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Ohio Laws and Rules
As used throughout rules adopted under Chapter 5123:2-8 of the Administrative Code, the following definitions shall apply:
(A) “Applicant” means a person or government entity that has submitted to the department an application for certification to provide services under the HCBS level one waiver.
(B) “Agency provider” means a person or government entity that provides services under the HCBS level one waiver other than an individual provider.
(C) “County board” means a county board of mental retardation and developmental disabilities established under Chapter 5126. of the Revised Code.
(D) “Covered service” means any service approved under the HCBS level one waiver.
(E) “CPR” means cardiopulmonary resuscitation.
(F) “Department” means the Ohio department of mental retardation and developmental disabilities as established by section 121.02 of the Revised Code.
(G) “Direct contact” means exercising supervision or control over the individual enrolled in the level one waiver and for whom a provider will be providing a waiver service.
(H) “Direct services position” has the same meaning as in section 5126.281 of the Revised Code.
(I) “Emergency assistance” means the services defined in rule 5123:2-8-11 of the Administrative Code.
(J) “Environmental accessibility adaptations” means the services defined in rule 5123:2-8-06 of the Administrative Code.
(K) “HCBS” means medicaid-funded home and community-based services provided under a medicaid component that the department administers pursuant to section 5111.871 of the Revised Code.
(L) “Homemaker/personal care” means the services defined in rule 5123:2-8-10 of the Administrative Code.
(M) “ICF/MR” means intermediate care facility for the mentally retarded.
(N) “Individual” means a person with mental retardation and/or developmental disabilities.
(O) “Individual provider” means a self-employed person who provides services under the HCBS level one waiver and does not employ, either directly, or through a contract, anyone else to provide such services.
(P) “Informal respite” means the services defined in rule 5123:2-8-03 of the Administrative Code.
(Q) “Institutional respite” means the services defined in rule 5123:2-8-04 of the Administrative Code.
(R) “ISP” means individual service plan.
(S) “Legally responsible person” means the individual or the individual’s guardian appointed by the probate court under Chapter 2111. of the Revised Code. If the individual is a minor for whom no guardian has been appointed under that chapter, “guardian” means the individual’s parent. If no guardian has been appointed for a minor and the minor is in the legal or permanent custody of a government agency or person other than the minor’s natural or adoptive parent, “guardian” means that government agency or person.
(T) “Level one waiver” means a waiver approved under the authority of section 1915(c) of the “Social Security Act,” under which federal reimbursement is provided for designated home and community-based services to individuals who without such services would be subject to institutionalization.
(U) “Licensed provider” means a provider licensed by the department pursuant to section 5123.19 of the Revised Code.
(V) “Limited provider” means a person who is known to the individual, is selected by the individual or the individual’s guardian and provides informal respite only to the individual or to multiple individuals who live in the same family setting.
(W) “Minor child” means a biological child, adoptive child, or stepchild under age eighteen.
(X) “ODJFS” means the Ohio department of job and family services as established by section 121.02 of the Revised Code.
(Y) “OSHA” means occupational safety and health administration.
(Z) “Personal emergency response systems” means the services defined in rule 5123:2-8-09 of the Administrative Code.
(AA) “Specialized medical equipment and supplies” means the services defined in rule 5123:2-8-08 of the Administrative Code.
(BB) “Spouse” means a partner in a marriage that is legally recognized by the state of Ohio.
(CC) “SSA” means the service and support administrator, a county board employee who provides a variety of coordination activities for individuals in accordance with section 5126.15 of the Revised Code.
(DD) “Subcontractor” means a person or agency who is contracted by a certified provider to perform services pursuant to the requirements of the level one waiver.
(EE) “Supported employment” means the services defined in rule 5123:2-9-13 of the Administrative Code.
(FF) “Three-year period” means a three-year period beginning with the first date the individual is eligible for services through the level one waiver and ending three years later. Subsequent three-year periods begin with the ending date of the previous three-year period and end three years later.
(GG) “Transportation” means the services defined in rule 5123:2-8-07 of the Administrative Code.
Effective: 07/01/2006
R.C. 119.032 review dates: 04/28/2008
Promulgated Under: 119.03
Statutory Authority: 5123.04, 5123.16, 5123.045, 5111.871
Rule Amplifies: 5123.04, 5123.16, 5123.045, 5111.871
Prior Effective Dates: 4/28/03
Rescinded eff 7-1-05
(A) Purpose
The purpose of this rule is to specify the service definition for informal respite and set forth the individual’s eligibility for this service and to set forth the certification standards required under section 5123.16 of the Revised Code for providers of informal respite to individuals enrolled in the HCBS level one waiver administered by the department. Informal respite is a service that is directed and monitored by family members with whom the individual resides.
(B) Definitions
(1) “Informal respite” means services provided by a limited provider to individuals unable to care for themselves, furnished on a short-term basis because of the absence or need for relief of those persons normally providing the care. Informal respite may be provided in the individual’s home or place of residence, home of a friend or family member or sites of community activities For purposes of this rule, “family member” means parent(s), brother(s), sister(s), spouse, son(s), daughter(s), grandparent(s), aunt(s), uncle(s), cousin(s), or guardian of the individual who has mental retardation or developmental disabilities. “Family member” 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 who has mental retardation or developmental disabilities lives with the person(s) and is dependent on him/her 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. The benefit limitation for this service, institutional respite, homemaker/personal care, and transportation combined shall not exceed five thousand dollars annually.
(2) “Limited provider” means a person who is known to the individual, is selected by the individual or the individual’s guardian and provides informal respite only to the individual or to multiple individuals who live in the same family setting.
(C) Family member responsibility and individual eligibility
(1) An individual enrolled in the level one waiver eligible for this service must have a family member who is able and willing to accept responsibility for training and monitoring health management activities, behavior support, major unusual incident reporting and other activities required to meet the needs of the individual as identified in the individual’s ISP. The responsible family member shall document the following on forms and according to procedures prescribed by the department:
(a) Orientation and training of a limited provider, prior to the delivery of services, about activities required to meet the needs and preferences of the individual(s) including any training stipulated for the individual(s) in his/her ISP and other information related to health and welfare needs of the individual who receives informal respite.
(b) At least annually, training to assure that the limited provider understands the following:
(i) The reporting requirements set forth in rule 5123:2-17-02 of the Administrative Code relating to incidents adversely affecting health and safety and the reasonable steps necessary to prevent the occurrence or reoccurrence of incidents adversely affecting health and safety;
(ii) The rights of an individual set forth in section 5123.62 of the Revised Code; and
(iii) The activities required to meet the needs and preferences of the individual(s), including any training stipulated for the individual(s) in his/her ISP and other information related to health and welfare needs of the individual.
(c) The family member shall verify the relationship with the individual by signature.
(2) For purposes of this service under the level one waiver, the family member shall provide the following to fulfill the program management requirements of section 5126.14 of the Revised Code:
(a) Monitor the delivery of the informal respite service as outlined in the ISP;
(b) Train limited providers in accordance with this rule;
(c) Communicate with the person responsible for service and support administration for the individual receiving informal respite;
(d) Monitor and report unusual and major unusual incidents;
(e) Take immediate actions as necessary to maintain the health, safety, and welfare of the individual receiving informal respite services.
(3) Failure of the family member to fulfill the requirements of paragraph (C) of this rule shall render the individual no longer eligible for informal respite services under the level one waiver and, subsequent to prior notice and hearing rights in accordance with Chapters 5101:6-1 to 5101:6-9 of the Administrative Code, the informal respite service shall be terminated.
(D) Standards and requirements for initial certification of limited providers
An applicant for limited provider certification for informal respite shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving informal respite services.
(1) The applicant shall be at least eighteen years of age.
(2) The applicant shall submit an application in accordance with rule 5123:2-9-09 of the Administrative Code.
(3) Criminal background check
(a) The applicant shall submit to the department written evidence that a background investigation has been completed in accordance with section 5126.281 of the Revised Code and rule 5123:2-1-05.1 of the Administrative Code.
(b) The department shall deny certification to any applicant who has been convicted of or pled guilty to any of the offenses listed in division (E) of section 5126.28 of the Revised Code, unless the applicant meets the standards set forth in paragraph (N) or (R) of rule 5123:2-1-05.1 of the Administrative Code.
(4) Abuser registry
(a) The department shall determine whether the applicant’s name appears on the abuser registry established under sections 5123.50 to 5123.54 of the Revised Code.
(b) The department shall deny certification to any applicant if the applicant’s name appears on the abuser registry.
(5) Training relating to incidents adversely affecting health and safety
The applicant shall submit to the department written assurance that the applicant understands reporting requirements set forth in rule 5123:2-17-02 of the Administrative code relating to incidents adversely affecting health and safety and that the applicant will take all reasonable steps necessary to prevent the occurrence or reoccurrence of incidents adversely affecting health and safety including, but not limited to, notification of the service and support administrator (SSA), family, or legally responsible person as applicable.
(E) Standards and requirements for continuing certification of limited providers
After being certified in accordance with paragraph (D) of this rule, all limited providers of informal respite shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving informal respite services.
(1) Criminal background check
(a) A limited provider shall report to the department if he or she is ever formally charged with, convicted of, or pleads guilty to any of the offenses listed in division (E) of section 5126.28 of the Revised Code. The limited provider shall make such report, in writing, not later than fourteen calendar days after the date of such charge, conviction or guilty plea.
(b) The limited provider shall comply with section 5126.281 of the Revised Code and rule 5123:2-1-05.1 of the Administrative Code.
(c) The department may initiate revocation proceedings for any limited provider who has failed to report in accordance with paragraph (E)(1)(a) of this rule that he or she was charged with, convicted of or pled guilty to any of the offenses listed in division (E) of section 5126.28 of the Revised Code.
(d) The department shall initiate revocation proceedings for any limited provider who has been convicted of or pled guilty to any of the offenses listed in division (E) of section 5126.28 of the Revised Code, unless the limited provider meets the standards set forth in paragraph (N) or (R) of rule 5123:2-1-05.1 of the Administrative Code.
(2) Abuser registry
The department shall initiate revocation proceedings for any limited provider whose name has been placed on the abuser registry established under sections 5123.50 to 5123.54 of the Revised Code.
(3) Selection by the individual/guardian and individual needs
The limited provider shall provide written documentation from the individual’s ISP that he or she has been selected by the individual or the individual’s guardian to provide informal respite services and shall present such documentation upon request by ODJFS, the department, or the county board. The limited provider shall not agree to provide services to any individual whose needs the limited provider cannot meet.
(4) Orientation and training by family member
(a) Prior to delivering services, the limited provider shall participate in an orientation and resulting training by the responsible family member about activities required to meet the needs and preferences of the individual(s), including any training stipulated for the individual(s) in his/her ISP and other information related to health and welfare needs of the individual who receives informal respite.
(b) At least annually, the limited provider shall:
(i) Participate in training stipulated for the individual(s) in his/her ISP;
(ii) Provide written assurance that the limited provider understands reporting requirements set forth in rule 5123:2-17-02 of the Administrative Code relating to incidents adversely affecting health;
(iii) Provide written assurance that the limited provider understands the rights of an individual set forth in section 5123.62 of the Revised Code. The limited provider shall report any violations of those rights in accordance with division (B) of section 5123.64 of the Revised Code.
(5) ISP compliance and notification
(a) The limited provider shall implement informal respite services in accordance with the ISP and shall notify the individual or family member if he/she is not able to provide informal respite services.
(b) The limited provider has and shall continue to take all reasonable steps necessary to prevent the occurrence or reoccurrence of incidents adversely affecting health and safety including, but not limited to, notification of the incident to the person responsible for service and support administration and the family member.
(c) The limited provider has and shall continue to communicate with service and support administration staff and the responsible family member for the purpose of coordinating activities to ensure that services are provided to the individual in accordance with the ISP and intended outcomes.
(6) Provider eligibility
The limited provider shall not provide informal respite services to his/her minor child
(under age eighteen) or to his/her spouse.
(7) Evidence of department certification
The limited provider shall maintain documentation from the department of the limited provider’s certification under this rule.
(F) Exception related to number of individuals served by a limited provider
Except in the case of multiple individuals enrolled in the HCBS level one waiver who live in the same family setting, the limited provider shall not provide informal respite under the HCBS level one waiver to more than one individual.
