Draft Rules
317:40-5-3. Agency companion services (ACS)
(a) Agency companion services (ACS) are:
(1) provided by agencies that have a provider agreement with the Oklahoma Health Care Authority (OHCA);
(2) provided by independent contractors of the provider agency and provide a shared living arrangement developed to meet the specific needs of the member that includes supervision, supportive assistance, and training in daily living skills, and integrates the member into the shared experiences of a family in a home owned or rented by the companion;
(3) available to members 18 years of age or older who are eligible for services through Community or Homeward Bound Waivers. Persons under 18 years of age may be served with approval from the Oklahoma Department of Human Services Developmental Disabilities Services (DDS) director or designee;
(4) based on the member's need for residential services per Oklahoma Administrative Code(OAC) 340:100-5-22 and support as described in the member's Individual Plan (Plan), per OAC 340:100-5-50 through 340:100-5-58.
(b) An agency companion:
(1) must have an approved home profile per OAC 317:40-5-3 and contract with a provider contract with a DDS approved provider agency approved by DDS;
(2) may provide companion services for one member. Exceptions to serve as companion for two members may be approved by the DDS director or designee. Exceptions may be approved when members have an existing relationship and to separate them would be detrimental to their well-being and the companion demonstrates the skill and ability required to serve as companion for two members;
(3) household is limited to one individual companion provider. Exceptions for two individual companion providers in a household who each provide companion services to different members may be approved by the DDS director or designee;
(4) may not provide companion services to more than two members at any time;
(5) household may not simultaneously serve more than three members through any combination of companion or respite services.When any one member is served at the pervasive rate the household may not simultaneously serve more than two members through any combination of companion or respite services;
(6) may not have employment, volunteer activities, or personal commitments that prevent the companion from fulfilling his or her responsibilities to the member per OAC 317:40-5.
(A) The companion may have employment when:
(i) personal support team (Team) documents and addresses all related concerns in the member's Plan;
(ii) employment is approved in advance by the DDS area residential services programs manager or designee; and
(iii)(ii) companion's employment does not require on-call duties and occurs during time the member is engaged in outside activities such as school, employment or other routine scheduled meaningful activities; and
(iv)(iii) companion provides assurance the employment is such that the member's needs will be met by the companion should the member's outside activities be disrupted.
(B) If, after receiving approval for employment, authorized DDS staff determines the employment interferes with the care, training, or supervision needed by the member, the companion must terminate, within 30 calendar days:
(i) his or her employment; or
(ii) his or her contract as an agency companion.
(C) Homemaker, habilitation training specialist, and respite services are not provided for the companion to maintain other employment.
(c) Each member may receive up to 60 calendar days per year of therapeutic leave without reduction in the agency companion's payment.
(1) Therapeutic leave:
(A) is a SoonerCare payment made to the contract provider to enable the member to retain services; and
(B) is claimed when the:
(i) member does not receive ACS for 24 consecutive hours due to:
(I) a visit with family or friends without the companion;
(II) vacation without the companion; or
(III) hospitalization, regardless of whether the companion is present; or
(ii) companion uses authorized respite time;
(C) is limited to no more than 14 consecutive, calendar days per event, not to exceed 60 calendar days per Plan of Care (POC) year; and
(D) cannot be carried over from one POC year to the next.
(2) The therapeutic leave daily rate is the same amount as the ACS per diem rate except for the pervasive rate that is paid at the enhanced agency companion per diem rate.
(3) The provider agency pays the agency companion the payment he or she would earn if the member were not on therapeutic leave.
(d) The companion may receive a combination of hourly or daily respite per POC year equal to 660 hours.
(e) Habilitation Training Specialist (HTS) services:
(1) may be approved by the DDS director or designee when providing ACS with additional support represents the most cost-effective placement for the member when there is an ongoing pattern of not:
(A) sleeping at night; or
(B) working or attending employment, educational, or day services;
(2) may be approved when a time-limited situation exists in which the companion provider is unable to provide ACS, and the provision of HTS will maintain the placement or provide needed stability for the member, and must be reduced when the situation changes;
(3) must be reviewed annually or more frequently as needed, which includes a change in agencies or individual companion providers; and
(4) must be documented by the Team and the Team must continue efforts to resolve the need for HTS.
(f) The contractor model does not include funding for the provider agency for the provision of benefits to the companion.
(g) The agency receives a daily rate based on the member's level of support. Levels of support for the member and corresponding payment are:
(1) determined by authorized DDS staff per levels described in (A) through(D); and
(2) re-evaluated when the member has a change in agency companion providers that includes a change in agencies or individual companion providers.
(A) Intermittent level of support. Intermittent level of support is authorized when the member:
(i) requires minimal physical assistance with basic daily living skills, such as bathing, dressing, and eating;
(ii) may be able to spend short periods of time unsupervised inside and outside the home; and
(iii) requires assistance with medication administration, money management, shopping, housekeeping, meal preparation, scheduling appointments, arranging transportation or other activities.
(B) Close level of support. Close level of support is authorized when the member requires the level of assistance outlined in (g)(2)(A) and at least two of the following:
(i) regular, frequent and sometimes constant physical assistance and support to complete daily living skills, such as bathing, dressing, eating, and toileting;
(ii) extensive assistance with medication administration, money management, shopping, housekeeping, meal preparation, scheduling appointments, arranging transportation or other activities; and or
(iii) assistance with health, medication, or behavior interventions that may include the need for specialized training, equipment, and diet.
(C) Enhanced level of support. Enhanced level of support is authorized when the member requires the level of assistance outlined in (g)(2)(B) and at least one of the following:
(i) is totally dependent on others for:
(I) completion of daily living skills, such as bathing, dressing, eating, and toileting; and
(II) medication administration, money management, shopping, housekeeping, meal preparation, scheduling appointments, and arranging transportation or other activities;
(ii) demonstrates ongoing complex medical issues requiring specialized training courses per OAC 340:100-5-26; or
(iii) has behavioral issues that requires a protective intervention plan protocol(PIP) with a restrictive or intrusive procedure per OAC 340:100-1-2. The PIP must:
(I) be approved by the Statewide Human Rights Behavior Review Committee (SBRC) (SHRBRC), per OAC 340:100-3-14; or
(II) be reviewed by the Human Rights Committee (HRC), per OAC 340:100-3-6, or
(III) have received expedited approval per OAC 340:100-5-57.
(iv) meets the requirements of (g)(2)(C)(i) through (iv); and does not have an available personal support system.The need for this service level:
(I) must be identified by the grand staffing committee, per OAC 340:75-8-40; and
(II) requires the provider to market, recruit, screen, and train potential companions for the member identified.
