Library: Policy

317:30-5-390. Home and Community-Based Services Waivers for adults with an intellectual disability or certain adults with related conditions

Revised 9-14-20

(a) Introduction to waiver services.Each Home and Community-Based Services (HCBS) waiver that includes services for adults with an intellectual disability or certain adults with related conditions allows payment for home health care services as defined in the waiver approved by the Centers for Medicare and Medicaid Services.

(1) Home health care services are skilled nursing services provided to a member by a registered nurse (RN) or a licensed practical nurse (LPN) that include:

(A) Direct nursing care;

(B) Assessment and documentation of health changes;

(C) Documentation of significant observations;

(D) Maintenance of nursing plans of care;

(E) Medication administration;

(F) Training of the member's health care needs;

(G) Preventive and health care procedures; and

(H) Preparing, analyzing, and presenting nursing assessment information regarding the member.

(2) The first thirty-six (36) visits provided by the home health care agency are covered by the Oklahoma Medicaid State Plan.

(b) Eligible providers.Skilled nursing services providers must enter into contractual agreements with the Oklahoma Health Care Authority (OHCA) to provide HCBS for adults with an intellectual disability or certain adults with related conditions.

(1) Individual providers must be currently licensed and in good standing in the state in which services are provided as a:

(A) RN; or

(B) LPN.

(2) Agency providers must:

(A) Have a current Medicaid HCBS home health care agency contract; or

(B) Be certified by the Oklahoma State Department of Health (OSDH) as a home health care agency.