(G) Denial, suspension, or revocation
(1) Failure to comply with the standards set forth in this rule for initial certification of providers may result in denial of certification by the department in accordance with rule 5123:2-9-09 of the Administrative Code.
(2) After being certified in accordance with this rule, providers shall comply with the continuing certification standards set forth in this rule. Providers shall be subject to monitoring and compliance reviews conducted by the county board and/or the department as set forth in rule 5123:2-9-08 of the Administrative Code. Failure to comply with the standards set forth in this rule for continuing certification of providers may result in corrective action by the department up to and including suspension or revocation of certification as set forth in rule 5123:2-9-08 of the Administrative Code.
(3) When denying, suspending, or revoking certification under this rule, the department shall comply with the notice and hearing requirements of Chapter 119. of the Revised Code.
Effective: 07/01/2006
R.C. 119.032 review dates: 04/28/2008
Promulgated Under: 119.03
Statutory Authority: 5123.04, 5123.045, 5123.16, 5111.871
Rule Amplifies: 5123.04, 5123.045, 5123.16, 5111.871
Prior Effective Dates: 4/28/03
(A) Purpose
The purpose of this rule is to specify the service definition for institutional respite and to set forth the certification standards required under section 5123.16 of the Revised Code for providers of institutional respite to individuals enrolled in the HCBS level one waiver administered by the department.
(B) Definition
“Institutional respite” means home and community-based services provided to individuals unable to care for themselves, furnished on a short term basis because of the absence or need for relief of those persons normally providing the care, in facilities certified as intermediate care facilities for the mentally retarded (ICFs/MR) or other facilities licensed by the department under section 5123.19 of the Revised Code. The benefit limitation for this service, informal respite, homemaker/personal care, and transportation combined shall not exceed five thousand dollars annually.
(C) Standards and requirements for initial and continuing certification of providers of institutional respite
An applicant for certification to provide institutional respite services shall meet all of the following requirements in order to ensure the health and welfare of the individuals receiving institutional respite services:
(1) The applicant shall submit an application in accordance with rule 5123:2-9-09 of the Administrative Code.
(2) ICFs/MR licensed by the department shall:
(a) Meet the requirements for and be certified as an ICF/MR by the Ohio department of health.
(b) Meet the requirements for and have a license issued by the department under section 5123.19 of the Revised Code.
(3) ICFs/MR licensed by the Ohio department of health shall:
(a) Meet the requirements for and be certified as an ICF/MR by the Ohio department of health.
(b) Meet the requirements for and have a license issued by the Ohio department of health under Chapter 3721. of the Revised Code.
(4) Other facilities licensed by the department shall meet the requirements for and have a license issued by the department under section 5123.19 of the Revised Code.
(5) Upon meeting the foregoing requirements, the application shall be processed by the department and the applicant shall be approved in accordance with rule 5123:2-9-09 of the Administrative Code.
(6) In order to maintain certification under this rule, the institutional respite provider shall maintain compliance with the requirements of paragraphs (C)(2), (C)(3), and (C)(4) of this rule as applicable to the provider.
(7) The institutional respite provider shall maintain documentation from the department of the institutional provider’s certification under this rule.
(D) Denial, suspension, or revocation
(1) Failure to comply with the standards set forth in this rule for initial certification of providers may result in denial of certification by the department in accordance with rule 5123:2-9-09 of the Administrative Code.
(2) After being certified in accordance with this rule, providers shall comply with the continuing certification standards set forth in this rule. Providers shall be subject to monitoring and compliance reviews conducted by the county board and/or the department as set forth in rule 5123:2-9-08 of the Administrative Code. Failure to comply with the standards set forth in this rule for continuing certification of providers may result in corrective action by the department up to and including suspension or revocation of certification as set forth in rule 5123:2-9-08 of the Administrative Code.
(3) When denying, suspending, or revoking certification under this rule, the department shall comply with the notice and hearing requirements of Chapter 119. of the Revised Code.
Effective: 07/01/2006
R.C. 119.032 review dates: 04/28/2008
Promulgated Under: 119.03
Statutory Authority: 5123.04, 5123.045, 5123.16, 5111.871
Rule Amplifies: 5123.04, 5123.045, 5123.16, 5111.871
Prior Effective Dates: 4/28/03
(A) Purpose
The purpose of this rule is to specify the service definition for environmental accessibility adaptations and to set forth the certification standards required under section 5123.16 of the Revised Code for providers of environmental accessibility adaptations to individuals enrolled in the HCBS level one waiver administered by the department.
(B) Definition
“Environmental accessibility adaptations” means those physical adaptations to the home, required by the individual’s ISP, which are necessary to ensure the health, welfare and safety of the individual, or which enable the individual to function with greater independence in the home, and without which, the individual would require institutionalization. Such adaptations may include the installation of ramps and grab-bars, widening of doorways, modification of bathroom facilities, or installation of specialized electric and plumbing systems that are necessary to accommodate the medical equipment and supplies that are necessary for the welfare of the individual. Excluded are those adaptations or improvements to the home that are of general utility, and are not of direct medical or remedial benefit to the individual, such as carpeting, roof repair, central air conditioning, etc. Adaptations that add to the total square footage of the home are excluded from this benefit. All services shall be provided in accordance with applicable state or local building codes. The benefit limitation for this service, personal emergency response systems, and specialized medical equipment and supplies combined shall not exceed six thousand dollars over a three-year period.
(C) Standards and requirements for initial certification of individual providers
An applicant for individual provider certification for environmental accessibility adaptations shall meet all the following requirements in order to ensure the health and welfare of individuals receiving environmental accessibility adaptations.
(1) The applicant shall be at least eighteen years of age.
(2) The applicant shall submit an application in accordance with rule 5123:2-9-09 of the Administrative Code.
(3) Experience
The applicant shall submit to the department documentation verifying experience in providing environmental accessibility adaptations.
(4) Demonstration of ability to meet state and local regulations
The applicant shall provide to the department written assurance that the applicant will meet all applicable state and local regulations that apply to the operation of the applicant’s business or trade.
(5) ISP compliance
The applicant shall provide to the department written assurance that the applicant shall implement environmental accessibility adaptations as specified in the ISP.
(6) Provider eligibility
The applicant shall provide to the department a written assurance that the applicant shall not provide environmental accessibility adaptations to his/her minor child (under age eighteen) or to his/her spouse.
(D) Standards and requirements for continuing certification of individual providers
After being certified in accordance with paragraph (C) of this rule, all individual providers of environmental accessibility adaptations shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving environmental accessibility adaptations.
(1) Experience
The individual provider shall maintain documentation verifying experience in providing environmental accessibility adaptations and shall provide such documentation upon request by ODJFS, the department, or the county board.
(2) Demonstration of ability to meet state and local regulations
The individual provider shall maintain documentation of the provider’s compliance with state and local regulations that apply to the operation of the individual provider’s business or trade and shall present such documentation upon request by ODJFS, the department, or the county board.
(3) ISP compliance
The individual provider shall implement environmental accessibility adaptations as specified in the ISP.
(4) Provider eligibility
The individual provider shall not provide environmental accessibility adaptations to his/her minor child (under age eighteen) or to his/her spouse.
(5) Evidence of department certification
The individual provider shall maintain documentation from the department of the individual provider’s certification under this rule.
(E) Standards and requirements for initial certification of agency providers
An applicant for agency provider certification for environmental accessibility adaptations shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving environmental accessibility adaptations.
(1) The applicant must submit an application in accordance with rule 5123:2-9-09 of the Administrative Code.
(2) Experience
The applicant shall submit to the department documentation verifying experience in providing environmental accessibility adaptations.
(3) Demonstration of ability to meet state and local regulations
The applicant shall provide to the department written assurance of the applicant’s compliance with all state and local regulations that apply to the operation of the applicant’s business or trade.
(4) ISP compliance
The applicant shall provide to the department written assurance that the applicant shall implement environmental accessibility adaptations as specified in the ISP.
(5) Provider eligibility
The applicant shall provide to the department written assurance that neither the applicant nor any employee of the applicant shall provide environmental accessibility adaptations to his/her minor child (under age eighteen) or to his/her spouse.
(F) Standards and requirements for continuing certification of agency providers
After being certified in accordance with paragraph (E) of this rule, all agency providers of environmental accessibility adaptations shall meet all of the following requirements in order to ensure the health and welfare of the individuals receiving environmental accessibility adaptations.
(1) Experience
The agency provider shall maintain written documentation of the agency provider’s experience in providing environmental accessibility adaptations and shall present such documentation upon request by ODJFS, the department, or the county board.
(2) Demonstration of ability to meet state and local regulations
The agency provider shall maintain written documentation of the agency provider’s compliance with state and local regulations that apply to the operation of its business or trade and shall present such documentation upon request by ODJFS, the department, or the county board.
(3) ISP compliance
The agency provider shall implement environmental accessibility adaptations as specified in the ISP.
(4) Provider eligibility
Neither the agency provider nor any employee of the agency provider shall provide environmental accessibility adaptations to his/her minor child (under age eighteen) or to his/her spouse.
(5) Evidence of department certification
The agency provider shall maintain documentation from the department of the agency provider’s certification under this rule.
(G) Request for information (RFI) process
(1) The county board, as the county board, shall use procedures for the RFI process that are established by the department to develop an initial list and subsequently add to the list of individual providers and agency providers of environmental accessibility adaptations. The county board shall repeat the RFI process no less frequently than once every three years. Providers who respond to the initial RFI in accordance with the established procedures will be added to the statewide list of providers.
(2) After the statewide list of providers is established, the department will add providers of environmental accessibility adaptations to the statewide list of providers as the department certifies new individual providers and agency providers.
(H) Subcontractors
Individual providers shall not subcontract the provision of environmental accessibility adaptations. Agency providers may subcontract the provision of environmental accessibility adaptations in accordance with the requirements of this paragraph.
(1) The agency provider shall be held responsible for the performance of the subcontractor and shall assure that the services are provided in accordance with the ISP.
(2) The agency provider shall give the county board notice of all subcontracts for environmental accessibility adaptations.
(3) The agency provider shall enter into a written contract with the subcontractor.
(I) Selection of provider(s) by individuals
Individuals shall select providers of environmental accessibility adaptations from the statewide list of certified individual providers and agency providers.
(J) Denial, suspension, or revocation
(1) Failure to comply with the standards set forth in this rule for initial certification of providers may result in denial of certification by the department in accordance with rule 5123:2-9-09 of the Administrative Code.
(2) After being certified in accordance with this rule, providers shall comply with the continuing certification standards set forth in this rule. Providers shall be subject to monitoring and compliance reviews conducted by the county board and/or the department as set forth in rule 5123:2-9-08 of the Administrative Code. Failure to comply with the standards set forth in this rule for continuing certification of providers may result in corrective action by the department up to and including suspension or revocation of certification as set forth in rule 5123:2-9-08 of the Administrative Code.
(3) When denying, suspending, or revoking certification under this rule, the department shall comply with the notice and hearing requirements of Chapter 119. of the Revised Code.
Effective: 07/01/2006
R.C. 119.032 review dates: 04/28/2008
Promulgated Under: 119.03
Statutory Authority: 5123.04, 5123.045, 5123.16, 5111.871
Rule Amplifies: 5123.04, 5123.045, 5123.16, 5111.871
Prior Effective Dates: 4/28/03
(A) Purpose
The purpose of this rule is to specify the definition of transportation services and to set forth the certification standards required under section 5123.16 of the Revised Code for providers of transportation services to individuals enrolled in the HCBS level one waiver administered by the department.
(B) Definition
(1) “Transportation” means a service offered in order to enable individuals served on the waiver to gain access to waiver and other community services, activities and resources, specified by the plan of care. This service is offered in addition to medical transportation required under Title 42 of the Code of Federal Regulations, section 431.53 (October 1, 2001) and transportation services under the state plan as defined at Title 42 of the Code of Federal Regulations, section 440.170(a) (October 1, 2001), if applicable, and shall not replace them. Transportation services under the level one waiver shall be offered in accordance with the individual’s ISP. Whenever possible, family, neighbors, friends, or community agencies, which can provide this service without charge, will be utilized. The benefit limitation for this service, institutional respite, informal respite, and homemaker/personal care do not exceed five thousand dollars annually.
