46:17:01:01.  Definitions. Terms used in this article 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 person supported to function with as much self-determination and independence as possible and to prevent regression or loss of current optimal functional status;

          (2)  "Behavior treatment plan," a written set of instructions for changing the behavior of the person supported;

          (3)  "Department," the Department of Human Services;

          (4)  "Developmental disability," as defined in SDCL 27B-1-18;

          (5)  "Division," the Division of Developmental Disabilities, a division of the Department of Human Services;

          (6)  "Highly restrictive procedures," physical restraint, psychotropic medications, time-out rooms, or other procedures with similar degrees of restriction or intrusion;

          (7)  "ICF/IID," intermediate care facility for individuals with intellectual disabilities;

          (8)  "Informed consent," consent voluntarily, knowingly, and competently given without any element of force, fraud, deceit, duress, threat, or other form of coercion, after explanation of all information that a reasonable person would consider significant to the decision in a manner reasonably comprehensible to general lay understanding;

          (9)  "ISP," individual support plan. A planning document written in measurable outcomes detailing how an ICF/IID will provide or access needed supports for the person;

          (10)  "Person" or "person supported," an individual residing at an ICF/IID who is receiving services;

          (11)  "Physical restraints," any technique which restricts the free movement of, or normal functioning of, a portion or portions of a person's body and is not used for the purpose of achieving proper body position, balance, or alignment;

          (12)  "Positive behavioral supports," procedures that do not infringe on the rights of the person supported;

          (13)  "QDDP," a qualified developmental disability professional. A person who has at least one year experience working with individuals with developmental disabilities or intellectual disabilities and is one of the following: a doctor of medicine or osteopathy, a registered nurse, or an individual who holds at least a bachelor's degree in a professional category specified within 42 C.F.R. § 483.430;

          (14)  "Restoration plan," a statement, written in clear, observable measures, developed by the interdisciplinary team to address how any rights limitation placed on the person supported will be lifted;

          (15)  "Time-out room," an enclosed area in which the person supported is placed contingent upon the exhibition of a maladaptive behavior, in which reinforcement is not available and from which egress is denied.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26.

          Law Implemented: SDCL 27B-2-26, 42 C.F.R. § 483.410 (October 1, 2002).

          46:17:02:02.  Grievance procedure. An ICF/IID shall have a written grievance procedure whereby the person supported, the parents if the person is under 18 years of age, a guardian or advocate, if any, may grieve a decision or action by the ICF/IID that affects the person in the areas of eligibility, modification, or termination of services or supports. The ICF/IID must provide assistance to the person in submitting a grievance if requested.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(4)

          Law Implemented: SDCL 27B-8-52, 42 C.F.R. § 483.420 (October 1, 2002).

          46:17:02:04.  Appeal of termination. The person supported, the guardian, if any, or the parent if the person is under 18 years of age, may appeal the decision of the ICF/IID to terminate services to the secretary of the department by submitting a written notice of appeal to the department within ten days after receipt of the notice to terminate services and requesting a fair hearing pursuant to SDCL chapter 1-26. The person shall continue receiving services from the ICF/IID until a decision is reached after a hearing pursuant to SDCL chapter 1-26.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-25.

          Law Implemented: SDCL 27B-2-25.

          46:17:02:05.  Discharge summaries. At the time of the discharge, the ICF/IID shall develop a final summary of the person's developmental, behavioral, social, health, and nutritional status and, with the informed consent of the person supported, a parent if the person is under 18 years of age, or a legal guardian, if any, shall provide a copy to authorized persons and agencies. The ICF/IID shall provide a post-discharge plan of care that will assist the person to adjust to the new living environment.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(3).

          Law Implemented: 42 C.F.R. § 483.440 (October 1, 2002).

          46:17:03:01.  Protection of records. The ICF/IID shall develop and maintain a record keeping system that includes a separate record for each person supported that documents the person's health care, active treatment, social information, and protection of the person's rights. The ICF/IID shall provide electronically-stored records with security to prevent access by unauthorized personnel. The ICF/IID shall keep confidential all information contained in the person's records, regardless of the form or storage method of the records. Policies and procedures governing the release of any information, including consents necessary from the person supported, a parent if the person is under 18 years of age, or the legal guardian, if any, must be written and executed.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(2).

