(A)To be eligible
for the adoption assistance connections (AAC) to age twenty-one, an adopted
young adult was adopted at age sixteen or seventeen and
was in the permanent custody of an Ohio public children services agency (PCSA)
and the child attained the age of sixteen before the adoption assistance
agreement became effective. The adopted young adult must meet one of the
following requirements is to meet the following
requirements:
(1)Was adopted at age sixteen or
seventeen;
(2)Was in the permanent custody of an Ohio
public children services agency (PCSA);
(3)Attained the age of sixteen before the
JFS 01453 "Adoption Assistance (AA) Agreement" became effective;
(4)Meets one of the following
requirements:
(1)(a) Is completing secondary education or a
program leading to an equivalent credential.;
(2)(b) Is enrolled in an institution that provides
post-secondary or vocational education.;
(3)(c) Is participating in a program or activity
designed to promote or remove barriers to employment.;
(4)(d) Is employed for at least eighty hours per
month.; or
(5)(e) Is incapable of doing any of the activities
described in paragraphs (A)(1) to (A)(4)(a) to (A)(4)(d) of this rule due to a diagnosed
physical or mental health condition, which incapacity is supported by updated
information semi-annually.
(5)Has reached the age of eighteen but is
not yet twenty-one years of age;
(6)Is continuing to receive parental
support;
(7)Is not enlisted in the military;
(8)Is not married; and
(9)Is not in receipt of adoption
assistance past age eighteen pursuant to rule 5101:2-49-04 of the
Administrative Code.
(B)The adoptive
parent(s) may apply for AAC if the adopted young adult has attained the age of
eighteen and meets the following requirements:
(1)The adopted
young adult meets one of the requirements in
paragraph (A) of this rule.; and
(2)The adoptive
parent(s) must maintain maintains
parental responsibility for the adopted young adult. An adoptive
parent(s) maintains parental responsibility if the adoptive parent(s) provides
the adopted young adult with shelter, food, and clothing, or other support
regardless of the physical location of the adopted young adult.
(C)The adoptive
parent(s) shall submit the JFS 00147 "Adoption Assistance Connections to
Age Twenty-One Application" (12/2017), and documentation that
the adopted young adult meets one of the eligibility requirements outlined in
paragraph (A)(4) of this rule, a copy of the signed JFS 01453 "Adoption Assistance
(AA) Agreement" with the PCSA, and documentation of parental
responsibility to the AAC representativeODJFS.
(D)The AAC representativeODJFS,
within thirty calendar days after a completed JFS 00147 and all necessary
documentation is received, shall determine eligibility in the statewide
automated child welfare information system (SACWIS) and approve or deny the AAC application within thirty
calendar days after a completed application and all required documentation is
provided.
(E)ODJFS, as the Title IV-E agency, is to
obtain documentation verifying completion of all completed adoptive parent
criminal record checks obtained by the PCSA prior to adoption finalization
pursuant to rule 5101:2-48-10 of the Administrative Code.
(F)If ODJFS determines an adopted young
adult is eligible for AAC, ODJFS is to provide the adoptive parent(s) with the
following:
(1)The adoption assistance connections to
age twenty-one (AAC) notice of eligibility approval form; and
(2)The JFS 04059 "Explanation of
State Hearing Procedures."
(E)(G) If an adopted young
adult is eligible,Upon determination of
eligibility, ODJFS will send the JFS 00148 "Adoption Assistance
Connections to Age Twenty-One Agreement" (12/2017) to the adoptive parent(s) for signature. The AAC agreement is
effective on the date it is signed by both the adoptive parent(s) and the AAC representative. ODJFS,
unless a later date is indicated for the subsidy to begin as designated on the
AAC agreement form "Article IX Effective Date," which will then
become the effective date of the AAC agreement.
(F)(H) The AAC agreement is binding on all parties.
The terms of the AAC agreement may be amended at any time if both parties agree
to the change.
(G)(I) The AAC agreement shall remain in effect
regardless of the state where the adoptive parent(s) or
the adopted young adult resides unless the AAC agreement is terminated.
