OKDHS - OAC 340:70-8-1. Eligibility and available services

340:70-8-1. Eligibility and availible services

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Revised 6-1-09

The Supplemental Security Income-Disabled Children's Program (SSI-DCP) is established under Section 1615 of the Social Security Act and administered by the Oklahoma Department of Human Services (OKDHS) Family Support Services Division (FSSD). The Social Security Administration (SSA) refers children under 18 who have been approved for Supplemental Security Income (SSI) to OKDHS, the designated state agency that provides social services.

(1) Eligibility. Any child from birth to 18 years of age is eligible for SSI-DCP services if the child receives a SSI payment. SSA establishes financial and medical eligibility for the SSI disability payment. Once the child turns 18, he or she is not eligible. • 1
(2) Service plan. A service plan must be written by a worker for each child receiving SSI-DCP services to plan current and future social service needs. • 2
- (A) This plan must be reviewed yearly in conjunction with the eligibility review.
- (B) If the child has other types of benefits that require a current social service plan, an additional social service plan is not necessary.
(3) Services and equipment. SSI-DCP provides funding for the services and equipment described in (A) through (E) of this paragraph. The parent, guardian, or caretaker must request services and equipment through the Family Support Services (FSS) worker in the local human services center (HSC). All equipment and services available through SSI-DCP must be pre-approved by FSSD Health Related and Medical Services (HR&MS) Section. HR&MS staff considers whether other resources are available or if the child is in a temporary living situation to determine whether to approve the service or equipment.
- (A) Equipment. Equipment approved through SSI-DCP must be used to aid the child in accessibility or mobility. The parent, guardian, or caretaker must provide a written recommendation from a professional, such as an occupational therapist, physical therapist, special education teacher, or physician, who has professional knowledge concerning the equipment needs of the child. SSI-DCP does not pay for repairs of purchased equipment, van lifts, or other items. • 3
  - (i) Computers or computer software are not in the scope of the program.
  - (ii) Educational or classroom devices, equipment, or supplies that are not adapted for the needs of the child are not in the scope of the program.
  - (iii) Van lifts are available to a child who is not in the custody of OKDHS, tribal custody, or in the Developmental Disabilities Home and Community-Based Waiver Program. Modifications to the van are not approved. • 4
    - (I) The parent, guardian, or caretaker must own the van as verified by title registration and license verification, and the van must be in operating condition.
    - (II) The worker advises the family that estimates are required from two van lift dealers who employ certified van lift installation technicians.
    - (III) Only a certified van lift specialist is approved to install the lift and the lift must have factory and dealership warranty equal to private purchase warranty.
    - (IV) The life expectancy of a van lift is ten years through SSI-DCP. Under no circumstances will the lift be replaced prior to the ten-year period.
    - (V) All repairs are the responsibility of the family.
- (B) Diapers. Certain diapers are available through the OKDHS Supply Warehouse. To be eligible to receive diapers, the child must be at least four years of age. Once the child turns 18, he or she is not eligible. A physician must document in writing that the child cannot be toilet trained. This service request must be renewed yearly at the time of the review to continue receipt of the diapers. • 5
- (C) Formula. Certain formula is available through the OKDHS Supply Warehouse. A physician or nutritionist must provide a prescription naming the brand of formula needed by the child. A prescription is required yearly at the time of the review to continue receipt of the formula. • 6
- (D) Developmental aid. A developmental aid is any device or equipment that is adapted to meet the needs of a child with special needs. A professional, such as an occupational therapist, physical therapist, special education teacher, or physician, must provide a written explanation concerning the goals and objectives this developmental aid would meet before it can be approved. • 7
- (E) Professional services. Professional services are non-medical services recommended by a physician, physical therapist, or occupational therapist that clearly define goals and objectives to achieve results. As the budget allows, certain services are available on a temporary basis. • 8
(4) Purchasing procedures. Equipment orders are processed through the OKDHS Support Services Division (SSD) Contracts and Purchasing Unit. • 9
(5) SSI-DCP notices. If a SSI-DCP request is denied, a computer-generated denial notice is sent to the child advising the item is not approved for purchase through the SSI-DCP funding. The family may request a fair hearing within 30 days from the date of the notice by completing Form 13MP001E, Request for a Fair Hearing. • 10
(6) Respite Voucher Program. The Respite Voucher Program provides financial assistance in the form of vouchers to families to pay for respite care so the caregiver can take a break. When the family appears to be eligible for the Respite Voucher Program, the worker advises the family to call a designated number to request a respite voucher application. • 11 Funds used to pay for these vouchers are provided by the SSI-DCP Program, other OKDHS programs, and other public and private agencies. • 12
- (A) The caregiver is the person who provides ongoing care for the child. He or she can be a parent, a grandparent, other relative, or a non-relative.
- (B) When respite care is approved it:
  - (i) is not designed to pay for ongoing care such as child care, therapy, in-home assistance, housekeeping, or home health services; and
  - (ii) cannot be provided by a member of the child's household. • 13