          Law Implemented: SDCL 27B-8-46 to 27B-8-49, 42 C.F.R. § 483.410 (October 1, 2002).

          46:17:03:02.  Management of personal finances. The ICF/IID may apply to become the representative payee of the person's finances after submitting a request for payeeship to the Social Security Administration.

          The ICF/IID shall maintain a system that:

          (1)  Assures a full and complete accounting of the person's personal funds entrusted to the ICF/IID; and

          (2)  Precludes any commingling of the person's funds with the ICF/IID funds or with the funds of any person other than another person receiving services at the ICF/IID.

          Each person's financial records shall be available upon request by the person supported, the parent if the person is under 18 years of age, or the legal guardian, if any.

          To the extent of their capabilities and as determined by the interdisciplinary team, the person shall have access to his or her financial resources and shall be taught to manage his or her financial affairs.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(2).

          Law Implemented: 42 C.F.R. § 483.420 (October 1, 2002).

          46:17:04:01.  Interdisciplinary team -- Composition and meetings. Within 30 calendar days after admission, the ICF/IID shall identify an interdisciplinary team for each person supported. The interdisciplinary team must be composed of the person and the person's QDDP, the person's family, guardian, or advocate, if applicable, other ICF/IID staff, and any other individual chosen by the person. Meetings of the interdisciplinary team must be scheduled and conducted so they facilitate the active participation of all members of the team. The interdisciplinary team must meet at least annually; however, the person or any other member of the interdisciplinary team may request a team meeting at any time.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(3).

          Law Implemented: 42 C.F.R. § 483.440 (October 1, 2002).

          46:17:04:02.  Comprehensive functional assessment. Except as otherwise provided by law, within 30 calendar days after admission and at least annually thereafter, the person supported and the identified interdisciplinary team shall review existing assessment information and complete new assessments or reassessments. The purpose of the comprehensive functional assessment is to determine the appropriateness of continued supports by the ICF/IID. The assessments must include the following:

          (1)  A physical examination and health assessment;

          (2)  A dental examination that includes an oral health assessment;

          (3)  A social assessment that includes a social and developmental history, delineation of the type and frequency of social interactions, and descriptions of the person's social support network;

          (4)  A psychological assessment including the person's emotional and intellectual status;

          (5)  A behavioral assessment;

          (6)  An assessment of adaptive behavior or independent living skills that includes functional skills in the areas of motor development, mobility, and personal health care;

          (7)  A developmental, educational, or vocational assessment; and

          (8)  Nutritional assessment and vision, auditory, speech, and language screenings.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(3).

          Law Implemented: SDCL 27B-3-25, 42 C.F.R. § 483.440 (October 1, 2002).

          46:17:04:05.  QDDP monitoring and coordination of ISP. A QDDP shall monitor on a monthly basis and coordinate all activities regarding the implementation of the ISP. A QDDP shall observe and revise the ISP and the delivery of supports and shall intervene as necessary to ensure implementation.

          The ISP must be reviewed by the QDDP for relevancy and revised as necessary, including situations in which the person supported:

          (1)  Has successfully completed an objective identified in the ISP;

          (2)  Is regressing or losing skills already gained;

          (3)  Is failing to progress toward identified objectives after reasonable efforts have been made; or

          (4)  Is being considered for supports or treatment toward new objectives.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(3).

          Law Implemented: 42 C.F.R. § 483.440 (October 1, 2002).

          46:17:04:06.  Professional program staff. The ICF/IID shall have available qualified professional staff to develop, implement, and monitor each person's ISP during the provision of active treatment in accordance with 42 C.F.R. § 483.440. These staff must participate as members of the interdisciplinary team process; must participate in ongoing staff development and training; and must be licensed, certified, or registered according to state licensure requirements, if applicable.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(1).

          Law Implemented: 42 C.F.R. §§ 483.430, 483.440 (October 1, 2002).

