(a) Agencies providing state-funded employment (sheltered workshop) services for eligible service recipients receive a flat daily rate approved by the Oklahoma Commission for Human Services.
- (1) The provider agency may receive prorated reimbursement as recommended by the service recipient's Team and documented in the Individual Plan (IP) for service recipients who are unable to work five hours per day. If a service recipient is unable to participate a full five hours, other eligible service recipients can fill the balance of the work day.
- (2) State-funded employment services for eligible service recipients must be included in the service recipient's IP.
- (3) Payment is only disbursed following the delivery of authorized services to eligible service recipients.
(b) Each service recipient is allowed 26 days per year of therapeutic leave without reduction in agency funding.
- (1) A maximum of 16 days of therapeutic leave may be used for:
- (A) holidays, up to a maximum of 12 days per state fiscal year; and
- (B) service recipient or family initiated vacations.
- (2) The remainder of each service recipient's leave days may be used for:
- (A) service recipient medical concerns, illnesses, doctor or therapy appointments, or injuries.
- (i) When a service recipient is absent more than five consecutive days and therapeutic leave is billed, a Team meeting must be held to determine whether the service recipient's employment program should be suspended to avoid exhausting all of the service recipient's therapeutic leave.
- (ii) Service recipients are encouraged to schedule appointments outside of employment hours;
- (B) severe weather conditions;
- (C) other conditions that threaten the safety or welfare of service recipients and staff; or
- (D) service recipient refusal to attend. When a service recipient refuses to attend for three consecutive days, the Team must identify and address related issues before additional billing is authorized.
(c) In extraordinary situations, the Oklahoma Department of Human Services (OKDHS) may approve up to 20 additional days for prolonged medical conditions as recommended by the service recipient's Team.
- (1) Requests for additional days for prolonged medical conditions are submitted to designated Developmental Disabilities Services Division (DDSD) staff for approval.
- (2) The request for additional days for prolonged medical conditions must be specific to the service recipient and include:
- (A) the name of the service recipient;
- (B) the specific reason for the leave request;
- (C) the number of extended medical leave days requested;
- (D) supporting documentation, such as physician report or Team minutes; and
- (E) the signature of the provider agency case manager or program coordinator.
- (3) The DDSD area manager or designee mails a written response of approval, denial, or request for additional information within five days of receipt of the request.
- (4) Providers cannot request more hours or days of therapeutic leave than the service recipient(s) was scheduled to work.
(d) If a service recipient has to stay home because the provider does not have adequate staff, therapeutic or extended leave is not authorized.