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Oklahoma - Adult Companion Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

In Oklahoma, Agency Companion Services are authorized under the Community Waiver and In-Home Supports Waiver (IHSW) for Adults, jointly administered by the Oklahoma Department of Human Services (OKDHS) Developmental Disabilities Services (DDS) and the Oklahoma Health Care Authority (OHCA). Providers must first submit a comprehensive operational application directly to the DDS State Office and demonstrate a minimum of $100,000 in liquid assets or lines of credit before they can execute a SoonerCare provider agreement.

This service provides non-medical supervision, socialization, and daily living assistance to adults with intellectual or developmental disabilities, enabling them to remain safely in community settings. Approval requires passing a rigorous financial solvency review by DDS, securing specific commercial liability insurance minimums, and completing the OHCA SoonerCare enrollment process.

1. Service Definition and Scope

Oklahoma defines this service under its HCBS waivers as Agency Companion Services, which provide non-medical care, supervision, and socialization to adults with intellectual disabilities. The service is designed to ensure the health and welfare of the member while fostering community integration.

Services are delivered in the community or the member's home and are strictly non-medical. Providers must adhere to person-centered planning principles outlined in the member's annual plan of care.

2. Regulatory and Oversight Agencies

The Oklahoma Department of Human Services (OKDHS) Developmental Disabilities Services (DDS) acts as the primary operating agency, responsible for reviewing provider applications, conducting orientations, and monitoring quality assurance. The Oklahoma Health Care Authority (OHCA) serves as the single state Medicaid agency, handling final provider enrollment and claims processing.

Providers must maintain compliance with both DDS operational rules and OHCA SoonerCare billing regulations.

3. Gatekeeping Prerequisites: Who Can Even Apply

Oklahoma imposes strict financial and operational prerequisites before an agency can even apply to provide Agency Companion Services. Per OAC 340:100-3-16, applicants must submit a detailed operational plan to the DDS State Office demonstrating financial solvency and service capacity.

The most rigid structural precondition is the financial asset requirement. Applicants must provide evidence of sufficient liquid assets or lines of credit in the agency's name indicating the greater of $100,000 or three times the average monthly-budgeted expenses.

4. Licensure and Certification Requirements

Oklahoma does not issue a traditional "facility license" for Agency Companion Services; instead, providers achieve certification through the OKDHS DDS application and approval process. This certification is codified under OAC 340:100-3-16.

The certification process requires the submission of a comprehensive narrative detailing the agency's service philosophy, quality assurance program, organizational structure, and personnel policies.

5. Medicaid Provider Enrollment

Once approved by OKDHS DDS, providers must complete the Medicaid enrollment process through the OHCA SoonerCare Provider Portal. Providers must disclose ownership and control information per 42 C.F.R. § 455.104.

OHCA provider enrollment contracts representatives may conduct on-site screening visits without prior notification to verify facility and business operations.

6. Staffing, Training and Background Checks

Agency Companion Services providers must adhere to strict personnel qualifications and background check requirements. Key personnel and direct care staff must undergo comprehensive screenings before providing services.

Training requirements are mandated by DHS per OAC 340:100-3-38, and providers must attest to compliance during the application process.

7. Documentation, Policies and Records

Providers must maintain extensive documentation to comply with both DDS quality assurance standards and OHCA billing rules. Records must support the delivery of services as outlined in the member's plan of care.

Agencies must have written policies covering suspected maltreatment reporting, protection of personal funds, and health and wellness maintenance.

8. Billing, Rates and Claims

Billing for Agency Companion Services is processed through the OHCA SoonerCare MMIS system. Providers must ensure that all claims align with the authorized units in the member's plan of care.

Rates are established by OHCA in conjunction with OKDHS and are published in the SoonerCare fee schedules. Providers must attend OHCA provider-billing training.

9. Approval Sequence and Timeline

The approval process is sequential, beginning with the OKDHS DDS State Office and concluding with OHCA SoonerCare enrollment. The timeline depends heavily on the completeness of the initial operational plan and financial documentation.

Once the DDS application is approved, the OHCA online enrollment typically takes 15 to 40 business days to process.

10. Common Denials and Survey Findings

Applications are frequently delayed or denied due to insufficient proof of financial solvency or incomplete operational narratives. DDS strictly enforces the $100,000 liquid asset requirement.

During post-enrollment surveys, common findings include failure to maintain required insurance minimums, incomplete background checks, and inadequate documentation of service delivery.

11. Key Contacts and Resources

Prospective providers should utilize the official OKDHS and OHCA websites for the most current forms, fee schedules, and policy updates. The DDS State Office is the primary point of contact for initial application inquiries.

Technical assistance for the enrollment portal is available through the OHCA Provider Enrollment help desk.

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