CHAPTER 173: DEPARTMENT OF AGING

The department of aging shall:

(A) Be the designated state agency to administer programs of the federal government relating to the aged, requiring action within the state, that are not the specific responsibility of another state agency under federal or state statutes. The department shall be the sole state agency to administer funds granted by the federal government under the “Older Americans Act of 1965,” 79 Stat. 219, 42 U.S.C. 3001, as amended. The department shall not supplant or take over for the counties or municipal corporations or from other state agencies or facilities any of the specific responsibilities borne by them on November 23, 1973. The department shall cooperate with such federal and state agencies, counties, and municipal corporations and private agencies or facilities within the state in furtherance of the purposes as set forth in this chapter.

(B) Administer state funds appropriated for its use for administration and for grants and may use appropriated state funds as state match for federal grants. All federal funds received shall be reported to the director of budget and management.

(C) Review all proposed plans, programs, and rules primarily affecting persons sixty years of age or older, and shall be sent a copy of all proposed and final rules, as well as proposals for plans and programs that primarily affect persons sixty years of age or older and notices of all hearings on such rules, plans, and programs. Any state agency proposing a plan, program, or rule that primarily affects persons sixty years of age or older shall submit a copy of such proposal to the department for its written comments. No such proposed plan, program, or rule shall take effect until the department’s comments have been requested. The department shall review the proposal and submit a written comment on such proposal to the agency making the proposal, within thirty days from the date the department receives the proposal. If the department does not agree that the proposed plan, program, or rule shall take effect as proposed, the department shall set forth in writing its reasons and its suggestions for changes in the proposed plan, program, or rule. If the agency making the proposal does not choose to comply with the suggestions of the department, the agency making the proposal shall send the department, no later than thirty days before the proposal becomes final, written notice of its intention not to comply with such suggestions and its reason for such noncompliance.

This section does not apply to plans or revisions adopted under section 5101.46 of the Revised Code.

(D) Plan, initiate, coordinate, and evaluate statewide programs, services, and activities for elderly people;

(E) Disseminate information concerning the problems of elderly people and establish and maintain a central clearinghouse of information on public programs at all levels of government that would be of interest or benefit to the elderly;

(F) Report annually to the governor and the general assembly on the department’s programs;

(G) Have authority to contract with public or private groups to perform services for the department;

(H) Conduct investigations under section 3721.17 of the Revised Code;

(I) Hire investigators to conduct investigations of alleged violations of sections 3721.10 to 3721.17 of the Revised Code pursuant to section 3721.17 of the Revised Code;

(J) Adopt rules under Chapter 119. of the Revised Code to govern investigations conducted under section 3721.17 of the Revised Code;

(K) Adopt rules pursuant to Chapter 119. of the Revised Code to govern the operation of services and facilities for the elderly that are provided, operated, contracted for, or supported by the department, and determine that those services and facilities are operated in conformity with the rules;

(L) Determine the needs of the elderly and represent their interests at all levels of government;

(M) Establish and operate a long-term care ombudsman program pursuant to section 307(a)(12)(A) of the “Older Americans Act of 1965,” as amended by the “Comprehensive Older Americans Act Amendments of 1978,” 92 Stat. 1524, 42 U.S.C. 3027, and amendments thereto.

Effective Date: 07-01-1985

(A) When administering funds granted under the “Older Americans Act of 1965,” 79 Stat. 219, 42 U.S.C. 3001, as amended, the department of aging may divide the state into separate multi-county regions that shall be known as planning and service areas. If the department divides the state into those areas, then, consistent with the rules adopted under division (C)(1) of this section, it shall designate one public entity or one private nonprofit entity as each area’s agency on aging. That agency shall administer programs on behalf of the department under the Older Americans Act of 1965 within its planning and service area.

(B) Consistent with the rules adopted under division (C)(2) of this section and following an adjudication hearing conducted in accordance with Chapter 119. of the Revised Code, the department may issue an adjudication order that withdraws or provisionally maintains the designation of an entity as an agency on aging.

(C) The department shall adopt rules under Chapter 119. of the Revised Code that do both of the following:

(1) Establish criteria to be used for designating an agency on aging;

(2) Provide procedures and grounds for withdrawing or provisionally maintaining the designation of an entity as an agency on aging of a planning and service area.

Effective Date: 09-29-1999

The department of aging shall adopt, and may rescind, rules as necessary to carry out the provisions of Chapter 173. of the Revised Code and may:

(A) Provide technical assistance and consultation to public and private nonprofit agencies with respect to programs, services, and activities for elderly people;

(B) Cooperate with federal agencies, other state agencies or departments, and organizations to conduct studies and surveys on the special problems of the aged in such matters as mental and physical health, housing, transportation, family relationships, employment, income, vocational rehabilitation, recreation, and education; make such reports as are appropriate to the governor and other federal and state agencies; and develop recommendations for administrative or legislative action to alleviate such problems;

(C) Develop and strengthen the services available for the aging in the state by coordinating the existing services provided by federal, state, and local departments and agencies, and private agencies and facilities;

(D) Extend and expand services for the aged through coordinating the interests and efforts of local communities in studying the problems of the aged citizens of this state;

(E) Encourage, promote, and aid in the establishment of programs and services on the local level for the betterment of the living conditions of the aged by making it possible for the aged to more fully enjoy and participate in family and community life;

(F) Sponsor voluntary community rehabilitation and recreational facilities for the purpose of improving the general welfare of the elderly;

(G) Stimulate the training of workers in the field of aging;

(H) Provide consultants to agencies, associations, or individuals providing services supported by the department;

(I) Provide support which shall include, but not be limited to, financial support for the Martin Janis multipurpose senior center in Columbus;

(J) Recommend methods of improving the effectiveness of state services for elderly citizens;

(K) Adopt rules pursuant to Chapter 119. of the Revised Code to request fees, if not prohibited by any federal or state law, from persons using services or facilities for the elderly that are provided, operated, contracted for, or supported by the department, provided that requesting the fees will not disqualify the department from receiving federal or state funds;

(L) Publish a description of the organization and functions of the department so that all interested agencies and individuals may receive information about, and be better able to solicit assistance from, the department.

Effective Date: 06-30-1997

Effective Date: 07-26-1984

(A) There is hereby created the Ohio advisory council for the aging, which shall consist of twelve members to be appointed by the governor with the advice and consent of the senate. Two ex officio members of the council shall be members of the house of representatives appointed by the speaker of the house of representatives and shall be members of two different political parties. Two ex officio members of the council shall be members of the senate appointed by the president of the senate and shall be members of two different political parties. The directors of mental health, mental retardation and developmental disabilities, health, and job and family services, or their designees, shall serve as ex officio members of the council. The council shall carry out its role as defined under the “Older Americans Act of 1965,” 79 Stat. 219, 42 U.S.C. 3001, as amended.

At the first meeting of the council, and annually thereafter, the members shall select one of their members to serve as chairperson and one of their members to serve as vice-chairperson.

(B) Members of the council shall be appointed for a term of three years, except that for the first appointment members of the Ohio commission on aging who were serving on the commission immediately prior to July 26, 1984, shall become members of the council for the remainder of their unexpired terms. Thereafter, appointment to the council shall be for a three-year term by the governor. Each member shall hold office from the date of appointment until the end of the term for which the member was appointed. Any member appointed to fill a vacancy occurring prior to the expiration of the term for which the member’s predecessor was appointed shall hold office for the remainder of the term. Any member may continue in office subsequent to the expiration date of the member’s term until a successor takes office and shall be compensated for the period served between the expiration of the member’s term and the beginning of the successor’s term.

(C) Membership of the council shall represent all areas of Ohio and shall be as follows:

(1) A majority of members of the council shall have attained the age of sixty and have a knowledge of and continuing interest in the affairs and welfare of the older citizens of Ohio. The fields of business, labor, health, law, and human services shall be represented in the membership.

(2) No more than seven members shall be of the same political party.

(D) Any member of the council may be removed from office by the governor for neglect of duty, misconduct, or malfeasance in office after being informed in writing of the charges and afforded an opportunity for a hearing. Two consecutive unexcused absences from regularly scheduled meetings constitute neglect of duty.

(E) Members of the council shall be compensated at the rate of fifty dollars for each day actually employed in the discharge of official duties but not to exceed two thousand dollars per year and in addition shall be allowed actual and necessary expenses.

(F) Council members are not limited as to the number of terms they may serve.

(G) Council members shall not be interested directly or indirectly in any contract awarded by the department of aging.

Effective Date: 07-01-2000

(A) As used in this section, “respite care” means short-term, temporary care or supervision provided to a person who has Alzheimer’s disease in the absence of the person who normally provides that care or supervision.

(B) Through the internet web site maintained by the department of aging, the director of aging shall disseminate Alzheimer’s disease training materials for licensed physicians, registered nurses, licensed practical nurses, administrators of health care programs, social workers, and other health care and social service personnel who participate or assist in the care or treatment of persons who have Alzheimer’s disease. The training materials disseminated through the web site may be developed by the director or obtained from other sources.

(C) To the extent funds are available, the director shall administer respite care programs and other supportive services for persons who have Alzheimer’s disease and their families or care givers. Respite care programs shall be approved by the director and shall be provided for the following purposes:

(1) Giving persons who normally provide care or supervision for a person who has Alzheimer’s disease relief from the stresses and responsibilities that result from providing such care;

(2) Preventing or reducing inappropriate institutional care and enabling persons who have Alzheimer’s disease to remain at home as long as possible.

(D) The director may provide services under this section to persons with Alzheimer’s disease and their families regardless of the age of the persons with Alzheimer’s disease.

(E) The director shall adopt rules in accordance with Chapter 119. of the Revised Code governing respite care programs and other supportive services, the distribution of funds, and the purpose for which funds may be utilized under this section.

(F) The director may create an Alzheimer’s disease and related disorders task force to advise the director on the following:

(1) The rights of persons with Alzheimer’s disease and related disorders;

(2) The development and evaluation of education and training programs, home care programs, and respite care programs that serve persons with Alzheimer’s disease and related disorders;

(3) How to serve persons with Alzheimer’s disease and related disorders in Ohio’s unified long-term care budget system.

If a task force is created, the members shall include representatives of the Alzheimer’s disease association and other organizations the director considers appropriate.

Effective Date: 07-01-1993; 2007 HB119 09-29-2007

Deputy director of the aging shall be the acting director when the director is absent or disabled or the position is vacant. The director shall specify who shall be the acting director if no deputy director has been appointed.

Effective Date: 07-26-1984

(A) The director of aging shall establish a golden buckeye card program and provide a golden buckeye card to any resident of this state who applies to the director for a card and is sixty years of age or older or is a person with a disability and is eighteen years of age or older. The director shall devise programs to provide benefits of any kind to card holders, and encourage support and participation in them by all persons, including governmental organizations. Card holders shall be entitled to any benefits granted to them by private persons or organizations, the laws of this state, or ordinances or resolutions of political subdivisions. This section does not require any person or organization to provide benefits to any card holder. The department of aging shall bear all costs of the program.

(B) Before issuing a golden buckeye card to any person, the director shall establish the identity of any person who applies for a card and shall ascertain that such person is sixty years of age or older or is a person with a disability and is eighteen years of age or older. The director shall adopt rules under Chapter 119. of the Revised Code to prevent the issuance of cards to persons not qualified to have them. Cards shall contain the signature of the card holder and any other information the director considers necessary to carry out the purposes of the golden buckeye card program under this section. Any card that the director issues shall be held in perpetuity by the original card holder and shall not be transferable to any other person. A person who loses the person’s card may obtain another card from the director upon providing the same information to the director as was required for the issuance of the original card.

(C) No person shall use a golden buckeye card except to obtain a benefit for the holder of the card to which the holder is entitled under the conditions of the offer.

(D) As used in this section, “person with a disability” means a person who has some impairment of body or mind and has been certified as permanently and totally disabled by an agency of this state or the United States having the function of so classifying persons.

Effective Date: 09-26-2003; 07-01-2007

Records identifying the recipients of golden buckeye cards issued under section 173.06 of the Revised Code are not public records subject to inspection or copying under section 149.43 of the Revised Code and may be disclosed only at the discretion of the director of aging. The director may disclose only information in records identifying the recipients of golden buckeye cards that does not contain the recipient’s medical history.

Effective Date: 09-26-2003; 07-01-2007

Effective Date: 07-01-2007

Effective Date: 07-01-2007

Effective Date: 07-01-2007

Effective Date: 07-01-2007

(A) The resident services coordinator program is established in the department of aging to fund resident services coordinators. The coordinators shall provide information to low-income and special-needs tenants, including the elderly, who live in financially assisted rental housing complexes, and assist those tenants in identifying and obtaining community and program services and other benefits for which they are eligible.

(B) The resident services coordinator program fund is hereby created in the state treasury to support the resident services coordinator program established pursuant to this section. The fund consists of all moneys the department of development sets aside pursuant to division (A)(4) of section 174.02 of the Revised Code and moneys the general assembly appropriates to the fund.

Effective Date: 09-26-2003; 07-01-2005

Effective Date: 11-15-1981

Effective Date: 09-29-1995

The department of aging shall, as appropriate and feasible and to the extent federal, state, and local funding is available, develop a system of community multipurpose senior centers for the purposes of:

(A) Providing centralized, coordinated medical, social, supportive, and rehabilitative services to older adults;

(B) Encouraging older adults to maintain physical, social, and emotional well-being and to live dignified and reasonably independent lives in their own homes;

(C) Diminishing the rate of inappropriate entry and placement of older adults in nursing homes, sheltered housing for older adults, and related facilities.

The department shall, in accordance with Chapter 119. of the Revised Code, adopt rules under which counties, townships, municipal corporations, or local nonprofit organizations may make application to the department to operate a multipurpose senior center or to participate in a multipurpose senior center program. Procedures shall be established for the maximum feasible participation by older adults and representatives of organizations of older adults in the planning of these programs. The area agency on aging, established under the “Older Americans Act of 1965,” 79 Stat. 219, 42 U.S.C. 3001, as amended, shall be given the opportunity to review and comment on all applications for the establishment of a center or the expansion of the scope of services provided by a senior center operated as part of the social services system under the agency’s area plan.

The department shall plan, coordinate, and monitor, and, to the extent feasible, provide funds for services for older adults under this section and section 173.12 of the Revised Code. In order to carry out the purposes of such sections, the department or the designated local entity may accept gifts and grants and enter into contracts for the purchase of services.

The multipurpose senior centers shall be centrally located and easily accessible to any public transportation available in such location. The centers may provide transportation for older adults who wish to utilize services available in the facility, but are unable to reach it because of the lack of financial resources or physical impairment. Centers shall be designed to provide ease of access and use considering the infirmities of frail and handicapped older adults. Special safety features shall be provided as unobtrusively as possible. In establishing the location of multipurpose senior centers, the department shall, to the extent feasible, give precedence to the use of existing buildings and facilities, which may be renovated, over the construction of new buildings and facilities.

Effective Date: 07-26-1984

The services provided by a multipurpose senior center shall be available to all residents of the area served by the center who are sixty years of age or older, except where legal requirements for the use of funds available for a component program specify other age limits. Persons who receive services from the center may be encouraged to make voluntary contributions to the center, but no otherwise eligible person shall be refused services because of inability to make a contribution.

Services provided by the center may include, but are not limited to, the following:

(A) Services available within the facility:

(1) Preventive medical services, diagnostic and treatment services, emergency health services, and counseling on health matters, which are provided on a regular basis by a licensed physician, or by a registered nurse or other qualified health professional;

(2) A program to locate full- or part-time employment opportunities;

(3) Information and counseling by professional or other persons specially trained or qualified to enable older adults to make decisions on personal matters, including income, health, housing, transportation, and social relationships;

(4) A listing of services available in the community for older adults to assist in identifying the type of assistance needed, to place them in contact with appropriate services, and to determine whether services have been received and identified needs met;

(5) Legal advice and assistance by an attorney or a legal assistant acting under the supervision of an attorney;

(6) Recreation, social activities, and educational activities.

(B) Services provided outside the facility:

(1) Routine health services necessary to help functionally impaired older adults to maintain an appropriate standard of personal health, provided to them in their homes by licensed physicians, registered nurses, or other qualified health service personnel;

(2) Household services, such as light housekeeping, laundering, meal preparation, personal and grocery shopping, check cashing and bill paying, friendly visiting, minor household repairs, and yard chores, that are necessary to help functionally impaired older adults meet the normal demands of daily living;

(3) The delivery, on a regular schedule, of hot or cold nourishing meals to functionally impaired older adults and the determination of the nutritional needs of such persons;

(4) Door-to-door vehicular transportation for functionally impaired or other older adults.

Other services, including social and recreational services, adult education courses, reassurance by telephone, escort services, and housing assistance may be added to the center’s program as appropriate, to the extent that resources are available.

Services may be furnished by public agencies or private persons or organizations, but all services shall be coordinated by a single management unit, operating within the center, that is established, staffed, and equipped for this purpose.

The department of aging, or the local entity approved by the department under section 173.11 of the Revised Code for the operation of a center, may contract for any or all of the services provided by the center with any other state agency, county, township, municipal corporation, school district, community or technical college district, health district, person, or organization.

The department shall provide for the necessary insurance coverage to protect all volunteers from the normal risks of personal liability while they are acting within the scope of their volunteer assignments for the provision of services under this section.

As used in this section, “functionally impaired older adult” means an individual sixty years of age or older who requires help from others in order to cope with the normal demands of daily living.

Effective Date: 07-26-1984

(A) As used in this section, “bingo,” “bingo game operator,” and “participant” have the same meanings as in section 2915.01 of the Revised Code.

