Oklahoma Administrative Code
Title 340 - Department of Human Services
Chapter 2 - Administrative Components
Subchapter 3 - Office of Client Advocacy
Part 9 - ADVOCACY PROGRAMS
Section 340:2-3-71 - Office of Client Advocacy (OCA) general advocacy services
Universal Citation: OK Admin Code 340:2-3-71
Current through Vol. 42, No. 1, September 16, 2024
(a) Legal authority and scope. OCA provides advocacy services to recipients of Developmental Disabilities Services (DDS) listed in this subsection, who are collectively referred to as "clients," per Oklahoma Administrative Code (OAC) 340:2-3-71 through 340:2-3-75.
(1) Section
1415.1(A)(2)
of Title 10 of the Oklahoma Statutes (10 O.S. § 1415.1(A)(2)) requires the
Oklahoma Department of Human Services (OKDHS) to establish an ombudsman program
for each institution and residential facility for persons with intellectual
disabilities operated by OKDHS. OKDHS conferred this responsibility on OCA. The
advocacy services provided to Robert M. Greer Center (Greer) and Laura Dester
Children's Center (SHIELD) residents are outlined in OAC 340:2-3-71 and
340:2-3-72.
(2) Orders of the United States District
Court for the Northern District of Oklahoma in Homeward Bound, Inc., et al. v.
Hissom Memorial Center, et al., Case No. 85-C-437-TCK-SAJ, require OKDHS and
OCA to provide advocacy services to individuals certified by the court as
members of the plaintiff class, known as Hissom Class Members (HCM)s. These
services are outlined in OAC 340:2-3-71 and
340:2-3-73.
(3) Former Northern Oklahoma Resource Center
of Enid (NORCE) and the Southern Oklahoma Resource Center (SORC) residents, who
transitioned after the Oklahoma Commission for Human Services resolution of
November 1, 2012, which closed the facilities, are provided with advocacy
services pursuant to that resolution and consistent with the obligation to
serve persons with disabilities in the most integrated setting appropriate to
their needs.
28 CFR §
35.130(d). Olmstead
v. L.C., 527 U.S. 581 (1999). These services are outlined in OAC
340:2-3-71 and
340:2-3-73.
(4) Consistent with the
requirements of Olmstead, OCA provides special advocacy
services on an as-needed basis to other DDS clients. These services are
outlined in OAC 340:2-3-71 and OAC
340:2-3-75.
(b) Definitions. The following words and terms, when used in OAC 340:2-3-71 through 340:2-3-75 shall have the following meaning unless the context clearly indicates otherwise:
(1)
"Capacity
assessment" means the process of determining an individual's ability to
make informed decisions and the need for assistance with decision-making
regarding personal and financial matters, per OAC
340:100-3-5.
(2)
"Human Rights Committee" or
"HRC" means the committee charged with the responsibility for
external monitoring and advocacy to address protection of individual rights.
(3)
"Individual plan"
or "IP" means a written document developed by the Personal Support
Team based upon assessment of need. The IP specifies outcomes pursued on behalf
of the individual, steps taken to achieve outcomes, and all services and
supports necessary to achieve outcomes.
(4)
"Informed consent" means the
ability to make and express voluntary decisions, given correct and sufficient
information about the nature, purpose, risks, benefits, and alternatives of a
proposed service or action. Individuals, 18 years of age and older, are
presumed to have capacity to give informed consent except to the extent
adjudicated incapacitated by the court. An individual is not considered
incapacitated solely by reason of his or her diagnosis. Individuals may be
adjudicated incapacitated in one area, while being fully capable of
understanding and exercising rights in other areas. Individuals have the right
to exercise judgment in all areas of capacity.
(5)
"Personal Support Team
(PST)" means the participants in the individual's assessment and
planning process. The PST includes the service recipient, case manager, legal
guardian, OCA advocate, service providers, and others whose participation is
necessary to achieve the outcomes desired by the service recipient.
(6)
"Program coordinator" or
"PC" means a person employed by a DDS residential or group home
contract provider agency responsible for the supervision, coordination, and
monitoring of services provided by the contract provider agency to a service
recipient.
(7)
"Service
review" means an assessment by an OCA advocate of a client's health,
living circumstances, and the delivery of supportive services. The service
review documents the extent of services provided to an individual client and
identifies problem areas in service delivery. Each service review is a snapshot
of an individual's life at the time the review is completed.
(8)
"Statewide Behavior Review
Committee" or "SBRC" means the committee established, per
OAC
340:100-3-14
that reviews each protective intervention plan with restrictive or intrusive
procedures. The review ensures the plan complies with DDS policy on the use of
restrictive or intrusive procedures, per OAC
340:100-5-57.
