Ohio Administrative Code › Title 5123 - Department of Developmental Disabilities › Chapter 5123-9 - Home and Community-Based Services Waivers › Section 5123-9-19 - Home and community-based services waivers - general requirements for adult day support, career planning, group employment support, individual employment support, non-medical transportation, and vocational habilitation

Current through all regulations passed and filed through July 1, 2024
(A) Purpose
This rule establishes general requirements governing provision
				of and payment for adult day support, career planning, group employment
				support, individual employment support, non-medical transportation, and
				vocational habilitation provided to individuals enrolled in home and
				community-based services waivers administered by the department.
(B) Definitions
For the purposes of this rule, the following definitions
				apply:
(1) "Acuity assessment
			 instrument" means the standardized instrument utilized by the department to
			 assess the relative non-residential services needs and circumstances of an
			 adult individual compared to other adult individuals for purposes of receiving
			 adult day support, career planning, group employment support, individual
			 employment support, and vocational habilitation. Scores resulting from
			 administration of the acuity assessment instrument have been grouped into
			 ranges and subsequently linked with staffing expectations that result in four
			 payment rates calibrated on group size that apply to adult day support, group
			 employment support, and vocational habilitation.
(2) "Administrative review" means the
			 processes internal to the department and subject to oversight by the Ohio
			 department of medicaid available to individuals who believe that their acuity
			 assessment instrument scores, their placement in group assignment A, A-1, or B,
			 and when applicable, the resulting budget limitation,
			 
									prevent access to or continuation in the adult day
			 support, career planning, group employment support, individual employment
			 support, and/or vocational habilitation services they have selected.
			 Administrative review is not applicable to individuals with placement in group
			 assignment C or to non-medical transportation.
(3) "Adult day services" means
			 non-residential services including adult day support, career planning, group
			 employment support, individual employment support, non-medical transportation,
			 and vocational habilitation.
(4)
			 "Adult day support" has the same meaning as in rule
			 5123-9-17 of the Administrative
			 Code.
(5) "Agency provider" has the
			 same meaning as in rule
			 5123-2-08 of the Administrative
			 Code.
(6) "Budget limitation" means
			 the funding amount available to enable an individual enrolled in the individual
			 options waiver to receive adult day support, career planning, group employment
			 support, individual employment support, and/or vocational habilitation within
			 each waiver eligibility span. A separate budget limitation enables an
			 individual enrolled in the individual options waiver to receive non-medical
			 transportation within each waiver eligibility span. The budget limitation
			 applicable to adult day support, career planning, group employment support,
			 individual employment support, and vocational habilitation and the budget
			 limitation applicable to non-medical transportation are above and beyond the
			 funding range to which an individual enrolled in the individual options waiver
			 has been assigned.
(7) "Career
			 planning" has the same meaning as in rule
			 5123-9-13 of the Administrative
			 Code.
(8) "County board" means a
			 county board of developmental disabilities.
(9) "Department" means the Ohio department of
			 developmental disabilities.
(10)
			 "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 other than adult day support,
			 career planning, group employment support, individual employment support,
			 non-medical transportation, vocational habilitation, waiver nursing delegation,
			 and waiver nursing services.
(11)
			 "Group employment support" has the same meaning as in rule
			 5123-9-16 of the Administrative
			 Code.
(12) "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.
(13) "Individual employment support" has the
			 same meaning as in rule
			 5123-9-15 of the Administrative
			 Code.
(14) "Individual service
			 plan" means the written description of services, supports, and activities to be
			 provided to an individual.
(15)
			 "Non-medical transportation" has the same meaning as in rule
			 5123-9-18 of the Administrative
			 Code.
(16) "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 
									5123-5-02 of the Administrative Code.
(17) "Vocational habilitation" has the same
			 meaning as in rule
			 5123-9-14 of the Administrative
			 Code.
(18) "Waiver eligibility
			 span" means the twelve-month period following either an individual's initial
			 waiver enrollment date or a subsequent eligibility re-determination
			 date.
(19) "Waiver nursing
			 delegation" has the same meaning as in rule
			 5123-9-37 of the Administrative
			 Code.
(20) "Waiver nursing
			 services" has the same meaning as in rule
			 5123-9-39 of the Administrative
			 Code.