Chapter 3701-44 Ryan White Program

3701-44-01 Definitions.

As used in this chapter:

(A) "AIDS" means acquired immune deficiency syndrome.

(B) "Department" means the Ohio department of health.

(C) "Director" means the director of health or the director of health's designee.

(D) "Family" means a group of individuals who are related by blood, marriage, or adoption.

(E) "HIV" means human immunodeficiency virus.

(F) "Ryan White part B program" means the program established by the Ryan White HIV/AIDS Treatment Modernization Act, 42 U.S.C. 300ff et seq. (as in effect on January 1, 2009), and administered by the director of health under division (D) of section 3701.241 of the Revised Code.

Replaces: 3701-44-01

Effective: 11/04/2011
R.C. 119.032 review dates: 11/01/2016
Promulgated Under: 119.03
Statutory Authority: R.C. 3701.241
Rule Amplifies: R.C. 3701.241
Prior Effective Dates: 9/23/1991 (Emer.), 12/22/91, 5/20/99, 7/20/01, 12/18/06, 8/2/09

3701-44-02 HIV medical case management.

(A) The department may provide HIV medical case management services or delegate the authority to provide medical case management services to another entity through the department's grant process.

(B) HIV medical case management services shall be provided in accordance with the Ryan White part B program, sections 3701.24 to 3701.249 of the Revised Code, chapter 3701-44 of the Administrative Code and guidelines established by the director.

Replaces: 3701-44-03

Effective: 11/04/2011
R.C. 119.032 review dates: 11/01/2016
Promulgated Under: 119.03
Statutory Authority: 3701.241
Rule Amplifies: 3701.241
Prior Effective Dates: 9/23/1991 (Emer.), 12/22/91, 5/20/99, 8/2/09

3701-44-03 Eligibility for benefits under the Ryan White part B program.

(A) To be eligible for benefits under the Ryan White part B program, an individual shall meet all of the following requirements:

(1) The individual must be an Ohio resident;

(2) The individual must have a verified HIV infection and must meet the medical guidelines set forth in appendix A to this rule; and

(3) The individual or individual's family must meet the financial guidelines set forth in appendix B to this rule.

(B) The director may deny an individual's application, or terminate an individual's program enrollment, or deny an individual's access to specific services, if the director determines:

(1) There are insufficient funds;

(2) With consideration given to the continuity of care, the individual does not meet the eligibility guidelines set forth in paragraph (A) of this rule;

(3) The individual submitted false or misleading information;

(4) The individual abused or misused an approved benefit; or

(5) The individual failed to apply for or use or disclose other available resources to which the individual has access to pay for Ryan White part B services.

(C) Pursuant to 42 U.S.C. 300ff -42 U.S.C. 21(2009) and 42 U.S.C. 42 U.S.C. 300ff-22 (2009), the Ryan White part B program funds are federal grants. If, at any time, there is insufficient fundng to sustain the current Ryan White part B programs, the director, pursuant to division (D) of section 3701.241 of the Revised Code, as necessary for the effective administration of available funds to the Ryan White part B programs, may, upon thirty-day notice to affected clients, restrict, reduce, or eliminate existing programs.

(D) An individual may seek reconsideration of a decision that is based on other than the insufficiency of program funds pertaining to the Ryan White part B programs pursuant to paragraph (B)(1) of this rule.

(1) An individual seeking reconsideration of a decision listed in paragraph (B) of this rule shall file a written request for reconsideration with the department. The request for reconsideration must be received within thirty days from the date the individual received a decision set forth in paragraph (B) of this rule. The request for reconsideration must contain a statement of the reasons that the individual believes that the decision is incorrect or inconsistent with the Ryan White part B program guidelines, and may include any written documentation, arguments, or other materials that the affected party wishes to submit for the purposes of the reconsideration.

(2) Upon receiving a timely request for reconsideration, the director shall:

(a) Review the information submitted within thirty days of receipt of the request. The director may request additional information which extends the review time. Except for good cause, additional information shall be submitted to the director within forty-five days of receiving a request for additional information.

(b) Render a written decision to the requestor of the reconsideration within thirty days of the receipt of the request for reconsideration or receipt of additional information, whichever is later. The written decision shall include the reasons for the decision. The decision of the director is final and there is no further review.

Replaces: 3701-44-03

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Effective: 08/30/2012
R.C. 119.032 review dates: 11/01/2016
Promulgated Under: 119.03
Statutory Authority: 3701.241
Rule Amplifies: 3701.241
Prior Effective Dates: 9/23/1991 (Emer.), 12/22/91, 5/20/99, 7/20/01, 12/20/01, 8/2/09, 11/4/11

3701-44-04 Waiver.

(A) Upon request from an applicant, client, or legal representative of an applicant or client, the director may waive any part of this chapter unless such a waiver is contrary to federal or state law or conflicts with the federal requirements for the Ryan White part B funding.

(B) The director may not grant a waiver request if the approval of the request is contrary to public interest or there are not sufficient funds to support a waiver request.

(C) The director's decision pursuant to a waiver request is final and not subject to further review.

Replaces: 3701-44-03, 3701-44-04, 3701-44-05, 3701-44-07

Effective: 11/04/2011
R.C. 119.032 review dates: 11/01/2016
Promulgated Under: 119.03
Statutory Authority: 3701.241
Rule Amplifies: 3701.241
Prior Effective Dates: 9/23/1991 (Emer.), 12/22/91, 5/20/99, 7/20/01, 8/2/09

3701-44-05 [Rescinded] Eligibility for benefits under the Ryan White part B program.

Effective: 11/04/2011
R.C. 119.032 review dates: 04/20/2011
Promulgated Under: 119.03
Statutory Authority: 3701.241
Rule Amplifies: 3701.241
Prior Effective Dates: 9/23/91 (Emer.), 12/22/91, 5/20/99, 12/20/01, 8/2/09

3701-44-06 [Rescinded] Provider eligibility for core medical services.

Effective: 11/04/2011
R.C. 119.032 review dates: 04/20/2011
Promulgated Under: 119.03
Statutory Authority: 3701.241
Rule Amplifies: 3701.241
Prior Effective Dates: 9/23/1991 (Emer.), 12/22/91, 5/20/99, 7/20/ 01, 8/2/09

3701-44-07 [Rescinded] Reconsideration process for denial or termination of eligibility.

Effective: 11/04/2011
R.C. 119.032 review dates: 04/20/2011
Promulgated Under: 119.03
Statutory Authority: 3701.241
Rule Amplifies: 3701.241
Prior Effective Dates: 9/23/1991 (Emer.), 12/22/91, 5/20/99, 7/20/01, 8/2/09

3701-44-08 [Rescinded] Ohio HIV drug assistance program eligibility requirements.

Effective: 11/04/2011
R.C. 119.032 review dates: 04/20/2011
Promulgated Under: 119.03
Statutory Authority: 3701.241
Rule Amplifies: 3701.241
Prior Effective Dates: 7/20/2001, 12/18/06, 8/2/09

3701-44-09 Operation of home health program; establishment of list of services covered by the home health program.[Rescinded].

Rescinded eff 8-2-09

3701-44-10 Payment for services under the Ryan White home health program.[Rescinded].

Rescinded eff 8-2-09

3701-44-11 Eligibility for benefits under the Ryan White home health program.[Rescinded].

Rescinded eff 8-2-09

3701-44-12 Eligibility of providers for Ryan White home health program.[Rescinded].

Rescinded eff 8-2-09

3701-44-13 Reconsideration of eligibility and authorization decisions.[Rescinded].

Rescinded eff 8-2-09