Medicaid - Community Waiver
Developmental Disabilities Services Division
Department of Human Services
The Community Waiver provides services and supports to Oklahoma residents with specific types of intellectual disabilities. The waiver assists individuals in their goal to lead healthy, independent and productive lives in the community. Services offered are not otherwise covered through Oklahoma’s Medicaid State Plan (SoonerCare). Services provided under the Community Waiver include assistive technology, as well as, other services, which may relate to assistive technology including audiology, dental, nutrition, occupational therapy, physical therapy, speech therapy, architectural modification and specialized medical supplies.
Paula Green, Program Manager
Oklahoma Department of Human Services
Developmental Disabilities Services Division
P.O. Box 25352
Oklahoma City, OK 73125
FAX: (405) 522-0729
See Appendix B for Department of Human Services DDSD Area Offices.
- An individual must be age three or older;
- meet SoonerCare financial eligibility requirements, which currently limit monthly countable income to $2,130, and a resource limit of $2,000. These figures are subject to change;
- not be simultaneously enrolled in any other waiver program or receiving services in an institution including a hospital, rehabilitation facility, mental health facility, nursing facility, residential care facility or Intermediate Care Facility for persons with Mental Retardation (ICF-MR);
- not be receiving DDSD state-funded services such as the Family Support Assistance Payment, Respite Voucher Program, sheltered workshop services, community integrated employment services or assisted living without waiver supports;
- have a disability as determined by the Social Security Administration (SSA) or the Oklahoma Health Care Authority’s (OHCA) Level of Care Evaluation Unit and must also have a diagnosis of mental retardation;
- be determined by the OHCA Level of Care Evaluation Unit to meet ICF-MR level of care requirements; and
- for additional information regarding waiver eligibility, please refer to Oklahoma’s rules. These rules may be found in the Provider,
AT SERVICES PROVIDED/COVERED
- Assessment for the need of assistive technology/auxiliary aids
- Training the service recipient/provider in the use and maintenance of equipment/auxiliary aids
- Repair of adaptive devices
- Interpreter services
- Reader services
AT DEVICES PROVIDED/COVERED
- Aids for Hearing Impaired
- Aids for Vision Impaired
- Speech Communication
- Environmental Adaptations
- Mobility/Seating & Positioning
- Oklahoma’s Developmental Disabilities Services Division (DDSD) operates statewide with four offices in the state. To apply for waiver services, please contact the area office nearest you.
- Anyone who applies for/or receives services from the Oklahoma Department of Human Services has a right to request the OKDHS Appeals Unit review an OKDHS action or delay action. This is called a Fair Hearing.
- You have the right to request a Fair Hearing within 30 days after you have been notified of a decision with which you don’t agree or when there has been unusual delay by OKDHS in reaching a decision on your application or case.
- If you want to request a hearing, contact the local OKDHS office that took the action or failure to act, that you disagree with. You will be asked to fill out a form that says exactly what you disagree with.
- You may represent yourself or be represented by a lawyer.
- The hearing decision will be made by the Appeals Committee, which is made up of the hearing officer and two OKDHS state office employees who were not involved in the action you are appealing. The Appeals Committee tries to get most cases decided within 30 days after the hearing. If the appeal is decided against you, you may ask the Director of OKDHS to review the hearing decision. The Appeals Committee letter will explain how to do this.
- Please refer to the OKDHS website at: www.okdhs.org/ for further details related to Fair Hearings and Appeals.
PIECES OF THE PUZZLE
- Currently, there is a waiting list to receive services through the Community Waiver.
- To be eligible for the Community Waiver, a person must have critical support needs that cannot bemet by the In-Home Supports waivers or other service alternatives.
- Services provided through Oklahoma’s SoonerCare Child Health Program will not be covered by the Community Waiver. The SoonerCare Child Health Program lets children with SoonerCare, ages 0-20, get free medical, vision, hearing and dental checkups. If your child’s SoonerCare doctor finds a health problem during a health checkup, he or she may send you to another provider or another place for follow-up care. Services needed to take care of the problem will be covered through SoonerCare.
- All Community Waiver services are provided by agencies or individuals who have entered into contract agreements with the Oklahoma Health Care Authority.
- A DDSD Case Manager assists with the development of a plan of care, which must be approved prior to all service delivery.
- DDSD Area Offices operate an assistive technology reuse program. Contact the area office closest to you for more information.
- Please refer to Oklahoma’s rules related to DDSD assistive technology (AT) devices and services. These rules may be viewed at: www.okhca.org in the Provider, Policies and Rules section under OAC 317:40-5-100.