OPASA - HB 215, 123rd Session
Posted by: Alan R. Cochrun
Date Mailed: Wednesday, March 10th 1999 11:39 AM
Date Mailed: Wednesday, March 10th 1999 11:39 AM
PART: 5 of 5
REFERENCE: 36E6BC422
PLANS DEVELOPED UNDER SECTION 5116.25 OF THE REVISED CODE; 2,545
(G) ASSISTS PARTICIPANTS IN MEETING THE GOALS SPECIFIED IN 2,548
THEIR INDIVIDUALIZED SERVICE PLANS; 2,549
(H) ASSISTS PARTICIPANTS IN MEETING OTHER GOALS THAT 2,552
PARTICIPANTS, REPRESENTATIVES, AND THE ADMINISTRATIVE AGENCY 2,553
CONSIDER APPROPRIATE;
(I) MEETS THE EXPECTATIONS OF THE PARTICIPANTS AND THEIR 2,556
56
REPRESENTATIVES.
Sec. 5119.061. (A) As used in this section[DEL: , "mentally :DEL] :
2,565
(1) "CENTER FOR INDEPENDENT LIVING" HAS THE SAME MEANING 2,567
AS IN SECTION 5116.01 OF THE REVISED CODE. 2,568
(2) "MENTALLY ill individual" and "specialized services" 2,571
have the same meanings as in section 5111.202 of the Revised 2,572
Code.
(B)(1) Except as provided in division (B)(2) of this 2,574
section and rules adopted under division [DEL: (E) :DEL] (F)(3) of this
2,575
section, for purposes of section 5111.202 of the Revised Code, 2,577
the department of mental health shall determine in accordance 2,578
with section 1919(e)(7) of the "Social Security Act," 49 Stat. 2,579
620 (1935), 42 U.S.C.A. 301, as amended, and regulations adopted 2,580
under section 1919(f)(8)(A) of that act whether, because of the 2,581
individual's physical and mental condition, a mentally ill 2,582
individual seeking admission to a nursing facility requires the 2,583
level of services provided by a nursing facility and, if the 2,584
individual requires that level of services, whether the 2,585
individual requires specialized services for mental illness. The 2,586
determination required by this division shall be based on an 2,587
independent physical and mental evaluation performed by a person 2,588
or entity other than the department. 2,589
(2) A determination under this division is not required 2,591
for any of the following: 2,592
(a) An individual seeking readmission to a nursing 2,594
facility after having been transferred from a nursing facility to 2,595
a hospital for care; 2,596
(b) An individual who meets all of the following 2,598
conditions:
(i) The individual is admitted to the nursing facility 2,600
directly from a hospital after receiving inpatient care at the 2,601
hospital;
(ii) The individual requires nursing facility services for 2,603
the condition for which care in the hospital was received; 2,604
57
(iii) The individual's attending physician has certified, 2,606
before admission to the nursing facility, that the individual is 2,608
likely to require less than thirty days of nursing facility 2,609
services.
(c) An individual transferred from one nursing facility to 2,611
another nursing facility, with or without an intervening hospital 2,612
stay. 2,613
(C) Except as provided in rules adopted under division 2,615
(F)(3) of this section, the department of mental health shall 2,616
review and determine for each resident of a nursing facility who 2,617
is mentally ill, whether the resident, because of the resident's 2,618
physical and mental condition, requires the level of services 2,619
provided by a nursing facility and whether the resident requires 2,620
specialized services for mental illness. The review and 2,621
determination shall be conducted in accordance with section 2,622
1919(e)(7) of the "Social Security Act" and the regulations 2,623
adopted under section 1919(f)(8)(A) of the act and based on an 2,624
independent physical and mental evaluation performed by a person 2,625
or entity other than the department. The review and 2,626
determination shall be completed promptly after a nursing 2,627
facility has notified the department that there has been a
significant change in the resident's mental or physical 2,628
condition.