(B) Notwithstanding sections 2915.07 to 2915.13 of the Revised Code, a multipurpose senior center may conduct bingo games described in division (S)(1) of section 2915.01 of the Revised Code, but only if it complies with all of the following requirements:

(1) All bingo games are conducted only on the premises of the facility.

(2) All participants are sixty years of age or older.

(3) All bingo game operators are sixty years of age or older and receive no compensation for serving as operators.

(4) No participant is charged an admission fee, and no participant is charged more than twenty-five cents to purchase a bingo card or sheet.

(5) All proceeds from games are used only for any of the following:

(a) To pay winners monetary or nonmonetary prizes;

(b) To provide refreshments;

(c) To defray any costs directly related to conducting the games;

(d) To defray costs of services the facility provides in accordance with section 173.12 of the Revised Code.

Effective Date: 04-03-2003

(A) As used in this section:

(1) “Continuing care” means the provision under a written agreement of board, lodging, medical services, nursing, and other health-related services to a person sixty years of age or older, unrelated by consanguinity or affinity to the provider, for the life of the person or for a period in excess of one year in return for the payment of an entrance fee or of periodic charges.

(2) “Entrance fee” means an initial or deferred payment of a sum of money or other property made or promised to be made by or on behalf of a person entering into a written agreement with a facility for the provision of continuing care services in consideration for acceptance of the person as a resident in the facility.

(B) The residents of a facility that provides continuing care may determine annually whether they wish to elect a resident of the facility to serve on the board of directors, board of trustees, or other board that operates the facility. Election of a resident to serve on the board shall be by a simple majority vote of all residents attending a meeting called to determine if residents of the facility wish to have representation on the board. The individual organizing the meeting shall give residents at least seven days’ notice of the meeting. A board to which a resident is elected under this section shall accept the resident as a nonvoting member and give him notice of and permit him to attend all meetings of the board.

(C) Every facility that provides continuing care shall, upon request, provide its residents and prospective residents with copies of any of its audited annual financial reports.

(D) Residents of facilities that provide continuing care shall have the right of self-organization.

(E) Each board of directors, board of trustees, or other board that operates a facility that provides continuing care, or a committee of the board, shall hold meetings at least quarterly with the residents of the facility, or with a committee of the residents, for the purpose of discussing facility income, expenditures, and financial matters and proposed changes in facility policies, programs, and services. The board shall give residents or the committee of residents at least seven days’ notice of each such meeting.

(F) A resident of a facility that provides continuing care may bring a civil action to enforce any of the rights granted under this section.

Effective Date: 10-20-1987

As used in sections 173.14 to 173.27 of the Revised Code:

(A)(1) Except as otherwise provided in division (A)(2) of this section, “long-term care facility” includes any residential facility that provides personal care services for more than twenty-four hours for two or more unrelated adults, including all of the following:

(a) A “nursing home,” “residential care facility,” or “home for the aging” as defined in section 3721.01 of the Revised Code;

(b) A facility authorized to provide extended care services under Title XVIII of the “Social Security Act,” 49 Stat. 620 (1935), 42 U.S.C. 301, as amended;

(c) A county home or district home operated pursuant to Chapter 5155. of the Revised Code;

(d) An “adult care facility” as defined in section 3722.01 of the Revised Code;

(e) A facility approved by the veterans administration under section 104(a) of the “Veterans Health Care Amendments of 1983,” 97 Stat. 993, 38 U.S.C. 630, as amended, and used exclusively for the placement and care of veterans;

(f) An adult foster home certified under section 173.36 of the Revised Code.

(2) “Long-term care facility” does not include a “residential facility” as defined in section 5119.22 of the Revised Code or a “residential facility” as defined in section 5123.19 of the Revised Code.

(B) “Resident” means a resident of a long-term care facility and, where appropriate, includes a prospective, previous, or deceased resident of a long-term care facility.

(C) “Community-based long-term care services” means health and social services provided to persons in their own homes or in community care settings, and includes any of the following:

(1) Case management;

(2) Home health care;

(3) Homemaker services;

(4) Chore services;

(5) Respite care;

(6) Adult day care;

(7) Home-delivered meals;

(8) Personal care;

(9) Physical, occupational, and speech therapy;

(10) Transportation;

(11) Any other health and social services provided to persons that allow them to retain their independence in their own homes or in community care settings.

(D) “Recipient” means a recipient of community-based long-term care services and, where appropriate, includes a prospective, previous, or deceased recipient of community-based long-term care services.

(E) “Sponsor” means an adult relative, friend, or guardian who has an interest in or responsibility for the welfare of a resident or a recipient.

(F) “Personal care services” has the same meaning as in section 3721.01 of the Revised Code.

(G) “Regional long-term care ombudsperson program” means an entity, either public or private and nonprofit, designated as a regional long-term care ombudsperson program by the state long-term care ombudsperson.

(H) “Representative of the office of the state long-term care ombudsperson program” means the state long-term care ombudsperson or a member of the ombudsperson’s staff, or a person certified as a representative of the office under section 173.21 of the Revised Code.

(I) “Area agency on aging” means an area agency on aging established under the “Older Americans Act of 1965,” 79 Stat. 219, 42 U.S.C.A. 3001, as amended.

Effective Date: 09-26-2003; 06-30-2006

The long-term care ombudsman program established by the department of aging pursuant to division (M) of section 173.01 of the Revised Code shall be known as “the office of the state long-term care ombudsman program.” It shall consist of the state long-term care ombudsman and his staff and regional long-term care ombudsman programs. In establishing and operating the office, the department shall consider the views of area agencies on aging, individuals age sixty or older, and agencies and other entities that provide services to individuals age sixty and older.

The department of aging shall appoint the state ombudsman, who shall serve at the pleasure of the department. The department shall appoint as state ombudsman an individual who has no conflict of interest with the position and is capable of administering the office impartially, has an understanding of long-term care issues, and has experience related to the concerns of residents and recipients, such as experience in the fields of aging, health care, and long-term care; work with community programs and health care providers; and work with and involvement in volunteer programs. No individual or entity whose interests are in conflict with the responsibilities of the state ombudsman shall be involved in his appointment.

The department shall ensure that no employee or representative of the office and no individual involved in the designation of the head of any regional long-term care ombudsman program has any interest that is, or may be, in conflict with the interests and concerns of the office and shall ensure that mechanisms are in place to remedy any conflicts.

For purposes of this section, conflicts of interest may include, but are not limited to, employment by a long-term care facility or a provider of community-based long-term care services within two years prior to being employed by or associated with the office of the state long-term care ombudsman program, affiliation with or financial interest in a long-term care facility or a provider of community-based long-term care services, and affiliation with or financial interest in a membership organization of long-term care providers.

Effective Date: 06-12-1990

(A) The department of aging shall designate regions to be served by regional long-term care ombudsman programs.

(B) Except as otherwise provided in division (C) of this section, the state long-term care ombudsman shall designate regional programs in accordance with criteria established by the department of aging in rules which the department shall adopt under Chapter 119. of the Revised Code. The criteria shall include specifications regarding the sites of the regional programs’ offices and requirements concerning staffing, levels of training required for staff members, program review, and tax exempt status for federal income tax purposes.

(C) An entity serving as a regional program on the effective date of this section shall be designated as a regional program unless the state ombudsman determines that the entity does not meet the requirements established under division (B) of this section. Except that the state ombudsman may designate as a regional program an entity that does not meet the requirements if it is serving as a regional program on the effective date of this section and the state ombudsman determines that it is the best qualified program to serve the region.

(D) In an adjudication conducted in accordance with Chapter 119. of the Revised Code, the state ombudsman may issue an adjudication order withdrawing or provisionally maintaining the designation of an entity as a regional program if it ceases to meet the criteria established pursuant to division (B) of this section or a conflict of interest develops between the regional program or a person associated with it and the office. If the designation of a regional program is provisionally maintained, the state ombudsman shall notify the program of the reasons for its provisional status, the changes or corrections necessary for the removal of its provisional status, the length of time it has to make the changes or corrections, and that the state ombudsman will withdraw the designation if the program does not comply with the requirements specified in the notice. If the designation of a regional program is withdrawn, the state ombudsman shall provide for the continuation of ombudsman services for that region.

Effective Date: 06-12-1990

(A) The state long-term care ombudsperson shall do all of the following:

(1) Appoint a staff and direct and administer the work of the staff;

(2) Supervise the nursing home investigative unit established under division (I) of section 173.01 of the Revised Code;

(3) Oversee the performance and operation of the office of the state long-term care ombudsperson program, including the operation of regional long-term care ombudsperson programs;

(4) Establish and maintain a statewide uniform reporting system to collect and analyze information relating to complaints and conditions in long-term care facilities and complaints regarding the provision of community-based long-term care services for the purpose of identifying and resolving significant problems;

(5) Provide for public forums to discuss concerns and problems relating to action, inaction, or decisions that may adversely affect the health, safety, welfare, or rights of residents and recipients of services by providers of long-term care and their representatives, public agencies and entities, and social service agencies. This may include any of the following: conducting public hearings; sponsoring workshops and conferences; holding meetings for the purpose of obtaining information about residents and recipients, discussing and publicizing their needs, and advocating solutions to their problems; and promoting the development of citizen organizations.

(6) Encourage, cooperate with, and assist in the development and operation of services to provide current, objective, and verified information about long-term care;

(7) Develop and implement, with the assistance of regional programs, a continuing program to publicize, through the media and civic organizations, the office, its purposes, and its methods of operation;

(8) Maintain written descriptions of the duties and qualifications of representatives of the office;

(9) Evaluate and make known concerns and issues regarding long-term care by doing all of the following:

(a) Preparing an annual report containing information and findings regarding the types of problems experienced by residents and recipients and the complaints made by or on behalf of residents and recipients. The report shall include recommendations for policy, regulatory, and legislative changes to solve problems, resolve complaints, and improve the quality of care and life for residents and recipients and shall be submitted to the governor, the speaker of the house of representatives, the president of the senate, the directors of health and of job and family services, and the commissioner of the administration on aging of the United States department of health and human services.

(b) Monitoring and analyzing the development and implementation of federal, state, and local laws, rules, and policies regarding long-term care services in this state and recommending to officials changes the office considers appropriate in these laws, rules, and policies;

(c) Providing information and making recommendations to public agencies, members of the general assembly, and others regarding problems and concerns of residents and recipients.

(10) Conduct training for employees and volunteers on ombudsperson’s staff and for representatives of the office employed by regional programs;

(11) Monitor the training of representatives of the office who provide volunteer services to regional programs, and provide technical assistance to the regional programs in conducting the training;

(12) Issue certificates attesting to the successful completion of training and specifying the level of responsibility for which a representative of the office who has completed training is qualified;

(13) Register as a residents’ rights advocate with the department of health under division (B) of section 3701.07 of the Revised Code;

(14) Perform other duties specified by the department of aging.

(B) The state ombudsperson may delegate any of the ombudsperson’s authority or duties under sections 173.14 to 173.26 of the Revised Code to any member of the ombudsperson’s staff. The state ombudsperson is responsible for any authority or duties the ombudsperson delegates.

Effective Date: 07-01-2000

Each regional long-term care ombudsman program designated under section 173.16 of the Revised Code shall do all of the following:

(A) Provide ombudsman services for the region in which it is located;

(B) Employ representatives of the office of the state long-term care ombudsman program or receive services from volunteers certified under section 173.21 of the Revised Code as representatives of the office, or both;

(C) Submit reports to the state long-term care ombudsman as he may require;

(D) Register as a residents’ rights advocate with the department of health under division (B) of section 3701.07 of the Revised Code.

Effective Date: 06-12-1990

(A) The office of the state long-term care ombudsperson program, through the state long-term care ombudsperson and the regional long-term care ombudsperson programs, shall receive, investigate, and attempt to resolve complaints made by residents, recipients, sponsors, providers of long-term care, or any person acting on behalf of a resident or recipient, relating to either of the following:

(1) The health, safety, welfare, or civil rights of a resident or recipient or any violation of a resident’s rights described in sections 3721.10 to 3721.17 of the Revised Code;

(2) Any action or inaction or decision by a provider of long-term care or representative of a provider, a governmental entity, or a private social service agency that may adversely affect the health, safety, welfare, or rights of a resident or recipient.

(B) The department of aging shall adopt rules in accordance with Chapter 119. of the Revised Code regarding the handling of complaints received under this section, including procedures for conducting investigations of complaints. The rules shall include procedures to ensure that no representative of the office investigates any complaint involving a provider of long-term care with which the representative was once employed or associated.

The state ombudsperson and regional programs shall establish procedures for handling complaints consistent with the department’s rules. Complaints shall be dealt with in accordance with the procedures established under this division.

(C) The office of the state long-term care ombudsperson program may decline to investigate any complaint if it determines any of the following:

(1) That the complaint is frivolous, vexatious, or not made in good faith;

(2) That the complaint was made so long after the occurrence of the incident on which it is based that it is no longer reasonable to conduct an investigation;

(3) That an adequate investigation cannot be conducted because of insufficient funds, insufficient staff, lack of staff expertise, or any other reasonable factor that would result in an inadequate investigation despite a good faith effort;

(4) That an investigation by the office would create a real or apparent conflict of interest.

(D) If a regional long-term care ombudsperson program declines to investigate a complaint, it shall refer the complaint to the state long-term care ombudsperson.

(E) Each complaint to be investigated by a regional program shall be assigned to a representative of the office of the state long-term care ombudsperson program. If the representative determines that the complaint is valid, the representative shall assist the parties in attempting to resolve it. If the representative is unable to resolve it, the representative shall refer the complaint to the state ombudsperson.

In order to carry out the duties of sections 173.14 to 173.26 of the Revised Code, a representative has the right to private communication with residents and their sponsors and access to long-term care facilities, including the right to tour resident areas unescorted and the right to tour facilities unescorted as reasonably necessary to the investigation of a complaint. Access to facilities shall be during reasonable hours or, during investigation of a complaint, at other times appropriate to the complaint.

When community-based long-term care services are provided at a location other than the recipient’s home, a representative has the right to private communication with the recipient and the recipient’s sponsors and access to the community-based long-term care site, including the right to tour the site unescorted. Access to the site shall be during reasonable hours or, during the investigation of a complaint, at other times appropriate to the complaint.

(F) The state ombudsperson shall determine whether complaints referred to the ombudsperson under division (D) or (E) of this section warrant investigation. The ombudsperson’s determination in this matter is final.

Effective Date: 07-01-2000

(A) If consent is given and unless otherwise prohibited by law, a representative of the office of the state long-term care ombudsman program shall have access to any records, including medical records, of a resident or a recipient that are reasonably necessary for investigation of a complaint. Consent may be given in any of the following ways:

(1) In writing by the resident or recipient;

(2) Orally by the resident or recipient, witnessed in writing at the time it is given by one other person, and, if the records involved are being maintained by a long-term care provider, also by an employee of the long-term care provider designated under division (E)(1) of this section;

(3) In writing by the guardian of the resident or recipient;

(4) In writing by the attorney in fact of the resident or recipient if the resident or recipient has authorized the attorney in fact to give such consent;

(5) In writing by the executor or administrator of the estate of a deceased resident or recipient.

(B) If consent to access to records is not refused by a resident or recipient or his legal representative but cannot be obtained and any of the following circumstances exist, a representative of the office of the state long-term care ombudsman program, on approval of the state long-term care ombudsman, may inspect the records of a resident or a recipient, including medical records, that are reasonably necessary for investigation of a complaint:

(1) The resident or recipient is unable to express written or oral consent and there is no guardian or attorney in fact;

(2) There is a guardian or attorney in fact, but he cannot be contacted within three working days;

(3) There is a guardianship or durable power of attorney, but its existence is unknown by the long-term care provider and the representative of the office at the time of the investigation;

(4) There is no executor or administrator of the estate of a deceased resident or recipient.

(C) If a representative of the office of the state long-term care ombudsman program has been refused access to records by a guardian or attorney in fact, but has reasonable cause to believe that the guardian or attorney in fact is not acting in the best interests of the resident or recipient, the representative may, on approval of the state long-term care ombudsman, inspect the records of the resident or recipient, including medical records, that are reasonably necessary for investigation of a complaint.

(D) A representative of the office of the state long-term care ombudsman program shall have access to any records of a long-term care provider reasonably necessary to an investigation conducted under this section, including but not limited to: incident reports, dietary records, policies and procedures of a facility required to be maintained under section 5111.21 of the Revised Code, admission agreements, staffing schedules, any document depicting the actual staffing pattern of the provider, any financial records that are matters of public record, resident council and grievance committee minutes, and any waiting list maintained by a facility in accordance with section 5111.31 of the Revised Code, or any similar records or lists maintained by a provider of community-based long-term care services. Pursuant to division (E)(2) of this section, a representative shall be permitted to make or obtain copies of any of these records after giving the long-term care provider twenty-four hours’ notice. A long-term care provider may impose a charge for providing copies of records under this division that does not exceed the actual and necessary expense of making the copies.

The state ombudsman shall take whatever action is necessary to ensure that any copy of a record made or obtained under this division is returned to the long-term care provider no later than three years after the date the investigation for which the copy was made or obtained is completed.

(E)(1) Each long-term care provider shall designate one or more of its employees to be responsible for witnessing the giving of oral consent under division (A) of this section. In the event that a designated employee is not available when a resident or recipient attempts to give oral consent, the provider shall designate another employee to witness the consent.

(2) Each long-term care provider shall designate one or more of its employees to be responsible for releasing records for copying to representatives of the office of the long-term care ombudsman program who request permission to make or obtain copies of records specified in division (D) of this section. In the event that a designated employee is not available when a representative of the office makes the request, the long-term care provider shall designate another employee to release the records for copying.

