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Part 1      AGENCY COMPANION SERVICES

317:40-5-1.Purpose of Agency Companion Services [REVOKED]
[Revoked 06-25-09]
317:40-5-2.Guidelines to staff [EXPIRED]
[Expired 5-26-96]
317:40-5-3.Agency companion services

[Revised 09-01-15]

(a) Agency companion services (ACS) are:

(1) provided by agencies that have a provider agreement with the Oklahoma Health Care Authority (OHCA);

(2) provided by independent contractors of the provider agency and provide a shared living arrangement developed to meet the specific needs of the member that includes supervision, supportive assistance, and training in daily living skills, and integrates the member into the shared experiences of a family in a home owned or rented by the companion;

(3) available to members 18 years of age or older who are eligible for services through Community or Homeward Bound Waivers. Persons under 18 years of age may be served with approval from the Oklahoma Department of Human Services Developmental Disabilities Services (DDS) director or designee;

(4) based on the member's need for residential services per Oklahoma Administrative Code(OAC) 340:100-5-22 and support as described in the member's Individual Plan (Plan),per OAC 340:100-5-50 through 340:100-5-58.

(b) An agency companion:

(1) must have an approved home profile per OAC 317:40-5-3 and contract with a provider contract with a provider agency approved by DDS;

(2) may provide companion services for one member.  Exceptions to serve as companion for two members may be approved by the DDS director or designee.  Exceptions may be approved when members have an existing relationship and to separate them would be detrimental to their well being and the companion demonstrates the skill and ability required to serve as companion for two members;

(3) household is limited to one individual companion provider. Exceptions for two individual companion providers in a household who each provide companion services to different members may be approved by the DDS director or designee;

(4) may not provide companion services to more than two members at any time;

(5) household may not serve more than three members through any combination of companion or respite services;

(6) may not have employment, volunteer activities, or personal commitments that prevent the companion from fulfilling his or her responsibilities to the member per OAC 317:40-5.

(A) The companion may have employment when:

(i) personal support team (Team) documents and addresses all related concerns in the member's Plan;

(ii) employment is approved in advance by the DDS area manager or designee; and

(iii) companion's employment does not require on-call duties and occurs during time the member is engaged in outside activities such as school, employment or other routine scheduled meaningful activities; and

(iv)  companion provides assurance the employment is such that the member's needs will be met by the companion should the member's outside activities be disrupted.

(B) If, after receiving approval for employment, authorized DDS staff determines the employment interferes with the care, training, or supervision needed by the member, the companion must terminate, within 30 calendar days:

(i) his or her employment; or

(ii) his or her contract as an agency companion.

(C) Homemaker, habilitation training specialist, and respite services are not provided for the companion to maintain other employment.

(c) Each member may receive up to 60 days per year of therapeutic leave without reduction in the agency companion's payment.

(1) Therapeutic leave:

(A) is a SoonerCare payment made to the contract provider to enable the member to retain services; and

(B) is claimed when the:

(i) member does not receive ACS for 24 consecutive hours due to:

(I) a visit with family or friends without the companion;

(II) vacation without the companion; or

(III) hospitalization, regardless of whether the companion is present; or

(ii) companion uses authorized respite time;

(C) is limited to no more than 14 consecutive, calendar days per event, not to exceed 60 days per Plan of Care (POC) year; and

(D) cannot be carried over from one POC year to the next.

(2) The therapeutic leave daily rate is the same amount as the ACS per diem rate except for the pervasive rate that is paid at the enhanced agency companion per diem rate.

(3) The provider agency pays the agency companion the payment he or she would earn if the member were not on therapeutic leave.

(d) The companion may receive a combination of hourly or daily respite per POC year equal to 660 hours.  

(e) Habilitation Training Specialist (HTS) services:

(1) may be approved by the DDS director or designee when providing ACS with additional support represents the most cost-effective placement for the member when there is an ongoing pattern of not:

(A) sleeping at night; or

(B) working or attending employment, educational, or day services;

(2) may be approved when a time-limited situation exists in which the companion provider is unable to provide ACS, and the provision of HTS will maintain the placement or provide needed stability for the member, and must be reduced when the situation changes;

(3) must be reviewed annually or more frequently as needed, which includes a change in agencies or individual companion providers; and

(4) must be documented by the Team and the Team must continue efforts to resolve the need for HTS.

(f) The contractor model does not include funding for the provider agency for the provision of benefits to the companion.

(g) The agency receives a daily rate based on the member's level of support.  Levels of support for the member and corresponding payment are:

(1) determined by authorized DDS staff per levels described in (A) through(D); and

(2) re-evaluated when the member has a change in agency companion providers that includes a change in agencies or individual companion providers.

