Homeward Bound Waiver, Community Waiver, In-Home Supports Waiver for Children, and In-Home Supports Waiver for Adults —  The Oklahoma Department of Human Services (OKDHS) is proposing amendments to four Medicaid Home and Community-Based Services (HCBS) waivers.

Proposed changes include the removal of the medical report and social summary as requirements for level of care eligibility, as well as the elimination of the performance measure that tracks annual medical reports for the Homeward Bound and Community Waivers. The amendments also clarify the criteria for a valid intellectual disability diagnosis, requiring documentation from either the Social Security Administration or OHCA’s Level of Care Evaluation Unit. Service definitions for Assistive Technology and Supported Employment are being updated to reflect the ability to coordinate (or "braid") services with the Oklahoma Department of Rehabilitative Services. Additional revisions include allowing a spouse to serve as a paid caregiver under participant-directed services, updating references to reflect the transfer of the Office of Client Advocacy to the Oklahoma State Department of Health, removing the Electronic Visit Verification (EVV) exemption for live-in caregivers, and clarifying that EVV requirements for Home Health providers have been in effect since January 1, 2024.

To comply with federal requirements, the amendments also incorporate updates required by the Centers for Medicare & Medicaid Services (CMS). These include training requirements for case managers on home and community-based settings and person-centered planning; identification of services that may be delivered remotely or via telehealth; and procedures to ensure continuity of care when a provider is added to the abuse registry. The revisions clarify rules regarding the provision of services by Legally Responsible Individuals, including payment policies for services delivered by relatives or legal guardians. Additional updates address how HCBS services may be provided during acute care hospital stays, how both residential and non-residential settings meet federal HCBS settings requirements, the use of temporary service plans, and state assurances related to the person-centered service planning process.

Interested persons may view the draft waiver amendments below and submit feedback via the comment box:

Community Waiver

Homeward Bound Waiver

In-Home Supports Waiver for Adults

In-Home Supports Waiver for Children

View the Public Notice

Circulation Date: June 20, 2025

Tribal Consultation: July 1, 2025

Public Comment Period: June 20, 2025 – July 20, 2025

Proposed Effective Date: October 1, 2025

Comment Due Date: July 20, 2025