COMMENT DUE DATE:
March 17, 2016
DATE:
February 16, 2016
Angela Burleigh, Office of Client Advocacy (405) 522-2728
Dena Thayer, OIRP Programs Administrator (405) 521-4326
Nancy Kelly, OIRP Policy Specialist, (405) 522-6703
RE:
APA WF 15-05
The proposed policy is Permanent . This proposal is subject to Administrative Procedures Act
SUBJECT:CHAPTER 2. ADMINISTRATIVE COMPONENTS
Subchapter 3. Office of Client Advocacy
Part 5. Grievances
OAC 340:2-3-46 [AMENDED]
OAC 340:2-3-50 [AMENDED]
OAC 340:2-3-56 [NEW]
Part 7. Grievance and Abuse Review Committee
OAC 340:2-3-64 [AMENDED]
Part 9. Advocacy Programs
OAC 340:2-3-71 [AMENDED]
OAC 340:2-3-73 through 340:2-3-74 [AMENDED]
(Reference WF 15-05)
SUMMARY:The proposed revisions to Chapter 2, Subchapter 3 amend the rules to:(1) reflect current terminology and acronym changes; (2) make grammatical changes; (3) update the foster care parent grievance policy; (4) update grievance system protocols; (5) update advocacy policy; and (6) add policy regarding the Foster Care Ombudsman (FCO) services.
PERMANENT APPROVAL:Permanent rulemaking is requested.
LEGAL AUTHORITY:Director of Human Services; O.S. 56 § 162; 10A O.S. § 162; 10A O.S. § 1-1-101 et seq.; 43A § 10-102 et seq.; and Section 5101 et seq. of Title 42 of the United States Code.
Rule Impact Statement
To:Programs administrator
Office of Intergovernmental Relations and Policy
From:Kathryn Boyle Brewer, Advocate General
Office of Client Advocacy (OAC)
Date:January 11, 2016
Re:CHAPTER 2. ADMINISTRATIVE COMPONENTS
Subchapter 3. Office of Client Advocacy
Part 5. Grievances
OAC 340:2-3-46 [AMENDED]
OAC 340:2-3-50 [AMENDED]
OAC 340:2-3-56 [ISSUED]
Part 7. Grievance and Abuse Review Committee
OAC 340:2-3-64 [AMENDED]
Part 9. Advocacy Programs
OAC 340:2-3-71 [AMENDED]
OAC 340:2-3-73 through 340:2-3-74 [AMENDED]
Contact:Angela Burleigh 405-522-2728
A.Brief description of the purpose of the proposed rule:
The proposed revisions to Chapter 2, Subchapter 3 amend the rules to:(1) reflect current terminology and acronym changes; (2) make grammatical changes; (3) update the foster care parent grievance policy; (4) update grievance system protocols; (5) update advocacy policy; and (6) add policy regarding the Foster Care Ombudsman (FCO) services.
Strategic Plan Impact.
The proposed revisions achieve Oklahoma Department of Human Services (DHS) goals by ensuring that OCA policy corresponds with Senate Bill (SB) 1793 and with Section 1-9-112(D)(1) of Title 10A to the Oklahoma Statutes (O.S. 10A § 1-9-112(D)(1)), and that OCA rules reflect the current standards regarding Child Welfare Services (CWS) and Developmental Disabilities Services (DDS) rules.
Substantive changes.
Oklahoma Administrative Code (OAC) 340:2-3-46 is amended to: (1) reference the contested grievance procedures for approved foster parents per OAC 340:2-3-50; (2) change acronyms; and (3) make grammatical changes.
OAC 340:2-3-50 is amended to: (1) change wording regarding contested grievances; (2) add language regarding informal problem resolution, foster parent mediation, and first level problem resolution; (3) update acronyms; and (4) correct a citation reference.
OAC 340:2-3-56 is issued to address Foster Care Ombudsman services within OCA regarding: (1) legal authority; (2) scope; (3) definitions; (4) confidentiality; (5) duties; (6) initial complaint disposition; (7) grievable issues; (8) intra-agency referrals; and (9) preliminary inquiry.
OAC 340:2-3-64 is amended to: (1) include the classes of people serviced by the Grievance and Abuse Review Committee (GARC); (2) add designee as a substitute to the advocate general; (3) delete the wording NORCE, as that facility is now closed; (4) revise how foster care parent grievances are processed by GARC related to the GARC summary, findings, and distribution of GARC's final report. These changes were made to modify the process for approved foster parents in order to meet the 60-day processing requirement per SB 1793; (5) make grammatical changes; and (6) update acronyms.
OAC 340:2-3-71 is amended to change the wording "developmental disability" to reflect the now accepted term "intellectual disability."
OAC 340:2-3-73 is amended to:(1) clarify OCA advocate performance expectations and time frames; (2) make grammatical changes; (3) update acronyms; and (4) correct terminology.
OAC 340:2-3-74 is amended to: (1) clarify OCA advocate performance expectations and time frames; (2) make grammatical changes; (3) update acronyms; and (4) correct terminology.
Reasons.
The proposed revisions clarify OCA advocate staff performance expectations, ensure that OCA policy corresponds with SB 1793 and with O.S. 10A § 1-9-112(D)(1), and that OCA policy reflects the current standards regarding CWS and DDS rules, make grammatical changes, and update acronyms.
Repercussions.
If the proposed rules are not implemented, some of the terminology in OCA rules will not be consistent with DHS rules and the OCA rules will not be in compliance with SB 1793 or with O.S. 10A § 1-9-112(D)(1).
Legal authority. Director of Human Services; O.S. 56 § 162; 10A O.S. § 162; 10A O.S. § 1-1-101 et seq.; 43A § 10-102 et seq.; and Section 5101 et seq. 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 rules are OCA Advocates, vulnerable adults receiving services from DDS, and foster parents.There is no cost associated with implementation of the rules.
C.A description of the classes of persons who will benefit from the proposed rule: The classes of persons who will benefit by the proposed rules are OCA Advocates, vulnerable adults receiving services from DDS, and foster parents.
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: There are no fee changes associated with the proposed rules.
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 probably cost to DHS includes the cost of printing and distributing the rules estimated to be less than $100.
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 rules do 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 rules.
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: There are no anticipated adverse effects on small business as provided by the Oklahoma Small Business Regulatory Flexibility Act.
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 neither less costly or non-regulatory methods, nor less intrusive methods to achieve compliance.
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: Implementation of the proposed rules will have a positive impact on OCA's monitoring of services for vulnerable adults receiving services from DDS, the OCA Grievance Program will be in compliance with SB1793, and the OCA Foster Care Ombudsman Program will be in compliance with Section 1-9-112(D)(1) of Title 10A.
J.A determination of any detrimental effect on the public health, safety, and environment if the proposed rule is not implemented: None.
K.The date the rule impact statement was prepared and, if modified, the date modified: Prepared December 11, 2015; modified January 11, 2016.
SUBCHAPTER 3. OFFICE OF CLIENT ADVOCACY
PART 5. GRIEVANCES
340:2-3-46. Contested grievances appealed to the state office State Office
Revised 7-1-099-15-16
(a) Application.This Section describes the processes for contesting the second level response to Oklahoma Department of Human Services (OKDHS) (DHS) grievances, facility grievances at OKDHS DHS-operated facilities, and provider grievances of Hissom class members.For contested grievances of approved foster parents refer to Oklahoma Administrative Code (OAC) 340:2-3-50.
(b) Definitions.The definitions in OAC 340:2-3-2 and 340:2-3-45(b) apply to this Section unless the context clearly indicates otherwise.
(c) Initiating the contested grievance.When a decisionmaker decision-maker asks to appeal a grievance to the state office State Office administrator, within three-business days of notice of the request, the local grievance coordinator (LGC) transmits the grievance to the Office of Client Advocacy (OCA), Attn. Attention OCA grievance liaison, with Form 15GR002E, Local Grievance Coordinator (LGC) Worksheet, attaching the corresponding Form 15GR001P, Grievance Form, and other documents and information relevant to the subject matter of the grievance.
(d) Documentation requirements.When Form 15GR002E is submitted to OCA, it has attached attachments are:
(1) the corresponding Form 15GR001P;
(2) supporting facts relating to the proposed resolution by the second level respondent, including documentation relating to the first level and second level of problem resolution processes; and
(3) any written rule, policy, procedure, regulation, and or other information relevant to the grievance subject matter of the grievance.
(e) OCA grievance processing of grievance.Within three-business days following receipt of an OCA receipt of a contested grievance, the OCA grievance liaison reviews the contested grievance and accompanying documentation and determines if any additional information is necessary for disposition of the appeal.When any information appears to be is missing, the OCA grievance liaison contacts the person(s) in possession of the needed information and sets deadlines for submission of the information by the most efficient means to avoid delays in processing the contested grievance.
(f) Rejected grievances.If When OCA determines the subject matter of a grievance falls in one of the categories listed in OAC 340:2-3-45(c)(2), the OCA grievance liaison returns the grievance to the LGC with a cover letter indicating the reason the grievance was not accepted for processing as a contested grievance.Within three-business days following receipt of receipt of the letter, the LGC contacts the grievant to inform the grievant of the status of the grievance.
(g) OCA transmittal to state office State Office administrator.Within three-business days following receipt of an OCA receipt of a contested grievance and all documents required by subsection (d) of this Section, the advocate general or designee prepares and sends Form 15GR011E, Contested Grievance Transmittal, to the state office State Office administrator with decision-making authority to respond to the subject of the grievance.
(h) State office Office administrator's response.The state office State Office administrator who receives a contested grievance responds to the grievant within ten 10-business days or by the due date on Form 15GR011E.The advocate general or designee may grant an extension when good cause is shown.The state office State Office administrator sends his or her response directly to the LGC after completing the middle designated portion of Form 15GR011E.A copy is sent to the advocate general, or designee.The state office State Office administrator attaches his or her response to Form 15GR011E and includes:
(1) the proposed resolution and how it is to will be implemented;
(2) the person(s) names of those responsible for implementing the proposed resolution;
(3) the proposed resolution target date for the proposed resolution;
(4) the facts and analysis supporting the proposed resolution, including relevant documentation; and
(5) any relevant written rules, policies, procedures, regulations, and or other information.
(i) Timely response required.The OCA grievance liaison monitors the timely response by the state office State Office administrator.If When a complete response is not timely received by the OCA grievance liaison and an extension has was not been granted, the OCA grievance liaison immediately processes the grievance for review by the Grievance and Review Committee (GARC), in accordance with per OAC 340:2-3-64(b).In that event, OCA notifies the grievant and affected state office State Office administrator that the grievance is being processed for GARC.
(j) Presentation of proposed resolution.The LGC or designee contacts the decisionmaker decision-maker within three-business days of following receipt by the LGC of the state office State Office administrator's response.If When the decisionmaker decision-maker accepts the proposed resolution, the LGC notes this on the OCA transmittal memo and files it in the client's grievance file.
(k) Request for GARC review.If When the grievant does not accept the State Office administrator's response of the state office administrator, the LGC completes the bottom designated portion of Form 15GR011E and returns it to the OCA grievance liaison within three-business days.Upon OCA receipt by OCA of Form 15GR011E, the grievance is processed for review by GARC, in accordance with per OAC 340:2-3-64.
