Self-Direction and FMS in Oklahoma
All states: self-direction map
In short: Self-direction runs through CD-PASS and DDS Self-Directed Services; Acumen Fiscal Agent handles payroll and workers clock in on its DCI system.
Oklahoma self-direction at a glance
| Self-directed programs | CD-PASS (ADvantage), DDS Self-Directed Services, Medically Fragile Waiver self-directed services and Living Choice self-directed services |
|---|---|
| FMS model | Fiscal/employer agent. In DDS programs the state is the FMS provider and uses a subagent. |
| FMS vendors | One fiscal agent across all four options: Acumen Fiscal Agent |
| Who is the employer | The member or a representative is the employer of record |
| Can family be paid | Yes, with limits. Spouses, legal guardians and parents of minors are paid only under state-approved exceptions, and rules differ by program. |
| EVV for self-directed workers | Yes. Workers clock in and out in Acumen's DCI app or by landline. |
| Budget authority | Yes in CD-PASS and DDS Self-Directed Services. OHCA describes participant budgets for Medically Fragile and Living Choice. |
Last verified against state sources: 2026-10-13.
Which Medicaid programs in Oklahoma offer self-direction?
Oklahoma offers self-direction in four places: CD-PASS in the ADvantage waiver, Self-Directed Services (SDS) in the Developmental Disabilities Services waivers, the Medically Fragile Waiver and the Living Choice program. In each one the member, or a representative acting for the member, hires and manages the workers. Oklahoma has no single statewide self-direction page, so the rules sit on three different state pages. State Plan Personal Care no longer has a member-hired assistant option.
- Consumer Directed Personal Assistance Services and Supports (CD-PASS): the self-directed option in the ADvantage Program, a 1915(c) waiver for older adults and adults with physical disabilities who would otherwise need nursing facility care. It is run by the ADvantage Administration inside Oklahoma Human Services (Community Living, Aging and Protective Services), with the Oklahoma Health Care Authority (OHCA) as the Medicaid agency. It is available in every county. The member has employer authority and budget authority. The workers are called Personal Services Assistants (PSA) and Advanced Personal Services Assistants (APSA).
- DDS Self-Directed Services (SDS): serves adults and children with intellectual and developmental disabilities who live in their own home or a family home. It is offered in the In-Home Supports Waiver for Adults, the In-Home Supports Waiver for Children and the Community Waiver (non-residential settings only), and is run by Oklahoma Human Services, Developmental Disabilities Services (DDS), under an agreement with OHCA. The member has employer authority and budget authority. Services that can be self-directed are Habilitation Training Specialist services (SD-HTS), job coaching and community based services for individual placements, transportation, and goods and services.
- Medically Fragile Waiver self-directed services: serves adults age 19 and older with physical disabilities and a chronic medical condition who meet a hospital or skilled nursing level of care. State rule says OHCA administers the waiver, and Oklahoma Human Services hosts the program page. Members can self-direct personal care, respite, advanced supportive and restorative assistance, and goods and services. OHCA's page describes budget worksheets and a monthly budget summary for these members.
- Living Choice self-directed services: Living Choice is Oklahoma's Money Follows the Person program, run by OHCA, for SoonerCare members with disabilities or long-term illnesses who are moving from an institution to the community. OHCA's self-directed services page lists it alongside Medically Fragile. That page is undated, and we did not find a second source showing how many Living Choice members self-direct today.
Employer authority means the member recruits, hires, schedules and supervises the workers. Budget authority means the member also manages a set amount of money. In CD-PASS the case manager sets the service plan hours, and the member then sets the worker's wage within an individual budget allocation and a state maximum. In DDS programs, the self-directed services rule (OAC 317:40-9-1) lets In-Home Supports Waiver members self-direct part or all of their waiver amount, and the budget has to cover fiscal agent fees, workers' compensation and background checks. The Oklahoma Human Services CD-PASS page also lists Medically Fragile Waiver members as eligible for CD-PASS, so the two are sometimes described together.
Who handles financial management services (FMS) in Oklahoma?
