Ohio Administrative Code
Title 173 - Department of Aging
Chapter 173-40 - State-Funded PASSPORT Program
Section 173-40-03 - PASSPORT program (state-funded component): individual disenrollment and other actions
Universal Citation: OH Admin Code 173-40-03
Current through all regulations passed and filed through December 16, 2024
(A) Presumptive: For each individual enrolled in the state-funded component of the PASSPORT program on the basis of paragraph (A) of rule 173-40-02 of the Administrative Code:
(1) Disenrollment: ODA or its designee
shall disenroll any individual who no longer meets all requirements under
paragraph (A) of rule
173-40-02 of the Administrative
Code unless the only requirement the individual no longer meets is the PETI
(i.e., patient-liability or share of cost) requirement listed in paragraph
(A)(5) of that rule, during a state of emergency declared by the governor, or
during a federal public health emergency if federal financial participation
pays for all of the individual's services.
(2) Post-disenrollment limitations: After ODA
or its designee disenrolls an individual from the state-funded component of the
PASSPORT program, the following limits apply:
(a) The individual is not eligible to
re-enroll into the state-funded component of the PASSPORT program on the basis
of presumptive eligibility.
(b) The
individual is not eligible to enroll into the medicaid-funded component of the
PASSPORT program until ODM's administrative agency determines the individual
meets all medicaid financial eligibility requirements and ODA or its designee
determines the individual meets all non-financial eligibility requirements
under rule
5160-31-03 of the Administrative
Code.
(c) The individual is not
eligible to enroll into the state-funded component of the assisted living
program.
(B) Grandparented: For an individual who is enrolled in the state-funded component of the PASSPORT program on the basis of paragraph (B) of rule 173-40-02 of the Administrative Code:
(1) Reassessment: ODA or its designee
shall do all of the following:
(a) Verify if
the individual continues to meet all eligibility requirements under paragraph
(B) of rule
173-40-02 of the Administrative
Code whenever ODA or its designee reassesses the condition and service needs of
the individual.
(b) Reassess the
individual to assess the individual's condition and service needs at least once
every twelve months or at any time the individual's condition or service needs
change substantially.
(c) Develop
and implement a revised person-centered services plan for the individual at
least once every six months so long as the individual continues to meet all the
eligibility requirements under paragraph (B) of rule
173-40-02 of the Administrative
Code.
(2) Disenrollment:
(a) ODA or its designee may propose to
disenroll an individual from the state-funded component of the PASSPORT program
for any of the following:
(i) The individual does not continue to meet
all the eligibility requirements under paragraph (B) of rule
173-40-02 of the Administrative
Code.
(ii) The individual's
permanent relocation.
(b) When the individual's services are
suspended for any reason for sixty calendar days, ODA or its designee shall
provide the individual (or the individual's authorized representative, if any)
with notice of disenrollment from the state-funded component of the PASSPORT
program.
(c) Suspensions which
ultimately result in disenrollment have a disenrollment date which is
retroactive to the first day of the suspension of services.
(3) Post-disenrollment
limitations: After ODA or its designee disenrolls an individual from the
state-funded component of the PASSPORT program, the following limits apply:
(a) The individual is not eligible to
re-enroll into the state-funded component of the PASSPORT program on the basis
of presumptive eligibility.
(b) The
individual is not eligible to enroll into the state-funded component of the
assisted living program.
(C) Appeals: An eligible individual may appeal a decision made under this rule pursuant to section 173.523 of the Revised Code. The individual's appeal is timely only if the request for a hearing is received by ODA within thirty days of the date in which ODA mailed the notice of opportunity for hearing.
Disclaimer: These regulations may not be the most recent version. Ohio may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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