SECTION 317:40-5-40. Home profile process

(a)   Applicability. This Section establishes procedures for the Developmental Disabilities Services (DDS) home profile process. A home profile is required for:

(1)   agency companion services (ACS);

(2)   specialized foster care (SFC) services;

(3)   respite services delivered in the provider's home;

(4)   approving services in a home shared by a non-relative provider and a member; and

(5)   any other situation that requires a home profile.

(b)   Pre-screening. Designated (DDS) staff provides the applicant with program orientation and pre-screening information that includes, but is not limited to:

(1)   facts, description, and guiding principles of the Home and Community-Based Services (HCBS) program;

(2)   an explanation of:

(A)   the home profile process;

(B)   basic provider qualifications;

(C)   health, safety, and environmental issues; and

(D)   training required per Oklahoma Administrative Code (OAC) 340:100-3-38;

(3)   the Oklahoma Department of Human Services (DHS) Form 06AC012E, Specialized Foster Care/Agency Companion Services Information Sheet;

(4)   explanation of a background investigation conducted on the applicant and any adult or child living in the applicant's home.

(A)   Background investigations are conducted at the time of application and include, but are not limited to:

(i)   an Oklahoma State Bureau of Investigation (OSBI) name and criminal records history search, including the Oklahoma Department of Public Safety (DPS), Sex Offender Registry and Mary Rippy Violent Offender Registries;

(ii)   Federal Bureau of Investigation (FBI) national criminal history search, based on the fingerprints of the applicant and any adult members of the household;

(iii)   search of any involvement as a party in a court action;

(iv)   search of all DHS records, including Child Welfare Services records and the Community Services Worker Registry;

(v)   a search of all applicable out-of-state child abuse and neglect registries for any applicant or adult household member who has not lived in Oklahoma continuously for the past five years. A home is not approved without the results of the out-of-state maintained child abuse and neglect registry checks, when a registry is maintained in the applicable state, for all adult household members living in the home. When a child abuse and neglect registry is not maintained in the applicable state, a request for information is made to the applicable state; and

(vi)   search of Juvenile Justice Information System (JOLTS) records for any child older than 13 years of age in the applicant's household.

(B)   An application is denied when the applicant or any person residing in the applicant's home:

(i)   has a criminal conviction of or pled guilty or no contest to:

(I)   physical assault, battery, or a drug-related offense in the five-year period preceding the application date;

(II)   child abuse or neglect;

(III)   domestic abuse;

(IV)   a crime against a child, including, but not limited to, child pornography;

(V)   a crime involving violence, including, but not limited to, rape, sexual assault, or homicide, including manslaughter, excluding physical assault and battery; or

(ii)   does not meet OAC 340:100-3-39 requirements;

(5)   DHS Form 06AC015E, Agency Companion/Specialized Foster Care Employment Record;

(6)   DHS Form 06AC016E, DDS Reference Information Waiver;

(7)   DHS Form 06AC029E, Employer Reference Letter; and

(8)   DHS Form 06AC013E, Pre-Screening for Specialized Foster Care/Agency Companion Services.

(c)   Home profile process. When the applicant meets the requirements of the prescreening, the initial home profile process described in (1) through (8) of this subsection is initiated.

(1)   The applicant completes the required forms and returns the forms to the DDS address provided. Required forms include DHS Forms:

(A)   06AC008E, Specialized Foster Care/Agency Companion Services Application;

(B)   06AC009E, Financial Assessment;

(C)   06AC011E, Family Health History;

(D)   06AC018E, Self Study Questionnaire;

(E)   06AC019E, Child's Questionnaire;

(F)   06AC010E, Medical Examination Report, when Form 06AC011E indicates conditions that may interfere with the provision of services;

(G)   06AC017E, Insurance Information; and

(H)   06AC020E, Evacuation/Escape Plan.

(2)   When an incomplete form or other information is returned to DDS, designated DDS staff sends a letter to the provider or provider agency identifying information needed to complete the required forms. The home profile is not completed until all required information is provided to DDS.

