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S. B. No. 214 As IntroducedAs Introduced
128th General Assembly | Regular Session | 2009-2010 |
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Senators Carey, Miller, D.
Cosponsors:
Senators Grendell, Schaffer, Seitz, Miller, R., Turner, Strahorn, Morano, Cafaro
A BILL
To amend sections 173.401, 3702.51, 3702.59, 5111.65,
5111.651, 5111.68, 5111.681, 5111.685, 5111.686,
5111.688, and 5111.894; to amend, for the purpose
of adopting a new section number as indicated in
parentheses, section 5111.688 (5111.689); and to
enact new section 5111.688 of
the Revised Code;
and to amend Section 209.20 of
Am. Sub. H.B. 1 of
the 128th General Assembly to
revise the waiting
list
provisions of the
PASSPORT and Assisted
Living
programs, to
require the Director of
Budget and Management to
make certain cash
transfers and expenditure
authorizations
regarding long-term care budget
services, to
revise the law governing the collection of
long-term care facilities' Medicaid debts, and to
revise the law governing the reasons for denying a
Certificate of Need application.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 173.401, 3702.51, 3702.59, 5111.65,
5111.651, 5111.68, 5111.681, 5111.685, 5111.686, 5111.688, and
5111.894 be amended; section 5111.688 (5111.689) be amended for
the purpose of adopting a new section number as indicated in
parentheses; and new section 5111.688 of
the Revised Code be
enacted to read as follows:
Sec. 173.401. (A) As used in this section:
"Area agency on aging" has the same meaning as in section
173.14 of the Revised Code.
"Long-term care consultation program" means the program
the
department of aging is required to develop under section
173.42
of
the Revised Code.
"Long-term care consultation program administrator" or
"administrator" means the department of aging or, if the
department contracts with an area agency on aging or other entity
to administer the long-term care consultation program for a
particular area, that agency or entity.
"Nursing facility" has the same meaning as in section
5111.20
of the Revised Code.
"PASSPORT waiver" means the federal medicaid waiver
granted
by the United States secretary of health and human
services that
authorizes the PASSPORT program.
(B) The director of job and family services shall submit to
the United States secretary of health and human services an
amendment to the PASSPORT waiver that authorizes additional
enrollments in the PASSPORT program pursuant to this section.
Beginning with the month following the month in which the United
States secretary approves the amendment and each The department of
aging may establish one or more waiting lists for the PASSPORT
program. Only individuals eligible for the PASSPORT program may be
placed on a waiting list.
(C) The department shall establish a home first component of
the PASSPORT program under which eligible individuals may be
enrolled in the PASSPORT program in accordance with this section.
An individual is eligible for the PASSPORT program's home first
component if the individual is on a PASSPORT program waiting list
and at least one of the following applies:
(1) The individual has been admitted to a nursing facility;
(2) A physician has determined and documented in writing that
the individual has a medical condition that, unless enrolled in
home and community-based services such as the PASSPORT program,
will require the individual to be admitted to a nursing facility
within thirty days of the physician's determination;
(3) The individual has been hospitalized and a physician has
determined and documented in writing that, unless the individual
is enrolled in home and community-based services such as the
PASSPORT program, the individual is to be transported directly
from the hospital to a nursing facility and admitted;
(4) Both of the following apply:
(a) The individual is the subject of a report made under
section 5101.61 of the Revised Code regarding abuse, neglect, or
exploitation or such a report referred to a county department of
job and family services under section 5126.31 of the Revised Code
or has made a request to a county department for protective
services as defined in section 5101.60 of the Revised Code;
(b) A county department of job and family services and an
area agency on aging have jointly documented in writing that,
unless the individual is enrolled in home and community-based
services such as the PASSPORT program, the individual should be
admitted to a nursing facility.
(D) Each month thereafter,
each area agency on aging shall
determine whether identify individuals who
reside residing in the
area that the area agency on aging serves and who are on
a
waiting list eligible for the home first component of the PASSPORT
program have been admitted to a
nursing facility.
If When an
area agency on aging determines that identifies such
an
individual has
been admitted to a nursing facility, the agency
shall notify the long-term care
consultation program
administrator
serving the area in which the
individual resides
about the
determination. The administrator
shall determine
whether the
PASSPORT program is appropriate for
the individual
and whether the
individual would rather
participate in the
PASSPORT program than
continue residing or
begin to reside in
the a nursing facility. If the administrator
determines that the
PASSPORT program is appropriate for the
individual and the
individual would rather participate in the
PASSPORT program than
continue residing or begin to reside in the
a nursing facility,
the administrator shall so notify the
department of aging. On
receipt of the notice from the
administrator, the department of
aging shall approve the
individual's enrollment in the PASSPORT
program regardless of the
PASSPORT program's waiting list and
even
though the enrollment
causes enrollment in the program to
exceed
the limit that would
otherwise apply, unless the
enrollment would cause the PASSPORT program to exceed any limit on
the number of individuals who may be enrolled in the program as
set by the United States secretary of health and human services in
the PASSPORT waiver.
(E) Each quarter, the department
of aging shall
certify to
the director of budget and management
the estimated
increase in
costs of the PASSPORT program resulting
from
enrollment of
individuals in the PASSPORT program pursuant to
this section.
Sec. 3702.51. As used in sections 3702.51 to 3702.62 of
the
Revised Code:
(A)
"Applicant" means any person that submits an
application
for a certificate of need and who is designated in
the application
as the applicant.
(B)
"Person" means any individual, corporation, business
trust, estate, firm, partnership, association, joint stock
company, insurance company, government unit, or other entity.
(C)
"Certificate of need" means a written approval granted
by
the director of health to an applicant to authorize conducting
a
reviewable activity.
(D)
"Health service area" means a geographic region
designated by the director of health under section 3702.58 of the
Revised Code.
(E)
"Health service" means a clinically related service,
such
as a diagnostic, treatment, rehabilitative, or preventive
service.
(F)
"Health service agency" means an agency designated to
serve a health service area in accordance with section 3702.58 of
the Revised Code.
(G)
"Health care facility" means:
(1) A hospital registered under section 3701.07 of the
Revised Code;
(2) A nursing home licensed under section 3721.02 of the
Revised Code, or by a political subdivision certified under
section 3721.09 of the Revised Code;
(3) A county home or a county nursing home as defined in
section 5155.31 of the Revised Code that is certified under Title
XVIII or XIX of the
"Social Security Act," 49 Stat. 620 (1935),
42
U.S.C.A. 301, as amended;
(4) A freestanding dialysis center;
(5) A freestanding inpatient rehabilitation facility;
(6) An ambulatory surgical facility;
(7) A freestanding cardiac catheterization facility;
(8) A freestanding birthing center;
(9) A freestanding or mobile diagnostic imaging center;
(10) A freestanding radiation therapy center.
