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Library: Policy

317:35-15-3. Application for State Plan Personal Care (SPPC) services

Revised 9-12-22

(a) Requests for SPPC services. The SPPC application process initiates when an online application is completed for SPPC services.  ■ 1 A written financial application is not required for an applicant who has an active SoonerCare case. A financial application for SPPC services is initiated when there is no active SoonerCare case. The Medicaid application is signed by the applicant, parent, spouse, guardian or someone acting on the applicant's behalf. All financial eligibility conditions are verified and documented in the case record. When current available information establishes eligibility, the information may be used by recording source and date of information. If the applicant also wishes to apply for a State Supplemental Payment, either the applicant or his or her guardian, or a person acting on the applicant's behalf, such as an authorized representative or power-of-attorney, signs the application form.  ■ 2

(b) Application date. The application date is when the benefits request is received and entered into the electronic system by OKDHS. Exceptions can occur when OKDHS has contracts with certain providers who accept and obtain applications and appropriate documentation. Once the documentation, for the SooonerCare eligibility determination, has been obtained, the contracted provider will forward the application and all applicable documentation to either the OKDHS county office or the Medicaid Services Unit-ADvantage Administration.

(c) Eligibility status. Financial and medical eligibility is established before services can be initiated.  ■ 3

Revised 9-1-15

1.  The county staff completes the 02HM001E, Uniform Comprehensive Assessment Tool (UCAT) Part 1, via FACS supplemental screen for ELDERS.  Once completed it automatically processes to the long-term care nurse and social services specialist.  

2.  When the application is completed and signed, the computer input form is prepared and registered on the terminal within five days of the application date or receipt of case record from another county office.

3.  The social worker notifies the LTC nurse of the financial eligibility of the client by updating the authorization line in IMS to F status.  If the client does not have an active Medicaid case, the social worker notifies the LTC nurse of this and again notifies the nurse when the eligibility determination has been made.