(2) “Public bus transportation provider” means regional transit authorities, county transit boards, and municipalities, counties and private entities that provide public transit services.
(C) Standards and requirements for initial certification of individual providers
An applicant for individual provider certification for transportation services shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving transportation services.
(1) The applicant shall be at least eighteen years of age.
(2) The applicant shall submit an application in accordance with rule 5123:2-9-09 of the Administrative Code.
(3) Proof of valid driver’s license
(a) The applicant shall submit to the department evidence of a valid driver’s license as specified by Ohio law.
(b) The applicant shall provide to the department written assurance that the applicant will provide immediate notification, in writing, to the department of any driver’s license suspension or revocation.
(4) Proof of insurance coverage
The applicant shall submit to the department proof of insurance coverage as specified under sections 4509.101 and 4509.47 of the Revised Code, as applicable.
(5) Criminal background check
(a) The applicant shall submit to the department written evidence that a background investigation has been completed in accordance with section 5126.281 of the Revised Code and rule 5123:2-1-05.1 of the Administrative Code.
(b) The department shall deny certification to any applicant who has been convicted of or pled guilty to any of the offenses listed in division (E) of section 5126.28 of the Revised Code, unless the applicant meets the standards set forth in paragraph (N) or (R) of rule 5123:2-1-05.1 of the Administrative Code.
(6) Abuser registry
(a) The department shall determine whether the applicant’s name appears on the abuser registry established under sections 5123.50 to 5123.54 of the Revised Code.
(b) The department shall deny certification to any applicant if the applicant’s name appears on the abuser registry.
(7) CPR
The applicant shall provide to the department evidence of a valid certification in CPR.
(8) Training relating to incidents adversely affecting health and safety
The applicant shall submit to the department documentation that the applicant has completed training in the requirements of rule 5123:2-17-02 of the Administrative Code relating to incidents adversely affecting health and safety.
(9) Assurance on prevention of incidents adversely affecting health and safety
The applicant shall provide to the department written assurance that the applicant shall take all reasonable steps necessary to prevent the occurrence or reoccurrence of incidents adversely affecting health and safety. Such steps shall be subject to limitations in applicable law and may include, but are not limited to, giving notice of the occurrence or reoccurrence of the incident to the SSA or the individual’s family, or to a legally responsible person.
(10) Assurance for individual needs
The applicant shall provide to the department written assurance that the applicant shall not agree to provide services to any individual whose needs the applicant cannot meet.
(11) Assurance for ISP compliance
The applicant shall provide to the department written assurance that the applicant shall implement transportation services in accordance with the ISP.
(12) Provider eligibility
The applicant shall provide to the department written assurance that the applicant shall not provide transportation services to his/her minor child (under age eighteen) or his/her spouse.
(D) Standards and requirements for continuing certification of individual providers
After being certified in accordance with paragraph (C) of this rule, all individual providers of transportation services shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving transportation services.
(1) Valid driver’s license
(a) An individual provider shall maintain a valid driver’s license as specified by Ohio law and shall present evidence of such valid driver’s license upon request by ODJFS, the department, or the the county board.
(b) An individual provider shall provide immediate notification, in writing, to the department of any driver’s license suspension or revocation.
(2) Insurance coverage
An individual provider shall maintain insurance coverage as specified under sections 4509.101 and 4509.47 of the Revised Code, as applicable, and shall present proof of such coverage upon request by ODJFS, the department, or the county board.
(3) Criminal background check
(a) An individual provider shall report to the department if he or she is ever formally charged with, convicted of, or pleads guilty to any of the offenses listed in division (E) of section 5126.28 of the Revised Code. The individual provider shall make such report, in writing, not later than fourteen calendar days after the date of such charge, conviction or guilty plea.
(b) The individual provider shall comply with section 5126.281 of the Revised Code and rule 5123:2-1-05.1 of the Administrative Code.
(c) The department may initiate revocation proceedings for any individual provider who has failed to report in accordance with paragraph (D)(1)(a) of this rule that he or she was charged with, convicted of or pled guilty to any of the offenses listed in division (E) of section 5126.28 of the Revised Code.
(d) The department shall initiate revocation proceedings for any individual provider who has been convicted of or pled guilty to any of the offenses listed in division (E) of section 5126.28 of the Revised Code, unless the individual provider meets the standards set forth in paragraph (N) or (R) of rule 5123:2-1-05.1 of the Administrative Code.
(4) Abuser registry
The department shall initiate revocation proceedings for any individual provider whose name has been placed on the abuser registry established under sections 5123.50 to 5123.54 of the Revised Code.
(5) CPR
The individual provider shall maintain a valid certification in CPR.
(6) Training relating to incidents adversely affecting health and safety
(a) At least annually, the individual provider shall complete training in the requirements of rule 5123:2-17-02 of the Administrative Code relating to incidents adversely affecting health and safety.
(b) The individual provider shall maintain documentation of such training and present such documentation upon request by ODJFS, the department, or the county board.
(7) Incidents adversely affecting health and safety
The individual provider shall comply with the requirements of rule 5123:2-17-02 of the Administrative Code, except that the individual provider is not required to comply with the following provisions of that rule:
(a) The development and implementation of a policy and procedure for the internal review, remedy, and prevention of major unusual incidents required under paragraph (F)(1) of that rule;
(b) The analysis of major unusual incidents to identify patterns and trends required under paragraph (G)(1) of that rule;
(c) The annual review and analysis of data required under paragraph (G)(4) of that rule;
(d) The completion of analysis and implementation of corrective measures required under paragraph (G)(5) of that rule;
(e) The development and implementation of a policy and procedure on unusual incident notification required under paragraph (H)(1) of that rule; and
(f) The development and implementation of a written policy and procedure for the internal review of unusual incidents required under paragraph (H)(2) of that rule.
(8) Prevention of incidents adversely affecting health and safety
The individual provider shall take all reasonable steps necessary to prevent the occurrence or reoccurrence of incidents adversely affecting health and safety. Such steps shall be subject to limitations in applicable law and may include, but are not limited to, giving notice of the occurrence or reoccurrence of the incident to the SSA or the individual’s family, or to a legally responsible person.
(9) Individual needs
The individual provider shall not agree to provide services to any individual whose needs the individual provider cannot meet.
(10) ISP compliance
The individual provider shall implement transportation services in accordance with the ISP.
(11) Provider eligibility
The individual provider shall not provide transportation services to his/her minor child
(under age eighteen) or to his/her spouse.
(12) Evidence of department certification
The individual provider shall maintain documentation from the department of the individual provider’s certification under this rule.
(E) Standards and requirements for initial certification of agency providers
An applicant for agency provider certification of transportation services must maintain written policies and procedures for all the requirements listed in this paragraph and shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving transportation services.
(1) The applicant shall submit an application in accordance with rule 5123:2-9-09 of the Administrative Code.
(2) Assurance for chief executive officer or a person responsible for administration
The applicant shall provide to the department written assurance that the applicant has employed a chief executive officer or a person responsible for administration who has either a bachelor’s degree from an accredited institution or at least two years experience in mental retardation or developmental disabilities, health care, social services, or transportation services.
(a) The chief executive officer or person responsible for administration shall be responsible for the following functions:
(i) Personnel matters;
(ii) Supervision of employees;
(iii) Program services; and
(iv) Financial management.
(b) In addition to the policies and procedures otherwise specified in this paragraph, the applicant shall have written policies and procedures that address the applicant’s management practices in the following areas:
(i) Confidentiality of individuals’ records;
(ii) Consumer satisfaction;
(iii) A description of internal monitoring and evaluating procedures to improve services delivered;
(iv) A table of organization;
(v) Staff training plan;
(vi) A requirement that drivers providing transportation services must be at least eighteen years of age.
(3) Proof of valid driver’s license
(a) The applicant shall provide to the department written assurance that all drivers shall have a valid driver’s license as specified by Ohio law.
(b) The applicant shall provide to the department written assurance that all drivers will provide immediate notification, in writing, to the applicant of any driver’s license suspension or revocation.
(4) Proof of insurance coverage
The applicant shall provide to the department written assurance that the applicant has insurance coverage as specified under sections 4509.101 and 4509.47 of the Revised Code.
(5) Criminal background check
The applicant shall provide to the department written assurance that the applicant has complied with the requirements for background investigations established under section 5126.281 of the Revised Code and rule 5123:2-1-05.1 of the Administrative Code
(6) Abuser registry
(a) The applicant shall provide written assurance that, as of the date of the application, no drivers are listed on the abuser registry established pursuant to sections 5123.50 to 5123.54 of the Revised Code.
(b) The applicant shall provide to the department written assurance that the applicant will follow the requirements of sections 5123.50 to 5123.54 of the Revised Code.
(7) Certification in CPR
The applicant shall provide to the department written assurance that at least one person with a valid certification in CPR shall be present when the individual is receiving transportation services from the applicant.
(8) Training relating to incidents adversely affecting health and safety
The applicant shall provide to the department written assurance that all drivers have completed training in the requirements of section 5123:2-17-02 of the Revised Code relating to incidents adversely affecting health and safety.
(9) Assurance on prevention of incidents adversely affecting health and safety
The applicant shall provide to the department written assurance that the applicant shall take all reasonable steps necessary to prevent the occurrence or reoccurrence of incidents adversely affecting health and safety. Such steps shall be subject to limitations in applicable law and may include, but are not limited to, giving notice of the occurrence or reoccurrence of the incident to the SSA or the individual’s family, or to a legally responsible person.
(10) Assurance for individual needs
The applicant shall provide to the department written assurance that the applicant shall not agree to provide services to any individual whose needs the applicant cannot meet.
(11) Assurance for ISP compliance
The applicant shall provide to the department written assurance that the applicant shall implement transportation services in accordance with the ISP.
(12) Assurance for provider eligibility
The applicant shall provide to the department written assurance that neither the applicant nor any driver of the applicant shall provide transportation services to his/her minor child
(under age eighteen) or his/her spouse.
(F) Standards and requirements for continuing certification of agency providers
After being certified in accordance with paragraph (E) of this rule, all agency providers of transportation services shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving transportation services.
(1) Chief executive officer or a person responsible for administration
The agency provider shall employ a chief executive officer or a person responsible for administration who has either a bachelor’s degree from an accredited institution or at least two years experience in mental retardation or developmental disabilities, health care, social services, or transportation services.
(a) The chief executive officer or person responsible for administration shall be responsible for the following functions:
(i) Personnel matters;
(ii) Supervision of employees;
(iii) Program services; and
(iv) Financial management.
(b) The agency provider shall have written policies and procedures that address the agency provider’s management practices in the following areas:
(i) Confidentiality of individuals’ records;
(ii) Consumer satisfaction;
(iii) A description of internal monitoring and evaluating procedures to improve services delivered.
(iv) A table of organization;
(v) Staff training plan;
(vi) A requirement that drivers providing transportation services must be at least eighteen years of age.
(2) Valid driver’s license
(a) The agency provider shall maintain evidence that all drivers of the agency provider have a valid driver’s license as specified by Ohio law and shall present such evidence upon request by ODJFS, the department, or the county board.
(b) The agency provider shall require all drivers to immediately report, in writing, to the agency provider if their driver’s license is ever suspended or revoked.
(c) The agency provider may dismiss from employment any driver who has failed to report in accordance with paragraph (F)(1)(b) of this rule that the driver’s license was suspended or revoked.
(d) The agency provider shall not permit a driver whose license has been suspended or revoked to provide transportation services under this rule.
(3) Proof of insurance coverage
The agency provider shall maintain proof of insurance coverage as specified under sections 4509.101 and 4509.47 of the Revised Code, as applicable, and shall present such proof of coverage upon request by ODJFS, the department, or the county board.
(4) Criminal background check
(a) The agency provider shall require all drivers in direct services positions to report, in writing, to the agency provider if the driver is ever formally charged with, convicted of, or plead guilty to any of the offenses listed in division (E) of section 5126.28 of the Revised Code not later than fourteen calendar days after the date of such charge, conviction or guilty plea.
(b) The agency provider shall comply with section 5126.281 of the Revised Code and rule 5123:2-1-05.1 of the Administrative Code.
