5123:2-9-06 Home and community-based services waivers - documentation and payment for services under the individual options and level one waivers.

 

 

 

 

 

 

 

 

 

NOTICE OF PUBLIC HEARING

 

The Ohio Department of Developmental Disabilities hereby gives notice of its intent to rescind and adopt the following rules of the Administrative Code on a permanent basis on or about January 1, 2016, and to conduct a public hearing thereon.

 

Rule 5123:1-5-02 entitled Assistance to Enable a County Board to Pay the Nonfederal Share of Medicaid Expenditures for Home and Community-Based Services is being rescinded and replaced by a new rule of the same number and title. The rule sets forth a process for a county board of developmental disabilities to request assistance from the Department in the event of failure of an operating levy for services for individuals with developmental disabilities in that county and for the Department to respond to such request in accordance with Section 5123.0413 of the Revised Code. The rule is being updated to eliminate use of acronyms and to correct a reference therein.

 

Rule 5123:2-1-08 entitled Waiting Lists is being rescinded and replaced by a new rule of the same number and title. The rule sets forth requirements for waiting lists established by county boards of developmental disabilities pursuant to Section 5126.042 of the Revised Code. The rule is being updated to include residents of Intermediate Care Facilities for Individuals with Intellectual Disabilities and Nursing Facilities as priority categories in accordance with House Bill 64 of the 131st General Assembly, to eliminate use of acronyms, and to correct references therein.

 

Rule 5123:2-9-01 entitled Home and Community-Based Services Waivers - Enrollment and Disenrollment is being rescinded and replaced by a new rule of the same number and title. The rule establishes procedures for the enrollment, denial of enrollment, and disenrollment of individuals with developmental disabilities in Medicaid Home and Community-Based Services waivers administered by the Department. The rule is being updated to reflect the new Developmental Disabilities Level of Care, to

 

 

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remove provisions regarding the Transitions Developmental Disabilities Waiver, to add a requirement for county boards of developmental disabilities to submit a Payment Authorization for Waiver Services within 90 days of an individual's enrollment in a Home and Community-Based Services waiver, and to correct references therein.

Rule 5123:2-9-06 entitled Home and Community-Based Services Waivers - Documentation and Payment for Services Under the Individual Options and Level One Waivers is being rescinded and replaced by a new rule of the same number and title. The rule establishes standards governing documentation and payment for the Individual Options and Level One waivers administered by the Department. The rule is being updated to increase Ohio Developmental Disabilities funding ranges, to increase Level One Waiver service caps, and to correct references therein.

Rule 5123:2-9-21 entitled Home and Community-Based Services Waivers - Informal Respite Under the Level One Waiver is being rescinded and replaced by a new rule of the same number and title. The rule defines Informal Respite and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment     standards for the service.  The rule is being updated to increase the annual cap for Level One Waiver services and to correct references therein.

Rule 5123:2-9-22 entitled Home and Community-Based Services Waivers - Community Respite Under the Individual Options, Level One, and Self-Empowered Life Funding Waivers is being rescinded and replaced by a new rule of the same number and title. The rule defines Community Respite and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service. The rule is being updated to increase the annual cap for Level One Waiver services and to correct references therein.

Rule 5123:2-9-24 entitled Home and Community-Based Services Waivers - Transportation Under the Individual Options and Level One Waivers is being rescinded and replaced by a new rule of the same number and title. The rule defines Transportation and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service. The rule is being updated to increase the annual cap for Level One Waiver services and to correct references therein.

Rule 5123:2-9-27 entitled Home and Community-Based Services Waivers - Emergency Assistance Under the Individual Options and Level One Waivers is being rescinded and replaced by a new rule of the same number and title. The rule sets forth the coverage and availability for Emergency Assistance under the Level One Waiver. The rule is being updated to increase the three-year cap for Emergency Assistance and to correct references therein.

Rule 5123:2-9-30 entitled Home and Community-Based Services Waivers - Homemaker/Personal Care Under the Individual Options and Level One Waivers is being rescinded and replaced by a new rule of the same number and title. The rule defines Homemaker/Personal Care and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service. The rule is being updated to increase payment rates, to increase the annual cap for Level One Waiver services, to align wording regarding the behavioral support rate modification with newer rule 5123:2-2-06, and to correct references therein.

Rule 5123:2-9-31 entitled Home and Community-Based Services Waivers - Homemaker/Personal Care Daily Billing Unit for Sites Where Individuals Enrolled in the Individual Options Waiver Share Services is being rescinded and replaced by a new rule of the same number and title. The rule establishes a daily billing unit for Homemaker/Personal Care to be used for individuals and sites that qualify. The rule is due for five-year review and is being updated to eliminate redundant provisions, to eliminate use of acronyms, and to correct references therein.

Rule 5123:2-9-32 entitled Home and Community-Based Services Waivers - Adult Family Living Under the Individual Options Waiver is being rescinded and replaced by a new rule of the same number and title. The rule defines Adult Family Living and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service. The rule is being updated to increase payment rates and to correct references therein.

Rule 5123:2-9-33 entitled Home and Community-Based Services Waivers - Adult Foster Care Under the Individual Options Waiver is being rescinded and replaced by a new rule of the same number and title. The rule defines Adult Foster Care and sets forth provider qualifications, requirements for service delivery and documentation of services, and

payment standards for the service. The rule is being updated to increase payment rates and to correct references therein.

Rule 5123:2-9-34 entitled Home and Community-Based Services Waivers - Residential Respite Under the Individual Options, Level One, and Self-Empowered Life Funding Waivers is being rescinded and replaced by a new rule of the same number and title. The rule defines Residential Respite and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service.  The rule is being updated to increase the annual cap for Level One Waiver services and to correct references therein.

A public hearing on the proposed rule actions will be held on November 16, 2015, beginning at 10:00 a.m., and continuing until all persons in attendance have had an opportunity to testify. The hearing will be held in the Tower Conference Room of the Rhodes State Office Tower located at 30 East Broad Street, Columbus, Ohio 43215.  At this hearing, the Department will accept verbal and/or written testimony on the proposed rule actions.

Persons unable to attend the public hearing may submit written comments on the proposed rule actions.  Any written comments received on or before the public hearing date will be treated as testimony and made available for public review.

Submittal of written comments may be made to Becky Phillips, Administrative Rules Coordinator, by email to [e-mail], by fax to 614/644- 5013, or by U.S. mail to 30 East Broad Street, 12th Floor, Columbus, Ohio 43215-3414.

The rules are available for review at the Register of Ohio website (http://registerofohio.state.oh.us) and at the Department's website (http://dodd.ohio.gov/RulesLaws/Pages/Rules-Under-Development.aspx). The rules are also available for review at each county board of developmental disabilities.