Management and Administration
5101:2-46-10 Case record requirements for Title IV-E kinship guardianship assistance program (KGAP)
FCASMTL 508
Effective Date: January 1, 2023

(A)Ohio department of job and family services (ODJFS) is to maintain a KGAP case record that is available upon request.

(B)The case record is to contain documentation which supports the public children services agency (PCSA) actions in determining eligibility for KGAP. The case record is to include the following information, when applicable:

(1)A copy of the signed JFS 00131 "Title IV-E Kinship Guardianship Assistance Program (KGAP) Application for Initial Eligibility," even if the kinship caregiver(s) declines.

(2)A copy of the signed JFS 00133 "Title IV-E Kinship Guardianship Assistance Program (KGAP) Agreement."

(3)A copy of the KGAP eligibility determination in the Ohio statewide automated child welfare information system (SACWIS).

(4)A copy of each signed JFS 00136 "Title IV-E Kinship Guardianship Assistance Program (KGAP) Annual Assurance of Legal Responsibility, School Attendance and Eligibility for Continued Medicaid Coverage."

(5)A copy of the ODM 06612 "Health Insurance Information Sheet," as completed by the kinship caregiver(s).

(6)A copy of the ODM 06613 "Accident/Injury Insurance Information," as completed by the kinship caregiver(s).

(7)A copy of the ODM 03528 "Healthchek and Pregnancy Related Services information Sheet," as applicable.

(8)A copy of the journalized court order granting the kinship caregiver(s) legal custody/guardianship.

(9)A copy of the documentation evidencing repayment of any identified KGAP overpayment.

(10)A copy of all state hearing, administrative appeal, and judicial review documentation.

(11)A copy of the interstate compact and KGAP medical assistance forms.

(C)For applications received from a kinship caregiver(s) who resides out of state, the case record is to include a copy of forms which contain, at a minimum, the information required by the JFS 00131 "Title IV-E Kinship Guardianship Assistance Program (KGAP) Application for Initial Eligibility."

Effective: 1/1/2023

Five Year Review (FYR) Dates: 01/01/2028

Certification: CERTIFIED ELECTRONICALLY

Date: 10/11/2022

Promulgated Under: 119.03

Statutory Authority: 5153.163, 5101.1417

Rule Amplifies: 5153.163, 5153.16