Oklahoma Administrative Code › Title 340 - Department of Human Services › Chapter 100 - Developmental Disabilities Services › Subchapter 1 - General Provisions › Section 340:100-1-2 - Definitions

Current through Vol. 41, No. 20, July 1, 2024
The following words and terms, when used in this Chapter,
				  shall have the following meanings, unless the context clearly indicates
				  otherwise:
"Active treatment"
means aggressive and
				  consistent implementation of a program of specialized and generic training,
				  treatment, and health services directed toward the service recipient's
				  acquisition of skills necessary, in order to function as independently as
				  possible.
"Advisory Committee on Services to Persons with
				  Developmental Disabilities"
means the committee appointed by the
				  Director of Human Services (Director) to review and make recommendations on
				  Developmental Disabilities Services (DDS) rules and programs.
"Advocate"
means a person who speaks for or on
				  behalf of a service recipient, especially when individual rights or interests
				  are at risk.
"Alternative appropriate setting"
means a
				  setting, other than a nursing facility, where needed habilitation services are
				  provided, including an intermediate care facility for individuals with
				  intellectual disabilities (ICF/IID) or Home and Community-Based Services
				  (HCBS).
"Assessment"
means one or more processes used to
				  obtain information about a service recipient, including his or her condition,
				  personal goals and preferences, functional limitations, health status, or other
				  factors relevant to service authorization or provision. Assessment information
				  supports the determination that an individual requires services and is used to
				  develop the Individual Plan (Plan).
"Back-up-plan"
means provision for alternative
				  service delivery arrangements for critical to the service recipient's
				  well-being in the event the service provider fails, is unable to deliver the
				  services, or the home where the person lives is no longer available.
"Capacity to give informed consent"
means an
				  individual's ability to make and express voluntary decisions, given correct and
				  sufficient information about the nature, purpose, risks, and benefits of a
				  proposed service or action, when the individual is not adjudicated
				  incapacitated by a court for purposes of the decision.
"Case manager"
means an Oklahoma Department of
				  Human Services (OKDHS) DDS professional who is responsible for assisting a
				  service recipient in gaining access to needed medical, social, educational, or
				  other services per Oklahoma Administrative Code (OAC)
				  317:30-5-1010.1.
				  Case management activities may include assessment, plan development, plan
				  implementation and monitoring, as well as assistance in accessing services and
				  other resources.
"Challenging behavior"
means a behavior that, by
				  its frequency or degree of intensity:
(A) places a service recipient's physical safety,
				  environment, relationships, or participation in the community at risk;
				  or
(B) creates a risk of involvement in civil or criminal
				  processes.
"Client Contact Manager (CCM)"
means a computer
				  software system used by DDS case managers to collect and monitor case
				  management data for service recipients.
"Community Integrated Employment (CIE)"
means a
				  service program that provides placement, job training, and short-term or
				  long-term supports to assist service recipients in achieving and maintaining
				  employment within the community.
"Confidential information"
means:
(A) information related to a service recipient generated by
				  OKDHS or contract providers; and
(B) observations of and discussions concerning service
				  recipients, their families, guardians, or friends.
"Consumer"
means a person who is a direct
				  recipient or beneficiary of service planning and delivery and is synonymous
				  with client, service recipient, individual, and member in Oklahoma Health Care
				  Authority (OHCA) policy.
"Contract provider or agency"
means an agency
				  rendering services to persons with developmental disabilities under a
				  contractual agreement with OKDHS or OHCA.
"Convalescent care"
means nursing facility
				  care:
(A) following a person's release from an acute care hospital
				  that is part of a medically prescribed recovery period; and
(B) not expected to exceed an established number of days.
"DDS"
means OKDHS Developmental Disabilities
				  Services.
"Developmental disability"
means a person's
				  severe chronic disability that:
(A) is attributable to a mental or physical impairment or
				  combination of mental and physical impairments;
(B) is manifested before the person is 22 years of
				  age;
(C) is likely to continue indefinitely;
(D) results in substantial functional limitations in three or
				  more major life activity areas:
(i) self-care;
(ii) receptive and expressive language;
(iii) learning;
(iv) mobility;
(v) self-direction;
(vi) capacity for independent living; and
(vii) economic self-sufficiency; and
(E) reflects the person's need for a combination and sequence
				  of special, interdisciplinary, or generic care, treatment, or other services
				  that are of lifelong or extended duration and are individually planned and
				  coordinated.
"Enabling technology"
means equipment, product
				  systems, engineered solutions, devices, or items that support a service
				  recipient's increased independence in the home, employment site, or the
				  community. These items address a service recipient's needs and outcomes
				  identified in his or her Plan.
