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This website publishes administrative rules on their effective dates, as designated by the adopting state agencies, colleges, and universities.

Chapter 5122-25 | Certification

 
 
 
Rule
Rule 5122-25-01 | Applicability.
 

(A) The provisions of the rules contained in this chapter are applicable to each provider:

(1) Providing mental health and addiction services that are funded by, or funding is being sought from:

(a) The Ohio medicaid program for community mental health or community addiction services.

(b) A board of alcohol, drug addiction, and mental health services.

(c) Federal or department block grant funding for certified services.

Any service contact provided by a provider that is paid for by the Ohio medicaid program for community mental health or community addiction services, or in whole or in part by any community mental health board of alcohol, drug addiction, and mental health service or federal or department block grant funding shall be subject to the provisions of this chapter.

(2) Providing the following addiction treatment services, regardless of payor source:

(a) Withdrawal management addiction services provided in a setting other than an acute care hospital;

(b) Addiction services provided in a residential treatment setting;

(c) Addiction services provided on an outpatient basis, including one or more of the following addiction services provided on an outpatient basis:

(i) General services.

(ii) Crisis intervention service.

(iii) Peer recovery services.

(iv) SUD case management services.

This paragraph does not apply to either of the following:

An individual who holds a valid license, certificate, or registration issued by this state authorizing the practice of a health care profession that includes the performance of the services described in paragraphs (A)(2)(a) to (A)(2)(c) of this rule, regardless of whether the services are performed as part of a sole proprietorship, partnership, or group practice;

An individual who provides the services described in paragraphs (A)(2)(a) to (A)(2)(c) of this rule as part of an employment or contractual relationship with a hospital outpatient clinic that is accredited by an accreditation agency or organization approved by the director of mental health and addiction services.

(3) Subject to department certification as a driver intervention program, public or private.

(4) Is seeking licensure as an opioid treatment program in accordance with Chapter 5122-40 of the Administrative Code.

(5) That voluntarily request certification.

(B) This chapter does not diminish or enhance the authority of boards of alcohol, drug addiction, and mental health services to administer the community mental health or addiction treatment system pursuant to the Ohio Revised Code, and applicable federal law.

Supplemental Information

Authorized By: 5119.36
Amplifies: 5119.36
Five Year Review Date: 2/1/2021
Prior Effective Dates: 2/1/2016
Rule 5122-25-02 | Accreditation and deemed status.
 

(A) A provider seeking certification for one or more of the following services may attain appropriate behavioral health accreditation, which includes an accrediting body survey of the actual provision of services, prior to submitting an application for certification:

(1) General services as defined in rule 5122-29-03 of the Administrative Code;

(2) Mental health day treatment service as defined in rule 5122-29-06 of the Administrative Code;

(3) Residential and withdrawal management substance use disorder service as defined in rule 5122-29-09 of the Administrative Code;

(4) Crisis intervention service as defined in rule 5122-29-10 of the Administrative Code;

(5) SUD case management service as defined in rule 5122-29-13 of the Administrative Code;

(6) Community psychiatric supportive treatment (CPST) service as defined in rule 5122-29-17 of the Administrative Code;

(7) Therapeutic behavioral services and psychosocial rehabilitation service as defined in rule 5122-29-18 of the Administrative Code;

(8) Intensive home based treatment (IHBT) service as defined in rule 5122-29-28 of the Administrative Code;

(9) Assertive community treatment (ACT) service as defined in rule 5122-29-29 of the Administrative Code;

(10) Prevention services as defined in rule 5122-29-20 of the Administrative Code.

(B) Behavioral health accreditation referenced in paragraph (A) of this rule shall be obtained from one or more of the following accrediting bodies:

(1) The joint commission;

(2) Commission on accreditation of rehabilitation facilities;

(3) Council on accreditation; or,

(4) Other behavioral health accreditation as determined by the director.

(C) A provider seeking certification for both substance use disorder (SUD) services and mental health services under deemed status must ensure the accrediting body reviews or accredits the provision of both SUD and mental health services.

(D) The department may:

(1) Add the names of other accrediting bodies to those listed in paragraph (B) of this rule if it determines that such bodies meet its accreditation requirements.

(2) Likewise, the department may delete the names of accrediting bodies from those listed in paragraph (B) of this rule if it determines that such bodies no longer meet its accreditation requirements.

A provider accredited by a body the department chooses to delete from those listed in paragraph (B) of this rule shall remain certified until its current accreditation expires. If a provider wishes to retain certification after that time, it must attain accreditation from a body recognized by the department or undergo the non-deemed status certification process in accordance with rule 5122-25-03 of the Administrative Code.

(E) A provider granted deemed status in accordance with rule 5122-25-04 of the Administrative Code shall maintain its accreditation throughout its term of certification. Should a provider choose to not submit a renewal application to its accrediting body, the provider shall notify the department within seven days of the accrediting body deadline for renewal and will be subject to a certification fee and full certification survey. A provider that does not provide timely notification of its decision not to renew its accreditation will be assessed an additional fee in accordance with rule 5122-25-08 of the Administrative Code. In addition, a provider granted deemed status that fails to notify the department that it did not submit a timely renewal application to its accrediting body may be subject to certification revocation in accordance with Chapter 119. of the Revised Code.

