Ohio Admin. Code 5101:9-6-05 - Income maintenance (IM) allocations
(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 paragraph
follows :
(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:
(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.
(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.
(3) Federal SCHIP funding is passed through
to the CDJFS at the current Affordable Care Act's
(ACA) enhanced federal MA
medical 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.
(4)
(3) Nonfederal share of SCHIP may be coded against the
IM allocation based on the ACA's enhanced federal MA
percentages
current 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.
(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 amount
to 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 amount
for the total MA
expenditures less the current FFP rate . Nonfederal
The
nonfederal share activities
of MA includes
include :
(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
5160-26
rule
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;
(f)
(h) Mental health and
developmental disabilities administration.
(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.
(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.
(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.
Notes
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
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