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(124th General Assembly)
(Substitute Senate Bill Number 191)
AN ACT
To amend sections 4731.053, 5123.19,
5123.50,
5123.611,
5126.30,
5126.31, 5126.312,
5126.354,
5126.355, and
5126.357; to amend, for
the purpose
of
adopting new
section numbers as
indicated in
parentheses,
sections 5126.312
(5126.34),
5126.354
(5123.422),
5126.355
(5123.651),
and
5126.357
(5123.47); to
enact
sections 4723.071, 5123.195,
5123.41,
5123.42, 5123.421, 5123.43, 5123.44,
5123.441,
5123.45,
5123.451, 5123.46, 5123.65,
and
5126.36;
and to
repeal
sections 4723.61,
4723.62,
5123.193,
5126.35, 5126.351,
5126.352,
5126.353,
and
5126.356 of the Revised
Code to
revise
the laws
governing the licensure of
residential
facilities
for individuals with mental
retardation
and
developmental disabilities,
to revise the laws
governing the authority of MR/DD
personnel to
perform specified
health
activities, to specify
that individuals
with
mental retardation
and
developmental disabilities have the right to
self-administer medication, to require MR/DD boards
to provide training for their employees and others
authorized to implement adult protective services,
and to create the
MR/DD Consumer Information
Advisory Council.
Be it enacted by the General Assembly of the State of Ohio:
SECTION 1. That sections 4731.053, 5123.19, 5123.50,
5123.611,
5126.30,
5126.31, 5126.312,
5126.354,
5126.355, and
5126.357 be amended;
sections 5126.312
(5126.34),
5126.354
(5123.422),
5126.355
(5123.651), and 5126.357
(5123.47)
be amended
for the
purpose of
adopting new section
numbers as
indicated in
parentheses; and
sections 4723.071, 5123.195, 5123.41, 5123.42,
5123.421,
5123.43, 5123.44, 5123.441, 5123.45, 5123.451, 5123.46,
5123.65,
and 5126.36
of
the Revised
Code be
enacted to read as
follows:
Sec. 4723.071. (A) As used in this section,
"health-related
activities," "MR/DD
personnel,"
"prescribed
medication," and "tube feeding" have
the
same meanings as in
section
5123.41 of
the
Revised Code. (B) The board of nursing shall adopt rules as it considers
necessary to
govern
nursing delegation
as it applies to MR/DD
personnel who
administer prescribed medications, perform
health-related
activities, and perform tube feedings pursuant to
the authority granted under
section
5123.42 of the
Revised Code.
The board shall
not establish in the rules any
requirement that is
inconsistent with the authority
of MR/DD personnel granted under
that section.
The rules
shall be adopted in
accordance
with
Chapter 119. of the
Revised
Code. (C) The board of nursing may accept complaints from any
person or government entity regarding the performance or
qualifications of
MR/DD
personnel who administer prescribed
medications, perform health-related activities, and perform tube
feedings pursuant to
the authority granted
under
section
5123.42
of the Revised Code.
The board
shall refer all
complaints received
to the department of
mental
retardation and
developmental
disabilities. The board may
participate in an
investigation of a
complaint being conducted by
the department
under section
5123.421 of the Revised
Code. Sec. 4731.053. (A) As used in this section,
"physician"
means
an individual authorized by this chapter to practice
medicine and
surgery, osteopathic medicine and surgery, or
podiatric medicine and
surgery. (B) The state medical board shall adopt rules
that establish
standards to be met and procedures
to be
followed by a physician
with respect to the physician's delegation
of the performance of a
medical task to a person who is not licensed or otherwise
specifically
authorized by the Revised Code
to
perform the task.
The rules shall be
adopted in accordance with Chapter 119. of the
Revised
Code. (C) To the extent that delegation applies to the
administration
of drugs, the rules adopted under this section
shall provide for all
of the following: (1) On-site supervision when the delegation
occurs in an
institution or other facility that is used primarily
for the
purpose of providing health care, unless the board establishes a
specific exception to the on-site supervision requirement with
respect to
routine administration of a topical drug, such as the
use of a medicated
shampoo; (2) Evaluation of whether delegation is appropriate
according to
the acuity of the patient involved; (3) Training and competency requirements that must be met by
the
person administering the drugs; (4) Other standards and procedures the board considers
relevant. (D) The board shall not adopt rules that do any of the
following: (1) Authorize a physician to transfer the physician's
responsibility for supervising a person who is performing a
delegated
medical task to a health professional other than another
physician; (2) Authorize an individual to whom a medical task is
delegated
to delegate the performance of that task to another
individual; (3) Except as provided in divisions (D)(4) to
(8)(7) of this
section, authorize a physician to delegate the administration of
anesthesia,
controlled substances, drugs administered
intravenously, or any other drug or
category of drug the board
considers to be inappropriate for delegation; (4) Prevent an individual from engaging in an activity
performed
for a handicapped child as a service needed to meet the
educational needs
of the child, as identified in the
individualized education program
developed for the child under
Chapter 3323. of the Revised
Code; (5)
Prevent delegation from occurring pursuant to section
5126.356 of the Revised Code within the programs and
services
offered by a county board of mental retardation and developmental
disabilities; (6) Conflict with any provision of the Revised Code that
specifically authorizes an individual to perform a particular
task;
(7)(6) Conflict with any rule adopted pursuant to the
Revised
Code that is in effect on the effective date of this
section, as
long
as the rule remains in effect, specifically
authorizing an
individual to
perform a particular task;
(8)(7) Prohibit a perfusionist from administering drugs
intravenously while
practicing as a perfusionist;
(9)(8) Authorize a physician assistant, anesthesiologist
assistant,
or any other professional regulated by the board to
delegate tasks pursuant to
this section.
Sec. 5123.19. (A) As used in this section and in
sections
5123.191, 5123.194, and 5123.20 of the
Revised Code: (1) "Residential facility" means a home or facility in
which
a mentally retarded or developmentally disabled person
resides,
except the home of a relative or legal guardian in which
a
mentally retarded or developmentally disabled person resides, a
respite care home certified under section 5126.05 of the Revised
Code, a county home or district home operated pursuant to Chapter
5155. of the Revised Code, or a dwelling in which the only
mentally
retarded or developmentally disabled residents are in an
independent living arrangement or are being provided supported
living. (2) "Political subdivision" means a municipal corporation,
county, or township. (3) "Independent living arrangement" means an arrangement
in
which a mentally retarded or developmentally disabled person
resides in an individualized setting chosen by the person or
the
person's
guardian, which is not dedicated principally to the
provision of
residential services for mentally retarded or
developmentally
disabled persons, and for which no financial
support is received
for rendering such service from any
governmental agency by a
provider of residential services. (4) "Supported living" has the same meaning as in section
5126.01 of the Revised Code. (5) "Licensee" means the person or government agency that
has applied for a license to operate a residential facility and
to
which the license was issued under this section. (B) Every person or government agency desiring to operate
a
residential facility shall apply for licensure of the facility
to
the director of mental retardation and developmental
disabilities
unless the residential facility is subject to
section 3721.02,
3722.04, 5103.03, or 5119.20 of the Revised
Code. Notwithstanding
Chapter 3721. of the Revised Code, a
nursing home that is
certified as an intermediate care facility
for the mentally
retarded under Title XIX of the "Social Security
Act,"
49
79 Stat.
620
286 (1935
1965), 42 U.S.C.A.
301
1396, as amended, shall
apply
for licensure of the portion of the home that is certified
as an
intermediate care facility for the mentally retarded. (C) The director of mental retardation and developmental
disabilities shall license
and
inspect the operation of
residential facilities.
The director may deny
or revoke such
licenses.
An Except as provided in divisions (G) and (O) of this
section,
a
initial license
is valid
until it is
shall be issued for a
period
that does not exceed one year, unless the director denies
the license under division (D) of this section. A license shall
be renewed for a
period that does not exceed three years, unless
the director refuses to renew the license under division (D) of
this section. The director, when
issuing or renewing a license,
shall specify the period for which
the license is being issued or
renewed. A license remains valid
for the length of the licensing
period specified by the director,
unless the
license is
terminated, revoked, or voluntarily
surrendered.
