Chapter 5123:2-1 County Board of Mental Retardation and Developmental Disabilities

5123:2-1-02 County board administration.

(A) Purpose. This rule directs the planning and administration of county board of MR/DD services, supports, programs and facilities. Implementation of this rule in county boards will promote the development of uniform policies and procedures which protect the rights of individuals with disabilities and ensure the safe and equitable provision of services and programs to eligible individuals and their families.

(B) Each county board shall develop and adopt an annual action plan which covers at a minimum the following:

(1) A statement of philosophy, an organizational chart, and goals and objectives which shall reflect the major components of the comprehensive program, the administrative personnel in charge of the program(s) and their lines of authority and responsibility, and public access to county board administrative offices.

(2) The results of the assessment of the facility, service, and support needs of eligible people of the county with the mental retardation or other developmental disabilities. The facility, service, and support needs shall be projected over the next year. The assessment results shall include, but not be limited to, the following:

(a) Documentation of input received from people and their families receiving services and supports, local public service agencies, county board staff, developmental centers, residential providers, and other providers of services to people with mental retardation or other developmental disabilities as to the quality of services and supports received, gaps in the services and supports available, and recommendations for change.

(b) The number of people needing to be served and the number of people actually served in each major program and service component of the county board's comprehensive program, including how the board will plan, set priorities, and acquire resources related to waiting lists.

(3) A statement(s) as to how the county board shall address the following service needs of individuals eligible to receive services: service coordination, service monitoring, crisis intervention, and major unusual incident review and assessment; and a statement of how the county board shall address information and referral activities, without regard to eligibility for service.

(4) The county board shall hold a public forum annually to gather public comment on the action plan. The county board shall provide a thirty-day notice of the date of the public forum and make the plan available for review by interested persons. The information gathered at the public forum shall be considered in final revisions to the plan which shall be available for distribution to staff, people served or their representative parents of a minor or guardians, and the interested public.

(C) Eligibility determination for developmental disabilities or developmental delay

(1) "Developmental disability" means a severe, chronic disability that is characterized by all of the following:

(a) It is attributable to a mental or physical impairment or a combination of mental and physical impairments, other than a mental or physical impairment solely caused by mental illness as defined in division (A) of section 5122.01 of the Revised Code;

(b) It is manifested before age twenty-two;

(c) It is likely to continue indefinitely;

(d) It results in one of the following:

(i) In the case of a person under age three, at least one developmental delay or an established risk;

(ii) In the case of a person at least age three but under six, at least two developmental delays or an established risk;

(iii) In the case of a person age six or older, a substantial functional limitation in at least three of the following areas of major life activity, as appropriate for his age: self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, and, if the person is at least age sixteen, capacity for economic self-sufficiency.

(e) It causes the person to need a combination and sequence of special, interdisciplinary, or other type of care, treatment, or provision of services for an extended period of time that is individually planned and coordinated for the person.

(2) A substantial functional limitation in a major life area is determined through completion of the "Ohio Eligibility Determination Instrument" (OEDI) and application of criteria found therein.

(3) For children age six through fifteen, a substantial functional limitation in a major life area is determined through completion of the "Children's Ohio Eligibility Determination Instrument" (COEDI) and application of criteria found therein. The COEDI is used in the eligibility determination process for the county board for all services and supports other than special education services.

(4) The OEDI and COEDI shall be administered by county board personnel authorized to do so by the department. At the local county board's discretion, other individuals may be authorized by the department to administer the OEDI and COEDI.

(5) Eligibility may be determined for individuals under the age of six who have an established risk of acquiring a developmental delay, or for individuals who have a biological or environmental risk of acquiring a developmental delay.

(6) "Developmental delay" means that a child has not reached developmental milestones expected for his chronological age as measured by qualified professionals using appropriate diagnostic instruments and/or procedures.

(a) Delay shall be demonstrated in one or more of the following developmental areas: adaptive behavior; physical development or maturation (fine and gross motor skills; growth); cognition; communication; social or emotional development; and sensory development; or

(b) An established risk involving early aberrant development related to diagnosed medical disorders, such as infants and toddlers who are on a ventilator, are adversely affected by drug exposure, or have a diagnosed medical disorder or physical or mental condition known to result in developmental delay such as Down syndrome.

(c) Depending on the plan and priorities established by the county board, a county board may serve a child who has a condition which has a high probability of resulting in developmental delay if early intervention services are not provided, including the following two categories:

(i) Biological risk: history of prenatal, neonatal, and early developmental events suggestive of biological insult(s) to the developing nervous system.

(ii) Environmental risk: at risk for delayed development because of limiting early environmental experiences.

(7) The county board shall complete eligibility determination within forty-five calendar days of the request for services or after all necessary information has been received from the referring party or applicant.

(8) The county board shall keep on file the documents used to determine eligibility of all persons who apply after July 1, 1991, whether or not such persons are found to be eligible. Information on persons found to be ineligible shall be maintained for five years after such determination is made. Information on persons determined to be eligible for the county board shall be maintained in accordance with this rule.

(9) When a person who has been determined eligible for a county board after July 1, 1991 moves to or wants to move to another county in Ohio, that person shall be considered to be eligible in the new county. In the case of a person wanting to move into another county, the request shall be reviewed every six months to determine if it is still current. The new county; however, may review the person's eligibility. During the review, the person continues to be eligible to receive services according to the county board's plan and priorities.

(10) All persons who were eligible for services and receiving services from programs offered by a county board pursuant to Chapter 5126. of the Revised Code on July 1, 1991, shall continue to be eligible for those services and to receive services in those programs as long as they are in need of services.

(11) All persons who were eligible for case management services and receiving case management services pursuant to Chapter 5126. of the Revised Code on January 10, 1992, shall continue to be eligible for case management services as long as they are in need of services.

(12) All persons found not to be eligible shall be referred, with their consent, to other agencies or sources of services.

(D) Contracts

(1) The county board may enter into contracts with other such county boards and with public or private nonprofit or profit-making agencies or organizations of the same or another county or with an individual to provide the facilities, programs, services, and supports authorized or required upon such terms as may be agreeable, and in accordance with Chapters 3323. and 5126. of the Revised Code and rules adopted thereunder.

(2) When services and supports are contracted, it shall be the responsibility of the county board initiating the contract to assure that the services and supports being provided are in accordance with the rules of the department. The county board entering into a contract to provide services and supports shall monitor contracted agencies on an ongoing basis to assure compliance.

(3) Reimbursement shall only be provided for contracted services and supports when individuals receiving such contracted services meet eligibility requirements established by the department.

(E) Waiting lists

The county board shall use the requirements set forth in rule 5123:2-1-08 of the Administrative Code to establish and maintain waiting lists, service substitution lists, and a long-term service planning registry.

(F) The county board shall develop policies and procedures that ensure, to the extent desired by the individual served and his family, that one process is used to develop the service and support plan, even when the individual is receiving services and supports from more than one county board program component.

(G) Administrative resolution of complaints

The county board shall use the administrative resolution of complaints process established in rule 5123:2-1-12 of the Administrative Code to resolve complaints involving the programs, services, policies, or administrative practices of the county board or the entities acting under contract with the county board.

(H) Volunteers

County boards may administer volunteer service programs and have volunteers as an integral part of the overall service delivery.

(1) Volunteers shall be used to supplement, not supplant, services and supports provided by qualified personnel.

(a) Volunteers shall receive direct supervision and training from qualified staff.

(b) Volunteers shall work from a written volunteer service plan.

(2) Written policies concerning recruitment, training, assignments, evaluation, and separation of volunteers shall be established by the county board. These policies shall be available to the entire staff.

(3) County boards may require background checks on volunteers.

(4) Volunteers shall not be considered in the calculation of staffing ratios.

(I) Records

All records required by the department shall be kept in the administrative office(s) of the county board.

(1) The county board shall maintain fiscal records that are in compliance with county and state auditor's requirements in section 149.38 of the Revised Code.

(2) The county board shall maintain a record of signed statements regarding criminal background checks completed by county board employees in accordance with section 5126.28 of the Revised Code.

(3) The county board shall adopt policies and have written procedures which address access, duplication, dissemination, and destruction of personnel records.

(4) The county board shall maintain personnel records which shall include the following:

(a) Name, permanent and current address, phone number, and person to notify in case of emergency;

(b) Job description which includes the essential functions of the job, requirements for certification, registration or license, civil service classification, and title as established by the department of administrative services if applicable, unless there is a collective bargaining agreement to the contrary;

(c) Records of accrued and used sick leave and vacation;

(d) Record of permanent or temporary certification, license or registration, as applicable;

(e) Bus driver annual physical examination form, as applicable;

(f) Records of inservice training;

(g) Personnel action forms;

(h) Annual performance evaluations signed by the immediate supervisor, the superintendent or his designee, and the employee;

(i) Payroll information;

(j) Record retention information; and

(k) Application forms.

(5) The country board shall maintain in a separate medical file a record of a physical examination current within sixty days of the date of hire (a physical examination completed within one year prior to the date of hire is acceptable). The county board may not require the applicant to pay the cost of a physical examination as a condition of employment.

(6) Personnel records shall be accessible to department personnel authorized by the director of the department.

(7) The county board shall adopt policies and have written procedures that address access, duplication, dissemination, and destruction of individual record information for persons served.

(a) Such policies and procedures shall ensure confidentiality and shall include:

(i) Obtaining written permission from the individual or parent of a minor or guardian prior to releasing information to persons not otherwise authorized to receive such information pursuant to applicable state or federal regulations, including Ohio department human services rule 5101:1-1-03 of the Administrative Code when applicable. The permission shall specify the person or organization to whom the information shall be released and the time period during which the permission is valid.

(ii) Transmitting information to a requesting person or agency after receiving a properly authorized written request.

(iii) The procedures by which information concerning an individual shall be collected, the procedures that shall be used to maintain the confidential nature of the information, its use, the recording procedures, the period for which records will be maintained, the procedures for the destruction of data determined to be no longer necessary to the education, services and supports of the individual, the persons to whom the records will be made available, and the conditions under which confidential information shall be made available.

(iv) A statement that lists the types and locations of records maintained that shall be made available to the individual or parent of a minor or guardian on request.

(v) The person responsible for ensuring the safekeeping of records and securing them against loss or use by unauthorized persons.

(vi) For persons placed by the LEA, confidentiality procedures which shall be in accordance with the rules for the education of handicapped children (rule 3301-51-02 of the Administrative Code).

(vii) Written permission of the individual or the parent of a minor or guardian will be obtained prior to destruction of individual record information. Copies of county board generated records shall be offered to the individual or the parent of a minor or guardian.

(b) Individual records shall be accessible to department personnel authorized by the director of the department, the parents of a minor, the guardian (when within the scope of guardianship authority), or the individual.

(c) Individual records shall be kept on file in a secure location to assure the permanence of the records for the time during which services are provided and for transmittal to an alternative program when an alternative placement occurs.

(d) Policies and procedures concerning confidentiality shall be made known to individuals and/or the parent of a minor or guardian of an adult, as applicable, and residential services/supports providers.

(e) The county board shall review, not less than once a year, the systems and safeguards employed by the agency and staff to preserve confidentiality of information.

(8) Records and reports related to the program shall be submitted as requested by the department.

(J) Behavior support policies and procedures

(1) Purpose

(a) The county board shall develop and implement written policies and procedures that support and assist individuals receiving services from county board programs to manage their own behaviors.

(b) These policies and procedures shall acknowledge that the purpose of behavior support is to promote the growth, development and independence of those individuals and promote individual choice in daily decision-making, emphasizing self-determination and self-management.

(c) The county board superintendent shall appoint a committee to implement paragraph (J) of this rule through the development of behavior support policies and procedures.

(d) The county board shall develop and implement written policies and procedures which shall:

(i) Focus on positive teaching and support strategies and encourage use of the least restrictive environment and least intrusive forms of services;

(ii) Specify a hierarchy of these teaching and support strategies, ranging from most positive or least intrusive to least positive or most intrusive, including approvals and review procedures; and

(iii) Be developed in accordance with department guidelines and relevant local, state and federal statutes and regulations.

(e) As used in paragraph (J) of this rule, "provider" refers to all persons and entities that provide specialized services, as defined in section 5126.281 of the Revised Code, and that are subject to regulation by the department, regardless of source of payment, including:

(i) A contracting entity of a county board, as defined in section 5126.281 of the Revised Code.

(ii) A provider licensed under section 5123.19 of the Revised Code. For the purposes of paragraph (J) of this rule, "provider" does not mean an intermediate care facility for the mentally retarded (ICF/MR) certified under Title XIX of the "Social Security Act."

(iii) A provider of supported living under section 5126.431 of the Revised Code.

(iv) A provider of respite care certified under sections 5123.171 and 5126.05 of the Revised Code.

(v) A provider approved to provide medicaid services under home and community-based services waivers administered by the department.

(2) The county board shall ensure that:

(a) Medical factors are considered in the development of behavior support plans.

(b) A behavior assessment is completed prior to implementation of any written behavior support plan to help identify the causes for a behavior and to determine the most appropriate teaching and support strategies. The behavior support plan shall be developed to follow the findings of the behavior assessment.

(c) Behavior support methods are integrated into individual plans and are designed to provide a systematic approach to helping the individual learn new, positive behaviors while reducing undesirable behaviors.

(d) Restraint and time-out, as defined in paragraph (J) of this rule, are only used with behaviors that are destructive to self or others and only when all other conditions required by paragraph (J) are met.

(e) Policies and procedures, including administrative resolution of complaints procedures in accordance with rule 5123:2-1-12 of the Administrative Code, are available to all staff, individuals receiving services from the county board, parents of minor children, legal guardians, and providers.

(f) Behavior support methods are employed with sufficient safeguards and supervision to ensure that the safety, welfare, due process, and civil and human rights of individuals receiving county board services are adequately protected.

(g) Aversive behavior support methods are never used for retaliation, for staff convenience, or as a substitute for an active treatment program (interdisciplinary team developed and approved per individual plans).

(h) Positive and less aversive teaching and support strategies are demonstrated to be ineffective prior to use of more intrusive procedures.

(i) Standing or as needed programs for the control of behavior are prohibited. A "standing or as needed program" refers to the use of a negative consequence or an emergency intervention as the standard response to an individual's behavior without developing a behavior support plan for the individual as required by paragraph (J) of this rule.

(j) A behavior support committee reviews and approves or rejects all plans that incorporate aversive methods, including restraint and time-out, and reviews ongoing plans that incorporate aversive methods, including restraint and time-out. The committee shall include persons knowledgeable in behavior support procedures, including administrators and persons employed by a provider who are responsible for implementing behavior support plans, but not those directly involved with the plan being reviewed. The authors of the behavior support plan may attend committee meetings to provide information and to facilitate incorporation of suggested changes.

(k) A human rights committee reviews and prior approves or rejects all behavior support plans using aversive methods, including restraint and time-out, and those which involve potential risks to the individual's rights and protections. The human rights committee shall ensure that the rights of individuals are protected. The committee shall include, at least, one parent of a minor or guardian of an individual eligible to receive services from a county board, at least one staff member of the county board or provider convening the committee, an individual receiving services from a county board, qualified persons who have either experience or training in contemporary practices to support behaviors of individuals with developmental disabilities, and, at least, one member with no direct involvement in the county board's programs. One human rights committee may serve more than one county board or provider.

(l) The behavior support committee and the human rights committee, which reviews the plan, is either those formed by the county board or those formed by the provider. In this situation, representatives of both agencies shall be involved. A county board or provider may establish one multi-purpose committee to fulfill all functions of the behavior support committee and the human rights committee. County boards and/or providers may jointly establish and share the operation of a behavior support committee, a human rights committee, or a multi-purpose committee.

(m) A behavior support plan includes a case history (including medical information), results of a behavior assessment, baseline data, behaviors to be increased and decreased, procedures to be used, persons responsible for implementation, review guidelines, and signature/date blocks including space for dissenting opinions.

(n) Training and experience required for staff who develop behavior support plans and for all persons employed by a provider who are responsible for implementing plans are specified and required training is documented.

(o) Prior documented informed consent is obtained from the individual receiving services from the county board program, or guardian if the individual is eighteen years old or older, or from the parent or guardian if the individual is under eighteen years of age. When informed consent cannot be documented in writing at the time it is obtained, such consent shall be documented in writing within three days of implementation. This written informed consent shall be updated at least annually. Any revisions to a behavior support plan requiring behavior support committee approval shall require written informed consent from the individual receiving services from the county board program, or guardian if the individual is eighteen years old or older, or from the parent or guardian if the individual is under eighteen years of age. "Informed consent" means an agreement to allow a proposed action, treatment or service to happen after a full disclosure of the relevant facts. The facts necessary to make the decision include information about the risks and benefits of the action, treatment or service; acceptable alternatives to such action, treatment or service; the consequences of not receiving such action, treatment or service; and the right to refuse such action, treatment or service. The behavior support plan shall be presented in a manner that can be understood by the individual or parent of a minor or guardian.

(p) A regular review of all behavior support plans is held, at least, in conjunction with individual plan updates. Plans that incorporate aversive methods, including restraint and time-out, shall be reviewed as determined by the interdisciplinary team but at least every thirty days. Status reports on a plan that incorporates aversive methods, including restraint and time-out, shall be provided to the individual receiving services from the county board program, or guardian if the individual is eighteen years old or older, or the parent or guardian if the individual is under eighteen years of age. Additionally, for individuals who receive services from a provider, status reports shall be provided to the provider.

(q) Prohibited actions are reported as major unusual incidents in accordance with rule 5123:2-17-02 of the Administrative Code. Prohibited actions shall include the following:

(i) Any physical abuse of an individual such as striking, spitting on, scratching, shoving, paddling, spanking, pinching, corporal punishment or any action to inflict pain.

(ii) Any sexual abuse of an individual.

(iii) Medically or psychologically contraindicated procedures.

(iv) Any psychological/verbal abuse such as threatening, ridiculing, or using abusive or demeaning language.

(v) Placing the individual in a room with no light.

(vi) Subjecting the individual to damaging or painful sound.

(vii) Denial of breakfast, lunch or dinner.

(viii) Squirting an individual with any substance as a consequence for a behavior.

(ix) Time-out in a time-out room exceeding one hour for any one incident and exceeding more than two hours in a twenty-four hour period. Use of a time-out room requires the additional oversight specified in paragraphs (J)(3) and (J)(4) of this rule and the following safeguards:

(a) A time-out room shall not be key locked, but the door may be held shut by a staff person or by a mechanism that requires constant physical pressure from a staff person to keep the mechanism engaged.

(b) The room must be adequately lighted and ventilated, and provide a safe environment for the individual.

(c) An individual in a time-out room must be protected from hazardous conditions including, but not limited to, presence of sharp corners and objects, uncovered light fixtures, or unprotected electrical outlets.

(d) The individual must be under constant visual supervision by staff at all times.

(e) A record of time-out activities must be kept.

(f) Emergency placement (i.e., without a written plan) of an individual in a time-out room is not allowable.

(x) Systematic, planned intervention using manual, mechanical, or chemical restraints, except when necessary to protect health, safety, and property and only when all other conditions required by paragraph (J) of this rule are met.

(xi) Medication for behavior control, unless it is prescribed by and under the supervision of a licensed physician who is involved in the interdisciplinary planning process.

(r) Behavior support policies and procedures adopted by the county board or the provider:

(i) Promote the growth, development and independence of the individual;

(ii) Address the extent to which individual choice will be accommodated in daily decision-making, emphasizing self-determination and self-management, to the extent possible;

(iii) Specify the individual's conduct to be allowed or not allowed;

(iv) Be available to all staff, the individual, parents of minor children, legal guardians, and providers;

(v) To the extent possible, be formulated with the individual's participation; and

(vi) Ensure that an individual must not discipline another individual, except as part of an organized system of self-government.

