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Sub. H. B. No. 366 As Reported by the Senate Medicaid, Health and Human Services CommitteeAs Reported by the Senate Medicaid, Health and Human Services Committee
130th General Assembly | Regular Session | 2013-2014 |
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Cosponsors:
Representatives Buchy, Hood, Phillips, Ruhl, Smith, Antonio, Barnes, Bishoff, Brown, Hagan, R., Schuring, Sears, Johnson, Adams, R., Amstutz, Anielski, Ashford, Baker, Beck, Blair, Blessing, Boose, Boyce, Budish, Burkley, Butler, Conditt, Damschroder, Derickson, DeVitis, Dovilla, Duffey, Fedor, Gerberry, Green, Hackett, Hagan, C., Hall, Hayes, Heard, Henne, Huffman, Landis, Letson, Lundy, Mallory, McClain, Milkovich, O'Brien, Perales, Pillich, Rogers, Rosenberger, Stebelton, Stinziano, Strahorn, Wachtmann, Williams, Winburn, Young Speaker Batchelder
Senators Tavares, Brown
A BILL
To amend sections 3712.03, 3712.04, and 3712.99 and
to enact section 3712.062 of the Revised Code to
require hospice care programs to establish
policies to prevent diversion of controlled
substances that contain opioids.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 3712.03, 3712.04, and 3712.99 be
amended and section 3712.062 of the Revised Code be enacted to
read as follows:
Sec. 3712.03. (A) In accordance with Chapter 119. of the
Revised Code, the director of health shall adopt, and may amend
and rescind, rules:
(1) Providing for the licensing of persons or public agencies
providing hospice care programs within this state by the
department of health and for the suspension and revocation of
licenses;
(2) Establishing a license fee and license renewal fee for
hospice care programs, neither of which shall, except as provided
in division (B) of this section, exceed six hundred dollars. The
fees shall cover the three-year period during which an existing
license is valid as provided in division (B) of section 3712.04 of
the Revised Code.
(3) Establishing an inspection fee for hospice care programs
not to exceed, except as provided in division (B) of this section,
one thousand seven hundred fifty dollars;
(4) Establishing requirements for hospice care program
facilities and services;
(5) Establishing procedures a hospice care program must
follow while investigating a sign of suspected diversion of
controlled substances containing opioids pursuant to division
(B)(5) of section 3712.062 of the Revised Code;
(6) Establishing requirements for reporting to a local law
enforcement agency pursuant to division (B)(6) of section 3712.062
of the Revised Code the results of an investigation of suspected
diversion;
(7) Providing for a waiver of the requirement for the
provision of physical, occupational, or speech or language therapy
contained in division (A)(2) of section 3712.01 of the Revised
Code when the requirement would create a hardship because such
therapy is not readily available in the geographic area served by
the provider of a hospice care program;
(6)(8) Providing for the granting of licenses to provide
hospice care programs to persons and public agencies that are
accredited or certified to provide such programs by an entity
whose standards for accreditation or certification equal or exceed
those provided for licensure under this chapter and rules adopted
under it;
(7)(9) Establishing interpretive guidelines for each rule
adopted under this section.
(B) Subject to the approval of the controlling board, the
director may establish fees in excess of the maximum amounts
specified in this section, provided that the fees do not exceed
those amounts by greater than fifty per cent.
(C) The department of health shall:
(1) Grant, suspend, and revoke licenses for hospice care
programs in accordance with this chapter and rules adopted under
it;
(2) Make such inspections as are necessary to determine
whether hospice care program facilities and services meet the
requirements of this chapter and rules adopted under it; and
(3) Implement and enforce provisions of this chapter and
rules adopted under it as such provisions apply to hospice care
programs.
Sec. 3712.04. (A) Every person or public agency that
proposes to provide a hospice care program shall apply to the
department of health for a license. Application shall be made on
forms prescribed and provided by the department, shall include
such information as the department requires, and shall be
accompanied by the license fee established by rules of the
director of health adopted under division (A) of section 3712.03
of the Revised Code.
The department shall grant a license to the applicant if the
applicant is in compliance with this chapter and rules adopted
under it.
(B) A license granted under this section shall be valid for
three years. Application for renewal of a license shall be made at
least ninety days before the expiration of the license in the same
manner as for an initial license, except that, if the program
provides hospice care and services in a hospice patient's home,
the application for renewal shall include written evidence
demonstrating that the applicant is in compliance with section
3712.062 of the Revised Code. The department shall renew the
license if the applicant meets the requirements of this chapter
and rules adopted under it.
(C) Subject to Chapter 119. of the Revised Code, the
department may suspend or revoke a license if the licensee made
any material misrepresentation in the application for the license
or no longer meets the requirements of this chapter or rules
adopted under it.
(D) A hospital, nursing home, home for the aged, county
medical care facility, or other health facility or agency that
provides a hospice care program shall be licensed to provide a
hospice care program under this section.
(E) A nursing home licensed under Chapter 3721. of the
Revised Code that does not hold itself out to be a hospice, does
not hold itself out as providing a hospice care program, does not
use the term hospice to describe or refer to its activities or
facilities, and that does not provide all of the services
enumerated in division (A) of section 3712.01 of the Revised Code
is not subject to the licensing provisions of this chapter.
