Ohio Administrative Code › Title 5123 - Department of Developmental Disabilities › Chapter 5123-9 - Home and Community-Based Services Waivers › Section 5123-9-20 - Home and community-based services waivers - money management under the individual options and level one waivers

Current through all regulations passed and filed through July 1, 2024
(A) Purpose
This rule defines money management 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 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) "Authorized
			 representative" means a person or an organization appointed by an individual to
			 discuss and negotiate benefits (e.g., medicaid, social security, or veterans'
			 administration) on behalf of an individual who needs assistance to manage or
			 direct the management of benefits for which the individual is eligible or may
			 be eligible.
(3) "County board"
			 means a county board of developmental disabilities.
(4) "Department" means the Ohio department of
			 developmental disabilities.
(5)
			 "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 fifteen-minute billing
			 units for the day.
(6)
			 "Homemaker/personal care" has the same meaning as in rule
			 5123-9-30 of the Administrative
			 Code.
(7) "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.
(8) "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.
(9) "Individual service plan" means the
			 written description of services, supports, and activities to be provided to an
			 individual.
(10) "Money management"
			 means services that provide assistance to individuals who need support managing
			 personal and financial affairs, including training to assist an individual to
			 acquire, retain, or improve related skills. The services meet a continuum of
			 individualized needs, from organizing and keeping track of financial records
			 and health insurance documentation, to assisting with bill-paying and
			 maintaining bank accounts. Money management does not take the place of services
			 provided by professionals in the accounting, investment, or social services
			 fields. Money management complements the work of other professionals by
			 facilitating the completion of the day-to-day tasks rather than determining or
			 executing long-term plans. Money management includes a broad range of tasks
			 determined necessary in the individual service plan. Examples of supports that
			 may be provided as a component of money management include:
(a) Bill-paying and preparing checks for
			 individuals to sign;
(b) Balancing
			 checkbooks, reconciling bank account statements, and maintaining or organizing
			 bank records;
(c) Preparing and
			 delivering bank account deposits;
(d) Assisting an individual with applying for
			 benefits such as medicaid buy-in for workers with disabilities and other
			 resources as appropriate;
(e)
			 Assisting an individual with maintaining eligibility for benefits such as food
			 stamps;
(f) Consulting or making
			 referrals for consultation regarding available benefits;
(g) Making referrals as appropriate for
			 establishment of special needs accounts (e.g., a qualified income trust or an
			 account established in accordance with the Achieving a Better Life Experience
			 Act program and section 529A of the Internal Revenue Code);
(h) Organizing tax documents and other
			 paperwork;
(i) Negotiating with
			 creditors;
(j) Deciphering medical
			 insurance papers and verifying proper processing of claims;
(k) Providing general organization
			 assistance;
(l) Providing referrals
			 to legal, tax, and investment professionals;
(m) Notarizing documents;
(n) Providing assistance associated with
			 financial tasks when an individual relocates (e.g., transferring bank accounts
			 or updating address with creditors); and
(o) Acting as power-of-attorney or authorized
			 representative, when so designated by the individual.
(11) "Participant-directed homemaker/personal
			 care" has the same meaning as in rule
			 5123-9-32 of the Administrative
			 Code.
(12) "Payee" means a person,
			 agency, organization, or institution appointed by the social security
			 administration to receive and manage benefits (e.g., medicaid, social security,
			 or supplemental security income) on behalf of an individual who needs
			 assistance to manage or direct the management of benefits. A payee has legal
			 authority to manage the benefits, uses the benefits to pay for the current and
			 future needs of the individual, and properly saves any benefits not needed to
			 meet current needs. A payee is required to keep records of expenses and provide
			 an accounting of how the payee used or saved the benefits. A payee
			 
									will
			 adhere to the standards and regulations set forth by the social security
			 administration.
(13) "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.
(14) "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.
(15) "Shared living" has the same meaning as
			 in rule 5123-9-33 of the Administrative
			 Code.
(16) "Team"
			 
									means the group of persons chosen by an
			 individual with the core responsibility to support the individual in directing
			 development of the individual service plan. The team includes the individual's
			 guardian or adult whom the individual has identified, as applicable, the
			 service and support administrator, direct support professionals, providers,
			 licensed or certified professionals, and any other persons chosen by the
			 individual to help the individual consider possibilities and make
			 decisions.