(A) Consistent with the requirements of the care management system implemented on February 1, 2023, to address medicaid population health and social determinants of health and encourage optimal health and self-sufficiency of medicaid enrollees, the department of medicaid, in collaboration with the department of job and family services, shall develop a program to assist medicaid enrollees with securing meaningful employment.

Ask an insurance law question, get an answer ASAP!
Click here to chat with a lawyer about your rights.

Terms Used In Ohio Code 5167.35

  • Care management system: means the system established under section 5167. See Ohio Code 5167.01
  • Conviction: A judgement of guilt against a criminal defendant.
  • Enrollee: means a medicaid recipient who participates in the care management system and enrolls in a medicaid MCO plan. See Ohio Code 5167.01
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Medicaid managed care organization: means a managed care organization under contract with the department of medicaid pursuant to section 5167. See Ohio Code 5167.01
  • Population: means that shown by the most recent regular federal census. See Ohio Code 1.59
  • state: means the state of Ohio. See Ohio Code 1.59

(B) As part of that program, each medicaid managed care organization shall develop a specialized component of its medicaid MCO plan to provide referral and support to medicaid enrollees in obtaining and maintaining meaningful employment. Each medicaid managed care organization shall give priority to identified enrollees who are of working age and are able-bodied, or who would benefit from assistance to overcome unemployment or underemployment. In carrying out the requirements of this section, each medicaid managed care organization shall do all of the following:

(1) Identify any barriers that an identified enrollee has to achieving greater financial independence, including the following:

(a) Education;

(b) Employment;

(c) Physical and behavioral health care;

(d) Transportation;

(e) Childcare;

(f) Housing;

(g) Legal history, including prior conviction of a criminal offense.

(2) Develop state and local relationships that link and refer identified enrollees to assessments, resources, and supports that assist with obtaining and maintaining meaningful employment.

(3) Utilize a standard health risk assessment form established by the medicaid director to identify enrollees to receive assistance under the program established by this section.

(C)(1) Not later than six months after the effective date of this section, the medicaid director and the director of job and family services shall convene a workgroup. The workgroup shall consist of the following members, selected by the directors:

(a) Representatives of the director of opportunities for Ohioans with disabilities, the director of developmental disabilities, and director of mental health and addiction services;

(b) Representatives of the Ohio job and family services directors’ association and workforce development agencies;

(c) Representatives of technical, career, and higher education;

(d) Representatives of each medicaid managed care organization;

(e) Representatives of other organizations with expertise and resources involved in career and job development, as determined by the medicaid director and director of job and family services.

(2) The workgroup shall do all of the following:

(a) Identify state and local resources that provide job skills and career development, including available resources to support identified enrollees to seek employment and develop needed skills;

(b) Develop models for local agreements or protocols for collaboration between medicaid managed care organizations and other community agencies;

(c) Identify conflicts among program requirements that should be addressed by state agencies and the general assembly to facilitate identified enrollees’ ability to secure and maintain employment.

(D) The medicaid director may do any of the following with respect to the program established under this section:

(1) Establish additional requirements for medicaid managed care organizations;

(2) Create supplemental assessments to assist in identifying barriers to achieving financial independence, in addition to the barriers identified in division (B)(1) of this section;

(3) Adopt rules, in accordance with Chapter 119 of the Revised Code, as necessary to implement these provisions.

(E) The medicaid director and the director of job and family services shall report to the governor, the senate medicaid committee, and any other standing legislative committee having jurisdiction over medicaid regarding the implementation and operation of the program. The directors shall report on a periodic basis during the first year of the program. Thereafter, the directors shall report not less than annually.

Last updated October 6, 2023 at 5:12 PM