Ohio Administrative Code|Rule 5160:1-2-06 | Medicaid: outstationing workers at disproportionate share hospitals and federally qualified health centers.

                                                
(A) This rule describes the
		  administrative agency's role in facilitating outreach services for
		  low-income children and pregnant women through the process of outstationing
		  workers at disproportionate share hospitals and federally qualified health
		  centers.
(B) Responsibilities of the
		  administrative agency.
(1) Locations. The
			 administrative agency:
(a) Must establish and staff outstation locations at each
				disproportionate share hospital and each federally-qualified health center
				participating in the medicaid program and providing services to
				medicaid-eligible children and pregnant women.
(b) May establish additional outstation locations at any
				other site where potentially eligible children or pregnant women receive
				services. These additional sites may include additional sites other than the
				main outstation location of federally-qualified health centers or
				disproportionate share hospitals.
(2) Hours.
(a) Workers must be available at each outstation location
				during the administrative agency's regular office operating hours to
				accept applications and to assist applicants with the application
				process
(b) If the administrative agency determines that an
				outstation site is infrequently used and does not require a full-time
				outstationed worker, a notice must be displayed:
(i)  Containing the
				  following information:
(a) The hours when an outstationed worker will be
					 available; and
(b) The telephone number of the administrative agency that
					 individuals may call for assistance.
(ii) Providing adequate
				  notice to persons who are blind or deaf or who are unable to read or understand
				  the English language.
(3) Workers and
			 assistance.
(a) The agency may use county employees, provider or
				contractor employees, or volunteers who have been properly trained to staff
				outstation locations under the following conditions:
(i) County outstation
				  intake workers may perform all eligibility processing functions, including the
				  eligibility determination, if the worker is authorized to do so at the regular
				  intake office.
(ii) Provider or
				  contractor employees and volunteers may perform only initial processing
				  functions. Provider and contractor employees and volunteers are subject
				  to:
(a) The confidentiality
					 of information rules specified in 42 C.F.R. part 431, subpart F (as in effect
					 on December 1, 2015);
(b) The requirements of
					 42 C.F.R. section 447.10 (as in effect on December 1, 2015), which prohibit
					 medicaid payments to anyone other than a provider or recipient except under
					 specific circumstances; and
(c) All other Ohio or
					 federal laws concerning conflicts of interest.
(b) The outstationed worker must:
(i) Complete the initial processing of the application for
				  medical assistance. 
(a) When authorized by
					 the administrative agency, the outstationed worker may also determine medicaid
					 eligibility.
(b) If the outstationed worker is only performing initial
					 processing duties, the outstationed worker must forward the application to the
					 administrative agency in accordance with Chapter 5160:1-1 and Chapter 5160:1-2
					 of the Administrative Code.
(ii) Accept and refer applications for other public
				  assistance programs to the administrative agency for processing.