reglab/statecodes huggingface dataset:
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:10 - Family support services › Section 46:11:10:01 - Definitions

Current through Register Vol. 51, page 10, July 15, 2024
Terms used in this chapter mean:
(1) "Coordinator," an individual employed by
  a provider meetinfi the requirements of this chapter, to assist participants
  who receive family support services in gaining access to needed family support
  and other available services, as well as needed medical social, educational,
  and other services, regardless of the funding source for the services to which
  access is gained;
(2) "Home," the
  participant's residence where family support services are provided;
(3) "Home modifications," remodeling or
  refurbishing of a home owned by the participant or the participant's family to
  increase accessibility, to enhance adaptability for that participant, to
  facilitate the participant's independence, or to allow a participant to remain
  in that home in lieu of an alternative living arrangement;
(4) "Individualized service plan" or "ISP," a
  written plan of services or supports for a participant, which is developed,
  implemented, reviewed, and modified according to the provisions of this
  chapter;
(5) "Parent," a
  participant's biological, adoptive, or stepparent, or any relative who acts in
  a parental capacity on an extended or full-time basis;
General Authority:
SDCL
		27B-2-26.
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:10 - Family support services › Section 46:11:10:02 - Local family support program

Current through Register Vol. 51, page 10, July 15, 2024
A local family support program provides services, supports, and other
	 assistance through a coordinator to a participant who has a developmental
	 disability and lives in a home. Services, supports, and other assistance
	 available under the local family support program include:
(1) Providing information and referral to
  other available resources as needed;
(2) Providing service coordination;
(3) Providing advocacy services;
  and
(4) Providing financial
  assistance to purchase supports and services that are included in the ISP and
  approved by the division.
General Authority:
SDCL
		27B-2-26(7).
Law Implemented:
SDCL
		27B-2-26(3)(7).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:10 - Family support services › Section 46:11:10:03

Current through Register Vol. 51, page 10, July 15, 2024
General Authority:
SDCL
		27B-2-26(7).
Law Implemented:
SDCL
		27B-2-26(3)(7).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:10 - Family support services › Section 46:11:10:04 - Local family support provider

Current through Register Vol. 51, page 10, July 15, 2024
A local family support provider must be a CSP or SP and have a provider
	 agreement with the division.
General Authority:
SDCL
		27B-2-26(7).
Law Implemented:
SDCL
		27B-2-26(7).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:10 - Family support services › Section 46:11:10:05 - Local family support eligibility

Current through Register Vol. 51, page 10, July 15, 2024
Eligibility for family support services is described in §
									67:54:09:12.
General Authority:
SDCL
		27B-2-26(7).
Law Implemented:
SDCL
		27B-2-26(7).
Prolonged assistance defined, §
		24:05:24.01:15.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:10 - Family support services › Section 46:11:10:06 - Strengthening families program

Current through Register Vol. 51, page 10, July 15, 2024
The strengthening families program is available to a family who has a
	 child or adult who meets eligibility criteria as defined in §
									46:11:10:07 and who is not
	 receiving services from a provider. The strengthening families program does not
	 provide service coordination to families. The division determines eligibility
	 and authorizes payment for items and supplies that are requested by eligible
	 families.
General Authority:
SDCL
		27B-2-26(7).
Law Implemented:
SDCL
		27B-2-26(3)(7).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:10 - Family support services › Section 46:11:10:07 - Strengthening families program eligibility

Current through Register Vol. 51, page 10, July 15, 2024
An individual must meet the following criteria to be eligible to
	 receive items and services under the strengthening families program:
(1) The individual must be a resident of
  South Dakota;
(2) The individual
  must have a developmental disability as defined in SDCL
  27B-1-18 or be a child, birth
  through two years of age, who has been identified by the Department of
  Education as a child needing prolonged assistance as defined in §
  24:05:24.01:15; and
(3) If the
  individual is under 18 years of age, the individual must be living in a home
  with a parent or guardian.
General Authority:
SDCL
		27B-2-26(7).
Law Implemented:
SDCL
		27B-2-26(7).
Prolonged assistance defined, §
		24:05:24.01:15.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:10 - Family support services › Section 46:11:10:08 - Strengthening families program notice of ineligibility

Current through Register Vol. 51, page 10, July 15, 2024
The division shall determine eligibility for any individual applying
	 for the strengthening families program within 14 calendar days of receipt of
	 the application.
The division shall send a written notice to the applicant or the
	 applicant's parent, if the applicant is under 18 years of age, or guardian
	 informing the applicant of the results of the eligibility determination. If the
	 applicant is determined to be ineligible, the notice shall state the reason the
	 applicant is not eligible and the process for appealing the decision pursuant
	 to §
									46:11:10:09.
General Authority:
SDCL
		27B-2-25,
		27B-2-26(7).
Law Implemented:
SDCL
		27B-2-25,
		27B-2-26(4)(7).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:10 - Family support services › Section 46:11:10:09 - Appeal of ineligibility of strengthening families program services

