ADvantage Waiver Program
The ADvantage Waiver program is administered by the DHS Aging Services Division. This program allows a Member to receive services while remaining in their home and prevents premature or unnecessary placement in a nursing facility. Some of the in-home services include: Case Management, Skilled Nursing, Personal Care, Advanced Supportive/Restorative Care, Home Delivered Meals, Prescriptions, Medical Equipment and Supplies.
The Adult Protective Services (APS) program is administered by DHS and provides vulnerable adults protection from abuse, neglect or exploitation. Any person having reasonable cause to believe that a vulnerable adult is suffering from abuse, neglect or exploitation should make a report as soon as the person is aware of the situation by contacting their local DHS Human Services Center or the Statewide Abuse Hotline at 1-800-522-3511.
An Advanced Supportive/Restorative (ASR) aide is a PCA who provides maintenance services to assist a Member with a stable, chronic condition with activities of daily living when such assistance requires devices and procedures related to altered body function. Examples of ASR aide tasks include: routine care of ostomies and catheters, administering bowel programs, applying prescription lotions or ointments, using a lift for transfers, and providing range of motion. The Independent Home Health Provider agency is responsible for ensuring the ASR aide demonstrates the ability to understand and carry out assigned tasks, and has current CPR certification.
A staff person, employed by an Independent Case Management Provider agency, who functions as a service coordinator and advocate for an ADvantage Member.
The Consumer Inquiry Services (CIS) number, also known as the ADvantage Care Line, is a toll-free statewide telephone number for a person to call who wants to apply, or has questions or complaints about the ADvantage program. The number is 1-800-435-4711.
The Centers for Medicare & Medicaid Services (CMS) is the federal agency that runs the Medicare program. In addition, CMS works with each state to run the state’s Medicaid program. CMS works to make sure that Oklahoma’s ADvantage Members receive high quality services.
Community Services Worker Registry
The Community Services Worker Registry is an online registry that is maintained by DHS. The Independent Home Health Provider agency is required to check the Community Services Worker Registry and must not hire a person whose name is listed on the Registry.
The Conditions of Provider Participation (COPP) is a contractual document that is signed by each Independent Case Management and Independent Home Health Provider agency. This document includes a written Code of Ethics that each Provider agency is required to distribute to all employees providing services to ADvantage Members.
Independent Case Management Provider
An agency that provides case management services to arrange and coordinate health and/or social services for ADvantage Members through assessment, service plan development and modification, monitoring and quality assurance.
Independent Home Health Provider
An agency that provides home health services such as Personal Care, In-Home Respite, Advanced Supportive/Restorative Care and Skilled Nursing for ADvantage Members. The agency also provides services for Medicaid State Plan Personal Care Members.
A Member is an individual who receives services through the ADvantage Waiver or Medicaid State Plan Personal Care program.
The Medicaid State Plan Personal Care (MSPPC) program is administered by the DHS Aging Services Division. This program allows a Member to receive services while remaining in their home. Some of the in-home services include: Personal Care and Skilled Nursing.
Medicaid State Plan Personal Care Provider
An Independent Home Health Provider agency that provides home health services for MSPPC Members.
A Personal Care Assistant (PCA) is an aide who provides non-skilled Personal Care services to assist a Member in carrying out activities such as bathing, dressing, grooming, toileting, preparing meals, housekeeping, laundry and errands. The PCA must be at least 18 years of age, must have passed an OSBI background check, and must not be listed on the DHS Community Services Worker Registry and the Oklahoma State Department of Health Nurse Aide Registry. The Independent Home Health Provider agency is responsible for ensuring the PCA demonstrates the ability to understand and carry out assigned tasks.
A document developed by the Case Manager or Independent Home Health Provider agency nurse. The Service Plan includes each service, service provider, unit and frequency, and begin, end, and authorized dates.
Service Plan Goals
A document developed by the Case Manager, Member and Independent Home Health Provider agency nurse. The Service Plan Goals include the Member’s long-term goal, challenges and strengths, anticipated outcomes and action steps to assist the Member in meeting the long-term goal.