1915(c) HCBS In Home Supports Waiver for Adults renewal effective: 07/01/2022 through 06/30/2027; contingent upon CMS approval

The Oklahoma Health Care Authority (OHCA) is seeking a waiver renewal of the 1915(c) HCBS In Home Supports Waiver for Adults. The goal of the program is to provide services for members age 18 and above with an intellectual disability, who are eligible for Medicaid, and who require an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) level of care.

The proposed revisions to the In Home Supports Waiver for Adults are as follows: 

• Appendix B - Unduplicated Number of Participants has been updated as follows:
  • Waiver Year 1 – from 1620 to 2450
  • Waiver Year 2 – from 1750 to 2450
  • Waiver Year 3 – from 1900 to 2450
  • Waiver Year 4 – from 2100 to 2450
  • Waiver Year 5 - from 2200 to 2450
• Appendix B - The Participant Safeguards section has been updated.  The annual limit of Assistive Technology Services or Environmental Accessibility Services may be increased to allow for major purchases in excess of $2,500.00, but not to exceed a combined service limit of $10,000.00, in any five year period.  The $10,000 combined service limit has been increased to $22,500.00. 
• Appendix B - The Participant Safeguards section has been updated.  An additional combined service limit of $5500.00 of Prevocational and Supported Employment services may be authorized when the member's need for one or both of the services cannot be met within the waiver limit described in Appendix B-2:a.
• Appendix C - Due to a statutory language change (Title 56 OS Sec. 1025.1 et seq.: OAC 340:100-3-39), the scope of background investigation language has been updated to include the option of a Federal Bureau of Investigation (FBI) Identity History Summary Check. 
• Appendix C - The Dental Service Type was updated from Other Service to Extended State Plan Service.  Also, the limit for this service was increased from $1000.00 per member plan of care year to $3500.00 per member plan of care year.
• Appendix C - The limits section of the Transportation service has been updated to reflect an increase for public transportation.  The public transportation limit has been increased from $5000.00 to the individual cost limit of this waiver, per 12 months.
• Appendix C - The Optometry service has been added to the Participant Services section.
• Appendix C - The Respite Daily service has been added to the Participant Services section.
• Appendix C - The Supported Employment service has been updated to include a statement indicating the service may be provided remotely, with prior approval by the Team. 
• Appendix C - The Environmental Accessibility Adaptations and Architectural Modification service limit language has been updated to allow a designee, as well as the DHS/DDS Division Administrator, to authorize modification of more than two different residences in a seven year period, in extenuating circumstances. Also, service limit language has been updated to clarify that additional limit language, is a combined additional service limit.
• Appendix C - Self Directed Goods and Services individual provider type and qualification has been updated to indicate the business or provider must be registered with the Secretary of State and in good standing in the state that offers the approved goods or services.
• Appendix C - The limits section of the Family Training service has been updated to increase the individual limit from $5500.00 per plan of care year to $6500.00 per plan of care year.  The group limit has also been increased from $5500.00 per plan of care year to $6500.00 per plan of care year.  The total for Family Training services may not exceed $13,000.00 per plan of care year. 
• Appendix C - The Occupational Therapy service definition has been updated to require a prescription by any licensed health care provider, not just a Physician, with appropriate prescriptive authority.
• Appendix C - The Physical Therapy service definition has been updated to require a prescription by any licensed health care provider, not just a Physician, with appropriate prescriptive authority.
• Appendix C - A statement indicating the Prevocational service may be provided remotely, with prior approval by the Team, has been added to the Prevocational service definition. 
• Appendix D - The Service Plan Development section has been updated to allow Team meetings, including Individual Plan meetings, to be conducted via HIPAA compliant teleconference or video conference.
• Appendix E - The Description of Participant Direction language has been updated to include the Supported Employment service as a service contributing to the individualized budget.
• Appendix I - The Optometry service has been added as a Medicaid rate in the Rate Determination Method section.
• Appendix I - Specialized Medical Supplies and Assistive Technology service, Rate Determination Method language has been updated.
• Appendix I - The Respite Daily service has been added as a fixed rate in the Rate Determination Method section. 
• Appendix I - Environmental Accessibility Adaptations and Architectural Modification service, Rate Determination Method section update.  The annual limit may also be authorized to allow for major expenses in excess of $2,500 of Environmental Accessibility Adaptations or Arch Mod services, combined with Assistive Technology, but not to exceed a combination of $10,000.00 in any 5-year period.  The $10,000.00 limit has been increased to $22,500.00.
• Appendix J - Cost neutrality information has been estimated and updated for the term of this waiver renewal, waiver years 1-5.

Please view the waiver renewal here: 1915(c) HCBS In Home Supports Waiver for Adults Renewal.

The above renewal will be effective upon approval by the Centers for Medicare and Medicaid Services (CMS) or July 1, 2022, whichever is earliest. 

Please submit all comments by close of business, February 18, 2022, via the comment box below. Written comments will also be accepted and can be sent to the Oklahoma Health Care Authority, 4345 N. Lincoln Blvd. Oklahoma City, Oklahoma 73105. Attention: Health Policy 1915(c) Waivers.

To request a hard copy of the waiver please call 1-888-287-2443 or send your request to the Oklahoma Health Care Authority, 4345 N. Lincoln Blvd. Oklahoma City, Oklahoma 73105. Attention: Health Policy 1915(c) Waivers.