LAW
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Ohio Laws and Rules
(A) The Ohio department of aging (ODA) is responsible for the daily administration of the choices home and community based services (HCBS) waiver. ODA will administer the waiver pursuant to an interagency agreement with the Ohio department of job and family services (ODJFS), in accordance with section 5111.91 of the Revised Code.
(B) The choices waiver provides HCBS to persons aged sixty and over who reside in the service area defined in the approved 1915(c) waiver for the choices program and who require intermediate level of care as set forth in rule 5101:3-3-06 of the Administrative Code or skilled care level of care as set forth in rule 5101:3-3-05 of the Administrative Code and are enrolled in the waiver.
(1) The choices HCBS waiver services and program eligibility criteria are set forth in Chapter 5101:3-32 of the Administrative Code.
(2) Financial eligibility for the choices HCBS waiver program is determined in accordance with Chapter 5101:1-39 of the Administrative Code.
(3) Maximum allowable reimbursement rates for the choices HCBS waiver program are listed in appendix A to this rule and are to be effective on July 1, 2008. The maximum allowable reimbursement rates for services rendered prior to July 1, 2008 are the maximum allowable reimbursement rates in appendix A to this rule less three per cent. Choices HCBS reimbursement must be provided in accordance with paragraphs (A) to (C) of rule 5101:3-1-60 of the Administrative Code.
Appendix A
Choices Waiver Rates
The following services are available only to choices enrollees in the service area defined in the approved 1915 (c) waiver for the choices program.
Service Billing Maximum Billing unit
Enhanced adult day service $42.44 1 day
Enhanced adult day service $21.22 1/2 day
Enhanced adult day service $1.33 15 minutes
Intensive adult day service $55.70 1 day
Intensive adult day service $27.85 1/2 day
Intensive adult day service $1.74 15 minutes
Adult day service transportation $2.25 1 mile
Adult day service transportation $16.80 1 one-way trip
Adult day service transportation $20.71 1 round trip
Home care attendant service $39.78 1/4 hour
Home medical equipment & supplies: Ambulatory $5,304.50 1 Item
Home medical equipment & supplies : Non-Ambulatory $5,304.50 1 Item
Home medical equipment & supplies: Hygiene and Disposables $5,304.50 1 Item
Home medical equipment & supplies: Equipment Repair $5,304.50 1 Item
Home medical equipment & supplies: Nutrition supplement and Supplies $5,304.50 1 Item
Emergency response system $47.74 1 month rental
Emergency response system $47.74 installation
Emergency response system $103.00 alternative ERS device
Minor home modification $7,956.75 1 completed work order
Meals: home delivered $6.70 1 meal
Meals: therapeutic $9.46 1 meal
Alternative meals service $31.83 1 meal
Pest control $795.68 1 job
All services are reimbursed at the usual and customary rates or the Medicaid maximum rate whichever is lower.
Effective: 07/01/2008
Promulgated Under: 119.03
Statutory Authority: 5111.85
Rule Amplifies: 5111.85
Prior Effective Dates: 1/1/04, 7/1/05, 7/1/06, 7/2/07 (Emer.), 10/1/07