reglab/statecodes huggingface dataset:
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:12 - Modified adjusted gross income (MAGI) Medicaid eligibility standards › Section 67:46:12:17 - Income Limit - Individuals age nineteen or older and under age sixty-five at or below one hundred thirty-three percent of the federal poverty level

Current through Register Vol. 51, page 10, July 15, 2024
To be eligible for assistance under this chapter, an individual's
	 income, based on family size determined under the provisions of 42 C.F.R.
	 § 435.60, may not exceed one hundred thirty-three percent of the federal
	 poverty level plus five percent of the current year's federal poverty
	 guidelines for that family size.
General Authority:
SDCL 28-6-1.
Law Implemented:
SDCL
		28-6-1(4)(6).
Application of modified adjusted gross income,
		42 C.F.R. §
												435.603, in effect on November 30,
		2016.
Definitions and use of terms,
		42 C.F.R. §
												435.4, in effect on November 3, 2022; Federal
		poverty level, §
											67:11:01:03.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:13 - Transitional medical benefits › Section 67:46:13:01 - Definitions

Current through Register Vol. 51, page 10, July 15, 2024
Terms used in this chapter mean:
(1) "Parent/caretaker relative," a Medicaid
  coverage group consisting of low income families eligible for Medicaid under
  the provisions of chapter 67:46:12; and
(2) "TMB" or "transitional medical benefits,"
  continued medical coverage immediately following ineligibility for
  parent/caretaker relative Medicaid.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
Medicaid eligibility -- Parent/caretaker relative, §
											67:46:12:02.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:13 - Transitional medical benefits › Section 67:46:13:02 - Initial eligibility for transitional medical benefits

Current through Register Vol. 51, page 10, July 15, 2024
An individual that becomes ineligible for parent/caretaker relative
	 Medicaid and any dependent child in the parent/caretaker relative's household
	 is eligible for TMB if the following conditions exist:
(1) The individual was receiving Medicaid
  under the provisions of chapter 67:46:12 in the immediately preceding month but
  became prospectively ineligible because the parent/caretaker relative had
  increased income from employment; and
(2) The individual received Medicaid under
  the provisions of chapter 67:46:12 in any 3 or more months during the 6-month
  period immediately before the month in which the parent/caretaker relative
  became ineligible.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:13 - Transitional medical benefits › Section 67:46:13:03 - TMB limited to 12 consecutive months

Current through Register Vol. 51, page 10, July 15, 2024
Transitional medical benefits may begin the first month the
	 parent/caretaker relative is ineligible for Medicaid under the provisions of
	 chapter 67:46:12 and is limited to the 12 consecutive months immediately
	 following ineligibility for Medicaid.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:13 - Transitional medical benefits › Section 67:46:13:04 - Continuing eligibility for TMB

Current through Register Vol. 51, page 10, July 15, 2024
Eligibility for TMB continues for 12 consecutive months if the family
	 continues to reside in the state and a dependent child who was a member of the
	 family at the time the family was determined first eligible for TMB continues
	 to live with the family.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
Definitions, §
											67:46:12:01.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:13 - Transitional medical benefits › Section 67:46:13:11 - Ineligibility for fraud

Current through Register Vol. 51, page 10, July 15, 2024
If a court of law finds that a member of a Medicaid household committed
	 fraud resulting in mistaken eligibility for Medicaid for one of the six months
	 preceding the current period of Medicaid ineligibility, all members of the
	 Medicaid household in which the fraud was committed are ineligible for
	 continued medical coverage under this chapter.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:14 - Children's health insurance (CHIP-NM) › Section 67:46:14:01 - Definitions

Current through Register Vol. 51, page 10, July 15, 2024
Terms used in this chapter mean;
(1) "Caretaker," the adult who lives with and
  provides care and control of a child eligible for services under this chapter.
  The caretaker may include the child's parent or parents;
(2) "Child," an individual who has not
  attained the age of 19;
(3)
  "CHIP-MN," the nonmedicaid children's health insurance program for children
  eligible under the provisions of this chapter;
(4) "Group health plan," a plan of, or
  contributed to by, an employer, including a self-employed person, or employee
  organization to provide health care, directly or otherwise, to the employees,
  former employees, the employer, others associated or formerly associated with
  the employer in a business relationship, or their families. A group health plan
  includes self-insured plans and plans of incorporated or unincorporated
  organizations that are organized and operated for educational, religious,
  charitable, or other purposes and that hold funds exclusively for its members
  and use those funds to meet the health care needs of its members;
(5) "Health insurance," benefits consisting
  of medical care provided directly, through insurance or reimbursement, or
  otherwise, under any hospital or medical service policy or certificate,
  hospital or medical service plan contract, or health maintenance organization
  contract offered by a health insurance issuer; and
(6) "Health insurance issuer," an insurance
  company, insurance service, or insurance organization, including a health
  maintenance organization, that is required to be licensed to engage in the
  business of insurance in South Dakota. A health insurance issuer does not
  include a group health plan;
(7)
  "Family size/Household," an individual's family size/household has the same
  meaning as determined under the provisions of
  42 C.F.R. §
										435.603.
General Authority:
SDCL 28-6-1.
Law Implemented:
SDCL
		28-6-1.
Application of modified adjusted gross income (MAGI),
		42 C.F.R. §
												435.603 (July 15,
		2013).
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:14 - Children's health insurance (CHIP-NM) › Section 67:46:14:02 - Eligibility requirements for CHIP-NM