(F) The provider shall inform the department, the appropriate boards, and local client advocacy groups in writing of its accreditation survey date at least thirty days prior to the beginning of a scheduled accreditation survey, or when the provider is given less than thirty days notice of a scheduled survey, within seven days of receiving notice from the accrediting body. A provider undergoing an unannounced or unscheduled accreditation survey shall inform the department in writing within seven days after the conclusion of the unannounced or unscheduled accreditation survey.

(G) The department shall accept the provider's appropriate behavioral health accreditation as evidence of compliance with the services identified in paragraphs (A) and (C) of this rule and Chapters 5122-26 to 5122-28 of the Administrative Code.

Rule 5122-26-13 of the Administrative Code (incident notification) is exempt from this paragraph and deemed status recognition. Regardless of accreditation and deemed status, providers must maintain compliance with this rule, including the requirement to submit incident notifications to the department.

(H) The department shall only grant deemed status for services which are accredited. The department may grant partial deemed status to a provider when:

(1) The provider has accreditation for some, but not all, of the services listed in paragraphs (A) and (C) of this rule;

(2) The provider is applying for certification to provide both SUD and mental health services, but the accrediting body has not reviewed and accredited the provision of both; or,

(3) The providers accrediting body did not review clinical services when issuing the accreditation.

(I) A provider applying for deemed status by the department must submit the most recent copy of the following:

(1) Each of the accrediting body's survey reports, and any modifications made to the survey report if applicable;

(2) Certificate, license or plaque awarded by the accrediting body; and,

(3) Accreditation award notification letter if requested by the department.

(J) A provider must notify the department within ten days of any change to its accreditation status, by providing a copy of the accreditation status change notification.

(1) Should a provider's accreditation status be granted as or modified to probation, stipulations, conditional, provisional, deferral, preliminary denial or other similar status, the department may ask for additional documentation until such time as full accreditation status is restored. Full accreditation status means the accrediting body has issued an accreditation decision of "accredited" or "accreditation" without additional conditions or modifiers other than three-year or one-year accreditation.

(2) Should a provider's accreditation be denied, suspended or revoked by the accrediting body, the department shall withdraw deemed status and the provider shall be subject to a certification fee and full certification survey or certification revocation in accordance with Chapter 119. of the Revised Code.

(K) The department may conduct surveys or review documentation of a sample of providers having achieved appropriate behavioral health accreditation in order to evaluate whether the accreditation processes used by the organizations are consistent with service delivery models the director considers appropriate for SUD and mental health services. The department will communicate to an accrediting organization any identified concerns, trends, needs, and recommendations. The department shall have access to all records necessary to evaluate the accrediting body processes, but may not conduct a survey or request documentation under this paragraph for the purpose of determining compliance with certifications standards.

Supplemental Information

Authorized By: 5119.36
Amplifies: 5119.36
Five Year Review Date: 1/27/2022
Prior Effective Dates: 11/15/2004
Rule 5122-25-03 | Certification procedure for non-deemed status.
 

(A) Any provider subject to or seeking certification under this rule shall apply to the department by filing an application.

(1) A provider that is not requesting deemed status by the department according to rule 5122-25-02 of the Administrative Code shall file an application that includes, but is not limited to:

(a) Identifying information including:

(i) Legal name as filed with the Ohio secretary of state, including any fictitious name ("doing business as") if applicable;

(ii) Addresses and telephone numbers at which the applicant operates and address for legal notice and correspondence. Each provider shall have at least one physical location that is certified. A location which would be considered the client's natural environment (e.g. school, home, job and family services agency) is not considered a site and need not be certified;

(iii) Governing structure and the names and contact information of the governing body, board of directors, LLC members, or similar body;

(iv) Provider budget;

(v) Table of organization;

(vi) Name and e-mail address of executive director, chief executive officer, or president;

(vii) Name and e-mail address of designated provider contact person who shall be the primary contact on behalf of the provider;

(viii) Current and previous history of state agency licensure and certification;

(ix) Whether the provider is requesting certification to provide mental health services, addiction treatment services, or services to both populations;

(x) Policies and procedures, plans and other documentation required by Chapters 5122-26 to 5122-29 of the Administrative Code;

(xi) List of qualified providers and supervisor according to Chapter 5122-29 of the Administrative Code and the services they provide and/or supervise, and license number;

(xii) List of services according to Chapter 5122-29 of the Administrative Code to be provided during the term of certification;

(xiii) Number of beds for each residential and withdrawal management substance use disorder services location; and,

(xiv) Other information or material if requested by the department to determine the applicants services meet certification standards.

(b) Upon request of the department, the following corporate information:

(i) A copy of the applicant's articles of incorporation and all amendments;

(ii) Identification of the statutory corporate agent for service; and,

(iii) If an out-of-state corporation, a copy of the certificate from the Ohio secretary of state, of registration to do business in Ohio.

Before requesting this information, the department shall first attempt to obtain the information from the Ohio secretary of state website.