(D) Pervasive level of support. Pervasive level of support requires the level of assistance outlined in (g)(2)(C), and is authorized when the member:
(i) requires additional professional level support to remain in an agency companion setting due to pervasive behavioral or emotional challenges. The support must be provided:
(I) by a licensed professional counselor (LPC) or professional with a minimum of Masters of Social Work (MSW) degree; and
(II) as ongoing support and training to the companion, offering best practice approaches in dealing with specific members; and
(III) as part of the ACS and not billed as a separate service. Waiver services may be authorized for the development of a PIP per OAC 340:100-5-57;
(ii) does not have an available personal support system. The need for this service level:
(I) must be identified by the grand staffing committee, per OAC 340:75-8-40; and
(II) requires the provider to market, recruit, screen, and train potential companions for the member identified.
(h) Authorization for payment of Agency Companion Service ACS is contingent upon receipt of:
(1) the applicant's approval letter authorizing ACS for the identified member;
(2) an approved relief and emergency back-up plan addressing a back-up location and provider;
(3) the Plan;
(4) the POC; and
(5) the date the member moved is scheduled to move to the companion home. When a member transitions from a DDS placement funded by a per diem the incoming provider may request eight hours of HTS for the first day of service.
(i) The Plan reflects the amount of room and board the member pays to the companion. The provider must use the room and board reimbursement payment to meet the member's needs. Items purchased with the room and board reimbursement payment include housing and food.
(j) If the amount exceeds $500, the additional amount must be:
(1) agreed upon by the member and, when applicable, legal guardian;
(2) recommended by the Team; and
(3) approved by the DDS area manager or designee The room and board payment may include all but $150 per month of the service recipient's income, up to a maximum of 90% of the current minimum Supplemental Security Income (SSI) payment for a single individual.
317:40-5-5. Agency Companion Services provider responsibilities
(a) Companions are required to meet all applicable standards outlined in this subchapter and competency-based training per Oklahoma Administrative Code (OAC) 340:100-3-38. The provider agency ensures all companions meet the criteria in this Section.
(b) Failure to follow any rules or standards, failure to promote the independence of the member, or failure to follow recommendation(s) of the personal support team (Team) results in problem resolution, per OAC 340:100-3-27, for the companion, and when warranted, revocation of approval of the companion.
(c) The companion:
(1) ensures no other adult or child is cared for in the home on a regular or part-time basis, including other Oklahoma Department of Human Services (DHS) (OKDHS) placements, family members, or friends without prior written authorization from the Developmental Disabilities Services Division (DDS) area residential services programs manager or designee state office residential services programs supervisor;
(2) meets the requirements of OAC 317:40-5-103. Neither the companion nor the provider agency may claim transportation reimbursement for vacation travel;
(3) transports or arranges transportation for the member to and from school, employment programs, recreational activities, medical appointments, and therapy appointments;
(4) delivers services in a manner that contributes to the member's enhanced independence, self-sufficiency, community inclusion, and well-being;
(5) participates as a member of the member's Team and assists in the development of the member's Individual Plan(Plan) for service provision;
(6) develops, implements, evaluates, and revises the training strategies corresponding to the relevant outcomes for which the companion is responsible, as identified in the Plan. The companion may request assistance from the case manager or program coordinator. The companion documents and provides monthly data and health care summaries to the provider agency program coordination staff.
(7) delivers services at appropriate times as directed in the Plan;
(8) does not deliver services that duplicate the services mandated to be provided by the public school district pursuant to the Individuals with Disabilities Education Act (IDEA);
(9) is sensitive to and assists the member in participating in the member's chosen religious faith. No member is expected to attend any religious service against his or her wishes;
(10) participates in, and supports visitation and contact with the member's natural family, guardian, and friends, when visitation is desired by the member;
(11) obtains permission from the member's legal guardian, when a guardian is assigned, and notifies the family, the provider agency program coordination staff, and the case manager prior to:
(A) traveling outofstate;
(B) overnight visits; or
(C) involvement of the member in any publicity;
(12) serves as the member's health care coordinator per OAC 340:100-5-26;
(13) ensures the monthly room and board contribution received from the member is used toward the cost of operating the household;
(14) assists the member in accessing entitlement programs for which the member may be eligible and maintains records required for the member's ongoing eligibility;
(15) works closely with the provider agency program coordination staff and the DDS case manager, to ensure all aspects of the member's program are implemented to the satisfaction of the member, the member's family or legal guardian, when appropriate, and the member's Team;
(16) assists the member to achieve the member's maximum level of independence;
(17) submits, in a timely manner, to the provider agency program coordination staff all necessary information regarding the member;
(18) ensures the member's confidentiality is maintained per OAC 340:100-3-2;
(19) supports the member in forming and maintaining friendships with neighbors, co-workers, and peers, including people who do not have disabilities;
(20) implements training and provides supports that enable the member to actively join in community life;
(21) does not serve as representative payee for the member without a written exception from the DDS area residential services programs manager or designee state office residential services programs manager.
(A) The written exception is and approved DDS home profile are retained in the member's home record.
(B) When serving as payee, the companion complies with OAC 340:100-3-4 requirements;
(22) ensures the member's funds are properly safeguarded;
(23) obtains prior approval from the member's representative payee when making a purchase of over $50 with the member's funds;
(24) allows provider agency and DDS staff to make announced and unannounced visits to the home;
(25) develops an Evacuation Plan, using DHS OKDHS Form 06AC020E, Evacuation/Escape Plan, for the home and conducts training with the member;
(26) conducts fire and weather drills at least quarterly and documents the fire and weather drills using OKDHS Form 06AC021E, Fire and Weather Drill Record;
(27) develops and maintains a personal possession inventory for personal possessions and adaptive equipment, using OKDHS Form 06AC022E, Personal Possession Inventory;
(28) supports the member's employment program by:
(A) assisting the member to wear appropriate work attire; and
(B) contacting the member's employer as outlined by the Team and in the Plan;
(29) is responsible for the cost of the member's meals and entertainment during recreational and leisure activities. Activities must be affordable to the member. Concerns about affordability are presented to the Team for resolution;
(30) for adults, reports suspected maltreatment including abuse, verbal abuse, sexual abuse, neglect, financial neglect, and/or exploitation of a vulnerable adult per Section 10-104 of Title 43A of the Oklahoma Statutes to the DHS OKDHS Office of Client Advocacy (OCA);
(31) for children, reports abuse, neglect, sexual abuse, or sexual exploitation per Section 1-2-101 of Title 10A of the Oklahoma Statutes to the Child Abuse and Neglect Hotline at 1-800-522-3511;
(32) follows all applicable rules promulgated by the Oklahoma Health Care Authority and DDS, including:
(A) OAC 340:100-3-40;
(B) OAC 340:100-5-50 through 100-5-58;
(C) OAC 340:100-5-26;
(D) OAC 340:100-5-34 340:100-5-33;
(E) OAC 340:100-5-32;
(F) OAC 340:100-5-22.1;
(G) OAC 340:100-3-27;
(H) OAC 340:100-3-38; and
(I) OAC 340:100-3-34;
(33) is neither the member's spouse, nor when the member is a minor child, the member's parent. A family member servicing as companion must meet all requirements listed in this Subchapter; and
(34) is not the Chief Executive Officer of a provider agency.
