SECTION 340:15-3-1. Eligibility and available services

(a)   Supplemental Security Income-Disabled Children's Program (SSI-DCP). SSI-DCP is established, per Sections 504 and 1615 of the Social Security Act and administered by the Oklahoma Department of Human Services (DHS) Adult and Family Services (AFS). The Social Security Administration (SSA) refers children younger than 18 years of age, approved for Supplemental Security Income (SSI) to DHS for SSI-DCP services and, to apply for the State Supplemental Payment (SSP).

(1)   Due to limited funding, requested SSI-DCP services are pre-approved by AFS Health Related and Medical Services (HR&MS) staff.

(2)   AFS HR&MS staff considers many factors in deciding which services or equipment to approve including, but not limited to:

(A)   the child's needs;

(B)   the availability of other resources;

(C)   whether the child is in a stable or temporary living situation;

(D)   the cost of the service or equipment; and

(E)   the availability of funding.

(b)   Eligibility. Any child from birth to 18 years of age may be eligible for SSI-DCP services when the child receives a SSI payment. SSA establishes financial and medical eligibility for the SSI disability payment. When the child becomes 18 years of age, he or she is no longer eligible for SSI-DCP services.

(c)   Child in DHS custody. When a child is in DHS custody and the child's SSI is retained by DHS, the child's SSI is used to pay for needed services and equipment prior to accessing SSI-DCP funds.

(d)   Service plan. The AFS worker completes a service plan prior to providing SSI-DCP services to the child, unless the child has a current service plan with another program within DHS or another agency.

(1)   The AFS worker makes a scheduled home visit, per Oklahoma Administrative Code (OAC) 340:65-3-4(1) to complete Form 08MA017E, SSI-DCP Service Plan, with the child's parent, guardian, or caretaker. The service plan is reviewed yearly. When the child receives SSP, the AFS worker completes Form 08MA017E in conjunction with the eligibility renewal.

(2)   When the child receives services from another agency that requires a current social service plan, such as early intervention services through SoonerStart or special education services through the local public school, the SSI-DCP service plan is not necessary.

(3)   Within DHS, the child may receive services from Child Welfare Services (CWS), Developmental Disabilities Services (DDS), or Aging Services for State Plan Personal Care. When applicable, the AFS worker collaborates with CWS or DDS to:

(A)   address the child's current and future social service needs; and

(B)   avoid duplication in providing services.

(e)   Services. SSI-DCP provides funding for the services described in (1) and (2) of this subsection. The parent, guardian, or caretaker requests services through the AFS worker in the county office and provides a prescription or written recommendation from an education or healthcare professional. The prescription or written recommendation is provided yearly at the time of the annual renewal.

(1)   Formula. A health care professional provides a prescription naming the brand of formula needed by the child. When approved by AFS HR&MS, authorized county staff orders available formula through the DHS Supply Warehouse. Only formula available through the DHS Supply Warehouse is approved.

(2)   Interaction and integration services. Non-medical services aimed at strengthening the child physically or mentally; providing opportunities for social interaction; or assisting with mobility may be approved when recommended by an education or health care professional and the recommendation clearly defines the goals and objectives for the child. Examples of such services include, but are not limited to, swimming or horseback riding lessons, sports activities, or a health club membership. Due to budget constraints, services are approved on a temporary basis.

(f)   Equipment. Equipment approved through SSI-DCP is used to aid the child in accessibility or mobility. Equipment available through SSI-DCP is pre-approved by AFS HR&MS Section staff. Available equipment that may be approved is described in (1) and (2) of this subsection. The parent, guardian, or caretaker provides a written recommendation from an education or health care professional with knowledge concerning the child's equipment needs. HR&MS staff does not approve requests for equipment the child can obtain through other sources, such as SoonerCare (Medicaid) or through the child's school.

(1)   Developmental aid. A developmental aid is any device or equipment adapted to meet the needs of a child with disabilities. An education or healthcare professional provides a written explanation concerning the goals and objectives this developmental aid meets before it is approved. Educational or classroom devices, equipment, or supplies not adapted for the child's needs are not in the scope of the program.

(2)   Van lifts. Van lifts are devices used for vehicular transportation of wheelchairs. Van lifts may be approved when needed to transport a child in a wheelchair. A van lift is not approved for a child in DHS or tribal custody or in the Developmental Disabilities Home and Community-Based Waiver Program. Modifications to the van are not approved.

(A)   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.

(B)   The family provides estimates from two van lift dealers who employ certified van lift installation technicians.

(C)   When the request is approved, HR&MS staff contacts the family and approved vendor to arrange installation of the van lift.

(D)   Only a certified van lift specialist is approved to install the lift and the lift must have factory and dealership warranties equal to the private purchase warranty.

(E)   HR&MS staff does not approve replacement of a van lift within 10 years of the purchase date.

(F)   SSI-DCP staff does not pay for repairs of vans or van lifts not purchased with SSI-DCP funds.

(g)   Exclusions. Items or supplies not in the scope of SSI-DCP are not approved. Examples of excluded items or supplies include, but are not limited to:

(1)   learning programs;

(2)   psychological programs;

(3)   books;

(4)   video or audio tapes;

(5)   paper, pencils, or art supplies;

(6)   computers, tablet computers, or computer software;

(7)   televisions; and

(8)   video games.

(h)   Purchasing procedures. SSI-DCP orders are processed through AFS HR&MS. Purchased equipment is shipped to the local county office.

(i)   SSI-DCP notices. When a SSI-DCP request is denied, AFS HR&MS staff sends Form 08MP038E, Client Notice of Action Taken, to inform the child's parent, guardian, or caretaker the item is not approved for purchase through SSI-DCP funding. The family may request a fair hearing by completing Form 13MP001E, Request for a Fair Hearing, within 30-calendar days from the issuance date of Form 08MP038E.

(j)   Respite Voucher Program. The Respite Voucher Program provides financial assistance in the form of vouchers to families to pay for respite care. When the family appears eligible for the Respite Voucher Program, the worker gives the client Form 08RV001E, Respite Voucher Application for Children With Special Health Care Needs, to complete. When funding is not available through HR&MS, the worker advises the family to call a designated number to request a respite voucher application from Sooner SUCCESS for the Lifespan Respite Grant Voucher Program. SSI-SSI-DCP, other DHS programs, and certain public and private agencies provide funding to the Respite Voucher Program.

(1)   The caregiver is the person who provides ongoing care for the child. He or she may be a parent, grandparent, other relative, or non-relative.

(2)   When respite care is approved the respite provider must be at least 18 years of age. Respite care is not:

(A)   designed to pay for ongoing care, such as child care, therapy, in-home assistance, housekeeping, or home health services; and

(B)   provided by a member of the child's household.

[Source: Added at 32 Ok Reg 1858, eff 9-15-15; Amended at 36 Ok Reg 1785, eff 9-16-19]