Current through Vol. 42, No. 1, September 16, 2024
(a)
Legal basis. Section
1020
of Title 56 of the Oklahoma Statutes authorizes the Oklahoma Department of
Human Services (DHS) to provide community services for persons with PWS.
(b)
Applicability.
The rules in this Section apply to services provided through (DHS) and
Developmental Disabilities Services (DDS) to persons with PWS through funds
appropriated by the Oklahoma Legislature.
(c)
General information.
Services for persons with PWS are intended to meet the service recipients'
specialized needs. DHS provides a monthly payment to the contracted-
residential provider to:
(1) ensure each
service recipient participates in regular recreation, leisure, and exercise
activities at home and in the community;
(2) provide program coordination staff who
serve no more than 12 service recipients within a 40-mile radius. The program
coordinator must visit each home at least four times per month when the service
recipient is present, and one of the visits must occur during night-time hours;
(3) assess the service recipient's
progress and challenges related to activities of daily living and safety and
provide a written summary to the case manager 30-calendar days prior to the
annual Individual Plan (Plan) meeting;
(4) ensure program coordination staff attend
an annual PWS conference and provide the direct service staff at least one hour
per month of PWS- related training;
(5) ensure service recipients are provided
specialized diets, per his or her Plan;
(6) ensure the service recipient's exercise
program is implemented and he or she is provided access to exercise equipment
and classes, per his or her Plan;
(7) work with the service recipient and his
or her team to develop a plan to replace property damaged by a service
recipient at no cost to DHS;
(8)
assist service recipients to conduct safety and evacuation drills, per Oklahoma
Administrative Code (OAC)
340:100-5-22.1;
and
(9) ensure the service
recipient's home is safe and secured, per his or her plans.
(d)
Eligibility. To
be eligible for PWS services, each person must:
(1) provide documentation from a licensed
physician that confirms the diagnosis of PWS as evidenced by the
deoxyribonucleic acid (DNA) Methylation Analysis of the PWS region of
chromosome 15; or
(2) provide
documentation that he or she has a condition closely related to PWS, except for
mental illness. The DDS director or his or her designee may grant an exception
to the confirmed PWS DNA Methylation analysis when the service recipient
provides documentation containing objective evidence that he or she has a
condition closely related to PWS. The condition:
(A) results in challenging behaviors that
create serious risk of physical injury or harm to the service recipient;
(B) results in substantial
impairments;
(C) is likely to
continue indefinitely;
(D)
requires treatment or services similar to those required for persons with PWS;
(E) requires strict control of
access to food and limitation of daily caloric intake required for the
individual's normal growth; and
(F) requires services and supports that are
not available from another source;
(3) be receiving Home and Community Based
Waiver Services (HCBS) or be on the Request for Waiver Services List, per OAC
317:40-1-1
and determined eligible for HCBS unless admitted to the program prior to July
1, 1997; and
(4) be 18 years of
age.
(e)
Waiting
list. When resources are unavailable to offer services through the PWS
program, applicant names are maintained on a statewide waiting list.
(1) The statewide waiting list is maintained
by the DDS residential programs manager or his or her designee.
(2) The statewide waiting list is maintained
in chronological order based on the date of receipt of a written request for
PWS services.
(3) The statewide
waiting list is administered by DDS uniformly throughout the state.
(4) An applicant is removed from the
statewide waiting list, when he or she :
(A)
is determined ineligible for services;
(B) cannot be located by DDS;
(C) does not provide DHS-requested
information or fails to respond;
(D) is not an Oklahoma resident at the
requested Waiver approval date; or
(E) declines an offer of PWS services and
indicates he or she does not want to remain on the statewide waiting list.
(5) When an applicant
is offered PWS services but declines because he or she is not at least 18 years
of age , the applicant maintains his or her position on the statewide waiting
list.
(f)
Scope. PWS services reimbursement is provided at a DHS- approved
rate within the program capacity determined by legislative appropriation.
(g)
Service
expectations. The contracted-residential provider ensures that:
(1) all applicable DHS and the Oklahoma
Health Care Authority rules are met, including OAC :
(A)
340:100-3-27;
(B)
340:100-3-34;
(C)
340:100-3-38;
(D)
340:100-3-40;
(E)
340:100-5-22.1;
(F)
340:100-5-26;
(G)
340:100-5-32;
and
(H)
340:100-5-50
through OAC
340:100-5-58;
(2) each service
recipient is weighed at least weekly;
(3) all food and money are safeguarded to
ensure a proper diet and health maintenance;
(4) transportation to and from vocational
activities, community outings, and medical appointments is provided, per the
service recipient's Plan;
(5)
staff implements periodic room, clothing, and baggage searches as necessary to
ensure that food and money are not present, per the service recipient's Plan;
and
(6) the staffing ratio is
appropriate to ensure the service recipient's safety, per his or her Plan.
Staff is trained to meet the PWS service recipient's needs.
(h)
Room and board.
Each service recipient is responsible for room and board, per OAC
340:100-3-4.
(1) When the home is owned or leased by the
service recipient or his or her family or guardian, the contracted-residential
provider develops a financial agreement for payment of household expenses by
the service recipient, per OAC
340:100-5-22.1.
(2) When the home is owned or
leased by the contracted-residential provider , the contracted-residential
provider may charge a room and board payment of all but $100 per month of the
service recipient's income, up to a maximum of 90 percent of the current Social
Security Supplemental income rate. In these circumstances the
contracted-residential provider must comply with OAC 340:100-6.
Added at 28 Ok Reg
897, eff 6-1-11
