927

Section 3. The organization of the Department of Health Care	38928
Administration as established by this act shall be in accordance	38929
with the business model, organization structure, cross-functional	38930
practices, information technology, state and local impact, fiscal	38931
and budget, transition, and long-term care recommendations as	38932
detailed in the Ohio Medicaid Administrative Study Council Final	38933
Report and Recommendations, as completed by the Ohio Medicaid	38934
Administrative Study Council in accordance with Am. Sub. H.B. 66	38935
of the 126th General Assembly.	38936

Section 4. On July 1, 2009, the Medicaid Program, Hospital	38937
Care Assurance Program, Children's Health Insurance Program,	38938
Children's Buy-In Program, and Disability Medical Assistance	38939
Program and all of the programs' functions, assets, and	38940
liabilities are transferred from the Department of Job and Family	38941
Services to the Department of Health Care Administration. The	38942
transferred programs are thereupon and thereafter successor to,	38943
assume the obligations of, and otherwise constitute the	38944
continuation of the programs as they were operated under Chapters	38945
5101., 5111., 5112., and 5115. of the Revised Code immediately	38946
prior to July 1, 2009.	38947

Any business of the programs commenced but not completed	38948
before July 1, 2009, shall be completed by the Department of	38949
Health Care Administration under Chapters 5160., 5161., 5162.,	38950
5163., 5164., 5165., 5166., 5167., and 5168. of the Revised Code.	38951
The business shall be completed in the same manner, and with the	38952
same effect, as if completed by the Department of Job and Family	38953
Services under Chapters 5101., 5111., 5112., and 5115. of the	38954
Revised Code immediately prior to July 1, 2009.	38955

No validation, cure, right, privilege, remedy, obligation, or	38956
liability pertaining to the programs is lost or impaired by reason	38957
of the programs' transfer from the Department of Job and Family	38958
Services to the Department of Health Care Administration. Each	38959
such validation, cure, right, privilege, remedy, obligation, or	38960
liability shall be administered by the Department of Health Care	38961
Administration pursuant to Chapters 5160., 5161., 5162., 5163.,	38962
5164., 5165., 5166., 5167., and 5168. of the Revised Code.	38963

All rules, orders, and determinations pertaining to the	38964
programs as they were operated under Chapters 5101., 5111., 5112.,	38965
and 5115. of the Revised Code immediately prior to July 1, 2009,	38966
continue in effect as rules, orders, and determinations of the	38967
programs under Chapters 5160., 5161., 5162., 5163., 5164., 5165.,	38968
5166., 5167., and 5168. of the Revised Code, until modified or	38969
rescinded by the Department of Health Care Administration. If	38970
necessary to ensure the integrity of the numbering of the	38971
Administrative Code, the Director of the Legislative Service	38972
Commission shall renumber the rules to reflect the transfer of the	38973
programs from the Department of Job and Family Services to the	38974
Department of Health Care Administration.	38975

Subject to the lay-off provisions of sections 124.321 to	38976
124.328 of the Revised Code, all of the programs' employees in the	38977
Department of Job and Family Services shall be transferred to the	38978
Department of Health Care Administration. The transferred	38979
employees shall retain their positions and all of the benefits	38980
accruing to those positions.	38981

The Director of Budget and Management shall determine the	38982
amount of the unexpended balances in the appropriation accounts	38983
that pertain to the programs as they were operated under Chapters	38984
5101., 5111., 5112., and 5115. of the Revised Code immediately	38985
prior to July 1, 2009, and shall recommend to the Controlling	38986
Board their transfer to the appropriation accounts that pertain to	38987
the Department of Health Care Administration. The Department of	38988
Job and Family Services shall provide full and timely information	38989
to the Controlling Board to facilitate this transfer. Any funds	38990
transferred under this section are hereby appropriated.	38991