Current through Register Vol. 51, page 10, July 15, 2024
A child is eligible for CHIP-NM if the child meets the following
	 criteria:
(1) Does not meet the
  financial eligibility criteria for the state's Medicaid program;
(2) Is a member of a CHIP-NM family whose
  income, as defined in 42
  C.F.R. §
										435.603, does not exceed 209
  percent of the federal poverty guidelines;
(3) Is not a member of a CHIP-NM unit in
  which the child's parent or legal guardian is an employee of a public agency
  and eligible to participate in the state health insurance benefit
  plan;
(4) Is not covered under
  health insurance or a group health plan;
(5) Has not had insurance under a group
  health plan in the three-month period immediately prior to the date of
  application for CHIP-NM;
(6) Except
  for §
									67:46:01:13, meets the
  requirements of chapter 67:46:01;
(7) Is not a resident of a public institution
  or patient in an institution for mental diseases;
(8) Meets the residency requirements of
  §§
									67:46:01:17 through
  67:46:01:28; and
(9) Meets the other requirements of this
  chapter.
General Authority:
SDCL
		28-6-1(1)(4)(6).
Law Implemented:
SDCL
		28-6-1(1)(4)(6).
Federal poverty level, §
											67:11:01:03; Determining size of
		CHIP-NM family, §
											67:46:14:05.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:14 - Children's health insurance (CHIP-NM) › Section 67:46:14:03 - Insurance - Exceptions

Current through Register Vol. 51, page 10, July 15, 2024
The provisions of subdivisions 67:46:14:02(3) and (4) do not apply if
	 any of the following circumstances exist:
(1) The child had coverage under a group
  health plan and the coverage was dropped for good cause;
(2) The child had health insurance coverage
  or was covered under a group health plan but access to care was not available
  under the policy; or
(3) The child
  has health insurance coverage or is covered under a group health plan but
  access to care is not available under the policy.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
Example:
If a child's absent parent is located in
		another state and covers the child through the parent's employer's health
		maintenance organization and the child cannot get treatment in South Dakota
		under the policy, the coverage is considered to be inaccessible to the
		child.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:14 - Children's health insurance (CHIP-NM) › Section 67:46:14:04 - Good cause for dropping insurance under a group health plan

Current through Register Vol. 51, page 10, July 15, 2024
Good cause for dropping insurance under a group health plan exists if
	 the insurance is dropped for reasons beyond the caretaker's control. Reasons
	 for dropping the insurance include circumstances such as the following:
(1) The cost of the insurance to cover the
  parent's children exceeds five percent of the CHIP-NM family's gross
  income;
(2) The parent providing
  the primary insurance is fired;
(3)
  The parent providing the primary insurance voluntarily quits a job and has not
  started a new job;
(4) The parent
  providing the primary insurance is laid off;
(5) The parent providing the primary
  insurance becomes disabled;
(6) The
  parent providing the primary insurance dies;
(7) The parent providing the primary
  insurance starts a new job and there is a lapse in insurance or the new
  employer does not provide dependent coverage; or
(8) The employer discontinued the
  insurance.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:14 - Children's health insurance (CHIP-NM) › Section 67:46:14:05 - Determining size of CHIP-NM family

Current through Register Vol. 51, page 10, July 15, 2024
A CHIP-NM family size/household is determined as defined in
	 42 C.F.R. §
										435.603.
General Authority:
SDCL 28-6-1.
Law Implemented:
SDCL
		28-6-1.
Application of modified adjusted gross income (MAGI),
		42 C.F.R. §
												435.603 (July 15,
		2013).
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:14 - Children's health insurance (CHIP-NM) › Section 67:46:14:13 - Members of CHIP-NM family must cooperate with department