(F) A long-term care provider or any employee of such a provider is immune from civil or criminal liability or action taken pursuant to a professional disciplinary procedure for the release or disclosure of records to a representative of the office pursuant to this section.

(G) A state or local government agency or entity with records relevant to a complaint or investigation being conducted by a representative of the office shall provide the representative access to the records.

(H) The state ombudsman, with the approval of the director of aging, may issue a subpoena to compel any person he reasonably believes may be able to provide information to appear before him or his designee and give sworn testimony and to produce documents, books, records, papers, or other evidence the state ombudsman believes is relevant to the investigation. On the refusal of a witness to be sworn or to answer any question put to him, or if a person disobeys a subpoena, the ombudsman shall apply to the Franklin County court of common pleas for a contempt order, as in the case of disobedience of the requirements of a subpoena issued from the court, or a refusal to testify in the court.

(I) The state ombudsman may petition the court of common pleas in the county in which a long-term care facility is located to issue an injunction against any long-term care facility in violation of sections 3721.10 to 3721.17 of the Revised Code.

(J) Any suspected violation of Chapter 3721. of the Revised Code discovered during the course of an investigation may be reported to the department of health. Any suspected criminal violation discovered during the course of an investigation shall be reported to the attorney general or other appropriate law enforcement authorities.

(K) The department of aging shall adopt rules in accordance with Chapter 119. of the Revised Code for referral by the state ombudsman and regional long-term care ombudsman programs of complaints to other public agencies or entities. A public agency or entity to which a complaint is referred shall keep the state ombudsman or regional program handling the complaint advised and notified in writing in a timely manner of the disposition of the complaint to the extent permitted by law.

Effective Date: 06-12-1990

(A) The office of the state long-term care ombudsman program, through the state long-term care ombudsman and the regional long-term care ombudsman programs, shall require each representative of the office to complete a training and certification program in accordance with this section and to meet the continuing education requirements established under this section.

(B) The department of aging shall adopt rules under Chapter 119. of the Revised Code specifying the content of training programs for representatives of the office of the state long-term care ombudsman program. Training for representatives other than those who are volunteers providing services through regional long-term care ombudsman programs shall include instruction regarding federal, state, and local laws, rules, and policies on long-term care facilities and community-based long-term care services; investigative techniques; and other topics considered relevant by the department and shall consist of the following:

(1) A minimum of forty clock hours of basic instruction, which shall be completed before the trainee is permitted to handle complaints without the supervision of a representative of the office certified under this section;

(2) An additional sixty clock hours of instruction, which shall be completed within the first fifteen months of employment;

(3) An internship of twenty clock hours, which shall be completed within the first twenty-four months of employment, including instruction in, and observation of, basic nursing care and long-term care provider operations and procedures. The internship shall be performed at a site that has been approved as an internship site by the state long-term care ombudsman.

(4) One of the following, which shall be completed within the first twenty-four months of employment:

(a) Observation of a survey conducted by the director of health to certify a facility to receive funds under sections 5111.20 to 5111.32 of the Revised Code;

(b) Observation of an inspection conducted by the director of health to license an adult care facility under section 3722.04 of the Revised Code.

(5) Any other training considered appropriate by the department.

(C) Persons who for a period of at least six months prior to June 11, 1990, served as ombudsmen through the long-term care ombudsman program established by the department of aging under division (M) of section 173.01 of the Revised Code shall not be required to complete a training program. These persons and persons who complete a training program shall take an examination administered by the department of aging. On attainment of a passing score, the person shall be certified by the department as a representative of the office. The department shall issue the person an identification card, which the representative shall show at the request of any person with whom he deals while performing his duties and which he shall surrender at the time he separates from the office.

(D) The state ombudsman and each regional program shall conduct training programs for volunteers on their respective staffs in accordance with the rules of the department of aging adopted under division (B) of this section. Training programs may be conducted that train volunteers to complete some, but not all, of the duties of a representative of the office. Each regional office shall bear the cost of training its representatives who are volunteers. On completion of a training program, the representative shall take an examination administered by the department of aging. On attainment of a passing score, he shall be certified by the department as a representative authorized to perform services specified in the certification. The department shall issue an identification card, which the representative shall show at the request of any person with whom he deals while performing his duties and which he shall surrender at the time he separates from the office. Except as a supervised part of a training program, no volunteer shall perform any duty unless he is certified as a representative having received appropriate training for that duty.

(E) The state ombudsman shall provide technical assistance to regional programs conducting training programs for volunteers and shall monitor the training programs.

(F) Prior to scheduling an observation of a certification survey or licensing inspection for purposes of division (B)(4) of this section, the state ombudsman shall obtain permission to have the survey or inspection observed from both the director of health and the long-term care facility at which the survey or inspection is to take place.

(G) The department of aging shall establish continuing education requirements for representatives of the office.

Effective Date: 10-29-1995

(A) The collection, compilation, analysis, and dissemination of information by the office of the state long-term care ombudsman program shall be performed in a manner that protects complainants, individuals providing information about a complaint, public entities, and confidential records of residents or recipients. The identity of a resident or recipient, a complainant who is not a resident or recipient, or an individual providing information about a complaint shall not be disclosed without the written consent of the resident or recipient, complainant, or individual, or his legal representative, or except as required by court order.

The investigative files, including any proprietary records of a long-term care provider contained in the files, of the office are not public records subject to inspection or copying under section 149.43 of the Revised Code. Information contained in investigative and other files maintained by the state long-term care ombudsman and regional long-term care ombudsman programs shall be disclosed only at the discretion of the state ombudsman or the regional program maintaining the records or if disclosure is required by court order.

(B) No report prepared by the state ombudsman or a regional program shall include any information that violates the confidentiality requirements of this section. Proprietary records of a specific long-term care provider are subject to the confidentiality requirements of this section.

Effective Date: 06-12-1990

(A) Representatives of the office of the state long-term care ombudsperson program are immune from civil or criminal liability for any action taken in the good faith performance of their official duties under sections 173.14 to 173.26 of the Revised Code. The department of aging shall ensure that adequate legal counsel is available to the office of the state long-term care ombudsperson program for advice and consultation and that legal representation is provided to any representative of the office against whom any legal action is brought in connection with the representative’s official duties under sections 173.14 to 173.26 of the Revised Code.

(B) A person acting in good faith is immune from civil or criminal liability incident to any of the following: providing information to the office, participating in registration of a complaint with the office, participating in investigation of a complaint by the office, or participating in an administrative or judicial proceeding resulting from a complaint.

(C) No person shall knowingly register a false complaint with the office, or knowingly swear or affirm the truth of a false complaint previously registered, when the statement is made with purpose to incriminate another.

Effective Date: 12-02-1996

(A) As used in this section, “employee” and “employer” have the same meanings as in section 4113.51 of the Revised Code.

(B) An employee providing information to or participating in good faith in registering a complaint with the office of the state long-term care ombudsman program or participating in the investigation of a complaint or in administrative or judicial proceedings resulting from a complaint registered with the office shall have the full protection against disciplinary or retaliatory action provided by division (G) of section 3721.17 and by sections 4113.51 to 4113.53 of the Revised Code.

(C) No long-term care provider, person employed by a long-term care provider, other entity, or employee of such other entity shall subject any resident or recipient to any form of retaliation, reprisal, discipline, or discrimination for providing information to the office or for participating in registering a complaint with the office, in the investigation of a complaint or in administrative or judicial proceedings resulting from a complaint registered with the office. Retaliatory actions include, but are not limited to, physical, mental, or verbal abuse; change of room assignment; the withholding of services; and failure to provide care in a timely manner.

Effective Date: 06-12-1990

The office of the state long-term care ombudsperson program shall, in carrying out the provisions and purposes of sections 173.14 to 173.26 of the Revised Code, advise, consult, and cooperate with any agency, program, or other entity related to the purposes of the office. Any agency, program, or other entity related to the purposes of the office shall advise, consult, and cooperate with the office.

The office shall attempt to establish effective coordination with government-sponsored programs that provide legal services to the elderly and with protective and advocacy programs for individuals with developmental disabilities, mental retardation, or mental illness.

Effective Date: 12-02-1996

(A) Each of the following facilities shall annually pay to the department of aging six dollars for each bed maintained by the facility for use by a resident during any part of the previous year:

(1) Nursing homes, residential care facilities, and homes for the aging as defined in section 3721.01 of the Revised Code;

(2) Facilities authorized to provide extended care services under Title XVIII of the “Social Security Act,” 49 Stat. 620 (1935), 42 U.S.C. 301, as amended;

(3) County homes and district homes operated pursuant to Chapter 5155. of the Revised Code;

(4) Adult care facilities as defined in section 3722.01 of the Revised Code;

(5) Facilities approved by the Veterans Administration under Section 104(a) of the “Veterans Health Care Amendments of 1983,” 97 Stat. 993, 38 U.S.C. 630, as amended, and used exclusively for the placement and care of veterans.

The department shall, by rule adopted in accordance with Chapter 119. of the Revised Code, establish deadlines for payments required by this section. A facility that fails, within ninety days after the established deadline, to pay a payment required by this section shall be assessed at two times the original invoiced payment.

(B) All money collected under this section shall be deposited in the state treasury to the credit of the office of the state long-term care ombudsperson program fund, which is hereby created. Money credited to the fund shall be used solely to pay the costs of operating the regional long-term care ombudsperson programs.

(C) The state long-term care ombudsperson and the regional programs may solicit and receive contributions to support the operation of the office or a regional program, except that no contribution shall be solicited or accepted that would interfere with the independence or objectivity of the office or program.

Effective Date: 09-29-1995; 09-29-2005

(A) As used in this section:

(1) “Applicant” means a person who is under final consideration for employment with the office of the state long-term care ombudsperson program in a full-time, part-time, or temporary position that involves providing ombudsperson services to residents and recipients. “Applicant” includes, but is not limited to, a person who is under final consideration for employment as the state long-term care ombudsperson or the head of a regional long-term care ombudsperson program. “Applicant” does not include a person who provides ombudsperson services to residents and recipients as a volunteer without receiving or expecting to receive any form of remuneration other than reimbursement for actual expenses.

(2) “Criminal records check” has the same meaning as in section 109.572 of the Revised Code.

(B)(1) The state long-term care ombudsperson or the ombudsperson’s designee shall request that the superintendent of the bureau of criminal identification and investigation conduct a criminal records check with respect to each applicant. However, if the applicant is under final consideration for employment as the state long-term care ombudsperson, the director of aging shall request that the superintendent conduct the criminal records check. If an applicant for whom a criminal records check request is required under this division does not present proof of having been a resident of this state for the five-year period immediately prior to the date the criminal records check is requested or provide evidence that within that five-year period the superintendent has requested information about the applicant from the federal bureau of investigation in a criminal records check, the ombudsperson, designee, or director shall request that the superintendent obtain information from the federal bureau of investigation as part of the criminal records check of the applicant. Even if an applicant for whom a criminal records check request is required under this division presents proof of having been a resident of this state for the five-year period, the ombudsperson, designee, or director may request that the superintendent include information from the federal bureau of investigation in the criminal records check.

(2) A person required by division (B)(1) of this section to request a criminal records check shall do both of the following:

(a) Provide to each applicant for whom a criminal records check request is required under that division a copy of the form prescribed pursuant to division (C)(1) of section 109.572 of the Revised Code and a standard fingerprint impression sheet prescribed pursuant to division (C)(2) of that section, and obtain the completed form and impression sheet from the applicant;

(b) Forward the completed form and impression sheet to the superintendent of the bureau of criminal identification and investigation.

(3) An applicant provided the form and fingerprint impression sheet under division (B)(2)(a) of this section who fails to complete the form or provide fingerprint impressions shall not be employed in any position for which a criminal records check is required by this section.

(C)(1) Except as provided in rules adopted by the director of aging in accordance with division (F) of this section and subject to division (C)(2) of this section, the office of the state long-term care ombudsperson may not employ a person in a position that involves providing ombudsperson services to residents and recipients if the person has been convicted of or pleaded guilty to any of the following:

(a) A violation of section 2903.01, 2903.02, 2903.03, 2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34, 2905.01, 2905.02, 2905.11, 2905.12, 2907.02, 2907.03, 2907.05, 2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 2907.25, 2907.31, 2907.32, 2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 2911.12, 2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21, 2913.31, 2913.40, 2913.43, 2913.47, 2913.51, 2919.25, 2921.36, 2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.11, 2925.13, 2925.22, 2925.23, or 3716.11 of the Revised Code.

(b) A violation of an existing or former law of this state, any other state, or the United States that is substantially equivalent to any of the offenses listed in division (C)(1)(a) of this section.

(2)(a) The office of the state long-term care ombudsperson program may employ conditionally an applicant for whom a criminal records check request is required under division (B) of this section prior to obtaining the results of a criminal records check regarding the individual, provided that the state long-term care ombudsperson, ombudsperson’s designee, or director of aging shall request a criminal records check regarding the individual in accordance with division (B)(1) of this section not later than five business days after the individual begins conditional employment.

(b) The office of the state long-term care ombudsperson program shall terminate the employment of an individual employed conditionally under division (C)(2)(a) of this section if the results of the criminal records check request under division (B) of this section, other than the results of any request for information from the federal bureau of investigation, are not obtained within the period ending sixty days after the date the request is made. Regardless of when the results of the criminal records check are obtained, if the results indicate that the individual has been convicted of or pleaded guilty to any of the offenses listed or described in division (C)(1) of this section, the office shall terminate the individual’s employment unless the office chooses to employ the individual pursuant to division (F) of this section. Termination of employment under this division shall be considered just cause for discharge for purposes of division (D)(2) of section 4141.29 of the Revised Code if the individual makes any attempt to deceive the office about the individual’s criminal record.

(D)(1) The office of the state long-term care ombudsperson program shall pay to the bureau of criminal identification and investigation the fee prescribed pursuant to division (C)(3) of section 109.572 of the Revised Code for each criminal records check conducted pursuant to a request made under division (B) of this section.

(2) The office of the state long-term care ombudsperson program may charge an applicant a fee not exceeding the amount the office pays under division (D)(1) of this section. The office may collect a fee only if the office notifies the applicant at the time of initial application for employment of the amount of the fee.

(E) The report of any criminal records check conducted pursuant to a request made under this section is not a public record for the purposes of section 149.43 of the Revised Code and shall not be made available to any person other than the following:

(1) The individual who is the subject of the criminal records check or the individual’s representative;

(2) The state long-term care ombudsperson, ombudsperson’s designee, director of aging, or the ombudsperson, designee, or director’s representative;

(3) If the state long-term care ombudsperson designates the head or other employee of a regional long-term care ombudsperson program to request a criminal records check under this section, a representative of the office of the state long-term care ombudsperson program who is responsible for monitoring the regional program’s compliance with this section;

(4) A court, hearing officer, or other necessary individual involved in a case dealing with a denial of employment of the applicant or dealing with employment or unemployment benefits of the applicant.

(F) The director of aging shall adopt rules in accordance with Chapter 119. of the Revised Code to implement this section. The rules shall specify circumstances under which the office of the state long-term care ombudsperson program may employ a person who has been convicted of or pleaded guilty to an offense listed or described in division (C)(1) of this section but meets personal character standards set by the director.

(G) The office of the state long-term care ombudsperson program shall inform each person, at the time of initial application for a position that involves providing ombudsperson services to residents and recipients, that the person is required to provide a set of fingerprint impressions and that a criminal records check is required to be conducted if the person comes under final consideration for employment.

(H) In a tort or other civil action for damages that is brought as the result of an injury, death, or loss to person or property caused by an individual who the office of the state long-term care ombudsperson program employs in a position that involves providing ombudsperson services to residents and recipients, all of the following shall apply:

(1) If the office employed the individual in good faith and reasonable reliance on the report of a criminal records check requested under this section, the office shall not be found negligent solely because of its reliance on the report, even if the information in the report is determined later to have been incomplete or inaccurate.

(2) If the office employed the individual in good faith on a conditional basis pursuant to division (C)(2) of this section, the office shall not be found negligent solely because it employed the individual prior to receiving the report of a criminal records check requested under this section.

(3) If the office in good faith employed the individual according to the personal character standards established in rules adopted under division (F) of this section, the office shall not be found negligent solely because the individual prior to being employed had been convicted of or pleaded guilty to an offense listed or described in division (C)(1) of this section.

Effective Date: 06-05-2006; 06-30-2006

(A) As used in this section, “PASSPORT administrative agency” means an entity under contract with the department of aging to provide administrative services regarding the PASSPORT program created under section 173.40 of the Revised Code.

(B) The department of aging shall administer the residential state supplement program under which the state supplements the supplemental security income payments received by aged, blind, or disabled adults under Title XVI of the “Social Security Act,” 49 Stat. 620 (1935), 42 U.S.C.A., as amended. Residential state supplement payments shall be used for the provision of accommodations, supervision, and personal care services to supplemental security income recipients who the department determines are at risk of needing institutional care.

(C) For an individual to be eligible for residential state supplement payments, all of the following must be the case:

(1) Except as provided by division (G) of this section, the individual must reside in one of the following:

(a) An adult foster home certified under section 173.36 of the Revised Code;

(b) A home or facility, other than a nursing home or nursing home unit of a home for the aging, licensed by the department of health under Chapter 3721. or 3722. of the Revised Code and certified in accordance with standards established by the director of aging under division (D)(2) of this section;

(c) A community alternative home licensed under section 3724.03 of the Revised Code and certified in accordance with standards established by the director of aging under division (D)(2) of this section;

(d) A residential facility as defined in division (A)(1)(d)(ii) of section 5119.22 of the Revised Code licensed by the department of mental health and certified in accordance with standards established by the director of aging under division (D)(2) of this section;

(e) An apartment or room used to provide community mental health housing services certified by the department of mental health under section 5119.611 of the Revised Code and approved by a board of alcohol, drug addiction, and mental health services under division (A)(14) of section 340.03 of the Revised Code and certified in accordance with standards established by the director of aging under division (D)(2) of this section.