(5) Abuser registry
The agency provider shall follow the requirements of sections 5123.50 to 5123.54 of the Revised Code and assure that drivers shall meet the requirements of sections 5123.50 to 5123.54 of the Revised Code.
(6) CPR
The agency provider shall provide evidence that at least one person with a valid certification in CPR shall be present when the individual is receiving transportation services.
(7) Training relating to incidents adversely affecting health and safety
(a) The agency provider shall provide evidence that all drivers have completed training in the requirements of rule 5123:2-17-02 of the Administrative Code relating to incidents adversely affecting health and safety. Such training shall be completed at least annually.
(b) The agency provider shall maintain documentation of such training and present such documentation upon request by ODJFS, the department, or the county board.
(c) The agency provider shall ensure that all drivers shall comply with the requirements of rule 5123:2-17-02 of the Administrative Code relating to incidents adversely affecting health and safety.
(8) Prevention of incidents adversely affecting health and safety
The agency provider shall take all reasonable steps necessary to prevent the occurrence or reoccurrence of incidents adversely affecting health and safety. Such steps shall be subject to limitations in applicable law and may include, but are not limited to, giving notice of the occurrence or reoccurrence of the incident to the SSA or the individual’s family, or to a legally responsible person.
(9) Individual needs
The agency provider shall not agree to provide services to any individual whose needs the agency provider cannot meet.
(10) ISP compliance
The agency provider shall implement transportation services in accordance with the ISP.
(11) Provider eligibility
Neither the agency provider nor any driver of the agency provider shall provide transportation services to his/her minor child (under age eighteen) or his/her spouse.
(12) Evidence of department certification
The agency provider shall maintain documentation from the department of the agency provider’s certification under this rule.
(G) Standards and requirements for initial certification of county board providers
A county board applicant for provider of transportation certification must maintain written policies and procedures for all the requirements listed in this paragraph and shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving transportation services.
(1) The applicant shall submit an application in accordance with rule 5123:2-9-09 of the Administrative Code.
(2) Proof of valid driver’s license
(a) The applicant shall provide to the department written assurance that all drivers shall have evidence of a valid driver’s license as specified by Ohio law.
(b) The applicant shall provide to the department written assurance that all drivers will provide immediate notification, in writing, to the applicant of any driver’s license suspension or revocation.
(3) Proof of insurance coverage
The applicant shall provide to the department written assurance that the applicant has insurance coverage as specified under sections 4509.101 and 4509.47 of the Revised Code, applicable.
(4) Criminal background check
The applicant shall provide to the department written assurance that the applicant has complied with the requirements for background investigations established under sections 5126.28 of the Revised Code and rule 5123:2-1-05 of the Administrative Code.
(5) Abuser registry
(a) The applicant shall provide to the department written assurance that, as of the date of the application, no drivers are listed on the abuser registry established pursuant to sections 5123.50 to 5123.54 of the Revised Code.
(b) The applicant shall provide to the department written assurance that the applicant will follow the requirements of sections 5123.50 to 5123.54 of the Revised Code.
(6) Certification in CPR
The applicant shall provide to the department written assurance that at least one person with a valid certification in CPR shall be present when the individual is receiving transportation services from the applicant.
(7) Training relating to incidents adversely affecting health and safety
The applicant shall provide to the department written assurance that all drivers have completed training in the requirements of rule 5123:2-17-02 of the Revised Code relating to incidents adversely affecting health and safety.
(8) Training in individual rights
The applicant shall provide to the department written assurance that all drivers have completed training in provisions governing rights of individuals set forth in sections 5123.62 to 5123.64 of the Revised Code.
(9) Assurance for behavior supports
The applicant shall provide written assurance that all drivers will comply with the requirements of behavior supports established under rules adopted by the department.
(10) Assurance for individual needs
The applicant shall provide to the department written assurance that the applicant shall not agree to provide services to any individual whose needs the applicant cannot meet.
(11) Assurance for ISP compliance
The applicant shall provide to the department written assurance that the applicant shall implement transportation services in accordance with the ISP.
(12) Assurance for provider eligibility
The applicant shall provide to the department written assurance that neither the applicant nor any driver of the applicant shall provide transportation services to his/her minor child
(under age eighteen) or his/her spouse
(H) Standards and requirements for continuing certification of county board providers
After being certified in accordance with paragraph (G) of the rule, all county board providers of transportation services shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving transportation services.
(1) Valid driver’s license
(a) The county board shall maintain evidence that all drivers have a valid driver’s license as specified by Ohio law and shall present such evidence upon request by ODJFS or the department.
(b) The county board shall require all drivers to immediately report, in writing, to the county board if their driver’s license is ever suspended or revoked.
(c) The county board may dismiss from employment any driver who has failed to report in accordance with paragraph (F)(1)(b) of this rule that the driver’s license was suspended or revoked.
(d) The county board shall not permit a driver whose license has been suspended or revoked to provide transportation services under this rule.
(2) Proof of insurance coverage
The county board shall maintain proof of insurance coverage as specified under section 4509.101 of the Revised Code and shall present such proof of insurance coverage upon request by ODJFS or the department.
(3) Criminal background check
(a) The county board shall require all drivers to report, in writing, to the county board if they are ever formally charged with, convicted of, or plead guilty to any of the offenses listed in division (E) of section 5126.28 of the Revised Code not later than fourteen calendar days after the date of such charge, conviction or guilty plea.
(b) The county board shall comply with section 5126.28 of the Revised Code and rule 5123:2-1-05 of the Revised Code.
(4) Abuser registry
The county board shall follow the requirements of sections 5123.50 to 5123.54 of the Revised Code and assure that drivers shall meet the requirements of sections 5123.50 to 5123.54 of the Revised Code.
(5) CPR
The county board shall provide evidence that at least one person with a valid certification in CPR shall be present when the individual is receiving transportation services.
(6) Training on incidents adversely affecting health and safety
(a) The county board shall provide evidence that all drivers have completed training in the requirements of rule 5123:2-17-02 relating to incidents adversely affecting health and safety. Such training shall be completed at least annually.
(b) The county board shall maintain documentation of such training and present such documentation upon request by ODJFS or the department.
(c) The county board shall ensure that all drivers shall comply with the requirements of rule 5123:2-17-02 of the Administrative Code relating to incidents adversely affecting health and safety.
(7) Training in individual right
(a) The county board shall provide evidence that all drivers have completed training in the provisions governing rights of individuals set forth in sections 5123.62 to 5123.64 of the Revised Code. Such training shall be completed at least annually.
(b) The county board shall maintain documentation of such training and present such documentation upon request by ODJFS or the department.
(8) Behavior supports
(a) The county board shall comply with the requirements of behavior supports established under rules adopted by the department.
(b) If there is an individual behavior support plan, the drivers responsible for implementing the plan shall be trained in the components of the plan.
(c) The county board shall maintain documentation of such training and present such documentation upon request to ODJFS or the department.
(9) Individual needs
The county board shall not agree to provide services to any individual whose needs the county board cannot meet.
(10) ISP compliance
(a) The county board shall implement transportation services in accordance with the ISP.
(b) The presence of a behavior support plan and the requirement for training as identified in paragraph (H)(8)(b) of this rule shall be specified in the ISP.
(11) Provider eligibility
Neither the county board nor any driver of the county board shall provide transportation services to his/her minor child (under age eighteen) or his/her spouse.
(12) Evidence of department certification
The county board shall maintain documentation from the department of the county board’s certification under this rule.
(I) Standards and requirements for initial certification of public bus transportation providers
(1) The applicant shall submit an application in accordance with rule 5123:2-9-09 of the Administrative Code.
(2) The applicant shall provide to the department written assurance that the applicant shall comply with all applicable state and/or local regulations that apply to the operation of its business.
(3) Public bus transportation providers are not required to submit a background investigation for bus drivers nor are these bus drivers subject to the requirements of rule 5123:2-17-02 of the Administrative Code relating to incidents adversely affecting health and safety.
(J) Standards and requirements for continuing certification of public bus transportation providers
The public bus transportation provider shall maintain written documentation of its compliance with all applicable state and/or local regulations that apply to the operation of its business and shall present such documentation upon request by ODJFS, the department, or the county board.
(K) Standards and requirements for initial certification of taxi service providers
An applicant for taxi service provider certification of transportation services shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving transportation services
(1) The applicant shall submit an application in accordance with rule 5123:2-9-09 of the Administrative Code.
(2) The applicant shall provide to the department written assurance that the applicant shall comply with all applicable state and/or local regulations that apply to the operation of its business.
(3) Criminal background check
The applicant shall provide to the department written assurance that the applicant has complied with the requirement for a background check investigation on all drivers in accordance with section 5126.281 of the Revised Code and rule 5123:2-1-05.1 of the Administrative Code.
(4) Abuser registry
(a) The applicant shall provide to the department written assurance that, as of the date of the application, no drivers are listed on the abuser registry established pursuant to sections 5123.50 to 5123.54 of the Revised Code.
(b) The applicant shall provide to the department written assurance that the applicant will follow the requirements of sections 5123.50 to 5123.54 of the Revised Code.
(5) Assurance for ISP compliance
The applicant shall provide to the department written assurance that the applicant shall implement transportation services in accordance with the ISP.
(6) Assurance for provider eligibility
The applicant shall provide to the department written assurance that neither the applicant nor any driver of the applicant shall provide transportation services to his/her minor child
(under age eighteen) or his/her spouse.
(L) Standards and requirements for continuing certification of taxi service providers
After being certified in accordance with paragraph (K) of this rule taxi service providers shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving transportation services.
(1) The taxi service provider shall maintain written documentation of its compliance with all applicable state and/or local regulations that apply to the operation of its business and shall present such documentation upon request by ODJFS, the department, or the county board.
(2) Criminal background check
(a) The taxi service provider shall require all drivers to report, in writing, to the taxi service provider if they are ever formally charged with, convicted of, or plead guilty to any of the offenses listed in division (E) of section 5126.28 of the Revised Code not later than fourteen calendar days after the date of such charge, conviction or guilty plea.
(b) The taxi service provider shall comply with section 5126.28 of the Revised Code and rule 5123:2-1-05 of the Revised Code.
(3) Abuser registry
The taxi service provider shall follow the requirements of sections 5123.50 to 5123.54 of the Revised Code and assure that drivers shall meet the requirements of sections 5123.50 to 5123.54 of the Revised Code.
(4) ISP compliance
The taxi service provider shall implement transportation services in accordance with the ISP.
(5) Provider eligibility
The taxi service provider shall provide to the department written assurance that neither the applicant nor any driver of the applicant shall provide transportation services to his/her minor child (under age eighteen) or his/her spouse.
(6) Evidence of department certification
The taxi service provider shall maintain documentation from the department of the taxi service provider’s certification under this rule.
(M) Subcontractors
Individual providers shall not subcontract the provision of transportation services. Agency providers may subcontract the provision of transportation services in accordance with the following requirements:
(1) All subcontractors for transportation services that are individual providers shall meet the requirements of the following paragraphs of this rule:
(a) Paragraph (C)(1) – applicant shall be at least eighteen years old;
(b) Paragraphs (C)(3) and (D)(1) – valid driver’s license;
(c) Paragraphs (C)(4) and (D)(2) – insurance coverage;
(d) Paragraphs (C)(5) and (D)(3) – criminal background check;
(e) Paragraphs (C)(6) and (D)(4) – abuser registry;
(f) Paragraphs (C)(7) and (D)(5) – CPR;
(g) Paragraphs (C)(8) and (D)(6) – training relating to incidents adversely affecting health and safety;
(h) Paragraphs (C)(9) and (D)(8) – prevention of incidents adversely affecting health and safety;
(i) Paragraphs (C)(10) and (D)(9) – individual needs;
(j) Paragraphs (C)(11) and (D)(10) – ISP compliance;
(k) Paragraphs (C)(12) and (D)(11) – provider eligibility.