Current through Register Vol. 51, page 10, July 15, 2024
The department may request information from members of the family
	 concerning the existence of actual or potential third-party liability coverage
	 or a third-party payment source for medical expenses. For purposes of this
	 rule, third-party liability coverage or a third-party payment source includes
	 the obligation of an entity other than the medical assistance program for
	 either partial or full payment of the medical cost of injury, disease, or
	 disability.
The individual or caretaker must also provide the department with the
	 necessary verifications to establish initial or continuing eligibility or
	 information necessary for federal reporting requirements or quality control
	 efforts. Failure or refusal to supply the necessary information results in the
	 denial of an application or the termination of current benefits.
An alien who fails or refuses to obtain the cooperation of the alien's
	 sponsor is ineligible for assistance.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
Acceptance of assistance as assignment and subrogation of support
		rights and insurance proceeds -- Liability of insurer or attorney, SDCL
		28-6-7.1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:14 - Children's health insurance (CHIP-NM) › Section 67:46:14:14 - Discontinuance of services

Current through Register Vol. 51, page 10, July 15, 2024
The department may discontinue services provided under the provisions
	 of this chapter if the department exhausts its financial resources for
	 providing the services.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:15 - REFUGEE MEDICAL PROGRAM › Section 67:46:15:01 - Qualifications for refugee assistance

Current through Register Vol. 51, page 10, July 15, 2024
Pursuant to the Refugee Act of 1980, Pub. L. No. 96-212 (March 17,
	 1980), assistance may be provided to individuals who have been granted asylum
	 or have been admitted as refugees. United States citizens and their dependents
	 who have been repatriated are excluded under the refugee assistance program for
	 the first 90 days they are in this country.
General Authority:
SDCL 28-1-50.
Law Implemented:
SDCL
		28-6-1.
Repatriate program, ch 67:12:13.
Refugee Act of 1980, Pub. L. No. 96-212 (March 17, 1980), 94 Stat.
		105.
Immigration and Nationality Act of 1959, 66 Stat. 166.
Project grants and contracts for services for refugees,
		8 U.S.C.
		1522(c)(1)(A)(iii) July 1,
		1997.
General eligibility requirements,
		45 C.F.R. §
												400.100(a)(2) (March 22,
		2000).
Federal funding for medical assistance,
		45 C.F.R. §
												400.203 (March 22,
		2000).
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:15 - REFUGEE MEDICAL PROGRAM › Section 67:46:15:02 - Documentation required

Current through Register Vol. 51, page 10, July 15, 2024
A refugee applying for assistance under this chapter must meet
	 immigration status and identification requirements pursuant to
	 45 C.F.R.
	 400.100(a)(2) (March 22,
	 2000).
General Authority:
SDCL 28-1-50.
Law Implemented:
SDCL
		28-6-1.
General eligibility requirements,
		45 C.F.R.
		400.100(a)(2) (March 22,
		2000).
Requirements for documentation of refugee status,
		45 C.F.R. §
												400.43 (March 22,
		2000).
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:15 - REFUGEE MEDICAL PROGRAM › Section 67:46:15:03 - Eligibility factors relating to refugees with children

Current through Register Vol. 51, page 10, July 15, 2024
Assistance may be provided to any child or any other member of the
	 household who would be eligible for assistance under chapters 67:12:01 to
	 67:12:02, 67:12:04 to 67:12:06, inclusive, but are not required to meet the
	 requirements of §§
									67:12:01:14,
	 67:12:01:19, and 67:12:01:29 to
	 67:12:01:39, inclusive.
General Authority:
SDCL 28-1-50.
Law Implemented:
SDCL
		28-6-1.
Citizenship and alienage, §
											67:12:01:14.
Age requirements for AFDC, §
											67:12:01:19.
Deprivation of parental support or care, §§
											67:12:01:29 to
		67:12:01:39, inclusive.
Eligibility of second parent in AFDC grant, §
											67:12:01:55.
Assistance for refugee children,
		8 U.S.C. §
												1522(d) (July 1,
		1997).
Financial eligibility standards,
		45 C.F.R. §
												400.101 (March 22,
		2000).
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:15 - REFUGEE MEDICAL PROGRAM › Section 67:46:15:04 - Earned income exemption not applied

Current through Register Vol. 51, page 10, July 15, 2024
When determining eligibility and computing the amount of assistance for
	 a refugee under this chapter, the earned income exemption may not be
	 applied.
General Authority:
SDCL 28-1-50.
Law Implemented:
SDCL
		28-6-1.
Earned income exemption for AFDC, §
											67:12:05:14.
Consideration of income and resource,
		45 C.F.R. §
												400.102 (March 22,
		2000).
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:15 - REFUGEE MEDICAL PROGRAM › Section 67:46:15:05 - Eligibility factors relating to adult refugees

