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Oklahoma Department of Human Services
Sequoyah Memorial Office Building, 2400 N. Lincoln Blvd. • Oklahoma City, OK 73105
(405) 521-3646 • Fax (405) 521-6684 • Internet: www.okdhs.org
OKDHS Home > Library > Policy > OAC 317 > Chapter 35. Medical Assistance for Adults and Children - Eligibility > 15. Personal Care Services > 3. Application for Personal Care
317:35-15-3. Application for Personal Care
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Revised 2-1-09

 

(a) Requests for Personal Care.  A request for Personal Care is made to the local OKDHS office.  • 1  A written financial application is not required for an individual who has an active SoonerCare case.  A financial application for Personal Care consists of the Medical Assistance Application form.  The form is signed by the applicant, parent, spouse, guardian or someone else acting on the applicant's behalf.  All conditions of financial eligibility must be verified and documented in the case record.  When current information already available in the local office establishes eligibility, the information may be used by recording source and date of information.  If the applicant also wishes to apply for a State Supplemental Payment, either the applicant or his/her guardian must sign the application form.  • 2

(b) Date of application.

  • (1) The date of application is:
    • (A) the date the applicant or someone acting on his/her behalf signs the application in the county office;
    • (B) the date the application is stamped into the county office when the application is initiated outside the county office; or,
    • (C) the date when the request for SoonerCare is made orally and the financial application form is signed later.
  • (2) An exception to paragraph (1) of this subsection would occur when OKDHS has contracts with certain providers to take applications and obtain documentation.  After the documentation is obtained, the contract provider forwards the application and documentation to the OKDHS county office of the applicant's county of residence for SoonerCare eligibility determination.  The application date is the date the applicant signed the application form for the provider.

(c) Eligibility status.  Financial and medical eligibility must be established before services can be initiated.  • 3

 

INSTRUCTIONS TO STAFF 317:35-15-3

  1. The county staff completes the AG-2, Part 1 (new form number 02HM001E), the Uniform Comprehensive Assessment Tool (UCAT).  The AG-2, Part 1 (new form number 02HM001E), is routed to both the Long Term Care Nurse (LTC nurse) and the social worker to begin processing the application.

  2. When the application is completed and signed, the computer input form is prepared and registered on the terminal within five days of the application date or receipt of case record from another county office.

  3. The social worker notifies the LTC nurse of the financial eligibility of the client, using DHS form ABCDM-37-D (new form number 08MA038E), Notice Regarding Financial Eligibility.  If the client does not have an active Medicaid case, the social worker notifies the LTC nurse of this and again notifies the nurse when the eligibility determination has been made.
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Oklahoma Department of Human Services
Street address: Sequoyah Memorial Office Building, 2400 N. Lincoln Blvd., Oklahoma City, OK 73105
Mailing address: P.O. Box 25352, Oklahoma City, OK 73125
(405) 521-3646
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