Ohio Administrative Code › Title 173 - Department of Aging › Chapter 173-51 - State-Funded Assisted Living Program › Section 173-51-02 - Assisted living program (state-funded component): eligibility

Current through all regulations passed and filed through July 1, 2024
(A) Only an individual meeting all of the
			 following 
								qualifications is eligible for the state-funded
			 component of the assisted living program:
(1)
			 Consultation: The individual participated in a long-term care consultation
			 under section 173.42 of the Revised Code and
			 Chapter 173-43 of the Administrative Code.
(2) Financial requirements:
(a) The individual contacted either ODA's
			 designee or ODM's administrative agency to apply for the medicaid-funded
			 component of the assisted living program, but the application is still pending
			 because ODM's administrative agency has not yet made a final determination on
			 the individual's financial eligibility. If
			 ODM's administrative agency already determined the individual was eligible to
			 participate in the medicaid-funded component of the assisted living program,
			 the individual would 
										enroll into the medicaid-funded component of the
			 assisted living program. If ODM's administrative agency already determined the
			 individual was not financially eligible to participate in the medicaid-funded
			 component of the assisted living program, the individual would also not be
			 eligible to participate in the state-funded component of the assisted living
			 program.
(b) The individual agreed
			 that, if the individual
			 
										enrolls into the state-funded component of the
			 assisted living program, 
										and ODM's administrative agency determines the
			 individual is financially eligible for the medicaid-funded component of the
			 assisted-living program, then the individual
			 would transfer immediately
			  to the medicaid-funded
			 component of the assisted living program.
(c) The individual is cooperative and actively assisting ODM's
			 administrative agency in determining if the individual is financially eligible
			 to participate in the medicaid-funded component of the assisted living program
			 by timely providing ODM's administrative agency with information and copies of
			 any records ODM's administrative agency needs to make its financial eligibility
			 determination.
(d) ODA or its
			 designee 
			 determined that ODM's administrative agency would most likely determine
			 that the individual meets all financial
			 eligibility requirements for the medicaid-funded component of the assisted
			 living program listed in rules
			 5160:1-2-03 and
			 5160:1-2-10 of the
			 Administrative Code.
(3) Non-financial requirements:
(a) ODA or its designee and the individual
			 
										entered into an enrollment agreement, and the
			 form indicated the individual chose to enroll in the state-funded component of
			 the assisted living program, named the individual's representative (if any),
			 and  authorized ODA
			 or its designee to release information.
(b) ODA or its designee determined the
			 individual meets all non-financial eligibility requirements for the
			 medicaid-funded component of the assisted living program in rule
			 5160-33-03 of the Administrative
			 Code.
(c) The individual agreed to
			 reside in a 
										resident unit of 
										a certified RCF
			  while receiving assisted living services under the
			 state-funded component of the assisted living program that meets the requirements for resident units in rule
			 173-39-02.16 of the
			 Administrative Code.
(4) Post-eligibility treatment of income
			 (PETI) (i.e., patient liability or share of cost): After ODA or its designee
			 assessed the individual's income and resources using the methodology described
			 in rule
			 5160:1-6-07.1 of the Administrative Code
			 to determine if the individual should pay any share of cost and the individual
			 agreed to pay, and does pay, any share of cost as it becomes due.