Current through Register Vol. 51, page 10, July 15, 2024
An individual, and individual's parent, if the individual is under 18
	 years of age, or an individual's guardian, if any, may appeal the strengthening
	 families program manager's decision regarding ineligibility of services to the
	 division.
An appeal shall be made in writing to the division within 30 calendar
	 days of receipt of the notice regarding ineligibility. The division shall
	 provide a determination within 30 calendar days of receipt of request for
	 appeal.
An individual, an individual's parent, if the individual is under 18
	 years of age, or an individual's guardian, if any, dissatisfied with the
	 division's determination regarding ineligibility of services may appeal the
	 division's decision.
An appeal shall be made in writing to the department secretary within
	 30 calendar days of receipt of the notice regarding ineligibility. The
	 department secretary shall provide a determination within 30 calendar days of
	 receipt of request for appeal.
An individual, an individual's parent, if the individual is under 18
	 years of age, or an individual's guardian, if any, dissatisfied with the
	 department secretary's determination regarding ineligibility of services may
	 request a fair hearing by notifying the department in writing within 30
	 calendar days of receipt of the department's decision. A fair hearing shall be
	 conducted pursuant to the provisions of SDCL chapter 1-26.
The department may not pay for legal fees for representing the
	 individual, the individual's parent, or guardian at a fair hearing pursuant to
	 this section.
General Authority:
SDCL
		27B-2-25,
		27B-2-26(7).
Law Implemented:
SDCL
		27B-2-25,
		27B-2-26(4)(7).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:10 - Family support services › Section 46:11:10:10 - Services and supports

Current through Register Vol. 51, page 10, July 15, 2024
Services and supports are based on each participant's needs as
	 identified through an assessment process and must be agreed to by the
	 participant, the participant's parent if the participant is under 18 years of
	 age, or the participant's guardian, if any, and the coordinator. The services
	 and supports provided by the local family support program must be documented in
	 the participant's ISP and submitted to the division for
	 approval.
General Authority:
SDCL
		27B-2-26(7).
Law Implemented:
SDCL
		27B-2-26(3)(7).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:10 - Family support services › Section 46:11:10:11 - Prior authorization required

Current through Register Vol. 51, page 10, July 15, 2024
The coordinator must approve the purchase of any services or supports
	 covered under this chapter for the local family support program before the
	 services or supports are purchased.
The division must approve the purchase of any items or supplies covered
	 under this chapter for the strengthening families program before the items or
	 supplies are purchased.
General Authority:
SDCL
		27B-2-26(7).
Law Implemented:
SDCL
		27B-2-26(3)(7).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:10 - Family support services › Section 46:11:10:12

Current through Register Vol. 51, page 10, July 15, 2024
General Authority:
SDCL
		27B-2-26(7).
Law Implemented:
SDCL
		27B-2-26(7).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:10 - Family support services › Section 46:11:10:13 - Non-covered expenses

Current through Register Vol. 51, page 10, July 15, 2024
The following items are not covered:
(1) Incontinence supplies for a child under 3
  years of age;
(2)
  Vehicles;
(3) Purchases made
  without the prior approval of the coordinator for the local family support
  program or the division for the strengthening families program; and
(4) Any services, items, or supplies eligible
  for payment under another payment source.
General Authority:
SDCL
		27B-2-26(7).
Law Implemented:
SDCL
		27B-2-26(7).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:10 - Family support services › Section 46:11:10:14 - Safety assurance

Current through Register Vol. 51, page 10, July 15, 2024
The coordinator must assess that services funded by the local family
	 support program are provided in a safe environment. The division shall provide
	 an internal checklist for home and community resources and a checklist of
	 safety guidelines. The coordinator shall complete the internal checklist and
	 the safety checklist upon initiation of services and annually thereafter. The
	 coordinator shall provide information to the participant and the participant's
	 family when safety concerns are identified. The coordinator shall monitor
	 actions taken.
General Authority:
SDCL
		27B-2-26(7).
Law Implemented:
SDCL
		27B-2-26(4)(7).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:10 - Family support services › Section 46:11:10:15 - Termination of services or benefits

