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On July 4, 2023, Governor DeWine signed House Bill 33 (HB 33) – the state’s biennial operating budget – into law. Among other policy changes, HB 33 codifies statutory requirements for new and currently licensed and/or certified community behavioral health services providers, private psychiatric hospitals, and residential facilities. Continue reading to learn about the most important updates from HB 33. Unless otherwise stated below, these changes become effective October 3, 2023.

Certification Requirement

• HB 33 requires almost all community behavioral health services providers to be certified by OhioMHAS in order to bill for a mental health or addiction service.

Exceptions

• Certification is not required for a Federally Qualified Health Center (FQHC) whose provision of behavioral health services is part of its FQHC designation as in-scope, Other Activities or Psychiatry (including the prescribing of psychotropics and medication assisted treatment).

• In scope, Other Activities or Psychiatry services are defined in the O.A.C. to include general services (see A.C. Section 5122-29-03), consultation services (see O.A.C. Section 5122-29-19) and referral and information services (see O.A.C. Section 5122-29-22).

• If a FQHC provides out-of-scope behavioral health services as part of its FQHC designation, then it must obtain OhioMHAS certification.

• FQHCs that contract with an OhioMHAS-certified provider for in-scope behavioral healthcare do not need to be certified by OhioMHAS.

• Certification is not required for Ohio-licensed health care professionals whose scope of practice includes an OhioMHAS-certified service and individuals who provide an OhioMHAS-certified service to an accredited hospital outpatient clinic.

• Prior to certification, community behavioral health services providers must show that they have adequate staffing and equipment.

• Penalty for non-compliance - If a provider fails to become certified, OhioMHAS has the authority to request that the Attorney General stop the provider from providing their services, and the provider will not receive state, federal, or local funds (including Medicaid, Medicare, and ADAMH Board funds) until they seek certification.

• A provider may not have their services or supports certified if the provider has been the subject of an adverse action during the three-year period immediately preceding the date of their application.

• A community behavioral health services provider must inform OhioMHAS of 1) any adverse action taken against them within the three years before their application and of 2) any notice of adverse action from a licensing or regulatory authority (other than OhioMHAS) within seven days of receiving the notice.

Accreditation Requirement

• Beginning October 3, 2023, new community behavioral health services providers seeking initial certification of services must be nationally accredited for all services deemed by OhioMHAS to have national accreditation standards. All certified services except prevention services require national accreditation.

• HB 33 gives current community behavioral health services providers—providers that either 1) have an application in submitted status prior to October 3, 2023, or 2) have OhioMHAS certification prior to October 3, 2023—until October 1, 2025, to comply.

• OhioMHAS currently recognizes three national accrediting bodies for providers: The Joint Commission (TJC), Commission on Accreditation of Rehabilitation Facilities (CARF), and Council on Accreditation (COA).

Required Notifications to the ADAMH Board

• HB 33 requires OhioMHAS, following its receipt of an initial or renewal application for certified services, to notify the local ADAMH board where the services will be provided to ensure each ADAMH board is aware of all resources within its community.

• OhioMHAS must also notify the ADAMH board when a community behavioral health services provider’s certification is no longer valid for any reason, including a provider’s failure to renew in a timely manner or the issuance of a final disciplinary action order.

• If the OhioMHAS Director determines that disciplinary action against a community behavioral health services provider is appropriate, the Director is required to 1) notify the board serving the ADAMH district where certifiable services or supports will be or were provided and 2) provide the ADAMH board with an opportunity to respond.

• HB 33 requires OhioMHAS to investigate a community behavioral health services provider within 10 days of a request made by the ADAMH board.

Miscellaneous Changes

• All community behavioral health services providers must notify the OhioMHAS Director within 10 days of any change in their accreditation status.

• HB 33 authorizes OhioMHAS to levy monetary fines against community behavioral health services providers that fail to provide statistical information on the care and treatment of persons with mental disabilities; and the care, treatment, and rehabilitation of persons with alcoholism, drug dependencies, or a gambling addiction to OhioMHAS.

• HB 33 authorizes the OhioMHAS Director to require a community mental health services provider or a community addiction services provider to submit cost reports. This requirement could be administratively burdensome for providers.

Regulatory Changes for Private Psychiatric Hospitals

• OhioMHAS will not issue licenses to private psychiatric hospitals if they do not have adequate staff and equipment to operate. However, no guidance on what constitutes “adequate” staff or equipment has been promulgated.

• Private psychiatric hospitals will not be licensed if they have been the subject of an adverse action, including an out-of-state adverse action, within the three-year period immediately preceding the date of application.

• Hospitals applying for licensure must notify OhioMHAS of any adverse action taken against the hospital or the hospital’s owner, sponsor, medical director, administrator, or principal within the three-year period immediately preceding their application date.

Regulatory Changes for Residential Facility Operators

• Beginning on October 3, 2023, residential facilities will only be licensed by OhioMHAS if they are managed and operated by qualified persons and are adequately staffed and equipped.

• No residential facility that has been the subject of an adverse action within the three-year period immediately preceding their application date will have their application granted.

If you would like more information about these important changes, contact BMD Member Daphne Kackloudis at dlkackloudis@bmdllc.com.