173-37-01 Choices program: enrollment process for individuals.

The medicaid waiver that authorizes the choices program is set to expire on June 30, 2014. The state shall not request federal authorization to continue the program. Therefore, in accordance with section 173.53 of the Revised Code, The program will suspend accepting enrollments on March 1, 2014. The suspension will remain in effect until the medicaid waiver has expired.

(A) An individual shall be enrolled in the medicaid-funded component of the PASSPORT program created under section 173.52 of the Revised Code at the time the individual begins the enrollment process for the choices program. The individual or a family member or the individual's case manager may initiate the contact with the choices program staff to request enrollment.

(B) An individual who requests enrollment into the choices program shall meet the program eligibility requirements described in rule 5160-32-03 of the Administrative Code in order to enroll in the program.

(C) Any applicant for choices program services is entitled to notice and hearing rights as set forth in section 5101.35 of the Revised Code, and division 5101:6 of the Administrative Code.

(1) ODA's designee shall notify the individual of the approval for enrollment for an individual determined to meet all choices program eligibility criteria.

(2) If ODA's designee determines that the individual does not meet the criteria for enrollment into the choices program, ODA's designee shall notify the CDJFS of the results of ODA's designee's determination, and the CDJFS shall send notice of denial of the application to the individual.

(3) If the CDJFS determines that the individual does not meet the financial eligibility criteria for enrollment in the choices program, the CDJFS shall send notice of denial of the application to the individual and notify ODA's designee.

(D) Waiting list: If an individual meets all of the eligibility criteria, but a slot is not available for enrollment in the choices program, ODA's designee shall place the individual on the unified waiting list under the terms of rule 173-44-04 of the Administrative Code.

(E) An authorized representative may represent an applicant in the enrollment process.

(F) Definitions for this rule:

(1) "Authorized representative" has the same meaning as in rule 5160:1-1-55.1 of the Administrative Code.

(2) "CDJFS" means the county department of job and family services.

(3) "Choices program" means the program created under section 173.53 of the Revised Code.

(4) "Individual" means an individual who is enrolled in the medicaid-funded component of the PASSPORT program who is applying to receive services from the choices program.

(5) "ODA's designee" has the same meaning as "PASSPORT administrative agency" in section 173.42 of the Revised Code. The current PASSPORT administrative agencies are the area agencies on aging listed in rule 173-2-04 of the Administrative Code plus "Catholic Social Services of the Miami Valley."

Effective: 03/01/2014
R.C. 119.032 review dates: 11/29/2013 and 03/01/2019
Promulgated Under: 119.03
Statutory Authority: 173.01 , 173.02
Rule Amplifies: 173.53 , 173.55
Prior Effective Dates: 07/16/2006, 03/12/2011, 02/16/2012