317:40-5-40. Home profile process ¢ 1 &2
(a) Applicability. This Section establishes procedures for the Developmental Disabilities Services (DDS) home profile process. A home profile is required for:
(1) agency companion services (ACS);
(2) specialized foster care (SFC) services;
(3) respite services delivered in the provider's home;
(4) approving services in a home shared by a non-relative provider and a member; and
(5) any other situation that requires a home profile.
(b) Pre-screening. Designated (DDS) staff provides the applicant with program orientation and completes pre-screening information that includes activities to include, but is not limited to:
(1) facts, description, and guiding principles of the Home and Community-Based Services (HCBS) program;
(2) an explanation of:
(A) the home profile process;
(B) basic provider qualifications;
(C) health, safety, and environmental issues; and
(D) training required per Oklahoma Administrative Code (OAC) 340:100-3-38;
(3) the Oklahoma Department of Human Services (DHS) Form 06AC012E, Specialized Foster Care/Agency Companion Services Information Sheet gathering relevant information about the family, including household members, address, and contact information, and motivation to provide services; and
(4) explanation of a background investigation conducted on the applicant and any adult or child living in the applicant's home.
(A) Background investigations are conducted at the time of application and include, but are not limited to:
(i) an Oklahoma State Bureau of Investigation (OSBI) name and criminal records history search, including the Oklahoma Department of Public Safety (DPS), Sex Offender Registry, and Mary Rippy Violent Offender Registries, and Nurse Aide and Nontechnical Services Worker Registry;
(ii) Federal Bureau of Investigation (FBI) national criminal history search, based on the fingerprints of the applicant and any adult members of the household; except when an exception is necessary as outlined below.
(I) Low quality fingerprints, as determined by OSBI, FBI, or both, make it impossible for the national crime information databases to provide results, a state, national, or both, name-based search may be authorized.
(II) When the DDS State Office residential staff request an exception from an individual, who has a severe physical condition precluding the individual from being fingerprinted, a state, national, or both, name-based search may be authorized;
(iii) search of any involvement as a party in a court action;
(iv) search of all DHS OKDHS records, including Child Welfare Services records, and the Community Services Worker Registry, and Restricted Registry;
(v) a search of all applicable out-of-state child abuse and neglect registries for any applicant or adult household member who has not lived in Oklahoma continuously for the past five years. A home is not approved without the results of the out-of-state maintained child abuse and neglect registry checks, when a registry is maintained in the applicable state, for all adult household members living in the home. When a child abuse and neglect registry is not maintained in the applicable state, a request for information is made to the applicable state; and
(vi) search of Juvenile Justice Information System (JOLTS) records for any child older than 13 years of age in the applicant's household.
(B) An application is denied when the applicant or any person residing in the applicant's home:
(i) has a criminal conviction of or pled guilty or no contest to:
(I) physical assault, battery, or a drug-related offense in the five-year period preceding the application date;
(II) child abuse or neglect;
(III) domestic abuse;
(IV) a crime against a child, including, but not limited to, child pornography;
(V) a crime involving violence, including, but not limited to, rape, sexual assault, or homicide, including manslaughter, excluding physical assault and battery; or
(ii) does not meet OAC 340:100-3-39 requirements; .
(5) DHS Form 06AC015E, Agency Companion/Specialized Foster Care Employment Record
(6) DHS Form 06AC016E, DDS Reference Information Waiver
(7) DHS Form 06AC029E, Employer Reference Letter; and
(8) DHS Form 06AC013E, Pre-Screening for Specialized Foster Care/Agency Companion Services.
(c) Home profile process. When the applicant meets the requirements of the prescreening, the initial home profile process described in (1) through (8) of this subsection is initiated.
(1) The applicant completes the required forms and returns the forms to the DDS address provided.Required forms include DHS Forms: provides required information for completion of the home profile.
(A) 06AC008E, Specialized Foster Care/Agency Companion Services Application;
(B) 06AC009E, Financial Assessment;
(C) 06AC011E, Family Health;
(D) 06AC018E, Self Study Questionnaire;
(E) 06AC019E, Child's Questionnaire;
(F) 06AC010E, Medical Examination Report, when Form 06AC011E indicates conditions that may interfere with the provision of services;
(G) 06AC017E, Insurance Information; and
(H) 06AC020E, Evacuation/Escape Plan.
(2) When an incomplete form or other information is returned to DDS, designated DDS staff sends a letter notice in writing to the provider or provider agency identifying information needed to complete the required forms. The home profile is not completed until all required information is provided to DDS.
(3) Designated DDS staff completes the home profile when all required forms are completed and provided to DDS.
(4) For each reference provided by the applicant, designated DDS staff completes DHS Form 06AC058E, Reference Letter documents the results of each completed reference;
(5) Designated DDS staff, through interviews, visits, and phone calls, gathers information required to complete DHS Form 06AC047E, Home Profile Notes the home profile.
(6) DHS Form 06AC069E, Review of Policies and Areas of Responsibilities, is dated and signed DDS staff review policies and areas of responsibilities with the applicant and acknowledgment is made in writing by the applicant and designated DDS staff.
(7) The DDS area residential services programs manager sends to the applicant:
(A) a provider approval letter confirming the applicant is approved to serve as a provider; or
(B) a denial letter stating the application and home profile are denied.
(8) DDS staff records the dates of completion of each part of the home profile process.
(d) Home standards. In order to qualify and remain in compliance, the applicant's or provider's home must meet the provisions in (1) through (11) of this subsection.
(1) General conditions.
(A) The home, buildings, and furnishings must be comfortable, clean, and in good repair and the grounds must be maintained. There must be no accumulation of garbage, debris, or rubbish or offensive odors.
(B) The home must:
(i) be accessible to school, employment, church, day programming, recreational activities, health facilities, and other community resources as needed;
(ii) have adequate heating, cooling and plumbing; and
(iii) provide space for the member's personal possessions and privacy;
(iv) allow adequate space for the recreational and social needs of the occupants.
(C) Provisions for the member's safety must be present, as needed, including:
(i) guards and rails on stairways;
(ii) wheelchair ramps;
(iii) widened doorways;
(iv) grab bars;
(v) adequate lighting;
(vi) anti-scald devices; and
(vii) heat and air conditioning equipment guarded and installed in accordance with manufacturer requirements. Home modifications and equipment may be provided through HCBS Waivers operated by DDS.