340:2-3-50. Grievances of foster parents
Revised 7-1-139-15-16
(a) Application.This Section describes processes relating to grievances of foster parents parent grievances approved by the Oklahoma Department of Human Services (OKDHS) (DHS).Section 1-9-120 of Title 10A of the Oklahoma Statutes (10A O.S. § 1-9-120) confers on OKDHS DHS the responsibility to establish grievance procedures for foster parents contracting with state agencies or child-placing agencies.
(b) Definitions.The definitions in Oklahoma Administrative Code (OAC) 340:2-3-2 and 340:2-3-45(b) apply to this Section unless the context clearly indicates otherwise.
(c) Notice of grievance rights.Form 15GR008E, Notice of Grievance Rights - Foster Parents, is given to each foster parent when approved as an OKDHS a DHS foster parent, andat reassessment, and with each new placement.It is given to the foster parent by the Child Welfare (CW) Services (CWS) specialist assigned to the foster home within two-business days of the approval, or the reassessment, or placement.This form Form 15GR008E is used to identify the local grievance coordinator (LGC) and to explain the foster parent's right to grieve and to inform the foster parent of the means through which a grievance may be filed.After the foster parent signs the form Form 15GR008E, a copy is given to the foster parent and the original is maintained in the permanent record for the foster parent.If the designated LGC changes, the state agency or child-placing agency notifies the foster parent(s) of the name and contact information of the new LGC within ten business days.¢ 1
(d) Grievance defined.Foster parents may file grievances with respect to the provision or receipt of services.
(1) Grievable issues.Except for the limitations listed in subsection (d)(2) of this Section, matters which can be that are the subject subjects of a grievance include:
(A) the substance or application of any DHS policy, rule, or regulation, written or unwritten, of OKDHS; or
(B) a decision, act, or omission of an a DHS employee of OKDHS.
(2) Summary dispositions Non-grievable issues.If When it is determined that the foster parent is asking to grieve a problem or concern covered by any of the categories in Section OAC 340:2-3-45(c)(2) or by any of the categories listed in (A) through (G) the LGC of this paragraph, the Office of Client Advocacy (OCA) Intake Unit must notify the Foster Care Ombudsman (FCO).It is the FCO's or designee's responsibility to notify informs the foster parent in writing, why the grievance is not being processed, using Form 15GR016E, Notice of Summary Disposition of Foster Parent Grievance.In addition to the categories in Section OAC 340:2-3-45(c)(2), situations that are not grievable by foster parents under this grievance system are:¢ 2
(A) a decision of a court;
(B) findings of a child abuse and neglect investigation or assessment in a foster home.The process for appealing these findings is found located at OAC 340:75-1-12.2 340:75-3-530;
(C) disposition of a fair hearing regarding closure of a foster home.The fair hearing process regarding closure of a foster home is found located at OAC 340:75-7-94;
(D) disputes with other foster parents;
(E) written plans of compliance.The foster parents provide their written input on the compliance documentation;
(F) replacement of a child in a decision not to return a child in DHS custody to a foster home after removal due to a child abuse or neglect investigation.The fair hearing process regarding replacement in foster care is found located at OAC 340:75-1-12.6; and
(G) a complaint alleges alleging retaliation by an a DHS employee of OKDHS,.When retaliation is alleged, the complaint is forwarded to the OCA Investigations Unit for review and disposition.
(3) Allegations of retaliation or harassment.Allegations of retaliation or discrimination harassment, as those terms are defined in per OAC 340:2-3-38(b), are processed, in accordance with per that Section.
(4) Allegations of discrimination.Allegations of discrimination or non-compliance based on sex, age, national origin, religion, race, color, national origin, sex, age, religion, or disability, political affiliation or opinion, or genetic information unless authorized by law are referred to the OKDHS DHS Office for Civil Rights (OCR) and the LGC FCO immediately forwards the complaint to the OKDHS civil rights DHS OCR administrator, and so informs the foster parent using Form 15GR016E in writing.
(e) Filing and processing of a grievance.A grievance filed by a foster parent is processed as an OKDHS a DHS grievance, per OAC 340:2-3-45 unless otherwise provided in this Section.
(1) The district director serves as the LGC for grievances filed by foster parents.For grievances involving specialized foster care, the applicable Developmental Disabilities Services Division (DDSD) area manager or designee serves as the LGC Foster parent grievances are filed with the Office of Juvenile System Oversight (OJSO) of the Oklahoma Commission on Children and Youth (OCCY).Resolution of disputes with foster parents must be accomplished quickly, informally, and at the lowest possible level.
(2) Foster parent grievances must be filed within 45-calendar days of the event.For a grievance to be considered valid, a complaint must be timely filed at OKfosterparentvoices.org or by phoning 1-405-606-4900 or to 1-866-335-9288.When a course of misconduct is alleged, the foster parent grievance must be filed within 45-calendar days of the most recent occurrence.
(3) After the grievance procedure has been is completed, a foster parent or former foster parent has a right of access to the grievance record of grievances the foster parent he or she filed.
(4) Foster parent grievances are deemed timely-resolved within no more than 60-calendar days of the complaint filing date.
(f) Contested grievances Informal Problem Resolution (IPR).Contested grievances are processed in accordance with OAC 340:2-3-46 unless otherwise provided in this Section.
(1) Within three-business days following receipt of the grievance from the OCA Intake Unit, the FCO identifies the respondent and submits the grievance and supporting documentation to the respondent.¢ 3
(2) The FCO monitors the respondent for a timely response.Within three-business days following receipt of the grievance from the FCO, the respondent reviews the grievance, prepares a proposed resolution, and submits the resolution to the FCO.The FCO may grant an extension to the respondent, when requested.When a timely response is not received the FCO immediately proceeds to first level problem resolution.¢ 4
(3) Within three-business days following receipt of the respondent's proposed resolution, the FCO or designee sends written notice to the decision-maker containing the proposed resolution and information on the right to elevate the grievance when dissatisfied with the proposed resolution.
(4) The decision-maker has three-business days to accept or reject the proposed resolution.Failure to respond to the proposed resolution is deemed acceptance of the resolution.When the decision-maker rejects the respondent's resolution at the IPR level, the grievance proceeds to the first level problem resolution unless the decision-maker requests mediation.¢ 5
(g) Foster parent mediation.When the decision-maker rejects the respondent's proposed resolution, the decision-maker may request mediation of the grievance.¢ 6
(1) When the decision-maker chooses not to request mediation after rejecting the respondent's proposed resolution, the grievance proceeds to the first level problem resolution process.
(2) When the decision-maker requests mediation, all deadlines are suspended while mediation is ongoing.When a foster parent requests an extension in order to pursue mediation through OCCY Foster Parent Mediation Program per 10 O.S. § 601.6, the FCO must grant the requested extension.The grievance is not processed until mediation is completed, and grievance timeframes are suspended for the duration of the mediation.When mediation resolves the original grievance, the foster parent(s) may withdraw the grievance or the FCO may declare the grievance "administratively resolved."When a foster parent grieves and requests mediation of the dispute through the OCCY mediation program before filing a grievance alleging retaliation, the FCO counts from the mediation date when computing deadlines.
(3) When the grievance is not resolved through mediation, the grievance proceeds to the first level problem resolution.
(h) First level problem resolution.
(1) Within three-business days after the grievant requests a first level review, the FCO identifies the first level respondent and submits the complaint and supporting documentation to the first level respondent.¢ 7
(2) The FCO monitors timely response by the first level respondent.Within five- business days following receipt of the grievance from the FCO, the first level respondent reviews the grievance, prepares a proposed resolution, and submits the resolution to the FCO.The FCO may grant an extension to the respondent, when requested.When a timely response is not received the FCO immediately proceeds to the "contested grievance"level.¢ 8
(3) Within three-business days following receipt of the first level respondent's proposed resolution, the FCO sends written notice including the proposed resolution and information on the grievant's right to elevate the grievance when the decision-maker is dissatisfied with the proposed resolution.
(4) The decision-maker has three-business days to accept or reject the proposed resolution.Failure to respond to the proposed resolution is deemed acceptance of the resolution.When the decision-maker opts to reject the first level respondent's proposed resolution, the grievance proceeds to the "contested grievance" level.¢ 9
(i) Contested grievances.
(1) When a decision-maker asks to appeal a grievance to the State Office administrator, within three-business days of the request, the FCO prepares and sends the following to the State Office administrator with decision-making authority to respond to the subject of the grievance:
(A) a copy of the complaint;
(B) all prior proposed resolutions;
(C) all responses by the grievant to said proposed resolutions; and
(D) instructions for response, including any relevant deadlines.
(2) The State Office administrator who receives a contested grievance responds to the grievant within seven-business days.The State Office administrator sends his or her response to the FCO.The contested level response must be on DHS letterhead and include:
(A) the proposed resolution and implementation;
(B) the person(s) responsible for implementing the proposed resolution;
(C) the target date for the proposed resolution;
(D) the facts and analysis supporting the proposed resolution including relevant documentation; and
(E) any relevant written rules, policies, procedures, regulations, or other information.
(3) The FCO monitors the timely response by the State Office administrator.The FCO may grant an extension, when requested.When a timely response is not received, the FCO immediately proceeds to the Grievance and Review Committee (GARC) per OAC 340:2-3-64(b).The FCO notifies the grievant and the affected State Office administrator that the grievance is being processed for GARC.
(4) Within three-business days following receipt of the proposed resolution, the FCO sends written notice to the decision-maker containing the proposed resolution and information on the right to elevate the grievance when dissatisfied with the proposed resolution.
(5) The decision-maker has three-business days to accept or reject the proposed resolution.Failure to respond to the proposed resolution is deemed acceptance of said resolution.When the decision-maker rejects the State Office administrator's proposed resolution, the grievance proceeds to GARC.¢ 10
(j) GARC review. A GARC review is conducted, per OAC 340:2-3-64.
INSTRUCTIONS TO STAFF 340:2-3-50
Issued 9-15-16
1.A foster parent grievance must be filed either online at www.okfosterparentvoices.org or via phone at 1-866-335-9288 to be valid.
2.(a) Upon receipt of a complaint the Office of Client Advocacy (OCA) intake unit reviews the complaint to determine if it meets the criteria for a grievance, an investigation for retaliation, harassment, or discrimination, or another disposition.The intake unit forwards the complaint disposition to the Foster Care Ombudsman (FCO).
(b) When the complaint presents a grievable issue, the FCO notifies the grievant in writing and explains the grievance resolution process.
(c) The FCO determines if an intra-agency referral is appropriate and, if so, makes necessary referrals.Foster parent complaints subject to an intra-agency referral are deemed closed at the time the intra-agency referral is made.
(d) When information contained in the initial foster parent complaint is insufficient to determine an appropriate disposition, a preliminary inquiry may be completed to obtain additional, necessary facts to determine the appropriate disposition of a complaint.
3.(a) In most Child Welfare Services (CWS) cases, the Informal Problem Resolution (IPR) respondent is the district director or foster care field manager for the district where the complaint originated.When the district director or foster care field manager is named in the complaint, the IPR respondent is the deputy director for that region.
(b) In most Developmental Disabilities Services (DDS) cases, the IPR respondent is the DDS foster care manager or assistant field manager for the area where the complaint originated.When the DDS foster care manager or assistant field manager is named in the complaint, the IPR respondent is the area manager for the DDS area.
