5101:1-5-01 The disability financial assistance program: definitions and payment standards.

 

 

 

5101:1-5-01                 The  disability  financial  assistance  program:  definitions  and payments standards.

 

 

 

(A)  Definition of the disability financial assistance program

 

(1)    Disability financial assistance (DFA) is a state and county-funded program which provides cash assistance to persons who meet DFA program requirements and who are ineligible for public assistance programs that are supported in whole or in part beby federal funds (e.g., Ohio works first (OWF), supplemental security income (SSI)). No federal regulations govern the administration of the DFA program.

 

(2)     When an assistance group is ineligible for any public assistance program supported in whole or in part by federal funds, the CDJFS shall explore DFA eligibility. DFA shall be authorized on an ongoing basis as long as all eligibility factors are met. It is not appropriate to issue DFA as temporary assistance to applicants or recipients of Ohio works first. DFA may be issued as temporary assistance to an assistance group pending federal categorical eligibility for SSI, if the individual is a member of one of the categories of covered individuals as set forth in paragraph (D) of this rule. If the assistance group is subsequently determined ineligible for SSI, DFA benefits may continue if all other DFA eligibility factors are met.

 

(B)  Definition and formation of the DFA family group

 

(1)    The DFA "family group" is defined as the assistance group (as set forth in paragraph (C) of this rule), and any persons related to any member of the assistance group by blood, adoption (i.e., parents and their children), or marriage who are living in the same home as the assistance group.

 

(a)       The family group shall include all children, their siblings and half-siblings, under the age of eighteen who are living with their biological or adoptive parents. Additionally, a married individual who is living with his spouse must be included in the same family group with his spouse (the definition of marriage is set forth in rule 5101:1-3-03 of the Administrative Code). If the spouse has biological or adoptive children under age eighteen living with him, those children must also be included in the family group.

 

(b)    A dependent child who is receiving DFA because the child is a covered individual as set forth in paragraph (D) of this rule, and who is living with someone who is standing in place of a parent who is eligible for DFA in his own right, shall not be included in that individual's family group.

 

 

 

(c)   An individual who is living in a residential treatment center for substance abuse that is certified by the Ohio department of alcohol and drug addiction services, as set forth in paragraph (D) of this rule, shall constitute his own family group, and shall not be in another family group while he remains in the residential treatment facility.

(d)   The income and resources of all members of the family group are used in determining the eligibility of the assistance group for DFA, as set forth in rules 5101:1-5-30 and 5101:1-5-40 of the Administrative Code.

(e)      The needs, income, and resources of the following individuals are excluded from the family group:

(i)   OWF participants.

(ii)   SSI recipients.

(iii)   Individuals for whom federal, state or local foster care maintenance payments are made.

(iv)     Individuals for whom federal, state or local adoption assistance payments are made.

(2)   The family group is formed beby selecting the following individuals:

(a)       Siblings and half-siblings under the age of eighteen (including emancipated minors);

(b)   The parent(s) of the children included in the family group;

(c)   The spouse(s) of all members of the family group; and

(d)  Any children of the spouse.

(C)  Definition and formation of the DFA assistance group

(1)   The DFA "assistance group" is defined as a group of applicants for or recipients of DFA who are living together and treated as a unit for purposes of determining eligibility for DFA and establishing the amount of DFA benefits for which the group is eligible. The assistance group is formed by selecting

all of the covered individuals (as set forth in paragraph (D) of this rule), from the family group (as defined in paragraph (B) of this rule). The assistance group can be the same composition as the family group, or a smaller group within the family group, depending upon the number of covered individuals within the family group.

(2)     The DFA assistance group is formed beby selecting the following covered individuals (defined in paragraph (D) of this rule) from the family group.

(a)     When there are children, the DFA assistance group shall contain the following covered individuals (as defined in paragraph (D) of this rule):

(i)     Siblings  and  half-siblings  under  the  age  of  eighteen  (including emancipated minors).

(ii)   The parents of the children.

(iii)   The spouse(s) of all members of the assistance group.

(iv)   The spouse's children.

