Current through all regulations passed and filed through September 16, 2024
(A)
Post adoption
special services subsidy (PASSS) is a state-funded program designed to assist
eligible adoptive families, after adoption finalization, to receive services
consistent with paragraphs (G) to (P) of this rule.
(B)
PASSS funding is
based on a state fiscal year (SFY), July first through June thirtieth. Once the
application is approved the family is eligible from the first day of the month
in which the completed application is approved, however the family may submit
the invoice from the initial assessment or evaluation required as part of the
application process. Applicants may only request funding for services rendered
during the SFY in which the JFS 01050 "Application for a Post Adoption Special
Services Subsidy" is made. A new JFS 01050 is to be submitted if additional
services are requested during the same SFY or any subsequent SFY. The new
application is to contain updated information, if applicable, as outlined in
paragraph (F) of this rule, including updated financial
information.
(C)
Pursuant to section
5101.1418 of the Revised Code
administration of PASSS will transition to the Ohio department of job and
family services effective July 1, 2022. All invoices for services approved for
SFY 2022, are to be paid by the PCSA and entered into Ohio SACWIS for
reimbursement by the PCSA by September 30, 2022. The public children services
agencies are not to accept PASSS applications for services that start after
June 30, 2022. The PCSAs are to forward any applications for services that will
start on or after July 1, 2022 to OhioKAN or ODJFS within fifteen calendar days
of receiving the application.
(D)
All of the
following requirements are to be met to be eligible for PASSS:
(1)
The child resides
in Ohio and the home of the adoptive parent(s) in which the application is
made.
(2)
The child has been adopted by someone other than a step
parent.
(3)
The child has a physical or developmental disability or
mental or emotional condition that either:
(a)
Existed before
the adoption petition was filed.
(b)
Developed after
the adoption petition was filed and can be directly attributed to factors in
the child's preadoption background or medical history, or biological family's
background or medical history.
(4)
The child meets
either of the following requirements:
(a)
The child is
under the age of eighteen.
(b)
The child is at
least eighteen years of age and less than twenty-one years of age and has been
diagnosed with one of the disabilities defined in this paragraph:
(i)
Mental or
emotional disability is a mental illness or emotional disturbance that impairs
the ability to meet activities of daily living.
(ii)
Developmental
disability is a developmental delay or intellectual disability that limits
functioning.
(iii)
Physical disability is a vision, speech or hearing
impairment; congenital orthopedic impairment, orthopedic impairment caused by
disease, or orthopedic impairment from other causes (e.g., amputation);
impairment caused by chronic or acute health problems (e.g., rheumatic fever);
or a concomitant of the aforementioned.
(5)
Other sources of
assistance are inadequate or are unavailable to meet the child's immediate
needs.
(E)
Families are to start the application process in
person, online or by calling the Ohio kinship and adoption navigator (OhioKAN)
program.
(F)
OhioKAN staff are to submit a completed JFS 01050
"Application for Post Adoption Special Services Subsidy" with the following
documentation to ODJFS:
(1)
A clear written statement of the child's needs as
defined in paragraph (D)(3) of this rule. The statement is to be supported by
an assessment or evaluation from a qualified professional including an opinion
as to the origin of the problem, past history, prognosis and recommendations
related to future treatment needs. For the purpose of this rule, a qualified
professional is defined as a licensed independent social worker (LISW),
professional counselor licensed by section
4757.23 of the Revised Code,
physician, physician assistant, certified nurse practitioner, chiropractor,
dentist, orthodontist, psychiatrist, psychologist, or occupational, physical or
speech therapist, a licensed social worker (LSW) or other licensed/certified
professionals who are under the direct supervision of any of the professionals
listed in this paragraph. The qualified professional is not to be responsible
for providing public casework services to the child. The qualified
professional's diagnosis of disability or condition is to be within the
professional's area of expertise.
(2)
A completed JFS
01052 "Credentials of Professional Providers of PASSS Funded Therapeutic
Services and Memorandum of Understanding," if applicable.
(3)
A written
statement that clearly indicates why the requested service is not within the
resources of the family, a copy of the JFS 01681 "Applicant Financial
Statement" and a copy of the family's most recent IRS tax
return.
(4)
A listing of community resources, as outlined on the
JFS 01050, that have been contacted including the date and results of those
contacts. OhioKAN staff is to work with the family to identify and exhaust
other resources prior to submitting the JFS 01050.
