Harmony Procedures – Financial Eligibility

ELDERS Procedures regarding Financial Eligibility

Harmony Procedures – Closures/Denials

ELDERS Procedures concerning Closures and Denials

Harmony Procedures – Approvals & Certifications

Harmony Procedures for Approval of Services

Differences between Personal Care & ADvantage Waivers

Key Differences between Personal Care and ADvantage Waivers.

Alerts to Social Services Specialist (SSS) Requesting Financial Eligibility

Examples of standardized wording that is sent to Social Services Specialists and Supervisor when the medical decision has been made on an application in ELDERS.

Annuities

The following are key policy points concerning the Treatment of annuities purchased on or after February 8, 2006.     317:35-5-41.8(c)  The purchase of an annuity shall be treated as the disposal of an asset for less than fair market value unless the Oklahoma Health Care Authority is named as the remainder beneficiary either: in the first […]

ADvantage and Other Waivers with SSP (Couple)

Although each spouse’s income is considered separately when determining financial eligibility for long-term care, there’s no provision in SSP policy to allow the Community Spouse to become eligibile for SSP when the couple’s combined income is over the ABD couple standard. When one or both is approved for ADvantage or other HCBW all income is […]

ADvantage Waiver Applications Processing Certifications

Updating Authorization to Financial “F” Status If the AFS worker determines the client to be financially eligible, the ADvantage authroization needs to be updated from “A” application to “F” financially eligible. DO NOT CODE AN AUTHORIZATION WITH “F” UNTIL 100%” CERTAIN OF FINANCIAL ELIGIBILITY In IMS, type EKL case number, and press enter. Tab down […]

Penalty Period

Penalty or disqualification period – the length of time an individual or household is not eligible or the benefit is reduced.  Depending on the program, the penalty may be removed as soon as the individual cooperates or it may be assigned for a certain time frame.  Policy regarding this term is located at: Child Care […]

Household Composition

Household composition – includes every household member that must be included in the benefit and/or whose income and/or resources are considered when determining eligibility.  Policy regarding this term is located at: Child Care: 340:40-7-6. Household composition and income consideration. 340:40-7-9. Mandatory pursuit of child support and other potential income; and 340:40-9-2. Case changes. Public Assistance […]