Ohio Administrative Code Search
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Rule 5160-42-01 | Medicaid home and community-based services program - level one waiver.
...(A) Purpose (1) The Ohio department of developmental disabilities (DODD) is responsible for the daily operation of the level one (L1) waiver which will be administered pursuant to sections 5166.20 and 5166.02 of the Revised Code. (2) DODD operates the L1 waiver program pursuant to an interagency agreement with the Ohio department of medicaid (ODM) in accordance with section 5162.35 of the Revis... |
Rule 5160-43-01 | Specialized recovery services program definitions.
...(A) This rule contains the definitions used in Chapter 5160-43 of the Administrative Code applicable to the specialized recovery services program. (B) Definitions. (1) "Acknowledgment of responsibility" means the document created between the Ohio department of medicaid (ODM) or its designee and an individual enrolled in the program that identifies the interventions recommended by the recovery manager to remedy risk... |
Rule 5160-43-01 | Specialized recovery services program definitions.
...(A) This rule contains the definitions used in Chapter 5160-43 of the Administrative Code applicable to the specialized recovery services program. (B) Definitions. (1) "Adult Needs and Strengths Assessment (ANSA)" (8/2021) is an integration information assessment tool for use in the development of individualized person-centered care plans, to monitor outcomes, and to help design and plan systems... |
Rule 5160-43-01 | Specialized recovery services program definitions.
...(A) The following definitions apply to Chapter 5160-43 of the Administrative Code: (1) "Adult Needs and Strengths Assessment (ANSA)" (8/2021) is an integration information assessment tool for use in the development of individualized person-centered care plans, to monitor outcomes, and to help design and plan systems of care for adults with behavioral health challenges. (2) "Authorized representa... |
Rule 5160-43-02 | Specialized recovery services program individual eligibility and program enrollment.
...(A) To be eligible for enrollment in the specialized recovery services program, an individual shall meet all of the following requirements: (1) Be at least twenty-one years of age; (2) Be determined eligible for Ohio medicaid in accordance with Chapters 5160:1-1 to 5160:1-5 of the Administrative Code; (3) Have a behavioral health diagnosis, be active on the solid organ or soft tissue waitin... |
Rule 5160-43-02 | Specialized recovery services program individual eligibility and program enrollment.
...(A) An individual may be eligible for enrollment in the specialized recovery services program if they meet all of the following: (1) Be at least twenty-one years of age; (2) Be determined eligible for Ohio medicaid in accordance with Chapters 5160:1-1 to 5160:1-5 of the Administrative Code; (3) Have a behavioral health diagnosis, be active on the solid organ or soft tissue waiting list, or ... |
Rule 5160-43-03 | Specialized recovery services program individual rights and responsibilities.
...(A) Enrollment in the specialized recovery services program is voluntary. Individuals enrolled in the program in accordance with rule 5160-43-02 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 services (HCBS), and the selection and control over the direction of... |
Rule 5160-43-03 | Specialized recovery services program individual rights and responsibilities.
...(A) Enrollment in the specialized recovery services program is voluntary. Individuals enrolled in the program in accordance with rule 5160-43-02 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 services (HCBS), and the selection and control over the direction of... |
Rule 5160-43-03 | Specialized recovery services program individual rights and responsibilities.
...(A) Enrollment in the specialized recovery services program is voluntary. Individuals enrolled in the program in accordance with rule 5160-43-02 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 services (HCBS), and the selection and control over the direction of... |
Rule 5160-43-04 | Specialized recovery services program covered services and provider requirements.
...(A) This rule sets forth the covered services available to an individual enrolled in the specialized recovery services program (SRSP) and the requirements for providers of those services. (B) Individualized placement and support - supported employment (IPS-SE) is the implementation of evidence-based practices allowing individuals to obtain and maintain meaningful employment by providing train... |
Rule 5160-43-04 | Specialized recovery services program covered services and provider requirements.
...(A) This rule sets forth the covered services available to an individual enrolled in the specialized recovery services program (SRSP) and the requirements for providers of those services. (B) Individualized placement and support - supported employment (IPS-SE) is the implementation of evidence-based practices allowing individuals to obtain and maintain meaningful employment by providing train... |
Rule 5160-43-04 | Specialized recovery services program covered services and provider requirements.
...(A) This rule sets forth the covered services available to an individual enrolled in the specialized recovery services program (SRSP) and the requirements for providers of those services. (B) Individualized placement and support - supported employment (IPS-SE) is the implementation of evidence-based practices allowing individuals to obtain and maintain meaningful employment by providing train... |
Rule 5160-43-05 | Specialized recovery services program provider conditions of participation.
...(A) Specialized recovery service program providers shall maintain professional relationships with the individuals they serve. Providers shall furnish services in a person-centered manner that is in accordance with the individual's approved person-centered care plan, is attentive to the individual's needs and maximizes the individual's independence. Providers shall refrain from any behavior that ma... |
Rule 5160-43-05 | Specialized recovery services program provider conditions of participation.