Appeals
(D) If it is determined that an applicant or licensee
is
not in compliance with a provision of this chapter that applies to
residential facilities or the rules adopted under
such a
provision,
the director may deny issuance of a license, refuse to
renew a
license, terminate a license, revoke a license, issue an
order for
the suspension of admissions to a facility, issue an
order for the
placement of a monitor at a facility, issue an order
for the
immediate removal of residents, or take any other action
the
director considers necessary consistent with the director's
authority under this chapter regarding residential facilities. In
the director's selection and
administration of the sanction to be
imposed, all of the following
apply:
(1) The director may deny, refuse to renew, or revoke a
license, if the director determines that the applicant or licensee
has demonstrated a pattern of serious noncompliance or that
a
violation creates a substantial risk to the health and safety of
residents of a residential facility. (2) The director may terminate a license if more than twelve
consecutive months have elapsed since the
residential facility was
last occupied by a resident or a notice
required by division (J)
of this section is not given. (3) The director may issue an order for the suspension of
admissions to a facility for any violation that may result in
sanctions under
division (D)(1) of this section and for any other
violation
specified in rules adopted under division (G)(2) of this
section.
If the suspension of admissions is imposed for a
violation that
may result in sanctions under division (D)(1) of
this section, the
director may impose the suspension before
providing an opportunity for an adjudication under Chapter 119. of
the Revised Code. The
director shall lift an order for the
suspension of admissions
when the director determines that the
violation that formed the basis
for the order has been
corrected.
(4) The director may order the placement of a monitor at a
residential facility for any violation specified in rules adopted
under division (G)(2) of this section. The director shall lift
the order when the director determines that the violation that
formed the basis for the order
has been corrected.
(5) If the director determines that two or more residential
facilities owned or operated by the same person or government
entity are not being operated in compliance with a provision of
this chapter that applies to residential facilities or
the rules
adopted under such a provision, and the director's findings are
based
on the same or a substantially similar action, practice,
circumstance, or incident that creates a substantial risk to the
health and safety of the residents, the director shall conduct a
survey as soon as practicable at each residential facility owned
or operated by that person or government entity. The director may
take any action authorized by this section with respect to any
facility found to be operating in violation of a provision of this
chapter that applies to residential facilities or the
rules
adopted under such a provision.
(6) When the director initiates license revocation
proceedings,
no opportunity for submitting a plan of correction
shall be
given.
The director shall notify the licensee by letter
of the
initiation
of such proceedings. The letter shall list the
deficiencies of
the residential facility and inform the licensee
that no plan of
correction will be accepted. The director shall
also notify each
affected resident, the resident's guardian if
the
resident is an
adult for whom a guardian has been appointed,
the
resident's
parent or guardian if the resident is a minor, and
the
county
board of mental retardation and developmental
disabilities. (7) Pursuant to rules which shall be adopted in
accordance
with
Chapter 119. of the Revised Code, the director may order the
immediate removal of residents from a residential facility
whenever conditions at the facility present an immediate danger
of
physical or psychological harm to the residents. (8) In determining whether a residential facility is being
operated in compliance with a provision of this chapter that
applies to residential facilities or the rules adopted
under such
a provision, or whether conditions at a residential facility
present
an immediate danger of physical or psychological harm to
the
residents, the director may rely on information obtained by a
county board of mental retardation and developmental disabilities
or other governmental agencies. (9) In proceedings initiated to deny, refuse to renew, or
revoke licenses, the director may deny, refuse to renew, or revoke
a license
regardless of whether some or all of the deficiencies
that
prompted the proceedings have been corrected at the time of
the
hearing. (E) The director shall establish a program
under which
public notification may be made when the director has initiated
license revocation proceedings or has issued an order for the
suspension of admissions, placement of a monitor, or removal of
residents. The director shall adopt rules in accordance with
Chapter 119. of the Revised Code to
implement this division. The
rules shall establish the procedures
by which the public
notification will be made and specify the
circumstances for which
the notification must be made.
The rules shall require that public
notification be made if the director
has
taken action against the
facility in the eighteen-month period
immediately preceding the
director's latest action against the
facility and the latest
action is being taken for the same or a
substantially similar
violation of a provision of this chapter that applies to
residential facilities or the rules
adopted under such a
provision. The rules shall specify a method for removing
or
amending the public notification if the
director's action is
found
to have been unjustified or the
violation at the residential
facility has been corrected. (F)(1) Except as provided in division (F)(2) of this section,
appeals from proceedings initiated to
deny
applications for
licenses or to
revoke
licenses
impose a sanction under division
(D) of this section shall be
conducted
in
accordance
with Chapter
119. of the Revised Code.
(2) Appeals from proceedings initiated to order the
suspension
of
admissions to a facility shall be conducted in
accordance with
Chapter 119. of the Revised Code, unless the order
was issued
before providing an opportunity for an adjudication, in
which case
all of the following apply:
(a) The licensee may request a hearing not later than
ten
days after receiving the notice specified in section 119.07 of
the
Revised Code.
(b) If a timely request for a hearing is made, the hearing
shall commence not later than thirty days after the department
receives the request.
(c) After commencing, the hearing shall continue
uninterrupted, except for Saturdays, Sundays, and legal holidays,
unless other interruptions are agreed to by the licensee and
the
director.
(d) If the hearing is conducted by a hearing examiner, the
hearing examiner shall file a report and recommendations not later
than ten days after the close of the hearing.
(e) Not later than five days after the hearing examiner
files the report and recommendations, the licensee may file
objections to the report and recommendations.
(f) Not later than fifteen days after the hearing examiner
files the report and recommendations, the director shall issue an
order approving, modifying, or disapproving the report and
recommendations.
(g) Notwithstanding the pendency of the hearing, the
director shall lift the order for the suspension of admissions
when the director determines that the violation that formed the
basis for the order has been
corrected.
(G) In accordance with Chapter 119. of the Revised Code, the
director shall adopt and may amend and rescind rules for
licensing
and regulating the operation of residential facilities.
The rules
shall establish
and specify the following: (1) Procedures
and criteria for issuing,
and renewing
licenses, including procedures and criteria for determining the
length of the licensing period that the director must specify for
each license when it is issued or renewed; (2) Procedures and criteria for denying,
refusing to renew,
terminating,
and revoking
licenses
and for ordering the suspension
of
admissions
to a facility, placement of a monitor
at a facility,
and the
immediate removal of residents from a facility; (2)(3) Fees for issuing
and renewing licenses;
(3)(4) Procedures for
the inspection of
surveying
residential
facilities;
(4)(5) Requirements for the training of residential facility
personnel;
(5)(6) Classifications for the various types of residential
facilities;
(6)(7) Certification procedures for licensees and management
contractors that the director determines are necessary to ensure
that they have the skills and qualifications to properly operate
or manage residential facilities;
(7)(8) The maximum number of persons who may be served in a
particular type of residential facility;
(8)(9) Uniform procedures for admission of persons to and
transfers and discharges of persons from residential facilities;
(9)(10) Other standards for the operation of residential
facilities and the services provided at residential facilities;
(10)(11) Procedures for waiving any provision of any rule
adopted under this section.
(D)(H) Before issuing a license, the director of the
department
or the director's designee shall conduct
an
inspection
a survey of
the
residential facility for which application is
made. The
director
or the director's designee shall conduct
an
inspection
a
survey of
each licensed
residential facility at least
once
each
year
during the period the license is valid and may
conduct
additional inspections as needed.
An inspection
A survey
includes
but is
not limited to an on-site examination and
evaluation of the
residential facility, its personnel, and the
services provided
there.
In conducting
inspections
surveys, the director or the
director's
designee
shall be given access to the residential
facility; all records,
accounts, and any other documents related
to the operation of the
facility; the licensee; the residents of
the facility; and all
persons acting on behalf of, under the
control of, or in
connection with the licensee. The licensee and
all persons on
behalf of, under the control of, or in connection
with the
licensee shall cooperate with the director or the
director's
designee in
conducting the
inspection
survey. Following each
inspection
survey, unless the director
initiates a license revocation proceeding, the director or the
director's designee shall
provide the licensee with a report
listing any deficiencies,
specifying a timetable within which the
licensee shall submit a
plan of correction describing how the
deficiencies will be
corrected, and, when appropriate, specifying
a timetable within
which the licensee must correct the
deficiencies. After a plan
of
correction is submitted, the
director or the director's
designee
shall
approve or disapprove
the plan. A copy of the report and
any
approved plan of
correction shall be provided to any person
who
requests it. If it is determined
that a residential facility
is not
being
operated in compliance with this chapter or the rules
adopted
under it, the director may take such steps as are
necessary,
including, but not
limited to,
suspension of
admissions
to the
residential facility, placement of a monitor at
the
residential
facility, and the
initiation of license
revocation
proceedings.
When the director initiates
license revocation proceedings,
no opportunity for submitting
a plan of correction shall be
given.
The director shall notify the
licensee by letter of the
initiation
of such proceedings. The
letter shall list the
deficiencies of
the residential facility and
inform the licensee
that no plan of
correction will be accepted.
The director shall
also notify each
affected resident, the
resident's guardian if
the resident is an
adult for whom a
guardian has been appointed,
the resident's
parent or guardian if
the resident is a minor, and
the county
board of mental
retardation and developmental
disabilities.
