Ohio Administrative Code › Title 5101:1 - Division of Public Assistance › Chapter 5101:1-17 - Residential State Supplement Program › Section 5101:1-17-02 - RSS eligibility requirements

Current through all regulations passed and filed through July 1, 2024
(A)
								 Non-financial
  eligibility requirements. The individual must complete a JFS 07120 "Residential
  State Supplement Referral" (rev. 3/2003) and meet all of the following criteria
  to be enrolled into the RSS program:
(1)
									 A county
  department of job and family services (CDJFS) must have determined the
  individual to be eligible for medicaid.
(2)
									 The individual
  must currently reside in a skilled nursing facility or need at least a
  protective level of care as defined in rule
  5101:3-3-08 of the
  Administrative Code.
(3)
									 The individual must not require more than one hundred
  twenty days of skilled nursing care, as defined in section
  3721.01 of the Revised Code,
  during any twelve month period unless the individual resides in a licensed
  residential care facility authorized to provide skilled nursing care in
  accordance with section
  3721.011 of the Revised
  Code.
(4)
									 The individual must not have a cognitive impairment
  which requires the presence of another person on a twenty-four hour a day basis
  for the purpose of supervision to prevent harm.
(5)
									 The individual
  must be accepted for placement or residing in an approved community living
  arrangement, and a residential state supplement administrative agency must have
  determined that the facility is appropriate for the individual's needs in
  accordance with section
  5119.69 of the Revised Code. The
  appropriate living arrangements are:
(a)
										 An "adult foster
  home" certified under section
  5119.692 of the Revised
  Code;
(b)
										 An "adult family home" as defined in section
  5119.70 of the Revised Code,
  that is licensed as an adult care facility under section
  5119.73 of the Revised
  Code;
(c)
										 An "adult group home" as defined in section
  5119.70 of the Revised Code,
  that is licensed as an adult care facility under section
  5119.73 of the Revised
  Code;
(d)
										 A "residential care facility" as defined in section
  3721.01 of the Revised Code,
  that is licensed under section
  3721.02 of the Revised
  Code;
(e)
										 A residential facility of the type defined in section
  5119.22 of the Revised Code,
  that is licensed by the Ohio department of mental health; or
(f)
										 An apartment or
  room that is used to provide community mental health services, is certified by
  the Ohio department of mental health under section
  5119.611 of the Revised Code,
  and is approved by a board of alcohol, drug addiction, and mental health
  services in accordance with section
  340.03 of the Revised
  Code.
(6)
									 The individual must not be related to the owner or
  caregiver of the RSS living arrangement.
(7)
									 The individual
  must not be a participant in any federal 1915C waiver program.
(8)
									 The individual
  must not be a participant in ODJFS' program of all-inclusive care for the
  elderly (PACE).
(9)
									 The individual must not be enrolled in a medicare or
  medicaid-certified hospice program.
(10)
									 The residential
  state supplement administrative agency must have funds available to make
  another RSS placement.
(11)
									 The individual must agree to participate in the
  development of a plan of care that includes residential needs and supports, and
  must sign the RSS resident agreement.
(12)
									 The individual
  must execute a release of information form permitting exchange of information
  between the RSS provider and other care providers and key contacts as needed
  for continuity of care and eligibility determination.
(13)
									 An individual
  who has been selected by the residential state supplement administrative agency
  for an RSS enrollment eligibility determination, or the individual's authorized
  representative, must apply for medicaid if he or she is not currently a
  medicaid recipient. The application for medicaid must be filed with the CDJFS
  within thirty days of the day the individual is notified of the
  selection.