Current through Register Vol. 51, page 10, July 15, 2024
Services or payment of items or supplies may be terminated if one of
	 the following occurs:
(1) The
  participant no longer meets eligibility criteria pursuant to §
									46:11:10:05 or
  46:11:10:07;
(2) A misuse of funds by the participant or
  the participant's parent or guardian is substantiated;
(3) There is a request to terminate services
  by the participant or the participant's parent or guardian; or
(4) Funding for the local family support or
  strengthening families program become unavailable.
If services or benefits are going to be terminated, the coordinator for
	 the local family support program or the division for the strengthening families
	 program shall provide a written notice to the participant or the participant's
	 parent or guardian, ten calendar days before the service or benefits are to be
	 discontinued. The notice shall contain the reason for the discontinuance and
	 the process for appeal pursuant to §
										46:11:10:09 for strengthening
	 families services or §
										46:11:10:16 for local family
	 support.
General Authority:
SDCL
		27B-2-25,
		27B-2-26(7).
Law Implemented:
SDCL
		27B-2-25,
		27B-2-26(4)(7).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:10 - Family support services › Section 46:11:10:16 - Appeal of ineligibility or termination of local family support services

Current through Register Vol. 51, page 10, July 15, 2024
A participant, a participant's parent if the participant is under 18
	 years of age, or a participant's guardian, if any, may appeal the agency's
	 decision regarding ineligibility or termination of services to the
	 division.
An appeal must be made in writing to the division within 30 calendar
	 days of receipt of the notice regarding ineligibility or termination. The
	 division shall provide a determination with 30 calendar days of receipt of
	 request for appeal.
A participant, a participant's parent if the participant is under 18
	 years of age, or a participant's guardian, if any, dissatisfied with the
	 division's determination regarding ineligibility or termination of services may
	 appeal the division's decision.
An appeal must be made in writing to the department secretary within 30
	 calendar days of receipt of the notice regarding ineligibility or termination.
	 The department secretary shall provide a determination within 30 calendar days
	 of receipt of request for appeal.
A participant, a participant's parent if the participant is under 18
	 years of age, or a participant's guardian, if any, dissatisfied with the
	 department secretary's determination may request a fair hearing by notifying
	 the department in writing within 30 calendar days of receipt of the
	 department's decision. A fair hearing shall be conducted pursuant to the
	 provisions of SDCL chapter 1-26.
When termination is being appealed the participant shall continue
	 receiving services from the local family support program until a final decision
	 is reached pursuant to SDCL chapter 1-26.
The department may not pay for legal fees for representing the
	 individual, the individual's parent, or guardian at a fair hearing pursuant to
	 this section.
General Authority:
SDCL
		27B-2-25,
		27B-2-26(7).
Law Implemented:
SDCL
		27B-2-25,
		27B-2-26(4)(7).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:11 - Community training services › Section 46:11:11:01 - Definitions

Current through Register Vol. 51, page 10, July 15, 2024
Terms used in this chapter mean:
(1) "Earned income," cash or in-kind payments
  consisting of wages or net earnings from self-employment;
(2) "Gross income," sums of money received
  from both earned and unearned income before deductions.
General Authority:
SDCL
		27B-2-26.
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:11 - Community training services › Section 46:11:11:02 - Community training services

Current through Register Vol. 51, page 10, July 15, 2024
Community training services, or CTS are those services a participant
	 may receive during a given week. These services must meet the service standards
	 of chapter 46:11:05. These services include:
(1) Prevocational training;
(2) Community living training; or
(3) Expanded follow-along services.
General Authority:
SDCL
		27B-2-26(3).
Law Implemented:
SDCL
		27B-2-26.
Service standards. Chapter
		46:11:05.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:11 - Community training services › Section 46:11:11:03 - Eligibility

Current through Register Vol. 51, page 10, July 15, 2024
To be eligible to receive CTS a participant shall meet the following
	 criteria:
(1) Have a developmental
  disability as defined in SDCL
  27B-1-18;
(2) Be at least 16 years of age or if 21
  years of age or younger, may not be eligible for special education services
  pursuant to chapter 24:05:24.01;
(3) Have three or more substantial functional
  limitations determined by an ICAP; and
(4) Meet the income guidelines in §
									46:11:11:05 or meet the criteria
  for a special emergency provision pursuant to §
									46:11:11:06.
An ICAP must be completed initially to determine eligibility and
	 annually thereafter to determine continued eligibility.
General Authority:
SDCL
		27B-2-26(2).
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:11 - Community training services › Section 46:11:11:04 - Unearned income defined