(s) The climate for behavior support is characterized by:

(i) Interactions and speech that reflect respect, dignity, and a positive regard for the individual;

(ii) The setting of acceptable behavioral limits for the individual;

(iii) The absence of group punishment;

(iv) The absence of demeaning, belittling or degrading speech or punishment;

(v) Staff speech that is even-toned made in positive and personal terms and without threatening overtones or coercion;

(vi) Conversations with the individual rather than about the individual while in the individual's presence;

(vii) Respect for the individual's privacy by not discussing the individual with someone who has no right to the information; and

(viii) The use of people-first language instead of referring to the individual by trait, behavior, or disability.

(3) Requirements for restraint and time-out

(a) The use of restraint and time-out, because of their possible adverse effects on health and safety, shall require additional oversight by the department. As used in paragraph (J) of this rule, the following definitions shall apply:

(i) "Restraint" means any one of the following:

(a) "Chemical restraint," which means a prescribed medication for the purpose of modifying, diminishing, controlling, or altering a specific behavior. "Chemical restraint" does not include the following:

(i) Medications prescribed for the treatment of a diagnosed disorder as found in the current version of the American psychiatric association's "Diagnostic and Statistical Manual"

(DSM);

(ii) Medications prescribed for treatment of a seizure disorder.

(b) "Emerging methods and technology," which means new methods of restraint or seclusion that create possible health and safety risks for the individual, including methods or technology that were not developed prior to the effective date of this rule.

(c) "Manual restraint," which means a hands-on method that is used to control an identified behavior by restricting the movement or function of the individual's head, neck, torso, one or more limbs or entire body, using sufficient force to cause the possibility of injury.

(d) "Mechanical restraint," which means a device that restricts an individual's movement or function applied for purposes of behavior support, including a device used in any vehicle, except a seat belt of a type found in an ordinary passenger vehicle or an age-appropriate child safety seat.

(ii) "Time-out," which means confining an individual in a room and preventing the individual from leaving the room by applying physical force or by closing a door or other barrier, including placement in such a room when a staff person remains in the room with the individual.

(b) Prior approval from the director must be obtained before using the following methods of restraint:

(i) Any emerging methods and technology designated by the director as requiring prior approval; or

(ii) Any other extraordinary measures designated by the director as requiring prior approval, including brief application of electric shock to a part of the individual's body following an identified behavior.

(c) Restraint or time-out shall be discontinued if it results in serious harm or injury to the individual or does not achieve the desired results as defined in the behavior support plan.

(d) Any use of restraint or time-out in an unapproved manner or without obtaining required consent, approval, or oversight shall be reported as a major unusual incident pursuant to rule 5123:2-17-02 of the Administrative Code.

(e) Any use of restraint or time-out that results in an injury that meets the definition of a major unusual incident or an unusual incident shall be reported as such pursuant to rule 5123:2-17-02 of the Administrative Code.

(f) Within five working days after local approval of a behavior support plan using restraint or time-out, the county board or provider shall notify the department by facsimile or other electronic means in a format prescribed by the department. Upon request by the department, the county board or provider shall submit any additional information regarding the use of the restraint or time-out.

(4) Department oversight of behavior support plans

(a) The department shall provide oversight of behavior support plans, policies, and procedures as deemed necessary to ensure individual rights and the health and safety of the individual.

(b) The department shall select a sample of behavior support plans for additional review to ensure that the plans are written and implemented in a manner that adequately protects individuals' health, safety, welfare, and civil and human rights. These reviews may be conducted by department staff designated by the director or by any qualified entity selected by the department.

(c) The department shall take immediate action, as necessary, to protect the health and safety of individuals served. Such action may include, as appropriate, the following:

(i) Suspension of any behavior support plan(s) not developed, implemented, documented, or monitored in accordance with paragraph (J) of this rule or where significant trends and patterns in data suggest the need for further review. When a behavior support plan is suspended, the department shall ensure that a new behavior support plan is developed and implemented in accordance with paragraph (J) of this rule.

(ii) Technical assistance in the development of a new behavior support plan.

(iii) Referral to the major unusual incident, licensure, or accreditation units of the department or to other state agencies or licensing bodies.

(d) The department shall compile information about the use of behavior supports throughout the state and share the results with county boards, providers, advocates, family members, and other interested parties. The department shall use the information to study and report on patterns and trends in the use of behavior supports, including strategies for addressing problems identified.

(e) By the effective date of this rule, the department shall establish a behavior support advisory committee made up of persons knowledgeable about behavior support and representatives of groups that have expressed an interest in the application of behavior support as specified in paragraph (J) of this rule. The behavior support advisory committee shall advise the department in the following matters:

(i) Trends and patterns in behavior support methods reported to the department;

(ii) Technical assistance needs throughout the state;

(iii) Behavior support issues raised by or referred to divisions or units of the department;

(iv) Plans for improving the quality of behavior support throughout the state;

(v) Any other pertinent issues related to implementation of this rule.

(K) Safety

(1) The design and maintenance of program facilities and equipment shall be in conformance with all applicable laws, including the Americans with Disabilities Act and Section 504 - Rehabilitation Act of 1973 and any reauthorization of these acts by the federal government.

(2) Each program facility owned, leased, or operated by the county board shall be inspected annually by the local fire marshal or designee to ensure compliance with fire safety practices.

(3) If the county board provides a swimming program, regardless of location, a person shall be present who has a current water safety instructor certificate, or a senior lifesaving certificate, or an adapted aquatics certificate.

(4) The county board shall develop written building emergency plans, which include procedures for fire, tornado, and other emergencies. These building emergency plans shall be available to and communicated in writing to all members of the staff, including volunteers.

(5) The building emergency plans shall include procedures for emergency closing of all program components operated in county board facilities as well as notification of families receiving home-based services and persons in other sites receiving or providing services.

(6) The building emergency plans shall include provisions for dealing with bomb threats, medical emergencies, power failures, and natural disasters.

(7) The building emergency plans shall provide for the training of at least one staff member in each building in techniques of fire suppression.

(8) The building emergency plans shall include procedures for reporting all accidents or injuries within twenty-four hours of the occurrence. Such report shall include recommendations for prevention at a future time. Information concerning health and special job considerations shall be communicated to appropriate supervisory personnel.

(9) The building emergency plans shall require all of the following:

(a) Emergency fire drills shall be conducted not less than once a month in each building and shall be recorded.

(b) Tornado drills shall be conducted monthly during the tornado season of April, May, June and July.

(c) A written analysis of the conduct and effectiveness of each fire drill and tornado drill shall be prepared by a designated staff member and submitted to the superintendent or designee.

(d) The evacuation plan for fire and tornado drills and other emergencies shall be posted in each room or special area of the facility.

(e) Fire extinguishers, fire gongs, and alarms shall be properly located, identified, and kept in good working order.

(f) Storage areas for combustible or flammable materials shall be effectively separated from all rooms and work areas in such a way as to minimize and inhibit the spread of a fire.

(g) All hallways, entrances, ramps, and corridors shall be kept clear and unobstructed at all times.

(h) Power equipment, fixed or portable, should include operating safeguards as required by the division of safety and hygiene, bureau of worker's compensation.

(L) Health

(1) County board policies and procedures regarding health shall be written, shall ensure the general health and well-being of all individuals and shall include the following:

(a) Reporting of all accidents and incidents to the parents of a minor or guardian and, when appropriate, other persons having care of the individual including residential services/supports providers, and maintaining a record of any such incident on file. The accident or incident record shall be initiated within twenty-four hours of when the accident or incident occurred.

(b) Providing first aid and emergency treatment.

(c) Securing emergency squad or ambulance services or the services or the individual's personal physician.

(d) Providing first aid and CPR training to appropriate county board registered, certified and licensed personnel by a person who has a valid training certificate in first aid and CPR.

(e) Providing suitable first-aid facilities, equipment, and supplies.

(f) Providing training to county board personnel in the recognition and reporting of abuse and neglect.

(g) Providing for the management of communicable diseases including temporary exclusion from the program for health reasons, handling of illness on-site and return to the program after an illness or other health condition. These procedures shall not exclude an individual from services for a handicapping condition, such as AIDS. These procedures shall include providing training to all county board personnel in the use of universal precautions.

(h) Posting emergency numbers by each telephone.

(2) These written policies and procedures shall be communicated to all personnel, persons served, parents of a minor or guardian, and residential services/supports providers, and shall be available in each county board program facility upon request.

(3) All medication shall be pharmacy-labeled to indicate owner, contents, required dosage and schedule. Such medication shall be secured in a locked cabinet and removed by designated staff persons.

(4) The county board shall adopt a policy concerning administration of medications.

(5) A health record shall be on file within thirty days of enrollment for each individual which contains ongoing pertinent health information, including authorization for emergency medical treatment, a record of current immunizations, a list of any medications, and a list of any allergies and treatments.

(M) Food service

All programs providing food service shall:

(1) Have on file in the administrative office, written evidence of an annual inspection of food preparation, storage, and serving areas by the local department of health; and

(2) Have on display all required permits in keeping with state department of health regulations and shall employ food handlers who meet all state and local health requirements.

(N) State reporting and subsidy

(1) The county board shall comply with reporting procedures and schedules requested by the director of the department.

(2) Subsidy from the department shall, subject to the approval of the director, be withdrawn or reduced in programs which:

(a) Employ staff who fail to meet certification, registration or licensing requirements as established by the department;

(b) Fail to comply with the minimum program and operating requirements as established by the department or do not have approved written plans for compliance, which include timelines and an outline of how minimum compliance will be reached. Such plans of compliance shall be approved by the department and be used by the county board in the development, review, and modification of its annual action plan; and

(c) Do not provide services and supports to former individuals of state mental retardation facilities on a nondiscriminatory basis.

(O) Each county board shall have a copy of Chapter 5126. of the Revised Code and the administrative rules of the department and shall make pertinent information available to administrative staff. The department will provide updated administrative rules.

(P) Waiver procedures

The county board or the department may initiate a request for approval by the department for a waiver of compliance regarding requirements outlined in the rules under Chapter 5123:2-1 of Administrative Code that govern the operation of county board programs and services, so long as the requirements are not those of the Ohio Revised Code.

R.C. 119.032 review dates: 12/23/2003

Promulgated Under: 119.03

Statutory Authority: 5123.011, 5123.04, 5123.19, 5126.01, 5126.041, 5126.05, 5126.08

Rule Amplifies: 5123.01 , 5123.011 , 5123.19 , 5126.01 , 5126.041 to 5126.044 , 5126.05 , 5126.08

Prior Effective Dates: 7/1/76, 12/11/83, 7/1/91 (Emer.), 9/13/91, 4/22/93, 6/2/95 (Emer.), 12/9/95, 2/28/96 (Emer.), 5/18/96, 7/12/97, 8/1/01, 3/21/02

5123:2-1-03 Locally-funded transportation.

(A) Purpose

The purpose of this rule is to establish standards and procedures for the provision of locally-funded transportation services to individuals eligible for county board services.

(B) Applicability

(1) The provisions of this rule shall apply to:

(a) County boards in their capacity as providers of specialized transportation and as otherwise specified in this rule.

(b) Providers of specialized transportation under contract with a county board which shall provide services in accordance with their contracts with the county board. Each contract shall specify the terms and conditions for the delivery of training, services, and supports to individuals served and shall be in compliance with applicable law. It is the responsibility of the county board to ensure that the contract meets such requirements, and that contracting entities are trained in and have access to applicable rules in the Administrative Code and to applicable policies of the county board.

(2) The provisions of this rule do not apply to transportation services provided under a medicaid waiver administered by the department which shall be provided in accordance with Chapter 5123:2-9 of the Administrative Code.

(C) Definitions

(1) "County board" means a county board of developmental disabilities.

(2) "Department" means the Ohio department of developmental disabilities.

(3) "Individual" means a person with a developmental disability.

(4) "Individual service plan" means the written description of services, supports, and activities to be provided to an individual.

(5) "Individualized education program" has the same meaning as in rule 3301-51-01 of the Administrative Code.

(6) "Medicaid" means the program that is authorized by Chapter 5111. of the Revised Code and provided by the Ohio department of job and family services under Chapter 5111. of the Revised Code, Title XIX of the Social Security Act, 79 Stat. 286 (1965), 42 U.S.C. 1396 , as amended, and the waivers of Title XIX requirements granted to the department by the centers for medicare and medicaid services.

(7) "Non-specialized transportation" means a transportation service available to the general public including, but not limited to, transportation provided by a public transit agency organized under Chapter 306. of the Revised Code and transportation provided by a participating agency under the Ohio department of transportation Ohio coordination program.

(8) "Specialized transportation" means a transportation service designed and operated to serve primarily individuals, including a transportation service provided by an entity licensed or certified by the department.

(D) Transportation services - general provisions

(1) A county board shall ensure, in accordance with section 5126.04 of the Revised Code, that an array of transportation services is available for individuals enrolled in the county board's programs.

(2) A county board may provide transportation services through collaborative arrangements with other entities. County boards are encouraged to cooperate with other local entities that provide transportation to persons who are elderly or who have disabilities and other types of transportation service providers.

(3) A county board shall provide transportation services in accordance with the individual service plan or individualized education program, as applicable, and shall incorporate within the individual service plan or individualized education program any specific transportation supports (e.g., travel training and safety issues).

(4) To meet an individual's transportation needs, a county board may provide specialized transportation or assist the individual in accessing non-specialized transportation.

(5) A county board shall ensure the development and provision of appropriate annual safety instruction to all individuals who use specialized transportation and/or annually communicate safety information to appropriate family members, as applicable, and caregivers.

(E) Specialized transportation

(1) Specialized transportation shall be provided in compliance with applicable law including, but not limited to, the requirements of this rule, rule 3301-51-10 of the Administrative Code, and Chapter 3301-83 of the Administrative Code.

(2) A provider of specialized transportation shall complete the following vehicle inspections:

(a) Annual vehicle safety inspection;

(b) Systematic preventative maintenance program inspections;

(c) Daily pre-trip safety inspection; and

(d) Daily post-trip inspection for remaining passengers and belongings.

(3) Notwithstanding paragraphs (E)(2)(a) and (E)(2)(b) of this rule, a county board may establish alternative safety requirements and procedures for staff-owned personal vehicles used to transport individuals.

(4) Individuals eligible for a county board program shall not travel in a vehicle on a regularly scheduled route more than ninety minutes one way on any day.

(5) A county board shall develop a written transportation procedure manual(s).

(6) A county board shall develop and implement written policies and procedures for the general supervision and operation of specialized transportation which shall address, but are not limited to:

(a) The requirements of this rule.

(b) Transportation during inclement weather.

(c) Emergency situations and evacuation drills.

(d) Qualifications of vehicle drivers, assistants, and substitutes that shall, at a minimum, address:

(i) Age requirements;

(ii) Driving experience;

(iii) Licensure requirements, including commercial drivers license and Ohio department of education qualifications, as applicable;

(iv) Driving record;

(v) Insurance coverage to be provided;

(vi) Drug and alcohol testing;

(vii) Criminal background check requirements;

(viii) Abuser registry check requirements;

(ix) Nurse aide registry check requirements;

(x) Training in the rights of individuals set forth in sections 5123.62 to 5123.64 of the Revised Code;

(xi) Training in the requirements of rule 5123:2-17-02 of the Administrative Code relating to incidents adversely affecting health and safety; and

(xii) Annual in-service requirements.

(e) Training for vehicle drivers, assistants, and substitutes prior to their assignment to a vehicle with passengers on board that shall, at a minimum, address:

(i) Review and distribution of appropriate transportation procedure manual(s);

(ii) General characteristics and needs of individuals;

(iii) Familiarization with vehicle operation;

(iv) Familiarization with proper use, operation, and safety inspection of adaptive equipment and securement systems such as wheelchairs, vests, and car seats; and

(v) Familiarization with the safe operation of wheelchair lift systems and the safe loading and unloading of individuals.

(7) Vehicle drivers, assistants, and substitutes shall have access to appropriate information about individuals to the degree that such information might affect safe transportation and medical well-being while being transported. This information shall be available in the vehicle, or readily accessible in the transportation provider's office, or county board's transportation office. If the information is not carried in the vehicle, drivers, assistants, and substitutes shall be instructed on how to access the information in the event of an emergency. This information shall be maintained in a confidential manner and at a minimum include:

(a) The identify of all authorized passengers, which in addition to the individuals being transported, may include family members, caregivers, and volunteers.

(b) Interventions specified in the individual service plans of individuals being transported. This information shall include specifics concerning how relevant restraints should properly be used during transportation as well as non-violent crisis intervention strategies identified in the individual service plan.

Replaces: 5123:2-1-03

Effective: 03/19/2012
R.C. 119.032 review dates: 03/19/2017
Promulgated Under: 119.03
Statutory Authority: 5123.04 , 5126.05 , 5126.08 , 5126.082
Rule Amplifies: 5123.04 , 5126.05 , 5126.052 , 5126.08 , 5126.082
Prior Effective Dates: 07/01/1976, 12/11/1983, 10/21/1994, 01/06/2005

5123:2-1-04 Early intervention.

(A) Purpose The purpose of this rule is to direct the county board in the provision of services and supports to infants and toddlers birth through age two with or at-risk for developmental delays or disabilities and their families. County board early intervention shall be part of a comprehensive, collaborative, coordinated, and family-centered system. Early intervention services are designed to meet the needs of the family related to enhancing the child's development and to meet the developmental needs of young children.

(B) Definitions

(1) "County board" means a county board of mental retardation and developmental disabilities established under Chapter 5126. of the Revised Code or a regional council of government formed under section 5126.13 of the Revised Code by two or more county boards.

(2) "Department" means the Ohio department of developmental disabilities established by section 121.02 of the Revised Code.

(3) "Developmental delay" means developmental milestones expected for a child's chronological age have not been achieved as measured by qualified professionals using appropriate diagnostic instruments and/or procedures.

(4) "Developmental disability" means a severe, chronic disability that is characterized by all of the following:

(a) It is attributable to a mental or physical impairment or a combination of mental and physical impairments, other than a mental or physical impairment solely caused by mental illness as defined in division (A) of section 5122.01 of the Revised Code;

(b) It is manifested before age twenty-two;

(c) It is likely to continue indefinitely; and

(d) It results in at least one developmental delay or a condition known to result in a delay in accordance with section 5126.01 of the Revised Code.

(5) "Early intervention" means services and supports provided as early as possible to enhance the family's ability to meet the developmental needs of their child.

Early intervention services and supports are designed to identify the presence of a disability, delay, or risk-factors which may lead to a delay, and provide interventions responsive to the preferences of the family that maximize the child's optimal growth and development. Early intervention services and supports may include any of the types of services listed under the "Individuals with Disabilities Education Act" (IDEA), Part C system, Title 34 of the Code of Federal Regulations, sections (c) and (d) of 303.12 (revised as of July 1, 2002). The identification of a need for any specific early intervention service or support results from the comprehensive, ongoing assessment of the child and family.

(6) "Early intervention specialist" means a professional, certified by the department in accordance with rule 5123:2-5-05 of the Administrative Code, trained to develop and implement strategies and interventions, which may include, but are not limited to, the special instruction identified in IDEA, Part C as follows:

(a) The design of learning environments and activities that promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction;

(b) Curriculum planning, including the planned interaction of personnel, materials, and time and space, that leads to achieving the outcomes in the child's IFSP;

(c) Providing families with information, skills and support related to enhancing the skill development of the child; and

(d) Working with the child to enhance the child's development.

