This letter transmits changes to the Disability Assistance (DA) cash rules. The rules are being proposed, pursuant to the provisions set forth in the budget bill, Amended Substitute House Bill 95 (Am. Sub. H.B. 95). Some of the rules were also scheduled for review pursuant to the five-year rule review requirements set forth in Section 119.03 of the Revised Code. If there are any changes made to the rules contained in the CAMTL during the JCARR review period, corrected rules will be sent out in the next CAMTL.

The budget bill contains many significant changes to the existing DA program. One of the changes is that the name of the Disability Assistance (DA) cash program will be changed to the Disability Financial Assistance program (DFA). As a result, all of the DA rules contained in Chapter 5101:1-5 of the Administrative Code are contained in this transmittal and are being modified to reflect the name change from DA to DFA. Additional references to the DA program contained in other rules contained in the Cash Assistance Manual will be modified to change the reference from DA to DFA as they come up for review or other policy changes. However, any reference to DA in any of the other rules contained in the Cash Assistance Manual shall be viewed as reference to the DFA program until such time as the rule is modified.

Another major change in the program that is provided in the budget bill is the elimination of the link between the cash and medical assistance provisions contained in the Disability Assistance program. The budget creates two separate programs: the Disability Financial Assistance (DFA) program and the Disability Medical Assistance (DMA) program.

Due to the separation of these programs, this CAMTL contains only changes that affect the DFA cash policy. All DFA rule language referencing DA medical assistance is being removed from the DFA rules. The Office of Health Plans (OHP) has responsibility for the DMA program policy and administration; therefore, the issuance of DMA program policy is being issued by OHP under separate cover for inclusion in the Medicaid Eligibility Manual.

A more detailed description of the major policy changes that are contained in the DFA rules follows.

Chapter 3000

5101:1-5-01 The disability financial assistance program definitions and payment standards

(CCN 5093)

The budget bill contains significant modifications to the categories of individuals who are potentially eligible for DFA. Essentially, the language in the bill provides for the elimination of the following categories of covered individuals, unless they meet the requirements of a DFA covered group:

• children under the age of eighteen;
• individuals who are pregnant; and
• individuals who are aged sixty or older and who apply on or after the effective date of the bill.

Eligibility for DFA as of the effective date of the budget bill is limited to: those individuals for whom a CMS determination finds that the individual is disabled; individuals who are residing in a residential treatment center certified by ODADAS; and, those individuals who on the day before the effective date of the budget bill were sixty years of age or older and one of the following is the case:

(a)the person was receiving or was scheduled to begin receiving financial assistance under Chapter 5115 of the Revised Code on the basis of being sixty years of age or older; or

(b)an eligibility determination was pending regarding the person's application to receive financial assistance under Chapter 5115 of the Revised Code on the basis of being sixty years of age or older and, on or after the effective date of the budget bill, the person receives a determination of eligibility based on that application.

As a result of these statutory modifications to the program, existing rule 5101:1-5-01 is being rescinded and will be replaced by the new rule contained in this CAMTL. Modifications to the family group, assistance group and covered individuals, including the removal of references to the DA medical program, have been made and sections of the rule have been amended to comport with the budget bill language.

Additionally, the rule has been modified to add three more conditions under which an individual is ineligible for DA. Those conditions are:

• the individual, or any of the other individuals included in determining the individual's eligibility, is involved in a strike;
• the individual is ineligible for OWF because the individual does not meet the minor parent living arrangement requirement; and
• the individual is ineligible for OWF because the individual terminated employment without just cause.

An additional modification to this rule was made after clearance. Specifically, language was added at the end of the rule in new paragraph (H) to provide policy regarding the possible suspension of applications to stay within the confines of the appropriated funds for the DFA program. At this time, there are no plans to suspend applications for the DFA program. However, based on the DFA appropriations it is possible that a suspension may have to be instituted in the future. Therefore, we included language in this rule to that effect.

5101:1-5-10 DFA: non-financial eligibility requirements. (CCN 5093)

This rule is being revised to remove all mention of DA medical assistance. DA is being changed to DFA (Disability Financial Assistance).