(c) The documentation submitted to the IPR respondent includes a copy of the complaint filed by the grievant and documentation of any information developed by the OCA Intake Unit and the FCO during the disposition process.
4.The IPR respondent develops the proposed resolution in consultation with the involved parties including the grievant.The IRP respondent submits the proposed resolution in writing on DHS letterhead.When the IPR respondent considers the matter not grievable, documentation of additional facts supporting this position are made available to the FCO, who determines if the matter remains grievable.
5.Upon acceptance of the proposed resolution, the FCO documents closure in the file and the database and sends written notice to the grievant and the relevant respondent.This notice informs the grievant and the relevant respondent that the grievance is resolved and the complaint file is closed.
6.When the grievant requests mediation and the criteria for mediation are met, the FCO requests mediation through the Oklahoma Commission on Children and Youth (OCCY).
7.(a) For CWS, the first level respondent is generally the deputy director for the CWS region in which the case originated.When the deputy director was the IPR respondent, the FCO identifies the individual who has the authority to provide the quickest and surest resolution to the problem at the lowest level in the organizational structure, and that individual acts as the first level respondent.
(b) For DDS, the first level respondent is generally the area manager for the DDS area in which the case originated.When the area manager was the IPR respondent, the FCO identifies the individual with authority to provide the quickest and surest resolution to the problem at the lowest level in the organizational structure and that individual acts as the first level respondent.
(c) The documentation submitted to the first level respondent must include a copy of the original complaint, any supporting documentation submitted to the IPR respondent, the resolution proposed by the IPR respondent, and other relevant documentation generated during the process.
8.The first level respondent must develop the proposed resolution in consultation with the involved parties including the grievant.When complete, the first level respondent submits the proposed resolution in writing on DHS letterhead to the FCO.
9.When the resolution proposed by the first level respondent is accepted by the decision-maker the FCO sends notice and documents closure in the file, per Instructions to Staff # 5 of this Section.
10.When the resolution proposed by the State Office administrator is accepted by the decision-maker the FCO sends written notice to the State Office administrator, county staff, and the grievant.
340:2-3-56. Foster Care Ombudsman (FCO) services
Issued 9-15-16
(a) Legal Authority.
(1) Section 1-9-112(D)(1) of Title 10A of the Oklahoma Statutes (10A O.S. § 1-9-112(D)(1)) requires the Office of Client Advocacy (OCA) investigate any complaint received by the Office of Juvenile System Oversight (OJSO) of the Oklahoma Commission on Children and Youth (OCCY) alleging that an Oklahoma Department of Human Services (DHS) or child-placing agency employee threatened a foster parent with removal of a child from the foster parent, harassed a foster parent, refused to place a child in a licensed or certified foster home, or disrupted a child placement as retaliation or discrimination toward a foster parent who engaged in a protected activity.
(2) 10A O.S. § 1-9-120 requires OCA establish grievance procedures for foster parents with whom DHS or child-placing agencies contract.
(3) 10A O.S. § 1-9-120(C) requires OCA to designate one employee to receive and process foster care grievances.OCA designated the FCO.OCA conferred the responsibility for fulfilling the duties set forth in (e) of this Section on the FCO.
(b) Scope.
(1) The FCO provides services relating to complaints brought by foster parents against employees of DHS or child-placing agencies.
(2) Per 10A O.S. § 1-9-112(D)(2), this Section shall not apply to any complaint by a foster parent regarding the result of a criminal, administrative, or civil proceeding for a violation of any law, rule, or contract provision by that foster parent or the action taken by DHS or any child-placing agency in conformity with the result of any such proceeding.
(c) Definitions.The definitions used in this Section are located in Oklahoma Administrative Code (OAC) 340:2-3-2, 340:2-3-45, and 340:2-3-50.
(d) Confidentiality.Information in OCA records relating to complaints filed by foster parents with the FCO is confidential and protected from unauthorized use.Only authorized individuals are given access to case records or provided information from these records.A breach of confidentiality may result in criminal prosecution.Violations by DHS employees can also result in personnel action.The relevant confidentiality provisions are located at 10A O.S. § 1-6-107 and OAC 340:75-1-42.
(e) Duties.The FCO is responsible for:
(1) overseeing and resolving grievances between foster parents and state agencies or child- placing agencies, per OAC 340:2-3-50;
(2) referring complaints meeting the criteria for retaliation per 10A O.S. § 1-9-112(D)(1) to the OCA Investigative Unit per OAC 340:2-3-38;
(3) referring cases for mediation, when appropriate, per OAC 340:2-3-50(g);
(4) collecting and maintaining data necessary to identify systemic issues that may be addressed and resolved to improve the foster care system.In partnership with OCCY, prepares an annual report for the legislature based on collected data and makes recommendations as appropriate for improvements of procedures and policies to benefit children and families;¢ 1
(5) conducting training, education, and outreach activities for the benefit of those involved in, or potentially involved in foster care, and maintaining personal accessibility in order to address questions and concerns;
(6) providing resources and referrals to interested parties; and
(7) collaborating with foster parents, Child Welfare Services, Developmental Disabilities Services, OCCY, and OJSO in efforts to improve the foster care system.
(f) Initial disposition of the complaint.Upon receipt, the OCA Intake Unit must examine the complaint to determine if it meets the criteria for a grievance, retaliation, harassment, discrimination investigation or if another disposition is appropriate.Foster parents may file grievances with respect to the provision or receipt of services.¢ 2
(1) Grievable issues.Except for the limitations listed in OAC 340:2-3-50(h), matters that can be the subject of a grievance include:
(i) the substance or application of any policy or rule of DHS or its agents; or
(ii) any decision or action by a DHS employee or its agent; or
(iii) a violation by a DHS or a child-placing agency employee of the Foster Parent Bill of Rights, per 10A O.S. § 1-9-119.
(2) Non-grievable issues and intra-agency referrals.When the OCA Intake Unit, working in consultation with the FCO determines the complaint is not grievable, and does not present an issue of retaliation, harassment, or discrimination suitable for investigation, the OCA Intake Unit forwards the complaint to the FCO. The FCO determines if an intra-agency referral is appropriate, makes any necessary referrals, and closes the file.Foster parent complaints subject to an intra-agency referral are deemed closed at the time the referral is made.¢ 3
(3) When the complaint meets none of the criteria above, but is resolvable through the provision of information readily obtainable by the FCO or designee, the FCO may, at his or her discretion, resolve the complaint by obtaining the necessary information.
(4) Preliminary inquiry.When the information contained in the complaint is insufficient to enable the OCA Intake Unit, in consultation with the FCO, to determine appropriate disposition, a preliminary examination may be completed.¢ 4
INSTRUCTIONS TO STAFF 340:2-3-56
Issued 9-15-16
1.Throughout the process, the Foster Care Ombudsman (FCO) tracks all data collected including, but not limited to, the number of complaints received, the number of complaints resolved, the nature of the complaints, and any other information deemed necessary for Oklahoma Department of Human Services (DHS) Leadership Team quarterly reports and annual legislative report.
2.A foster parent grievance must be filed either online at www.okfosterparentvoices.org or by phone at 1-866-335-9288, to be valid.
3.(a) Office of Client Advocacy (OCA) Intake staff, in consultation with the FCO or designee, determines if a non-grievable issue is referred to another part of DHS for attention, such as the Director's Helpline.
(b) If the complaint presents a grievable issue, the FCO notifies the grievant in writing of this fact and explains, in the same writing, the grievance resolution process.
4.(a) In most cases, the referral process consists of the FCO determining which DHS office is best able to address the foster parent's issue and providing the foster parent in writing with contact information for that office.
(b) In cases where referral to the Director's Helpline is appropriate, the FCO forwards the complaint to the Director's Helpline.
(c) When the FCO determines the foster parent's needs are best served by directly forwarding a complaint to another DHS office, the FCO may, at his or her discretion, directly forward the complaint.
(d) When the procedure in (a), (b), or (c) of this Instruction is followed, the FCO informs the foster parent in writing of the intra-agency referral.This notice also includes a request that the foster parent contact the FCO when the office referred to does not respond to the foster parent.
PART 7. GRIEVANCE AND ABUSE REVIEW COMMITTEE
340:2-3-64. Grievance and Abuse Review Committee (GARC) review of unresolved contested grievances
Revised 7-1-099-15-16
(a) Application.The Grievance and Abuse Review Committee (GARC) reviews unresolved contested grievances of children in Oklahoma Department of Human Services (DHS) custody, Developmental Disabilities Services (DDS) service recipients, and approved or kinship foster parents when the advocate general receives a proper request for a GARC review, in accordance with per Oklahoma Administrative Code (OAC) 340:2-3-46(k).
(b) The GARC worksheet.If When the grievance was filed by, or on behalf of, a Developmental Disabilities Services Division (DDSD) services DDS service recipient who receives Office of Client Advocacy (OCA) advocacy services, including residents of the Southern Oklahoma Resource Center (SORC), the Northern Oklahoma Resource Center of Enid (NORCE), or the Greer Center Facility (Greer), the OCA advocate prepares a GARC worksheet using a format prescribed by OCA which that includes:
(1) the grievance number and the names of the resident, grievant, guardian, parent(s), case manager, and OCA advocate;
(2) a summary of the grievance process, resolutions offered at each level, and the decision-makers' responses;
(3) the applicable statutes, policies, and other authorities;
(4) the resolution sought by the grievant;
(5) relevant documentation;
(6) the OCA advocacy position with regard to the subject of the grievance; and
(7) a copy copies of Form Forms 15GR001E, Grievance Form, and Form 15GR002E, Local Grievance Coordinator (LGC) Worksheet.
(c) GARC review summary.For all children in DHS custody or DDS service recipient grievances of DHS custody children or DDS service recipients being reviewed by GARC, the OCA grievance liaison prepares a GARC review summary that is included and includes it in the GARC file.For approved foster parents the grievance is submitted on the GARC report summarizing all responses from initiation.
(d) Scope of GARC review.GARC conducts a de novo paper review of the grievance.
(1) Within three-business days following receipt of receiving a proper request for GARC review, pursuant to per OAC 340:2-3-46(k), the advocate general or designee informs the affected state office State Office administrator and administrator of the date of the GARC meeting date.
(2) The grievant, administrators, state office State Office administrators, and their designees may attend the GARC meeting to answer questions.If When a grievance involves a Hissom class member, the OCA programs administrator for the community advocacy program may also attend.
(3) If When the grievant wants to submit additional evidence not considered during the processing of the grievance, it is submitted to the advocate general within five- business days of the request for GARC review, but not less than seven-business days prior to the GARC meeting.If When the administrator or affected state office State Office administrator wants to submit additional evidence not considered during the processing of the grievance, or when the GARC review is the result of an untimely response, in accordance with per OAC 340:2-3-46(I), or for good cause shown, evidence can be submitted to the advocate general seven-business days before the GARC meeting.
(4) When additional information is needed in order for GARC to complete its review, GARC may continue it's the grievance review of a grievance until it's the next meeting.GARC may request additional information from OCA, an administrator, or a state office State Office administrator.