(7) "Family and children first council" means the council established pursuant to section 121.37 of the Revised Code at state and local levels with a stated purpose of helping families seeking government services by streamlining and coordinating existing services and supports for children birth through twenty-one years of age.

(8) "HMG" means "Help Me Grow," an Ohio family and children first initiative directed by the Ohio department of health and coordinated on the county level by the family and children first council. HMG is Ohio's birth through two system designed to create, nourish and maintain a coordinated, community-based infrastructure that promotes transdisciplinary, family-centered services and supports to eligible expectant parents, newborns, infants and toddlers, and their families.

(9) "IFSP" means individualized family service plan, a written plan for providing early intervention services to a child eligible under IDEA, Part C. The IFSP may serve to authorize CAFS services in accordance with rule 5123:2-15-18 of the Administrative Code if the requirements of that rule are met with respect to such services. In Ohio, an IFSP is also written for a child in the HMG system at-risk for delays.

(10) "Lead agency " means the agency legislated or designated by the governor as responsible for the administration of the "Individuals with Disabilities Education Act" (IDEA), Part C. In Ohio, the department of health is the lead agency for Part C of IDEA and the HMG statewide system.

(11) "Parent" means a parent, guardian, person acting as a parent of a child, or surrogate parent who has been appointed in accordance with the Ohio department of health. "Parent" does not include the state if the child is a ward of the state.

(12) "Part C" means the section of the "Individuals with Disabilities Education Act"

(IDEA), under Title 34 of the Code of Federal Regulations, Part 303 (revised as of July 1, 2002), which regulates the early intervention program for infants and toddlers with disabilities.

(C) Description of services The county board shall describe in writing its role in the county's comprehensive early intervention system of services and supports. The county board shall base this description on the county family and children first council's governance of their HMG system, the plan and priorities developed under section 5126.04 of the Revised Code, and the availability of funds. This description should identify how the county board will provide choices and options to families that enhance quality outcomes for the child and family. The county board shall communicate this to families, county agency partners, and regulatory bodies for the purpose of clarifying the board's role within the HMG system. This description shall include but not be limited to:

(1) How the county board, as an integral part of the system that serves children birth through age two, provides year-round services and supports to children with developmental delays and disabilities, and may provide services to children at-risk for developmental delays or disabilities, and their families, based on the county board's plans, priorities, and availability of funds; and

(2) What the county board's role is in the provision of the HMG program components:

(a) Outreach/child find/intake/procedural safeguards;

(b) Prenatal visits;

(c) Newborn home visits;

(d) Ongoing home visiting services;

(e) Service coordination/individualized family service plan development, implementation, and review;

(f) Family support services;

(g) Evaluation to determine eligibility and ongoing assessment;

(h) Specialized services in everyday routines, activities, and places.

(D) Personnel qualifications

(1) Employees of county boards or contracting entities who are hired to work as early intervention specialists, program assistants, or supervisors, shall hold applicable registration or certification in accordance with rule 5123:2-5-05 of the Administrative Code.

(2) A person who substitutes in any one assigned early intervention specialist's position for more than sixty consecutive working days shall obtain either a substitute grade or temporary grade early intervention specialist level certification. A person who substitutes in any one assigned early intervention specialist's position for sixty or fewer consecutive working days is not required to hold a credential issued by the department.

(3) A person employed on or before December 4, 1992 as a supervisor of an early intervention program for less than .5 F.T.E.

(full-time equivalent) is not required to hold a credential issued by the department. A person newly employed after December 4, 1992 as a supervisor of an early intervention program for less than .5 F.T.E.

(full-time equivalent) shall possess:

(a) Early intervention supervisor level certification issued by the department; or

(b) A currently valid Ohio department of education provisional certificate in supervision with validation in early education of the handicapped or special education for children with disabilities; or

(c) A master's degree in a related field (e.g., audiology, education, family therapy, medicine, nursing, nutrition, occupational therapy, orientation and mobility, pediatrics, physical therapy, psychology, social work, special education, or speech and language pathology) from an approved educational institution, and five years related paid work experience in early intervention, birth through two, two of which are within the last five years.

(4) Employees of county boards or contracting entities providing services and supports to infants and toddlers and their families shall possess a currently valid Ohio license, certificate, or credential issued by the appropriate professional licensing, certifying, or credentialing entity that governs requirements for the respective service provided.

(5) Employees of county boards or contracting entities who are hired to provide services solely to the HMG system, (e.g. family support specialists, HMG project directors, service coordinators) shall meet Ohio department of health policies on personnel standards, and are not required to hold a credential issued by the department.

(E) Eligibility for children with developmental delays or disabilities

(1) Eligibility definition County boards shall provide services and supports to children under three years of age with developmental delays or disabilities and their families. To be eligible for HMG services and supports provided by a county board, an infant or toddler shall:

(a) Have a developmental delay in one or more of the following areas, as measured by a research-based developmental evaluation tool and informed clinical opinion as defined by the lead agency:

(i) Cognitive development,

(ii) Physical development, including vision, hearing and nutrition,

(iii) Communication development,

(iv) Social or emotional development,

(v) Adaptive development (self-help); or

(b) Have a diagnosed physical or mental condition that has a high probability of resulting in a developmental delay or disability that is based on a written medical report; or

(c) Have already been determined Part C eligible in the state of Ohio.

(2) Eligibility criteria To determine if an infant or toddler has a developmental delay or disability, the evaluation to determine eligibility shall:

(a) Be preceded by a developmental screening, unless the child has a diagnosed physical or mental condition. The developmental screening must be completed and shared with the family within forty-five calendar days of referral to the HMG system.

(b) Be completed by a developmental evaluation team, which includes the parents, and at least two appropriately licensed or certified professionals from two different disciplines, one of whom may be the service coordinator. It is recommended that one member of the evaluation team have specialized training or expertise with the child's suspected need or primary area of delay.

(c) Be based on at least one research-based developmental evaluation tool and informed clinical opinion. If a delay is not confirmed using a developmental evaluation tool, then informed clinical opinion can be used by the members of the developmental evaluation team to determine a delay.

(d) Include the five developmental areas specified in paragraph (E)(1)(a) of this rule with a focus on the child's unique strengths and needs in each domain.

(e) Include a vision, hearing, and nutrition screening completed by qualified personnel.

(f) Be provided at no cost to the family.

(g) Include a review of pertinent records related to the child's health, developmental and medical history. If a child has already had an evaluation in all or some of the domains including a medical evaluation within the past ninety days, this information must be used as part of the developmental evaluation.

(h) Be preceded by informed, written parental consent for the screening and evaluation.

(i) Be conducted in collaboration with the family in settings and at times that are selected by families.

(j) Be administered in the primary language of the child and family or other mode of communication unless it is clearly not feasible to do so.

(k) Be selected and administered so as not to be racially or culturally discriminatory.

(l) Be coordinated by the family's service coordinator.

(m) Be written and include the date or dates of the evaluation, evaluation method, summary of the child's unique strengths and needs in each domain, statement of eligibility, identification of the domains that are delayed, and each evaluator's agency, degree, certification and/or professional license.

(n) Be completed and a copy of the report shared with the family within forty-five calendar days of the initial referral to the system for a suspected delay. If the child is eligible, the IFSP is developed and signed within the same forty-five calendar days and without undue delay. If the family disagrees with the eligibility determination, their rights shall be explained and, upon consent, the appropriate referral made. In the event of exceptional family circumstances, which make it impossible to complete the developmental evaluation within forty-five calendar days, the service coordinator shall document the exceptional circumstances and that the parents were informed and understood that there is an alternative timeline and are in agreement.

(3) If the county board is not involved in the evaluation to determine eligibility for HMG as described in paragraphs (E)(1) and (E)(2) of this rule, the county board shall request a copy of the written evaluation report for the child's record and shall maintain documentation that a request was made if the information is not available.

(F) Eligibility for children who are at-risk for developmental delays or disabilities County boards may provide services and supports to children under three years of age who are at-risk for developmental delays or disabilities and their families as determined by the county board through the board's plan and priorities developed under section 5126.04 of the Revised Code.

(1) Eligibility definition If the county board has determined through its planning process to serve children who are at-risk for developmental delays or disabilities, the infant or toddler shall:

(a) Meet the definition of at-risk for developmental delay as defined by the lead agency; and

(b) Have had a screening indicating no delay is suspected.

(2) Eligibility criteria

(a) The developmental screening must be completed and shared with the family within forty-five calendar days of referral.

(b) The service coordinator assigned to the family shall verify the family has four or more risk factors, which lead to eligibility for the infant or toddler. When the service coordinator is not a county board employee, the county board shall request a copy of the eligibility determination for the child's record and shall maintain documentation that a request was made if the information is not available.

(G) Ongoing family and child assessment

(1) Children who are eligible for HMG services and supports and their families shall receive ongoing family and child assessments. Within forty-five calendar days of the initial referral to the system, the first family and child assessment shall be completed to gather information on the strengths, needs and choices of the child and family for the purpose of program planning.

(2) Ongoing assessments for program planning shall be completed by qualified personnel and shall be summarized, documented, and provide detailed strength-oriented information on the child's abilities and recommended approaches for future interventions. This information shall be provided to parents and other team members as parental consent allows. The family shall be provided every opportunity to take an active role in the assessment process. For children receiving ongoing county board services, the team members must review all current existing developmental and family information so that duplication of information gathering does not occur.

(H) Intake and referral Policies and procedures for intake and referral into the HMG system shall include the following:

(1) Upon receipt of a referral from the family or other source, the county board shall immediately refer the family to the centralized intake and referral system. Communication to the centralized intake and referral system shall include the date and time the initial referral was received by the county board to ensure that verbal or written contact can be made with the family within two working days after the initial referral.

(2) The county board may assume the responsibility for intake as part of the HMG system. When the county board receives the initial referral and proceeds with intake, the county board shall:

(a) Complete an intake form that includes the minimum requirements of the lead agency;

(b) Make verbal or written contact with the family within two working days after the initial referral;

(c) Ensure assignment of a service coordinator for that family and inform them that there must be only one service coordinator per family for the HMG system;

(d) Inform families that family support services are available, as ensured by the county family and children first council, as well as the opportunity to receive services from the family support specialist in the county;

(e) Provide data according to the data collection procedures of the county HMG system;

(f) Obtain written parent consent for release of all personally identifiable data, including medical diagnosis, to anyone other than the lead agency;

(g) Provide written follow-up to the referral source within forty-five days of the initial referral date, including information regarding the status of the referral; and

(h) Maintain intake records per the lead agency's "Client Records Policy."

(I) Child records

(1) For each child birth through two years of age enrolled in the county board to receive early intervention services and supports or service coordination from the county board, the following information shall be compiled and kept on file:

(a) Verification of birth. Acceptable documents which may be copied and kept on file include: a passport or attested transcript of a passport filed with a registrar of passports at a point of entry of the United States showing the date and place of birth of the child, an attested transcript of the certificate of birth, an attested transcript of the certificate of baptism or other religious record showing the date and place of birth of the child, an attested transcript of a hospital record showing the date and place of birth of the child, or a birth affidavit.

(b) Documents used to determine eligibility, including a record of four risk factors, the written report of the developmental evaluation, or the written medical report.

(c) Documentation verifying the date of request for or referral to services in the HMG system and the date of initial contact with the county board if the county board is assisting in the initial evaluation/assessment process.

(d) Any ongoing assessments of the child and family.

(e) A health record that contains ongoing pertinent health information, which includes a record of current immunizations or the exemption or waiver where an immunization is medically contraindicated, a list of medications, a list of any allergies and treatments, and authorization for emergency medical treatments.

(f) Unusual incident and major unusual incident forms.

(g) Center-based attendance, home and other community based visitation records, and ongoing, systematic program data. Documentation by each county board provider shall include date, duration, frequency, intensity and specific type of service provided, and outcomes in accordance with the IFSP. A summary of this data shall form the basis for the one-hundred-twenty-day progress report and be used to measure progress on the outcomes identified on the IFSP.

(h) Current IFSP, subsequent reviews, written notices regarding meetings, and other related correspondence with the family.

(i) Signed written consents and releases including, but not limited to, informed written consent for the developmental screening, developmental evaluation, family assessments, and ongoing services.

(j) Documentation that a request for a copy of any required information was made, but the information was not available.

(2) For each child birth through two years of age who is not enrolled in the county board for early intervention services and supports or for whom services are provided by an employee of the county board hired solely to assist the HMG system, the lead agency client records policy applies.

(J) IFSP and service coordination through the IFSP process

(1) The child's service coordinator is responsible to ensure the development, implementation, review and monitoring of the IFSP and its timelines. If the county board provides service coordination for an eligible child throughout the IFSP process, the service coordinator shall:

(a) Ensure all sections of the statewide IFSP form are completed.

(b) Ensure that written notice of all IFSP meetings is provided to families and providers.

(i) Meeting arrangements shall be made with, and written notices provided to, the family and other providers by the family's service coordinator early enough before the meeting date to ensure they will be able to attend.

(ii) IFSP meetings shall be conducted in settings and at times convenient to families and in the native language of the family or other mode of communication used by the family unless it is clearly not feasible to do so.

(c) Ensure required participation in and scheduling and facilitation of IFSP meetings and reviews. Facilitation includes coordinating a meeting time and location that results in the participation of as many service providers involved with the family as possible.

(i) Each initial IFSP meeting shall include the following participants:

(a) The parent or parents of the child;

(b) The service coordinator;

(c) A person or persons directly involved in conducting the evaluations and assessments;

(d) Persons who will be providing services to the child or family, as appropriate;

(e) Other family members, as requested by the parent, if feasible to do so;

(f) An advocate or person outside of the family, if the parent requests that person's participation;

(g) If a person or persons directly involved in conducting the evaluation and assessment or who will be providing services to the child or family is unable to attend a meeting, arrangements must be made for the person's involvement through other means.

(ii) Each review shall:

(a) Provide for the participation of persons in paragraphs (J)(1)(c)(i)(a) to

(J)(1)(c)(i)(d) of this rule. If conditions warrant, provisions must be made for the participation of other representatives identified in paragraph (J)(1)(c)(i) of this rule.

(b) Be conducted every one hundred twenty days or more frequently if conditions warrant or if the family or IFSP team member requests such a review.

(c) Determine the degree to which progress toward achieving the outcomes is being made, whether modifications or revisions of the outcomes or services are necessary, and include progress information from the child's parent(s) and service provider(s) identified by the family.

(iii) Each annual meeting to evaluate the IFSP shall:

(a) Include the participants listed in paragraphs (J)(1)(c)(i)(a) to (J)(1)(c)(i)(g) of this rule; and

(b) Be conducted on at least an annual basis to evaluate the IFSP for a child and the child's family and, as appropriate, to revise its provisions. The results of any current evaluations and other information available from the ongoing assessment of the child's family must be used to update the IFSP and determine what services are needed and will be provided.

(d) Ensure the following components of the IFSP are completed:

(i) The IFSP must include a statement of the child's present levels of development: cognitive, physical (including vision hearing and nutrition), communication, social or emotional, and adaptive. This information must be based on objective criteria and include parent input.

(ii) With the concurrence of the family, the IFSP must include a statement of the family's resources, priorities, and concerns related to enhancing the development of the child.

(iii) A statement of the major outcomes expected to be achieved for the child and family.

(iv) The criteria, procedures, and timelines used to determine the degree to which progress toward achieving the outcomes is being made and whether modifications or revisions of the outcomes or services are necessary.

(v) The IFSP must include a statement of the specific early intervention services necessary to meet the unique needs of the child and the family to achieve the outcomes including:

(a) The frequency, intensity, duration, location, and method of delivering the services.

(b) The natural environment, to the extent possible, including home and other community-based settings in which children without disabilities participate. If early intervention services cannot be achieved satisfactorily in the natural environment, a justification of the extent, if any, to which the services will not be provided in a natural environment.

(c) The payment arrangements, if any.

(vi) Medical and other services the child needs, including the funding sources to be used, dates for initiation, and the anticipated duration of those services.

(vii) The name of the service coordinator. This person will be responsible to ensure the implementation of the IFSP and coordination with other agencies and persons.

(e) Address transition throughout the IFSP process, particularly by providing support and information specific to the transition of the child at age three or from the HMG system at anytime.

(i) The transition planning process shall be completed:

(a) For program and service setting changes under the age of three, such as from the hospital to home, or from an early intervention program to a preschool program for children with or without special needs;

(b) At termination of early intervention services and supports; and

(c) For program and service setting changes for the child turning age three, preparation for the transition planning conference shall begin one hundred eighty days prior to the child's third birthday. The transition planning conference shall occur one hundred twenty days prior to the child's third birthday and shall be preceded by written notice of the conference in sufficient time to ensure attendance. This conference can occur at a scheduled one-hundred-twenty-day IFSP review.

(ii) All records shall be maintained in the child's file to document that mandated steps have been completed according to the Ohio department of health and the Ohio department of education transition guidelines.

(iii) The steps to be taken to support transition of the child and family to preschool special education services or other appropriate services shall include:

(a) Discussions with and training of parents regarding program and service options for which the child might be eligible, financial resources as they relate to the transition of the child.

(b) Procedures to prepare the child for changes in service delivery, including steps to help the child and family adjust to and function in a new setting.

(c) The transmission of information about the child to the receiving agency to ensure continuity of services, including evaluation and assessment information, copies of IFSPs that have been developed and implemented, and other relevant data, per written parental consent.

(f) Ensure team members present at the IFSP meeting sign the signature page documenting attendance at the meeting.

(g) Ensure written consent from the parent is obtained before any ongoing services listed on the IFSP may begin.

(h) Ensure families receive a signed copy of the IFSP within five business days of the meeting. This copy shall include documentation of all changes and updates at the conclusion of the meeting.

(i) Ensure, with parent consent, a copy of the IFSP is sent to the child's primary care physician (i.e., medical home) and all service providers listed on the outcome page of the IFSP.

(j) Provide service coordination to a weighted caseload of no more than forty-five children.

(k) Receive eight hours clinical supervision per month from a clinical supervisor who meets lead agency requirements. Personnel who are less than full-time equivalent must receive a proportionate amount of clinical supervision.

(l) Gather and submit data, including information for early track.

(m) Comply with the lead agency's policy on service coordination.

(2) Providers of services and supports to eligible children and their families shall participate in the development, implementation, review, and monitoring of the IFSP and its timelines. If the county board is participating in any part of the IFSP process, but is not providing service coordination for an eligible child, the county board shall:

(a) Use the statewide IFSP form made available through the Ohio department of health.

(b) Participate with the parent and other service providers in the development of one IFSP only, including attending the initial, review, and annual IFSP meetings as requested by the service coordinator or family.

(c) Provide information related to the IFSP process to the child's service coordinator, the IFSP team, or the parent, as appropriate, including evaluation or assessment information if the provider is directly involved and unable to attend a meeting.

(d) Supply required information for the IFSP when the county board or contract agency is requested to provide or fund a service or support leading to accomplishment of a child or family outcome. The county board must consent to the provision or funding of that service or support before it is listed on and obligated by the IFSP.

(e) Participate in data collection and ongoing assessment related to the accomplishment of child and family outcomes for the IFSP review at least every one hundred twenty days and for the annual meeting to evaluate the IFSP and to revise its provisions as needed.

(f) Participate in transition planning as requested by the service coordinator or parent six months prior to the child's third birthday or when the child exits the system at any other time.

(K) Parents' rights and procedural safeguards For infants and toddlers in the HMG system, the lead agency has established parents' rights and procedural safeguards that protect the rights of parents and their eligible children. The lead agency, in partnership with the state and county family and children first councils, is responsible for assuring effective implementation of these parents' rights and procedural safeguards by each local agency that is involved in the provision of early intervention services.

