Rule Impact Statement
To: Programs administrator
Legal Services - Policy
From: Beth Scrutchins, Director
Developmental Disabilities Services
Date: June 13, 2025
Re: CHAPTER 100. DEVELOPMENTAL DISABILITIES SERVICES
Subchapter 3. Administration
Part 1. General Administration
340:100-3-4 [AMENDED]
Part 3. Administration
340:100-3-27 [AMENDED]
340:100-3-34 [AMENDED]
340:100-3-35 [AMENDED]
340:100-3-38.14 [NEW]
340:100-3-40 [AMENDED]
Subchapter 5. Client Services
Part 3. Service Provisions
340:100-5-33 [AMENDED]
Part 5. Individual Planning
340:100-5-57 [AMENDED]
340:100-5-58 [AMENDED]
(Reference WF 26-01)
Contact: Darrin Thompson 405-301-2895
A. Brief description of the purpose of the proposed rule:
i. Purpose.
The proposed amendments update the rules to implement changes recommended during the annual Developmental Disabilities Services (DDS) rule review process.
(I) Rule classification
The proposed amendments are classified as non-major rules as they will not exceed one million dollars over the initial five-year period following the promulgation of the proposed rule. The total cost of annual implementation and compliance is estimated to be zero dollars.
(II) A determination whether the proposed rule is mandated by federal law, or as a requirement for participation in, or implementation of, a federally subsidized or assisted program.
Federal law partially mandates the proposed substantive amendments to operate a Home and Community-Based Services (HCBS) waiver. Per Section 302(a)(6), Part 441, Title 42 of the Code of Federal Regulations (42 C.F.R. § 441.302 (2025), OKDHS must operate and maintain an incident management system that identifies, reports, triages, investigates, resolves, tracks, and trends critical incidents for individuals who receive services through an HCBS waiver. 42 C.F.R § 447.203 (2025), requires states to have ongoing mechanisms for beneficiary and provider input on access to care per the federal Medicaid Access Final Rule implemented in July 2024. Revisions to OAC 340:100-3-34 are made to meet the criteria of this federal mandate.
(III) A determination whether the proposed rule exceeds the requirements of the applicable federal law.
The proposed amendments meet, but do not exceed, the requirements as outlined in 42 C.F.R, §§ 441.300-313 or § 447.203
(IV) A summary and preliminary comparison of any existing or proposed federal regulations that are intended to address the activities to be regulated by the proposed rule.
Federal law at 42 C.F.R §§ 441.300-313 provides the rules for operating an HCBS waiver. Per Section 302(a)(6), Part 441, Title 42 of the Code of Federal Regulations (42 C.F.R. § 441.302 (2025), OKDHS must operate and maintain an incident management system that identifies, reports, triages, investigates, resolves, tracks, and trends critical incidents for individuals who receive services through an HCBS waiver. 42 C.F.R § 447.203 (2025), requires states to have ongoing mechanisms for beneficiary and provider input on access to care per the federal Medicaid Access Final Rule implemented in July 2024. Revisions to OAC 340:100-3-34 are made to meet the criteria of this federal mandate.
(ii). Strategic Plan Impact.
The proposed amendments position Oklahoma Human Services (OKDHS) DDS to improve services to individuals with intellectual and developmental disabilities; support DDS goals of improving vulnerable Oklahomans' quality of life by increasing individuals' abilities to lead safer, healthier, more independent, and productive lives; and to comply with federal requirements
(iii). Substantive changes.
Subchapter 3. Administration
Part 1. General Administration
Oklahoma Administrative Code (OAC) 340:100-3-4 is amended to add prohibition of a provider agency staff or DDS employee from being named as a beneficiary of a life insurance policy for a service recipient of DDS waiver services except when the agency staff or DDS employee is a family member to the service recipient.
Part 3. Administration
OAC 340:100-3-27 is amended to: (1) change references from area manager to regional field administrator; (2) update the problem resolution process to include regional field manager; (3) add requirement that the DDS community services deputy director or designee provide a plan of correction when issues included in the problem resolution process cannot be solved at a lower level; (4) include monitoring of the self-directed services program by quality assurance staff; (5) update language regarding consumer service evaluations and assessments; (6) change language from Oklahoma Advocates involved in Monitoring OK-AIM to volunteer based contract monitoring; (7) remove language specific to OK-AIM; and (8) update the process for reporting of findings of volunteer based contract monitors.
OAC 340:100-3-34 is amended to: (1) meet new reporting requirements of Centers for Medicare and Medicaid (CMS); (2) add new, tiered reporting criteria; (3) update critical and non-critical incident reporting categories; (4) update time requirements for reporting; (5) add new requirements for providers response to incidents; (6) add new requirements for staff training; (7) add new language regarding failure to report; (8) add new language on reporting technical difficulties; and (9) update case manager responsibilities in Instructions to Staff.