Pursuant to rules which shall be adopted in
accordance with
Chapter 119. of the Revised Code, the director may order the
immediate removal of residents from a residential facility
whenever conditions at the facility present an immediate danger
of
physical or psychological harm to the residents.
In determining whether a residential facility is being
operated in compliance with this chapter or the rules adopted
under it, or whether conditions at a residential facility present
an immediate danger of physical or psychological harm to the
residents, the director may rely on information obtained by a
county board of mental retardation and developmental disabilities
or other governmental agencies
in the course of investigating
major unusual incidents.
The director shall adopt rules in
accordance with Chapter 119. of the Revised Code that specify
what
constitute "major unusual incidents."
The director shall
suspend without pay for a period of at
least three days
initiate disciplinary action against any
department employee who notifies or causes
the notification to any
unauthorized person of an unannounced
inspection
survey of a
residential facility by an authorized
representative of the
department. (E) In proceedings initiated to deny or
revoke licenses
under this section, the director may deny or revoke a license
regardless of whether some or all of
the deficiencies that
prompted the proceedings have been corrected
at the time of the
hearing.
(F)(I) In addition to any other information which may be
required of applicants for
a
license pursuant to this
section,
the
director shall require each applicant
to provide a
copy of an
approved plan for a proposed
residential facility
pursuant to
section 5123.042 of the Revised
Code.
This division does not apply
to renewal of a license.
(G) Pursuant
(J) A licensee shall notify the owner of the
building in
which the licensee's residential facility is located
of any
significant change in the identity of the licensee or
management
contractor before the effective date of the change if
the licensee
is not the owner of the building.
Pursuant to rules which shall
be adopted in
accordance
with
Chapter 119. of the Revised Code,
the director may
require
notification to the department of any
significant change
in the
ownership of a residential facility or
in the identity of
the
licensee or management contractor.
When
such notification is
not
given, the director may
cancel
the
residential
facility's
license.
If the director determines that a
significant
change of
ownership
is proposed, the director shall
consider the
proposed
change to
be
an application for development
by a new
operator
pursuant to
section 5123.042 of the Revised Code
and
shall
advise
the
applicant within sixty days of such
notification
that
the
current
license shall continue in effect or
a new license
will be
required
pursuant to this section.
If the
director requires a new
license,
the director shall permit the
facility to continue to
operate
under the current license until
the new license is issued,
unless
the current license is revoked,
refused to be renewed, or
terminated in accordance with Chapter
119. of the Revised Code. (H)(K) A county board of mental retardation and
developmental
disabilities, the legal rights service, and any
interested person
may file complaints alleging violations of
statute or department
rule relating to residential facilities with
the department. All
complaints shall be in writing and shall
state the facts
constituting the basis of the allegation. The
department shall
not reveal the source of any complaint unless the
complainant
agrees in writing to waive the right to
confidentiality or until
so ordered by a court of competent
jurisdiction.
The department shall
acknowledge receipt of the complaint
and
notify the complainant of the action that will be taken with
respect to it within five working days of receiving it
adopt rules
in accordance with Chapter 119. of the Revised Code establishing
procedures for the receipt, referral, investigation, and
disposition of complaints filed with the department under this
division. The substance of a complaint shall not be provided to a
licensee until the commencement of an inspection or
investigation.
(I)(L) The department shall establish procedures for the
notification of interested parties of the transfer or interim
care
of residents from residential facilities that are closing or
are
losing their license.
(J)(M)
Before issuing a license under this section to a
residential facility that will
accommodate at any time
more than
one mentally retarded or developmentally disabled
individual, the
director shall, by first class
mail, notify the following:
(1) If the facility will be located in a municipal
corporation, the clerk of the legislative authority of the
municipal corporation; (2) If the facility will be located in unincorporated
territory, the clerk of the appropriate board of county
commissioners and the clerk of the appropriate board of township
trustees. The director shall
not
issue the license for ten
days
after
mailing the notice, excluding
Saturdays, Sundays, and legal
holidays, in order to give the
notified local officials time in
which to comment on the proposed
issuance. Any legislative authority of a municipal corporation, board
of county commissioners, or board of township trustees that
receives notice under this division of the proposed issuance of a
license for a residential facility may comment on it in writing
to
the director within ten days after the director mailed the
notice,
excluding Saturdays, Sundays, and legal holidays. If the
director
receives written comments from any notified officials
within the
specified time, the director shall make written
findings
concerning the comments and the director's decision on the
issuance of the
license. If the director does not receive written
comments from
any notified local officials within the specified
time, the
director shall
continue the process for issuance of the
license. (K)(N) Any person may operate a licensed residential
facility
that provides room and board, personal care, habilitation
services,
and supervision in a family setting for at least six but
not more than eight
persons with mental retardation or a
developmental disability as a
permitted use in any residential
district or zone, including any
single-family residential district
or zone, of any political
subdivision. These residential
facilities may be
required to comply with area,
height, yard, and
architectural compatibility requirements that
are uniformly
imposed upon all single-family residences within
the district or
zone.
(L)(O) Any person may operate a licensed residential
facility that provides room and board, personal care, habilitation
services,
and supervision in a family setting for at least nine
but not more than
sixteen persons with mental retardation or a
developmental
disability as a
permitted use in any multiple-family
residential district or zone
of any political subdivision, except
that a political subdivision
that has enacted a zoning ordinance
or resolution establishing
planned unit development districts may
exclude these
residential facilities from
such districts, and a
political subdivision that has enacted a
zoning ordinance or
resolution may regulate these
residential facilities in
multiple-family residential districts or zones as a conditionally
permitted use or special exception, in either case, under
reasonable and specific standards and conditions set out in the
zoning ordinance or resolution to:
(1) Require the architectural design and site layout of
the
residential facility and the location, nature, and
height of any
walls,
screens, and fences to be compatible with adjoining land
uses and
the residential character of the neighborhood; (2) Require compliance with yard, parking, and sign
regulation; (3) Limit excessive concentration of these residential
facilities. (M)(P) This section does not prohibit a political
subdivision
from applying to residential facilities
nondiscriminatory
regulations requiring compliance with health,
fire, and safety
regulations and building standards and
regulations.
(N)(Q) Divisions
(K)(N)
and
(L)(O) of this section are not
applicable to municipal corporations that had in effect on June
15, 1977, an ordinance specifically permitting in residential
zones licensed residential facilities by means of permitted uses,
conditional uses, or special exception, so long as such ordinance
remains in effect without any substantive modification.
(O)(R)(1) The director may issue an interim license to
operate a
residential facility to an applicant for a license under
this
section if
all
either of the following
conditions are met
is
the case:
(1)(a) The director determines that an emergency exists
that
requires
requiring immediate placement of persons in a residential
facility,
and
that insufficient licensed beds are available.
(2) The residential facility meets
standards
in
rules for
interim licenses
that the director shall adopt in
accordance with
Chapter 119. of the Revised Code.
(3) The director determines, and that the residential
facility
is likely to receive a
permanent license under this
section within
thirty
days after issuance of the interim license.
(b) The director determines that the issuance of an interim
license is necessary to meet a temporary need for a residential
facility. (2) To be eligible to receive an interim license, an
applicant must meet the same criteria that must be met to receive
a permanent license under this section, except for any differing
procedures and time frames that may apply to issuance of a
permanent license.
(3) An interim license shall be valid for thirty days and
may
be renewed by the director
no more than twice
for a period not
to exceed one hundred fifty days. (4) The director shall adopt rules in accordance with
Chapter 119. of the Revised Code as the director considers
necessary to administer the issuance of interim licenses.
(P)(S) Notwithstanding rules adopted pursuant to this
section
establishing the maximum number of persons who may be
served in a
particular type of residential facility, a residential
facility
shall be permitted to serve the same number of persons
being
served by the facility on the effective date of such rules
or the
number of persons for which the facility is authorized
pursuant
to a current application for a certificate of need with a
letter
of support from the department of mental retardation and
developmental disabilities and which is in the review process
prior to April 4, 1986.
(Q)(T) The director or the director's designee may enter at
any time,
for purposes of investigation, any home, facility, or
other
structure that has been reported to the director or that the
director has reasonable cause to believe is being operated as a
residential facility without a license issued under this section.
The director may petition the court of common pleas of the
county in which an unlicensed residential facility is located for
an order enjoining the person or governmental agency operating
the
facility from continuing to operate without a license. The
court
may grant the injunction on a showing that the person or
governmental agency named in the petition is operating a
residential facility without a license. The court may grant the
injunction, regardless of whether the residential facility meets
the requirements for receiving a license under this section.