(2) All subcontractors for transportation services that are agency providers shall meet the requirements of the following paragraphs of this rule:
(a) Paragraphs (E)(3) and (F)(2) – valid driver’s license;
(b) Paragraphs (E)(4) and (F)(3) – insurance coverage;
(c) Paragraphs (E)(5) and (F)(4) – criminal background check;
(d) Paragraphs (E)(6) and (F)(5) – abuser registry;
(e) Paragraphs (E)(7) and (F)(6) – CPR;
(f) Paragraphs (E)(8) and (F)(7) – training relating to incidents adversely affecting health and safety;
(g) Paragraphs (E)(9) and (F)(8) – prevention of incidents adversely affecting health and safety;
(h) Paragraphs (E)(10) and (F)(9) – individual needs;
(i) Paragraphs (E)(11) and (F)(10) – ISP compliance;
(j) Paragraphs (E)(12) and (F)(11) – provider eligibility
(3) The agency provider shall give the county board notice of all subcontracts for transportation services.
(4) The agency provider shall enter into a written contract with the subcontractor.
(5) An agency provider that subcontracts the provision of transportation services shall ensure that the subcontractor complies with all applicable requirements of this rule.
(N) Denial, suspension, or revocation
(1) Failure to comply with the standards set forth in this rule for initial certification of providers may result in denial of certification by the department in accordance with rule 5123:2-9-09 of the Administrative Code.
(2) After being certified in accordance with this rule, providers shall comply with the continuing certification standards set forth in this rule. Providers shall be subject to monitoring and compliance reviews conducted by the county board and/or the department as set forth in rule 5123:2-9-08 of the Administrative Code. Failure to comply with the standards set forth in this rule for continuing certification of providers may result in corrective action by the department up to and including suspension or revocation of certification as set forth in rule 5123:2-9-08 of the Administrative Code.
(3) When denying, suspending, or revoking certification under this rule, the department shall comply with the notice and hearing requirements of Chapter 119. of the Revised Code.
Effective: 07/01/2006
R.C. 119.032 review dates: 04/28/2008
Promulgated Under: 119.03
Statutory Authority: 5123.04, 5123.045, 5123.16, 5111.871
Rule Amplifies: 5123.04, 5123.045, 5123.16, 5111.871
Prior Effective Dates: 4/28/03
(A) Purpose
The purpose of this rule is to specify the service definition for specialized medical equipment and supplies and to set forth the certification standards required under section 5123.16 of the Revised Code for providers of specialized medical equipment and supplies to individuals enrolled in the HCBS level one waiver administered by the department.
(B) Definition
“Specialized medical equipment and supplies” means those specialized medical equipment and supplies that include devices, controls, or appliances, specified in the individual’s ISP, which enable individuals to increase their abilities to perform activities of daily living, or to perceive, control, or communicate with the environment in which they live.
This service also includes items necessary for life support, ancillary supplies and equipment necessary to the proper functioning of such items, and durable and non-durable medical equipment not available under the medicaid state plan. Items reimbursed with waiver funds shall be in addition to any medical equipment and supplies furnished under the state plan and shall exclude those items that are not of direct medical or remedial benefit to the individual. All items shall meet applicable standards of manufacture, design, and installation. The benefit limitation for this service, personal emergency response systems, and environmental accessibility adaptations combined shall not exceed six thousand dollars over a three-year period.
(C) Standards and requirements for initial certification of individual providers
The applicant for individual provider certification for specialized medical equipment and supplies shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving specialized medical equipment and supplies.
(1) The applicant shall be at least eighteen years of age.
(2) The applicant shall submit an application in accordance with rule 5123:2-9-09 of the Administrative Code.
(3) Experience
The applicant shall submit documentation verifying experience in providing the services/products.
(4) Demonstration of ability to meet state and local regulations
The applicant shall provide to the department written assurance that the applicant shall comply with all state and local regulations that apply to the operation of the applicant’s business or trade.
(5) Assurance for ISP compliance
The applicant shall provide to the department written assurance that the applicant shall implement specialized medical equipment and supplies as specified in the ISP.
(6) Assurance for provider eligibility
The applicant shall provide to the department written assurance that the applicant shall not provide specialized medical equipment and supplies to his/her minor child (under age eighteen) or to his/her spouse.
(D) Standards and requirements for continuing certification of individual providers
After being certified in accordance with paragraph (C) of this rule, all individual providers of specialized medical equipment and supplies shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving specialized medical equipment and supplies.
(1) Experience
The individual provider shall maintain written documentation of his/her experience in providing services/products and shall present such documentation upon request by ODJFS, the department, or the county board.
(2) Demonstration of ability to meet state and local regulations
The individual provider shall maintain written documentation of his/her compliance with all state and local regulations that apply to the operation of his/her business or trade and shall present such documentation upon request by ODJFS, the department, or the county board.
(3) ISP compliance
The individual provider shall implement specialized medical equipment and supplies as specified in the ISP.
(4) Provider eligibility
The individual provider shall not provide specialized medical equipment and supplies to his/her minor child (under age eighteen) or to his/her spouse.
(5) Evidence of department certification
The individual provider shall maintain documentation from the department of the individual provider’s certification under this rule.
(E) Standards and requirements for initial certification of agency providers
The applicant for agency provider certification for specialized medical equipment and supplies shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving specialized medical equipment and supplies.
(1) The applicant shall submit an application in accordance with rule 5123:2-9-09 of the Administrative Code.
(2) Experience
The applicant shall submit to the department documentation verifying the applicant’s experience in providing the services/products.
(3) Demonstration of ability to meet state and local regulations
The applicant shall provide to the department written assurance of the applicant’s compliance with all state and local regulations that apply to the operation of the applicant’s business or trade.
(4) ISP compliance
The applicant shall provide to the department written assurance that the applicant shall implement specialized medical equipment and supplies as specified in the ISP.
(5) Assurance for provider eligibility
The applicant shall provide to the department written assurance that neither the applicant nor any employee of the applicant shall provide specialized medical equipment and supplies to his/her minor child (under age eighteen) or to his/her spouse.
(F) Standards and requirements for continuing certification of agency providers
After being certified in accordance with paragraph (E) of this rule, all agency providers of specialized medical equipment and supplies shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving specialized medical equipment and supplies.
(1) Experience
The agency provider shall maintain written documentation of the agency provider’s experience in providing these services/products and shall present such documentation upon request by ODJFS, the department, or the county board.
(2) Demonstration of ability to meet state and local regulations
The agency provider shall maintain written documentation of its compliance with state and local regulations that apply to the operation of its business or trade and shall present such documentation upon request by ODJFS, the department, or the county board.
(3) ISP compliance
The agency provider shall implement specialized medical equipment and supplies as specified in the ISP.
(4) Provider eligibility
Neither the agency provider nor any employee of the agency provider shall provide specialized medical equipment and supplies to his/her minor child (under age eighteen) or to his/her spouse.
(5) Evidence of department certification
The agency provider shall maintain documentation from the department of the agency provider’s certification under this rule.
(G) Request for information (RFI) process
(1) The county board shall use procedures for the RFI that are established by the department to develop an initial list and subsequently add to the list of individual providers and agency providers of specialized medical equipment and supplies. The county board shall repeat the RFI process no less frequently than once every three years. Providers who respond to the initial RFI process in accordance with established procedures will be added to the statewide list of providers.
(2) After the statewide list of providers is established, the department will add providers of specialized medical equipment and supplies to the statewide list of providers as the department certifies new individual providers and agency providers.
(H) Subcontractors
Individual providers shall not subcontract the provision of specialized medical equipment and supplies. Agency providers may subcontract the provision of specialized medical equipment and supplies.
(1) The agency provider shall be held responsible for the performance of the subcontractor and shall assure that the services are provided in accordance with the ISP.
(2) The agency provider shall give the county board notice of all subcontracts for specialized medical equipment and supplies.
(3) The agency provider shall enter into a written contract with the subcontractor.
(I) Selection of provider(s) by the individual
An individual shall select a provider(s) of specialized medical equipment and supplies from the statewide list of certified individual providers and agency providers.
(J) Denial, suspension, or revocation
(1) Failure to comply with the standards set forth in this rule for initial certification of providers may result in denial of certification by the department in accordance with rule 5123:2-9-09 of the Administrative Code.
(2) After being certified in accordance with this rule, providers shall comply with the continuing certification standards set forth in this rule. Providers shall be subject to monitoring and compliance reviews conducted by the county board and/or the department as set forth in rule 5123:2-9-08 of the Administrative Code. Failure to comply with the standards set forth in this rule for continuing certification of providers may result in corrective action by the department up to and including suspension or revocation of certification as set forth in rule 5123:2-9-08 of the Administrative Code.
(3) When denying, suspending, or revoking certification under this rule, the department shall comply with the notice and hearing requirements of Chapter 119. of the Revised Code.
Effective: 07/01/2006
R.C. 119.032 review dates: 04/28/2008
Promulgated Under: 119.03
Statutory Authority: 5123.04, 5123.045, 5123.16, 5111.871
Rule Amplifies: 5123.04, 5123.045, 5123.16, 5111.871
Prior Effective Dates: 4/28/03
(A) Purpose
The purpose of this rule is to specify the service definition for personal emergency response systems and to set forth the certification standards required under section 5123.16 of the Revised Code for providers of personal emergency response system services to individuals enrolled in the HCBS level one waiver administered by the department.
(B) Definition
“Personal emergency response systems (PERS)” means an electronic device, which enables certain individuals at high risk of institutionalization to secure help in an emergency. The individual may also wear a portable “help” button to allow for mobility. The system is connected to the individual’s phone and programmed to signal a response center once a “help” button is activated. PERS services are limited to those individuals who live alone, or who are alone for significant parts of the day, and have no regular caregiver for extended periods of time, and who would otherwise require extensive routine supervision. The benefit limitation for this service, environmental accessibility adaptations, and specialized medical equipment and supplies combined shall not exceed six thousand dollars over a three-year period.
(C) Individual providers
No individual provider shall be certified to provide PERS.
(D) Standards and requirements for initial certification of agency providers
An applicant for agency provider certification for PERS shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving PERS.
(1) The applicant shall submit an application in accordance with rule 5123:2-9-09 of the Administrative Code.
(2) Experience
The applicant shall submit to the department documentation verifying the applicant’s experience in providing these products/services.
(3) Demonstration of ability to meet state and local regulations
The applicant shall provide to the department written assurance of the applicant’s compliance with all state and local regulations that apply to the operation of the applicant’s business or trade.
(4) Assurance for ISP compliance
The applicant shall provide to the department written assurance that the applicant shall implement PERS as specified in the ISP.
(5) Assurance for provider eligibility
The applicant shall provide to the department written assurance that neither the applicant nor any employee of the applicant shall provide PERS to his/her minor child (under age eighteen) or to his/her spouse.
(6) Assurance for response center coverage
The applicant shall provide to the department written assurance of the applicant’s ability to provide response center coverage twenty-four hours per day and seven days per week.
(7) Assurance for operation of equipment
The applicant shall provide to the department written assurance that its equipment is in operating order, that the applicant conducts preventative maintenance checks to ensure the operational integrity of the equipment, and that equipment is tested at least quarterly.
(8) Assurance for emergency personnel notification
The applicant shall provide to the department written assurance of the applicant’s capacity to notify, by electronic means, emergency personnel such as police, fire, ambulance, and psychiatric crisis response entities.
(9) Assurance for training individuals
The applicant shall provide to the department written assurance of the applicant’s ability to train individuals to utilize their PERS.
(E) Standards and requirements for continuing certification of agency providers
After being certified in accordance with paragraph (D) of this rule, all agency providers of PERS shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving PERS.
(1) Experience
The agency provider shall maintain written documentation of the agency provider’s experience in providing these products/services and shall present such documentation upon request to ODJFS, the department, or the county board.
(2) Demonstration of ability to meet state and local regulations
The agency provider shall maintain written documentation of the agency provider’s compliance with state and local regulations that apply to the operation of its business or trade and shall present such documentation upon request to ODJFS, the department, or the county board.
(3) ISP compliance
The agency provider shall implement PERS as specified in the ISP.
(4) Provider eligibility
Neither the agency provider nor any employee of the agency provider shall provide PERS to his/her minor child (under age eighteen) or to his/her spouse.
(5) Response center coverage
The agency provider shall document the provider’s provision of response center coverage twenty-four hours per day and seven days per week and shall present such documentation upon request by ODJFS, the department, or the county board.
