Ohio Administrative Code

19.03 PDF: (A) If the agency determines that a loss of SNAP benefits has occurred and that the assistance group is or may be entitled to restoration of those benefits, the assistance group will be provided prompt written notice of the agency's determination.The notice will contai…

19.03 PDF: When the agency approves, denies, or delays an assistance group's request for replacement SNAP benefits, the assistance group will be provided written notice of the action.(A) The notice will be mailed or personally delivered no less than ten days from the date the los…

19.03 PDF: (A) The JFS 04022 "Notice of Medical Determination and a Right to a State Hearing," or an Ohio department of medicaid (ODM) approved equivalent will be mailed or personally delivered to the individual and authorized representative in the following situations:(1) When, …

19.03 PDF: When a request for prior authorization for a medical or dental service is denied, the individual and authorized representative will be provided prompt written notice of the decision. Copies will also be sent to the provider and to the local agency.(A) The notice will c…

19.03 PDF: (A) Notice of adverse preadmission screening (PAS) determinationWhen an applicant for admission to a nursing facility, receives an adverse determination as the result of a preadmission screening (PAS) performed by the Ohio department of mental health and addiction serv…

19.03 PDF: (A) Following the bureau of managed health care's determination that the request does not meet one of the criteria for just cause termination of managed care plan membership, the Ohio department of medicaid, bureau of managed care, will send a notice to an individual.(…

19.03 PDF: (A) The purpose of this rule is to describe the process by which the Ohio department of medicaid (ODM) or a medicaid managed care plan (MCP), as described in rule 5160-26-01 of the Administrative Code, informs an individual of notice and hearing rights for the medicaid…

19.03 PDF: When, as the result of an interim assistance agreement, the local agency receives an individual's retroactive supplemental security income (SSI) payment for initial or initial post-eligibility SSI benefits, the individual and authorized representative shall be provided…

19.03 PDF: (A) Chapter 5101:6-20 of the Administrative Code governs disqualification for intentional program violation in the Ohio works first (OWF), prevention, retention and contingency (PRC) and supplemental nutrition assistance program (SNAP) programs.(B) An individual may be…

19.03 PDF: (A) In the Ohio works first (OWF) program, an intentional program violation will consist of any action by an individual, for the purpose of establishing or maintaining the family's eligibility for OWF or for increasing or preventing a reduction in the amount of the mon…

19.03 PDF: (A) Under the provisions of rule 5101:6-20-01 of the Administrative Code, individuals who have been found to have committed an intentional program violation (IPV) either through an administrative disqualification hearing, a federal, state, or local court, or who have s…

19.03 PDF: (A) The local agency will inform the assistance group in writing of the disqualification penalties for an intentional program violation each time the assistance group files an application for program benefits.(B) Disqualification penalties will be in clear, prominent, …

19.03 PDF: (A) To initiate an administrative disqualification hearing, the local agency will complete and submit a JFS 04060 "Referral for Administrative Disqualification Hearing," or an Ohio department of job and family services notice, to the bureau of state hearings.(B) The JF…

19.03 PDF: (A) An individual's state hearing, in accordance with Chapters 5101:6-1 to 5101:6-9 of the Administrative Code, and an administrative disqualification hearing may be combined into a single hearing if the factual issues arise out of the same or related circumstances.(B)…

19.03 PDF: (A) The bureau of state hearings will provide written notice to the accused individual at least thirty days prior to the hearing date, unless the thirty-day advance notice period has been waived under the provisions of rule 5101:6-20-11 of the Administrative Code.(B) T…

19.03 PDF: (A) A pending administrative disqualification hearing shall not affect the right of either the accused individual, or the assistance group, to apply for program benefits and to receive them if otherwise eligible.(B) A pending administrative disqualification hearing sha…

19.03 PDF: (A) If the accused individual or authorized representative fails, without good cause, to appear at the hearing, the hearing will still be conducted, without the individual being represented, if:(1) The bureau of state hearings has proof of either receipt or refusal to …

19.03 PDF: (A) The following provisions apply to the administrative disqualification hearing process:(1) The accused individual and authorized representative will be provided access to documents and regulations in accordance with rule 5101:6-5-01 of the Administrative Code.(2) Th…

19.03 PDF: (A) The bureau of state hearings is responsible for preparing and issuing administrative disqualification hearing decisions under the authority of the director of the Ohio department of job and family services (ODJFS). The bureau of state hearings will designate hearin…

19.03 PDF: (A) Disqualification(1) When the hearing decision finds that the accused individual has committed an intentional program violation, he or she will be disqualified in accordance with rule 5101:6-20-03 of the Administrative Code.(2) Prior to implementing the disqualifica…

19.03 PDF: (A) The local agency will provide an individual found to have committed an intentional program violation a written notice of disqualification.(1) If more than one member of an assistance group is to be disqualified, a separate disqualification notice will be provided t…

19.03 PDF: (A) No further administrative appeal procedures exist after an adverse administrative disqualification hearing decision, or after the individual waives the right to an administrative disqualification hearing and a disqualification penalty has been imposed.(B) The disqu…

19.03 PDF: (A) An individual suspected of having committed an intentional program violation will be provided written notice that he or she can waive the right to an administrative disqualification hearing.(1) The local agency will provide the notice at least fifteen days prior to…

19.03 PDF: (A) The local agency has the option of establishing procedures to allow an individual suspected of an intentional program violation to sign a disqualification consent agreement. Local agencies are encouraged to use this option for those cases in which a determination o…

