Ohio Administrative Code › Title 5122 - Department of Mental Health and Addiction Services › Chapter 5122-36 - Residential State Supplement Program › Section 5122-36-02 - RSS non-financial eligibility

Current through all regulations passed and filed through July 1, 2024
(A)An individual is
			 to meet all criteria specified in paragraph (C) of rule
			 5160:1-5-01
			 of the Administrative Code to be eligible for RSS payments. OhioMHAS first determines whether the individual
			 meets the non-financial eligibility criteria and
			 then the appropriate CDJFS completes the financial eligibility determination.
			 The RSS non-financial eligibility criteria are all of the following:
(1) The individual is
			 at least eighteen years of age.
(2) The individual
			 meets at
			 least the criteria for a protective level of care
			 as specified in rule
			 5160-3-06
			 of the Administrative Code. An individual who is receiving (or authorized for)
			 medicaid vendor payment of the nursing facility stay and is being discharged
			 from a nursing facility as defined in section
			 5165.01 of the
			 Revised Code
									meets this requirement without the
			 need for an additional level of care assessment by the
			 local area agency on aging.
(3) The individual
			 does 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
			 
									does 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 has
			 been accepted for placement or is residing in one of the following living
			 arrangements:
(a) A class two
			 residential facility of the type described in
			 division (B)(1)(b) of section
			 5119.34
			 of the Revised Code that is licensed by
			 and in good standing with the Ohio department of mental health and addiction
			 services; or
b Either a
			 residential care facility, as defined in
			 section
			 3721.01
			 of the Revised Code, that is licensed and in good standing with the Ohio
			 department of health under  section
			 3721.02
			 of the Revised Code, or an assisted living program, as defined in section 
											173.51
										 of the Revised Code, as long as either of the following
			 applies:
(i)
											The facility or
			 program is in a county where there are no class two residential
			 facilities licensed by the Ohio department of mental health and addiction
			 services; or
(ii) There are no open
			 beds in licensed class two residential facilities within the county that
			 provide housing to individuals with mental illness.
Individuals who were enrolled in
				the RSS program on November 20, 2014, may continue to
				reside in the living arrangement they were in on that
				date without regard to the living arrangement's eligibility pursuant to this
				paragraph.
(6) The individual
			 is not
			  related to the owner or caregiver of the
			 living arrangement.
(7) The individual
			 is not
			  a participant in any federal waiver
			 program.
(8) The individual
			 is not
			  a participant in the Ohio department of
			 job and family services' program of all-inclusive care for the elderly
			 (PACE).
(9) The individual
			 is not
			  enrolled in a medicare or
			 medicaid-certified hospice program.
(10) The individual is
			 not a consumer of any home and community-based waiver program.
(11)
			 The individual or legal
			 representative has executed a release of information form permitting
			 exchange of information between OhioMHAS, the Ohio
			 department of medicaid, the Ohio department of job and family services, the
			 CDJFS, the local area agency on aging, the living arrangement operator,
			 and other care providers and key contacts as needed for continuity of care and
			 eligibility determination.