A health care facility does not include the offices of
private physicians and dentists whether for individual or group
practice, residential facilities licensed under section
5123.19 of
the Revised Code, or an institution for
the sick that is operated
exclusively for patients who use
spiritual means for
healing and
for whom the acceptance of medical
care is inconsistent with their
religious beliefs, accredited by a
national accrediting
organization, exempt
from federal income
taxation under section
501 of the Internal
Revenue Code of 1986,
100 Stat. 2085, 26
U.S.C.A. 1, as
amended, and providing
twenty-four hour nursing
care pursuant to the exemption
in
division (E) of section 4723.32
of the Revised Code from
the
licensing requirements of Chapter
4723. of the Revised Code.
(H)
"Medical equipment" means a single unit of medical
equipment or a single system of components with related functions
that is used to provide health services.
(I)
"Third-party payer" means a health insuring corporation
licensed under Chapter
1751.
of the Revised Code, a health
maintenance organization as defined in
division (K) of this
section, an
insurance company that issues sickness and accident
insurance in
conformity with Chapter 3923. of the Revised Code, a
state-financed health insurance program under Chapter 3701.,
4123., or 5111. of the Revised Code, or any self-insurance plan.
(J)
"Government unit" means the state and any county,
municipal corporation, township, or other political subdivision
of
the state, or any department, division, board, or other agency
of
the state or a political subdivision.
(K)
"Health maintenance organization" means a public or
private organization organized under the law of any state that is
qualified under section 1310(d) of Title XIII of the
"Public
Health Service Act," 87 Stat. 931 (1973), 42 U.S.C.
300e-9.
(L)
"Existing health care facility" means either of the
following:
(1) A health care
facility that is licensed or otherwise
authorized to operate in
this state in accordance with applicable
law, including a county home or a county nursing home that is
certified as of February 1, 2008, under Title XVIII or Title XIX
of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.
301,
as amended, is staffed and
equipped to provide health care
services, and is actively providing
health services;
(2) A health care facility that is licensed or otherwise
authorized to operate in this state in accordance with applicable
law, including a county home or a county nursing home that is
certified as of February 1, 2008, under Title XVIII or Title XIX
of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.
301,
as amended, or that has beds registered under section 3701.07
of
the Revised Code as skilled nursing beds or long-term care beds
and has provided services for at least three hundred sixty-five
consecutive days within the twenty-four months immediately
preceding the date a certificate of need application is filed with
the director of health.
(M)
"State" means the state of Ohio, including, but not
limited to, the general assembly, the supreme court, the offices
of all elected state officers, and all departments, boards,
offices, commissions, agencies, institutions, and other
instrumentalities of the state of Ohio.
"State" does not include
political subdivisions.
(N)
"Political subdivision" means a municipal corporation,
township, county, school district, and all other bodies corporate
and politic responsible for governmental activities only in
geographic areas smaller than that of the state to which the
sovereign immunity of the state attaches.
(O)
"Affected person" means:
(1) An applicant for a certificate of need, including an
applicant whose application was reviewed comparatively with the
application in question;
(2) The person that requested the reviewability ruling in
question;
(3) Any person that resides or regularly uses health care
facilities within the geographic area served or to be served by
the health care services that would be provided under the
certificate of need or reviewability ruling in question;
(4) Any health care facility that is located in the health
service area where the health care services would be provided
under the certificate of need or reviewability ruling in question;
(5) Third-party payers that reimburse health care
facilities
for services in the health service area where the
health care
services would be provided under the certificate of need or
reviewability ruling in question;
(6) Any other person who testified at a public hearing
held
under division (B) of section 3702.52 of the Revised Code or
submitted written comments in the course of review of the
certificate of need application in question.
(P)
"Osteopathic hospital" means a hospital registered
under
section 3701.07 of the Revised Code that advocates
osteopathic
principles and the practice and perpetuation of
osteopathic
medicine by doing any of the following:
(1) Maintaining a department or service of osteopathic
medicine or a committee on the utilization of osteopathic
principles and methods, under the supervision of an osteopathic
physician;
(2) Maintaining an active medical staff, the majority of
which is comprised of osteopathic physicians;
(3) Maintaining a medical staff executive committee that
has
osteopathic physicians as a majority of its members.
(Q)
"Ambulatory surgical facility" has the same meaning as
in
section 3702.30 of the Revised Code.
(R) Except as provided in division
(S) of this section,
"reviewable activity" means any of the following
activities:
(1) The establishment, development, or construction of a
new
long-term care facility;
(2) The replacement of an existing long-term care
facility;
(3) The renovation of a long-term care facility that
involves
a capital expenditure of two million dollars or more,
not
including expenditures for equipment, staffing, or
operational
costs;
(4) Either of the following changes in long-term care bed
capacity:
(a) An increase in bed capacity;
(b) A relocation of beds from one
physical facility or site
to another, excluding the relocation
of beds within a long-term
care facility or among buildings of a
long-term care facility at
the same site.
(5) Any change in the health services, bed capacity, or
site,
or any other failure to conduct the reviewable activity in
substantial accordance with the approved application for which a
certificate of need concerning long-term care beds was granted,
if
the change is made within five years after the implementation
of
the reviewable activity for which the certificate was
granted;
(6) The expenditure of more than one hundred ten per cent
of
the maximum expenditure specified in a certificate of need
concerning long-term care beds.
(S)
"Reviewable activity" does not include any of the
following activities:
(1) Acquisition of computer hardware or software;
(2) Acquisition of a telephone system;
(3) Construction or acquisition of parking facilities;
(4) Correction of cited deficiencies that are in violation
of
federal, state, or local fire, building, or safety laws and
rules
and that constitute an imminent threat to public health or
safety;
(5) Acquisition of an existing health care facility that
does
not involve a change in the number of the beds, by service,
or in
the number or type of health services;
(6) Correction of cited deficiencies identified by
accreditation surveys of the joint commission on accreditation of
healthcare organizations or of the American osteopathic
association;
(7) Acquisition of medical equipment to replace the same
or
similar equipment for which a certificate of need has been
issued
if the replaced equipment is removed from service;
(8) Mergers, consolidations, or other corporate
reorganizations of health care facilities that do not involve a
change in the number of beds, by service, or in the number or
type
of health services;
(9) Construction, repair, or renovation of bathroom
facilities;
(10) Construction of laundry facilities, waste disposal
facilities, dietary department projects, heating and air
conditioning projects, administrative offices, and portions of
medical office buildings used exclusively for physician services;
(11) Acquisition of medical equipment to conduct research
required by the United States food and drug administration or
clinical trials sponsored by the national institute of health.