(1) For all infants and toddlers served by the county board, the county board shall:

(a) Ensure that parents are informed of their rights as outlined in the "Parents Rights in Help Me Grow" brochure and document that the parent has received a copy exists.

(b) Give annual notification of the availability of a procedure based on the resolution of complaints and due process under rule 5123:2-1-12 of the Administrative Code. The procedure must include timelines that ensure the process is completed within thirty days as stipulated by the lead agency.

(2) For all Part C eligible infants and toddlers served by the county board, the county board shall:

(a) Comply with the Ohio department of health's "Ohio Procedural Safeguards" policy;

(b) Ensure that parents are informed of these procedural safeguards afforded under the lead agency, provide a copy upon receipt of a complaint and upon request, and ensure that families are aware that they may file a complaint with the lead agency at any time;

(c) Ensure parents are afforded all requirements under section 5123.63 of the Revised Code, distribution of the "Bill of Rights."

(3) The county board shall ensure that parents of all children eligible and served by the county board are annually informed of the complaint resolution process through the county board. Upon entrance into the county board, the county board shall ensure that parents have been informed of their procedural safeguards through the Ohio department of health and the county family and children first council, and that they have been given a copy of the Ohio department of health's "Parents Rights in Help Me Grow" brochure.

(L) Staffing ratios The county board shall determine a methodology to ensure a reasonable child-toearly intervention specialist and support staff ratio and shall review caseloads at least annually. Procedures shall be written and shall ensure the county board will be able to provide services and supports to families and children as determined by the IFSP team. Some variables that may affect the ratio and be incorporated into the procedures include:

(1) The extent and intensity of the family supports provided;

(2) The extent and intensity of the child's needs;

(3) Location of services and supports including travel time for home-based services;

(4) The extent and time required to ensure completion of service coordination responsibilities, if applicable;

(5) The involvement and assistance of other services, supports, and agencies;

(6) The participation of age-eligible, typically developing children in center-based programming; and

(7) The resources available within the county board and the community.

(M) Program facility, materials and equipment The county board shall ensure that sufficient facilities, materials and equipment are available to address the programmatic needs of young children and families enrolled in the county board.

(N) Calendar In conjunction with the county family and children first council's comprehensive year-round HMG system, the county board shall ensure and make available early intervention services and supports on a year-round basis for a minimum of two hundred thirty-two days based on the availability of funds.

(O) Reporting and monitoring requirements To establish and maintain standards for early intervention services and supports offered by county boards, the county board shall:

(1) Participate in the department's monitoring system through the accreditation process established pursuant to section 5126.081 of the Revised Code and rule 5123:2-4-01 of the Administrative Code; and

(2) Provide information requested by the lead agency for the purpose of monitoring for compliance with Ohio department of health policies or Part C federal regulations.

(P) "Help Me Grow" (HMG) policies

A copy of the Ohio department of health's policies on the HMG system (final - October 2002) is available on the department's web site at http://odmrdd.state.oh.us.

This information is also available on the "Help Me Grow" web site at http://www.ohiohelpmegrow.org/.

Replaces: 5123:2-1-04

Effective: 06/28/2004
R.C. 119.032 review dates: 06/28/2009
Promulgated Under: 119.03
Statutory Authority: 5123.04 , 5126.05 , 5126.08 , 5126.082
Rule Amplifies: 5123.04 , 5126.05 , 5126.08 , 5126.082 , 121.37
Prior Effective Dates: 7/1/76, 12/11/83, 7/1/91, 9/2/93, 4/11/97

5123:2-1-05 [Rescinded]Background investigations on applicants for employment with a county board.

Effective: 01/01/2013
R.C. 119.032 review dates: 10/16/2012
Promulgated Under: 119.03
Statutory Authority: 5126.28
Rule Amplifies: 5126.28
Prior Effective Dates: 05/12/1995, 09/22/2002

5123:2-1-05.1 [Rescinded]Background investigations on persons employed in direct service positions by contracting entities of county boards.

Effective: 01/01/2013
R.C. 119.032 review dates: 10/16/2012
Promulgated Under: 119.03
Statutory Authority: 5126.281
Rule Amplifies: 5126.28 , 5126.281
Prior Effective Dates: 05/12/1995, 09/22/2002

5123:2-1-06 Adult services.

(A) Guiding principles

(1) Persons with developmental disabilities have the right to receive the full range of supports and services they need to be participating members of their communities. Employment services, continuing education, transportation services, technological supports, and therapeutic services should be available to individuals dependent upon their choices, desires and preferences.

(2) Employment options include but are not limited to community competitive employment, supported employment, mobile work crews, enclaves, entrepreneurships and sheltered employment. Regardless of the individual's choice of a work site, adults should have access to the supports necessary to be successful and should receive the benefits provided to other workers in the same setting.

(3) Individuals should have supports as needed to have access to retirement, recreational, social and employment activities. Services may be provided in an individual's home if appropriate. Individuals for whom work is not a priority have the right to spend their days involved in activities of interest and personal benefit in integrated, community-based settings. The county board shall plan and set priorities for services based on available resources.

(B) Personnel qualifications

Staff employed by the county board in adult services shall comply with rules 5123:2-5-01 and 5123:2-5-02 of the Administrative Code.

(C) County boards of MR/DD participating in the community alternative funding system or under the jurisdiction of other licensing or certifying bodies must comply with additional requirements as outlined in rules governing those programs.

(D) Eligibility

(1) Each county board shall have on file written procedures regarding entry into the program. This information shall be disseminated to the applicant, the applicant's legal guardian, staff and others upon request and reviewed annually. Information about the mission, programs and services of the county board shall be provided to the individual requesting services and, if appropriate family and friends, in a format that can be easily understood by the individual.

(2) To be eligible for adult services, an individual shall:

(a) Be sixteen years of age or older;

(b) Have a developmental disability as defined in section 5126.01 of the Revised Code; and

(c) If applicable, be placed into the program by the school district of residence as the least-restrictive environment in accordance with rule 3301-51-02 of the Administrative Code.

(3) Notwithstanding the definitions of "developmental disability" and "developmentally disabled person" in section 5126.01 of the Revised Code, all persons who were eligible for services and participated in programs offered by a county board of MR/DD on July 1, 1991, shall continue to be eligible for those services and to participate in those programs as long as they are in need of services.

(4) The county board shall ensure that eligibility determinations on behalf of an applicant be conducted in a timely manner and within forty-five calendar days after all information necessary to make the determination has been received from the referring party or applicant.

(5) The superintendent or his designee shall have the authority to make the final decision regarding eligibility of the individual.

(6) Individuals determined ineligible for county board of MR/DD services shall be afforded due process rights pursuant to rule 5123:2-1-02 of the Administrative Code. Records of individuals determined ineligible shall be maintained for five years after determination has been made. Individuals determined ineligible for county board services shall be referred to other appropriate community agencies.

(E) Assessment of an individual's desires and preferences

(1) Each county board of MR/DD shall develop a functional assessment process for each individual to determine his or her choices, desires and preferences in home, vocational and community environments.

(2) If services or supports are requested, the assessment shall commence within sixty calendar days from the date that eligibility is established. This time frame may be extended based upon extenuating circumstances and with agreement from the individual. The assessment process is ongoing.

(3) The initial assessment shall begin with a review of available information to determine if supplemental situational and/or other formal or informal evaluations should occur.

(4) A written assessment plan shall be developed in conjunction with the applicant, the applicant's legal guardian and, if desired, the advocate of the applicant's choice. The results of the plan shall be used for the provision and/or coordination of services.

(5) A medical examination current within six months from the date that eligibility was established shall be available or be completed.

(6) Participation in adult services or placement onto a waiting list shall take place within thirty calendar days from the date that the initial assessment begins. Individuals placed on a waiting list shall be referred to other community service and support providers as appropriate.

(7) The start date for participation in the program may be postponed based upon extenuating circumstances and with agreement of the individual requesting services.

(F) Waiting lists

When it is necessary to establish waiting lists for services, records shall be maintained in accordance with rule 5123:2-1-02 of the Administrative Code.

(G) Individual plan (IP)

Each individual shall have a written plan. The individual plan (IP) outlines the services, supports, education and training program that will be provided and coordinated for the individual by various agencies and persons.

(1) A certificated staff member of the county board shall serve as an individual plan coordinator. The meeting to develop the IP shall include at a minimum, the individual, the individual's legal guardian, a certificated staff member of the county board and, if desired, the individual's advocate or friend. The individual plan coordinator in conjunction with the individual and/or his representative shall determine which other people shall be present at the meeting. The individual plan coordinator shall be responsible for the development of the IP and shall ensure that services, goals and objectives implemented are not conflicting with each other. The provision of adult services is contingent upon the consent of the individual or legal guardian. Such consent may be modified or withdrawn at any time. The individual plan coordinator shall advise and present options in an appropriate manner to the individual so the individual may have a voice in matters pertaining to his life. A written summary of the meeting which includes any dissenting opinions of those present shall be made and entered into the individual's permanent record.

(2) The adult services provider team may vary in size and composition according to the needs and preferences of the individual. The team shall include those persons directly providing services to the individual, and it shall meet on a formal or informal basis as needed. Members of the team assist the individual in determining the services, supports, goals, methodologies and procedures contained within the plan. Members do not need to attend the IP development meeting to be part of the individual's team.

(3) The initial IP shall be developed within a maximum of thirty calendar days after entry of the individual into adult services. An IP shall be maintained for all individuals. This time frame may be extended based upon extenuating circumstances and with agreement from the individual.

(4) After the initial plan is developed for an individual, appropriate team members shall meet at least annually to review, revise, and/or redevelop the IP or whenever a major change in training, continuing education, services, employment or supports is proposed.

(5) The IP shall be signed by each adult services provider and persons who participated in the development of the IP.

(6) The IP is to be a working document. The individual plan coordinator shall be responsible for assuring that the individual receives services required by the IP that are identified as the responsibility of the county board and for assuring that copies of applicable portions of the IP shall be in the possession of appropriate adult service providers. Confidentiality shall be maintained. An IP shall be given to the individual, legal guardian, person responsible for the plan, and other designated people involved in the individual's plan.

(7) The county board shall assure that the IP shall be developed and implemented in coordination with other appropriate service providers or agencies.

(8) Appropriate signed and dated notations in the record shall verify that the individual being served has received all services to which he has been referred or explanations of why services have not been provided.

(9) The IP shall be based on priorities identified in the current assessment of choices, desires and preferences. The IP shall include opportunities:

(a) For the individual to control his life through informed choices;

(b) For developing significant social relationships within the community;

(c) For working and participating in the life of his community;

(d) That are in accordance with the individual's selected lifestyle;

(e) That support each individual's choices, desires and preferences leading to interdependence and full community inclusion;

(f) That address how services/supports will follow the individual into activities that take place in the community; and

(g) That enable the individual to fulfill his lifelong plans.

(10) The training, continuing education or therapeutic components of the IP shall include at a minimum:

(a) Goals;

(b) Measurable objectives for each goal;

(c) The goal and objective review schedule;

(d) Frequency, duration and location of continuing education and therapeutic components or training;

(e) Implementation strategies and methodologies and the person responsible for the implementation; and

(f) A statement regarding the frequency and type of documentation that should be maintained.

(11) The services/supports component of the IP shall include:

(a) A statement of services/supports to be provided;

(b) Frequency and duration of services/supports;

(c) Identification of the adult services provider;

(d) A statement regarding the frequency and type of documentation that should be maintained; and

(e) The frequency at which the services/supports should be reviewed for effectiveness.

(H) Operating requirements

(1) The county board shall adopt a policy regarding staffing requirements for adult services. The staffing requirements shall be based upon individual plans and resulting outcomes of the provision of services/supports for individuals for all programs available. The policy shall be reviewed annually.

(2) Adult services shall be in operation a minimum of two hundred thirty-two days. An individual's needs may require more or fewer days of employment, continuing education, training, services and/or supports.

(3) The county board shall prepare information on the program and distribute this information to all individuals participating in the program and to all legal guardians. This information shall include at least the following:

(a) A description of adult services;

(b) Eligibility criteria;

(c) Transportation policies and procedures;

(d) Payroll procedures and applicable fringe benefits;

(e) Explanation of attendance policies;

(f) Grievance procedures;

(g) Work hours and breaks; and

(h) Individual rights, confidentiality, and due process information.

(4) Each county board shall adopt a policy regarding behavior management and confidentiality of records as outlined in rule 5123:2-1-02 of the Administrative Code.

(5) A committee shall be formed of representatives of management and individuals participating in the program for the purpose of discussing matters of mutual concern, including aspects of the adult services operation. Meetings shall be held at least quarterly during the year.

(6) All applicable components of adult services shall be in compliance with the regulations of the United States department of labor, wage and hour division, 29 C.F.R. 525.

(7) Individuals engaged in paid work shall be provided coverage under the bureau of workers' compensation or its equivalent.

(I) Records

(1) Records shall be maintained in a confidential manner and in a secure manner and include:

(a) Initial date of inquiry and date individual begins participation in adult services;

(b) Verification of age;

(c) Emergency contact sheet;

(e) Medical report;

(f) Assessment of preferences, strengths, and needs;

(g) Special job accommodations;

(h) A copy of the current IP;

(i) Evidence of IP or IP reviews and revisions;

(j) Incident reports;

(k) Accident reports;

(l) Medication reports;

(m) Other reports;

(n) Attendance records; and

(o) Individual production and payroll records.

(2) Designated staff shall review semiannually a representative sample of the records to measure their adequacy and fulfillment of record-keeping requirements.

(3) Unusual incidents and medical emergencies shall be reported as soon as possible and within twenty-four hours of occurrence and in compliance with major unusual incident procedures as in accordance with rule 5123:2-17-02 of the Administrative Code.

(4) There shall be a written procedure for reporting all accidents with recommendations regarding the safety program and handling of accidents and injuries. Information concerning health, safety and special job considerations shall be clearly communicated to appropriate staff.

(5) Closure and transfer summaries shall be recorded within two weeks following the individual's exit from the program.

(J) Physical facilities

(1) Program facilities owned or leased by the county board shall be in compliance with state and local building and mechanical codes with respect to the design, construction, and equipment applicable to the occupancy classification.

(2) Adult services sites shall be in compliance with the "Ohio Fire Code" as administered by the state or local fire official.

(3) Plumbing and sanitary installation shall be in compliance with the Ohio and local plumbing codes as administered by the Ohio health department or the local official having jurisdiction.

(4) Facilities having food preparation areas shall have a valid food service license issued by the local health authorities having jurisdiction.

(5) Breakrooms, restrooms, and dining areas shall be maintained in an orderly and sanitary manner.

(6) Power equipment, fixed or portable, should include operating safeguards as required by the division of safety and hygiene, bureau of workers' compensation.

Replaces: 5123:2-1-06, 5123:2-1-07, 5123:2-1-08

R.C. 119.032 review dates: 11/24/2004 and 05/24/2006

Promulgated Under: 119.03

Statutory Authority: 5126.01, 5126.05, 5126.08

Rule Amplifies: 5126.01, 5126.05, 5126.08

Prior Effective Dates: 7/1/76, 12/11/83, 3/31/88, 4/22/93

5123:2-1-07 Medication administration: delegation, self-administration, and assistance with self-administration. [Rescinded].

Rescinded eff 1-8-04

5123:2-1-08 Waiting lists.

(A) Purpose

The purpose of this rule is to set forth the requirements for waiting lists established by a county board under section 5126.042 of the Revised Code.

(B) Definitions

(1) "Alternative services" means the various programs, services, and supports, regardless of funding source, other than home and community-based services, that exist as part of the developmental disabilities service system and other service systems including, but not limited to:

(a) Services provided directly by a county board;

(b) Services funded by a county board through providers;

(c) Services provided and funded outside the developmental disabilities service system; and

(d) Services provided at the state level.

(2) "County board" means a county board of developmental disabilities.

(3) "Date of request" means the earliest date and time of any written or other documented request for home and community-based services. The request, including the date and time of request, shall be included in an individual's record maintained by a county board. Documentation of the date of request may include the Ohio department of job and family services form 02399, "Request for Medicaid Home and Community-Based Services," signature date.

(4) "Department" means the Ohio department of developmental disabilities.

(5) "Emergency status" means an individual is facing a situation that creates for the individual a risk of substantial self-harm or substantial harm to others if action is not taken within thirty days. Emergency status may result from, but is not limited to, one or more of the following:

(a) Loss of present residence for any reason, including legal action;

(b) Loss of present caretaker for any reason, including serious illness of the caretaker, change in the caretaker's status, or inability of the caretaker to perform effectively for the individual;

(c) Abuse, neglect, or exploitation of the individual;

(d) Health and safety conditions that pose a serious risk to the individual or others of immediate harm or death; or

(e) Change in emotional or physical condition of the individual that necessitates substantial accommodation that cannot be reasonably provided by the individual's existing caretaker.

(6) "Home and community-based services" means medicaid-funded home and community-based services specified in division (B)(1) of section 5111.87 of the Revised Code and provided under the medicaid components the department administers pursuant to section 5111.871 of the Revised Code.

(7) "ICFMR" means intermediate care facilities for the mentally retarded, including state-operated developmental centers.

(8) "Individual" means a person with a developmental disability or for purposes of giving, refusing to give, or withdrawing consent for services, his or her guardian in accordance with section 5126.043 of the Revised Code.

(9) "Individual service plan" means the written description of services, supports, and activities to be provided to an individual.

(C) There shall be no waiting list for the following services:

(1) Medicaid state plan services;

(2) Home and community-based services for individuals already enrolled in a home and community-based services waiver administered by the department;

(3) Home and community-based services for children who are subject to a determination under section 121.38 of the Revised Code and require the services; and

(4) Home and community-based services for individuals who are transferred to a home and community-based services waiver pursuant to paragraph (H) of this rule.

(D) Waiting list for home and community-based services

(1) If a county board determines that available resources are not sufficient to meet the needs of all individuals who request home and community-based services, the board shall establish a waiting list for the services.

(2) When an individual requests home and community-based services for which there is a waiting list, a county board shall:

(a) With the agreement of the individual, place the individual's name on the waiting list;

(b) Inform the individual, the individual's guardian, and in accordance with section 5126.044 of the Revised Code, the individual's family, as applicable, of the individual's position on the waiting list and the individual's due process rights in accordance with paragraph (J) of this rule;

(c) Identify the individual's immediate needs; and

(d) Assist the individual in identifying and obtaining alternative services that are available to meet those needs, including applying for medicaid. An individual who accepts alternative services may, at the individual's choice, remain on the waiting list in his or her current position.

(3) An individual's date of request is the controlling date for placement on a waiting list for home and community-based services and shall be documented at the time of any such request.

(4) When there is a dispute regarding an individual's date of request, the individual or a person with legal authority to act on behalf of the individual, may appeal under procedures set forth in paragraph (J) of this rule.

(5) When an individual relocates or expresses a desire to relocate from one county to another county, any waiting list for home and community-based services shall be reordered in the new county based on the individual's date of request for such services.

(6) When home and community-based services for which there is a waiting list become available, a county board shall offer the services to the individual next scheduled on the waiting list to receive the services subject to a determination of the individual's eligibility for the services. If the individual refuses the services, the individual may, at the individual's choice, remain on the waiting list in his or her current position.

(7) Annually, a county board shall:

(a) Review the current status, reassess the service needs, and notify the individual, the individual's guardian, and in accordance with section 5126.044 of the Revised Code, the individual's family, as applicable, of the individual's position on the waiting list; and

(b) Provide contact information for a person at the county board who can provide resource information to address, to the extent possible, immediate needs of the individual and who can respond to questions about the notice.