Sec. 5123.195. (A) Not later than sixty days after the end
of calendar years 2003, 2004, and 2005, the director of mental
retardation and developmental disabilities shall submit a report
to the president and minority leader of the senate and speaker and
minority leader of the house of representatives regarding the
implementation of section 5123.19 of the Revised Code since the
effective date of this section. The director shall include in the
report all of the following information: (1) A summary of any rules adopted under that section to
implement the amendments to that section that go into effect on
the effective date of this section; (2) The number of residential facility licenses issued,
renewed, and denied under that section since the effective date of
the amendments to section 5123.19 of the Revised Code that go into
effect on the effective date of this section or, in the case of
the reports due in 2005 and 2006, since the previous report was
submitted; (3) The length of time for which residential facility
licenses are issued and renewed under that section; (4) The sanctions imposed pursuant to division (D) of
section 5123.19 of the Revised Code and the kinds of violations
that cause the sanctions; (5) Any other information the director determines is
important to the implementation of the amendments to section
5123.19 of the Revised Code that go into effect on the effective
date of this section. (B) On submission of the report under division (A) of this
section, the director shall inform each member of the general
assembly that the report is available. Sec. 5123.41. As used in this section and sections
5123.42
to 5123.47 of the Revised Code:
(A) "Adult services" has the same meaning as in section
5126.01 of the Revised Code. (B) "Certified home and community-based services provider"
means a person or government entity certified under section
5123.045 of the Revised Code. (C) "Certified supported living provider" means a person or
government entity certified under section 5126.431 of the Revised
Code.
(D)
"Drug" has the same meaning as in section 4729.01 of
the
Revised Code.
(E) "Family support services" has the same meaning as in
section 5126.01 of the Revised Code. (F) "Health-related activities" means the following:
(1) Taking vital signs;
(2) Application of clean dressings that do not require
health
assessment;
(3) Basic measurement of bodily intake and output;
(4) Oral suctioning;
(5) Use of glucometers;
(6) External urinary catheter care;
(7) Emptying and replacing colostomy bags;
(8) Collection of specimens by noninvasive means.
(G) "Licensed health professional authorized to prescribe
drugs" has the same meaning as in section 4729.01 of the Revised
Code. (H) "Medicaid" has the same meaning as in section 5111.01 of
the Revised Code. (I) "MR/DD personnel" means the employees and the workers
under
contract who provide
specialized services to individuals
with
mental retardation and
developmental disabilities. "MR/DD
personnel" includes those who provide the services as follows: (1) Through
direct employment with the department of mental
retardation and
developmental disabilities or a county board of
mental retardation
and developmental disabilities; (2) Through an
entity under contract with the department of
mental retardation
and developmental disabilities or a county
board of mental
retardation and developmental disabilities;
(3) Through
direct employment or by being under contract
with private
entities, including private entities that operate
residential
facilities.
(J) "Nursing delegation" means the process established in
rules adopted by the board of nursing pursuant to Chapter 4723. of
the Revised Code under which a registered nurse or licensed
practical nurse acting at the direction of a registered nurse
transfers the performance of a particular nursing activity or task
to another person who is not otherwise authorized to perform
the
activity or task.
(K) "Prescribed medication" means a drug that is to be
administered according to the instructions of a licensed health
professional authorized to prescribe drugs. (L) "Residential facility" means a facility licensed under
section 5123.19 of the Revised Code or subject to section 5123.192
of the Revised Code. (M) "Specialized services" has the same meaning as in
section 5123.50 of the Revised Code. (N) "Tube feeding" means the provision of nutrition to an
individual through a gastrostomy tube or a jejunostomy tube.
Sec. 5123.42. (A) Beginning nine months after the
effective
date of this section, MR/DD personnel who are not
specifically
authorized by other provisions of the Revised Code to administer
prescribed medications, perform health-related activities, or
perform tube feedings may
do so pursuant to this
section as part
of the specialized services the MR/DD personnel provide
to
individuals
with mental retardation and developmental
disabilities
in the
following categories:
(1)
Recipients of early intervention, preschool, and
school-age services offered or provided pursuant to this chapter
or Chapter 5126. of the Revised Code; (2) Recipients of adult services offered or provided
pursuant to this chapter or Chapter 5126. of the Revised Code; (3)
Recipients of family support services offered or
provided pursuant to this chapter or Chapter 5126. of the Revised
Code;
(4) Recipients of services from certified supported living
providers, if the services are offered or provided pursuant to
this chapter or Chapter 5126. of the Revised Code; (5) Recipients of residential support services from certified
home and
community-based services providers, if the services are
received in a community living arrangement that includes not
more
than four individuals with mental retardation and developmental
disabilities and the services are offered or
provided pursuant to
this chapter or Chapter 5126. of the Revised
Code;
(6) Recipients of services not included in
divisions (A)(1)
to (5) of this section that are offered or
provided pursuant to
this chapter or Chapter 5126. of the Revised Code;
(7) Residents of a residential facility with
five or
fewer
resident beds;
(8) Residents of a residential facility with at least six
but not more than sixteen resident beds;
(9) Residents of a residential facility with seventeen or
more resident beds
who are on a field trip from the
facility, if
all of the following are the case:
(a) The field trip is sponsored by the facility for
purposes of complying with federal medicaid statutes and
regulations, state medicaid statutes and rules, or other federal
or state statutes, regulations, or rules that require the facility
to provide habilitation, community integration, or normalization
services to its residents.
(b) Not more than five field trip participants are
residents who have health needs requiring the administration of
prescribed medications, excluding participants who self-administer
prescribed medications or receive assistance with
self-administration of prescribed medications.
(c) The facility staffs the field trip with MR/DD personnel
in such a manner that one person will administer prescribed
medications, perform health-related activities, or perform tube
feedings for not more than two participants if one or both of
those participants have health needs requiring the person to
administer prescribed medications through a gastrostomy or
jejunostomy tube.
(d) According to the instructions of a health care
professional acting within the scope of the professional's
practice, the health needs of the participants who require
administration of prescribed medications by MR/DD personnel are
such that the participants must receive the medications during the
field trip to avoid jeopardizing their health and safety.
(B)(1) In the case of recipients of early intervention,
preschool, and school-age services, as specified in division
(A)(1) of this section, all
of the following apply:
(a) With nursing delegation, MR/DD personnel may perform
health-related activities. (b) With nursing delegation, MR/DD personnel may administer
oral and topical
prescribed medications.
(c) With nursing delegation, MR/DD personnel may administer
prescribed medications through gastrostomy and jejunostomy tubes,
if the tubes being used are stable and labeled. (d) With nursing delegation, MR/DD personnel may perform
routine tube feedings, if the gastrostomy and jejunostomy tubes
being used are stable and labeled.
(2) In the case of recipients of adult services, as
specified in division (A)(2) of this section, all of
the following
apply:
(a) With nursing delegation, MR/DD personnel may perform
health-related activities. (b) With nursing delegation, MR/DD personnel may administer
oral and topical
prescribed medications.
(c) With nursing delegation, MR/DD personnel may administer
prescribed medications through gastrostomy and jejunostomy tubes,
if the tubes being used are stable and labeled. (d) With nursing delegation, MR/DD personnel may perform
routine tube feedings, if the gastrostomy and jejunostomy tubes
being used are stable and labeled.
(3) In the case of recipients of family support services,
as specified in division (A)(3) of this section,
all of the
following apply:
(a) Without nursing delegation, MR/DD personnel may perform
health-related activities. (b) Without nursing delegation, MR/DD personnel may
administer oral and topical
prescribed medications.
(c) With nursing delegation, MR/DD personnel may administer
prescribed medications through
gastrostomy and jejunostomy tubes,
if the tubes being used are stable and labeled. (d) With nursing delegation, MR/DD personnel may perform
routine tube feedings, if the gastrostomy and jejunostomy tubes
being used are stable and labeled.
(e) With nursing delegation, MR/DD personnel may administer
routine doses of insulin through subcutaneous injections and
insulin pumps.
(4) In the case of recipients of services from certified
supported living providers, as specified in division (A)(4) of
this section, all of the following apply:
(a) Without nursing delegation, MR/DD personnel may perform
health-related activities. (b) Without nursing delegation, MR/DD personnel may
administer oral and topical
prescribed medications.
(c) With nursing delegation, MR/DD personnel may administer
prescribed medications through
gastrostomy and jejunostomy tubes,
if the tubes being used are stable and labeled. (d) With nursing delegation, MR/DD personnel may perform
routine tube feedings, if the gastrostomy and jejunostomy tubes
being used are stable and labeled.
(e) With nursing delegation, MR/DD personnel may administer
routine doses of insulin through subcutaneous injections and
insulin pumps.