(2) Effective July 1, 2000, a PASSPORT administrative agency must have determined that the environment in which the individual will be living while receiving the payments is appropriate for the individual’s needs. If the individual is eligible for supplemental security income payments or social security disability insurance benefits because of a mental disability, the PASSPORT administrative agency shall refer the individual to a community mental health agency for the community mental health agency to issue in accordance with section 340.091 of the Revised Code a recommendation on whether the PASSPORT administrative agency should determine that the environment in which the individual will be living while receiving the payments is appropriate for the individual’s needs. Division (C)(2) of this section does not apply to an individual receiving residential state supplement payments on June 30, 2000, until the individual’s first eligibility redetermination after that date.

(3) The individual satisfies all eligibility requirements established by rules adopted under division (D) of this section.

(D)(1) The directors of aging and job and family services shall adopt rules in accordance with section 111.15 of the Revised Code as necessary to implement the residential state supplement program.

To the extent permitted by Title XVI of the “Social Security Act,” and any other provision of federal law, the director of job and family services shall adopt rules establishing standards for adjusting the eligibility requirements concerning the level of impairment a person must have so that the amount appropriated for the program by the general assembly is adequate for the number of eligible individuals. The rules shall not limit the eligibility of disabled persons solely on a basis classifying disabilities as physical or mental. The director of job and family services also shall adopt rules that establish eligibility standards for aged, blind, or disabled individuals who reside in one of the homes or facilities specified in division (C)(1) of this section but who, because of their income, do not receive supplemental security income payments. The rules may provide that these individuals may include individuals who receive other types of benefits, including, social security disability insurance benefits provided under Title II of the “Social Security Act,” 49 Stat. 620 (1935), 42 U.S.C.A. 401, as amended. Notwithstanding division (B) of this section, such payments may be made if funds are available for them.

The director of aging shall adopt rules establishing the method to be used to determine the amount an eligible individual will receive under the program. The amount the general assembly appropriates for the program shall be a factor included in the method that department establishes.

(2) The director of aging shall adopt rules in accordance with Chapter 119. of the Revised Code establishing standards for certification of living facilities described in division (C)(1) of this section.

The directors of aging and mental health shall enter into an agreement to certify facilities that apply for certification and meet the standards established by the director of aging under this division.

(E) The county department of job and family services of the county in which an applicant for the residential state supplement program resides shall determine whether the applicant meets income and resource requirements for the program.

(F) The department of aging shall maintain a waiting list of any individuals eligible for payments under this section but not receiving them because moneys appropriated to the department for the purposes of this section are insufficient to make payments to all eligible individuals. An individual may apply to be placed on the waiting list even though the individual does not reside in one of the homes or facilities specified in division (C)(1) of this section at the time of application. The director of aging, by rules adopted in accordance with Chapter 119. of the Revised Code, shall specify procedures and requirements for placing an individual on the waiting list and priorities for the order in which individuals placed on the waiting list are to begin to receive residential state supplement payments. The rules specifying priorities may give priority to individuals placed on the waiting list on or after July 1, 2006, who receive supplemental security income benefits under Title XVI of the “Social Security Act,” 86 Stat. 1475 (1972), 42 U.S.C. 1381, as amended. The rules shall not affect the place on the waiting list of any person who was on the list on July 1, 2006. The rules specifying priorities may also set additional priorities based on living arrangement, such as whether an individual resides in a facility listed in division (C)(1) of this section or has been admitted to a nursing facility.

(G) An individual in a licensed or certified living arrangement receiving state supplementation on November 15, 1990, under former section 5101.531 of the Revised Code shall not become ineligible for payments under this section solely by reason of the individual’s living arrangement as long as the individual remains in the living arrangement in which the individual resided on November 15, 1990.

(H) The department of aging shall notify each person denied approval for payments under this section of the person’s right to a hearing. On request, the hearing shall be provided by the department of job and family services in accordance with section 5101.35 of the Revised Code.

Effective Date: 09-05-2001; 2007 HB119 06-30-2007

(A) As used in this section:

“Area agency on aging” has the same meaning as in section 173.14 of the Revised Code.

“Long-term care consultation program” means the program the department of aging is required to develop under section 173.42 of the Revised Code.

“Long-term care consultation program administrator” or “administrator” means the department of aging or, if the department contracts with an area agency on aging or other entity to administer the long-term care consultation program for a particular area, that agency or entity.

“Nursing facility” has the same meaning as in section 5111.20 of the Revised Code.

“Residential state supplement program” means the program administered pursuant to section 173.35 of the Revised Code.

(B) Each month, each area agency on aging shall determine whether individuals who reside in the area that the area agency on aging serves and are on a waiting list for the residential state supplement program have been admitted to a nursing facility. If an area agency on aging determines that such an individual has been admitted to a nursing facility, the agency shall notify the long-term care consultation program administrator serving the area in which the individual resides about the determination. The administrator shall determine whether the residential state supplement program is appropriate for the individual and whether the individual would rather participate in the program than continue residing in the nursing facility. If the administrator determines that the residential state supplement program is appropriate for the individual and the individual would rather participate in the program than continue residing in the nursing facility, the administrator shall so notify the department of aging. On receipt of the notice from the administrator, the department of aging shall approve the individual’s enrollment in the residential state supplement program in accordance with the priorities specified in rules adopted under division (F) of section 173.35 of the Revised Code. Each quarter, the department of aging shall certify to the director of budget and management the estimated increase in costs of the residential state supplement program resulting from enrollment of individuals in the program pursuant to this section.

(C) Not later than the last day of each calendar year, the director of aging shall submit to the general assembly a report regarding the number of individuals enrolled in the residential state supplement program pursuant to this section and the costs incurred and savings achieved as a result of the enrollments.

Effective Date: 2007 HB119 07-01-2007

As used in this section, “adult foster home” means a residence, other than a residence certified or licensed by the department of mental health, in which accommodations and personal care services, as defined in section 3722.01 of the Revised Code, are provided to one or two adults who are unrelated to the owners of the residence.

The department of aging shall adopt rules in accordance with Chapter 119. of the Revised Code establishing standards for the certification of adult foster homes. The department or its designee shall certify adult foster homes that apply for certification and meet the standards established by the department.

Effective Date: 07-01-1993

(A) As used in sections 173.39 to 173.394 of the Revised Code:

(1) “Community-based long-term care agency” means a person or government entity that provides community-based long-term care services under a program the department of aging administers, regardless of whether the person or government entity is certified under section 173.391 or authorized to receive payment for the services from the department under section 173.392 of the Revised Code. “Community-based long-term care agency” includes a person or government entity that provides home and community-based services to older adults through the PASSPORT program created under section 173.40 of the Revised Code.

(2) “Community-based long-term care services” has the same meaning as in section 173.14 of the Revised Code.

(B) Except as provided in section 173.392 of the Revised Code, the department of aging may not pay a person or government entity for providing community-based long-term care services under a program the department administers unless the person or government entity is certified under section 173.391 of the Revised Code and provides the services.

Effective Date: 09-29-2005; 06-30-2006

(A) The department of aging or its designee shall do all of the following in accordance with Chapter 119. of the Revised Code:

(1) Certify a person or government entity to provide community-based long-term care services under a program the department administers if the person or government entity satisfies the requirements for certification established by rules adopted under division (B) of this section;

(2) When required to do so by rules adopted under division (B) of this section, take one or more of the following disciplinary actions against a person or government entity issued a certificate under division (A)(1) of this section:

(a) Issue a written warning;

(b) Require the submission of a plan of correction;

(c) Suspend referrals;

(d) Remove clients;

(e) Impose a fiscal sanction such as a civil monetary penalty or an order that unearned funds be repaid;

(f) Revoke the certificate;

(g) Impose another sanction.

(3) Hold hearings when there is a dispute between the department or its designee and a person or government entity concerning actions the department or its designee takes or does not take under division (A)(1) or (2)(c) to (g) of this section.

(B) The director of aging shall adopt rules in accordance with Chapter 119. of the Revised Code establishing certification requirements and standards for determining which type of disciplinary action to take under division (A)(2) of this section in individual situations. The rules shall establish procedures for all of the following:

(1) Ensuring that community-based long-term care agencies comply with section 173.394 of the Revised Code;

(2) Evaluating the services provided to ensure that they are provided in a quality manner advantageous to the individual receiving the services;

(3) Determining when to take disciplinary action under division (A)(2) of this section and which disciplinary action to take.

(C) The procedures established in rules adopted under division (B)(2) of this section shall require that all of the following be considered as part of an evaluation:

(1) The service provider’s experience and financial responsibility;

(2) The service provider’s ability to comply with standards for the community-based long-term care services that the provider provides under a program the department administers;

(3) The service provider’s ability to meet the needs of the individuals served;

(4) Any other factor the director considers relevant.

(D) The rules adopted under division (B)(3) of this section shall specify that the reasons disciplinary action may be taken under division (A)(2) of this section include good cause, including misfeasance, malfeasance, nonfeasance, confirmed abuse or neglect, financial irresponsibility, or other conduct the director determines is injurious to the health or safety of individuals being served.

Effective Date: 09-29-2005; 06-30-2006

(A) The department of aging may pay a person or government entity for providing community-based long-term care services under a program the department administers, even though the person or government entity is not certified under section 173.391 of the Revised Code if all of the following are the case:

(1) The person or government entity has a contract with the department of aging or the department’s designee to provide the services;

(2) The contract includes detailed conditions of participation for providers of services under a program the department administers and service standards that the person or government entity is required to satisfy;

(3) The person or government entity complies with the contract;

(4) The contract is not for medicaid-funded services, other than services provided under the PACE program administered by the department of aging under section 173.50 of the Revised Code.

(B) The director of aging shall adopt rules in accordance with Chapter 119. of the Revised Code governing both of the following:

(1) Contracts between the department of aging and persons and government entities regarding community-based long-term care services provided under a program the department administers;

(2) The department’s payment for community-based long-term care services provided under such a contract.

Effective Date: 09-29-2005

(A) Except as provided in division (B) of this section, the records of an evaluation conducted in accordance with rules adopted under division (B)(2) of section 173.391 of the Revised Code are public records for purposes of section 149.43 of the Revised Code and shall be made available on request of any person, including individuals receiving or seeking community-based long-term care services under a program the department of aging administers.

(B) A part of a record of an evaluation that is otherwise available as a public record under division (A) of this section is not available as a public record if its release would violate a federal or state statute, regulation, or rule, including regulations adopted by the United States department of health and human services to implement the health information privacy provisions of the “Health Insurance Portability and Accountability Act of 1996,” 110 Stat. 1955, 42 U.S.C. 1320d, et seq., as amended.

Effective Date: 09-29-2005

(A) As used in this section:

(1) “Applicant” means a person who is under final consideration for employment with a community-based long-term care agency in a full-time, part-time, or temporary position that involves providing direct care to an individual. “Applicant” does not include a person who provides direct care as a volunteer without receiving or expecting to receive any form of remuneration other than reimbursement for actual expenses.

(2) “Criminal records check” has the same meaning as in section 109.572 of the Revised Code.

(B)(1) Except as provided in division (I) of this section, the chief administrator of a community-based long-term care agency shall request that the superintendent of the bureau of criminal identification and investigation conduct a criminal records check with respect to each applicant. If an applicant for whom a criminal records check request is required under this division does not present proof of having been a resident of this state for the five-year period immediately prior to the date the criminal records check is requested or provide evidence that within that five-year period the superintendent has requested information about the applicant from the federal bureau of investigation in a criminal records check, the chief administrator shall request that the superintendent obtain information from the federal bureau of investigation as part of the criminal records check of the applicant. Even if an applicant for whom a criminal records check request is required under this division presents proof of having been a resident of this state for the five-year period, the chief administrator may request that the superintendent include information from the federal bureau of investigation in the criminal records check.

(2) A person required by division (B)(1) of this section to request a criminal records check shall do both of the following:

(a) Provide to each applicant for whom a criminal records check request is required under that division a copy of the form prescribed pursuant to division (C)(1) of section 109.572 of the Revised Code and a standard fingerprint impression sheet prescribed pursuant to division (C)(2) of that section, and obtain the completed form and impression sheet from the applicant;

(b) Forward the completed form and impression sheet to the superintendent of the bureau of criminal identification and investigation.

(3) An applicant provided the form and fingerprint impression sheet under division (B)(2)(a) of this section who fails to complete the form or provide fingerprint impressions shall not be employed in any position for which a criminal records check is required by this section.

(C)(1) Except as provided in rules adopted by the department of aging in accordance with division (F) of this section and subject to division (C)(2) of this section, no community-based long-term care agency shall employ a person in a position that involves providing direct care to an individual if the person has been convicted of or pleaded guilty to any of the following:

(a) A violation of section 2903.01, 2903.02, 2903.03, 2903.04, 2903.11, 2903.12, 2903.13, 2903.16, 2903.21, 2903.34, 2905.01, 2905.02, 2905.11, 2905.12, 2907.02, 2907.03, 2907.05, 2907.06, 2907.07, 2907.08, 2907.09, 2907.12, 2907.25, 2907.31, 2907.32, 2907.321, 2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 2911.12, 2911.13, 2913.02, 2913.03, 2913.04, 2913.11, 2913.21, 2913.31, 2913.40, 2913.43, 2913.47, 2913.51, 2919.25, 2921.36, 2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.11, 2925.13, 2925.22, 2925.23, or 3716.11 of the Revised Code.

(b) A violation of an existing or former law of this state, any other state, or the United States that is substantially equivalent to any of the offenses listed in division (C)(1)(a) of this section.

(2)(a) A community-based long-term care agency may employ conditionally an applicant for whom a criminal records check request is required under division (B) of this section prior to obtaining the results of a criminal records check regarding the individual, provided that the agency shall request a criminal records check regarding the individual in accordance with division (B)(1) of this section not later than five business days after the individual begins conditional employment. In the circumstances described in division (I)(2) of this section, a community-based long-term care agency may employ conditionally an applicant who has been referred to the agency by an employment service that supplies full-time, part-time, or temporary staff for positions involving the direct care of individuals and for whom, pursuant to that division, a criminal records check is not required under division (B) of this section.

(b) A community-based long-term care agency that employs an individual conditionally under authority of division (C)(2)(a) of this section shall terminate the individual’s employment if the results of the criminal records check request under division (B) of this section or described in division (I)(2) of this section, other than the results of any request for information from the federal bureau of investigation, are not obtained within the period ending sixty days after the date the request is made. Regardless of when the results of the criminal records check are obtained, if the results indicate that the individual has been convicted of or pleaded guilty to any of the offenses listed or described in division (C)(1) of this section, the agency shall terminate the individual’s employment unless the agency chooses to employ the individual pursuant to division (F) of this section. Termination of employment under this division shall be considered just cause for discharge for purposes of division (D)(2) of section 4141.29 of the Revised Code if the individual makes any attempt to deceive the agency about the individual’s criminal record.

(D)(1) Each community-based long-term care agency shall pay to the bureau of criminal identification and investigation the fee prescribed pursuant to division (C)(3) of section 109.572 of the Revised Code for each criminal records check conducted pursuant to a request made under division (B) of this section.

(2) A community-based long-term care agency may charge an applicant a fee not exceeding the amount the agency pays under division (D)(1) of this section. An agency may collect a fee only if both of the following apply:

(a) The agency notifies the person at the time of initial application for employment of the amount of the fee and that, unless the fee is paid, the person will not be considered for employment;

(b) The medicaid program established under Chapter 5111. of the Revised Code does not reimburse the agency the fee it pays under division (D)(1) of this section.

(E) The report of any criminal records check conducted pursuant to a request made under this section is not a public record for the purposes of section 149.43 of the Revised Code and shall not be made available to any person other than the following:

(1) The individual who is the subject of the criminal records check or the individual’s representative;

(2) The chief administrator of the agency requesting the criminal records check or the administrator’s representative;

(3) The administrator of any other facility, agency, or program that provides direct care to individuals that is owned or operated by the same entity that owns or operates the community-based long-term care agency;

(4) The director of aging or a person authorized by the director to monitor a community-based long-term care agency’s compliance with this section;

(5) A court, hearing officer, or other necessary individual involved in a case dealing with a denial of employment of the applicant or dealing with employment or unemployment benefits of the applicant;

(6) Any person to whom the report is provided pursuant to, and in accordance with, division (I)(1) or (2) of this section.

(F) The department of aging shall adopt rules in accordance with Chapter 119. of the Revised Code to implement this section. The rules shall specify circumstances under which a community-based long-term care agency may employ a person who has been convicted of or pleaded guilty to an offense listed or described in division (C)(1) of this section but meets personal character standards set by the department.

(G) The chief administrator of a community-based long-term care agency shall inform each person, at the time of initial application for a position that involves providing direct care to an individual, that the person is required to provide a set of fingerprint impressions and that a criminal records check is required to be conducted if the person comes under final consideration for employment.