(D) Providers must not permit members to access or use swimming or other pools, hot tubs, saunas, ponds, or spas on the premises without supervision. Swimming pools, hot tubs, saunas, ponds, or spas must be equipped with sufficient safety barriers or devices designed to prevent accidental injury or unsupervised access.
(E) The household must be covered by homeowner's or renter's insurance including personal liability insurance.
(2) Sanitation.
(A) Sanitary facilities must be adequate and safe, including toilet and bathing facilities, water supply, and garbage and sewer disposal.
(B) When a septic tank or other non-municipal sewage disposal system is used, it must be in good working order.
(C) Garbage and refuse must be stored in readily cleanable containers, pending weekly removal.
(D) Sanitation for household pets and other domestic animals must be adequate to prevent health hazards.
(i) Proof of rabies or other vaccinations as required by a licensed veterinarian for household pets must be maintained on the premises.
(ii) Pets not confined in enclosures must be under control and not present a danger to members or guests.
(E) There must be adequate control of insects and rodents, including screens used for ventilation in good repair on doors and windows.
(F) Universal precautions for infection control must be followed in care to the member. Hands and other skin surfaces must be washed immediately and thoroughly when contaminated with blood or other body fluids.
(G) Laundry equipment, if in the home, must be located in a safe, well-ventilated, and clean area, with the dryer vented to the outside.
(3) Bathrooms. A bathroom must:
(A) provide for individual privacy and have a finished interior;
(B) be clean and free of objectionable odors; and
(C) have a bathtub or shower, flush toilet, and sink in good repair, and hot and cold water in sufficient supply to meet the member's hygiene needs.
(i) A sink must be located near each toilet.
(ii) A toilet and sink must be provided on each floor where rooms of members who are non-ambulatory or with limited mobility are located.
(iii) There must be at least one toilet, one sink, and one bathtub or shower for every six household occupants, including the provider and family.
(4) Bedrooms. A bedroom must:
(A) have been constructed as such when the home was built or remodeled under permit;
(B) be provided for each member.
(i)Exception to allow members to share a bedroom may be made by DDS area residential program manager, when DDS determines sharing a bedroom is in the best interest of the member. Minor members must not share bedrooms with adults.
(ii) A member must not share a bedroom with more than one other person;
(C) have a minimum of 80 square feet of usable floor space for each member or 120 square feet for two members and two means of egress. The provider, family members, or other occupants of the home must not sleep in areas designated as common use living areas, nor share bedrooms with members;
(D) be finished with walls or partitions of standard construction that go from floor to ceiling;
(E) be adequately ventilated, heated, cooled, and lighted;
(F) include an individual bed for each member consisting of a frame, box spring, and mattress at least 36 inches wide, unless a specialized bed is required to meet identified needs. Cots, rollaways, couches, futons, and folding beds must not be used for members.
(i) Each bed must have clean bedding in good condition consisting of a mattress pad, bedspread, two sheets, pillow, pillowcase, and blankets adequate for the weather.
(ii) Sheets and pillowcases must be laundered at least weekly or more often if necessary.
(iii) Waterproof mattress covers must be used for members who are incontinent;
(G) have sufficient space for each member's clothing and personal effects, including hygiene and grooming supplies.
(i) Members must be allowed to keep and use reasonable amounts of personal belongings and have private, secure storage space.
(ii) The provider assists the member in furnishing and decorating the member's bedroom.
(iii) Window coverings must be in good condition and allow privacy for members;
(H) be on ground level for members with impaired mobility or who are non-ambulatory; and
(I) be in close enough proximity to the provider to alert the provider to nighttime needs or emergencies, or be equipped with a call bell or intercom an alert system.
(5) Food.
(A) Adequate storage must be available to maintain food at the proper temperature, including a properly working refrigerator. Food storage must be such that food is protected from dirt and contamination and maintained at proper temperatures to prevent spoilage.
(B) Utensils, dishes, glassware, and food supplies must not be stored in bedrooms, bathrooms, or living areas.
(C) Utensils, dishes, and glassware must be washed and stored to prevent contamination.
(D) Food storage and preparation areas and equipment must be clean, free of offensive odors, and in good repair.
(6) Phone.
(A) A working phone must be provided in the home that is available and accessible for the member's use for incoming and outgoing calls.
(B) Phone numbers to the home and providers must be kept current and provided to DDS and, when applicable, the provider agency.
(7) Safety.
(A) Buildings must meet all applicable state building, mechanical, and housing codes.
(B) Heating, in accordance with manufacturer's specifications, and electrical equipment, including wood stoves, must be installed in accordance with all applicable fire and life safety codes. Such equipment must be used and maintained properly and in good repair.
(i) Protective glass screens or metal mesh curtains attached at top and bottom are required on fireplaces.
(ii) Unvented portable oil, gas, or kerosene heaters are prohibited.
(C) Extension cord wiring must not be used in place of permanent wiring.
(D) Hardware for all exit and interior doors must have an obvious method of operation that cannot be locked against egress.
(8) Emergencies.
(A) Working smoke detectors must be provided in each bedroom, adjacent hallways, and in two story homes at the top of each stairway. Alarms must be equipped with a device that warns of low battery condition, when battery operated.
(B) At least one working fire extinguisher must be in a readily accessible location.
(C) A working flashlight must be available for emergency lighting on each floor of the home.
(D) The provider:
(i) maintains a working carbon monoxide detector in the home;
(ii) maintains a written evacuation plan for the home and conducts training for evacuation with the member;
(iii) conducts fire drills quarterly and severe weather drills twice per year;
(iv) makes fire and severe weather drill documentation available for review by DDS;
(v) has a written back-up plan for temporary housing in the event of an emergency; and
(vi) is responsible to re-establish a residence, if the home becomes uninhabitable.
(E) A first aid kit must be available in the home.
(F) The address of the home must be clearly visible from the street.
(9) Special hazards.
(A) Firearms and other dangerous weapons must be stored in a locked permanent enclosure. Ammunition must be stored in a separate locked location. Providers are prohibited from assisting members to obtain, possess, or use dangerous or deadly weapons per OAC 340:100-5-22.1.
(B) Flammable and combustible liquids and hazardous materials must be safely and properly stored in original, properly labeled containers.
(C) Cleaning supplies, medical sharps containers, poisons, and insecticides must be properly stored in original, properly labeled containers in a safe area away from food, food preparation areas, dining areas, and medications.
(D) Illegal substances are not permitted on the premises.
(10) Vehicles.
(A) All vehicles used to transport members must meet local and state requirements for licensing, inspection, insurance, and capacity.