Use
of medical equipment that was acquired without a certificate
of
need under division (S)(11) of this section and for
which
premarket approval has been granted by the United States food and
drug administration to provide services for which patients or
reimbursement entities will be charged shall be a reviewable
activity.
(12) Removal of asbestos from a health care facility.
Only that portion of a project that meets the requirements
of
this
division is not a reviewable
activity.
(T)
"Small rural hospital" means a hospital that is
located
within a rural area, has fewer than
one hundred beds, and
to
which
fewer than four thousand persons
were admitted during the
most
recent calendar year.
(U)
"Children's hospital" means any of the following:
(1) A hospital registered under section 3701.07 of the
Revised Code that provides general pediatric medical and surgical
care, and in which at least seventy-five per cent of annual
inpatient discharges for the preceding two calendar years were
individuals less than eighteen years of age;
(2) A distinct portion of a hospital registered under
section
3701.07 of the Revised Code that provides general
pediatric
medical and surgical care, has a total of at least one
hundred
fifty registered pediatric special care and pediatric
acute care
beds, and in which at least seventy-five per cent of
annual
inpatient discharges for the preceding two calendar years
were
individuals less than eighteen years of age;
(3) A distinct portion of a hospital, if the hospital is
registered under section 3701.07 of the Revised Code as a
children's hospital and the children's hospital meets all the
requirements of division (U)(1) of this section.
(V)
"Long-term care facility" means any of the following:
(1) A nursing home licensed under section 3721.02 of the
Revised Code or by a political subdivision certified under section
3721.09 of
the Revised Code;
(2) The portion of any facility, including a county home or
county
nursing home, that is certified as a skilled nursing
facility or a nursing
facility under Title XVIII or XIX of the
"Social Security Act";
(3) The portion of any hospital that contains beds
registered
under
section 3701.07 of the Revised Code as skilled
nursing beds
or long-term care
beds.
(W)
"Long-term care bed" means a bed in a long-term care
facility.
(X)
"Freestanding birthing center" means any facility in
which
deliveries routinely occur, regardless of whether
the
facility is located on the campus of another health care facility,
and
which is not licensed under Chapter 3711. of
the Revised
Code
as a level one, two, or three maternity
unit or a limited
maternity unit.
(Y)(1)
"Reviewability ruling" means a ruling issued by
the
director of health under division (A) of section 3702.52 of
the
Revised Code
as to whether a particular proposed project is or
is
not a
reviewable activity.
(2)
"Nonreviewability ruling" means a ruling issued under
that division that a particular proposed project is not a
reviewable
activity.
(Z)(1)
"Metropolitan
statistical area" means an area of
this
state designated a
metropolitan statistical area or primary
metropolitan
statistical area in United
States office of
management and
budget bulletin no. 93-17,
June 30, 1993, and
its
attachments.
(2)
"Rural area" means any area of this state not located
within a metropolitan statistical area.
(AA) "County nursing home" has the same meaning as in
section
5155.31 of the Revised Code.
(BB) "Principal participant" means both of the following:
(1) A person who has an ownership or controlling interest of
at least five per cent in an applicant, in a health care facility
that is the subject of an application for a certificate of need,
or in the owner or operator of the applicant or such a facility;
(2) An officer, director, trustee, or general partner of an
applicant, of a health care facility that is the subject of an
application for a certificate of need, or of the owner or operator
of the applicant or such a facility.
(CC) "Actual harm but not immediate jeopardy deficiency"
means a deficiency that, under 42 C.F.R. 488.404, either
constitutes a pattern of deficiencies resulting in actual harm
that is not immediate jeopardy or represents widespread
deficiencies resulting in actual harm that is not immediate
jeopardy.
(DD) "Immediate jeopardy deficiency" means a deficiency that,
under 42 C.F.R. 488.404, either constitutes a pattern of
deficiencies resulting in immediate jeopardy to resident health or
safety or represents widespread deficiencies resulting in
immediate jeopardy to resident health or safety.
Sec. 3702.59. (A)
The director of health shall accept for
review
certificate
of need applications as provided in sections
3702.592,
3702.593,
and 3702.594 of the Revised Code.
(B)(1) The director shall not approve an application for a
certificate of need for the addition of long-term care beds to an
existing health care facility or for the
development of a new
health care facility if any of the following apply:
(1)(a) The existing health care facility in which the beds
are
being placed has one or more waivers for life
safety code
deficiencies,
one or more state fire code
violations,
or one or
more state
building
code
violations, and the
project
identified in the
application
does not propose
to correct all
life safety code
deficiencies for which a
waiver
has been
granted, all state fire
code violations, and all
state
building
code violations at the
existing health care
facility
in
which
the beds are being
placed;
(2)(b) During the sixty-month period preceding the filing of
the application, a notice of proposed license revocation was
issued under section 3721.03 of the Revised
Code for the existing
health care facility
in which the beds
are being placed or a
nursing home owned or
operated by the applicant
or the
corporation or other
business
that operates or seeks to operate
the health
care facility
in which the beds are being placed a
principal participant.
(3)(c) During
the period that precedes the filing of the
application and is
encompassed by the three most recent standard
surveys of the
existing health care facility in which the beds
are being
placed, the any of the following occurred:
(i) The facility was cited on three or more
separate
occasions for final, nonappealable actual harm but not immediate
jeopardy deficiencies that,
under 42
C.F.R. 488.404, either
constitute a pattern of
deficiencies
resulting in actual harm
that is not immediate
jeopardy or are
widespread deficiencies
resulting in actual harm
that is not
immediate jeopardy.
(4) During the period that precedes the filing of the
application and is encompassed by the three most recent standard
surveys of the existing health care facility in which the beds are
being placed, the (ii) The facility was cited on two or more
separate
occasions for final, nonappealable immediate jeopardy
deficiencies that, under 42
C.F.R. 488.404, either constitute a
pattern of deficiencies
resulting in immediate jeopardy to
resident health or safety or
are widespread deficiencies
resulting in immediate jeopardy to
resident health or safety.
(5) During the period that precedes the filing of the
application and is encompassed by the three most recent standard
surveys of the existing health care facility in which the beds are
being placed, more (iii) The facility was cited on two separate
occasions for final, nonappealable actual harm but not immediate
jeopardy deficiencies and on one occasion for a final,
nonappealable immediate jeopardy deficiency.
(d) More than two nursing homes owned or operated in this
state
by the applicant or the person who operates the facility in
which
the beds are being placed a principal participant or, if
the applicant or person a principal participant owns or
operates
more than twenty nursing homes in this state, more than
ten per
cent of those nursing homes, were each cited on during the period
that precedes the filing of the application for the certificate of
need and is encompassed by the three most recent standard surveys
of the nursing homes that were so cited in any of the following
manners:
(i) On three or
more
separate occasions for final,
nonappealable actual harm but not immediate jeopardy deficiencies
that,
under 42 C.F.R. 488.404, either constitute a pattern of
deficiencies resulting in actual harm that is not immediate
jeopardy or are widespread deficiencies resulting in actual harm
that is not immediate jeopardy.
