Agency Schedule Detail

Authorization Number : 50750072

Agency Series No. : 500-00-27

Status : Active

Agency Web Link :

Agency : ODM

Confidential Description :

Division : ODMPOLI

Vital Description :

Section : ODMPOLILTSS

Record Title : Medicaid School Program

Revision : 1

Record Description : The program provide Medicaid reimbursement for service provided to Medicaid eligible children ages 3 to 21 who receive services at school through an Individualized Education Plan. Allows reimbursement for cost for direct service provided by licensed individuals, administrative activities and transportation services. Records to include service utilization and fiscal reports, interagency agreements, program summaries, provide list, State Plan amendments.

Retention Period	Retention Justification	Media Code	Method of Disposal
Retain in office 5 years and destroy.	OAC 5160-1-27	Electronic	Erase
Retain in office (1) year and then image.		Paper	Shred

Approvals

Status	Name	Title	Date
Approved	Dennis Hawk	Records Coordinator	2/12/2019 12:57:00 PM
Approved	Lisa Stafford	Records Officer	2/12/2019 1:29:00 PM
Approved	Terri Dittmar	Record Administrator	2/13/2019 9:39:00 AM
Approved	Fred Previts	State Archivist	2/13/2019 10:40:00 AM
Approved	Martin Meeks	State Auditor	2/28/2019 7:46:00 AM

Notes

Date	Reason	User