(H) In a tort or other civil action for damages that is brought as the result of an injury, death, or loss to person or property caused by an individual who a community-based long-term care agency employs in a position that involves providing direct care to individuals, all of the following shall apply:

(1) If the agency employed the individual in good faith and reasonable reliance on the report of a criminal records check requested under this section, the agency shall not be found negligent solely because of its reliance on the report, even if the information in the report is determined later to have been incomplete or inaccurate;

(2) If the agency employed the individual in good faith on a conditional basis pursuant to division (C)(2) of this section, the agency shall not be found negligent solely because it employed the individual prior to receiving the report of a criminal records check requested under this section;

(3) If the agency in good faith employed the individual according to the personal character standards established in rules adopted under division (F) of this section, the agency shall not be found negligent solely because the individual prior to being employed had been convicted of or pleaded guilty to an offense listed or described in division (C)(1) of this section.

(I)(1) The chief administrator of a community-based long-term care agency is not required to request that the superintendent of the bureau of criminal identification and investigation conduct a criminal records check of an applicant if the applicant has been referred to the agency by an employment service that supplies full-time, part-time, or temporary staff for positions involving the direct care of individuals and both of the following apply:

(a) The chief administrator receives from the employment service or the applicant a report of the results of a criminal records check regarding the applicant that has been conducted by the superintendent within the one-year period immediately preceding the applicant’s referral;

(b) The report of the criminal records check demonstrates that the person has not been convicted of or pleaded guilty to an offense listed or described in division (C)(1) of this section, or the report demonstrates that the person has been convicted of or pleaded guilty to one or more of those offenses, but the community-based long-term care agency chooses to employ the individual pursuant to division (F) of this section.

(2) The chief administrator of a community-based long-term care agency is not required to request that the superintendent of the bureau of criminal identification and investigation conduct a criminal records check of an applicant and may employ the applicant conditionally as described in this division, if the applicant has been referred to the agency by an employment service that supplies full-time, part-time, or temporary staff for positions involving the direct care of individuals and if the chief administrator receives from the employment service or the applicant a letter from the employment service that is on the letterhead of the employment service, dated, and signed by a supervisor or another designated official of the employment service and that states that the employment service has requested the superintendent to conduct a criminal records check regarding the applicant, that the requested criminal records check will include a determination of whether the applicant has been convicted of or pleaded guilty to any offense listed or described in division (C)(1) of this section, that, as of the date set forth on the letter, the employment service had not received the results of the criminal records check, and that, when the employment service receives the results of the criminal records check, it promptly will send a copy of the results to the community-based long-term care agency. If a community-based long-term care agency employs an applicant conditionally in accordance with this division, the employment service, upon its receipt of the results of the criminal records check, promptly shall send a copy of the results to the community-based long-term care agency, and division (C)(2)(b) of this section applies regarding the conditional employment.

Effective Date: 06-30-2006

There is hereby created a medicaid waiver component , as defined in section 5111.85 of the Revised Code, to be known as the preadmission screening system providing options and resources today program, or PASSPORT. The PASSPORT program shall provide home and community-based services as an alternative to nursing facility placement for aged and disabled medicaid recipients. The program shall be operated pursuant to a home and community-based waiver granted by the United States secretary of health and human services under section 1915 of the “Social Security Act,” 49 Stat. 620 (1935), 42 U.S.C. 1396n, as amended. The department of aging shall administer the program through a contract entered into with the department of job and family services under section 5111.91 of the Revised Code. The director of job and family services shall adopt rules under section 5111.85 of the Revised Code and the director of aging shall adopt rules in accordance with Chapter 119. of the Revised Code to implement the program.

Effective Date: 06-05-2002; 09-29-2005

(A) As used in this section:

“Area agency on aging” has the same meaning as in section 173.14 of the Revised Code.

“Long-term care consultation program” means the program the department of aging is required to develop under section 173.42 of the Revised Code.

“Long-term care consultation program administrator” or “administrator” means the department of aging or, if the department contracts with an area agency on aging or other entity to administer the long-term care consultation program for a particular area, that agency or entity.

“Nursing facility” has the same meaning as in section 5111.20 of the Revised Code.

“PASSPORT program” means the program created under section 173.40 of the Revised Code.

“PASSPORT waiver” means the federal medicaid waiver granted by the United States secretary of health and human services that authorizes the PASSPORT program.

(B) The director of job and family services shall submit to the United States secretary of health and human services an amendment to the PASSPORT waiver that authorizes additional enrollments in the PASSPORT program pursuant to this section. Beginning with the month following the month in which the United States secretary approves the amendment and each month thereafter, each area agency on aging shall determine whether individuals who reside in the area that the area agency on aging serves and are on a waiting list for the PASSPORT program have been admitted to a nursing facility. If an area agency on aging determines that such an individual has been admitted to a nursing facility, the agency shall notify the long-term care consultation program administrator serving the area in which the individual resides about the determination. The administrator shall determine whether the PASSPORT program is appropriate for the individual and whether the individual would rather participate in the PASSPORT program than continue residing in the nursing facility. If the administrator determines that the PASSPORT program is appropriate for the individual and the individual would rather participate in the PASSPORT program than continue residing in the nursing facility, the administrator shall so notify the department of aging. On receipt of the notice from the administrator, the department of aging shall approve the individual’s enrollment in the PASSPORT program regardless of the PASSPORT program’s waiting list and even though the enrollment causes enrollment in the program to exceed the limit that would otherwise apply. Each quarter, the department of aging shall certify to the director of budget and management the estimated increase in costs of the PASSPORT program resulting from enrollment of individuals in the PASSPORT program pursuant to this section.

(C) Not later than the last day of each calendar year, the director of job and family services shall submit to the general assembly a report regarding the number of individuals enrolled in the PASSPORT program pursuant to this section and the costs incurred and savings achieved as a result of the enrollments.

Effective Date: 2007 HB119 07-01-2007

Effective Date: 06-30-2006

(A) As used in this section:

(1) “Area agency on aging” means a public or private nonprofit entity designated under section 173.011 of the Revised Code to administer programs on behalf of the department of aging.

(2) “Long-term care consultation” means the process used to provide services under the long-term care consultation program established pursuant to this section, including, but not limited to, such services as the provision of information about long-term care options and costs, the assessment of an individual’s functional capabilities, and the conduct of all or part of the reviews, assessments, and determinations specified in sections 5111.202, 5111.204, 5119.061, and 5123.021 of the Revised Code and the rules adopted under those sections.

(3) “Medicaid” means the medical assistance program established under Chapter 5111. of the Revised Code.

(4) “Nursing facility” has the same meaning as in section 5111.20 of the Revised Code.

(5) “Representative” means a person acting on behalf of an individual seeking a long-term care consultation, applying for admission to a nursing facility, or residing in a nursing facility. A representative may be a family member, attorney, hospital social worker, or any other person chosen to act on behalf of the individual.

(B) The department of aging shall develop a long-term care consultation program whereby individuals or their representatives are provided with long-term care consultations and receive through these professional consultations information about options available to meet long-term care needs and information about factors to consider in making long-term care decisions. The long-term care consultations provided under the program may be provided at any appropriate time, as permitted or required under this section and the rules adopted under it, including either prior to or after the individual who is the subject of a consultation has been admitted to a nursing facility.

(C) The long-term care consultation program shall be administered by the department of aging, except that the department may enter into a contract with an area agency on aging or other entity selected by the department under which the program for a particular area is administered by the area agency on aging or other entity pursuant to the contract.

(D) The long-term care consultations provided for purposes of the program shall be provided by individuals certified by the department under section 173.43 of the Revised Code.

(E) The information provided through a long-term care consultation shall be appropriate to the individual’s needs and situation and shall address all of the following:

(1) The availability of any long-term care options open to the individual;

(2) Sources and methods of both public and private payment for long-term care services;

(3) Factors to consider when choosing among the available programs, services, and benefits;

(4) Opportunities and methods for maximizing independence and self-reliance, including support services provided by the individual’s family, friends, and community.

(F) An individual’s long-term care consultation may include an assessment of the individual’s functional capabilities. The consultation may incorporate portions of the determinations required under sections 5111.202, 5119.061, and 5123.021 of the Revised Code and may be provided concurrently with the assessment required under section 5111.204 of the Revised Code.

(G)(1) Unless an exemption specified in division (I) of this section is applicable, each individual in the following categories shall be provided with a long-term care consultation:

(a) Individuals who apply or indicate an intention to apply for admission to a nursing facility, regardless of the source of payment to be used for their care in a nursing facility;

(b) Nursing facility residents who apply or indicate an intention to apply for medicaid;

(c) Nursing facility residents who are likely to spend down their resources within six months after admission to a nursing facility to a level at which they are financially eligible for medicaid;

(d) Individuals who request a long-term care consultation.

(2) In addition to the individuals included in the categories specified in division (G)(1) of this section, long-term care consultations may be provided to nursing facility residents who have not applied and have not indicated an intention to apply for medicaid. The purpose of the consultations provided to these individuals shall be to determine continued need for nursing facility services, to provide information on alternative services, and to make referrals to alternative services.

(H)(1) When a long-term care consultation is required to be provided pursuant to division (G)(1) of this section, the consultation shall be provided as follows or pursuant to division (H)(2) or (3) of this section:

(a) If the individual for whom the consultation is being provided has applied for medicaid and the consultation is being provided concurrently with the assessment required under section 5111.204 of the Revised Code, the consultation shall be completed in accordance with the applicable time frames specified in that section for providing a level of care determination based on the assessment.

(b) In all other cases, the consultation shall be provided not later than five calendar days after the department or the program administrator under contract with the department receives notice of the reason for which the consultation is required to be provided pursuant to division (G)(1) of this section.

(2) An individual or the individual’s representative may request that a long-term care consultation be provided on a date that is later than the date required under division (H)(1)(a) or (b) of this section.

(3) If a long-term care consultation cannot be completed within the number of days required by division (H)(1) or (2) of this section, the department or the program administrator under contract with the department may do any of the following:

(a) Exempt the individual from the consultation pursuant to rules that may be adopted under division (L) of this section;

(b) In the case of an applicant for admission to a nursing facility, provide the consultation after the individual is admitted to the nursing facility;

(c) In the case of a resident of a nursing facility, provide the consultation as soon as practicable.

(I) An individual is not required to be provided a long-term care consultation under this section if any of the following apply:

(1) The individual or the individual’s representative chooses to forego participation in the consultation pursuant to criteria specified in rules adopted under division (L) of this section ;

(2) The individual is to receive care in a nursing facility under a contract for continuing care as defined in section 173.13 of the Revised Code;

(3) The individual has a contractual right to admission to a nursing facility operated as part of a system of continuing care in conjunction with one or more facilities that provide a less intensive level of services, including a residential care facility licensed under Chapter 3721. of the Revised Code, an adult care facility licensed under Chapter 3722. of the Revised Code, or an independent living arrangement;

(4) The individual is to receive continual care in a home for the aged exempt from taxation under section 5701.13 of the Revised Code;

(5) The individual is seeking admission to a facility that is not a nursing facility with a provider agreement under section 5111.22 of the Revised Code;

(6) The individual is to be transferred from another nursing facility;

(7) The individual is to be readmitted to a nursing facility following a period of hospitalization;

(8) The individual is exempted from the long-term care consultation requirement by the department or the program administrator pursuant to rules that may be adopted under division (L) of this section.

(J) At the conclusion of an individual’s long-term care consultation, the department or the program administrator under contract with the department shall provide the individual or individual’s representative with a written summary of options and resources available to meet the individual’s needs. Even though the summary may specify that a source of long-term care other than care in a nursing facility is appropriate and available, the individual is not required to seek an alternative source of long-term care and may be admitted to or continue to reside in a nursing facility .

(K) No nursing facility for which an operator has a provider agreement under section 5111.22 of the Revised Code shall admit or retain any individual as a resident, unless the nursing facility has received evidence that a long-term care consultation has been completed for the individual or division (I) of this section is applicable to the individual.

(L) The director of aging may adopt any rules the director considers necessary for the implementation and administration of this section. The rules shall be adopted in accordance with Chapter 119. of the Revised Code and may specify any or all of the following:

(1) Procedures for providing long-term care consultations pursuant to this section;

(2) Information to be provided through long-term care consultations regarding long-term care services that are available;

(3) Criteria under which an individual or the individual’s representative may choose to forego participation in a long-term care consultation;

(4) Criteria for exempting individuals from the long-term care consultation requirement;

(5) Circumstances under which it may be appropriate to provide an individual’s long-term care consultation after the individual’s admission to a nursing facility rather than before admission;

(6) Criteria for identifying nursing facility residents who would benefit from the provision of a long-term care consultation.

(M) The director of aging may fine a nursing facility an amount determined by rules the director shall adopt in accordance with Chapter 119. of the Revised Code if the nursing facility admits or retains an individual, without evidence that a long-term care consultation has been provided, as required by this section.

In accordance with section 5111.62 of the Revised Code, all fines collected under this division shall be deposited into the state treasury to the credit of the residents protection fund .

Effective Date: 09-29-2005

The department of aging shall certify individuals who meet certification requirements established by rule to provide long-term care consultations for purposes of section 173.42 of the Revised Code. The director of aging shall adopt rules in accordance with Chapter 119. of the Revised Code governing the certification process and requirements. The rules shall specify the education, experience, or training in long-term care a person must have to qualify for certification.

Effective Date: 09-29-2005

(A) As used in this section, “nursing home” and “residential care facility” have the same meanings as in section 3721.01 of the Revised Code.

(B) The department of aging may conduct an annual survey of nursing homes and residential care facilities. The survey shall include questions about capacity, occupancy, and private pay charges. The department may contract with an outside entity to conduct the survey and analyze the results. The results of the survey and any analysis completed by the department or its designee shall be made available to the general assembly, other state agencies, nursing home and residential care facility providers, and the general public.

(C) No nursing home or residential care facility shall recklessly fail to complete the survey.

Effective Date: 09-29-2005

As used in this section and in sections 173.46 to 173.49 of the Revised Code:

(A) “Long-term care facility” means a nursing home or residential care facility.

(B) “Nursing home” and “residential care facility” have the same meanings as in section 3721.01 of the Revised Code.

(C) “Nursing facility” has the same meaning as in section 5111.20 of the Revised Code.

Effective Date: 09-29-2005

(A) The department of aging shall develop and publish a guide to long-term care facilities for use by individuals considering long-term care facility admission and their families, friends, and advisors. The guide, which shall be titled the Ohio long-term care consumer guide, may be published in printed form or in electronic form for distribution over the internet. The guide may be developed as a continuation or modification of the guide published by the department prior to the effective date of this section under rules adopted under section 173.02 of the Revised Code.

(B) The Ohio long-term care consumer guide shall include information on each long-term care facility in this state. For each facility, the guide shall include the following information, as applicable to the facility:

(1) Information regarding the facility’s compliance with state statutes and rules and federal statutes and regulations;

(2) Information generated by the centers for medicare and medicaid services of the United States department of health and human services from the quality measures developed as part of its nursing home quality initiative;

(3) Results of the customer satisfaction surveys conducted under section 173.47 of the Revised Code;

(4) Any other information the department specifies in rules adopted under section 173.49 of the Revised Code.

Effective Date: 09-29-2005

(A) For purposes of publishing the Ohio long-term care consumer guide, the department of aging shall conduct or provide for the conduct of an annual customer satisfaction survey of each long-term care facility. The results of the surveys may include information obtained from long-term care facility residents, their families, or both.

(B)(1) The department may charge fees for the conduct of annual customer satisfaction surveys. The department may contract with any person or government entity to collect the fees on its behalf. All fees collected under this section shall be deposited in accordance with section 173.48 of the Revised Code.

(2) The fees charged under this section shall not exceed the following amounts:

(a) Four hundred dollars for the customer satisfaction survey of a long-term care facility that is a nursing home;

(b) Three hundred dollars for the customer satisfaction survey pertaining to a long-term care facility that is a residential care facility.

(3) Fees paid by a long-term care facility that is a nursing facility shall be reimbursed through the medicaid program operated under Chapter 5111. of the Revised Code.

(C) Each long-term care facility shall cooperate in the conduct of its annual customer satisfaction survey.

Effective Date: 09-29-2005

There is hereby created in the state treasury the long-term care consumer guide fund. Money collected from the fees charged for the conduct of customer satisfaction surveys under section 173.47 of the Revised Code shall be credited to the fund. The department of aging shall use money in the fund for costs associated with publishing the Ohio long-term care consumer guide, including, but not limited to, costs incurred in conducting or providing for the conduct of customer satisfaction surveys.

Effective Date: 09-29-2005

The department of aging shall adopt rules as the department considers necessary to implement and administer sections 173.45 to 173.48 of the Revised Code. The rules shall be adopted under Chapter 119. of the Revised Code.

Effective Date: 09-29-2005

(A) Pursuant to a contract entered into with the department of job and family services as an interagency agreement under section 5111.91 of the Revised Code, the department of aging shall carry out the day-to-day administration of the component of the medicaid program established under Chapter 5111. of the Revised Code known as the program of all-inclusive care for the elderly or PACE. The department of aging shall carry out its PACE administrative duties in accordance with the provisions of the interagency agreement and all applicable federal laws, including the “Social Security Act,” 79 Stat. 286 (1965), 42 U.S.C. 1396u-4, as amended.

(B) The department of aging may adopt rules in accordance with Chapter 119. of the Revised Code regarding the PACE program, subject to both of the following:

(1) The rules shall be authorized by rules adopted by the department of job and family services.

(2) The rules shall address only those issues that are not addressed in rules adopted by the department of job and family services for the PACE program.

Effective Date: 09-29-2005

Effective Date: 06-26-2003

As used in sections 173.71 to 173.91 of the Revised Code:

(A) “Children’s health insurance program” means the children’s health insurance program part I, part II, and part III established under sections 5101.50 to 5101.529 of the Revised Code.

(B) “Disability medical assistance program” means the program established under section 5115.10 of the Revised Code.