(B) Drivers of vehicles must have valid and appropriate driver licenses.
(11) Medication. Medication for the member is stored per OAC 340:100-5-32.
(e) Evaluating the applicant and home. The initial home profile evaluation includes, but is not limited to:
(1) evaluating the applicant's:
(A) interest and motivation;
(B) life skills;
(C) children;
(D) methods of behavior support and discipline;
(E) marital status, background, and household composition;
(F) income and money management; and
(G) teamwork and supervision, back-up plan, and use of relief; and
(2) assessment and recommendation. DDS staff:
(A) evaluates the ability of the applicant to provide services;
(B) assesses the overall compatibility of the applicant and the service recipient, ensuring the lifestyles and personalities of each are compatible for the shared living arrangement. The applicant must:
(i) express a long term commitment to the service member unless the applicant will only be providing respite services;
(ii) demonstrate the skills to meet the individual needs of the member;
(iii) express an understanding of the commitment required as a provider of services;
(iv) express an understanding of the impact the arrangement will have on personal and family life;
(v) demonstrate the ability to establish and maintain positive relationships, especially during stressful situations; and
(vi) demonstrates the ability to work collaboratively and cooperatively with others in a team process;
(C) approves only applicants who can fulfill the expectations of the role of service provider;
(D) when the applicant does not meet standards per OAC 317:40-5-40, ensures the final recommendation includes:
(i) a basis for the denial decision; and
(ii) an effective date for determining the applicant does not meet standards. Reasons for denying a request to be a provider may include, but are not limited to:
(I) a lack of stable, adequate income to meet the applicant's own or total family needs or poor management of the available income;
(II) a physical facility that is inadequate to accommodate the addition of a member to the home or presents health or safety concerns;
(III) the age, health, or any other condition of the applicant that impedes the applicant's ability to provide appropriate care for a member;
(IV) relationships in the applicant's household that are unstable and unsatisfactory;
(V) the mental health of the applicant or other family or household member that impedes the applicant's ability to provide appropriate care for a member;
(VI) references who are guarded or have reservations in recommending the applicant;
(VII) the applicant failed to complete the application, required training, or verifications in a timely manner as requested or provided incomplete, inconsistent, or untruthful information;
(VIII) the home is determined unsuitable for the member requiring placement;
(IX) confirmed abuse, neglect, or exploitation of any person;
(X) breach of confidentiality;
(XI) involvement of the applicant or provider involvement in criminal activity or criminal activity in the home;
(XII) failure to complete training per OAC 340:100-3-38;
(XIII) failure of the home to meet standards per subsection (d) of this Section;
(XIV) failure to follow applicable DHS OKDHS or Oklahoma Health Care Authority (OHCA)rules;
(E) notifies the applicant in writing of the final approval or denial of the home profile;
(F) when an application is canceled or withdrawn prior to completion of the home profile, completes a final written assessment that includes the:
(i) reason the application was canceled or withdrawn; and
(ii) DDS staff's impression of the applicant based on information obtained; and
(iii) effective date of cancellation or withdrawal. Written notice is sent to the applicant to confirm cancellation or withdrawal of the application, and a copy is included in local and State Office records.
(f) Frequency of evaluation. Home profile evaluations are completed for initial approval or denial of an applicant. After an initial approval, a home profile review is conducted annually and as needed for compliance and continued approval. DDS area residential services staff conduct at least biannual home visits to specialized foster care providers. The annual home profile review is a comprehensive review of the living arrangement, the provider's continued ability to meet standards, the needs of the member and the home to ensure ongoing compliance with home standards. A home profile review is conducted when a provider notifies DDS of his or her intent to move to a new residence. DDS staff asses the home to ensure the new home meets home standards and is suitable to meet the member's needs. The annual home profile review;
(1) includes information specifically related to the provider's home and is documented on DHS Form 06AC024E, Annual Review as an annual review;
(2) includes form 06AC010E,Medical Examination Report, a medical examination report completed a minimum of every three years following the initial approval, unless medical circumstances warrant more frequent completion;
(3) includes information from the DDS case manager, the provider of agency companion or SFC services, the Child Welfare specialist, Adult Protective Services, and Office of Client Advocacy staff, and the provider agency program coordinator when applicable.
(4) includes information from the service member indicating satisfaction with service and a desire to continue the arrangement;
(5) addresses areas of service where improvement is needed;
(6) includes areas of service where progress was noted or were of significant benefit to the member;
(7) ensures background investigation per OAC 317:40-5-40(b) is repeated every year, except for the OSBI and FBI national criminal history search;
(8) ensures the FBI national criminal history search per OAC 317:40-5-40(b)(4)(A)(ii) is repeated every five years;
(9) includes written notification to providers and agencies, when applicable, of the continued approval of the provider.
(10) includes written notification to providers and agencies, when the provider or agency fails to comply with the home standards per OAC 317:40-5-40 including deadlines for correction of the identified standards; and includes copies of DHS Forms 06AC024E and, when applicable, 06AC010E, in local and State Office records.
(g) Reasons a home profile review may be denied include, but are not limited to:
(1) lack of stable, adequate income to meet the provider's own or total family needs or poor management of available income;
(2) a physical facility that is inadequate to accommodate the addition of a member to the home or presents health or safety concerns;
(3) the age, health, or any other condition of the provider that impedes the provider's ability to provide appropriate care for a member;
(4) relationships in the provider's household that are unstable and unsatisfactory;
(5)the mental health of the provider or other family or household member impedes the provider's ability to provide appropriate care for a member;
(6) the provider fails to complete required training, or verifications in a timely manner as requested or provides incomplete, inconsistent, or untruthful information;
(7) the home is determined unsuitable for the member;
(8) failure of the provider to complete tasks related to problem resolution, as agreed, per OAC 340:100-3-27;
(9) failure of the provider to complete a plan of action, as agreed, per OAC 317:40-5-63;
(10) confirmed abuse, neglect, or exploitation of any person;
(11) breach of confidentiality;
(12) involvement of the applicant or provider involvement in the criminal activity or criminal activity in the home;
(13) failure to provide for the care and well-being of the service member;
(14) failure or continued failure to implement the individual Plan, per OAC 340:100-5-50 through 100-5-58;
(15) failure to complete and maintain training per OAC 340:100-3-38;
(16) failure to report changes in the household;
(17) failure to meet standards of the home per subsection (d) of this Section;
(18) failure or continued failure to follow applicable DHS OKDHS or OHCA rules;
(19) decline of the provider's health to the point he or she can no longer meet the needs of the service member;
(20) employment by the provider without prior approval of the DDS area programs manager for residential services; or
(21) domestic disputes that cause emotional distress to the member.
