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OHCA Policies and Rules

317:35-9-48.1. Determining ICF/IID institutional level of care for TEFRA children

[Revised 09-01-24]

In order to determine Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) level of care for Tax Equity and Fiscal Responsibility Act (TEFRA) children:

(1) The child must be age eighteen (18) years or younger and expected to meet the following criteria for at least thirty (30) days.

(A) Applicants under age three (3) must:

(i) Have a diagnosis of a developmental disability; and

(ii) Have been evaluated by the SoonerStart Early Intervention Program or other appropriate healthcare provider, and found to have severe functional deficiencies with findings of at least two (2) standard deviations in at least two (2) total domain areas.

(B) Applicants age three (3) years and older must:

(i) Have a diagnosis of intellectual disability or a developmental disability; and

(ii) Have received a psychological evaluation by a licensed psychologist, or school psychologist certified by the Oklahoma Department of Education (ODE) within the last twelve (12) months, certified psychometrist, psychological technician of a psychologist, or licensed behavioral health professional (LBHP). The evaluation must include intelligence testing that yields a full-scale intelligence quotient, as determined appropriate by the provider, and a full-scale functional or adaptive assessment that yields a composite functional age. Eligibility for TEFRA ICF/IID level of institutional care requires either an IQ of seventy (70) or less, or a full-scale functional assessment indicating a functional age composite that does not exceed fifty (50) percent of the child's chronological age. In no case shall eligibility be granted for a functional age greater than eight (8) years.

(2) Psychological evaluations are required for children who are approved for TEFRA under ICF/IID level of care. Children under evaluation, including both intelligence testing and adaptive/functional assessment, by a licensed psychologist, school psychologist certified by the ODE, certified psychometrist, psychological technician of a psychologist, or licensed behavioral health professional (LBHP) at application, at two (2) years (but no later than three (3) years) after the initial psychological evaluation, and at two (2) years (but no later than three (3) years) after the second psychological evaluation and, if medically necessary, thereafter, to ascertain continued eligibility for TEFRA under the ICF/IID level of institutional care.

Disclaimer. The OHCA rules found on this Web site are unofficial. The official rules are published by the Oklahoma Secretary of State Office of Administrative Rules as Title 317 of the Oklahoma Administrative Code. To order an official copy of these rules, contact the Office of Administrative Rules at (405) 521-4911.