INSTRUCTIONS TO STAFF 340:70-8-1

Revised 6-1-09

1. (a) Even if the child is considered disabled by another agency such as the Social Security Administration (SSA) or Veterans Administration (VA), the child must receive at least one dollar of Supplemental Security Income (SSI) to be eligible for the Supplemental Security Income-Disabled Children's Program (SSI-DCP).

(b) To determine if the child is eligible for a State Supplemental Payment (SSP), the Information Management System (IMS) transaction, CID, must be used to determine family income and compare this calculation with Schedule VIII.A of Oklahoma Department of Human Services (OKDHS) Appendix C-1, Schedule of Maximum Income, Resource, and Payment Standards. It is possible for the child with disabilities to be eligible for SSI payment but ineligible for SSP due to family income in excess of the standard on Appendix C-1 Schedule VIII.A.

(c) To determine if the child is receiving SSI, the worker uses IMS transaction PY space Social Security number (SSN).

2. (a) When no other social service program is involved, the worker offers social services to the parent, guardian, or caretaker for the child.

(1) The worker interviews the parent, guardian, or caretaker during a home visit to assess the child, evaluate the child's needs, and document social service needs by completing Form 08MA017E, SSI-DCP Service Plan.

(2) To approve the child for SSI-DCP, the worker certifies the Social Services tab in the Eligibility Notebook of the Family Assistance/Client Services (FACS) system and adds the child to "social services" in the "benefit" field of the Household tab in the FACS Interview Notebook.

(3) The worker also documents case actions in FACS Case Notes.

(4) The worker must update the SNCU screen to reflect the family's response to the social services offer.

(b) If the child is receiving social services from another OKDHS division, such as Children and Family Services Division (CFSD) or Developmental Disabilities Services Division (DDSD), the worker must review the social service plan with a representative from each division to determine if the current service plan is adequate. The Family Support Services (FSS) worker updates any additions, changes, or notations on Form 08MA017E or in FACS Case Notes.

(1) The FSS worker is the primary worker. If any of the division representatives do not consider the plan adequate, staff in the different divisions must collaborate to develop a plan agreeable to all representatives on Form 08MA017E.

(2) The FSS worker must complete Form 08MA017E within ten calendar days and document the collaborative efforts among programs to obtain social services. The original form must be filed in the FSS case record. A copy of the form must be filed in the DDSD and/or CFSD record.

(3) Information concerning the home visit and any case actions must be documented in FACS Case Notes.

(c) At the annual review, the FSS worker makes a visit to the child's home and updates the social service plan on Form 08MA017E to reflect changes or new requests.

(1) If another division is involved, such as CFSD or DDSD, the FSS worker must collaborate with the other division representative to develop the social service plan on Form 08MA017E.

(2) A copy of Form 08MA017E is included in each division's case record.

(3) The FSS worker documents case actions, including the home visit, in FACS Case Notes.

(d) If DDSD or CFSD has a service plan that contains duplication of service needs in the SSI-DCP service plan, that plan may be substituted for Form 08MA017E at the certification or the annual review. The FSS worker must obtain written approval from the immediate supervisor before making a program substitution. The FSS worker files the social service plan substitute and the written approval from the worker's immediate supervisor in the case record.

3. (a) Equipment is recommended by a professional, such as an occupational therapist, physical therapist, special education teacher, or physician, who evaluates the needs of the child. Classroom supplies or equipment for educational purposes are not in the scope of SSI-DCP. Examples of items not covered are:

(1) devices for learning;

(2) learning programs;

(3) psychological programs;

(4) books;

(5) video tapes;

(6) audio tapes;

(7) paper;

(8) pencils;

(9) art supplies; and

(10) other items directly related to classroom learning.