(A) Intermittent level of support.  Intermittent level of support is authorized when the member:

(i) requires minimal physical assistance with basic daily living skills, such as bathing, dressing, and eating;

(ii) may be able to spend short periods of time unsupervised inside and outside the home; and

(iii) requires assistance with medication administration, money management, shopping, housekeeping, meal preparation, scheduling appointments, arranging transportation or other activities.

(B) Close level of support.  Close level of support is authorized when the member requires:

(i) regular, frequent and sometimes constant physical assistance and support to complete daily living skills, such as bathing, dressing, eating, and toileting;

(ii) extensive assistance with medication administration, money management, shopping, housekeeping, meal preparation, scheduling appointments, arranging transportation or other activities; and

(iii)  assistance with health, medication, or behavior interventions that may include the need for specialized training, equipment, and diet.

(C) Enhanced level of support.  Enhanced level of support is authorized when the member:

(i) is totally dependent on others for:

(I) completion of daily living skills, such as bathing, dressing, eating, and toileting; and

(II) medication administration, money management, shopping, housekeeping, meal preparation, scheduling appointments, and arranging transportation or other activities;

(ii) demonstrates ongoing complex medical issues requiring specialized training courses per OAC 340:100-5-26; or

(iii) has behavioral issues that requires a protective intervention plan (PIP) with a restrictive or intrusive procedure per OAC 340:100-1-2.  The PIP must:

(I) be approved by the Statewide Behavior Review Committee (SBRC), per OAC 340:100-3-14;

(II) be reviewed by the Human Rights Committee (HRC), per OAC 340:100-3-6, or

(III) have received expedited approval per OAC 340:100-5-57.

(D) Pervasive level of support.  Pervasive level of support is authorized when the member:

(i) requires additional professional level support to remain in an agency companion setting due to pervasive behavioral or emotional challenges.  The support must be provided:

(I) by a licensed professional counselor (LPC) or professional with a minimum of Masters of Social Work (MSW) degree; and

(II) as ongoing support and training to the companion, offering best practice approaches in dealing with specific members; and

(ii) does not have an available personal support system.  The need for this service level:

(I) must be identified by the grand staffing committee, per OAC 340:75-8-40; and

(II) requires the provider to market, recruit, screen, and train potential companions for the member identified.

(h) Authorization for payment of Agency Companion Service is contingent upon receipt of:

(1) the applicant's approval letter authorizing ACS for the   

identified member;

(2) an approved relief and emergency back-up plan addressing 

a back-up location and provider;

(3) the Plan;

(4) the POC; and

(5) the date the member moved to the companion home.

(i) The Plan reflects the amount of room and board the member pays to the companion. The provider must use the room and board reimbursement payment to meet the member's needs. Items purchased with the room and board reimbursement payment include housing and food.

(j) If the amount exceeds $500, the additional amount must be:

(1) agreed upon by the member and, when applicable, legal guardian;

(2) recommended by the Team; and
(3) approved by the DDS area manager or designee.

317:40-5-4.Selection of Agency Companion Services provider [REVOKED]
[Revoked 02-09-15]
317:40-5-5.Agency Companion Services provider responsibilities

[Revised 09-01-15]

(a) Companions are required to meet all applicable standards outlined in this subchapter and competency-based training per Oklahoma Administrative Code (OAC) 340:100-3-38.  The provider agency ensures all companions meet the criteria in this Section.

(b) Failure to follow any rules or standards, failure to promote the independence of the member, or failure to follow  recommendation(s) of the personal support team (Team) results in problem resolution, per OAC 340:100-3-27, for the companion, and when warranted, revocation of approval of the companion.

(c) The companion:

(1) ensures no other adult or child is cared for in the home on a regular or part-time basis, including other Oklahoma Department of Human Services (DHS) placements, family members, or friends without prior written authorization from the Developmental Disabilities Services Division (DDS) area manager or designee;

(2) meets the requirements of OAC 317:40-5-103. Neither the companion nor the provider agency may claim transportation reimbursement for vacation travel;

(3) transports or arranges transportation for the member to and from school, employment programs, recreational activities, medical appointments, and therapy appointments;

(4) delivers services in a manner that contributes to the member's enhanced independence, self-sufficiency, community inclusion, and well-being;

(5) participates as a member of the member's Team and assists in the development of the member's Individual Plan(Plan) for service provision;

(6) develops, implements, evaluates, and revises the training strategies corresponding to the relevant outcomes for which the companion is responsible, as identified in the Plan. The companion may request assistance from the case manager or program coordinator. The companion documents and provides monthly data and health care summaries to the provider agency program coordination staff.