(c) Copies of approved physical inspections, either initial or renewal, for each building owned or leased, including:

(i) A building inspection by a local certified building inspector or a certificate of occupancy issued by the department of industrial relations, to be re-inspected whenever there are major alterations or modifications to the building or facility. An additional building inspection shall be required for any major change in the use of space that would make the facility subject to review under different building code standards;

(ii) Approved fire inspection conducted within the previous twelve months, which shall be free of deficiencies, and was conducted by a certified fire authority, or where there is none available, by the division of the state fire marshal of the department of commerce;

(iii) Water supply and sewage disposal inspection for facilities in which these systems are not connected with public services to certify compliance with rules of the department of health and any other state or local regulations, rules, codes or ordinances;

(iv) Current boiler certificate of operation, if applicable;

(v) Current elevator permit, if applicable; and,

(vi) Food service license or permit, if required by the department of health.

(d) The applicable non-refundable certification fee as provided for in rule 5122-25-08 of the Administrative Code.

(e) Documentation of any existing waivers or variances from the department regarding the certification standards, and justification if the provider is seeking their renewal.

(f) Notification if the provider uses seclusion or restraint as defined in rule 5122-26-16 of the Administrative Code; and,

(g) If a provider is seeking certification for supplemental behavioral health services as defined in rule 5122-29-27 of the Administrative Code, that are funded in whole or in part by a board, and for which there are no specific certification standards, the name of the service, a brief description of the service, and a letter of approval from the board shall be submitted.

(h) Driver intervention programs shall include:

(i) The total number of hours of operation, including the total number of program hours;

(ii) If services are provided at a camp, a copy of the "Permission to Operate a Camp" issued by the local county/city health department pursuant to rule 3701-25-02 of the Administrative Code.

(iii) If services are provided at a hotel or motel, a copy of the hotel/motel license from the division of the state fire marshal of the Ohio department of commerce will be accepted in lieu of a copy of a occupancy and use certificate and annual fire inspection.

(B) Upon receipt of an application, the department shall review the materials to determine if they are complete. If an application is incomplete, the department shall notify the applicant of corrections or additions needed, and may return the materials to the applicant.

Incomplete materials, including failure to pay the full certification fee, shall not be considered an application for certification, and return of the materials or failure to issue a certificate shall not constitute a denial of an application for certification.

(C) Following the department's acceptance of materials as a complete application, the department shall determine whether the applicant's services and activities meet certification standards. The process for such a determination consists of:

(1) Interim certification application process:

(a) The department shall review the application materials for compliance with Chapters 5122-26 to 5122-29 of the Administrative Code.

(b) The department may conduct an on-site inspection of the physical plant environment.

(c) The provider must demonstrate clinical readiness to meet the documentation requirements of Chapter 5122-27 of the Administrative Code by demonstrating it has acquired an electronic health record system that supports documentation to meet these requirements and/or providing samples of paper forms.

(d) A provider that fails to respond to a request to submit additional documentation or a request to submit a corrective response (e.g. corrective action plan or plan of correction) within ninety days shall automatically be considered to have withdrawn its application. If the provider wishes to seek certification, it shall file a new initial application.

(2) Initial renewal and full certification application process:

(a) Review the application materials for compliance with Chapters 5122-26 to 5122-29 of the Administrative Code.

(b) For an initial certification only, a provider that fails to respond to a request to submit additional documentation or a request to submit a corrective response (e.g. corrective action plan or plan of correction) within ninety days shall automatically be considered to have withdrawn its application. If the provider wishes to seek certification, it shall file a new initial application.

(c) Schedule and conduct an on-site survey or otherwise evaluate the applicant's services and activities.

(i) The department shall schedule and conduct an on-site survey prior to the expiration date of an interim certificate issued in accordance with paragraph (C)(1) of this rule and paragraph (F)(2)(a) of rule 5122-25-05 of the Administrative Code.

(ii) The department may schedule and conduct an on-site survey or otherwise evaluate the applicants services and activities for a provider seeking or granted any other initial certification or for a provider seeking renewal certification.

(iii) If conducting an on-site survey, the department shall send the provider a letter confirming the date of the on-site survey, and notify, in writing, the applicable board of the date of the on-site survey.

(iv) At least thirty days before a scheduled survey date, the applicant shall post notices of the survey date and of the opportunity for the public to participate in a public information interview during the survey. Such notices shall be posted in public areas, on bulletin boards near major entrances, and in treatment or residential areas of the applicant.

(v) The department shall have access to all written, electronic and recorded records to verify compliance with certification standards as established by department rules. The department may conduct interviews with members of the provider's governing authority, staff, others in the community and clients with the client's permission.

(vi) Exit interviews with provider staff shall be conducted during routine initial and renewal on-site surveys.

(D) The department may conduct an on-site survey or otherwise evaluate a provider at any time based on cause, including complaints made by or on behalf of consumers and confirmed or alleged deficiencies brought to the attention of the director. The department may or may not notify a provider in advance of a survey conducted for cause.

The department shall have access to all written, electronic and recorded records or media to verify compliance with certification standards as established by department rules. The department may conduct interviews with members of the provider's governing authority, staff, others in the community and clients with the client's permission.

