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/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, entered into prior to the age of
eighteen, if the child meets one of the criteria
identified in paragraphs (B)(1) to (B)(5) of this rule and the adoptive
parent(s) is supporting the child as identified in paragraph
(F)
of
rule 5101:2-49-10 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, as defined in rule
5101:2-1-01 of the
Administrative Code, 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 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
culturally competent, "qualified professional" in
the professional's area of expertise 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 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,
dysfunction
or 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 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 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), as evidenced by the implementation of an
individual service plan (ISP).
(C) A clear written 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 adoptive
parent(s) requests to continue the AA payment beyond age eighteen due to any of
the criteria 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)
Through mutual
agreement between the PCSA and adoptive parent(s) 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, notify the
adoptive parent(s) 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, at age eighteen, if eligibility is denied based on
any of the criteria identified in paragraph (B) of this rule.
(a)
If the adoptive
parent(s) requested a state hearing within fifteen days of the date the
termination notice was issued then the PCSA continues the AA until the hearing
decision has been rendered.
(b)
If the adoptive
parent(s) has not requested a state hearing within fifteen days of the date the
termination notice was issued, the PCSA:
(i)
Terminates the AA
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 adoptive parent(s)
resides, in compliance with the medical pre-termination review.
(iii)
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.