Sec. 3712.062. (A) Each hospice care program licensed under
this chapter that provides hospice care and services in a hospice
patient's home shall establish a written policy establishing
procedures to be followed in preventing the diversion of
controlled substances containing opioids that are prescribed to
its hospice patients. The policy shall include procedures for the
disposal of any such drugs prescribed to a hospice patient as part
of the patient's interdisciplinary plan of care that are
relinquished to the program after the patient's death or that
otherwise are no longer needed by the patient. The policy shall
require that the disposal be documented by a program employee and
conducted in any of the following ways:
(1) Performed by a program employee and witnessed by the
patient or patient's family member;
(2) Performed by the patient or patient's family member and
witnessed by a program employee;
(3) Performed by a program employee and witnessed by another
program employee.
(B) As part of a hospice patient's interdisciplinary plan of
care required by section 3712.06 of the Revised Code, each hospice
care program that provides hospice care and services in the
patient's home shall do all of the following:
(1) Before providing hospice care and services, distribute a
copy of the written policy established under division (A) of this
section to the patient and patient's family and discuss the
procedures included in the policy with the patient and patient's
family;
(2) Assess the patient, the patient's family, and the care
environment for any risk factors associated with diversion;
(3) Maintain records of controlled substances containing
opioids prescribed to the patient and included in the patient's
interdisciplinary plan of care, including accurate counts of the
numbers dispensed and used;
(4) Monitor the use and consumption of controlled substances
containing opioids prescribed to the patient and included in the
patient's interdisciplinary plan of care, including prescription
refills, for signs of diversion;
(5) Investigate any sign of suspected diversion in accordance
with rules adopted under division (A)(5) of section 3712.03 of the
Revised Code.
(6) Report the results of an investigation of suspected
diversion to the local law enforcement agency with jurisdiction
over the territory in which the hospice patient's home is located
in accordance with rules adopted under division (A)(6) of section
3712.03 of the Revised Code;
(7) Before providing hospice care and services, inform the
patient and the patient's family that the hospice care program
will dispose of any controlled substances containing opioids that
are no longer needed by the patient and were included in the
patient's interdisciplinary plan of care;
(8) After the patient's death or when no longer needed by the
patient, request, in writing, that the patient or patient's family
relinquish to the program for disposal any remaining controlled
substances containing opioids that were included in the patient's
interdisciplinary plan of care to the program;
(9) Report to the local law enforcement agency with
jurisdiction over the territory in which the hospice patient's
home is located the quantity and type of any remaining controlled
substances containing opioids that were included in the patient's
interdisciplinary plan of care and were not relinquished to the
program by the patient or patient's family.
(C) If a hospice care program complies with divisions (B)(8)
and (9) of this section, none of the following shall be liable in
damages to any person or government entity in a civil action for
injury, death, or loss to person or property that allegedly arises
from an action or omission relative to this section unless the
action or omission constitutes willful or wanton misconduct: the
program; a program employee, officer, or director; or a prescriber
of controlled substances containing opioids that were included in
the patient's interdisciplinary plan of care.
(D) No person who receives a written request under division
(B)(8) of this section shall fail to relinquish controlled
substances containing opioids that were included in a patient's
interdisciplinary plan of care.
(E) Following a report from a hospice program under division
(B)(9) of this section, the local law enforcement agency with
jurisdiction over the territory in which the hospice patient's
home is located shall investigate and dispose of the remaining
controlled substances containing opioids that were reported to the
agency pursuant to division (B)(9) of this section.
(F) After a review of the written evidence submitted under
division (B) of section 3712.04 of the Revised Code with an
application for license renewal, if the department determines that
the program is not in compliance with this section, the department
may suspend the program's license for not more than six months and
impose a fine not to exceed twenty thousand dollars.
(G) Not later than one year after the effective date of this
section, the director of health shall adopt rules in accordance
with Chapter 119. of the Revised Code establishing standards and
procedures for the submission and review of the written evidence
required by division (B) of section 3712.04 of the Revised Code
for renewal of a hospice care program license.
Sec. 3712.99. (A) Any person who violates division (A) of
section 3712.05 or division (A) of section 3712.051 of the Revised
Code is guilty of a misdemeanor of the second degree on a first
offense; on each subsequent offense the person is guilty of a
misdemeanor of the first degree.
(B) Any person who violates division (D) of section 3712.062
of the Revised Code is guilty of a minor misdemeanor.
Section 2. That existing sections 3712.03, 3712.04, and
3712.99 of the Revised Code are hereby repealed.
Section 3. Not later than one year after the effective date
of this act, each hospice care program that holds a license under
Chapter 3712. of the Revised Code on the act's effective date and
that provides hospice care and services in a hospice patient's
home shall submit to the Department of Health written evidence
demonstrating that the program is in compliance with section
3712.062 of the Revised Code, as enacted by this act. After a
review of the evidence submitted, if the Department determines
that the program is not in compliance with that section, the
Department may suspend the program's license for not more than six
months and impose a fine not to exceed twenty thousand dollars.
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