Okla. Stat. tit. 63, § 63-5051.3

A. Pursuant to the provisions of this section, the Oklahoma

Health Care Authority is authorized to file and enforce a lien

against the homestead of a recipient for payments of medical

assistance made by the Authority to the recipient who is an

inpatient of a nursing facility or an intermediate care facility for

individuals with intellectual disabilities (ICF/IID) if the

Authority, upon competent medical testimony, determines the

recipient cannot reasonably be expected to be discharged and

returned home. A one-year period of compensated inpatient care at a

nursing facility or an ICF/IID shall constitute a determination by

the Authority that the recipient cannot reasonably be expected to be

discharged and returned home.

B. Upon certification for Title XIX of the federal Social

Security Act payments for a nursing facility or ICF/IID care, the

Authority shall provide written notice to the recipient that:

1. A one-year period of compensated inpatient care at a nursing

facility or ICF/IID shall constitute a determination by the

Authority that the recipient cannot reasonably be expected to be

discharged and returned home;

2. A lien will be filed against the homestead of the recipient

pursuant to the provisions of this section and that the amount of

the lien shall be for the amount of assistance paid by the Authority

from the date the recipient became eligible for compensated

inpatient care at a nursing facility or ICF/IID until the time of

the filing of the lien and for any amount paid thereafter for such

medical assistance to the recipient; and

3. The recipient is entitled to a hearing with the Authority

prior to the filing of the lien pursuant to this section.

The notice shall also contain an explanation of the lien and the

effect the lien will have on the ownership of the homestead of the

recipient and any other person residing in the homestead. The

notice shall be signed by the recipient or the legal guardian of the

recipient acknowledging that the recipient or the legal guardian of

the recipient understands the notice and the effect that the payment

of medical assistance on the recipient's behalf will have upon the

homestead of the recipient.

Oklahoma Statutes - Title 63. Public Health and Safety Page 1745

C. The lien filed pursuant to subsection E of this section

shall be for the amount of assistance paid beginning from the date

the recipient began receiving inpatient care from a nursing facility

or ICF/IID and for any amount paid thereafter for the medical

assistance to the recipient.

D. The Authority shall not file a lien on the homestead of the

recipient pursuant to subsection E of this section while the

homestead is the lawful residence of:

1. The surviving spouse of the recipient;

2. A child related to the recipient by blood or marriage who is

twenty (20) years of age or less;

3. An adult child related to the recipient by blood or marriage

who is incapacitated as defined by the Authority; or

4. A brother or sister of the recipient who has an equity

interest in the home and who was residing in the home for at least

one (1) year immediately preceding the date the recipient was

admitted to the nursing facility or ICF/IID and has resided there on

a continuous basis since that time.

E. No lien for payment of medical assistance pursuant to this

section shall be effective unless:

1. The Authority has provided notice to the recipient of the

intent to file a lien against the homestead of the recipient and of

the opportunity for a hearing on the matter; and

2. After the notice specified in paragraph 1 of this subsection

has been given, a lien is filed for record against the legal

description of the homestead in the office of the county clerk of

the county in which the homestead of the recipient is located. The

lien shall contain the following information:

a. the name and address of the place of residence of the

recipient,
ng on the matter; and

2. After the notice specified in paragraph 1 of this subsection

has been given, a lien is filed for record against the legal

description of the homestead in the office of the county clerk of

the county in which the homestead of the recipient is located. The

lien shall contain the following information:

a. the name and address of the place of residence of the

recipient,

b. the amount of the assistance paid at the time of the

filing of the lien,

c. the date the recipient began receiving compensated

inpatient care at a nursing facility or ICF/IID,

d. the legal description of the real property against

which the lien will be recorded, and

e. such other information as the Authority requires.

