Ohio Administrative Code › Title 5123 - Department of Developmental Disabilities › Chapter 5123-9 - Home and Community-Based Services Waivers › Section 5123-9-22 - Home and community-based services waivers - community respite 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 community respite 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) "Community respite" means
			 care and support services
			  furnished to an individual on
			 a short-term basis because of the absence or need for relief of those persons
			 routinely providing  care. Community
			 respite 
									is provided outside of an individual's home in a
			 camp, recreation center, or other place where an organized community program or
			 activity occurs.
(3) "Community
			 respite 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 community respite
			 fifteen-minute billing units for the day.
(4) "Community respite full day billing unit"
			 means a billing unit that 
									will be used when community respite is provided
			 for more than seven hours during the day and the individual stays overnight at
			 the community respite service delivery location.
(5) "Community respite partial day billing
			 unit" means a billing unit that 
									will be used when community respite is provided
			 for between five and seven hours during the day and the individual does not
			 stay overnight at the community respite service delivery location.
(6) "County board" means a county board of
			 developmental disabilities.
(7)
			 "Department" means the Ohio department of developmental disabilities.
(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) "Homemaker/personal care" has the same
			 meaning as in rule
			 5123-9-30 of the Administrative
			 Code.
(10) "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.
(11) "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.
(12) "Individual service plan" means the
			 written description of services, supports, and activities to be provided to an
			 individual.
(13) "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.
(14)
			 "Participant-directed homemaker/personal care" has the same meaning as in rule
			 5123-9-32 of the Administrative
			 Code.
(15) "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.
(16) "Waiver eligibility span" means the
			 twelve-month period following either an individual's initial waiver enrollment
			 date or a subsequent eligibility re-determination date.