HB 811: Regards Behavioral Health licensed residential facilities
The bill amends section 5119.34 of the revised code to clarify the definition of residential facilities. A residential facility is a publicly or privately operated home or facility that provides accommodations, supervision, and personal care services to unrelated adults or children with mental illnesses. The facilities are categorized into three classes based on the number of residents and the services provided. The bill prohibits personal care services to be imposed on residents who are capable of performing the activity without assistance. Staff members are allowed to assist residents with medication administration, but they cannot administer medication themselves. The bill requires operators to apply for licensure with the department of behavioral health, pay a nonrefundable application fee, and provide information to the local ADAMHS board. The department of behavioral health is res…
| May. 13, 2026 | Referred to committee: Children and Human Services |
| Apr. 07, 2026 | Introduced |
136th General Assembly
Regular Session
2025-2026
Representative Lett
regarding residential facilities licensed by the
Department of Behavioral Health.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
That section 5119.34 of the Revised Code be
amended to read as follows:
(A) As used in this section and sections
5119.341 to 5119.344 of the Revised Code:
means housing, daily meal
preparation, laundry, housekeeping, arranging for
transportation, social and recreational activities, maintenance,
security, and other services that do not constitute personal
care services or skilled nursing care.
means a board of alcohol, drug
addiction, and mental health services.
means a person who is eighteen years of age or
older, other than a person described in division (A)(4) of this
section who is between eighteen and twenty-one years of age.
means a person who is under eighteen years of
age or a person with a mental disability who is under twenty-one
years of age.
means the person or persons, firm,
partnership, agency, governing body, association, corporation,
or other entity that is responsible for the administration and
management of a residential facility and that is the applicant
for a residential facility license.
means services including, but
not limited to, the following:
Assisting residents with activities of daily living;
Assisting residents with self-administration of
medication in accordance with rules adopted under this section;
Preparing special diets, other than complex
therapeutic diets, for residents pursuant to the instructions of
a physician or a licensed dietitian, in accordance with rules
adopted under this section.
"Personal care services" does not include "skilled nursing
care" as defined in section 3721.01 of the Revised Code. A
facility need not provide more than one of the services listed
in division (A)(6) of this section to be considered to be
providing personal care services.
means the provision of sleeping and
living space, meals or meal preparation, laundry services,
housekeeping services, or any combination thereof.
means the
program established under section 5119.41 of the Revised Code.
means any of the following:
Observing a resident to ensure the resident's health,
safety, and welfare while the resident engages in activities of
daily living or other activities;
Reminding a resident to perform or complete an
activity, such as reminding a resident to engage in personal
hygiene or other self-care activities;
Assisting a resident in making or keeping an
appointment.
means that a resident is not related to
the owner or operator of a residential facility or to the
owner's or operator's spouse as a parent, grandparent, child,
stepchild, grandchild, brother, sister, niece, nephew, aunt, or
uncle, or as the child of an aunt or uncle.
A "residential facility" is a publicly or privately
operated home or facility that falls into one of the following
categories:
Class one facilities provide accommodations,
supervision, personal care services, and mental health services
for one or more unrelated adults with mental illness or one or
more unrelated children or adolescents with severe emotional
disturbances;
Class two facilities provide accommodations,
supervision, and personal care services to any of the following:
One or two unrelated persons with mental illness;
One or two unrelated adults who are receiving
payments under the residential state supplement program;
Three to sixteen unrelated adults.
Class three facilities provide room and board for five
or more unrelated adults with mental illness.
"Residential facility" does not include any of the
following:
A hospital subject to licensure under section 5119.33
of the Revised Code or an institution maintained, operated,
managed, and governed by the department of behavioral health for
the hospitalization of persons with mental illnesses pursuant to
section 5119.14 of the Revised Code;
A residential facility licensed under section 5123.19
of the Revised Code or otherwise regulated by the department of
developmental disabilities;
An institution or association subject to certification
under section 5103.03 of the Revised Code;
A facility operated by a hospice care program licensed
under section 3712.04 of the Revised Code that is used
exclusively for care of hospice patients;
A nursing home, residential care facility, or home for
the aging as defined in section 3721.02 of the Revised Code;
A facility licensed under section 5119.37 of the
Revised Code to operate an opioid treatment program;
Any facility that receives funding for operating costs
from the department of development under any program established
to provide emergency shelter housing or transitional housing for
the homeless;
A terminal care facility for the homeless that has
entered into an agreement with a hospice care program under
section 3712.07 of the Revised Code;
A facility approved by the veterans administration under section 104(a) of the "Veterans Health Care Amendments of 1983," 97 Stat. 993, 38 U.S.C. 630, as amended, and used exclusively for the placement and care of veterans;
The residence of a relative or guardian of a person with mental illness.
