5101:3-50-05 Transitions carve-out waiver program: calculation of the individual cost cap.

(A) An individual cost cap shall be assigned for consumers receiving services under the transitions carve-out waiver. The individual cost cap shall be reassigned annually and when a consumer experiences a significant change as defined in rule 5101:3-45-01 of the Administrative Code.

(B) Individual cost cap has the same definition as set forth in rule 5101:3-45-01 of the Administrative Code. It is based on the information from the data collection that is related to the consumer's functional ability, need for skilled and unskilled services, cognitive ability and need for services in the absence of a caregiver.

(C) Before services begin, and at the time of any change in the all services plan affecting the individual cost cap, the consumer shall be informed by the case management agency, or ODJFS, of the individual cost cap assigned. The consumer shall be afforded notice and hearing rights in accordance with division 5101:6 of the Administrative Code.

Replaces: Part of 5101:3-12-09

Effective: 02/15/2007
R.C. 119.032 review dates: 02/01/2012
Promulgated Under: 119.03
Statutory Authority: 5111.85
Rule Amplifies: 5111.01 , 5111.02 , 5111.85
Prior Effective Dates: 7/1/98