(8) If at any time it is determined that an individual on a waiting list for home and community-based services is not eligible for home and community-based services, the county board shall remove the individual's name from the waiting list and shall assist the individual with contacting other agencies/programs for which the individual may be eligible. Individuals removed from the waiting list have a right to due process as set forth in paragraph (J) of this rule.

(E) Emergency status

The individuals who may be placed on a waiting list include individuals with emergency status. An individual with emergency status shall receive first priority for home and community-based services. No individual may receive priority for home and community-based services pursuant to paragraph (F) of this rule over an individual placed on a waiting list with emergency status. When two or more individuals have emergency status pursuant to this paragraph, the county board shall offer the services to such individuals in the order they are placed on the waiting list based on their date of request.

(F) Priority categories

Except as provided in paragraph (E) of this rule, a county board shall give priority to all of the following in accordance with the assessment component approved under section 5123.046 of the Revised Code of the county board's plan developed under section 5126.054 of the Revised Code.

(1) Refinancing of supported living and family support services. An individual who is eligible for home and community-based services and meets both of the following requirements shall be given priority on a waiting list established under paragraph (D) of this rule:

(a) The individual is twenty-two years of age or older; and

(b) The individual receives supported living or family support services.

(2) Refinancing of adult services. An individual who is eligible for home and community-based services and meets both of the following requirements shall be given priority on a waiting list established under paragraph (D) of this rule:

(a) The individual resides in the individual's own home or the home of the individual's family and will continue to reside in that home after enrollment in home and community-based services; and

(b) The individual receives adult services from the county board.

(3) Aging caregiver or intensive needs. An individual who is eligible for home and community-based services and meets either of the following requirements shall be given priority on a waiting list established under paragraph (D) of this rule:

(a) The individual does not receive residential services or supported living, either needs services in the individual's current living arrangement or will need services in a new living arrangement, and has a primary caregiver who is sixty years of age or older; or

(b) The individual has at least one of the following service needs that is unusual in scope or intensity:

(i) Severe behavior problems for which a behavior support plan is needed;

(ii) A mental health diagnosis for which medication has been prescribed;

(iii) A medical condition that leaves the individual dependent on life-support medical technology;

(iv) A condition affecting multiple body systems for which a combination of specialized medical, psychological, educational, or habilitation services is needed; or

(v) A condition the county board determines to be comparable in severity to any condition described in paragraphs (F)(3)(b)(i) to (F)(3)(b)(iv) of this rule and places the individual at significant risk of institutionalization.

(G) Order for offering services to individuals within priority categories established in paragraph (F) of this rule

(1) If two or more individuals on a waiting list for home and community-based services have priority for the services pursuant to paragraph (F) of this rule, a county board shall use the following criteria to determine the order in which the individuals with priority are offered the services:

(a) The maximization of federal funding;

(b) A mix among the individuals in each of the priority categories in paragraph (F) of this rule; and

(c) With regard to living arrangements, promoting:

(i) Individuals' ability to choose other individuals with priority under paragraph (F) of this rule with whom to live if the individuals have an existing relationship; and

(ii) Sharing of services among any individuals with priority under paragraph (F) of this rule when the services are appropriate for the individuals.

(2) When individuals are offered home and community-based services in accordance with the criteria in paragraph (G)(1) of this rule and two or more individuals have equal rank, the county board shall offer the services to such individuals in the order they are placed on the waiting list based on their date of request.

(H) Transfer to a self-empowered life funding waiver

Once the self-empowered life funding waiver has been approved by the centers for medicare and medicaid services, if an individual who is enrolled in the individual options waiver or the level one waiver requests enrollment in the self-empowered life funding waiver, the department may transfer the individual to the self-empowered life funding waiver provided the individual's needs can be more appropriately met by the self-empowered life funding waiver, the individual meets all eligibility criteria for the self-empowered life funding waiver, and the county board requests to enroll the individual in the self-empowered life funding waiver. At any time within one hundred eighty days of enrollment in the self-empowered life funding waiver, at the individual's request, the county board shall request that the individual be re-enrolled in the waiver from which the transfer was made.

(I) Waiting lists for non-medicaid programs and services

If a county board determines that available resources are not sufficient to meet the needs of all individuals who request non-medicaid programs or services, the county board shall establish one or more waiting lists for such programs or services in accordance with the county board's plan developed under section 5126.04 of the Revised Code.

(J) Due process

(1) Due process shall be available to an individual aggrieved by an action of a county board related to any of the following:

(a) The approval, denial, withholding, reduction, suspension, or termination of a service funded by the state medicaid program; and

(b) The establishment or maintenance of, placement on, the failure to offer services in accordance with, or removal from a waiting list.

(2) Due process shall be provided in accordance with Chapters 5101:6-1 to 5101:6-9 of the Administrative Code when the service involved is funded by the state medicaid program and in accordance with rule 5123:2-1-12 of the Administrative Code when the service involved is not medicaid-funded.

(3) If an individual is aggrieved in accordance with paragraph (J)(1) of this rule, a county board may, if it has adopted a grievance procedure under rule 5123:2-1-12 of the Administrative Code, attempt to informally resolve the matter through the grievance procedure. The filing of a grievance under the grievance procedure shall not affect the right of the individual to due process in accordance with paragraph (J)(1) of this rule.

(4) A county board shall, in the manner specified in rule 5123:2-1-12 of the Administrative Code, give notice to each individual on the waiting list, the individual's guardian, and in accordance with section 5126.044 of the Revised Code, the individual's family, as applicable, of the individual's due process rights. The county board shall document that such notice was given and the content of the notice.

(K) Upon the department's request, a county board shall submit in a format specified by the department, documentation related to its waiting list for home and community-based services and any waiting list established pursuant to paragraph (I) of this rule including, but not limited to, information regarding individuals who requested services or were removed from the waiting list.

(L) The department shall monitor compliance with this rule by county boards and their contract agencies. The department shall provide technical support upon request and through regional and statewide trainings.

(M) County boards that operate ICFMR and other operators of ICFMR shall not be subject to the requirements of this rule with respect to persons requesting admission to ICFMR. Requests for admission to ICFMR shall be subject to the requirements of rule 5101:3-3-02 of the Administrative Code.

(N) Nothing in this rule shall be interpreted to alter the obligation of a county board to provide a service, which it is required to provide under applicable law. Nothing in this rule shall be interpreted to create an obligation of a county board to provide a service, unless the obligation exists under applicable law.

Replaces: 5123:2-1-08

Effective: 12/01/2011
R.C. 119.032 review dates: 12/01/2016
Promulgated Under: 119.03
Statutory Authority: 5123.04 , 5126.042
Rule Amplifies: 5123, 04, 5126.042 , 5126.044 , 5126.054 , 5126.055
Prior Effective Dates: 07/01/1976, 12/11/1983, 07/01/1991 (Emer), 09/13/1991, 04/22/1993, 06/02/1995 (Emer), 12/09/1995, 02/28/1996 (Emer), 05/18/1996, 05/28/1996, 07/12/1997, 08/01/2001, 01/02/2002 (Emer), 03/21/2002

5123:2-1-09 Family support services.

(A) Purpose. This rule establishes guidelines for the implementation of a family support services program through a county board of mental retardation and developmental disabilities. A family support services program assists a family who keeps at home a family member with mental retardation and/or a developmental disability. The program promotes the unity of the family by assisting it to meet the special needs of the individual with mental retardation and/or a developmental disability. It also assists the individual to maximize self-sufficiency and prevent inappropriate institutionalization. The objectives of the family support services program are:

(1) To enable individuals with mental retardation and/or developmental disabilities to return to their families from developmental centers which are under the managing responsibility of the department;

(2) To enable individuals found to be subject to institutionalization by court order under section 5123.76 of the Revised Code to remain with their families with the aid of reimbursable services; and

(3) To provide reimbursable services to families of eligible children and adults living at home who may or may not be currently receiving services from the county board.

(4) To further the unity of the family by enabling the family to meet the special needs of the individual and to live as much like other families as possible.

(B) Applicability. This rule does not apply to family support services that are funded under the state medicaid plan as either home and community-based services or habilitation center services.

(C) As part of the county board's overall philosophy, each county board shall have a written philosophy for the family support services program which shall include, but not be limited to, the following premises:

(1) All individuals with mental retardation and/or developmental disabilities have a right to live in a stable home, enjoy membership in a family, have access to the array and quantity of supports needed to enable them to participate in the life of their communities to the degree they choose, and experience enduring relationships with brothers, sisters, other family members, and friends committed to their welfare.

(2) Reimbursable service and supports through the family support services program shall be tailored to the unique needs of individuals with mental retardation or other developmental disabilities and their families and shall be defined in accordance with section 5126.11 of the Revised Code and this rule.

(3) Family support services should:

(a) Seek and nurture partnerships between family members, other supportive people, and the professionals who serve both these individuals and their families;

(b) Build on the unique strengths and characteristics of each family;

(c) Utilize the resources in each family's social network and home community; and

(d) Respect the beliefs, values and structures of each family.

(D) Family eligibility. "Family," as stated in this rule, means parent(s), brother(s), sister(s), spouse(s), son(s), daughter(s), grandparent(s), aunt(s), uncle(s), cousin(s), or guardian(s) of the individual with mental retardation or developmental disabilities and includes the individual with mental retardation or developmental disabilities. "Family" also means person(s) acting in a role similar to those specified in this paragraph even though no legal or blood relationship exists if the individual with mental retardation or developmental disabilities lives with the person(s) and is dependent on him the person to the extent that if the supports were withdrawn another living arrangement would have to be found. The person(s) shall verify the relationship by signature.

(1) Planned service. A family shall be eligible for reimbursement of family support services if it includes a family member who resides at home and has been determined eligible for the county board according to section 5126.01 of the Revised Code.

(2) Emergency services. The following families shall be considered eligible for reimbursement according to the county board policy on emergencies in accordance with section 5126.042 of the Revised Code.

(a) A family that includes an individual living at home who is eligible for services from county board according to section 5126.01 of the Revised Code; and

(b) Other families that include an individual living at home with mental retardation and/or a developmental disability who is not receiving services from the county board but is determined by the superintendent or designee of the county board as eligible for family support services.

(3) If resources are not available, the county board shall place the family on a waiting list for family support services in accordance with rule 5123:2-1-08 of the Administrative Code.

(E) Request process

(1) The request for services shall be initiated by a family. The family's request for family support services shall be honored if funds and services are available and consistent with the family support services section of the county board's plan as outlined in paragraph (G) of this rule and the written philosophy in paragraph (C) of this rule and if the requirements of this rule and section 5126.11 of the Revised Code are met. The county board shall work with the family to obtain supports and services. At the family's request, the county board shall assist families in developing individual plans and strategies for family supports. Family support services shall be considered a component of the individual planning process in accordance with rules adopted by the department.

(a) Family support services may be provided in a county other than the one in which the reimbursing county board is located. The reimbursing county board is responsible for determining that providers meet the requirements of this rule.

(b) Family support services may be provided by agencies or persons other than the county board including, but not limited to, generic agencies or service providers in the community.

(c) The county board may contract with another agency to administer all or a portion of the family support services program. The county board shall ensure that any contract agency administering family support services adheres to the administrative rules governing the program.

(2) The family may request a list of certified respite care providers from the county board before deciding on a provider, or the family may recommend a provider to the county board.

(3) To be assured of reimbursement, the family shall obtain the estimated cost and prior approval of the expenditure from the county board before agreeing to services or signing a contract with a provider.

(4) The county board shall respond to an eligible family's request for reimbursement within seven working days after receiving the request. The request shall be reviewed based only on the following criteria:

(a) The family is eligible according to paragraph (D) of this rule;

(b) Funds are available according to the county board's plan and administrative procedures;

(c) The requested service is directly related to improving the living environment or facilitating the care of the individual with mental retardation and/or a developmental disability; and

(d) Compliance with the requirements of this rule and section 5126.11 of the Revised Code.

(5) Payments may be made for the following services:

(a) Respite care, in or out of the home;

(b) Counseling, supervision, training and education of the individual, the individual's caregivers, and members of the individual's family that aid the family in providing proper care for the individual, provide for the special needs of the family, and assist in all aspects of the individual's daily living;

(c) Special diets, purchase or lease of special equipment or modifications of the home, if such diets, equipment, or modifications are necessary to improve or facilitate the care and living environment of the individual;

(d) Providing support necessary for the individual's continued skill development, including such services as development of interventions to cope with unique problems that may occur within the complexity of the family, enrollment of the individual in special summer programs, provision of appropriate leisure activities, and other social skills development activities;

(e) Any other services that are consistent with the purposes specified in paragraph (A) of this rule and specified in the individual's service plan.

(6) Reimbursement/payment for services shall be made by the county board using one of the following procedures:

(a) Upon approval of the request for family support services, the county board shall give the family a voucher in the amount of the approved service provider payment. The family shall present the voucher and the family's share of the cost of the service to the provider when the service has been received or at such time as mutually agreed. The provider shall redeem the voucher through the county board. The county board shall redeem the voucher within forty-five days after the provider submits it; or

(b) Upon approval of the request for family support services, the county board shall give the family a written statement of the amount of approved reimbursement. The family shall present a receipt for approved incurred cost to the county board. The county board shall reimburse the family within forty-five days after the family submits the receipt; or

(c) The county board may develop a reimbursement/service provider payment system that meets county auditor requirements and is responsive to family needs.

(7) At the time of initial application, the family support services coordinator shall inform the family of their informal complaint resolution and due process rights under rule 5123:2-1-12 of the Administrative Code. This information shall be presented in the native language of the family or other mode of communication used by the family unless it is clearly not feasible.

(F) Reimbursement

(1) Maximum annual reimbursement. The maximum annual reimbursement to each family shall be determined through the family support services component of the county board's annual plan. The plan shall allow for flexibility in tailoring the level of reimbursement to the unique needs of families.

(2) Copayment schedule

(a) The copayment schedule for a family shall be based on the family's taxable income as certified by signature. Income shall be based on 5123:2-1-09 5 the federal taxable income (after applicable deductions). The individual and/or family shall be responsible for reporting any changes in income.

(b) The board may consider extenuating circumstances in the determination of copayment.

(c) The percentage of each family support service that the family pays shall be determined according to the following income schedule:

Income Schedule

Income Percentage of Contribution

$27,258 or less 0%

$27, 259 - $37,759 10%

$37,760 - $48,260 30%

$48,261 - $62,261 50%

$62,262 - $79,762 75%

$79,763 and over 100%

(G) Planning process

(1) The family support services component of the county board's annual plan shall include, but not be limited to:

(a) The procedures for, and the results of, the assessment of the family support services funding needs of the families of residents of the county with mental retardation and/or a developmental disability.

(i) The number of eligible families projected to need family support services funding;

(ii) The amount of family support services funds available to each family for the year addressed in the plan; and

(iii) The number of eligible families currently receiving family support services funds.

(b) The projected number of families to be served each year.

(c) Prioritization of funding, with corresponding justification, shall include:

(i) Comprehensive family support services funding to relatively few families who have extensive needs;

(ii) Limited family support services funding to a broad base of families.

(d) Collaborative county board linkage with needed programs or services from other community agencies.

(e) The commitment of funds to the family support services program.

(f) The projected amount and percentage of the county board's allocation of state funds to be used for routine services and the amount and percentage to be used for emergencies shall be determined through the county board planning process. The percentage to be used for emergencies shall not exceed twenty-five per cent of the total dollar amount committed to the family support services program.

(g) The organizational structure for implementing the family support services program.

(h) An evaluation of the family support services program annually on the basis of data collected from the individuals served, families and providers and the direct monitoring of providers.

(i) A description of the procedures and schedule of events used to make families and other agencies in the community aware of the family support services program and planning process.

(2) County board administrative procedures. The county board shall have procedures for:

(a) Identifying other resources that the family could use to pay for the family support services.

(b) Determining that the family has exhausted all other sources.

(c) Identifying and developing providers.

(d) Certifying the individual respite provider or administering agency when applicable. In certifying the provider, the county board shall use standards which include those in paragraph

(H) of this rule.

(e) Direct monitoring of county board certified providers.

(f) Reimbursing families for services:

(i) Estimating the amount of funds needed to reimburse families between regular meetings of the county board, encumbering those funds and authorizing expenditures;

(ii) Reimbursing families in a timely manner, no later than forty-five days after the family has notified the county board that the expense has been incurred; and

(iii) Redeeming vouchers for providers within forty-five days after the county board receives them.

(g) Maintaining a list of certified respite care providers as a guide to families. The list shall include available respite beds in community facilities that are funded according to section 5123.18 of the Revised Code or Title XIX of the Social Security Act, if the department provides that information to the county board.

(h) Assuring that no reimbursement is made on behalf of an individual who is living in a residential facility that is providing services that are funded according to section 5123.18 of the Revised Code or Title XIX of the Social Security Act or by a county board.

(i) Assuring that funds appropriated for the family support services program and allocated to the county board for this purpose shall not be used to reimburse families for respite care or other family support services that are provided in a bed in a facility if that bed is funded according to section 5123.18 of the Revised Code or Title XIX of the Social Security Act.

(3) Additional provisions applicable to county boards

(a) No more than seven per cent of the county board's allocation may be used for the administrative cost of the county board.

(b) The county board shall not be required to make reimbursements at a level of funding that exceeds available state and federal funds for this purpose.

(c) The county board shall not use funds allocated for family support services to replace existing locally funded programs other than family support services or for any purpose other than family support services.

(d) The county board may support the family support services with additional locally generated funds.

(e) The county board may use the funds allocated for the family support services program as match for appropriate federal funds. When family support services is used to match federal funds, no copayment will be assessed to families for services provided through those federal funds.

(4) Standards for supervision. The county board shall supervise the family support services program and shall be responsible for the following:

(a) The approval of services and costs prior to the provision of services; and

(b) The enforcement of ceilings on reimbursement to a family based on income.

(H) Certification of respite providers

(1) Family selected respite providers. Respite providers selected by families need not be county board certified. When using a family selected provider, the family shall sign an assurance assuming responsibility that the health and safety needs of the individual will be met and that no liability shall be incurred by the county board.

(2) Non-family selected respite providers. The county board shall maintain a list of trained and certified respite providers.

(a) Board certified respite providers shall receive up to forty hours of training which shall include but not be limited to:

(i) Practicum (supervised);

(ii) Time spent with individuals with mental retardation and/or developmental disabilities and their families;

(iii) CPR; and

(iv) First aid.

(b) This training may be waived by the superintendent or designee if the provider has experience with individuals with mental retardation and/or developmental disabilities. Respite providers that are board certified prior to September 18, 1992 shall continue to be certified.

(c) The county board shall perform a criminal background check on all non-family selected, certified respite providers.

(d) County board certified providers of out-of-home respite shall be subject to the provisions of rule 5123:2-12-01 ("Supported Living Quality Assurance Standards") of the Administrative Code as follows to promote conditions that consider the health and safety of the individual:

(i) Housing. The individual has housing that meets local requirements for residential homes, is secure, and has adequate heating, water, and electricity. The individual has the basic furnishings necessary for daily living including, but not limited to, a bed, chairs, table, kitchen facilities, and lighting.

(ii) Health. The individual's health is maintained through adequate hygiene, nutrition, exercise, safe behavior, medical and dental monitoring, and appropriate medications when needed. The individual receives prompt and up-to-date treatment for physical problems.

(iii) Safety. Potential dangers in the environment are minimized. The individual has access to prompt and appropriate emergency services, when needed, such as police, fire department, ambulance, and crisis line.