Nothing in division (B) of this section shall be construed to permit personal care services to be imposed on a resident who is capable of performing the activity in question without assistance.
Except in the case of a residential facility described in division (B)(1)(a) of this section, members of the staff of a residential facility shall not administer medication to the facility's residents, but may do any of the following:
Remind a resident when to take medication and watch to ensure that the resident follows the directions on the container;
Assist a resident in the self-administration of medication by taking the medication from the locked area where it is stored, in accordance with rules adopted pursuant to this section, and handing it to the resident. If the resident is physically unable to open the container, a staff member may open the container for the resident.
Assist a resident who is physically impaired but mentally alert, such as a resident with arthritis, cerebral palsy, or Parkinson's disease, in removing oral or topical medication from containers and in consuming or applying the medication, upon request by or with the consent of the resident. If a resident is physically unable to place a dose of medicine
to the resident's mouth without spilling it, a staff member may
place the dose in a container and place the container to the
mouth of the resident.
A person operating or seeking to operate a residential
facility shall apply for licensure of the facility to the
department of behavioral health. The application shall be
submitted by the operator. When applying for the license, the
applicant shall pay to the department the application fee
specified in rules adopted under division (N) of this section.
The fee is nonrefundable.
The department shall send a copy of an application to the
ADAMHS board serving the county in which the person operates or
seeks to operate the facility. The ADAMHS board shall review the
application and provide to the department any information about
the applicant or the facility that the board would like the
department to consider in reviewing the application.
The department of behavioral health shall inspect and
license the operation of residential facilities.
The department may issue full, probationary, and interim
licenses. A full license shall expire up to three years after
the date of issuance, a probationary license shall expire in a
shorter period of time as specified in rules adopted by the
director of behavioral health under division (N) of this
section, and an interim license shall expire ninety days after
the date of issuance. A license may be renewed in accordance
with rules adopted by the director under division (N) of this
section. The renewal application shall be submitted by the
operator. When applying for renewal of a license, the applicant
shall pay to the department the renewal fee specified in rules
adopted under division (N) of this section. The fee is
nonrefundable.
If the department finds any of the following with
respect to a residential facility, the department may shall
issue an order suspending the admission of residents to the
facility, refuse to issue or renew a license for the facility,
or revoke the facility's license:
The facility is not in compliance with rules adopted
by the director pursuant to division (N) of this section;
Any facility operated by the applicant or licensee has
been cited for a pattern of serious noncompliance or repeated
violations of statutes or rules during the period of current or
previous licenses;
The applicant or licensee submits false or misleading
information as part of a license application, renewal, or
investigation.
The facility is not managed and operated by qualified
persons or adequately staffed and equipped to operate.
The department has been notified under section
5119.343 of the Revised Code or otherwise becomes aware that the
facility, any owner, operator, or manager of the facility, or
any subsidiary of the facility, owner, or operator has been the
subject of an adverse action, as defined in that section, taken
during the three-year period immediately preceding the date of
notification or date of becoming aware of the adverse action.
The department has been notified under section
5119.343 of the Revised Code or otherwise becomes aware that the
facility, any owner, operator, or manager of the facility, or
any subsidiary of the facility, owner, or operator has been the
subject of an adverse action, as defined in that section, taken
at any time based on an act or omission that violated the right
of a residential facility resident to be free from abuse,
neglect, or exploitation.
Proceedings initiated to deny applications for full or
probationary licenses, to refuse to renew full or probationary
licenses, or to revoke full or probationary licenses are
governed by Chapter 119. of the Revised Code. If an order has
been issued suspending the admission of residents to the
facility, the order remains in effect during the pendency of
those proceedings.
