(A) An individual shall be enrolled in the medicaid-funded component of the PASSPORT program created under section 173.40 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 5101:3-32-03 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" means a person eighteen years of age or older who acts on behalf of an individual who is applying for or receiving medical assistance. An authorized representative may be a family member, attorney, hospital social worker, or any person chosen to act on the individual's behalf.
In accordance with rule 5101:1-38-01.2 of the Administrative Code, the individual shall provide a written statement naming the authorized representative and the duties that the named authorized representative may perform on the individual's behalf.
(2) "CDJFS" means the county department of job and family services.
(3) "Choices program" means the program created under section 173.403 of the Revised Code.
(4) "Individual" means an individual who is enrolled in the PASSPORT medicaid waiver 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."
R.C. 119.032 review dates: 11/30/2011 and 02/16/2017
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, 173.404
Rule Amplifies: 173.40, 173.403, 173.404
Prior Effective Dates: 07/16/2006, 03/12/2011