(E) An applicant that fails to comply with any or all of the certification standards applicable to the provider shall receive a written statement from the department citing items that are not in compliance.

(1) This statement shall describe the deficiencies, actions needed for correction as applicable, and a time frame for the provider to submit a written corrective action plan.

(2) The provider's corrective action plan shall describe the actions to be taken and shall specify a time frame for correction of deficiencies.

(F) If a provider adds a service or activity subject to certification during the term of certification, the provider shall submit a description of the service or activity and the list of qualified providers and supervisors, including license number and licensing or credentialing body, or diploma or degree if applicable. Upon determination by the department that the service or activity is in compliance with certification standards, including conducting an on-site survey, if indicated, the department will certify the provider to provide that service or activity.

(G) If a provider adds a new location during the term of certification, the provider shall submit the documentation required in paragraph (A)(1)(c) of this rule. Upon determination by the department that the site is in compliance with certification standards, the department will certify the agency provider to provide services at that location.

(1) The following services are site specific, meaning that a provider must request certification at each specific location:

(a) Residential and withdrawal management substance use disorder provided in accordance with rule 5122-29-09 of the Administrative Code.

(b) Driver intervention program provided in accordance with rule 5122-29-12 of the Administrative Code.

(2) A provider may provide any currently certified service not included in paragraph (G)(1) of this rule at any certified location.

(H) Each provider shall submit an application for certification renewal no fewer than ninety days prior to the expiration of the current certificate.

(I) A provider that has not previously notified the department that it utilizes seclusion and restraint must do so and submit any documentation requested by the department to verify its compliance with the Administrative Code prior to utilizing these measures. A provider shall not utilize seclusion restraint without written acknowledgment from the department that it is authorized to do so.

Supplemental Information

Authorized By: 5119.36
Amplifies: 5119.36
Five Year Review Date: 1/27/2022
Prior Effective Dates: 11/24/2011, 10/1/2012
Rule 5122-25-04 | Certification procedure for deemed status.
 

(A) Any provider subject to or seeking certification under this rule shall apply to the department by filing an application.

(1) A provider that has received accreditation for one or more of the services in which it is seeking certification, and is applying for deemed status from the department according to rule 5122-25-02 of the Administrative Code shall file an application that includes:

(a) Identifying information including:

(i) Legal name as filed with the Ohio secretary of state, including any fictitious name ("doing business as") if applicable;

(ii) Addresses and telephone numbers at which the applicant operates and address for legal notice and correspondence. Each provider shall have at least one physical site that is certified. A location which would be considered the client's natural environment (e.g. school, home, job and family services agency) is not considered a site and need not be certified;

(iii) Governing structure and the names and contact information of the governing body, board of directors, LLC members or similar body;

(iv) Name and e-mail address of executive director, chief executive officer or president; and

(v) Name and e-mail address of designated provider contact person who shall be the primary contact on behalf of the provider;

(vi) Current and previous history of state agency licensure and certification;

(vii) Whether the provider is requesting certification to provide mental health services, addiction treatment services, or services to both populations;

(viii) A list of services according to Chapter 5122-29 of the Administrative Code to be provided during the term of certification;

(ix) Number of beds for each residential and withdrawal management substance use disorder services location;

(x) A description of the provider's purpose, mission and goals if a provider is applying for its first certification; and,

(xi) Other information or material if requested by the department to determine the applicants services meet certification standards.

(b) Upon request of the department, the following corporate information. Before requesting this information, the department shall first attempt to obtain the information from the Ohio secretary of state website:

(i) Identification of the statutory corporate agent for service; and

(ii) If an out-of-state corporation, a copy of the certificate from the Ohio secretary of state, of registration to do business in Ohio.

(c) For any site which has not been approved or accredited by the provider's accrediting body, copies of approved physical inspections, either initial or renewal, for each building owned or leased, including:

(i) A building inspection by a local certified building inspector or a certificate of occupancy issued by the department of industrial relations, to be re-inspected whenever there are major alterations or modifications to the building or facility. An additional building inspection shall be required for any major change in the use of space that would make the facility subject to review under different building code standards;

(ii) Approved fire inspection conducted within the previous twelve months, which shall be free of deficiencies, and was conducted by a certified fire authority, or where there is none available, by the division of the state fire marshal of the department of commerce;

(iii) Water supply and sewage disposal inspection for facilities in which these systems are not connected with public services to certify compliance with rules of the department of health and any other state or local regulations, rules, codes or ordinances;

(iv) Current boiler certificate of operation, if applicable;

(v) Current elevator permit, if applicable; and,

(vi) Food service license or permit, if required by the department of health.

(d) The applicable non-refundable certification fee as provided for in rule 5122-25-08 of the Administrative Code for services which are not accredited, if applicable.

(e) Documentation of any existing waivers or variances from the department regarding the certification standards, and justification if the provider is seeking their renewal.

(f) Notification if the provider uses seclusion or restraint as defined in rule 5122-26-16 of the Administrative Code.