Proceedings initiated to suspend the admission of
residents to a facility are governed by Chapter 119. of the
Revised Code, except as provided in division (H) of this
section.
In a proceeding initiated to suspend the admission of
residents to a facility, to deny an application for a full or
probationary license, to refuse to renew a full or probationary
license, or to revoke a full or probationary license, the
department may order the suspension, denial, refusal, or
revocation regardless of whether some or all of the deficiencies
that prompted the proceedings have been corrected at the time of
the hearing.
When the department issues an order suspending the
admission of residents to a facility, denies an application for
a full or probationary license, refuses to renew a full or
probationary license, or revokes a full or probationary license,
the department shall not grant an opportunity for submitting a
plan of correction.
If a suspension of admissions of residents to a
facility is proposed because the director has determined that
the licensee has demonstrated a pattern of serious noncompliance
or that a violation creates a substantial risk to the health and
safety of residents, the director may issue an order imposing
the suspension of admissions before providing an opportunity for
an adjudication under Chapter 119. of the Revised Code. The
director shall lift the order for the suspension of admissions
if the director determines that the violation that formed the
basis for the order has been corrected.
Appeals from proceedings initiated to order the
suspension of admissions to a facility shall be conducted in
accordance with Chapter 119. of the Revised Code, unless the
order was issued before providing an opportunity for an
adjudication, in which case all of the following apply:
The licensee may request a hearing not later than ten
days after being served in accordance with sections 119.05 and
119.07 of the Revised Code.
If a timely request for a hearing that includes the
licensee's current address is made, the hearing shall commence
not later than thirty days after the department receives the
request.
After commencing, the hearing shall continue
uninterrupted, except for Saturdays, Sundays, and legal
holidays, unless other interruptions are agreed to by the
licensee and the director.
If the hearing is conducted by a hearing examiner, the
hearing examiner shall file a report and recommendations with
the department not later than ten days after the last of the
following:
The close of the hearing;
If a transcript of the proceedings is ordered, the
hearing examiner receives the transcript;
If post-hearing briefs are timely filed, the hearing
examiner receives the briefs.
The hearing examiner shall send a written copy of the
report and recommendations, by certified mail, to the licensee,
or the licensee's attorney, if applicable, not later than five
days after the report is filed with the department.
Not later than five days after receiving the report
and recommendations, the licensee may file objections with the
department.
Not later than fifteen days after the hearing examiner
files the report and recommendations, the department shall issue
an order approving, modifying, or disapproving the report and
recommendations.
Notwithstanding the pendency of the hearing, the
department shall lift the order for the suspension of admissions
if the department determines the violation that formed the basis
for the order has been corrected.
The department may issue an interim license to operate
a residential facility if both of the following conditions are
met:
The department determines that the closing of or the
need to remove residents from another residential facility has
created an emergency situation requiring immediate removal of
residents and an insufficient number of licensed beds are
available.
The residential facility applying for an interim
license meets standards established for interim licenses in
rules adopted by the director under division (N) of this
section.
An interim license shall be valid for ninety days and may
be renewed by the director no more than twice. Proceedings
initiated to deny applications for or to revoke interim licenses
under this division are not subject to Chapter 119. of the
Revised Code.
The department of behavioral health may conduct an
inspection of a residential facility as follows:
Prior to issuance of a license for the facility;
Prior to renewal of the license;
To determine whether the facility has completed a plan
of correction required pursuant to division (J)(2) of this
section and corrected deficiencies to the satisfaction of the
department and in compliance with this section and rules adopted
pursuant to it;
Upon complaint by any individual or agency;
At any time the director considers an inspection to be
necessary in order to determine whether the facility is in
compliance with this section and rules adopted pursuant to this
section.
In conducting inspections the department may conduct
an on-site examination and evaluation of the residential
facility and its personnel, activities, and services. The
department shall have access to examine and copy all records,
accounts, and any other documents relating to the operation of
the residential facility, including records pertaining to
residents, and shall have access to the facility in order to
conduct interviews with the operator, staff, and residents.
Following each inspection and review, the department shall
complete a report listing any deficiencies, and including, when
appropriate, a time table within which the operator shall
correct the deficiencies. The department may require the
operator to submit a plan of correction describing how the
deficiencies will be corrected.