(6) During the period that precedes the filing of the
application and is encompassed by the three most recent standard
surveys of the existing health care facility in which the beds are
being placed, more than two nursing homes operated in this
state
by the applicant or the person who operates the facility in
which
the beds are being placed or, if the applicant or person
operates
more than twenty nursing homes in this state, more than
ten per
cent of those nursing homes, were each cited on;
(ii) On two or
more
separate occasions for final,
nonappealable immediate jeopardy deficiencies
that,
under 42
C.F.R. 488.404, either constitute a pattern of
deficiencies
resulting in immediate jeopardy to resident health or
safety or
are widespread deficiencies resulting in immediate
jeopardy to
resident health or safety;
(iii) On two separate occasions for final, nonappealable
actual harm but not immediate jeopardy deficiencies and on one
occasion for a final, nonappealable immediate jeopardy deficiency.
(7) During the sixty-month period preceding the filing of
the application, the applicant has violated this chapter on two or
more separate occasions.
(2) In applying divisions (B)(1)(a) to (6)(d) of this
section,
the
director shall not consider deficiencies or
violations cited before the
current
operator applicant or a
principal participant acquired or began to own or operate the
health care facility at
which the
deficiencies or violations
were cited. The director may disregard
deficiencies
and
violations cited after the health care facility was acquired or
began to be operated by
the current
operator applicant or a
principal participant if the deficiencies or violations were
attributable to
circumstances
that arose under the previous
owner or operator and the
current operator
applicant or
principal participant has implemented measures to alleviate the
circumstances. In the
case of an application proposing
development
of a new health care
facility by relocation of beds,
the director
shall not consider
deficiencies or violations that
were solely attributable to
the physical plant
of the existing
health care facility from which
the beds are
being relocated.
(C) The director also shall accept for review any
application
for the conversion of infirmary
beds to long-term
care beds if
the
infirmary
meets all of the following conditions:
(1) Is
operated exclusively by a
religious order;
(2) Provides care exclusively to
members of religious
orders
who take vows of celibacy and live by virtue of
their vows
within
the orders as if related;
(3) Was providing care
exclusively
to members of such a
religious order on January 1,
1994.
At no time shall individuals
other than those described in
division (C)(2) of this section be
admitted to a facility to use
beds for which a certificate of need
is approved under this
division.
Sec. 5111.65. As used in sections 5111.65 to 5111.688
5111.689 of the Revised Code:
(A) "Affiliated operator" means an operator affiliated with
either of the following:
(1) The exiting operator for whom the affiliated operator is
to assume liability for the entire amount of the exiting
operator's debt under the medicaid program or the portion of the
debt that represents the franchise permit fee the exiting operator
owes;
(2) The entering operator involved in the change of operator
with the exiting operator specified in division (A)(1) of this
section.
(B) "Change of operator" means an entering operator becoming
the operator of a nursing facility or intermediate care facility
for the mentally retarded in the place of the exiting operator.
(1) Actions that constitute a change of operator include the
following:
(a) A change in an exiting operator's form of legal
organization, including the formation of a partnership or
corporation from a sole proprietorship;
(b) A transfer of all the exiting operator's ownership
interest in the operation of the facility to the entering
operator, regardless of whether ownership of any or all of the
real property or personal property associated with the facility is
also transferred;
(c) A lease of the facility to the entering operator or the
exiting operator's termination of the exiting operator's lease;
(d) If the exiting operator is a partnership, dissolution of
the partnership;
(e) If the exiting operator is a partnership, a change in
composition of the partnership unless both of the following apply:
(i) The change in composition does not cause the
partnership's dissolution under state law.
(ii) The partners agree that the change in composition does
not constitute a change in operator.
(f) If the operator is a corporation, dissolution of the
corporation, a merger of the corporation into another corporation
that is the survivor of the merger, or a consolidation of one or
more other corporations to form a new corporation.
(2) The following, alone, do not constitute a change of
operator:
(a) A contract for an entity to manage a nursing facility or
intermediate care facility for the mentally retarded as the
operator's agent, subject to the operator's approval of daily
operating and management decisions;
(b) A change of ownership, lease, or termination of a lease
of real property or personal property associated with a nursing
facility or intermediate care facility for the mentally retarded
if an entering operator does not become the operator in place of
an exiting operator;
(c) If the operator is a corporation, a change of one or more
members of the corporation's governing body or transfer of
ownership of one or more shares of the corporation's stock, if the
same corporation continues to be the operator.
(B)(C) "Effective date of a change of operator" means the day
the entering operator becomes the operator of the nursing facility
or intermediate care facility for the mentally retarded.
(C)(D) "Effective date of a facility closure" means the last
day
that the last of the residents of the nursing facility or
intermediate care facility for the mentally retarded resides in
the facility.
(D)(E) "Effective date of a voluntary termination" means the
day
the intermediate care facility for the mentally retarded
ceases to
accept medicaid patients.
(E)(F) "Effective date of a voluntary withdrawal of
participation" means the day the nursing facility ceases to accept
new medicaid patients other than the individuals who reside in the
nursing facility on the day before the effective date of the
voluntary withdrawal of participation.
(F)(G) "Entering operator" means the person or government
entity
that will become the operator of a nursing facility or
intermediate care facility for the mentally retarded when a change
of operator occurs.
(G)(H) "Exiting operator" means any of the following:
(1) An operator that will cease to be the operator of a
nursing facility or intermediate care facility for the mentally
retarded on the effective date of a change of operator;
(2) An operator that will cease to be the operator of a
nursing facility or intermediate care facility for the mentally
retarded on the effective date of a facility closure;
(3) An operator of an intermediate care facility for the
mentally retarded that is undergoing or has undergone a voluntary
termination;
(4) An operator of a nursing facility that is undergoing or
has undergone a voluntary withdrawal of participation.
(H)(I)(1) "Facility closure" means discontinuance of the use
of
the building, or part of the building, that houses the
facility as
a nursing facility or intermediate care facility for
the mentally
retarded that results in the relocation of all of
the facility's
residents. A facility closure occurs regardless of
any of the
following:
(a) The operator completely or partially replacing the
facility by constructing a new facility or transferring the
facility's license to another facility;
(b) The facility's residents relocating to another of the
operator's facilities;
(c) Any action the department of health takes regarding the
facility's certification under Title XIX of the "Social Security
Act," 79 Stat. 286 (1965), 42 U.S.C. 1396, as amended, that may
result in the transfer of part of the facility's survey findings
to another of the operator's facilities;
(d) Any action the department of health takes regarding the
facility's license under Chapter 3721. of the Revised Code;
(e) Any action the department of mental retardation and
developmental disabilities takes regarding the facility's license
under section 5123.19 of the Revised Code.