(b)     When there are no children, the assistance group shall contain the following covered individuals:

(i)   An individual; or

(ii)   A married couple.

(D)  Covered individuals

(1)   Eligibility for DFA is limited to the following individuals:

(a)    An individual who is unable to do any substantial or gainful activity by reason of a medically determinable physical or mental impairment that can be expected to result in death or has lasted or can be expected to last for not less than nine months, as determined by the county medical services section (CMS). The disability determination process is set forth in rule 5101:1-5-20 of the Administrative Code.

(b) A resident of a residential treatment center certified as an alcohol or drug addiction  program  by  the  Ohio  department  of  alcohol  and  drug

addiction services ODADAS), under section 3793.06 of the Revised Code.

(c)(b) An individual who, on June 30, 2003the day before the effective date of this rule, was sixty years of age or older and one of the following is the case:

(i)    The individual was receiving or was scheduled to begin receiving financial assistance under Chapter 5115. of the Revised Code on the basis of being sixty years of age or older;

(ii)    An eligibility determination was pending regarding the individual's application to receive financial assistance under Chapter 5115. of the Revised Code on the basis of being sixty years of age or older and, on or after July 1, 2003the effective date of this rule, the individual receives a determination of eligibility based on that application.

(2)      All individuals who are determined potentially eligible for DFA under paragraph (D)(1)(a) of this rule shall have their disability determined through the county medical services section of the ODJFS.

(3)    DFA is the category of financial assistance for a minor child who meets the conditions set forth in paragraph (D) of this rule, and who is living with a nonrelated caretaker who is standing in place of the parent but does not meet the OWF living arrangement requirement set forth in rule 5101:1-3-03 of the Administrative Code. The individual standing in place of the parent must either be at least eighteen years old or emancipated. A referral to the children services agency may be appropriate in these nonrelative situations.

(E)  Ineligible individuals

An individual is not eligible for DFA if any of the following conditions set forth in this paragraph apply.

(1)   The individual is eligible to participate in the OWF program established under Chapter 5107. of the Revised Code. An individual who is eligible for OWF solely due to their status as a specified relative as defined in section 5107.02 of the Revised Code, has the option to participate in the OWF program or the DFA program.

(2)      The individual is eligible to receive supplemental security income (SSI) pursuant to Title XVI of the "Social Security Act, " 86 Stat. 1475 (1972), 42

USC 1383, as amended.

(3)   The individual is eligible to participate in or receive assistance through another state or federal program that provides financial assistance similar to disability financial assistance, as determined by the director of ODJFS.

(4)   The individual is ineligible to participate in the OWF program because of any of the following:

(a)   The time limit established by section 5107.18 of the Revised Code;

(b)   Failure to comply with an application or verification procedure;

(c)    The fraud control provisions of section 5101.83 of the Revised Code, or the fraud control program established pursuant to 45 CFR 235.112, as in effect July 1, 1996;

(d)   The self-sufficiency contract and related sanction provisions of sections

5107.14 and 5107.16 of the Revised Code;

(e)    The minor parent provisions set forth in section 5107.24 of the Revised Code;

(f)      The provisions of section 5107.26 of the Revised Code regarding termination of employment without just cause.

(5)     Ineligibility under paragraphs (E)(4)(c) to (E)(4)(d) of this rule applies as follows:

(a)     In the case of an individual who is under eighteen years of age, the individual is ineligible only if the individual caused the assistance group to be ineligible to participate in the OWF program or resides with an individual eighteen years of age or older who was a member of the same ineligible assistance group.

(b)    In the case of an individual who is eighteen years of age or older, the individual is ineligible regardless of whether the individual caused the assistance group to be ineligible to participate in OWF.

(6)      Except for those individuals determined ineligible pursuant to paragraph (E)(4)(f) of this rule, a member of a DFA assistance group who has quit or

refused employment or training within the past thirty days without good cause is ineligible for DFA for thirty days beginning with the date of the refusal or termination of employment or training.

(7)    The individual, or any of the other individuals included in determining the individual's eligibility for DFA, is involved in a strike, as defined in section

5107.10 of the Revised Code.