OAC 340:100-3-35 is amended to permit legally responsible individuals to provide certain services through a DDS HCBS waiver to individuals for whom they are legally responsible.
OAC 340:100-3-38.14 is issued to identify required traning requirements for staff, volunteers, and direct supervisors providing either full- or part-time direct supports for a service recipient receiving ERS, per OAC 317:40-5-154.
OAC 340:100-3-40 is amended to remove a reference to a revoked policy.
Subchapter 5. Client Services
Part 3. Service Provisions
OAC 340:100-5-33 is amended to: (1) change the name from medication events to medication errors to reflect updated CMS reporting requirements; (2) add reporting requirement for staff providing self-directed services; (3) add language to clarify the responsibilities of contract provider staff regarding reporting and responding to medication errors; (4) identify that employers of record of self-directed services and specialized foster care providers are subject to sanctions when failing to correct identified problems with medication errors; (5) remove references to DDSD medical services unit as it no longer exists; (6) provide clarification regarding DDS case manager responsibilities for responding to new tier 1 and tier 4 medication errors identified in the updated incident reported policy; and (7) update Instructions to Staff.
Part 5. Individual Planning
OAC 340:100-5-57 is amended to Remove medical restraint in a medical context.
OAC 340:100-5-58 is amended to: (1) add medical restraint in a medical context; and (2) add criteria for the use of enclosed beds for DDS waiver recipients.
(iv). Reasons.
The proposed amendments update and clarify DDS rules, per Section 1020 of Title 56 of the Oklahoma Statues (56 O.S. § 1020).
(v). Repercussions.
The proposed amendments contribute to the health and safety of vulnerable Oklahomans and positions Oklahoma to continue to improve service provision.
(vi). Legal authority.
Director of Human Services; 56 O.S. § 162.
(vii). Permanent rulemaking approval is requested.
B. A comprehensive analysis of the rule's economic impact on the Agency, including but not limited to, full-time employee count and any costs or benefits. The analysis includes a detailed explanation of the methodology and assumptions used to determine the economic impact, including, whenever possible, the dollar amounts calculated: The proposed amendments are not expected to have an economic impact on OKDHS, so no comprehensive analysis of impact is needed at this time.
C. A comprehensive analysis of the rule's economic impact outside the Agency, including a detailed quantification of implementation and compliance costs on the affected businesses, business sectors, public utility ratepayers, individuals, state or local government units, and on the state economy. The analysis includes a detailed explanation of the methodology and assumptions used to determine the economic impact, including, whenever possible, the dollar amounts calculated, as well as a list of fee changes with a separate justification for each fee change: OKDHS does not anticipate a negative economic impact outside the agency.
D. 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 affected by the proposed amendments are individuals receiving DDS services, who bear no costs associated with the rule's implementation.
E. A description of the classes of persons who will benefit from the proposed rule: The classes of persons who benefit are individuals receiving DDS services.
F. 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: OKDHS does not anticipate a negative economic impact on individuals who receive DDS services.
G. 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: OKDHS does not anticipate the proposed amendments to have a negative impact on any political subdivisions or require their cooperation in enforcing the rules.
H. A determination whether implementation of the proposed rule will have an adverse economic effect on small business as provided by the Oklahoma Small Business Regulatory Flexibility Act: The proposed amendments do not have an adverse effect on small business as provided by the Oklahoma Small Business Regulatory Flexibility Act.
I. A description of any measure taken by the Agency to minimize the cost and impact of the proposed rule on business and economic development in this state, local government units of this state, and individuals: OKDHS will provide training to agency and provider staff on the changes resulting from these rules. OKDHS does not anticipate the proposed amendments will negatively impact business and economic development, local government units or individuals.
J. 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: The proposed amendments bring the rules into compliance with federal and state law, thereby increasing program effectiveness and positively impacting the health, safety, and well-being of affected individuals.
K. A determination of any detrimental effect on the public health, safety, and environment if the proposed rule is not implemented: If the proposed amendments are not implemented, the rules will not comply with federal regulations and state laws.
L. An analysis of alternatives to adopting the rule: OKDHS determined there are no alternatives to adopting the proposed amendments.
M. Estimates of the amount of time that would be spent by state employees to develop the rule and of the amount of other resources that would be utilized to develop the rule: The amount of time expected to be spent by state employees to develop the rules is 10 hours. This includes time spent developing training material and scheduling and conducting training sessions.
N. The date the rule impact statement was prepared and, if modified, the date modified: Prepared; June 13, 2025 modified; Sept 30, 2025.
