Library: Policy

317:35-15-7. Certification for State Plan Personal Care

Revised 9-12-22

(a) State Plan Personal Care (SPPC) certification period. The first month of the SPPC certification period is the first month the member is determined financially and medically eligible for SPPC. When eligibility or ineligibility for SPPC is established, the local OKDHS office updates the computer-generated notice and the appropriate notice is mailed to the member.   • 1

(b) Financial certification period. The financial certification period for SPPC services is twelve (12) months. Eligibility redetermination is completed according to the categorical relationship.

(c) Medical certification period. A medical certification period of not more than thirty-six (36) months is assigned for a member who is approved for SPPC. The certification period for SPPC services is based on the Uniform Comprehensive Assessment Tool evaluation and clinical judgment of the Oklahoma Human Services HCMN III. 

INSTRUCTIONS TO STAFF 317:35-15-7

Revised 12-27-21

1.  The Oklahoma Health Care Authority no longer issues or prints medical identification (ID) cards.  Providers verify a member's eligibility by accessing the Eligibility Verification System, also known as the "Provider Network," at www.okhca.org through the Provider Portal.  When members need to verify SoonerCare (Medicaid) eligibility for community resources purposes:

(1) Online Enrollment members may log on to their Online Member Account and print the card; and

(2) Non-Online Enrollment members that Oklahoma Human Services (OKDHS) serves may contact:

(A) their medical provider for assistance; or

(B) an OKDHS county office to obtain a printed version of the card.  OKDHS staff enters the member’s information into the Eligibility tab on the Medicaid Management Information System Extranet and clicks on the link "Display Member ID Card" to print a copy of the front and back of the medical ID card for the population OKDHS serves.