(5) In the case of recipients of residential support
services from certified
home and community-based services
providers, as specified in
division (A)(5) of this section, all of
the following apply: (a) Without nursing delegation, MR/DD personnel may perform
health-related activities. (b) Without nursing delegation, MR/DD personnel may
administer
oral and topical prescribed medications. (c) With nursing delegation, MR/DD personnel may administer
prescribed medications through gastrostomy and jejunostomy tubes,
if the tubes being used are stable and labeled. (d) With nursing delegation, MR/DD personnel may perform
routine tube feedings, if the gastrostomy and jejunostomy tubes
being used are stable and labeled. (e) With nursing delegation, MR/DD personnel may administer
routine doses of insulin through subcutaneous injections and
insulin pumps. (6) In the case of recipients of services not included in
divisions (A)(1) to (5) of this section, as specified in division
(A)(6) of this section, all of
the following apply:
(a) With nursing delegation, MR/DD personnel may perform
health-related activities. (b) With nursing delegation, MR/DD personnel may administer
oral and topical
prescribed medications.
(c) With nursing delegation, MR/DD personnel may administer
prescribed medications through
gastrostomy and jejunostomy tubes,
if the tubes being used are stable and labeled.
(d) With nursing delegation, MR/DD personnel may perform
routine tube feedings, if the gastrostomy and jejunostomy tubes
being used are stable and labeled.
(7) In the case of
residents of
a residential facility with
five
or fewer beds, as specified in division (A)(7) of this
section, all of the
following apply: (a)
Without nursing delegation, MR/DD personnel may perform
health-related activities. (b) Without nursing delegation, MR/DD personnel may
administer
oral and topical
prescribed medications. (c) With
nursing delegation, MR/DD personnel may administer
prescribed
medications through gastrostomy and jejunostomy tubes,
if the tubes being used are stable and labeled.
(d) With nursing delegation, MR/DD personnel may perform
routine tube feedings, if the gastrostomy and jejunostomy tubes
being used are stable and labeled. (e) With nursing delegation, MR/DD
personnel may administer
routine doses of insulin through
subcutaneous injections and
insulin pumps.
(8) In the case of residents of a
residential facility with
at least six but
not
more than sixteen resident
beds, as specified
in division (A)(8) of this section, all of the
following apply: (a) With nursing
delegation, MR/DD personnel may perform
health-related activities. (b) With nursing delegation, MR/DD personnel may administer
oral and topical
prescribed medications. (c) With nursing delegation, MR/DD personnel may administer
prescribed
medications through
gastrostomy and jejunostomy tubes,
if the tubes being used are stable and labeled.
(d) With nursing delegation, MR/DD personnel may perform
routine tube feedings, if the gastrostomy and jejunostomy tubes
being used are stable and labeled.
(9) In the case of residents of a residential facility with
seventeen or more resident beds who are on a field
trip from the
facility, all of the
following apply during the field trip,
subject to the limitations specified in division (A)(9) of this
section:
(a) With nursing delegation, MR/DD personnel may perform
health-related activities. (b) With nursing delegation, MR/DD personnel may administer
oral and topical
prescribed medications.
(c) With nursing delegation, MR/DD personnel may administer
prescribed medications through gastrostomy and jejunostomy tubes,
if the tubes being used are stable and labeled.
(d) With nursing delegation, MR/DD personnel may perform
routine tube feedings, if the
gastrostomy and jejunostomy tubes
being used are stable and labeled.
(C) The authority of MR/DD personnel to administer
prescribed medications, perform health-related activities, and
perform tube feedings pursuant to this section is subject to
all
of the following:
(1) To administer prescribed medications, perform
health-related activities, or perform tube feedings for
individuals in the categories specified under divisions (A)(1) to
(8) of this section, MR/DD personnel shall obtain the certificate
or certificates required by the department of mental retardation
and developmental disabilities and issued under section 5123.45 of
the Revised Code. MR/DD personnel shall administer prescribed
medication, perform health-related activities, and perform tube
feedings only as authorized by the certificate or certificates
held.
(2) To administer prescribed medications, perform
health-related activities, or perform tube feedings for
individuals in the category specified under division (A)(9) of
this section, MR/DD personnel shall successfully complete the
training course or courses developed under section 5123.43 of
the
Revised Code for the MR/DD personnel. MR/DD personnel shall
administer prescribed medication, perform health-related
activities, and perform tube feedings only as authorized by the
training completed.
(3) If nursing delegation is required under division (B) of
this section, MR/DD personnel shall not act without nursing
delegation or in a manner that is inconsistent with the
delegation.
(4) The employer of MR/DD personnel shall ensure that MR/DD
personnel have been trained specifically with respect to each
individual for whom they administer prescribed medications,
perform health-related activities, or perform tube feedings.
MR/DD
personnel shall not administer prescribed medications,
perform
health-related activities, or perform tube feedings for
any
individual for whom they have not been specifically trained.
(5) If the employer of MR/DD personnel believes that MR/DD
personnel have not or will not safely administer prescribed
medications, perform health-related activities, or perform tube
feedings, the employer shall prohibit the action from continuing
or commencing. MR/DD personnel shall not engage in the action or
actions subject to an employer's prohibition.
(D)
In accordance with section 5123.46 of the Revised
Code,
the department of mental retardation and developmental
disabilities shall adopt rules governing its
implementation of
this section. The rules shall include the following:
(1) Requirements for documentation of the administration of
prescribed medications, performance of health-related activities,
and performance of tube feedings
by MR/DD personnel
pursuant to
the authority granted under this
section;
(2) Procedures for reporting errors that occur in the
administration of prescribed medications, performance of
health-related activities, and performance of tube feedings
by
MR/DD personnel pursuant to the
authority granted under this
section;
(3) Other standards and procedures the department considers
necessary for implementation of this section.
Sec. 5123.421. The department of mental retardation and
developmental disabilities shall accept complaints from any person
or government entity regarding the administration of prescribed
medications, performance of health-related activities, and
performance of tube feedings by MR/DD personnel pursuant to the
authority granted under section 5123.42 of the Revised Code. The
department shall conduct investigations of complaints as it
considers appropriate. The department shall adopt rules in
accordance with section 5123.46 of the Revised Code establishing
procedures for accepting complaints and conducting investigations
under this section.
Sec. 5126.354
5123.422.
A county board worker authorized to
give
or apply
MR/DD personnel who administer prescribed
medication
or
medications, perform
a delegated nursing
task
health-related
activities, or
both, is
perform tube feedings pursuant to the
authority granted
under section 5123.42 of the Revised Code are
not liable for any
injury caused by
administering the
medication
medications, performing the
health-related activities, or
task
performing the tube feedings,
if
all
both of the
following apply: (A)
Prior to giving or applying the medication
or peforming
the nursing task, the county board worker received a
copy of the
statement or the revised statement required to be
given under
division (C) of section 5126.353 of the
Revised Code; (B) The
county board worker gave or applied the
medication
or performed the nursing task
MR/DD personnel acted in
accordance
with the methods taught in training completed
pursuant
to division
(D)(2) of
in compliance with section
5126.351
5123.42 of the
Revised Code;
(C)(B) The
county board worker
MR/DD personnel did not act
in a
manner that constitutes wanton or reckless misconduct.
Sec. 5123.43. (A) The
department
of mental retardation
and
developmental disabilities
shall develop
courses for
the training
of MR/DD personnel in the administration of
prescribed
medications, performance of health-related activities,
and
performance of tube feedings
pursuant to the authority granted
under section 5123.42 of the
Revised Code.
The department may
develop separate or combined training
courses for the
administration of prescribed medications,
performance of
health-related activities, and performance of tube
feedings.
Training in the administration of prescribed
medications through
gastrostomy and jejunostomy tubes may be
included in a course
providing training in tube feedings.
Training in the
administration of insulin may be developed as
a separate course or
included in a course providing training in
the administration of
other prescribed medications.
(B)(1) The department shall adopt rules in accordance
with section 5123.46 of the Revised Code that specify the content
and length of the training courses developed under this section.
The rules may include any other standards the department considers
necessary for the training courses. (2) In adopting rules that specify the content of a training
course or part of a training course that trains MR/DD personnel in
the administration of prescribed medications, the department shall
ensure that the content includes
all of
the
following:
(a) Infection control and universal precautions;
(b) Correct and safe practices, procedures, and techniques
for administering prescribed medication;
(c) Assessment of drug reaction, including known side
effects, interactions, and the proper course of action if a side
effect occurs;
(d) The requirements for documentation of medications
administered to each individual;
(e) The requirements for documentation and notification of
medication errors;
(f) Information regarding the proper storage and care of
medications;
(g) Information about proper receipt of prescriptions and
transcription of prescriptions into an individual's medication
administration record, except when the MR/DD personnel being
trained will administer prescribed medications only to residents
of
a residential facility with seventeen or more resident beds who
are
participating in a field trip, as specified in division (A)(9)
of
section 5123.42 of the Revised Code; (h) Course completion standards that require successful
demonstration of proficiency in administering prescribed
medications;
(i)
Any other material or course completion standards that
the department
considers
relevant to the administration of
prescribed medications
by MR/DD
personnel.