(3)   Designated DDS staff completes the home profile when all required forms are completed and provided to DDS.

(4)   For each reference provided by the applicant, designated DDS staff completes DHS Form 06AC058E, Reference Letter;

(5)   Designated DDS staff, through interviews, visits, and phone calls, gathers information required to complete DHS Form 06AC047E, Home Profile Notes.

(6)   DHS Form 06AC069E, Review of Policies and Areas of Responsibilities, is dated and signed by the applicant and designated DDS staff.

(7)   The DDS area residential services programs manager sends to the applicant:

(A)   a provider approval letter confirming the applicant is approved to serve as a provider; or

(B)   a denial letter stating the application and home profile are denied.

(8)   DDS staff records the dates of completion of each part of the home profile process.

(d)   Home standards. In order to qualify and remain in compliance, the applicant's or provider's home must meet the provisions in (1) through (11) of this subsection.

(1)   General conditions.

(A)   The home, buildings, and furnishings must be comfortable, clean, and in good repair and the grounds must be maintained. There must be no accumulation of garbage, debris, or rubbish or offensive odors.

(B)   The home must:

(i)   be accessible to school, employment, church, day programming, recreational activities, health facilities, and other community resources as needed;

(ii)   have adequate heating, cooling and plumbing; and

(iii)   provide space for the member's personal possessions and privacy;

(iv)   allow adequate space for the recreational and social needs of the occupants.

(C)   Provisions for the member's safety must be present, as needed, including:

(i)   guards and rails on stairways;

(ii)   wheelchair ramps;

(iii)   widened doorways;

(iv)   grab bars;

(v)   adequate lighting;

(vi)   anti-scald devices; and

(vii)   heat and air conditioning equipment guarded and installed in accordance with manufacturer requirements. Home modifications and equipment may be provided through HCBS Waivers operated by DDS.

(D)   Providers must not permit members to access or use swimming or other pools, hot tubs, saunas, ponds, or spas on the premises without supervision. Swimming pools, hot tubs, saunas, ponds, or spas must be equipped with sufficient safety barriers or devices designed to prevent accidental injury or unsupervised access.

(E)   The household must be covered by homeowner's or renter's insurance including personal liability insurance.

(2)   Sanitation.

(A)   Sanitary facilities must be adequate and safe, including toilet and bathing facilities, water supply, and garbage and sewer disposal.

(B)   When a septic tank or other non-municipal sewage disposal system is used, it must be in good working order.

(C)   Garbage and refuse must be stored in readily cleanable containers, pending weekly removal.

(D)   Sanitation for household pets and other domestic animals must be adequate to prevent health hazards.

(i)   Proof of rabies or other vaccinations as required by a licensed veterinarian for household pets must be maintained on the premises.

(ii)   Pets not confined in enclosures must be under control and not present a danger to members or guests.

(E)   There must be adequate control of insects and rodents, including screens used for ventilation in good repair on doors and windows.

(F)   Universal precautions for infection control must be followed in care to the member. Hands and other skin surfaces must be washed immediately and thoroughly when contaminated with blood or other body fluids.

(G)   Laundry equipment, if in the home, must be located in a safe, well-ventilated, and clean area, with the dryer vented to the outside.

(3)   Bathrooms. A bathroom must:

(A)   provide for individual privacy and have a finished interior;

(B)   be clean and free of objectionable odors; and

(C)   have a bathtub or shower, flush toilet, and sink in good repair, and hot and cold water in sufficient supply to meet the member's hygiene needs.

(i)   A sink must be located near each toilet.

(ii)   A toilet and sink must be provided on each floor where rooms of members who are non-ambulatory or with limited mobility are located.

(iii)   There must be at least one toilet, one sink, and one bathtub or shower for every six household occupants, including the provider and family.

(4)   Bedrooms. A bedroom must:

(A)   have been constructed as such when the home was built or remodeled under permit;

(B)   be provided for each member.

(i)   Exception to allow members to share a bedroom may be made by DDS area residential program manager, when DDS determines sharing a bedroom is in the best interest of the member. Minor members must not share bedrooms with adults.