(g) If a provider is seeking certification for supplemental behavioral health services as defined in rule 5122-29-27 of the Administrative Code, that are funded in whole or in part by a board, and for which there are no specific certification standards, the name of the service, a brief description of the service, and a letter of approval from the board shall be submitted.

(h) The documentation required in paragraph (I) of rule 5122-25-02 of the Administrative Code, unless it has already been submitted and deemed status approved by the department.

(i) Driver intervention programs shall include:

(i) The total number of hours of operation, including the total number of program hours;

(ii) If services are provided at a camp, a copy of the "Permission to Operate a Camp" issued by the local county/city health department pursuant to rule 3701-25-02 of the Administrative Code.

(iii) If services are provided at a hotel or motel, a copy of the hotel/motel license from the division of the state fire marshal of the Ohio department of commerce will be accepted in lieu of a copy of a occupancy and use certificate and annual fire inspection.

(j) Documentation requested by the department for any service not included under the deemed status provision of rule 5122-25-02 of the Administrative Code.

(B) Upon receipt of an application, the department shall review the materials to determine if they are complete. If an application is incomplete, the department shall notify the applicant of corrections or additions needed, and may return the materials to the applicant. Incomplete materials shall not be considered an application for certification, and return of the materials or failure to issue a certificate shall not constitute a denial of an application for certification.

(C) Following the department's acceptance of materials as a complete application, the department shall determine whether the applicant's services and activities meet certification standards. The process for such a determination consists of the following:

(1) For a provider applying for deemed status, the department shall review the application materials, and issue the certification for services covered under deemed status without further evaluation of the services, except that the department may conduct an on-site survey or otherwise evaluate the provider for cause, including complaints made by or on behalf of consumers and confirmed or alleged deficiencies brought to the attention of the department.

(2) For services not included in a provider's deemed status approval, the department may schedule and conduct an on-site survey of or otherwise evaluate the applicant's services and activities.

If conducting an on-site survey, the department shall send the provider a letter confirming the date of the on-site survey, and notify, in writing, the applicable board of the date of the on-site survey. At least thirty days before a scheduled survey date, the applicant shall post notices of the survey date and of the opportunity for the public to participate in a public information interview during the survey. Such notices shall be posted in public areas, on bulletin boards near major entrances, and in treatment or residential areas of the applicant.

The department shall have access to all written, electronic and recorded records to verify compliance with certification standards as established by department rules. The department may conduct interviews with members of the provider's governing authority, staff, others in the community and clients with the client's permission.

Exit interviews with provider staff shall be conducted during routine initial and renewal on-site surveys.

(D) The department may conduct an on-site survey or otherwise evaluate a provider applying for or granted deemed status at any time based on cause, including complaints made by or on behalf of consumers and confirmed or alleged deficiencies brought to the attention of the director. The department may or may not notify a provider in advance of a survey conducted for cause.

The department shall have access to all written, electronic and recorded records or media to verify compliance with certification standards as established by department rules. The department may conduct interviews with members of the provider's governing authority, staff, others in the community and clients with the client's permission.

(E) An applicant that fails to comply with any or all of the certification standards applicable to the agency shall receive a written statement from the department citing items that are not in compliance.

(1) This statement shall describe the deficiencies, actions needed for correction, and a time frame for the provider to submit a written plan of correction.

(2) The provider's plan of correction shall describe the actions to be taken and shall specify a time frame for correction of deficiencies.

(F) If a provider adds a service or activity subject to certification during the term of certification, the provider shall submit:

(1) For a provider applying for deemed status, the documentation required in paragraph (K) of rule 5122-25-02 of the Administrative Code. Upon determination by the department that the provider has obtained appropriate behavioral health accreditation, the department will certify the provider to provide that service or activity.

(2) Interim certification application process:

(a) The department shall review the application materials for compliance with Chapters 5122-26 to 5122-29 of the Administrative Code.

(b) The department may conduct an on-site inspection of the physical plant environment if the location is not accredited by the accrediting body.

(c) The provider must demonstrate clinical readiness to meet the documentation requirements of Chapter 5122-27 of the Administrative Code by demonstrating it has acquired an electronic health record system that supports documentation to meet these requirements and/or providing samples of paper forms.

(d) A provider that fails to respond to a request to submit additional documentation or a request to submit a corrective response (e.g. corrective action plan or plan of correction) within ninety days shall automatically be considered to have withdrawn its application. If the provider wishes to seek certification, it shall file a new initial application.

(3) Initial full certification application process:

(a) Review the application materials for compliance with Chapters 5122-26 to 5122-29 of the Administrative Code.

(b) For an initial certification only, a provider that fails to respond to a request to submit additional documentation or a request to submit a corrective response (e.g. corrective action plan or plan of correction) within ninety days shall automatically be considered to have withdrawn its application. If the provider wishes to seek certification, it shall file a new initial application.

(c) The department shall schedule and conduct an on-site survey prior to the expiration date of an interim certificate issued in accordance with paragraph (F)(2) of this rule and paragraph (F)(2)(a) of rule 5122-25-05 of the Administrative Code unless the provider has obtained accreditation for the service that includes an on-site survey by the accrediting body to review the provision of the service.

