I/DD Waivers in Oklahoma

All states: Medicaid disability services map

Oklahoma I/DD services at a glance

Last verified against state sources: 2026-10-23.

Who runs I/DD services in Oklahoma?

Developmental Disabilities Services (DDS), a division of Oklahoma Human Services, runs Oklahoma's I/DD waivers day to day. The Oklahoma Health Care Authority (OHCA) is the state Medicaid agency. It runs SoonerCare, Oklahoma's Medicaid program, and pays waiver providers. DDS case managers, who are state staff, coordinate each person's services.

• Oklahoma Human Services, Developmental Disabilities Services: operates the four 1915(c) waivers, handles intake and the waiting list, approves providers, licenses group homes and employs the case managers. DDS also runs state-funded services, such as Family Support Assistance and state-funded group homes, that sit outside Medicaid.
• Oklahoma Health Care Authority (OHCA): the Medicaid agency. It holds the SoonerCare provider agreements, sets rates and pays claims. Its Level of Care Evaluation Unit makes the first decision on whether a person meets the level of care the waivers require.
• Front door: people apply online through Oklahoma Human Services or by email to DDSintake@libertyhealth.com (405-500-1866). Liberty of Oklahoma, a DDS contractor, helps applicants gather eligibility documents and keeps in touch with people who are waiting.
• Case management: DDS case managers handle case management for all four waivers and lead the person-centered Individual Plan team.

What Medicaid waivers and programs serve people with I/DD in Oklahoma?

Oklahoma has four 1915(c) waivers for people with intellectual disabilities, all run by DDS. A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. As of August 31, 2026, DDS reported 8,522 people on the four waivers.

• Community Waiver (control number OK.0179): Oklahoma's first I/DD waiver, approved in 1988, and its largest (3,803 people). It serves people age 3 and older with intellectual disabilities or certain related conditions whose support needs are too high for the In-Home Supports Waivers. Services include group homes, agency companion (shared living), Daily Living Supports, specialized foster care, Extensive Residential Supports, Habilitation Training Specialist (HTS) in-home supports, Intensive Personal Supports, adult day services, prevocational services, supported employment, respite, nursing, therapies, dental, transportation and remote supports. The renewal approved effective July 1, 2026 sets capacity at 4,250 people in year 1 rising to 5,250 in year 5, and reserves 20 slots a year for people leaving an institution and 100 for crisis.
• Homeward Bound Waiver (control number OK.0399): a closed waiver for adults who are certified members of the class in the lawsuit Homeward Bound et al. v. The Hissom Memorial Center et al., plus certain long-term nursing facility residents. It offers residential, day, employment and in-home services similar to the Community Waiver and served 399 people as of August 31, 2026. Its renewal was also approved effective July 1, 2026.
• In-Home Supports Waiver for Adults (IHSW-A): a capped waiver created in 1999 for adults 18 and older who live in their own home, with family or friends, or in a DHS foster or group home. The annual limit is $36,143, plus up to $7,562.50 a year for added employment services. Services include HTS, respite, adult day services, prevocational and supported employment, nursing, therapies, transportation, adaptive equipment, home modifications, family training and dental. It served 3,294 people as of August 31, 2026.
• In-Home Supports Waiver for Children (IHSW-C, control number OK.0351): serves children ages 3 through 17 who live with family, in their own home or in a DHS foster or group home. The annual limit is $24,104, lower than the adult waiver because children also get other Medicaid services. Services include HTS, respite, family training, adaptive equipment, home modifications and specialized medical supplies. It served 1,026 children as of August 31, 2026.

All four waivers require the person to meet the level of care for an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), the institutional setting the waivers are an alternative to.

Does Oklahoma pay for I/DD services through managed care?

No. OHCA rules exclude people enrolled in a 1915(c) waiver, and people with ICF/IID level of care, from SoonerSelect, Oklahoma's Medicaid managed care program. Waiver services are paid fee-for-service by SoonerCare, and DDS state staff coordinate services.

• Managed care exclusion: the rule is OHCA rule 317:55-3-1, on OHCA's mandatory, voluntary and excluded populations page.
• Who pays: providers hold a SoonerCare provider agreement with OHCA and are paid fixed statewide rates for each service.
• Who coordinates: DDS case managers lead each person's planning team and coordinate services.

Is there a waiting list for I/DD services in Oklahoma?

Yes, but it is much shorter than it was. DDS limits waiver slots and does not publish a total count of people waiting. It works requests in order of application date, in groups called cohorts, and says the wait has fallen from 13 years in 2022 to about one year.

