Current through all regulations passed and filed through September 16, 2024
(A)
KGAP is available
for an eligible child whose kinship caregiver(s) entered into an initial KGAP
agreement prior to the child's eighteenth birthday through the end of the month
of the child's eighteenth birthday.
(B)
KGAP is available
for a child with a physical/mental disability or medical condition who is
between the age of eighteen and twenty-one with an existing KGAP agreement if
the child meets one of the requirements identified in paragraphs (B)(1) to
(B)(5) of this rule and the kinship caregiver(s) is supporting the child as
identified in paragraph (D) of rule
5101:2-46-06 of the
Administrative Code. The ongoing medical treatment of the physical/mental
disability or medical condition is to be verified annually for continued
eligibility by a culturally competent qualified professional in the
professional's scope of practice. The child is considered to have a
physical/mental disability or medical condition if any of the following
apply:
(1)
A
designated social security administration claims representative has determined
that the child meets the disability criteria and is therefore eligible for one
of the following:
(a)
Title XVI supplemental security income (SSI)
benefits.
(b)
Social security disability benefits.
(c)
Social security
benefits due to the death or disability of the biological
parent(s).
(2)
The child has been diagnosed by a culturally competent
"qualified professional" in the professional's scope of practice who is not
responsible for providing casework services to the child to have a
physical/mental disability or medical condition.
(a)
For the purpose
of this rule, a "qualified professional" is an individual who is one of the
following: an audiologist, orthopedist, physician, certified nurse
practitioner, physician assistant, psychiatrist, psychologist, school
psychologist, licensed marriage and family therapist, speech and language
pathologist, a licensed independent social worker, licensed professional
clinical counselor, a licensed social worker who is under the direct
supervision of a licensed independent social worker or a licensed professional
counselor who is under the direct supervision of a licensed professional
clinical counselor.
(i)
The kinship caregiver(s) is to provide Ohio department
of job and family services (ODJFS) with a clear written statement from a
qualified professional that the child is substantially limited in one or more
major life activities, including self-care and the overall capacity for
self-sufficiency/meeting the ordinary demands of life. This statement is to
include an opinion as to the origin of the problem, past history, prognosis,
and recommendations related to potential treatment needs. The child's
documented disability is the direct result of one of the following:
(a)
A developmental
disability, as defined in
28 C.F.R.
35.108 [August 11, 2016] and section 5123.01
of the Revised Code.
(b)
A medical condition causing permanent distress, pain,
dysfunction, or social problems diagnosed by a qualified professional that
results in ongoing medical treatment. The medical condition is to be diagnosed
prior to legal custody/guardianship or can be attributable to factors or
conditions in the child's or birth family's history that existed prior to legal
custody/guardianship.
(c)
Mental illness, as defined in section
5122.01 of the Revised
Code.
(3)
The child is
participating in one of the following rehabilitation programs or a program
equivalent in the state where the child resides:
(a)
Vocational
rehabilitation, as evidenced by the implementation of an individual plan of
employment (IPE), administered by the bureau of vocational rehabilitation
through opportunities for Ohioans with disabilities.
(b)
Services for the
visually impaired, as evidenced by the implementation of an IPE, administered
by the bureau of services for the visually impaired through the opportunities
for Ohioans with disabilities.
(4)
The child is in
the process of obtaining a secondary education and meets the eligibility
criteria for a child with a disability receiving special education and related
services from the Ohio department of education (ODE), local education agency or
school district or a program equivalent in the state where the child resides.
The kinship caregiver(s) is responsible for providing official documentation
from the school that the child is attending and participating in special
education services.
(5)
The child is eligible for services administered through
the department of developmental disabilities (DODD), as evidenced by the
implementation of an individual service plan (ISP).
(C)
A clear statement
documenting the child's physical/mental disability or medical condition is to
be accompanied by an assessment, evaluation, or update within the last twelve
months from the qualified professional including an opinion as to the prognosis
and recommendations for future treatment needs.
(D)
If the kinship
caregiver(s) requests to continue the KGAP payment beyond age eighteen due to
any of the requirements identified in paragraph (B) of this rule, ODJFS is to
do one of the following:
(1)
Amend the KGAP agreement to begin the KGAP monthly
payment based on the date of eligibility for any of the programs identified in
paragraph (B)(1) of this rule.
(2)
Notify the
kinship caregiver(s) of the intent to amend the JFS 00133 "Title IVE Kinship
Guardianship Assistance Program (KGAP) Agreement" to a KGAP agreement with no
payment pending the approval of any program outlined in paragraph (B) of this
rule and provide the kinship caregiver(s) with notification of state hearing
rights.
(3)
Notify the kinship caregiver(s) of the intent to
terminate the KGAP agreement, at age eighteen, if eligibility is denied based
on any of the requirements identified in paragraph (B) of this rule.
(a)
If the kinship
caregiver(s) requested a state hearing within fifteen days of the date the
termination notice was issued then ODJFS continues the KGAP until the hearing
decision has been rendered.
(b)
If the kinship
caregiver(s) has not requested a state hearing within fifteen days of the date
the termination notice was issued, ODJFS:
(i)
Terminates the
KGAP agreement.
(ii)
Completes the ODM 01958 "Referral for Medicaid
Continuing Eligibility Review" and submit it to the county department of job
and family services (CDJFS) located in the county where the kinship
caregiver(s) resides, in compliance with the medical pretermination
review.
(iii)
ODJFS will notify medicaid to terminates the Title XIX
medical coverage.
(E)
It is the
responsibility of the kinship caregiver(s) to provide ODJFS with documentation
that application has been made for any services the child needs in paragraph
(B) of this rule.
(F)
ODJFS is to advise the kinship caregiver(s) of all
necessary documentation that is to be submitted to continue a KGAP
agreement.
(G)
For cases in which the year and month the child was
born can be established, but not the exact day, the first of the month is used
as the child's birth date.