(b) The professional submits a written recommendation to the worker listing the item name and item number, the name, address, and phone number of the vendor, the objectives and goals to be achieved through the purchase of the equipment, and the cost of the item.

(c) The worker inputs the request on the AUSN-E screen for approval and sends the written recommendation to FSSD Health Related and Medical Services (HR&MS) Section attached to Form 23AD117E, Routing and Transmittal Slip.

(1) If the requested item is over $2500, the worker must contact FSSD HR&MS Section for further instruction.

(2) To determine the result of the request, the worker checks the AUSN-E screen for the decision.

(3) When the equipment is received in the local human services center (HSC), the worker checks the equipment to be sure the proper order was received and updates the AUSN-E screen to reflect the date the equipment is received.

(4) The worker delivers the equipment to the child.

(d) HSC staff are responsible for paying invoices promptly to avoid difficulties with the vendor and to prevent paying interest charges on a delinquent invoice.

4. (a) Van lifts are not approved for any child in an out-of-home placement, including DDSD Home and Community-Based Waiver Services (HCBWS) program, or any CFSD program.

(b) The worker submits the two estimates and Form 23AD117E to FSSD HR&MS Section for approval.

(c) When the van lift request is approved, the worker enters the information on the AUSN-E screen.

(d) A van lift request is not approved if the current van lift is less than ten years old.

(e) SSI-DCP does not pay for repairs of vans or van lifts.

5. (a) Authorized HSC staff are responsible for ordering diapers on the OKDHS consumable supply screen and updating the AUSN-D screen requesting size and number.

(b) Diapers are stocked in the OKDHS Supply Warehouse and distributed as requested to local HSCs.

(c) The worker is responsible for delivery of the diapers to the client.

6. (a) Authorized HSC staff are responsible for ordering formula through the OKDHS consumable supply screen and updating the AUSN-F screen requesting the brand and amount of formula needed.

(b) Formula is stocked in the OKDHS Supply Warehouse and distributed as requested to the local HSC.

(c) The worker is responsible for delivery of the formula to the child.

7. Developmental aids requested by the professional must be adapted to meet the special needs of the child with disabilities. Even if the child could use a regular toy, it is not in the scope of the program.

8. Professional services are any services that enhance the child's mobility. Examples of services to enhance mobility are swimming lessons, gymnastics lessons, or health club membership. These services are requested on the AUSN-P screen.

9. (a) Orders are shipped to the local HSC unless otherwise specified. Heavy objects such as beds can be shipped directly to the child's home.

(b) After the requested items are delivered to the local HSC, the worker updates the AUSN-E screen to document receipt of equipment.

(c) Local HSC staff must pay for SSI-DCP equipment within 45 calendar days of equipment receipt to avoid interest charges being assessed by the vendor for a late payment. Delayed payment by HSC staff creates a problem for current or future orders because vendors hold those orders until all late payments are received. One unpaid invoice can hold up all orders in the state for OKDHS and other agencies.

(d) Local HSC staff is responsible for delivering all SSI-DCP items to the child.

10. (a) To view a list of notices on IMS, enter NL space case number.

(b) To view a particular notice listed on the NL screen, enter NI beside the notice selected.

(c) If the system does not create a notice, the FSS worker sends to the client a hand-generated notice on Form 08MA004E, Notification of Eligibility Status for Medical Assistance.

11.(a) Caregivers can request a respite voucher application by calling toll-free 1-888-771-4550 or 271-4550 in the Oklahoma City metro area. If the family meets the qualifications for the Respite Voucher Program, an application is mailed to them.

(b) Eligibility guidelines and the approval process for the Respite Voucher Program can be found at http://oasis.ouhsc.edu/voucher.htm.

12. (a) After the application is returned, the length of time before approval varies depending on the availability of funds.

(b) Once approved, the voucher is sent to the caregiver and can be used to purchase respite care.

(c) The child's caregiver and the respite provider completes the respite voucher and sends it to the OKDHS Finance Division for payment.

(d) Respite vouchers must be used within three months of the issue date. If a voucher expires, the caregiver must call 1-888-771-4550 or 271-4550 to request another voucher.

13. The respite provider must be 18 years of age or older.

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