Current through Register Vol. 51, page 10, July 15, 2024
Assistance may be provided to adult refugees without children who would
	 be eligible under the income and resource limitations according to chapters
	 67:12:04 to 67:12:06, inclusive.
General Authority:
SDCL 28-1-50.
Law Implemented:
SDCL
		28-6-1.
Refugee Act of 1980, Pub. L. No. 96-212 (March 17, 1980), 94 Stat.
		114.
Limitations on real property, ch 67:12:04.
Limitations on personal property, ch 67:12:05.
Budgeting, ch 67:12:06.
Financial eligibility standards,
		45 C.F.R. §
												400.101 (March 22,
		2000).
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:15 - REFUGEE MEDICAL PROGRAM › Section 67:46:15:06 - Children of refugees who are U.S. citizens

Current through Register Vol. 51, page 10, July 15, 2024
A child of a refugee who is a United States citizen because the child
	 was born in this country is considered a part of the refugee family for
	 purposes of eligibility for medical care.
General Authority:
SDCL 28-1-50.
Law Implemented:
SDCL
		28-6-1.
Refugee Act of 1980, Pub. L. No. 96-212 (March 17, 1980), 94 Stat.
		103.
Claims involving family units which include both refugees and
		nonrefugees, 45 C.F.R.
		§
												400.208 (March 22,
		2000).
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:15 - REFUGEE MEDICAL PROGRAM › Section 67:46:15:07 - Exempted income and resources

Current through Register Vol. 51, page 10, July 15, 2024
Resources or income of the sponsor and resources not currently
	 available to the refugee, such as resources remaining in the refugee's
	 homeland, shall be exempted in the determination of initial or continuing
	 eligibility for the program.
General Authority:
SDCL 28-1-50.
Law Implemented:
SDCL
		28-6-1.
Refugee Act of 1980, Pub. L. No. 96-212 (March 17, 1980), 94 Stat.
		102.
Limitations on real property, ch 67:12:04.
Limitations on personal property, ch 67:12:05.
Budgeting, ch 67:12:06.
Consideration of income and resource,
		45 C.F.R. §
												400.102 (March 22, 2000).
Continued coverage of recipients who receive increased earnings from
		employment, 45 C.F.R. §
												400.104 (March 22,
		2000).
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:15 - REFUGEE MEDICAL PROGRAM › Section 67:46:15:08 - Medical services

Current through Register Vol. 51, page 10, July 15, 2024
If a refugee is eligible for services under this chapter, medical
	 assistance may be provided for a period of twelve months from the date the
	 refugee entered the United States.
General Authority:
SDCL 28-1-50.
Law Implemented:
SDCL
		28-6-1.
Medical assistance for refugees, §
											67:46:01:09.
Refugee Act of 1980, Pub. L. No. 96-212 (March 17, 1980), 94 Stat.
		115.
Covered medical services, art 67:16.
Methodology to be used to determine time-eligibility of refugees,
		45 C.F.R. §
												400.211 (March 22, 2000).
Extending Refugee Cash Assistance and Refugee Medical Assistance
		From 8 Months to 12 Months, 87 Fed. Reg. 17312 (March 28,
		2022).
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:46 - Eligibility for medical services › Chapter 67:46:15 - REFUGEE MEDICAL PROGRAM › Section 67:46:15:09 - Fair hearings

Current through Register Vol. 51, page 10, July 15, 2024
An applicant or a recipient is entitled to a fair hearing in accordance
	 with chapter 67:17:02.
General Authority:
SDCL 28-1-50.
Law Implemented:
SDCL
		28-6-1.
Hearings, 45
		C.F.R. §
												400.23 (March 22,
		2000).
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:02 - Application for child care services

Current through Register Vol. 51, page 10, July 15, 2024
A recipient desiring direct child care assistance must submit a
	 completed, written, and signed application for assistance to the department. An
	 application may not be submitted more than 30 days before the child care
	 services are needed. An initial application must show a need for at least 30
	 days of child care services.
The recipient and child must reside in South Dakota and the child must
	 be a citizen of the United States or provide proof of resident alien
	 status.
An application becomes void if the department requests additional
	 information and the recipient fails to respond within 10 working days after the
	 request.
General Authority:
SDCL
		28-1-61.
Law Implemented:
SDCL
		28-1-60.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:03 - Child care services available for certain children

