Ohio Administrative Code
Title 5123:2 - Community Services
Chapter 5123:2-1 - County Boards of Developmental Disabilities
Section 5123:2-1-02 - Administration and operation of county boards of developmental disabilities
Universal Citation: OH Admin Code 5123:2-1-02
Current through all regulations passed and filed through December 16, 2024
(A) Purpose
The purpose of this rule is to establish standards for the administration and operation of county boards of developmental disabilities that protect the rights of individuals and ensure the safe and equitable provision of services to eligible individuals and their families.
(B) Definitions
(1)
"Adult services" has the same meaning as in section
5126.01 of the Revised
Code.
(2)
"County board" means a county board of developmental
disabilities.
(3)
"Department" means the Ohio department of
developmental disabilities.
(4)
"Developmental
delay" means that a child has not reached developmental milestones expected for
his or her chronological age as measured by qualified professionals using
appropriate diagnostic instruments and/or procedures.
(a)
For children
under age three, developmental delay shall be established in accordance with
Part C of the Individuals with Disabilities Education Act,
20 U.S.C.
1431 through 1445, as in effect on the
effective date of this rule,
34 C.F.R.
303.10, as in effect on the effective date of
this rule, and rules promulgated by the Ohio department of
health.
(b)
For children age three through age five, developmental
delay shall be established in accordance with rules promulgated by the Ohio
department of education.
(5)
"Developmental
disability" means a severe, chronic disability that is characterized by all of
the following:
(a)
It is attributable to a mental or physical impairment
or a combination of mental and physical impairments, other than a mental or
physical impairment solely caused by mental illness as defined in division (A)
of section 5122.01 of the Revised
Code;
(b)
It is manifested before age
twenty-two;
(c)
It is likely to continue indefinitely;
(d)
It results in
one of the following:
(i)
In the case of a person under age three, at least one
developmental delay or a diagnosed physical or mental condition that has a high
probability of resulting in a developmental delay;
(ii)
In the case of
a person age three through age five, at least two developmental delays;
or
(iii)
In the case of a person age six or older, a
substantial functional limitation in at least three of the following areas of
major life activity, as appropriate for his or her age: self-care, receptive
and expressive language, learning, mobility, self-direction, capacity for
independent living, and, if the person is age sixteen or older, capacity for
economic self-sufficiency; and
(e)
It causes the
person to need a combination and sequence of special, interdisciplinary, or
other type of care, treatment, or provision of services for an extended period
of time that is individually planned and coordinated for the
person.
(6)
"Early intervention services" means developmental
services selected in collaboration with the parents of an infant or toddler
birth through age two who is eligible for services under Part C of the
Individuals with Disabilities Education Act,
20 U.S.C.
1431 through 1445, as in effect on the
effective date of this rule, and 34 C.F.R. Part 303, as in effect on the
effective date of this rule, and designed to meet the developmental needs of
the infant or toddler and the needs of the family to assist appropriately in
the infant's or toddler's development as identified by the individual family
service planning team.
(7)
"Family support services" means a family support
services program described in and administered pursuant to section
5126.11 of the Revised
Code.
(8)
"Help Me Grow" means Ohio's coordinated,
community-based system that promotes transdisciplinary, family-centered
services and supports to eligible expectant parents, newborns, and infants and
toddlers birth through age two and their families. The system is directed by
the Ohio department of health.
(9)
"Home and
community-based services" has the same meaning as in section
5123.01 of the Revised
Code.
(10)
"Individual" means a person with a developmental
disability.
(11)
"Intermediate care facility" means an intermediate
care facility for individuals with intellectual disabilities as defined in rule
5123:2-7-01
of the Administrative Code.
(12)
"Medicaid local
administrative authority" has the same meaning as in section
5126.055 of the Revised
Code.
(13)
"Service and support administration" means the duties
performed by a service and support administrator pursuant to section
5126.15 of the Revised
Code.
(C) Strategic plan
(1)
The county board
shall develop and adopt by resolution a strategic plan that meets the
requirements of sections
5126.04 and
5126.054 of the Revised Code,
includes the county board's mission and vision, and addresses the county
board's strategy for:
(a)
Promoting self-advocacy by individuals served by the
county board;
(b)
Ensuring that individuals receive services in the most
integrated setting appropriate to their needs;
(c)
Reducing the
number of individuals in the county waiting for services;
(d)
Increasing the
number of individuals of working age engaged in community
employment;
(e)
Taking measures to recruit sufficient providers of
services to meet the needs of individuals receiving services in the county;
and
(f)
Meeting with each newly certified independent provider
within sixty days of the provider being selected to provide services to an
individual, for purposes of confirming the provider understands the individual
service plan and the provider's responsibilities and ensuring the provider has
contact information for the county board.
