OKLAHOMA
Although budget shortfalls caused reductions in spending for many long-term care services in Oklahoma in 2002, the state moved forward with a long-term care planning effort that will identify gaps in existing programs and services and recommend options for expanding home and community-based options for people with disabilities. The Legislature also allowed flexible staff scheduling for nursing homes that meet certain staffing standards and addressed elder abuse issues.
The Budget
Faced with severe budget cuts, the Oklahoma Health Care Authority cut services and benefits to thousands of Medicaid recipients for FY 2003. The cuts, which began January 1, 2003, involved home health services and nursing home reimbursements, among others. Additional cuts included the elimination of payments for behavioral and psychological health services in nursing homes. An annual cost-of-living rate adjustment for nursing homes (24 cents per resident per day) was delayed.
Planning and Reports
Lawmakers established the Olmstead Strategic Planning Work Group in 2002 to develop a comprehensive strategic plan for providing services to people with disabilities in the most integrated setting. The lead state agencies for the effort are the Office of the Attorney General, the Department of Human Services, the Health Care Authority and the Department of Mental Health. A number of other state agencies also are involved, as are private organizations such as the Centers for Independent Living, the Developmental Disability Council, the Brain Injury Association, and the Oklahoma Mental Health Consumer Council.
The work group will review the state's service delivery system for services for people with disabilities; review existing statutes, policies, programs and funding sources that affect these populations; and identify gaps and barriers in programs and services. The committee is expected to report its findings and recommendations to the Legislature and governor by July 15, 2003, and each July 15 thereafter, as necessary, until completion of the strategic plan.
Work Force
In 2002, the Legislature amended nursing home staffing standards for direct care and 24-hour staffing levels. The bill allows nursing homes and intermediate care facilities to vary the starting times for their eight-hour shifts by one hour before or after the times designated in existing statute without overlapping shifts. Facilities that have complied with shift-based staffing ratios for at least three months are allowed to implement flexible staff scheduling. With the flexible schedule, facilities must maintain a direct care staff-to-resident ratio of 2.86 hours per day per occupied bed; one direct care staff person on duty for every 16 residents at all times; and at least two direct care staff on duty and awake at all times.
Elder Abuse
For the second year in a row, the Legislature addressed the issue of elder abuse. Lawmakers authorized the court to appoint a guardian ad litem for a vulnerable adult when a petition is filed alleging that the person has been abused, neglected, exploited or disabled.
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