Current through Vol. 42, No. 1, September 16, 2024
(a)
Representation. OCA provides
ombudsman and advocacy services to former HCMs and NORCE and SORC residents of
the facilities, per Oklahoma Administrative Code (OAC)
340:2-3-71.
An OCA advocate is assigned to act as an independent resource to ensure the
client's needs are met and ensure that he or she is provided with the
information, skills, opportunities, and support to:
(1) make informed choices and decisions about
their lives;
(2) live in homes and
communities where individuals can exercise full rights and responsibilities as
citizens;
(3) pursue meaningful and
productive lives;
(4) contribute to
their family, community, state, and nation;
(5) have interdependent friendships and
relationships with others;
(6) live
free from abuse, neglect, financial and sexual exploitation, and other legal
rights violations; and
(7) achieve
maximum health and full integration and inclusion in society; in an
individualized manner consistent with unique strengths, resources, and
priorities.
(b)
OCA
advocate assignment. OCA assigns an advocate to each HCM living in
Oklahoma and to each former resident of NORCE and SORC. These OCA advocates are
assigned for the client's lifetime, so long as they are residing in Oklahoma.
Clients are provided choices regarding the OCA advocate assigned to represent
them to the extent feasible considering the geographic location of the client's
residence and OCA advocate caseloads. Requests for a change in the OCA advocate
representing an individual are made to the advocate general or
designee.
(c)
Personal
Support Team (PST) membership. As a representative of a HCM or of a
Developmental Disabilities Services (DDS) client living in a community
residential placement, an OCA advocate is a member of the client's PST.
(1) As a PST member, the OCA advocate
receives from the client's DDS case manager, timely notice of all PST meetings,
including emergency PST meetings.
(2) The OCA advocate attends the client's:
(A) annual individual plan (IP) meetings;
(B) person-centered planning
meetings;
(C) interim meetings;
(D) follow-up planning meetings;
(E) emergency PST meetings;
(F) PST guardianship assessment
meetings;
(G) other PST meetings
when significant issues are addressed, including when a rights restriction or
an intrusive behavior intervention strategy is contemplated or recommended;
(H) PST capacity assessments; and
(I) other PST meetings, at the
client's, guardian's, or involved family's or friend's request.
(3) Within the PST context, the
OCA advocate assists the client and represents the client's interests without
relinquishing priority to client safety and rights.
(d)
Guardianship issues. The OCA
advocate ensures a client has a current capacity assessment and attends
capacity assessment meetings. When a client with a full guardianship has
sufficient capacity to require no guardian or only a limited guardian, the OCA
advocate promotes the filing of a petition with the guardianship court to
terminate or limit the guardianship appointment. When the current capacity
assessment for the client who does not have a guardian recommends a guardian or
volunteer advocate, the OCA advocate participates with the PST to identify
persons who might serve as the client's guardian or volunteer advocate. An OCA
advocate encourages the development of friends in the community who might
become the client's guardian or volunteer advocate. The OCA advocate monitors
the implementation of the recommendations in the capacity assessment and
advocates for timely achievement. When a guardian is needed and a suitable
guardian is identified, the OCA advocate promotes the filing of a petition with
the guardianship court to appoint a guardian.
(e)
OCA advocacy and monitoring.
OCA provides advocacy and monitoring to ensure compliance with rules,
regulations, and policies, applicable to their client's health, safety, and
well-being. In addition to the services described in OAC
340:2-3-71(h),
OCA advocacy and monitoring activities on behalf of each client, include:
(1) verifying that Form 06CB034E, Residential
Pre-Service Checklist, was completed and everything on the checklist is in
place prior to any change in residence;
(2) visiting the client's home within
30-calendar days after the client moves into a new residence;
(3) conducting a face-to-face visit with the
client at least once every three months and, more frequently as indicated;
(4) completing a meaningful
contact regarding each client served, at least monthly;
(5) completing a service review at least once
every six months;
(6) verifying
that direct contact staff completed required training in connection with each
service review;
(7) requesting that
DDS Quality Assurance staff conduct an administrative inquiry of suspected
provider contract violations, per OAC
340:100-3-27;
(8) assisting the client and his or her
guardian or representative with proposed financial agreements and contracts
reviews between the client and the provider;
(9) reviewing documents and electronic files
including, but not limited to:
(A)
assessments, IP, and interim IP documents;
(B) incident reports;
(C) Adult Protective Services and OCA
investigation findings; and
(D)
behavior data collection forms;
(10) attending mortality review meetings, per
OAC
340:100-3-35;
(11) attending legal proceedings involving
the client, including guardianship proceedings, as circumstances
warrant;
(12) providing an annual
copy of Form 15GR007E, Notice of Grievance Rights, Hissom Class Members, or of
Form 15GR006E, Notice of Grievance Rights: DDS Service Recipients, as
appropriate, to each client and/or guardian;
(13) monitoring the water temperature in
homes every six months, using a thermometer to ensure the water does not exceed
120 degrees Fahrenheit;
(14)
verifying that appropriate records are kept with regard to an individual's
personal finances, at least once every six months; and
(15) advocating for the provision of adequate
staff to be present in the hospital with HCMs only, prior to and during a
hospitalization, as circumstances warrant.
(f)
Advocacy and monitoring services
specific to HCMs and former residents of NORCE and SORC, who reside in private
intermediate care facilities for individuals with intellectual disabilities
(ICF/IID).