(2)
The strategic
plan shall be made readily available to individuals and families who receive
services, employees of the county board, citizens of the county, and any other
interested persons.
(3)
The county board shall prepare a strategic plan
progress report at least once per year. The strategic plan progress report
shall be made readily available to individuals and families who receive
services, employees of the county board, citizens of the county, and any other
interested persons.
(4)
The county board shall have a mechanism for accepting
public feedback regarding the strategic plan and strategic plan progress
reports.
(D) Eligibility determination for county board services
(1)
Except as provided in paragraph (G) of this rule, the county board shall make
eligibility determinations for county board services in accordance with the
definition of "developmental disability" in paragraph (B)(5) of this
rule.
(2)
For persons age sixteen or older, a substantial
functional limitation in a major life area is determined through completion of
the Ohio eligibility determination instrument (available at https://doddportal.dodd.ohio.gov/cnt ) or an alternative instrument issued by the department for
use in determining eligibility for county board services and application of
criteria found therein.
(3)
For persons age six through age fifteen, a substantial
functional limitation in a major life area is determined through completion of
the children's Ohio eligibility determination instrument (available at
https://doddportal.dodd.ohio.gov/cnt ) or an alternative instrument issued by the department for
use in determining eligibility for county board services and application of
criteria found therein. The children's Ohio eligibility determination
instrument or an alternative instrument issued by the department for use in
determining eligibility for county board services is used in the eligibility
determination process for the county board for all services and supports other
than special education services.
(4)
The Ohio
eligibility determination instrument, the children's Ohio eligibility
determination instrument, and any alternative instrument issued by the
department for use in determining eligibility for county board services shall
be administered by persons employed by county boards or regional councils of
governments formed under section
5126.13 of the Revised Code by
two or more county boards and authorized to do so by the
department.
(5)
The county board may establish eligibility for county
board services for any preschool child with a disability eligible for services
under section 3323.02 of the Revised Code
whose disability is not attributable solely to mental illness as defined in
section 5122.01 of the Revised
Code.
(6)
The county board shall complete eligibility
determination within forty-five days of the request for services or after all
necessary information has been received from the referring party or applicant
except that:
(a)
For children under age three, the eligibility report
completed by or for "Help Me Grow" shall be used for eligibility determination;
and
(b)
For children age three through age five, the
evaluation completed by or for the school district for preschool special
education may be used for eligibility determination.
(7)
The county board
shall keep on file the documents used to determine eligibility for county board
services of all persons who apply after July 1, 1991, whether or not such
persons are found to be eligible. Information on persons found to be ineligible
shall be maintained for five years after such determination is
made.
(8)
When a person who has been determined eligible for
county board services after July 1, 1991 moves or wants to move to another
county in Ohio, that person shall be deemed eligible by the new county board.
The new county board, however, may review the person's eligibility. During the
review, the person continues to be eligible to receive services according to
the new county board's strategic plan and priorities.
(9)
All persons who
were eligible for county board services and receiving county board services
pursuant to Chapter 5126. of the Revised Code on July 1, 1991, shall continue
to be eligible for those services and to receive services as long as they are
in need of services.
(10)
All persons who were eligible for case management
services and receiving case management services pursuant to Chapter 5126. of
the Revised Code on January 10, 1992, shall continue to be eligible for those
services and to receive services as long as they are in need of
services.
(11)
All persons determined ineligible for county board
services shall be referred, with their consent, to other agencies or sources of
services.
(E) Statutory authority
The county board shall carry out its duties and responsibilities in accordance with Chapter 5126. of the Revised Code. If a county board operates classrooms for children, the county board shall be licensed by the Ohio department of job and family services or the Ohio department of education, as applicable.
(F) Medicaid local administrative authority
(1)
A county board with medicaid local administrative
authority shall abide by all terms and conditions set forth in the
federally-approved waiver documents including any appendices and attachments,
sections 5126.055 and
5166.21 of the Revised Code, and
administrative rules promulgated by the Ohio department of
medicaid.
(2)
The department shall oversee medicaid local
administrative authority activities to ensure compliance with applicable laws.
If the department determines that a county board with medicaid local
administrative authority is deficient in its administration of medicaid waiver
services, the department may take appropriate actions authorized by applicable
law including, but not limited to, division (G) of section
5126.055 of the Revised Code or
section 5126.056 of the Revised
Code.