          46:17:04:07.  Direct support professionals. The ICF/IID must maintain sufficient direct support professionals to provide adequate support and treatment for the person supported in accordance with the person's ISP. Minimum staff-to-person ratios must be maintained in accordance with 42 C.F.R. § 483.430.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(1).

          Law Implemented: 42 C.F.R. § 483.430 (October 1, 2002).

          46:17:04:09.  Time-out rooms. Time-out rooms may be used only under continuous observation of the person supported by ICF/IID staff, may not be locked, and must allow for immediate staff entry. Time-out rooms may only be used as part of a behavior treatment plan approved by both the human rights and behavior support committees of the ICF/IID. Each use of time out may not exceed 15 minutes. The ICF/IID staff shall record any use of a time-out room.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(4).

          Law Implemented: SDCL 27B-8-54 to 27B-8-56, 42 C.F.R. § 483.450 (October 1, 2002).

          Cross-References: Behavior support committee, § 46:17:04:14; Human rights committee -- Composition, § 46:17:04:15.

          46:17:04:12.  Physical restraints. The ICF/IID may employ physical restraint only as an integral part of an ISP that is intended to lead to less restrictive means of managing and eliminating the behavior for which the restraint is applied, or as an emergency measure, but only if necessary to protect the person supported or others from injury.

          Any authorization to use or extend restraints as an emergency must be in effect no longer than 12 consecutive hours and obtained as soon as the person is restrained. The ICF/IID may not issue orders for restraint on a standing or as needed basis.

          Any person placed in restraint must be checked at least every 30 minutes or more frequently, as prescribed by the approved behavior treatment plan, by staff trained in the use of restraints, and released from the restraint as quickly as possible. Staff shall make a record of these checks and usage of the restraints.

          Restraints must be designed and used so as not to cause physical injury to the person and so as to cause the least possible discomfort. If the person's range of motion is affected, the person shall be given an opportunity for motion and exercise for a period of not less than ten minutes within each two hour period in which the restraint is employed, and a record of such activity must be kept.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(3).

          Law Implemented: SDCL 27B-8-55, 42 C.F.R. § 483.450 (October 1, 2002).

          46:17:04:13.  Management of maladaptive behaviors. The ICF/IID shall specify all behaviors and approved plans on a hierarchy from most positive to most restrictive. Prior to the development and implementation of a behavior treatment plan, records of maladaptive behaviors shall be maintained. These records shall document a functional assessment of behavior and the frequency and duration of the behavior.

          The ISP of a person supported who exhibits maladaptive behavior must include provisions to teach the person the circumstances, if any, under which the behavior can be exhibited adaptively; to teach the person how to channel the behavior into similar but adaptive expressions; or to replace the behavior with behavior that is adaptive. Prior to the use of more restrictive procedures, the person's record must document that strategies incorporating the use of less restrictive procedures have been tried systematically and demonstrated to be ineffective.

          Highly restrictive procedures may be used only in conjunction with positive behavioral procedures.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(3).

          Law Implemented: SDCL 27B-8-54 to 27B-8-56, 42 C.F.R. § 483.450 (October 1, 2002).

          46:17:04:14.  Behavior support committee. The ICF/IID shall have a behavior support committee whose members are appointed by the administrator of the ICF/IID. The behavior support committee shall review the technical adequacy of all behavior treatment plans and approve any plan deemed clinically appropriate.

          The behavior support committee shall be composed of psychologists, behavior therapists, and managers with experience or training regarding behavior supports and qualified to evaluate proposals for the use of highly restrictive behavior procedures.

          The committee shall function as a safeguard against inhumane treatment and violation of the person's rights and assure the plan is clinically appropriate.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(4).

          Law Implemented: SDCL 27B-8-50, 42 C.F.R. § 483.440 (October 1, 2002).

          46:17:04:15.  Human rights committee -- Composition. The ICF/IID shall have a human rights committee with a minimum of five members. The human rights committee shall be composed of qualified persons who have either experience or training in current practices to change inappropriate behavior of a person supported and others who have no ownership or controlling interest in the ICF/IID. Specific members for the committee must be selected from the personnel of the ICF/IID from positions deemed appropriate by the administrator and include at least one member who has training or experience with issues and decisions regarding human rights. At least one member of the committee must be a member of the community and not employed by the ICF/IID.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(4).