(2) A facility closure does not occur if all of the
facility's residents are relocated due to an emergency evacuation
and one or more of the residents return to a medicaid-certified
bed in the facility not later than thirty days after the
evacuation occurs.
(I)(J) "Fiscal year," "franchise permit fee," "intermediate
care
facility for the
mentally retarded," "nursing facility,"
"operator," "owner," and
"provider agreement" have the same
meanings as in section 5111.20
of the Revised Code.
(J)(K) "Voluntary termination" means an operator's voluntary
election to terminate the participation of an intermediate care
facility for the mentally retarded in the medicaid program but to
continue to provide service of the type provided by a residential
facility as defined in section 5123.19 of the Revised Code.
(K)(L) "Voluntary withdrawal of participation" means an
operator's voluntary election to terminate the participation of a
nursing facility in the medicaid program but to continue to
provide service of the type provided by a nursing facility.
Sec. 5111.651. Sections 5111.65 to 5111.688 5111.689 of the
Revised
Code do not apply to a nursing facility or intermediate
care
facility for the mentally retarded that undergoes a facility
closure, voluntary termination, voluntary withdrawal of
participation, or change of operator on or before September 30,
2005, if the exiting operator provided written notice of the
facility closure, voluntary termination, voluntary withdrawal of
participation, or change of operator to the department of job and
family services on or before June 30, 2005.
Sec. 5111.68. (A) On receipt of a written notice under
section 5111.66 of the Revised Code of a facility closure,
voluntary termination, or voluntary withdrawal of participation or
a written notice under section 5111.67 of the Revised Code of a
change of operator, the department of job and family services
shall determine estimate the amount of any overpayments made under
the
medicaid program to the exiting operator, including
overpayments
the exiting operator disputes, and other actual and
potential
debts the exiting operator owes or may owe to the
department and
United States centers for medicare and medicaid
services under the
medicaid program, including a franchise permit
fee. In determining
(B) In estimating the exiting operator's other
actual and
potential debts to the department and the United States centers
for medicare and medicaid services under the medicaid
program,
the
department shall include use a debt estimation methodology
the director of job and family services shall establish in rules
adopted under section 5111.689 of the Revised Code. The
methodology shall provide for estimating all of the following that
the
department
determines is are applicable:
(1) Refunds due the department under section 5111.27 of the
Revised Code;
(2) Interest owed to the department and United States centers
for medicare and medicaid services;
(3) Final civil monetary and other penalties for which all
right of appeal has been exhausted;
(4) Money owed the department and United States centers for
medicare and medicaid services from any outstanding final fiscal
audit, including a final fiscal audit for the last fiscal year or
portion thereof in which the exiting operator participated in the
medicaid program;
(5) Other amounts the department determines are applicable.
(B) If the department is unable to determine the amount of
the overpayments and other debts for any period before the
effective date of the entering operator's provider agreement or
the effective date of the facility closure, voluntary termination,
or voluntary withdrawal of participation, the department shall
make a reasonable estimate of the overpayments and other debts for
the period. The department shall make the estimate using
information available to the department, including prior
determinations of overpayments and other debts.
(C) The department shall provide the exiting operator written
notice of the department's estimate under division (A) of
this
section not later than thirty days after the department
receives
the
notice under section 5111.66 of the Revised Code of
the
facility
closure, voluntary termination, or voluntary
withdrawal
of
participation or the notice under section 5111.67
of the
Revised
Code of the change of operator. The department's
written
notice
shall include the basis for the
estimate.
Sec. 5111.681. (A) Except as provided in division divisions
(B) and (C) of this section, the department of job and family
services shall may withhold the greater of the following from
payment
due an exiting operator under the medicaid program:
(1) The the total amount of any
overpayments made under the
medicaid program to the exiting
operator, including overpayments
the exiting operator disputes,
and other actual and potential
debts, including any unpaid
penalties, specified in the notice
provided under division (C) of section 5111.68 of the Revised Code
that the exiting operator owes or may owe to the department
and
United States centers for medicare and medicaid services under
the medicaid program;
(2) An amount equal to the average amount of monthly payments
to the exiting operator under the medicaid program for the
twelve-month period immediately preceding the month that includes
the last day the exiting operator's provider agreement is in
effect or, in the case of a voluntary withdrawal of participation,
the effective date of the voluntary withdrawal of participation.
(B) The In the case of a change of operator and subject to
division (D) of this section, the following
shall apply regarding
a withholding under division (A) of this
section if the exiting
operator or entering operator or an affiliated
operator executes
a successor liability agreement meeting the
requirements of
division (E) of this section:
(1) If the exiting operator, entering operator, or affiliated
operator assumes
liability for the
total, actual amount of debt
the exiting operator owes the department and the United States
centers for medicare and medicaid services under the medicaid
program as determined under section 5111.685 of the Revised Code,
the
department may choose shall
not to make the
withholding
under
division (A) of this section if
an entering
operator does
both
of the following:
(1) Enters into a nontransferable, unconditional, written
agreement with the department to pay the department any debt the
exiting operator owes the department under the medicaid program;
(2) Provides the department a copy of the entering operator's
balance sheet that assists the department in determining whether
to make the withholding under division (A) of this section.
(2) If the exiting operator, entering operator, or affiliated
operator
assumes
liability for only the portion of the amount
specified in
division (B)(1) of this section that represents the
franchise
permit fee the exiting
operator owes, the department
shall
withhold not more than the difference between the total
amount
specified in the notice provided under division (C) of
section
5111.68 of the Revised Code and
the
amount for which the
entering
operator or affiliated operator assumes liability.
(C) In the case of a voluntary termination, voluntary
withdrawal of participation, or facility closure and subject to
division (D) of this section, the following
shall apply regarding
a withholding under division (A) of this
section if the exiting
operator or an affiliated operator
executes a successor
liability agreement meeting the requirements of division (E) of
this section:
(1) If the exiting operator or affiliated operator
assumes
liability for the total, actual amount of debt the
exiting
operator owes the department and the United States centers
for
medicare and medicaid services under the medicaid program as
determined under section 5111.685 of the Revised Code,
the
department shall not make the withholding.
(2) If the exiting operator or affiliated operator
assumes
liability for only the portion of the amount specified in
division (C)(1) of this section that represents the franchise
permit fee the exiting
operator owes, the department shall
withhold not more than the difference between the total amount
specified in the notice provided under division (C) of section
5111.68 of the Revised Code and
the
amount for which the exiting
operator or affiliated
operator assumes liability.
