5101:1-40-07 Covered families and children medicaid: medicaid eligibility and OWF sanctions.

(A) In accordance with section 5107.16 of the Revised Code, an adult member of an OWF assistance group who is subject to an OWF sanction as a result of a self-sufficiency contract failure does not lose eligibility for healthy families/LIF medicaid as a result of a first or second failure to comply without good cause.

(B) An adult member of an OWF assistance group who is sanctioned as a result of her/his own third or subsequent failure to comply with a provision of an OWF self-sufficiency contract related to a work activity as defined in division (D) of section 5107.40 of the Revised Code loses eligibility for healthy families/LIF medicaid until he/she complies with the work activity as described in paragraph (C) of this rule. Before proposing to terminate the sanctioned adult’s medicaid eligibility under this paragraph, the CDJFS must complete a pre-termination review (PTR) of continuing medicaid eligibility for the sanctioned adult under every other medicaid category as described in rule 5101:1-38-01.1 of the Administrative Code.

(C) There is no minimum sanction period for the sanctioned adult member of the assistance group who has lost eligibility under the provisions outlined in paragraph (B) of this rule. The sanctioned adult immediately regains medicaid eligibility by complying with the work activity. The CDJFS must permit the sanctioned adult to comply immediately without any delay due to the OWF minimum sanction period. Immediately upon compliance, the sanctioned adult shall be eligible for healthy families/Lif medicaid as described in rule 5101:1-40-02.1 of the Administrative Code beginning the first day of the month in which he/she complies.

(D) The eligibility for covered families and children medicaid of a pregnant woman (Including a woman in her sixty-day postpartum period), a non-sanctioned adult, or minor child who is a member of an OWF assistance group subject to an OWF sanction is not affected at any tier.

HISTORY: Eff 7-1-00; 10-1-01

Rule promulgated under: RC 111.15

Rule authorized by: RC 5111.011

Rule amplifies: RC 5107.16, 5111.01, 5111.011

RC 119.032 REVIEW DATES: 7/1/2005