...(A) Specialized recovery service program providers shall maintain professional relationships with the individuals they serve. Providers shall furnish services in a person-centered manner that is in accordance with the individual's approved person-centered service plan, is attentive to the individual's needs and maximizes the individual's independence. Providers shall refrain from any behavior that... |
Rule 5160-43-05 | Specialized recovery services program provider conditions of participation.
...(A) Specialized recovery service program providers shall maintain professional relationships with the individuals they serve. Providers shall furnish services in a person-centered manner that is in accordance with the individual's approved person-centered service plan, is attentive to the individual's needs and maximizes the individual's independence. Providers shall refrain from any behavior that... |
Rule 5160-43-07 | Specialized recovery services program compliance: provider monitoring, oversight, structural reviews and investigations.
...(A) The Ohio department of medicaid (ODM) is responsible for the ongoing monitoring and oversight of all providers of specialized recovery services (hereafter referred to as providers) and contractors to ensure compliance with program requirements. (B) Monitoring and oversight of specialized recovery services program providers and recovery management contractors: (1) ODM and/or its designee (hereaft... |
Rule 5160-43-07 | Specialized recovery services program compliance: provider monitoring, oversight, and investigations.
...(A) The Ohio department of medicaid (ODM) is responsible for the ongoing monitoring and oversight of all providers of specialized recovery services (hereafter referred to as providers) and contractors to ensure compliance with program requirements. (B) Monitoring and oversight of specialized recovery services program providers and recovery management contractors: (1) ODM and/or its designee ... |
Rule 5160-43-08 | Specialized recovery services program billing procedures and payment rates for recovery management.
...(A) Definitions of terms used for billing and calculating rates. (1) "Billing unit" as used in column 4 of paragraph (C) of this rule, means a single fixed item, amount of time or measurement. (2) "Unit rate" as used in column 3 of paragraph (C) of this rule, means the amount reimbursed by the Ohio department of medicaid (ODM) for each fifteen minutes of service delivered. (B) Payment rates for individualized plac... |
Rule 5160-43-08 | Specialized recovery services program billing procedures and payment rates for recovery management.
...(A) Definitions of terms used for billing and calculating rates. (1) "Billing unit" as used in column 4 of paragraph (C) of this rule, means a single fixed item, amount of time or measurement. (2) "Unit rate" as used in column 3 of paragraph (C) of this rule, means the amount reimbursed by the Ohio department of medicaid (ODM) for each fifteen minutes of service delivered. (B) Payment rates for individualized plac... |
Rule 5160-43-08 | Specialized recovery services program billing procedures and payment rates for recovery management.
...(A) Definitions of terms used for billing and calculating rates. (1) "Billing unit" as used in column 4 of paragraph (C) of this rule, means a single fixed item, amount of time or measurement. (2) "Unit rate" as used in column 3 of paragraph (C) of this rule, means the amount reimbursed by the Ohio department of medicaid (ODM) for each fifteen minutes of service delivered. (B) Payment rates for individualized plac... |
Rule 5160-43-09 | Specialized recovery services program criminal records checks for providers.
...(A) This rule sets forth the process and requirements for the criminal records checks of providers of home and community-based services (HCBS) to individuals enrolled in the specialized recovery services program. HCBS include peer recovery support and individualized placement and support-supported employment (IPS-SE). This rule only applies to all persons under final consideration for employment w... |
Rule 5160-43-09 | Specialized recovery services program criminal records checks for providers.
...(A) This rule sets forth the process and requirements for the criminal records checks of providers of home and community-based services (HCBS) to individuals enrolled in the specialized recovery services program. HCBS include recovery management, peer recovery support and individualized placement and support-supported employment (IPS-SE). This rule only applies to all persons under final considera... |
Rule 5160-43-09 | Specialized recovery services program criminal records checks for providers.
...(A) This rule sets forth the process and requirements for the criminal records checks of providers of home and community-based services (HCBS) to individuals enrolled in the specialized recovery services program. HCBS include recovery management and individualized placement and support-supported employment (IPS-SE). This rule only applies to all persons under final consideration for employment wit... |
Rule 5160-44-01 | Nursing facility-based level of care home and community-based services programs: home and community-based settings.
...(A) Notwithstanding any provisions to the contrary in paragraph (E) of this rule, individuals receiving home and community-based services (HCBS) through either an Ohio department of medicaid (ODM) or Ohio department of aging (ODA) -administered waiver 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 und... |
Rule 5160-44-01 | Nursing facility-based level of care home and community-based services programs: home and community-based settings.
...(A) Notwithstanding any provisions to the contrary in paragraph (E) of this rule, individuals receiving home and community-based services (HCBS) through either an Ohio department of medicaid (ODM) or Ohio department of aging (ODA) -administered waiver 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 und... |