PERSONAL CARE SERVICES PROVIDER IN OKLAHOMA

DELIVERING DAILY LIVING SUPPORT TO PROMOTE INDEPENDENCE, DIGNITY, AND COMMUNITY LIVING

Personal Care Services in Oklahoma provide non-medical assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs) to individuals with disabilities, chronic illnesses, or aging-related limitations. These services help individuals maintain independence in their homes and prevent unnecessary institutionalization. Personal Care Services are authorized under Oklahoma Medicaid’s Home and Community-Based Services (HCBS) programs and State Plan Personal Care.

1. GOVERNING AGENCIES

Agency: Oklahoma Health Care Authority (OHCA)

Role: Administers Medicaid, oversees personal care provider enrollment, service authorization, and billing.

Agency: Oklahoma Department of Human Services (OKDHS), Aging Services Division

Role: Coordinates personal care services for older adults and adults with disabilities.

Agency: Oklahoma Department of Rehabilitation Services (DRS)**

Role: May provide vocational and independent living supports that complement personal care services.

Agency: Centers for Medicare & Medicaid Services (CMS)**

Role: Provides federal oversight and ensures that personal care services meet HCBS and state plan Medicaid standards.

2. PERSONAL CARE SERVICES OVERVIEW

Personal Care Services help eligible individuals with routine daily activities needed to live safely in their homes and communities. Services must be based on assessed need and documented in a person-centered care plan.

Approved providers may deliver:

• ADL Assistance: Bathing, grooming, dressing, toileting, eating, and mobility.

• IADL Support: Meal preparation, light housekeeping, laundry, and shopping.

• Medication Assistance (Non-Skilled): Reminders or observing self-administration.

• Escort Services: Assistance with transportation to medical appointments or errands.

• Health Observation: Noting changes in behavior or health status and reporting to supervisors.

• Respite Care (when authorized): Temporary relief for family caregivers providing similar support.

• Documentation: Logging time, services delivered, and observations.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register the business with the Oklahoma Secretary of State.

• Obtain EIN from the IRS and NPI (Type 2).

• Enroll as a Personal Care provider with OHCA through the SoonerCare Provider Portal.

• Maintain general and professional liability insurance.

• Comply with state guidelines for home care agency licensure (if applicable).

• Develop policies for ADL support, supervision, HIPAA, safety, and documentation.

• Ensure aides and staff pass background checks, complete training, and meet certification requirements.

4. OKLAHOMA PROVIDER ENROLLMENT PROCESS

Initial Application:

• Complete provider enrollment via the OHCA Sooner

• Care Provider Portal under "Personal Care Services."

Documentation Submission:

• Submit business registration, insurance certificates, service policies, and staff credentials.

Program Readiness Review:

• OHCA and OKDHS review operational capacity, care protocols, and quality assurance measures.

Approval & Medicaid Billing Authorization:

• Once approved, providers are issued a Sooner

• Care billing number and may begin service delivery.

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License

• IRS EIN confirmation

• NPI confirmation

• Liability insurance

• Personal Care Services Policy & Procedure Manual including:

  • ADL and IADL task protocols

  • Staff credentialing, supervision, and in-service training

  • Documentation logs, shift notes, and Medicaid billing procedures

  • Participant rights and grievance resolution

  • HIPAA compliance and confidentiality safeguards

  • Emergency response procedures and incident reporting

  • Quality assurance and satisfaction monitoring

6. STAFFING REQUIREMENTS

Role: Personal Care Administrator

Requirements: Experience in home care program administration; knowledge of Medicaid compliance.

Role: Personal Care Aides (PCAs) / Home Health Aides

Requirements: Completion of state-approved personal care aide training (or CNA certification); CPR/First Aid preferred; background check clearance.

Role: Supervising Nurse (if required by plan of care)**

Requirements: Oklahoma RN license; oversees assessments, care plan implementation, and aide performance.

All staff must complete:

• HIPAA and participant rights training

• In-service training in ADLs, infection control, and communication

• Annual performance reviews and continuing education

• Documentation procedures and emergency protocols

7. MEDICAID WAIVER PROGRAMS

Personal Care Services are available under the following Oklahoma Medicaid programs:

• State Plan Personal Care (SoonerCare)

• ADvantage Waiver Program – for frail elders and adults with disabilities

• Medically Fragile Waiver – for individuals requiring high levels of care

• DDS Waivers – for individuals with intellectual or developmental disabilities

• Living Choice Program – for transitioning individuals from institutional to home settings

8. TIMELINE TO LAUNCH

Phase: Business Formation & Compliance Setup

Timeline: 1–2 months

Phase: Staff Hiring, Policy Development & Training

Timeline: 2–3 months

Phase: OHCA Enrollment & Program Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing Setup & Service Delivery

Timeline: 30–45 days

9. CONTACT INFORMATION

Oklahoma Health Care Authority (OHCA)

Website: https://oklahoma.gov/ohca

Oklahoma Department of Human Services (OKDHS) – Aging Services

Website: https://oklahoma.gov/okdhs/services/aging.html

Oklahoma Secretary of State

Website: https://www.sos.ok.gov

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — OKLAHOMA PERSONAL CARE SERVICES PROVIDER

WCG supports new agencies in launching compliant Personal Care Services across Oklahoma by providing:

Scope of Work:

• Business registration, Medicaid enrollment, and OHCA credentialing

• Policy and procedure manual development for ADL/IADL assistance

• Staff hiring tools, credentialing templates, and compliance tracking

• Medicaid billing setup and audit-ready documentation systems

• Branding, website development, and caregiver outreach materials

• Quality assurance programs for service delivery monitoring and client satisfaction

• Coordination support with OKDHS case managers and Sooner

• Care authorizations

Continue To Our Client Portal To Get Started

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.