(3)
A county board that participates in the department's
medicaid administrative claiming program shall comply with the department's
policies and procedures governing medicaid administrative claiming and refund
any payments that are disallowed by the department, the Ohio department of
medicaid, or the centers for medicare and medicaid services. A county board may
challenge a disallowance by the department in accordance with rule
5123:2-17-01
of the Administrative Code.
(4)
When the
department refers an individual for whom the department is paying the
nonfederal share of medicaid expenditures for home and community-based services
to a county board for enrollment in home and community-based services, the
county board shall assist the department in expediting the
enrollment.
(G) Service and support administration
The county board shall determine eligibility for service and support administration, provide service and support administration, and ensure individual service plans are developed in accordance with rule 5123:2-1-11 of the Administrative Code.
(H) Non-medicaid adult services
(1)
A county board providing non-medicaid adult services
shall adopt a written policy outlining provision of the
services.
(2)
Non-medicaid adult services shall be provided pursuant
to section 5126.01 of the Revised Code and
rule
5123:2-2-05 of
the Administrative Code.
(3)
Planning for non-medicaid adult services shall be
conducted in accordance with the person-centered planning process described in
paragraph (F)(2)(b) of rule
5123:2-1-11
of the Administrative Code.
(4)
Persons engaged
in the direct provision of non-medicaid adult services shall meet the training
requirements for persons engaged in the direct provision of comparable medicaid
adult services as set forth in:
(a)
Rule
5123:2-9-14
of the Administrative Code for vocational habilitation;
(b)
Rule
5123:2-9-15
of the Administrative Code for supported employment-community;
(c)
Rule
5123:2-9-16
of the Administrative Code for supported employment-enclave;
(d)
Rule
5123:2-9-17
of the Administrative Code for adult day support;
(e)
Rule
5123:2-9-44
of the Administrative Code for integrated employment; and
(f)
Rule
5123:2-9-51
of the Administrative Code for adult day health center
services.
(I) Early intervention services
(1)
A county board providing early intervention services
shall do so in accordance with Part C of the Individuals with Disabilities
Education Act,
20 U.S.C.
1431 through 1445, as in effect on the
effective date of this rule, 34 C.F.R. Part 303, as in effect on the effective
date of this rule, and rules promulgated by the Ohio department of
health.
(2)
A county board providing early intervention services
shall adopt a written policy describing the county board's role in the county's
comprehensive system for early intervention services and supports. The policy
shall identify how the county board will provide early intervention services on
a year-round basis for a minimum of two hundred forty days to eligible infants
and toddlers and their families as part of a comprehensive, coordinated,
transdisciplinary, interagency early intervention system. The policy shall
describe the specific role the county board has agreed to fulfill as a partner
in the local "Help Me Grow" network and may include:
(a)
Public
awareness/child find;
(b)
Evaluation to determine eligibility;
(c)
Child and family
assessment;
(d)
Service coordination;
(e)
Early
intervention services in everyday routines, activities, and places as developed
through the individual family service plan development process;
(f)
Assurances for
procedural safeguards required by Part C of the Individuals with Disabilities
Education Act,
20 U.S.C.
1431 through 1445, as in effect on the
effective date of this rule, 34 C.F.R. Part 303, Subpart E, as in effect on the
effective date of this rule, and rules promulgated by the Ohio department of
health; and
(g)
Whether the county board utilizes funds from the Ohio
department of health to administer central coordination, evaluation and
assessment, or service coordination.
(3)
Early
intervention services shall be designed to meet the needs of the family related
to enhancing the child's development and participation in family life. County
boards shall participate in the development of individual family service plan
outcomes for children and families that promote engagement, independence, and
full community participation.
(4)
The county board
shall maintain the following records for each child birth through age two
receiving services from the county board:
(a)
Documentation
verifying the date of initial referral to the early intervention system and
date of request for the county board to assist in the initial evaluation and
assessment process when the county board participates in the early intervention
child and family evaluation and assessment;
(b)
Documentation of
eligibility;
(c)
Other records related to services provided or arranged
by the county board including the current individual family service plan;
consent forms; correspondence with the family; services and case notes;
documents developed by the county board including evaluations, assessments,
progress reports, and documentation of records requested and documents shared
or released; and documentation of the date, frequency, duration, and intensity
of services delivered; and
(d)
Documentation
demonstrating that early intervention services provided or arranged by the
county board meet the requirements of Part C of the Individuals with
Disabilities Education Act,
20 U.S.C.
1431 through 1445, as in effect on the
effective date of this rule, 34 C.F.R. Part 303, Subpart E, as in effect on the
effective date of this rule, and rules promulgated by the Ohio department of
health with regard to parents' rights and procedural
safeguards.
