(A) Child care
services provided under Title XX are excluded from the requirements contained in
this rule and the county department of job and family services (CDJFS) shall
follow child care requirements contained in Chapter 5101:2-16 of the
Administrative Code.
(B) Reimbursement
under Title XX for expenditures for services delivered to individuals is
contingent upon the following:
(1) Service is
included in the "Comprehensive Title XX Social Services Plan" (CTXXSSP).
(2) The
individual who receives the service is a member of one of the eligibility
categories to which the service is available in the county of residence.
Availability of services to eligibility categories is shown in the countycounty's profiledata section of theCTXXSSP .
(3) The
individual receiving the service(s) correctly met the eligibility factors which
are applicable to the service(s) received by the individual and the individual's
eligibility category.
(C) When the CDJFS
provides Title XX social services for free or for a fee, it shall establish
eligibility standards or a fee schedule based on income level guidelines. The
CDJFS shall formalize these eligibility standards and fee schedules in a written
document which the CDJFS shall make available at all times for public review.
(D) Categories of
eligibility under the Title XX program are as follows:
(1) Income
eligible
(a) Services for
free, as determined by the CDJFS.
(b) Services for
a fee, as determined by the CDJFS.
(i) Services for
a fee is the amount charged by the CDJFS or provider agency under contract with
the CDJFS.
(ii) The CDJFS
may offer any service(s) identified in their current CTXXSSPcounty
profile in the "Service for a Fee" category
with the exception of information and referral services, protective services for
adults and protective services for children.
(iii) Only those
services to which fees are applicable are counted in determining the amount of
the fee. Services that are available to consumers without regard to income would
therefore not be counted.
(2) Without
regard to income, as determined by the CDJFS.
(a) A written
application is not required where service is deemed without regard to income.
(b) Protective
services for adults and children and information and referral may be provided
without regard to income.
(E) Eligibility
determinations and redeterminations may be conducted by the agency providing the
service; however the CDJFS may make eligibility determinations if it concludes
that doing so would benefit consumers or result in more efficient operation of
the Title XX social services program in the county, or if it concludes that a
provider is making unsatisfactory eligibility determinations. The CDJFS will
determine the frequency of redeterminations, based upon the service plan.
(F) Proper and
improper determination and redetermination of eligibility, under the Title XX
program are as follows:
(1) Reimbursement
is available for services provided during the period of proper eligibility
determination and until the end of the month in which the individual is
subsequently determined to be ineligible for services.
(2) A proper
determination of eligibility is based on a correct assessment of all necessary
information available to the CDJFS or provider agency at the time of such
determination. The determination must be made within thirty calendar days of the
date of the initial application or request for services, or prior to the due
date of a redetermination.
(3) Written
notification of approval or denial of an application or request for Title XX
social services, shall be made within fifteen calendar days of the date of
determination. Paragraph (H) of this rule shall apply.
(4) If a consumer
is found to have been improperly determined eligible for services, reimbursement
is not available for the services provided during the period of improper
determination.
(5) Reimbursement
from the Ohio department of job and family services (ODJFS) to the CDJFS or from
the CDJFS to the provider agency is not available prior to the date of the
initial application or request for services.
(G) The CDJFS or
the agency under contract thatmakemakes eligibility determinations and redeterminations for Title XX
social services shall:
(1) Accept
consumer applications and requests for services.
(2) Complete a
social service plan.
(3) Determine
eligibility.
(4) Authorize
requested services, if appropriate.
(5) Fulfill all
applicable responsibilities relative to state hearings in accordance with
division 5101:6 of the Administrative Code.
(H) When Title XX
eligibility determination and redetermination are conducted by the purchased
service provider under contract, the CDJFS must assure that the provider agency
will explain to the consumer the following rights and responsibilities:
(1) The consumer
has the right:
(a) To apply for
services and have eligibility determined within thirty calendar days of the
receipt of the application.
(b) To receive
any needed serviceservices listed
in the county's profile as provided in the consumer's eligibility category in
the consumers' county , provided all eligibility factors are met and sufficient
funds are available to provide the services.
(c) To a state
hearing as described in division 5101:6 of the Administrative Code.
(d) To be advised
of the eligibility requirements for social services.
(e) To the
safeguarding of information reported by or about the consumer, to the extent
permitted by law.
(2) The consumer
has the responsibility:
(a) To report,
within ten calendar days, any information that may affect eligibility.
(b) To provide
documentation to substantiate eligibility.
(c) To cooperate
with subsequent efforts to assess any error rate made in the eligibility
process.
Effective: 06/01/2017
Five Year Review (FYR)
Dates: 02/08/2017 and 06/01/2022
Certification: CERTIFIED
ELECTRONICALLY
Date: 04/27/2017
Promulgated Under: 119.03
Statutory Authority:
5101.46
Rule Amplifies: 5101.46
Prior Effective Dates:
10/01/82, 10/01/90, 08/15/91, 11/01/91 (Emer.), 1/10/92, 8/1/98, 1/1/04,
1/12/07, 5/31/12