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

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 ODA's designee. The individual may contact either the CDJFS or ODA's designee 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 5160:1-1 to 5160:1-5 of the Administrative Code. The CDJFS shall notify the ODA's designee of the individual's application for waiver services. The ODA's designee shall initiate contact with the individual to complete the enrollment process.

(2) Individuals initially contacting ODA's designee 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, ODA's designee may assist the individual.

(B) If the individual has been determined eligible and a waiver slot is available, the individual 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 5160:1-2-01.6 of the Administrative Code, if a individual is determined eligible for medicaid by the CDJFS, the individual shall not enroll in the assisted living HCBS waiver program until ODA's designee establishes a waiver program enrollment date and authorizes the provision of waiver services by an ODA certified assisted living provider. The waiver program enrollment date shall in no way restrict retroactive eligibility for non-assisted living waiver services available to individuals 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: 4/1/2017
Five Year Review (FYR) Dates: 12/27/2016 and 04/01/2022
Promulgated Under: 119.03
Statutory Authority: 5166.02
Rule Amplifies: 173.54
Prior Effective Dates: 7/1/06, 3/22/08, 9/19/09, 9/29/2011