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(127th General Assembly)
(Substitute House Bill Number 331)
AN ACT
To amend sections 3701.83, 3702.11, 3702.55, and
3709.09; to enact sections 3711.14, 3711.16,
3711.20, 3711.21, and 3711.22; to enact new
sections 3711.01, 3711.02, 3711.04, 3711.05,
3711.06,
3711.08, 3711.10, and 3711.12; and to
repeal
sections 3711.01, 3711.02, 3711.021,
3711.03,
3711.04, 3711.05, 3711.06, 3711.07,
3711.08,
3711.09, 3711.10, 3711.11, 3711.12,
3711.13, and
3711.99 of the Revised Code
regarding the
licensure of hospital maternity
units, hospital newborn care nurseries, and
maternity homes.
Be it enacted by the General Assembly of the State of Ohio:
SECTION 1. That sections 3701.83, 3702.11, 3702.55, and
3709.09 be amended and new sections 3711.01, 3711.02, 3711.04,
3711.05,
3711.06, 3711.08, 3711.10, and 3711.12 and sections
3711.14,
3711.16, 3711.20, 3711.21, and 3711.22 of the Revised
Code be
enacted to read as follows:
Sec. 3701.83. (A) There is hereby created in the state
treasury the
general operations fund. Moneys in the fund shall be
used for the
purposes specified in sections 3701.04, 3701.344,
3702.20, 3710.15,
3711.021 3711.16, 3717.45, 3718.06, 3721.02,
3722.04, 3729.07, 3733.04, 3733.25, 3733.43, 3748.04,
3748.05,
3748.07, 3748.12, 3748.13, 3749.04, 3749.07, 4747.04, 4751.04, and
4769.09 of the Revised Code.
(B) The alcohol testing program fund is hereby
created in the
state treasury. The director of health shall use the fund to
administer and enforce the alcohol testing and permit program
authorized by section 3701.143 of the Revised Code.
The fund shall receive
transfers from the liquor control fund
created under section 4301.12
of the Revised Code. All investment
earnings of the alcohol
testing program fund shall be credited to
the fund.
Sec. 3702.11. The director of health shall adopt rules
establishing safety standards and quality-of-care standards for
each of the
following:
(A) Solid organ and bone marrow
transplantation;
(B) Stem cell harvesting
and reinfusion;
(C) Cardiac
catheterization;
(D) Open-heart surgery;
(E) Obstetric and
newborn care;
(F) Pediatric intensive
care;
(G)(F) Operation of linear accelerators;
(H)(G) Operation of cobalt radiation therapy units;
(I)(H) Operation of gamma knives.
Sec. 3702.55. Except as provided in section 3702.542 of the
Revised Code, a
person that the director of health determines has
violated section 3702.53 of
the Revised Code shall cease
conducting the activity that constitutes the
violation or
utilizing the equipment or facility resulting from the violation
not later than thirty days after the person receives the notice
mailed under
section 3702.532 of the Revised Code
or, if the
person appeals the director's determination under
section 3702.60
of the Revised Code, thirty days
after the person receives an
order upholding the director's
determination that is not subject
to further appeal. A person
that applies for a certificate of
need
as described in section
3702.542 of the Revised Code shall
cease
conducting the activity or using the equipment or facility
in
accordance with the timetable established by the director of
health under that section.