(e) GARC report contents.Within 15-business days of a GARC meeting to review an unresolved grievance of a child in DHS custody or a DDS service recipient, GARC prepares a report that includes the:
(1) the subject of the grievance and identifying information about the grievant, the administrator, and the state office State Office administrator;
(2) the grievance procedural history of the grievance, and identifying proposed resolutions and responses at each level in the grievance process, prior to the GARC review;
(3) the resolution sought by the grievant and the resolution proposed by the state office State Office administrator;
(4) GARC recommended resolution of the grievance;
(5) the facts on which GARC bases its recommendation;
(6) the information GARC considered in making its recommendation; and
(7) areas of concern identified by GARC during its review of the grievance.
(f) GARC findings regarding approved foster parents.Within three-business days following the GARC meeting, GARC records the decision on the GARC report.The completed GARC report for foster parent grievances includes the:
(1) subject of the grievance and identifying information about the grievant and the State Office administrator;
(2) procedural history of the grievance including, but not limited to, proposed resolutions and responses at each level in the grievance process prior to the GARC review;
(3) resolution sought by the grievant and the resolution proposed by the State Office administrator;
(4) GARC recommended resolution of the grievance;
(5) facts on which GARC bases its recommendation;
(6) information GARC considered in making its recommendation; and
(7) areas of concern identified by GARC during its review of the grievance.
(f)(g) Distribution of GARC report.The advocate general forwards the GARC report to the applicable local grievance coordinator (LGC).Within three-business days following receipt of receipt of the GARC report, the LGC contacts the decisionmaker decision-maker to inform him or her of the GARC recommended resolution, and determines if the decisionmaker decision-maker is satisfied with it.
(1) If When the decisionmaker decision-maker needs time to decide whether to accept the proposed resolution, the decisionmaker decision-maker has three-business days to make a decision.If no When a decision is not communicated to the LGC within three-business days, the decisionmaker decision-maker is deemed to have accepted the proposed resolution.
(2) If When the decisionmaker decision-maker is satisfied, the LGC notifies the advocate general, and the advocate general then notifies interested parties.An affected state office State Office administrator has three-business days from following receipt of this notification to submit to the advocate general a written request for review by the Oklahoma Department of Human Services (OKDHS) (DHS) Director to the advocate general.
(3) If When the decisionmaker decision-maker is not satisfied with the GARC recommended resolution and elects to contest it, the LGC notifies the advocate general within four-business days of following receipt of the GARC report.The advocate general or designee transmits the request and the GARC report for review by the OKDHS DHS Director.
(h) Distribution of GARC report for approved foster parents.The advocate general forwards the final GARC resolution on the GARC report to the FCO.Within one- business day following receipt of the GARC report, the FCO notifies the decision-maker and affected State Office administrator of the GARC recommended resolution.
(1) The FCO upon notifying the decision-maker and affected State Office administrator of GARC's recommended resolution, advises the parties of their right to appeal the decision to the DHS Director.An affected State Office administrator or decision-maker has three-business days following receipt of this notification to submit a written request to the advocate general for review by the DHS Director.
(2) When the resolution of the grievance involves an action to be taken by a DHS employee by a future target date, the FCO monitors compliance with that target date.In the event the resolution is not implemented or not implemented within the time specified, the FCO informs the advocate general and he or she notifies the DHS Director in writing.
(3) When an appeal is not requested by the decision-maker or affected State Office administrator within three-business days following receipt of the recommended resolution, the FCO sends the closure notice to the grievant and State Office administrator.
(g)(i) OKDHS DHS Director's review of a GARC recommendation.Upon receipt by the advocate general of a proper and timely written request for review by the OKDHS DHS Director, pursuant to subsection per (e) of this Section, the advocate general or designee transmits the request and the GARC report to the OKDHS DHS Director.
(1) Within 15-business days of following receipt of the GARC report, the OKDHS DHS Director decides whether to:
(A) adopt the GARC recommended resolution;
(B) adopt the GARC recommendation with modifications;
(C) return the matter to GARC for further consideration; or
(D) direct another resolution of the grievance.
(2) If When the OKDHS DHS Director does not respond within 15-business days, the grievance or appeal is deemed resolved, in accordance with per the GARC recommended resolution.
(3) The advocate general notifies the grievant and other interested parties of the result of the OKDHS DHS Director's review.The decisionmaker decision-maker is informed that this concludes the grievant's administrative remedies.If When the grievant is a minor or foster parent, a copy of the grievance and related materials are forwarded to the Office of Juvenile Systems Oversight in the Oklahoma Commission for Children and Youth of the Oklahoma Commission for Children and Youth.
(h)(j) Monitoring of resolution for children in DHS custody or DDS recipients.If When the resolution of the grievance involves an action to be taken by an OKDHS a DHS employee by a future target date, the OCA grievance liaison monitors compliance with that target date.In the event the resolution is not implemented or not implemented within the time specified, the OCA grievance liaison informs the advocate general and the advocate general notifies the OKDHS DHS Director in writing.
PART 9. ADVOCACY PROGRAMS
340:2-3-71. Office of Client Advocacy (OCA) general advocacy services
Revised 9-15-159-15-16
(a) Legal authority.
(1) Section 1415.1(A)(2) of Title 10 to of the Oklahoma Statutes (10 O.S. § 1415.1(A(2)) requires the Oklahoma Department of Human Services (DHS) to establish an ombudsman program for each institution and residential facility for persons with intellectual disabilities operated by DHS.DHS conferred this responsibility on the Office of Client Advocacy (OCA).
(2) Orders of the United States District Court for the Northern District of Oklahoma in Homeward Bound, Inc., et al. v. Hissom Memorial Center, et al., Case No. 85-C-437-TCK-SAJ, require DHS and OCA to provide advocacy services to individuals certified by the court as members of the plaintiff class, known as Hissom class members.
(3) DHS assigned OCA other advocacy responsibilities as outlined in Part 9 Per, Oklahoma Administrative Code (OAC) 340:2-3-71 through 340:2-3-75, DHS assigned additional advocacy responsibilities to OCA.
(b) Scope.OCA provides advocacy services to clients of the Developmental Disabilities Services (DDS) clients listed in this subsection, who are collectively referred to as "clients" in Part 9, OAC 340:2-3-71 through 340:2-3-75.
(1) OCA advocacy services for residents of the Robert M. Greer Center (Greer) are outlined in greater detail per Oklahoma Administrative Code (OAC) 340:2-3-72.
(2) OCA advocacy services for former residents of the Southern Oklahoma Resource Center (SORC), and the Northern Oklahoma Resource Center of Enid (NORCE) are outlined in greater detail in OAC 340:2-3-73.
m class members are outlined in greater detail in OAC 340:2-3-74.
(3) OCA advocacy services for for Hissom class members are outlined in greater detail in OAC 340:2-3-74.
(4) OCA provides advocacy services on a short-term or emergency basis for other DDS clients who have a special advocacy needs per OAC 340:2-3-75.
(c) Guiding principles.OCA advocacy programs advance the capacity and recognition of individual choice, the realization of rights and responsibilities of citizenship, and the personal well-being of recipients of DDS services.In addition to the guiding principles listed in OAC 340:100-1-3.1, the guiding principles for OCA advocacy on behalf of clients are: listed in (A) through (D) of this paragraph.
(1) Self-determination self-determination.Advocates promote the individual as the driving force of life choices and decisions.;
(2) Meaningful meaningful choice.Advocates promote the development of meaningful choices for persons with developmental disabilities consistent with their unique strengths, resources, priorities, concerns, abilities, capabilities, and interests.;
(3) Active active citizenry.Advocates promote the inclusion and involvement of persons with developmental disabilities in the social and political structures of the community.; and
(4) Well-being well-being.Advocates promote access to physical and emotional supports necessary for a healthy life-style.
(d) Definitions.In addition to definitions in OAC 340:2-3-2, the following words and terms when used in OAC 340:2-3-71 through 340:2-3-75 shall have the following meaning, unless the context clearly indicates otherwise:
(1) "Capacity assessment" means the process of determining an individual's ability to make informed decisions and the need for assistance with decision-making regarding personal and financial matters,per OAC 340:100-3-5.
(2) "Human Rights Committee" or "HRC" means the committee charged with the responsibility for external monitoring and advocacy to address protection of individual rights.
(3) "Individual plan" or "IP" or "plan" means a written document developed by the Personal Support Team based upon assessment of need.The plan IP specifies outcomes being pursued on behalf of the individual, steps being taken to achieve outcomes, and all services and supports necessary to achieve outcomes.
(4) "Informed consent" means informed consent per OAC 340:100-3-5.Individuals, 18 years of age and older, are presumed to have capacity to give informed consent except to the extent adjudicated incapacitated by the court.An individual is not considered incapacitated solely by reason of his or her diagnosis.Individuals may be adjudicated incapacitated in one area, while being fully capable of understanding and exercising rights in other areas.Individuals have the right to exercise judgment in all areas of capacity.
(5) "Personal Support Team (PST)" means the participants in the individual's assessment and planning process.The PST includes the service recipient, case manager, legal guardian, advocate, service providers, and others whose participation is necessary to achieve the outcomes desired by the service recipient.
(6) "Program coordinator" or "PC" means a person employed by a DDS residential or group home contract provider agency responsible for the supervision, coordination, and monitoring of services provided by the contract provider agency to a service recipient.
(7) "Service review" means an assessment by an OCA advocate of a client's health, living circumstances, and the delivery of supportive services.The service review documents the extent of services provided to an individual client and identifies problem areas in service delivery.Each service review is a snapshot of the life of an individual at the time the review is completed.
(8) "Statewide Behavior Review Committee" or "SBRC" means the SBRC established per OAC 340:100-3-14 to review each protective intervention plan with restrictive or intrusive procedures to ensure the plan complies with DDS policy on the use of restrictive or intrusive procedures, per OAC 340:100-5-57.
(e) Confidentiality Client records.Information in OCA records relating to advocacy services provided to the clients listed in subsection (b) of this Section is confidential and protected from unauthorized use.Only authorized individuals are given access to client records or provided information from those records.¢ 1
(1) The confidentiality provisions of OAC 340:100-3-2 applies apply to OCA client files.
(2) The confidentiality provisions of OAC 340:5-1-5 apply to information in OCA records regarding allegations of abuse, neglect, and exploitation of a vulnerable adult, as those terms are defined in Section 10-103 of Title 43A of the Oklahoma Statutes 43A O.S. § 10-103, 10-110, and 10-110.1.
(3) A breach of confidentiality may result in a criminal prosecution.Violations by DHS employees can also result in personnel action.
(f) Training requirements for advocates.New and tenured OCA advocates receive appropriate training consistent with their background and experience.¢ 2 This includes training on the rights of DDS clients under Oklahoma and federal and state law.¢ 3
(g) Client representation.
(1) OCA assigns advocates to represent Greer residents.
(2) OCA assigns advocates, per Part 9, OAC 340:2-3-71 through 340:2-3-75, to represent specific DDS clients living in community residential settings, including Hissom class members living in Oklahoma and former residents of SORC and NORCE.¢ 5
(3) An OCA advocate is knowledgeable about the clients he or she represents and seeks to understand each client's specific challenges and communication styles, needs, interests, and goals.¢ 4 An advocate ascertains the client's preferences and choices.An advocate becomes familiar with a client by:
(A) reviewing relevant client records and files;
(B) visits and other contacts with the client at home, at work, and in other contexts; and
(C) communication with the client's relatives, loved ones, guardians, program coordinator and other provider staff, case manager, and others in the client's circle of support.
(h) OCA advocacy services.