Current through Register Vol. 51, page 10, July 15, 2024
Unearned income is all income that is not earned. It may be received in
	 cash or in kind. The following are types of unearned income:
(1) Annuities, pensions, and other periodic
  payments, such as private pensions, social security benefits, disability
  benefits, veterans' benefits, workers' compensation, railroad retirement
  annuities, and unemployment insurance benefits;
(2) Alimony and child support
  payments;
(3) Dividends, interest,
  and royalties;
(4) Death benefits;
  and
(5) Gifts and
  inheritances.
General Authority:
SDCL
		27B-2-26.
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:11 - Community training services › Section 46:11:11:05 - Payment for CTS

Current through Register Vol. 51, page 10, July 15, 2024
CTS shall be provided cost-free to an eligible participant whose net
	 income is less than 185 percent of the federal poverty level or is a recipient
	 of or eligible for Supplemental Security Income. If the participant's income
	 equals or exceeds 185 percent of the federal poverty level, the participant
	 shall pay 100 percent of the costs of services received.
General Authority:
SDCL
		27B-2-26(2).
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:11 - Community training services › Section 46:11:11:06 - Special emergency provision

Current through Register Vol. 51, page 10, July 15, 2024
To be eligible to receive a special emergency provision a participant
	 shall meet the following criteria;
(1)
  Have an income that falls below 115 percent of the state median
  income;
(2) Be at imminent risk of
  hospitalization or require more comprehensive and costly support; and
(3) Have explored and exhausted all other
  available options.
General Authority:
SDCL
		27B-2-26(2).
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:11 - Community training services › Section 46:11:11:07 - Appeal of ineligibility of services

Current through Register Vol. 51, page 10, July 15, 2024
A participant, a participant's parent if the participant is under 18
	 years of age, or a participant's guardian, if any, may appeal the agency's
	 decision regarding ineligibility of services to the division.
An appeal shall be made in writing to the division within 30 calendar
	 days of receipt of the notice regarding ineligibility. The division shall
	 provide a determination within 30 calendar days of receipt of request for
	 appeal.
A participant, a participant's parent if the participant is under 18
	 years of age, or a participant's guardian, if any, dissatisfied with the
	 division's determination regarding ineligibility of services may appeal the
	 division's decision.
An appeal shall be made in writing to the department secretary within
	 30 calendar days of receipt of the notice regarding ineligibility. The
	 department secretary shall provide a determination within 30 calendar days of
	 receipt of request for appeal.
A participant, a participant's parent if the participant is under 18
	 years of age, or a participant's guardian, if any, dissatisfied with the
	 department secretary's determination may request a fair hearing by notifying
	 the department in writing within 30 calendar days of receipt of the
	 department's decision. A fair hearing shall be conducted pursuant to the
	 provisions of SDCL chapter 1-26.
The department may not pay for legal fees for representing the
	 individual, the individual's parent, or guardian at a fair hearing pursuant to
	 this section.
General Authority:
SDCL
		27B-2-25,
		27B-2-26(7).
Law Implemented:
SDCL
		27B-2-25,
		27B-2-26(4)(7).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:12 - Respite care services › Section 46:11:12:01 - Definitions

Current through Register Vol. 51, page 10, July 15, 2024
Terms used in this chapter mean:
(1) "Respite care," services provided to
  families of a child or adult participant for a short time because of the
  absence of or need for relief of the family member normally providing the
  care.
General Authority:
SDCL
		27B-2-26(6).
Law Implemented:
SDCL
		27B-2-26(6).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:12 - Respite care services › Section 46:11:12:02 - Eligibility

Current through Register Vol. 51, page 10, July 15, 2024
A family residing in South Dakota may be eligible for respite care if
	 the family has a child or adult family member who lives with a parent or other
	 family member on a full-time basis and one of the following apply to the child
	 or adult family member:
(1) Is a child
  or an adult and has a developmental disability as defined in SDCL
  27B-1-18;
(2) Is three years of age or younger and has
  a developmental delay;
(3) Is a
  child and has a serious emotional disturbance as defined in SDCL
  27A-15-1.1;
(4) Is an adult and has a severe and
  persistent mental illness as defined in subdivision 46:20:18:01(22);
(5) Is a child and has a chronic medical
  condition;
(6) Is a child and a
  member of a post-adoptive family; or
(7) Is a child or an adult and has a
  traumatic brain injury.
An adult or child eligible for family support waiver services is not
	 eligible for services under this chapter.
General Authority:
SDCL
		27B-2-26(6).
Law Implemented:
SDCL
		27B-2-26(6).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:12 - Respite care services › Section 46:11:12:03 - Application and approval