• How the list works: state rule OAC 317:40-1-1 keeps a Request for Waiver Services List in order of the date DDS receives a completed request. Exceptions let some people move ahead, including emergencies, special appropriations, people leaving an ICF/IID or state custody, and certain nursing facility cases.
• Latest cohort: in April 2026 DDS began cohort 12, covering 729 people who applied between January and June 2025. It said more than 3,000 waitlist families had been approved or were receiving services. Once someone is contacted and approved, moving onto services usually takes 6 to 9 months.
• Earlier figures: the Oklahoma Human Services annual report says the 2022 backlog was more than 5,000 applicants and that the Legislature added $3 million in fiscal year 2025 to process 1,328 more applications. It set a goal of ending the 13-year waitlist by June 2026.

The DDS waiting list page still describes cohorts and says DDS is working toward becoming a no-wait state. We did not find a statement that the list has ended. For a current count or a person's place on the list, families can email TellDDS@okdhs.org.

How do people apply for I/DD services in Oklahoma, and how are budgets set?

People apply online through Oklahoma Human Services or by email to the DDS intake contractor, Liberty of Oklahoma. OHCA's Level of Care Evaluation Unit then decides whether the person meets ICF/IID level of care using the LTC-7 form. Services are set by a person-centered team plan within each waiver's limits. We did not find a published tool that sets individual budgets.

• Apply: through the Oklahoma Human Services online application, or by email to DDSintake@libertyhealth.com (405-500-1866). DDS area offices handle intake.
• Eligibility: an Oklahoma resident age 3 or older with a primary diagnosis of intellectual disability from a licensed psychologist (a child under 6 with global developmental delay and an IQ near 70 can qualify), SoonerCare financial eligibility, ICF/IID level of care, a disability determination from Social Security or OHCA, and needs that DDS services can address.
• Assessment: the LTC-7 form (Disability and ICF/IID Level of Care Determination), backed by a psychological evaluation with IQ and adaptive testing. DDS Level of Care Reviewers do the routine yearly reevaluations.
• Budgets: the In-Home Supports Waivers have annual limits ($36,143 for adults and $24,104 for children). Waiver rates are fixed statewide and are not tiered by an assessment score.

What day and residential services can I/DD providers offer in Oklahoma?

Waiver providers can offer three kinds of day and employment services: adult day services, prevocational services and supported employment. Residential options include group homes, Daily Living Supports, agency companion, specialized foster care and Extensive Residential Supports. Oklahoma Human Services licenses group homes, and adult day centers need a license from the Oklahoma State Department of Health.

Day and employment services (Community, Homeward Bound and IHSW-A)

• Adult Day Services: a day program in a licensed adult day care center. The center needs a license from the Oklahoma State Department of Health under OAC 310:605 and a SoonerCare provider agreement. The DDS rule adopts the licensing ratio of 1 staff to 8 participants, with two responsible people on site. Billed in 15-minute units (S5100) at $2.86 a unit since October 1, 2024.
• Prevocational services (community-based and center-based): learning and work experiences, including volunteer work and community training, that build skills toward a paid job. They may be delivered remotely with team approval. Providers need a SoonerCare provider agreement and DDS approval, and job coach staff need a high school diploma or GED and DDS-approved training. Paid per hour of participation, with a higher rate for enhanced supports. The research did not find a published ratio.
• Supported employment: job coaching, enhanced job coaching, stabilization and employment training specialist services for individual or group jobs, under an employment-first policy. Job coaching applies when a coach is on site more than 20 percent of paid hours, and stabilization at 20 percent or less. Services must take place at non-residential sites. Job coaching and stabilization are paid per hour worked, and the October 2024 rate letter lists employment specialist and group job coaching in 15-minute units. Oklahoma also pays quality payments for moves into competitive integrated employment. The research did not find a published ratio.

Residential services (Community and Homeward Bound)

• Group homes: licensed shared homes for up to 12 adults, with 24-hour response staff and training in daily living skills. Licensed by Oklahoma Human Services under 10 O.S. 1430.1 and following sections. Paid per day, with community living rates set by home size (6 to 9 beds). State-funded group home slots also exist outside Medicaid.
• Daily Living Supports (supported living): supports for adults in a home they lease or own, with up to 8 hours a day of direct support, house management help and therapeutic leave. Billed per day.
• Agency companion (shared living): the person lives with a companion they choose, often someone they know, who is an independent contractor of an agency and provides supervision and daily living training. Paid per day at levels such as enhanced and pervasive.
• Specialized foster care (Specialized Family Home): care for one to four members in the provider's own home, with four levels set by age and need.
• Extensive Residential Supports (Community Waiver only): up to 24 hours a day of direct support for people with significant challenging behavior, added June 19, 2023. Billed as one daily unit and not combined with other residential services.