(h) Termination of placement. When an existing placement is terminated for any reason:
(1) the Team meets to develop an orderly transition plan; and
(2) DDS staff ensures the property of the member and state is removed promptly and appropriately by the member or his or her designee.
INSTRUCTIONS TO STAFF 317:40-5-40
Revised
1.Evaluating the applicant and home.
(1) Interest and motivation. Explore the applicant's interest and motivation for providing services.
(A) How did the applicant learn about the applicable Home and Community-Based Services (HCBS) program?
(B) Is there an existing relationship between the applicant and a specific member for placement? If so, explain the relationship.
(C) Why does the applicant wish to expand the applicant's family?
(D) Has the applicant ever had a home profile completed? If so, when, where, and what were the results?
(E) Is assuming the care of a member, in part, an attempt to work through a loss or to repeat or replace a major relationship?
(F) What expectations does the applicant have for the member?
(G) Is the extended family supportive of the decision to participate in the applicable HCBS program?
(H) Has the applicant had experience with an individual with developmental disabilities? If not, the applicant is made aware of the physical and emotional requirements of a person for whom the applicant may provide care.Prescreening process. Oklahoma Human Services (OKDHS) Developmental Disabilities Services (DDS) staff engages the applicant in the evaluation of the household as outlined in (1) and (2) of this paragraph. Begin with exploring the applicants interest and motivation for providing services.The prescreening process is the initial phase of the evaluation process and includes:
(A) OKDHS Form 06AC013E, Pre-Screening for Specialized Foster Care/Agency Companion Services;
(B) OKDHS Form 04AD003E, Request for background check;
(C) JOLTS check through the Office of Juvenile Affairs;
(D) OKDHS Form 04FT007E, Request to Release Child Abuse and Neglect Findings;
(E) fingerprints obtained through OKDHS;
(F) copy of driver license or state issued Identification for all adult household members;
(G) OKDHS Form 06MP050E, Notice of Responsibility Regarding Online Training. DDS staff enrolls the applicant in required training; and
(H) the safety checklist to ensure necessary safety measures are addressed in the home.
(2) Applicant and any other adult in the home. Knowledge of past experience and influences is vital in understanding the applicant's and other adult's current functioning.
(A) life skills and general attitudes of the applicant;
(B) childhood relationships with parents, siblings, relatives, or other meaningful persons, asking what each adult's childhood was like;
(C) experiences, such as death, illness, divorce, or poverty that had an impact on each person's attitudes, feelings, and expectations;
(D) whether the applicant ever knew anyone who was sexually or physically abused. When so, the applicant's experience is explored in depth and information is included in Oklahoma Department of Human Services (OKDHS) Form 06AC047E, Home Profile Notes;
(E) concepts of appropriate behavior support and discipline and the manner in which behavior supports must be administered, especially as applied to persons with developmental disabilities;
(F) the meaning of education and training to the applicant;
(G) the general physical and emotional health of household members.
(i) Adult family members must complete DHS Form 06AC011E, Family Health History.
(ii) When a household member has a physical disability, does the disability affect the ability to function as a provider of services providing adequate care and supervision? When yes, in what manner?
(iii) Do any household members experience a medical or emotional condition? Is any household member under professional care for any condition that requires the use of prescribed drugs or narcotics? If any household member uses prescribed drugs or narcotics, explore the extent of the use
(H) the emotional abilities of family members to provide services.
(i) If any household member previously received psychiatric or psychological counseling, the circumstances and results must be explored in depth.
(ii) A release of information is obtained allowing contact with the person who provided the counseling;
(I) the applicant's physical description;
(J) an employment record regarding work stability and satisfaction derived from employment;
(K) social relationships with members of the community, including hobbies, skills, talents, and special interests;
(L) religious influences, affiliations, and activities.
(i) Does the applicant have any specific religious beliefs that may affect a member in areas, such as dress code, holiday observances, medical care, daily living, or social activities?
(ii) Will the applicant ensure the member is able to attend the member's choice of place of worship as often as desired and practice his or her faith as desired;
(M) the reaction to stressful situations;
(N) the current relationships within the family, including marital and parent-child relationships;
(O) the relationship with children, adults and minors, living outside of the home.Adult children must be interviewed by DDS staff in writing, by phone, or in person;
(P) special training, ability, or experience in working with or caring for a person with physical disabilities, mental retardation, behavior problems, emotional disturbances, or other special needs;
(Q) guidelines for background investigations during annual reviews:
(i) yearly Oklahoma State Bureau of Investigation (OSBI) background checks are not necessary as RapBack serves the purpose for a yearly Oklahoma criminal background check for active, specialized foster parents and/or companion homes.
(ii) The Federal Bureau of Investigation does not have a program similar to OSBI RapBack and continued fingerprinting for national criminal history records checks is necessary for active, specialized foster parents and/or companion homes every five years.
(S) explanations of any arrests or convictions, including status of parole or probation, from information obtained from the required background investigation per OAC 317:40-5-40(b); and
(T) explanations of any allegations of abuse, neglect, or exploitation of child, adult, or animal.
(i) If there are no findings on the required searches, the absence of findings is stated as such on DHS Form 06ACO47E, Home Profile Notes.
(ii) A copy of background investigation searches and findings is included in local and State Office recordsApplication process.The application process builds on the prescreening process.
(A) The applicant provides information through:
(i) OKDHS Form 06AC008E, Specialized Foster Care/Agency Companion Services Application;
(ii) OKDHS Form 04AF010E Resource Family Financial Assessment;
(iii) OKDHS Form 06AC010E, Medical Examination Report, or physician generated physical exam report;
(iv) OKDHS Form 04AF017E Resource Parent Health History;
(v) OKDHS Form 06AC018E, Self-Study Questionnaire;
(vi) copies of:
(I) utility references;
(II) Social Security card;
(III) home insurance;
(IV) vehicle insurance;
(V) pet vaccinations;
(VI) immunizations for children in the home; and
(VII) water testing when the household water source is well water.
(B) DDS staff reviews the information provided in (2)(A) and:
(i) completes OKDHS Form 06AC058E, Reference Letter, for each reference provided by the applicant;
(ii) shares OKDHS Form 06AC029E, Employer Reference Letter, with the employer for completion or completes when checking references by phone;
(iii) discusses OKDHS Form 06AC020E, Evacuation/Escape Plan;
(iv) discusses OKDHS Form 06AC069E, Review of Policies and Areas of Responsibilities, with the applicant;
(v) completes a final inspection of the home prior to approval of the home profile; and
(vi) completes the safety checklist with input from the applicant.
