5101:4-6-26 Food assistance: group living arrangements.

 

 

 

5101:4-6-26                 Food stamps: Residents residents of group homes.

 

 

 

(A)    If a group living arrangement provides a resident a majority of his/her meals, the resident shall not be allowed to participate in the program unless the resident and the group home meet the criteria in the definition of "group home" as contained in rule 5101:4-1-03 of the Administrative Code.

 

(1)   Eligibility requirements - resident is blind or disabled

 

The resident(s) must be blind or disabled as defined in paragraphs (Q)(2) to (Q)(11) the paragraph (A) definition of "Elderly or Disabled member" items two through eleven of rule 5101:4-1-03 of the Administrative Code. Aged residents who are not also blind or disabled are not eligible.

 

(2)   Eligibility requirements - non profit group home

 

The group home may be operated by a public agency or private organization but must be considered nonprofit as defined by the "Internal Revenue Code." in section 501 of the Internal Revenue Code, as amended in 1993. The group home may verify its nonprofit status by verifying that it is authorized by the food and nutrition service to accept food stamp benefits or by providing other documents. The verification of nonprofit status may be contained in the license/certificate issued by the appropriate state agency. Not all group homes certified/licensed by the state of Ohio are nonprofit organizations. The county agency needs to ensure that the group home has appropriate nonprofit status.

 

(3)   Eligibility requirements - group home of sixteen or fewer residents

 

In order to participate in the program under this rule, the maximum number of residents in the group home shall be sixteen. Not all residents have to be eligible for food stamp benefits for others to be eligible. For example: there are sixteen residents in a group home. Only ten apply and nine are found eligible. The ineligibility of the one person does not affect the eligibility of the others.

 

(4)   Eligibility requirements - group home certification and licensure

 

The group home shall be certified or licensed by an agency of the state of Ohio that is authorized under section 1616(e) of the Social Security Act of 1935 or under standards determined by the USDA United States department of agriculture (USDA) secretary to be comparable to standards implemented by appropriate state agencies under section 1616(e) of the Social Security Act. Section 1616(e) of the Social Security Act requires Ohio to designate one or more state agencies with the authority to set and enforce standards for various types of group homes. The eligibility worker county agency shall

 

 

 

review the license or certificate of the particular group home. The designated state agencies, their responsibilities, and the statutory references are:

(a)    Ohio department of mental health - licensing of residential facilities for the mentally ill (section 5119.22 of the Revised Code; Chapter 5122:3-5 of the Administrative Code).

(b)    Ohio department of mental retardation and developmental disabilities - licensing of residential facilities for the mentally retarded and the developmentally disabled (section 5123.19 of the Revised Code; Chapter 5123:2-3 of the Administrative Code).

(c)    Ohio department of aging - certifying sheltered housing for older adults and investigating complaints of persons residing in facilities licensed by the Ohio department of health (Chapter 173. of the Revised Code; agency-level designation 173 of the Administrative Code).

(d)  Ohio department of job and family services - licensing of group homes for children (section 5103.03 of the Revised Code; Chapter 5101:2-09 of the Administrative Code).

(e)    Ohio department of health - licensing of facilities identified as "adult group homes" in division (A)(8) of section 3722.01 of the Revised Code (Chapter 3722. of the Revised Code). Note: To meet the license/certification requirement, a group home which is licensed or certified by a governmental agency not listed in this paragraph must be determined by the United States department of agriculture (USDA) USDA to have been certified or licensed under standards comparable to those under Section 1616 (e) of the Social Security Act. The group home must provide information regarding the standards it uses to evaluate its group homes and the county agency should forward this information to its district office. ODJFS will then present the information to the USDA for a determination of comparability.

(B)  Certification policy for persons residing in a group living arrangement (GLA)

(1)   The application process

(a)    Disabled or blind residents of a group living arrangement (GLA) may apply either through the use of an authorized representative employed and designated by the GLA or on their own behalf or through an authorized representative of their choice.

(b)   The GLA must determine if a resident may apply on his or her own behalf based on the resident's physical and mental ability to handle his or her own affairs.

(c)    Some residents of the GLA may apply on their own behalf while other residents of the same GLA may apply through the GLA's representative.

(d)   Prior to certifying any residents, the county agency must verify that the GLA is authorized by FNS food and nutrition service (FNS) or is certified by the state of Ohio including the agency's determination that the center is a nonprofit organization.

(e)   If FNS disqualifies the GLA as an authorized retail food store, the county agency must suspend its authorized representative status for the same time; but residents applying on their own behalf will still be able to participate if otherwise eligible.

(2)   Assistance group (AG) composition

(a)     If the residents apply on their own behalf, the AG size must be in accordance with the definition in rule 5101:4-2-03 of  the Administrative Code. The county agency must certify these residents using the same provisions that apply to all other AGs.

(b)      If the residents apply through the use of the GLA's authorized representative, their eligibility must be determined as a one-person AG.

(C)(3) Use of food stamp benefits

(1)(a) If the residents are certified on their own behalf, the food stamp benefits may either be either returned to the GLA to be used to purchase meals served either communally or individually to eligible residents or retained and used to purchase and prepare food for their own consumption.

(2)(b) The GLA may purchase and prepare food to be consumed by eligible residents on a group basis if residents normally obtain their meals at a central location as part of the GLA's service or if meals are served in prepared at a central location for delivery to the individual residents.

(3)(c) If personalized meals are prepared and paid for with food stamp benefits, the GLA must ensure that the resident's benefits are used for meals intended for that resident.

(4) Exemptions from work registration

Since one of the prerequisites for the participation of group home residents is that they be disabled or blind, these individuals are exempt from work registration or completion of the information form.