Current through Register Vol. 51, page 10, July 15, 2024
A parent or guardian may be eligible for direct child care services if
	 the parent or guardian has a child who meets one of the following
	 requirements:
(1) The child is under
  age 13;
(2) The child is under age
  18 and physically or mentally incapable of self-care;
(3) The child is under age 19, is enrolled in
  school and expected to graduate, and is physically or mentally incapable of
  self-care; or
(4) The child is
  under age 18, or under 19 if enrolled in school and expected to graduate, and
  is under court supervision.
The child must reside with a recipient who is working or attending a
	 job training or educational program or the child must be receiving protective
	 services.
General Authority:
SDCL
		28-1-61.
Law Implemented:
SDCL
		28-1-60.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:03.01 - Time requirements for work and education - Exceptions

Current through Register Vol. 51, page 10, July 15, 2024
If employed, the recipient must be employed a minimum of 80 hours a
	 month and must receive a salary which is equivalent to the federal minimum wage
	 per hour. If in school, the recipient must be attending 80 school hours a
	 month. If the recipient is working and attending school, the combination of
	 actual work and school hours must be a minimum of 80 hours a month and the
	 recipient must receive a salary that is equivalent to the hourly federal
	 minimum wage. In determining whether a student has met the school hour
	 requirement, the department shall count the actual hours spent in class, work
	 study, unpaid internships, practice teaching, and clinical work
	 experience.
The recipient has met the requirements of this section if attending a
	 college, university, or technical institute a minimum of 12 semester credit
	 hours. If the household contains both parents, each parent must meet the
	 requirements of this section.
A recipient who is enrolled in and physically attending a program of
	 study or training leading to a GED or a high school diploma is exempt from the
	 requirements of this section.
General Authority:
SDCL
		28-1-61(1).
Law Implemented:
SDCL
		28-1-60.
Child care services available for certain children, §
											67:47:01:03.
Determination of incapacity, §
											67:47:01:03.03.
Certain individuals ineligible to receive child care assistance,
		§
											67:47:01:27.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:03.02 - Child care assistance for recipient working at night

Current through Register Vol. 51, page 10, July 15, 2024
A recipient who works a graveyard shift and sleeps during the day is
	 eligible for child care assistance while the recipient sleeps. Child care
	 assistance for sleep-time hours is limited to eight hours a day.
A graveyard shift consists of at least six hours of work between the
	 hours of 6:00 p.m. and 8:00 a.m.
General Authority:
SDCL
		28-1-61(2).
Law Implemented:
SDCL
		28-1-60.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:03.03 - Determination of incapacity and inability to provide child care

Current through Register Vol. 51, page 10, July 15, 2024
A recipient who is unable to work and provide child care because of an
	 incapacity that has caused a break in ongoing employment or school attendance
	 within the past year and who met the requirements of §
									67:47:01:03.01 at the time of the
	 incapacity or a recipient who has a spouse who cannot work or provide child
	 care due to a medical condition must obtain a statement from a licensed or
	 certified physician, physician's assistant, nurse practitioner, psychologist,
	 or social worker-PIP describing the recipient's incapacity, specifying the
	 length of time the incapacity is expected to last, and stating whether or not
	 the recipient who is incapacitated is able to care for the child for whom
	 assistance is being requested.
The recipient must provide the statement to the department.
The department shall use the statement to determine whether the
	 recipient is incapacitated and unable to provide child care.
General Authority:
SDCL
		28-1-61.
Law Implemented:
SDCL
		28-1-60.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:04 - Required documentation

Current through Register Vol. 51, page 10, July 15, 2024
If a child is considered a child with special needs because of a
	 physical or mental incapacity, the client must supply a document from a
	 physician, physician's assistant, nurse practitioner, psychologist, psychiatric
	 social worker, special education teacher, physical or occupational therapist,
	 or social worker which attests to the child's incapacity and documents the need
	 for special accommodations.
If a child is considered a child with special needs because the child
	 is under court supervision, the client must supply a copy of the court order
	 requiring the child care.
General Authority:
SDCL
		28-1-61(1)(5).
Law Implemented:
SDCL
		28-1-60.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:05.01 - Adjustment to gross earned income

Current through Register Vol. 51, page 10, July 15, 2024
After determining the recipient's annual gross earned income, the
	 department shall reduce that amount by four percent before computing the
	 recipient's share of child care costs.
General Authority:
SDCL
		28-1-61.
Law Implemented:
SDCL
		28-1-60.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:06 - Deadline for determining eligibility - Beginning date of eligibility

Current through Register Vol. 51, page 10, July 15, 2024
The department shall determine eligibility for child care services
	 within ten working days after receiving the completed application.
If an application is received between the 1st and 15th of the current
	 month, eligibility for assistance will begin on the 1st. If an application is
	 received on or after the 16th of the current month, eligibility will begin on
	 the 16th.
General Authority:
SDCL
		28-1-61.
Law Implemented:
SDCL
		28-1-60.
Provider eligibility, §
											67:47:01:11.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:07 - Notice to household - Issuance of child care certificate