Sec. 5123.44. The department of mental retardation and
developmental disabilities shall develop courses that train
registered nurses to provide the MR/DD personnel training courses
developed under section 5123.43 of the Revised Code. The
department may develop courses that train registered nurses to
provide all of the courses developed under section 5123.43 of the
Revised Code or any one or more of the courses developed under
that section. The department shall adopt rules in accordance with section
5123.46 of the Revised Code that specify the content and length of
the training courses. The rules may include any other standards
the department considers necessary for the training courses.
Sec. 5123.441. (A) Each MR/DD personnel training course
developed under
section 5123.43 of the Revised Code shall be
provided by a
registered nurse. (B)(1) Except as provided in division (B)(2) of this section,
to provide a training course or courses to MR/DD personnel, a
registered nurse shall obtain the certificate or certificates
required by the department and issued under section 5123.45 of the
Revised Code. The registered nurse shall provide only the
training course or courses
authorized by the certificate or
certificates the registered nurse holds.
(2) A registered nurse is not required to obtain a
certificate to provide a training course to MR/DD personnel if the
only MR/DD personnel to whom the course or courses are provided
are those who administer prescribed medications, perform
health-related activities, or perform tube feedings for residents
of a residential facility with seventeen or more resident beds who
are on a field trip from the facility, as specified in division
(A)(9) of section 5123.42 of the Revised Code. To provide the
training course or courses, the registered nurse shall
successfully complete the training required by the department
through the courses it develops under section 5123.44 of the
Revised Code. The registered nurse shall provide only the
training courses authorized by the training the registered nurse
completes.
Sec. 5123.45. (A) The department of mental retardation
and
developmental disabilities shall establish a program under
which
the department issues certificates to the following:
(1) MR/DD personnel, for purposes of meeting the
requirement of division (C)(1) of section 5123.42 of the Revised
Code to obtain a certificate or certificates to administer
prescribed medications, perform health-related activities, and
perform tube feedings;
(2) Registered nurses, for purposes of meeting the
requirement of division (B)(1) of section 5123.441 of the Revised
Code
to obtain a certificate or certificates to provide the MR/DD
personnel training courses developed under section 5123.43 of the
Revised Code.
(B)(1) Except as provided in division (B)(2) of this
section, to receive a certificate issued under this section, MR/DD
personnel and registered nurses
shall
successfully complete
the
applicable
training course or courses and meet all
other
applicable
requirements established in
rules adopted
pursuant to
this
section. The department shall issue the appropriate
certificate or certificates to MR/DD personnel and registered
nurses who meet the requirements for the certificate or
certificates. (2) The department shall include
provisions in the program
for issuing
certificates to the following: (a) MR/DD personnel who, on the effective date
of this
section, are authorized to provide care to individuals with mental
retardation and developmental disabilities pursuant to section
5123.193 or
sections
5126.351 to
5126.354 of
the Revised Code. A
person
who receives a
certificate under division (B)(2)(a) of this
section
shall not
administer insulin until the person has been
trained by
a
registered nurse who has received a certificate under
this
section
that allows the registered nurse to provide training
courses to MR/DD
personnel
in the administration of insulin. (b) Registered nurses who, on the effective date of
this
section, are authorized to train MR/DD personnel to provide care
to individuals with mental retardation and developmental
disabilities pursuant to section 5123.193 or sections 5126.351 to
5126.354 of the
Revised Code. A registered nurse who receives a
certificate
under
division (B)(2)(b) of this section shall not
provide training courses to
MR/DD
personnel in the administration
of insulin unless the registered nurse
completes a course
developed under section 5123.44 of the Revised
Code that enables
the
registered nurse to receive a certificate to provide training
courses to
MR/DD personnel
in the administration of insulin. (C) Certificates issued to MR/DD personnel are valid for one
year and may be renewed. Certificates issued to registered nurses
are valid for two years and may be renewed. To be eligible
for
renewal, MR/DD personnel and registered
nurses shall meet the
applicable continued competency requirements
and continuing
education requirements specified in rules adopted
under division
(D) of this section. In the case of registered
nurses, continuing
nursing education completed in compliance with
the license renewal
requirements established under Chapter 4723.
of the Revised Code
may be counted toward meeting the continuing
education
requirements established in the rules adopted under
division (D)
of this section.
(D) In accordance with section 5123.46 of the Revised
Code,
the department shall adopt rules that
establish all of the
following:
(1) Requirements that MR/DD personnel and registered nurses
must meet to be
eligible to take a training course;
(2) Standards that must be met to receive a certificate,
including requirements pertaining to an applicant's criminal
background;
(3) Procedures to be followed in applying for a certificate
and issuing a certificate;
(4) Standards and procedures for renewing a certificate,
including requirements for continuing education and, in the case
of MR/DD personnel who administer prescribed medications,
standards that require
successful demonstration of proficiency in
administering prescribed medications;
(5) Standards and procedures for suspending or revoking a
certificate;
(6) Standards and procedures for suspending a certificate
without a hearing pending the outcome of an investigation; (7) Any other standards or procedures the department
considers necessary to administer the certification program.
Sec. 5123.451. The department of mental retardation and
developmental disabilities shall establish and maintain a registry
that lists all MR/DD personnel and registered nurses holding valid
certificates issued
under section 5123.45 of the Revised Code.
The
registry
shall
specify the type of
certificate held and any
limitations
that
apply to a certificate holder. The department
shall make the
information in the registry available to the public
in
computerized form or any other manner that provides continuous
access to the information in the registry.
Sec. 5123.46. All rules adopted under sections 5123.41
to
5123.45 of the Revised Code shall be adopted in consultation
with
the board of nursing and the Ohio nurses association. The
rules
shall be adopted in accordance with Chapter 119. of the
Revised
Code.
Sec. 5126.357
5123.47. (A) As used in this section: (1)
"In-home care" means the supportive services provided
within
the home of an individual
with mental retardation or a
developmental disability who receives funding for the
services
as
through a county
board
client
of mental retardation
and
developmental disabilities, including any
client who
receives
recipient of residential services funded
through
as
home
and
community-based services,
family support services
provided under
section 5126.11 of the
Revised Code, or supported living
provided
in accordance with sections
5126.41 to 5126.47 of the Revised
Code.
"In-home care" includes care that is provided outside
a
client's
an individual's home in places incidental to the home,
and while
traveling to places
incidental to the
home, except that
"in-home
care" does not include care provided
in the
facilities of
a county
board of mental retardation and
developmental
disabilities or care
provided in schools. (2)
"Parent" means either parent of a child, including an
adoptive
parent but not a foster parent. (3)
"Unlicensed in-home care worker" means an individual who
provides in-home care but is not a health care professional.
A
county board
worker
may be
an unlicensed in-home
care
worker. (4)
"Family member" means a parent, sibling, spouse, son,
daughter, grandparent, aunt, uncle, cousin, or guardian of the
individual with
mental retardation or a developmental disability
if the individual with mental
retardation or developmental
disabilities lives with the person and is
dependent on the person
to the extent that, if the supports were withdrawn,
another living
arrangement would have to be found.
(5) "Health care professional" means any of the following:
(a) A dentist who holds a valid license issued under Chapter
4715. of the Revised Code;
(b) A registered or licensed practical nurse who holds a
valid license issued under Chapter 4723. of the Revised Code;
(c) An optometrist who holds a valid license issued under
Chapter 4725. of the Revised Code; (d) A pharmacist who holds a valid license issued under
Chapter 4729. of the Revised Code;
(e) A person who holds a valid certificate issued under
Chapter 4731. of the Revised Code to practice medicine and
surgery, osteopathic medicine and surgery, podiatric medicine and
surgery, or a limited brand of medicine; (f) A physician assistant who holds a valid certificate
issued under Chapter 4730. of the Revised Code;
(g) An occupational therapist or occupational therapy
assistant or a physical therapist or physical therapist assistant
who holds a valid license issued under Chapter 4755. of the
Revised Code;
(h) A respiratory care professional who holds a valid
license issued under Chapter 4761. of the Revised Code. (6) "Health care task" means a task that is prescribed,
ordered, delegated, or otherwise directed by a health care
professional acting within the scope of the professional's
practice. (B) Except as provided in division
(D)(E) of this section,
a
family member of an individual with mental
retardation or a
developmental
disability may authorize an unlicensed in-home care
worker to
give or
apply
administer oral and topical prescribed
medication
medications or perform other
health care tasks
as
part
of the
in-home care
provided
the worker provides to the
individual, if
the
all of the
following apply: (1) The family member
is the primary supervisor of the
care
and the. (2) The unlicensed in-home care worker
has been selected by
the family member
or the individual receiving care and is under
the direct supervision of
the
family member.
