Current through Vol. 42, No. 1, September 16, 2024
(a)
Applicability. Habilitation
Training Specialist (HTS) services, per OAC
317:30-5-482,
are authorized per OAC
317:40-5-110
or
317:40-5-111
and OAC
340:100-3-33
and applies to nonresidential HTS services provided to service recipients not
receiving community residential or group home services, per OAC
340:100-5-22.1
or OAC 340:100-6.
(b)
General
information.
(1) Non-residential HTS
services are authorized:
(A) as a result of
needs identified by the Developmental Disabilities Services (DDS) Personal
Support Team (Team) and informed selection by the service recipient;
(B) only during periods when staff are
engaged in purposeful activity that directly or indirectly benefits the service
recipient;
(C) when directed toward
the development or maintenance of a skill in order to achieve a specifically
stated outcome; and
(D) when the
service provided is not a function that the parent would provide for the
individual without charge as a matter of course in the relationship among
members of the nuclear family when the member resides in a family
home.
(2) Non-residential
HTS services are not authorized when a service recipient is in need of:
(A) sleep time supervision; or
(B) assistance responding to emergencies, in
which case a residential alternative, per OAC
317:40-1-2,
must be selected, unless unpaid natural supports are available to meet these
needs and identified in the Individual Plan (Plan).
(3) Non-residential HTS services are not
authorized for:
(A) services provided in the
home of the HTS, unless the service recipient and the HTS reside in the same
home;
(B) employment supports that
are provided, per OAC 317:40-7;
(C)
respite services provided, per OAC
317:30-5-517;
(D) homemaker services provided, per OAC
317:30-5-537;
(E) adult day services provided, per OAC
317:40-5-113;
(F) child care services; or
(G) services provided by the legal guardian,
biological or adoptive parent of a minor child, per OAC
340:100-3-33.2.
(4) In accordance with OAC
340:100-3-33.1,
services must be provided in the most cost effective manner. When the need for
HTS services is expected to continue to exceed an average of nine hours daily,
cost effective community residential services must be considered and requested,
per OAC
317:40-1-2.
For adults, continuation of non-residential services in excess of nine hours
per day for more than one plan of care year is not authorized except:
(A) when needed for members who receive
services through the Homeward Bound Waiver;
(B) when determined by the division
administrator or designee to be the most cost effective option; or
(C) as a transition period of 120-calendar
days or less to allow for identification of and transition to a cost effective
residential option. Members who do not want to receive residential services are
assisted to identify options that meet their needs within an average of nine
hours daily.
(5)
Non-residential HTS providers may not perform any job duties associated with
other employment, including on call duties at the same time they are providing
HTS services.
(6) Non-residential
HTS services are limited to no more than 40 hours per week for the household
when the HTS resides in the same home as the service recipients. When one or
more service recipient lives in the same household, services provided by
individuals living in the home may not exceed a total of 40 hours per week. If
additional hours of service are needed, they must be provided by someone living
outside the home. Exceptions may be authorized when needed for service
recipients who receive services through the Homeward Bound Waiver.
(7) When the service recipient also receives
nursing or Homemaker services or is out of the home for school, work, adult day
services, or other non-HTS supported activities, the total number of hours of
non-residential HTS, Homemaker, and hours away from the home cannot exceed 12
hours per day, unless an exception is granted, per OAC
317:40-5-110.
(c)
Service location.
(1) Non-residential HTS services are provided
in the:
(A) service recipient's home; or
(B) community.
(2) Non-residential HTS services
are not provided in:
(A) a school;
(B) a nursing facility;
(C) an intermediate care facility for persons
with intellectual disabilities (ICF/ID);
(D) an unlicensed facility-based program;
(E) a private home except the
service recipient's home or the home of a relative, unless the home was
approved, per OAC
317:40-5-40;
or
(F) the service recipient's
employment setting or any other employment
setting.
(d)
Backup plan. Prior to service delivery, an emergency backup plan
must be developed and specify how the service recipient's needs will be met
when paid staff are unavailable. The emergency backup plan is included in the
Plan.
(e)
Service
requirements.
(1) The provider:
(A) implements the service recipient's Plan;
(B) promotes community inclusion;
(C) promotes the service
recipient's health and welfare, increased independence, self-sufficiency; and
(D) cooperates in securing
alternative services while continuing to provide services when the service
recipient, legal guardian, or provider wants to discontinue services until the
Team confirms all essential services are in place.
