Current through Vol. 42, No. 1, September 16, 2024
(a)
Application process.
(1) An
application for adult day services is initiated by a request from an adult
wishing to participate, a person responsible for the care of the adult, or by a
referral from an adult day services vendor. The application is documented on
Form 02AS003E, Adult Day Services Referral/Application.
(2) Applicants for adult day services are
referred to the ADvantage Waiver or the Developmental Disabilities Services
Division (DDSD) Home and Community-Based Services (HCBS) Waiver, as
appropriate. Adult day services may be received while the application for
waivered services is pending.
(3)
All adult day services participants must be determined ineligible for either
the ADvantage Waiver or the DDSD HCBS Waiver or be placed on the DDSD waiting
list.
(A) If the participant is not
determined ineligible in four months, the participant may not continue in
Oklahoma Department of Human Services (OKDHS) funded adult day services. The
authorization is closed and services are terminated.
(B) An exception or extension of the four
months rule must be requested.
(4) The service opening date is no earlier
than the date on Form 02AS003E or the date of the oral request. If the
participant does not sign Form 02AS003E at the time of request, a staff person
completes the form and explains on the signature line why the participant did
not sign, such as an oral request.
(A) If the
services are court-ordered and there is no Form 08AP001E, Adult Protective
Services Referral, the service opening date is the date of the court
order.
(B) If the day services
facility makes the referral by sending Form 02AS003E, the service opening date
is the date the form is stamped "received" in the county office.
(5) An application must be
processed within 30 days for public assistance cases and 45 days for non-public
assistance cases. The application is:
(A)
certified or approved when a participant is determined eligible;
(B) denied when a participant is determined
ineligible; or
(C) canceled when a
participant requests cancellation prior to other disposition.
(6) In determining eligibility for
adult day services, the participant must:
(A)
receive services in a facility that holds a valid contract with OKDHS for
provision of adult day services; and
(B) meet need, age, and income
requirements.
(b)
Need for adult day services.
Adult day services are appropriate for persons who are physically or mentally
unable to function totally independently but do not require 24-hour care.
(1) To qualify for adult day services, one of
the conditions in (A) and (B) of this paragraph must be met.
(A) Adult day services provide respite or
time needed to maintain employment for an adult's primary caregiver.
(B) Adult day services provide beneficial
socialization and access to needed therapy for a functionally impaired
adult.
(2) If the
participant is receiving state-funded 24-hour care, adult day services are not
approved.
(c)
Age. Adult day services are available to impaired adults age 60
years and older. An age waiver may be requested, and is granted by Aging
Services Division (ASD) for a person younger than 60 if one of the conditions
in (1) and (2) of this paragraph is met.
(1)
The adult is suffering from Alzheimer's disease, any other form of dementia, or
another degenerative condition, either physical or mental.
(2) The adult has recently sustained a
stroke, fracture, paralysis, or other incapacitating condition and the services
offered in an adult day services program aid the adult in maintaining or
returning to as much of an independent lifestyle as possible, avoiding
institutionalization.
(d)
Income. Sources of income
considered, verification, and computation of income for the adult day services
program are described in this subsection. Co-payment and maximum allowable
income are shown on OKDHS Appendix M-105, Eligibility Schedule/Rates for Adult
Day Services. OKDHS Appendix M-105 reflects the sliding fee scale based upon
the United States Bureau of Census, National Poverty Guidelines, as printed in
the Federal Register. The schedule is subject to change.
(1)
Predetermined eligible.
Persons are predetermined eligible based on receipt of Public Assistance,
Supplemental Security Income (SSI), or Refugee Assistance. If services are
requested by Adult Protective Services (APS), the participant is universally
approved for 60 days only without regard to income. For APS participants, no
co-payment is considered during the 60 calendar days.
(2)
Income eligible. Income
eligibility determination is based upon the amount of the family's gross income
and family's size. Family income includes income from predetermined eligible
members.
(A) Anticipated income is never
included in determining eligibility until it is available to and under the
control of the participant.
(B)
Income is computed on a monthly basis. If income is received every two weeks,
the weekly rate is determined and multiplied by 4.3 to compute the monthly
income. When income is received twice a month, for example, 1st and 15th, it is
multiplied by two.
(C) Any income
that is received regularly, but in amounts that vary greatly, or income
received irregularly is averaged over a six-month period. Examples are overtime
pay, sporadic second jobs, irregular child support, and other occasional
changes in the monthly gross child support or other monthly gross
income.
(D) When one or both
persons of a married couple is in adult day services, the total gross income of
both is considered and eligibility is computed based on one half of the total
income.