(7) delivers services at appropriate times as directed in the Plan;

(8) does not deliver services that duplicate the services mandated to be provided by the public school district pursuant to the Individuals with Disabilities Education Act (IDEA);

(9) is sensitive to and assists the member in participating in the member's chosen religious faith.  No member is expected to attend any religious service against his or her wishes;
(10) participates in, and supports visitation and contact with the member's natural family, guardian, and friends, when visitation is desired by the member;

(11) obtains permission from the member's legal guardian, a guardian is assigned, and notifies the family, the provider agency program coordination staff, and the case manager prior to:

(A) traveling out of state;

(B) overnight visits; or

(C) involvement of the member in any publicity;

(12) serves as the member's health care coordinator per OAC 340:100-5-26;

(13) ensures the monthly room and board contribution received from the member is used toward the cost of operating the household;

(14) assists the member in accessing entitlement programs for which the member may be eligible and maintains records required for the member's ongoing eligibility;

(15) works closely with the provider agency program coordination staff and the DDS case manager, to ensure all aspects of the member's program are implemented to the satisfaction of the member, the member's family or legal guardian, when appropriate, and the member's Team;

(16) assists the member to achieve the member's maximum level of independence;

(17) submits, in a timely manner, to the provider agency program coordination staff all necessary information regarding the member;

(18) ensures the member's confidentiality is maintained per OAC 340:100-3-2;

(19) supports the member in forming and maintaining friendships with neighbors, co-workers, and peers, including people who do not have disabilities;

(20) implements training and provides supports that enable the member to actively join in community life;

(21) does not serve as representative payee for the member without a written exception from the DDS area manager or designee.

(A) The written exception is retained in the member's home record.

(B) When serving as payee, the companion complies with OAC 340:100-3-4 requirements;

(22) ensures the member's funds are properly safeguarded;

(23) obtains prior approval from the member's representative payee when making a purchase of over $50 with the member's funds;

(24) allows provider agency and DDS staff to make announced and unannounced visits to the home;

(25) develops an Evacuation Plan, using DHS Form 06AC020E, Evacuation/Escape Plan, for the home and conducts training with the member;

(26) conducts fire and weather drills at least quarterly and documents the fire and weather drills using Form 06AC021E, Fire and Weather Drill Record;

(27) develops and maintains a personal possession inventory for personal possessions and adaptive equipment, using Form 06AC022E, Personal Possession Inventory;

(28) supports the member's employment program by:

(A) assisting the member to wear appropriate work attire; and

(B) contacting the member's employer as outlined by the Team and in the Plan;

(29) is responsible for the cost of the member's meals and entertainment during recreational and leisure activities.  Activities must be affordable to the member.  Concerns about affordability are presented to the Team for resolution;

(30) for adults, reports suspected maltreatment including abuse, verbal abuse, sexual abuse, neglect, financial neglect, and/or exploitation of a vulnerable adult per Section 10-104 of Title 43A of the Oklahoma Statutes to the DHS Office of Client Advocacy (OCA);

(31) for children, reports abuse, neglect, sexual abuse, or sexual exploitation per Section 1-2-101 of Title 10A of the Oklahoma Statutes to the Child Abuse and Neglect Hotline at 1-800-522-3511;

(32) follows all applicable rules promulgated by the Oklahoma Health Care Authority and DDS, including:

(A) OAC 340:100-3-40;

(B) OAC 340:100-5-50 through 100-5-58;

(C) OAC 340:100-5-26;

(D) OAC 340:100-5-34;

(E) OAC 340:100-5-32;

(F) OAC 340:100-5-22.1;

(G) OAC 340:100-3-27;

(H) OAC 340:100-3-38; and

(I) OAC 340:100-3-34;

(33) is neither the member's spouse, nor when the member is a minor child, the member's parent.  A family member servicing as companion must meet all requirements listed in this Subchapter; and
(34) is not the Chief Executive Officer of a provider agency.

317:40-5-6.Agency Companion Services provider requirements
[Revised 09-01-15]

(a) The service recipient or legal guardian, the provider agency, or the Oklahoma Department of Human Services Developmental Disabilities Services (DDS) case manager may identify an applicant to be screened for approval to serve as companion.

(b) Approval by DDS for a person to provide contracted Agency Companion Services (ACS) requires the applicant:

(1) is 21 years of age or older;

(2) has attended the DDS or provider agency ACS orientation;

(3) contracts with a provider agency having a current contract with the Oklahoma Health Care Authority to provide ACS;

(4) submits the completed DDS application packet per Oklahoma Administrative Code (OAC) 317:40-5-40 within the required time period to designated DDS staff or the provider agency staff;

(5) cooperates with designated DDS or provider agency staff in the development and completion of the home profile approval process per OAC 317:40-5-40; and
(6) has completed all training required by OAC 340:100-3-38, including medication administration training, and all provider agency pre-employment training per OAC 317:40-5-40.