(5)
A copy of the
relevant provisions in any public or private health insurance policy held by
the family regarding the child's eligibility for services and the services that
are covered under the policy.
(6)
OhioKAN staff are
to assist families in gathering any documentation needed.
(G)
As a
condition of continued eligibility for PASSS funds, the adoptive parent(s) is
to submit a copy of the child's treatment plan, completed by the service
provider, which details the therapeutic intervention(s) that will be provided
to the child for the period in which the JFS 01050 will be in effect. The
treatment plan is to be submitted to ODJFS within forty-five days of the
adoptive child's initial visit to the provider. If ODJFS has not received the
treatment plan within forty-five days, ODJFS is to mail the family a JFS 01049
"Verification of Treatment Plan" letter.
(H)
If ODJFS does not
receive the treatment plan by the sixtieth day PASSS funds are subject to
suspension.
(I)
ODJFS may encumber PASSS funds for the reasonable costs
of services for any of the following allowable services:
(1)
Medical and
surgical services. All medical and surgical services are to be determined to be
medically necessary by a qualified professional. The medically necessary
service is to be the lowest cost alternative that effectively addresses and
treats the child's medical problem(s). Medical and surgical services are not to
include the cost of dental or orthodontia unless documentation can be provided
that the service is medically necessary and meets the criteria of paragraphs
(D)(3)(a) and (D)(3)(b) of this rule.
(2)
Psychiatric,
psychological, and counseling services. All psychiatric, psychological and
counseling services are to be determined to be necessary by a qualified
professional. These services can include:
(a)
Specialized
therapeutic camps that offer services that are provided by a qualified
professional listed in paragraph (F)(1) of this rule. The invoice for these
services is to be itemized to indicate the cost of the therapeutic components
of the program. Only the therapeutic cost will be covered these are not to
include food or meals, lodging, or recreational activities.
(b)
Brain balance
programs that offers services that are provided by a qualified professional
listed in paragraph (F)(1) of this rule. The invoice for these services is to
be itemized to indicate the cost of the therapeutic components of the program.
Only the therapeutic cost will be covered.
(3)
Residential
treatment, treatment foster care or in-patient hospitalization services
(excluding private non-profit, therapeutic wilderness camps) if required by
psychiatric, psychological or counseling needs and approved by a qualified
professional.
(a)
These services may include maintenance costs as long as
the costs are included as part of a residential treatment, treatment foster
care or inpatient hospitalization program.
(b)
Residential
treatment services are not to include the cost of educational
services.
(c)
Approved services for any type of residential treatment
facility or treatment foster care home are to be provided by a residential
facility or treatment foster care home that is licensed by the Ohio department
of job and family services (ODJFS) or the Ohio department of mental health and
addiction services (OMHAS) or a comparable agency which is recognized by a
state or a similar licensing body.
(4)
Respite care
services for the purpose of this rule are defined as services designed to
provide planned or emergency temporary relief of child caring functions.
Respite care services may provide planned or emergency short-term and
time-limited breaks for families of children with medical, surgical or mental
health needs of the child. Respite care services are to be administered by an
independent provider who resides outside the family home. A relative may
provide respite for a child that may have behaviors or needs that are best
addressed by that provider. Respite care services are not hospice, regular
child care, therapy, nursing services and other rehabilitative services.
Respite care services may be approved for:
(a)
Medical and
surgical respite care services if required by medical or surgical needs of the
child. Medical and surgical respite care services are not to exceed two
thousand four hundred dollars per child per SFY. ODJFS may elect, on a case by
case basis, to approve up to an additional two thousand four hundred dollars
per child per SFY for medical and surgical respite care services under special
circumstances.
(b)
Mental health respite care services if required by
psychiatric, psychological or counseling needs. Mental health respite care
services are not to exceed two thousand four hundred dollars per child per SFY.
ODJFS may elect, on a case by case basis, to approve up to an additional two
thousand four hundred dollars per child per SFY for mental health respite care
services under special circumstances.
(J)
Special
circumstances may include:
(1)
The family demonstrating a financial
need.
(2)
A written statement of the child's need from a
qualified professional.
(K)
Approved services
are to address the child's physical or developmental disability or mental or
emotional condition that either existed before the adoption petition was filed
or developed after the adoption petition was filed and can be attributed to
factors in the child's preadoption background, medical history, or biological
family's background or medical history.