Section 5. On July 1, 2009, the Residential State Supplement	38992
Program and Ohio's Best Rx Program and all of the programs'	38993
functions, assets, and liabilities are transferred from the	38994
Department of Aging to the Department of Health Care	38995
Administration. The transferred programs are thereupon and	38996
thereafter successor to, assume the obligations of, and otherwise	38997
constitute the continuation of the programs as they were operated	38998
under Chapter 173. of the Revised Code immediately prior to July	38999
1, 2009.	39000

Any business of the program commenced but not completed	39001
before July 1, 2009, shall be completed by the Department of	39002
Health Care Administration under Chapters 5160. and 5169. of the	39003
Revised Code. The business shall be completed in the same manner,	39004
and with the same effect, as if completed by the Department of	39005
Aging under Chapter 173. of the Revised Code immediately prior to	39006
July 1, 2009.	39007

No validation, cure, right, privilege, remedy, obligation, or	39008
liability pertaining to the programs is lost or impaired by reason	39009
of the programs' transfer from the Department of Aging to the	39010
Department of Health Care Administration. Each such validation,	39011
cure, right, privilege, remedy, obligation, or liability shall be	39012
administered by the Department of Health Care Administration	39013
pursuant to Chapters 5160. and 5169. of the Revised Code.	39014

All rules, orders, and determinations pertaining to the	39015
programs as they were operated under Chapter 173. of the Revised	39016
Code immediately prior to July 1, 2009, continue in effect as	39017
rules, orders, and determinations of the programs under Chapters	39018
5160. and 5169. of the Revised Code, until modified or rescinded	39019
by the Department of Health Care Administration. If necessary to	39020
ensure the integrity of the numbering of the Administrative Code,	39021
the Director of the Legislative Service Commission shall renumber	39022
the rules to reflect the transfer of the programs from the	39023
Department of Aging to the Department of Health Care	39024
Administration.	39025

Subject to the lay-off provisions of sections 124.321 to	39026
124.328 of the Revised Code, all of the programs' employees in the	39027
Department of Aging shall be transferred to the Department of	39028
Health Care Administration. The transferred employees shall retain	39029
their positions and all of the benefits accruing to those	39030
positions.	39031

The Director of Budget and Management shall determine the	39032
amount of the unexpended balances in the appropriation accounts	39033
that pertain to the programs as they were operated under Chapter	39034
173. of the Revised Code immediately prior to July 1, 2009, and	39035
shall recommend to the Controlling Board their transfer to the	39036
appropriation accounts that pertain to the Department of Health	39037
Care Administration. The Department of Aging shall provide full	39038
and timely information to the Controlling Board to facilitate this	39039
transfer. Any funds transferred under this section are hereby	39040
appropriated.	39041

Section 6. The amendments of sections 4723.063, 5112.01,	39042
5112.03, 5112.04, 5112.05, 5112.06, 5112.07, 5112.08, 5112.09,	39043
5112.10, 5112.11, 5112.18, 5112.19, 5112.21, and 5112.99 of the	39044
Revised Code are not intended to supersede the earlier repeals,	39045
with delayed effective dates, of those sections.	39046

Section 7. The sections of law amended, enacted, or repealed	39047
by this act, and the items of law of which such sections are	39048
composed, are not subject to the referendum. Therefore, under Ohio	39049
Constitution, Article II, Section 1d and section 1.471 of the	39050
Revised Code, the sections go into effect July 1, 2009.	39051

Section 8. The General Assembly, applying the principle	39052
stated in division (B) of section 1.52 of the Revised Code that	39053
amendments are to be harmonized if reasonably capable of	39054
simultaneous operation, finds that the following sections,	39055
presented in this act as composites of the sections as amended by	39056
the acts indicated, are the resulting versions of the sections in	39057
effect prior to the effective date of the sections as presented in	39058
this act:	39059

Section 109.572 of the Revised Code as amended by Sub. H.B.	39060
195, Sub. H.B. 545, and Sub. S.B. 247, all of the 127th General	39061
Assembly.	39062

Section 1751.01 of the Revised Code as amended by both Am.	39063
Sub. H.B. 562 and Sub. S.B. 186 of the 127th General Assembly.	39064