          Law Implemented: 42 C.F.R. § 483.440 (October 1, 2002).

          46:17:04:16.  Human rights committee -- Functions. The functions of the human rights committee for the person supported are as follows:

          (1)  Review, approve or disapprove, and monitor any behavior treatment plan designed to manage maladaptive behavior that involves limitations;

          (2)  Review any behavior treatment plan at least annually or sooner as deemed appropriate by the committee;

          (3)  Review and monitor limitations on a person's movement, any other potential limitation on human rights, including involuntary medication, limitation of privileges, and limitations on the use of a person's funds and other possessions;

          (4)  Ensure any behavior treatment plan to manage maladaptive behavior is employed with sufficient safeguards and supervision to ensure the safety, welfare, and civil and human rights of the person are protected and not infringed upon for the convenience of staff, relatives, or the community, or as a substitute for active treatment;

          (5)  Ensure any behavior treatment plan is conducted only with the written informed consent of the person, the person's parent if the person is under 18 years of age, or the legal guardian, if any; and

          (6)  Review, monitor, and make suggestions about practices of the ICF/IID related to psychotropic medications, restraints, time-out rooms, highly restrictive procedures, protection of  rights, and any other area the human rights committee believes needs to be addressed.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 37 SDR 131, effective January 10, 2011; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(4).

          Law Implemented: SDCL 27B-8-54, 42 C.F.R. § 483.440 (October 1, 2002).

          46:17:04:17.  Staff orientation training. Within 30 days of employment, newly-hired staff must receive an orientation training program. Orientation shall include:

          (1)  Instruction in the ethical principles related to basic positive behavior supports or approaches;

          (2)  Definitions of abuse, neglect, and exploitation of persons supported;

          (3)  Techniques of identifying and observing signs of abuse, neglect, and exploitation;

          (4)  Procedures used in reporting, investigating, and documenting alleged instances of abuse, neglect, exploitation, or injury of unknown source;

          (5)  Disability awareness;

          (6)  The philosophy and mission of the ICF/IID;

          (7)  Emergency plans and procedures, including first aid; and

          (8)  Knowledge and understanding of the person's rights.

          Those staff who work or are expected to work most closely with the person must receive training at least annually in courses including crisis intervention, behavior management, cardiopulmonary resuscitation, emergency evacuation, first aid techniques, safety and sanitation, and proper lifting and transferring techniques.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(1).

          Law Implemented: SDCL 27B-2-27, 42 C.F.R. § 483.430 (October 1, 2002).

          46:17:04:18.  Communication with parents or legal guardian. The ICF/IID shall notify the person's parent if the person supported is under 18 years of age or the legal guardian, if any, of any significant incidents or changes in the condition of the person including the following:

          (1)  Serious illness;

          (2)  Serious accident;

          (3)  Death;

          (4)  Alleged instances of abuse or neglect; or

          (5)  Unauthorized absence.

          An ICF/IID shall have written procedures defining communication between the agency and the parent if the person is under 18 years of age or legal guardian, if any.

          Source: 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(4).

          Law Implemented: SDCL 27B-8-53 to 27B-8-56, 42 C.F.R. § 483.420(c)(6) (October 1, 2002).

          46:17:05:01.  Licensure. Health care service personnel providing services at the ICF/IID, including physicians, physicians assistants, registered nurses, licensed practical nurses, certified nurse practitioners, dieticians, occupational and physical therapists, dentists, dental hygienists, pharmacists, and audiologists, must have a license to practice in the State of South Dakota.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(1).

          Law Implemented: SDCL 27B-2-26(1), 42 C.F.R. § 483.460 (October 1, 2002).

          46:17:05:02.  Physician services. The ICF/IID shall ensure the availability of physician services 24 hours a day. The ICF/IID shall provide or obtain preventive and general medical care as well as annual physical examinations of each person supported that, at a minimum, include the following:

          (1)  Evaluation of vision and hearing;

          (2)  Immunizations; and

          (3)  Tuberculosis control.