317:40-5-7.Process for approval or disapproval of Agency Companion Services applicants [REVOKED]
[Revoked 7-11-05]
317:40-5-8.Agency companion Services service authorization budget

[Revoked 06-25-12]
 

317:40-5-9.Payment authorization for Agency Companion Services [REVOKED]
[Revoked 02-09-15]

317:40-5-10.Agency companion services (ACS) annual review [REVOKED]
[Revoked 02-09-15]
317:40-5-11.Termination of Agency Companion placement
[Revised 09-01-15]

(a) Oklahoma Department of Human Services Developmental Disabilities Services (DDS) staff may terminate an individual agency companion (AC) placement for reasons including, but not limited to the:

(1) member's decision to move to a different residence;

(2) request of the companion;and

(3) personal support team determines the AC placement is no longer the most appropriate placement for the member;

(b) Upon termination of the placementthe Team meets to develop an orderly transition plan and arranges for the member's property to be moved as necessitated by the transition plan.

(c) Termination of an individual companion placement may also occur in conjunction with denial of a home profile per OAC 317:40-5-40.
317:40-5-12.Selection of a provider agency [REVOKED]
[Revoked 7-11-05]
317:40-5-13.Agency Companion Services provider agency responsibilities
[Revised 09-01-15]

(a) The agency providing Agency Companion Services (ACS) complies with Oklahoma Health Care Authority and Oklahoma Department of Human Services (DHS) policies and procedures governing all aspects of service provision.

(b) The provider agency is responsible for all contract provider related activities detailed in this Subchapter.

(c) In the event the provider agency wishes to discontinue services immediately due to an emergency, the provider agency cooperates with the DHS Developmental Disabilities Services (DDS) to secure alternative services in the least restrictive environment.

(d) The provider agency ensures that services provided meet requirements of Oklahoma Administrative Code (OAC) 340:100-5-22.1, unless other requirements are stated in this Section.

(e) When the provider agency serves as the member's representative payee, the provider agency must adhere to OAC 340:100-3-4.1 requirements.

(f) The provider agency acts immediately to remedy any situation posing a risk to the health, well-being, or provision of specified services to the member.

(1)  The provider agency's program coordination staff completes and submits incident and injury reports to DDS per OAC 340:100-3-34.

(2) A companion's contract is immediately terminated when a provider agency becomes aware a companion's name appears on the Community Services Worker Registry per OAC 340:100-3-39.

(g) The provider agency ensures only one member is served in a provider home.  Exceptions may be approved by the DDS area manager or designee.

(h) Team members, including the provider agency program coordinator, companion, member, legal guardian, advocate, and DDS case manager work together to resolve issues to ensure the member's needs are met and the shared living arrangement is successful.

(i) The choice of provider agency is made by the member or his or her legal guardian.

(j) When a member transfers from a provider agency, the outgoing provider agency ensures the member has a 30 calendar-day supply of medication and a seven-day supply of food, household, and personal supplies.

(k) Provider agency's program coordination staff responsibilities are to:

(1) visit the provider home daily during the first week of placement;

(2) make a minimum of three face to face visits per month per OAC 340:100-5-22.1;

(3) allow the member's needs to determine the frequency of all other visits;

(4) coordinate and submit quarterly reports to the provider agency for submission to the DDS area office; and

(5) communicate regularly with the DDS case manager regarding any changes in the household or any other program issues or concerns.

(l) The provider agency, companion, member, and guardian develop a back-up plan identifying respite staff and an alternate location in the event the home becomes uninhabitable.  The back-up plan:

(1) is submitted to the DDS case manager for approval;

(2) describes expected and emergency back-up support and program monitoring for the home; and

(3) is incorporated into the member's Individual Plan (Plan).

(m) The respite provider is:

(1) knowledgeable about the member;

(2) trained to implement the member's Plan;

(3) trained per OAC 340:100-3-38;

(4) responsible for the cost of the member's meals and entertainment during recreation and leisure activities. 

Activities selected must be affordable to the member and respite staff.  Concerns about affordability are presented to the Team for resolution.

(n) The spouse or other adult residing in the home is considered a natural support and may provide ACS in the absence of the companion, when trained per OAC 340:100-3-38.12.

(o) The spouse or other adult residing in the home cannot serve as paid respite staff.
317:40-5-14.Department case manager role and responsibilities [REVOKED]
[Revoked 7-11-05]
317:40-5-15.Department Agency Companion Services (ACS) staff role and responsibilities[REVOKED]
[Revoked 7-11-05]

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.