(H)(J) The AAC representativeODJFS shall give a copy of the signed AAC agreement and
all amendments to the adoptive parent(s) and keep the originals in the AAC case
record.
(I)(K) The AAC representativeODJFS, as the agency that entered into the AAC
agreement, shall secure Title XIX medicaid and
Title XX social services block grant services if the services are not available
in the state or county where the adopted young adult resides in accordance with
rule 5101:2-51-01 of the Administrative Code.
(J)(L) Nothing shall prohibit the adoptive family
from seeking Title XX services available in the county of residence even if
they are not specified in the AAC agreement. The adoptive parent(s) may:
(1)Apply for the
Title XX services in the county where they reside; and
(2)Request to
amend the AAC agreement.
(K)(M) If the AAC
representativeODJFS determines an adopted
young adult is ineligible for AACdoes not meet eligibility requirements outlined in paragraphs
(A) and (B) of this rule, the AAC representativeODJFS shall provide the adoptive parent(s) with the
following:
(1)The JFS 07334
"Notice of Denial of your Application for Assistance." (rev. 9/2011).
(2)The JFS 04059 "Explanation of State Hearing Procedures" (rev.
01/2015).
(N)Semiannual redetermination is to be
completed every one hundred eighty calendar days to maintain program
eligibility for AAC. The semiannual redetermination date is determined by the
initial AAC effective date.
(O)No later than thirty calendar days
prior to the semiannual redetermination due date, ODJFS is to provide the
adoptive parent(s) with the following:
(1)The adoption assistance connections
(AAC) to age twenty-one notice of redetermination;
(2)The JFS 00149 "Title IV-E Adoption
Assistance Connections to Age Twenty-One Semi-Annual Assurance of Parental
Responsibility and Eligibility for Continued Medicaid Coverage"; and
(3)The JFS 00150 "Title IV-E Adoption
Assistance Connections to Age Twenty-One Adopted Young Adult Semi-Annual
Assurance of Parental Responsibility and Eligibility for Continued Medicaid
Coverage."
(P)Completed JFS 00149 and JFS 00150
forms, documentation that the adopted young adult meets one of the eligibility
requirements outlined in paragraph (A)(4) of this rule, and documentation of
parental responsibility is to be received prior to the semiannual
redetermination due date. Upon receipt of the required forms and documentation
listed in this paragraph, ODJFS will check for continued eligibility as
follows:
(1)If redetermined as eligible, ODJFS is
to provide the adoptive parent(s) with the following:
(a)The adoption assistance connections to
age twenty-one (AAC) notice of continued approval form; and
(b)The JFS 04059.
(2)If redetermined as ineligible, or if
documentation is not received by the redetermination due date, ODJFS is to
provide the adoptive parent(s) with written notice of the proposal to terminate
AAC and the right to a state hearing. ODJFS is to provide the adoptive
parent(s) with the following thirty calendar days prior to the termination
date:
(a)The adoption assistance connections to
age twenty-one (AAC) notice of termination form; and
(b)The JFS 4059.
(3)If sufficient documentation to support
eligibility is received by ODJFS from the adoptive parent(s) and/or adopted
young adult prior to the termination date, ODJFS may proceed with semiannual
redetermination of continued eligibility for AAC.
(Q)The adoptive parent(s) and the adopted
young adult are to submit the JFS 00149 and JFS 00150 semiannually and whenever
there is a significant change in the family situation for continued
eligibility.
(R)At any time a JFS 00148 is in effect,
the JFS 00148 may be amended.
(1)The adoptive parent(s) and ODJFS may by
mutual agreement amend the JFS 00148 to reflect changes for payment amount or
provision of services. Upon agreement, the following is to occur:
(a)ODJFS and the adoptive parent(s) are to
sign the amended AAC agreement;
(b)ODJFS is to provide a copy of the
amended AAC agreement to the adoptive parent(s) and retain the original in the
case record; and
(c)ODJFS is to provide the adoptive
parent(s) with the JFS 04059.
