Okla. Admin. Code § 317:40-5-40

Current through Vol. 42, No. 3, October 15, 2024

Section 317:40-5-40 - Home profile process

(a)Applicability. This Section establishes procedures for 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 completes pre-screening activities that include, but are not limited to:

(1) Facts description;

(2) An explanation of:

(A) Home and Community-Based Services (HCBS) program's guiding principles;

(B) The home profile process;

(C) Basic provider qualifications;

(D) Health, safety, and environmental issues; and

(E) Training required per Oklahoma Administrative Code (OAC) 340:100-3-38; and

(3) Gathering relevant information about the applicant and applicant's family, including household members, addresses, contact information, and motivation to provide services; and

(4) An explanation of the background investigation that is conducted on the applicant and on 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, Sex Offender Registry, Mary Rippy Violent Offender Registries, and Nurse Aide and Non-technical Services Worker Registry;

(ii) Federal Bureau of Investigation (FBI) national criminal history search, which is based on the applicant's fingerprints and any adult household member's fingerprints; except when an exception is necessary as outlined in (I) through (II) of this subsection.

(I) When fingerprints are low quality, as determined by OSBI, FBI, or both, and make it impossible for the national crime information databases to provide results. In this instance, a name-based search, state, national, or both, may be authorized.

(II) When the DDS State Office residential staff requests an exception from an individual who has a severe physical condition precluding the individual from being fingerprinted, a name-based search, state, national, or both may be authorized.

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

(iv) A search of all OKDHS records, including Child Welfare Services records, Community Services Worker Registry, and Restricted 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 (5) years. A home is not approved without the results out-of-state child abuse and neglect registry check for all adult household members living in the home. When a child abuse and neglect registry is not maintained in the applicable state, an information request is made to the applicable state; and

(vi) A search of Juvenile Justice Information System records for any child older than thirteen (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(5) 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;

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

(1) The applicant provides required information for home profile completion.

(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 the applicant provides, designated DDS staff documents the completed reference check results.

(5) Designated DDS staff, through interviews, visits, and phone calls, gathers information required to complete the home profile.

(6) DDS staff review policies and responsibility areas with the applicant and DDS staff and the applicant acknowledge the review in writing.

(7) The DDS area residential services programs manager sends 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 completion dates 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 are comfortable, clean, and in good repair, and the grounds are maintained. There is no accumulating garbage, debris, 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;

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

(iv) Allow adequate space for the occupants' recreational and social needs.

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

(i) Guards and rails on stairways;

(ii) Wheelchair ramps;

(iii) Widened doorways;

(iv) Grab bars;

(v) Appropriate lifting equipment as needed for safe transfers;

(vi) Access to safe bathing and toileting;

(vii) Adequate lighting;

(viii) Anti-scald devices; and

(ix) 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 are equipped with sufficient safety barriers or devices designed to prevent accidental injury or unsupervised access.

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

(2)Sanitation.

(A) Sanitary facilities are 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 is in good working order.

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

(D) There is adequate control of insects and rodents, including doors and windows with ventilation screens in good repair.

(E) Universal precautions for infection control are followed in the member's care. Hands and other skin surfaces are washed immediately and thoroughly when contaminated with blood or other body fluids.

(F) Laundry equipment, if in the home, is 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 is located near each toilet.

(ii) For members who are non-ambulatory or who have limited mobility, a toilet, shower and sink are provided on each floor wheretheir rooms are located.

(iii) There must be at least one (1) toilet, one (1) sink, and one (1) bathtub or shower for every six (6) household occupants, including the provider and family.

(4)Bedrooms. A bedroom:

(A) Has been constructed for that purpose when the home was built or remodeled under permit;

(B) Is provided for each member.

(i) The DDS are residential services program manager may make exceptions to allow members to share a bedroom when DDS determines sharing a bedroom is in the members' best interests.

