COMMENT DUE DATE:
March 19, 2015
DATE:
February 9, 2015
Laura Brown, AFS (405)-521-4396
Dena Thayer, OIRP Programs Administrator (405) 521-4326
RE:
APA WF 14-14
The proposed policy is Permanent . This proposal is subject to the Administrative Procedures Act
SUBJECT:CHAPTER 15. STATE SUPPLEMENTAL PAYMENT AND THE SUPPLEMENTAL SECURITY INCOME-DISABLE CHILDREN'S PROGRAM
Subchapter 1. State Supplemental Payment [NEW]
Subchapter 3. Supplemental Security Income-Disabled Children's Program [NEW]
OAC 340:15-3-1. Eligibility and available services [NEW]
(Reference APA WF 14-14)
SUMMARY:Chapter 15 Subchapter 3 is issued with the reorganized and clarified Supplemental Security Income-Disabled Children's (SSI-DCP) Program rule revoked from Chapter 70 Subchapter 8.
PERMANENT APPROVAL:Permanent rulemaking is requested.
LEGAL AUTHORITY:Director of Human Services; Section 162 of Title 56 of the Oklahoma Statues; and Section 701 and 1382d of Title 42 of the United States Code.
Rule Impact Statement
To:Programs administrator
Office of Intergovernmental Relations and Policy
From:Jim Struby, Director
Adult and Family Services
Date:January 16, 2015
Re:CHAPTER 15. STATE SUPPLEMENTAL PAYMENT AND THE SUPPLEMENTAL SECURITY INCOME-DISABLE CHILDREN'S PROGRAM
Subchapter 1. State Supplemental Payment [NEW]
Subchapter 3. Supplemental Security Income-Disabled Children's Program [NEW]
OAC 340:15-3-1. Eligibility and available services [NEW]
(Reference APA WF 14-14)
Contact:Laura Brown 405-521-4396
A.Brief description of the purpose of the proposed rule:
Chapter 15 Subchapter 3 is issued with the reorganized and clarified Supplemental Security Income-Disabled Children's (SSI-DCP) Program rule revoked from Chapter 70 Subchapter 8.
Strategic Plan Impact.The proposed rule achieves Oklahoma Department of Human Services (DHS) goals by continuously improving systems and processes to achieve DHS efficiency.
Substantive changes.
Oklahoma Administrative Code 340:15-3-1 is issued to include SSI-DCP rules revoked in OAC 340:70-8-1.The SSI-DCP rule is reorganized and clarified for easier understanding.
Reasons.
The SSI-DCP rule is revoked in OAC 340:70-8-1 and issued in Chapter 15 containing State Supplemental Payment (SSP) rules to make it easier for staff and clients to locate as most children receiving SSI-DCP services also receive a SSP cash assistance payment.The SSI-DCP rule is reorganized and clarified for easier understanding.
Repercussions.
The proposed rule provides clients and staff with clear, concise, updated, and easier to locate rules.If the proposed rule is not issued, staff and clients will continue to have trouble locating SSI-DCP rules and processes may not be followed as intended.
Legal authority.Director of Human Services; Section 162 of Title 56 of the Oklahoma Statues; and Section 701 and 1382d of Title 42 of the United States Code.
Permanent rulemaking approval is requested.
B.A description of the classes of persons who most likely will be affected by the proposed rule, including classes that will bear the costs of the proposed rule, and any information on cost impacts received by the Agency from any private or public entities:The classes of persons most likely to be affected by the proposed rule is DHS staff, children with disabilities eligible for Supplemental Security Income (SSI), and their families.The affected classes of personsbear no costs associated with implementation of the rule.
C.A description of the classes of persons who will benefit from the proposed rule:The classes of persons most likely to benefit from the proposed rule is DHS staff, children with disabilities eligible for SSI, and their families.
