5101:3-1-06.5 Home and community based service waivers: Assisted Living.

(A) The Ohio department of aging (ODA) is responsible for the daily administration of the assisted living home and community based services (HCBS) waiver. ODA will administer this 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 assisted living home and community based services (HCBS) waiver is an alternative to nursing facility placement for persons age twenty-one and over who require intermediate level of care as set forth in rule 5101:3-3-06 of the Administrative Code or skilled level of care as set forth in rule 5101:3-3-05 of the Administrative Code and are enrolled in the waiver.

(1) The assisted living HCBS waiver services and program eligibility criteria are set forth in Chapter 5101:3-33 of the Administrative Code.

(2) Financial eligibility for the assisted living HCBS waiver program is determined in accordance with Chapter 5101:1-39 of the Administrative Code.

(3) Maximum allowable reimbursement rates for the assisted living HCBS waiver program are listed in appendix A to this rule. Assisted living HCBS reimbursement must be provided in accordance with paragraphs (A) to (C) of rule 5101:3-1-60 of the Administrative Code.

The billing maximum for the community transition service listed in appendix A to this rule represents the cumulative maximum for the items purchased or deposits made through the community transition service during the consumer’s period of eligibility for this service as established in rule 173-39-02.17 of the Administrative Code.

APPENDIX A

Assisted Living Waiver Rates

Effective July 1, 2006

Service                         Billing Maximum     Billing Unit

Assisted Living Service-Tier 1       $49.98       1 day

Assisted Living Service-Tier 2       $60.00       1 day

Assisted Living Service-Tier 3       $69.98       1 day

Community Transition Service       $1500.00       1 completed job order or deposit made

Effective: 03/22/2008

R.C. 119.032 review dates: 11/13/2007 and 03/01/2013

Promulgated Under: 119.03

Statutory Authority: 5111.85, 5111.89

Rule Amplifies: 5111.85, 5111.89

Prior Effective Dates: 07/01/2006