Sections 4723.62 and
5126.351 to 5126.356
of the
Revised Code do not apply to the
in-home care
authorized by a
family member under this
section.
Instead, a
(3) The unlicensed in-home care worker is providing the
care through an employment or other arrangement
entered into
directly with the family member and is not otherwise employed by
or under contract
with a person or government entity to provide
services
to individuals with mental retardation and developmental
disabilities. (C) A family member
shall
obtain a prescription, if
applicable, and written
instructions
from a health care
professional for the care to be
provided to the
individual. The
family
member shall authorize the
unlicensed
in-home
care worker
to provide the
care by preparing a
written
document granting the
authority.
The family member shall
provide
the
unlicensed in-home
care worker with
appropriate
training and
written instructions in
accordance with
the
instructions obtained
from the health care
professional.
(C)(D) A family member who authorizes an unlicensed in-home
care worker to
give or apply
administer oral and topical
prescribed
medication
medications or perform
other health care
tasks retains
full responsibility for the health
and safety of
the
individual
receiving the care and for ensuring
that the worker
provides the
care appropriately and safely. No
entity that funds
or monitors
the provision of in-home care
may be
held liable for
the results
of the
care provided under this
section by an
unlicensed in-home
care worker,
including
such
entities as the
county board of mental
retardation and
developmental disabilities,
any other entity that
employs an
unlicensed
in-home care worker,
and the department of
mental
retardation and
developmental
disabilities.
An unlicensed in-home care worker who is authorized under
this section by a
family member to provide care to an
individual
may not be held liable for
any
injury caused in providing the
care, unless the worker provides the care
in a manner that is not
in accordance with the training and
instructions received or the
worker acts in a manner that
constitutes wanton or reckless
misconduct. (D)(E) A county board of mental retardation and
developmental
disabilities may evaluate the authority granted by a
family member
under
this section to an unlicensed in-home care
worker at any
time it considers
necessary and shall evaluate the
authority on
receipt of a complaint. If the
board determines that
a family
member has
acted in a manner
that is inappropriate for
the health
and safety of the individual receiving
the
services
care,
the
authorization granted by the family member to
an
unlicensed
in-home care worker is void, and the
family member may
not
authorize other
unlicensed in-home care workers to provide the
care. In making such a
determination, the board shall use
appropriately licensed health
care professionals and shall provide
the family member an
opportunity to file a complaint under section
5126.06 of the Revised Code.
Sec. 5123.50. As used in this section and sections 5123.51
and
5123.52 of the Revised Code: (A) "Abuse" means all of the following: (1) The use of physical force that can reasonably be
expected to result in
physical harm or serious physical harm; (2) Sexual abuse; (3) Verbal abuse. (B) "Misappropriation" means depriving, defrauding, or
otherwise
obtaining the real or personal property of an individual
by any means
prohibited by the Revised Code, including violations
of
Chapter 2911. or 2913. of the Revised Code. (C) "MR/DD employee" means all of the following: (1) An employee of the department of mental retardation and
developmental disabilities; (2) An employee of a county board of mental retardation and
developmental disabilities; (3)
An "ICF/MR worker," as defined in section 5123.193 of the
Revised Code; (4) An
individual who is employed
employee in a position
that
includes providing
specialized services to an
individual with
mental retardation or a developmental disability.
(D) "Neglect" means, when there is a duty to do so, failing
to
provide an individual with any
treatment, care, goods, or
services that are necessary to maintain the
health and safety of
the individual. (E) "Physical harm" and "serious physical harm" have the
same
meanings as in section 2901.01 of the Revised Code. (F) "Sexual abuse" means unlawful sexual conduct or sexual
contact, as those terms are defined in section 2907.01 of the
Revised Code. (G) "Specialized services" means any program or service
designed
and operated to serve primarily individuals with mental
retardation
or a
developmental
disability,
including a program or
service provided by an entity licensed or
certified by the
department of mental retardation and
developmental disabilities.
A
program or service available to
the
general public is not a
specialized service. (H) "Verbal abuse" means purposely using words to threaten,
coerce, intimidate, harass, or humiliate an individual.
Sec. 5123.611. (A) As used in this section,
"MR/DD
employee"
means all of the following: (1) An employee of the department of mental retardation and
developmental disabilities; (2) An employee of a county board of mental retardation and
developmental disabilities; (3)
An "ICF/MR worker," as defined in section 5123.193 of the
Revised Code; (4) An
individual who is employed
employee in a position
that
includes
providing specialized services, as defined in
section
5123.50 of the Revised Code, to an individual with
mental
retardation
or a developmental disability.
(B) At the conclusion of a review of a report of abuse,
neglect,
or a major unusual incident that is conducted by a review
committee established pursuant to section
5123.61 of the Revised
Code, the committee shall issue
recommendations to the department.
The department shall review the committee's recommendations and
issue a report of its findings.
The department shall make the
report available to all of the
following: (1) The
person
individual with mental retardation or a
developmental disability who is the subject of the report; (2) That
person's
individual's guardian or legal counsel; (3) The licensee, as defined in section 5123.19 of the
Revised
Code, of a residential facility in which
the
person
individual
resides; (4) The employer of any MR/DD employee who allegedly
committed or
was responsible for the abuse, neglect, or major
unusual incident. (C) Except as provided in this section, the department shall
not
disclose its report to any person or government entity that is
not authorized to investigate reports
of abuse, neglect, or other
major unusual incidents, unless the
person
individual with mental
retardation or a developmental disability who is the subject of
the report or the
person's
individual's guardian
gives the
department written
consent.
Sec. 5123.65. In addition to the rights specified in section
5123.62 of the Revised Code, individuals with mental retardation
and developmental disabilities who can safely self-administer
medication or receive assistance with self-administration of
medication have the right to self-administer medication or receive
assistance with the self-administration of medication. The
department of mental retardation and developmental disabilities
shall adopt rules as it considers necessary to implement and
enforce this section. The rules shall be adopted in accordance
with Chapter 119. of the Revised Code.
Sec. 5126.355
5123.651.
A county board of mental retardation
and
developmental disabilities may permit a county board worker to
assist a county board client
(A) As used in this section, "MR/DD
personnel" and "prescribed medication" have the same meanings as
in section 5123.41 of the Revised Code. (B) MR/DD personnel who are not
specifically authorized by
other provisions of the Revised Code to
provide assistance in the
self-administration of
prescribed
medication. When
may, under
this section, provide that assistance
as
part of the services they
provide to individuals with mental
retardation and developmental
disabilities. To provide assistance
with self-administration of
prescribed
medication, MR/DD personnel are not
required to be
trained or
certified in accordance with section
5123.42 of the
Revised Code.
(C) When assisting
a
county board client in
the
self-administration of prescribed
medication,
a county board
worker
MR/DD personnel shall take only
those
the following actions
authorized by the
board of
nursing pursuant to
rules
adopted under
section
4723.62 of the
Revised Code:
(1) Remind an individual when to take the medication and
observe the individual to ensure that the individual follows the
directions on the container;
(2) Assist an individual by taking the medication in its
container from the area where it is stored, handing the container
with the medication in it to the individual, and opening the
container, if the individual is physically unable to open the
container;
(3) Assist, on request by or with the consent of, a
physically impaired but mentally alert individual, with removal of
oral or topical medication from the container and with the
individual's taking or applying of the medication. If an
individual is physically unable to place a dose of oral medication
to
the individual's mouth without spilling or dropping it, MR/DD
personnel may place the dose in another container and place that
container to the individual's mouth.
Sec. 5126.30. As used in sections 5126.30 to
5126.33
5126.34
of
the Revised Code: (A) "Adult" means a person eighteen
years of age or older
with mental retardation
or a developmental disability. (B) "Caretaker" means a person who is responsible for the
care of an adult by order of a court, including an order of
guardianship, or who assumes the responsibility for the care of
an
adult as a volunteer, as a family member, by contract, or by
the
acceptance of payment for care. (C) "Abuse" has the same meaning as in section
5123.50 of
the Revised Code, except that it includes
a misappropriation, as
defined in that section. (D) "Neglect" has the same meaning as in section 5123.50 of
the
Revised Code. (E) "Working day" means Monday, Tuesday, Wednesday,
Thursday, or Friday, except when that day is a holiday as defined
in section 1.14 of the Revised Code. (F) "Incapacitated" means lacking understanding or
capacity,
with or without the assistance of a caretaker, to make
and carry
out decisions regarding food, clothing, shelter, health
care, or
other necessities, but does not include mere refusal to
consent to
the provision of services.