(1) The assigned OCA
advocate conducts a face-to-face visit with a client living in a private
ICF/IID at least once every 90-calendar days and more frequently, as warranted.
(2) Service reviews are not
completed.
(3) The OCA advocate
maintains a helping relationship with the client, assessing the realization of
desired and targeted outcomes, and initiating change through referral or
grievance as needed. During client contacts, the OCA advocate inquires about
the client's satisfaction with current supports and provides information
regarding available options for community supports.
(4) The OCA advocate, at least once every six
months, contacts the client's guardian when one is appointed. The OCA advocate,
in response to a client's expression of dissatisfaction with the current
residential arrangements, contacts the guardian. These contacts reaffirm the
availability of service options to clients for support in community settings.
Contacts with the guardian occur in person, by phone or mail as circumstances
warrant.
(5) The OCA advocate
contacts the private ICF/IID case manager, informs the case manager of the OCA
advocate's intent to attend yearly planning meetings, and requests notification
in advance of yearly planning, interim, and emergency meetings.
(6) The OCA advocate participates in annual
planning meetings at the private ICF/IID. The OCA advocate provides advocacy
assistance regarding the client's expressed preferences. The OCA advocate
brings the individual's expressed desires and any concerns expressed by him or
her, the guardian, or other family members to the attention of the PST. The OCA
advocate participates in interim meetings and addresses significant changes in
the client's residence, work, health, or important relationships.
(7) The OCA advocate assesses the client's
welfare and determines if OCA advocacy is needed. The OCA advocate develops a
working knowledge of the facility's grievance procedure as well as other
problem resolution processes and resources for change. The OCA advocate
provides assistance, either directly or through referral, resolving concerns
identified by the client or by others on the client's behalf, which may include
contacting the Office of the State Long-Term Care Ombudsman.
(8) The OCA advocate provides information and
encouragement to the client to consider community residential
settings.
(g)
OCA
advocacy and monitoring services specific to HCMs and former residents of NORCE
and SORC who are in Oklahoma Department of Corrections (DOC) or county sheriff
custody. OCA advocacy and monitoring services for clients, who are in
DOC or county sheriff custody, except those who are detained pre-trial, are
contained in this subsection. The assigned OCA advocate:
(1) contacts the client at least once every
six months. These contacts are in person unless contraindicated by the
individual;
(2) obtains copies of
court documents that reflect the sentence the client is serving;
(3) assesses the client's welfare and
determines if OCA advocacy assistance is needed. The OCA advocate provides
assistance, either directly or through referral, resolving concerns identified
by the client or by others on the client's behalf. OCA advocacy assistance is
provided to enforce the rights of clients under the Americans with Disabilities
Act and other federal and state laws, to the extent they are applicable to
persons who are in custody; and
(4)
provides OCA advocacy assistance with the DDS case manager to commence
transition planning when the client has less than a year remaining to serve in
custody. The OCA advocate participates in and monitors transition planning,
representing the client's interests.
(h)
Services specific to HCMs and
former residents of NORCE and SORC who decline DDS services. Clients and
their legal representatives have the right to refuse DDS services, per OAC
340:100-3-11.
The OCA advocate for a client, who has declined DDS services contacts the
individual at least once every six months and remains available to assist him
or her, when requested with OCA advocacy regarding non-specialized assistance.
If the OCA advocate determines the client's need or desire for specialized
supports has changed, he or she takes appropriate follow-up action with DDS
case management.
(i)
OCA
advocate services specific to HCMs on the Focused Advocacy List (FAL).
Pursuant to court order, OCA formally assumed the responsibility of acting as
advocate for plaintiff class-members identified in Homeward Bound, et
al. v. The Hissom Memorial Center, et al. [85-C-437]. In response, OCA
created the Focused Advocacy program to provide increased OCA advocacy supports
to HCMs with limited or no family involvement. In addition to the activities
described in (e) & (f) of this Section and OAC
340:2-3-71(h),
OCA advocacy and monitoring activities on behalf of each client include:
(1) ensuring the assigned DDS representative
is invited to the PST meetings when warranted to review and update progress in
securing a volunteer advocate or guardian for all clients on the FAL;
(2) visiting each member on the
FAL at least once every two months, and more frequently when warranted. Visits
include home visits, worksite visits, and other face-to-face contacts;
(3) placing a priority on
expanding HCM's circles of support to include persons, who are not paid to be
involved in the HCM's life, which includes identifying relatives, not involved
in the HCM's life who might be encouraged to become more involved;
(4) identifying HCMs who have the greatest
immediate need of a volunteer advocate or guardian. OCA advocates must promptly
inform the OCA Focused Advocacy manager when a HCM is identified as having a
priority need; and
(5) ensuring a
Team Review of Advocate/Guardian Participation (TRAGP) document is prepared for
each HCM assigned to them at least annually and one is completed much more
frequently whenever there is a significant change in circumstances warranting
review of the involvement of persons who are not paid to be involved in the
HCM's life. The TRAGP form includes information documenting the need for the
individual to remain on, be added to, or be removed from the FAL. The Focused
Advocacy Committee meets regularly to review TRAGP forms and determine if HCMs
remain on the FAL or require prioritized identification of a volunteer advocate
or guardian.
Added at 19 Ok Reg
1730, eff 6-14-02; Amended at 20 Ok Reg 1994, eff 7-1-03; Amended at 21 Ok Reg
2330, eff 6-25-04; Amended at 24 Ok Reg 978, eff 7-1-07; Amended at 26 Ok Reg
2195, eff 7-1-09
