Oklahoma Medicaid Resources:

• State Medicaid Website: Oklahoma
• Oklahoma Developmental Disabilities Council Website
• Chapters of the Arc in Oklahoma

Oklahoma Medicaid Facts: From Kaiser Family Foundation Medicaid Fact Sheet (2009)

There are 104,400 people with disabilities covered by Medicaid in Oklahoma. Oklahoma spent $13,093 on each Medicaid recipient with a disability in 2007.

15% of all people covered by Medicaid in Oklahoma have a disability, which is the same percentage of people covered by Medicaid who have a disability nationally.

Oklahoma spends 41% of all the money it spends on Medicaid on services for people with disabilities, which is also almost the same as the national percentage of Medicaid spending on these services (42%).

SoonerCare:

This program provides a wide variety of medical services to children and adults with disabilities. It does not cover people living in nursing or intermediate care facilities, people eligible for Medicare, or people participating in an HCBS waiver.

• Community: transportation
• Health: dental, disease management, durable medical equipment, early and periodic screening, diagnosis and treatment, family planning, hearing, immunization, hospital, mental health, substance abuse treatment, laboratory, occupational therapy, institutional costs, pharmacy, physical therapy, physician services, podiatry, skilled nursing facilities, speech therapy, vision, x-ray
• Home: home health care
• Social Services: case management

SoonerRide:

This is a non-emergency transportation program that helps provide transportation to and from regular doctor’s appointments and other medical errands. Some people who are eligible for Medicare will not qualify for this program. People participating in the HCBS waiver will not qualify for this program.

• Community: transportation

Program of All-Inclusive Care for the Elderly (PACE):

PACE programs are designed for people 55 and older who need nursing care, which includes many people with disabilities. These programs provide integrated care and support including a high level of preventive care. PACE programs must provide all services otherwise included in a person’s Medicaid or Medicare benefit, as well as all other services deemed medically necessary.

Ages: 55 and older

Level of Care: nursing

Restrictions: you must live close enough to a PACE center to be eligible.

• Community: day care, health-related transportation
• Health: primary and specialty care, nursing, physical therapy, occupational therapy, speech therapy, recreation therapy, prescription drugs
• Home: home care, home and environmental modifications
• Social Services: case management

Community Waiver:

The community waiver provides services to people with intellectual and developmental disabilities who do not want to live in intermediate care facilities or nursing homes. It covers people who are eligible for SoonerCare and live at home.

Ages: 3 and older

• Health: assistive technology services, reader services, assistive technology assessments, training in the use of assistive technology, and repair.
• Social Services: sign language interpretation

Homeward Bound waiver:

This waiver serves adults with intellectual and developmental disabilities and are members of the plaintiff class in the Homeward Bound vs. Hissom Memorial Center lawsuit (see your state Medicaid agency for more information on this).

Ages: 18 and older

• Community: transportation
• Health: assistive technology, audiology, dental, habilitation, nutrition, occupational therapy, physical therapy, physician services, prescription drugs, psychological services, medical supplies, speech therapy, intensive personal supports
• Home: companion services, home modification, daily living supports, family counseling and training, group housing, home health care, homemaker services, respite care, foster care
• Work: prevocational services, supported employment

In-Home Supports Waiver for Adults:

This waiver covers people with intellectual and developmental disabilities. Services can be provided in the home or community so that individuals do not have to move into an intermediate care facility.

Ages: 3 and over

Level of Care: intermediate

• Health: assessments and evaluations for assistive technology, maintenance and repairs of assistive devices, case management, construction of assistive devices and supporting software
• Home: training for individuals and family
• Social Services: advocacy, information and referrals

Medically Fragile waiver:

This waiver is targeted at physically disabled adults who would require institutional care if their needs were not met. Applicants have a chronic condition that requires frequent medical help, and be technology-dependent.

Ages: 19 and older

Option for Self-Directed Care: This program allows patients to have some control over their services.

• Community: adult day care
• Health: specialized medical equipment and supplies, physical therapy, occupational therapy, speech therapy, respiratory therapy, skilled nursing, hospice care, some prescription drugs, personal emergency response systems
• Home: respite, environmental modifications, home delivered meals, personal care
• Social Services: case management

My Life My Choice Program:

This waiver covers people with physical disabilities.

Level of Care: nursing

Option for Self-Direction: This waiver allows the person with the disability to make choices about his or her own care.

• Community: adult day care, transportation
• Health: assistive technology, audiology, dental services, hospice care, nutritional counseling, prescription drugs, personal emergency response systems, psychiatric and psychologist services, skilled nursing, private duty nursing, specialized medical equipment and supplies, occupational therapy, physical therapy, speech therapy, vision services
• Home: environmental adaptations, family counseling and training, home delivered meals, personal care, respite
• Social Services: case management, independent living skills training