(6) Preventative maintenance checks on equipment
The agency provider shall document the provider’s preventative maintenance checks for all equipment and shall present such documentation upon request by ODJFS, the department, or the county board.
(7) Testing of equipment
The agency provider shall document the provider’s quarterly tests of the provider’s equipment and shall present such documentation upon request by ODJFS, the department, or the county board.
(8) Emergency personnel notification
The agency provider shall document the provider’s notification by electronic means to emergency personnel such as police, fire, ambulance, and psychiatric crisis response entities and shall present such documentation upon request by ODJFS, the department, or the county board.
(9) Training of individuals using PERS
The agency provider shall document training provided to individuals using PERS and shall present such documentation upon request by ODJFS, the department, or the county board.
(10) Evidence of department certification
The agency provider shall maintain documentation from the department of the agency provider’s certification under this rule.
(F) Request for information (RFI) process
(1) The county board shall use procedures for the RFI process that are established by the department to develop an initial list and subsequently add to the list of agency providers of PERS. The county board shall repeat the RFI process no less frequently than once every three years. Providers who respond to the initial RFI in accordance with established procedures will be added to the statewide list of providers.
(2) After the statewide list of providers is established, the department will add providers of PERS to the statewide list of providers as the department certifies new agency providers.
(G) Selection of provider(s) by the individual
An individual shall select a provider of PERS from the statewide list of certified agency providers.
(H) Subcontractors
Agency providers may subcontract the provision of PERS in accordance with the requirements of this paragraph.
(1) The agency provider shall be held responsible for the performance of the subcontractor and shall assure that the services are provided in accordance with the ISP.
(2) The agency provider shall give the county board notice of all subcontracts for PERS.
(3) The agency provider shall enter into a written contract with the subcontractor.
(I) Denial, suspension, or revocation
(1) Failure to comply with the standards set forth in this rule for initial certification of providers may result in denial of certification by the department in accordance with rule 5123:2-9-09 of the Administrative Code.
(2) After being certified in accordance with this rule, providers shall comply with the continuing certification standards set forth in this rule. Providers shall be subject to monitoring and compliance reviews conducted by the county board and/or the department as set forth in rule 5123:2-9-08 of the Administrative Code. Failure to comply with the standards set forth in this rule for continuing certification of providers may result in corrective action by the department up to and including suspension or revocation of certification as set forth in rule 5123:2-9-08 of the Administrative Code.
(3) When denying, suspending, or revoking certification under this rule, the department shall comply with the notice and hearing requirements of Chapter 119. of the Revised Code.
Effective: 07/01/2006
R.C. 119.032 review dates: 04/28/2008
Promulgated Under: 119.03
Statutory Authority: 5123.04, 5123.045, 5123.16, 5111.871
Rule Amplifies: 5123.04, 5123.045, 5123.16, 5111.871
Prior Effective Dates: 4/28/03
(A) Purpose
The purpose of this rule is to specify the service definition for homemaker/personal care and to set forth the certification standards required under section 5123.16 of the Revised Code for providers of homemaker/personal care services to individuals enrolled in the HCBS level one waiver administered by the department.
(B) Definitions
(1) “Homemaker/personal care (HPC)” means the coordinated provision of a variety of services, supports and supervision necessary for the health and welfare of an individual which enables the individual to live in the community. These are tasks directed at increasing the independence of the individual within his/her home or community. The service includes tasks directed at the individual’s immediate environment that are necessitated by his or her physical or mental condition, including emotional and/or behavioral and is of a supportive or maintenance type. This service will help the individual meet daily living needs, and without this service, alone or in combination with other waiver services, the individual would require institutionalization. The benefit limitation for this service, institutional respite, informal respite, and transportation combined shall not exceed five thousand dollars annually. In addition, due to the scope of services available, homemaker/personal care services may not be used at the same time as any non-residential habilitation or supported employment services.
(a) The homemaker/personal care provider should perform such tasks as assisting the individual with activities of daily living, personal hygiene, dressing, feeding, transfer, and ambulatory needs or skills development. Skills development is intervention that focuses on both preventing the loss of skills and enhancing skills that are already present that will lead to greater independence within the residence or the community. The provider may also perform homemaking tasks for the individual. These tasks may include cooking, cleaning, laundry and shopping, among others. Homemaking and personal tasks are combined into a single service titled homemaker/personal care because, in actual practice, a single person provides both services and does so as part of the natural flow of the day. For example, the provider may prepare a dish and place it in the oven to cook (homemaking), assist the individual in washing up before a meal and assist him/her to the table (personal care), put the prepared meal on the table (homemaking), and assist the individual in eating (personal care). Segregating these activities into discrete services is impractical.
(b) Services provided include the following:
(i) Basic personal care and grooming, including bathing, care of the hair and assistance with clothing:
(ii) Assistance with bladder and/or bowel requirements or problems, including helping the individual to and from the bathroom or assisting the individual with bedpan routines;
(iii) Assisting the individual with self-medication or provision of medication administration for prescribed medications, and assisting the individual with, or performing health care activities;
(iv) Performing household services essential to the individual’s health and comfort in the home (e.g., necessary changing of bed linens or rearranging of furniture to enable the individual to move about more easily in his/her home);
(v) Assessing, monitoring, and supervising the individual to ensure the individual’s safety, health, and welfare;
(vi) Light cleaning tasks in areas of the home used by the individual;
(vii) Preparation of a shopping list appropriate to the individual’s dietary needs and financial circumstances, performance of grocery shopping activities as necessary, and preparation of meals;
(viii) Personal laundry;
(ix) Incidental neighborhood errands as necessary, including accompanying the individual to medical and other appropriate appointments and accompanying the individual for short walks outside the home; and
(x) Activities incidental to summer camp participation provided that respite is not billed.
(c) Providers of homemaker/personal care shall:
(i) Participate in the individual’s ISP meetings, if and when the individual requests them to attend;
(ii) Perform tasks and duties according to the individual’s ISP;
(iii) Recognize changes in the individual’s condition and behavior as well as safety and sanitation hazards, report to the SSA and record the changes in the individual’s written record;
(iv) Document all services provided to and on behalf of the individual; and
(v) Monitor incidents and take necessary actions when necessary to ensure the health, safety, and welfare of individuals and provide notice to the county board.
(d) Homemaker/personal care agency providers shall provide administrative oversight as required by section 5126.14 of the Revised Code.
(e) For purposes of section 5126.281 of the Revised Code and rules adopted under that section, homemaker/personal care services shall not be deemed to be services provided under a family support services program established under section 5126.11 of the Revised Code or subject to section 5126.11 of the Revised Code or rules adopted under that section.
(2) “Homemaker/personal care subcontracted service” means any program or service provided pursuant to a subcontract, which program or service is designed and operated primarily to serve individuals with mental retardation or a developmental disability, including a program or service provided by an entity licensed or certified by the department. For purposes of certification under this rule, a generic community service or other program or service available to the general public (e.g., lawn care and house cleaning services) is not subject to homemaker/personal care requirements when said service is subcontracted.
(C) Standards and requirements for initial certification of individual providers
An applicant for individual provider certification for homemaker/personal care services shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving homemaker/personal care services.
(1) The applicant shall be at least eighteen years of age.
(2) The applicant shall submit an application in accordance with rule 5123:2-9-09 of the Administrative Code.
(3) Criminal background check
(a) The applicant shall submit to the department written evidence that a background investigation has been completed in accordance with section 5126.281 of the Revised Code and rule 5123:2-1-05.1 of the Administrative Code.
(b) The department shall deny certification to any applicant who has been convicted of or pled guilty to any of the offenses listed in division (E) of section 5126.28 of the Revised Code, unless the applicant meets the standards set forth in paragraph (N) or (R) of rule 5123:2-1-05.1 of the Administrative Code.
(4) Abuser registry
(a) The department shall determine whether the applicant’s name appears on the abuser registry established under sections 5123.50 to 5123.54 of the Revised Code.
(b) The department shall deny certification to any applicant if the applicant’s name appears on the abuser registry.
(5) Nurse aide registry
The department shall contact the Ohio department of health to inquire whether the nurse aide registry established under section 3721.32 of the Revised Code, reveals that its director has made a determination of abuse, neglect, or misappropriation of property of a resident of a long-term care facility or residential care facility by the person.
(6) CPR
The applicant shall provide to the department evidence of a valid certification in CPR.
(7) Training relating to incidents adversely affecting health and safety
The applicant shall submit to the department documentation that the applicant has completed training in the requirements of rule 5123:2-17-02 of the Administrative Code relating to incidents adversely affecting health and safety.
(8) Assurance on prevention of incidents adversely affecting health and safety
The applicant shall provide to the department written assurance that the applicant shall take all reasonable steps necessary to prevent the occurrence or reoccurrence of incidents adversely affecting health and safety.
(9) Training in individual rights
The applicant shall submit to the department documentation that the applicant has completed training in the provisions governing rights of individuals set forth in sections 5123.62 to 5123.64 of the Revised Code.
(10) Assurance for ongoing training
The applicant shall provide to the department written assurance that the applicant will receive training in accordance with paragraph (J) of this rule.
(11) Assurance for behavior supports
The applicant shall provide to the department written assurance that the applicant will comply with the requirements of behavior supports established under rules adopted by the department.
(12) Assurance for substitute coverage
The applicant shall provide to the department written assurance acknowledging that the applicant will:
(a) Arrange for substitute coverage, if necessary, only from a list of homemaker/personal care certified providers supplied by the department and as identified in the individual’s ISP;
(b) Notify the individual or legally responsible persons in the event that substitute coverage is necessary; and
(c) Notify the person identified in the ISP when substitute coverage is not available to allow such person to make other arrangements.
(13) Assurance for medication administration and the performance of health care tasks
The applicant shall provide to the department written assurance that the applicant shall not administer any medication to or perform health care tasks for the individual unless the applicant meets the applicable requirements of Chapters 4723., 5123., and 5126. of the Revised Code and rules adopted under those chapters.
(14) Assurance for coordination of services
The applicant shall provide to the department written acknowledgement of the applicant’s ongoing responsibility to coordinate with designated persons and family members, where appropriate, to ensure the provision of services in accordance with the ISP.
(15) Assurance for individual needs
The applicant shall provide to the department written assurance that the applicant shall only agree to provide services to any individual whose needs the applicant can meet.
(16) Assurance for ISP compliance
The applicant shall provide to the department written assurance that the applicant shall implement homemaker/personal care services in accordance with the ISP.
(17) Assurance for provider eligibility
The applicant shall provide to the department written assurance that the applicant shall not provide homemaker/personal care services to his/her minor child (under age eighteen) or to his/her spouse.
(D) Standards and requirements for continuing certification of individual providers
After being certified in accordance with paragraph (C) of this rule, all individual providers of homemaker/personal care services shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving homemaker/personal care services.
(1) Criminal background check
(a) An individual provider shall report to the department if he or she is ever formally charged with, convicted of, or pleads guilty to any of the offenses listed in division (E) of section 5126.28 of the Revised Code. The individual provider shall make such report, in writing, not later than fourteen calendar days after the date of such charge, conviction or guilty plea.
(b) The individual provider shall comply with section 5126.281 of the Revised Code and rule 5123:2-1-05.1 of the Administrative Code.
(c) The department may initiate revocation proceedings for any individual provider who has failed to report in accordance with paragraph (D)(1)(a) of this rule that he or she was charged with, convicted of or pled guilty to any of the offenses listed in division (E) of section 5126.28 of the Revised Code.
(d) The department shall initiate revocation proceedings for any individual provider who has been convicted of or pled guilty to any of the offenses listed in division (E) of section 5126.28 of the Revised Code, unless the individual provider meets the standards set forth in paragraph (N) or (R) of rule 5123:2-1-05.1 of the Administrative Code.
(2) Abuser registry
The department shall initiate revocation proceedings for any individual provider whose name has been placed on the abuser registry established under sections 5123.50 to 5123.54 of the Revised Code.
(3) CPR
The individual provider shall maintain a valid certification in CPR.
(4) Training relating to incidents adversely affecting health and safety
(a) At least annually, the individual provider shall complete training in the requirements of rule 5123:2-17-02 of the Administrative Code relating to incidents adversely affecting health and safety.
(b) The individual provider shall maintain documentation of such training in accordance with paragraph (J)(8) of this rule and present such documentation upon request by ODJFS, the department, or the county board.