(3) Children in the home. Provide a description of children living in the home regarding:
(A) age and physical appearance;
(B) personality, interests, and skills;
(C) strengths and problems in parent-child relationships, school adjustment, behavior, and health;
(D) ability to get along with other persons, especially persons with developmental disabilities;
(E) physical or developmental disabilities and health, including current immunizations;
(F) attitude toward having a relationship with a person who has developmental disabilities; and
(G) depending on age, attitude toward persons receiving services.
(4) Behavior support and discipline. Applicants are advised on discipline and behavior management, per OAC 340:110-5-62, and individual planning and protective intervention, per OAC 340:100-5-50 through 340:100-5-57.
(A) DDS staff discusses with the applicant how he or she disciplines his or her natural children.
(i) When there is a divergence between DHSOKDHS policy and the methods used to discipline natural children, DDS staff explores how the applicant will deal with any problems that may result from this difference.
(ii) DDS staff discusses with the applicant how the applicant was disciplined as a child and any effects it has on the applicant's attitude toward discipline.
(iii) From information obtained through training and discussion with the applicant, DDS staff documents the applicant's understanding and acceptance of applicable Oklahoma Health Care Authority (OHCA) or DHSOKDHS policy on DHS Form 06AC047E, Home Profile Notes. This information is considered in the final recommendation.
(iv) DDS staff determines whether there is agreement among all adults in the household on methods of discipline.
(v) Any applicant who does not agree to abide by applicable OHCA or DHSOKDHS policy is not approved to provide services.
(B) Members may require behavior supports. An Individual Plan (IP) is developed by the Personal Support Team (Team) that includes the service provider.
(C) Prohibited procedures, per OAC 340:100-5-58, must be upheld in the home.
(5)(4) Marital status and background, household composition, and children. DDS staff documents aspects of the applicant's marital status.
(A) Current marriage, when applicable. DDS staff describes the applicant's marriage regarding:
(i) the length of the present marriage;
(ii) the stability of the marriage;
(iii) the methods used to resolve marital problems; and
(iv) whether the decision to become a provider is a joint decision.
(B) Previous marriage, when applicable. DDS staff discusses with the provider, his or her previous marriage regarding the:
(i) number and lengths of the previous marriages;
(ii) reason the marriages ended; and
(iii) children involved, visitation, and child support arrangements, if applicable.
(C) Single or never married. When the applicant is not married, DDS staff discusses the:
(i) best and most difficult aspects of being single;
(ii) applicant's source of support; and
(iii) significant adult relationships in the applicant's life.
(6)(5) Income and money management. Verification of income and expenses is required.
(A) DHS Form 06AC009E, Financial Assessment, must be completed.
(B) Any financial problem areas are discussed and included in DHS Form 06AC047E.
(C) The applicant, and family when applicable, shows financial stability by being able to pay their bills and to live within their financial means.
(7)(6) Teamwork and supervision, back-up plan, and use of relief. DHS Form06AC047E the The home profile includes a brief description of the provider's intent to work with Child Welfare, DDS, community professional providers, and other partners in the care of individuals that will be served in the home.:
(A) fundamental responsibility of DHS to meet the member's physical, emotional, and medical needs;
(B) responsibility of the provider for the member's daily care ensuring all areas of need are met;
(C) primary responsibility of Child Welfare Services staff and the DDS case manager as liaisons in all planning with the member, natural family, provider, Team, provider agency, and court, as applicable;
(D) situations necessitating placement;
(E) varying lengths of time for which members require services;
(F) characteristics of members requiring services;
(G) differences between service provision and adoption;
(H) importance of teamwork in:
(i) working toward member reunification with his or her biological family, if appropriate; or
(ii) when reunification is not possible, developing an alternative permanent plan for the member; and
(I) OHCA and DHS policies and procedures regarding:
(i) room and board payments;
(ii) clothing provisions;
(iii) medical care;
(iv) behavior support;
(v) confidentiality;
(vi) education; and
(vii) religious training.
(7) Background checks. Results of background investigations are discussed with the family when necessary and a summary of results is added to the Home Profile.
(8) Guidelines for background investigations during annual reviews.
(A) Yearly Oklahoma State Bureau of Investigation background checks are not necessary as RapBack serves the purpose for a yearly Oklahoma criminal background check for active, specialized foster parents and/or companion homes.
(B) National criminal history records checks through fingerprinting are necessary for active, specialized foster parents and/or companion homes every five years.
(C). When background results reveal new concerns, DDS staff reviews the results with the provider requesting:
(i) explanation of any arrests or convictions, including status of parole or probation, from information obtained from the required background investigation per OAC 317:40-5-40(b); and
(ii) explanation of any allegations of abuse, neglect, or exploitation of child, adult, or animal.
(1) If there are no findings on the required searches, the absence of findings is stated as such in the home profile.
(2) A copy of background investigation searches and findings is included in local and State Office records.
2. Consultation. Consultation may be obtained from the DDS area residential programs manager, area manager, or State Office residential programs manager in the assessment and recommendationpre-screening and application process.
317:40-5-152. Group home services for persons with an intellectual disability or certain persons with related conditions
Revised 9-1-15
(a) General Information. Group homes provide a congregate living arrangement offering up to 24-hour per day supervision, supportive assistance, and training in daily living skills to persons who are eligible and 18 years of age or older. Upon approval of the Oklahoma Department of Human Services DHS (OKDHS) Developmental Disabilities Services (DDS) director or designee, persons younger than 18 years of age may be served.
(1) Group homes ensure members reside and participate in the community. Services are provided in homes located in close proximity to generic community services and activities.
(2) Group homes must be licensed by DHS OKDHS per Section 1430.1 et seq. of Title 10 of the Oklahoma Statutes.
(3) Residents of group homes receive no other form of residential supports.
(4) Habilitation training specialist (HTS) services or homemaker services for residents of group homes may only be approved by the DDS director or designee:
(A) for a resident of a group home to resolve a temporary emergency when no other resolution exists; or
(B) for a resident of a community living group home when the resident's needs are so extensive that additional supports are needed for identified specific activities; and
(C) weekly average of 56 hours of direct contact staff must be provided to the resident before HTS services may be approved.
(b) Minimum provider qualifications. Approved providers must have a current contract with the Oklahoma Health Care Authority (OHCA) to provide DDS Home and Community-Based Services (HCBS) for persons with an intellectual disability or related conditions.
(1) Group home providers must have a completed and approved application to provide DDS group home services.
(2) Group home staff must:
(A) complete the DHS DDS-sanctioned training curriculum per OAC 340:100-3-38; and
(B) fulfill requirements for pre-employment screening per OAC 340:100-3-39.
(c) Description of services.
(1) Group home services:
(A) meet all applicable requirements of OAC 340:100; and
(B) are provided in accordance with each member's Individual Plan (IP) developed per OAC 340:100-5-50 through 340:100-5-58.
(i) Health care services are secured for each member per OAC 340:100-5-26.
