(A)The Ohio
department of job and family services (ODJFS) issues two separate IM
allocations to the county department of job and family services (CDJFS) to meet
federal matching fund requirements:
(1)An allocation
for administrative expenditures incurred in the administration of supplemental
nutrition assistance program (SNAP); and
(2)An allocation
for administrative expenditures incurred in the administration of the medical
assistance (MA) program and the state children's health insurance program
(SCHIP) issued on behalf of the Ohio department of medicaid.
(B)The funding for
each IM allocation consists of one hundred per cent state funds, and is in
addition to the county mandated share required by section 5101.16 of the
Revised Code and detailed in rule 5101:9-6-31 of the Administrative Code.
Federal funds are passed through to the CDJFS as follows:
(1)Federal SNAP
administration funding is passed through to the CDJFS at the current federal financial participation (FFP) rate of fifty per cent.
(2)Federal MA
administrative expenses are passed through to the CDJFS at the current FFP rate of fifty per
cent or seventy-five per cent as described in
this paragraphfollows:
(a)Federal MA
administrative expenses passed through at the current FFP
rate of fifty per cent include activities which
precede the eligibility determination and activities subsequent to the
eligibility determination such as:
(i)Outreach and
marketing, including general public outreach and beneficiary education and
outreach, explanations of eligibility policies, program and benefits, plan
choice counseling, and plan enrollment.
(ii)Policy
development and research, including items related to eligibility determination
standards and methodologies.
(iii)Training on
eligibility rules, other staff development, and training for end users within
the system who are not making eligibility determinations.
(iv)Community-based
application assistance such as assisting with application completion and
navigation, etc.
(v)Program
integrity, including audits and investigations, and any other quality assurance
activities.
(vi)Formal appeals
of eligibility decisions, including accepting and processing appeals and
hearings, and decision if rendered by the state.
(vii) Customer
service, including call center activities and out-stationed eligibility worker
activities related to beneficiary education, benefits, plan choice, enrollment
and civil rights complaints; and
(viii) Postage,
including mailing of any medicaid related documents for any reason.
(b)Federal MA administration
expenses passed through at the current FFP rate of seventy-five per cent include activities within and
related to support for the eligibility determination information technology
system, Ohio benefits (OB), such as:
(i)Intake
including activities related to receipt of the application or data related
applications.
(ii)Acceptance
including manual and automated edits and verification of data.
(iii)Eligibility
determination including activities related to assisting the automated
eligibility determination system in the evaluation of the edited, verified data
to make an eligibility determination.
(iv)Outputs
including the issuance of the eligibility notice to the beneficiary, file
updates and all activities related to notification to partners of the decision.
Mailing of notices are eligible at the fifty per cent rate.
(v)On-going case
maintenance including receipt of data related to the ongoing eligibility and
maintenance of a beneficiary's eligibility, such as annual renewals, address
changes, income changes, household composition changes, etc. and the related
steps as described in paragraphs (B)(2)(b)(i) to (B)(2)(b)(iv) of this rule.
(vi)Customer
service including call center activities related to the receipt of data
required for an initial eligibility determination and the on-going eligibility
and maintenance of a beneficiary's eligibility, but not verification activities
as defined in paragraph (B)(2)(b)(ii) of this rule. Activities of call center
staff are eligible at the seventy-five percent rate only for activities related
to eligibility determination or on-going case maintenance.
(vii) Costs of outstationed eligibility workers
including entering eligibility application data also would be eligible for
seventy-five per cent FFP. Costs of workers conducting consumer assistance
would only be eligible for fifty per cent FFP.
(viii)(vii)System maintenance and routine system
updates including routine system maintenance, security updates and other
routine maintenance activities related to the eligibility determination system:
and
(ix)(viii)System training for the operation of
the eligibility system, including workers processing claims or determining
eligibility.
(3)Federal SCHIP
funding is passed through to the CDJFS at the current Affordable
Care Act's (ACA) enhanced federal MAmedical assistance
percentages (FMAP).