(J) Family support services
(1)
The county board shall adopt a written policy governing provision of family
support services. The policy shall:
(a)
Specify that individuals or family members of
individuals may receive family support services funds;
(b)
Define family
members who are eligible to receive family support services
funds;
(c)
Describe goods and services that may be purchased with
family support services funds;
(d)
Address whether
or not the county board will use an income-based fee schedule to determine
eligibility for family support services funds, and if an income-based fee
schedule is used, whether or not the county board will require applicants to
submit documentation to verify their income;
(e)
Set forth the
process for individuals and family members to apply for family support services
funds and for the county board to review and approve/disapprove applications;
and
(f)
Describe payment processes that meet requirements
established by the county auditor.
(2)
The county board
may use funds allocated for the family support services program as match for
medicaid waivers.
(K) Volunteers
The county board may utilize volunteers as an integral part of overall service delivery. The county board shall require background investigations on volunteers. Volunteers shall not be considered in the calculation of staffing ratios.
(L) Cost reports
The county board shall annually prepare and electronically file a cost report detailing its income and expenditures in accordance with section 5126.131 of the Revised Code and guidelines established by the department and shall:
(1)
Reconcile its
income and expenditures on a monthly basis in accordance with standards
established by the county auditor;
(2)
Retain the cost
report and accurate records and documentation necessary to support the cost
report for six years from the date of receipt of payment for the final
settlement of the cost report or until an initiated audit is resolved,
whichever is longer; and
(3)
Ensure its business manager and other county board
personnel who prepare cost reports or supporting documentation successfully
complete:
(a)
A department-provided orientation program in cost report preparation within
ninety days of employment or contract; and
(b)
Department-provided annual training in cost report preparation
thereafter.
(M) Records
(1)
The county board
shall maintain fiscal records that are in compliance with county and state
auditor's requirements pursuant to section
149.38 of the Revised
Code.
(2)
The county board shall adopt written policies and
procedures which address confidentiality, access, duplication, dissemination,
and destruction of personnel records.
(3)
The county board
shall adopt written policies and procedures which address confidentiality,
access, duplication, dissemination, and destruction of records of individuals
served in accordance with the Health Insurance Portability and Accountability
Act,
42 U.S.C.
1320 d, as in effect on the effective date of
this rule and as applicable, the Family Educational Rights and Privacy Act,
20
U.S.C. 1232 g, as in effect on the effective
date of this rule.
(4)
Records of the county board shall be accessible to
department personnel authorized by the director of the
department.
(5)
The county board shall submit information and reports
as directed by the department.
(N) Safety
(1)
The design and
maintenance of county board facilities and equipment shall be in conformance
with all applicable laws, including the Americans with Disabilities Act and
Section 504 of the Rehabilitation Act of 1973 as in effect on the effective
date of this rule.
(2)
Each facility owned, leased, or operated by the county
board shall be inspected annually by the local fire marshal or designee to
ensure compliance with fire safety practices.
(3)
If the county
board provides a swimming program, regardless of location, a person who holds a
current "American Red Cross" or equivalent lifeguarding certificate shall be
present.
(4)
The county board shall develop written building
emergency plans which include procedures for fire, tornado, bomb threat, power
failure, natural disaster, medical emergency, and other emergencies. The
building emergency plans shall be available to all personnel, volunteers,
individuals served, parents, and guardians.
(O) Health
(1)
When the county
board is directly providing facility-based services, the county board shall
adopt written policies and procedures that ensure the general health and
well-being of all individuals served and address:
(a)
Providing first
aid and emergency treatment;
(b)
Securing
emergency squad or ambulance services or the services of the individual's
personal physician;
(c)
Providing first aid training, cardiopulmonary
resuscitation training, and training in universal precautions for infection
control including hand-washing and disposal of bodily waste to county board
personnel engaged in direct services positions in accordance with rule
5123:2-2-01
of the Administrative Code;
(d)
Providing
suitable first-aid facilities, equipment, and supplies;
(e)
Providing for
the management of communicable diseases, handling of illness on-site, and
return after an illness or other health condition; and
(f)
Posting
emergency numbers by each telephone.
(2)
The written
policies and procedures described in paragraph (O)(1) of this rule shall be
communicated to all personnel, individuals served, parents, guardians, and
providers of services, and shall be available in each county board facility
upon request.
(3)
The county board shall adopt a written policy
consistent with applicable statutes concerning administration of medication by
county board personnel.
