Current through all regulations passed and filed through September 16, 2024
(A) Child care services provided under Title
XX are excluded from the requirements contained in this rule and the county
department of job and family services (CDJFS) shall follow child care
requirements contained in Chapter 5101:2-16 of the Administrative
Code.
(B) Reimbursement under Title
XX for expenditures for services delivered to individuals is contingent upon
the following:
(1) Service is
defined in the
"Comprehensive Title XX Social Services Plan" (CTXXSSP) and specifically
included in the county's "Title XX County Profile," maintained in the federal
reporting SSBG Title XX system.
(2) The individual who receives the service
is a member of one of the eligibility categories to which the service is
available in the county of residence. Eligibility information will be
documented in accordance with paragraphs (D) and (E) of this
rule.
(3) The individual
receiving the service(s) correctly met the eligibility factors which are
applicable to the service(s) received by the individual and the individual's
eligibility category.
(C)
Eligibility categories under the Title XX program
are as follows:
(1) Income eligible
(a) Services for free.
(i)
Under services
for free, no cost is paid by the client to either the CDJFS or the
provider.
(ii)
Income eligibility will be determined in accordance
with the agency's defined policy, utilizing an application or other means to
document the income for the assistance group.
(b) Services for a fee.
(i) Services for a fee is the amount charged
to the client by the CDJFS or provider agency
under
agreement with the CDJFS.
(ii) Only those
services to which fees are applicable are counted in determining the amount of
the fee. Services that are available to consumers without regard to income
would therefore not be counted.
(2) Without regard to income.
(a)
Any service category can be designated
as without regard to income; however, the following categories are typically
provided without regard to income:
(i)
Protective
services for adults.
(ii)
Protective services for children.
(iii)
Information and
referral.
(b)
A written application is not needed where service is
deemed without regard to income.
(D)
When the CDJFS has determined that any Title XX service will
be provided as services for free or services for a fee, the CDJFS will
establish a written policy to document the established income eligibility
criteria applicable to each service. If different eligibility criteria are
established for different services, the policy will clearly define the
eligibility criteria applicable for each individual service. The written policy
should identify the types of income that will be counted or not counted in the
eligibility determination. Additionally, the policy should establish the length
of time the eligibility determination is considered valid, and the frequency of
any eligibility redeterminations. This written policy will be available at all
times for public review.
(E)
When the CDJFS has determined any Title XX service will
be provided a service for a fee the CDJFS will establish a fee schedule for the
individual services. Any such fee schedule will be documented in a written
policy, available at all times for public review.
(F)
Eligibility
determinations and redeterminations may be conducted by the agency providing
the service; however the CDJFS may make eligibility determinations if it
concludes that doing so would benefit consumers or result in more efficient
operation of the Title XX social services program in the county, or if it
concludes that a provider is making unsatisfactory eligibility
determinations.
(G) Proper and improper
determination and redetermination of eligibility, under the Title XX program
are as follows:
(1) Reimbursement is available
for services provided during the period of proper eligibility determination and
until the end of the month in which the individual is subsequently determined
to be ineligible for services or in which the
eligibility determination has expired.
(2) A proper determination of eligibility is
based on a correct assessment of all necessary information available to the
CDJFS or provider agency at the time of such determination. The determination
must be made within thirty calendar days of the date of the initial application
or request for services, or prior to the due date of a
redetermination.
(3) Written
notification of approval or denial of an application or request for Title XX
social services shall be made within fifteen calendar days of the date of
determination. Paragraph (H) of this rule shall apply.
(4) If a consumer is found to have been
improperly determined eligible for services, reimbursement is not available for
the services provided during the period of improper determination.
(5) Reimbursement from the Ohio department of
job and family services (ODJFS) to the CDJFS or from the CDJFS to the provider
agency is not available prior to the date of the initial application or request
for services.
(H) The CDJFS or the
provider under agreement that makes eligibility
determinations and redeterminations for Title XX social services shall:
(1) Accept consumer applications and requests
for services.
(2) Complete a social
service plan.
(3) Determine
eligibility.
(4) Authorize
requested services, if appropriate.
(5) Fulfill all applicable responsibilities
relative to state hearings in accordance with division 5101:6 of the
Administrative Code.
(I) When Title XX
eligibility determination and redetermination are conducted by the
provider under the agreement, the CDJFS must
assure that the provider will
explain to the consumer the following rights and responsibilities:
(1) The consumer has the right:
(a) To apply for services and have
eligibility determined within thirty calendar days of the receipt of the
application.
(b) To receive any
needed services listed in the county's "Title XX County Profile," maintained in
the federal reporting SSBG Title XX system, provided all eligibility
factors are met and sufficient funds are available to provide the
services.
(c) To a state hearing as
described in division 5101:6 of the Administrative Code.
(d) To be advised of the eligibility
requirements for social services.
(e) To the safeguarding of information
reported by or about the consumer, to the extent permitted by law.
(2) The consumer has the
responsibility:
(a) To report, within ten
calendar days, any information that may affect eligibility.
(b) To provide documentation to substantiate
eligibility.
(c) To cooperate with
subsequent efforts to assess any error rate made in the eligibility
process.
