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Part       RESPITE CARE

317:30⊂chapter=5∂=55--515.Home and Community-Based Services Waivers for persons with an intellectual disability or certain persons with related conditions

[Revised 06-25-12]
The Oklahoma Health Care Authority administers Home and Community-Based Services (HCBS) Waivers for persons with an intellectual disability or certain persons with related conditions that are operated by the Oklahoma Department of Human Services Developmental Disabilities Services Division. Each waiver allows payment for respite care as defined in the waiver approved by the Centers for Medicare and Medicaid Services.


 

317:30⊂chapter=5∂=55--516.Coverage

[Revised 06-01-08]
All respite care must be included in the member's Individual Plan (IP). Arrangements for this service must be made through the member's case manager.

317:30⊂chapter=5∂=55--517.Description of services

[Revised 06-01-08]
Respite care is:
(1) available to eligible members not receiving daily living supports or group home services and who are unable to care for themselves; and
(2) furnished on a short-term basis due to the absence or need for relief of those persons normally providing the care, and includes:
(A) homemaker respite per OAC 317:30-5-535 through 317:30-5-538;
(B) daily respite provided in a group home.
(i) Group homes providing respite must be licensed per OAC 340:100-6.
(ii) Respite care provided in a group home is authorized as respite at the applicable group home rate as identified in the member's Plan of Care;
(C) daily respite provided in an agency companion services (ACS) home.
(i) Respite must be approved in accordance with the home profile process, per OAC 317:40-5-40, and required training, per OAC 340:100-3-38.
(ii) Respite provided in an ACS home is authorized as respite at the applicable level of support per OAC 317:40-5-3.
(iii) Respite providers are limited to providing 52 days of respite per year when they concurrently provide ACS; and
(D) daily respite provided in any other approved home. Respite:
(i) must be approved in accordance with the home profile process, per OAC 317:40-5-40, and required training, per OAC 340-100-3-38;
(ii) is based on the member's needs and includes:
(I) maximum supervision - for members with extensive needs;
(II) close supervision - for members with moderate needs; and
(III) intermittent supervision - for members with minimum needs; and
(iii) providers must:
(I) pass a background investigation per OAC 317:40-5-40 and OAC 340:100-3-39; and
(II) be at least 18 years of age.

317:30⊂chapter=5∂=55--518.Coverage limitations

[Revised 09-01-17]
(a) Payment is not made for daily respite care and specialized foster care or agency companion services (ACS) for the same member on the same date of service.

(b) Respite care:

(1) is not available to members in Oklahoma Department of Human Services (DHS) custody or in out-of-home placement funded by DHS Child Welfare Services; and

(2) for members not receiving ACS, is limited to 30 days or 720 hours annually per member, except as approved by the DHS Developmental Disabilities Services director and authorized in the member's Plan of Care; or

(3) for members receiving ACS, is limited per Oklahoma Administrative Code 317:40-5-3.

 

317:30⊂chapter=5∂=55--519.Diagnosis codes [REVOKED]

[Revoked 07-01-13]

Disclaimer. The OHCA rules found on this Web site are unofficial. The official rules are published by the Oklahoma Secretary of State Office of Administrative Rules as Title 317 of the Oklahoma Administrative Code. To order an official copy of these rules, contact the Office of Administrative Rules at (405) 521-4911.