One company handles financial management services for every self-directed option in Oklahoma: Acumen Fiscal Agent. Oklahoma uses a fiscal/employer agent model, which means the fiscal agent runs payroll and taxes while the member or a representative stays the employer of record. Because the same fiscal agent serves all four options, we did not find a list of FMS vendors for members to choose from.
A fiscal agent is the organization that handles the paperwork side of being an employer. It collects the workers' time, pays them, files the employer taxes and tracks the budget. An OHCA rule (OAC 317:30-3-61) requires every SoonerCare self-direction program to use a financial management service for payroll and vendor payments.
- CD-PASS: the member is the employer of record of the PSA and APSA. State rule describes FMS as an administrative service provided through the ADvantage Administration, which acts as the fiscal reporting agent for the IRS, runs payroll at least twice a month and handles background checks. Acumen Fiscal Agent does this work.
- DDS Self-Directed Services: the rule sets up a government fiscal/employer agent model. DDS itself is the FMS provider and names an FMS subagent to handle payroll, taxes, timesheets, goods and services invoices and budget tracking. The DDS Self-Directed Services page sends members to Acumen for enrollment, forms and clocking in. The member or a representative is the Employer of Record.
- Medically Fragile and Living Choice: OHCA says Acumen is responsible for the financial management of self-directed services, processes background checks and issues a monthly budget summary. OHCA's page does not use the term employer of record for these two programs.
Acumen published pay schedules for July 2026 to June 2027 for CD-PASS, Medically Fragile and DDS, and it lists offices in Tulsa and Oklahoma City. We did not find whether Acumen holds one state contract or several, or when the work is next due for bid. For contract questions, ask Oklahoma Human Services or OHCA.
Who can be a paid caregiver under self-direction in Oklahoma?
Members can hire relatives, but Oklahoma limits pay to the people closest to the member. Spouses, legal guardians and parents of minor children are paid only under exceptions the state approves, and the rules differ by program. The person who directs the services cannot also be the paid worker.
Important: For CD-PASS, we did not find a clear rule on whether a spouse or legal guardian can be hired. The ADvantage rule allows a spouse or guardian to be paid as a personal care provider under an approved exception, but it does not say whether that exception reaches CD-PASS. Call the ADvantage Administration at (800) 435-4711 before planning around it.
- CD-PASS: the state does not authorize a worker who also holds an active power of attorney for the member. The member may name an adult family member or friend as authorized representative, and that person cannot be the PSA or APSA. Under the wider ADvantage eligible providers rule, a spouse or legal guardian may be paid for personal care only with Oklahoma Human Services approval, when no agency staff are available, the member's needs are too complex, or care by anyone else would be harmful. The limit is 40 hours in seven days, with monthly case manager visits.
- DDS Self-Directed Services: a legally responsible individual (a parent, stepparent, foster parent or guardian of a minor, or the spouse of an adult) may be paid only for non-residential Habilitation Training Specialist services, and only after a DDS assessment finds extraordinary caregiving needs. When that person lives in the same household, the limit is 40 hours in seven days. DDS describes the process on its legally responsible individuals page, which says it began February 3, 2025. The Employer of Record cannot also be the paid SD-HTS, so a parent or spouse who wants to be paid must hand the Employer of Record role to someone else.
- Medically Fragile Waiver: under the Medically Fragile eligible providers rule, Oklahoma Human Services may authorize a spouse or legal guardian of an adult member as a paid personal care provider when no other provider is available or able. The limit is 40 hours in any seven days.
- Living Choice: we did not find a published rule on paid family caregivers for Living Choice self-direction. Ask OHCA at 888-287-2443.
Hours are capped in DDS programs. A self-directed Habilitation Training Specialist may work no more than 40 hours a week, with no paid sleep time. We could not read the CD-PASS Employer Handbook, so the CD-PASS wage maximum and overtime rules are not stated here.
Does EVV apply to self-directed workers in Oklahoma?
Yes. Electronic visit verification (EVV) applies to self-directed services in Oklahoma, including care given by live-in caregivers. Workers clock in and out in Acumen's DCI system, by mobile app or by a landline or internet phone in the employer's home. State rule says SoonerCare will not pay a claim without data from an OHCA-authorized EVV system or aggregator.