(3)
Determination of co-payments for persons not predetermined
eligible. In determining the co-payment for persons not predetermined
eligible, the guidelines are:
(A) married
couple, one spouse in adult day services, the total gross income of both
spouses is considered, with the co-payment computed on one half of the total
income;
(B) married couple, both in
adult day services, the total gross income is divided equally between the two,
with the co-payment for each based on the computed individual amount of income;
or
(C) single person in adult day
services, only the total gross income of that person is considered.
(4)
Sources of income
considered. The sources of income considered in determining monthly
gross income are:
(A) wages, such as total
money earnings received for work performed as an employee, including armed
forces pay, commissions, tips, piece-rate payments, on-the-job training
programs, cash bonuses, bonds, pensions, union dues, credit union payments,
garnishments, and similar purposes. Tips are not considered part of the wages
for Temporary Assistance for Needy Families (TANF) recipients who are
participating in the Work Supplementation Program;
(B) net income from self-employment, farm and
non-farm, determined by taking 50 percent of the gross income. When a
participant:
(i) rents a house to someone
else, the net income amount considered is 50 percent of the rent. The other 50
percent is allowed for expenses;
(ii) rents a room in his or her house to
someone else, the net income amount considered is 75 percent of the rent;
and
(iii) provides room and board
in his or her home, the net income amount considered is 50 percent of the gross
amount charged;
(C)
pensions, SSI, survivors' benefits, and Social Security Administration
permanent disability insurance, prior to deductions for medical insurance, and
Railroad Retirement Insurance;
(D)
dividends, interest, and income from estates, trusts, and mineral rights. If
this income varies or is received irregularly, it is averaged over six
months;
(E) pensions and annuities
or retirement benefits paid to a retired person or his or her survivors by a
former employer or by a union, either directly or through an insurance company,
and periodic receipts from annuities or insurance;
(F) unemployment compensation received from
government unemployment insurance agencies or private companies during periods
of unemployment and any strike benefits received from union funds;
(G) workers' compensation received
periodically from private or public insurance companies for injuries incurred
at work. The cost of this insurance must have been paid by the employer and not
by the participant;
(H)
alimony;
(I) child
support;
(J) veterans'
compensations and pensions paid periodically by Veterans Affairs to disabled
members of the armed forces or to survivors of deceased veterans, as
subsistence allowances paid to veterans for veterans' education and on-the-job
training, and to ex-servicemen as GI insurance premiums called
refunds;
(K) contributions in the
form of money received regularly from anyone; and
(L) income of minor children. If the adult in
an adult day services program has minor children living in the same home, the
children's income is considered.
(5)
Sources of income not
considered. The sources of income not considered monthly gross income
are:
(A) per capita payments to or funds held
in trust for any individual in satisfaction of a judgment of the Indian Claims
Commission of the Court of Claims;
(B) payments made pursuant to the Alaska
Native Claims Settlement Act, to the extent that such payments are exempt from
taxation under Section 21(a) of the Act;
(C) money received from sale of a resource,
such as stocks, bonds, land, house, or car. If the person is in the business of
selling such property, the net proceeds are counted as income from
self-employment;
(D) withdrawals of
bank deposits;
(E) tax refunds,
including the Earned Income Credit Advance payment which is received
monthly;
(F) gifts or money
received occasionally, such as at birthdays, anniversaries, and
Christmas;
(G) lump sum
inheritances, insurance payments, or one-time lump sum payments;
(H) capital gain;
(I) the value of the food benefit allotment
under the Food Stamp Act of 1977, as amended;
(J) any payment received under the Uniform
Relocation Assistance and Real Property Acquisition Policies Act of
1970;
(K) loans and grants obtained
and used under conditions that preclude their use for current living
costs;
(L) money received as
reimbursement for expenses because of participation in a component of the TANF
Work Program;
(M) home produce
utilized for household consumption; and
(N) the income of adult children or other
relatives residing in the same home as the adult day services
participant.
(e)
Resources. Resources are not
considered in determining eligibility for adult day services.
(f)
Notification. A ten-day
notice is required for any adverse action. Notification to the participant is
required and is computer-generated when:
(1) a
decision regarding initial eligibility or continued eligibility is
made;
(2) there is a change in the
participant's income or co-payment; and
(3) the participant is no longer eligible or
requests termination of adult day services.
Amended at 9 Ok Reg
1727, eff 4-20-92 (emergency); Amended at 9 Ok Reg 2917, eff 7-13-92; Amended
at 15 Ok Reg 1316, eff 3-1-98 (emergency); Amended at 16 Ok Reg 1058, eff
4-26-99; Amended at 16 Ok Reg 3383, eff 5-11-99 (emergency); Amended at 17 Ok
Reg 1320, eff 5-11-00; Amended at 18 Ok Reg 2138, eff 6-11-01; Amended at 23 Ok
Reg 393, eff 11-8-05 (emergency); Amended at 23 Ok Reg 1062, eff 7-15-06;
Amended at 24 Ok Reg 1325, eff 6-1-07