D.A description of the probable economic impact of the proposed rule upon the affected classes of persons or political subdivisions, including a listing of all fee changes and, whenever possible, a separate justification for each fee change:The proposed rule does not have an economic impact on the affected entities.There are no fee changes associated with the revised rule.
E.The probable costs and benefits to the Agency and to any other agency of the implementation and enforcement of the proposed rule, the source of revenue to be used for implementation and enforcement of the proposed rule and any anticipated effect on state revenues, including a projected net loss or gain in such revenues if it can be projected by the Agency:The proposed rule may result in enhanced delivery of services to children with disabilities eligible for SSI and their families.The probable DHS cost of printing and distributing the rule is estimated to be less than $20.
F.A determination whether implementation of the proposed rule will have an impact on any political subdivisions or require their cooperation in implementing or enforcing the rule:The proposed rule will not have an economic impact on any political subdivision, nor will the cooperation of any political subdivisions be required in implementation or enforcement of the rule.
G.A determination whether implementation of the proposed rule will have an adverse economic effect on small business as provided by the Oklahoma Small Business Regulatory Flexibility Act:The proposed rule will not have an adverse economic effect on small businesses.
H.An explanation of the measures the Agency has taken to minimize compliance costs and a determination whether there are less costly or nonregulatory methods or less intrusive methods for achieving the purpose of the proposed rule:There are no less costly or nonregulatory methods or less intrusive methods for achieving the purpose of the proposed rule.
I.A determination of the effect of the proposed rule on the public health, safety, and environment and, if the proposed rule is designed to reduce significant risks to the public health, safety, and environment, an explanation of the nature of the risk and to what extent the proposed rule will reduce the risk:It is hoped that by making the SSI-DCP rule easier to understand and locate, families of children eligible for SSI-DCP services will request and receive services appropriate for the child thereby reducing health and safety risks for the child.
J.A determination of any detrimental effect on the public health, safety, and environment if the proposed rule is not implemented:If the proposed rule is not implemented, families may be less aware of services available to the child to help the child reach his or her maximum potential.
K.The date the rule impact statement was prepared and, if modified, the date modified: Prepared 5/29/2014; modified January 16, 2015
CHAPTER 15. STATE SUPPLEMENTAL PAYMENT AND THE SUPPLEMENTAL SECURITY INCOME-DISABLED CHILDREN'S PROGRAM
SUBCHAPTER 1. STATE SUPPLEMENTAL PAYMENT
SUBCHAPTER 3. SUPPLEMENTAL SECURITY INCOME-DISABLED CHILDREN'S PROGRAM
340:15-3-1. Eligibility and available services
Issued 9-1-15
(a) Supplemental Security Income-Disabled Children's Program (SSI-DCP).SSI-DCP is established per Section 1615 of the Social Security Act and administered by the Oklahoma Department of Human Services (DHS) Adult and Family Services (AFS) The Social Security Administration (SSA) refers children less than 18 years of age approved for Supplemental Security Income (SSI) to DHS for SSI-DCP services and to apply for the State Supplemental Payment (SSP).
(1) Due to limited funding, requested SSI-DCP services are pre-approved by AFS Health Related and Medical Services (HR&MS) staff.
(2) AFS HR&MS staff considers many factors in deciding which services or equipment to approve, including but not limited to:
(A) the child's needs;
(B) the availability of other resources;
(C) whether the child is in a stable or temporary living situation;
(D) the cost of the service or equipment; and
(E) the availability of funding.
(b) Eligibility.Any child from birth to 18 years of age is eligible for SSI-DCP services when the child receives a SSI payment.SSA establishes financial and medical eligibility for the SSI disability payment.When the child turns 18 years of age, he or she is no longer eligible for SSI-DCP services.A child receiving SSI is not automatically eligible for SSP.¢ 1
(c) Service plan.The AFS worker completes a service plan prior to providing SSI-DCP services to the child unless the child has a current service plan with another program within DHS or another agency.
