Ohio Administrative Code › Title 5123:2 - Community Services › Chapter 5123:2-9 - Home and Community-Based Services Waivers › Section 5123:2-9-46 - Home and community-based services waivers - participant/family stability assistance under the self-empowered life funding waiver

Current through all regulations passed and filed through July 1, 2024
(A)
								 Purpose
The purpose of this rule is to define
				participant/family stability assistance and set forth provider qualifications,
				requirements for service delivery and documentation of services, and payment
				standards for these services.
(B)
								
			 Definitions
(1)
									 "Agency provider" means an entity that employs persons for
			 the purpose of providing services.
(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 person who provides
			 services 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 who is his or her own
			 guardian may designate another person to assist the individual 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
			 or either.
(7)
									 "Individual service plan" means the written
			 description of services, supports, and activities to be provided to an
			 individual.
(8)
									 "Participant/family stability assistance" means
			 training (including education and instruction) and counseling (including
			 consultation) that enhance an individual's ability to direct his or her own
			 services and/or enable an individual and/or family members who reside with the
			 individual to understand how best to support the individual in order that the
			 individual and his or her family members may live as much like other families
			 as possible and to prevent or delay unwanted out-of-home placement.
(a)
										
			 Participant/family stability assistance may be utilized only by the individual
			 and family members who reside with the individual and shall be outcome-based,
			 meaning that there shall be a specific goal for the service which is recorded
			 in the individual service plan.
(b)
										
			 Participant/family stability assistance includes training and counseling
			 related to accommodating the individual's disability in the home, accessing
			 supports offered in the community, effectively supporting the individual so
			 that he or she may be fully engaged in the life of the family, and supporting
			 the unique needs of the individual.
(c)
										
			 Participant/family stability assistance includes the cost of enrollment fees
			 and materials, but does not cover travel expenses or experimental and
			 prohibited treatments.
(9)
									 "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.
(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 shall include the items delineated in paragraph (F) of
			 this rule to validate payment for medicaid services.
(11)
									 "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.
(12)
									 "Usual and
			 customary charge" means the amount charged to other persons for the same
			 service.