5101: 1-5-20 DFA: definitions and determinations of disability. (CCN 5093)

This rule is being revised to remove all mention of DA medical assistance. DA is being changed to DFA (Disability Financial Assistance). CDHS is being changed to CDJFS. All mention of ODHS forms are being changed to JFS 0 (form number).

Paragraph (C) (7) (d) has the reference to chapters struck out while adding the 'division level designation 5101:6' for the hearing and appeal rights applicable for the CMS decision.

5101: 1-5-30 DFA: resources. (CCN 5093)

This rule is being revised to remove all references to DA medical assistance. DA is being changed to DFA (Disability Financial Assistance).

As a result of the Farm Bill options adopted for the food stamp program, an administrative decision has been made to exempt the following resources to align with their treatment in food stamps: retirement plans and IDA accounts.

Paragraph (C)(26) retirement plans - The cash value of pension plans or funds, including the funds that remain in the public employees retirement system (PERS) and the other retirement systems and the Ohio public employees deferred compensation program, IRAs, Keogh plans with no contractual obligation with anyone who is not a family group member, and simplified employer pension plans (SEPIRAs), are all exempt as resources.

Paragraph (C)(27) IDA accounts - Individual development accounts (IDAs) regardless of their funding source are exempt as resources.

Currently ORC Section 5115.061 provides that tuition payments, scholarship awards, and payments made by the Ohio tuition trust authority are exempt as resources. These exemptions are being added to this rule for clarity at paragraph (C)(25).

Under the section for countable resources, accrued dividends and interest and retirement plans have been struck out as they are no longer countable resources.

Language has been added to paragraph (E) dealing with the transfer of property, clarifying that the two year transfer language also applies from the most recent redetermination, not just with the date of application, pursuant to section 5115.02 of the Revised Code.

5101:1-5-40 DFA: Income (CCN 5093)

This rule has been modified to change all references from DA to DFA. Also, language has been added to the exempt income paragraph to specifically provide for the exemption of any tuition payment contract entered into under section 3334.09 of the Revised Code or any scholarship awarded under section 3334.18 of the Revised Code, and the amount of Ohio tuition trust authority under section 3334.09 of the Revised Code pursuant to the contract or scholarship, from consideration as income in DFA. Because the language in the Revised Code states that the director shall consider as income any refund paid under section 3334.10 of the Revised Code, language to that effect was also added under the "Unearned income" paragraph of the rule.

The rule is also modified for clarity at paragraph (I) of the rule with respect to the applicability of the provisions requiring the assessment of parental responsibility for eighteen to twenty-two year old DFA applicants. This paragraph has been reorganized to provide a clearer statement of the applicability of the provisions contained within that paragraph. There are no substantive modifications made to this paragraph.

5101:1-5-50 DFA: payments. (CCN 5093)

This rule is being revised to remove all references to DA medical assistance. DA is being changed to DFA (Disability Financial Assistance). CDHS is being changed to CDJFS. All mention of ODHS forms are being changed to JFS 0 (form number).

5101:1-5-60 Supplemental Security Income (SSI) Case Management Program Objective and Structure (CCN 5093)

This rule is being revised to change the name of Ohio Department of Human Services to Ohio Department of Job and Family Services as well as to change the name of County Department of Human Services to County Department of Job and Family Services. Throughout this rule, reference to the Disability Assistance (DA) program will be changed to Disability Financial Assistance (DFA). Paragraph (J)(1)(b)(iii) of this policy is being revised to remove reference to the Third Party Query (TPQY) card for tracking the status of an SSI applicant's claim and replacing the TPQY card with the Electronic State Verification and Exchange System (SVES).

Paragraph (K) has been amended to address the issue of payment of attorney/representative fees in concurrent SSI/SSD claims. In concurrent SSI/SSD claims, the Social Security Administration (SSA) pays the fee for the SSD portion directly to the attorney/representative, up to the current maximum of $5300. If the fee paid on the SSD claim is less than the maximum amount, the attorney/representative fee can be approved out of the Interim Assistance Reimbursement, up to the amount authorized in paragraph (L), not to exceed the SSA maximum amount.

The "Application for Release of Interim Assistance Reimbursement to Attorney/Representative of an SSI Applicant," JFS 07365 has been revised to require the attorney/representative to forward a copy of each notice with the application for release so that appropriate SSI reimbursement may be determined by the county department.