(1) The AFS worker makes a scheduled home visit per Oklahoma Administrative Code (OAC) 340:65-3-4(1) to complete Form 08MA017E, SSI-DCP Service Plan, with the child's parent, guardian, or caretaker.The service plan is reviewed yearly.When the child receives SSP, the worker completes Form 08MA017E in conjunction with the eligibility review.¢ 2
(2) When the child receives services from another agency that requires a current social service plan, such as early intervention services through SoonerStart or special education services through the local public school, the SSI-DCP service plan is not necessary.¢ 3
(3) Within DHS, the child may receive services from Child Welfare Services (CWS), Developmental Disabilities Services (DDS), or Aging Services for State Plan Personal Care.When applicable, the worker collaborates with CWS or DDS to:
(A) address the child's current and future social service needs; and
(B) avoid duplication in providing services.¢ 4
(d) Services.SSI-DCP provides funding for the services described in (1) through (3) of this subsection.The parent, guardian, or caretaker requests services through the AFS worker in the county office and provides a prescription or written recommendation from an education or healthcare professional.The prescription or written recommendation is provided yearly at the time of the annual renewal.¢ 5
(1) Diapers.To be eligible to receive diapers, the child is at least 4 years of age.Once the child turns 18 years of age, he or she is not eligible for diapers.Prior to approval, a health care professional documents in writing that the child cannot be toilet trained.When approved by AFS HR&MS staff, authorized county staff orders available diapers through the DHS Supply Warehouse.Only diapers available through the DHS Supply Warehouse are approved.¢ 6
(2) Formula.A health care professional provides a prescription naming the brand of formula needed by the child.When approved by AFS HR&MS, authorized county staff orders available formula through the DHS Supply Warehouse.Only formula available through the DHS Supply Warehouse is approved.¢ 7
(3) Interaction and integration services.Non-medical services aimed at strengthening the child physically or mentally; providing opportunities for social interaction; or assisting with mobility may be approved when recommended by an education or health care professional and the recommendation clearly defines the goals and objectives for the child.Examples of such services include, but are not limited to, swimming or horseback riding lessons, sports activities, or a health club membership.Due to budget constraints, services are approved on a temporary basis.¢ 8
(e) Equipment.Equipment approved through SSI-DCP is used to aid the child in accessibility or mobility.Equipment available through SSI-DCP is pre-approved by AFS HR&MS Section staff.Available equipment that may be approved is described in (1) and (2) of this subsection.The parent, guardian, or caretaker provides a written recommendation from an education or health care professional with knowledge concerning the child's equipment needs.HR&MS Section staff does not approve requests for equipment the child can obtain through other sources, such as SoonerCare (Medicaid) or through the child's school.¢ 9
(1) Developmental aid.A developmental aid is any device or equipment adapted to meet the needs of a child with disabilities.An education or healthcare professional provides a written explanation concerning the goals and objectives this developmental aid meets before it is approved. Educational or classroom devices, equipment, or supplies not adapted for the child's needs are not in the scope of the program.
(2) Van lifts.Van lifts are devices used for vehicular transportation of wheelchairs.Van lifts may be approved when needed to transport a child in a wheelchair.A van lift is not approved for a child in DHS or tribal custody or in the Developmental Disabilities Home and Community-Based Waiver Program.Modifications to the van are not approved.
(A) The parent, guardian, or caretaker must own the van as verified by title registration and license verification, and the van must be in operating condition.
(B) The family provides estimates from two van lift dealers who employ certified van lift installation technicians.¢ 10
(C) When the request is approved, HR&MS staff contacts the family and approved vendor to arrange installation of the van lift.
(D) Only a certified van lift specialist is approved to install the lift and the lift must have factory and dealership warranty equal to private purchase warranty.
(E) HR&MS staff does not approve replacement of a van lift within 10 years of the purchase date.
(F) SSI-DCP staff does not pay for van repairs of vans or van lifts not purchased with SSI-DCP funds.
