3701-44-05 Eligibility for benefits under the Ryan White program.

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

(1) The individual shall be an Ohio resident;

(2) The individual shall have a verified HIV infection ; and

(3) The individual’s or family’s monthly gross income, excluding taxes and any mandatory retirement deduction, does not exceed three hundred percent of the currently applicable supplemental security income payment under Title XVI of the “Social Security Act,” 49 Stat. 620 (1935), 42 U.S.C. 301, as amended. The director may adjust this eligibility standard if he or she determines that it is necessary due to program fiscal considerations.

(B) The community-based HIV case manager for the area where the applicant for program eligibility resides shall determine whether the applicant meets the requirements specified in paragraph (A) of this rule. Upon determining that the applicant is eligible, the case manager shall assign the applicant an identification number and shall report the applicant’s number to the third-party administrator responsible for making payments under rule 3701-44-04 of the Administrative Code. The case manager also shall report the applicant’s identification number and date of birth to the director.

(C) The community-based case manager may give the applicant for program eligibility written notification of the decision on eligibility. If eligibility is denied, the case manager shall state in the notice the reasons for denial and the process for reconsideration under rule 3701-44-07 of the Administrative Code.

R.C. 119.032 review dates: 04/30/2004 and 04/30/2009

Promulgated Under: 119.03

Statutory Authority: 3701.241

Rule Amplifies: 3701.241

Prior Effective Dates: 5/20/1999