Current through Register Vol. 51, page 10, July 15, 2024
If a recipient is eligible for child care benefits, the department
	 shall send a written notice to the recipient of the amount of child care
	 benefits payable and a child care certificate containing the amount of the
	 household's copayment. The household's copayment is determined according to
	 §
									67:47:01:08.
General Authority:
SDCL
		28-1-61.
Law Implemented:
SDCL
		28-1-60.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:08 - Household required to participate in child care costs

Current through Register Vol. 51, page 10, July 15, 2024
Household contribution rates where applicable, are available on the
	 department's website at:
http://dss.sd.gov/childcare/childcareassistance/eligible.aspx
.
The household shall pay its share of child care costs directly to its
	 primary care provider. The amount remaining on the allowable child care costs
	 is paid by the department directly to the provider.
General Authority:
SDCL
		28-1-61(2).
Law Implemented:
SDCL
		28-1-60,
		28-1-61(2).
Federal poverty level, §
											67:11:01:03; Adjustment to gross
		earned income, §
											67:47:01:05.01.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:08.01 - Family pays cost when lump sum income exceeds federal poverty level (Repealed)

Current through Register Vol. 51, page 10, July 15, 2024
General Authority:
SDCL
		28-1-61(2).
Law Implemented:
SDCL
		28-1-60.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:09 - Ineligibility when household fails to make copayments (Repealed)

Current through Register Vol. 51, page 10, July 15, 2024
General Authority:
SDCL
		28-1-61.
Law Implemented:
SDCL
		28-1-60.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:09.01 - Cooperation with Division of Child Support as condition of eligibility

Current through Register Vol. 51, page 10, July 15, 2024
Recipients of child care assistance must cooperate with the department
	 in identifying and locating the absent parent or parents, obtaining support
	 payments, establishing paternity, or obtaining any other payments or resources
	 legally due applicants or recipients. A recipient must complete an application
	 for enforcement services with the Division of Child Support as a condition of
	 eligibility for child care services. Failure to comply with this requirement or
	 failure to maintain an active enforcement case may be considered an intentional
	 program violation and may result in ineligibility for child care assistance
	 services.
The provisions of this rule do not apply if the recipient can establish
	 good cause for refusing to cooperate. Good cause is determined according to
	 §§
									67:10:01:27 to
	 67:10:01:34,
	 inclusive.
General Authority:
SDCL
		28-1-61(1).
Law Implemented:
SDCL
		28-1-60.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:10 - Maximum rates payable for child care service costs (Repealed)

Current through Register Vol. 51, page 10, July 15, 2024
General Authority:
SDCL 28-1-61(2).
Law Implemented:
SDCL
		28-1-60.
Payment rates established,
		45 C.F.R. §
												98.43
		(b).
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:10.02 - Maximum rates payable for family day care provider choosing to care for infants and toddlers and limit the number of children in care to six or less

Current through Register Vol. 51, page 10, July 15, 2024
A family day care provider who chooses to care for infants and
	 toddlers up to age three and limit the number of children in care to six or
	 less may receive a rate of reimbursement that is 25 percent higher than the
	 family day care rates. The maximum rate of reimbursement is available on the
	 department's website:
https://dss.sd.gov/childcare/childcareassistance
.
	 The provider must inform the department so the provider's registration
	 certificate may be adjusted to reflect the reduced number of
	 children.
General Authority:
SDCL
		28-1-61(2).
Law Implemented:
SDCL
		28-1-60.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:11 - Provider eligibility

Current through Register Vol. 51, page 10, July 15, 2024
Except for an in-home provider, an informal provider, or a relative
	 provider, a provider of services under this chapter must meet the applicable
	 licensing or registration requirements of article 67:42.
A relative provider must meet the requirements of §
									67:47:01:13.
An in-home provider or an informal provider must meet the requirements
	 of §
									67:47:01:13.01.
A provider registered under the requirements of chapter 67:42:17 may
	 not receive child care assistance payments for children who reside in the
	 provider's household.
A provider under this chapter must submit to the department a completed
	 and signed Internal Revenue Service W-9 form.
General Authority:
SDCL
		28-1-61.
Law Implemented:
SDCL
		28-1-60,
		28-1-61(1)(11).
Deadline for determining eligibility -- Beginning date of
		eligibility, §
											67:47:01:06.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:11.01 - Time limits for meeting provider eligibility requirements - Beginning date of payment

