Okla. Admin. Code § 340:100-3-4

Current through Vol. 42, No. 4, November 1, 2024

Section 340:100-3-4 - Service recipient personal funds

(a)General information. Each service recipient receiving services from Developmental Disabilities Services (DDS) is ensured access to his or her personal funds.

(1) Personal funds include income from all sources, earned or unearned, and assets.

(A) Income is money received in the current month.

(B) Any income not used to meet the service recipient's needs during the current month is a resource or asset of the service recipient in the following month(s).

(2) Services do not include the provision of room and board or personal spending. Each service recipient is responsible for meeting his or her room and board and personal spending needs including, but not limited to:

(A) healthcare;

(B) medications and co-pays not provided by Medicare, Medicaid (SoonerCare) or other health insurance;

(C) legal fees;

(D) vacation costs;

(E) recreation and social expenses;

(F) educational expenses;

(G) clothing; and

(H) furniture or household items.

(3) After the service recipient's day-to-day needs for food and shelter are met, personal funds may be used for the service recipient's needs, such as recreation, clothing, and other expenses. The provider agency staff and DDS Personal Support Team (Team) members work with the service recipient to ensure all needs are met.

(b)Prohibited transactions.

(1) Provider agency and DDS employees are prohibited from engaging in any financial transaction with a service recipient, including:

(A) giving gifts to a service recipient with a cumulative annual value of more than $100;

(B) accepting gifts from a service recipient with a cumulative annual value of more than $20;

(C) selling, purchasing, leasing, or trading any item except:

(i) as part of an established business in which fair market value is received; or

(ii) when approved in advance and in writing by the Team;

(D) borrowing personal funds or any item of value from the service recipient; and

(E) loaning funds to a service recipient, except:

(i) small amounts, such as money for a meal or a recreational activity, for periods of time less than 24 hours; or

(ii) as part of a program authorized in advance and in writing by the Team.

(2) Except for client trust accounts managed, per Oklahoma Administrative Code(OAC) 340:2-11-86, DDS employees are prohibited from assisting service recipients in conducting financial transactions or being listed on a service recipient's bank account; although case managers may monitor service recipient expenditures through financial record reviews.

(c)Living expenses. The provider agency:

(1) may lend funds to a service recipient to cover the service recipient's living expenses in expectation that funds will be available in the future enabling the service recipient to repay the loan; and

(2) must submit ongoing written reports to the Team regarding the status of the service recipient's financial condition of the loan and repayment.

(d)Protection of personal funds.

(1) Per OAC 340:100-3-1.2 each service recipient, when not in conflict with a guardianship order or representative payee agreement, has the right to:

(A) manage his or her financial affairs;

(B) be taught to manage his or her financial affairs;

(C) receive assistance in managing his or her financial affairs; and

(D) access all financial records regarding his or her personal funds.

(2) When a provider agency serves as representative payee, or when provider agency staff provides assistance in managing, or have access to personal funds for service recipients receiving community residential supports or group home services:

(A) the provider agency retains, safeguards, and accounts for the service recipient's personal funds when determined necessary by the service recipient's Team and as authorized by the service recipient, applicable guardian, or when the provider agency is the representative payee; and

(B) spending programs may be implemented on an individual basis, provided they are requested by the service recipient, guardian, or parent of a minor service recipient and reviewed by the service recipient's Team. A portion of the service recipient's funds may be designated for personal use when the exact amount of the spending program is documented in the service recipient's Individual Plan (Plan). A spending program consists of a fixed amount of money regularly given to the service recipient to spend as he or she chooses.

(3) Provider agency staff who have access to, or assist the service recipient with personal funds, ensures:

(A) the service recipient's personal funds are not co-mingled with provider agency funds;

(B) a separate financial record is maintained for each service recipient including receipts for all expenditures that are:

(i) more than $5; and

(ii) made with provider agency staff involvement;

(C) a written accounting of the service recipient's personal funds is maintained;

(D) a summary of financial transactions is available to the service recipient, guardian, DDS case manager, and the Office of Client Advocacy (OCA) advocate, when involved:

(i) monthly; and

(ii) when the service recipient ceases receiving service from the provider agency;

(E) copies of the written accounting and summary of financial transactions are provided to the service recipient, guardian, case manager upon request, and OCA advocate when involved;

(F) the service recipient's personal funds account is reconciled at least monthly by provider agency staff who does not have authority to disburse funds from, or responsibility to, deposit funds to the account;

(G) documentation is maintained to support all transactions involving the service recipient's personal funds that are not independently controlled by the service recipient;

(H) the service recipient's income is deposited to the service recipient's personal account within seven-calendar days of receipt;

(I) when the service recipient's income is held in an interest bearing account, the interest accrues to the service recipient;

(J) any personal cash not in the service recipient's possession is properly protected against theft;

(K) the service recipient receives requested funds within one banking day of request;

(L) the service recipient, minor service recipient's parent, guardian, or representative payee, as applicable, and DDS case manager are advised of eligibility requirements when the service recipient's account accumulates $1100; unless the Plan includes specific provisions to maintain Medicaid (SoonerCare) eligibility;

(M) the service recipient's personal funds are not used to supplement service rates or to purchase items that are part of the services that the service recipient is currently authorized to receive;

(N) prior to receiving services from a provider agency, a written agreement is executed between the service recipient or guardian as applicable, and provider agency. Copies of the agreement are provided to each party and filed in the service recipient's record. The agreement includes the:

(i) provider agency's responsibilities to the service recipient in handling his or her personal funds;

(ii) service recipient's fiscal responsibilities; and

(iii) services for which the service recipient's personal funds must be used;

(O) all requested financial information necessary for the maintenance of the service recipient's financial eligibility is provided in a timely manner to Oklahoma Human Services and the Social Security Administration;

(P) the service recipient receives choices in the selection of stores for the purchase of food, clothing, and personal items; and

(Q) except for minor repairs, the service recipient's personal funds are not used to make permanent modifications to a home not owned by the service recipient.

(4) For service recipients not receiving community residential supports or group home services that do not meet the criteria established in (2) of this subsection; the Team discusses and documents the party responsible for maintaining and planning for continued participation in Medicaid (SoonerCare) and other benefit programs for which the service recipient is eligible.

(5) Allegations of exploitation must be reported in accordance with OAC 340:2-3-33. When a provider agency is a service recipient's representative payee, it must fulfill its duties per applicable federal regulations defining those duties.

(e)Team planning and assistance to manage personal funds. The Team may limit, but not totally deny a service recipient without a guardian access to or use of his or her personal funds only when a determination is made, per OAC 340:100-3-4, when the limitation is essential to prevent the service recipient from unreasonably or significantly dissipating his or her personal funds.

(1) The Team follows rules, per OAC 340:100-3-1.2.

(2) Justification for limiting access to and use of personal funds is documented in the service recipient's Plan. The Team develops a Plan to remove the restriction and includes specific dates to review the Plan.

(3) The Team ensures the service recipient is afforded due process prior to implementation of any financial restrictions.

(4) When determining whether to limit a service recipient's access to personal funds, the Team addresses if the service recipient:

(A) recognizes currency, coins, and values of such;

(B) does not lose money regularly;

(C) does not leave money unattended;

(D) does not give money away;

(E) has the ability to make change or knows when to wait for change;

(F) shows responsible behavior regarding his or her money, such as paying bills on time, writing checks only when he or she has sufficient funds, or saving or planning for special items;

(G) understands his or her responsibility to pay room and board expenses; and

(H) understands budgeting so money will last all month.

(f)Payee responsibilities. In addition to the requirements of OAC 340:100-3-4, persons or organizations serving as representative payee for a service recipient's personal funds are responsible for obtaining a copy of the dispersing agency's regulations regarding representative payee responsibilities and adhering to the dispersing agency's requirements.

(1) The service recipient, guardian, or representative payee is responsible for paying for room and board from the service recipient's income.

(2) A provider agency serving as payee uses direct deposit of benefits, when available.

Okla. Admin. Code § 340:100-3-4

Amended at 8 Ok Reg 2163, eff 5-13-91 (emergency); Amended at 9 Ok Reg 1549, eff 4-27-92; Amended at 23 Ok Reg 1026, eff 5-11-06; Amended at 26 Ok Reg 922, eff 5-15-09; Amended at 27 Ok Reg 838, eff 7-1-10; Amended at 29 Ok Reg 822, eff 7-1-12

Amended by Oklahoma Register, Volume 38, Issue 24, September 1, 2021, eff. 9/15/2021