If any person determined to have violated section 3702.53 of
the Revised Code
fails to cease conducting an activity or using
equipment or a facility as
required by this section or a timetable
established
under section 3702.542 of the Revised Code, or if
the
person continues to seek payment or reimbursement for
services
rendered or costs incurred in conducting the activity as
prohibited by section 3702.56 of the Revised Code, in
addition to
the
penalties imposed under section 3702.54, 3702.541, or 3702.542
or former section 3702.543 of
the Revised Code:
(A) The director of health may refuse to
include any beds
involved in the activity in the bed capacity of
a hospital for
purposes of registration under section 3701.07 of
the Revised
Code;
(B) The director of health may refuse to
license, or may
revoke a license or reduce bed capacity
previously granted to, a
maternity boardinghouse or lying-in
hospital under section 3711.02
of the Revised
Code; a hospice care program under section 3712.04
of the
Revised Code; a nursing home, rest home, or home
for the
aging under section 3721.02 of the Revised
Code; or any beds
within any of those facilities that are
involved in the activity;
(C) A political subdivision certified under
section 3721.09
of the Revised Code may refuse to
license, or may revoke a license
or reduce bed capacity
previously granted to, a nursing home, rest
home, or home for the
aging, or any beds within any of those
facilities that are
involved in the activity;
(D) The director of mental health may refuse to
license
under
section 5119.20 of the Revised
Code, or may revoke a license
or
reduce bed capacity
previously granted to, a hospital receiving
mentally ill persons
or beds within such a hospital that are
involved in the activity;
(E) The department of job and family services may refuse
to
enter into a provider agreement that includes a facility,
beds, or
services that result from the activity.
Sec. 3709.09. (A) The board of health of a city or
general
health district may, by rule, establish a uniform system
of fees
to pay the costs of any services provided by the board.
The fee for issuance of a certified copy of a vital record or
a certification of birth shall not be less than the fee prescribed
for the same service under division (A)(1) of section 3705.24 of
the Revised Code and shall include the fees required by division
(B) of section 3705.24 and section 3109.14 of the Revised Code.
Fees for services provided by the board for purposes
specified in
sections 3701.344, 3711.05 3711.10, 3718.06, 3729.07,
3730.03, 3733.04,
3733.25, and
3749.04 of the Revised Code shall
be established in accordance
with rules adopted under division (B)
of this section. The
district advisory council, in the case of a
general health
district, and the legislative authority of the
city, in the case
of a city health district, may disapprove any
fee established by
the board of health under this division, and
any such fee, as
disapproved, shall not be charged by the board of
health.
(B) The public health
council shall adopt rules under section
111.15 of the Revised
Code that establish fee categories and
uniform methodologies for
use in calculating the costs of services
provided for purposes
specified in sections 3701.344, 3711.05
3711.10,
3718.06, 3729.07, 3730.03,
3733.04, 3733.25, and 3749.04
of the
Revised Code. In adopting the rules,
the public health
council
shall consider recommendations it
receives from advisory
boards
established either by statute or
the director of health
for
entities subject to the fees.
(C) At least thirty days prior to establishing a fee for a
service provided by the board for a purpose specified in section
3701.344, 3711.05 3711.10, 3718.06, 3729.07, 3730.03, 3733.04,
3733.25, or
3749.04 of the
Revised Code, a board of health shall
notify any
entity that would be
affected by the proposed fee of
the amount of
the proposed fee.
Sec. 3711.01. As used in this chapter:
(A) "Board of health" means a board of health of a city or
general health district or the authority having the duties of a
board of health under section 3709.05 of the
Revised Code.
(B) "Maternity home" means a facility for pregnant girls and
women where accommodations, medical care, and social services are
provided during the prenatal and postpartal periods. "Maternity
home" does not include a private residence where obstetric or
newborn services are received by a resident of the home.
(C) "Maternity unit" means a distinct portion of a hospital
in which inpatient care is provided to women during all or part of
the maternity cycle.
(D) "Newborn care nursery" means a distinct portion of a
hospital in which inpatient care is provided to infants. "Newborn
care nursery" includes a distinct portion of a hospital in which
intensive care is provided to infants.
Sec. 3711.02. (A) Except as provided in division (B) of this
section, no person shall operate any of the following, unless the
person holds the appropriate license issued under this chapter and
the license is valid:
(1) A maternity unit;
(2) A newborn care nursery;
(3) A maternity home.
(B) Division (A) of this section does not apply to a health
care facility as defined in division (A)(4) of section 3702.30 of
the Revised Code.