(2) The provider develops and maintains
written policies and procedures that are consistent with Oklahoma Human
Services (OKDHS) rules and govern all aspects of service provision, with the
exception of services provided, per OAC
317:40-9-1.
(A) Provider agency policies are made
available to each service recipient, service recipient's parent(s), legal
guardian, advocate, provider agency staff, and OKDHS.
(B) Provider agency policies and procedures
include, but are not limited to:
(i) service
recipient rights protection;
(ii)
services provided;
(iii) admission
and discharge criteria;
(iv)
grievance procedures;
(v)
prevention and reporting of abuse, neglect, and exploitation;
(vi) confidentiality;
(vii) emergency management;
(viii) fees paid by service recipient;
(ix) health and safety
precautions;
(x) safeguarding
service recipient funds;
(xi)
medication administration; and
(xii) incident reporting.
(3) The provider agency
designates one person who, in the absence of the agency administrator, is
responsible for the administration of the agency and is empowered to act on
behalf of the provider agency, with the exception of services provided, per OAC
317:40-9-1.
(4) The provider agency is responsible for
recruitment, screening, training, and supervision of staff or volunteers
providing direct services, and ensuring direct support staff:
(A) are not supervised by a relative or
person living in the staff's home. A relative includes wife, husband, children,
parents, stepparents, parents-in-law, grandchildren, grandparents, brothers,
sisters, stepchildren, brothers-in-law, sisters-in-law, sons-in-law,
daughters-in-law, aunts, uncles, nieces, nephews, first cousins or any such
person with whom the employee shares a foster relationship;
(B) who provide backup services are available
and have received training, per OAC
340:100-3-38;
(C) are at least 18 years of age;
(D) are present as specified in the Plan and
as authorized by the service recipient's Plan of Care;
(E) are physically able and mentally alert to
carry out the job duties;
(F)
implement and follow the service recipient's Plan; and
(G) do not take the service recipient to
visit staff's home, unless the Team provided advance written approval of any
visit with the purpose specified in the Plan.
(5) The provider agency ensures supervision,
guidance, and oversight of all aspects of programming associated with receipt
of non-residential HTS supports.
(A) The
program coordination staff (PCS) must:
(i)
ensure staff are familiar with Plan requirements;
(ii) make supervisory visits to the service
site. The PCS makes a minimum of one monitoring visit per:
(I) month, when a service recipient receives
an average of 30 or more hours of HTS weekly; or
(II) quarter based on calendar year quarters,
when a service recipient receives an average of 29 or fewer hours of HTS
weekly;
(iii) supervise
direct contact staff to promote achievement of Plan outcomes;
(iv) ensure staffing levels meet the
requirements of the service recipient's Plan, with staff trained, per OAC
340:100-3-38;
(v) ensure records are maintained, per OAC
340:100-3-40;
(vi) assist the DDS case manager as requested
to prepare for and implement the Plan and its revisions, per OAC
340:100-5-50
through
340:100-5-58;
(vii) ensure applicable OKDHS and Oklahoma
Health Care Authority (OHCA) rules are followed;
(viii) complete necessary training, per OAC
340:100-3-38;
and
(ix) have a minimum of four
years of any combination of college level education or full-time equivalent
experience in serving persons with disabilities, or full-time equivalent
experience in a supervisory position, unless this requirement is waived in
writing by the DDS director or designee.
(B) Provider agencies assign PCS caseloads,
per OAC
340:100-5-22.1.
(6) Staff, when assisting a service recipient
with bathing or showering, must ensure the water temperature is safe and
comfortable for the service recipient. The requirements of this paragraph are
enforced even when an anti-scald device is used. Staff:
(A) tests the water temperature by touch or
with a thermometer designed to test hot liquids, before the service recipient
enters the water. The water must be determined safe and comfortable for the
service recipient, not merely comfortable for the staff.
(B) is trained by his or her employer in the
unique needs of each service recipient, including tolerance to water
temperature and bathing or showering needs; and
(C) does not leave a service recipient who is
unable to attend to safety considerations, alone in the bath or shower.
Added at 28 Ok Reg
897, eff 6-1-11; Amended at 29 Ok Reg 1227, eff
7-1-12