Current through Register Vol. 51, page 10, July 15, 2024
Payment of benefits begins with the date the department receives the
	 completed application if the provider is licensed or registered or in the
	 process of being licensed or registered. The department shall discontinue
	 payments if the required license or registration is not obtained within the
	 sixty day limit.
A relative provider has ten days to complete, sign, and return the home
	 health and safety checklist, child care services authorization form,
	 immunization verification form, and Internal Revenue Service W-9 form required
	 in §
									67:47:01:13. Payment of benefits
	 begins the date the department receives these correctly completed forms. The
	 home health and safety checklist must also contain the applicant's signature.
	 The signatures of the provider and the applicant on the home health and safety
	 checklist are acknowledgements that the provider has fulfilled the requirements
	 of the health and safety checklist. The completed forms must be postmarked
	 within ten days from the date the department mailed the forms to the
	 provider.
An in-home or informal provider must comply with the requirements of
	 §
									67:47:01:13.01. Payment for
	 services begins the date the department receives the completed intent to
	 provide services form, results of the state criminal background check, and
	 verified completion of CPR training.
If an in-home or informal provider is ineligible to receive payment due
	 to the results of the state criminal background check, the department shall
	 provide notice that they are ineligible and provide guidance regarding the
	 appeal process.
General Authority:
SDCL
		28-1-61.
Law Implemented:
SDCL
		28-1-60,
		28-1-61(1)(4).
Application for license or registration certificate, §
											67:42:17:02.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:12 - Access of recipient to child

Current through Register Vol. 51, page 10, July 15, 2024
A provider must allow a recipient unlimited access to the recipient's
	 child during the provider's normal hours of operation or whenever the child is
	 in care.
General Authority:
SDCL
		28-1-61.
Law Implemented:
SDCL
		28-1-60.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:13 - Requirements for relative provider

Current through Register Vol. 51, page 10, July 15, 2024
A relative provider must meet the following requirements:
(1) Be at least 18 years old;
(2) Have completed, signed, and returned to
  the department the health and safety checklist provided by the
  department;
(3) Have completed,
  signed, and returned to the department the form which verifies that the
  children in care meet the Department of Health's immunization
  standards;
(4) Except for an aunt,
  uncle, grandparent, or great-grandparent of the child, reside separately from
  the family receiving child care assistance;
(5) Have completed, signed, and returned to
  the department an Internal Revenue Service W-9 form; and
(6) Have completed, signed, and returned to
  the department the form that certifies the provider has read the provider
  manual, has shared the information concerning child immunizations with the
  parents, is at least 18 years old, and is providing child care services only
  for the children from one particular family.
General Authority:
SDCL
		28-1-61(1)(11).
Law Implemented:
SDCL
		28-1-60.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:13.01 - Requirements for an in-home or informal provider

Current through Register Vol. 51, page 10, July 15, 2024
An in-home or informal provider shall:
(1) Be at least eighteen years old;
(2) Submit to a background check and comply
  with the requirements of §
									67:42:17:13 for any individual who
  cares for supervises, or has unsupervised access to a child;
(3) Have documentation of orientation
  training within ninety days after the receipt of the application in each of the
  training areas listed in §
									67:42:17:17;
(4) Submit to an annual inspection and meet
  health and safety standards included in the topics listed in subdivision (3) of
  this section; and
(5) Complete a
  minimum of three hours per year of on-going training and provide verification
  of completion. Training may include any of the orientation training categories
  listed in §
									67:42:17:17.
General Authority:
SDCL
		28-1-61.
Law Implemented:
SDCL
		28-1-60,
		28-1-61(1)(11).
Background check, §
											67:42:17:13.
Orientation training, §
											67:42:17:17.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:15 - Provider's portion of child care certificate - Completion of request for payment form required for payment - Provider to bill usual and customary charge

Current through Register Vol. 51, page 10, July 15, 2024
When the recipient has selected a qualifying provider, a copy of the
	 child care certificate will be sent to the provider. To receive payment, the
	 provider must complete the request for payment within 60 days following the
	 expiration date contained on the child care certificate. The unit price billed
	 for the child care services provided must be the provider's usual and customary
	 charge for the same services provided on the same date to the general
	 public.
When the recipient has changed providers, the department shall notify
	 the previous provider in writing and shall indicate on the notice the revised
	 expiration date.
General Authority:
SDCL
		28-1-61.
Law Implemented:
SDCL
		28-1-60.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:16 - Payment of benefits

