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

 

 

 

Rule Summary and Fiscal Analysis (Part A)

 

Department of Developmental Disabilities

Agency Name

 

Community Services                                           Becky Phillips

Division                                                                  Contact

 

30 East Broad Street, 12th Floor Columbus OH 43215-3414

[phone]     (614)

752-8551

Agency Mailing Address (Plus Zip)                                       Phone                     Fax

5123:2-9-06

Rule Number

NEW

TYPE of rule filing

Rule Title/Tag Line              Home and community-based services waivers - payment for

waiver services.

RULE SUMMARY

1.  Is the rule being filed consistent with the requirements of the RC 119.032 review? No

2.  Are you proposing this rule as a result of recent legislation? No

3.  Statute prescribing the procedure in accordance with the agency is required to adopt the rule: 119.03

4.  Statute(s) authorizing agency to adopt the rule: 5123.04, 5111.871, 5111.873

5.  Statute(s) the rule, as filed, amplifies or implements: 5123.04, 5111.871, 5111.873

6.  State the reason(s) for proposing (i.e., why are you filing,) this rule:

The department is bringing forth a new rule as necessary amendments to the existing rule would affect more than fifty per cent of the rule.

7.  If the rule is an AMENDMENT, then summarize the changes and the content of the proposed rule; If the rule type is RESCISSION, NEW or NO CHANGE, then summarize the content of the rule:

The rule establishes the standards governing payment for home and community-based services under components of the medicaid program that the Ohio department of developmental disabilities administers pursuant to section 5111.871 of the Revised Code.

8.  If the rule incorporates a text or other material by reference and the agency claims the incorporation by reference is exempt from compliance with sections

121.71 to 121.74 of the Revised Code because the text or other material is generally available to persons who reasonably can be expected to be affected by the rule, provide an explanation of how the text or other material is generally available to those persons:

The incorporated references are to regulations in the Code of Federal Regulations. The Code of Federal Regulations is generally available to the public at law libraries, depository libraries, and on the internet. A link to the Code of Federal Regulations is provided on the department's website at http://dodd.ohio.gov/rules/rules.htm.

Pursuant to section 121.75 of the Revised Code, the requirements in sections

121.71 to 121.74 do not apply to the Code of Federal Regulations.

9.  If the rule incorporates a text or other material by reference, and it was infeasible for the agency to file the text or other material electronically, provide an explanation of why filing the text or other material electronically was infeasible:

Not applicable.

10.  If the rule is being rescinded and incorporates a text or other material by reference, and it was infeasible for the agency to file the text or other material, provide an explanation of why filing the text or other material was infeasible:

Not Applicable.

11.  If revising or refiling this rule, identify changes made from the previously filed version of this rule; if none, please state so:

Revised tagline from: "HCBS waivers - payment for waiver services" to: "Home and community-based services waivers - payment for waiver services."

Paragraph (B)(3): Added second sentence: "The department shall publish any changes to the CPT thirty days prior to implementation."

Paragraph (B)(12): Replaced word "reimbursed" with word "paid" in second

sentence.

Paragraph (B)(15): Replaced word "reimbursed" with word "paid" in second sentence.

Paragraph (I)(9): Replaced "Timeframe for implementation of the CPT:" with "Beginning October 1, 2010, county boards shall complete a cost projection using the CPT when an individual is initially enrolled on an individual options or level one waiver and when an individual is annually re-determined eligible for continued enrollment on an individual options or level one waiver. CPT will be the only authorized cost projection instrument on and after October 1, 2010."

Paragraph (I)(9)(a): Deleted entirely. Paragraph (I)(9)(b): Deleted entirely. Paragraph (I)(9)(c): Deleted entirely. Paragraph (I)(9)(d): Deleted entirely.

Paragraph (J)(3): Removed word "may" from second sentence. Revised second sentence from: "HPC services may extend to those times when..." to: "HPC services extend to those times when..."

Paragraph (J)(7): Removed word "may" from third sentence. Revised third sentence from: "Transportation services may extend to those times when..." to: "Transportation services extend to those times when..."

Paragraph (K)(3): Revised second sentence from: "No claims shall be paid that do not provide the number of units of service, the number of staff providing the service, and the number of individuals sharing the service." to: "Claims for payment shall include the number of units of service. Added third sentence: "Except for claims for HPC daily billing unit, claims for payment shall include the number of staff providing the service and the number of individuals sharing the service."

12.  119.032 Rule Review Date:

(If the rule is not exempt and you answered NO to question No. 1, provide the scheduled review date. If you answered YES to No. 1, the review date for this rule is the filing date.)

NOTE: If the rule is not exempt at the time of final filing, two dates are required: the current review date plus a date not to exceed 5 years from the effective date for Amended rules or a date not to exceed 5 years from the review date for No Change rules.

FISCAL ANALYSIS

13.  Estimate the total amount by which this proposed rule would increase / decrease either revenues / expenditures for the agency during the current biennium (in dollars): Explain the net impact of the proposed changes to the budget of your agency/department.

This will have no impact on revenues or expenditures.

$ 0

The proposed rule neither increases nor decreases revenues or expenditures.

14.  Identify the appropriation (by line item etc.) that authorizes each expenditure necessitated by the proposed rule:

Not applicable.

15.  Provide a summary of the estimated cost of compliance with the rule to all directly affected persons. When appropriate, please include the source for your information/estimated costs, e.g. industry, CFR, internal/agency:

The rule requires county boards of developmental disabilities to use the new cost projection tool to project the cost of services for individuals enrolled on individual options and level one waivers. The cost projection tool is a web-based analytical tool that is being developed and will be administered and maintained by the department. The cost projection tool will ultimately yield administrative efficiencies throughout the service delivery system; initially, however, there will be a learning curve while staff of county boards and providers of services receive training and become proficient in the use of the tool.

16.  Does this rule have a fiscal effect on school districts, counties, townships, or municipal corporations? No

17.  Does this rule deal with environmental protection or contain a component dealing with environmental protection as defined in R. C. 121.39? No