(D)(1) In the case of a nursing facility resident who has 2,630
continuously resided in a nursing facility for at least thirty 2,631
months before the date of a review and determination under 2,632
division (C) of this section, if the resident is determined not 2,633
to require the level of services provided by a nursing facility, 2,634
but is determined to require specialized services for mental 2,635
illness, the department, in consultation with the resident's 2,636
family or legal representative and care givers, shall do all of 2,637
the following:
(a) Inform the resident of the institutional and 2,639
noninstitutional alternatives covered under the state plan for 2,640
58
medical assistance; 2,641
(b) Offer the resident the choice of remaining in the 2,643
nursing facility or receiving covered services in an alternative 2,644
institutional or noninstitutional setting; 2,645
(c) Clarify the effect on eligibility for services under 2,647
the state plan for medical assistance if the resident chooses to 2,648
leave the facility, including its effect on readmission to the 2,649
facility; 2,650
(d) Provide for or arrange for the provision of 2,652
specialized services for the resident's mental illness in the 2,653
setting chosen by the resident. 2,654
(2) In the case of a nursing facility resident who has 2,656
continuously resided in a nursing facility for less than thirty 2,657
months before the date of the review and determination under 2,658
division (C) of this section, if the resident is determined not 2,659
to require the level of services provided by a nursing facility, 2,660
but is determined to require specialized services for mental 2,661
illness, or if the resident is determined to require neither the 2,662
level of services provided by a nursing facility nor specialized 2,663
services for mental illness, the department shall act in 2,664
accordance with its alternative disposition plan approved by the 2,665
United States department of health and human services under 2,666
section 1919(e)(7)(E) of the "Social Security Act." 2,667
(3) In the case of an individual who is determined under 2,669
division (B) or (C) of this section to require both the level of 2,670
services provided by a nursing facility and specialized services 2,671
for mental illness, the department of mental health shall provide 2,672
or arrange for the provision of the specialized services needed 2,673
by the individual or resident while residing in a nursing 2,674
facility.
(E) A REPRESENTATIVE OF A CENTER FOR INDEPENDENT LIVING 2,676
MAY REQUEST TO PARTICIPATE IN A DETERMINATION MADE UNDER DIVISION 2,677
(B) OR (C) OF THIS SECTION. THE DEPARTMENT OF MENTAL HEALTH MAY 2,678
NOT REFUSE A REQUEST. 2,680
59
(F) The department of mental health shall adopt rules in 2,682
accordance with Chapter 119. of the Revised Code that do all of 2,683
the following: 2,684
(1) Establish criteria to be used in making the 2,686
determinations required by divisions (B) and (C) of this section. 2,687
The criteria shall not exceed the criteria established by 2,688
regulations adopted by the United States department of health and 2,689
human services under section 1919(f)(8)(A) of the "Social 2,690
Security Act."
(2) Specify information to be provided by the individual 2,692
or nursing facility resident being assessed; 2,693
(3) Specify any circumstances, in addition to 2,695
circumstances listed in division (B) of this section, under which 2,696
determinations under divisions (B) and (C) of this section are 2,697
not required to be made. 2,698
Sec. 5123.021. (A) As used in this section[DEL: , "mentally :DEL] :
2,707
(1) "CENTER FOR INDEPENDENT LIVING" HAS THE SAME MEANING 2,709
AS IN SECTION 5116.01 OF THE REVISED CODE. 2,710
(2) "MENTALLY retarded individual" and "specialized 2,713
services" have the same meanings as in section 5111.202 of the 2,714
Revised Code.