          The ICF/IID may utilize physician assistants and certified nurse practitioners to provide physician services. The physician, physician's assistant, or certified nurse practitioner must participate in the establishment of each newly-admitted person's ISP. A physician must participate as part of the interdisciplinary team process, either in person or through a written report to the interdisciplinary team. The physician, physician's assistant, or certified nurse practitioner must develop a medical care plan of treatment if the person requires 24-hour licensed nursing care.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(1).

          Law Implemented: SDCL 27B-3-17, 27B-8-39, 42 C.F.R. § 483.460 (October 1, 2002).

          46:17:05:03.  Nursing services. The ICF/IID must provide any person supported with nursing services in accordance with the person's needs. These services include:

          (1)  Participation in the interdisciplinary team process, as indicated by the person's needs;

          (2)  Development with a physician, physician's assistant, or certified nurse practitioner of a medical care plan of treatment if it has been determined by the physician, physician's assistant, or certified nurse practitioner that the person requires such a plan;

          (3)  Other nursing care as prescribed by the physician, physician's assistant, certified nurse practitioner, or dentist, or as identified by the person's needs; and

          (4)  Implementation with other members of the interdisciplinary team, of appropriate protective and preventive health measures that include:

               (a)  Training the person and staff in appropriate health and hygiene methods;

               (b)  Control of communicable diseases and infections; and

               (c)  Training staff in detecting signs and symptoms of illness or dysfunction, first aid for accidents or illness, and basic skills required to meet the person's health needs.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(1).

          Law Implemented: SDCL 27B-8-39, 42 C.F.R. § 483.460 (October 1, 2002).

          46:17:05:04.  Dental services. The ICF/IID shall provide or make arrangements for comprehensive diagnostic and treatment services for each person supported from qualified personnel, including licensed dentists and dental hygienists.

          A complete oral examination using all diagnostic aids to evaluate mouth health must be completed within 30 days for each newly-admitted person.

          If appropriate, dental professionals must participate in the development, review, and update of an ISP as part of the interdisciplinary process, either in person or through written report, to the interdisciplinary team.

          The ICF/IID must provide education and training in the maintenance of oral health and ensure comprehensive dental treatment services that include:

          (1)  Periodic examination and diagnosis performed at least annually;

          (2)  The availability for emergency dental treatment on a 24-hour-a-day basis by a licensed dentist; and

          (3)  Dental care needed for relief of pain and infections, restoration of teeth, and maintenance of dental health.

          The ICF/IID must keep a permanent dental record for each person.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(1).

          Law Implemented: SDCL 27B-8-39, 42 C.F.R. § 483.460 (October 1, 2002).

          46:17:05:05.  Pharmacy services. All medications must be labeled according to current pharmacological practices, including precautionary and accessory instruction. Outdated drugs or those with worn labels or those that have been discontinued by a physician, physician assistant, or certified nurse practitioner must be removed from the medication supply of the person supported. The ICF/IID shall provide or make arrangements for the provision of routine and emergency medication to any person it serves. A pharmacist, with input from the interdisciplinary team, shall review the drug regimen of each person at least quarterly, report any irregularities in the person's drug regimens, and prepare a record of the drug regimen for each person, which the ICF/IID shall maintain.

          An individual medication administration record must be maintained for each person. As appropriate, the pharmacist shall participate in each person's support plan, either in person or through a written report to the interdisciplinary team.

          The ICF/IID shall have an organized system for drug administration that identifies each drug up to the point of administration. The system must assure compliance with SDCL chapter 36-11. This system must also address drug administration errors, reporting process, and correction procedures.

          Those staff administering medications must have completed an approved medication administration course. All medication must be administered in compliance with the physician's, physician assistant's, certified nurse practitioner's, or dentist's orders.

          Source: 26 SDR 96, effective January 24, 2000; 27 SDR 63, effective December 31, 2000; 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(3).

          Law Implemented: 42 C.F.R. § 483.460 (October 1, 2002).