Current through Register Vol. 51, page 10, July 15, 2024
A family who wishes to participate in the respite care program must
	 submit a signed, completed application to the division on the form provided by
	 the division. If the application is approved, Information and Request for
	 Payment forms shall be sent to the family.
General Authority:
SDCL
		27B-2-26(6).
Law Implemented:
SDCL
		27B-2-26(6).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:12 - Respite care services › Section 46:11:12:04 - Documentation required

Current through Register Vol. 51, page 10, July 15, 2024
If the individual has a developmental disability, developmental delay,
	 traumatic brain injury, or chronic medical condition, a copy of a document
	 containing the diagnosis and name of the physician, psychiatrist, or
	 psychologist issuing the diagnosis must be submitted with the
	 application.
If the individual is a child with a serious emotional disturbance or if
	 the individual is an adult with a severe and persistent mental illness, a
	 Mental Health Summary Evaluation form as provided by the division must be
	 submitted with the application.
If a post-adoptive family is seeking services, a copy of the court
	 order of adoption must be submitted with the completed
	 application.
General Authority:
SDCL
		27B-2-26(6).
Law Implemented:
SDCL
		27B-2-26(6).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:12 - Respite care services › Section 46:11:12:05 - Notice of ineligibility

Current through Register Vol. 51, page 10, July 15, 2024
If the division determines that a family is ineligible, the division
	 shall notify the family in writing of the reason for ineligibility within 60
	 calendar days upon receipt of the completed application. The notice shall
	 include the process of appeal pursuant to §
									46:11:12:11.
General Authority:
SDCL
		27B-2-25,
		27B-2-26(6).
Law Implemented:
SDCL
		27B-2-25,
		27B-2-26(6).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:12 - Respite care services › Section 46:11:12:06 - Providers

Current through Register Vol. 51, page 10, July 15, 2024
Any family participating in the respite care program is responsible for
	 recruiting, screening, selecting, and training respite care
	 providers.
General Authority:
SDCL
		27B-2-26(6).
Law Implemented:
SDCL
		27B-2-26(6).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:12 - Respite care services › Section 46:11:12:07 - Mid-year application

Current through Register Vol. 51, page 10, July 15, 2024
An eligible family that applies after December 1 may receive
	 authorization for up to one-half the current annual amount allotted to that
	 family.
General Authority:
SDCL
		27B-2-26(6).
Law Implemented:
SDCL
		27B-2-26(6).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:12 - Respite care services › Section 46:11:12:08 - Extraordinary respite care funding

Current through Register Vol. 51, page 10, July 15, 2024
After the first six months of the state's fiscal year, additional
	 respite care funding may be authorized for a family after the annual amount
	 allotted to that family has been expended. If funding is available, a family
	 may receive one additional allotment up to the original amount in the following
	 situations:
(1) The primary caretaker
  is hospitalized;
(2) A natural
  disaster has occurred at or near the family's home;
(3) The eligible child or eligible adult has
  developed an unexpected illness or has been hospitalized; or
(4) The family will suffer a significant
  hardship that can be alleviated by respite care.
General Authority:
SDCL
		27B-2-26(6).
Law Implemented:
SDCL
		27B-2-26(6).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:12 - Respite care services › Section 46:11:12:09 - Recovery of overpayments

Current through Register Vol. 51, page 10, July 15, 2024
Any respite care payment made as a result of an agency error, client
	 error, or fraud is considered an overpayment and is subject to recovery by the
	 division.
General Authority:
SDCL
		27B-2-26(6).
Law Implemented:
SDCL
		27B-2-26(6).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:12 - Respite care services › Section 46:11:12:10 - Termination of services

Current through Register Vol. 51, page 10, July 15, 2024
Services shall terminate when:
(1) The family no longer meets the
  eligibility criteria as defined in §
									46:11:12:02;
(2) A misuse of funds is substantiated;
  or
(3) There is a request by the
  family or the participant's guardian to terminate services.
If termination occurs pursuant to subdivisions (1) and (2) of this
	 section, the division shall provide a written notice of the reason for
	 termination to the family ten calendar days prior to the termination of
	 services. The notice shall include the process of appeal pursuant to §
										46:11:12:11.
General Authority:
SDCL
		27B-2-25,
		27B-2-26(6).
Law Implemented:
SDCL
		27B-2-25,
		27B-2-26(6).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:12 - Respite care services › Section 46:11:12:11 - Appeal of ineligibility or termination