(1) Advocacy.Advocacy is the function of assisting an individual in voicing his or her interests.Clients are encouraged to engage in self-determination and are assisted to the extent they need and desire.When a client has a limitation in voicing his or her own interests, needs, and preferences, an advocate seeks to speak on behalf of the client.Advocacy services provided by OCA advocates include:
(A) supporting the implementation of the least restrictive alternative in residential, vocational, therapeutic, and medical settings;
(B) supporting the most appropriate living environment for each client consistent with the client's needs and objectives;
(C) encouraging the development of natural supports, including friends, coworkers, and neighbors in the community where the individual lives; and
(D) advocating for those responsible for providing services for a client to fulfill their responsibilities by bringing performance issues to the attention of those who are responsible for correcting the situation.¢ 6
(2) Monitoring.OCA monitors the well-being and provision of services to a client by means of:
(A) visits and other forms of contact with the client, staff, family members, and others who know the client;
(B) reviewing records, documentation, contracts, and financial agreements between clients and providers of services, incident reports, and professional assessments; and
(C) attendance at IP and other Personal Support Team (PST) meetings.
(D) OCA advocates cooperate with, and render assistance to, outside monitoring and advocacy entities as provided for by federal and state laws, in accordance with the per laws and rules relating to client confidentiality, and release of information protocols.
(E) The monitoring role of an OCA advocate ensures:
(A)(i) individual needs, preferences, and choices are identified and met appropriately and consistently;
(B)(ii) health, safety, and welfare standards and safeguards are maintained; and
(C)(iii) problems and issues are addressed at the earliest juncture by appropriate persons and entities in a prompt manner.
(3) Informal problem resolution.An advocate seeks to resolve issues and client concerns by means of informal problem resolution at the lowest level of administrative responsibility or decision-making.Informal problem resolution seeks to resolve issues and reach a consensus with the client on a plan of action to informally resolve the problem.An advocate uses the problem resolution activity consistent with the nature and imminence of the problem.An advocate assists a client in the development of problem resolution skills and self-advocacy.¢ 6 & 7
(4) Grievances.As needed, an An OCA advocate files grievances on behalf of clients, per Part 5, OAC 340:2-3-45 through 340:2-3-55, as needed.OCA also advises clients and assists them with filing file grievances on their own behalf.¢ 8
(5) Protection and safety.OCA staff take appropriate action under the circumstances to protect the health, safety, and well-being of clients, including reporting allegations of abuse, neglect, maltreatment, and exploitation, per Part 3, OAC 340:2-3-32 through 340:2-3-39.
(A) OCA advocates assist OCA, and Adult Protective Services investigators, and law enforcement officers to obtain information necessary to complete investigations when a client is an alleged victim.
(B) Advocates engage in appropriate follow-up activity in response to a referral from the OCA intake unit Intake Unit, per OAC 340:2-3-35.¢ 9
(C) When an advocate has a concern related to a client's health, safety, well-being, or program implementation, the advocate advises the client's case manager or designated QMRP qualified intellectual disabilities professional (QIDP), as applicable, and others;, such as DDS staff, provider or facility staff, treatment staff, or health care professionals as circumstances warrant.
(D) Immediately upon becoming aware of concerns regarding imminent risk of harm, an advocate advises the applicable residential or vocational provider and the client's case manager.
(E) An OCA advocate ensures that allegations of abuse, neglect, maltreatment, and/or exploitation allegations are reported to the OCA intake Intake Unit, per OAC 340:2-3-33.
(6) Promoting informed choice.An OCA advocate promotes informed decision-making, consistent with a client's unique strengths, resources, priorities, concerns, abilities, capabilities, and interests, through provision of necessary information and assistance to a client in understanding options and potential consequences of a decision.If When a client is unable to make an informed choice, the advocate seeks to provide the client's legal guardian, Guardian ad Litem, volunteer advocate, and other representative(s) with access to information to make an informed decision on the client's behalf.The advocate general does not provide legal advice to clients, but may provide information about the law.
(7) Protection of rights.An OCA advocate promotes the full exercise of legal rights guaranteed clients under federal and state laws.An advocate takes appropriate steps to protect a client's rights, including ensuring those rights are considered in PST decisions and in the manner PST decisions are carried out.An advocate seeks to ensure the application of due process in administrative, quasi-judicial, and judicial proceedings involving a client that might result in a rights restriction or a reduction in services.When a rights restriction is absolutely necessary, OCA supports the least restriction necessary for the shortest period of time possible, and a plan to remove the restriction as soon as possible.
(8) Access to services.An OCA advocate promotes client access to the full range of supports per federal and state and federal requirements.Although an advocate takes a position with regard to services needed by a client, an advocate does not have authority to approve services.
(9) Guardianship issues.The Oklahoma Guardianship and Conservatorship Act promotes the participation of persons as fully as possible in the decisions that affect them, in the development of maximum self-reliance and independence, and the appointments of guardians and others, only to the extent necessitated by the mental and adaptive limitations or other conditions of individuals, per 30 O.S. § 1-103.Because a full guardianship of the person and his or her estate is the most restrictive intrusion on an individual's decision-making, OCA advocates for the least restrictive alternative to a full guardianship feasible under the circumstances including, but not limited to:
(A) limited guardianship;
(B) representative payee for financial benefits;
(C) volunteer advocate;
(D) supportive friends and family;
(E) health care proxy;
(F) durable power of attorney; and
(G) advance directives.
(10) Promoting inclusion.An advocate:
(A) promotes the realization of active citizenship and inclusion in the community.This includes, but is not limited to, encouraging clients to:
(i) learn the rights and responsibilities of good citizenship,;
(ii) vote,;
(iii) take classes,;
(iv) participate in volunteer services organizations,;
(v) attend religious services of the client's choice,;
(vi) attend recreational, cultural and social events,; and
(vii) join citizen advocacy organizations that promote inclusion in the community.;
(B) An advocate encourages the development of friends who can serve as natural supports for a client.; and
(C) An advocate assists a client in locating relatives who are not currently active in the client's life and encourages relationship building between the client and family members.
(11) End-of-life issues.End-of-life issues for an individual with a developmental or intellectual disability do not differ from those of other individuals.Regardless of the medical circumstance that brought these issues to the forefront, an OCA advocate seeks to have a client's physicians, guardians, and loved ones adhere to Oklahoma laws relating to do-not-resuscitate orders, withdrawal or denial of nutrition or hydration, and withdrawal or termination of medical treatment.In the absence of clear and convincing evidence of a client's choices, an advocate presumes the client would choose life-sustaining measures.¢ 10
(i) Contacting an OCA advocate.When an advocate is not available during office hours, his or her supervisor serves as a an advocate back-up to the advocate.Information about the name of the advocate assigned to a client, the advocate's phone numbers and the name of the advocate's supervisor is obtained from by phoning OCA at 1-800-522-8014.
(j) OCA access to client records and information.OCA staff is provided access to all records, files, documents, and information needed to fulfill OCA responsibilities regarding a client.DDS case managers and employees, and provider agency staff send the assigned OCA advocate copies of documents and notices sent to the client.
INSTRUCTIONS TO STAFF 340:2-3-71
Revised 9-15-159-15-16
1.Office of Client Advocacy (OCA) files.OCA maintains a client file for each Hissom class member and other Developmental Disabilities Services (DDS) service recipient it serves, including former residents of Southern Oklahoma Resource Center (SORC), Northern Oklahoma Resource Center of Enid (NORCE), residents of the Greer Center Facility (Greer), and persons provided short-term advocacy services per Oklahoma Administrative Code (OAC) 340:2-3-75.Each client's paper file contains legal documents, documents that OCA originated, and that do not exist in electronic format.The advocate ensures all service reviews, Form 06CB035E, Site Visit Report (multiple reports may be included), Form 15GR006E, Notice of Grievance Rights DDS Service Recipients, and Form 15GR007E, Notice of Grievance Rights - Hissom Class members are completed and stored in the Document section of OCA's Client Contact Manager (CCM).Advocates complete all required documentation ensuring it is concise, accurate, and timely.
2.Advocate training.
(1) Before a new OCA advocate is assigned to represent clients, the advocate attendsDDS Foundations Training or its equivalent, unless the advocate previously completed training, and receives on-the-job training.
(2) Before an OCA advocate assumes responsibility for a client, the advocate reviews the OCA client file, discusses the case with the previous advocate when possible, and becomes familiar with essential information about the client including specialized supports, rights, restrictions, and intrusive procedures, and pending informal problem resolution activities and grievances.The advocate also completes individual-specific training when the advocate's supervisor or the OCA advocacy programs administrator determines it is warranted.
(3) Advocates avail themselves of appropriate opportunities for professional development.Advocates remain current in knowledge regarding relevant policies, laws, procedures, and best practices.Advocates complete required training per Oklahoma Department of Human Services (DHS) policy and the OCA "Training Guide for Community Advocates."Advocates complete a minimum of 20 hours of training per year.
3.Client rights.Sources of information regarding clients' rights include, but are not limited to:OAC 340:2-5-40; OAC 340:100-3-1.2; OAC 317:35-13-1; and OAC 612:10-1-6; the Developmental Disabilities Assistance and Bill of Rights Act [(42 U.S.C. § 6000 et seq.]); Section 504 of the Rehabilitation Act of 1973 [(29 U.S.C. § 794]); the Americans with Disabilities Act [(42 U.S.C. § 12101 et seq. ]); and the Civil Rights of Institutionalized Persons Act [(42 U.S.C. § 1997 et seq. ]).
4.Scope of representation.In assigning advocates to represent clients, OCA avoids actual or perceived conflicts of interest that could prevent an advocate from being objective about the client's interests and preferences of a client.For example, an OCA advocate is not assigned to represent an individual who is related to the advocate by blood or marriage to the advocate, or to represent an individual who is receiving services from a person related to the advocate.Advocates comply with OAC 340:2-1-8, the Rules of the Ethics Commission, and Oklahoma Law.[(74 O.S. Chapter 62]).An advocate represents the client's interests independent of the advocate's own biases, preferences, and belief systems.In advocating for the client's interests and preferences, an advocate does not support any action by the client or others that constitutes criminal activity or places the client at imminent risk of serious harm.An advocate supports providing Advocates provide clients with information necessary for informed and voluntary decision-making with knowledge of the potential consequences of a decision.The advocate, with the client and the client's Personal Support Team (PST), explores alternatives that minimizes minimize risk of harm to the client's health, safety, or well-being.
5.Changes in assigned advocate.Advocacy caseloads are assigned geographically to maximize the advocate's time.Some clients require more advocacy services than others and consideration is made when assigning caseloads.Caution is exercised when changing assigned advocates in order to foster continuity and promote relationships.OCA cannot guarantee the availability of a particular advocate to provide services to a specific client.Requests made by a client or client's representative to change an assigned advocate are reviewed by the advocacy programs administrator and decided on a case-by-case basis.Requests are referred to the advocate's supervisor to evaluate the basis for the request and determine if another action may resolve the matter.When the request to change advocates cannot be resolved informally, the programs administrator determines the response to the request.OCA complies with all federal and state laws prohibiting discrimination based on sex, race, color age, national origin, religion, disability, or other protected class sex, age, religion, disability, political affiliation or opinion, or genetic information unless authorized by law.In order to ensure OCA advocates are given timely and adequate notice of PST meetings, emergency meetings, and similar type meetings, appropriate persons are informed whenever when there is a change in advocate assignment.When a client is transferred from one advocate to another, protocols (1) through (6) of this Instruction are followed.
