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Ohio Laws and Rules
(A) The director shall designate HIV care consortia for purposes of the Ryan White program. The director shall establish geographic areas to be served by consortia and shall designate one consortium for each geographic area. The geographic areas may include one or more counties,
(B) To be designated as a HIV care consortium, an applicant shall submit an application to the director that contains documentation showing that the applicant meets all of the following criteria:
(1) The consortium will have no fewer than seven and no more than twenty members, unless the director determines that a larger number of members is needed to appropriately represent affected individuals and organizations in the geographic area. The membership of the consortium shall be approved by the director and shall include agencies and community-based organizations that meet both of the following criteria:
(a) The agencies or organizations have a record of service to populations and subpopulations with HIV disease requiring care in the community to be served; and
(b) The agencies or organizations are representative of populations and subpopulations reflecting the local incidence of HIV and that are located in areas in which the populations reside;
(2) The consortium will include at least one representative of a public health care provider, one representative of a private non-profit health care provider, and one representative from a local community-based organization. The director also may consider whether the consortium will include representatives of rural areas, affected subpopulations, an individual with HIV infection and a representative of a drug and alcohol treatment organization and others as deemed necessary and appropriate;
(3) The consortium will include a community-based HIV case manager;
(4) The applicant has carried out an assessment of service needs within the geographic area to be served and, after consultation with the entities described in paragraph (C) of this rule, has established a plan to ensure the delivery of services to meet the identified needs that shall include all of the following:
(a) Assurances that service needs will be addressed through the coordination and expansion of existing programs before new programs are created;
(b) Assurances that, in metropolitan areas, the geographic area to be served by the consortium will correspond to the geographic boundaries of local health and support services delivery systems to the extent practicable;
(c) Assurances that, in the case of services for individuals residing in rural areas, the applicant consortium shall deliver case management services that link available community support services to appropriate specialized medical services. Case management under this paragraph shall be provided through community-based HIV case managers; and
(d) Assurances that the assessment of service needs and the planning of the delivery of services will include participation by individuals with HIV disease; and
(e) Assurances that the full continuum of health and social services needed for individuals with HIV disease has been considered;
(5) The applicant demonstrates that adequate planning has occurred to meet the special needs of families with HIV disease, including family centered care. As used in this paragraph “family centered care” means the system of services described in paragraph (B) of rule 3701-44-03 of the Administrative Code that is targeted specifically to the special needs of infants, children, women, and families. Family centered care shall be based on a partnership between parents, professionals, and the community designed to ensure an integrated, coordinated, culturally sensitive, and community-based continuum of care for children, women, and families with HIV disease;
(6) The applicant demonstrates that an independent committee has created a mechanism to periodically evaluate the success of the consortium in responding to identified needs and the cost effectiveness of the mechanisms employed by the consortium to deliver comprehensive care. The consortium shall provide for this evaluation by establishing an independent committee consisting of at least three but no more than six individuals who are not members of the consortium but who have experience in quality assurance review. The committee shall meet at least every twelve months to review services provided to individuals affected by HIV disease with special attention to quality based on availability, appropriateness, timeliness, and access;
(7) The applicant demonstrates that the consortium will report to the director the results of the evaluations described in paragraph (B)(6) of this rule. The consortium shall make this report by authorizing the independent committee established under that paragraph to provide the results of its evaluations directly to the director. The consortium also shall make available to the director or the secretary of the United States department of human services, on request, such data and information on the program methodology that may be required to perform an independent evaluation; and
(8) The consortium provides the following assurances:
(a) Within any locality in which the consortium is to operate, the populations and subpopulations of individuals and families with HIV disease have been identified by the consortium;
(b) The service plan established under paragraph (B)(4) of this rule by the consortium addresses the special needs of the populations and subpopulations identified under paragraph (B)(8)(a) of this rule; and
(c) The consortium will be a single coordinating entity that will integrate the delivery of services among the populations and subpopulations identified under paragraph (B)(8)(a) of this rule.
If more than one applicant seeks designation as an HIV care consortium, the director shall determine which applicant appears to be most capable of effectively serving the needs of individuals and families in the area who are affected by HIV disease.
(C) In establishing the plan required under paragraph (B)(4) of this rule, the consortium shall consult with either an agency described in paragraph (C)(1)(a) of this rule or an agency described in paragraph (C)(1)(b) of this rule.
(1) The consortium shall consult with either of the following:
(a) The public health agency that provides or supports ambulatory and outpatient HIV-related health care services within the geographic area to be served; or
(b) In the case of a public health agency that does not directly provide HIV-related health care services, the agency shall consult with an entity or entities that directly provide ambulatory and outpatient HIV-related health care services within the geographic area to be served.
(D) The director may request any additional information necessary to determine whether the applicant meets the requirements for designation established by this rule. The applicant shall provide the requested information within the time and in the manner specified by the director.
(E) The director shall provide written notification of his or her decision whether or not to designate an applicant as an HIV care consortium under this rule. If the director does not designate the applicant, the notice shall state the reasons for the decision and inform the applicant of the reconsideration process under paragraph (G) of this rule.
(F) The director may revoke the designation of an HIV care consortium upon a determination that the consortium is not adequately discharging its responsibilities under this chapter. The director shall provide written notice of the revocation which shall state the reasons for the decision and inform the consortium of the reconsideration process under paragraph (G) of this rule.
(G) If the director denies or revokes a consortium’s designation under paragraph (E) or (F) of this rule, the consortium may request reconsideration of the decision by submitting a written request for reconsideration. The request shall be filed with the director within fifteen days after the date of mailing of the denial or revocation of designation. The request shall be accompanied by any written information that the consortium wishes to have considered. The director shall render a written decision on reconsideration which shall be final.
R.C. 119.032 review dates: 04/30/2004 and 04/30/2009
Promulgated Under: 119.03
Statutory Authority: 3701.241
Rule Amplifies: 3701.241
Prior Effective Dates: 5/20/1999