Ohio Administrative Code Search

...er program authorized under section 1915(c) of the Social Security Act (as in effect on January 1, 2020) or the Ohio medicaid state plan authorized under section 1915(i) of the Social Security Act (as in effect on January 1, 2020) must reside in and/or receive HCBS in a private residence or another setting that meets the home and community-based setting requirements set forth in this rule. (1) A ...

...er program authorized under section 1915(c) of the Social Security Act (as in effect on January 1, 2021) or the Ohio medicaid state plan authorized under section 1915(i) of the Social Security Act (as in effect on January 1, 2021) must reside in and/or receive HCBS in a private residence or another setting that meets the home and community-based setting requirements set forth in this rule. (1) A ...

...er program authorized under section 1915(c) of the Social Security Act (as in effect on January 1, 2023) or the Ohio medicaid state plan authorized under section 1915(i) of the Social Security Act (as in effect on January 1, 2023) have to reside in and/or receive HCBS in a private residence or another setting that meets the home and community-based setting requirements set forth in this rule. (1)...

...er program authorized under section 1915(c) of the Social Security Act (as in effect on January 1, 2016) or the Ohio medicaid state plan authorized under section 1915(i) of the Social Security Act (as in effect on January 1, 2016) will lead the person-centered planning process where possible. The individual's authorized representative should have a participatory role, as needed, and as defined by ...

...er program authorized under section 1915(c) of the Social Security Act (as in effect on January 1, 2021) or the Ohio medicaid state plan authorized under section 1915(i) of the Social Security Act (as in effect on January 1, 2021) will lead the person-centered planning process where possible. The individual's authorized representative should have a participatory role, as needed, and as defined by ...

...er program authorized under section 1915(c) of the Social Security Act (as in effect on January 1, 2024) or the Ohio medicaid state plan authorized under section 1915(i) of the Social Security Act (as in effect on January 1, 2024) will lead the person-centered planning process where possible. The individual's authorized representative should have a participatory role, as needed, and as defined by ...

... the following definitions apply: (1) "Care management entity" means an entity delegated or contracted by ODA or ODM to perform care management activities and related functions for individuals enrolled on a waiver, or enrolled concurrently on the MyCare Ohio managed care program and the SRS program. (2) "Critical incident" means incidents identified in paragraph (C) of this rule. (3) "...

... the following definitions apply: (1) "Care management entity" (CME) means the agency described in rule 5160-59-03.2 of the Administrative Code. (2) "Health and safety action plan" or "HSAP" means a document developed by the waiver case management agency or recovery management agency that identifies situations, circumstances, and behaviors that without intervention may jeopardize the ind...

... shall include an overnight stay. (1) An out-of-home respite provider shall make available the following: (a) Waiver nursing services as set forth in rule 5160-44-22 of the Administrative Code; (b) Personal care services as set forth in rule 5160-46-04 of the Administrative Code if the individual is enrolled on an Ohio department of medicaid (ODM) -administered waiver, or rule 173-39-02.11 of t...

...e will include an overnight stay. (1) An out-of-home respite provider will make available the following: (a) Waiver nursing services as set forth in rule 5160-44-22 of the Administrative Code; (b) Personal care services as set forth in rule 5160-46-04 of the Administrative Code if the individual is enrolled on an Ohio department of medicaid (ODM) -administered waiver, or rule 173-39-02.11 of th...

... (LPN) at the direction of an RN. (1) All nurses providing waiver nursing services to individuals shall: (a) Possess a current, valid and unrestricted license with the Ohio board of nursing; (b) Possess an active medicaid provider agreement or be employed by an entity that has an active medicaid provider agreement; and (c) Provide services within the nurse's scope of practice as set forth in ...

... (LPN) at the direction of an RN. (1) All nurses providing waiver nursing services to individuals will: (a) Possess a current, valid and unrestricted license with the Ohio board of nursing; and (b) Possess an active medicaid provider agreement or be employed by an entity that has an active medicaid provider agreement; and (c) Provide services within the nurse's scope of practice as set forth ...

...S) setting that is compliant with rule 5160-44-01 of the Administrative Code. Community transition services: (1) Include expenses necessary to enable an individual to establish a basic household. Examples include: (a) Security deposits and rental expenses required to obtain a residential lease; (b) Basic household items required to occupy and maintain housing, including window coverings, food p...

