Rule 3304-4-04 | Disciplinary infractions.
(A) An eligible individual shall be determined as noncompliant with the personal care assistance (PCA) program for the following disciplinary infractions:
(1) A determination by the Ohio department of taxation, the bureau of workers' compensation, the Ohio department of job and family services, or the internal revenue service of non-payment of employer costs required by federal, state, and local law;
(2) Failure to submit W-2, 1099, or other pertinent tax documents to the appropriate authorities;
(3) Failure to pay an assistant for all services provided to the eligible individual for which they invoiced to OOD and/or failure to pay an assistant within two weeks after receipt of invoiced funds from OOD or within the specified time frames established by the PCA program;
(4) Paying an assistant for services not rendered;
(5) Using any PCA program funds as personal income;
(6) Make, present, or use any information knowing it to be false and submitting it to OOD or to the local community rehabilitation program;
(7) Misrepresenting the need for PCA program funds to OOD or to the local community rehabilitation program during application or any other time thereafter;
(8) Not responding within a specified time frame to a request for information or for a home visit by a local community rehabilitation program and/or OOD;
(9) Failure to report permanent change of residency;
(10) Violation of any requirement contained in Chapter 3304-4 of the Administrative Code;
(11) Failure to complete the annual review within the specified time frames;
(12) Failure to complete a fiscal audit within the specified time frames;
(13) Failure to produce any documentation requested by the PCA program within the specified time frames;
(14) Pattern of missing deadlines for submitting required documentation to the PCA program;
(15) Failure to report applicable changes in income status, employment status, job seeking status, training status, or changes in their vocational rehabilitation case to the PCA program within ten business days from the change;
(16) Failure to comply with PCA program rules, including individualized case decisions; and
(17) Receipt of more than one written notice from the PCA program over the course of the PCA program case for any of the above disciplinary infractions, or other suspicious activity.
(B) The PCA program shall conduct a case review to determine if an infraction occurred that results in noncompliance.
(1) The PCA program may ask the eligible individual for additional information to determine if an infraction has occurred, when appropriate. The eligible individual shall be provided with a clear submission deadline when additional information is requested.
(2) The eligible individual may be placed on a temporary suspension (invoices on hold) during the case review and/or pending the submission of information.
(C) The PCA program shall make a case decision determining if an infraction occurred and therefore an eligible individual's case is noncompliant with the PCA program's requirements. If it is determined that an infraction occurred and the case is noncompliant, the PCA program shall implement corrective action.
(D) Should the PCA program determine that an eligible individual's case is noncompliant and thereby requires corrective action, the PCA program may take any of the following, but not limited to, measures based on its review of the severity and or pattern of noncompliance as determined by the PCA program:
(1) Written reminder of the PCA program's requirements;
(2) Additional case requirement(s) implemented to facilitate compliance;
(3) Funding suspension (forfeiture of funds); and
(4) Removal from the PCA program.
(a) The PCA program may set a time frame where an application will not be accepted from an individual who was removed from the PCA program.
(E) The PCA program shall implement corrective action for any case decision with a finding of noncompliance within five business days of the determination.
(F) The eligible individual shall be notified in writing of the decision to implement corrective action.
(G) The eligible individual may initiate the grievance process pursuant to Rule 3304-4-03 regarding any PCA program case decision.
(H) The seriousness of the infraction may dictate that the case is subject to review by authorities outside of the PCA program. This review may result in additional actions from those authorities, such as criminal charges issued and prosecution in a court of law. Cost recovery may be invoiced as part of corrective action and shall take into account any additional eligible individual response and supplemental documentation provided, which may mitigate cost recovery amounts. Eligible individuals shall have forty-five days to submit any amount payable to OOD. If the amount owed to OOD is not paid within forty-five days of receipt of the notice of invoiced questioned cost, the account shall be submitted to the attorney general for collection pursuant to section 131.02 of the Revised Code.
Last updated December 1, 2025 at 1:20 PM
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