(5) Incidents adversely affecting health and safety
The individual provider shall comply with the requirements of rule 5123:2-17-02 of the Administrative Code, except that the individual provider is not required to comply with the following provisions of that rule:
(a) The development and implementation of a policy and procedure for the internal review, remedy, and prevention of major unusual incidents required under paragraph (F)(1) of that rule;
(b) The analysis of major unusual incidents to identify patterns and trends required under paragraph (G)(1) of that rule;
(c) The annual review and analysis of data required under paragraph (G)(4) of that rule;
(d) The completion of analysis and implementation of corrective measures required under paragraph (G)(5) of that rule;
(e) The development and implementation of a policy and procedure on unusual incident notification required under paragraph (H)(1) of that rule; and
(f) The development and implementation of a written policy and procedure for the internal review of unusual incidents required under paragraph (H)(2) of that rule.
(6) Prevention of incidents adversely affecting health and safety
The individual provider shall take all reasonable steps necessary to prevent the occurrence or reoccurrence of incidents adversely affecting health and safety.
(7) Training in individual rights
(a) At least annually, the individual provider shall complete training in the provisions governing rights of individuals set forth in sections 5123.62 to 5123.64 of the Revised Code.
(b) The individual provider shall maintain documentation of such training in accordance with paragraph (J)(8) of this rule and present such documentation upon request by ODJFS, the department, or the county board.
(8) Behavior supports
(a) The individual provider shall comply with the requirements of behavior supports established under rules adopted by the department.
(b) If there is an individual behavior support plan, the individual provider shall be trained in the components of the plan.
(c) The individual provider shall maintain documentation of such training in accordance with paragraph (J)(8) of this rule and present such documentation upon request by ODJFS, the department, or the county board.
(9) Substitute coverage
The individual provider shall:
(a) Arrange for substitute coverage, if necessary, only from a list of homemaker/personal care certified providers supplied by the department and as identified in the individual’s ISP.
(b) Notify the individual or legally responsible persons in the event that substitute coverage is necessary.
(c) Notify the person identified in the ISP when substitute coverage is not available to allow such person to make other arrangements.
(10) Medication administration and performance of health care tasks
The individual provider shall not administer any medication to or perform health care tasks for the individual unless the individual provider meets the applicable requirements of Chapters 4723., 5123., and 5126. of the Revised Code and rules adopted under those chapters.
(11) Coordination of services
The individual provider shall coordinate with designated persons and family members, where appropriate, to ensure the provision of services in accordance with the ISP.
(12) Individual needs
The individual provider shall only agree to provide services to any individual whose needs the individual provider can meet.
(13) ISP compliance
(a) The individual provider shall implement homemaker/personal care services in accordance with the ISP.
(b) The need for assistance with medications or health care tasks as identified in paragraph (D)(10) of this rule shall be specified in the ISP. The presence of a behavior support plan and the requirements for training as identified in paragraph (D)(8)(b) of this rule shall be specified in the ISP.
(14) Provider eligibility
The individual provider shall not provide homemaker/personal care services to his/her minor child (under age eighteen) or to his/her spouse.
(15) Continuing education/training
The individual provider shall receive annual continuing education/training as specified in paragraph (J) of this rule.
(16) Evidence of department certification
The individual provider shall maintain documentation from the department of the individual provider’s certification under this rule.
(E) Standards and requirements for initial certification of agency providers
An applicant for agency provider certification for homemaker/personal care services shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving homemaker/personal care services.
(1) The applicant shall submit an application in accordance with rule 5123:2-9-09 of the Administrative Code.
(2) Assurance for chief executive officer or a person responsible for administration
The applicant shall provide to the department written assurance that the applicant has employed a chief executive officer or a person responsible for administration who has either a bachelor’s degree from an accredited institution or at least two years experience in mental retardation or developmental disabilities, health care, social services, or homemaker/personal care.
(a) The chief executive officer or person responsible for administration shall be responsible for the following functions:
(i) Personnel matters;
(ii) Supervision of employees;
(iii) Program services; and
(iv) Financial management.
(b) The applicant shall have written policies and procedures that address the applicant’s management practices in the following areas:
(i) Confidentiality of individuals’ records;
(ii) Individual satisfaction;
(iii) A description of internal monitoring and evaluating procedures to improve services delivered;
(iv) A table of organization;
(v) Staff training plan;
(vi) A requirement that employees who have direct contact with individuals receiving homemaker/personal care must be at least eighteen years of age.
(3) Criminal background check
The applicant shall provide to the department written assurance that the applicant has complied with the requirements for background investigations established under section 5126.281 of the Revised Code and rule 5123:2-1-05.1 of the Administrative Code.
(4) Abuser registry
(a) For employees, subcontractors of the applicant, and employees of subcontractors who provide specialized services to an individual with mental retardation or a developmental disability as defined in division (G) of section 5123.50 of the Revised Code, the applicant shall provide to the department written assurance that, as of the date of the application, no such persons are listed on the abuser registry established pursuant to sections 5123.50 to 5123.54 of the Revised Code.
(b) The applicant shall provide to the department written assurance that the applicant will follow the requirements of sections 5123.50 to 5123.54 of the Revised Code.
(5) Nurse aide registry
For employees, subcontractors of the applicant, and employees of subcontractors who provide specialized services to an individual with mental retardation or a developmental disability as defined in division (G) of section 5123.50 of the Revised Code, the applicant shall provide to the department written assurance that, as of the date of the application, no such persons are listed on the nurse aide registry established under section 3721.32 of the Revised Code indicating that the director of the Ohio department of health has made a determination of abuse, neglect, or misappropriation of property of a resident of a long-term care facility or residential care facility by the person.
(6) Certification in CPR
The applicant shall provide to the department written assurance that at least one person with a valid certification in CPR shall be present when an individual is receiving any homemaker/personal care program or service that requires the provider to be in direct contact with the individual.
(7) Assurance for ongoing training
The applicant shall provide to the department written assurance that all employees who will have direct contact with individuals receiving homemaker/personal care services will receive training in accordance with paragraph (J) of this rule.
(8) Training relating to incidents adversely affecting health and safety
The applicant shall provide to the department written assurance that all employees who will have direct contact with individuals receiving homemaker/personal care services have completed training in the requirements of rule 5123:2-17-02 of the Administrative Code relating to incidents adversely affecting health and safety.
(9) Assurance on prevention of incidents adversely affecting health and safety
The applicant shall provide to the department written assurance that the applicant shall take all reasonable steps necessary to prevent the occurrence or reoccurrence of incidents adversely affecting health and safety.
(10) Training in individual rights
The applicant shall provide to the department written assurance that all employees who will have direct contact with individuals receiving homemaker/personal care services have completed training in the provisions governing rights of individuals set forth in sections 5123.62 to 5123.64 of the Revised Code.
(11) Assurance for behavior supports
The applicant shall provide to the department written assurance that the applicant will comply with the requirements of behavior supports established in rules adopted by the department.
(12) Assurance for substitute coverage
The applicant shall provide to the department written assurance acknowledging that the applicant will:
(a) Arrange for substitute coverage, if necessary, only from a list of homemaker/personal care certified providers supplied by the department and as identified in the individual’s ISP;
(b) Notify the individual or legally responsible persons in the event that substitute coverage is necessary; and
(c) Notify the person identified in the ISP when substitute coverage is not available to allow such person to make other arrangements.
(13) Assurance for medication administration and the performance of health care tasks
The applicant shall provide to the department written assurance that all medication administration and the performance of health care tasks shall be carried out in accordance with the applicable requirements of Chapters 4723., 5123., and 5126. of the Revised Code and rules adopted under those chapters.
(14) Assurance for program management
The applicant shall provide to the department written acknowledgement of the applicant’s ongoing responsibility to coordinate with designated persons and family members, where appropriate, to ensure the provision of program management services in accordance with section 5126.14 of the Revised Code.
(15) Assurance for individual needs
The applicant shall provide to the department written assurance that the applicant shall only agree to provide services to any individual whose needs the applicant can meet.
(16) Assurance for ISP compliance
The applicant shall provide to the department written assurance that the applicant shall implement homemaker/personal care services in accordance with the ISP.
(17) Assurance for provider eligibility
The applicant shall provide to the department written assurance that neither the applicant nor any employee of the applicant shall provide homemaker/personal care services to his/her minor child (under age eighteen) or his/her spouse.
(F) Standards and requirements for continuing certification of agency providers
After being certified in accordance with paragraph (E) of this rule, all agency providers of homemaker/personal care services shall meet all of the following requirements in order to ensure the health and welfare of individuals receiving homemaker/personal care services:
(1) Chief executive officer or a person responsible for administration
The agency provider shall employ a chief executive officer or a person responsible for administration who has either a bachelor’s degree from an accredited institution or at least two years experience in mental retardation or developmental disabilities, health care, social services, or homemaker/personal care.
(a) The chief executive officer or person responsible for administration shall be responsible for the following functions:
(i) Personnel matters;
(ii) Supervision of employees;
(iii) Program services; and
(iv) Financial management.
(b) The agency provider shall have written policies and procedures that address the agency provider’s management practices in the following areas:
(i) Confidentiality of individuals’ records;
(ii) Individual satisfaction;
(iii) A description of internal monitoring and evaluating procedures to improve services delivered;
(iv) A table of organization;
(v) Staff training plan;
(vi) A requirement that employees who have direct contact with individuals receiving homemaker/personal care services must be at least eighteen years of age.
(2) Criminal background check
(a) The agency provider shall require any employee in a direct services position to report, in writing, to the agency provider if the employee is ever formally charged with, convicted of, or plead guilty to any of the offenses listed in division (E) of section 5126.28 of the Revised Code not later than fourteen calendar days after the date of such charge, conviction or guilty plea.
(b) The agency provider shall comply with section 5126.281 of the Revised Code and rule 5123:2-1-05.1 of the Administrative Code.
(3) Abuser registry
The agency provider shall follow the requirements of sections 5123.50 to 5123.54 of the Revised Code and assure that subcontractors who provide specialized services as defined in division (G) of section 5123.50 of the Revised Code shall meet the requirements of sections 5123.50 to 5123.54 of the Revised Code.
(4) Nurse aide registry
Prior to hiring an employee, the agency provider shall contact the Ohio department of health to inquire whether the nurse aide registry established under section 3721.32 of the Revised Code reveals that its director has made a determination of abuse, neglect, or misappropriation of property of a resident of a long-term care facility or residential care facility by the person.
(5) CPR
The agency provider shall provide evidence that at least one person with a valid certification in CPR is present when the individual is receiving any homemaker/personal care program or service that requires the provider to be in direct contact with the individual.
(6) Training relating to incidents adversely affecting health and safety
(a) The agency provider shall provide evidence that all employees who have direct contact with individuals receiving homemaker/personal care services have completed training in the requirements of rule 5123:2-17-02 of the Administrative Code relating to incidents adversely affecting health and safety. Such training shall be completed at least annually.
(b) The agency provider shall maintain documentation of such training in accordance with paragraph (J)(8) of this rule and present such documentation upon request by ODJFS, the department, or the county board.
(c) The agency provider shall ensure that all employees who have direct contact with individuals receiving homemaker/personal care services shall comply with the requirements of rule 5123:2-17-02 of the Administrative Code relating to incidents adversely affecting health and safety.
(7) Prevention of incidents adversely affecting health and safety
The applicant shall take all reasonable steps necessary to prevent the occurrence or reoccurrence of incidents adversely affecting health and safety.
(8) Training in individual rights
(a) The agency provider shall provide evidence that all employees who will have direct contact with individuals receiving homemaker/personal care services have completed training in the provisions governing rights of individuals set forth in sections 5123.62 to 5123.64 of the Revised Code. Such training shall be completed at least annually.
(b) The agency provider shall maintain documentation of such training in accordance with paragraph (J)(8) of this rule and present such documentation upon request by ODJFS, the department, or the county board.
(9) Behavior supports
(a) All employees of the agency provider shall comply with the requirements of behavior supports established in rules adopted by the department.
(b) If there is an individual behavior support plan, the employees of the agency provider responsible for implementing the plan shall be trained in the components of the plan.