(ii) Members are offered recreational and leisure activities maximizing the use of generic programs and resources, including individual and group activities.
(2) Group home providers:
(A) follow protective intervention practices per OAC 340:100-5-57 and 340:100-5-58;
(B) in addition to the documentation required per OAC 340:100-3-40, must maintain:
(i) staff time sheets that document the hours each staff was present and on duty in the group home; and
(ii) documentation of each member's presence or absence on the daily attendance form provided by DDS; and
(C) ensure program coordination staff (PCS) meet staff qualifications and supervise, guide, and oversee all aspects of group home services per OAC 340:100-5-22.6 and 340:100-6, as applicable.
(d) Coverage limitations. Group home services are provided up to 366 days per year.
(e) Types of group home services. Three types of group home services are provided through HCBS Waivers.
(1) Traditional group homes. Traditional group homes serve no more than 12 members per OAC 340:100-6.
(2) Community living homes. Community living homes serve no more than 12 members.
(A) Members who receive community living home services:
(i) have needs that cannot be met in a less structured setting; and
(ii) require regular, frequent, and sometimes constant assistance and support to complete daily living skills, such as bathing, dressing, eating, and toileting; or
(iii) require supervision and training in appropriate social and interactive skills, due to on-going behavioral issues to remain included in the community.
(B) Services offered in a community living home include:
(i) 24-hour awake supervision when a member's IP indicates it is necessary; and
(ii) program supervision and oversight including hands-on assistance in performing activities of daily living, transferring, positioning, skill-building, and training.
(C) Services may be approved for individuals in a traditional group home at the community living service rate when the member has had a change in health status or behavior and meets the requirements to receive community living home services. Requests to receive community living home services are sent to the DDS Community Services Residential Unit.
(3) Alternative group homes. Alternative group homes serve no more than four members who have evidence of behavioral or emotional challenges in addition to an intellectual disability and require extensive supervision and assistance in order to remain in the community.
(A) Members who receive alternative group home services must meet criteria per in OAC 340:100-5-22.6.
(B) A determination must be made by the DDS Community Services Unit director or designee that alternative group home services are appropriate.
317:40-7-11. Stabilization Services
Stabilization Services are ongoing support services needed to maintain a member in an integrated competitive employment site. Stabilization Services are provided for up to two years per job. Stabilization Services continue until the next Plan of Care following the end of two years of Stabilization Services.
(1) Stabilization Services are provided when the job coach intervention time required at the job site is 20% or less of the member's total work hours for four consecutive weeks or when the member moved from Department of Rehabilitation Services (DRS) services.
(A) If, after the member moves to Stabilization Services, the Team determines that support is needed above 20% for longer than two weeks, the Team may revise the member's Plan of Care to reflect the need for Job Coaching Services.
(B) A member receiving services from DRS moves to services funded by DDSD Developmental Disabilities Services DDS upon completion of the Job Stabilization milestone. The employment provider agency submits the request for transfer of funding during the Job Stabilization milestone as described in the DRS Supported Employment contract.
(2) Stabilization Services must:
(A) identify the supports needed, including development of natural supports;
(B) specify, in a measurable manner, the services to be provided.
(3) Reimbursement for Stabilization Services is based upon the number of hours the member is employed at a rate of minimum wage or above.
(4) If the member needs job coach services after the expiration of Stabilization Services, Employment Training Specialist Services may be authorized for the hours necessary to provide direct support to the member or consultation to the employer as described in outcomes and methods in the Individual Plan Stabilization Services may be authorized through remote supports per a Health Insurance Portability and Accountability Act (HIPAA) compliant technology, when the Team has an approved remote supports risk assessment.
(5) If the member needs job coach services after the expiration of Stabilization Services, Employment Training Specialist Services may be authorized for the hours necessary to provide direct support to the member or consultation to the employer as described in outcomes and methods in the Individual Plan.
317:40-7-15. Service requirements for employment services through Home and Community-Based Services(HCBS) Waivers
(a) The Oklahoma Department of Human Services (DHS) (OKDHS) Developmental Disabilities Services (DDS) case manager, the member, the member's family or, when applicable, the member's legal guardian, and the member's provider develop a preliminary plan of services including the:
(1) site and amount of the services offered;
(2) types of services to be delivered; and
(3) expected outcomes.
(b) To promote community integration and inclusion, employment services are delivered in non-residential sites.
(1) Employment services through HCBS waivers cannot be reimbursed when those services occur in the residence or property of the member or provider-paid staff, including garages and sheds, whether the garage or shed is attached to the home or not.
(2) No exceptions to Oklahoma Administrative Code (OAC) 317:40-7-15(b) are authorized except when a home-based business is established and supported through the Oklahoma Department of Rehabilitation Services (OKDRS) (DRS). Once OKDRS DRS stabilization services end, DDS stabilization services are then utilized.
(c) The service provider is required to notify the DDS case manager in writing when the member:
(1) is placed in a new job;
(2) loses his or her job. A personal support team (Team) meeting must be held when the member loses the job;
(3) experiences significant changes in the community-based or employment schedule; or
(4) is involved in critical and non-critical incidents per OAC 340:100-3-34.
(d) The provider submits a DHS Provider Progress Report, per OAC 340:100-5-52, for each member receiving services.
(e) The cost of a member's employment services, excluding transportation and state-funded services per OAC 340:100-17-30, cannot exceed $27,000 limits set forth in OKDHS Appendix D-26, Developmental Disabilities Services Rates Schedule per Plan of Care (POC) year.
(f) Each member receiving HCBS is supported in opportunities to seek employment and work in competitive integrated settings. When the member is not employed in a competitive integrated job, the Team identifies outcomes, and/or action steps, or both, to create opportunities that move the member toward competitive integrated employment.
(g) Each member receiving residential supports, per OAC 340:100-5-22.1, or group-home services is employed for thirty (30) hours per week or receives a minimum of thirty (30) hours of employment services each week, excluding transportation to and from his or her residence.
(1) Thirty (30) hours of employment service each week may be a combination of community-based services, center-based services, employment training specialist (ETS) intensive training services, stabilization services, or job coaching services. Center-based services cannot exceed fifteen (15) hours per week for members receiving services through the Homeward Bound Waiver.
(2) When the member does not participate in thirty (30) hours per week of employment services, the Team:
(A) documents the outcomes and/or action steps to create a pathway that moves toward employment activities;
(B) describes a plan to provide a meaningful day in the community; or
(C) increases the member's employment activities to thirty (30) hours per week.
(h) Adult members receiving In-Home Supports Waiver (IHSW) services can access individual placement in job coaching, stabilization, and employment training specialist services not to exceed limits specified in OKDHS Appendix D-26 per POC year.