(C)ODJFS will
communicate the funding and liquidation periods for these allocations through
the county finance information system (CFIS). The CDJFS shall expend funds by
the end of the funding period and disburse and report expenditures no later
than the end of the liquidation period.
(D)ODJFS uses the
following methodology to distribute available IM funds for all allocations.
ODJFS allocates:
(1)Thirty per cent
of the statewide allocations based on each county's population less than one
hundred per cent of the federal poverty level utilizing the most recent
calendar year (CY) data from the U.S. bureau of census.
(2)Thirty per cent
of the statewide allocations based on each county's population less than two
hundred per cent of the federal poverty level utilizing the most recently
available CY data from the U.S. bureau of census.
(3)Thirty per cent
of the statewide allocations based on each county's "adjusted
recipients." The number of adjusted recipients is equal to the total of
the categories of non-public assistance SNAP recipients, disability financial
assistance (DFA) recipients and disability medical assistance (DMA) recipients,
adult medicaid recipients, healthy start recipients, SCHIP recipients,
TANF-related medicaid recipients, and TANF recipients.
(4)Five per cent
of the statewide allocations based upon the county's average unemployment rate
as compared statewide in the same category, utilizing the most recently
available report month.
(5)Five per cent
of the statewide allocations based upon the county's poverty rate. A county's
poverty rate is identified as the percentage of the county's population living
at or below the federal poverty level.
(E)Upon completion
of the steps in paragraph (D) of this rule, the ODJFS utilizes a 0.30 per cent
adjusting factor to increase or decrease the funding based upon the county
difference to the statewide average per capita income.
(F)ODJFS caps the
formula-calculated allocation amounts at a four per cent increase and decrease
from the previous SFY. If a decrease or increase in the statewide amount
results in counties' allocations fluctuating more than four per cent, ODJFS
will not apply the formula, but will decrease or increase each county's
previous state fiscal year (SFY) allocation by the percentage of change to the
statewide amount.
(G)The CDJFS may
code the following expenditures against this funding.
(1)Nonfederal
share of SNAP administration as contained in division 5101:4 of the
Administrative Code may be coded at fifty per cent of
the total expended amountto the IM allocation for
the total SNAP expenditures less the current FFP rate including excess
SNAP employment and training expenditures as detailed in rule 5101:9-6-09.3 of
the Administrative Code;
(2)Nonfederal
share of MA may be coded against the IM allocation at
fifty per cent of the total expended amountfor
the total MA expenditures less the current FFP rate. NonfederalThe nonfederal
share activities of MA
includesinclude:
(a)Federal MA administrative expense
activities which precede the eligibility determination and activities
subsequent to the eligibility determination such as:
(i)Outreach and marketing, including
general public outreach and beneficiary education and outreach, explanations of
eligibility policies, program and benefits, plan choice counseling, and plan
enrollment.
(ii)Policy development and research,
including items related to eligibility determination standards and
methodologies.
(iii)Training on eligibility rules, other
staff development, and training for end users within the system who are not
making eligibility determinations.
(iv)Community-based application assistance
such as assisting with application completion and navigation, etc.
(v)Program integrity, including audits and
investigations, and any other quality assurance activities.
(vi)Formal appeals of eligibility decisions,
including accepting and processing appeals and hearings, and decision if
rendered by the state.
(vii) Customer service, including call center
activities and out-stationed eligibility worker activities related to
beneficiary education, benefits, plan choice, enrollment and civil rights
complaints; and
(viii) Postage, including mailing of any medicaid
related documents for any reason.
(b)Federal MA administrative expense
activities which precede the eligibility determination and activities
subsequent to the eligibility determination such as:
(i)Intake including activities related to
receipt of the application or data related applications.
(ii)Acceptance including manual and
automated edits and verification of data.
(iii)Eligibility determination including
activities related to assisting the automated eligibility determination system
in the evaluation of the edited, verified data.
(iv)Outputs including the issuance of the
eligibility notice to the beneficiary, file updates and all activities related
to notification to partners of the decision. Mailing of notices are eligible at
the fifty per cent rate.
