Oklahoma Administrative Code
Title 340 - Department of Human Services
Chapter 100 - Developmental Disabilities Services
Subchapter 3 - Administration
Part 3 - ADMINISTRATION
Section 340:100-3-33 - Service authorization
Universal Citation: OK Admin Code 340:100-3-33
Current through Vol. 42, No. 1, September 16, 2024
(a) Developmental Disabilities Services Division (DDSD) provides services using state and federal funds.
(1) All Medicaid
services are implemented in accordance with Title XIX regulations.
(2) Oklahoma Health Care Authority (OHCA)
authorizes Title XIX compensability of all Home and Community-Based Services
(HCBS) Waiver and intermediate care facility for persons with mental
retardation (ICF/MR) services.
(3)
HCBS Waiver services are included in the service recipient's Plan of Care (POC)
and are identified in accordance with OAC
340:100-5-53.
(4) Facility administrators of Northern
Oklahoma Resource Center of Enid (NORCE), Southern Oklahoma Resource Center
(SORC), and Robert M. Greer (Greer) are authorized to approve habilitation and
support services required by the service recipient's individual program plan
and regulatory standards, including the purchase of adaptive and mobility
equipment.
(5) All authorized
state-funded services are implemented in accordance with Oklahoma Department of
Human Services (OKDHS) purchasing and contract policy and procedures.
Authorization of services is contingent upon the availability of adequate
resources.
(b) DDSD case managers may implement services that are:
(1)
generic non-specialized services accessed when possible;
(2) approved for DDSD payment;
(3) identified in the service recipient's
POC.
(A) The amount of HCBS Waiver services
must not exceed service specific utilization limitations and comply with
related OHCA policy.
(B) Total
expense of HCBS Waiver services must not exceed the statewide congregate
average annual cost of HCBS Waiver services per service recipient.
(C) The total POC cost must not exceed annual
per capita limitations, if any, established in the applicable HCBS Waiver;
and
(4) State funds are
approved to meet critical needs when there is no other resolution and funds are
necessary to resolve an emergency, such as necessary utilities, clothing,
furniture, food and shelter. Funds cannot exceed $750.00 per event.
(c) The DDSD area manager or designee must review and approve implementation of expenditures for:
(1) HCBS Waiver services prescribed for a
service recipient on the POC, exceeding the statewide, congregate average
annual HCBS Waiver expenditure by 35% or less per year; and
(2) short term emergency services required to
meet critical needs and ensure the continuity of care when no other resolution
exists.
(d) The DDSD director or designee must review and approve implementation of:
(1) expenditures for HCBS Waiver services
exceeding the statewide, congregate average annual cost of HCBS Waiver services
by more than 35%; and
(2) support
or habilitative services not otherwise authorized by OKDHS policy, subject to
approval by OKDHS Director, Oklahoma Commission for Human Services or
both.
(e) Service recipients:
(1) maintain the right to appeal
service eligibility determinations as stipulated by the Oklahoma State Medicaid
Plan and OKDHS policy; and
(2) are
provided literature and an understandable explanation describing procedures for
exercising this right.
Amended at 8 Ok Reg 2163, eff 5-13-91 (emergency); Amended at 9 Ok Reg 1549, eff 4-27-92; Amended at 11 Ok Reg 4107, eff 6-29-94 (emergency); Amended at 12 Ok Reg 1761, eff 6-12-95; Amended at 26 Ok Reg 922, eff 5-15-09
Disclaimer: These regulations may not be the most recent version. Oklahoma may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
