Ohio Administrative Code › Title 5123 - Department of Developmental Disabilities › Chapter 5123-9 - Home and Community-Based Services Waivers › Section 5123-9-47 - Home and community-based services waivers-support brokerage under the self-empowered life funding waiver

Current through all regulations passed and filed through July 1, 2024
(A)
								Purpose
This rule defines support brokerage and
				sets forth provider qualifications, requirements for service delivery and
				documentation of services, and payment standards for the
				service.
(B)
								Definitions
(1)
									"Agency provider" means an entity that directly employs
			 at least one person in addition to the chief executive officer for the purpose
			 of providing services for which the entity must be certified in accordance with
			 rule
			 5123:2-2-01
			 of the Administrative Code.
(2)
									"County board"
			 means a county board of developmental disabilities.
(3)
									"Department"
			 means the Ohio department of developmental disabilities.
(4)
									"Family member"
			 means a person who is related to the individual by blood, marriage, or
			 adoption.
(5)
									"Independent provider" means a self-employed person who
			 provides services for which he or she must be certified in accordance with rule
			 5123:2-2-01
			 of the Administrative Code and does not employ, either directly or through
			 contract, anyone else to provide the services.
(6)
									"Individual"
			 means a person with a developmental disability or for the purposes of giving,
			 refusing to give, or withdrawing consent for services, his or her guardian in
			 accordance with section
			 5126.043 of the Revised Code or
			 other person authorized to give consent. An individual may designate another
			 person to assist with development of the individual service plan and budget,
			 selection of residence and providers, and negotiation of payment rates for
			 services; the individual's designee shall not be employed by a county board or
			 a provider, or a contractor of either.
(7)
									"Individual
			 service plan" means the written description of services, supports, and
			 activities to be provided to an individual.
(8)
									"Service and
			 support administrator" means a person, regardless of title, employed by or
			 under contract with a county board to perform the functions of service and
			 support administration and who holds the appropriate certification in
			 accordance with rule
			 5123:2-5-02
			 of the Administrative Code.
(9)
									"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 shall include the items delineated in paragraph (E) of
			 this rule to validate payment for medicaid services.
(10)
									"Support broker"
			 means a person who is responsible, on a continuing basis, for providing an
			 individual with representation, advocacy, advice, and assistance related to the
			 day-to-day coordination of services (particularly those associated with
			 participant direction) in accordance with the individual service plan. The
			 support broker assists the individual with the individual's responsibilities
			 regarding participant direction, including understanding employer authority and
			 budget authority, locating and selecting providers, negotiating payment rates,
			 and keeping the focus of the services and support delivery on the individual
			 and his or her desired outcomes. The support broker, working in conjunction
			 with the service and support administrator, assists the individual with
			 creating the individual service plan, developing the waiver budget, and doing
			 day-to-day monitoring of the provision of services as specified in the
			 individual service plan.
(11)
									"Support brokerage" means the services of a support
			 broker.
(12)
									"Waiver eligibility span" means the twelve-month period
			 following either an individual's initial waiver enrollment date or a subsequent
			 eligibility redetermination date.