(d) The department may schedule and conduct an on-site survey or otherwise evaluate the applicants services and activities if a provider is seeking any other initial certification.

(e) If conducting an on-site survey, the department shall send the provider a letter confirming the date of the on-site survey, and notify, in writing, the applicable board of the date of the on-site survey.

(f) At least thirty days before a scheduled survey date, the applicant shall post notices of the survey date and of the opportunity for the public to participate in a public information interview during the survey. Such notices shall be posted in public areas, on bulletin boards near major entrances, and in treatment or residential areas of the applicant.

(g) The department shall have access to all written, electronic and recorded records to verify compliance with certification standards as established by department rules. The department may conduct interviews with members of the provider's governing authority, staff, others in the community and clients with the client's permission.

(h) Exit interviews with provider staff shall be conducted during routine initial and renewal on-site surveys.

(G) If a provider adds a new location during the term of certification, the provider shall submit either the documentation required in paragraph (A)(1)(c) of this rule, or evidence that the site has been approved by its accrediting body. Upon determination by the department that the site is in compliance with certification standards, the department will certify the provider to provide services at that location.

(1) The following services are site specific, meaning that a provider must request certification at each specific location:

(a) Residential and withdrawal management substance use disorder provided in accordance with rule 5122-29-09 of the Administrative Code.

(b) Driver intervention program provided in accordance with rule 5122-29-12 of the Administrative Code.

(2) A provider may provide any currently certified service not included in paragraph (G)(1) of this rule at any certified location.

(H) Each agency shall submit an application for certification renewal no fewer than ninety days prior to the expiration of the current certificate.

(I) A provider that has not previously notified the department that it utilizes seclusion and restraint must do so and submit any documentation requested by the department to verify its compliance with the Administrative Code prior to utilizing these measures. A provider shall not utilize seclusion restraint without written acknowledgment from the department that it is authorized to do so.

Supplemental Information

Authorized By: 5119.36
Amplifies: 5119.36
Five Year Review Date: 1/27/2022
Prior Effective Dates: 10/1/2012, 2/1/2016
Rule 5122-25-05 | Interim certification process and provisions of certification.
 

(A) Except as provided for in this rule, no person or government entity shall provide any of the following alcohol and drug addiction services unless the services have been certified under this chapter:

(1) Residential and withdrawal management substance use disorder services provided in a setting other than an acute care hospital;

(2) Addiction services provided in a residential treatment setting;

(3) One or more of the following addiction services provided on an outpatient basis:

(a) General services.

(b) Crisis intervention service.

(c) Peer recovery services.

(d) SUD case management services.

(B) Paragraph (A) of this rule does not apply to either of the following:

(1) An individual who holds a valid license, certificate, or registration issued by this state authorizing the practice of a health care profession that includes the performance of the services described in paragraphs (A)(1) to (A)(3) of this rule, regardless of whether the services are performed as part of a sole proprietorship, partnership, or group practice;

(2) An individual who provides the services described paragraphs (A)(1) to (A)(3) of this rule as part of an employment or contractual relationship with a hospital outpatient clinic that is accredited by an accreditation agency or organization approved by the director of mental health and addiction services.

(C) A provider seeking initial provider certification for any addiction treatment services described in paragraph (A) of this rule shall obtain interim certification from the department prior to providing the services.

(D) A provider seeking initial certification to provide mental health and/or addiction treatment services shall submit an application for certification. Upon approval, the department shall issue an interim certification for one hundred eighty days or a full certification for up to three years. The determination of whether to issue an interim or full certification is dependent upon the service(s) for which the provider is seeking certification.

(E) A certified provider seeking to add additional services to its existing certification shall be granted an interim or full certification after the department determines that the providers services or activities are compliant with the applicable services standards. The determination of whether to issue an interim or full certification is dependent upon the service(s) for which the provider is seeking additional certification.

(F) The department may issue one of three types of certificates to a provider, based upon its determination pursuant to either rule 5122-25-03 or rule 5122-25-04 of the Administrative Code:

(1) A probationary certificate, which shall replace a full certificate during the term of probation, and which shall expire within one hundred twenty days of the date of issuance, to be used when:

(a) Serious deficiencies are found during the department's determination of a provider's compliance with the certification standards; or

(b) The provider's documented corrective action is not approved by the department.

(2) An interim certificate:

(a) For one hundred eighty days when a provider is seeking initial certification for any service included in paragraph (A) of this rule.

(b) For up to ninety days after the date of issuance, to be used for emergency certification purposes or administrative reasons as determined by the department.

(3) A full certificate specifying the term of certification, which shall not exceed three calendar years from the date of issuance by the department. This certificate shall remain in effect until it is renewed, terminated or revoked. It shall automatically terminate sixty days after the department notifies the provider of its failure to file an application for certification. The department shall issue a full certificate within thirty days of:

(a) Receipt of complete and compliant application materials; or

(b) Receipt of an acceptable plan of correction, as determined by the department.

(G) A probationary, interim and full certificate is renewable, except that an interim certificate may be renewed only twice.

(H) The certificate is valid only for the specified services.