No person shall do any of the following:
Operate a residential facility unless the facility
holds a valid license;
Violate any of the conditions of licensure after
having been granted a license;
Interfere with a state or local official's inspection
or investigation of a residential facility;
Violate any of the provisions of this section or any
rules adopted pursuant to this section.
The following may enter a residential facility at any
time:
Employees designated by the director of behavioral
health;
Employees of an ADAMHS board under either of the
following circumstances:
When a resident of the facility is receiving services
from a community mental health services provider under contract
with that ADAMHS board or another ADAMHS board;
When authorized by section 340.05 of the Revised Code.
Employees of a community mental health services
provider under either of the following circumstances:
When the provider has a person receiving services
residing in the facility;
When the provider is acting as an agent of an ADAMHS
board other than the board with which it is under contract.
Representatives of the state long-term care ombudsman
program when the facility provides accommodations, supervision,
and personal care services for three to sixteen unrelated adults
or to one or two unrelated adults who are receiving payments
under the residential state supplement program.
The persons specified in division (L) of this section
shall be afforded access to examine and copy all records,
accounts, and any other documents relating to the operation of
the residential facility, including records pertaining to
residents.
Employees of the department of behavioral health may
enter, for the purpose of investigation, any institution,
residence, facility, or other structure which has been reported
to the department as, or that the department has reasonable
cause to believe is, operating as a residential facility without
a valid license.
The director of behavioral health shall adopt and may
amend and rescind rules pursuant to Chapter 119. of the Revised
Code governing the licensing and operation of residential
facilities. The rules shall establish all of the following:
Minimum standards for the health, safety, adequacy,
and cultural competency of treatment of and services for persons
in residential facilities;
Procedures for the issuance, renewal, or revocation of
the licenses of residential facilities;
Procedures for conducting background investigations
for prospective or current operators, employees, volunteers, and
other non-resident occupants who may have direct access to
facility residents;
The fee to be paid when applying for a new residential
facility license or renewing the license;
Procedures for the operator of a residential facility
to follow when notifying the ADAMHS board serving the county in
which the facility is located when the facility is serving
residents with mental illness or severe mental disability,
including the circumstances under which the operator is required
to make such a notification;
Procedures for the issuance and termination of orders
of suspension of admission of residents to a residential
facility;
Measures to be taken by residential facilities
relative to residents' medication;
Requirements relating to preparation of special diets;
The maximum number of residents who may be served in a
residential facility;
The rights of residents of residential facilities and
procedures to protect such rights;
Standards and procedures under which the director may
waive the requirements of any of the rules adopted.
The department of behavioral health may withhold the source of any complaint reported as a violation of this section when the department determines that disclosure could be detrimental to the department's purposes or could jeopardize the investigation. The department may disclose the source of any complaint if the complainant agrees in writing to such disclosure and shall disclose the source upon order by a court of competent jurisdiction.
Any person who makes a complaint under division (O)(1) of this section, or any person who participates in an administrative or judicial proceeding resulting from such a complaint, is immune from civil liability and is not subject to criminal prosecution, other than for perjury, unless the person has acted in bad faith or with malicious purpose.
The director of behavioral health may petition the court of common pleas of the county in which a residential facility is located for an order enjoining any person from operating a residential facility without a license or from operating a licensed facility when, in the director's judgment, there is a present danger to the health or safety of any of the occupants of the facility. The court shall have jurisdiction to grant such injunctive relief upon a showing that the respondent named in the petition is operating a facility without a license or there is a present danger to the health or safety of any residents of the facility.
When the court grants injunctive relief in the case of a facility operating without a license, the court shall issue, at a minimum, an order enjoining the facility from admitting new residents to the facility and an order requiring the facility to
assist with the safe and orderly relocation of the facility's
residents.
If injunctive relief is granted against a facility for
operating without a license and the facility continues to
operate without a license, the director shall refer the case to
the attorney general for further action.
The director of behavioral health may fine a person
for violating division (K) of this section. The fine shall be
five hundred dollars for a first offense; for each subsequent
offense, the fine shall be one thousand dollars. The director's
actions in imposing a fine shall be taken in accordance with
Chapter 119. of the Revised Code.
That existing section 5119.34 of the Revised
Code is hereby repealed.