...etting that is compliant with rule 5160-44-01 of the Administrative Code. Community transition: (1) Community transition includes the following: (a) Expenses necessary to enable an individual to establish a basic household. Examples include: (i) Security deposits and rental fees needed to obtain a lease on an apartment or home and rental expenses required to obtain a residential lease;...

...ce" has the same meaning as in section 3719.01 of the Revised Code. (4) "Custodian" has the same meaning as in section 2151.011 of the Revised Code. (5) "Gastrostomy tube" means a percutaneously inserted catheter that terminates in the stomach. (6) "Group setting" means a situation in which a home care attendant service provider furnishes home care attendant services in accordance with thi...

...ce" has the same meaning as in section 3719.01 of the Revised Code. (4) "Custodian" has the same meaning as in section 2151.011 of the Revised Code. (5) "Gastrostomy tube" means a percutaneously inserted catheter that terminates in the stomach. (6) "Group setting" means a situation in which a home care attendant service provider furnishes home care attendant services in accordance with thi...

...ed waiver service provider shall: (1) Maintain an active, valid medicaid provider agreement as set forth in rule 5160-1-17.2 of the Administrative Code. (2) Comply with all provider requirements set forth in Chapters 5160-44 and 5160-45 of the Administrative Code, and Chapter 5160-46 or 5160-58 of the Administrative Code, depending upon the waiver(s) for which the provider is rendering servi...

...ed waiver service provider shall: (1) Maintain an active, valid medicaid provider agreement as set forth in rule 5160-1-17.2 of the Administrative Code. (2) Comply with all provider requirements set forth in Chapters 5160-44 and 5160-45 of the Administrative Code, and Chapter 5160-46 or 5160-58 of the Administrative Code, depending upon the waiver(s) for which the provider is rendering servi...

...red waiver service provider will: (1) Maintain an active, valid medicaid provider agreement as set forth in rule 5160-1-17.2 of the Administrative Code. (2) Comply with all provider requirements set forth in Chapters 5160-44 and 5160-45 of the Administrative Code, and Chapter 5160-46 or 5160-58 of the Administrative Code, depending upon the waiver(s) for which the provider is rendering servi...

...llowing waiver programs and services: (1) Individual options services, as described in Chapter 5123-9 of the Administrative Code: (a) Homemaker/personal care, participant-directed and provided through an agency; and (b) Waiver nursing, provided through an agency. (2) Level one homemaker/personal care services, participant-directed and provided through an agency, as described in Chapter 512...

...vidual meets the following criteria: (1) The caregiver resides with the individual in the individual's private home or resides with the individual in the caregiver's private home. (2) The individual needs assistance with daily personal care and household support, and assistance with activities needed to promote independence and integration into the community. (3) The individual chooses t...

... same meaning as set forth in rule 5160-44-05 of the Administrative Code. (B) "Accreditation commission for health care" or "(ACHC)" is a national organization that evaluates and accredits agencies seeking to participate in the medicare and medicaid programs. For the purpose of providing services to individuals enrolled on an ODM-administered waiver, ACHC-accredited agencies are "otherwis...

... same meaning as set forth in rule 5160-44-05 of the Administrative Code. (B) "Accreditation commission for health care" or "(ACHC)" is a national organization that evaluates and accredits agencies seeking to participate in the medicare and medicaid programs. For the purpose of providing services to individuals enrolled on an ODM-administered waiver, ACHC-accredited agencies are "otherwis...

...tered waiver in accordance with rule 5160-46-02 of the Administrative Code shall be informed of their rights and responsibilities. Individuals also have choice and control over the arrangement and provision of home and community-based waiver services, and the selection and control over the direction of approved waiver service providers. (A) Individual rights. An individual enrolled in an ODM-administered ...

...tered waiver in accordance with rule 5160-46-02 of the Administrative Code shall be informed of their rights and responsibilities. Individuals also have choice and control over the arrangement and provision of home and community-based waiver services, and the selection and control over the direction of approved waiver service providers. (A) Individual rights. An individual enrolled in an ODM-administered ...