5101:1-5-70 DFA: Interim Assistance (CCN 5093)

This rule is being modified to remove references to the DA program and to replace them with DFA. There are no significant or substantive policy changes made to this rule.

TECHNICAL CHANGES

The Outline of Contents to Chapter 3000 has been modified to reflect the program name changes in the rules from DA to DFA.

CRIS-E: PROCESSING CHANGES IN DA CASH ELIGIBILITY

The CRIS-E system is being modified to support the changes in the DFA program policy. The specific CRIS-E actions and activities are outlined in detail in the CRIS-E View Flash Bulletin titled "Legislative changes to the DA program ". A description of the systems changes follows.

CRIS-E Mass Change: Current recipients

A mass change will be run over the weekend of July 4, 2003 to terminate or reduce DA cash AGs that contain a pregnant woman or a child(ren) under the age of 18. If the individual is either pregnant or a child under the age of 18, the mass change program will explore if the recipient meets one of the following covered categories, prior to terminating or reducing the DA cash assistance:

• the individual is age 60 or older; or
• the individual is a resident of an ODADAS-certified residential treatment facility; or
• the individual has been determined to be disabled by CMS.

Reason Code 525 will used by mass change and will be displayed on AEWAA for the termination or reduction of the DA cash assistance. Special mass change notices (MC50T1 and MC50R1) will be sent to affected AGs notifying them of the termination or reduction of DA cash assistance benefits. The terminations and reductions will be effective 7/31/03. The provisions set forth in Chapter 5101:6 of the Administrative Code regarding timely requests for state hearings, and including continued benefits based on such requests are applicable.

Recalculation of food stamp benefits

Recalculation of food stamp benefits for related Food Stamp AGs will not occur in the mass change. Instead, mass change alert 372 -RE RUN AEABC/AEONG will be generated by mass change if there will be a food stamp allotment change as a result of the termination or reduction action.

New Applicants

Applications Submitted on or after July 1, 2003

Applications submitted on or after July 1, 2003 shall be processed in accordance with the DFA rules in effect as of July 1, 2003. Therefore, in order to qualify for DFA based on an application submitted on or after July 1, 2003, an individual must be determined to be disabled by CMS or must be residing in a drug or alcohol treatment facility certified by ODADAS. If an individual does not meet either of these categories, the individual is ineligible for DFA, and CRIS-E will fail the individual. Reason code 525 is the appropriate code to use to deny the application.

Applications Submitted Prior to July 1, 2003 and Still Pending as of July 1, 2003

Applications submitted prior to July 1, 2003 and still pending as of July 1, 2003, must be processed using the DA rules in effect through June 30, 2003 for eligibility periods prior to and including June 30, 2003. Eligibility for DFA benefits for the period beginning July 1, 2003 must be determined using the DFA rules in effect as of July 1. This means that, an individual can meet all eligibility requirements for the period up to and including June 30, and will be eligible for DA cash benefits for the prior period, but not meet the July 1, 2003 eligibility requirements for DFA cash assistance. In this case, CRIS-E will fail the AG effective July 1, 2003, but pass the AG for the prior period and issue a retroactive benefit for prior months as appropriate.

Applications Submitted and Approved Prior to July 1, 2003

Applications submitted prior to July 1, 2003 and approved prior to July 1, 2003 based upon pregnancy or under the age of 18, will be terminated during the mass change process.

Online system changes will be in CRIS-E for July 1, 2003 processing of cases.

Table Changes

TBCD-This table has been modified to reflect the new program names - Disability Financial Assistance and Disability Medical Assistance. All notices will reflect the new names.

TSRC-Numerous changes have been made to reason codes to support the DFA changes. Reason codes 023, 488, 489, 490 and 530 have been inactivated for DFA. Language on reason code 525 has been modified to reflect the current categories of eligibility for DFA.

TLPF

A new code 'CD' has been added to support the separation of the DFA and DMA programs, since eligibility for DMA is no automatic with receipt of DFA. In addition, the 'CK' B/D VR code on AEIDP will continue to PEND the DFA while a CMS decision is pending. This is a correction to the system.

INSTRUCTIONS: