Home and Community-Based Services (HCBS) Waivers
SoonerCare operates five programs to provide home and community care as a cost-effective alternative to institutionalization. These are known as "waiver" programs because standard program requirements are waived to allow the program to operate. The waiver programs provide some services that otherwise are not covered under Medicaid (SoonerCare in Oklahoma).
- Community waiver: Serves individuals who are 3 years of age or older who have mental retardation and it serves certain persons with related conditions who would otherwise require placement in an intermediate care facility for the mentally retarded (ICF/MR).
- In-home supports waiver for adults: Serves the needs of individuals 18 years of age or older with mental retardation who would otherwise require placement in an ICF/MR.
- In-home supports waiver for children: Serves the needs of children ages 3 through 17 years with mental retardation who would otherwise require placement in an ICF/MR.
- ADvantage waiver: Serves the frail elderly individuals age 65 or older and adult Oklahomans age 21 and older with physical disabilities who would otherwise require placement in a nursing facility.
- Homeward bound waiver: Serves individuals who are 18 years of age or older who have mental retardation and it serves certain persons with related conditions who: (1) would otherwise require placement in an ICF/MR; and (2) have been certified by the U.S. District Court for the Northern District of Oklahoma as being members of the Plaintiff class in Homeward Bound et al. v. The Hissom Memorial Center et al., Case No. 85-C-437-e.
Depending on the needs identified in each individual's plan of care and other factors, SoonerCare will pay for the following services:
- Adult day health or adult day services;
- Assistive technology;
- Case management;
- Comprehensive home care;
- Environmental accessibility (architectural) modifications;
- Habilitation services;
- Home delivered meals;
- Institution transition services;
- Personal care and/or advance supportive/restorative assistance;
- Personal emergency response system (PERS);
- Prescription drugs;
- Respite care;
- Skilled nursing;
- Specialized medical equipment and supplies;