Rules Under Development 

Proposed Rule Actions For Review and Comment


The Department is seeking your comments on the following proposed rule actions.


Rule 5123:2-2-02 (Background Investigations for Employment) is due for five-year review.  The rule establishes standards for conducting background investigations on persons employed or seeking employment in Ohio's service delivery system for individuals with developmental disabilities.  The Department is proposing to rescind existing rule 5123:2-2-02 and adopt a new replacement of the same title numbered 5123-2-02.  New rule 5123-2-02 reflects revisions based on the comprehensive five-year review, including:

  • Adding a definition of the Ohio Attorney General's "Retained Applicant Fingerprint Database" (also known as "Rapback").
  • Correcting the website address for the database of Incarcerated and Supervised Offenders established pursuant to section 5120.066 of the Revised Code.
  • Adding a requirement for a responsible entity to check the Ohio Department of Medicaid Provider Exclusion and Suspension List.
  • Replacing "Bureau of Criminal Identification and Investigation" with "Bureau of Criminal Investigation."
  • Removing provisions regarding implementation of rule 5123:2-2-02 when the rule went into effect in 2013.
  • Adding a requirement that responsible entities enroll employees in direct services positions in Rapback, which had not yet been established when rule 5123:2-2-02 went into effect in 2013.  Enrolling employees in Rapback is more effective and less costly than requesting that the Bureau of Criminal Investigation conduct a criminal records check on employees every five years.

Although the Department is rescinding the existing rule and adopting a new replacement rule, a version of the rule identifying, via underline and strikethrough, the revisions being made is provided so stakeholders can readily see what is changing.  See the Business Impact Analysis for details.   Please send your comments to the Common Sense Initiative Office at CSIPublicComments@governor.ohio.gov and to Becky.Phillips@dodd.ohio.gov by December 6.


Rule 5123:2-2-03 (Quality Assurance) is due for five-year review.  The rule delineates processes that the Department employs to achieve quality outcomes for individuals who receive services.  The Department is proposing to rescind existing rule 5123:2-2-03 and adopt a new replacement rule of the same title numbered 5123-2-03.  New rule 5123-2-03 reflects revisions based on the comprehensive five-year review, to update references to the Ohio Administrative Code.  Although the Department is rescinding the existing rule and adopting a new replacement rule, a version of the rule identifying, via underline and strikethrough, the revisions being made is provided so you can readily see what is changing.   Please send your comments to Becky.Phillips@dodd.ohio.gov by December 6.


Rule 5123:2-2-04 (Compliance Reviews of Certified Providers) is due for five-year review.  The rule governs compliance reviews conducted by the Department and county boards of developmental disabilities to ensure compliance by providers of services with applicable requirements.  The Department is proposing to rescind existing rule 5123:2-2-04 and adopt a new replacement rule of the same title numbered 5123-2-04.  New rule 5123-2-04 reflects revisions based on the comprehensive five-year review, including:

  • Updating references to the Ohio Administrative Code, the Ohio Revised Code, the Ohio Department of Medicaid, and the federal quality initiative; and
  • Incorporating qualifications for persons conducting compliance reviews recommended by representatives of county boards of developmental disabilities.

Although the Department is rescinding the existing rule and adopting a new replacement rule, a version of the rule identifying, via underline and strikethrough, the revisions being made is provided so stakeholders can readily see what is changing.  See the Business Impact Analysis for details.   Please send your comments to the Common Sense Initiative Office at CSIPublicComments@governor.ohio.gov and to Becky.Phillips@dodd.ohio.gov by December 6.



Public Hearings Scheduled for Proposed Rules


The Department has given notice of its intent to adopt/rescind/amend the following rules and to conduct a public hearing thereon.  The public hearing will be held on the date specified.


January 3, 2019 (See Public Hearing Notice for Details)

The Department is adopting new rule 5123-7-34 (Intermediate Care Facilities for Individuals with Intellectual Disabilities - Quality Indicators and the Quality Incentive Payment Program).  The rule sets forth a method and process for determining the quality incentive payment that may be paid to an Intermediate Care Facility for Individuals with Intellectual Disabilities for achieving quality indicators pursuant to Section 5124.24 of the Revised Code.


The Department is rescinding rule 5123:2-8-01 (Developmental Disabilities Level of Care) and adopting a new replacement rule of the same title numbered 5123-8-01.  The rules set forth the criteria and process used to determine whether an individual requires the level of care necessary to receive Medicaid-funded services from an Intermediate Care Facility for Individuals with Intellectual Disabilities or through enrollment in a Home and Community-Based Services waiver administered by the Department.  New rule 5123-8-01 reflects revisions made to permit a Certified Nurse Practitioner to complete the required medical evaluation and to clarify that a determination by the Department that an individual meets the criteria for a developmental disabilities level of care is valid for up to twelve months.