Current through Register Vol. 51, page 10, July 15, 2024
A family may appeal the division's decision regarding ineligibility or
	 termination of services by requesting a fair hearing pursuant to SDCL 1-26 by
	 notifying the department in writing within 30 calendar days of receipt of the
	 division's decision. The family shall continue receiving services until a
	 decision is reached.
Nothing in this section may be construed as indicating that the
	 department will pay for legal fees for representing the family at a fair
	 hearing pursuant to this section.
General Authority:
SDCL
		27B-2-25,
		27B-2-26(6).
Law Implemented:
SDCL
		27B-2-25,
		27B-2-26(6).
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:12 - Respite care services › Section 46:11:12:12 - Time and place of hearing - Time extension

Current through Register Vol. 51, page 10, July 15, 2024
A fair hearing, pursuant to SDCL 1-26, by an impartial hearing officer
	 shall be held within 90 calendar days after receipt for a request by the
	 participant or the participant's parent or guardian. The impartial hearing
	 officer shall set a time and place for the hearing to be held at the earliest
	 reasonable time. The hearing examiner may continue the hearing at the request
	 of any party involved. A request for a continuance must be made at least ten
	 calendar days prior to the date of the hearing.
General Authority:
SDCL
		27B-2-25.
Law Implemented:
SDCL
		27B-2-25.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:13 - Preadmission screening and resident reviews › Section 46:11:13:01 - Definitions

Current through Register Vol. 51, page 10, July 15, 2024
Terms in this chapter mean:
(1) "Active treatment," the implementation of
  a program of specialized and generic training, treatment, health services, and
  related services that lead to the acquisition of the behaviors necessary for
  the individual to function with as much self-determination and independence as
  possible and to prevent regression or loss of current optimal functional
  status;
(2) "Dementia," disorders
  characterized by the development of multiple cognitive deficits, including
  memory impairment, that are due to the direct physiological effects of a
  general medical condition, to the persisting effects of a substance, or to
  multiple etiologies such as the combined effects of cerebrovascular disease and
  Alzheimer's disease:
(3) "Nursing
  facility," as defined in subdivision 67:45:01:01(9);
(4) "Preadmission screening and resident
  review" or "PASRR," a process made up of a Level I screening completed by the
  Department of Social Services and a Level II review completed by the division
  to determine eligibility when an individual with a diagnosis of developmental
  disability as defined in SDCL
  27B-1-18 applies to reside in a
  Medicaid certified swing bed or nursing facility;
(5) "Resident review," a review to determine
  if residence in a nursing facility remains appropriate and if specialized
  services are needed;
(6)
  "Specialized services," the services specified by the state for the individual
  which, combined with the services provided by the nursing facility or other
  service providers, results in active treatment;
(7) "Swing bed," as defined in subdivision
  67:45:01:01(2).
General Authority:
SDCL
		27B-2-26(8).
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:13 - Preadmission screening and resident reviews › Section 46:11:13:02 - Level I screening

Current through Register Vol. 51, page 10, July 15, 2024
The Department of Social Services shall conduct a Level I screening
	 that identifies each individual who is seeking a Medicaid certified swing bed
	 or nursing facility services who may have an intellectual disability or
	 developmental disability.
General Authority:
SDCL
		27B-2-26(8).
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:13 - Preadmission screening and resident reviews › Section 46:11:13:03 - Level II review exemptions

Current through Register Vol. 51, page 10, July 15, 2024
An individual is exempt from a Level II review if at least one of the
	 following occurs:
(1) The diagnosis of
  an intellectual disability or developmental disability is
  unsubstantiated;
(2) An individual
  is readmitted to a Medicaid certified swing bed or nursing facility from a
  hospital to which the individual was transferred for the purpose of receiving
  care;
(3) An individual is
  transferred from a Medicaid certified swing bed or nursing facility to another
  and a PASRR has previously been completed;
(4) The physician identifies the need for
  convalescent care following hospitalization for a duration of less than 100
  days; or
(5) A physician ordered
  respite stay of 30 days or less.
The Department of Social Services shall complete a Level I screening
	 form to notify appropriate parties of the determination of the
	 exemption.
General Authority:
SDCL
		27B-2-26(8).
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:13 - Preadmission screening and resident reviews › Section 46:11:13:04 - Exempt hospital discharge

Current through Register Vol. 51, page 10, July 15, 2024
An individual is exempt from a PASRR following a hospital discharge if
	 the following conditions are met:
(1)
  The individual is admitted to a Medicaid certified swing bed or nursing
  facility directly from a hospital after receiving acute inpatient care at the
  hospital;
(2) The individual
  requires Medicaid certified swing bed or nursing facility services for the same
  condition for which care was received in the hospital; and
(3) The individual's attending physician has
  certified before admission to the Medicaid certified swing bed or nursing
  facility that the individual is likely to require less than 30 calendar days of
  Medicaid certified swing bed or nursing facility services.
If an individual enters a Medicaid certified swing bed or nursing
	 facility as an exempt hospital discharge and is later found to require more
	 than 30 days of nursing care, the facility shall request a PASRR prior to the
	 expiration of that 30 days.
General Authority:
SDCL
		27B-2-26(8).
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:13 - Preadmission screening and resident reviews › Section 46:11:13:05 - Categorical determinations for Level I

