Long-Term Care Services and Supports
Long-term care refers to medical, social, personal care and supportive services needed by people who have difficulty taking care of themselves due to chronic illness or disability, whether physical or mental. Long-term care is provided in people’s homes, in nursing homes, in small and large residential care facilities or group homes, and in the workplace.
The Opportunities for Living Life program offers long-term care services and support benefits to certain members who are enrolled in SoonerCare Traditional or SoonerCare Supplemental plans. Some benefits and supports provided under OLL are:
Home and Community-Based Services – SoonerCare operates five programs to provide home and community care as a cost-effective alternative to institutionalization. These are known as "waiver" programs because standard program requirements are waived to allow the program to operate. The waiver programs provide some services that otherwise are not covered under SoonerCare.
Living Choice - The Oklahoma Living Choice Project promotes community living for people of all ages who have disabilities or long-term illnesses. The project gives Oklahomans more options for managing their health care needs and adding more balance to the state’s long-term care system.
Oklahoma Long-Term Care Partnership - The Oklahoma Health Care Authority and the Oklahoma Insurance Department are working with private insurers to create the Oklahoma Long-Term Care Partnership program, a program with benefit options that may protect the consumer’s financial future.
- Personal Care Services – An in-home benefit providing assistance with mobility, meals, hygiene, grooming and other non-skilled personal services.
TEFRA – An in-home benefit for children with physical or mental disabilities as an alternative to institutional care.
Money Follows the Person – A five year project to transition older persons and persons with disabilities from institutional care to community-based care.
Focus on Excellence – A program established as an incentive-based rate plan for nursing facilities designed to measure improvements in the quality of life, care and services.
PASRR – A process designed to ensure that people living in nursing facilities who are also affected by mental illness and/or developmental disability receive federally required evaluations.
Disability/Incapacity Determination - Determines and serves disability and incapacity for the citizens and immigrants of Oklahoma who will be substantially unable to perform their normal daily functions for 30 days or more due to a physical or mental incapacity.
Program of All-Inclusive Care for the Elderly (PACE) - A unique, capitated, one-stop, home and community based program that provides an array of necessary medical and social services for the frail and elderly within the home or at the Cherokee Elder Care Center in Tahlequah. It is the first Native American sponsored program in the United States.
Quality of Care Reporting – A process to collect monthly submitted Quality of Care reports from all long-term care facilities statewide for the purposes of documenting the extent to which such facilities are compliant with the minimum direct-care-staff-to-resident ratios. The monthly process also determines penalties for non-compliance and related operational activities which are coordinated with the finance division in collecting any assessed penalties and information related to the billing of assessment fees. The compiled information is then disseminated to the Oklahoma State Department of Health for their review.
Eligibility
There are income and asset limits to eligibility for long-term care services. OLL pays for care for those with middle incomes only after they have exhausted their own financial resources. You may visit or call your local county office of the Oklahoma Department of Human Services to apply. See also Applying for Long-Term Care.