(L)
Approved services
that involve any type of therapy are to be provided by a qualified
professional, as outlined in this rule, and the JFS 01052, who is practicing
within their scope of practice as noted by their education, training and
experience. The provider is to indicate that their therapeutic interventions
will comply with all treatment aspects contained in rules 5122-26-16,
5122-26-16.1, and
5122-26-16.2 of the
Administrative Code.
(M)
Invoices for approved services are to be dated after
the approval date listed on the "Approval or Denial for Post Adoption Special
Services Subsidy" report. The only exception is the initial assessment or
evaluation as described in paragraph (F)(1) of this rule.
(N)
Except as
provided in paragraph (O) of this rule, no more than ten thousand dollars is to
be encumbered for any one child in one SFY.
(O)
If ODJFS
determines that either of the following exists, the limit outlined in paragraph
(N) of this rule may be increased up to five thousand dollars for a total of
fifteen thousand dollars per child per SFY if:
(1)
The family's
income and resources substantially decreased due to the involuntary loss of
employment and the family has completed the JFS 01051 "Application for
Additional Post Adoption Special Services Subsidy (PASSS) Funding for
Extraordinary Circumstances."
(2)
A qualified
professional as described in paragraph (F)(1) of this rule recommends
residential treatment, in-patient hospitalization, or therapeutic foster care
to prevent disruption of the adoption. This recommendation is to be submitted
along with a copy of the JFS 01051.
(P)
If a family is
requesting additional PASSS funding and meets the requirements outlined in
paragraph (O) of this rule, ODJFS may review and approve the JFS 01051 along
with the initial JFS 01050.
(Q)
The adoptive
parent or parents who receive PASSS funds are required to pay at least a five
per cent co-pay of the total cost of all approved services provided to the
child.
(1)
If
the gross income of the child's adoptive family is less than two hundred per
cent of the federal poverty guideline, ODJFS may waive the five per cent
requirement.
(2)
If the service amount is higher than the approved
amount, the adoptive parent is responsible for the co-pay percentage amount and
the overage cost of the service.
(R)
Interventions
involving planned physical restraint or coercion (e.g., "compression holding"
or "rebirthing therapy"), or promotion of regression for "reattachment" are not
to be provided utilizing PASSS dollars. In addition, the following therapeutic
techniques are not permitted on a treatment plan to be paid from PASSS funds
under any circumstances:
(1)
Face down restraint with back pressure.
(2)
Any technique
that obstructs the airway or impairs breathing.
(3)
Any technique
that obstructs vision.
(4)
Any technique that restricts the recipient's ability to
communicate.
(5)
Pepper spray, mace, handcuffs or electronic restraint
devices such as stun guns.
(6)
A drug or
medication that is used as a restraint to control behavior or restrict the
individual's freedom of movement that is not a standard treatment for the
individual's medical or psychiatric condition.
(S)
The following
services are not subject to approval for PASSS for funding:
(1)
Educational
services such as tuition and tutoring.
(2)
Cosmetic dental
and/or orthodontia services.
(3)
Medical and/or
mental health co-payments, prescriptions and/or prescription
co-payments.
(4)
Any recreational services including but not limited to
karate, gymnastics, dance classes and fitness club memberships.
(5)
Travel related
expenses such as mileage reimbursement, airfare, lodging etc., and automobile
purchases and repairs. PASSS funding may be used for specific types of vehicle
modifications, e.g. lift added to van, car or transportation services that are
related to the child's special needs.
(6)
Computer
equipment and software that has not been recommended by a qualified
professional that will help or improve the mental and physical condition of the
child.
(7)
Child care services.
(8)
Property
fences.
(9)
Food, meal supplements and nutrition
drinks.
(10)
Service animals.
(11)
Services
provided by a PCSA or private child placing agency (PCPA) to make arrangements
for adoptive placements.
(12)
Services that are equivalent to or are of greater
benefit to other members of the family, not including family counseling and
respite.
(13)
Services to a child for whom a parent-child
relationship does not exist.
(14)
Services that
facilitate contact with a parent whose rights have been
terminated.
(15)
Services for a child in the custody of a PCSA, PCPA,
court or any other agency.
(16)
Legal fees to
finalize the adoption or for any other legal action.
(T)
ODJFS may approve
PASSS funding for the child's insurance deductible, if the service is covered
by private insurance, in lieu of approving PASSS funds for the cost of services
for the child. Applications will be reviewed on case by case basis, if it is
determined that it would be more cost effective to pay the insurance deductible
rather than to pay the cost of the services.
Replaces: 5101:2-44- 13.1