(ii)   A member must not share a bedroom with more than one other person;

(C)   have a minimum of 80 square feet of usable floor space for each member or 120 square feet for two members and two means of egress. The provider, family members, or other occupants of the home must not sleep in areas designated as common use living areas, nor share bedrooms with members;

(D)   be finished with walls or partitions of standard construction that go from floor to ceiling;

(E)   be adequately ventilated, heated, cooled, and lighted;

(F)   include an individual bed for each member consisting of a frame, box spring, and mattress at least 36 inches wide, unless a specialized bed is required to meet identified needs. Cots, rollaways, couches, futons, and folding beds must not be used for members.

(i)   Each bed must have clean bedding in good condition consisting of a mattress pad, bedspread, two sheets, pillow, pillowcase, and blankets adequate for the weather.

(ii)   Sheets and pillowcases must be laundered at least weekly or more often if necessary.

(iii)   Waterproof mattress covers must be used for members who are incontinent;

(G)   have sufficient space for each member's clothing and personal effects, including hygiene and grooming supplies.

(i)   Members must be allowed to keep and use reasonable amounts of personal belongings and have private, secure storage space.

(ii)   The provider assists the member in furnishing and decorating the member's bedroom.

(iii)   Window coverings must be in good condition and allow privacy for members;

(H)   be on ground level for members with impaired mobility or who are non-ambulatory; and

(I)   be in close enough proximity to the provider to alert the provider to nighttime needs or emergencies, or be equipped with a call bell or intercom.

(5)   Food.

(A)   Adequate storage must be available to maintain food at the proper temperature, including a properly working refrigerator. Food storage must be such that food is protected from dirt and contamination and maintained at proper temperatures to prevent spoilage.

(B)   Utensils, dishes, glassware, and food supplies must not be stored in bedrooms, bathrooms, or living areas.

(C)   Utensils, dishes, and glassware must be washed and stored to prevent contamination.

(D)   Food storage and preparation areas and equipment must be clean, free of offensive odors, and in good repair.

(6)   Phone.

(A)   A working phone must be provided in the home that is available and accessible for the member's use for incoming and outgoing calls.

(B)   Phone numbers to the home and providers must be kept current and provided to DDS and, when applicable, the provider agency.

(7)   Safety.

(A)   Buildings must meet all applicable state building, mechanical, and housing codes.

(B)   Heating, in accordance with manufacturer's specifications, and electrical equipment, including wood stoves, must be installed in accordance with all applicable fire and life safety codes. Such equipment must be used and maintained properly and in good repair.

(i)   Protective glass screens or metal mesh curtains attached at top and bottom are required on fireplaces.

(ii)   Unvented portable oil, gas, or kerosene heaters are prohibited.

(C)   Extension cord wiring must not be used in place of permanent wiring.

(D)   Hardware for all exit and interior doors must have an obvious method of operation that cannot be locked against egress.

(8)   Emergencies.

(A)   Working smoke detectors must be provided in each bedroom, adjacent hallways, and in two story homes at the top of each stairway. Alarms must be equipped with a device that warns of low battery condition, when battery operated.

(B)   At least one working fire extinguisher must be in a readily accessible location.

(C)   A working flashlight must be available for emergency lighting on each floor of the home.

(D)   The provider:

(i)   maintains a working carbon monoxide detector in the home;

(ii)   maintains a written evacuation plan for the home and conducts training for evacuation with the member;

(iii)   conducts fire drills quarterly and severe weather drills twice per year;

(iv)   makes fire and severe weather drill documentation available for review by DDS;

(v)   has a written back-up plan for temporary housing in the event of an emergency; and

(vi)   is responsible to re-establish a residence, if the home becomes uninhabitable.

(E)   A first aid kit must be available in the home.

(F)   The address of the home must be clearly visible from the street.

(9)   Special hazards.

(A)   Firearms and other dangerous weapons must be stored in a locked permanent enclosure. Ammunition must be stored in a separate locked location. Providers are prohibited from assisting members to obtain, possess, or use dangerous or deadly weapons per OAC 340:100-5-22.1.