We did not find a separate license requirement for Daily Living Supports, agency companion, specialized foster care or Extensive Residential Supports. Providers should ask DDS at DDS.Residential@okdhs.org.

How are I/DD provider rates set and how do agencies enroll in Oklahoma?

Oklahoma pays fixed, uniform statewide rates for each waiver service. OHCA sets them through its rate committee, a public rate hearing and the OHCA Board, and the Legislature usually funds increases. To enroll, an agency needs a SoonerCare provider agreement with OHCA plus DDS approval and training, and some services also need a license.

• Latest broad increase: on October 1, 2024, most DDS waiver rates rose about 10 percent and many rose 25 percent, according to the DDS provider letter. For example, HTS went from $5.26 to $6.58 per 15 minutes, and Daily Living Supports rose 12.5 percent. Group home rates for 6 to 9 bed homes were later raised back to the same date (a 6-bed home went from $216.78 to $238.46 a day).
• Latest change: the transportation rate (S0215) rose from $0.73 to $0.76 a unit on July 1, 2026. It is tied to the federal mileage rate.
• Rate reviews: the Community Waiver says the state finished a rate study in January 2023 and reviews rates at least every five years.
• Enrollment: each waiver service needs a current SoonerCare provider agreement with OHCA plus DDS requirements such as approved training. Start on the DDS provider page. DDS asks prospective providers to email DDS.Vocational@okdhs.org about its Potential DDS Provider Course, and DDS.Residential@okdhs.org about residential services. In 2026, OHCA also required its contracted providers, including DDS providers, to upload a signed compliance attestation under an executive order.
• EVV: electronic visit verification (EVV) is required for in-home services such as non-residential HTS, in-home respite, nursing and therapies. Since October 1, 2025, live-in caregivers are no longer exempt for non-residential HTS. Agencies use Fiserv AuthentiCare (app or landline) or a compliant third-party system, and self-directed workers use Acumen DCI. Claims for EVV services are denied unless they go through the state aggregator. Group homes and 24-hour residential settings are exempt.

What is changing next for I/DD services in Oklahoma?

Oklahoma's EVV system is moving from Fiserv AuthentiCare to Acumen powered by DCI. DDS expected the move in fall 2026, but as of October 23, 2026 no go-live date had been published. A proposed change to the adult In-Home Supports Waiver is also pending approval.

• EVV system change: DDS announced an EVV 2.0 contract award to Acumen, and OHCA's EVV page describes the state system and aggregator moving to Acumen powered by DCI. Agencies that use AuthentiCare or send data from their own system should watch for DDS provider letters with the switch date and training.
• Proposed IHSW-A amendment: OHCA proposed an amendment to remove Homemaker, add Educational Supports and change case manager qualifications. It depended on federal approval, and we did not find confirmation that it was approved.

Several changes already took effect on July 1, 2026: the Community and Homeward Bound renewals, the Community Waiver's higher capacity and reserved slots, and an IHSW-C amendment that loosened degree requirements for case managers and level of care evaluators and dropped the annual medical report. The Community Waiver renewal also removed remote delivery of Daily Living Supports. We did not find a new provider rate increase for fiscal year 2027 beyond the transportation rate.

Oklahoma I/DD sources

• Oklahoma Human Services: Developmental Disabilities Services
• Oklahoma Human Services: DDS waiting list
• OHCA: HCBS waivers for persons with intellectual disabilities (OAC 317:40-1-1)
• OHCA: Managed care mandatory, voluntary and excluded populations (OAC 317:55-3-1)
• Community Waiver (OK.0179), renewal effective July 1, 2026
• Homeward Bound Waiver (OK.0399), renewal effective July 1, 2026
• In-Home Supports Waiver for Children (OK.0351)
• DDS provider letter: October 1, 2024 rate increases
• DDS provider letter: EVV changes (November 2025)
• OHCA: Electronic visit verification

Related reading

• Disability Services and Independent Living Guide
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Disability Services DayHab has a dilemma - how to solve it
• Outcome Measures in Disability Services: Measuring what matters
• I/DD services in every state (map)
• Oklahoma EVV requirements

Page history

• October 23, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.