CHAPTER 3724: COMMUNITY ALTERNATIVE HOMES

As used in this chapter:

(A) “Personal assistance” and “skilled nursing care” have the same meanings as in section 3721.01 of the Revised Code.

(B) “Community alternative home” means a residence or facility that provides accommodations, personal assistance, and supervision for three to five unrelated individuals who have acquired immunodeficiency syndrome or a condition related to acquired immunodeficiency syndrome. “Community alternative home” does not include any of the following:

(1) A home licensed as a nursing home, residential care facility, or home for the aging under Chapter 3721. of the Revised Code;

(2) An adult foster care facility as defined in section 5103.31 of the Revised Code;

(3) An institution for children as defined in section 5103.03 of the Revised Code;

(4) A hospice care program as defined in section 3712.01 of the Revised Code.

(C) “Operator” means the person responsible for the overall operation of a community alternative home.

(D) “Residence manager” means the person responsible for the day-to-day operation of a community alternative home. The residence manager and the operator may be the same person.

(E) “Caregiver” means an individual employed by or under contract with the operator or residence manager to give supervision and direct care to the residents of a community alternative home.

(F) “Supervision” means:

(1) Assisting residents with activities of daily living, as by reminding them to engage in personal hygiene and other self-care activities and, when necessary, observing or assisting while they attend to those activities;

(2) Reminding residents of appointments and being aware of a resident’s general whereabouts when he is away from the home.

(G) “Unrelated” means that a resident is not related to the operator or residence manager of a community alternative home or to his spouse as a parent, grandparent, child, stepchild, grandchild, brother, sister, niece, nephew, aunt, or uncle or as the child of an aunt or uncle.

(H) “Physician” means a physician licensed under Chapter 4731. of the Revised Code to practice medicine or surgery or osteopathic medicine and surgery.

(I) “Dentist” means a dentist licensed under Chapter 4715. of the Revised Code.

(J) “Registered nurse” means a registered nurse licensed under Chapter 4723. of the Revised Code.

Effective Date: 09-29-1995

(A) No person and no agency of state or local government shall:

(1) Operate a community alternative home without a license issued by the director of health under this chapter;

(2) Interfere with an inspection or investigation of a licensed community alternative home by the director of health or his agent as required by this chapter;

(3) Violate any of the provisions of this chapter or any rules adopted under it.

(B) No community alternative home shall:

(1) Admit more residents than the number authorized in its license;

(2) Provide skilled nursing care or admit or retain a resident in need of skilled nursing care, unless the care will be provided by a person or agency not employed by or affiliated with the home who is, or is working under the direction and review of, a registered nurse, physician, or dentist, not employed by or affiliated with the home;

(3) Permit a person or agency providing skilled nursing care to residents of the home under division (B)(2) of this section to train employees of the home to assist in providing skilled nursing care;

(4) Admit or retain a resident unless a physician, or a dentist who has prescribed medication for the resident, certifies in writing that the resident is capable of administering medication to himself, with or without assistance as authorized by section 3724.021 of the Revised Code, or unless any medication prescribed for the resident will be administered by one of the following:

(a) A person or agency providing skilled nursing care under division (B)(2) of this section;

(b) A physician;

(c) A dentist;

(d) A podiatrist licensed under Chapter 4731. of the Revised Code.

(C) For the purposes of this section, an individual who receives no compensation for work he does in a community alternative home or for residents of the home is not considered to be affiliated with or associated with the home.

Effective Date: 11-01-1989

Employees of a community alternative home and volunteers in the home may do any of the following:

(A) Remind a resident to take medication and observe to ensure that he follows the directions on the container;

(B) Assist a resident in the self-administration of medication by taking the medication from a storage area, handing it to the resident, and opening the container if the resident is physically unable to open it;

(C) On a request by, or with the consent of, a resident who is mentally alert but physically impaired or in a weakened state, assist the resident to remove oral or topical medication from containers and consume or apply it, including, if the resident is unable to consume liquid medication without spilling it, placing the medication in a container, and holding the container to the mouth of the resident;

(D) Pursuant to rules adopted under section 3724.05 of the Revised Code, prepare special diets for residents in accordance with the instructions of a physician or a dietitian licensed under Chapter 4739. of the Revised Code.

Effective Date: 11-01-1989

(A) Application for a license to operate a community alternative home shall be made by the operator to the director of health on forms provided by the director. After investigating the application and inspecting the home, the director shall issue a license if the director determines that the following requirements have been met:

(1) The home is in compliance with this chapter and rules adopted by the public health council under section 3724.05 of the Revised Code.

(2) The home meets the fire safety standards established by rules adopted under section 3724.05 of the Revised Code and has been inspected and approved by a certified electrical safety inspector.

