Current through all regulations passed and filed through September 16, 2024
(A)
Initial contact:
An individual may contact either ODM's administrative agency or ODA's designee
to apply for the medicaid-funded component of the PASSPORT program. The two
agencies coordinate processing applications for enrollment as follows:
(1)
If the individual
makes initial contact with ODM's administrative agency, then ODM's
administrative agency shall help the individual apply and process the
applications for medicaid (unless already enrolled in medicaid) and the
medicaid-funded component of the PASSPORT program. If ODM's administrative
agency notifies ODA's designee that the individual meets all financial
eligibility requirements, then ODA's designee shall initiate contact with the
individual to conduct an assessment by telephone, video conference, or in
person to determine if the individual meets all non-financial eligibility
requirements in rule
5160-31-03 of the Administrative
Code.
(2)
If the individual makes initial contact with ODA's
designee, then ODA's designee shall help the individual apply for medicaid
(unless already enrolled in medicaid) and the medicaid-funded component of the
PASSPORT program and conduct an assessment by telephone, video conference, or
in person to determine if the individual meets all non-financial eligibility
requirements in rule
5160-31-03 of the Administrative
Code.
(3)
After the individual applies for the medicaid-funded
component of the PASSPORT program, ODA or its designee shall notify the
individual of the existence of the state-funded component of the PASSPORT
program in Chapter 173-40 of the Administrative Code and offer the individual
an opportunity to apply for enrollment in the state-funded component of the
program.
(B)
Denial: If ODM's administrative agency or ODA's
designee determines the individual does not meet all eligibility requirements
for the program under rule
5160-31-03 of the Administrative
Code, then the following responsibilities apply:
(1)
If ODM's
administrative agency determines the individual does not meet all financial
eligibility requirements, it shall notify ODA's designee and notify the
individual of the denied application and appeal rights under section
5101.35 of the Revised Code and
division 5101:6 of the Administrative Code.
(2)
If ODA's designee
determines the individual does not meet all non-financial eligibility
requirements, it shall notify the individual of the denied application and
appeal rights under section
5101.35 of the Revised Code and
division 5101:6 of the Administrative Code.
(C)
Enrollment: If
ODM's administrative agency or ODA's designee determines the individual meets
all eligibility requirements for the program under rule
5160-31-03 of the Administrative
Code, then ODA's designee shall notify the individual that the individual meets
all eligibility requirements and enroll the individual according to paragraph
(C)(1) or (C)(2) of this rule.
(1)
Available slot: ODA's designee shall enroll the
individual in the program without placing the individual on the unified waiting
list, if all the following conditions exist:
(a)
A waiver slot in
the medicaid-funded component of the PASSPORT program is
available.
(b)
The individual continues to meet the eligibility
requirements for the program.
(c)
The individual
continues to want to enroll in the program.
(2)
No available
slot: If a waiver slot is not available in the medicaid-funded component of the
PASSPORT program, ODA's designee may enroll the individual when a waiver slot
becomes available by one of the following two means:
(a)
Unified waiting
list: If an individual meets all the non-financial eligibility requirements,
but a slot is not available in the PASSPORT program, ODA's designee shall place
the individual on the unified waiting list according to rule
173-44-04 of the Administrative
Code, unless the individual qualifies for the home first component of the
PASSPORT program, as addressed in paragraph (C)(2)(b) of this
rule.
(b)
Home first: If an individual meets all requirements for
the home first component of the PASSPORT program in section
173.521 of the Revised Code,
ODA's designee shall enroll the individual before enrolling any individual from
the unified waiting list.
(D)
Reassessment:
ODA's designee shall reassess each individual enrolled in the medicaid-funded
component of the PASSPORT program no less often than one time before each
anniversary date of enrollment. After ODA's designee conducts each
reassessment, if the individual continues to qualify for the medicaid-funded
component of the program, the individual may decide if the individual wishes to
remain in the program by signing an ODA-approved enrollment agreement as a
condition of continued enrollment. During an emergency declared by the governor
or a federal public health emergency, ODA's designee may collect the
individual's handwritten or electronic signature on the enrollment agreement on
a date later than the date the individual agrees to continue in the program,
but no later than the next reassessment of the individual.
(E)
An authorized
representative may represent an individual in the enrollment and reassessment
processes.
Replaces: 173-42-03