(D) For an exiting operator or affiliated operator to be
eligible to enter into a
successor liability agreement under
division (B) or (C) of this section,
both of the following must
apply:
(1) The exiting operator or affiliated operator must have one
or more valid provider
agreements, other than the provider
agreement for the nursing
facility or intermediate care facility
for the mentally retarded
that is the subject of the voluntary
termination, voluntary
withdrawal of participation, facility
closure, or change of operator;
(2) During the twelve-month period preceding the month in
which the department receives the notice of the voluntary
termination, voluntary withdrawal of participation, or facility
closure under section 5111.66 of the Revised Code or the notice of
the change of operator under section 5111.67 of the Revised Code,
the average
monthly medicaid payment made to the exiting operator
or affiliated operator pursuant to
the exiting operator's or
affiliated operator's one or more provider agreements, other than
the provider agreement for the nursing facility or intermediate
care facility for the mentally retarded that is the subject of the
voluntary termination, voluntary withdrawal of participation,
facility closure, or change of operator, must equal at least
ninety per cent of the
sum of the following:
(a) The average monthly medicaid payment made to the exiting
operator pursuant to the exiting operator's provider agreement for
the nursing facility or intermediate care facility for the
mentally retarded that is the subject of the voluntary
termination, voluntary withdrawal of participation, facility
closure, or change of operator;
(b) Whichever of the following apply:
(i) If the exiting operator or affiliated operator has
assumed liability under one or more other successor liability
agreements, the total amount for which the exiting operator or
affiliated operator has assumed liability under the other
successor liability agreements;
(ii) If the exiting operator or affiliated operator has not
assumed liability under any other successor liability agreements,
zero.
(E) A successor liability agreement executed under this
section must comply with all of the following:
(1) It must provide for the operator who executes the
successor liability agreement to assume liability for either of
the following as specified in the agreement:
(a) The total, actual amount of debt the exiting operator
owes the department and the United States centers for medicare and
medicaid services under the medicaid program as determined under
section 5111.685 of the Revised Code;
(b) The portion of the amount specified in division (E)(1)(a)
of this section that represents the franchise permit fee the
exiting operator owes.
(2) It may not require the operator who executes the
successor liability agreement to furnish a surety bond.
(3) It must provide that the department, after determining
under section 5111.685 of the Revised Code the actual amount of
debt the exiting operator owes the department and United States
centers for medicare and medicaid services under the medicaid
program, may deduct the lesser of the following from medicaid
payments made to the operator who executes the successor liability
agreement:
(a) The total, actual amount of debt the exiting operator
owes the department and the United States centers for medicare and
medicaid services under the medicaid program as determined under
section 5111.685 of the Revised Code;
(b) The amount for which the operator who executes the
successor liability agreement assumes liability under the
agreement.
(4) It must provide that the deductions authorized by
division (E)(3) of this section are to be made for a number of
months, not to exceed six, agreed to by the operator who executes
the successor liability agreement and the department or, if the
operator who executes the successor liability agreement and
department cannot agree on a number of months that is less than
six, a greater number of months determined by the attorney general
pursuant to a claims collection process authorized by statute of
this state.
(5) It must provide that, if the attorney general determines
the number of months for which the deductions authorized by
division (E)(3) of this section are to be made, the operator who
executes the successor liability agreement shall pay, in addition
to the amount collected pursuant to the attorney general's claims
collection process, the part of the amount so collected that, if
not for division (G) of this section, would be required by section
109.081 of the Revised Code to be paid into the attorney general
claims fund.
(F) Execution of a successor liability agreement does not
waive an exiting operator's right to contest the amount specified
in the notice the department provides the exiting operator under
division (C) of section 5111.68 of the Revised Code.
(G) Notwithstanding section 109.081 of the Revised Code, the
entire amount that the attorney general, whether by employees or
agents of the attorney general or by special counsel appointed
pursuant to section 109.08 of the Revised Code, collects under a
successor liability agreement, other than the additional amount
the operator who executes the agreement is required by division
(E)(5) of this section to pay, shall be paid to the department of
job and family services for deposit into the appropriate fund. The
additional amount that the operator is required to pay shall be
paid into the state treasury to the credit of the attorney general
claims fund created under section 109.081 of the Revised Code.
Sec. 5111.685. The department of job and family services
shall determine the actual amount of debt an exiting operator owes
the department and the United States centers for medicare and
medicaid services under the medicaid program by completing all
final
fiscal audits not already completed and performing all
other
appropriate actions the department determines to be
necessary. The
department shall issue a an initial debt summary
report on
this matter not
later than ninety sixty days after the
date the
exiting operator files
the properly completed cost
report
required by section 5111.682 of
the Revised Code with the
department or, if the department waives
the cost report
requirement for the exiting operator, ninety sixty days
after the
date the department waives the cost report requirement.
The
report shall include the department's findings and the amount
of
debt the department determines the exiting operator owes the
department and United States centers for medicare and medicaid
services under the medicaid program. Only the parts of the
report
that are subject to an
adjudication
as
specified in
section
5111.30 of the Revised
Code are subject
to
an
adjudication
conducted The initial debt summary report becomes the final debt
summary report thirty-one days after the department issues the
initial debt summary report unless the exiting operator, or an
affiliated operator who executes a successor liability
agreement
under section 5111.681 of the Revised Code, requests a
review
before that date.
The exiting operator, and an affiliated operator who
executes
a successor liability agreement under section 5111.681
of the
Revised Code, may request a review to contest any of the
department's findings included in
the initial debt summary
report. The request for the review
must be submitted to the
department not later than thirty days
after the date the
department issues the initial debt summary
report. The department
shall conduct the review on receipt of a timely request and issue
a revised debt summary report. If the department has withheld
money from payment due the
exiting operator under division (A) of
section 5111.681 of the
Revised Code, the department shall issue
the revised debt summary report not
later
than ninety days after
the date the department
receives the
timely request for the
review unless the
department and
exiting operator or
affiliated
operator agree to a later date.
The exiting operator
or
affiliated
operator may
submit information to the
department
explaining
what the operator
contests before and
during
the
review,
including
documentation of the amount of any
debt
the
department
owes the
operator. The exiting operator or
affiliated operator may submit additional information to
the
department not later than thirty days after the department
issues
the revised debt summary report. The revised debt summary
report
becomes the final debt summary report thirty-one days after
the
department issues the revised debt summary report unless the
exiting operator or affiliated operator timely submits
additional
information to the department. If the exiting operator
or
affiliated operator timely submits additional
information to the
department, the department shall consider the
additional
information and issue a final debt summary report not
later than
sixty days after the department issues the revised debt
summary
report unless the department and exiting operator or affiliated
operator agree to a later date.
Each debt summary report the department issues under this
section
shall include the
department's
findings and the amount
of debt the
department
determines the
exiting operator owes the
department and
United
States centers
for medicare and medicaid
services under the
medicaid program.
