Current through all regulations passed and filed through September 16, 2024
(A) The United States centers for medicare
and medicaid services limits the number of slots available for enrollment in
the medicaid-funded components of the assisted living and PASSPORT programs
which may cause a waiting list. A lack of capacity in PACE may also cause a
waiting list. (This rule does not apply to the state-funded components
of the assisted living or PASSPORT programs.)
(B) Waiting list:
(1) If ODA's designee determines an
individual meets all non-financial eligibility requirements for the program to
which the individual applied, but a slot is not available for enrollment in the
program, ODA's designee or the PACE organization
shall place the individual on the unified waiting list established under
section 173.55 of the Revised Code
according to the latter of the date the individual applied for the program
or the date
the individual met all non-financial eligibility requirements for the program
to which the individual applied.
(2)
ODA's designee or the PACE
organization shall offer enrollment to any individual on the unified
waiting list for the assisted living, PACE, or PASSPORT programs who meets all
of the eligibility requirements for the program to which the individual
applied, in compliance with the enrollment rule for the program
, according
to the chronological order that ODA's designee placed
the
individual on the waiting list, unless prohibited
by rule 173-38-03, 173-50-03, or
173-42-03 of the Administrative
Code.
(a) The following rules present
the eligibility requirements:
(i) Assisted
living: See rule
5160-33-03 of the Administrative
Code.
(ii) PACE: See rule
173-50-02 of the Administrative
Code.
(iii) PASSPORT: See rule
5160-31-03 of the Administrative
Code.
(b) The following
rules present the enrollment process:
(i)
Assisted living: See rules
173-38-03 and
5160-33-04 of the Administrative
Code.
(ii) PACE: See rule
173-50-03 of the Administrative
Code.
(iii) PASSPORT: See rules
173-42-03 and
5160-31-04 of the Administrative
Code.
(3) If ODA's designee
offers enrollment to an individual from the unified waiting list, but the
individual declines enrollment, the individual may remain on the unified
waiting list and ODA's designee shall offer enrollment to the next individual
on the list according to the order this rule establishes.
(4) If
a slot is available in the program to which an eligible individual applied,
ODA's designee or the PACE organization shall not place the individual on the
unified waiting list.
(C) Definitions for this rule:
"Assisted living program" (program) means the medicaid-funded
component of the assisted living program created under section
173.54 of the Revised Code.
"ODA" means "the Ohio department of aging."
"ODA's designee" has the same meaning as in rule
173-39-01 of the Administrative
Code.
"PACE" means "the program of all-inclusive care for the
elderly."
"PASSPORT program" (PASSPORT) means the medicaid-funded
component of the PASSPORT program created under section
173.52 of the Revised
Code.