"Family homes"
means residences maintained by
				  persons related by biology, adoption, marriage or common law, to a service
				  recipient.
"Family training"
means activities designed to
				  equip family members, significant others, and persons with developmental
				  disabilities with knowledge and skills that allow a family member with
				  developmental disabilities to remain in, or return to, his or her home.
"Goals"
means long-term categorical statements
				  that describe what the service recipient is expected to achieve in a given time
				  frame and are used synonymously with outcomes.
"Guardian"
means a person appointed by a court
				  as general or limited guardian of the person, general or limited guardian of
				  property, special guardian, or temporary guardian as provided by state
				  statutes. A guardian ensures the essential requirements for the ward's health
				  and safety are met and manages the ward's estate, financial resources, or
				  both.
"Guardian ad litem"
means a person appointed by
				  a court to represent the interests of a person in a legal action.
"Habilitation services"
means goal-directed
				  services and therapy activities:
(A) designed to assist a service recipient in acquiring a
				  variety of skills, including self-help, socialization, adaptive skills, and
				  prevention of loss of skills; and
(B) based on the service recipient's capacity to increase his
				  or her own level of physical, mental, and social functioning.
"Human Rights Committee"
means the committee
				  charged with the responsibility for external monitoring and advocacy to address
				  protection of individual rights.
"ICF/IID"
means an intermediate care facility
				  for individuals with intellectual disabilities (ID) that is:
(A) a residential facility licensed in accordance with
				  Oklahoma law; and
(B) certified by the federal government as a Medicaid
				  services provider to persons who have ID or related conditions.
"Incapacitated"
means a court determination that
				  a person is unable to provide for and make decisions for his or her own needs
				  and safety.
"Individual Plan (Plan)"
means a written
				  document developed by the Personal Support Team (Team) based on a need
				  assessment. The Plan:
(A) specifies outcomes pursued on the service recipient's
				  behalf, steps taken to achieve outcomes; and
(B) is a single, comprehensive plan that encompasses all
				  relevant components of the service recipient's life. Various aspects of the
				  Plan are assigned to those persons or agencies designated by the Team to
				  provide services.
"Individual provider"
means a person rendering
				  services to persons with ID under a contractual agreement with OKDHS or
				  OHCA.
"Intake"
means the process a person goes through
				  to gain access to DDS services. Intake staff:
(A) provides answers to specific service inquiries;
(B) assists in the identification of needs in times of
				  crisis;
(C) supplies information regarding the range and means of
				  accessing available services;
(D) provides assistance as necessary in service application;
				  and
(E) facilitates eligibility determination.
"Intellectual Disability (ID)"
means a person,
				  per Section
				  1408 of
				  Title 10 of the Oklahoma Statutes who:
(A) has significantly sub average functioning, an
				  intelligence quotient (IQ) of less than 70 that manifests before 18 years of
				  age; and
(B) exists concurrently with related limitations in two or
				  more of the applicable adaptive skill areas that are:
(i) communication;
(ii) self-care;
(iii) home living;
(iv) social skills;
(v) use of community resources;
(vi) self-direction;
(vii) health and safety;
(viii) functional academics;
(ix) leisure; and
(x) work.
"Integrated employment site"
means a location or
				  activity that provides service recipients with regular interaction with persons
				  without disabilities, excluding service providers, to the same extent that a
				  worker without disabilities, in a comparable position, interacts with
				  others.
"Intrusive procedure"
means a procedure that
				  impinges upon the service recipient's bodily integrity, per OAC
				  340:100-5-57
				  and OAC
				  340:100-5-58.
				  Intrusive procedures include, but are not limited to:
(A) p.r.n. psychotropic medications used for behavioral
				  control;
(B) physical management or physical restraint; and
(C) mechanical restraints for behavioral reasons.
"Job coach"
means a person who holds an OKDHS
				  approved job coach certification and provides ongoing support services to
				  service recipients in supported employment placements. Services directly
				  support the service recipient's work activity, including:
(A) marketing and job development;
(B) job and work site assessment;
(C) training and assessment;
(D) job matching procedures;
(E) developing co-worker supports; and
(F) teaching job skills.
"Least restrictive"
means services and supports
				  that maximize the service recipient's independence and freedom and are provided
				  in a manner that is the least restrictive and intrusive possible to meet the
				  service recipient's needs.
"Long-term resident"
means a nursing facility
				  resident with ID or related conditions who has continuously resided in a
				  nursing facility for at least 30- consecutive months prior to the date of the
				  first preadmission screening and resident review (PASRR) disposition.
