State Hearing Decision - Hearing Decisions

STATE HEARING DECISION CONTINUATION
6. The Appellant’s mother (mother) argued that the Appellant had been approved by Warren
County BODD and papers were signed on July 20, 2011.
7. Mother reported in August 2011 the Appellant was moving to Clark County.
8. Warren BODD testified the state DODD must approve the IO waiver and the papers were
never sent to the state DODD because the Appellant moved out of the county.
9. Warren BODD testified the IO waiver process was stopped once they were notified the
Appellant was moving.
10. Warren BODD testified the Individualized Service Plan (ISP) that was sent to the Appellant
was a draft and not a finalized plan.
11. The Level One waiver eligibility was transferred from Warren BODD to Clark BODD.
CONCLUSIONS OF POLICY
Policy
The Individual Options (IO) Waiver is a Medicaid waiver program administered by the Ohio
Department of Developmental Disabilities (Ohio DODD) through the local county boards of DD.
ODJFS entered into a contract with Ohio DODD to allow Ohio DODD to administer the waiver
on behalf of ODJFS, the single state Medicaid Agency. Ohio Rev. Code § 5111.871 (2009)
The individual options waiver program provides necessary waiver services to individuals who
meet the level of care criteria for an intermediate care facility for individuals with mental
retardation and other developmental disabilities (ICF/MR) as set forth in rule 5101:3-3-07 of the
Administrative Code, as well as other eligibility requirements established by rule. Ohio Admin.
Code § 5101:3-40-01 (2008)
Ohio Revised Code 5126.055 (A) states a county board of developmental disabilities has
Medicaid local administrative authority to, and shall, do all of the following for an individual
with mental retardation or other developmental disability who resides in the county that the
county board serves (emphasis added) and seeks or receives home and community-based
services.
Ohio Administrative Code §5123-2-9-01 (E) states for each separate HCBS waiver, the
department (Ohio Department of Developmental Disabilities) may authorize enrollment by
allocating to county boards enrollment numbers. Paragraph( G)(1) states individuals determined
eligible for waiver services shall receive written notice from the department and waiver services
may be initiated on the date indicated by the department. The department shall also notify the
county board.
Analysis
The record developed at the hearing supports the Warren County BODD’s position that the
Appellant was in the approval process for placement on the IO waiver when she moved from
Warren County to Clark County. Enrollment in the IO waiver is dependent upon the waiting list
in the county in which the individual lives. In this case the Appellant was living in Warren
County at the time she was notified that a slot was available. Although an ISP was developed by
Warren BODD, an ISP is not an approval of the IO waiver. The approval of the waiver must be
issued by the Ohio Department of Developmental Disabilities. In this case, the ODODD did not
complete a final approval of the IO waiver prior to the mother signing the withdrawal/exit report.
The Appellant’s mother/guardian signed a withdrawal/exit report on September 8, 2011 because
the Appellant moved to Clark County. The withdrawal/exit report stopped the approval process
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