(3) The home complies with local zoning regulations.

(4) If applicable, the home has a valid food service license issued under Chapter 3717. of the Revised Code.

(5) The operator has not been convicted of a felony or a crime involving moral turpitude.

(6) The operator has provided all documentation requested by the director.

(7) The operator has developed policies for infection control and for educating caregivers about acquired immunodeficiency syndrome.

(8) The operator has paid the license fee established by rule of the public health council under section 3724.05 of the Revised Code.

At the request of the operator on a form furnished by the director, the director, in accordance with rules adopted by the public health council, may waive any licensing requirement established by rule of the council if the director determines that strict application of the requirement would cause undue hardship to the home and that the grant of a waiver would not jeopardize the health and safety of any resident of the home. The waiver may be granted at the time of initial licensing or renewal or during a licensing period and may be temporary or permanent.

The license shall contain the name and address of the home for which it is issued, the date of expiration of the license, and the maximum number of residents that may be accommodated by the home. A license is valid for two years from the date of issuance.

Sections 3781.06 to 3781.18 and 3791.04 of the Revised Code and building standards adopted pursuant to those sections do not apply to any structure for which application is made for licensure as a community alternative home unless the license is denied.

(B) The director may issue a temporary license pending completion of the licensing inspection if the application and documentation meet the requirements of this chapter and the rules adopted by the public health council. A temporary license is valid for ninety days and may be renewed for an additional ninety days. The director also may renew a temporary license for the duration of proceedings under Chapter 119. of the Revised Code regarding the denial of a license if the director determines that the continued operation of the home will not jeopardize the health or safety of the residents.

(C) Application for renewal of a license to operate a community alternative home shall be made by the operator to the director of health on forms provided by the director. In addition to submitting the application and a fee in the amount established by rules of the public health council, the operator shall inform the director of any changes in the ownership or structure of the buildings housing the home. If the electrical wiring has been altered, the operator shall submit proof that the alteration has been inspected and approved by a certified electrical safety inspector. The director shall inspect the facility and shall renew the license if the director determines that the home complies with the requirements of this chapter and the rules adopted by the public health council.

(D) In accordance with Chapter 119. of the Revised Code, the director may deny, revoke, or refuse to issue or renew a license or a temporary license for any community alternative home that fails to comply with any requirement of this chapter or with any rules adopted by the public health council.

Effective Date: 11-03-1999

(A) The director of health shall make at least one unannounced inspection of a community alternative home during each licensure period in addition to inspecting the home to determine whether a license should be issued or renewed. The director may make other inspections at any time he considers appropriate.

(B) The director may issue an emergency order to a community alternative home on finding an emergency requiring immediate action to protect the health or safety of the public or of residents of the home. The order shall specify action to be taken to correct the situation causing the emergency, shall be effective immediately, and shall continue in effect for ninety days. The home shall comply with the order immediately but, on application to the director, shall be afforded a hearing as soon as possible to determine whether the order should be modified or withdrawn.

(C) Any duty or responsibility imposed on the director by this chapter may be carried out by another official or employee of the department of health.

Effective Date: 11-01-1989

The public health council, in accordance with Chapter 119. of the Revised Code, shall adopt rules governing licensing and operation of community alternative homes. The rules shall do all of the following:

(A) Establish criteria and procedures for issuance, renewal, and revocation of licenses and temporary licenses, for the granting and denial of waivers, and for issuance and termination of emergency orders;

(B) Specify qualifications, including training, education, work experience, health requirements, and standards of conduct, for operators, residence managers, caregivers, and other employees of community alternative homes, and the number of staff members required in a home;

(C) Establish nonrefundable fees for issuance and renewal of licenses under this chapter in an amount calculated to defray the costs of administering and enforcing the requirements of this chapter and rules for licensure;

(D) Establish requirements regarding the minimum space a community alternative home must provide each resident and requirements for equipment of the home;

(E) Establish adequate building, fire, safety, and sanitation standards for homes;

(F) Specify the types of services to be provided by a home and establish criteria and standards for these services;

(G) Establish procedures for enforcing the residents’ rights enumerated in section 3724.07 of the Revised Code;

(H) Establish requirements for record keeping and maintaining confidentiality of records;

(I) Establish minimum requirements for policies and procedures to be followed by a home regarding residents’ medications, including storage, disposal, and the provision of assistance with self-administration of medication;

(J) Establish requirements regarding special diets that may be prepared under division (D) of section 3724.021 of the Revised Code;

(K) Establish requirements for initial and periodic health assessments of residents by physicians, including assessment of each resident’s capacity for self-administration of prescribed medications, to ensure that residents do not require care that a community alternative home is not licensed to provide;

(L) Regulate any other matters necessary for the implementation of this chapter.

