OHCA Policies and Rules
317:30-5-423. Coverage limitations
[Revised 06-25-12]
(a) Coverage limitations for residential supports for members with an intellectual disability are:
(1) Description: agency companion services (ACS); Unit: one day; Limitation: 366 units per year;
(2) Description: specialized foster care (SFC); Unit: one day; Limitation: 366 units per year;
(3) Description: daily living supports (DLS); Unit: one day; Limitation: 366 units per year; and
(4) Description: group home services; Unit: one day; Limitation: 366 units per year.
(b) Members may not receive ACS, SFC, DLS and group home services at the same time.
(c) Community transition services (CTS) are limited to $2,400 per eligible member.
(1) CTS is limited to one transition over the member's lifetime. If the member's situation changes after receipt of CTS and hospitalization or readmission to an intermediate care facility for the mentally retarded (ICF/MR) is necessary, CTS is not authorized upon transition back into the community.
(2) Members moving into a group home, SFC, or ACS arrangement in the companion's home are not eligible to receive CTS.
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.
