(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