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Library: Policy

340:100-5-26.2. End-of-life issues

Revised 9-15-2021

(a) Purpose.  Rules in this Section are established to support the decisions of persons receiving services from Developmental Disabilities Services (DDS) regarding end-of-life issues.  DDS affirms life and regards dying as a normal process.  DDS encourages each person to fully exercise his or her rights and make decisions about end-of-life issues that allow the person to live with dignity and comfort.

(b) Applicability.  Rules in this Section apply to DDS staff and contracted service providers licensed or funded through DDS Home and Community-Based Services Waivers or DDS state services and serve a person who is certified by a physician to be terminally ill.  A person is considered terminally ill when he or she has a medical prognosis of life expectancy of six months or less.

(c) End-of-life services.  When a person is diagnosed by a physician with a terminal illness, referred for hospice services, or a Do-Not-Resuscitate Consent Form is signed per Section 3131.1 et.seq. of Title 63 of the Oklahoma Statutes, the case manager holds a Personal Support Team (Team) meeting within five working days to review the person's needs, services, and supports.  •  1

(d) DDS Case manager responsibilities.  When the person, guardian, or next of kin elects hospice care, the case manager:

(1) identifies resources, including funding available, prior to selection of a hospice provider;

(2) notifies the DDS state office programs administrator or designee and assigned DDS nurse, when applicable, that hospice care is elected;

(3) arranges to meet with Team members and the hospice provider to develop a treatment plan;

(4) integrates the hospice treatment plan into the Individual Plan (Plan) and amends the plan of care to terminate services no longer needed and add needed services; and

(5) ensures DDS does not duplicate services provided by hospice.

(e) DDS nurse role.  When the person, guardian, or next of kin elects hospice care, the DDS nurse is available, upon request, to:

(1) assist the Team with identification of available hospice providers; and

(2) assist hospice and residential providers to ensure medications are administered per Oklahoma Administrative Code (OAC) 340:100-5-32


1.  Hospice care.  The purpose of hospice care is to provide for the palliative care or management of the terminal illness and related conditions.  Hospice:

(1) recognizes death as the final stage of life, and helps the person live his or her final days to the fullest, surrounded by family and friends;

(2) does not deliberately prolong the process of dying.  The focus is on the person, not the terminal illness.  Support focuses on pain management and symptom control, rather than disease treatment;

(3) provides state-of-the-art comfort through quality medical and emotional care;

(4) is person-centered, taking into account and honoring the needs, wishes, beliefs, and situation of the person and family; and

(5) outcomes include:

(A) living with dignity and comfort;

(B) controlling and managing pain;

(C) focusing on the whole person, including his or her physical, social, emotional, and spiritual well-being;

(D) providing support to the person to maintain control over his or her life as much as possible for as long as possible;

(E) providing care in a familiar environment, usually the person's home;

(F) providing support to the person, family members, and caregivers with their emotional, interpersonal, and spiritual needs;

(G) acknowledging the person's advance health care decisions per Section 3101.1 et.seq. of Title 63 of the Oklahoma Statutes and Do-Not-Resuscitate Consent per the Oklahoma Do-Not-Resuscitate Act; and

(H) assisting individuals to secure information regarding an Advance Directive for Health Care and Do-Not-Resuscitate Consent.  Hospice services are not contingent on the execution of an Advance Directive for Health Care or Do-Not-Resuscitate Consent.

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