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.
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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.
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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.
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