(B)   Flammable and combustible liquids and hazardous materials must be safely and properly stored in original, properly labeled containers.

(C)   Cleaning supplies, medical sharps containers, poisons, and insecticides must be properly stored in original, properly labeled containers in a safe area away from food, food preparation areas, dining areas, and medications.

(D)   Illegal substances are not permitted on the premises.

(10)   Vehicles.

(A)   All vehicles used to transport members must meet local and state requirements for licensing, inspection, insurance, and capacity.

(B)   Drivers of vehicles must have valid and appropriate driver licenses.

(11)   Medication. Medication for the member is stored per OAC 340:100-5-32.

(e)   Evaluating the applicant and home. The initial home profile evaluation includes, but is not limited to:

(1)   evaluating the applicant's:

(A)   interest and motivation;

(B)   life skills;

(C)   children;

(D)   methods of behavior support and discipline;

(E)   marital status, background, and household composition;

(F)   income and money management; and

(G)   teamwork and supervision, back-up plan, and use of relief; and

(2)   assessment and recommendation. DDS staff:

(A)   evaluates the ability of the applicant to provide services ;

(B)   assesses the overall compatibility of the applicant and the service recipient, ensuring the lifestyles and personalities of each are compatible for the shared living arrangement. The applicant must:

(i)   express a long term commitment to the service member unless the applicant will only be providing respite services;

(ii)   demonstrate the skills to meet the individual needs of the member;

(iii)   express an understanding of the commitment required as a provider of services;

(iv)   express an understanding of the impact the arrangement will have on personal and family life;

(v)   demonstrate the ability to establish and maintain positive relationships, especially during stressful situations; and

(vi)   demonstrates the ability to work collaboratively and cooperatively with others in a team process;

(C)   approves only applicants who can fulfill the expectations of the role of service provider;

(D)   when the applicant does not meet standards per OAC 317:40-5-40, ensures the final recommendation includes:

(i)   a basis for the denial decision; and

(ii)   an effective date for determining the applicant does not meet standards. Reasons for denying a request to be a provider may include, but are not limited to:

(I)   a lack of stable, adequate income to meet the applicant's own or total family needs or poor management of the available income;

(II)   a physical facility that is inadequate to accommodate the addition of a member to the home or presents health or safety concerns;

(III)   the age, health, or any other condition of the applicant that impedes the applicant's ability to provide appropriate care for a member;

(IV)   relationships in the applicant's household that are unstable and unsatisfactory;

(V)   the mental health of the applicant or other family or household member that impedes the applicant's ability to provide appropriate care for a member;

(VI)   references who are guarded or have reservations in recommending the applicant;

(VII)   the applicant failed to complete the application, required training, or verifications in a timely manner as requested or provided incomplete, inconsistent, or untruthful information;

(VIII)   the home is determined unsuitable for the member requiring placement;

(IX)   confirmed abuse, neglect, or exploitation of any person;

(X)   breach of confidentiality;

(XI)   involvement of the applicant or provider involvement in criminal activity or criminal activity in the home;

(XII)   failure to complete training per OAC 340:100-3-38;

(XIII)   failure of the home to meet standards per subsection (d) of this Section;

(XIV)   failure to follow applicable DHS or Oklahoma Health Care Authority (OHCA) rules;

(E)   notifies the applicant in writing of the final approval or denial of the home profile;

(F)   when an application is canceled or withdrawn prior to completion of the home profile, completes a final written assessment that includes the:

(i)   reason the application was canceled or withdrawn; and

(ii)   DDS staff's impression of the applicant based on information obtained; and

(iii)   effective date of cancellation or withdrawal. Written notice is sent to the applicant to confirm cancellation or withdrawal of the application, and a copy is included in local and State Office records.