House Bill 483 of the 131st General Assembly transferred responsibility for implementing the Early Intervention program from the Ohio Department of Health to the Ohio Department of Developmental Disabilities and charged the Ohio Department of Developmental Disabilities with adopting rules necessary to implement the program.  The first of new rules to be developed, 5123:2-10-01 (Early Intervention Services - System of Payments) went into effect in 2017.  Department staff have since continued to work with system stakeholders to develop the comprehensive body of rules governing the program.  Based on that work:

  • The Department is rescinding rule 5123:2-10-01 (Early Intervention Services - System of Payments).  The rule establishes a structure to pay for activities and expenses that are reasonable and necessary for implementing Ohio's Early Intervention system for eligible children and their families.  The rule is being replaced by new rule 5123-10-03, described below.
  • The Department is adopting new rule 5123-10-01 (Early Intervention Program - Procedural Safeguards).  The rule sets forth the procedural safeguards in the Early Intervention program including the provisions of parental consent and notice; retention, confidentiality, access to, and amendment of Early Intervention records; and dispute resolution. 
  • The Department is adopting new rule 5123-10-02 (Early Intervention Program - Eligibility and Services).  The rule sets forth Early Intervention program requirements for eligibility, developmental screening, evaluation, assessment, individualized family service plan meetings and content, transition to preschool and other programs, service coordination, records, and exiting and transferring from the Early Intervention program.
  • The Department is adopting new rule 5123-10-03 (Early Intervention Program - System of Payments).  The rule establishes a structure to pay for activities and expenses that are reasonable and necessary for implementing Ohio's Early Intervention program for eligible children and their families.
  • The Department is adopting new rule 5123-10-04 (Early Intervention Program - Credentials for Early Intervention Service Coordinators and Early Intervention Service Coordination Supervisors).  The rule establishes minimum qualifications through credentialing standards for Early Intervention Service Coordinators and Early Intervention Service Coordination Supervisors.   

Proposed Rules Slated for JCARR Meeting Agenda


The following rule actions are slated for the Joint Committee on Agency Rule Review (JCARR) meeting agenda on the date specified.


December 10, 2018

The Department is rescinding existing rule 5123:2-17-02 (Addressing Major Unusual Incidents and Unusual Incidents to Ensure Health, Welfare, and Continuous Quality Improvement) with Appendix A, Appendix B, and Appendix C and adopting a new replacement rule of the same title numbered 5123-17-02 with Appendix A, Appendix B, and Appendix C.

The Department is proposing actions involving rules governing Medicaid Home and Community-Based Services waivers:

Technology Services

  • New rule 5123-9-12 (Home and Community-Based Services Waivers - Assistive Technology Under the Individual Options, Level One, and SELF Waivers) with Appendix is being adopted to implement the new Assistive Technology service.  The rule defines Assistive Technology and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service.  Assistive Technology will replace Personal Emergency Response Systems, Remote Monitoring Equipment, and the Assistive Technology Assessment component of the Career Planning service.
  • Existing rule 5123:2-9-13 (Home and Community-Based Services Waivers - Career Planning under the Individual Options, Level One, and SELF Waivers) with Appendix is being rescinded and replaced by a new rule of the same title numbered 5123-9-13 with Appendix.  The rule defines Career Planning and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service.  New rule 5123-9-13 reflects elimination of the Assistive Technology Assessment component of the Career Planning service, because that component will instead be covered under the new Assistive Technology service described in new rule 5123-9-12.  Additionally, the Appendix to new rule 5123-9-13 reflects a payment rate increase for the Benefits Education and Analysis component of Career Planning.
  • Existing rule 5123-9-25 (Home and Community-Based Services Waivers - Specialized Medical Equipment and Supplies Under the Individual Options and Level One Waivers) with Appendix is being amended.  The rule defines Specialized Medical Equipment and Supplies and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service. 
  • Existing rule 5123-9-26 (Home and Community-Based Services Waivers - Personal Emergency Response Systems Under the Level One Waiver) with Appendix is being rescinded.  The rule defines Personal Emergency Response Systems and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service.  The Personal Emergency Response Systems service is being eliminated because the service will instead be covered under the new Assistive Technology service described in new rule 5123-9-12.
  • Existing rule 5123:2-9-35 (Home and Community-Based Services Waivers - Remote Monitoring and Remote Monitoring Equipment Under the Individual Options, Level One, and SELF Waivers) with Appendix is being rescinded and replaced by new rule 5123-9-35 (Home and Community-Based Services Waivers - Remote Support Under the Individual Options, Level One, and SELF Waivers) with Appendix.  New rule 5123-9-35 reflects the renaming of Remote Monitoring to Remote Support and clarifies roles of Remote Support providers, Remote Support vendors, and backup support persons.  The Remote Monitoring Equipment service is being eliminated because the service will instead be covered under the new Assistive Technology service described in new rule 5123-9-12.