Current through Register Vol. 51, page 10, July 15, 2024
A categorical determination is made by the Department of Social
	 Services. A categorical determination may warrant Medicaid certified swing bed
	 or nursing facility services but does not warrant specialized services. A
	 situation known as a categorical situation is one of the following:
(1) A terminal illness diagnosis, determined
  by a physician or hospice involvement that includes a life expectancy of six
  months or less;
(2) A severe
  physical illness which has resulted in a coma or ventilator
  dependence;
(3) The age of the
  individual is 75 years or older; or
(4) A primary diagnosis of dementia,
  including Alzheimer's disease or a related disorder; or a non-primary diagnosis
  of dementia without a primary diagnosis that is a serious mental illness.
For any of these situations, the Department of Social Services shall
	 complete a Level I screening form. A copy of the form shall be sent to the
	 division and any appropriate facility.
General Authority:
SDCL
		27B-2-26(8).
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:13 - Preadmission screening and resident reviews › Section 46:11:13:06 - Level II review

Current through Register Vol. 51, page 10, July 15, 2024
The division shall conduct a Level II review that consists of
	 determining appropriateness of Medicaid certified swing bed or nursing facility
	 services and specialized services for individuals identified in the Level I
	 screening.
Each individual is reviewed for appropriateness of placement,
	 regardless of the source of payment for the swing bed or nursing facility
	 services. A determination whether or not an individual requires the level of
	 services provided by the facility and whether or not an individual can benefit
	 from specialized services is made.
General Authority:
SDCL
		27B-2-26(8).
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:13 - Preadmission screening and resident reviews › Section 46:11:13:07 - Level II determination - Data requirements

Current through Register Vol. 51, page 10, July 15, 2024
The data used for a Level II determination includes:
(1) A comprehensive social and developmental
  history and physical, including:
(a) Medical
  history;
(b) Review of body
  systems;
(c) Evaluation of the
  individual's neurological system in the areas of motor functioning, sensory
  functioning, gait, deep tendon reflexes, cranial nerves, and abnormal reflexes;
  and
(d) Additional evaluations
  conducted by appropriate specialists in case of abnormal findings;
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:13 - Preadmission screening and resident reviews › Section 46:11:13:08 - Determination of services

Current through Register Vol. 51, page 10, July 15, 2024
The division shall determine if the individual requires the level of
	 services provided by a Medicaid certified swing bed or nursing facility due to
	 the individual's physical or mental condition. If the division determines that
	 an individual requires a Medicaid certified swing bed or nursing facility
	 services, the facility may admit or retain the individual. If the division
	 determines that an individual does not require Medicaid certified swing bed or
	 nursing facility services, the individual may not be
	 admitted.
General Authority:
SDCL
		27B-2-26(8).
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:13 - Preadmission screening and resident reviews › Section 46:11:13:09 - Determination of specialized services

Current through Register Vol. 51, page 10, July 15, 2024
If the division determines that the individual requires Medicaid
	 certified swing bed or nursing facility services, the division shall also
	 determine whether the individual may benefit from specialized services as
	 defined in subdivision 46:11:13:01(6).
If the division determines that an individual requires both Medicaid
	 certified swing bed or nursing facility services and specialized services, the
	 nursing facility may admit or retain the individual and the state shall provide
	 or arrange for the provision of the specialized services needed by the
	 individual in the Medicaid certified swing bed or nursing facility.
If the division determines that the individual does not require
	 Medicaid certified swing bed or nursing facility services, but may benefit from
	 specialized services, the division shall provide the individual with
	 information regarding service options.
General Authority:
SDCL
		27B-2-26(8).
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:13 - Preadmission screening and resident reviews › Section 46:11:13:10 - Timeliness of determination of Level II review

Current through Register Vol. 51, page 10, July 15, 2024
The division shall make each Level II determination within an annual
	 average of seven to nine business days of receipt of the Level I screening and
	 all the information required in §
									46:11:13:07.
General Authority:
SDCL
		27B-2-26(8).
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:13 - Preadmission screening and resident reviews › Section 46:11:13:11 - Notification of Level II determination