(f) Exclusions.Items or supplies not in the scope of SSI-DCP are not approved.Examples of excluded items or supplies include, but are not limited to:
(1) learning programs;
(2) psychological programs;
(3) books;
(4) video or audio tapes;
(5) paper, pencils, or art supplies;
(6) computers, tablet computers, or computer software;
(7) televisions; and
(8) video games.
(g) Purchasing procedures.SSI-DCP orders are processed through AFS HR&MS.Purchased equipment is shipped to the local county office.¢ 11
(h) SSI-DCP notices.When a SSI-DCP request is denied, the AFS worker sends a hand-generated denial notice using Form 08MA004E, Notification of Eligibility Status for Medical Assistance, to inform the child's parent, guardian, or caretaker the item is not approved for purchase through SSI-DCP funding.¢ 12The family may request a fair hearing within 30 calendar days from the date of the notice by completing Form 13MP001E, Request for a Fair Hearing.¢ 13
(i) Respite Voucher Program.The Respite Voucher Program provides financial assistance in the form of vouchers to families to pay for respite.When the family appears eligible for the Respite Voucher Program, the worker advises the family to call a designated number to request a respite voucher application.The SSI-DCP, other DHS programs, and certain public and private agencies provide funding to the Respite Voucher Program.¢ 14
(1) The caregiver is the person who provides ongoing care for the child.He or she may be a parent, grandparent, other relative, or non-relative.
(2 When respite care is approved it is not:¢ 15
(A) designed to pay for ongoing care such as child care, therapy, in-home assistance, housekeeping, or home health services; and
(B)provided by a member of the child's household.
INSTRUCTIONS TO STAFF 340:15-3-1
Issued 9-1-15
1.(a) A child receiving disability benefits from the Social Security Administration (SSA) or the Veterans Administration (VA), must receive at least one dollar of Supplemental Security Income (SSI) to be eligible for the Supplemental Security Income-Disabled Children's Program (SSI-DCP).
(b) To determine if the child is receiving SSI, the worker uses IMS transaction PY space Social Security number (SSN).
2.(a) When no other social service program is involved, the worker offers social services to the parent, guardian, or caretaker for the child.
(1) The worker interviews the parent, guardian, or caretaker during a home visit to assess the child, evaluate the child's medical, developmental, social, educational, and rehabilitation needs, and documents social service needs by completing Form 08MA017E, SSI-DCP Service Plan.Form 08MA017E is available in the Family Assistance/Client Services (FACS) system.The worker images and files the completed form in the case record.
(2) To approve the child for SSI-DCP, the worker certifies the Social Services tab in the FACS Eligibility Notebook and adds the child to "social services" in the "benefit" field of the Household tab in the FACS Interview Notebook.
(3) The worker also documents case actions in FACS Case Notes.
(b) At the annual renewal, the Adult and Family Services (AFS) worker makes a visit to the child's home and updates the social service plan on Form 08MA017E to reflect changes or new requests.
3.(a) SoonerStart is an early intervention program within the Oklahoma State Department of Health that provides services for children from birth to 3 years of age with disabilities or developmental delays.SoonerStart staff and the parent, guardian, or caretaker complete an Individualized Family Service Plan (IFSP) to address the child's needs.
(b) Local public school staff and the parent, guardian, or caretaker complete an Individualized Education Program (IEP) social service plan for children 3 years of age and older requiring special education and related services.
(c) The AFS worker images the alternate plan and makes a notation in FACS case notes.If the alternate plan is not available, the AFS worker and the parent, guardian, or caretaker complete Form 08MA017E.
4.When the child receives Child Welfare Services (CWS) or Developmental Disabilities Services (DDS) services, the child's equipment and service needs are normally met using CWS or DDS funding.In the event SSI-DCP services are requested for the child, the AFS worker images the CWS or DDS service plan and emails AFS Health Related & Medical Services (HR&MS) staff for instructions.
