How Oklahoma pays for disability services

Waiver inventory

Total DDS waiver enrollment: 8,470 as of June 30, 2026 (dashboard). Total receiving waivered plus state services: more than 10,000. Governing rule: OAC 317:40-1-1, oklahoma.gov

State-only funded programs

• Family Support Assistance Payment (FSAP). Cash payment of $250 to $400 per month to families caring at home for children under 18 with intellectual or other developmental disabilities. Explicitly described as "State-funded cash payment in lieu of Medicaid Home and Community-Based services." Income limit $45,000 adjusted gross. Administered by OKDHS Developmental Disabilities Services. Annual appropriation not published. oklahoma.gov
• Assisted Living (DDS). State-funded residential support for people with intellectual disabilities who are not on an HCBS waiver and need minimal staff support in their own home. Rate raised from $24.06 to $26.47 per day effective Oct. 1, 2024. oklahoma.gov
• State-funded group home slots. DDS maintains state-funded group home placements for people who do not qualify for a waiver; others are being converted to waiver funding. oklahoma.gov
• Sheltered Workshop, Adult Day, and Competitive Integrated Employment (state-funded tracks). Rates raised Oct. 1, 2024: Sheltered Workshop $30.28 to $33.31 per 5-hour day; Adult Day full $10.00 to $11.00, part $6.00 to $6.60; Competitive Integrated Employment $33.13 to $36.45 per day. oklahoma.gov
• Respite Voucher Program. Vouchers for caregivers of people with developmental disabilities who are not on a DDS waiver and receive fewer than 20 hours per week of state-funded services; caregiver income limit $75,000. Appropriation not published. oklahoma.gov
• Volunteer Guardianship Program. oklahoma.gov

Per-program appropriations for these state-only lines were not located in OKDHS or Oklahoma Office of Management and Enterprise Services documents I retrieved.

County / regional / local funding

None identified. Oklahoma DDS is a single statewide state-administered system; case management is performed by state DDS employees rather than county boards. I checked the OKDHS DDS program pages, the OHCA DDS policy chapter (OAC 317:40), the DDS provider letters index, and the OKDHS FY2024 statistical tables. Table 17 reports waiver participants by county but shows no county funding stream. oklahoma.gov

Funding scale

• Total OKDHS expenditures SFY2024: $3,747,911,214 (all divisions, all funds). DDS-only total spending was not published in the annual report or statistical tables. oklahoma.gov
• 2022 waitlist elimination appropriation: $32.5 million in state funds, appropriated May 2022 to serve everyone then on the waiting list. okpolicy.org
• SFY2026 OKDHS budget request: nearly $23 million to sustain waiver increases and cover state match tied to the FMAP change. oklahoma.gov
• DSP+ direct support professional incentive payments FY2024: $16.6 million to 14,665 people. oklahoma.gov
• Oklahoma FY2026 FMAP: 66.47 percent federal share. macpac.gov
• People in DDS waivers: 8,470 (June 30, 2026), up 2,851 net since May 2, 2022. Self-directed services: 1,540. oklahoma.gov
• Per-participant spending: not published. Proxy caps exist: In-Home Supports Waiver annual limits are $36,143 (adults) and $24,104 (children) after the 25 percent increase effective Oct. 1, 2024; a Community/Homeward Bound combined services limit of $60,245.90 was added. oklahoma.gov
• Waiting list: DDS states the waitlist was eliminated and that people applying after the May 2022 funding wait roughly one year, with transition typically 6 to 9 months after approval. As of August 2025, of approximately 6,300 people who applied before October 2023, 2,603 were receiving or approved for services and 560 were pending. oklahoma.gov and okpolicy.org

Residential funding detail

Oklahoma funds a layered set of residential models, all paid as per diems except in-home habilitation, which is paid in 15-minute units.