Effective Date: 11-01-1989

There is hereby created in the state treasury the community alternative home fund. Notwithstanding section 2335.37 of the Revised Code, all fees collected under this chapter, civil penalties assessed under section 3724.13 of the Revised Code, fines imposed under section 3724.99 of the Revised Code, and any other moneys received by the director of health for the purposes of this chapter shall be credited to the fund and expended only for the administration and enforcement of this chapter and rules adopted under it.

Effective Date: 11-01-1989

(A) As used in this section:

(1) “Sponsor” means a guardian or an adult relative or friend of a resident of a community alternative home who has an interest in or responsibility for the welfare of the resident.

(2) “Physical restraint” includes, but is not limited to, a geriatric chair, the locked door of a room, or any article, device, or garment that interferes with the free movement of the resident and that he is unable to remove easily.

(3) “Chemical restraint” means chlorpromazine hydrochloride or any drug that is listed in the schedules of controlled substances under section 3719.41 of the Revised Code as a substance having a depressant effect on the central nervous system.

(B) The rights of a resident of a community alternative home include all of the following:

(1) The right to a safe, healthy, and decent living environment;

(2) The right to be treated at all times with courtesy, respect, and full recognition of personal dignity and individuality;

(3) The right to have all reasonable requests and inquiries responded to promptly;

(4) The right to have clothes and bed sheets changed as the need arises, to ensure that his condition is comfortable or sanitary;

(5) The right to confidential treatment of personal and medical records, and the right to approve or refuse the release of these records to any individual except as authorized by law or rule, except in the case of transfer to another community alternative home or health care facility;

(6) The right to privacy during medical examination or treatment and in the care of personal or bodily needs;

(7) The right to exercise all civil rights, unless he has been adjudicated incompetent pursuant to Chapter 2111. of the Revised Code and has not been restored to legal capacity, as well as the right to the cooperation of the operator or residence manager in making arrangements for him to exercise the right to vote;

(8) The right to retire and rise in accordance with his reasonable request, if he does not disturb others or interfere with meal schedules;

(9) The right to refuse medical treatment or services, or if he has been adjudicated incompetent pursuant to Chapter 2111. of the Revised Code, the right to have his legal guardian make decisions about medical treatment and services for him;

(10) The right to observe religious obligations and participate in religious activities;

(11) The right to manage personal financial affairs;

(12) The right to ownership and reasonable use of personal property, including clothing, so as to maintain dignity and individuality;

(13) The right to engage in activities of his own choosing within reason, or to refrain from engaging in activities;

(14) The right to participate in activities within the home and use the common areas within reason unless his physician has indicated, in his medical record, that an activity is not medically advisable;

(15) The right to private and unrestricted communications including:

(a) The right to receive and send sealed, unopened correspondence;

(b) The right to reasonable access to a telephone for private communications;

(c) The right to private visits at a reasonable hour.

(16) The right to initiate and maintain contact with the community, including the right to participate in the activities of community groups at his initiative or at the initiative of community groups, unless his physician has indicated, in his medical record, that an activity is not medically advisable;

(17) The right to retain the services of a health care or social services provider at his own expense;

(18) The right to be free from abuse, neglect, or exploitation;

(19) The right to be free from physical or chemical restraints or prolonged isolation except as specified in rules of the public health council adopted under section 3724.05 of the Revised Code;

(20) The right to examine billing records pertaining to his care, to be informed, in writing, of the rates charged by the home as well as any additional charges, and to receive thirty days’ notice, in writing, of any change in the rates and charges;

(21) The right to state grievances and recommend changes in policies and services to the home’s staff, to a governmental agency, or to any other person without reprisal;

(22) The right to have any significant change in his health reported to his sponsor;

(23) The right not to be transferred or discharged from the home except as authorized by section 3724.10 of the Revised Code.

(C) A sponsor may assert on behalf of a resident any of the rights enumerated in this section.

(D) A resident whose rights under this section have been violated has a civil cause of action against the home or person committing the violation. The action may be commenced by the resident or by a sponsor on his behalf.

Effective Date: 11-01-1989

The following persons may become residents’ rights advocates for community alternative homes by registering with the department of health under section 3701.07 of the Revised Code:

(A) An employee or representative of any entity of state or local government that has a responsibility for residents of a community alternative home;

(B) An employee or representative, other than an operator or employee of a community alternative home or nursing home, of any private nonprofit corporation or association that qualifies for tax-exempt status under section 501(a) of the “Internal Revenue Code of 1986,” 100 Stat. 2085, 26 U.S.C. 501, as amended, whose purposes include educating and counseling residents, helping residents resolve problems and complaints concerning their care and treatment, and helping them secure adequate services.

