Rules Under Development 

Proposed Rule Actions For Review and Comment


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


The Department is adopting new rule 5123-7-34 (Intermediate Care Facilities for Individuals with Intellectual Disabilities [ICFIID] - Quality Indicators and the Quality Incentive Payment).  The rule is being adopted  to implement Section 5124.24 of the Revised Code.  The rule sets forth a method and process for determining the Quality Incentive Payment that may be paid to an ICFIID that chooses to participate in the program.  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 Friday, October 26.


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.


November 7, 2018 (See Public Hearing Notice for details.)

  • The Department is rescinding rule 5123:2-5-04 (Denial, Suspension, and Revocation of Adult Services and Service and Support Administration Registration and Certification).  The rule establishes the grounds and procedure for Superintendents of county boards of developmental disabilities to deny, suspend, and revoke Adult Services and Service and Support Administration registration and certification issued in accordance with Section 5126.25 of the Revised Code.  The rule is being replaced by new rule 5123-5-04.
  • The Department is adopting new rule 5123-5-04 (Denial, Suspension, and Revocation of Adult Services, Business Manager, and Service and Support Administration Registration and Certification).  The rule establishes the grounds and procedure for Superintendents of county boards of developmental disabilities to deny, suspend, and revoke Adult Services, Business Manager, and Service and Support Administration registration and certification issued in accordance with Section 5126.25 of the Revised Code.  The rule replaces rule 5123:2-5-04 and reflects the new Business Manager certification established by new rule 5123-5-08.
  • The Department is adopting new rule 5123-5-08 (Certification Standards for Business Managers of County Boards of Developmental Disabilities).  The rule establishes minimum qualifications through certification standards for persons employed or under contract with county boards of developmental disabilities as Business Managers in accordance with Section 5126.054 of the Revised Code.


November 16, 2018 (See Public Hearing Notice for details.)

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 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.

      
October 15, 2018

The Department is amending rule 5123-9-04 (Home and Community-Based Services Waivers - Waiting List) with Appendix.  The rule sets forth requirements for the waiting list established pursuant to Section 5126.042 of the Revised Code when a county board of developmental disabilities determines that available resources are insufficient to enroll individuals who are assessed to need and who choose Medicaid Home and Community-Based Services in Department-administered waivers.  Rule 5123-9-04 that went into effect on September 1, 2018, was developed by a coalition of people with disabilities, family members, and organizations representing guardians, county boards, and providers to simplify the system and more efficiently direct supports to people and families who need them most.  The rule is being amended to restore paragraph (B)(5)(f), which was inadvertently omitted when the rule was original-filed on March 28, 2018.

The Department is rescinding rule 5123:2-9-07 (
Home and Community-Based Services Waivers - Request for Prior Authorization for Individuals Enrolled in the Individual Options Waiver) and adopting new replacement rule 5123-9-07 of the same title.  The rule establishes standards and procedures for prior authorization of waiver services when an individual funding level exceeds the funding range determined by the Ohio Developmental Disabilities Profile for individuals enrolled in the Individual Options Waiver.  As a result of the required five-year review, the rule is being revised to update the list of services that are included in an individual's funding range; make clear that the Department shall not consider a request submitted after the end date of an individual's waiver eligibility span; set forth that the Department may conduct an abbreviated review of a request resulting from a payment rate increase taking effect during an individual's waiver eligibility span; require a county board of developmental disabilities, when so requested by the Department, to submit additional information within five business days; and correct a reference to the Administrative Code. 

The Department is rescinding rule 5123:2-9-27 (Home and Community-Based Services Waivers - Emergency Assistance Under the Level One Waiver) with Appendix and adopting new replacement rule 5123-9-27 of the same title with Appendix.  The rule sets forth coverage and eligibility for an individual enrolled in the Level One Waiver in an emergency situation to receive increased amounts of some services, including Homemaker/Personal Care.  The rule is being revised to reflect the availability of a payment rate increase (i.e., the Staff Competency Rate Modification) when qualified staff deliver the Homemaker/Personal Care service as Emergency Assistance, align definitions with those used in newer rules, and correct references to administrative rules.   


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.

        [None at this time.]