Sec. 3711.04. Each person seeking to operate a maternity
unit, newborn care nursery, or
maternity home shall
apply to the
director
of health for a license under this chapter. The
application
shall be submitted in the
form and manner prescribed
by the
public health council in rules
adopted under section
3711.12 of
the Revised Code.
A single application and license is required if an applicant
will operate both a maternity unit and newborn care nursery.
Sec. 3711.05. (A) The director of health shall review all
applications received under section 3711.04 of the Revised Code.
On receipt of a complete application, the director shall send a
copy of the application to the board of health of the city or
general health district in which the maternity unit, newborn care
nursery, or maternity home is to be operated.
Unless the board finds that an applicant is not in compliance
with an applicable health regulation adopted by the board, the
board shall approve the application. The board shall notify the
director of its determination to approve or disapprove the
application. If the board does not notify the director of its
determination by the end of the thirtieth day after the board
receives the copy of the application, the application is deemed to
have been approved by the board.
(B) The director shall issue a license to an applicant if
all of the following requirements are met:
(1) The board of health approves the application or the
application is deemed to have been approved;
(2) The
applicant meets the standards specified in rules
adopted under
section 3711.12 of the Revised Code;
(3) The applicant passes the inspection
required by section
3711.06 of the Revised Code.
(C) On issuance of a license, the director shall notify the
board of health to which the application was sent under division
(A) of this section. In the notice, the director shall specify the
terms that apply to the license.
Sec. 3711.06. The director of health shall inspect each
maternity unit, newborn care nursery, or
maternity home for which
a person has
applied for an initial license
under section
3711.04 of the
Revised Code prior to issuing the
license.
Inspections shall be conducted in
accordance with
inspection
criteria, procedures, and guidelines
adopted by the
public
health council under section 3711.12 of the
Revised Code.
Sec. 3711.08. A license issued under this chapter is valid
for three years, unless earlier revoked or
suspended
under
section 3711.14 of the Revised Code. The license
may be
renewed
in the manner prescribed by the public health
council in
rules
adopted under section 3711.12 of the Revised
Code. The
license
renewal fee specified in the rules shall be
paid not later
than
sixty days after the director of health
mails an invoice
for
the fee to the license holder. A penalty of
ten per cent of
the
amount of the renewal fee shall be assessed
for each month the
fee is overdue.
Sec. 3711.10. The director of health shall monitor
compliance with this chapter and the rules adopted under it. The
director may conduct inspections of a maternity unit, newborn care
nursery, or maternity home as necessary to adequately monitor
compliance with this chapter and the rules adopted under it. The
inspections may be scheduled or random.
The board of health of the city or
general health district
in which a maternity unit, newborn care
nursery, or maternity
home is located may conduct inspections of
the unit, nursery, or
home as necessary to adequately monitor compliance with any
applicable health regulation adopted by the board. The inspections
may be scheduled or
random.
Sec. 3711.12. (A) The public health council shall adopt
rules in accordance with Chapter 119. of the Revised Code as the
council considers necessary to implement the requirements of this
chapter for licensure and operation of maternity units, newborn
care nurseries, and maternity homes. The
rules shall include
provisions for the following:
(1) Licensure application forms and procedures;
(2) Renewal procedures, including procedures that
address
the right of the director of health, at the director's sole
discretion, to
conduct an inspection prior to renewal of a
license;
(3) Initial license fees and license renewal fees;
(4) Fees for inspections conducted by the director under
section 3711.10 of the Revised Code;
(5) Safety standards, quality-of-care standards, and
quality-of-care data reporting requirements;
(6) Reporting and auditing requirements;
(7) Inspection criteria, procedures, and guidelines;
(8) Any other rules necessary to implement this chapter.
(B) When adopting rules under this section, the public health
council shall give consideration to recommendations regarding
obstetric and newborn care issued by the
American college of
obstetricians and gynecologists; American
academy of pediatrics;
American academy of family physicians;
American society of
anesthesiologists; American college of nurse
midwives; United
States
centers for disease control and prevention;
association
of
women's health, obstetric and neonatal nurses;
and
association of perioperative registered nurses, or their successor
organizations. The council
shall also consider the
recommendations of the maternity and
newborn advisory council
established in section 3711.20 of the
Revised Code.