(I) A certificate is valid only at the locations specified on the certificate.

(1) The following services are site specific, meaning that a provider must request certification at each specific location:

(a) Residential and withdrawal management substance use disorder services provided in accordance with rule 5122-29-09 of the Administrative Code.

(b) Driver intervention program provided in accordance with rule 5122-29-12 of the Administrative Code.

(2) A provider may provide any currently certified service not included in paragraph (I)(1) of this rule at any certified location.

(J) A provider may not alter or modify a certificate.

(K) A certificate is not transferable to any other location, provider site, or building.

(L) A certificate is valid only for the applicant named in the application, and is not transferable to or assumable by any other person, corporation, owner or entity, including any person or entity which purchases the certified programs corporate or managing entity, or enters into any similar purchase agreement. . A provider may not grant the use of its certification to another entity.

(M) A provider shall produce the certificate for review upon request of a client or the department.

(N) A provider shall immediately notify the department and the applicable alcohol and drug addiction services board or alcohol, drug addiction and mental health services board in writing of any changes in its operations that affect the provider's continued compliance with the department's certification requirements.

(O) A provider shall notify the department of any change to its executive director, CEO, president or similar title, to include the name, telephone number and e-mail address of the replacement individual.

(P) A provider shall notify the department in writing of any planned changes to the ownership of the provider. Owners are individuals or corporations with a five per cent or more ownership or controlling interest. Notification shall be made at least thirty days prior to the effective date of the ownership change and include ownership information required by the department.

Supplemental Information

Authorized By: 5119.36
Amplifies: 5119.36
Five Year Review Date: 10/31/2024
Prior Effective Dates: 11/24/2011, 2/1/2016
Rule 5122-25-06 | Waivers and variances.
 

(A) The department may grant a waiver or variance from any certification standard, or portion thereof, for a period of time determined by the department, but that shall not exceed the expiration date of the current certificate. However, requests for waivers and variances that would adversely affect the quality of services or the health and safety of clients will not be granted.

(B) A provider shall submit a written request to the department for a waiver or variance. The written request shall state clearly the rationale and need for the requested waiver or variance.

Within thirty days of receipt of the written request, the department shall:

(1) Provide a specific response to the request; or

(2) Provide an estimate to the provider of the timeframe in which the department will be able to provide a specific response to the request.

Supplemental Information

Authorized By: 5119.36
Amplifies: 5119.36
Five Year Review Date: 1/27/2022
Prior Effective Dates: 10/1/2003
Rule 5122-25-07 | Denial, revocation, and termination of certification.
 

(A) The director may deny or revoke certification for one or more of the following reasons:

(1) The provider fails to comply with any certification standard for which it has not been granted deemed status in accordance with rule 5122-25-02 of the Administrative Code;

(2) The provider misuses or fails to properly account for the disbursement of state or federal funds;

(3) The provider provides false or misleading information or documentation to the department, Ohio medicaid, or a board;

(4) The provider permits an employee to falsify information on client records;

(5) The provider becomes aware of an employee falsifying information on client records which have been billed to the Ohio medicaid program for community mental health or community addiction services and fails to pay back the funds within thirty days or notify Ohio medicaid within thirty days.

(6) The provider is aware of an employee who has abused or neglected a client and has failed to take appropriate disciplinary action to correct the situation;

(7) The provider fails to provide timely access to its records as requested by the department;

(8) Upon the renewal of a provider's probationary certificate issued in accordance with paragraph (F)(1) of rule 5122-25-05 of the Administrative Code; or,

(9) The provider:

(a) Loses accreditation as specified in paragraphs (A) and (C) of rule 5122-25-02 of the Administrative Code; or

(b) Fails to timely notify the department of its decision not to renew its accreditation; or,

(c) If the provider or principal in the provider has been convicted of medicaid fraud.

(10) The provider alters or modifies its certificate.

(B) The denial of an application for certification or the revocation of certification is subject to appeal under Chapter 119. of the Revised Code.

(C) Any provider which has had its certification revoked pursuant to this rule shall not be eligible to apply to the department for certification for at least five years from the date of revocation without the written consent of the department. Any provider with a principal who was a principal of another organization that had its certification revoked shall not be eligible to apply to the department for certification for at least five years from the date of revocation without the written consent of the department.

(D) Any provider which has been denied certification pursuant to this rule shall not be eligible to apply to the department for certification for at least three years from the date of denial without the written consent of the department. Any provider with a principal who was a principal of another organization that had its certification denied shall not be eligible to apply to the department for certification for at least three years from the date of denial without the written consent of the department.

(E) A certificate shall be considered terminated and invalid if the provider fails to reapply sixty days after the department notifies the provider of its failure to file an application for certification., voluntarily relinquishes the certificate, or goes out of business.

(F) Certificates shall be returned to the department upon denial, termination, revocation, or upon voluntarily discontinuing operation of the provider.

Supplemental Information

Authorized By: 5119.36
Amplifies: 5119.36
Five Year Review Date: 1/27/2022
Prior Effective Dates: 2/1/2016
Rule 5122-25-08 | Certification fees.
 