The department shall
explain its findings and
determination in
each debt summary
report.
The exiting operator, and an affiliated operator who
executes
a successor liability agreement under section 5111.681
of the
Revised Code, may request, in accordance with Chapter 119.
of
the
Revised Code, an adjudication regarding a finding in a
final debt summary report that pertains to an audit or alleged
overpayment made under the medicaid program to the exiting
operator.
The adjudication shall be consolidated with
any other
uncompleted adjudication that concerns a matter
addressed in the
final debt summary report.
Sec. 5111.686. The department of job and family
services
shall release the actual amount withheld under division
(A) of
section 5111.681 of the Revised Code, less any amount the
exiting
operator owes the department and United States centers
for
medicare and medicaid services under the medicaid program, as
follows:
(A) Ninety-one days after the date the exiting operator files
a properly completed cost report required by section 5111.682 of
the Revised Code unless Unless the department issues the initial
debt summary report required
by section 5111.685 of the Revised
Code not later than ninety sixty days
after the date the exiting
operator files the properly completed
cost report required by
section 5111.682 of the Revised Code, sixty-one days after the
date the exiting operator files the properly completed cost
report;
(B) Not later than thirty days after the exiting operator
agrees to a final fiscal audit resulting from the report required
by section 5111.685 of the Revised Code if If the department
issues
the initial debt summary report required by section
5111.685 of the Revised Code not later than ninety sixty days
after the date the exiting
operator files a properly completed
cost report required by
section 5111.682 of the Revised Code, not
later than the following:
(1) Thirty days after the deadline for
requesting an
adjudication under section
5111.685 of the Revised Code regarding
the final debt summary
report if the exiting operator, and an
affiliated operator
who
executes a successor liability
agreement under section
5111.681 of
the Revised Code, fail to
request
the adjudication on or before the deadline;
(2) Thirty days after the completion of an adjudication of
the final debt summary report if the exiting operator,
or an
affiliated operator who executes a successor
liability
agreement
under section 5111.681 of the Revised Code,
requests
the
adjudication on or before the deadline for
requesting
the
adjudication.
(C) Ninety-one days after the date the department waives the
cost report requirement of section 5111.682 of the Revised Code
unless Unless the department issues the initial debt summary
report required by section
5111.685 of the Revised Code not later
than ninety sixty days after the
date the department waives the
cost report requirement of section 5111.682 of the Revised Code,
sixty-one days after the date the department waives the cost
report requirement;
(D) Not later than thirty days after the exiting operator
agrees to a final fiscal audit resulting from the report required
by section 5111.685 of the Revised Code if If the department
issues
the initial debt summary report required by section
5111.685 of the Revised Code not later than ninety sixty days
after the date the
department waives the cost report requirement
of section 5111.682
of the Revised Code, not later than the
following:
(1) Thirty days after the deadline for
requesting an
adjudication under section
5111.685 of the Revised Code regarding
the final debt summary
report if the exiting operator, and an
affiliated operator
who
executes a successor liability
agreement under section
5111.681 of
the Revised Code, fail to
request the adjudication on or before the deadline;
(2) Thirty days after the completion of an adjudication of
the final debt summary report if the exiting operator,
or an
affiliated operator who executes a successor
liability
agreement
under section 5111.681 of the Revised Code,
requests
the
adjudication on or before the deadline for
requesting
the
adjudication.
Sec. 5111.688. (A) All amounts withheld under
section
5111.681 of the Revised Code from payment due an exiting
operator
under the medicaid program shall be deposited into the medicaid
payment withholding
fund created by the controlling board pursuant
to section 131.35 of the Revised Code. Money
in the fund shall be
used as follows:
(1) To pay an exiting operator when a withholding is released
to the exiting operator under section 5111.686 or 5111.687 of the
Revised Code;
(2) To pay the department of job and family services and
United States centers for medicare and medicaid services the
amount an exiting operator owes the department and United States
centers under the medicaid program.
(B) Amounts paid from the medicaid payment withholding fund
pursuant to
division (A)(2) of this section shall be
deposited
into the
appropriate department fund.
Sec. 5111.688 5111.689. The director of job and family
services
shall
adopt rules under section 5111.02 of the
Revised
Code
to
implement sections 5111.65 to 5111.688 5111.689
of the
Revised
Code,
including rules applicable to an exiting
operator
that
provides
written notification under section 5111.66
of the
Revised
Code
of a voluntary withdrawal of participation.
Rules
adopted
under
this section shall comply with section
1919(c)(2)(F) of the
"Social Security Act," 79 Stat. 286 (1965),
42 U.S.C.
1396r(c)(2)(F), regarding restrictions on transfers or
discharges
of nursing facility residents in the case of a
voluntary
withdrawal of participation. The rules may prescribe a
medicaid
reimbursement methodology and other procedures that are
applicable
after the effective date of a voluntary withdrawal of
participation that differ from the reimbursement methodology and
other procedures that would otherwise apply.
Sec. 5111.894.
(A) The state administrative agency may
establish one or
more waiting lists for the assisted living
program. Only
individuals eligible for the medicaid assisted
living program may be
placed on a
waiting list.
(B) The state administrative agency shall establish a home
first component of the assisted living program under which
eligible individuals may be enrolled in the assisted living
program in accordance with this section. An individual is eligible
for the assisted living program's home first component if the
individual is on an assisted living program waiting list and at
least one of the following applies:
(1) The individual has been admitted to a nursing facility;
(2) A physician has determined and documented in writing that
the individual has a medical condition that, unless enrolled in
home and community-based services such as the assisted living
program, will require the individual to be admitted to a nursing
facility within thirty days of the physician's determination;
(3) The individual has been hospitalized and a physician has
determined and documented in writing that, unless the individual
is enrolled in home and community-based services such as the
assisted living program, the individual is to be transported
directly from the hospital to a nursing facility admitted;
(4) Both of the following apply:
(a) The individual is the subject of a report made under
section 5101.61 of the Revised Code regarding abuse, neglect, or
exploitation or such a report referred to a county department of
job and family services under section 5126.31 of the Revised Code
or has made a request to a county department for protective
services as defined in section 5101.60 of the Revised Code;
(b) A county department of job and family services and an
area agency on aging have jointly documented in writing that,
unless the individual is enrolled in home and community-based
services such as the assisted living program, the individual
should be admitted to a nursing facility;
(5) The individual resided in a residential care facility for
at least six months immediately before applying for the assisted
living program and is at risk of imminent admission to a nursing
facility because the costs of residing in the residential care
facility have depleted the individual's resources such that the
individual is unable to continue to afford the cost of residing in
the residential care facility.