(1) The transferring advocate completes the "OCA Case File Transfer" and organizes the client case file.
(2) The transferring advocate is responsible for documenting and entering a summary of the client's current status, including any pending issues or concerns, into the OCA database.
(3) The transferring advocate briefs the receiving advocate on the case and any pending matters or concerns.The receiving advocate documents this in a contact sheet.
(4) The transferring advocate notifies the client of the change of advocate.When feasible, the transferring and receiving advocate jointly visit the client to explain the change and introduce the client to the receiving advocate.
(5) When the case is ready for transfer, the transferring advocate's supervisor reviews the case for approval and transfers the case to the receiving advocate's supervisor.The receiving supervisor is responsible for reviewing the case to ensure it is complete.The receiving supervisor is responsible for making the case change in the OCA database.The receiving advocate is responsible for providing advocacy beginning on the date the receiving supervisor assigns the case in the database.
(6) Upon receipt of the case, the receiving advocate sends an email or letter to the case manager and to the guardians or family informing them of the change.
6.Role of the OCA advocate in resolving problems.The advocate utilizes the client's case manager as a primary resource for resolving a client's support deficiencies.The role of the OCA advocate is to report service deficiencies to those responsible for providing services.An OCA advocate takes immediate action, appropriate under the circumstances, in situations where the client is at imminent risk of harm, such as preventing staff from using a defective piece of adaptive equipment.Following an action of this nature, the advocate immediately notifies the DDS case manager, the case manager's supervisor, or the DDS on-call administrator to report the circumstances that prompted the advocate's action,.; and to request prompt follow-up to address the situation, and to prevent a reoccurrence.An advocate does not function as a case manager or a provider of direct contact services for a client.
7.Informal problem resolution.The OCA advocate attempts to resolve all identified issues requiring informal problem resolution within 30-calendar days.Issues not resolved within 30-calendar days must be staffed with the advocate's supervisor and documented in the OCA database.Informal problem resolution activities include, but are not limited to:
(1) contact with the case manager, seeking to resolve problems at the lowest possible level of administrative responsibility;
(2) requesting a PST meeting;
(3) identifying and articulating client concerns during PST meetings;
(4) acting to facilitate resolution of a problem;
(5) representing the preferences of the client in PST meetings when known and when capacity is not an issue;
(6) facilitating informed-consent decision-making by the client or guardian(s);
(7) identifying acceptable alternatives;
(8) filing an advocate's inquiry, per OAC 340:2-3-51 or 340:2-3-52, as applicable;
(9) advocating for proper implementation of federal and state and federal laws and for changes in DHS rules;
(10) facilitating information and referral on the client's behalf either with DHS staff or other persons or entities who can provide problem resolution or support services; and
(11) assisting with making arrangements for mediation arrangements.
8.Grievances.
(1) When an OCA advocate files a grievance against OKDHS DHS on behalf of a Hissom Class member DDS service recipient, the grievance format used includes at a minimum, the:
(A) the name of the client,;
(B) the grievant if when other than the client,;
(C) the client's guardian if when there is one, the provider, the case manager, the OCA advocate, and the guardian ad litem (GAL) representative if there is one;
(D) the issue being grieved,;
(E) the facts relevant to the grievance;
(F) the grievant's contentions;
(G) relevant statutes, policies, and other authorities;
(H) the proposed solution; and
(I) the OCA advocacy position of OCA.
(2)For each subsequent level the grievance is submitted for resolution, the grievance format used also provides the procedural history of the grievance, including a summary of the responses to the grievance at each level it was considered and relevant documentation.
9.Referral to Advocate.The OCA Intake Unit may refer allegations to the advocate when the alleged facts are insufficient to warrant an investigation.These referrals are sent to the advocate to assess client safety, obtain additional information to determine whether if an investigation is warranted, and respond with appropriate advocacy follow-up as to the allegations.OCA advocates adhere to the procedures listed in (1) through (4) of this Instruction.
(1) Within five-business days of the intake date, the advocate:
(A) conducts a face-to-face visit with the victim, unless intake the OCA Intake Unitrequests additional information in order to make an appropriate case disposition or a safety concern exists, in which case the response time is determined by the advocate's supervisor;
(B) researches the referral to determine if any additional information exists that may warrant a change in disposition to investigate.This includes reviewing the:
(i) entire referral in the OCA database;
(ii) DDS Client Contact Manager database (CCM) for any related documentation, such as incident reports and medical records, and client records in the home;
(C) staffs the case immediately with his or her supervisor when any information obtained may warrant a change in disposition.When information is obtained that warrants a change in disposition, the advocate's supervisor immediately notifies the intakeOCA Intake Unit supervisor.If information is not obtained that warrants a change in disposition, the advocate develops an advocacy plan with the advocate's supervisor that includes target dates; and
(D) notifies the guardian or next of kin of OCA's receipt of the allegation.
(2) The advocate does not disclose the identity of the reporting party.
(3) The advocate documents all work on the referral in OCA's the OCA CCM.
(4) The advocate informs his or her supervisor when all issues identified in the referral are resolved.When the supervisor agrees all issues are sufficiently resolved, the supervisor instructs the advocate to provide a summary of the findings to the guardian or next of kin and closes the Refer to Advocate case.Refer to Advocate cases must be resolved and closed within 30-calendar days of the intake date.Extensions may be approved by the advocate's supervisor, when warranted.
10.Guardian's authority to make end-of-life decisions.A guardian does not have authority to consent to a do-not-resuscitate (DNR) order merely because he or she is a guardian of a ward.Oklahoma's Guardianship and Conservatorship Act requires a guardian to obtain a court order that authorizes the guardian to make DNR decisions on behalf of a ward.[,per 30 O.S. § 3-119(1)].In the absence of an order, a guardian can only communicate to a physician, facts about the known values and preferences of the ward, on the basis of which the physician can determine whether if there is clear and convincing evidence of the client's desires with regard to regarding a DNR order.If When a client has never had the ability to communicate, verbally or non-verbally, the client's wishes with regard to end-of-life issues, clear and convincing evidence does not exist.
340:2-3-73. Advocacy services for former residents of the Northern Oklahoma Resource Center of Enid (NORCE) and the Southern Oklahoma Resource Center (SORC)
Revised 9-15-159-15-16
(a) Application.This Section describes advocacy services the Office of Client Advocacy (OCA) provides to former residents of SORC, and NORCE) who transition after the Oklahoma Commission for Human Services November 1, 2012, resolution to close those facilities.Ombudsman and advocacy services are provided to former residents of the facilities, per Oklahoma Administrative Code (OAC) 340:2-3-71.Pursuant to the Oklahoma Commission for Human Services November 1, 2012, resolution the Advocate General advocate general, as OCA chief administrative officer, was directed to review every individual's plan for community placement and certify all services and supports were in place prior to the person moving to a community home.Additionally, each former resident had has an OCA advocate assigned to act as a separate voice to ensure his or her needs were are met and ensure they were are provided the information, skills, opportunities, and support to:
(1) make informed choices and decisions about their lives;
(2) live in homes and communities where individuals can exercise their full rights and responsibilities as citizens;
(3) pursue meaningful and productive lives;
(4) contribute to their family, community, state, and nation;
(5) have interdependent friendships and relationships with others;
(6) live free from abuse, neglect, financial and sexual exploitation, and other legal rights violations of legal rights; and
(7) achieve maximum health and full integration and inclusion in society; in an individualized manner consistent with unique strengths, resources, and priorities.
(b) Representation.OCA assigns an advocate to each former resident of NORCE and SORC living in Oklahoma for the duration of the resident's lifetime.¢ 1Clients are provided choices with regard to regarding the advocate assigned to represent them to the extent feasible, considering the geographic location of the client's residence and the OCA advocate caseloads.Requests for a change in the advocate representing an individual are made to the advocate general or designee.¢ 2
(c) Personal Support Team (PST) membership.As a representative of a Developmental Disabilities Services (DDS) client living in a community residential placement, an OCA advocate is a member of the client's PST.As a PST member, the advocate receives from the client's DDS case manager timely notice of all PST meetings, including emergency PST meetings from the client's DDS case manager.Within the PST context, the advocate assists the client and represents the client's interests without relinquishing priority to client safety and rights.
(d) Guardianship issues.The OCA advocate ensures a client has a current capacity assessment and attends capacity assessment meetings.When a client has sufficient capacity to require no guardian or only a limited guardian, the advocate promotes the filing of a petition with the guardianship court to terminate or limit the guardianship appointment.When the current capacity assessment for the client recommends a guardian or volunteer advocate, the OCA advocate participates with the PST in identifying persons who might serve as the client's guardian or volunteer advocate.An advocate encourages the development of friends in the community who might become the client's guardian or volunteer advocate.The OCA advocate monitors the implementation of the recommendations in the capacity assessment and advocates for timely achievement.When a guardian is needed and a suitable guardian is identified, the OCA advocate promotes the filing of a petition with the guardianship court to appoint a guardian.
(e) Advocacy and monitoring.OCA advocates provide advocacy and monitoring to ensure compliance with policies, rules, and regulations applicable to the health, safety, and well-being of clients. In addition to the services described, in per OAC 340:2-3-71(h), advocacy and monitoring activities on behalf of each client include:
(1) verifying that Form 06CB034E, Residential Pre-Service Checklist, has been was completed and everything on the checklist is in place prior to any change in residence;
(2) making a home visit with the client visiting the client's home within 30-calendar days after the client moves into a new residence;
(3) conducting a face-to-face visit with the client at least quarterly once every three months and more frequently as indicated;¢ 3
(4) visits with the client at the request of the client, the client's legal guardian, or other person concerned about the well-being of the client completing a meaningful contact regarding each client served, at least monthly;¢ 4
(5) completion of completing a service review semi-annually every six months;¢ 45
(6) verifying that direct contact staff have completed required training in connection with each service review, verifying that direct contact staff have completed required training;
(7) participating as a member of a resident's PST;
(8) attending annual individual plan (IP) meetings, person-centered planning meetings, interim meetings, and follow-up planning meetings;
(9) attending emergency PST meetings;
(10) attending other PST meetings when significant issues are addressed, including when a rights restriction or an intrusive behavior intervention strategy is contemplated or recommended;
(11) attending the client's PST capacity assessment meetings of the client's PST;
(12) attending other PST meetings at the request of the client, guardian, or involved family or friend;
(13) requesting DDS Quality Assurance to conduct an administrative inquiry of suspected provider contract violations, per OAC 340:100-3-27;
(14) assisting the client and the client's guardian or representative with the review of proposed financial agreements and contracts between the client and the provider;
(15) review of reviewing documents and electronic files including, but not limited to:¢ 6
(A) assessments, IP, and interim IP documents;
(B) incident reports;
(C) Adult Protective Services and OCA investigation findings; and
(D) behavior data collection forms;
(16) attending mortality review meetings held, per OAC 340:100-3-35;
(17) attending legal proceedings involving the client, including guardianship proceedings, as warranted by the circumstances;
(18)providing an annual copy of Form 15GR006E, Notice of Grievance Rights: DDS Service Recipients, to each client or guardian an annual copy of Form 15GR006E, Notice of Grievance Rights: DDS Service Recipients;
(19) monitoring semi-annually the hot water temperature in homes every six months, using a thermometer to ensure the water does not exceed 114 degrees Fahrenheit; and
(20) bi-annually at least every six months, verifying that appropriate records have been kept with regard to an individual's personal finances every five to seven months, verifying appropriate records are kept with regard to an individual's personal finances.
