5160-33-04 Enrollment process for assisted living home and community based services (HCBS) waiver program.

(A) Individuals who wish to enroll in the assisted living HCBS waiver must have an eligibility determination made by the county department of job and family services (CDJFS) and an assessment of assisted living HCBS waiver eligibility made by the PASSPORT administrative agency (PAA). The individual may contact either the CDJFS or the PAA to start the enrollment process and the two agencies shall coordinate processing the request for enrollment into the assisted living HCBS waiver program:

(1) Individuals initially contacting the CDJFS will complete the JFS 07200 "Request for Cash, Food Stamps, and Medical Assistance" (rev. 03/10) and the JFS 02399 "Request for Medicaid Home and Community Based Services" (rev. 01/06) in accordance with rules 5101:1-38- 01.2and 5101:1-38.01.6 of the Administrative Code. The CDJFS shall notify the PAA of the individual's application for waiver services. The PAA shall initiate contact with the individual to complete the enrollment process.

(2) Individuals initially contacting the PAA will receive an in-person assessment to determine eligibility for the assisted living HCBS waiver program. If the individual has not already initiated an application for medicaid or waiver eligibility as described in paragraph (A)(1) of this rule, the PAA may assist the individual.

(B) If the individual has been determined eligible and a waiver slot is available, the consumer shall be enrolled in accordance with the assisted living HCBS waiver's home first component, if applicable, and rule 173-38-03 of the Administrative Code.

(C) Pursuant to rule 5101:1-38-01.6 of the Administrative Code, if a consumer is determined eligible for medicaid by the CDJFS, the consumer shall not enroll in the assisted living HCBS waiver program until the PAA establishes a waiver program enrollment date and authorizes the provision of waiver services by an ODA certified RCF. The waiver program enrollment date shall in no way restrict retroactive eligibility for non-assisted living waiver services available to consumers through the medicaid state plan.

(D) Any applicant for assisted living services HCBS waiver program services is entitled to notice and hearing rights as set forth in section 5101.35 of the Revised Code and division 5101:6 of the Administrative Code.

Effective: 09/29/2011
R.C. 119.032 review dates: 07/14/2011 and 09/01/2016
Promulgated Under: 119.03
Statutory Authority: 5111.85, 5111.89
Rule Amplifies: 5111.85, 5111.89
Prior Effective Dates: 7/01/06, 3/22/08, 9/19/09