Current through all regulations passed and filed through September 16, 2024
(A) An adoptive
child in receipt of a JFS 01615 "Approval for
State Adoption Maintenance Subsidy " (rev.
4/2019) may be
eligible for medicaid as outlined in rule
5160:1-4-06 of the Administrative Code based only upon
the child's income, resources, and special needs for medical, mental health, or
rehabilitative care.
(B) In order
for an adoptive child to be considered a child with special needs for medical,
mental health, or rehabilitative care, the public children services agency
(PCSA) responsible for determining state adoption maintenance subsidy program
eligibility shall determine that, at the time of adoptive placement, the child
has a medical necessity as defined in rule
5160-1-01 of the Administrative
Code. The medical necessity includes at least one of the following needs or
circumstances that may be a barrier to the adoptive placement without medical
assistance because the child:
(1) Has a
medical condition, physical impairment, or developmental disability.
(2) Has been diagnosed with a mental disorder
as characterized by a behavioral, psychological, or biological
dysfunction.
(3) Has been diagnosed
with a substance-related disorder.
(C) Eligibility criteria:
(1) For any such child for whom the approval
for state adoption special services subsidy was entered into between April
7, 1986 and June 30, 2004, medicaid
eligibility as outlined in rule
5160:1-4-06
of the Administrative Code, is contingent upon the following:
(a) A determination by the PCSA administering
the agreement that the child's state adoption special
services
subsidy case
record contains sufficient documentation that the child cannot be placed with
the adoptive parents or parent without medical assistance because of the
child's special needs for medical or rehabilitative care.
(b) A finding by the county department of job
and family services (CDJFS) of the child's residence that either the child was
eligible for medicaid as outlined in rule
5160:1-4-06
of the Administrative Code, prior to the approval
for state adoption special services
subsidy being entered into; or
that the child would have been eligible for medicaid, based on the child's
income, during any of the six months prior to the approval for state
adoption special services subsidy being entered
into.
(2) For any child
for whom a JFS 01615 was entered into on or after July 1, 2004,
medicaid eligibility as outlined in
rule
5160:1-4-06 of the Administrative Code, is contingent
upon all of the following:
(a) A finding by
the PCSA administering the agreement that the child has a medical necessity as
outlined in paragraph (B) of this rule which makes the child with special needs
eligible for medical, mental health, or rehabilitative care as documented on
the JFS 01449 "Determination of Special Needs for Medical, Mental Health, or
Rehabilitative Care" (rev.
7/2016).
(b) The adoptive parent or parents are
eligible for a state adoption maintenance subsidy under division (B) of section
5153.163 of the Revised
Code.