(c) Client records. Information in OCA records relating to advocacy services provided to the clients listed in (b) of this Section is confidential and protected from unauthorized use. Only authorized individuals are given access to client records or provided information from those records.
(1) The
confidentiality provisions of OAC
340:100-3-2
apply to OCA client files.
(2) The
confidentiality provisions of OAC
340:5-1-5 apply
to information in OCA records regarding allegations of abuse, neglect, and
exploitation of a vulnerable adult, as those terms are defined in 43A O.S.
§§ 10-103, 10-110, and 10-110.1.
(3) A breach of confidentiality may result in
criminal prosecution. Violations by OKDHS employees may also result in
personnel action.
(d) OCA advocate training requirements. New and tenured OCA advocates receive appropriate training consistent with background and experience. Training includes the rights of DDS clients under federal and state law.
(e) Client representation.
(1) OCA assigns OCA
advocates to represent:
(A) Greer residents,
per Title 10, Section
1415.1(A)(2);
and
(B) specific DDS clients living
in Oklahoma and former NORCE and SORC residents, per Part 9, OAC 340:2-3-71
through
340:2-3-75.
(2) An OCA advocate is knowledgeable about
the clients he or she represents and seeks to understand each client's specific
challenges and communication styles, needs, interests, and goals. An OCA
advocate ascertains the client's preferences and choices and becomes familiar
with a client by:
(A) reviewing relevant
client records and files;
(B)
conducting in-person visits and other contacts with the client at home, at
work, and in other contexts; and
(C) communicating with the client's program
coordinator and provider staff, case manager, and others in the client's circle
of support, such as relatives, loved ones, and
guardians.
(f) OCA advocacy services.
(1)
Advocacy. Advocacy is assisting an individual in voicing his or
her interests. Clients are encouraged to engage in self-determination and are
assisted to the extent they need and desire. When a client has a limitation in
voicing his or her own interests, needs, and preferences, an OCA advocate seeks
to speak on behalf of the client. Advocacy services provided by OCA advocates
include, but are not limited to:
(A)
supporting the implementation of the least restrictive alternative in
residential, vocational, therapeutic, and medical settings;
(B) supporting the most appropriate living
environment for each client consistent with the client's needs and
objectives;
(C) encouraging the
development of natural supports including friends, coworkers, and neighbors in
the community where the individual lives; and
(D) bringing performance issues or service
deficiencies to the attention of those who are responsible for correcting the
situation.
(2)
Monitoring. OCA monitors the well-being and provision of services
to a client.
(A) Monitoring is done by means
of:
(i) visits and other forms of contact
with the client, staff, family members, and those who know the client;
(ii) reviewing records,
documentation, contracts, and financial agreements between clients and
providers of services, incident reports, and professional assessments; and
(iii) attendance at IP and other
PST meetings.
(B) OCA
advocates cooperate with and, render assistance to outside monitoring and
advocacy entities as provided for by federal and state laws, relating to client
confidentiality and release of information protocols.
(C) The monitoring role of an OCA advocate
ensures the client's:
(i) individual needs,
preferences, and choices are identified and met appropriately and consistently;
(ii) health, safety, and welfare
standards and safeguards are maintained; and
(iii) problems and issues are addressed at
the earliest juncture by appropriate persons and entities in a prompt
manner.
(3)
Informal problem resolution. An OCA advocate seeks to resolve
issues and client concerns at the lowest level of administrative responsibility
or decision-making. Informal problem resolution seeks to resolve issues and
reach a consensus with the client on a plan of action. An OCA advocate seeks to
apply an appropriate problem resolution activity that most effectively
addresses the nature and imminence of the problem. An OCA advocate assists a
client in the development of problem resolution skills and
self-advocacy.
(4)
Grievances. An OCA advocate advises clients and assists them in
filing grievances on their own behalf. An OCA advocate may also file grievances
on behalf of clients as circumstances require. Grievance policies are found in
OAC
340:2-3-45
through
340:2-3-55.
(5)
Protection and safety. OCA
staff takes appropriate action to protect the client's health, safety, and
welfare, including reporting allegations of abuse, neglect, maltreatment, and
exploitation, per OAC
340:2-3-32
through
340:2-3-39.
(A) OCA advocates assist OCA staff, Adult
Protective Services investigators, and law enforcement officers in obtaining
information necessary to complete investigations when a client is an alleged
victim.
(B) OCA advocates engage in
appropriate follow-up activity in response to a referral from the OCA Intake
Unit, per OAC
340:2-3-35.
(C) When an OCA advocate has a concern
related to a client's health, safety, welfare, or program implementation, he or
she advises the client's case manager or designated qualified intellectual
disabilities professional (QIDP), as applicable, and others, such as DDS staff,
provider or facility staff, treatment staff, or health care professionals as
circumstances warrant.