(8)      The individual is an undocumented alien who fails to meet citizenship requirements.

(9)    The individual became ineligible for SSI due to a failure to comply with SSI program requirements.

(10)   For the purpose of avoiding consideration of property in determinations of the individual's eligibility for DFA or a greater amount of assistance, the individual has transferred property for less than fair market value during the two years preceding application for or most recent reapplication of eligibility for DFA.

(11)   The individual is a child and does not live with the child's parents, guardians, or other persons standing in place of parents, unless the child is emancipated by being married, by serving in the armed forces, or by court order.

(12)      The individual resides in a county home, city infirmary, jail or public institution.

(13)   The individual is a fugitive felon as defined in section 5101.26 of the Revised Code.

(14)     The individual is violating a condition of probation, a community control sanction, parole, or a post-release control sanction imposed under federal or state law.

(F)   For purposes of determining eligibility for any covered individuals in the home (as set forth in paragraph (D) of this rule), the ineligible individual/family is part of the DFA family group (as defined in paragraph (B) of this rule), and the resources and income of the ineligible individual/family are countable to the family group.

(G)  Need

(1)    Need is defined as the deficit between the requirements of the family group according to the applicable DFA standard and the income available for immediate use.

(a)    An assistance group with available countable income in excess of the appropriate DFA payment standard is not eligible regardless of whether other eligibility factors are met.

(b)     An assistance group with available countable income less than the appropriate DFA payment standard is eligible for financial assistance in an amount equal to the difference between the appropriate DFA payment standard less the countable income or the state DFA payment standard for the DFA covered individual(s), whichever is the lesser amount, provided all other eligibility factors are met.

(2)     The assistance group must meet all eligibility criteria set forth in Chapter 5101:1-5 of the Administrative Code and must not have its needs met by another source of financial assistance.

(3)    The amount of DFA benefits to be issued depends upon the number of DFA covered individuals in the DFA assistance group. The standard for the appropriate family/assistance group size is provided in paragraph (G)(5) of this rule.

(4)     The DFA payment standard is the figure used in evaluating need and in determining eligibility for the DFA program. The payment standard is the figure which is used to calculate the actual DFA payment and from which all countable income is deducted.

(5)   The following chart shows the DFA payment standard.

Number in family/assistance group	DA payment standard
1	$ 115
2	159
3	193
4	225
5	251

6	281
7	312
8	361
9	394
10	426
11	458
12	490
13	522
14	554
15	594
for each person above 15 add	40

(H)   In order to confine DFA expenditures to appropriated state funds, the director of job and family services, or his designee, may issue an order at any time suspending the approval of any new applications for DFA. The order will be distributed to all CDJFS on the same day and will remain in effect until rescinded. During a program suspension, all new applicants will be advised that a suspension is in effect. All new applications will be denied during the same time that a suspension is in effect. No waiting lists will be established during the periods of suspension.

Effective:                                                     09/29/2005

R.C. 119.032 review dates:                         07/01/2008

CERTIFIED ELECTRONICALLY

Certification

09/19/2005

Date

Promulgated Under:                           111.15

Statutory Authority:                           5115.02, 5115.03

Rule Amplifies:                                  5115.01, 5115.02, 5115.03

Prior Effective Dates:                         7-1-76, 9-1-76, 1-1-85 (Emer.), 4-1-85, 8-1-85

(Emer.), 10-17-85, 8-1-86 (Emer.), 9-15-86 (Emer.),

11-5-86, 4-1-88 (Emer.), 6-30-88, 10-1-91 (Emer.),

12-20-91, 4-1-92 (Emer.), 6-30-92, 7-1-92, 11-1-92,

7-1-93, 9-1-93, 12-30-93 (Emer.), 3-18-94, 7-1-94,

9-1-94, 8-1-95 (Emer.), 10-30-95, 7-1-96 (Emer.),

9-29-96, 10-1-96 (Emer.), 12-20-96, 9-3-97 (Emer.),

10-1-97, 7-1-98, 10-1-99, 7-1-01, 7-1-03 (Emer.),

9-30-03, 7/1/05 (Emer.)