5160-31-05 PASSPORT HCBS waiver program covered services.

 

 

 

5160-31-05                  PASSPORT HCBS waiver program covered services.

 

 

 

(A)    The purpose of this rule is to establish the services covered by the pre-admission screening system providing options and resources today (PASSPORT) home and community based services (HCBS) wavier program.

 

(B)   The PASSPORT HCBS waiver program benefit package is limited to the following services:

 

(1)  Adult day services as set forth in rule 173-39-02.1 of the Administrative Code;

 

(2)   Alternative meal services as set forth in rule 173-39-02.2 of the Administrative Code;

 

(3)    Choices home care attendant services as set forth in rule 173-39-02.4 of the Administrative Code;

 

(4)   Chore services as set forth in rule 173-39-02.5 of the Administrative Code;

 

(5)      Community  transition  services  as  set  forth  in  rule  173-39-02.17  of  the Administrative Code;

 

(6)    Emergency response system services as set forth in rule 173-39-02.6 of the Administrative Code;

 

(7)    Enhanced community living services as set forth in rule 173-39-02.20 of the Administrative Code;

 

(8)    Homemaker services as set forth in rule 173-39-02.8 of the Administrative Code;

 

(9)Home  care  attendant  services  as  set  forth  in  rule  173-39-02.24  of  the Administrative Code;

 

(9)(10) Home delivered meal services as set forth in rule 173-39-02.14 of the Administrative Code;

 

(10)(11)  Home  medical  equipment  and  supplies  services  as  set  forth  in  rule 173-39-02.7 of the Administrative Code;

 

(11)(12) Independent living assistance services as set forth in rule 173-39-02.15 of the Administrative Code;

 

 

(12)(13) Minor home modification, maintenance and repair services as set forth in rule 173-39-02.9 of the Administrative Code;

(13)(14) Non-medical transportation services as set forth in rule 173-39-02.18 of the Administrative Code; and

(14)(15) Nutrition consultation services as set forth in rule 173-39-02.10 of the Administrative Code;

(16)  Out-of-home  respite  services  as  set  forth  in  rule  173-39-02.23  of  the Administrative Code;

(15)(17)   Personal   care   services   as   set   forth   in   rule   173-39-02.11   of   the Administrative Code;

(16)(18) Pest control services as set forth in rule 173-39-02.3 of the Administrative Code;

(17)(19) Social work counseling services as set forth in rule 173-39-02.12 of the Administrative Code; and

(18)(20)   Transportation   services   as   set   forth   in   rule   173-39-02.13   of   the Administrative Code. ; and

(21) Waiver nursing services as set forth in rule 173-39-02.22 of the Administrative Code.

(C)     Services shall be delivered by providers in a manner that is consistent with the individual's service plan as documented in the PASSPORT information management system (PIMS).

(D)   If an individual enrolled on PASSPORT is also a participant in the helping ohioans move, expanding (HOME) choice demonstration program in accordance with Chapter 5160-51 of the Administrative Code, the individual may, at the individual's discretion, use the HOME choice community transitions service in lieu of, but not in addition to, the community transition service available through the PASSPORT waiver program.

(E)     If an individual receives enhanced community living services, per the federally approved waiver, the consumer may not receive either personal care or homemaker services available through the PASSPORT waiver program.

(F)   In accordance with the federally approved PASSPORT waiver the services identified in this paragraph are subject to employer and/or budget authority if elected by the individual. Services are to be furnished in accordance with the requirements in paragraph (B) of this rule:

(1)   The following services are subject to employer authority, which includes but is not limited to, the ability to hire, fire, and train employees:

(a)   Choices home care attendant service; and

(b)   Personal care services.

(2)   The following services are subject to budget authority, which includes but is not limited to, the ability to negotiate reimbursement rates paid to providers furnishing services:

(a)   Alternative meals service;

(b)   Choices home care attendant service

(c)   Home medical equipment and supplies service;

(d)  Minor home modification, maintenance and repair services; and

(e)   Pest control service

(G)   An individual who elects to self-direct any of the services provided in paragraph (F) of this rule shall be assessed by their case manager to determine the individual's ability to self-direct their services as set forth in rule 173-42-06 of the Administrative Code.

(1)     If an individual demonstrates the ability to self-direct their care the case manager may initiate the orientation process to familiarize the individual with the self-direction of services including the role of the financial management service (FMS).

(2)   If the individual is unable to demonstrate the ability to self-direct his or her care and to assume the responsibilities associated with the self-direction authorities in paragraph (F) of this rule, the individual may choose an authorized representative to act on his or her behalf.

(3)    If no authorized representative is available, the case manager will assist the individual with obtaining services through ODA-certified long-term care agency providers.

(H)    If an individual who is seeking to self-direct his or her care chooses an authorized representative to act on his or her behalf in accordance with paragraph (G)(2) of this rule, the authorized representative shall not simultaneously serve as the consumer's authorized representative and the consumer's provider.

Effective:                                                     07/01/2014

R.C. 119.032 review dates:                         03/01/2019

CERTIFIED ELECTRONICALLY

Certification

06/20/2014

Date

Promulgated Under:                           119.03

Statutory Authority:                           5166.02

Rule Amplifies:                                  5166.02, 173.52

Prior Effective Dates:                         7/16/84, 12/22/86 (Emer.), 3/23/87, 7/1/90, 9/1/98,

7/1/06, 7/1/08, 6/28/09, 3/17/11, 3/1/14