(2)If the adoptive parent(s) and ODJFS
cannot agree on the amendment requested by the adoptive parent(s) or ODJFS, the
following is to occur:
(a)ODJFS and the adoptive parent(s) may
complete a JFS 00148 for a mutually acceptable AAC agreement while negotiations
continue through the state mediation process, or the adoptive parent(s) request
a state hearing; or
(b)ODJFS is to provide the adoptive
parent(s) with a JFS 07334, and a JFS 04059.
(S)The adoptive parent(s) is to notify
ODJFS within fifteen calendar days of the date of any of the following:
(1)The adopted young adult's primary
health care insurance coverage changes from medicaid to private health care
insurance. The adoptive parent(s) is to complete an ODM 06612 "Health
Insurance Information Sheet" as a result of this change.
(2)The family relocates.
(3)The adopted young adult enlists in the
military.
(4)The adopted young adult has married.
(5)The adoptive parent(s) no longer has
parental responsibility for the adopted young adult.
(6)The adopted young adult is no longer
eligible pursuant to paragraphs (A) and (B) of this rule.
(T)The AAC agreement will terminate when
any of the following circumstances apply:
(1)At the end of the month of the adopted
young adult's twenty-first birthday.
(2)If the adoptive parent(s) no longer has
parental responsibility for the adopted young adult as defined in paragraph
(B)(2) of this rule.
(3)If the adoptive parent(s) requests to
terminate the AAC agreement.
(4)If the adoptive parent(s) dies.
(5)If the adopted young adult dies.
(6)If the adopted young adult marries.
(7)If the adopted young adult enlists in
the military.
(L)(U) If the AAC
representativeODJFS will proposespropose to
terminate the AAC agreement, the AAC representative
shall provide the adoptive parent(s) with a written notice of the proposal and
the right to a state hearing thirty calendar days prior to the termination date
under any of the following circumstances:
(1)The AAC representativeODJFS
denies eligibility for AAC at semiannual redetermination.
(2)The AAC representativeODJFS
denies the amount of monthly payment requested by the adoptive parent(s) in the AAC agreement.
(3)The AAC representativeODJFS
and the adoptive parent(s) are unable to come to a mutual agreement following a
state mediation conference.
(4)The AAC representative ODJFS proposes
to reduce or terminate the amount of the payment specified on the current AAC
agreement.
(5)The AAC representativeODJFS
denies a request by the adoptive parent(s) to amend the
payment amount or provision of service terms of the current AAC
agreement.
(V)If ODJFS proposes to terminate the AAC
agreement due to any of the circumstances listed in paragraph (S) of this rule,
ODJFS is to provide the following to the adoptive parent(s) thirty calendar
days prior to the termination date:
(1)The adoption assistance connections to
age twenty-one (AAC) notice of termination form; and
(2)The JFS 04059.
(M)The AAC representative shall provide
written notification to the adoptive parent(s) if any of the following occur:
(1)A determination to deny AAC
eligibility.
(2)A denial for a request to increase the
amount of the monthly payment.
(3)A denial for a request by the adoptive
parent(s) to amend the terms of the current AAC agreement.
(4)The AAC representative and the adoptive
parent(s) are unable to come to a mutual agreement following a state mediation
conference.
(5)A reduction or termination of the
monthly payment.
(N)The AAC representative shall inform the
adoptive parent(s) of all decisions to deny or approve AAC and include a copy
of the JFS 04059.
(O)The AAC representative shall provide
the adoptive parent(s) with the JFS 00149 "Adoption Assistance Connections
to Twenty-One Semi-Annual Assurance of Parental Responsibility, School
Attendance and Eligibility for Continued Medicaid Coverage" (12/2017) and
adopted young adult with JFS 00150 "Adoption Assistance Connections to
Twenty-One Adopted Young Adult Semi-Annual Assurance of Parental
Responsibility, School Attendance and Eligibility for Continued Medicaid
Coverage" (12/2017). The adoptive parent(s) and the adopted young adult
shall submit the JFS 00149 and JFS 00150 semi-annually or whenever there is a
significant change in the family situation for continued eligibility.