(iv) Major unusual incidents shall be reported in compliance with rule 5123:2-17-02 of the Administrative Code.

(e) The county board shall assure quality control of the county board certified providers of respite through:

(i) An initial on-site visit before providing certification of out-of-home respite providers.

(ii) A periodic on-site visit at least annually to each out-of-home provider in the county by county board personnel.

(iii) Structured, written feedback from a significant sample of respite sessions completed by the family and the county board certified respite provider. The sample shall include the first respite session by each newly certified provider.

(3) The family, provider, and any applicable agency shall plan the continuation of school, workshops, or other habilitation programs during respite care.

(I) County board reports and evaluation

Upon the department's request, the county board shall submit in a format specified by the department written reports related to the family support services program.

(J) Department responsibilities

(1) The department shall allocate funds to the county boards operating under this rule as follows:

(a) To receive the annual family support services allocation, the county board shall submit reports required under paragraph (I) of this rule.

(b) Allocation shall be determined according to a formula established by the department and reviewed and disseminated annually to the county board at the beginning of each fiscal year. The allocation of family support services funds to county boards is based according to a formula based equally on the following three factors:

(i) The number of enrollees in the county board programs;

(ii) The population of the county; and

(iii) The number of people in the county whose income falls below the poverty level as determined by the Ohio department of job and family services.

(2) As part of the department's annual report, the status of the family support services program shall be included.

Replaces rule 5123:2-1-09, 5123:2-4-01 to 5123:2-4-21; Eff 7-1-82; 9-30-83; 12-19-83 (Emer.); 3-22-84; 7-25-85; 3-3-90; 9-18-92; 1-8-94; 12-10-04
Rule promulgated under: RC 119.03
Rule authorized by: RC 5123.04 , 5123.171 , 5126.05 , 5126.08 , 5126.082 , 5126.11 , section 71.02 of A.S.H.B. 95 of the 125th General Assembly
Rule amplifies: 5123.04 , 5123.171 , 5126.01 , 5126.03 , 5126.042 , 5126.05 , 5126.08 , 5126.082 , 5126.11 , 5126.281 , section 71.02 of A.S.H.B. 95 of the 125th General Assembly
Replaces: 5123:2-1- 09.1 and 5123:2-1- 09.2
R.C. 119.032 review dates: 09/24/2004 and 12/10/2009

5123:2-1-09.1 Income schedule. [Rescinded].

Rescinded eff 12-10-04

5123:2-1-09.2 Formula for distributing money to county boards. [Rescinded].

Rescinded eff 12-10-04

5123:2-1-10 Cooperation with other organizations to coordinate service delivery to children and families. [Rescinded].

Rescinded eff 12-23-04

5123:2-1-11 [Effective until 3/17/2014]Service and support administration.

(A) Purpose

The purpose of this rule is to define the responsibilities of a county board for service and support administration and to establish a process for individuals who receive service and support administration to have an identified service and support administrator who is a single point of accountability.

(B) Decision-making responsibility

(1) An individual shall be responsible for making all decisions regarding the provision of services, including requesting services and giving, refusing to give, or withdrawing consent for services, unless the individual has a guardian, in which case the guardian shall be responsible for making such decisions.

(2) Individuals, including those with guardians, have the right to participate in decisions that affect their lives and to have their needs, desires, and preferences considered.

(3) An individual who does not have a guardian or an individual's guardian may designate another person, including a member of the individual's family, to participate in the process of making decisions regarding services provided to the individual in accordance with paragraph (P) of this rule.

(C) Definitions

(1) "Assessment" means the gathering of comprehensive information concerning each individual's preferences, personal goals, needs, and abilities, health status and other available supports.

(2) "Alternative services" means the various programs, services, and supports, regardless of funding source, that exist as part of the MRDD service system and other service systems including, but not limited to:

(a) Services provided directly by the county board;

(b) Services by non-county board providers and funded by the county board;

(c) Services provided and funded outside the MRDD system; or

(d) Services provided at the state level.

(3) "Budgets for services" means the projected cost required to implement the ISP regardless of funding source.

(4) "County board" means a county board of mental retardation and developmental disabilities as established under Chapter 5126. of the Revised Code.

(5) "Circle of support" means one or more persons who agree to meet on a regular basis to help the individual to identify and accomplish personal visions or goals. The majority of persons in a circle of support are not paid to be there and are involved because they care about the individual and they have made a commitment to work together on behalf of the individual.

(6) "Department" means the Ohio department of developmental disabilities as established by section 121.02 of the Revised Code.

(7) "Direct support staff" means a person in a direct services position as defined in division (A)(2) of section 5126.281 of the Revised Code.

(8) "Emergency intervention" is the immediate response to an unanticipated event that requires an immediate change in an individual's existing situation and/or ISP to ensure health and safety.

(9) "Feasible alternatives" means alternatives that come with HCBS waiver enrollment as approved by the centers for medicare and medicaid services in the waiver document.

(10) "Guardian" means the guardian of the person of a minor or an adult. If no guardian of the person has been appointed for a minor, "guardian" means either parent of a minor unless the parents are separated or divorced or their marriage has been dissolved or annulled, in which case "guardian" means the parent who is the residential parent and legal custodian of the minor. If no guardian of the person has been appointed for a minor and the minor is in the legal or permanent custody of a person or government agency, "guardian" means that person or government agency.

(11) "Habilitation management" means the following administrative oversight functions within adult day habilitation services as described in section 5126.14 of the Revised Code:

(a) Having available supervisory personnel to monitor and ensure implementation of all interventions in accordance with every ISP implemented by the staff who work with the individuals receiving the services;

(b) Providing appropriate training and technical assistance for all staff who work with the individuals receiving services;

(c) Communicating with service and support administration staff for the purpose of coordinating activities to ensure that services are provided to individuals in accordance with ISPs and intended outcomes;

(d) Monitoring for unusual and major unusual incidents and cases of abuse, neglect, exploitation, or misappropriation of funds; taking immediate actions as necessary to maintain the health, safety, and welfare of the individuals receiving the services; and providing notice of unusual and major unusual incidents and suspected cases of abuse, neglect, exploitation, or misappropriation of funds to the county board; and

(e) Performing other administrative duties as required by state or federal law or by contracts with the county board.

(12) "HCBS" means home and community-based services as defined in section 5126.01 of the Revised Code.

(13) "HCBS waiver" means an HCBS waiver administered by the department in accordance with section 5111.871 of the Revised Code.

(14) "HMG" means "Help Me Grow," an Ohio family and children first initiative directed by the Ohio department of health and coordinated on the county level by the family and children first council. HMG is Ohio's birth through two system designed to implement requirements of IDEA, Part C under 34 C.F.R. part 303. HMG creates, nourishes and maintains a coordinated, community-based infrastructure that promotes transdisciplinary, family-centered services and supports to eligible expectant parents, newborns, infants and toddlers, and their families.

(15) "ICF/MR" means an intermediate care facility for the mentally retarded.

(16) "Individual" means a person with mental retardation and/or developmental disabilities.

(17) "ISP" means the individual service plan, a written description of the services, supports, and activities to be provided to an individual.

(18) "Medicaid case management services" has the same meaning as in section 5126.01 of the Revised Code.

(19) "MRDD" means mental retardation and developmental disabilities.

(20) "Program management" means the following administrative oversight functions within residential services and supported living as described in section 5126.14 of the Revised Code:

(a) Having available supervisory personnel to monitor and ensure implementation of all interventions in accordance with every ISP implemented by the staff who work with the individuals receiving the services;

(b) Providing appropriate training and technical assistance for all staff who work with the individuals receiving services;

(c) Communicating with service and support administration staff for the purpose of coordinating activities to ensure that services are provided to individuals in accordance with ISPs and intended outcomes;

(d) Monitoring for unusual and major unusual incidents and cases of abuse, neglect, exploitation, or misappropriation of funds; taking immediate actions as necessary to maintain the health, safety, and welfare of the individuals receiving the services; and providing notice of unusual and major unusual incidents and suspected cases of abuse, neglect, exploitation, or misappropriation of funds to the county board; and

(e) Performing other administrative duties as required by state or federal law or by contracts with the county board.

(21) "ODJFS" means the Ohio department of job and family services as established by section 121.02 of the Revised Code.

(22) "Service and support administration" has the same meaning as in section 5126.01 of the Revised Code, and pursuant to section 5126.15 of the Revised Code, includes a set of mandated functions to be provided by the county board. Service and support administration supports individuals in determining and pursuing goals and maintains the individual as the focus while coordinating services across multiple systems.

(23) "Service and support administrator" means a person, regardless of title, employed by or under subcontract with a county board to perform the functions of service and support administration and who holds the appropriate certification in accordance with rule 5123:2-5-02 of the Administrative Code.

(24) "Single point of accountability" means the identified service and support administrator who is responsible to an individual for the effective implementation and coordination of his or her ISP process.

(25) "Team" means the individual's circle of support, the service and support administrator who is the single point of accountability for the individual, the person designated under paragraph (P) of this rule to provide daily representation, direct support staff, providers, licensed or certified professionals and other persons chosen by the individual to help the individual think through possibilities and decisions. The purpose of the team is to provide written and/or verbal information relevant to the development of the ISP for the individual. Team members may be invited by the individual to actively participate in the development of the ISP.

(D) Eligibility for service and support administration

(1) A county board shall provide service and support administration to the following:

(a) Each individual, regardless of age, who is applying for or enrolled in an HCBS waiver;

(b) Each individual three years of age or older who is eligible for county board services, and requests, or a person on the individual's behalf requests pursuant to paragraph (B) of this rule, service and support administration;

(c) An individual residing in an ICF/MR is eligible for service and support administration related to moving the individual from the ICF/MR to a non-ICF/MR community setting.

(2) A county board may provide service and support administration to the following:

(a) In accordance with the service coordination requirements of 34 C.F.R. 303.23 , an individual under three years of age eligible for early intervention services under 34 C.F.R. part 303;

(b) An individual who is not eligible for other services of the board.

(E) A county board shall provide service and support administration in accordance with the requirements of section 5126.15 of the Revised Code. A county board may provide service and support administration by directly employing service and support administrators or by subcontracting with qualified entities for the performance of service and support administration.

(1) Only a service and support administration supervisor, a service and support administrator, or a conditional status service and support administrator who holds the appropriate certification in accordance with rule 5123:2-5-02 of the Administrative Code may provide service and support administration.

(2) Any person who is employed to assist a service and support administration supervisor, a service and support administrator, or a conditional status service and support administrator in the performance of their duties shall have a registered service level service and support administration registration in accordance with rule 5123:2-5-02 of the Administrative Code.

(3) Persons employed or under subcontract as service and support administrators shall not be in the same collective bargaining unit as employees who perform duties that are not administrative.

(4) The county board shall provide adequate supervision to persons employed to perform the functions of service and support administration. A conditional status service and support administrator shall perform the duties of service and support administration only under the supervision of a management employee who is a service and support administration supervisor or a professional employee who is a service and support administrator.

(5) Persons employed or under subcontract as service and support administrators shall not be assigned responsibilities for implementing other services for individuals and shall not be employed by or serve in a decision-making or policy-making capacity for any other entity that provides programs or services to individuals.

(F) Notwithstanding the requirements of paragraph (E) of this rule, persons employed or under subcontract with a county board who meet the requirements established by the Ohio department of health for service coordinators in the HMG system may provide service and support administration in accordance with the service coordination requirements of 34 C.F.R. 303.23 to an individual under three years of age eligible for early intervention services under 34 C.F.R. part 303.

(G) Single point of accountability

(1) A county board shall identify a service and support administrator for each individual receiving service and support administration who shall be the single point of accountability for the individual and who shall perform the following duties:

(a) Assess the individual's need for services in accordance with paragraph (I) of this rule;

(b) Develop and revise the individual's ISP in accordance with paragraph (J) of this rule;

(c) Establish the individual's budget for services in accordance with paragraph (K) of this rule;

(d) Assist the individual in choosing providers in accordance with paragraph (L) of this rule;

(e) Ensure that the individual's services are effectively coordinated and provided by appropriate providers in accordance with paragraph (M) of this rule;

(f) Monitor the implementation of the individual's ISP in accordance with paragraph (N) of this rule;

(g) Ensure that the individual has a designated person to provide daily representation in accordance with paragraph (P) of this rule.

(2) The single point of accountability may perform the duties set forth in paragraph

(G)(1) of this rule with the assistance of appropriate others on the individual's team. In order to receive such assistance, the single point of accountability shall:

(a) Maintain the responsibility to ensure that activities performed on behalf of the individual are completed in accordance with the ISP and to the benefit and satisfaction of the individual;

(b) Ensure that the person providing the assistance has a clear understanding of the expectations and desired outcomes of the task(s);

(c) Maintain contact with the person providing assistance as frequently as necessary to monitor the completion of the assigned task(s);

(d) Retain responsibility for all decision-making regarding service and support administration functions and the communication of any such decisions to the individual.

(3) A person who provides assistance pursuant to paragraph (G)(2) of this rule is not required to have a registered service level service and support administration registration in accordance with rule 5123:2-5-02 of the Administrative Code unless the person is employed to provide such assistance.

(4) A county board may assign the responsibility for eligibility determinations and quality assurance reviews to a person(s) employed by or under subcontract with the county board to provide service and support administration who does not perform other service and support administration duties. In such a case, the results and information from eligibility determinations and quality assurance reviews shall be shared in a timely manner with the individual, the individual's guardian, the person designated under paragraph (P) of this rule to provide daily representation, and the service and support administrator who is the single point of accountability for the individual in order to facilitate the coordination of services and supports.

(H) Eligibility determinations

The persons employed by or under subcontract with a county board to provide service and support administration shall establish an individual's eligibility for the services of the county board. The person performing this duty for an individual shall:

(1) Establish the individual's eligibility for the services provided or administered by the county board in accordance with rules adopted by the department.

(2) Explain to the individual, in conjunction with the process of recommending eligibility determination and/or assisting in making application for enrollment in an HCBS waiver or any other medicaid service, and in accordance with rules adopted by the department, the following:

(a) Alternative services available to the individual;

(b) Due process and appeal rights;

(c) Right to choose any qualified and willing provider.

(3) At the time the individual is being recommended for enrollment in an HCBS waiver:

(a) Explain to the individual:

(i) Choice of waiver enrollment as an alternative to ICF/MR placement;

(ii) Feasible alternatives available upon enrollment in an HCBS waiver; and

(b) Make a recommendation to ODJFS or its designee, in accordance with rule 5101:3-3-15.3 of the Administrative Code, as to whether the individual meets the criteria for an ICF/MR level of care in accordance with rule 5101:3-3-07 of the Administrative Code.

(I) Assessments

The persons employed by or under subcontract with a county board to provide service and support administration shall assess individual needs for services. The service and support administrator who is the single point of accountability for an individual shall perform this duty and shall:

(1) After the initial request for services and at least annually thereafter, complete or coordinate and ensure the completion of assessments. The assessment process shall include all types of assessments based upon input obtained from the individual, the individual's guardian, the person designated under paragraph (P) of this rule to provide daily representation, and the individual's team.

(a) The information obtained shall include the individual's likes, dislikes, priorities, and desired outcomes, as well as what is important to and for the individual, including skill development, health, safety, and welfare needs, as applicable.

(b) The completion of assessments and evaluations by licensed or certified professionals is not required annually, but shall be done at a time dictated by the needs of the individual.

(2) Recommend to the department and ODJFS, the continued need for an ICF/MR level of care for an individual enrolled in an HCBS waiver for the annual redetermination in accordance with rule 5101:3-3-15.5 of the Administrative Code.

(J) ISP development

The persons employed by or under subcontract with a county board to provide service and support administration shall develop ISPs. If an ISP includes HCBS waiver services or medicaid case management services, those services shall be subject to approval by the department and ODJFS. If either department approves, reduces, denies, or terminates HCBS waiver services, or medicaid case management services included in an ISP, the service and support administrator who is the single point of accountability for the individual shall communicate with the individual to ensure compliance with paragraphs (J)(3) and (S) of this rule. That person shall also:

(1) Ensure that the development or revision of the ISP:

(a) Occurs with the active participation of the individual to be served and other persons selected by the individual, and, when applicable, the provider(s) selected by the individual;

(b) Addresses the results of the assessment process pursuant to paragraph (I) of this rule and of the monitoring conducted pursuant to paragraph (N) of this rule;

(c) Focuses on the individual's strengths, interests and talents;

(d) Integrates all sources of supports, including alternative services, available to meet the needs and desired outcomes of the individual;

(e) Occurs in accordance with rules adopted by the department.

(2) Certify by signature and date that an ISP meets the following criteria for approval. This approval shall occur prior to implementation.

(a) All ISPs shall:

(i) Assist the individual to engage in meaningful, productive activities and develop community connections; and

(ii) Indicate the provider, the frequency, and the funding source for each service and activity; and

(iii) Specify which services will be coordinated among which providers and across all appropriate settings for the individual.

(b) An ISP that includes HCBS waiver services shall:

(i) Meet the requirements of paragraph (J)(2)(a) of this rule;

(ii) Indicate the provider type; and

(iii) With respect to that portion of the ISP that pertains to HCBS waiver services, meet the requirements of paragraph (C)(2) of rule 5123:2-9-04 of the Administrative Code.

(3) Review and revise the ISP as appropriate under any of the following circumstances:

(a) At the request of the individual or a member of the individual's team;

(b) Whenever the individual's assessed needs, circumstances or status changes;

(c) As a result of ongoing monitoring of ISP implementation, quality assurance reviews, and/or identified trends and patterns of unusual incidents or major unusual incidents; or

(d) With respect to HCBS waiver services and medicaid case management services, if a service is reduced, denied, or terminated by the department or ODJFS.

(4) Provide a complete copy of the ISP to the individual or his or her guardian and a copy of relevant sections of the ISP to the individual's providers.

(5) Provide an individual with written notification and explanation of the individual's right to a medicaid fair hearing if the ISP process results in a recommendation for the approval, reduction, denial, or termination of an HCBS waiver service or medicaid case management service. Notice shall be provided in accordance with section 5101.35 of the Revised Code.

(6) Provide an individual with written notification and explanation of the individual's right to use the administrative resolution of complaint process if the ISP process results in the reduction, denial, or termination of a service other than an HCBS waiver service or medicaid case management service. Such written notice and explanation shall also be provided to an individual if the ISP process results in an approved service that the individual does not want to receive, but is necessary to ensure the individual's health, safety, and welfare. Notice shall be provided in accordance with rule 5123:2-1-12 of the Administrative Code.

(K) Budget for services

The persons employed by or under subcontract with a county board to provide service and support administration shall establish budgets for services. The service and support administrator who is the single point of accountability for an individual shall establish a recommendation for and obtain approval of budgets for services based on the ISP for the individual and the individual's assessed needs and preferred ways of meeting those needs. Funding of services for individuals enrolled in an HCBS waiver shall be subject to rule 5123:2-9-06 of the Administrative Code.

(L) Provider selection

The persons employed by or under subcontract with a county board to provide service and support administration shall through objective facilitation assist individuals in choosing providers. The service and support administrator who is the single point of accountability for an individual shall perform this duty and shall:

(1) Ensure that individuals are given the opportunity to select service providers from all willing and qualified providers in accordance with applicable state and federal laws and regulations;

(2) Assist individuals, as necessary, to work with their provider(s) to resolve concerns involving the direct support staff assigned to work with them.