19.03 PDF: (A) If a court finds that an individual committed an intentional program violation, the local agency will disqualify the individual in accordance with the court order.(B) Prior to implementing the disqualification, the local agency will provide the individual a JFS 040…

19.03 PDF: (A) The right to a state hearing is limited to actions by the Ohio department of job and family services (ODJFS), the Ohio department of medicaid (ODM), the local agency, or an agent of ODJFS, ODM, or the local agency. A hearing need not be granted when a change in sta…

19.03 PDF: (A) Definition(1) A "request for a state hearing" is defined as a clear expression, by the individual or authorized representative, to the effect that he or she wishes to appeal a decision or wants the opportunity to present his or her case to a higher authority. The r…

19.03 PDF: (A) When a request for a state hearing is received by the state, a managed care plan (MCP), a "MyCare Ohio" plan (MCOP), or local agency within the fifteen-calendar day prior notice period, benefits will not be reduced, suspended, or terminated until a state hearing de…

19.03 PDF: (A) The bureau of state hearings (BSH) will handle the receipt and processing of the request for a state hearing. When the hearing request is made to the local agency, the local agency will date stamp the request, retain a copy, and mail or transmit the request to "ODJ…

19.03 PDF: (A) Postponement is a request prior to the hearing date to schedule the hearing for a later date.(1) Public assistance, social services, and child support services(a) The hearing may be postponed at the request of the individual or authorized representative when good c…

19.03 PDF: (A) The local agency shall not deny or dismiss any request for a state hearing. All requests shall be sent to the bureau of state hearings, in accordance with rule 5101:6-5-01 of the Administrative Code.(B) When a state hearing request is denied or dismissed, the indiv…

19.03 PDF: (A) Time and place of the hearing(1) The hearing shall be conducted at a reasonable time, date, and place. The hearing will usually be conducted virtually, since it is usually most convenient to the individual. However, there may be circumstances which warrant conducti…

19.03 PDF: (A) The agency representativeThe agency representative presents and is the advocate for the agency's case at the hearing. This person shall explain the reasons for the agency's action, cite the regulations upon which the action was based, provide relevant case informat…

19.03 PDF: (A) All state hearings will be recorded by the hearing officer. The recording will be started at the beginning of the hearing and will continue until the hearing is concluded. There will be no testimony or other proceedings off the record. The recording will not be alt…

19.03 PDF: (A) Hearing authority(1) The bureau of state hearings is responsible for preparing and issuing state hearing decisions under the authority of the director of the Ohio department of job and family services (ODJFS). For this purpose, the chief of the bureau of state hear…

19.03 PDF: (A) PurposeThis rule sets forth the standards to be applied in a state hearing requested for the purpose of revising a community spouse's minimum monthly maintenance needs allowance in accordance with rule 5160:1-6-07 of the Administrative Code, or the community spouse…

19.03 PDF: (A) Responsibility(1) When the hearing decision orders action to be taken by the agency, the agency that is ordered to take the action is responsible for promptly and fully implementing the decision.(2) State hearings is responsible for monitoring timely compliance wit…

19.03 PDF: (A) An individual who disagrees with a state hearing decision, or with a decision by the hearing authority to deny or dismiss a hearing request, has the right to request an administrative appeal.The administrative appeal process does not apply to administrative disqual…

19.03 PDF: (A) Any local agency that disagrees with a state hearing decision, to which it was a party, may request that the decision be reviewed by the bureau of state hearings, through a process similar to the administrative appeal process described in rule 5101:6-8-01 of the Ad…

19.03 PDF: (A) Judicial review(1) Individuals who disagree with an administrative appeal decision have the right to appeal that decision to the court of common pleas, with the following exceptions:(a) Judicial review does not apply to administrative appeals subject to the appeal …

11.15 PDF: (A) The Ohio department of job and family services (ODJFS) allocates costs in accordance with the ODJFS federally approved cost allocation plan (CAP). This quarterly plan is submitted to the United States department of health and human services and defines the method u…

11.15 PDF: (A) In accordance with the Ohio department of job and family services (ODJFS) federally approved cost allocation plan, "direct costs" are costs that: (1) Benefit two or more state or federal programs in proportions that can be determined without undue effort or cost an…

11.15 PDF: (A) The Ohio department of job and family services (ODJFS) allocates costs in accordance with the ODJFS federally approved cost allocation plan (CAP). This quarterly plan is submitted to the United States department of health and human services (HHS) and defines the me…

11.15 PDF: (A) Definition.Shared costs are indirect costs incurred for a common purpose that benefit two or more major program areas of the Ohio department of job and family services (ODJFS) acknowledged cost structures outlined in paragraph (B) of rule 5101:9-1-02 of the Adminis…

11.15 PDF: (A) "Countywide central service costs" are allowable costs of services provided by a governmental unit on a centralized basis to its departments and agencies. Countywide central service costs include costs that are incurred by other county agencies such as the county a…

11.15 PDF: (A) The Ohio department of job and family services (ODJFS) currently recognizes, the following county family services agency (CFSA) organizational structures as designated by the board of county commissioners (BOCC), in accordance with sections 307.981 and 329.40 of th…

11.15 PDF: (A) Cost principles, as outlined in 2 C.F.R. 200 subpart E, communicate the general criteria to determine when a cost is allowable to claim as a direct or an allocable indirect cost to a federal grant. The following basic criteria assists in determining allowable costs…