(C) “Medicaid program” or “medicaid” means the medical assistance program established under Chapter 5111. of the Revised Code.

(D) “National drug code number” means the number registered for a drug pursuant to the listing system established by the United States food and drug administration under the “Drug Listing Act of 1972,” 86 Stat. 559, 21 U.S.C. 360, as amended.

(E) “Ohio’s best Rx program participant” or “participant” means an individual determined eligible for the Ohio’s best Rx program and included under an Ohio’s best Rx program enrollment card.

(F) “Participating manufacturer” means a drug manufacturer participating in the Ohio’s best Rx program pursuant to a manufacturer agreement entered into under section 173.81 of the Revised Code.

(G) “Participating terminal distributor” means a terminal distributor of dangerous drugs participating in the Ohio’s best Rx program pursuant to an agreement entered into under section 173.79 of the Revised Code.

(H) “Political subdivision” has the same meaning as in section 9.23 of the Revised Code.

(I) “State agency” has the same meaning as in section 9.23 of the Revised Code.

(J) “Terminal distributor of dangerous drugs” has the same meaning as in section 4729.01 of the Revised Code.

(K) “Third-party payer” has the same meaning as in section 3901.38 of the Revised Code.

(L) “Trade secret” has the same meaning as in section 1333.61 of the Revised Code.

(M) “Usual and customary charge” means the amount a participating terminal distributor or the drug mail order system included in the Ohio’s best Rx program pursuant to section 173.78 of the Revised Code charges when a drug included in the program is purchased by an individual who does not receive a discounted price for the drug pursuant to any drug discount program, including the Ohio’s best Rx program or a pharmacy assistance program established by any person or government entity, and for whom no third-party payer or program funded in whole or part with state or federal funds is responsible for all or part of the cost of the drug.

Effective Date: 07-01-2007; 2007 HB119 09-29-2007

There is hereby established the Ohio’s best Rx program for the purpose of providing outpatient prescription drug discounts to individuals residing in this state who are enrolled in the program by meeting the eligibility requirements specified in section 173.76 of the Revised Code, including eligible individuals who are sixty years of age or older, eligible individuals who have low incomes but are not eligible for medicaid, and other eligible individuals who do not have health benefits that cover outpatient drugs. The program shall include all drugs that are included in a manufacturer agreement entered into under section 173.81 of the Revised Code and all other drugs that may be dispensed only pursuant to a prescription issued by a licensed health professional authorized to prescribe drugs, as defined in section 4729.01 of the Revised Code.

Effective Date: 07-01-2007

(A) Except as provided in division (B) of this section, the Ohio’s best Rx program shall be administered by the department of aging.

(B)(1) The department may enter into a contract with any person under which the person serves as the administrator of the Ohio’s best Rx program. Before entering into a contract for a program administrator, the department shall issue a request for proposals from persons seeking to be considered. The department shall develop a process to be used in issuing the request for proposals, receiving responses to the request, and evaluating the responses on a competitive basis. In accordance with that process, the department shall select the person to be awarded the contract.

(2) Subject to divisions (B)(5) and (6) of this section, the department may delegate to the person awarded the contract any of the department’s powers or duties specified in sections 173.71 to 173.91 of the Revised Code or any other provision of the Revised Code pertaining to the Ohio’s best Rx program. The terms of the contract shall specify the extent to which the powers or duties are delegated to the program administrator.

(3) In exercising powers or performing duties delegated under the contract, the program administrator is subject to the same provisions of sections 173.71 to 173.91 of the Revised Code or other provisions of the Revised Code that grant the powers or duties to the department, as well as any limitations or restrictions that are applicable to or associated with those powers or duties.

(4) Wherever the department is referred to in sections 173.71 to 173.91 of the Revised Code or another provision of the Revised Code relative to a power or duty delegated to the program administrator, both of the following apply:

(a) If the department has delegated the power or duty in whole to the program administrator, the reference to the department is, instead, a reference to the administrator.

(b) If the department retains any part of the power or duty that is delegated to the program administrator, the reference to the department is a reference to both the department and the administrator.

(5) The terms of a contract for a program administrator shall include provisions for offering the drug mail order system included in the Ohio’s best Rx program pursuant to section 173.78 of the Revised Code. The terms of the contract may permit the administrator to offer the drug mail order system by contracting with another person.

(6) The department shall not delegate to a program administrator the department’s powers or duties to do any of the following:

(a) Enter into contracts under this section other than a contract to offer a drug mail order system;

(b) Receive verification of drug pricing information under section 173.742 of the Revised Code or verification of drug manufacturer payment information under section 173.814 of the Revised Code from the pharmacy benefit manager selected under section 173.731 of the Revised Code to serve as the Ohio’s best Rx program’s consulting pharmacy benefit manager;

(c) Request the program’s consulting pharmacy benefit manager to provide for an audit under section 173.732 of the Revised Code;

(d) Review or use any information contained in or pertaining to an audit provided for by the program’s consulting pharmacy benefit manager other than the audit’s findings of whether the consulting pharmacy benefit manager provided valid information when providing drug pricing verification services or drug manufacturer payment verification services;

(e) Adopt rules under section 173.83 or 173.84 of the Revised Code;

(f) Employ an ombudsperson pursuant to section 173.723 of the Revised Code.

Effective Date: 07-01-2007

The department of aging shall undertake outreach efforts to publicize the Ohio’s best Rx program and maximize participation in the program.

Effective Date: 07-01-2007

The department of aging shall employ an ombudsperson to assist terminal distributors of dangerous drugs with grievances regarding the Ohio’s best Rx program.

Effective Date: 07-01-2007

The department of aging may coordinate the Ohio’s best Rx program with either of the following:

(A) The golden buckeye card program established under section 173.06 of the Revised Code. In coordinating the programs, the department may establish a card that serves as both a golden buckeye card provided under section 173.06 of the Revised Code and an Ohio’s best Rx program enrollment card issued under section 173.773 of the Revised Code. The department may identify the card by including the names of both programs on the card or by selecting a combined name for inclusion on the card.

(B) Any health benefit plan offered to the employees of state agencies and the eligible dependents of those employees, for purposes of enhancing efficiency, reducing the cost of drugs, and maximizing the benefits of the Ohio’s best Rx program and the health benefit plan.

Effective Date: 07-01-2007

(A) Any entity that provides services as a pharmacy benefit manager relative to the outpatient drug coverage included in a health benefit plan offered to the employees or retirees of a state agency or political subdivision and the eligible dependents of those employees or retirees shall provide drug pricing verification services under section 173.742 of the Revised Code and drug manufacturer payment verification services under section 173.814 of the Revised Code if the entity is selected under section 173.731 of the Revised Code by the department of aging to serve as the Ohio’s best Rx program’s consulting pharmacy benefit manager for purposes of providing the verification services.

(B) Both of the following apply to the entity selected to serve as the Ohio’s best Rx program’s consulting pharmacy benefit manager:

(1) The entity shall provide the drug pricing verification services and drug manufacturer payment verification services without charge, either to the Ohio’s best Rx program or to the state agency or political subdivision for which it provides services as a pharmacy benefit manager.

(2) The entity shall provide the verification services for the entire year for which it is selected to serve as the program’s consulting pharmacy benefit manager, regardless of the duration or termination of its responsibility to the state agency or political subdivision for which it provides services as a pharmacy benefit manager.

(C) If the entity selected to serve as the consulting pharmacy benefit manager fails to provide the program with drug pricing verification services or drug manufacturer payment verification services, or fails to provide for an audit when requested to do so under section 173.732 of the Revised Code, the department may ask the attorney general to bring an action for injunctive relief in any court of competent jurisdiction. On the filing of an appropriate petition in the court, the court shall conduct a hearing on the petition. If it is demonstrated in the proceedings that the pharmacy benefit manager has failed to provide the verification services or has failed to provide for the audit, the court shall grant a temporary or permanent injunction enjoining the pharmacy benefit manager from continuing to fail to provide the verification services or from continuing to fail to provide for the audit.

(D) This section does not impose any duty on the state agency or political subdivision for which an entity provides services as a pharmacy benefit manager.

Effective Date: 07-01-2007

Annually, the department of aging shall select a pharmacy benefit manager, from among the pharmacy benefit managers subject to section 173.73 of the Revised Code, to serve as the Ohio’s best Rx program’s consulting pharmacy benefit manager for purposes of providing drug pricing verification services under section 173.742 of the Revised Code and drug manufacturer payment verification services under section 173.814 of the Revised Code. The department shall select the pharmacy benefit manager that the department considers to be the most appropriate pharmacy benefit manager to provide the verification services for the Ohio’s best Rx program. In making the selection, the department shall consider the pharmacy benefit manager that provides services relative to the outpatient drug coverage included in the health benefit plan offered to the greatest number of employees or retirees of a state agency or political subdivision and the eligible dependents of those employees or retirees.

The department shall provide written notice to the pharmacy benefit manager that it has been selected to serve as the Ohio’s best Rx program’s consulting pharmacy benefit manager. The notice shall specify the date on which the pharmacy benefit manager is to begin serving as the program’s consulting pharmacy benefit manager for the ensuing year.

Before the end of the one-year period during which a pharmacy benefit manager is to serve as the program’s consulting pharmacy benefit manager, the department shall make another selection in accordance with this section. In making the selection, the department may select the same pharmacy benefit manager to serve as the program’s consulting pharmacy benefit manager or may select another pharmacy benefit manager.

Effective Date: 07-01-2007

(A) To determine whether the pharmacy benefit manager selected under section 173.731 of the Revised Code to serve as the Ohio’s best Rx program’s consulting pharmacy benefit manager has provided valid information when providing drug pricing verification services under section 173.742 of the Revised Code or drug manufacturer payment verification services under section 173.814 of the Revised Code, the department of aging may request that the consulting pharmacy benefit manager provide for an audit of its relevant contracts with drug manufacturers and terminal distributors of dangerous drugs.

In making audit requests under this section, both of the following apply:

(1) The department may request an audit on a regularly occurring basis, but not more frequently than once every three years.

(2) The department may request an audit at any time it has a reasonable basis to believe that the consulting pharmacy benefit manager is not acting in good faith in providing drug pricing verification services or drug manufacturer payment verification services. Notice of the request shall be made in writing and signed by the director of aging. The notice may specify the basis for the belief that the consulting pharmacy benefit manager is not acting in good faith. If the basis for the belief is not specified and the audit findings demonstrate that the consulting pharmacy benefit manager acted in good faith, the department shall pay the cost incurred by the consulting pharmacy benefit manager in providing for the audit.

(B) An audit provided for under this section shall be performed only by an auditor that is mutually satisfactory to the department and consulting pharmacy benefit manager and independent of both the department and consulting pharmacy benefit manager.

(C) If the findings of an audit provided for under this section demonstrate that the verification services provided by the consulting pharmacy benefit manager did not result in valid information, the department shall use the audit findings for purposes of confirming the validity of the one or more drug pricing formulas designated under section 173.741 of the Revised Code and entering into agreements with drug manufacturers under section 173.81 of the Revised Code.

Effective Date: 07-01-2007

Annually, the department of aging shall establish a base price for each drug included in the Ohio’s best Rx program. In the case of drugs dispensed by a terminal distributor of dangerous drugs that has entered into an agreement under section 173.79 of the Revised Code, the base price shall be established by using the one or more formulas designated under section 173.741 of the Revised Code. In the case of the drug mail order system included in the program pursuant to section 173.78 of the Revised Code, the base price shall be established in accordance with the rules adopted under section 173.83 of the Revised Code governing the drug mail order system.

Effective Date: 07-01-2007

Annually, the department of aging shall designate one or more formulas for use in establishing under section 173.74 of the Revised Code the Ohio’s best Rx program’s base price for drugs dispensed by a terminal distributor of dangerous drugs that has entered into an agreement under section 173.79 of the Revised Code. Each formula shall include a drug pricing discount component that is expressed as a percentage discount. The formula used for generic drugs may include the maximum allowable cost limits that apply to generic drugs under the medicaid program.

In designating the one or more formulas, the department shall use the best information on drug pricing that is available to the department, including information obtained through the drug pricing verification services provided under section 173.742 of the Revised Code by the Ohio’s best Rx program’s consulting pharmacy benefit manager selected under section 173.731 of the Revised Code. Based on the available information, the department shall modify the one or more formulas as it considers appropriate to maximize the benefits provided to Ohio’s best Rx program participants.

Effective Date: 07-01-2007

For purposes of section 173.741 of the Revised Code, the department of aging shall obtain verification of drug pricing information from the Ohio’s best Rx program’s consulting pharmacy benefit manager selected under section 173.731 of the Revised Code. The information shall be obtained in accordance with the following procedures:

(A) For brand name drugs, excluding generic drugs marketed under brand names, the department shall submit to the consulting pharmacy benefit manager the formula the department proposes to use to establish the program’s base price for brand name drugs during the year.

The consulting pharmacy benefit manager shall review the formula submitted by the department. In conducting the review, the consulting pharmacy benefit manager shall compare the drug pricing discount percentage included in the department’s formula to the drug pricing discount percentage included in the formula most commonly used by the consulting pharmacy benefit manager to establish part of its payment rate for brand name drugs dispensed by terminal distributors of dangerous drugs other than drug mail order systems. If the formulas are not expressed in equivalent terms, the consulting pharmacy benefit manager shall make all accommodations necessary to make the comparison of the discount percentages.

After conducting the review, the consulting pharmacy benefit manager shall provide information to the department verifying whether the discount percentage included in the department’s formula is more than two percentage points below the discount percentage included in the formula used by the consulting pharmacy benefit manager. The information provided to the department shall be certified by signature of an officer of the consulting pharmacy benefit manager.

(B) For generic drugs, the department shall identify the fifty generic drugs most frequently purchased by Ohio’s best Rx program participants in the immediately preceding year from terminal distributors of dangerous drugs other than the drug mail order system included in the program pursuant to section 173.78 of the Revised Code. The department shall submit to the consulting pharmacy benefit manager the names of the fifty drugs, the number of prescriptions filled for each of the drugs, the formula used to compute the base price for the drugs during the year, and the weighted average base price for the drugs that resulted for the year.

The consulting pharmacy benefit manager shall review the submitted information. In conducting the review, the consulting pharmacy benefit manager shall compare the department’s weighted average base price to the equivalent part of the consulting pharmacy benefit manager’s weighted average payment rate for the same drugs when dispensed by terminal distributors of dangerous drugs other than drug mail order systems. For purposes of the comparison, the department and consulting pharmacy benefit manager shall express the weighted average base price and payment rate in terms of a discount percentage that is taken from the drugs’ average wholesale price, as identified by a national drug price reporting service selected by the department and the consulting pharmacy benefit manager.

After conducting the review, the consulting pharmacy benefit manager shall provide information to the department verifying whether the discount percentage reflected in the department’s weighted average base price for the drugs is more than two percentage points below the equivalent part of the consulting pharmacy benefit manager’s weighted average payment rate for the same drugs. The information provided to the department shall be certified by signature of an officer of the consulting pharmacy benefit manager.

Effective Date: 07-01-2007

(A) Subject to division (B) of this section, the amount that an Ohio’s best Rx program participant is to be charged for a quantity of a drug purchased under the program shall be established in accordance with all of the following:

(1) If the drug is not included in a manufacturer agreement entered into under section 173.81 of the Revised Code, the participant shall be charged an amount that is computed according to the drug’s base price established under section 173.74 of the Revised Code.

(2) If the drug is included in a manufacturer agreement entered into under section 173.81 of the Revised Code, the participant shall be charged an amount that is computed by subtracting from the drug’s base price established under section 173.74 of the Revised Code the amount of the manufacturer payment that applies to the transaction, as established under section 173.812 of the Revised Code.

(3) If an administrative fee is specified in rules adopted under section 173.83 of the Revised Code, the participant shall be charged the amount of the administrative fee.

(4) If the drug is dispensed by a terminal distributor of dangerous drugs under an agreement entered into under section 173.79 of the Revised Code, and the terminal distributor charges a professional fee pursuant to the agreement, the participant shall be charged the amount of the professional fee.

(5) If the drug is dispensed through the drug mail order system included in the program pursuant to section 173.78 of the Revised Code, the participant shall not be charged a professional fee.

(B) When a quantity of a drug is purchased by an Ohio’s best Rx program participant, the participating terminal distributor or drug mail order system dispensing the drug shall charge the lesser of the amount that applies to the transaction, as established in accordance with division (A) of this section, or the usual and customary charge that otherwise would apply to the transaction. When a drug is purchased at the usual and customary charge pursuant to this division, the transaction is not subject to sections 173.71 to 173.91 of the Revised Code as the purchase or dispensing of a drug under the program.

Effective Date: 07-01-2007

The department of aging shall report the following to each participating terminal distributor and the drug mail order system included in the Ohio’s best Rx program pursuant to section 173.78 of the Revised Code in a manner enabling the distributor and system to comply with section 173.75 of the Revised Code:

(A) For each drug included in the program, the amount to be charged under division (A)(1) or (2) of section 173.75 of the Revised Code;

(B) The administrative fee, if any, specified by the department in rules adopted under section 173.83 of the Revised Code.

Effective Date: 07-01-2007

The amount that an Ohio’s best Rx program participant saves when a drug is purchased under the program shall be determined by subtracting the amount that the participant is charged in accordance with division (A) of section 173.75 of the Revised Code from the usual and customary charge that otherwise would apply to the transaction.