- State rule: the OHCA EVV rule requires EVV for self-directed services and for live-in caregivers. Only residential and 24-hour congregate settings are exempt.
- CD-PASS and Medically Fragile: an Acumen FAQ dated February 2020 says workers meet the EVV mandate by using the DCI system, and that the employer confirms each shift by PIN or photo and approves the hours. Paper timesheets are not accepted. A separate ADvantage rule requires the designated statewide EVV for in-home PSA and APSA time.
- DDS Self-Directed Services: the SD-HTS clocks in and out in the DCI app or by landline. DDS ended the live-in caregiver exemption on October 1, 2025 for all non-residential HTS services, self-directed included. DDS's EVV update also says that entries typed in by the Employer of Record in the DCI portal are not EVV compliant, and that OHCA's goal is 90 percent compliance.
- Living Choice: OHCA's self-directed services page links the same Acumen EVV material for Living Choice as for Medically Fragile.
One point could not be confirmed. The rules speak to claims, and we did not find any state or Acumen document saying that a worker's paycheck is held when a shift is not EVV compliant. For that question, ask Acumen or the program office (DDS at DDS.SDS@okdhs.org, or the ADvantage Administration at (800) 435-4711).
What is changing next for self-direction in Oklahoma?
We did not find a dated, confirmed change to self-direction in Oklahoma as of the last check. One announced change is worth watching: the state plans to move its statewide EVV system and aggregator from Fiserv AuthentiCare to Acumen powered by DCI. No go-live date has been published, and self-directed workers already record their time in Acumen DCI.
A DDS letter pointed to fall 2026 for the statewide move, but that was an expectation and not a set date. OHCA's EVV page still lists only Authenticare/Fiserv and HHAeXchange, and says the next town hall is to be determined. We did not find any statement that the move will change how CD-PASS or DDS self-directed workers clock in. Check the OHCA page for the current status before acting on any date.
Three sets of rules show a revision date of September 1, 2026: the DDS self-directed services rule (OAC 317:40-9-1), the ADvantage description of services rule (OAC 317:30-5-763) and the Medically Fragile rules (OAC 317:50-1-3 and 317:50-1-12). The rule pages show only the date, and we did not determine what changed in each. If you rely on any of these rules, read the current text. We also did not find a procurement notice for the fiscal agent work.
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Who to ask about self-direction in Oklahoma
Questions about self-direction in Oklahoma are best put to the state. Start with Oklahoma Human Services, DDS Self-Directed Services. Published contact: DDS.SDS@okdhs.org (DDS Self-Directed Services); CD-PASS: (800) 435-4711.
Oklahoma self-direction sources
- Oklahoma Human Services: DDS Self-Directed Services
- Oklahoma Human Services: CD-PASS
- Oklahoma Health Care Authority: Self-Directed Services (Living Choice and Medically Fragile)
- OHCA rule: DDS Self-Directed Services (OAC 317:40-9-1)
- OHCA rule: ADvantage Program eligible providers
- OHCA rule: Medically Fragile Waiver eligible providers
- Oklahoma Human Services: DDS legally responsible individuals as paid caregivers
- Oklahoma Human Services: DDS Self-Directed Services EVV update
- OHCA rule: Electronic Visit Verification system
Related reading
- Self-Directed Medicaid Home Care Services in 2026
- Understanding Self-Direction and FMS
- Self-Direction Fiscal Intermediary: A Guide for Participant-Directed Care
- 5 Big Challenges in Self-Directed Care And How FMS Providers Can Solve Them
- Self-direction in every state (map)
- Oklahoma EVV requirements
Other states with one statewide FMS vendor
Arkansas, Connecticut, District of Columbia, Indiana, Iowa, New Mexico, North Dakota, South Carolina, Tennessee, Vermont, Washington, West Virginia, Wyoming. See every state on the self-direction map.
Page history
- October 13, 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 FMS organizations and agencies that support self-direction. If you would like to talk through your program, contact Ankota or read more about Ankota's self-direction and FMS software.