(f) Advocacy services for former residents of NORCE and SORC who reside in private Intermediate Care Facilities intermediate care facilities for persons individuals with Intellectual Disabilities (ICF/ID) intellectual disabilities (ICF/IID).Advocacy and monitoring services for former residents of NORCE and SORC who reside in a private (ICF/ID) ICF/IID in Oklahoma are contained in this subsection.
(1) The assigned OCA advocate conducts a face-to-face visit with a client living in a private (ICF/ID) ICF/IID at least once every 120-calendar days, and more frequently, as warranted.
(2) The OCA advocate maintains a helping relationship with the client, assessing the realization of desired and targeted outcomes, and initiating change through referral or grievance as needed.During contacts with the client contacts, the advocate inquires about individual the client's satisfaction with current supports and provides information regarding options available to clients for community supports.
(3) The OCA advocate, at least once every six months, contacts the guardian of the client if when one has been is appointed.The OCA advocate also contacts the guardian in response to an expression by the client of dissatisfaction with the current residential arrangements, contacts the guardian.These contacts reaffirm the availability of service options to clients for support in community settings.Contacts with the guardian occur in person, by phone, or by mail as circumstances warrant.
(4) The OCA advocate contacts the private (ICF/ID) ICF/IID case manager and requests to be notified notification in advance of yearly planning meetings, interim, and emergency meetings.The advocate brings the expressed desires of the individual and any concerns expressed by the individual, guardian, or other family members to the attention of the PST the expressed desires of the individual and any concerns expressed by the individual, guardian, or other family members.
(5) The OCA advocate assesses the client's welfare and determines if advocacy is needed.The OCA advocate develops a working knowledge of the facility's grievance procedure as well as other problem resolution processes and resources for change.The advocate provides assistance, either directly or through referral, resolving concerns identified by the client or by others on behalf of the client.This may include contacting the DHS Aging Services Long-Term Care Ombudsman long-term care ombudsman.
(g) Advocacy services for former residents of NORCE and SORC who are in Oklahoma Department of Corrections (DOC) or county sheriff custody.Advocacy and monitoring services for clients, who are in DOC or county sheriff custody, except those who are detained pre-trial, are contained in this subsection.The assigned OCA advocate:
(1) contacts the client at least once every six months. These contacts are in person unless contraindicated by the individual;¢ 7, 8, & 9
(2) obtains copies of court documents that reflect the sentence the client is serving;
(3) assesses the welfare of the client and determines if advocacy assistance is needed.The advocate provides assistance, either directly or through referral, resolving concerns identified by the client or by others on behalf of the client.Advocacy assistance is provided to enforce the rights of clients under the Americans with Disabilities Act and other federal and state and federal laws to the extent they are applicable to persons who are in custody; and
(4) provides advocacy assistance with the DDS case manager to commence transition planning when the client has less than a year remaining to serve in custody.The advocate participates in and monitors transition planning, representing the client's interests.¢ 911
(h) Services for former residents of NORCE and SORC who decline DDS services.Per OAC 340:100-3-11, clients and their legal representatives have the right to refuse DDS services.The OCA advocate for a client who has declined DDS services contacts the individual at least once every six months and remains available to assist with advocacy regarding non-specialized assistance, when requested by the individual.If the OCA advocate determines the client's need or desire for specialized supports has changed, the advocate takes appropriate follow-up action with DDS case management.
¢ 8
INSTRUCTIONS TO STAFF 340:2-3-73
Revised 9-25-159-15-16
1.Advocate caseloads.Each advocate is assigned no more than 50 clients, including Hissom class members, former residents of the Northern Oklahoma Resource Center of Enid (NORCE) and the Southern Oklahoma Resource Center (SORC), and other Developmental Disabilities Services (DDS) clients living in community residential settings.
2.Changes in the assigned Office of Client Advocacy (OCA) advocate.All requests by a client or the client's representative for a change in assigned advocate are considered and addressed.
3.Client contacts.Quarterly Face-to-face visits are made with each client at least once every three months.A minimum of two visits each year must occur in the home of the client.
4.In addition to the DDS CCM review, the advocate is required to complete and document at least one meaningful contact every month.These contacts may be any type of informative contact with, or regarding a client served.This may be a phone conversation, email, visit, or a meeting with the client, family, guardian, provider, case manager, or team member.There must be at least one documented contact each month in addition to the DDS CCM review for each client caseload.Clients who are incarcerated or refuse services are the only exceptions to this Instruction.
45.Service reviews.An advocate completes a service review every six months for each client.Sources of information for completing the service review include a home visit, the home record, observations, incident reports, verbal accounts by clients and persons involved in their lives, and other documentation since the last service review.A completed service review is entered on the OCA Client Contact Manager database within five-business days of the home visit.
6.The OCA advocate reviews the DDS Client Contact Manager (CCM) database for each client on his or her caseload at least monthly and documents the review in the OCA CCM database.A review consists of opening and reading the content of the contact note, document, or incident report.The advocate's documented review must state the time period and the number of CCM contact notes, documents, and incident reports present and reviewed.Advocates must state if any new information was obtained from the review and detail any identified issues requiring follow-up in the documented review.Advocates pay close attention to health and safety concerns and initiate informal problem resolutions when appropriate.
57.The OCA advocate becomes familiar with and observes the rules and regulations in effect at the facility where the client is in custody, specifically regulations regarding what items are permissible to give to or receive from inmates in that facility.The advocate does not provide anything facility rules prohibit.
68.This may include contacting the prison case manager assigned to the client to ensure the facility is aware of the client's abilities and limitations relevant to the individual's classification, safety, and participation in vocational and other programs.
79.The OCA advocate provides information to the client's attorney and other officials, including parole officers, relevant to the client's conviction, sentence, appeal, prison classification, assignments, living, work, and education within the prison.This includes general information regarding the client's particular developmental disabilities, such as the potential for impaired understanding of consequences, vulnerability to exploitation, and learning challenges.The advocate obtains the client's and/or guardian's written consent of the client and/or guardian before releasing confidential information about the client.
810.Per Oklahoma Administrative Code 340:100-3-11, when services are refused, the client and the client's legal representation are advised of any risks accompanying the decision to refuse services, and are informed of the fair hearing process.The policy also requires the Personal Support Team (PST) to engage in and document consideration and attempts to initiate alternatives to resolving the concerns expressed by the client, legal representative, or both.Appropriate legal resolutions are sought when it is determined the exercise of the right to refuse services by a client, who has not been determined incapacitated to act on his or her own behalf, presents a risk to the individual, per Oklahoma Statutes.
911.Persons who are in DOC custody are deemed not to be Waiver recipients.Therefore assessments, such as the capacity assessment are not required; however, it is appropriate for the advocate to request assessments be completed as part of the transition process when the client is close to discharge from custody.
340:2-3-74. Advocacy services for Hissom class members
Revised 9-15-159-15-16
(a) Application.This Section describes Office of Client Advocacy (OCA) advocacy services for Hissom class members who reside in Oklahoma.Advocacy services are provided to Hissom class members per Oklahoma Administrative Code (OAC) 340:2-3-71.Orders of the United States District Court for the Northern District of Oklahoma in Homeward Bound, Inc., et al. vs. Hissom Memorial Center, et al., Case No. 85-C-437-TCK-SAJ, require the Oklahoma Department of Human Services (DHS) and OCA to provide independent advocacy services to individuals certified by the court as members of the plaintiff class, known as Hissom class members.This includes, but is not limited to:
(1) independently advocating for class members' rights and interests regarding: their daily lives, proposed movements, medical and behavioral emergencies including hospitalizations, appropriate consents, financial interests, and meetings held on their behalf;
(2) challenging adverse service authorization actions through the DHS administrative appeal and/or grievance procedures; and
(3) referral to Oklahoma protection and advocacy agencies to obtain legal counsel and legal advocacy services.¢ 1
(b) Assignment of advocate.OCA assigns an advocate to each Hissom class member living in Oklahoma.Clients are provided choices with regard to the advocate assigned to represent them to the extent feasible, taking into consideration the geographic location of the client's residence and OCA advocates' caseloads.Requests for a change in the advocate representing an individual are made to the advocate general or designee.¢ 1 & 2
(c) Personal Support Team (PST) membership.As a representative of a Hissom class member living in a community residential placement, an OCA advocate is a member of the client's PST.As a PST member, the advocate receives from the client's Developmental Disabilities Services (DDS) case manager timely notice of all PST meetings, including emergency PST meetings.Within the team context, the advocate assists the client and represents the client's interests without relinquishing priority to client safety and rights.
(d) Guardianship issues.The OCA advocate ensures the client has a current capacity assessment and attends capacity assessment meetings.If a client with a full guardianship has sufficient capacity to require no guardian or only a limited guardian, the advocate promotes the filing of a petition with the guardianship court to limit or terminate the guardianship.If the current capacity assessment of a client who does not have a guardian recommends a guardian or volunteer advocate, the OCA advocate participates with the PST in identifying persons who might serve as guardian or advocate for the client.This includes encouraging the development of friends in the community who might become a guardian or volunteer advocate for the client.The OCA advocate monitors the implementation of the recommendations in the capacity assessment and advocates for their timely achievement.When a guardian is needed and a suitable guardian is identified, the advocate promotes the filing of a petition with the guardianship court to appoint a guardian.
(e) Advocacy and monitoring services for class members in residential community settings.OCA advocates provide advocacy and monitoring to class members living in community residential settings, including group homes, to ensure compliance with policies, rules, and regulations applicable to the client's health, safety, and well-being.In addition to the activities described in OAC 340:2-3-71(h), advocacy and monitoring activities on behalf of each client include:
(1) verifying a Form 06CB034E, Residential Pre-service Checklist, is completed prior to any change in residence, and making a home visit with the client within 30-calendar days after the client moves into a new residence;
(2) a face-to-face visit with the client at least once every three months;¢ 3
(3) visits with the client at the request of the client, the client's legal guardian, or other person concerned about the well-being of the client completing a meaningful contact regarding each client served, at least monthly;¢ 114
(4) completion of a service review twice a year, at least once every six months;¢ 45
(5) verifying direct contact staff have completed required training in connection with each service review, verifying direct contact staff have completed required training;
(6) participating as a member of a client's PST;
(7) attending annual individual plan (IP) meetings, person-centered planning meetings, interim meetings, and follow-up planning meetings;
(8) attending emergency PST meetings;
(9) attending other PST meetings when significant issues are addressed, including when a rights restriction or an intrusive behavior intervention strategy is contemplated or recommended;
(10) attending guardianship assessment meetings of the client's PST;
(11) attending other team meetings at the request of the client, guardian, or involved family or friend;
(12) requesting DDS Quality Assurance to conduct an administrative inquiry of suspected provider contract violations per OAC 340:100-3-27;
(13) assisting the client and the client's guardian or representative with the review of proposed financial agreements and contracts between the client and the provider;
(14) prior to and during a hospitalization, advocating for the provision of adequate staff to be present in the hospital with the client as circumstances warrant;
(15) review of documents and electronic files including, but not limited to:¢ 6
(A) assessments, IP, and interim IP documents;
(B) incident reports;
(C) behavior data collection forms; and
(D) Adult Protective Services and OCA investigation findings;
(16) attending mortality reviews conducted, per OAC 340:100-3-35;
(17) communicating to the client, the client's guardian, and the client's family as appropriate, the final finding of an OCA investigation in which the client was named as an alleged victim;
(18) attending legal proceedings involving the client, including guardianship proceedings, as warranted by the circumstances;
(19) monitoring, semi-annually, of the hot water temperature in homes every six months, using a thermometer to ensure the water does not exceed 114 degrees Fahrenheit;
(20) verifying that appropriate records are kept with regard to an individual's personal finances at least once every six months; and
(21) providing each client or guardian an annual copy of Form 15GR007E, Notice of Grievance Rights:Hissom Class Members.