Current through Register Vol. 51, page 10, July 15, 2024
The division shall issue a written notification of the Level II review
	 determination. The notification shall include:
(1) The name of each professional who
  performed an evaluation used to make the Level II determination;
(2) The date each portion of the evaluation
  was administered; and
(3) Any other
  information used to make the Level II determination.
A copy of this notification shall be sent to the individual the Level
	 II review was completed on, the individual's legal representative if
	 applicable, the Medicaid certified swing bed or nursing facility, and any other
	 party affected by the Level II determination.
General Authority:
SDCL
		27B-2-26(8).
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:13 - Preadmission screening and resident reviews › Section 46:11:13:12 - Determination may not be countermanded

Current through Register Vol. 51, page 10, July 15, 2024
A Level II determination made by the division may not be countermanded
	 by the Department of Social Services.
General Authority:
SDCL
		27B-2-26(8).
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:13 - Preadmission screening and resident reviews › Section 46:11:13:13 - Appeal of ineligibility of Level II determination

Current through Register Vol. 51, page 10, July 15, 2024
The individual, or the individual's legal representative, may request a
	 fair hearing within 30 calendar days of receipt of the notice of ineligibility
	 pursuant to SDCL chapter 1-26 by notifying the department orally or in writing.
	 Any costs associated with legal counsel obtained to represent the individual
	 are not the responsibility of the department.
General Authority:
SDCL
		27B-2-26(8).
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:13 - Preadmission screening and resident reviews › Section 46:11:13:14 - Length of stay

Current through Register Vol. 51, page 10, July 15, 2024
For the purpose of establishing length of stay in a Medicaid certified
	 swing bed or nursing facility, the 30 months of continuous residence in a
	 Medicaid certified swing bed or nursing facility may include temporary absences
	 for hospitalization or therapeutic leave and may consist of consecutive
	 residences in more than one Medicaid certified swing bed or nursing
	 facility.
General Authority:
SDCL
		27B-2-26(8).
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:13 - Preadmission screening and resident reviews › Section 46:11:13:15 - Individuals not requiring swing bed or nursing facility services but requiring specialized services - 30 month determination

Current through Register Vol. 51, page 10, July 15, 2024
(1) If the
  individual has continuously resided in a Medicaid certified swing bed or
  nursing facility at least 30 months prior to a determination of eligibility,
  and determined not eligible for swing bed or nursing home services, but who
  require specialized services, the Department of Social Services and the
  Department of Human Services, in consultation with the individual's family or
  legal representative and caregivers, shall:
(a) Offer the choice of remaining in the
  nursing facility or of receiving services in an alternative setting;
(b) Inform the individual of the
  institutional and noninstitutional alternatives covered under the state
  Medicaid plan;
(c) Clarify the
  effect on the individual's eligibility for Medicaid services under the state
  plan if the individual chooses to leave the nursing facility, including the
  effect on readmission to the nursing facility; and
(d) Provide for, or arrange for the provision
  of, specialized services for the intellectual disability or developmental
  disability; or
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:13 - Preadmission screening and resident reviews › Section 46:11:13:16 - Significant change

Current through Register Vol. 51, page 10, July 15, 2024
A significant change is a decline or improvement in an individual's
	 status that:
(1) Will not normally
  resolve itself without intervention by staff or by implementing standard
  disease-related clinical interventions, is not "self-limiting" (for decline
  only);
(2) Impacts more than one
  area of the individual's health status; and
(3) Requires interdisciplinary review or
  revision of the care plan.
If a significant change occurs for an individual known or suspected to
	 have an intellectual disability or a condition related to an intellectual
	 disability, the Medicaid certified swing bed or nursing facility shall make a
	 referral to the division for a possible Level II review. The referral shall
	 occur as soon as evidence of a significant change is
	 identified.
General Authority:
SDCL
		27B-2-26(8).
Law Implemented:
SDCL
		27B-2-26.
South Dakota Administrative Rules › Title 46 - Department of Human Services › Article 46:11 - Developmental disabilities › Chapter 46:11:13 - Preadmission screening and resident reviews › Section 46:11:13:17 - New admission and readmission

Current through Register Vol. 51, page 10, July 15, 2024
A new admission occurs when an individual is admitted to any Medicaid
	 certified swing bed or nursing facility for the first time or when an admission
	 does not qualify as a readmission. With the exception of certain hospital
	 discharges described in §
									46:11:13:04, new admissions are
	 subject to PASRR.
A readmission occurs when an individual is readmitted to a Medicaid
	 certified swing bed or nursing facility from a hospital to which the individual
	 was transferred from the nursing facility for the purpose of receiving medical
	 care. This type of readmission does not require a PASRR.
General Authority:
SDCL
		27B-2-26(8).
Law Implemented:
SDCL
		27B-2-26.