Oklahoma In-Home Supports Waiver and HCBS Waivers Explained

Oklahoma's Three DDS Waiver Programs

Oklahoma Human Services Developmental Disabilities Services (DDS) administers home and community-based services (HCBS) waivers funded through Section 1915(c) of the Social Security Act. These waivers fund specialized services for individuals with intellectual and developmental disabilities as an alternative to institutional care.

There are three primary waiver programs, each serving different support levels:

In-Home Supports Waiver for Adults (IHSW-A) — For individuals 18 and older who live in their own home or a family home. Services include Habilitation Training Specialist (HTS) hours, respite care, speech therapy, and assistive technology. The IHSW-A has an annual funding cap of $36,143 per person.

Community Waiver — Known colloquially as the "Big Waiver," this program provides comprehensive services for individuals of any age who need a more intensive level of support, including 24/7 residential services. Unlike the In-Home Supports Waiver, the Community Waiver has no annual cap, allowing funding to scale to meet documented medical and behavioral needs.

Homeward Bound Waiver — A specialized waiver for individuals 18 and older who are certified members of the plaintiff class in Homeward Bound et al. v. The Hissom Memorial Center. This waiver serves a closed population and is not available for new applicants.

Eligibility: Who Qualifies

DDS waiver eligibility requires meeting strict clinical, diagnostic, and financial criteria:

Diagnostic requirement: The applicant must have a primary diagnosis of intellectual disability as defined by the DSM. A developmental disability diagnosis alone — such as autism, cerebral palsy, or Down syndrome — qualifies only if accompanied by a primary intellectual disability component.

Cognitive criteria: A psychological evaluation from a licensed psychologist showing a Full-Scale IQ of approximately 70 or below. Testing results obtained at age 16 or older are considered valid indefinitely if compatible with current functional behavior.

Functional deficits: The evaluation must include an adaptive behavior assessment showing significant limitations in daily living skills.

Level of Care: The applicant must meet the medical Level of Care criteria for an ICF/IID, documented on Form LTC-300.

SSI / Medicaid disability determination: The applicant must have an official disability determination from the SSA or the Oklahoma Health Care Authority (OHCA) Level of Care Evaluation Unit.

If a young adult's IQ is above 70, they are generally ineligible for DDS In-Home Supports or Community Waivers, even with substantial support needs. In those cases, families must look to State Plan Personal Care (SPPC) or the ADvantage Waiver as alternatives.

The Waitlist Is Largely Cleared

Oklahoma's DDS waiting list was once one of the state's most criticized systems, with waits exceeding 13 years and affecting over 5,000 families. In May 2022, the legislature appropriated $32.5 million to eliminate the backlog, followed by an additional $3 million for fiscal year 2025.

DDS processes applications in chronological cohorts based on application date. Cohorts 1 through 10 — applications from May 2009 through May 2024 — are cleared. Cohort 12, covering January 2025 through June 2025 applications, began processing in April 2026.

The current wait time for new applicants is approximately one year — a dramatic improvement from the historical backlog. But "placed on the list" does not mean "receiving services." Once a cohort is activated, it typically takes 6 to 9 months to complete assessments, verify financial eligibility, select providers, and authorize services.

Regional Area Offices

DDS manages intake and administration through three geographical Area Offices:

Area I — Oklahoma City and Northwest Oklahoma (counties north of I-40, west of I-35). Phone: (405) 522-6925 or toll-free 1-800-522-1064.

Area II — Tulsa and Northeast Oklahoma (counties north of I-40, east of I-35). Phone: (918) 560-4848 or toll-free 1-800-522-1075.

Area III — Southern Oklahoma (counties south of I-40, office in Pauls Valley). Phone: (405) 238-4700 or toll-free 1-800-522-1086.

Contact the appropriate Area Office to begin the application process. New intake inquiries can also be directed to [email protected] or (405) 500-1866.

What "Getting on the Waiver" Requires from the Family

Families often underestimate the documentation needed once their cohort is called. Having these items ready can compress the 6-to-9 month activation timeline to a few weeks:

• A current psychological evaluation showing an intellectual disability diagnosis with onset before age 18
• Adaptive behavior assessment results
• A complete SoonerCare (Oklahoma Medicaid) application — SSI approval does not automatically enroll the individual in Medicaid. A separate application must be filed with the Oklahoma Health Care Authority
• Documentation that the individual's monthly income does not exceed the institutional income limit ($2,982/month in 2026). If it does, the family must establish a Qualified Income Trust (Miller Trust) to redirect excess income

The Connection to Guardianship and Legal Authority

When DDS activates services, someone needs legal authority to sign the waiver enrollment agreements, choose service providers, and authorize the individual plan. If the young adult is 18 or older and has a guardian, the guardian handles this. If no guardianship is in place, the young adult signs for themselves — or a supported decision-maker helps them understand and execute the paperwork.

This is one of the turning-18 planning moments where families realize they need some form of legal authority established before the DDS enrollment process begins.

The Oklahoma Adult Guardianship & Alternatives Guide covers the full spectrum of decision-making options — from supported decision-making through guardianship — with specific attention to the documentation needed for DDS waiver enrollment, SoonerCare coordination, and the financial planning tools that protect waiver eligibility.

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