(f) Advocate services for Hissom class members on the Focused Advocacy List (FAL).On December 1, 2004, the judge in Homeward Bound, et al. vs. The Hissom Memorial Center, et al., U.S. District Court for the Northern District of Oklahoma, Case No. 85-C-437-E, issued an order for the transition of responsibilities and phase-out of the combined office of the Homeward Bound review panel and Guardian ad Litem (GAL).The Court Order specified "advocacy services provided by the Guardian ad Litem's Office for all class members on the GAL List will be transferred to and be assumed by the Office of Client Advocacy" by January 31, 2005.In response, OCA created the Focused Advocacy program to provide increased advocacy supports to class members with limited or no family involvement.In addition to the activities described in section (e) of this Section and OAC 340:2-3-71(h), advocacy and monitoring activities on behalf of each client include:
(1) ensuring the assigned developmental disabilities representative is invited to PST meetings when warranted to review and update progress in securing a volunteer advocate or guardian for all clients on the FAL;
(2) visiting each class member on the FAL at least once every two months, and more frequently when warranted. Visits include home visits, work-site visits, and other face-to-face contacts;
(3) placing a priority on expanding the circles of support of a class member on the FAL to include persons who are not paid to be involved in the class member's life, including identifying relatives not involved in the class member's life who may be encouraged to become more involved;
(4) identifying class members who have the greatest immediate need for a volunteer advocate or guardian.Advocates must promptly inform the OCA Focused Advocacy manager when a class member is identified as having a priority need; and
(5) ensuring a Team Review of Advocate/Guardian Participation (TRAGP) document is prepared for each class member assigned to them at least annually and one is completed more frequently whenever there is a significant change in circumstances warranting review of the involvement of persons who are not paid to be involved in the class member's life.The form includes information documenting the need for the individual to remain on, be added to, or be removed from the FAL.The Focused Advocacy Committee meets regularly to review TRAGP forms and determine whether class members remain on the FAL or require prioritized identification of a volunteer advocate or guardian.
(g) Advocacy services for Hissom class members in a private intermediate care facility for persons with intellectual disabilities (ICF/ID) intermediate care facilities for individuals with intellectual disabilities (ICF/IID).Advocacy and monitoring services for class members who reside in a private (ICF/ID) ICF/IID in Oklahoma are contained in this subsection.
(1) The assigned OCA advocate personally visits a client living in a private (ICF/ID) ICF/IID at least quarterly, and more frequently as warranted.
(2) The OCA advocate maintains a helping relationship with the client, assessing the realization of desired and targeted outcomes, and initiating change through referral or grievance as needed.During contacts with the client, the advocate inquires about individual satisfaction with current supports and provides information regarding options available to clients for community supports.
(3) The OCA advocate, at least bi-annually, contacts the guardian of the client if one has been was appointed.The OCA advocate also contacts the guardian in response to an expression by the client of dissatisfaction with the current residential arrangements.These contacts reaffirm the availability of service options to clients for support in community settings.Contacts with the guardian occur in person, by phone, or by mail as the circumstances warrant.
(4) The OCA advocate contacts the private (ICF/ID) ICF/IID case manager, generally a Qualified Mental Retardation Professional qualified intellectual disability professional, responsible for yearly care planning for the client.The advocate informs the facility case manager of the advocate's intent to attend yearly planning meetings.The advocate asks to be notified in advance of yearly planning meetings and emergency meetings.The advocate checks periodically to ensure meetings have not been held without notice to the advocate.
(5) The OCA advocate participates in annual planning meetings at the private (ICF/ID) ICF/IID.The advocate provides advocacy assistance regarding the individual's expressed desires.The advocate brings concerns expressed by the client, guardian, or other family members to the PST attention.The advocate participates in interim meetings addressing any significant change in residence, work, health, or important relationships.
(6) The OCA advocate develops a working knowledge of the facility's grievance procedure as well as other problem resolution processes and resources for change, such as the Long-Term Care Ombudsman Program and licensing agencies.The advocate uses these services, either directly or through referral, as needed for the benefit of the individual.
(7) The OCA advocate assesses the welfare of the client and determines if advocacy assistance OCA can provide is needed which OCA can provide.The advocate, either directly or through referral, provides assistance, either directly or through referral, with resolving concerns identified by the client or by others on behalf of the client.This includes contacting the DHS Aging Services, long-term care ombudsman.The advocate also informs the Long-Term Care Ombudsman Office long-term care ombudsman office of concerns involving other individuals living in an (ICF/ID) ICF/IID that come to the advocate's attention.
(8) Service reviews are not completed.
(9) The OCA advocate requests a capacity assessment on behalf of the client when there has been a substantial change in circumstances regarding the individual's need for a guardian.
(10) The OCA advocate provides information and encouragement to consider community residential settings.
(h) Advocacy services for Hissom class members who are in the Oklahoma Department of Corrections (DOC) or a county sheriff's custody.Advocacy and monitoring services for class members who are in DOC or a county sheriff's custody, except those who are detained pre-trial, are contained in this subsection.The assigned OCA advocate:
(1) contacts the client at least every six months; these contacts are in person when feasible;¢ 7, 8 & 9
(2) obtains copies of court documents that reflect the sentence the class member is serving;
(3) assesses the welfare of the client and determines if advocacy assistance is needed.The advocate provides assistance, either directly or through referral, with resolving concerns identified by the client or by others on behalf of the client. Advocacy assistance is provided in regard to enforcing the rights of clients under the Americans with Disabilities Act and other federal and state and federal laws to the extent they are applicable to persons who are in custody; and
(4) provides advocacy assistance and works with the DDS case manager to begin transition planning when the client has less than one year remaining to serve in custody.The advocate participates in and monitors transition planning, representing the client's interests.¢ 45
(i) Services for Hissom class members who decline DDS services.Per OAC 340:100-3-11, class members and their legal representatives have the right to refuse services from DHS DDS. The OCA advocate for a class member, who declined DDS services, contacts the individual at least once every six months, and remains available to assist with advocacy regarding non-specialized assistance when requested by the individual.If the OCA advocate determines the client's need or desire for specialized supports has changed, the advocate takes appropriate follow-up action with DDS case management.¢ 810
INSTRUCTIONS TO STAFF 340:2-3-74
Revised 9-15-159-15-16
1.Advocate caseloads.Each advocate is assigned no more than 50 clients, including Hissom class members and other Developmental Disabilities Services Division (DDSD) (DDS) clients living in community residential settings.
2.Changes in the assigned Office of Client Advocacy (OCA) advocate.OCA considers requests to change the assigned advocate.All requests by a client or the client's representative for a change in assigned advocate are considered and responded to appropriately.Requests for an advocate of a particular gender or other characteristic are considered in a manner which that complies with all federal and state laws prohibiting discrimination on the basis of sex, race, color age, national origin, religion, disability, or other protected classes sex, age, religion, disability, political affiliation or opinion, or genetic information unless authorized by law.
3.Client contacts.Quarterly Face-to-face visits are made with each individual represented with a minimum of two home visits each year client at least once every three months.A minimum of two visits each year must occur in the home of the client.Quarterly visits are made with each client a minimum of two home visits each year.In exceptional circumstances, the OCA advocate can forego a quarterly visit with a particular client with prior approval of the advocate's supervisor provided:
(1) the advocate documents in a contact sheet the approval and the reason it was given; and
(2) at least semi-annual visits are made with the client.
4.In addition to the DDS CCM review, the advocate is required to complete and document at least one meaningful contact every month.These contacts may be any type of informative contact with or regarding a client served.This may be a phone conversation, email, visit, or meeting with the client, family, guardian, provider, case manager, or team member.There must be at least one documented contact each month, in addition to the DDS CCM review, for each client caseload.Clients that are incarcerated or refusing services are the only exception to this requirement.
45.Service reviews.An advocate completes a service review every five-to-seven six months for each client.Sources of information for completing the service review include a home visit, the home record, observations, incident reports, verbal accounts by clients and persons involved in their lives, and other documentation since the last service review.After filling out a service review on the database, the advocate fills out a contact sheet on the database with regard to the home visit and service review.The electronic number assigned to a service review is entered on the contact sheet in the appropriate box in the upper right-hand corner of the contact sheet screen.A completed service review is entered on the OCA's Client Contact Manager database within five- working business days of the home visit.
6.The OCA advocate reviews the DDS Client Contact Manager (CCM) database for each client on his or her caseload at least monthly and documents the review in OCA's CCM database.A review consists of opening and reading the content of the contact note, document, or incident report. The advocate's documented review must state the time period and the number of CCM contact notes, documents, and incident reports present and reviewed.Advocates must state in the review if new information was obtained from the review and detail any identified issues requiring follow-up.Advocates pay close attention to health and safety concerns and initiate informal problem resolutions when appropriate.
57.The OCA advocate becomes familiar with and observes the rules and regulations in effect at the facility where the client is in custody, especially regulations regarding what items it is permissible items to give to or receive from inmates in that the facility.The advocate does not facilitate on behalf of a client anything facility rules prohibit inmates to do, on a client's behalf.In some facilities, stamps, pens, and paper clips are contraband items, and inmates are not allowed to communicate in writing with each other.
68.This can may include contacting the prison case manager assigned to the client to ensure the facility is aware of the client's abilities and limitations which may be that are relevant to the individual's classification, safety, and participation in vocational and other prison programs in prison.
79.The OCA advocate provides information to the client's attorney and other officials, including parole officers, that is relevant to the client's conviction, sentence, appeal, prison classification, and assignments, regarding living, work, and education assignments, within the prison facility.This includes general information regarding the client's particular developmental disabilities, for example, such as the potential for impaired understanding of consequences, vulnerability to exploitation, and learning challenges.The advocate obtains written consent of the client and/or guardian before releasing confidential information about the client.
810.In accordance with Per OAC 340:100-3-11, when services are refused, the client and the client's legal representative(s) are advised of any risks accompanying the decision to refuse services, and are informed of the fair hearing process.The policy also requires teams Personal Support Teams to engage in and document consideration and attempts to initiate alternatives to resolving the concerns expressed by the client, legal representative, or both.Appropriate legal resolutions are sought when it is determined that the exercise of the right to refuse services by an adult client, who has not been determined incapacitated to act on his or her own behalf, presents a risk to the individual, per as defined by Oklahoma statutes.
911.Persons who are in custody are deemed to not waiver considered Waiver recipients; while in custody.Hence, therefore, assessments, such as the capacity assessment are not required.However, it is appropriate for the advocate to request assessments be completed as part of the transition process when the client is close to discharge from custody.
