Ohio Administrative Code › Title 5123 - Department of Developmental Disabilities › Chapter 5123-9 - Home and Community-Based Services Waivers › Section 5123-9-26 - Home and community-based services waivers - self-directed transportation under the individual options, level one, and self-empowered life funding waivers

Current through all regulations passed and filed through July 1, 2024
(A) Purpose
This rule defines self-directed transportation 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) "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.
(2) "Department" means the
			 Ohio department of developmental disabilities.
(3) "Financial management services entity"
			 means a governmental entity and/or another third-party entity designated by the
			 department to perform necessary financial transactions on behalf of individuals
			 who receive participant-directed services.
(4) "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.
(5) "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.
(6) "Individual service plan" means the
			 written description of services, supports, and activities to be provided to an
			 individual.
(7) "Modified vehicle"
			 means:
(a) A motor vehicle to be used upon
			 public streets and highways that has been structurally modified in a permanent
			 manner to meet the physical or behavioral needs of the individual being
			 transported; or
(b) A motor vehicle
			 that has been designed, constructed, or fabricated and equipped to be used upon
			 public streets and highways for transportation of individuals who require use
			 of a wheelchair and that :
(i)
											Has permanent
			 fasteners to secure a wheelchair to the floor or side of the vehicle to prevent
			 wheelchair movement;
(ii)
											Has
			 safety harnesses or belts in the vehicle for the purpose of securing
			 individuals in wheelchairs;
(iii)
											Is equipped
			 with a stable access ramp specifically designed for wheelchairs or a hydraulic
			 lift specifically designed for wheelchairs; and
(iv)
											Is inspected, on
			 each day the vehicle is used to provide self-directed transportation, by the
			 first driver of the vehicle and prior to transporting an individual in a
			 wheelchair, to ensure the permanent fasteners, safety harnesses or belts, and
			 access ramp or hydraulic lift are working. The inspection shall be documented
			 by the driver that conducts the inspection.
(8) "Participant-directed budget" means the
			 total amount of annual waiver funding available for participant-directed
			 services in the individual service plan of an individual who chooses to receive
			 participant-directed services. An individual may reallocate funds among
			 participant-directed services as long as reallocation is preceded by a
			 corresponding revision to the individual service plan.
(9) "Self-directed transportation" means a
			 service purchased through the participant-directed budget, that enables an
			 individual to access activities and opportunities available in the broader
			 community such as competitive integrated workplaces, integrated community
			 participation and contribution (e.g., advocacy activities and events),
			 community resources, and businesses consistent with the individual service
			 plan. Self-directed transportation enhances independence as it is available
			 around the clock, including on weekends and holidays, to accommodate an
			 individual's scheduled and spontaneous transportation needs.
(a) Self-directed transportation includes:
(i) Purchase of prepaid vouchers, cards,
			 passes, or tokens to access modes of ground transportation available to the
			 general public such as modes available from regional transit authorities and
			 ride-hailing services (e.g., taxicab, "Lyft," or "Uber") at the usual and
			 customary rate or fare; and
(ii)
			 Per-mile or per-trip reimbursement made to a person who meets the provider
			 qualifications in paragraph (C) of this rule and who has a written agreement
			 for provision of self-directed transportation with the individual being
			 transported.
(b) An
			 individual's self-directed transportation budget for a waiver eligibility span
			 is determined based on the individual's needs and consideration of the
			 individual's preferences and available funds.
(10) "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.
(11) "Waiver eligibility span" means the
			 twelve-month period following either an individual's initial waiver enrollment
			 date or a subsequent eligibility re-determination date.