(4)
All medication administered by county board personnel
shall be pharmacy-labeled to indicate owner, contents, required dosage, and
schedule. Such medication shall be secured in a locked cabinet and removed by
designated and qualified personnel.
(P) County board accreditation
(1)
The department shall conduct an accreditation review
of each county board at least once every three years to determine the county
board's compliance with applicable statutes and rules. An accreditation review
shall include a comprehensive on-site review conducted by representatives of
the department at the county board's offices and facilities and may include
off-site review of records, documents, or other materials.
(2)
There are three
possible outcomes of an accreditation review:
(a)
The department
shall issue accreditation for a term of three years to a county board that
exceeds minimum compliance with applicable statutes and rules;
(b)
The department
shall issue accreditation for a term of one year to a county board that
demonstrates minimum compliance with applicable statutes and rules;
or
(c)
The department shall hold accreditation in abeyance
for a county board that is not in compliance with applicable statutes and
rules. The department shall work with the county board to develop an acceptable
plan of correction within ninety days. If an acceptable plan of correction is
not developed within ninety days, the county board may be subject to
receivership pursuant to section
5126.081 of the Revised Code.
While a county board's accreditation is in abeyance, the county board shall not
enroll individuals in home and community-based services
waivers.
(3)
The department shall notify a county board at least
ninety days prior to conducting an accreditation review.
(4)
After conclusion
of the comprehensive on-site review, the department shall conduct an exit
conference with the president of the county board or the president's designee,
the superintendent of the county board, and any other persons the county board
invites. The purpose of the exit conference is to provide the county board with
an oral summary of the county board's compliance status and present any
findings of noncompliance. The exit conference may be held on-site at the
conclusion of the on-site review but shall be conducted no more than five
business days following the conclusion of the on-site review except by mutual
agreement between the department and the superintendent of the county
board.
(5)
The department shall issue a written accreditation
review summary to the superintendent of the county board within seven days of
conclusion of the on-site review. The accreditation review summary shall be
objective in terms of observations and citations, relying upon documentation
that clearly addresses the standards reviewed.
(6)
Within fourteen
days of receipt of a written accreditation review summary that includes one or
more citations, the county board shall submit to the department, a written
appeal or a written plan of correction for each citation. If the county board
does not submit a written appeal within fourteen days, the accreditation review
summary shall be final and not subject to appeal by the county board.
(a)
The appeal for a
citation shall include the county board's basis with supporting documentation
for challenging the citation. The department shall allow or disallow the appeal
within ten days of receipt.
(b)
If the appeal is
disallowed, the county board shall submit a written plan of correction for each
citation to the department within fourteen days. The written plan of correction
shall include:
(i)
A description of corrective action, including systemic
changes necessary to prevent recurrence;
(ii)
Implementation
date of corrective action;
(iii)
Person
responsible for implementing corrective action; and
(iv)
Supporting
documentation which verifies implementation of corrective
action.
(c)
The department shall approve or disapprove the plan of
correction within twenty days of receipt.
(d)
The department
shall not issue accreditation until the county board's written plan of
correction is approved.
(7)
The department
shall develop and implement a system for recognizing county boards that
demonstrate excellence through achievement of outstanding results or
development of successful approaches regarding employment, self-advocacy,
substantial downsizing or conversion of intermediate care facilities,
person-centered planning, or serving individuals presenting complex challenges.
The department shall recognize a county board that demonstrates excellence by
issuing a letter of distinction to the county board. The department shall post
letters of distinction at its website as a means of sharing innovative
practices among county boards.
(Q) Compliance reviews
A county board that is certified by the department pursuant to section 5123.161 of the Revised Code to provide supported living or home and community-based services is subject to rule 5123:2-2-04 of the Administrative Code and may be eligible for an abbreviated compliance review in accordance with that rule.
(R) Providing applicable statutes and rules
The county board shall upon request, assist any interested party to locate and secure a copy of provisions of Chapter 5126. of the Revised Code and the administrative rules of the department. The county board shall ensure that employees of the county board and entities under contract with the county board receive information about revisions to the Revised Code and administrative rules of the department that are pertinent to their roles.
(S) Waiver of requirements in Chapter 5123:2-1 of the Administrative Code
The county board may request or the department may initiate a waiver of requirements outlined in Chapter 5123:2-1 of the Administrative Code that govern the administration and operation of county boards, so long as the requirements are not those of the Revised Code.
Replaces: 5123:2-1-02, 5123:2-1-04, 5123:2-1-06, 5123:2-1-09, 5123:2-4-01, 5123:2-9-04
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