(ii) A member must not share a bedroom with more than one (1) other member;

(iii) Minor members must not share bedrooms with an adult member. Exceptions may be approved by the DDS Area Field Administrator when (I) through (III) of this section are met. Additional exceptions to these rules may be approved by the division director or designee:

(I) The minor is at least sixteen (16) years of age;

(II) The adult member does not present a risk of harm to the minor; and

(III) The members are sharing a room at the time the older member turns eighteen (18) years of age;

(C) Has two (2) means of egress and a minimum of eighty (80) square feet of usable floor space for each member or one-hundred and twenty (120) square feet for two (2) members. The home's provider, family members, or other occupants must not sleep in areas designated as common use living areas, nor share bedrooms with members.

(i) Exceptions to allow non-members and members to share a bedroom may be approved by the Division Director or designee when:

(I) The member agrees and the agreement is documented in the IP annually;

(II) Neither the member nor the non-member are determined to be at risk or harm; and

(III) Neither the member not the non-member are eighteen (18) years are older; and

(ii) Consideration is given to age, gender, support needs, behavioral health needs, number of restrooms available in the home, and total household square footage.

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

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

(F) Includes an individual bed for each member consisting of a frame, box spring when other support is not included in the frame, and a mattress at least thirty-six (36) inches wide, unless a specialized bed is required to meet identified needs. Cots, roll away beds, couches, futons, air mattresses, and folding beds are not used for members. The division director or designee may make exceptions for temporary respite when the Personal Support Team (Team) is able to demonstrate that privacy can be maintained.

(i) Each bed has clean bedding in good condition consisting of a mattress pad, bedspread, two (2) sheets, pillow, pillowcase, and blankets adequate for the weather.

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

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

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

(i) Members are 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 are in good condition and allow privacy for members;

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

(I) Is in close enough proximity to the provider to alert the provider to nighttime needs or emergencies, or be equipped with an alert system.

(5)Food.

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

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

(C) Utensils, dishes, and glassware are 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) There is a working phone in the home that is available and accessible for the member's use, including during periods of time when the member is home alone.

(B) Phone numbers to the home and providers are 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, are installed in accordance with all applicable fire and life safety codes. Such equipment is used and maintained properly and kept in good repair.

(i) Fireplaces are required to have protective glass screens or metal mesh curtains attached at top and bottom.

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

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

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

(8)Emergencies.

(A) Working smoke detectors are provided in each bedroom, adjacent hallways, and in two (2) story homes, at the top of each stairway. Alarms are equipped with a device that has a low battery warning when battery operated.

(B) At least one (1) working fire extinguisher is in a readily accessible location.

(C) A working flashlight is 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 the home's written evacuation plan evacuation training 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 DDS review;

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

(vi) Is responsible for re-establishing a residence if the home becomes uninhabitable.

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

(F) The home's address is clearly visible from the street.

(9)Special hazards.

(A) Firearms and other dangerous weapons are stored in a locked permanent enclosure. Ammunition is 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 are safely and properly stored in original, properly labeled containers.

(C) Cleaning supplies, medical sharps containers, poisons, and insecticides are 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 meet local and state requirements for accessibility, safe transit, licensing, inspection, insurance, and capacity.

(B) Drivers have valid and appropriate driver licenses.

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

(12)Pets. Sanitation for household pets and other domestic animals is required to prevent health hazards.

(A) For all household pets, proof of rabies and/or other vaccinations as required by a licensed veterinarian is maintained on the premises.

(B) Pets not confined in enclosures must not jeopardize the safety of residents and visitors to the home.

(C) Animals and pets are in good health, do not show evidence of carrying disease, and do not present a threat to member health, safety, or welfare.

(D) Appropriate supervision is required when the member is in the presence of household animals and pets.

(E) If an animal or pet bites a member, the provider ensures the member receives medical treatment when appropriate, contacts designated DDS staff as soon as the member is safe, and completes an incident report per OAC 340:100-3-34.