5.The worker images and files the written recommendation in the case record and documents the content of the recommendation in FACS case notes.
6.(a) Authorized county staff is responsible for ordering diapers on the Financial Services AS400 system consumable supply screen.An authorization is completed on the AUSN-D screen listing the size and number of needed diapers.
(b) The Oklahoma Department of Human Services (DHS) Supply Warehouse stores and distributes diapers as requested to local county offices.
(c) The AFS worker is responsible for ensuring the client receives the diapers.
7.(a) Authorized county staff is responsible for ordering formula on the DHS Financial Services AS400 system consumable supply screen.An authorization is completed on the AUSN-F screen listing the brand and amount of formula needed.
(b) The DHS Supply Warehouse stocks and distributes formula as requested to the local county office.
(c) The AFS worker is responsible for ensuring the client receives the formula.
8.Authorized county staff requests services on the AUSN-P screen.
9.(a) The imaged recommendation lists the:
(1) item name and number;
(2) vendor name, address, and phone number;
(3) item cost; and
(4) objectives and goals to be achieved through use of the equipment.
(b) The AFS worker inputs the request on the AUSN-E screen.
(1) The AFS worker contacts HR&MS staff prior to entering requests over $1,000 on the AUSN-E screen.
(2) To determine if the request has been approved, the worker checks the AUSN screen under the HRS-APR column and looks for an 'A' for approval.
(3) Returned requests have an 'R' under the HRS-APR column along with the reason documented in the description area.In addition, HR&MS staff sends an email to the worker.
10.The AFS worker images and files the two estimates in the case record and inputs the van lift request on the AUSN-E screen to request approval.AFS HR&MS Section staff inputs the approval or denial on the AUSN-E screen.
11.(a) Orders are shipped to the local county office unless otherwise specified.Heavier equipment items may be shipped directly to the child's home.
(1) The AFS worker ensures items shipped to the home were received intact without damage.The AFS worker calls or makes a home visit to confirm receipt and condition and documents the contact in FACS case notes.When the family reports damage, the AFS worker contacts HR&MS Section staff for instructions.
(2) When the equipment is shipped to the local county office, the worker is responsible for checking the shipment for accuracy and condition.
(3) The worker updates the AUSN-E screen under the CO DATE field to input the date the equipment was received.
(b) Local county staff pays for SSI-DCP equipment within 45 calendar days of equipment receipt to avoid interest charges being assessed by the vendor for a late payment.Delayed payment by county staff creates a problem for current or future orders because vendors hold orders until all late payments are received.
(c) Local county staff ensures delivery of all SSI-DCP items to the child.
12.AFS HR&MS staff notes SSI-DCP request denials on the AUSN screen:
(1) in the description area for equipment; or
(2) by entering an 'N' for 'not approved' under the HRS APR column for diapers and formula.
13.When AFS HR&MS staff denies a request for services or equipment and the family requests an appeal, the AFS worker ensures the family receives Form 12MP001E, Request for a Fair Hearing.
14.(a) Caregivers may request a respite voucher application by calling toll-free 1-888-771-4550 or 271-4550 in the Oklahoma City metro area.Limited respite funds are available through HR&MS.
(b) Refer to the Sooner Success website at http://oasis.ouhsc.edu/voucher.htm under the Respite tab for the Respite Voucher Program eligibility guidelines and approval process.
(c) When the family meets the qualifications for the Respite Voucher Program, an application is mailed to the family.
15.(a) After the caregiver returns the application and it is approved, the voucher is sent to the caregiver and may be used to purchase respite care.
(b) The respite provider must be 18 years of age or older.
(c) The child's caregiver and the respite provider complete the respite voucher and send it to DHS Financial Services for payment.
(d) Respite vouchers are used within three months of the issue date.When a voucher expires, the caregiver calls 1-888-771-4550 toll free or 271-4550 in the Oklahoma City metro area to request another voucher.