(M) Coordinating services

The persons employed by or under subcontract with a county board to provide service and support administration shall ensure that services are effectively coordinated and provided by providers, as identified in the ISP, by facilitating communication with the individual and among providers across all settings and systems. The person who is the single point of accountability for an individual shall perform this duty and shall directly communicate with all providers of residential and day program services through their employees who are designated as responsible for habilitation management and program management and to the designated staff of all other providers including, but not limited to, transportation services providers. Relevant sections of the ISP shall be shared with providers. Such communication, as applicable, shall include, but not be limited to, the following:

(1) ISP revisions;

(2) Relocation plans of the individual, including information necessary to determine the health, safety, and welfare factors of the proposed living situation;

(3) Hospitalizations, incarcerations, or other changes in individual status that result in suspension or disenrollment from services including, but not limited to, services under an HCBS waiver;

(4) Coordination activities to ensure that services are provided to individuals in accordance with their ISPs and desired outcomes;

(5) Results of the monitoring conducted pursuant to paragraph (N) of this rule.

(N) Monitoring ISP implementation

The persons employed by or under subcontract with a county board to provide service and support administration shall, in accordance with policies and procedures that shall be established by the board and any protocols that may be established by the department, establish and implement an ongoing system of monitoring the implementation of an individual's ISP. The service and support administrator who is the single point of accountability for an individual shall perform this duty in accordance with the following requirements:

(1) The purpose of this monitoring shall be to verify:

(a) The health, safety and welfare of the individual;

(b) Consistent implementation of services;

(c) Achievement of the desired outcomes for the individual as stated in the ISP; and

(d) That services received are those reflected in the ISP.

(2) Areas to be monitored, as applicable to each individual, shall include, but not be limited to, the following:

(a) Behavior support;

(b) Emergency intervention;

(c) Identified trends and patterns of unusual incidents and major unusual incidents and the development and implementation of prevention and/or risk management plans;

(d) Results of quality assurance reviews; and

(e) Other individual needs as determined by the assessment process conducted pursuant to paragraph (I) of this rule.

(3) If this monitoring indicates areas of provider non-compliance with continuing certification standards for providers certified as HCBS waiver providers, the county board shall conduct provider compliance reviews in accordance with rule 5123:2-9-08 of the Administrative Code.

(O) Quality assurance reviews

(1) The persons employed by or under subcontract with a county board to provide service and support administration shall conduct quality assurance reviews. The person performing this duty for an individual shall:

(a) Conduct quality assurance reviews in accordance with rules adopted by the department.

(b) Conduct quality assurance reviews that result in outcomes at two levels:

(i) Identification of areas of concern and recommendations necessary to achieve desired outcomes for the individual as stated in the ISP;

(ii) Identification of trends and patterns common to a significant number of individuals that indicate possible need for modification of an agency and/or county board system to achieve desired outcomes for individuals.

(2) The person performing this duty shall not conduct quality assurance reviews for an individual for whom he/she is the service and support administrator who is the single point of accountability.

(3) If a quality assurance review indicates areas of provider non-compliance with continuing certification standards for providers certified as HCBS waiver providers, the county board shall conduct provider compliance reviews in accordance with rule 5123:2-9-08 of the Administrative Code.

(P) Designated person to provide daily representation

(1) Each individual receiving service and support administration shall have a designated person to provide daily representation who is responsible on a continuing basis for providing the individual with representation, advocacy, advice and assistance related to the day-to-day coordination of services in accordance with the ISP.

(a) The role of the person designated is to assist the individual to keep the service and support delivery system focused on his/her desired outcomes.

(b) The person designated shall be willing to interact regularly with the individual in order to maintain or develop a relationship that will allow him/her to fulfill this role.

(c) A designated person who is not legally responsible shall not receive any privileged information without consent of the individual.

(d) Neither the service and support administrator who is the single point of accountability for the individual nor any other person providing service and support administration shall be the person designated.

(2) The service and support administrator who is the single point of accountability for an individual shall ensure that the individual has a person designated to provide daily representation and shall:

(a) Give the individual an opportunity, at least annually, to designate such person.

(b) Make the designation if the individual declines to do so, taking into consideration the designated person's credibility with the individual, the person's understanding of the individual's desired outcomes, and the person's reliability. If an individual has no such person involved in his/her life, actions shall be specified in the ISP that will lead to the development of a circle of support for the individual.

(c) Document the person designated, by name, in the individual's ISP.

(d) Permit an individual to change at any time the person designated to provide daily representation.

(3) Paragraphs (P)(1) and (P)(2) of this rule are not intended to prevent an individual from representing himself or herself or advocating on behalf of himself or herself.

(Q) Emergency intervention

The county board shall, in coordination with the provision of service and support administration, make an on-call emergency response system available twenty-four-hours per day, seven days per week. Persons who are available for the on-call emergency response system shall:

(1) Provide emergency intervention directly or through immediate linkage with the service and support administrator who is the single point of accountability for the individual or primary provider.

(2) Be trained and have the skills to identify the problem; determine what immediate response is needed to alleviate the emergency and ensure health and safety; and identify and contact the person(s) to take the needed action.

(3) Notify the provider(s) and the service and support administrator(s) who is the single point of accountability for the individual(s) to assure adequate follow-up. The county board's investigative agent under section 5126.221 of the Revised Code shall also be notified as determined necessary by the nature of the emergency.

(4) Document the emergency in accordance with county board procedures.

(R) Records Records shall be maintained on individuals receiving service and support administration and shall include, at a minimum, the following:

(1) Identifying data;

(2) Information identifying guardianship, trusteeship, or protectorship;

(3) Date of request for services from the county board;

(4) Evidence of eligibility for county board services;

(5) Assessment information relevant to the request for services and the planning process for supports and services;

(6) Current ISP;

(7) Current budget for support and services;

(8) Documentation of provider selection process;

(9) Quality assurance review summary reports;

(10) Documentation of unusual incidents;

(11) Major unusual incident investigation summary reports;

(12) The name of the service and support administrator who is the single point of accountability for the individual;

(13) The name of the person designated to provide daily representation;

(14) Emergency information;

(15) Personal financial information, when appropriate;

(16) Release of information and consent forms;

(17) Case notes which include coordination of services and monitoring activities.

(S) Due process

Due process shall be afforded to each individual receiving service and support administration pursuant to either rule 5123:2-1-12 of the Administrative Code for services other than HCBS waiver services and medicaid case management services or section 5101.35 of the Revised Code for HCBS waiver services and medicaid case management services.

(T) Department monitoring and technical assistance

The department shall monitor compliance with this rule by county boards and their subcontract agencies in accordance with sections 5123.044 and 5126.055 of the Revised Code. Technical support, as determined necessary by the department, shall be provided upon request and through regional and statewide trainings.

(U) ODJFS monitoring of medicaid case management services

For all medicaid eligible recipients, ODJFS retains final authority to monitor the provision of medicaid case management services in accordance with rule 5101:3-48-01 of the Administrative Code.

Replaces: 5123:2-1-11

Effective: 07/01/2005
R.C. 119.032 review dates: 07/01/2010
Promulgated Under: 119.03
Statutory Authority: 5123.04 , 5126.05 , 5126.08 , section 75.04 of House Bill 94 of the 124th General Assembly
Rule Amplifies: 5123.04 , 5126.041 , 5126.05 , 5126.055 , 5126.08 , 5126.15 , section 75.04 of House Bill 94 of the 124th General Assembly
Prior Effective Dates: 8/23/85 (Emer.), 11/22/85 (Emer.), 1/18/86, 3/11/88, 3/3/90, 11/18/95

5123:2-1-11 [Effective 3/17/2014]Service and support administration.

(A) Purpose

The purpose of this rule is to define the responsibilities of a county board of developmental disabilities for service and support administration and to establish a process for individuals who receive service and support administration to have an identified service and support administrator who is the primary point of coordination.

(B) Definitions

(1) "Alternative services" has the same meaning as in rule 5123:2-1-08 of the Administrative Code.

(2) "Assessment" means the individualized process of gathering comprehensive information concerning the individual's preferences, desired outcomes, needs, interests, abilities, health status, and other available supports.

(3) "Budget for services" means the projected cost of implementing the individual service plan regardless of funding source.

(4) "County board" means a county board of developmental disabilities.

(5) "Department" means the Ohio department of developmental disabilities.

(6) "Home and community-based services waiver" means a medicaid waiver administered by the department in accordance with section 5166.21 of the Revised Code.

(7) "Individual" means a person with a developmental disability.

(8) "Individual service plan" means the written description of services, supports, and activities to be provided to an individual.

(9) "Intermediate care facility" means an intermediate care facility for individuals with intellectual disabilities as defined in rule 5123:2-7-01 of the Administrative Code.

(10) "Natural supports" means the personal associations and relationships typically developed in the community that enhance the quality of life for individuals. Natural supports may include family members, friends, neighbors, and others in the community or organizations that serve the general public who provide voluntary support to help an individual achieve agreed upon outcomes through the individual service plan development.

(11) "Person-centered planning" means an ongoing process directed by an individual and others chosen by the individual to identify the individual's unique strengths, interests, abilities, preferences, resources, and desired outcomes as they relate to the individual's support needs.

(12) "Primary point of coordination" means the identified service and support administrator who is responsible to an individual for the effective development, implementation, and coordination of the individual service plan.

(13) "Service and support administration" means the duties performed by a service and support administrator pursuant to section 5126.15 of the Revised Code.

(14) "Team" means the group of persons chosen by the individual with the core responsibility to support the individual in directing development of his or her individual service plan. The team includes the individual's guardian or adult whom the individual has identified, as applicable, the service and support administrator, direct support staff, providers, licensed or certified professionals, and any other persons chosen by the individual to help the individual consider possibilities and make decisions.

(C) Decision-making responsibility

(1) Individuals, including individuals who have been adjudicated incompetent pursuant to Chapter 2111. of the Revised Code, have the right to participate in decisions that affect their lives and to have their needs, desires, and preferences considered.

(2) An individual for whom a guardian has not been appointed shall make decisions regarding receipt of a service or support or participation in a program provided for or funded under Chapter 5123. or 5126. of the Revised Code. The individual may obtain support and guidance from another person; doing so does not affect the right of the individual to make decisions.

(3) An individual for whom a guardian has not been appointed may, in accordance with section 5126.043 of the Revised Code, authorize an adult (who may be referred to as a "chosen representative") to make a decision described in paragraph (C)(2) of this rule on behalf of the individual as long as the adult does not have a financial interest in the decision. The authorization shall be made in writing.

(4) When a guardian has been appointed for an individual, the guardian shall make a decision described in paragraph (C)(2) of this rule on behalf of the individual within the scope of the guardian's authority. This paragraph shall not be construed to require appointment of a guardian.

(5) An adult or guardian who makes a decision pursuant to paragraph (C)(3) or (C)(4) of this rule shall make a decision that is in the best interest of the individual on whose behalf the decision is made and that is consistent with the individual's needs, desires, and preferences.

(D) Provision of service and support administration

(1) A county board shall provide service and support administration to:

(a) An individual, regardless of age or eligibility for county board services, who is applying for or enrolled in a home and community-based services waiver;

(b) An individual three years of age or older who is eligible for county board services and requests, or a person on the individual's behalf requests pursuant to paragraph (C) of this rule, service and support administration; and

(c) An individual residing in an intermediate care facility who requests, or a person on the individual's behalf requests pursuant to paragraph (C) of this rule, assistance to move from the intermediate care facility to a community setting.

(2) A county board shall provide service and support administration in accordance with the requirements of section 5126.15 of the Revised Code.

(3) An individual who is eligible for service and support administration in accordance with paragraph (D)(1) of this rule and requests, or a person on the individual's behalf requests pursuant to paragraph (C) of this rule, service and support administration shall receive service and support administration and shall not be placed on a waiting list for service and support administration.

(E) Determination of eligibility for county board services

Service and support administrators shall, in accordance with rules adopted by the department, determine individuals' eligibility for county board services. A county board may assign responsibility for eligibility determination to a service and support administrator who does not perform other service and support administration functions; in such a case, results of the eligibility determination shall be shared with the service and support administrator who is the primary point of coordination for the individual in order to ensure coordination of services and supports. Results of the eligibility determination shall be shared in a timely manner with the individual and the individual's guardian, and/or the adult whom the individual has identified, as applicable.

(F) Primary point of coordination

(1) A county board shall identify a service and support administrator for each individual receiving service and support administration who shall be the primary point of coordination for the individual. An individual shall be given the opportunity to request a different service and support administrator from the county board.

(2) With the active participation of the individual and members of the team, the service and support administrator shall perform the following duties:

(a) Initially, and at least every twelve months thereafter, coordinate assessment of the individual.

(i) The assessment shall take into consideration:

(a) What is important to the individual to promote satisfaction and achievement of desired outcomes;

(b) What is important for the individual to maintain health and welfare;

(c) Known and likely risks;

(d) The individual's place on the path to community employment; and

(e)What is working and not working in the individual's life.

(ii) The assessment shall identify supports that promote the individual's:

(a) Rights (e.g., equality, citizenship, access, due process, and responsibility);

(b) Self-determination (e.g., choices, opportunities, personal control, and self-advocacy);

(c) Physical well-being (e.g., routine and preventative health care and daily living skills appropriate to age);

(d) Emotional well-being (e.g., self-worth, self-esteem, satisfaction with life, and spirituality);

(e) Material well-being (e.g., employment, money, education, and housing);

(f) Personal development (e.g., achievement, success, and personal competence);

(g) Interpersonal relationships (e.g., social contacts, relationships, and emotional supports); and

(h) Social inclusion (e.g., community participation and social supports).

(b) Using person-centered planning, develop, review, and revise the individual service plan and ensure that the individual service plan:

(i) Reflects results of the assessment.

(ii) Includes services and supports that:

(a) Ensure health and welfare;

(b) Assist the individual to engage in meaningful and productive activities;

(c) Support community connections and networking with persons or groups including persons with disabilities and others;

(d) Assist the individual to improve self-advocacy skills and increase the individual's opportunities to participate in advocacy activities, to the extent desired by the individual;

(e) Ensure achievement of outcomes that are important to the individual and outcomes that are important for the individual and address the balance of and any conflicts between what is important to the individual and what is important for the individual;

(f) Address identified risks and include supports to prevent or minimize risks;

(iii) Integrates all sources of services and supports, including natural supports and alternative services, available to meet the individual's needs and desired outcomes;

(iv) Reflects services and supports that are consistent with efficiency, economy, and quality of care; and

(v) Is updated throughout the year.

(c) Establish a recommendation for and obtain approval of the budget for services based on the individual's assessed needs and preferred ways of meeting those needs.

(d) Through objective facilitation, assist the individual in choosing providers by:

(i) Ensuring that the individual is given the opportunity to select providers from all willing and qualified providers in accordance with applicable federal and state laws and regulations including rule 5123:2-9-11 of the Administrative Code; and

(ii) Assisting the individual as necessary to work with providers to resolve concerns involving a provider or direct support staff who are assigned to work with the individual.

(e) Secure commitments from providers to support the individual in achievement of his or her desired outcomes.

(f) Verify by signature and date that prior to implementation each individual service plan:

(i) Indicates the provider, frequency, and funding source for each service and support; and

(ii) Specifies which provider will deliver each service or support across all settings.

(g) Establish and maintain contact with providers as frequently as necessary to ensure that each provider is trained on the individual service plan and has a clear understanding of the expectations and desired outcomes of the supports being provided.

(h) Establish and maintain contact with natural supports as frequently as necessary to ensure that natural supports are available and meeting desired outcomes as indicated in the individual service plan.

(i) Facilitate effective communication and coordination among the individual and members of the team by ensuring that the individual and each member of the team has a copy of the current individual service plan unless otherwise directed by the individual, the individual's guardian, or the adult whom the individual has identified, as applicable. The individual and his or her providers shall receive a copy of the individual service plan at least fifteen calendar days in advance of implementation unless extenuating circumstances make fifteen-day advance copy impractical and with agreement by the individual and his or her providers.

(i) A member of the team who becomes aware that revisions to the individual service plan are indicated shall notify the service and support administrator.

(ii) A member of the team may disagree with any provision in the individual service plan at any time. All dissenting opinions shall be specifically noted in writing and attached to the individual service plan.

(j) Provide ongoing individual service plan coordination to ensure services and supports are provided in accordance with the individual service plan and to the benefit and satisfaction of the individual. Ongoing individual service plan coordination shall:

(i) Occur with the active participation of the individual and members of the team;

(ii) Focus on achievement of the desired outcomes of the individual;

(iii) Balance what is important to the individual and what is important for the individual;

(iv) Examine service satisfaction (i.e., what is working for the individual and what is not working); and

(v) Use the individual service plan as the fundamental tool to ensure the health and welfare of the individual.

(k) Review and revise the individual service plan at least every twelve months and more frequently under the following circumstances:

(i) At the request of the individual or a member of the team, in which case revisions to the individual service plan shall occur within thirty calendar days of the request;

(ii) Whenever the individual's assessed needs, situation, circumstances, or status changes;

(iii) If the individual chooses a new provider or type of service or support;

(iv) As a result of reviews conducted in accordance with paragraph (F)(2)(q) of this rule;

(v) Identified trends and patterns of unusual incidents or major unusual incidents; and

(vi) When services are reduced, denied, or terminated by the department or the Ohio department of medicaid.

(l) Take the following actions with regard to medicaid services:

(i) Explain to the individual, in conjunction with the process of recommending eligibility and/or assisting the individual in making application for enrollment in a home and community-based services waiver or any other medicaid service, and in accordance with rules adopted by the department:

(a) Alternative services available to the individual;

(b) The individual's due process and appeal rights; and

(c)The individual's right to choose any qualified and willing provider.

(ii) Explain to the individual, at the time the individual is being recommended for enrollment in a home and community-based services waiver:

(a) Choice of enrollment in a home and community-based services waiver as an alternative to intermediate care facility placement; and

(b)Services and supports funded by a home and community-based services waiver.

(iii) Provide an individual with written notification and explanation of the individual's right to a medicaid state hearing if the individual service plan process results in a recommendation for the approval, reduction, denial, or termination of services funded by a home and community-based services waiver. Notice shall be provided in accordance with section 5101.35 of the Revised Code.

(iv) Make a recommendation to the Ohio department of medicaid or its designee, in accordance with rule 5101:3-3-15.3 of the Administrative Code, as to whether the individual meets the criteria for an intermediate care facility level of care in accordance with rule 5101:3-3-07 of the Administrative Code.

(v) Explain to an individual whose individual service plan includes services funded by a home and community-based services waiver or other medicaid services that the services are subject to approval by the department and the Ohio department of medicaid. If the department or the Ohio department of medicaid approves, reduces, denies, or terminates services funded by a home and community-based services waiver or other medicaid services included in an individual service plan, the service and support administrator shall communicate with the individual about this action.

(m) Provide an individual with written notification and explanation of the individual's right to use the administrative resolution of complaint process set forth in rule 5123:2-1-12 of the Administrative Code if the individual service plan process results in the reduction, denial, or termination of a service other than a service funded by a home and community-based services waiver or targeted case management services. Such written notice and explanation shall also be provided to an individual if the individual service plan process results in an approved service that the individual does not want to receive, but is necessary to ensure the individual's health, safety, and welfare. Notice shall be provided in accordance with rule 5123:2-1-12 of the Administrative Code.

(n) Advise members of the team of their right to file a complaint in accordance with rule 5123:2-1-12 of the Administrative Code.

(o) Retain responsibility for all decision-making regarding service and support administration functions and the communication of any such decisions to the individual.

(p) Take actions necessary to remediate any immediate concerns regarding the individual's health and welfare.

(q) Implement a continuous review process to ensure that individual service plans are developed and implemented in accordance with this rule.

(i) The continuous review process shall be tailored to the individual and based on information provided by the individual and the team.