(1)If the documentation is received within
thirty calendar days of the mailing date of the JFS 00149 and the JFS 00150 the
AAC representative will check for continued eligibility.
(a)If eligible, the AAC representative
will send a notice of eligibility.
(b)If determined ineligible, the AAC will
send a notice of termination.
(2)If documentation is not received within
thirty calendar days of the mailing date of the JFS 00149, the AAC
representative will send a notice of termination as specified in paragraph (T)
of this rule.
(P)For an adopted young adult who has an
AAC agreement, the AAC representative shall assure that the case record
contains documentation of one of the circumstances described in paragraphs
(A)(1) to (A)(5) of this rule.
(Q)The adoptive parent(s) shall notify the
AAC representative within fifteen calendar days of the date of any of the
following:
(1)The adopted young adult’s primary
health care insurance coverage changes from medicaid to private health care
insurance. The adoptive parent(s) shall complete an ODM 06612 "Health
Insurance Information Sheet" (rev. 9/2016) as a result of this change.
(2)The family relocates.
(3)The adopted young adult enlisted in the
military service.
(4)The adopted young adult has married.
(5)The adoptive parent(s) no longer has
parental responsibility for the adopted young adult.
(6)The adopted young adult is no longer
eligible pursuant to paragraphs (A) and (B) of this rule.
(R)If the adopted young adult meets the
requirements described in paragraphs (Q)(3) to (Q)(6) of this rule, the AAC
representative shall terminate the AAC agreement.
(S)The AAC agreement shall terminate when
any of the following circumstances apply:
(1)At the end of the month of the adopted
young adult’s twenty-first birthday.
(2)If the adoptive parent(s) no longer has
parental responsibility for the adopted young adult as defined in paragraph (B)
of this rule.
(3)If the adoptive parent(s) requests to
terminate the AAC agreement.
(4)If the adoptive parent(s) dies.
(5)If the adopted young adult dies.
(T)(W) If the AAC
representativeODJFS proposes to terminate
the AAC agreement, and the adoptive parent(s) has requested a state hearing,
the following shall apply:
(1)If a state
hearing is requested within fifteen calendar days of the mailing date on the
notice in accordance with provisions set forth in Chapters 5101:6-1 to 5101:6-9
of the Administrative Code, the AAC agreement shall continue to be in effect
until a state hearing decision is issued.
(2)If a state
hearing is requested within fifteen calendar days of the mailing date on the
notice and the hearing decision is favorable to the adoptive parent(s), the AAC
agreement shall remain in effect or an amended AAC agreement may be entered
into by mutual agreement.
(3)If a state hearing
is requested within fifteen calendar days of the mailing date on the notice and
the hearing decision is to terminate the AAC agreement as specified in
paragraph (O) of this rule, the adoptive parent(s) is not required to return
the payments received prior to the issuance of the state hearing decision.
(4)If no timely
hearing is requested, the AAC agreement shall be terminated. Following the
termination, the adoptive parent(s) may reapply for the AAC at any time prior
to the adopted young adult attaining the age of twenty-one.
(U)(X) If the AAC representative
determines the AAC agreement should beis terminated, the AAC
representativeODJFS shall: complete the ODM 01958
"Referral for Medicaid Continuing Eligibility Review" (rev. 7/2014)
pursuant to rule 5160:1-2-01.2 of the Administrative Code and send the ODM
07236 "Your Rights & Responsibilities as a Consumer of Medicaid Health
Coverage" (rev. 7/2014) to the adoptive parent(s).
(1)Send the adoption assistance
connections to age twenty-one (AAC) notice of termination form to the adoptive
parent(s); and
(2)Send the ODM 07236 "Your Rights
& Responsibilities as a Consumer of Medicaid Health Coverage" to the
adoptive parent(s).
Effective: 2/1/2020
Five Year Review (FYR) Dates: 1/10/2023
Certification: CERTIFIED ELECTRONICALLY
Date: 12/30/2019
Promulgated Under: 119.03
Statutory Authority: 5101.1414
Rule Amplifies: 5101.1411, 5101.1412, 5101.1413, 5101.1414
Prior Effective Dates: 01/10/2018