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Ohio Laws and Rules
(A) Federal P.L. 104-193, the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) (effective August 22, 1996) eliminated the aid to dependent children (ADC) program and replaced it with a block grant program called temporary assistance for needy families (TANF). PRWORA eliminated the automatic link between the receipt of cash assistance and medicaid. However, states are required to find individuals eligible for medicaid if they would have been eligible for ADC in July 1996 with a few exceptions. This covered group is known as low-income families medicaid (LIF).
(B) Ohio Sub. H.B. 408 created the Ohio works first (OWF) program. It also established the automatic link between cash assistance and medicaid eligibility in Ohio as specified in rules 5101:1-40-01.1 and 5101:1-40-02 of the Administrative Code. This covered group is known as OWF medicaid.
(C) The following definitions apply specifically to the low-income families medicaid (LIF) and OWF covered groups.
(1) LIF medicaid – those individuals found eligible under the July 1996 ADC eligibility requirements.
(2) OWF medicaid – those individuals automatically eligible for medicaid because of their eligibility for OWF cash assistance.
(3) Child – as defined in section 5107.02 of the Revised Code.
(4) Specified relative – as defined in section 5107.02 of the Revised Code.
(5) Income standards – the income standards used to determine financial eligibility for LIF medicaid are the need standard and the payment standard as defined in rule 5101:1-40-26 of the Administrative Code.
(6) Gross countable income – the amount of nonexempt unearned income and earned income (including countable gross earnings from self-employment as defined in paragraph (B) of rule 5101:1-40-20.4 of the Administrative Code) that is compared to the ninety per cent federal poverty level (FPL) standard to determine eligibility for LIF medicaid. Gross countable income is determined by adding all non-exempt unearned income and all earned income without earned income disregards.
(7) Countable income – the amount of income which is compared to the appropriate payment or need standard to determine if a family is eligible for LIF medicaid. Countable income is determined by adding nonexempt gross unearned income and gross earned income minus appropriate earned income disregards.
(D) LIF eligibility requirements
An assistance group making application for LIF medicaid must meet the following eligibility requirements:
(1) The family must include a child as defined in section 5107.02 of the Revised Code.
(2) Family countable income that does not exceed the payment or need standard as defined in rule 5101:1-40-26 of the Administrative Code.
(E) The following provisions apply to the LIF group.
(1) The fifty dollar child support disregard is an allowable disregard in the determination of countable income as set forth in rule 5101:1-40-20.3 of the Administrative Code.
(2) The earned income disregards are applied at the individual level as set forth in rule 5101:1-40-20.5 of the Administrative Code.
(3) The use of the pregnancy allowance in budget calculations remains applicable as set forth in rule 5101:1-40-26 of the Administrative Code.
(F) July 1996 ADC provisions that no longer apply to the LIF group.
(1) Resource limits
(2) Deprivation
(G) OWF provisions that do not apply include, but are not limited to:
(1) The signing of a self-sufficiency contract.
(2) The OWF sanction policy as set forth in section 5107.16 of the Revised Code.
(3) The time-limited participation in OWF as set forth in section 5107.18 of the Revised Code.
(H) OWF medicaid
Individuals who meet the OWF cash assistance eligibility requirements as outlined in Chapters 5101:1-3 and 5101:1-23 of the Administrative Code are automatically eligible for OWF medicaid.
(I) Relationship between LIF, OWF, transitional medicaid and four-month extended medicaid:
(1) Assistance groups who become ineligible for LIF or OWF medicaid due to child or spousal support payments may be eligible for four-month extended medicaid in accordance with Chapter 5101:1-40 of the Administrative Code.
(2) Assistance groups who become ineligible for LIF or OWF medicaid due to income from employment may be eligible for transitional medicaid in accordance with Chapter 5101:1-40 of the Administrative Code.
(3) Assistance groups who lose eligibility for OWF cash due to expiration of the OWF program time- limited participation as set forth in section 5107.18 of the Revised Code shall have their eligibility for LIF medicaid explored prior to the termination of OWF medicaid.
Effective: 01/01/2006
R.C. 119.032 review dates: 10/14/2005 and 01/01/2011
Promulgated Under: 111.15
Statutory Authority: 5111.01
Rule Amplifies: 5111.01 and 5111.019
Prior Effective Dates: 10/31/97 (Emer.), 12/31/97 (Emer.), 3/9/98, 9/01/98, 10/01/99, 07/01/00