Level One Waiver Payment Limitations

The Level One Waiver has two payment limitations.  A limitation of $7,500 applies to several services used alone or in combination by an individual in a three-year period.  A limitation of $5,325 applies to several other services used alone or in combination per an individual's one-year waiver eligibility span.  Remote Monitoring and Remote Monitoring Equipment services have been subject to the $7,500 limitation; the new Remote Support service (which is replacing Remote Monitoring) will be included in the $5,325 limitation.  Because the payment limitations are called out in the rules for services subject to the limitations, this change affects multiple rules:

  • Existing rule 5123:2-9-06 (Home and Community-Based Services Waivers - Documentation and Payment for Services Under the Individual Options and Level One Waivers) with Appendix A and Appendix B is being rescinded and replaced by a new rule of the same title numbered 5123-9-06 with Appendix A and Appendix B.  The rule establishes standards governing documentation and payment for services under the Individual Options and Level One waivers. 
  • Existing rule 5123:2-9-20 (Home and Community-Based Services Waivers - Money Management Under the Individual Options and Level One Waivers) with Appendix A and Appendix B is being rescinded and replaced by a new rule of the same title numbered 5123-9-20 with Appendix A and Appendix B.  The rule defines Money Management and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service. 
  • Existing rule 5123:2-9-21 (Home and Community-Based Services Waivers - Informal Respite Under the Level One Waiver) with Appendix is being rescinded and replaced by a new rule of the same title numbered 5123-9-21 with Appendix.  The rule defines Informal Respite and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service.
  • Existing rule 5123-9-22 (Home and Community-Based Services Waivers - Community Respite Under the Individual Options, Level One, and SELF Waivers) with Appendix A and Appendix B is being amended.  The rule defines Community Respite and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service.
  • Existing rule 5123:2-9-23 (Home and Community-Based Services Waivers - Environmental Accessibility Adaptations Under the Individual Options and Level One Waivers) with Appendix is being rescinded and replaced by a new rule of the same title numbered 5123-9-23 with Appendix.  The rule defines Environmental Accessibility Adaptations and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service.
  • Existing rule 5123:2-9-24 (Home and Community-Based Services Waivers - Transportation Under the Individual Options, Level One, and SELF Waivers) with Appendix is being rescinded and replaced by a new rule of the same title numbered 5123-9-24 with Appendix.  The rule defines Transportation and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service.
  • Existing rule 5123:2-9-29 (Home and Community-Based Services Waivers - Home-Delivered Meals Under the Individual Options Waiver) with Appendix is being rescinded and replaced by a new rule of the same title numbered 5123-9-29 with Appendix.  The rule defines Home-Delivered Meals and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service.
  • Rule 5123-9-30 (Home and Community-Based Services Waivers - Homemaker/Personal Care Under the Individual Options and Level One Waivers) with Appendix A and Appendix B is being amended.  The rule defines Homemaker/Personal Care and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service.
  • Rule 5123:2-9-32 (Home and Community-Based Services Waivers - Participant-Directed Homemaker/Personal Care Under the Individual Options, Level One, and SELF Waivers) with Appendix is being rescinded and replaced by a new rule of the same title numbered 5123-9-32 with Appendix.  The rule defines Participant-Directed Homemaker/Personal Care and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service.
  • Rule 5123-9-34 (Home and Community-Based Services Waivers - Residential Respite Under the Individual Options, Level One, and SELF Waivers) with Appendix is being amended.  The rule defines Residential Respite and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service.

Simplification of Homemaker/Personal Care Daily Billing Unit

  • Existing rule 5123:2-9-31 (Home and Community-Based Services Waivers - Homemaker/Personal Care Daily Billing Unit for Sites Where Individuals Enrolled in the Individual Options Waiver Share Services) with Appendix is being rescinded and replaced by a new rule of the same title numbered 5123-9-31 with Appendix.  The rule establishes a daily billing unit for Homemaker/Personal Care when individuals share the services of the same provider at the same site.  The new rule reflects changes made to simplify calculation of the daily rate paid to providers, thereby reducing the administrative costs associated with projecting and adjusting the cost of services to be apportioned to each individual who lives at a site.

New Community Transition Service

  • New rule 5123-9-48 (Home and Community-Based Services Waivers - Community Transition Under the Individual Options Waiver) with Appendix is being adopted to implement the new Community Transition service.  The rule defines Community Transition and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service.

Proposed Rules Designated "To Be Refiled"


The Department has designated the following rule actions "To Be Refiled" to afford time for additional dialogue with stakeholders.

       
        [None at this time.]



Effective Dates for Newly Adopted/Amended Rules


The following rules will be effective on the date specified.

January 1, 2019 (Projected)

5123-5-04 (Denial, Suspension, and Revocation of Adult Services, Business Manager, and Service and Support Administration Registration and Certification)

5123-5-08 (Certification Standards for Business Managers of County Boards of Developmental Disabilities)