Sec. 3711.14. (A) In accordance with Chapter 119. of the
Revised Code, the director of health may do any of the following:
(1) Impose a civil penalty of not less than one thousand
dollars and not more than two hundred fifty thousand dollars on a
person who violates a provision of this chapter or the rules
adopted under it;
(2) Summarily suspend, in accordance with division (B) of
this section, a license issued under this chapter if the director
believes there is clear and
convincing evidence that the
continued operation of a maternity unit, newborn care nursery, or
maternity
home
presents a danger of immediate and serious harm
to the public;
(3) Revoke a license issued under this chapter if the
director determines that a violation of a provision of this
chapter
or the rules adopted under it has occurred in such a
manner as to pose an
imminent threat of serious physical or
life-threatening danger.
(B) If the director suspends a license under
division (A)(2)
of this section, the director shall issue a
written order of
suspension and cause it to be delivered by
certified mail or in
person in accordance with section 119.07 of
the Revised Code. The
order shall not be subject to suspension by
the court while an
appeal filed under section 119.12 of the
Revised Code is pending.
If the individual subject to the
suspension requests an
adjudication, the date set for the
adjudication shall be within
fifteen days but not earlier than
seven days after the individual
makes the request, unless another
date is agreed to by both the
individual and the director. The
summary suspension shall remain
in effect, unless reversed by the
director, until a final
adjudication order issued by the director
pursuant to this
section and Chapter 119. of the Revised Code
becomes effective.
The director shall issue a final adjudication order not later
than
ninety days after completion of the adjudication. If the
director
does not issue a final order within the ninety-day
period, the
summary suspension shall be void, but any final
adjudication order
issued subsequent to the ninety-day period
shall not be affected.
(C) If the director issues an order revoking or suspending a
license issued
under this chapter and the
license holder
continues to operate a maternity unit, newborn care nursery, or
maternity home, the director may
ask the
attorney general to
apply to the court of common pleas of
the
county in which the
person is located for an order enjoining
the
person from
operating the unit, nursery, or home. The court shall
grant
the
order on a showing that the person is operating the unit, nursery,
or
home.
Sec. 3711.16. All initial license fees, renewal fees,
late
renewal penalties, fees for inspections conducted by the director
of health, and civil penalties collected under this
chapter shall
be deposited in the state treasury to the credit of
the general
operations fund created under section 3701.83 of the
Revised
Code. The moneys shall be used solely for purposes of
administering and enforcing this chapter and the rules adopted
under it.
Sec. 3711.20. (A) As used in this section:
(1) "Board-certified" means that a physician has been
certified in an area of practice by a medical specialty board of
the American medical association or the American osteopathic
association.
(2) "Level I," "level II," or "level III" means the
service-level designation applicable to the portion of a hospital
in which obstetric care or newborn care is
provided, as those
levels are reported by the hospital to the department of health
pursuant to section 3701.07 of the Revised Code.
(B) There is hereby created the maternity and
newborn
advisory
council within the department of health. The
governor,
with the
advice and consent of the senate, shall appoint
the
following
members:
(1) Two board-certified obstetricians;
(2) A board-certified pediatrician;
(3) A nurse manager or administrator responsible for the
organization and supervision of nursing services in a level I
obstetric care service;
(4) A nurse manager or administrator responsible for the
organization and supervision of nursing services in a level I
newborn care service;
(5) A nurse manager or administrator responsible for the
organization and supervision of nursing services in a level II
obstetric care service;
(6) A nurse manager or administrator responsible for the
organization and supervision of nursing services in a level II
newborn care service;
(7) A nurse manager or administrator responsible for the
organization and supervision of nursing services in a level III
obstetric care service;
(8) A nurse manager or administrator responsible for the
organization and supervision of nursing services in a level III
newborn care service;
(9) A licensed dietitian with knowledge of newborn nutrition;
(10) A licensed social worker with knowledge of newborn
psychosocial and family support services;
(11) A lactation consultant certified by the international
board of lactation consultant examiners;
(12) An individual to represent the public;
(13) A board-certified perinatologist;
(14) A board-certified neonatologist;
(15) A certified nurse-midwife, certified nurse practitioner,
clinical nurse specialist, or certified registered nurse
anesthetist;
(16) A board-certified anesthesiologist;
(17) A board-certified family practice physician who delivers
children or provides newborn care.
