5123:2-9-02 Home and community-based services waivers - ensuring the suitability of services and service settings.

 

 

 

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]     [phone]

Agency Mailing Address (Plus Zip)                                       Phone                     Fax

[e-mail]

Email

5123:2-9-02

Rule Number

NEW

TYPE of rule filing

Rule Title/Tag Line              Home and community-based services waivers - ensuring the

suitability of services and service settings.

RULE SUMMARY

1.  Is the rule being filed for five year review (FYR)? 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, 5123.19, 5166.21

5.  Statute(s) the rule, as filed, amplifies or implements: 5123.04, 5123.19, 5166.21

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

On January 16, 2014, the United States Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS) published 42 CFR 441.301(c) (4)-(6) in the Federal Register which detailed new requirements that settings must meet in order to be eligible for reimbursement for Medicaid Home and Community-Based Services (HCBS) provided under section 1915(c) of the Social Security Act. The final rule required states to submit a Transition Plan describing the actions that will be taken to ensure initial and ongoing compliance with the

regulations. Ohio submitted its Transition Plan to CMS on March 13, 2015. The Transition Plan called for the Department to adopt and implement an overarching waiver administration rule that details requirements for HCBS settings.

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 standards to ensure that Medicaid Home and

Community-Based Services waivers administered by the Department maximize opportunities for enrolled individuals to access the benefits of community living and receive services in the most integrated setting.

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 the Individuals with Disabilities Education Improvement Act, the Rehabilitation Act, and the United States Code, which are generally available to the public at law libraries, depository libraries, and on the internet.

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. If applicable, indicate each specific paragraph of the rule that has been modified:

Paragraph (C)(1) revised from:

The purpose of home and community-based services is to support full community participation and achievement of individual-specific outcomes. An individual receiving services shall have opportunities to access age-appropriate activities, engage in competitive employment and meaningful non-work activities, and pursue activities with persons of his or her choosing and in settings not created exclusively for individuals with disabilities.

to:

The purpose of home and community-based services is to support full community participation and achievement of individual-specific outcomes. An individual receiving services shall have opportunities to access age-appropriate activities, engage in meaningful employment and non-work activities, and pursue activities with persons of his or her choosing and in settings not created exclusively for individuals with disabilities.

12.  Five Year Review (FYR) 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 rule will neither increase nor decrease revenues or expenditures for the Department.

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:

Paragraph (F)(1) of the rule requires providers of Home and Community-Based Services (HCBS) in licensed residential facilities and provider-controlled residential settings to have a lease or enter into a residency agreement with each individual served. This requirement will apply to:

-   Licensed residential facilities that provide HCBS (approximately 650), and

-   Certified providers providing services in provider-controlled residential settings (number unknown).

Preparing and securing signatures on leases/residency agreements will take provider staff time; the amount of time will vary depending on the nature and complexity of provider operations and the number of individuals served by the provider.

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

S.B. 2 (129th General Assembly) Questions

18.  Has this rule been filed with the Common Sense Initiative Office pursuant to

R.C. 121.82? Yes

19.  Specific to this rule, answer the following:

A.) Does this rule require a license, permit, or any other prior authorization to engage in or operate a line of business? No

B.) Does this rule impose a criminal penalty, a civil penalty, or another sanction, or create a cause of action, for failure to comply with its terms? Yes

All providers of Medicaid Home and Community-Based Services (HCBS) must be authorized (i.e., certified under Section 5123.161 of the Revised Code or licensed

under Section 5123.19 of the Revised Code) to provide services to individuals enrolled in HCBS waivers. Failure to comply with the rule could result in suspension of a provider's ability to provide services to additional individuals or revocation of a provider's certification or license.

C.) Does this rule require specific expenditures or the report of information as a condition of compliance? No