Sec. 5126.31. (A) A county board of mental retardation
and
developmental disabilities shall review reports of abuse and
neglect made under section 5123.61 of the Revised Code and
reports
referred to it under section 5101.611 of the Revised Code
to
determine whether the person who is the subject of the report
is
an adult
with mental retardation or a developmental disability in
need
of services to deal with the abuse or neglect. The board
shall
give notice of each report to the registry office of the
department of mental retardation and developmental disabilities
established pursuant to section 5123.61 of the Revised Code on
the
first working day after receipt of the report. If the report
alleges that there is a substantial risk to the adult of
immediate
physical harm or death, the board shall initiate review
within
twenty-four hours of its receipt of the report. If the
board
determines that the person is sixty years of age or older
but does
not have mental retardation or a developmental
disability, it
shall refer the case to the county department of job and
family
services. If the board determines that the person is an adult
with mental retardation or a
developmental disability, it shall
continue its review of
the case. (B) For each review over which the board retains
responsibility under division (A) of this section, it shall do
all
of the following: (1) Give both written and oral notice of the purpose of
the
review to the adult and, if any, to the
adult's legal counsel or
caretaker, in simple and clear language; (2) Visit the adult, in the adult's
residence if possible,
and
explain the notice given under division (B)(1) of this
section; (3) Request from the registry office any prior reports
concerning the adult or other principals in the case; (4) Consult, if feasible, with the person who made the
report under section 5101.61 or 5123.61 of the Revised Code and
with any agencies or persons who have information about the
alleged abuse or neglect; (5) Cooperate fully with the law enforcement agency
responsible for investigating the report and for filing any
resulting criminal charges and, on request, turn over evidence to
the agency; (6) Determine whether the adult needs services, and
prepare
a written report stating reasons for the determination.
No adult
shall be determined to be abused, neglected, or in need
of
services for the sole reason that, in lieu of medical
treatment,
the adult relies on or is being furnished
spiritual treatment
through prayer alone in accordance with the tenets and practices
of a church or religious denomination of which the adult is a
member or
adherent. (C) The board shall arrange for the provision of services
for the prevention, correction or discontinuance of abuse or
neglect or of a condition resulting from abuse or neglect for any
adult who has been determined to need the services and consents
to
receive them. These services may include, but are not limited
to,
service and support administration, fiscal
management, medical,
mental health,
home health care, homemaker,
legal, and residential
services and
the provision of temporary
accommodations and
necessities such as
food and clothing. The
services do not
include acting as a
guardian, trustee, or
protector as defined in
section 5123.55 of
the Revised Code. If
the provision of
residential services would
require expenditures
by the department
of mental retardation and
developmental
disabilities, the board
shall obtain the approval
of the
department prior to arranging the
residential services. To arrange services, the board shall: (1) Develop an individualized service plan
identifying the
types of services required for the adult, the
goals for the
services, and the persons or agencies that will
provide them; (2) In accordance with rules established by the director
of
mental retardation and developmental disabilities, obtain the
consent of the adult or the adult's guardian to the
provision of
any of
these services and obtain the signature of the adult or
guardian
on the individual service plan. An adult who has been
found
incompetent under Chapter 2111. of the Revised Code may
consent
to services. If the board is unable to obtain consent, it
may
seek, if the adult is incapacitated, a court order pursuant to
section 5126.33 of the Revised Code authorizing the board to
arrange these services. (D) The board shall ensure that the adult receives the
services arranged by the board from the provider and shall have
the services terminated if the adult withdraws consent. (E) On completion of a review, the board shall submit a
written report to the registry office established under
section
5123.61 of the Revised Code. If the report includes a finding
that a person with
mental retardation or a developmental
disability is a victim of action or
inaction that may constitute a
crime under federal law or the law of this
state, the board shall
submit the report to the law enforcement agency
responsible for
investigating the report. Reports
prepared under this section are
not public records as defined in
section 149.43 of the Revised
Code. (F) The board shall provide comprehensive formal training
for employees and other persons authorized to implement the
requirements of this section.
Sec. 5126.312
5126.34. The
Each county board of mental
retardation and developmental disabilities shall provide
comprehensive, formal training for county board employees and
other persons authorized to implement sections 5126.30 to 5126.34
of the Revised Code. The department of mental retardation and
developmental
disabilities shall adopt rules establishing minimum
standards for
the training provided by county boards
of mental
retardation and
developmental disabilities pursuant to
division
(F) of
this
section
5126.31 of the
Revised Code. The training
provided by the
county boards shall meet the minimum standards prescribed
by the
rules.
Sec. 5126.36. (A) As used in this section, "health-related
activities," "prescribed medication," and
"tube feeding"
have the
same meanings as in section 5123.41 of the
Revised Code. (B) In accordance with sections 5123.42 and 5123.651 of the
Revised Code,
an
employee of
a county board of
mental retardation
or
developmental
disabilities
or an entity
under contract with the
board who is not
specifically
authorized by other provisions of
the Revised Code to
administer
prescribed medications, perform
health-related
activities, perform tube feedings, or provide
assistance in the self-administration of prescribed medications
may do so
pursuant to the authority granted
under those
sections.
SECTION 2. That existing sections 4731.053, 5123.19,
5123.50,
5123.611,
5126.30, 5126.31, 5126.312, 5126.354,
5126.355,
and
5126.357 of
the Revised Code
are
hereby
repealed.
SECTION 3. Except as otherwise provided in this section,
Sections 1 and 2 of this act take effect at the earliest time
permitted by law. Sections 4731.053, 5123.50, 5123.611, 5126.354
(5123.422),
and 5126.357 (5123.47) of the Revised Code, as amended
by this
act, take effect nine months after the effective date of
this
section.
SECTION 4. Sections 4723.61, 4723.62, 5123.193, 5126.35,
5126.351, 5126.352, 5126.353, and 5126.356 of the Revised Code are
hereby repealed, effective nine months after the effective date of
this section.
SECTION 5. The Director of Mental Retardation and
Developmental Disabilities shall adopt rules in accordance with
Chapter 119. of the Revised Code establishing a schedule for
residential facilities licensed under section 5123.19 of the
Revised Code on the effective date of this section to seek renewal
of the license in accordance with the amendments made by this act
to that section. Notwithstanding
division (C) of section 5123.19
of the
Revised Code, as amended by
this act, a residential
facility
license in effect on the effective date of this section
shall
remain in
effect until the Director renews or refuses to
renew the
license,
unless the
license
is terminated,
revoked, or
voluntarily
surrendered.
SECTION 6. (A) There is hereby created the MR/DD Consumer
Information Advisory Council consisting of the following members: (1) One representative of the Department of Mental
Retardation and Developmental Disabilities, appointed by the
Director of Mental Retardation and Developmental Disabilities; (2) One representative of People First of Ohio, appointed by
the organization's president; (3) One representative of the Ohio Association of County
Boards of Mental Retardation and Developmental Disabilities,
appointed by the association's president; (4) Two representatives of the Ohio Health Care Association,
appointed by the association's chairperson; (5) Two representatives of the Ohio Provider Resource
Association, appointed by the association's president; (6) One representative of the ARC of Ohio, appointed by the
association's president; (7) One representative of the Ohio Legal Rights Service,
appointed by its administrator; (8) One representative of the Ohio Superintendents of County
Boards of Mental
Retardation and Developmental Disabilities,
appointed by, the organization's president; (9) One representative of Advocacy and Protective Services,
Inc., appointed by the organization's executive director; (10) One representative of the Ohio Developmental
Disabilities Council, appointed by the organization's executive
director. (B) Each member of the Council shall serve at the discretion
of the member's appointing authority. Except to the extent that
serving as a member is part of
a member's regular employment
duties, members shall serve
without compensation or
reimbursement
for expenses. (C) The representative of the Department of Mental
Retardation and Developmental Disabilities shall serve as the
Council's chairperson and shall convene the Council's meetings. (D) The Department of Mental Retardation and Developmental
Disabilities shall supply meeting space and staff support for the
Council. (E) The Council shall develop recommendations on methods of
providing consumer information about services available under
Chapters 5123. and 5126. of the Revised Code in a manner that
promotes awareness of the range of available services and is easy
to use and understand. The Council shall issue a report on its
recommendations to the Director of Mental Retardation and
Developmental Disabilities not later than September 1, 2003. On
issuance of the report, the Council shall cease to exist.
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