Ohio Administrative Code › Title 5123 - Department of Developmental Disabilities › Chapter 5123-9 - Home and Community-Based Services Waivers › Section 5123-9-30 - Home and community-based services waivers - homemaker/personal care under the individual options and level one waivers

Current through all regulations passed and filed through July 1, 2024
(A) Purpose
This rule defines homemaker/personal care and sets forth
				provider qualifications, requirements for service delivery and documentation of
				services, and payment standards for the service.
(B) Definitions
For the purposes of this rule, the following definitions
				 apply:
(1)
									"Acute care
			 hospital" means a hospital that provides inpatient medical care and other
			 related services for surgery, acute medical conditions, or injuries (usually
			 for a short-term illness or condition).
(2) "Adult day support"
			 has the same meaning as in rule
			 5123-9-17 of the Administrative
			 Code.
(3) "Agency provider"
			 
									means an entity that directly employs at least one
			 person in addition to a director of operations for the purpose of providing
			 services for which the entity is certified in accordance with rule
			 5123-2-08 of the Administrative
			 Code.
(4) "County board"
			 means a county board of developmental disabilities.
(5) "Department" means
			 the Ohio department of developmental disabilities.
(6) "Developmental
			 center" means a 
									department-operated  intermediate care facility
			 for individuals with intellectual disabilities.
(7) "Fifteen-minute
			 billing unit" means a billing unit that equals fifteen minutes of service
			 delivery time or is greater or equal to eight minutes and less than or equal to
			 twenty-two minutes of service delivery time. Minutes of service delivery time
			 accrued throughout a day 
									will be added together for the purpose of
			 calculating the number of fifteen-minute billing units for the day.
(8)
			 "Funding range" means one of the dollar ranges contained in appendix A to rule
			 5123-9-06 of the Administrative
			 Code to which individuals enrolled in the individual options waiver have been
			 assigned for the purpose of funding services. The funding range applicable to
			 an individual is determined by the score derived from the Ohio developmental
			 disabilities profile that has been completed by a county board employee
			 qualified to administer the tool.
(9) "Group employment
			 support" has the same meaning as in rule
			 5123-9-16 of the Administrative
			 Code.
(10) "Group size" means
			 the number of individuals who are sharing services, regardless of the funding
			 source for those services.
(11)
			 "Homemaker/personal care" means the coordinated provision of a variety of
			 services, supports, and supervision necessary to ensure the health and welfare
			 of an individual who lives in the community. Homemaker/personal care advances
			 the individual's independence within 
									the individual's home and community
			 and helps the individual meet daily living needs. Examples of supports that may
			 be provided as homemaker/personal care include:
(a) Self-advocacy training to assist in the
			 expression of personal preferences, self-representation, self-protection from
			 and reporting of abuse, neglect, and exploitation, asserting individual rights,
			 and making increasingly responsible choices.
(b) Self-direction, including the
			 identification of and response to dangerous or threatening situations, making
			 decisions and choices affecting the individual's life, and initiating changes
			 in living arrangements and life activities.
(c) Daily living skills including training in
			 and providing assistance with routine household tasks, meal preparation,
			 personal care, self-administration of medication, and other areas of day-to-day
			 living including proper use of adaptive and assistive devices, appliances, home
			 safety, first aid, and communication skills such as using the
			 telephone.
(d) Implementation of
			 recommended therapeutic interventions under the direction of a professional or
			 extension of therapeutic services, which consist of reinforcing physical,
			 occupational, speech, and other therapeutic programs for the purpose of
			 increasing the overall effective functioning of the individual.
(e)
										Implementation of
			 behavioral support strategies including training and assistance in
			 appropriate expressions of emotions or desires, assertiveness, acquisition of
			 socially-appropriate behaviors, or extension of therapeutic services for the
			 purpose of increasing the overall effective functioning of the
			 individual.
(f) Medical and health
			 care services that are integral to meeting the daily needs of the individual
			 such as routine administration of medication or tending to the needs of
			 individuals who are ill or require attention to their medical needs on an
			 ongoing basis.
(g) Emergency
			 response training including development of responses in case of emergencies,
			 prevention planning, and training in the use of equipment or technologies used
			 to access emergency response systems.
(h) Community access services that explore
			 community services available to all people, natural supports available to the
			 individual, and develop methods to access additional services, supports, and
			 activities needed by the individual to be integrated in and have full access to
			 the community.
(i) When provided in
			 conjunction with other components of homemaker/personal care, assistance with
			 personal finances which may include training, planning, and decision-making
			 regarding the individual's personal finances.
(12)
			 "Independent provider" 
									means a self-employed person who provides
			 services for which the person is certified in accordance with rule
			 5123-2-09 of the Administrative
			 Code and does not employ, either directly or through
			 contract, anyone else to provide the services.
(13) "Individual"
			 means a person with a developmental disability or for purposes of giving,
			 refusing to give, or withdrawing consent for services,
			 
									the
			 person's guardian in accordance with section
			 5126.043 of the Revised Code or
			 other person authorized to give consent.
(14)
			 "Individual employment support" has the same meaning as in rule
			 5123-9-15 of the Administrative
			 Code.
(15) "Individual
			 service plan" means the written description of services, supports, and
			 activities to be provided to an individual.
(16) "Intermediate
			 care facility for individuals with intellectual disabilities" has the same
			 meaning as in section
			 5124.01 of the Revised
			 Code.
(17) "Money
			 management" has the same meaning as in rule
			 5123-9-20 of the Administrative
			 Code.
(18) "Non-medical
			 transportation" has the same meaning as in rule
			 5123-9-18 of the Administrative
			 Code.
(19) "Ohio
			 developmental disabilities profile" means the standardized instrument utilized
			 by the department to assess the relative needs and circumstances of an
			 individual compared to others. The individual's responses are scored and the
			 individual is linked to a funding range, which enables similarly situated
			 individuals to access comparable waiver services paid in accordance with rules
			 adopted by the department.
(20) "On-site/on-call"
			 means a rate authorized when no need for supervision or supports is anticipated
			 because the individual is expected to be asleep for a continuous period of no
			 less than five hours, and a provider must be present and readily available to
			 provide homemaker/personal care if an unanticipated need arises but is not
			 required to remain awake. This rate and service may
			 only be authorized in the residence of the individual or at another location in
			 the community selected by the individual other than the residence of the
			 provider of the service.
(21) "Residential
			 respite" has the same meaning as in rule
			 5123-9-34 of the Administrative
			 Code.
(22) "Service
			 documentation" means all records and information on one or more documents,
			 including documents that may be created or maintained in electronic software
			 programs, created and maintained contemporaneously with the delivery of
			 services, and kept in a manner as to fully disclose the nature and extent of
			 services delivered that 
									includes the items delineated in paragraph (E) of
			 this rule to validate payment for medicaid services.
(23) "Shared living"
			 has the same meaning as in rule
			 5123-9-33 of the Administrative
			 Code.
(24) "Team"
			 
									means the group of persons chosen by an
			 individual with the core responsibility to support the individual in directing
			 development of the individual service plan. The team includes the individual's
			 guardian or adult whom the individual has identified, as applicable, the
			 service and support administrator, direct support professionals, providers,
			 licensed or certified professionals, and any other persons chosen by the
			 individual to help the individual consider possibilities and make
			 decisions.
(25) "Vocational
			 habilitation" has the same meaning as in rule
			 5123-9-14 of the Administrative
			 Code.
(26) "Waiver
			 eligibility span" means the twelve-month period following either an
			 individual's initial waiver enrollment date or a subsequent eligibility
			 re-determination date.