"Mechanical restraint"
means any device used to
				  hinder, forcibly confine, or control an individual's freedom of bodily
				  movement.
"Monitoring"
means the ongoing service provision
				  observation and analysis to determine whether the services are furnished per
				  the Plan and effectively meet the service recipient's needs, including whether
				  services adequately protect his or her health and welfare. Monitoring
				  activities may include, but are not limited to, telephone contact,
				  observations, and interviewing the service recipient, family, or service
				  provider.
"Natural supports"
means assistance provided by
				  a person, such as a service recipient's family, friend, co-worker, neighbor, or
				  member of a service recipient's club, church, or interest group, or others in
				  the service recipient's community, who:
(A) are not paid specifically to provide assistance to the
				  service recipient; and
(B) provide voluntary assistance.
"Non-prescription medication"
means a
				  pharmacological drug sold without a prescription, prepackaged for the service
				  recipient's use, and labeled per state and federal statutes and
				  regulations.
"Nursing facility"
means an Oklahoma
				  Medicaid-certified institution providing skilled nursing and related services,
				  excluding a facility certified as ICF/IID.
"Personal Support Team (Team)"
means the
				  participants in the service recipient's assessment and planning process and
				  includes:
(A) the service recipient; and
(B) service recipient's:
(i) case manager;
(ii) legal guardian; and
(iii) when applicable, advocate, who may be a parent, family
				  member, friend, or other person who knows the service recipient well;
				  and
(C) others, including service providers, whose participation
				  is necessary to achieve the service recipient's desired outcomes.
"Physical management"
means an intrusive
				  procedure involving any physical guidance of a service recipient to overcome
				  his or her resistance, or a brief upper body hold to ensure safety per OAC
				  340:100-5-57.
"Physical restraint"
means an intrusive
				  procedure where the service recipient is physically held to restrict
				  movement.
"Plan of Care (POC)"
means a summary listing of
				  services requested as a result of needs identified within the Plan that
				  indicates the amount, duration, and cost of each service recommended for
				  funding through DDS HCBS Waivers.
"Preadmission screening and resident review
				  (PASRR)"
means the process of evaluating, reviewing, and establishing
				  the need for nursing facility services in contrast to other services for
				  persons with ID and related conditions.
"Prescription medication"
means any drug ordered
				  by a health care provider, who is licensed by law to prescribe a drug, intended
				  to be filled, compounded, or dispensed by a pharmacist.
"p.r.n."
means to take or administer a
				  medication as needed.
"Program coordinator"
means a person employed by
				  a DDS residential or group home contract provider agency who supervises,
				  coordinates, and monitors the contract agency's service provision to a service
				  recipient.
"Program manager"
means a person employed by a
				  DDS employment contract provider agency who supervises, coordinates, and
				  monitors the contract agency's service provision to a service recipient.
"Psychotropic medication"
means a
				  pharmacological drug used to treat a mental disorder, or any drug prescribed to
				  stabilize or improve mood, mental status, or behavior.
"Punishment"
means the intentional application
				  of something undesirable or unpleasant, or the removal of something desirable
				  or pleasant, in response to a behavior deemed unacceptable.
"Punitive"
means inflicting or involving
				  punishment.
"QIDP"
means a qualified ID professional who
				  meets ICF/IID regulations per Section 483.430 of Title 42 of the Code of
				  Federal Regulations (42 C.F.R. §
										483.430) . A QIDP must have a baccalaureate
				  degree in a human services field, in addition to one year of experience serving
				  persons with ID.
"Related condition"
means a severe chronic
				  disability, per
				  42 C.F.R. §
										435.1010 that:
(A) is attributable to:
(i) cerebral palsy;
(ii) epilepsy; or
(iii) other condition except mental illness (MI) that is
				  closely related to ID as it results in impairment of general intellectual
				  functioning or adaptive behavior similar to that of persons with ID and
				  requires treatment or services similar to those required for persons with
				  ID;
(B) is manifested before the person reaches 22 years of
				  age;
(C) is likely to continue indefinitely; and
(D) results in substantial functional limitations in three or
				  more major life activity areas, including:
(i) self-care;
(ii) understanding and use of language;
(iii) learning;
(iv) mobility;
(v) self-direction; and
(vi) independent living.
"Response cost procedure"
means the removal of a
				  reinforcer the individual values as a consequence of a behavior with the intent
				  of reducing the frequency of the behavior.