(D)
Immediately upon becoming aware of concerns regarding imminent risk of harm, an
OCA advocate advises the applicable residential or vocational provider and the
client's case manager.
(E) An OCA
advocate ensures that abuse, neglect, maltreatment, and/or exploitation
allegations are reported to the OCA Intake Unit, per OAC
340:2-3-33.
(6)
Promoting informed choice.
An OCA advocate promotes informed decision-making, consistent with a client's
unique strengths, resources, priorities, concerns, abilities, capabilities, and
interests through provision of necessary information and assistance to a client
to understand his or her options and potential consequences of a decision. When
a client is unable to make an informed choice, the OCA advocate seeks to
provide the client's legal guardian, guardian ad litem, volunteer advocate, and
other representative(s) with access to information to assist him or her to make
an informed decision on the client's behalf. The advocate general does not
provide legal advice to clients but may provide information about the
law.
(7)
Protection of
rights. An OCA advocate promotes the full exercise of legal rights
guaranteed clients under federal and state laws. An OCA advocate takes
appropriate steps to protect a client's rights including ensuring those rights
are considered in PST decisions and in the manner PST decisions are carried
out. An OCA advocate seeks to ensure the application of due process in
administrative, quasi-judicial, and judicial proceedings involving a client
that might result in a rights restriction or a reduction in services. When a
rights restriction is absolutely necessary, OCA supports the least restriction
necessary for the shortest period of time possible, with a plan to remove the
restriction as soon as possible.
(8)
Access to services. An OCA
advocate promotes client access to the full range of supports per federal and
state requirements. Although an OCA advocate takes a position with regard to
services needed by a client, an OCA advocate does not have authority to approve
services.
(9)
Guardianship
issues. The Oklahoma Guardianship and Conservatorship Act promotes the
participation of persons as fully as possible in the decisions that affect
them, in the development of maximum self-reliance and independence, and the
appointments of guardians and others, only to the extent necessitated by the
mental and adaptive limitations or other conditions of individuals, per 30 O.S.
§ 1-103. Because a full guardianship of the person and his or her estate
is the most restrictive intrusion on an individual's decision-making, OCA
advocates for the least restrictive alternative to a full guardianship feasible
under the circumstances including, but not limited to:
(A) a limited guardianship;
(B) a representative payee for financial
benefits;
(C) a volunteer
advocate;
(D) a supportive friends
and family;
(E) a health care
proxy;
(F) a durable power of
attorney; and
(G) advance
directives.
(10)
Promoting inclusion. An OCA advocate:
(A) promotes the realization of active
citizenship and inclusion in the community. This includes, but is not limited
to, encouraging clients to:
(i) learn the
rights and responsibilities of good citizenship;
(ii) vote;
(iii) take classes;
(iv) participate in volunteer services
organizations;
(v) attend religious
services of his or her choice;
(vi)
attend recreational, cultural, and social events; and
(vii) join citizen advocacy organizations
that promote inclusion in the community;
(B) encourages the development of friends who
can serve as natural supports for a client; and
(C) assists a client in locating relatives
who are not currently active in the client's life and encourages relationship
building between him or her and family members.
(11)
End-of-life issues.
End-of-life issues for an individual with a developmental or intellectual
disability do not differ from those of other individuals. Regardless of the
medical circumstance that brought end-of-life issues to the forefront, an OCA
advocate seeks to have a client's physicians, guardians, and loved ones adhere
to Oklahoma laws relating to do-not-resuscitate orders, withdrawal or denial of
nutrition or hydration, and withdrawal or termination of medical treatment. In
the absence of clear and convincing evidence of a client's choices, an OCA
advocate presumes the client would choose life-sustaining
measures.
(g) Contacting an OCA advocate. When an OCA advocate is not available during office hours, his or her supervisor serves as back-up. Information about the name of the OCA advocate assigned to a client, the OCA advocate's contact information, and the name of the advocate's supervisor is obtained by phoning OCA at 1-800-522-8014.
(h) OCA access to client records and information. OCA staff is provided access to all records, files, documents, and information needed to fulfill OCA responsibilities regarding a client. DDS case managers, employees, and provider agency staff send the assigned OCA advocate copies of documents and notices sent to the client.
Added at 19 Ok Reg 1730, eff 6-14-02; Amended at 20 Ok Reg 1994, eff 7-1-03; Amended at 22 Ok Reg 1180, eff 5-26-05; Amended at 23 Ok Reg 1776, eff 6-11-06; Amended at 26 Ok Reg 2195, eff 7-1-09
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.
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