Current through all regulations passed and filed through September 16, 2024
(A) AA is available for an eligible child
whose adoptive parent(s) enter into an initial AA agreement prior to the
child's eighteenth birthday through the end of the month of the child's
eighteenth birthday.
(B) AA
is available for a child with a physical or
mental disability or medical condition pursuant to rule
5101:2-49-03 of the
Administrative Code who is between the age of eighteen and twenty-one with an
existing AA agreement if the child meets one of the requirements identified in
paragraphs (B)(1) to (B)(5) of this rule and the adoptive parent(s) is
supporting the child as identified in paragraph (D) of rule
5101:2-49-10 of the
Administrative Code. The physical or mental disability or medical condition
is to
be verified annually for continued eligibility. The child is considered to have
a physical or mental disability or medical condition if any of the following
applies:
(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 or adoptive
parent(s).
(2) The
child has been diagnosed by a
"qualified professional" in the
professional's area of expertise who is not responsible for providing casework
services to the child to have a physical or
mental
disability or
medical condition.
(a) For the purpose of this
rule, a "qualified professional" is an individual who
is
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 qualified professional
is to
provide a clear written statement 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, dysfunctionor social problems
diagnosed by a qualified professional that results in
ongoing medical treatment. The medical condition is to be
diagnosed prior to adoption or can be attributable to factors or
conditions in the child's or birth family's history that existed prior to
adoption.
(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 administered by the bureau of vocational rehabilitation
through opportunities for Ohioans with
disabilities.
(b) Services
for the visually impaired as 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 adoptive parent(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).
(C) A clear written statement documenting the
child's physical or 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
adoptive parent(s) requests
to
continue the AA payment beyond age eighteen due to any of the
requirements identified in paragraph (B) of this
rule, the PCSA is to
do one of the following:
(1) Amend the AA agreement to begin the AA
monthly payment based on the date of eligibility for any of the programs
identified in paragraph (B) of this rule.
(2) Notify the adoptive parent(s) of the
intent to amend the JFS 01453 "Title IV-E Adoption Assistance Agreement"
to an AA agreement with no
payment pending the approval of any program outlined in paragraph (B) of this
rule and provide the adoptive parent(s) with notification of state hearing
rights.
(3)
Notify the adoptive parent(s) of the intent to
terminate the AA agreement if eligibility is denied based on any of the
requirements identified in paragraph (B) of this rule.
(4)
If the adoptive
parent(s) requested a state hearing within fifteen calendar days of the date
the termination notice was issued then the PCSA continues the AA until the
hearing decision has been rendered.
(5)
If the adoptive
parent(s) has not requested a state hearing within fifteen calendar days of the
date the termination notice was issued, the PCSA:
(a)
Terminates the AA
agreement.
(b)
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 adoptive parent(s)
resides, in compliance with the medical pre-termination review.
(c)
Terminates the
Title XIX medical coverage.
(E) It is the responsibility of the adoptive
parent(s) to provide the PCSA with documentation that application has been made
for any services the child needs in paragraph (B) of this rule.
(F) The PCSA advises
the adoptive parent(s) of all necessary documentation that
is to
be submitted to continue an AA 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.