(D)(C) Group home responsibility

The group home operator has the responsibility of acting as a fiduciary for residents for whom it is an authorized representative and the operator must be aware of his/her responsibilities which include notifying the county agency of changes in the AG's circumstances as specified in rule 5101:4-7-01 of the Administrative Code.

(1)   List of food stamp participants

On a periodic basis as determined by the county agency, each group home shall provide the county agency with a list of currently participating residents and this list shall contain include a statement signed by the group home operator official attesting to the fact validity of that the list is accurate.

(2)   On-site visits

The group home shall cooperate with the county department of job and family services as the county agency must conduct periodic random (as determined by the county) on-site visits to the home to assure the accuracy of the list and that the county agency's records are consistent and up to date. During the visit, the county may also verify other information needed to certify the home's residents (e.g., license issued, etc.).

(3)   When the AG leaves the group home

When the AG leaves the group home facility, the operator group home, either acting as an authorized representative or retaining the use of the benefits on behalf of the residents (regardless of the method of application), shall notify the county agency that the AG has left the group home and provide the residents with its ID card and return its their EBT electronic benefit transfer (EBT) card, if applicable. The AG, not the group home, shall be allowed to sign for and receive any remaining benefits authorized on CRIS-E client registry information system-enhanced (CRIS-E). Also, the departing AG shall

receive its full allotment if issued and no benefits have been spent on behalf of that individual AG. These procedures are applicable at anytime any time during the month.

(a)    However, if the benefits have already been issued and any portion spent on behalf of the AG, and the AG leaves the group home prior to the sixteenth day of the month, the operator facility shall provide the AG with its ID card (if applicable) and one-half of its monthly benefit allotment. If the AG leaves on or after the sixteenth day of the month and benefits have already been issued, the AG shall receive any portion of its remaining allotment.

(b)   If a group of residents within the home have been certified as one AG and have returned the benefits to the facility to use, the departing residents shall be given a pro rata share of one-half of the AG's monthly benefit allotment if leaving prior to the sixteenth day of the month and shall be instructed to obtain ID cards or written authorization to use the benefits from the county agency.

(c)   If residents apply on their own behalf and retain use of their own coupons benefits, these individuals are entitled to keep the benefits when they leave. Once the resident leaves, the group home no longer acts  as his/her authorized representative. The group home shall, if possible, provide the AG with a change report form to report to the county agency the individual's new address and other circumstances after leaving the group living arrangement and shall advise the AG to return the form to the appropriate office of the county agency within ten days the timeframe outlined in rule 5101:4-7-01 of the Administrative Code.

(d)    The group home shall return to the county agency any benefits not provided to departing residents at the end of each month. These returned benefits shall include those not provided to departing residents because the AG left on or after the sixteenth of the month or they left prior to the sixteenth and the facility was unable to provide the AG with benefits.

(4)   Reporting changes

If the resident has made application on his/her own behalf, the resident is responsible for reporting changes to the county agency as provided in rule 5101:4-7-01 of the Administrative Code. If the group home operator is acting in the capacity of an authorized representative, the operator group home shall report tonotify the county agency, as provided in rule 5101:4-7-01 of the

Administrative  Code,  any  of  changes  in  the  AG's

income  or  other  AG

circumstances and also report when the resident leaves the group home.

(5)   Loss, misuse or overissuanceoverpayment

The group home shall be responsible for any misrepresentation or intentional program violation which it knowingly commits in the certification of its residents. As an authorized representative, the group home must be knowledgeable about AG circumstances and should carefully review those circumstances with residents prior to applying on their behalf. The group home shall be strictly liable for all losses or misuse of benefits held on behalf of resident AGs and for all overpayments which occur when while acting as an authorized representative. However, the group home is not responsible for any misrepresentation or intentional program violation if a resident has made application on his/her own behalf. The resident applying on his/her own behalf shall be responsible for overpayments as would any other AG.

(E)(D) Group home as a retail food store

The group home may serve meals prepared especially for one or all of its residents in exchange for food stamp benefits. Under FNS regulations, the only way a group home operator can redeem these benefits is if the group home is classified as a retail food store. The following paragraphs advise of the regulations governing retail food stores.

(1)   FNS shall authorize as retail food stores those group homes wishing to redeem benefits directly through a food wholesaler. The county agency shall advise any group home wishing to be certified as a retail food store to contact FNS.

(2)   The group home authorized by FNS as a retail food store may be penalized or disqualified if it is determined administratively or judicially that benefits were misappropriated or used for purchases that did not contribute to a certified AG's meals.

(a)    The state and/or county agency shall promptly notify FNS when it has reason to believe that an organization or institution is misusing benefits in its possession. However, the county agency shall take no action prior to FNS action against the organization or institution.

(b)   The county agency shall establish a claim for overpayments of food stamp benefits held on behalf of resident clients in accordance with paragraph (C)(5) of this rule if any overpayments are discovered during an investigation or hearing procedure for redemption violations.

Effective:                                                     12/01/2005

R.C. 119.032 review dates:                         09/15/2005 and 12/01/2010

CERTIFIED ELECTRONICALLY

Certification

11/21/2005

Date

Promulgated Under:                           111.15

Statutory Authority:                           5101.54

Rule Amplifies:                                  329.04, 329.042, 5101.54

Prior Effective Dates:                         12/1/80, 9/27/82, 2/15/85 (Emer.), 5/12/85, 8/16/85

(Emer), 11/1/85 (Emer.), 1/1/86, 10/1/90, 12/1/91, 8/1/92 (Emer.), 10/30/92, 9/1/94, 7/1/96, 2/1/99,

6/1/01 (Emer.), 8/27/01