(C) The governor shall make the initial appointments to the
council not later than sixty days after the effective date of this
section. Of the initial appointments, six shall be for a term of
three years, six for a term of four years, and six for a term of
five years. Thereafter, terms of office shall be five years with
each term ending on the same day of the same month as the term it
succeeds. Each member shall hold office from the date of the
member's appointment until the end of the term for which the
member was appointed. Members may be reappointed. Vacancies shall
be filled in the manner provided for original appointment. Any
member appointed to fill a vacancy prior to the expiration of the
term for which the member's predecessor was appointed shall hold
office for the remainder of that term. A member shall continue in
office subsequent to the expiration of the member's term or until
a period of sixty days has elapsed, whichever occurs first.
(D) The council shall hold four meetings in the first year
after the initial appointments to the council are made under
division (B) of this section. Thereafter, the council shall hold
two meetings each year. Additional meetings may be held at the
call of the chairperson or the director of health.
The chairperson shall be selected annually by members of the
council. Following each meeting, the chairperson may submit a
report to the director summarizing the activities, discussion, and
recommendations of the council. Eight voting members of the
council constitute a quorum.
(E) Members of the council shall be reimbursed for actual and
necessary expenses incurred in the
performance of their official
duties.
(F) The department of health shall provide the council the
administrative support necessary to execute its duties.
Sec. 3711.21. The maternity and newborn advisory council
shall do all of the following:
(A) Advise and consult with the director of health in the
development of rules to be presented to the public health council
for proposed adoption under this chapter;
(B) Advise and consult with the director concerning
the
implementation and enforcement of this chapter;
(C) Advise and consult with the director in the development
of inspection criteria, procedures, and guidelines to be used in
enforcement of this chapter;
(D) Advise and consult with the
director regarding
recommendations to be presented to the public health council
regarding improving maternity and newborn care in
this state;
(E) Prepare and submit to the director an annual report
evaluating the department's enforcement of this chapter.
Sec. 3711.22. The maternity and newborn advisory council may
establish committees to focus on specific components of the
enforcement of this chapter. Chairpersons of the committees shall
be appointed by the chairperson of the council and shall be
members of the council. Other members of the committees shall be
appointed by the chairperson of the council and may include
individuals who are not members of the council.
The membership and responsibilities of each committee
established under this section shall be subject to the approval of
the director of health. Members of the committees shall be
reimbursed for actual and necessary expenses incurred in the
performance of their official duties.
Committee reports shall be presented to the council at each
regular meeting of the council.
SECTION 2. That existing sections 3701.83, 3702.11, 3702.55,
and 3709.09 and sections 3711.01, 3711.02, 3711.021, 3711.03,
3711.04, 3711.05, 3711.06, 3711.07, 3711.08, 3711.09, 3711.10,
3711.11, 3711.12, 3711.13, and 3711.99 of the Revised Code are
hereby repealed.
SECTION 3. Notwithstanding the provisions of Sections 1 and 2
of this act, a person may continue to operate a maternity unit,
newborn care nursery, or maternity home pursuant
to a license
issued under Chapter 3711. of the Revised Code, as
that chapter
existed immediately prior to the effective date of
this act,
until the person's license expires or is revoked.
Until the rules required by sections 3711.04 and 3711.10 of
the Revised Code as enacted by this act are adopted, the
Department of Health may renew licenses and issue new licenses
under the rules adopted under former Chapter 3711. of the Revised
Code.
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