Rule 5160-31-02 | Pre-admission screening system providing options and resources today (PASSPORT) HCBS waiver program definitions.
(A) The purpose of this rule is to define the terms used in Chapter 5160-31 of the Administrative Code governing the preadmission screening system providing options and resources today (PASSPORT) home and community-based services (HCBS) waiver program.
(B) "Assessment" means an evaluation used to obtain information about an individual including their condition, personal goals and preferences, functional limitations, health status, and other factors that are relevant to the authorization and provision of services. Information obtained from the assessment supports the determination of program eligibility and the development of the person-centered services plan.
(C) "Authorized representative" means as defined in rule 5160-1-33 of the Administrative Code.
(D) "Case manager" means as defined in rule 173-39-01 of the Administrative Code.
(E) "Centers for medicare and medicaid services (CMS)" means the federal agency that is part of the United States department of health and human services, and that administers the medicaid program and approves HCBS waivers.
(F) "Financial management service (FMS)" means a support provided to waiver participants who direct some or all of their waiver services. In the PASSPORT waiver, this support is conducted as an administrative activity through an entity under contract with the state of Ohio. When used in conjunction with the participant-directed authorities available to individuals enrolled in PASSPORT, this support includes operating a payroll service for participant-employed workers and making required payroll withholdings.
(G) "Home and community-based services (HCBS)" means services furnished under the provisions set forth in 42 C.F.R. 441 Subpart G (October 1, 2024) that permit individuals to live in a home setting rather than in a facility. HCBS waiver services are approved by CMS for specific populations and are not otherwise available under the medicaid state plan.
(H) "Home first" means the component of the PASSPORT HCBS waiver program that offers priority enrollment in the waiver for certain individuals in accordance with section 173.521 of the Revised Code.
(I) "Individual" means a person applying for or receiving medical assistance or home and community-based services.
(J) "Level of care (LOC)" means the designation describing an individual's person's functional levels and nursing needs pursuant to the criteria defined in rule 5160-3-05 of the Administrative Code.
(K) "Nursing Facility (NF)" means as defined in section 5165.01 of the Revised Code.
(L) "ODA's designee" means as defined in rule 173-39-01 of the Administrative Code.
(M) "ODM's administrative agency" has the same meaning as "administrative agency" as defined in rule 5160:1-1-01 of the Administrative Code.
(N) "PASSPORT" or "PASSPORT HCBS waiver program" means the medicaid-funded component of the PASSPORT program created under section 173.52 of the Revised Code and approved by the centers for medicare and medicaid services.
(O) "Person-centered services plan" means as defined in rule 5160-44-02 of the Administrative Code.
(P) "Provider" means an agency or a person with a signed medicaid provider agreement with ODM and certified by ODA.
Last updated September 22, 2025 at 7:44 AM
Supplemental Information