Effective Date: 07-01-2007

Not later than the first day of March of each year, the department of aging shall do all of the following:

(A) Create a list of the twenty-five drugs most often dispensed to Ohio’s best Rx program participants under the program, using data from the most recent six-month period for which the data is available;

(B) Determine the average amount that participants are charged under the program, on a date selected by the department, for each drug included on the list created under division (A) of this section;

(C) Determine, for the date selected for division (B) of this section, the average usual and customary charge for each drug included on the list created under division (A) of this section;

(D) By comparing the average charges determined under divisions (B) and (C) of this section, determine the average percentage savings Ohio’s best Rx program participants receive for each drug included on the list created under division (A) of this section.

Effective Date: 07-01-2007

(A) To be eligible for the Ohio’s best Rx program, an individual must meet all of the following requirements at the time of application for the program:

(1) The individual must be a resident of this state.

(2) One of the following must be the case:

(a) The individual has family income, as determined under rules adopted pursuant to section 173.83 of the Revised Code, that does not exceed three hundred per cent of the federal poverty guidelines, as revised annually by the United States department of health and human services in accordance with section 673(2) of the “Omnibus Budget Reconciliation Act of 1981,” 95 Stat. 511, 42 U.S.C. 9902, as amended;

(b) The individual is sixty years of age or older;

(c) The individual is a person with a disability, as defined in section 173.06 of the Revised Code.

(3) Except as provided in division (B) of this section, the individual must not have coverage for outpatient drugs paid for in whole or in part by any of the following:

(a) A third-party payer, including an employer;

(b) The medicaid program;

(c) The children’s health insurance program;

(d) The disability medical assistance program;

(e) Another health plan or pharmacy assistance program that uses state or federal funds to pay part or all of the cost of the individual’s outpatient drugs.

(4) The individual must not have had coverage for outpatient drugs paid for by any of the entities or programs specified in division (A)(3) of this section during any of the four months preceding the month in which the application for the Ohio’s best Rx program is made, unless any of the following applies:

(a) The individual is sixty years of age or older.

(b) The third-party payer, including an employer, that paid for the coverage filed for bankruptcy under federal bankruptcy laws.

(c) The individual is no longer eligible for coverage provided through a retirement plan subject to protection under the “Employee Retirement Income Security Act of 1974,” 88 Stat. 832, 29 U.S.C. 1001, as amended.

(d) The individual is no longer eligible for the medicaid program, children’s health insurance program, or disability medical assistance program.

(e) The individual is either temporarily or permanently discharged from employment due to a business reorganization.

(B) An individual is not subject to division (A)(3) of this section if the individual has coverage for outpatient drugs paid for in whole or in part by either of the following:

(1) The workers’ compensation program;

(2) A medicare prescription drug plan offered pursuant to the “Medicare Prescription Drug, Improvement, and Modernization Act of 2003,” 117 Stat. 2071, 42 U.S.C. 1395w-101, as amended, but only if all of the following are the case with respect to the particular drug being purchased through the Ohio’s best Rx program:

(a) The individual is responsible for the full cost of the drug.

(b) The drug is not subject to a rebate from the manufacturer under the individual’s medicare prescription drug plan.

(c) The manufacturer of the drug has agreed to the Ohio’s best Rx program’s inclusion of individuals who have coverage through a medicare prescription drug plan.

Effective Date: 07-01-2007

Application for participation in the Ohio’s best Rx program shall be made in accordance with rules adopted by the department of aging under section 173.83 of the Revised Code. When applying for participation, an individual may include application for participation by the individual’s spouse and children. An individual’s guardian or custodian may apply on behalf of the individual.

When submitting an application, the applicant shall include the information and documentation specified in the department’s rules as necessary to verify eligibility for the program. The application may be submitted on a paper form prescribed and supplied by the department or pursuant to any other application method the department makes available for the program, including methods that permit an individual to apply by telephone or through the internet.

An applicant shall attest that the information and documentation the applicant submits with an application is accurate to the best knowledge and belief of the applicant. In the case of a paper application form, the applicant’s signature shall be used to certify that the applicant has attested to the accuracy of the information and documentation. In the case of other application methods, the application certification process specified in the department’s rules shall be used to certify that the applicant has attested to the accuracy of the information and documentation.

The department shall inform each applicant that knowingly making a false statement in an application is falsification under section 2921.13 of the Revised Code, a misdemeanor of the first degree. In the case of a paper application form, the department shall provide the information by including on the form a statement printed in bold letters.

Effective Date: 07-01-2007

The department of aging shall provide each applicant for the Ohio’s best Rx program information about the medicaid program in accordance with rules adopted under section 173.83 of the Revised Code. The information shall include general eligibility requirements, application procedures, and benefits. The information shall also explain the ways in which the medicaid program’s drug benefits are better than the Ohio’s best Rx program.

Effective Date: 07-01-2007

On receipt of applications, the department of aging shall make eligibility determinations for the Ohio’s best Rx program in accordance with procedures established in rules adopted under section 173.83 of the Revised Code.

An eligibility determination under this section may not be appealed under Chapter 119., section 5101.35, or any other provision of the Revised Code.

Effective Date: 07-01-2007

(A) The department of aging shall issue Ohio’s best Rx program enrollment cards to or on behalf of individuals determined eligible to participate. One enrollment card may cover each member of a family determined eligible to participate.

The department shall determine the information to be included on the card, including an identification number, and shall determine the card’s size and format. If the department establishes an application method that permits individuals to apply through the internet, the department may issue the enrollment card by sending the applicant an electronic version of the card in a printable format.

(B) Each time a drug is purchased under the program, the entity dispensing the drug shall confirm whether the individual for whom the drug is dispensed is enrolled in the program. If the drug is being purchased from a participating terminal distributor rather than the drug mail order system included in the program pursuant to section 173.78 of the Revised Code, and the individual’s enrollment card is available for presentation at the time of the purchase, the purchaser shall present the card to the participating terminal distributor as confirmation of the individual’s enrollment in the program. If the drug is being purchased through the drug mail order system and the individual’s program identification number is available, the purchaser shall present the identification number as confirmation of enrollment. Otherwise, the terminal distributor or mail order system shall confirm the individual’s enrollment through the department. The department shall establish the methods to be used in confirming enrollment through the department, including confirmation by telephone, through the internet, or by any other electronic means.

(C) Purchasing a drug under the program by using an enrollment card or any other method shall serve as an attestation by the participant for whom the drug is dispensed that the participant meets the eligibility requirements specified in division (A)(3) of section 173.76 of the Revised Code regarding not having coverage for outpatient drugs.

Effective Date: 07-01-2007

(A) For purposes of making drugs included in the Ohio’s best Rx program available to participants by mail, the department of aging shall include a drug mail order system within the program. Not more than one drug mail order system shall be included in the program. Subject to division (B) of this section, the program’s drug mail order system shall be provided in accordance with rules adopted under section 173.83 of the Revised Code.

(B) Neither the department nor the drug mail order system shall promote the purchase of drugs through the system by using information collected under the program regarding the drugs purchased by participants from participating terminal distributors. This division does not preclude the use of the information for purposes of limiting the amount that a participant may be charged for a quantity of a drug purchased through the drug mail order system to an amount that is not more than the amount that would be charged if the same quantity of the drug were purchased from a participating terminal distributor.

Effective Date: 07-01-2007

(A) For purposes of making drugs included in the Ohio’s best Rx program available to participants from terminal distributors of dangerous drugs other than the drug mail order system included in the program pursuant to section 173.78 of the Revised Code, the department of aging shall enter into agreements under this section with terminal distributors of dangerous drugs. Any terminal distributor of dangerous drugs may enter into an agreement with the department to participate in the program pursuant to this section.

Before entering into an agreement with a terminal distributor, the department shall provide the terminal distributor with one of the following:

(1) A formula that allows the terminal distributor to calculate for each drug included in the program the amount to be charged under division (A)(1) or (2) of section 173.75 of the Revised Code by participating terminal distributors.

(2) A statistically valid sampling of drug prices that includes the amount to be charged under division (A)(1) or (2) of section 173.75 of the Revised Code by participating terminal distributors for not fewer than two brand name drugs and two generic drugs from each category of drugs included in the program.

(3) The current amount to be charged under division (A)(1) or (2) of section 173.75 of the Revised Code by participating terminal distributors for each drug included in the program.

(B) An agreement entered into under this section shall do all of the following:

(1) Except as provided in division (B)(3) of this section, be in effect for not less than one year;

(2) Specify the dates that the agreement is to begin and end;

(3) Permit the terminal distributor to terminate the agreement before the date the agreement would otherwise end as specified pursuant to division (B)(2) of this section by providing the department notice of early termination at least thirty days before the effective date of the early termination;

(4) Require that the terminal distributor comply with section 173.75 of the Revised Code when charging for a drug purchased under the program;

(5) Permit the terminal distributor to add to the amount to be charged under division (A)(1) or (2) of section 173.75 of the Revised Code a professional fee in an amount not to exceed, except as provided in rules adopted under section 173.83 of the Revised Code, three dollars;

(6) Require the terminal distributor to disclose to each participant the amount the participant saves under the program as determined in accordance with section 173.752 of the Revised Code;

(7) Require the terminal distributor to submit a claim to the department under section 173.80 of the Revised Code for each sale of a drug to a participant;

(8) Permit the terminal distributor to deliver drugs to Ohio’s best Rx program participants by mail, but not by using a drug mail order system operated in the same manner as the system included in the program pursuant to section 173.78 of the Revised Code.

Effective Date: 07-01-2007

A terminal distributor of dangerous drugs shall not be prohibited from participating in any program or any network of health care providers on the basis that the terminal distributor has not entered into an agreement under section 173.79 of the Revised Code to participate in the Ohio’s best Rx program.

Effective Date: 07-01-2007

For each drug dispensed under the Ohio’s best Rx program, a claim shall be submitted to the department of aging. The participating terminal distributor or the drug mail order system included in the program pursuant to section 173.78 of the Revised Code that dispensed the drug shall submit the claim not later than thirty days after the drug is dispensed. The claim shall be submitted in accordance with the electronic method provided for in rules adopted under section 173.83 of the Revised Code.

The claim shall specify all of the following:

(A) The prescription number of the participant’s prescription under which the drug was dispensed to the participant;

(B) The name of, and national drug code number for, the drug dispensed to the participant;

(C) The number of units of the drug dispensed to the participant;

(D) The amount the participant was charged for the drug;

(E) The date the drug was dispensed to the participant;

(F) Any additional information required by rules adopted under section 173.83 of the Revised Code.

Effective Date: 07-01-2007

(A) In accordance with rules adopted under section 173.83 of the Revised Code and subject to section 173.803 of the Revised Code, the department of aging shall make payments under the Ohio’s best Rx program for complete and timely claims submitted under section 173.80 of the Revised Code for drugs included in the program that are also included in a manufacturer agreement entered into under section 173.81 of the Revised Code. The payment for a complete and timely claim shall be made by a date that is not later than two weeks after the department receives the claim from the participating terminal distributor or the drug mail order system included in the program pursuant to section 173.78 of the Revised Code.

(B) Subject to division (D) of this section, the amount to be paid for a claim for a drug dispensed under the program shall be determined as follows:

(1) Compute the manufacturer payment amount that applies to the transaction, based on quantity of the drug dispensed and the drug’s national drug code number, in accordance with the provisions of division (B) of section 173.812 of the Revised Code;

(2) If rules adopted under section 173.83 of the Revised Code require that program participants be charged an administrative fee for each transaction in which a quantity of the drug was dispensed, subtract from the amount computed under division (B)(1) of this section the administrative fee amount specified in those rules.

(C) The department may combine the claims submitted by a participating terminal distributor or the program’s drug mail order system to make aggregate payments under this section to the distributor or system.

(D) If the total of the amounts computed under division (B) of this section for any period for which payments are due is a negative number, the participating terminal distributor or the program’s drug mail order system that submitted the claims has been overpaid for the claims. When there is an overpayment, the department shall reduce future payments made under this section to the distributor or system or collect an amount from the distributor or system sufficient to reimburse the department for the overpayment.

Effective Date: 07-01-2007

Neither a participating terminal distributor nor the drug mail order system included in the Ohio’s best Rx program pursuant to section 173.78 of the Revised Code may be charged by the department of aging for the submission of a claim under section 173.80 of the Revised Code or the processing of a claim under section 173.801 of the Revised Code.

Effective Date: 07-01-2007

The department of aging may not make a payment under section 173.801 of the Revised Code for a claim submitted under section 173.80 of the Revised Code if any of the following are the case:

(A) The claim is submitted by either a terminal distributor of dangerous drugs that is not a participating terminal distributor or a drug mail order system that is not the system included in the Ohio’s best Rx program pursuant to section 173.78 of the Revised Code.

(B) The claim is for a drug that is not included in the program.

(C) The claim is for a drug included in the program but the drug is dispensed to an individual who is not covered by an Ohio’s best Rx program enrollment card.

(D) A person or government entity has paid the participating terminal distributor or the program’s drug mail order system through any other prescription drug coverage program or prescription drug discount program for dispensing the drug, unless the payment is reimbursement for redeeming a coupon or is an amount directly paid by a drug manufacturer to the distributor or system for dispensing drugs to residents of a long-term care facility.

Effective Date: 07-01-2007

For purposes of participating in the Ohio’s best Rx program, any drug manufacturer may enter into an agreement with the department of aging under which the manufacturer agrees to make payments to the department with respect to one or more of the manufacturer’s drugs when the one or more drugs are dispensed under the program. The terms of the agreement shall comply with section 173.811 of the Revised Code.

Effective Date: 07-01-2007

(A) A manufacturer agreement entered into under section 173.81 of the Revised Code by a drug manufacturer and the department of aging shall include terms that do all of the following:

(1) Specify the time the agreement is to be in effect, which shall be not less than one year from the date the agreement is entered into;

(2) Specify which of the manufacturer’s drugs are included in the agreement;

(3) Permit the department to remove a drug from the agreement in the event of a dispute over the drug’s utilization;

(4) Require that the manufacturer specify a per unit amount that will be paid to the department for each drug included in the agreement that is dispensed to an Ohio’s best Rx program participant;

(5) Require that the per unit amount specified by the manufacturer be an amount that the manufacturer believes is greater than or comparable to the per unit amount generally payable by the manufacturer for the same drug when the drug is dispensed to an individual using the outpatient drug coverage included in a health benefit plan offered in this state or another state to public employees or retirees and the eligible dependents of those employees or retirees;

(6) Require the manufacturer to make payments in accordance with the amounts computed under division (A) of section 173.812 of the Revised Code;

(7) Require that the manufacturer make the payments on a quarterly basis or in accordance with a schedule established by rules adopted under section 173.83 of the Revised Code.

(B) For any drug included in a manufacturer agreement, the terms of the agreement may provide for the establishment of a process for referring Ohio’s best Rx program applicants and participants to a patient assistance program operated or sponsored by the manufacturer. The referral process may be included only if the manufacturer agrees to refer to the Ohio’s best Rx program residents of this state who apply but are found to be ineligible for the patient assistance program.

Effective Date: 07-01-2007

When a drug included in a manufacturer agreement entered into under section 173.81 of the Revised Code is dispensed under the Ohio’s best Rx program, the manufacturer payment amount that applies to the transaction shall be established in accordance with the following:

(A) For purposes of the amount to be paid by the manufacturer, the manufacturer payment amount shall be computed by multiplying the per unit amount specified for the drug in the manufacturer agreement by the number of units dispensed.

(B) For purposes of the amount that a participant is to be charged under section 173.75 of the Revised Code and the amount to be paid for claims under section 173.801 of the Revised Code, both of the following apply:

(1) If a program administration percentage is not determined by the department of aging in rules adopted under section 173.83 of the Revised Code, the manufacturer payment amount shall be the same as the manufacturer payment amount computed under division (A) of this section.

(2) If a program administration percentage is determined by the department, the manufacturer payment amount shall be computed as follows:

(a) Multiply the per unit amount specified for the drug in the agreement by the program administration percentage;

(b) Subtract the product determined under division (B)(2)(a) of this section from the per unit amount specified for the drug in the agreement;

(c) Multiply the per unit amount resulting from the computation under division (B)(2)(b) of this section by the number of units dispensed.

Effective Date: 07-01-2007

In its negotiations with a drug manufacturer proposing to enter into an agreement under section 173.81 of the Revised Code, the department of aging shall use the best information on manufacturer payments that is available to the department, including information obtained from the verifications made under section 173.814 of the Revised Code by the Ohio’s best Rx program’s consulting pharmacy benefit manager selected under section 173.731 of the Revised Code. The department shall use the information in an attempt to obtain manufacturer payments that maximize the benefits provided to Ohio’s best Rx program participants.

Effective Date: 07-01-2007

Annually, the department of aging shall select a sample of not more than ten of the drugs that were included in the manufacturer agreements entered into under section 173.81 of the Revised Code in the immediately preceding year. The department shall submit to the program’s consulting pharmacy benefit manager selected under section 173.731 of the Revised Code information that identifies the per unit amount of the manufacturer payments that applied to each of the drugs in the sample.

The consulting pharmacy benefit manager shall review the submitted information. After the review, the consulting pharmacy benefit manager shall provide information to the department verifying whether any of the per unit payment amounts that applied to the selected drugs were more than two per cent lower than the per unit payment amounts negotiated by the consulting pharmacy benefit manager for the same drugs in connection with health benefit plans that generally do not use formularies to restrict the outpatient drug coverage included in the plans. The consulting pharmacy benefit manager shall specify which, if any, of the drugs in the sample were subject to the lower per unit payment amounts. The information provided to the department shall be certified by signature of an officer of the consulting pharmacy benefit manager.

Effective Date: 07-01-2007

(A) The department of aging shall seek from the centers for medicare and medicaid services of the United States department of health and human services written confirmation that manufacturer payments made pursuant to an agreement entered into under section 173.81 of the Revised Code are exempt from the medicaid best price computation applicable under Title XIX of the “Social Security Act,” 79 Stat. 286 (1965), 42 U.S.C. 1396r-8, as amended.