Effective Date: 11-01-1989

The operator of a community alternative home shall establish a written residents’ rights policy containing the residents’ rights enumerated in section 3724.07 of the Revised Code, any rules pertaining to residents’ rights adopted by the public health council under section 3724.05 of the Revised Code, and the grievance procedure and policies of the home. At the time of admission, the residence manager shall give a copy of the residents’ rights policy to the resident and his sponsor, if any, and explain the contents of the policy to them.

The operator or residence manager shall post prominently within the community alternative home a copy of the residents’ rights listed in section 3724.07 of the Revised Code and a list of residents’ rights advocates for community alternative homes.

Effective Date: 11-01-1989

(A) In the absence of a request from a resident to do so, an administrator may transfer or discharge a resident from a community alternative home only for one or more of the following reasons:

(1) Charges for the resident’s accommodations and services have not been paid within a reasonable time of the date on which they became due;

(2) The medical condition of the resident requires care the home is not licensed to provide;

(3) The safety or welfare of the resident or of another resident requires a transfer or discharge;

(4) The license of the home has been revoked or renewal has been denied;

(5) The operator is closing the home.

(B) The operator shall notify a resident in writing at least thirty days before a transfer or discharge from a community alternative home unless the transfer or discharge is for a reason given in divisions (A)(2) to (5) of this section and an emergency exists. At the request of the resident, the director of health shall conduct a hearing if the transfer or discharge is for a reason given in division (A)(1), (2), or (3) of this section. The notice shall set forth the reasons for the proposed transfer or discharge and, if the resident is entitled to a hearing, shall apprise him of this right and outline the procedure for requesting a hearing.

A request for a hearing shall be submitted to the director within ten days after the resident receives the written notice. The hearing shall be held within ten days after the director receives the request; a representative of the director shall preside. Within five days after the hearing, the director shall issue an order, which may prohibit or place conditions on the discharge or transfer or, in the case of transfer, may require that the transfer be to an institution or facility specified by the director. The hearing is not subject to section 121.22 of the Revised Code.

Effective Date: 11-01-1989

Any person who believes that a community alternative home or a person or agency of state or local government is in violation of this chapter or any of the rules adopted by the public health council under section 3724.05 of the Revised Code may make a report to the director of health. The identity of the person shall not be released without his written consent. The director shall not reveal any reports made under this section except that he may provide information contained in a report to a government agency responsible for enforcing laws governing community alternative homes. The director shall investigate the reports and take any necessary action authorized by this chapter and rules adopted by the public health council. The director shall keep a record of the investigation and any resulting action and shall inform the operator of the home of the investigation results.

On receipt of a report to the department or on a reasonable belief that an institution, residence, or other facility is being operated as a community alternative home without a license, the director or employees of the department may enter the facility to make an investigation.

Any person who makes a report pursuant to this section or any person who participates in an administrative or judicial proceeding resulting from the report is immune from civil liability for these actions unless the person acted in bad faith or with malicious purpose. No employer shall take any action detrimental to an employee or retaliate against an employee as a result of the employee’s having filed a report under this section.

Effective Date: 11-01-1989

Employees of the departments of health and aging and persons employed pursuant to division (M) of section 173.01 of the Revised Code in the long-term care facilities ombudsperson program may enter a community alternative home at any time.

Persons who may enter a community alternative home during reasonable hours are a resident’s sponsor, residents’ rights advocates, a resident’s attorney, a physician or other person providing health care services to a resident, a prospective resident and prospective resident’s sponsor, employees of county departments of job and family services, and a minister, priest, rabbi, or other person ministering to a resident’s religious needs.

Effective Date: 07-01-2000

The director of health may request that the attorney general bring an action in the court of common pleas in the county in which a community alternative home is located for appropriate injunctive relief against the home if the director determines that the operation of the home constitutes a real and present danger to the health and safety of any of the residents or if the director determines that the home is operating without a license. The court shall grant appropriate injunctive relief on a showing that the operation of the home constitutes a real and present danger to the health or safety of any of the residents or that the home is operating without a license.

At the request of the director of health, the attorney general shall bring an action for appropriate relief, including civil penalties, in the court of common pleas of the county in which a violation of this chapter or the rules adopted under it has occurred or is occurring. The court may impose on the violator a civil penalty of not more than one thousand dollars for each day a violation continues.

The remedies in this section are cumulative to other remedies available under federal or state law or municipal ordinance.

At the request of the director of health, the attorney general may investigate alleged violations of section 3724.02 of the Revised Code. The director of health may request a prosecuting attorney, a city director of law, or a village solicitor to prosecute any person for a violation of section 3724.02 of the Revised Code.

Effective Date: 10-10-1989

Whoever violates section 3724.02 of the Revised Code is guilty of a misdemeanor of the first degree.

Effective Date: 11-01-1989