(c) The agency provider shall maintain documentation of such training in accordance with paragraph (J)(8) of this rule and present such documentation upon request by ODJFS, the department, or the county board.
(10) Substitute coverage
The agency provider shall:
(a) Arrange for substitute coverage, if necessary, only from a list of homemaker/personal care certified providers supplied by the department and as identified in the individual’s ISP.
(b) Notify the individual or legally responsible persons in the event that substitute coverage is necessary.
(c) Notify the person identified in the ISP when substitute coverage is not available to allow such person to make other arrangements.
(11) Medication administration and the performance of health care tasks
The agency provider shall provide evidence that all medication administration and the performance of health care tasks are carried out in accordance with the applicable requirements of Chapters 4723., 5123., and 5126. of the Revised Code and rules adopted under those chapters.
(12) Program management
The agency provider shall coordinate with designated persons and family members, where appropriate, to ensure the provision of program management services in accordance with section 5126.14 of the Revised Code.
(13) Individual needs
The agency provider shall only agree to provide services to any individual whose needs the agency provider can meet
(14) ISP compliance
(a) The agency provider shall implement homemaker/personal care services in accordance with the ISP.
(b) The need for assistance with medications or health care tasks as identified in paragraph (F)(11) of this rule shall be specified in the ISP. The presence of a behavior support plan and the requirement for training as identified in paragraph (F)(9)(b) of this rule shall be specified in the ISP.
(15) Provider eligibility
Neither the agency provider nor any employee of the agency provider shall provide homemaker/personal care services to his/her minor child (under age eighteen) or his/her spouse.
(16) Continuing education/training
All employees of agency providers who have direct contact with individuals receiving homemaker/personal care services shall receive annual continuing education/training in accordance with paragraph (J) of this rule.
(17) Evidence of department certification
The agency provider shall maintain documentation from the department of the agency provider’s certification under this rule.
(G) Standards and requirements for county boards
(1) No county board shall be certified to provide homemaker/personal care services or enter into a medicaid provider agreement with ODJFS for homemaker/personal care services.
(2) No county board shall provide homemaker/personal care services as a subcontractor.
(3) In the event that there is no certified private person or entity willing and able to provide homemaker/personal care services, a county board may provide homemaker/personal care services through an independent contractor who is employed in another capacity by the county board. Such independent contractor shall comply with the requirements of sections 5126.032, 5126.033, and 5123.64 of the Revised Code.
(H) Standards and requirements for initial and continuing certification of licensed providers
An applicant for certification to provide homemaker/personal care services as a licensed provider shall meet all of the following requirements in order to ensure the health and welfare of the individuals receiving homemaker/personal care services:
(1) The applicant shall submit an application in accordance with rule 5123:2-9-09 of the Administrative Code.
(2) The applicant shall provide to the department written assurance acknowledging that the applicant will:
(a) Arrange for substitute coverage, if necessary, only from a list of homemaker/personal care certified providers supplied by the department and as identified in the individual’s ISP;
(b) Notify the individual or legally responsible persons in the event that substitute coverage is necessary.
(c) Notify the person identified in the ISP when substitute coverage is not available to allow such person to make other arrangements.
(3) The licensed provider shall meet all of the requirements set forth in and have a license issued under section 5123.19 of the Revised Code.
(4) Upon meeting such requirements and the issuance of such license, the application shall be processed by the department and the licensed provider shall be approved in accordance with rule 5123:2-9-09 of the Administrative Code.
(5) In order to maintain certification under this rule, the licensed provider shall maintain its license in accordance with section 5123.19 of the Revised Code, and maintain a current medicaid provider agreement with ODJFS, and comply with the requirements for substitute coverage set forth in paragraph (H)(2) of this rule.
(I) Subcontractors
Individual providers shall not subcontract the provision of homemaker/personal care services. Agency providers may subcontract the provision of homemaker/personal care services in accordance with the following requirements:
(1) All subcontractors for homemaker/personal care subcontracted services that are individual providers shall meet the requirements of the following paragraphs of this rule:
(a) Paragraph (C)(1) – applicant shall be at least eighteen years old;
(b) Paragraphs (C)(3) and (D)(1) – criminal background check;
(c) Paragraphs (C)(4) and (D)(2) – abuser registry;
(d) Paragraph (C)(5) – nurse aide registry;
(e) Paragraphs (C)(6) and (D)(3) – CPR;
(f) Paragraphs (C)(7) and (D)(4) – training relating to incidents adversely affecting health and safety;
(g) Paragraphs (C)(8) and (D)(6) – prevention of incidents adversely affecting health and safety;
(h) Paragraphs (C)(9) and (D)(7) – training in individual rights;
(i) Paragraphs (C)(11) and (D)(8) – behavior supports;
(j) Paragraphs (C)(13) and (D)(10) – medication administration and the performance of health care tasks;
(k) Paragraphs (C)(15) and (D)(12) – individual needs;
(l) Paragraphs (C)(16) and (D)(13) – ISP compliance;
(m) Paragraphs (C)(17) and (D)(14) – provider eligibility.
(2) All subcontractors for homemaker/personal care subcontracted services that are agency providers shall meet the requirements of the following paragraphs of this rule:
(a) Paragraphs (E)(3) and (F)(2) – criminal background check;
(b) Paragraphs (E)(4) and (F)(3) – abuser registry;
(c) Paragraphs (E)(5) and (F)(4) – nurse aide registry;
(d) Paragraphs (E)(6) and (F)(5) – CPR;
(e) Paragraphs (E)(8) and (F)(6) – training relating to incidents adversely affecting health and safety;
(f) Paragraphs (E)(9) and (F)(7) – prevention of incidents adversely affecting health and safety;
(g) Paragraphs (E)(10) and (F)(8) – training in individual rights;
(h) Paragraphs (E)(11) and (F)(9) – behavior supports;
(i) Paragraphs (E)(13) and (F)(11) – medication administration and performance of health care tasks;
(j) Paragraphs (E)(15) and (F)(13) – individual needs;
(k) Paragraphs (E)(16) and (F)(14) – ISP compliance;
(l) Paragraphs (E)(17) and (F)(15) – provider eligibility
(3) The agency provider shall give the county board notice of all subcontracts for homemaker/personal care services.
(4) The agency provider shall enter into a written contract with the subcontractor.
(5) An agency provider that subcontracts the provision of homemaker/personal care services shall ensure that the subcontractor complies with all applicable requirements of this rule.
(J) Training
(1) Individual providers and all employees of agency providers who have direct contact with individuals receiving homemaker/personal care services shall receive annual training in accordance with the requirements of this paragraph.
(2) Each individual provider shall be required to obtain at least eight hours of continuing education/training every year after the individual provider has been certified.
(3) An agency provider shall ensure that each employee of the agency provider who has direct contact with individuals receiving homemaker/personal care services receives at least eight hours of continuing education/training every year based on the employee’s date of hire.
(4) An employee of an agency provider or individual provider shall be deemed to have met the requirements in paragraph (J)(2) or (J)(3) of this rule if such employee is scheduled for training and the training is completed within thirty days of the deadline.
(5) Carryover
(a) Any hours in excess of the amounts required in paragraphs (J)(2) and (J)(3) of this rule cannot be carried over to any subsequent year.
(b) An employee of an agency provider may transfer hours of continuing education/training from one agency provider to another provided that the employee has proper documentation that the training was completed.
(6) Continuing education/training shall be designed to enhance the skills and competencies of the individual provider or employees of the agency provider relevant to their job responsibilities.
(a) The continuing education/training areas shall include annual training in:
(i) Identification and response to incidents adversely affecting an individual’s health and safety:
(ii) Individual rights.
(b) Other topics may include, but are not limited to:
(i) CPR;
(ii) Behavior supports;
(iii) Medication administration and performance of health care tasks;
(iv) OSHA requirements;
(v) Other areas that enhance the skills and competencies of the individual provider or employee of an agency provider relevant to his/her job responsibilities.
(7) Continuing education/training may be structured or unstructured and may include, but not be limited to, the following:
(a) Lectures, seminars or formal course work;
(b) Workshops and conferences;
(c) Demonstrations and displays;
(d) Visitations and observations of other facilities, services and programs;
(e) Distance learning and other electronic means of learning;
(f) Video and other audio-visual training; and
(g) Staff meetings.
(8) The provider shall maintain a written record, which may include an electronic record, of each person’s continuing education/training. This information shall be presented upon request by ODJFS, the department, or the county board. Documentation shall include the following:
(a) The name of the person receiving the training;
(b) Date(s) of training;
(c) Length of training;
(d) Training topic;
(e) Instructor’s name, if applicable;
(f) Brief description of the content of the training.
(K) Denial, suspension or revocation of certification
(1) Failure to comply with the standards set forth in this rule for initial certification of providers may result in denial of certification by the department pursuant to rule 5123:2-9-09 of the Administrative Code.
(2) After being certified in accordance with this rule, providers shall comply with the continuing certification standards set forth in this rule. Providers shall be subject to monitoring and compliance reviews conducted by the county board and/or the department as set forth in rule 5123:2-9-08 of the Administrative Code. Failure to comply with the standards set forth in this rule for continuing certification of providers may result in corrective action by the department up to and including suspension or revocation of certification as set forth in rule 5123:2-9-08 of the Administrative Code.
(3) When denying, supending, or revoking certification under this rule, the department shall comply with the notice and hearing requirements of Chapter 119. of the Revised Code.
Effective: 07/01/2006
R.C. 119.032 review dates: 04/28/2008
Promulgated Under: 119.03
Statutory Authority: 5123.04, 5123.045, 5123.16, 5111.871
Rule Amplifies: 5123.04, 5123.045, 5123.16, 5111.871
Prior Effective Dates: 4/28/03
(A) Purpose
The purpose of this rule is to set forth the coverage for emergency assistance under the HCBS level one waiver administered by the department and the eligibility for receiving emergency assistance.
(B) Definition
“Emergency assistance” means an increased level of homemaker/personal care, institutional respite, environmental accessibility adaptations, specialized medical equipment and supplies, transportation, or personal emergency response systems. Emergency assistance shall be used for interim services up to the maximum reimbursement amount until the emergency situation has been resolved or the individual is transferred to alternative residential supports applicable to the individual’s assessed needs including an ICF/MR or applicable supports under an alternative HCBS waiver for which the individual is eligible and a slot is available. The benefit package in the level one waiver includes a limitation of eight thousand dollars for emergency assistance over a three-year period.
(C) Eligibility for emergency assistance
(1) An individual enrolled in the HCBS level one waiver shall be subject to one of the following situations to be eligible for emergency assistance:
(a) Involuntary loss of present residence for any reason, including legal action;
(b) Loss of present caregiver for any reason, including death of caregiver or change in caregiver’s mental or physical status resulting in the caregiver’s inability to perform effectively for the individual;
(c) Abuse, neglect, or exploitation of the individual;
(d) Health and welfare conditions that pose a serious risk to the individual of immediate harm or death; or
(e) Significant changes in the emotional or physical condition of the individual that necessitate substantial, expanded accommodations that cannot be reasonably provided by the individual’s existing caregiver.
(2) Eligibility, as specified in paragraphs (C)(1)(a) to (C)(1)(e) of this rule, for emergency assistance shall be determined through the ISP process for the individual.
(3) Emergency assistance shall be provided pursuant to the ISP for the individual.
(4) If the individual is determined to be eligible for emergency assistance, then the SSA, through the ISP process, shall recommend emergency assistance funds in an amount not to exceed eight thousand dollars. The eight thousand dollars is cumulative for each individual enrolled in the HCBS level one waiver for a three-year period.
(5) If the individual’s or the individual’s guardian’s request for emergency assistance is denied, the county board will give the individual or the individual’s guardian notice of due process and hearing rights under section 5101.35 of the Revised Code and Chapters 5101:6-1 to 5101:6-9 of the Administrative Code.
Effective: 07/01/2006
R.C. 119.032 review dates: 04/28/2008
Promulgated Under: 119.03
Statutory Authority: 5123.04, 5123.045, 5123.16, 5111.871
Rule Amplifies: 5123.04, 5123.045, 5123.16, 5111.871
Prior Effective Dates: 4/28/03
Rescinded eff 7-1-06
Rescinded eff 1-1-07
Rescinded eff 7-8-04