(B)(1) Except as provided in division (B)(2) of this 2,716
section and rules adopted under division [DEL: (E) :DEL] (F)(3) of this
2,717
section, for purposes of section 5111.202 of the Revised Code, 2,718
the department of mental retardation and developmental 2,719
disabilities shall determine in accordance with section 2,720
1919(e)(7) of the "Social Security Act," 49 Stat. 620 (1935), 42 2,721
U.S.C.A. 301, as amended, and regulations adopted under section 2,722
1919(f)(8)(A) of that act whether, because of the individual's 2,723
physical and mental condition, a mentally retarded individual 2,724
seeking admission to a nursing facility requires the level of 2,725
services provided by a nursing facility and, if the individual 2,726
requires that level of services, whether the individual requires 2,727
specialized services for mental retardation. 2,728
60
(2) A determination under this division is not required 2,730
for any of the following: 2,731
(a) An individual seeking readmission to a nursing 2,733
facility after having been transferred from a nursing facility to 2,734
a hospital for care; 2,735
(b) An individual who meets all of the following 2,737
conditions:
(i) [DEL: the :DEL] THE individual is admitted to the nursing facility
2,739
directly from a hospital after receiving inpatient care at the 2,741
hospital;
(ii) The individual requires nursing facility services for 2,743
the condition for which the individual received care in the 2,744
hospital; 2,745
(iii) [DEL: the :DEL] THE individual's attending physician has
2,747
certified, before admission to the nursing facility, that the 2,749
individual is likely to require less than thirty days of nursing 2,750
facility services.
(c) An individual transferred from one nursing facility to 2,752
another nursing facility, with or without an intervening hospital 2,753
stay. 2,754
(C) Except as provided in rules adopted under division 2,756
(F)(3) of this section, the department of mental retardation and 2,757
developmental disabilities shall review and determine, for each 2,758
resident of a nursing facility who is mentally retarded, whether 2,759
the resident, because of the resident's physical and mental 2,760
condition, requires the level of services provided by a nursing 2,762
facility and whether the resident requires specialized services 2,763
for mental retardation. The review and determination shall be 2,764
conducted in accordance with section 1919(e)(7) of the "Social 2,765
Security Act" and the regulations adopted under section 2,766
1919(f)(8)(A) of the act. The review and determination shall be 2,767
completed promptly after a nursing facility has notified the
department that there has been a significant change in the 2,768
resident's mental or physical condition. 2,769
61
(D)(1) In the case of a nursing facility resident who has 2,771
continuously resided in a nursing facility for at least thirty 2,772
months before the date of a review and determination under 2,773
division (C) of this section, if the resident is determined not 2,774
to require the level of services provided by a nursing facility, 2,775
but is determined to require specialized services for mental 2,776
retardation, the department, in consultation with the resident's 2,777
family or legal representative and care givers, shall do all of 2,778
the following: 2,779
(a) Inform the resident of the institutional and 2,781
noninstitutional alternatives covered under the state plan for 2,782
medical assistance; 2,783
(b) Offer the resident the choice of remaining in the 2,785
nursing facility or receiving covered services in an alternative 2,786
institutional or noninstitutional setting; 2,787
(c) Clarify the effect on eligibility for services under 2,789
the state plan for medical assistance if the resident chooses to 2,790
leave the facility, including its effect on readmission to the 2,791
facility; 2,792
(d) Provide for or arrange for the provision of 2,794
specialized services for the resident's mental retardation in the 2,795
setting chosen by the resident. 2,796
(2) In the case of a nursing facility resident who has 2,798
continuously resided in a nursing facility for less than thirty 2,799
months before the date of the review and determination under 2,800
division (C) of this section, if the resident is determined not 2,802
to require the level of services provided by a nursing facility,
but is determined to require specialized services for mental 2,803
retardation, or if the resident is determined to require neither 2,804
the level of services provided by a nursing facility nor 2,805
specialized services for mental retardation, the department shall 2,806
act in accordance with its alternative disposition plan approved 2,807
by the United States department of health and human services 2,808
under section 1919(e)(7)(E) of the "Social Security Act." 2,809
62
(3) In the case of an individual who is determined under 2,811
