Library: Policy

317:35-16-5. Certification for State Plan Personal Care

Issued 3-28-23

(a) State Plan Personal Care (SPPC) certification period. The first month of the SPPC certification period is the first month the member is determined financially and medically eligible for SPPC. When eligibility or ineligibility for SPPC is established, OHCA updates the computer-generated notice and the appropriate notice is mailed to the member.

(b) Financial certification period. The financial certification period for SPPC services is twelve (12) months. Eligibility redetermination is completed according to the categorical relationship.

(c) Medical certification period. A medical certification period of not more than thirty-six (36) months is assigned for a member who is approved for SPPC. The certification period for SPPC services is based on the Uniform Comprehensive Assessment Tool evaluation and clinical judgment of the OHCA nurse.