Ohio Administrative Code
Title 4123 - Bureau of Workers' Compensation
Chapter 4123-6 - Health Partnership Program
Section 4123-6-38.1 - Payment for nursing and caregiver services provided by persons other than home health agency employees

(a) Prior to December 14, 1992, caregiver services provided by a nonlicensed person including injured worker's spouse, friend or family member were considered for reimbursement in cases where the injured worker, as a result of an allowed injury or occupational disease, was bedfast, confined to a wheelchair, had a disability of two or more extremities which prevented the injured worker from caring for their own body needs or was otherwise unable to take care of their own bodily functions. Services include, but are not limited to, feeding, bathing, dressing, providing personal hygiene, and transferring from bed to chair. Household, personal or other duties related to maintaining a household, including but not limited to care or upkeep to the inside or outside of the residence, washing clothes, preparing meals, or running errands, are not considered nursing services, and will not be reimbursed, except to the extent such services are incidental to care of the injured worker.

(b) Requests for an extension of caregiver services initially approved prior to December 14, 1992, delivered by a non-licensed person, other than an attendant, aide, or injured worker's spouse, but including other family members or friends, will be approved only if:

(c) In the event the caregiver is no longer able to provide approved services or if services are stopped and later restarted, services shall be provided only by an employee of a a home health agency certified in accordance with rule 4123-6-02.2 of the Administrative Code.

(a) Requests for approval of caregiver services delivered by a non-licensed person, other than an attendant, aide, or injured worker's spouse were considered for reimbursement only if the injured worker did not have a spouse or the spouse was physically or mentally incapable of caring for the injured worker, or an approved home health agency was greater than thirty-five miles from the injured worker's location and the home health agency refused to provide services to the claimant.

(b) Criteria for approval of caregiver services were as indicated in paragraph (B)(1)(a) of this rule.

(c) After January 9, 1995, persons who are not home health agency home health aides or attendants, but who are currently approved to provide caregiver services to an injured worker, may continue to do so until services are no longer medically necessary or unless services are not authorized. After January 9, 1995, approval of caregiver services shall only be considered when services are rendered by a home health agency home health aide or attendant.

(d) In the event the caregiver is no longer able to provide approved services or if services are stopped and later restarted, services shall be provided only by an employee of a home health agency certified in accordance with rule 4123-6-02.2 of the Administrative Code.