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Part 53      SPECIALIZED FOSTER CARE

317:30-5-495.Home and Community-Based Services Waivers for persons with an intellectual disability or certain persons with related conditions

[Revised 06-25-12]
(a) Introduction to waiver services. The Oklahoma Health Care Authority (OHCA) administers Home and Community-Based Services (HCBS) Waivers for persons with an intellectual disability or certain persons with related conditions that are operated by Oklahoma Department of Human Services (OKDHS) Developmental Disabilities Services Division (DDSD). The Community Waiver and Homeward Bound Waiver allow payment for specialized foster care (SFC), also known as specialized family care, as defined in the waiver approved by Centers for Medicare and Medicaid Services.
(b) Eligible providers. All SFC providers must:
(1) enter into contractual agreements with the OHCA to provide HCBS for persons with an intellectual disability or certain persons with related conditions;
(2) have an approved home profile per OAC 317:40-5-40;
(3) complete training per OAC 340:100-3-38;
(4) have the ability to implement the member's Individual Plan (IP); and
(5) be emotionally and financially stable, in good health, and of reputable character.

317:30-5-496.Coverage

[Revised 07-25-08]
All specialized foster care must be included in the member's Individual Plan (IP). Arrangements for care under this program must be made through the member's case manager.

317:30-5-497.Description of services

[Revised 07-25-08]
Specialized foster care (SFC) is an individualized living arrangement offering 24-hour per day supervision, supportive assistance, and training in daily living skills. Services are intended to allow the member to reside with a surrogate family. Services are provided to one to three members in the home in which the SFC provider resides. Four levels of SFC, based upon the member's age and level of need as determined by the Personal Support Team, are:
(1) maximum supervision - for members 18 years of age or younger with extensive needs;(2) close supervision - for members 18 years of age or younger with moderate needs;
(3) maximum supervision - for members 19 years of age or older with extensive needs; and
(4) close supervision - for members 19 years of age or older with moderate needs.

317:30-5-498.Coverage limitations

[Revised 07-25-08]
(a) Coverage limitations for specialized foster care (SFC) are:
(1) Description: close supervision; Unit: one day; 366 units each 12 months.
(2) Description: maximum supervision; Unit: one day; 366 units each 12 months.
(b) Members are required to pay room and board expenses from their own funds as SFC does not include the cost of room and board.
(c) Members may not simultaneously receive group home services, daily living supports, or agency companion services.
(d) Members who are in the custody of the Oklahoma Department of Human Services (OKDHS) and in out-of-home placement funded by OKDHS Children and Family Services Division are not eligible for SFC.
(e) When a member changes providers, only the outgoing service provider claims for the date the member moves.

317:30-5-499.Diagnosis code [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.