"Restrictive procedure"
or
"restriction"
means a procedure that results in limiting the
				  service recipient's rights, per OAC
				  340:100-5-57
				  and OAC
				  340:100-5-58
				  and includes:
(A) limiting communication or association with others;
(B) any limitation of access to:
(i) leisure activities;
(ii) the service recipient's own money, personal property, or
				  items purchased with the individual's money; and
(iii) food or beverages;
(C) any movement limitation at home or in the
				  community;
(D) visual or electronic supervision during times or places
				  that would otherwise be considered private; or
(E) the use of a response cost procedure.
"Sheltered employment"
means a service that:
(A) assists service recipients toward achieving their
				  vocational potential through a controlled work environment;
(B) provides worker reimbursement in accordance with
				  individual production and Fair Labor Standards Act (FLSA); and
(C) includes assessment, training, and transitional
				  programming leading to community job placements.
"Sheltered workshop"
means a facility that
				  contracts with DDS to provide employment training and sheltered employment
				  services for workers with disabilities.
"Short-term resident"
means any resident with ID
				  or related conditions who resided in a nursing facility for less than 30 months
				  prior to the first PASRR disposition date.
"Specialized services"
means individualized
				  services specified in PASRR evaluations DDS completes that, combined with
				  services the nursing facility or other service providers provide, results in a
				  treatment regimen leading to continued and ongoing independence
				  enhancement.
"Supplemental Security Income (SSI)"
means a
				  federal income subsidy program administered by the Social Security
				  Administration.
"Supported employment"
means competitive work in
				  an integrated work setting with ongoing support services for service recipients
				  with severe disabilities for whom competitive employment has not traditionally
				  occurred or has been interrupted or intermittent as a result of severe
				  disabilities.
"Terminal illness"
means, as certified by a
				  physician, a person with a medical prognosis of life expectancy of six months
				  or less, when the illness runs its natural course.
"Transition"
means a service recipient's planned
				  movement from one service setting to another, occurring as a result of a Team
				  recommendation and the service recipient's informed consent.
"Treatment team for specialized services"
means
				  the team whose purpose is to develop a prescribed plan of specialized services
				  for each service recipient. The team:
(A) is composed of the service recipient, guardian or
				  advocate, nursing home representative, and other professionals and
				  paraprofessionals as needed to develop a comprehensive service plan; and
(B) may include a psychologist, physical therapist, speech
				  pathologist, physician, and nurse's aide among others.
"Vocational assessment"
means the employment
				  service evaluation, whether standardized procedures are employed, that:
(A) identifies the service recipient's unique preferences,
				  strengths, and needs;
(B) evaluates work skills and work behaviors;
(C) is supplemented by personal interviews and behavioral
				  observations; and
(D) incorporates information that addresses the service
				  recipient's:
(i) medical;
(ii) physical;
(iii) psychological;
(iv) social;
(v) cultural;
(vi) educational goals and objectives; and
(vii) present and future employment options.
"Volunteer guardian"
means a person unrelated to
				  the service recipient who:
(A) serves as guardian for the service recipient and is
				  trained and certified by the volunteer guardianship agency; and
(B) is appointed by and responsible to the court to ensure
				  essential requirements for the health and safety of the service recipient are
				  met.
"Ward"
means a person who has a court-appointed
				  guardian.
Amended at 8 Ok Reg
				  2163, eff 5-13-91 (emergency); Amended at 9 Ok Reg 1549, eff 4-27-92; Amended
				  at 11 Ok Reg 177, eff 10-11-93 (emergency); Amended at 11 Ok Reg 2303, eff
				  5-26-94; Amended at 12 Ok Reg 409, eff 11-17-94 (emergency); Amended at 12 Ok
				  Reg 1761, eff 6-12-95; Amended at 12 Ok Reg 2491, eff 6-26-95; Amended at 13 Ok
				  Reg 1555, eff 4-2-96 (emergency); Amended at 14 Ok Reg 1399, eff 5-12-97;
				  Amended at 14 Ok Reg 3600, eff 7-25-97 (emergency); Amended at 15 Ok Reg 948,
				  eff 1-1-98 (emergency); Amended at 15 Ok Reg 1666, eff 5-11-98; Amended at 16
				  Ok Reg 2115, eff 5-20-98 (emergency); Amended at 16 Ok Reg 2915, eff 7-12-99;
				  Amended at 20 Ok Reg 97, eff 10-16-02 (emergency); Amended at 20 Ok Reg 936,
				  eff 6-1-03; Amended at 23 Ok Reg 1026, eff 5-11-06; Amended at 24 Ok Reg 1046,
				  eff 5-11-07; Amended at 27 Ok Reg 838, eff
				  7-1-10