          46:17:06:02.  Scope. Each section in this article applies to a private ICF/IID.

          Source: 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(1)(2)(3)(4)(5)(9)(10).

          Law Implemented: SDCL 27B-2-26(1)(2)(3)(4)(5)(9)(10).

          46:17:06:04.  Occupancy of homes used by persons supported. No more than eight persons may reside in any one home managed by an ICF/IID receiving initial approval after January 1, 2011. Each home must consist of single occupancy bedrooms.

          Source: 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(2)(4)(10).

          Law Implemented: SDCL 27B-2-26(2)(4)(10).

          46:17:06:05.  Division visits. The division may review an ICF/IID at any given time without prior notice for the purposes of verifying compliance with this article and chapter 67:54:03. The ICF/IID must grant the division access to any facility, activity, and record necessary to determine compliance.

          Source: 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(1)(2)(3)(4)(5)(9)(10).

          Law Implemented: SDCL 27B-2-26(1)(2)(3)(4)(5)(9)(10).

          46:17:06:06.  Inventory for client and agency planning (ICAP). To determine the level of a person's functional limitations, an ICF/IID must submit a completed ICAP to the division, using the ICAP Compuscore software. The division must receive this data within 11 months following the annual on-site review and inspection. For a person's record to be valid, the evaluation date may not be more than 13 months old.

          No deficit exists if the following criteria are met:

          (1)  Self care: The personal living skills domain score exceeds the age-related criterion in Appendix A at the end of this chapter and, for persons over four years of age, the person has no arm/hand limitations in daily activities (ICAP item C8=1);

          (2)  Language: The social and communication skills domain score exceeds the age-related criterion in Appendix A at the end of this chapter and, for persons over four years of age, the person speaks (ICAP item A7=3);

          (3)  Learning/cognition: The person does not have an intellectual disability (ICAP item C1=1);

          (4)  Mobility: The person walks (ICAP item C9=1) and, for persons over four years of age, no mobility assistance is needed (ICAP item C10=1);

          (5)  Self-direction: The general maladaptive index is in the normal range (ICAP, GM1>-11), the person's community living skills domain score exceeds the age-related criterion in Appendix A at the end of this chapter, and there is no psychiatric diagnosis (neither ICAP items B11 nor B12 checked;

          (6)  Independent living: The person's community living skills domain score exceeds the age-related criterion in Appendix A at the end of this chapter and, for persons 18 years of age and older, the recommended residential placement is "independent in own home or rental unit" (ICAP, page 10, F2=3); and

          (7)  Economic self-sufficiency: The person's recommended daytime program (ICAP item G2) is "competitive employment."

          A substantial deficit is present if the preceding criteria are not met.

          Source: 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(2).

          Law Implemented: SDCL 27B-2-26(2).

          Editor's Note: Appendix A was omitted when this rule was promulgated. It will be added at a later date.

          Reference: Compuscore for the ICAP, Bradley K. Hill, 1999, Riverside Publishing Company, 3800 Golf Rd, Ste. 100, Rolling Meadows, IL 60008; cost $334.

          46:17:06:07.  Rights. Any person supported has rights guaranteed pursuant to § 46:17:02:01 and this section:

          (1)  To be able to communicate in the primary language or primary mode of communication of the person;

          (2)  To be able to refuse or discontinue services;

          (3)  To have access to, read, and challenge any information contained in the person's record compiled by the ICF/IID; and

          (4)  To have access to an advocate as defined in subdivision 46:17:06:01(1) or an employee of the state's designated protection and advocacy system.

          The private ICF/IID shall provide the person supported a document describing the person's rights in an accessible format and if necessary shall provide training on those rights.

          Source: 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(4).

          Law Implemented: SDCL 27B-2-26(4), 42 C.F.R. § 483.420 (October 1, 2002).