(B) Entering into a manufacturer agreement under section 173.81 of the Revised Code does not require a drug manufacturer to make a manufacturer payment that would establish the manufacturer’s medicaid best price for a drug.

Effective Date: 07-01-2007

A drug manufacturer that enters into an agreement under section 173.81 of the Revised Code may submit a request to the department of aging to audit claims submitted under section 173.80 of the Revised Code. On submission of a request that the department considers reasonable, the department shall permit the manufacturer to audit the claims.

Effective Date: 07-01-2007

The department of aging shall adopt rules in accordance with Chapter 119. of the Revised Code to implement the Ohio’s best Rx program. The rules shall provide for all of the following:

(A) Standards and procedures for establishing, pursuant to section 173.74 of the Revised Code, the base price for each drug included in the program;

(B) Determination of family income for the purpose of division (A)(2)(a) of section 173.76 of the Revised Code;

(C) For the purpose of section 173.77 of the Revised Code, the application process for the program, including the information and documentation to be submitted with applications to verify eligibility and a process to be used in certifying that an applicant has attested to the accuracy of the submitted information and documentation;

(D) The method of providing information about the medicaid program to applicants under section 173.771 of the Revised Code;

(E) For the purpose of section 173.772 of the Revised Code, eligibility determination procedures;

(F) Standards and procedures governing the drug mail order system included in the program pursuant to section 173.78 of the Revised Code;

(G) Subject to section 173.831 of the Revised Code, periodically increasing the maximum professional fee that participating terminal distributors may charge Ohio’s best Rx program participants pursuant to an agreement entered into under section 173.79 of the Revised Code;

(H) Subject to section 173.832 of the Revised Code, the amount of the administrative fee, if any, that Ohio’s best Rx program participants are to be charged under the program;

(I) The electronic method for submission of claims to the department under section 173.80 of the Revised Code;

(J) Additional information to be included on claims submitted under section 173.80 of the Revised Code that the department determines is necessary for the department to be able to make payments under section 173.801 of the Revised Code;

(K) The method for making payments under section 173.801 of the Revised Code;

(L) Subject to section 173.833 of the Revised Code, the percentage, if any, that is the program administration percentage;

(M) If the department determines it is best that participating manufacturers make payments pursuant to manufacturer agreements entered into under section 173.81 of the Revised Code on a basis other than quarterly, a schedule for making the payments;

(N) Procedures for making computations under sections 173.75 and 173.812 of the Revised Code;

(O) Standards and procedures for the use and preservation of records regarding the Ohio’s best Rx program pursuant to section 173.91 of the Revised Code;

(P) The efficient administration of other provisions of sections 173.71 to 173.91 of the Revised Code for which the department determines rules are necessary.

Effective Date: 07-01-2007

As used in this section, “medicaid dispensing fee” means the dispensing fee established under section 5111.071 of the Revised Code for the medicaid program.

In adopting a rule under division (G) of section 173.83 of the Revised Code increasing the maximum amount of the professional fee participating terminal distributors may charge Ohio’s best Rx program participants pursuant to an agreement entered into under section 173.79 of the Revised Code, the department of aging shall review the amount of the professional fee once a year or, at the department’s discretion, at more frequent intervals. The department shall not increase the professional fee to an amount exceeding the medicaid dispensing fee.

A participating terminal distributor may charge a maximum three dollar professional fee regardless of whether the medicaid dispensing fee for that drug is less than that amount. The department, however, may not adopt a rule increasing the maximum professional fee for that drug until the medicaid dispensing fee for that drug exceeds that amount.

Effective Date: 07-01-2007

(A) Once a year or, at the discretion of the department of aging, at more frequent intervals, the department shall determine the amount, if any, that each Ohio’s best Rx program participant will be charged as an administrative fee to be used in paying the administrative costs of the program. The fee, which shall not exceed one dollar per transaction, shall be specified in rules adopted under section 173.83 of the Revised Code. In adopting the rules, the department shall specify a fee that results in an amount that equals or is less than the amount needed to cover the administrative costs of the Ohio’s best Rx program when added to the sum of the following:

(1) The amount resulting from the program administration percentage, if the department determines a program administration percentage in rules adopted under section 173.83 of the Revised Code;

(2) The investment earnings of the Ohio’s best Rx program fund created by section 173.85 of the Revised Code;

(3) Any amounts accepted by the department as donations to the Ohio’s best Rx program fund.

(B) Once a year or, at the discretion of the department, at more frequent intervals, the department shall report the methodology underlying the determination of the administrative fee to the Ohio’s best Rx program council.

Effective Date: 07-01-2007

(A) At least once a year or, at the discretion of the department of aging, at more frequent intervals, the department shall determine the percentage, if any, of each manufacturer payment made under an agreement entered into under section 173.81 of the Revised Code that will be retained by the department for use in paying the administrative costs of the Ohio’s best Rx program. The percentage, which shall not exceed five per cent, shall be specified in rules adopted under section 173.83 of the Revised Code. In adopting the rules, the department shall specify a percentage that results in an amount that equals or is less than the amount needed to cover the administrative costs of the Ohio’s best Rx program when added to the sum of the following:

(1) The amount resulting from administrative fees, if the department determines an administrative fee in rules adopted under section 173.83 of the Revised Code;

(2) The investment earnings of the Ohio’s best Rx program fund created by section 173.85 of the Revised Code;

(3) Any amounts accepted by the department as donations to the Ohio’s best Rx program fund.

(B) Once a year or, at the discretion of the department, at more frequent intervals, the department shall report the methodology underlying the determination of the program administration percentage to the Ohio’s best Rx program council.

Effective Date: 07-01-2007

Notwithstanding any conflicting provision of sections 173.71 to 173.91 of the Revised Code, the department of aging may adopt rules in accordance with Chapter 119. of the Revised Code to make adjustments to the Ohio’s best Rx program that the department considers appropriate to conform the program to, or coordinate it with, any federally funded prescription drug program created after October 1, 2003.

Effective Date: 07-01-2007

(A) The Ohio’s best Rx program fund is hereby created in the state treasury. The fund shall consist of the following:

(1) Manufacturer payments made by participating manufacturers pursuant to agreements entered into under section 173.81 of the Revised Code;

(2) Administrative fees, if an administrative fee is determined by the department of aging in rules adopted under section 173.83 of the Revised Code;

(3) Any amounts donated to the fund and accepted by the department;

(4) The fund’s investment earnings.

(B) Money in the Ohio’s best Rx program fund shall be used to make payments under section 173.801 of the Revised Code and to make transfers to the Ohio’s best Rx administration fund in accordance with section 173.86 of the Revised Code.

Effective Date: 07-01-2007; 2007 HB119 09-29-2007

(A) The Ohio’s best Rx administration fund is hereby created in the state treasury. The director of budget and management shall transfer from the Ohio’s best Rx program fund to the Ohio’s best Rx administration fund amounts equal to the following:

(1) Amounts resulting from application of the program administration percentage, if a program administration percentage is determined by the department of aging in rules adopted under section 173.83 of the Revised Code;

(2) The amount of the administrative fees charged Ohio’s best Rx participants, if an administrative fee is determined by the department of aging in rules adopted under section 173.83 of the Revised Code;

(3) The amount of any donations credited to the Ohio’s best Rx program fund;

(4) The amount of investment earnings credited to the Ohio’s best Rx program fund.

The director of budget and management shall make the transfers in accordance with a schedule developed by the director and the department of aging.

(B) The department of aging shall use money in the Ohio’s best Rx administration fund to pay the administrative costs of the Ohio’s best Rx program, including, but not limited to, costs associated with contracted services, staff, outreach activities, computers and network services, and the Ohio’s best Rx program council. If the fund includes an amount that exceeds the amount necessary to pay the administrative costs of the program, the department may use the excess amount to pay the cost of subsidies provided to Ohio’s best Rx program participants under any subsidy program established pursuant to section 173.861 of the Revised Code.

Effective Date: 07-01-2007; 2007 HB119 09-29-2007

The department of aging may establish a component of the Ohio’s best Rx program under which subsidies are provided to participants to assist them with the cost of purchasing drugs under the program, including the cost of any professional fees charged for dispensing the drugs. The subsidies shall be provided only when the Ohio’s best Rx administration fund created under section 173.86 of the Revised Code includes an amount that exceeds the amount necessary to pay the administrative costs of the program.

Effective Date: 07-01-2007

There is hereby created the Ohio’s best Rx program council. The council shall advise the department of aging on the Ohio’s best Rx program. With the approval of a majority of the council’s appointed members, the council may initiate studies to determine whether there are more effective ways to administer the program and provide the department with suggestions for improvements.

Effective Date: 07-01-2007

The Ohio’s best Rx program council shall consist of the following members:

(A) The president of the senate;

(B) The speaker of the house of representatives;

(C) The minority leader of the senate;

(D) The minority leader of the house of representatives;

(E) A representative of the Ohio chapter of the American federation of labor-congress of industrial organizations, appointed by the governor from a list of names submitted to the governor by that organization;

(F) A representative of the Ohio chapter of the American association of retired persons, appointed by the governor from a list of names submitted to the governor by that organization;

(G) A representative of a disability advocacy organization located in the state of Ohio, appointed by the governor from a list of names submitted to the governor by disability advocacy organizations located in the state of Ohio;

(H) A representative of the Ohio chapter of the united way, appointed by the governor from a list of names submitted to the governor by that organization;

(I) A representative of the Ohio alliance of retired Americans, appointed by the governor from a list of names submitted to the governor by that organization;

(J) Three representatives of research-based drug manufacturers, appointed by the governor from a list of names submitted to the governor by the pharmaceutical research and manufacturers of America;

(K) A pharmacist licensed under Chapter 4729. of the Revised Code, appointed by the governor from a list of names submitted to the governor by the Ohio pharmacists association.

Effective Date: 07-01-2007

The governor shall make initial appointments to the Ohio’s best Rx program council not later than thirty days after December 18, 2003. The members appointed by the governor shall serve at the pleasure of the governor. If an appointed member’s seat becomes vacant, the governor shall fill the vacancy not later than thirty days after the vacancy occurs and in the manner provided for the initial appointment.

Effective Date: 07-01-2007

The president of the senate and speaker of the house of representatives shall serve as co-chairs of the Ohio’s best Rx program council.

The president of the senate, the minority leader of the senate, the speaker of the house of representatives, and the minority leader of the house of representatives may each appoint a member of the general assembly to attend any meeting of the Ohio’s best Rx program council on behalf of the president of the senate, the minority leader of the senate, the speaker of the house of representatives, or the minority leader of the house of representatives, respectively.

Effective Date: 07-01-2007

Members of the Ohio’s best Rx program council shall serve without compensation and shall not be reimbursed for any expenses associated with their duties on the council.

Effective Date: 07-01-2007

Except for any part of records that contain a trade secret, the Ohio’s best Rx program council’s records are a public record for the purpose of section 149.43 of the Revised Code.

Effective Date: 07-01-2007

Sections 101.82 to 101.87 of the Revised Code do not apply to the Ohio’s best Rx program council.

Effective Date: 07-01-2007

(A) The department of aging shall compile both of the following lists regarding the Ohio’s best Rx program:

(1) A list consisting of the name of each drug manufacturer that enters into a manufacturer agreement under section 173.791 of the Revised Code and the names of the drugs included in each manufacturer agreement;

(2) A list consisting of the name of each participating terminal distributor and the name of the drug mail order system included in the program pursuant to section 173.78 of the Revised Code.

(B) As part of the list compiled under division (A)(1) of this section, the department may include aggregate information regarding the drugs selected under section 173.814 of the Revised Code that were verified under that section as having per unit manufacturer payment amounts that were not more than two per cent lower than the per unit payment amounts negotiated for the same drugs by the program’s consulting pharmacy benefit manager selected under section 173.731 of the Revised Code. The information shall not identify a specific drug and shall be expressed only as a percentage of the sample of drugs selected under section 173.814 of the Revised Code.

(C) The lists compiled under this section are public records for the purpose of section 149.43 of the Revised Code. The department shall specifically make the lists available to physicians, participating terminal distributors, and other health professionals.

Effective Date: 07-01-2007

Information transmitted by or to any of the following for any purpose related to the Ohio’s best Rx program is confidential to the extent required by federal and state law:

(A) Drug manufacturers;

(B) Terminal distributors of dangerous drugs;

(C) The department of aging;

(D) The program’s consulting pharmacy benefit manager selected under section 173.731 of the Revised Code;

(E) Ohio’s best Rx program participants;

(F) Any other government entity or person.

Effective Date: 07-01-2007

(A) Except as provided by section 173.892 of the Revised Code, all of the following are trade secrets, are not public records for the purposes of section 149.43 of the Revised Code, and shall not be used, released, published, or disclosed in a form that reveals a specific drug or the identity of a drug manufacturer:

(1) The amounts determined under section 173.801 of the Revised Code for payment of claims submitted by participating terminal distributors and the drug mail order system included in the Ohio’s best Rx program pursuant to section 173.78 of the Revised Code;

(2) Information disclosed in a manufacturer agreement entered into under section 173.81 of the Revised Code or in communications related to an agreement;

(3) Drug pricing and drug manufacturer payment information verified under sections 173.742 and 173.814 of the Revised Code by the program’s consulting pharmacy benefit manager selected under section 173.731 of the Revised Code;

(4) Information contained in or pertaining to an audit provided for by the program’s consulting pharmacy benefit manager under section 173.732 of the Revised Code;

(5) The elements of the computations made pursuant to sections 173.75, 173.801, and 173.812 of the Revised Code and any results of those computations that reveal or could be used to reveal the manufacturer payment amounts used to make the computations.

(B) No person or government entity shall use or reveal any information specified in division (A) of this section except as required for the implementation of sections 173.71 to 173.91 of the Revised Code.

Effective Date: 07-01-2007

Sections 173.89 and 173.891 of the Revised Code shall not preclude the department of aging from disclosing information necessary for the implementation of sections 173.71 to 173.91 of the Revised Code, including the amount an Ohio’s best Rx program participant is to be charged when the amount is disclosed under section 173.751 of the Revised Code to participating terminal distributors or the drug mail order system included in the program pursuant to section 173.78 of the Revised Code.

Effective Date: 07-01-2007

(A) As used in this section, “identifying information” means information that identifies or could be used to identify an Ohio’s best Rx program applicant or participant. “Identifying information” does not include aggregate information about applicants and participants that does not identify and could not be used to identify an individual applicant or participant.

(B) Except as provided in divisions (C), (D), and (E) of this section, no person or government entity shall sell, solicit, disclose, receive, or use identifying information or knowingly permit the use of identifying information.

(C)(1) The department of aging may solicit, disclose, receive, or use identifying information or knowingly permit the use of identifying information for a purpose directly connected to the administration of the Ohio’s best Rx program, including disclosing and knowingly permitting the use of identifying information included in a claim that a participating manufacturer audits pursuant to section 173.82 of the Revised Code, contacting Ohio’s best Rx program applicants or participants regarding participation in the program, and notifying applicants and participants regarding participating terminal distributors and the drug mail order system included in the program pursuant to section 173.78 of the Revised Code.

(2) The department may solicit, disclose, receive, or use identifying information or knowingly permit the use of identifying information to the extent required by federal law.

(3) The department may disclose identifying information to the Ohio’s best Rx program applicant or participant who is the subject of that information or to the parent, spouse, guardian, or custodian of that applicant or participant.

(D)(1) A participating terminal distributor may solicit, disclose, receive, or use identifying information or knowingly permit the use of identifying information to the extent required or permitted by an agreement the distributor enters into under section 173.79 of the Revised Code.

(2) Subject to division (B) of section 173.78 of the Revised Code, the drug mail order system included in the program pursuant to section 173.78 of the Revised Code may solicit, disclose, receive, or use identifying information or knowingly permit the use of identifying information to the extent required or permitted by the department.

(E) A participating manufacturer may, for the purpose of auditing a claim pursuant to section 173.82 of the Revised Code, solicit, receive, and use identifying information included in the claim.

Effective Date: 07-01-2007

(A) Except as provided in division (B) of this section, the department of aging shall use and preserve records regarding the Ohio’s best Rx program in accordance with rules adopted under section 173.83 of the Revised Code. The department shall use and preserve the records in accordance with those rules, regardless of whether the department generated the records or received them from another government entity or any person.

(B) All records received by the department under sections 173.742 and 173.814 of the Revised Code from the program’s consulting pharmacy benefit manager selected under section 173.731 of the Revised Code shall be destroyed promptly after the department has completed the purpose for which the information contained in the records was obtained.

Effective Date: 07-01-2007

(A) A long-term care provider, person employed by a long-term care provider, other entity, or employee of such other entity that violates division (C) of section 173.24 of the Revised Code is subject to a fine not to exceed one thousand dollars for each violation.

(B) Whoever violates division (C) of section 173.23 of the Revised Code is guilty of registering a false complaint, a misdemeanor of the first degree.

(C) A long-term care provider, other entity, or person employed by a long-term care provider or other entity that violates division (E) of section 173.19 of the Revised Code by denying a representative of the office of the state long-term care ombudsperson program the access required by that division is subject to a fine not to exceed five hundred dollars for each violation.

(D) Whoever violates division (C) of section 173.44 of the Revised Code is subject to a fine of one hundred dollars.

(E) Whoever violates division (B) of section 173.90 of the Revised Code is guilty of a misdemeanor of the first degree.

Effective Date: 06-12-1990; 09-29-2005; 07-01-2007