Regulatory Review of Adult Day Services: Final Report - Section 2. Oklahoma

08/26/2005

Overview

To operate an adult day care center in Oklahoma, the center provider must possess a current, valid license issued pursuant to the Adult Day Care Act. The licensing standards are promulgated, as provided for by the Adult Day Care Act (Title 63 O.S. Section 1-870 et seq.), to establish criteria for issuance or renewal of an adult day care center license. Oklahoma Medicaid Aged & Disabled Waiver and State Plan providers are required to have the applicable state licenses and must have a Medicaid contract with The Oklahoma Health Care Authority.

Licensure and Certification Requirements

Licensure and Certification Requirements
Licensure Only  ☒ 
Certification Only  ☐ 
Both Required  ☐ 
Other  ☐ 

Definitions

Adult day care center or center means a facility that provides basic day care services to unrelated impaired adults for more than 4 hours in a 24-hour period. A center shall be a distinct entity, either freestanding or a separate program of a larger organization. A center shall have a separately verifiable staff, space, budget, and participant record system. The terms adult day care center or center shall not include retirement centers and senior citizen centers.

Basic day care services means supervised health, social supportive, and recreational services in a structured daytime program that serves functionally impaired adults who cannot take care of themselves and who continues to live in their own homes, usually with the aid of family caregivers.

Parameters for Who Can Be Served

No parameters specified except that provider may discharge participants whose continued attendance would infringe on the safety or well being of other participants or staff.

Inspection and Monitoring

Inspection and Monitoring
Yes  ☒ 
No  ☐ 

Licenses must be renewed annually. Licenses shall expire on July 31 of each year, provided an initial license shall expire 180 days after the date of issuance. The Department shall inspect each adult day care center to determine compliance with the Adult Day Care Act and rules and regulations promulgated thereto, at least annually and whenever it deems necessary. A notice of violation shall be sent to any adult day care center when violations are cited as a result of an inspection. The center shall have 10 days after receipt of the notice of violation in which to prepare and submit a plan of correction. The plan of correction shall include a fixed time period, not in excess of 30 calendar days, within which the violations are to be corrected.

Required and Optional Services

  Adult Day Care
Required Optional
Activities of Daily Living (ADL) Assistance  ☒   ☐ 
Health Education and Counseling  ☐   ☐ 
Health Monitoring/Health-Related Services  ☐   ☒ 
Medication Administration  ☐   ☒ 
Nursing Services  ☐   ☒ 
Physical Therapy, Occupational Therapy, or Speech Therapy  ☐   ☒ 
Skilled Nursing Services  ☐   ☐ 
Social Services  ☒   ☐ 
Transportation  ☐   ☒ 

Provisions Regarding Medications

Participants shall be encouraged to retain and administer their own medications while attending the adult day care program. Centers that administer medication shall have a registered nurse (RN), licensed practical nurse (LPN.), certified medication aide (CMA), or a medication administration technician (MAT) who has successfully completed a course of training in administration of medications approved by the Department. Monthly consultation by an RN or LPN shall be required for centers where medications are administered by a CMA or MAT.

Provisions for Groups with Special Needs

Provisions for Groups with Special Needs
Dementia  ☐ 
Mental Retardation/Developmental Disabilities  ☐ 
Other  ☐ 

Staffing Requirements

Type of staff. Each adult day care center shall have an adequate number of staff that are appropriately qualified and trained to provide the essential services of the center. Each adult day care center shall have the following positions: a director who shall have the authority and responsibility for managing and implementing the day care program; activity director; social services coordinator, or case manager; and a dietary supervisor. Centers that are a part of larger organization that provides food service to the center or centers that contract with an outside service for food service may employ a part-time dietary supervisor. Each center shall employ additional staff, such as nurses, therapists, consultants, drivers, etc., as needed. A nurse shall be a registered or a licensed vocation/practical nurse who is currently licensed by the State of Oklahoma and has experience working with the aging and chronically impaired adult.

Staffing ratios. There shall be provided a sufficient number of direct care staff on duty at all times to meet the needs of each participant. There shall be a minimum of one full-time equivalent direct care staff person for every eight participants who are present and one additional direct care staff person for a major portion of eight additional participants present. There shall be at least two responsible persons at the center when participants are present; one shall be a staff member.

Training Requirements

All staff, prior to performing job responsibilities, including non-direct care, direct care, and volunteers, shall be given a general orientation to the program; its policies; and its fire, safety, and emergency procedures. In-service training for each staff person shall be provided quarterly.

Relevant Medicaid Contracting Requirements for Adult Day Services Providers

Adult day health providers are eligible to be a Medicaid provider if they have a current Adult Day Services contract with the Department of Human Services/Aging Services. Providers must also meet the minimum qualifications specific to the particular services furnished as established by Oklahoma and federal law (e.g., adult day care licensing requirements) and additional minimum qualifications as specified in the ADvantage Program Provider Standards and ADvantage Program Provider Standards for Adult Day Health Care (specified below).

ADvantage Program (Waiver) Service Standards for Adult Day Health Care

Service definition. Services that are furnished 4 or more hours per day on a regularly scheduled basis for 1 or more days per week in an outpatient setting and that encompass both health and social services needed to ensure the optimal functioning of the consumer. Meals provided as part of these services shall not constitute a "full nutritional regimen" (three meals per day). Transportation between the consumer's place of residence and the adult day health center will be provided as a component of adult day health services.

Minimum provider qualifications. The facility shall have a current ADvantage Program certification and Oklahoma Medicaid contract to provide adult day health care services to ADvantage Program consumers. Facilities must meet all training and certification requirements set forth in State Regulation 56 O.S., Sec. 1-177 et seq. Direct care employees must have completed an ADvantage Program-approved training program that incorporates the agency's Service Delivery Principles and a Bill of Consumer Assurances.

Service enhancements to adult day health care include personal care and physical, occupational, speech/language, and/or respiratory therapy. Therapy services are provided by a licensed physical, occupational, respiratory, and/or speech therapist as specified by the physician's orders or by an appropriate certified therapy aide working under the direction of the licensed therapist.

Location of Licensing, Certification, or Other Requirements

  1. http://www.health.state.ok.us/program/condiv/605adult.pdf
  2. http://www.health.state.ok.us/program/condiv/605act.pdf

Citations

  1. Title 310 Oklahoma State Department of Health Chapter Section 605 Adult Day Care Centers. Oklahoma Administrative Code. [Codified 6/11/92]
  2. Adult Day Care Act. Title 63 of the Oklahoma Statutes Supplement Sections 1-870 et seq. [As amended 2000]

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