(f)   Frequency of evaluation. Home profile evaluations are completed for initial approval or denial of an applicant. After an initial approval, a home profile review is conducted annually and as needed for compliance and continued approval. DDS area residential services staff conduct at least biannual home visits to specialized foster care providers. The annual home profile review is a comprehensive review of the living arrangement, the provider's continued ability to meet standards, the needs of the member and the home to ensure ongoing compliance with home standards. A home profile review is conducted when a provider notifies DDS of his or her intent to move to a new residence. DDS staff asses the home to ensure the new home meets home standards and is suitable to meet the member's needs. The annual home profile review;

(1)   includes information specifically related to the provider's home and is documented on DHS Form 06AC024E, Annual Review;

(2)   includes form 06AC010E, Medical Examination Report, completed a minimum of every three years following the initial approval, unless medical circumstances warrant more frequent completion;

(3)   includes information from the DDS case manager, the provider of agency companion or SFC services, the Child Welfare specialist, Adult Protective Services, and Office of Client Advocacy staff, and the provider agency program coordinator when applicable.

(4)   includes information from the service member indicating satisfaction with service and a desire to continue the arrangement;

(5)   addresses areas of service where improvement is needed;

(6)   includes areas of service where progress was noted or were of significant benefit to the member;

(7)   ensures background investigation per OAC 317:40-5-40(b) is repeated every year, except for the OSBI and FBI national criminal history search;

(8)   ensures the FBI national criminal history search per OAC 317:40-5-40(b)(4)(A)(ii) is repeated every five years;

(9)   includes written notification to providers and agencies, when applicable, of the continued approval of the provider.

(10)   includes written notification to providers and agencies, when the provider or agency fails to comply with the home standards per OAC 317:40-5-40 including deadlines for correction of the identified standards; and includes copies of DHS Forms 06AC024E and, when applicable, 06AC010E, in local and State Office records.

(g)   Reasons a home profile review may be denied include, but are not limited to:

(1)   lack of stable, adequate income to meet the provider's own or total family needs or poor management of available income;

(2)   a physical facility that is inadequate to accommodate the addition of a member to the home or presents health or safety concerns;

(3)   the age, health, or any other condition of the provider that impedes the provider's ability to provide appropriate care for a member;

(4)   relationships in the provider's household that are unstable and unsatisfactory;

(5)   the mental health of the provider or other family or household member impedes the provider's ability to provide appropriate care for a member;

(6)   the provider fails to complete required training, or verifications in a timely manner as requested or provides incomplete, inconsistent, or untruthful information;

(7)   the home is determined unsuitable for the member;

(8)   failure of the provider to complete tasks related to problem resolution, as agreed, per OAC 340:100-3-27;

(9)   failure of the provider to complete a plan of action, as agreed, per OAC 317:40-5-63;

(10)   confirmed abuse, neglect, or exploitation of any person;

(11)   breach of confidentiality;

(12)   involvement of the applicant or provider involvement in the criminal activity or criminal activity in the home;

(13)   failure to provide for the care and well-being of the service member;

(14)   failure or continued failure to implement the individual Plan, per OAC 340:100-5-50 through 100-5-58;

(15)   failure to complete and maintain training per OAC 340:100-3-38;

(16)   failure to report changes in the household;

(17)   failure to meet standards of the home per subsection (d) of this Section;

(18)   failure or continued failure to follow applicable DHS or OHCA rules;

(19)   decline of the provider's health to the point he or she can no longer meet the needs of the service member;

(20)   employment by the provider without prior approval of the DDS area programs manager for residential services; or

(21)   domestic disputes that cause emotional distress to the member.

(h)   Termination of placement. When an existing placement is terminated for any reason:

(1)   the Team meets to develop an orderly transition plan; and

(2)   DDS staff ensures the property of the member and state is removed promptly and appropriately by the member or his or her designee.

[Source: Added at 22 Ok Reg 2531, eff 7-11-05; Amended at 25 Ok Reg 2714, eff 7-25-08; Amended at 28 Ok Reg 1550, eff 6-25-11; Amended at 32 Ok Reg 615, eff 2-9-15 (emergency); Amended at 32 Ok Reg 1170, eff 8-27-15]