• Community Living Group Homes (T1020), 6 to 9 beds. Per diem declining with bed count: $238.46 (6-bed), $204.49 (7-bed), $197.70 (8-bed), $175.54 (9-bed), retroactive to Oct. 1, 2024. oklahoma.gov
• Group Home Daily Services, 6 to 12 beds. Separate per diem series: $103.68 (6-bed) to $57.56 (12-bed) effective Oct. 1, 2024. Group homes serve 6 to 12 adults 18 and older in single-family homes owned or leased by a private agency. oklahoma.gov
• Daily Living Supports (T2033). $225.23 per day. Adults typically living with two housemates who need an average of at least 8 hours of direct support daily and whose needs cannot be met in the family home. oklahoma.gov
• Agency Companion Services (S5126), the host home or shared living model. Three acuity tiers per day: Close $138.00, Enhanced $179.47, Pervasive $223.04, effective Oct. 1, 2024.
• Specialized Family/Foster Care. Adult maximum (S5140) and child maximum (S5145) both $77.22 per day. oklahoma.gov
• In-home and family settings. Habilitation Training Specialist (T2017) and Intensive Personal Supports (T2017 TF) at $6.58 per 15-minute unit, $26.32 per hour equivalent. oklahoma.gov
• Assisted Living. State-funded, $26.47 per day, for people not on a waiver.
• ICF/IID. Private ICFs/IID operate in Oklahoma under OHCA contract; I did not locate a published ICF/IID per diem schedule. OHCA states that provider-specific and specialty-based contracted rates are not included in the Title XIX fee schedule. oklahoma.gov

Acuity is handled through service mix and tier (Agency Companion levels, HTS versus Intensive Personal Supports) rather than a single acuity-scored residential rate.

Room and board. The published rates are service rates. No room-and-board component appears in the DDS rate letters or in the group home rule (OAC 317:40-5-152). The Assisted Living program page directs provider agencies, before placement, to assess whether the person "can financially maintain his or her home," weighing food benefits, rental subsidy, employment income, and public assistance, which indicates housing costs fall to the individual's own income, principally SSI. oklahoma.gov Oklahoma also runs a State Supplemental Payment for aged, blind, and disabled recipients, averaging 88,343 people monthly in FY2024, though it is not DDS-specific. oklahoma.gov

Comparable service rates

Official rate schedule links

• Administrative Letter 24-02, rate increases effective Oct. 1, 2024 (full waiver and state-funded rate tables): oklahoma.gov
• Administrative Letter 25-02, retroactive Community Living Group Home rates: oklahoma.gov
• Administrative Letter 24-01, transportation rate increase: oklahoma.gov
• Administrative Letter 25-01, transportation rate increase: oklahoma.gov
• Administrative Letter 26-01, transportation rate increase (Feb. 13, 2026): oklahoma.gov
• Administrative Letter 26-03, transportation rate increase (July 31, 2026): oklahoma.gov
• DDS provider letters index: oklahoma.gov
• OHCA Title XIX fee schedule (does not include DDS contracted rates): oklahoma.gov

Notable features and flags

• May 2022: The Legislature appropriated $32.5 million to serve everyone then on the DDS waiting list, which had exceeded 12 to 13 years. OKDHS projected an 18 to 24 month timeline. okpolicy.org
• Nov. 13, 2024: OKDHS announced the waitlist had been cut from 13 years to two years. As of the June 30, 2026 dashboard, DDS states the original waitlist is eliminated and new applicants wait roughly one year. oklahoma.gov and oklahoma.gov
• Oct. 1, 2024: Second legislatively funded rate increase in two years, 10 to 25 percent across DDS services, with a 25 percent increase in In-Home Supports Waiver annual limits. oklahoma.gov
• Feb. 24, 2025: Community Living Group Home rates for 6, 7, 8, and 9-bed homes were approved retroactively to Oct. 1, 2024, requiring providers to void and rebill claims. Signals that the 2024 increase was implemented in stages. oklahoma.gov
• FY2024: $16.6 million in DSP+ retention payments to 14,665 direct support professionals, plus the "Called to Care" recruitment campaign, both aimed at workforce capacity constraints that limit how fast approved people can start services. oklahoma.gov
• Self-direction: 1,540 people were using self-directed services as of June 30, 2026, a route available across the waivers. oklahoma.gov
• Feb. and July 2026: Two further transportation rate adjustments issued, indicating ongoing incremental rate maintenance rather than a new comprehensive rebasing. oklahoma.gov

Confidence

Solid: waiver inventory, enrollment by waiver and county, the Oct. 1, 2024 rate table down to procedure code, the retroactive group home rates, the state-only Family Support Assistance Payment and Assisted Living programs, the waitlist history and current status, and the FY2026 FMAP. All come from OKDHS or OHCA pages and provider letters, or MACPAC. Estimated or partial: nothing in the rate tables is estimated, but the respite S5150 unit is labeled "hourly" while the rate table lists a 15-minute unit, so treat that row cautiously. Could not find: a DDS-only total spending figure for any fiscal year, per-participant spending, an ICF/IID per diem schedule, appropriations for the individual state-only programs, and any room-and-board rule or supplement specific to DDS residential settings. OKDHS statistical tables for SFY2025 were not yet posted at the annual report URLs.

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