(A) Deemed status

Providers who have received deemed status pursuant to rule 5122-25-04 of the Administrative Code are subject to the following fee structure:

(1) A provider applying for initial or renewal certification and deemed status that has obtained appropriate accreditation for all of the services in which it is seeking certification and for which its accrediting body has standards shall be exempt from paying a certification fee unless a fee is owed under paragraph (F) or (G) of this rule. Paragraph (C) of this rule is not applicable to a provider who has all services accredited for which an accrediting body has standards, regardless of requesting certification for other services.

(2) A provider applying for initial or renewal certification and deemed status which has obtained accreditation for some, but not all, of the services for which it is seeking certification and for which an accrediting body has standards shall pay a certification fee in accordance with paragraph (C) of this rule for those services which are not accredited, along with an additional partial deemed status fee of one thousand dollars. If applicable, the provider is also subject to a certification fee in accordance with paragraph (F) and/or paragraph (G) of this rule.

(B) Non-deemed status

(1) Initial certification: A provider not seeking deemed status shall pay the certification fee at the time of application.

(2) A non-deemed status provider seeking to renew its certification shall pay a renewal fee at least ninety days prior to the expiration of its current certification.

(C) The certification fee shall be based on the total number of services which are being certified, but are not accredited.

(1) The certification fee is two hundred dollars per service for each of the following services. The minimum certification fee is one thousand dollars.

(a) General services pursuant to rule 5122-29-03 of the Administrative Code;

(b) Mental health day treatment services pursuant to rule 5122-29-06 of the Administrative Code;

(c) Residential and inpatient substance use disorder services pursuant to rule 5122-29-09 of the Administrative Code;

(d) Crisis intervention services pursuant to rule 5122-29-10 of the Administrative Code;

(e) Driver intervention program pursuant to rule 5122-29-12 of the Administrative Code

(f) Case management services pursuant to rule 5122-29-13 of the Administrative Code;

(g) Peer recovery services pursuant to rule 5122-29-15 of the Administrative Code;

(h) Community psychiatric supportive treatment (CPST) service pursuant to rule 5122-29-17 of the Administrative Code;

(i) Therapeutic behavioral services and psychosocial rehabilitation services pursuant to rule 5122-29-18 of the Administrative Code;

(j) Prevention services pursuant to rule 5122-29-20 of the Administrative Code;

(k) Intensive home based treatment (IHBT) services pursuant to rule 5122-29-28 of the Administrative Code; and,

(l) Assertive community treatment (ACT) services pursuant to rule 5122-29-29 of the Administrative Code.

(2) The certification fee for all other services is one hundred dollars for each service to be certified. No minimum certification fee is owed under this paragraph, however a provider also seeking certification for one or more services in paragraph (C)(1) of this rule is subject to the one thousand dollars minimum specified by that paragraph.

(3) Peer run organizations, as certified pursuant to rule 5122-29-16 of the Administrative Code, shall be exempt from the certification fee.

(4) Fees are non-refundable.

(D) Additional services

(1) Non-deemed providers.

A non-deemed provider adding an additional service during the term of certification shall pay an additional certification fee based upon the schedule set forth in paragraph (C) of this rule for each occurrence of adding one or more additional service. Except no minimum certification fee is owed under this paragraph.

(2) Deemed providers.

A deemed provider adding an additional service during the term of certification shall pay an additional certification fee only for those additional services for which the provider is not accredited. The fee shall be calculated using the schedule set forth in paragraph (C) of this rule. Except no minimum certification fee is owed under this paragraph.

(E) A provider choosing not to renew its accreditation for some or all of its services shall be assessed a certification fee in accordance with this rule. The certification fee shall be due within sixty days of notification to the department of its decision not to apply to its accrediting body to renew some or all of its accredited services. A provider that fails to inform the department of its decision to not apply to its accrediting body for renewal of some or all of its accredited services no later than seven calendar days after its accrediting body deadline for applying for renewal, shall pay an additional fee of twenty-five hundred dollars. This fee shall be in addition to all other fees owed in accordance with this rule.

(F) If a certification application is returned for being incomplete, the application may be resubmitted but the provider may be required to pay a new certification fee in accordance with the provisions of this rule. The department may waive the new certification fee at its discretion. No fee is owed when the department notifies the applicant that its application is incomplete, but does not return the application.

(G) If the department notifies a provider that the application materials are non-compliant, the provider may submit an application corrective action plan with no penalty. If the department notifies a provider that the resubmitted documentation is non-compliant, the provider may again submit an application corrective action plan with no penalty. If the department notifies a provider that a third application plan of correction is required, the provider will incur a two hundred fifty dollar resubmission fee. The department may waive this fee at its discretion if the application only requires minor corrections. Each subsequent notification of a non-compliant application and application plan of correction requirement shall incur a five hundred dollar resubmission fee. The department may waive this fee at its discretion if the application only requires minor corrections.

(H) The certification fee must be paid by the provider into the sale of goods and services fund created pursuant to section 5119.44 of the Revised Code.

Supplemental Information

Authorized By: 5119.36
Amplifies: 5119.36
Five Year Review Date: 10/31/2024