division (B) or (C) of this section to require both the level of 2,812
services provided by a nursing facility and specialized services 2,813
for mental retardation, the department of mental retardation and 2,814
developmental disabilities shall provide or arrange for the 2,815
provision of the specialized services needed by the individual or 2,816
resident while residing in a nursing facility. 2,817
(E) A REPRESENTATIVE OF A CENTER FOR INDEPENDENT LIVING 2,819
MAY REQUEST TO PARTICIPATE IN A DETERMINATION MADE UNDER DIVISION 2,820
(B) OR (C) OF THIS SECTION. THE DEPARTMENT OF MENTAL RETARDATION 2,822
AND DEVELOPMENTAL DISABILITIES MAY NOT REFUSE A REQUEST. 2,823
(F) The department of mental retardation and developmental 2,825
disabilities shall adopt rules in accordance with Chapter 119. of 2,826
the Revised Code that do all of the following: 2,827
(1) Establish criteria to be used in making the 2,829
determinations required by divisions (B) and (C) of this section. 2,830
The criteria shall not exceed the criteria established by 2,831
regulations adopted by the United States department of health and 2,832
human services under section 1919(f)(8)(A) of the "Social 2,833
Security Act." 2,834
(2) Specify information to be provided by the individual 2,836
or nursing facility resident being assessed; 2,837
(3) Specify any circumstances, in addition to 2,839
circumstances listed in division (B) of this section, under which 2,840
determinations under divisions (B) and (C) of this section are 2,841
not required to be made. 2,842
Section 2. That existing sections 109.57, 2953.32, 2,844
3701.881, 5101.35, 5101.75, 5111.202, 5111.204, 5119.061, and 2,845
5123.021 of the Revised Code are hereby repealed. 2,846
Section 3. Notwithstanding the requirements of division 2,848
(N) of section 5116.05 and division (A)(1) of section 5116.06 of 2,849
the Revised Code that the Governor appoint Personal Assistance 2,851
Services Program participants to the Personal Assistance Services 2,853
Policy Council, in making initial appointments to the Council the 2,854
63
Governor shall appoint individuals who would be eligible for the 2,855
Program if it were established.
Section 4. Not later than December 31, 2001, the Personal 2,857
Assistance Services Policy Council shall report to the General 2,858
Assembly on the implementation and administration of the Personal 2,860
Assistance Services Program.
Section 5. All items in this section are hereby 2,862
appropriated as designated out of any money in the state treasury 2,863
to the credit of the General Revenue Fund Group. For all 2,864
appropriations made in this act, those in the first column are
for fiscal year 2000 and those in the second column are for 2,865
fiscal year 2001. The appropriations made in this act are in 2,866
addition to any other appropriations made for the 1999-2001 2,867
biennium.
RSC REHABILITATION SERVICES COMMISSION 2,868
General Revenue Fund Group 2,871
GRF 415-401 Personal Care 2,873
Assistance $ 1,000,000 $ 2,000,000 2,875
TOTAL GRF General Revenue 2,876
Fund Group $ 1,000,000 $ 2,000,000 2,879
TOTAL ALL BUDGET FUND GROUPS $ 1,000,000 $ 2,000,000 2,882
Personal Care Assistance 2,885
The foregoing appropriation item 415-401, Personal Care 2,886
Assistance, shall be used in addition to the federal Social 2,887
Security reimbursement funds used to provide personal care 2,888
assistance services. These funds shall not be used in lieu of 2,889
the Social Security reimbursement funds.
This section is not subject to the referendum. Therefore, 2,891
under Ohio Constitution, Article II, Section 1d and section 1.471 2,892
of the Revised Code, this section goes into immediate effect when 2,893
this act becomes law.
Section 6. Except as otherwise specifically provided in 2,895
this act, the sections of law contained in this act are subject 2,896
to the referendum. Therefore, under Ohio Constitution, Article 2,897
64
II, Section 1c and section 1.471 of the Revised Code, the 2,898
sections take effect on the ninety-first day after this act is
filed with the Secretary of State. If, however, a referendum 2,899
petition is filed against a section, the section, unless rejected 2,900
at the referendum, takes effect at the earliest time permitted by 2,901
law.
Section 7. Section 2953.32 of the Revised Code is 2,903
presented in this act as a composite of the section as amended by 2,904
both Am. Sub. H.B. 566 and Am. Sub. S.B. 160 of the 121st General 2,905
Assembly, with the new language of neither of the acts shown in 2,907
capital letters. This is in recognition of the principle stated 2,908
in division (B) of section 1.52 of the Revised Code that such 2,909
amendments are to be harmonized where not substantively 2,910
irreconcilable and constitutes a legislative finding that such is 2,911
the resulting version in effect prior to the effective date of 2,912
this act.
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