(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 relief use; and

(2) Assessment and recommendation. DDS staff:

(A) Evaluates the applicant's ability to provide services;

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

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

(ii) Demonstrates the skills to meet the member's needs;

(iii) Expresses an understanding of the commitment required as a service provider;

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

(v) Demonstrates 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) Only approves applicants who can fulfill service provider expectations; and

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

(i) A basis for the denial decision;

(ii) An effective date for determining the applicant does not meet standards; and

(iii) Reasons for denying a request to be a provider. Reasons 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 applicant's age, health, or any other condition that impedes his or her ability to provide appropriate care for a member;

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

(V) The applicant's, other family member's or household member's 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) The applicant's failure to complete verifications in a timely manner as requested, or the applicant's provision of incomplete, inconsistent, or untruthful information;

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

(VIII) Confirmed abuse, neglect, or exploitation of any person;

(IX) Confidentiality breach;

(X) Applicant or provider involvement in criminal activity or criminal activity in the home;

(XI) Failures to complete training, per OAC 340:100-3-38;

(XII) Home's failure to meet standards per subsection (d) of this Section;

(XIII) Failure to follow applicable OKDHS or Oklahoma Health Care Authority (OHCA) rules;

(XIV) References who are guarded or have reservations in recommending the applicant; and

(XV) The applicant's failure to complete the application in a timely manner.

(E) Notifies the applicant in writing of the home profile's final approval or denial; and

(F) Completes a final written assessment when an application is canceled or withdrawn prior to the home profile's completion. The written assessment includes the:

(i) Reason the application was canceled or withdrawn;

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

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

(f)Unrelated habilitation training specialist (HTS) staff home. Designated DDS staff and provider agency staff work together to complete a home evaluation when the member lives with an unrelated HTS staff.

(1) The provider agency:

(A) Obtains pre-employment screening in compliance with OAC 340:100-3-39;

(B) Obtains background checks for all household residents in accordance with (b) (4) of this Section; and

(C) Assesses HTS fitness for work; and the

(2) Designated DDS staff:

(A) Assesses household members' appropriateness;

(B) Develops an evacuation plan;

(C) Reviews policy, procedures, and responsibilities with the HTS;

(D) Ensures pet vaccinations are current;

(E) Evaluates any other conditions that may affect the health or safety of a member's care; and

(F) Completes a home safety inspection initially and annually, then as needed.

(g)Evaluation frequency. Home profile evaluations are completed for an applicant's initial approval or denial. After an initial approval, a home profile review is conducted annually and as needed for compliance and continued approval. DDS area residential services staff conducts at least biannual home visits to SFC providers. The annual home profile review is a comprehensive review of the living arrangement, the provider's continued ability to meet standards, and the member's and home's needs 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 assesses 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, as an annual review;

(2) Includes a medical examination report completed a minimum of every three (3) years following the initial approval, unless medical circumstances warrant more frequent completion;

(3) Includes information from the DDS case manager, 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) Includes serviceareas where improvement is needed;

(6) Includes serviceareas 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 (5) years;

(9) When applicable, ensures written notification of continued provider approval to providers and agencies; and

(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 correction deadlines for the identified standards.

(h)Home profile denial. Reasons a home profile review may be denied include, but are not limited to, reasons stated in subsection (e) (2) (D) (iii) (I through XIII) of this Section and:

(1) Provider's failure to complete tasks related to problem resolution, as agreed, per OAC 340:100-3-27;

(2) Provider's failure to complete an action plan, as agreed, per OAC 317:40-5-63;

(3) Failure to provide for the service member's care and well-being;

(4) Failure or continued failure to implement the member's Individual Plan, per OAC 340:100-5-50 through 100-5-58;

(5) Failure to report changes in the household;

(6) Decline in the provider's health to the point he or she can no longer meet the service member's needs;

(7) Provider employment without prior DDS area residential services programs manager approval; or

(8) Domestic disputes that cause emotional distress to the member.

(i)Placement termination. When an existing placement is terminated for any reason:

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

(2) DDS staff ensures themember's and state property are removed promptly and appropriately by the member or his or her designee.

Okla. Admin. Code § 317:40-5-40

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 by Oklahoma Register, Volume 32, Issue 23, August 17, 2015, eff. 8/27/2015

Amended by Oklahoma Register, Volume 38, Issue 23, August 16, 2021, eff. 9/1/2021

Amended by Oklahoma Register, Volume 39, Issue 24, September 1, 2022, eff. 9/12/2022