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Library: Policy

317:35-15-13.1. Individual personal care assistant (IPCA) service management

Revised 9-12-22

(a) An Individual Personal Care Assistant (IPCA) may be utilized to provide SPPC services when it is documented to be in the member's best interest to have an IPCA, or when there are no qualified personal care provider agencies available in the member's local area. Oklahoma Health Care Authority (OHCA) checks the list of providers barred from Medicare/Medicaid participation to ensure the IPCA is not listed.

(b) After SPPC services eligibility is established, and prior to implementation of SPPC services using an IPCA, the OKDHS Health Care Management Nurse I or II reviews the care plan with the member and IPCA and notifies them to begin SPPC services delivery. The OKDHS HCMN I or II maintains the original care plan and forwards a copy to the selected IPCA and member within one (1) business day of approval receipt.

(c) The HCMN I or II contacts the member within five (5) business days to ensure services are in place and meeting the member's needs. The HCMN I or II also monitors the care plan for members with an IPCA. For any member receiving SPPC services utilizing an IPCA, the OKDHS HCMN I or II makes a home visit at least every six (6) months beginning within ninety (90) calendar days from the date of service initiation. OKDHS HCMN I or II assesses the member's satisfaction with his or her SPPC services and evaluates the care plan for adequacy of goals and units allocated. Requests for changes in the units authorized in the care plan are approved by the HCMN III prior to implementation.