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Guidance: Level of Care Rule

In collaboration with the Ohio Association of County Boards and its members, the Ohio Department of Developmental Disabilities would like to share the following guidance to clarify the Level of Care (LOC) rule and its implementation. 

Below is a list of items that were agreed upon to clarify the LOC procedure going forward.

  • "Current diagnosis" means a written determination by a qualified professional whose scope of practice includes diagnosis, which lists the diagnosed conditions that currently affect a person's health and functional abilities. The Ohio Department of Developmental Disabilities is no longer stipulating "current" as the past 12 months. "Current" means the documentation containing the diagnoses is accurate at the date of submittal. 
  • SELF Waiver: "Change of Condition" is not required when going from "Child" to "Adult." The county board will need to complete an LOC date change and attest to the new waiver span for the person as an adult.
  • Change of Condition at age 10: The documentation submitted with the "Change of Condition" may be the documentation that was submitted with the initial Level of Care unless the documentation identifies a substantial developmental delay. 
  • Change of Condition for re-enrollment in a waiver: Current diagnosis documentation should be submitted. A new diagnosis verification is not needed unless the person experienced a change in their physical or mental condition or functional abilities that results in a change in their Level of Care.
  • There is a grace period for accepting the old clinician's verification form (CVF). If the clinician has signed an old form, the department is not requiring the county board to have the clinician sign the new form to replace it. 
  • County boards should begin using the new CVF. It is permissible for the CVF to be completed and signed by a Certified Nurse Practitioner (CNP) for conditions within the CNP's scope of practice, beginning February 14, 2019, and going forward.  

All questions related to this guidance should be directed to LOC@dodd.ohio.gov