Library: Policy

317:30-5-515. Respite in Home and Community-Based Services (HCBS) Waivers for persons with an intellectual disability or certain persons with related conditions

Revised 9-15-23

(a) The Oklahoma Health Care Authority (OHCA) administers HCBS Waivers for persons with an intellectual disability or certain persons with related conditions that are operated by Oklahoma Human Services (OKDHS) Developmental Disabilities Services (DDS). Each waiver allows payment for respite care as defined in the waiver approved by the Centers for Medicare and Medicaid Services.

(b) Respite providers enter into contractual agreements with the OHCA to provide HCBS services for persons with an intellectual disability or related conditions.

(c) Respite care is included in the member's Individual Plan (Plan). Arrangements for this service are made through the member's DDS case manager.

(d) Respite care is:

(1) available to eligible members not receiving daily living supports or group home services and who are unable to care for themselves; and

(2) furnished on a short-term basis due to the absence or need for relief of those persons normally providing the care, and includes:

(A) daily respite provided in a group home.

(i) Group homes providing respite must be licensed per Oklahoma Administrative Code (OAC) 340:100-6.

(ii) Respite care provided in a group home is authorized as respite at the applicable group home rate as identified in the member's Plan; and

(B) daily respite provided in an agency companion services (ACS) home.

(i) Respite must be approved in accordance with the home profile process, per OAC 317:40-5-40, and required training, per OAC 340:100-3-38.

(ii) Respite provided in an ACS home is authorized as respite at the applicable level of support per OAC 317:40-5-3.

(iii) Respite providers are limited to providing 52-calendar days of respite per year when they concurrently provide ACS. Exceptions may be made by the DDS director or designee; and

(i) Respite must be approved in accordance with the home profile process, per OAC 317:40-5-40, and required training, per OAC 340-100-3-38.

(ii) Respite provided in a SFC or any other approved home other than ACS or a group home is authorized as respite at the applicable rate as identified in the member's Plan.

(iii) The respite provider is at least 18 years of age.

(e) Payment is not made for daily respite care and SFC or ACS for the same member on the same date of service.

(f) Respite care:

(1) is not available to members in OKDHS custody and in an out-of-home placement funded by OKDHS Child Welfare Services; and

(2) is limited to 30-calendar days or 720 hours annually per member, exceptions may be made by the DDS director or designee;