Medicaid-Home & Community-Based Waiver Program (HCBW)
Developmental Disabilities Services Division (DDSD),
Department of Human Services (DHS)
PURPOSE
Medicaid’s optional Home and Community Based Waiver Program affords states the flexibility to develop and implement creative alternatives to institutionalizing Medicaid eligible individuals. The program recognizes that many individuals at risk of institutionalization can be cared for in their homes and communities, preserving their independence and ties to family and friends, at a cost no higher than that of institutional care. The Social Security Act specifically lists seven services which may be provided: case management, homemaker services, home health aid services, personal care services, adult day health, habilitation and respite care. Other services such as transportation, in-home support services, meal services, special communication services, employment, minor home modifications, and adult day care are provided as part of the Oklahoma Home and Community-Based Waiver plan.
CONTACT
Mr. David Taylor, Program Assistant Administrator
Developmental Disabilities Services Division
Oklahoma Department of Human Services
PO Box 25352
Oklahoma City, OK 73125
(405) 521-6267
FAX: (405) 522-3037
www.okdhs.org
CONTACT
To make application for services, contact the Developmental
Disabilities Services Division (DDSD) area office nearest you.
Area I
729 Overland Trail
Enid, OK 73703
(580) 237-0995
(800) 522-1064
4545 N Lincoln Blvd, Ste 102
Oklahoma City, OK 73105
(405) 522-6925
(800) 522-1064
FAX: (405) 522-6995
Area II
Laura Dester Center
1427 E 8th St
Tulsa, OK 74120
(918) 560-4848
(800) 522-1075
FAX: (918) 560-4898
Area III
301 S Indian Meridian Rd
Pauls Valley, OK 73075
(405) 238-4700
(800) 522-1086
FAX: (405) 238-4745
See Appendix B for Department of Human Services County Office.
FINANCIAL CRITERIA
• See “Eligibility.
ELIGIBILITY
• Applicants must be age 3 or above.
• Applicants must have a developmental disability with a diagnosis of mental retardation as determined by the Social Security Administration or the OHCA’s Level of Care Evaluation Unit.
• Applicants must be determined by the OHCA’s Level of Care Evaluation Unit to meet the ICF/MR/Waiver Level of Care requirements.
• Applicants (not the Applicant’s family) must be determined financially eligible through the DHS Family Support Services Division with a countable monthly income limit of $1869.00, and a resource limit of $2000. This figure is subject to change.
• Only the applicant’s income and resources are counted for waiver services.
AT SERVICES PROVIDED/COVERED
• Assessments & Evaluations
• Maintenance & Repairs
• Case Management
• Training for Consumer & Family
• Advocacy/Other
• Information & Referral
• Fabrication of Devices
• Supporting Software
AT DEVICES PROVIDED/COVERED
Adapted Toys & Games
Home Modifications
Aids for Daily Living
Hospital Beds
Aids for Hearing Impaired
Medical Supplies
Aids for Vision Impaired
Prosthetics & Orthotics
Augmentative Communication
Recreation & Leisure Devices
Computer Applications
Seating & Positioning Equipment
Educational Devices & Adaptation
Vehicle Modifications
Environmental Controls
Wheelchairs & Mobility Aids
Worksite & Office Modifications
APPLICATION PROCESS
Contact the DDSD office located nearest you. (See “Contacts.”) They will guide you through official application forms.
Application process includes:
completion of DDS-1 form,
arrangement for interviews and testing by professionals,
development of a complete plan of care and summary of services by the applicant’s team, which includes the applicant, service providers, case manager and other interested persons.
Applicants will be notified of approval or denial in writing by DHS.
APPEALS PROCESS
An individual may request assistance from a DHS/DDSD employee in obtaining forms, writing, or filing an appeal.
An appeal of a decision a client wishes to protest must be filed within 30 days notice of the decision. The appeal is processed by completing Appendix G 2 of the Oklahoma Administrative Code, Title 340 Chapter 2, “Request For A Fair Hearing.”
A hearing, if requested, will be conducted by an Administrative Hearing Officer who is a member of the Appeals Unit and who has not had a part in the protested decision. Individuals may have an authorized representative appear with them at the hearing and have the right to present testimony and evidence regarding their situation. The appeals committee will determine whether the Department acted correctly in taking the adverse action.
After the decision has been reached, a letter specifying the reason for the decision and identifying the supporting evidence will be sent to the individual. The Appeals Unit has the responsibility of assuring the decision is carried out.
PIECES OF THE PUZZLE
Currently there is a long waiting list to receive Home and Community-Based Waiver Services.
In order to get on this waiting list, individuals must make a request for services.
DDSD Area Offices operate an AT recycling program. Contact the area office closest to you for further information.