(ii) The scope, type, and frequency of reviews shall be specified in the individual service plan and shall include, but are not limited to:

(a) Face-to-face visits, occurring at a time and place convenient for the individual, at least annually or more frequently as needed by the individual; and

(b)Contact via phone, email, or other appropriate means as needed.

(iii) The frequency of reviews may be increased when:

(a) The individual has intensive behavioral or medical needs;

(b) The individual has an interruption of services of more than thirty calendar days;

(c) The individual encounters a crisis or multiple less serious but destabilizing events within a three-month period;

(d) The individual has transitioned from an intermediate care facility to a community setting within the past twelve months;

(e) The individual has transitioned to a new provider of homemaker/personal care within the past twelve months;

(f) The individual receives services from a provider that has been notified of the department's intent to suspend or revoke the provider's certification or license; or

(g)Requested by the individual, the individual's guardian, or the adult whom the individual has identified, as applicable.

(iv) The service and support administrator shall share results of reviews in a timely manner with the individual, the individual's guardian, and/or the adult whom the individual has identified, as applicable, and the individual's providers, as appropriate.

(v) If the continuous review process indicates areas of non-compliance with standards for providers of services funded by a home and community-based services waiver, the county board shall conduct a provider compliance review in accordance with rule 5123:2-2-04 of the Administrative Code.

(G) Emergency response system

The county board shall, in coordination with the provision of service and support administration, make an on-call emergency response system available twenty-four-hours per day, seven days per week to provide immediate response to an unanticipated event that requires an immediate change in an individual's existing situation and/or individual service plan to ensure health and safety. Persons who are available for the on-call emergency response system shall:

(1) Provide emergency response directly or through immediate linkage with the service and support administrator who is the primary point of coordination for the individual or with the primary provider;

(2) Be trained and have the skills to identify the problem, determine what immediate response is needed to alleviate the emergency and ensure health and welfare, and identify and contact persons to take the needed action;

(3) Notify the providers and the service and support administrator who is the primary point of coordination for the individual to ensure adequate follow-up;

(4) Notify the county board's investigative agent as determined necessary by the nature of the emergency; and

(5) Document the emergency in accordance with county board procedures.

(H) Records

(1) Paper or electronic records shall be maintained for individuals receiving service and support administration and shall include, at a minimum:

(a) Identifying data;

(b) Information identifying guardianship, other adult whom the individual has identified, trusteeship, or protectorship;

(c) Date of request for services from the county board;

(d) Evidence of eligibility for county board services;

(e) Assessment information relevant for services and the individual service plan process for supports and services;

(f) Current individual service plan;

(g) Current budget for services;

(h) Documentation that the individual exercised freedom of choice in the provider selection process;

(i) Documentation of unusual incidents;

(j) Major unusual incident investigation summary reports;

(k) The name of the service and support administrator;

(l) Emergency information;

(m) Personal financial information, when appropriate;

(n) Release of information and consent forms;

(o) Case notes which include coordination of services and supports and continuous review process activities; and

(p) Documentation that the individual was afforded due process in accordance with paragraph (I) of this rule, including but not limited to, appropriate prior notice of any action to deny, reduce, or terminate services and an opportunity for a hearing.

(2) When the county board uses electronic record keeping and electronic signatures, the county board shall establish policies and procedures for verifying and maintaining such records.

(I) Due process

Due process shall be afforded to each individual receiving service and support administration pursuant to section 5101.35 of the Revised Code for services funded by a home and community-based services waiver and targeted case management services or pursuant to rule 5123:2-1-12 of the Administrative Code for services other than services funded by a home and community-based services waiver and targeted case management services.

(J) Department monitoring and technical assistance

The department shall monitor compliance with this rule by county boards. Technical assistance, as determined necessary by the department, shall be provided upon request and through regional and statewide trainings.

(K) Ohio department of medicaid monitoring of targeted case management services

The Ohio department of medicaid retains final authority to monitor the provision of targeted case management services in accordance with rule 5101:3-48-01 of the Administrative Code.

Replaces: 5123:2-1-11

Effective: 03/17/2014
R.C. 119.032 review dates: 03/17/2019
Promulgated Under: 119.03
Statutory Authority: 5123.04 , 5126.041 , 5126.05 , 5126.08
Rule Amplifies: 5123.04 , 5126.041 , 5126.05 , 5126.055 , 5126.08 , 5126.15
Prior Effective Dates: 08/23/1985 (Emer.), 11/22/1985 (Emer.), 01/18/1986, 03/11/1988, 03/03/1990, 11/18/1995, 07/01/2005

5123:2-1-12 Administrative resolution of complaints for county boards.

(A) This rule establishes the process for county boards for the administrative resolution of complaints involving the programs, services, policies, or administrative practices of a county board or the entities acting under contract with a county board. Areas subject to administrative resolution by a county board include, but are not necessarily limited to, eligibility determination, arranging appropriate services for eligible individuals, or any denial, reduction or termination of services to individuals by the county board.

(B) Application

(1) Any person, other than an employee of a county board, may file a complaint using the administrative resolution process established under this rule, and shall use this process prior to commencing a civil action regarding the complaint.

(2) For an individual placed by the local education agency into the county board program, the rules for the education of handicapped children, as promulgated by the state board of education, shall be followed. Other eligible individuals shall be afforded the right to the administrative resolution process outlined in this rule.

(3) The provisions of this rule shall not apply to an individual applying for or enrolled in services provided pursuant to the medicaid home and community-based services waiver. All such appeals of decisions of the county board shall be made to the Ohio department of human services (ODHS) in accordance with applicable rules for appeals promulgated by ODHS under Chapters 5101:6-1 to 5101:6-9 of the Administrative Code. Such individuals may appeal other decisions of the county board related to services or administrative practices of the county board other than HCBS waiver services using the applicable process under this rule. Concurrent to any such appeal to ODHS, the individual and the county board may attempt to informally resolve issues related to HCBS waivers through the grievance policy adopted by said board in accordance with paragraph (E) of this rule.

(4) The provisions of this rule shall not apply to complaints regarding the performance of delegable nursing tasks at county boards. The procedures outlined in rules 4723-21-28 and 5123:2-1-07 of the Administrative Code shall apply.

(5) An entity or individual receiving services under contract with a county board for the provision of supported living shall follow the process for resolving complaints established under division (B) of section 5126.45 of the Revised Code prior to initiating an appeal pursuant to this rule. After exhausting the process for resolving complaints established by contract, an individual may initiate an appeal under paragraph (F)(8) of this rule.

(C) As used in this rule:

(1) "Complainant" means a person as defined in section 1.59 of the Revised Code, and shall include any person other than an individual as defined in this rule, a corporation, business trust, estate, trust, partnership, and association when such person has an interest with the county board through a contract or in relation to an administrative practice of the board.

(2) "County board" means a county board of mental retardation and developmental disabilities, including board members as an entity, the superintendent and any person employed by or under contract with the board who has authority for administrative or service implementation on behalf of said board.

(3) "Department" means the Ohio department of developmental disabilities.

(4) "Employee" means unclassified employees of the county board seeking to resolve employment issues who shall follow the procedures in the contract entered into pursuant to section 5126.21 of the Revised Code and in accordance with section 5126.23 of the Revised Code and classified employees of the county board seeking to resolve employment issues who shall follow the procedures in Chapter 124. of the Revised Code or within an applicable collective bargaining agreement entered into pursuant to Chapter 4117. of the Revised Code.

(5) "Individual" means a person applying for, determined eligible for, denied eligibility, or enrolled in the programs, services, and supports provided or arranged in accordance with Chapter 5126. of the Revised Code and includes the parents of an individual who is a minor, any guardian, or any other legally appointed representative acting in a legal capacity on the individual's behalf.

(D) Notification of the administrative resolution process

(1) The county board shall give annual notification of the availability of the procedure for administrative resolution of complaints to individuals and any entity in the county that serves persons or provides or desires to provide other goods or services under a contract with the county board. The county board shall post the toll free number for the department and Ohio legal rights service in a visible place. The county board shall inform the individual that a representative of the county board is available to assist the individual with the administrative resolution procedures outlined in this rule.

(2) Upon receipt of any complaint subject to administrative resolution under this rule, the superintendent or appropriate designee shall provide written notice of the rights to administrative resolution of the complaint to the complainant or individual. Where circumstances permit, this notice shall be given at least ten days before the action is taken. Such notice shall be written in terms reasonably calculated to be understood by the complainant or individual, and shall include the following:

(a) A detailed description of the proposed action;

(b) A clear statement of the reasons for the proposed action, including the specification of any evaluative instruments or reports upon which such action is proposed;

(c) A statement that the complainant or individual has the right to seek administrative resolution regarding complaints about such decision; and

(d) A copy of the written administrative resolution process.

(E) The county board may adopt a grievance procedure as an informal process for the resolution of disputes with complainants or individuals. Such a policy shall authorize the superintendent to appoint one or more persons to conduct an informal hearing of such disputes seeking to resolve the issue within a timeframe of no more than thirty days. Filing of such grievances under this policy shall not affect the rights of the complainant or individual to file an appeal through the administrative resolution procedures under paragraph (F) of this rule.

(F) Administrative resolution procedures

(1) Subject to the limitations of section 5123.043 of the Revised Code, any request for administrative resolution of a complaint filed in accordance with this rule will not abrogate any other rights to services. If the county board is requesting a termination or reduction of services or change in services for an individual, current services shall continue to be provided pending final resolution unless an entity under contract with a county board for the provision of supported living terminates the services it is providing that individual in accordance with the terms of its contract with the county board.

(2) Notwithstanding any other provisions of this rule, the appeal of any action of a county board or its employees shall begin at the level in which the decision or action was made.

(3) When a complaint involves the action of the county board, the request for administrative resolution shall be in writing and shall be filed with the supervisor of the applicable service component of the county board. If an individual has difficulty in reading or writing, an oral report may be accepted and documented by the county board supervisor receiving the report. An individual who wishes to seek administrative resolution in accordance with this rule may be assisted by an advocate who may speak on behalf of the individual at the individual's request.

(a) The county board supervisor will conduct an investigation of the complaint within ten calendar days of receipt of the request for administrative resolution of the complaint.

(b) Within ten calendar days of the completion of the investigation, a written report and decision will be completed and discussed with the complainant or individual. Such report shall include a description of the next step in the administrative resolution process.

(c) Within ten calendar days of receipt of the county board supervisor's written decision, the complainant or individual may request administrative review of the supervisor's written decision.

(d) Timelines may be extended if mutually agreeable to all involved parties.

(4) If the complainant or individual wishes an administrative review of the county board supervisor's decision, the following shall occur:

(a) A request for administrative review shall be made in writing by the complainant or individual within ten calendar days of receipt of the supervisor's written decision. The request for administrative review of the supervisor's written decision shall be made to the superintendent of the county board or his designee.

(b) Upon receipt of a request for administrative review of the supervisor's written decision, the superintendent or his designee shall, within ten calendar days, meet with the party initiating the request and conduct an administrative review.

(i) During the administrative review, the superintendent or his designee may ask questions to clarify and review the circumstances and facts related to the decision, and provide the party initiating the request the opportunity to present reasons as to why the decision should be reconsidered.

(ii) Within five working days of the administrative review, the superintendent's decision shall be made known, in writing, to the complainant or individual and shall include a rationale for such decision, and a description of the next step in the administrative resolution process.

(c) Timelines may be extended if mutually agreeable to all involved parties.

(5) If the complainant or individual is not satisfied with the decision of the superintendent, a written appeal may be filed with the county board president. The written appeal shall be filed with the county board president within ten calendar days of receipt of the superintendent's decision.

(a) Upon receipt of a written request to appeal, the county board president or his designee shall conduct a hearing no sooner than seven calendar days, nor later than the next regularly scheduled board meeting, at a time and place convenient to all parties. The county board may hear the case as a full board or the president of the board with concurrence of the board may establish a committee of two or more board members to hear such appeals. Such a committee shall be vested with the full rights and authorities as the county board in handling the appeal.

(b) No less than seven days prior to the hearing, the complainant or individual shall be provided access to county board records pertaining to the specifics of the appeal.

(c) The hearing shall be a closed meeting unless the complainant or individual requests an open meeting.

(d) During the hearing, evidence shall be presented by both parties to support their positions.

(e) The complainant or individual shall be afforded the right to be represented by legal counsel. An individual shall further have the right to be represented by such other representative of the party's choice and at the expense of the individual.

(f) The complainant or individual shall be afforded the right to have in attendance and question any official, employee or agent of the county board who may have evidence upon which the appeal is based.

(g) The decision of the county board shall be based solely upon evidence presented at the hearing.

(h) Evidence presented at the hearing shall be recorded by stenographic means or by use of audio-electronic recording devices as the county board determines at the time of the hearing. Such record shall be made at the expense of the county board and, upon request, one copy of the verbatim transcript shall be provided to the complainant or individual at no cost.

(i) In any hearing held under the authority of the county board pursuant to this rule, the county board may appoint a hearing examiner to conduct said hearing. The hearing examiner shall have the same powers and authority in conducting the hearing as granted to the county board. The hearing examiner shall not be an employee of the county board. The hearing examiner need not be admitted to the practice of law, but shall be possessed of such qualifications as to be able to render neutral and informed decisions on matters presented in the complaint. The director or his designee shall maintain a list of approved hearing examiners which a county board may request in order to select a qualified hearing examiner. The county board may also request the department to certify a hearing examiner as qualified to hear one or more cases for the county board in accordance with the person's experience and educational background.

(i) Within five calendar days of the date the hearing is deemed closed, the hearing examiner shall issue a written report and recommendation, setting forth findings of fact, conclusions of law, and a recommendation for the disposition of the complaint. The report and recommendation shall be served upon the parties to the hearing by certified mail.

(ii) The parties to the hearing may file with the county board written objections to the report and recommendation within ten days of receipt of the report and recommendation.

(j) Within five calendar days of the hearing or within five calendar days following the board's action upon receipt of the hearing examiner's report and any objections thereto, written notification of the county board's decision shall be sent by certified mail to the complainant or individual. Such notification shall include a rationale for the county board decision and a description of the next step in the process.

(k) Timelines may be extended if mutually agreeable to all involved parties.

(6) The county board shall at all times maintain confidentiality concerning the identities of individuals, complainants, witnesses, and other involved parties who provide information unless the individual, in writing, authorizes the release of information.

(7) Subject to the limitations of sections 5123.043 of the Revised Code, the administrative resolution process provided by this rule is in addition to any other rights an individual or the parent of minor or guardian may otherwise have pursuant to the Ohio Revised Code or any other applicable state or federal law.

(8) When a complaint has been made against the county board and the complaint has been made by an individual involving services or supports provided or arranged by the county board for the individual, the individual shall have the right to appeal the decision of the county board to the director of the department. The following procedures shall be followed in such appeals to the director:

(a) The appeal must be filed with the director within fifteen calendar days of receipt of the county board's decision. Copies of the appeal letter shall also be sent to the superintendent, the county board president, and the legal counsel or other representative of either or both parties.

(b) Upon receipt of notice of the appeal from the administrative action of the county board, the county board shall send to the department copies of the verbatim transcript of the hearing with the county board, any exhibits incorporated into the transcript, and the county board's written decision.

(c) The director or his designee shall review the appeal within thirty calendar days of receipt of the appeal. The Director or his designee shall determine if the decision of the county board is based upon applicable statute and/or administrative rule.

(d) Within fourteen calendar days following the department level review, the director's decision shall be made known, in writing, to all affected parties, and shall include a rationale for the decision.

(e) Timelines may be extended if mutually agreeable to all involved parties.

(9) After exhausting the administrative remedies required in this rule, an individual may commence a civil action if the complaint is not settled to his satisfaction.

(10) After exhausting the administrative remedies required in this rule, if the complaint is not settled to his satisfaction, a complainant may either file a complaint with the department as permitted by rule 5123:2-17-01 of the Administrative Code or commence a civil action against the county board.

Replaces: Part of 5123:2-1-02

R.C. 119.032 review dates: 12/23/2003 and 07/01/2004

Promulgated Under: 119.03

Statutory Authority: 5123.043

Rule Amplifies: 5123.043 , 5126.041

Prior Effective Dates: 7/1/76, 12/11/83, 7/1/91 (Emer.), 9/13/91, 4/22/93, 6/2/95 (Emer.), 9/1/95 (Emer.), 12/2/95

5123:2-1-13 In-service training for members of county boards of mental retardation and developmental disabilities.

(A) Purpose

The purpose of this rule is to delineate requirements for annual in-service training for board members of county boards of mental retardation and developmental disabilities.

(B) Definitions

(1) "Annual organizational meeting" means the meeting held by each county board of mental retardation and developmental disabilities, no later than January thirty-first of each calendar year, to elect its officers and conduct other business pursuant to section 5126.022 of the Revised Code.

(2) "Appointing authority" means the entity with statutory authority to appoint members to boards of mental retardation and developmental disabilities pursuant to division (B) of section 5126.02 of the Revised Code.

(3) "Board member" or "member" means a member of a county board of mental retardation and developmental disabilities.

(4) "County board" or "board" means a county board of mental retardation and developmental disabilities as established pursuant to section 5126.02 of the Revised Code.

(5) "Department" means the Ohio department of developmental disabilities.

(6) "In-service training" means department provided or approved training of board members pursuant to division (C) of section 5126.02 of the Revised Code that may include, but is not limited to, the following topics: ethics, including conflicts of interest and the board's ethics council; boardmanship; open meeting requirements; confidentiality; and current issues in the field of mental retardation and developmental disabilities.

(7) "Superintendent" means the chief executive of a county board appointed pursuant to section 5126.023 of the Revised Code.

(8) "Unit" means fifty minutes of instruction.

(C) In-service training requirements

(1) During each calendar year of a board member's term, the member shall attend a minimum of four units of in-service training, except as provided in paragraph (C)(2) of this rule.

(2) Board members appointed after the board's annual organizational meeting and board members appointed to complete the remainder of a former board member's term shall attend in-service training during the first calendar year of the member's appointment in accordance with the following schedule:

(a) Members appointed prior to April first shall attend a minimum of four units of in-service training.

(b) Members appointed after March thirty-first but prior to July first shall attend a minimum of three units of in-service training.

(c) Members appointed after June thirtieth but prior to October first shall attend a minimum of two units of in-service training.

(d) Members appointed after September thirtieth but prior to the succeeding January first shall attend a minimum of one unit of in-service training.

(D) In-service training sessions shall not be considered regularly scheduled meetings of the board.

(E) The department shall approve in-service training sessions on forms prescribed by the department.

(F) Superintendents shall annually verify to the department, on forms prescribed by the department, that board members have attended required in-service training.

(G) Consequences for failure to attend required in-service training

(1) If a board member fails to attend in-service training as specified in paragraph (C) of this rule, the board shall, by resolution, supply the board member and the member's appointing authority with written notice of the charges against the member. The board shall send a copy of this resolution to the department.

(2) The appointing authority shall afford the member an opportunity for a hearing, in accordance with procedures it adopts, and shall, upon determining that the charges are accurate, remove the member and appoint another person to complete the member's term.

(3) The superintendent shall notify the department of any action the appointing authority takes regarding the board member.

(4) A member who is removed from the board for failing to attend in-service training is ineligible for reappointment to the board for not less than one year.

(5) If a member is removed from the board for failing to attend in-service training, the board shall specify to the appointing authority the training the member must complete prior to being eligible for reappointment.

Effective: 01/01/2004
R.C. 119.032 review dates: 01/01/2009
Promulgated Under: 119.03
Statutory Authority: 5126.05 , 5126.08 , 5123.04
Rule Amplifies: 5123.04 , 5126.02 , 5126.022 , 5126.05 , 5126.08