F. 1. After the lien has been filed pursuant to subsection E

of this section, the Authority may enforce a lien only:

a. after the death of the surviving spouse of the

recipient,

b. when there is no child related to the recipient by

blood or marriage who is twenty (20) years of age or

less residing in the homestead,

c. when there is no adult child related to the recipient

by blood or marriage who is incapacitated as defined

by the Authority residing in the homestead, and

Oklahoma Statutes - Title 63. Public Health and Safety Page 1746

d. when no brother or sister of the recipient is residing

in the homestead, who has resided there for at least

one (1) year immediately before the date of the

recipient's admission to the facility or institution,

and has resided there on a continuous basis since that

time.

2. A lien filed pursuant to subsection E of this section shall

remain on the homestead:

a. until the lien is satisfied,

b. until the value of the homestead is consumed by the

lien, at which time the Authority may force the sale

of the homestead to satisfy the lien, or

c. after transfer of title of the real property by

conveyance, sale, succession, inheritance, or will.

3. The lien filed pursuant to subsection E of this section may

be enforceable by the Authority before or after the death of the

recipient.

4. The lien created by this section shall be treated as a

mortgage and shall be assignable by the Authority to another entity

and shall be released in accordance with the provisions as set forth

in Section 15 of Title 46 of the Oklahoma Statutes.

5. The lien shall sever a joint tenancy; however, the lien

shall be enforceable only to the extent of the ownership of the

person receiving assistance as it existed at the time the recipient

began receiving assistance.

G. The recipient, the heirs, personal representative, or

assigns of the recipient may discharge said lien at any time by

paying the amount of the lien to the Authority.

H. At the end of the one-year limitation, the Authority shall

exclude from consideration as a resource the value of the homestead

of the recipient.

I. The payment of medical assistance on behalf of the recipient

by the Authority and the signing of the notice pursuant to

subsection B of this section shall constitute a waiver of the

homestead rights of the recipient for the purposes of this section

and Section 3 of Article XII of the Oklahoma Constitution.

J. 1. Pursuant to the provisions of this subsection, if the

homestead is sold to enforce the lien authorized pursuant to the

provisions of this section, an amount up to Six Thousand Dollars

($6,000.00) from the proceeds of the sale of the homestead, less the

value of any prepaid burial or insurance policies or designated

accounts for funeral expenses already owned by the recipient, may be

set aside in an irrevocable trust on behalf of the recipient, in

which the Authority is to be included as the remainder, and the

funds are to be used for the funeral expenses of the recipient.

2. Payment of the funeral expenses from the proceeds of the

sale of the homestead shall be made as follows:

Oklahoma Statutes - Title 63. Public Health and Safety Page 1747
ned by the recipient, may be

set aside in an irrevocable trust on behalf of the recipient, in

which the Authority is to be included as the remainder, and the

funds are to be used for the funeral expenses of the recipient.

2. Payment of the funeral expenses from the proceeds of the

sale of the homestead shall be made as follows:

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a. if the proceeds exceed the amount of the lien, the

payment of funeral expenses shall be first satisfied

from any amount in excess of the lien amount. After

the excess is exhausted, the remainder of funeral

expenses shall be satisfied from the lien amount prior

to payment of any reimbursement to the Authority, and

b. if the proceeds from the sale of the homestead do not

exceed the amount of the lien, the payment of funeral

expenses shall be satisfied from the lien amount prior

to payment of any reimbursement to the Authority.

K. As used in this section:

1. "Nursing facility" means any home, establishment, or

institution which offers or provides on a regular basis twenty-four-

hour medical services, skilled nursing care, necessary special

dietary service, and personal care and supervision to three or more

of its residents who are not related to the owner or administrator

of the facility; and

2. "ICF/IID" means intermediate care facilities for individuals

with intellectual disabilities, which provide comprehensive and

individualized health care and rehabilitation services to

individuals to promote their functional status and independence.

L. If any provision of this section shall be in conflict with

any applicable federal statutes and regulations, the federal

statutes and regulations shall prevail and be controlling until such

time as the federal statutes and regulations shall be revised to

conform to this section.