5120-5-13. Correctional healthcare services co-payment

(A) No inmate shall be denied needed medical treatment because of a lack of ability to pay. Inmates shall receive appropriate medical care based on their present need, without regard to financial status. Inmates shall be notified of the co-payment requirement during orientation.

(B) For the purposes of this rule, the following definitions apply:

(1) "Indigent inmate." An inmate is considered indigent if, at the time of the request for medical services, the inmate has earned or received less than twelve dollars during the immediately preceding thirty-day period, and if the inmate's account balance has not exceeded twelve dollars at any time during the immediately preceding thirty day period.

(2) "Medical emergency." Medical services that require an emergency trip outside the institution or an admission to an infirmary.

(C) All medical services initiated by an inmate through the appropriate health services request form will carry a two dollar inmate co-pay charge. All medical services initiated by an inmate through emergency procedures will not carry an inmate co-pay charge, if an actual emergency exists.

(1) If an inmate requests emergency medical procedures, and it is determined by medical staff that no actual medical emergency exists, the inmate will be charged a three dollar co-payment charge.

(D) The medical staff will notify the cashier's office of the inmate to be debited and the date of the visit. The cashier will then debit the account of the inmate.

(E) Inmates will not be charged a co-payment charge in the following circumstances:

(1) If the inmate is indigent, as defined by this rule.

(2) If the request for medical services is solely for a refill of a current, active prescription for which a refill is available.

(3) If the medical services are provided in an in-patient setting .

(4) If the request is for dental services.

(5) Medical services initiated by staff reporting requirements, including but not limited to sexual assaults, use of force and accident reports.

(F) Inmates may contest a co-pay charge by utilizing the inmate grievance procedures as provided by rule 5120-9-31 of the Administrative Code. Pursuant to this rule, an inmate's informal complaint, the first step in the grievance procedure, should be directed to the institution's health care administrator.

(G) Each institution shall make a copy of this rule available at the institution library.

Five Year Review (FYR) Dates: 7/3/2019 and 01/24/2024
Promulgated Under: 111.15
Statutory Authority: 5120.01, 5120.56
Rule Amplifies: 5120.56
Prior Effective Dates: 05/16/1998, 03/28/1999, 08/05/2003, 01/12/2009, 05/23/2014

Prior History: (Effective: 05/23/2014
R.C. 119.032 review dates: 01/10/2014 and 01/08/2019
Promulgated Under: 111.15
Statutory Authority: 5120.01, 5120.56
Rule Amplifies: 5120.56
Prior Effective Dates: 5/16/98, 3/28/99, 8/5/2003, 1/12/2009)