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.
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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.
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.
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