(v)On-going case maintenance including
receipt of data related to the ongoing eligibility and maintenance of a
beneficiary's eligibility, such as annual renewals, address changes, income
changes, household composition changes, etc. and the related steps as described
in paragraphs (B)(2)(b)(i) to (B)(2)(b)(iv) of this rule.
(vi)Customer service including call center
activities related to the receipt of data required for an initial eligibility
determination and the on-going eligibility and maintenance of a beneficiary's
eligibility, but not verification activities as defined in paragraph
(B)(2)(b)(ii) of this rule. Activities of call center staff are eligible at the
seventy-five per cent rate only for activities related to eligibility
determination or on-going case maintenance.
(vii) System maintenance and routine system
updates including routine system maintenance, security updates and other
routine maintenance activities related to the eligibility determination system;
and
(viii) System training for the operation of the
eligibility system, including workers processing claims or determining
eligibility.
(a)(c) Non-emergency transportation (NET)
administration as contained in rule 5160-15-13 of the Administrative Code;
(b)(d) Managed health care program (MHCP) as
contained in Chapter 5160-26rule 5160-26-01 of the Administrative Code;
(c)(e) Supplemental security income (SSI)
administration as contained in rule 5101:1-1-01 of the Administrative Code; and
(d)(f) Pregnancy related services and
transportation (PRST) administration as contained in rules 5160-21-04 and
5160-15-13 of the Administrative Code;
(e)(g) Healthchek administration as contained in rule
5160-1-14 of the Administrative Code;
(f)(h) Mental health and developmental disabilities
administration.
(3)Nonfederal share of enhanced MA may be
coded against the IM allocation at twenty-five per cent in accordance with rule
5101:9-6-05.1 of the Administrative Code.
(4)(3) Nonfederal share of SCHIP may be coded against
the IM allocation based on the ACA's enhanced federal MA
percentagescurrent FMAP.
(5)(4) In the event that a CDJFS's IM allocations are
exhausted prior to the end of the SFY, the CDJFS shall be required to provide
local nonfederal funds to be used as MA, SCHIP and FA match.
(H)A CDJFS may
request to move funding between the IM SNAP allocation and the IM MA
allocation. The CDJFS shall use the budget request function in CFIS to request
the transfer of funding no later than the last day of the liquidation period.
(I)The CDJFS may
provide all or a portion of its IM allocations to the child support enforcement
agency (CSEA) for use in meeting matching fund requirements for the Title IV-D
program or to reimburse the county for administrative expenditures incurred in
the administration of the child support program.
(1)If the amount
includes any portion of the IM MA allocation, a CDJFS shall use the budget
request function as outlined in paragraph (H) of this rule to request a
transfer of the IM MA amount to the IM DFA/FA allocation.
(2)The CDJFS will
submit draw requests and report the transferred amount as expenditures using
codes established in CFIS for this purpose.
(3)The CSEA will
report receipt of the transferred amount using codes established in CFIS for
this purpose.
(J)A CDJFS and
CSEA shall report expenditures as described in rule 5101:9-7-29 of the
Administrative Code.
(K)The
definitions, requirements, and responsibilities contained in rule 5101:9-6-50
of the Administrative Code are applicable to this rule.
Effective: 6/14/2021
Certification: CERTIFIED ELECTRONICALLY
Date: 06/03/2021
Promulgated Under: 111.15
Statutory Authority: 5101.02
Rule Amplifies: 5101.54, 5162.03
Prior Effective Dates: 06/02/1979, 07/01/1980, 08/24/1981,
07/01/1983, 01/07/1985 (Emer.), 09/29/1985, 10/01/1985 (Emer.), 12/22/1985,
01/02/1986, 07/01/1987, 09/11/1987, 10/06/1987 (Emer.), 12/24/1987, 01/26/1988
(Emer.), 04/28/1988, 01/07/1989, 11/23/1991, 02/22/1993, 08/30/1997,
01/26/1998, 07/02/2002 (Emer.), 09/28/2002, 02/20/2004, 02/05/2006, 10/24/2008,
07/20/2009, 12/18/2009, 01/09/2011, 10/15/2011, 07/05/2013, 01/20/2015,
07/01/2016, 03/18/2019, 08/03/2019