Current through Register Vol. 51, page 10, July 15, 2024
The department shall pay child care service benefits directly to the
	 provider within 15 working days following receipt of the completed forms
	 required under §
									67:47:01:15. The maximum amount
	 paid is the difference between the actual allowable child care service costs
	 and the amount the household is required to pay from its own
	 funds.
General Authority:
SDCL
		28-1-61.
Law Implemented:
SDCL
		28-1-60.
Maximum child care service costs, §
											67:47:01:01; Household required to
		participate in child care costs, §
											67:47:01:08.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:17

Current through Register Vol. 51, page 10, July 15, 2024
General Authority:
SDCL
		28-1-61.
Law Implemented:
SDCL
		28-1-60.
Provider eligibility -- Exemptions, §
											67:47:01:11.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:18 - Household to report change in circumstances

Current through Register Vol. 51, page 10, July 15, 2024
A household shall report to the department when they experience any of
	 the following changes:
(1) A permanent
  change in employment or school status;
(2) A change in child care
  provider;
(3) An address change;
  or
(4) If the monthly household
  gross income exceeds 85 percent of the state median income.
All changes shall be reported to the department in writing. If the
	 change positively affects the household's level of assistance, the change in
	 circumstances is effective the date the change occurred if the notice is
	 postmarked within ten working days after the date of the change. If the notice
	 is postmarked more than ten working days after the change occurred, the change
	 is effective the date the change of notice is received.
If a family has a permanent change in employment or school status, care
	 may be extended three months from the last date of employment or school
	 attendance to allow the recipient time to meet the minimum work and/or school
	 requirements.
General Authority:
SDCL
		28-1-61.
Law Implemented:
SDCL
		28-1-60.
Department may withhold payments, §
											67:47:01:24.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:19 - Redetermination of eligibility and copayment

Current through Register Vol. 51, page 10, July 15, 2024
The department shall determine a recipient's eligibility for child
	 care assistance and the amount of the recipient's copayment once every twelve
	 months. If during the twelve-month period one of the following situations
	 occurs, the department shall reevaluate program eligibility:
(1) The recipient's child(ren) has excessive
  unexplained absences from the child care program in excess of 10 consecutive
  days;
(2) The recipient has moved
  out of the state of South Dakota;
(3) There has been a substantiated fraud or
  intentional program violation that invalidates the recipient's prior
  eligibility determination; or
(4)
  The recipient's household income has increased and now exceeds 85 percent of
  the state median income.
A household that reapplies for child care assistance within 30 days
	 immediately following a month of eligibility and whose income now exceeds 209
	 percent of the federal poverty level may receive up to an additional twelve
	 months of child care assistance.
General Authority:
SDCL
		28-1-61(1)(2)(11).
Law Implemented:
SDCL
		28-1-60.
Recovery of overpayments, §
											67:47:01:22.
Department to investigate report -- Notice of action -- Review --
		Final determination, §
											67:47:01:25.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:20 - Financial complaints

Current through Register Vol. 51, page 10, July 15, 2024
The department shall maintain a record of financial complaints between
	 a recipient and the child care provider. The department shall make information
	 concerning financial complaints available to the public on
	 request.
General Authority:
SDCL
		28-1-61.
Law Implemented:
SDCL
		28-1-60.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:22 - Recovery of overpayments

Current through Register Vol. 51, page 10, July 15, 2024
A household is ineligible to receive continued child care services if
	 it fails to supply information which adversely affects its level of child care
	 assistance, it supplies false information, or it fails to repay or make
	 arrangements with the department for the repayment of overpayments.
	 Overpayments are subject to recovery by the department.
General Authority:
SDCL
		28-1-61.
Law Implemented:
SDCL
		28-1-60.
South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:47 - Child care services › Chapter 67:47:01 - Assistance with child care costs › Section 67:47:01:24 - Department may withhold payments

Current through Register Vol. 51, page 10, July 15, 2024
The department may withhold payments, in whole or in part, to a
	 provider if any of the following situations exist:
(1) The department has information which
  verifies that the provider is not entitled to receive child care
  benefits;
(2) The provider is
  serving a disqualification penalty under the provisions of chapter
  67:48:05;
(3) The department has
  information which verifies that the provider is receiving reimbursement for the
  same service from another program or agency;
(4) The department has an outstanding
  overissuance against the provider; or
(5) The department requests sign-in and
  sign-out sheets, and the provider does not provide them to the department
  within the requested time frame.
The department shall send notice of the action to the provider no later
	 than the date the provider would normally receive a child care payment. The
	 notice shall specify the reason the child care assistance payment is being
	 adjusted or withheld.
General Authority:
SDCL
		28-1-61.
Law Implemented:
SDCL
		28-1-60.
Overpayments -- Hearings -- Payments made pending hearing, §
											67:47:01:25.01.