Current through all regulations passed and filed through September 16, 2024
(A) This rule describes eligibility criteria
for medical assistance for individuals who are in receipt of:
(1) Adoption or foster care assistance under
Title IV-E of the Social Security Act (as in effect October 1,
2023);
or
(2) State foster care
assistance; or
(3) State adoption
assistance subsidies; or
(4) State
adoption assistance in accordance with
42 C.F.R.
435.227 (as in effect October 1,
2023).
(B) Individual or authorized representative
responsibilities. The individual or authorized representative must:
(1) Sign and date the application in
accordance with rule
5160:1-2-08 of the
Administrative Code; and
(2) Meet
the conditions of eligibility described in rule
5160:1-2-10 of the
Administrative Code; and
(3)
Cooperate in establishing eligibility; and
(4) Report changes that impact the
eligibility criteria identified in this rule in accordance with rule
5160:1-2-08 of the
Administrative Code.
(C)
Eligibility criteria for an individual in receipt of adoption or foster care
assistance under Title IV-E of the Social Security Act (as in effect October 1,
2023).
(1) The individual must:
(a) Meet the age requirements identified in
Chapter 5101:2-47 of the Administrative Code and be in the custody of a public
children services agency (PCSA), private child placing agency (PCPA), or Title
IV-E agency and in receipt of Title IV-E foster care maintenance payments;
or
(b) Meet the age requirements
identified in Chapter 5101:2-49 of the Administrative Code and have a Title
IV-E adoption agreement in effect, whether or not an adoption assistance
payment is being made or a judicial decree of adoption has been
issued.
(2) When the
individual receives adoption or foster care assistance under Title IV-E of the
Social Security Act and meets the eligibility criteria under this paragraph,
there is no income or resource test required to be eligible for medical
assistance.
(D)
Eligibility criteria for an individual in receipt of kinship guardianship
assistance program (KGAP) payments under Title IV-E of the Social Security Act
(as in effect October 1, 2023).
(1) The
individual must:
(a) Meet the eligiblity
requirements identified in rule
5101:2-46-02 or rule
5101:2-55-02 of the
Administrative Code; and
(b) Have a
current IV-E KGAP or IV-E kinship guardianship assistance program connections
to twenty-one (KGAP C21) agreement in effect.
(2) When the individual receives KGAP
payments under Title IV-E of the Social Security Act and meets the eligiblity
criteria under this paragraph, there is no income or resource test required to
be eligible for medical assistance.
(E) Eligibility criteria for an individual in
receipt of state foster care assistance.
(1)
The individual must:
(a) Be in the custody of
a PCSA, PCPA, or Title IV-E agency; and
(b) Be in receipt of state foster care
assistance.
(2) When the
individual receives state foster care assistance and meets the eligibility
criteria under this paragraph, there is no income or resource test required to
be eligible for medical assistance.
(3)
Eligibility is
coterminous with receipt of foster care assistance and ends on the date the
child's foster care placement ends, subject to a pre-termination review as
defined in rule
5160:1-1-01 of the
Administrative Code.
(F) Eligibility criteria for an individual in
receipt of a state adoption maintenance subsidy.
(1) The individual must:
(a) Meet the age requirements identified in
rule 5101:2-44-06 of the
Administrative Code; and
(b) Have a
state adoption agreement in effect, whether or not a judicial decree of
adoption has been issued.
(2) When the individual receives a state
adoption maintenance subsidy and meets the eligibility criteria under this
paragraph, there is no income or resource test required to be eligible for
medical assistance.
(G)
Eligibility criteria for an individual in receipt of state adoption assistance
in accordance with 42 C.F.R.
435.227 (as in effect October 1,
2023).
(1) The individual must:
(a) Be under the age of twenty-one;
and
(b) Have been determined by the
PCSA responsible for determining state adoption maintenance subsidy program
eligibility to have special needs for medical or rehabilitative care that may
be a barrier to the adoptive placement, as described in rule
5101:2-44-05.1 of the
Administrative Code, or have a state adoption subsidy agreement in effect with
another state, as described in rule
5101:2-44-05.2 of the
Administrative Code; and
(c) Have
been receiving or eligible to receive medicaid prior to the execution of the
adoption agreement, under any category of medical assistance.
(2) When the individual receives
state adoption assistance, has special needs for medical or rehabilitative
care, and meets the eligibility criteria under this paragraph, there is no
income or resource test required to be eligible for medical
assistance.
(H) An
individual who meets eligibility requirements identified in rule
5101:2-56-02 of the
Administrative Code and is in receipt of state KGAP payments is not eligible
for medical assistance under this rule on the basis of receiving KGAP
payments.