(C) Each month, each area agency on aging
shall determine
whether any individual who resides identify individuals residing
in the area
that the area
agency on aging serves and is on a
waiting list who are eligible for
the home first component of the
assisted
living program has been admitted to a nursing
facility. If When an
area agency on aging
determines that
identifies such
an
individual has been
admitted
to a
nursing
facility
and determines that there is a vacancy in a
residential
care
facility
participating in the assisted living
program that
is
acceptable
to the individual, the agency shall
notify the
long-term care
consultation program administrator
serving the
area in which the
individual resides about the
determination.
The
administrator
shall determine whether the
assisted living
program
is
appropriate
for the individual and
whether the
individual
would
rather
participate in the assisted
living
program than
continue
residing or begin to reside
in the a
nursing facility.
If the
administrator
determines that the
assisted living program
is
appropriate for
the individual and
the
individual would
rather
participate in the
assisted living
program
than continue
residing or begin to reside in the a
nursing
facility, the
administrator
shall so
notify the state
administrative agency.
On agency. On receipt of the notice from the administrator,
the
state
administrative agency shall approve the individual's
enrollment in
the assisted living program regardless of any
waiting list for the
assisted living
program, unless the
enrollment would cause the
assisted living program to exceed any
limit on the number of
individuals who may participate in the
program as set by the
United States secretary of health and human
services when the
medicaid waiver authorizing the program is
approved. Each
(D) Each quarter,
the state
administrative agency
shall
certify to the director
of budget
and management the
estimated
increase in costs of
the assisted
living program
resulting from
enrollment of
individuals in the
assisted living
program
pursuant
to this
section.
Section 2. That existing sections 173.401, 3702.51, 3702.59,
5111.65, 5111.651, 5111.68, 5111.681, 5111.685, 5111.686,
5111.688, and
5111.894 of the Revised Code are hereby repealed.
Section 3. That Section 209.20 of Am. Sub. H.B. 1 of the
128th General Assembly be amended to read as follows:
Sec. 209.20. LONG-TERM CARE
Pursuant to an interagency agreement, the Department of Job
and
Family
Services shall
designate the Department of Aging to
perform
assessments under
section 5111.204 of the
Revised
Code.
The Department of Aging shall provide long-term care consultations
under section 173.42 of the Revised Code to assist individuals in
planning for their long-term health care needs. The foregoing
appropriation items 490423, Long Term Care Budget – State, and
490623, Long Term Care Budget, may be used to provide the
preadmission screening and resident review (PASRR), which includes
screening,
assessments, and determinations made under sections
5111.02,
5111.204, 5119.061, and 5123.021 of the Revised Code.
The foregoing appropriation items 490423, Long Term Care
Budget - State, and 490623, Long Term Care Budget, may be
used to
assess and provide long-term care consultations to clients
regardless of Medicaid eligibility.
The Director of Aging shall adopt rules under
section 111.15
of the Revised Code governing the nonwaiver funded
PASSPORT
program, including client eligibility. The foregoing appropriation
item 490423, Long Term Care Budget - State, may be used by the
Department of Aging to provide nonwaiver funded PASSPORT services
to persons the Department has determined to be eligible to
participate in the nonwaiver funded PASSPORT Program, including
those persons not yet determined to be financially eligible to
participate in the Medicaid waiver component of the PASSPORT
Program by a county department of job and family services.
The Department of Aging shall administer the Medicaid
waiver-funded PASSPORT Home Care Program, the Choices Program, the
Assisted Living Program, and the PACE Program as delegated by the
Department
of Job and Family Services in an interagency agreement.
The
foregoing
appropriation item 490423, Long Term Care
Budget -
State,
shall
be used
to
provide the required state match
for
federal
Medicaid funds
supporting the Medicaid Waiver-funded
PASSPORT Home
Care
Program, the Choices Program, the Assisted
Living Program, and the PACE Program.
The foregoing appropriation
items 490423, Long Term Care Budget - State, and 490623, Long Term
Care Budget, may
also be
used
to support
the Department of Aging's
administrative costs
associated with
operating the PASSPORT,
Choices, Assisted Living, and PACE programs.
The foregoing appropriation item 490623, Long Term Care
Budget, shall
be
used to provide the federal matching share for
all program costs determined by the Department of Job and Family
Services to
be
eligible for Medicaid reimbursement.
(A) As used in this section, "Long Term Care Budget Services"
includes the following existing programs: PASSPORT, Assisted
Living, Residential State Supplement, and PACE.
(B) On a quarterly basis, on receipt of the certified
expenditures related to sections 173.401, 173.351, and 5111.894 of
the Revised Code during fiscal years 2010 and 2011, the Director
of Budget and Management may do
all of the following for fiscal
years 2010 and 2011:
(1) Transfer shall transfer cash on a quarterly basis from
the
Nursing Facility Stabilization
Fund (Fund 5R20), used by the
Department of Job and Family
Services, to the
PASSPORT/Residential State Supplement Fund (Fund
4J40), used
by
the Department of Aging. The
The transferred cash is hereby appropriated to appropriation
item 490610, PASSPORT/Residential State Supplement.
(2) If receipts credited to the PASSPORT Fund (Fund 3C40)
exceed the amounts appropriated from the fund, the Director of
Aging may shall request the Director of Budget and Management to
authorize expenditures from the fund in excess of the amounts
appropriated. The Director of Budget and Management shall
authorize the expenditures on receipt of the Director of Aging's
request. Upon the approval authorization of the Director of Budget
and
Management, the additional amounts are hereby appropriated.
(3) If receipts credited to the Interagency Reimbursement
Fund (Fund 3G50) exceed the amounts appropriated from the fund,
the Director of Job and Family Services may shall request the
Director
of Budget and Management to authorize expenditures from
the fund
in excess of the amounts appropriated. The Director of
Budget and Management shall authorize the expenditures on receipt
of the Director of Job and Family Services' request. Upon the
approval authorization of the
Director of Budget and Management,
the additional amounts are
hereby appropriated.
(C) The individuals placed in Long Term Care Budget Services
pursuant to this section shall be in addition to the individuals
placed in Long Term Care Budget Services during fiscal years 2010
and 2011 before any transfers to appropriation item 490423, Long
Term Care Budget-State, are made under this section.
In order to effectively administer and manage growth within
the PACE Program, the Director of Aging may, as the director deems
appropriate and to the extent funding is available, expand the
PACE Program to regions of Ohio beyond those currently served by
the PACE Program. In implementing the expansion, the Director may
not
decrease the number of residents of
Cuyahoga and Hamilton
counties and parts of Butler, Clermont,
and Warren counties who
are participating in the PACE Program below the number of
residents of those counties and parts of counties who were
enrolled
in the PACE Program on
July 1, 2008.
Section 4. That existing Section 209.20 of Am. Sub. H.B. 1 of
the 128th General Assembly is hereby repealed.
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