          46:17:06:10.  Policy on abuse, neglect, exploitation, or injury of unknown source. The ICF/IID shall have a policy approved by the division that prohibits abuse, neglect, or exploitation of a person supported. The policy must contain the following:

          (1)  A definition of abuse, neglect, and exploitation pursuant to SDCL 22-46-1;

          (2)  A requirement to report to the division pursuant to § 46:17:06:12;

          (3)  A requirement to report any abuse, neglect, exploitation, or injury of unknown source immediately to the administrator;

          (4)  A requirement to report to the Department of Social Services pursuant to SDCL 26-8A-3 to 26-8A-8, inclusive;

          (5)  A procedure for disciplinary action to be taken if staff has engaged in abuse, neglect, or exploitation of any person supported;

          (6)  A procedure to inform the guardian, if any, or the parent if the person supported is under 18 years of age, and any advocate, of any allegations of abuse, neglect, or exploitation and any information not otherwise prohibited by law about the action taken within 24 hours after the alleged incident unless the guardian, parent, or advocate is accused of the alleged incident;

          (7)  A procedure to document the actions to be implemented to reduce the likelihood of or prevent repeated incidents or abuse, neglect, or exploitation if the allegations are substantiated;

          (8)  A procedure to inform the person supported, or the parent if the person is under 18 years of age, and the guardian or advocate, if any, in writing or in an accessible format, of the rights of  the person as outlined in § 46:17:06:08 upon admission and annually thereafter; and

          (9)  A procedure for training the person on self reporting of any abuse, neglect, or exploitation by another.

          Source: 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(2)(3)(4).

          Law Implemented: SDCL 26-8A-3, 27B-2-26(2)(3)(4), 42 C.F.R. § 483.420 (October 1, 2002).

          46:17:06:11.  Investigation of abuse, neglect, exploitation, or injury of unknown source. Any allegations of abuse, neglect, exploitation, or injury of unknown source shall be thoroughly investigated by the ICF/IID.

          The results of the investigation shall be reported to the administrator or designated representative and the division within five working days of the incident. If the allegations are substantiated, appropriate corrective action must be taken.

          Source: 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(2)(3)(4).

          Law Implemented: SDCL 27B-2-26(2)(3)(4), 42 C.F.R. § 483.420 (October 1, 2002).

          46:17:06:12.  Critical incident reports -- Submission to division. The ICF/IID shall give verbal notice of any critical incident involving a person supported to the division no later than the end of the division's next working day from the time the ICF/IID becomes aware of the incident. The ICF/IID shall submit a written critical incident report utilizing the division's on-line reporting system within seven calendar days after the initial notice is made. A report must be submitted for the following:

          (1)  Death;

          (2)  Life-threatening illness or injury;

          (3)  Alleged instance of abuse, neglect, or exploitation against or by the person supported;

          (4)  Injury of unknown source;

          (5)  Change in health or behavior that may jeopardize continued services;

          (6)  Any serious medication error. A serious medication error is the inappropriate administration of a medication to the person by ICF/IID personnel that results in emergency medical treatment, hospitalization, or death;

          (7)  Illness or injury that resulted from unsafe or unsanitary conditions;

          (8)  Any illegal activity involving the person that involves law enforcement;

          (9)  Any use of physical or mechanical restraint or chemical intervention not part of an approved plan;

          (10)  Any bruise or injury resulting from the use of a physical or mechanical restraint or chemical intervention; or

          (11)  Any diagnosed case of a reportable communicable disease involving the person.

          The report must contain a description of the incident, specifying what happened, when it happened, and where it happened, the status of the person, and any action taken by the ICF/IID. The division may request further information or follow-up related to the critical incident.

          The ICF/IID shall notify the parents, if the person is under 18 years of age, or the guardian or advocate, if any, that a critical incident report has been submitted and the reason why unless the parent, guardian, or advocate, is accused of the incident.

          Source: 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(2)(3)(4).

          Law Implemented: SDCL 27B-2-26(2)(3)(4).

          46:17:06:13.  Individual support plan -- Person centered planning. An ICF/IID must demonstrate how each supported person's preferences are identified and prioritized during the ISP planning process. The preference and priorities shall be documented in the person's ISP.

          Source: 37 SDR 69, effective October 18, 2010; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 27B-2-26(3).

          Law Implemented: SDCL 27B-2-26(3).