CHAPTER 67:61:16
CLINICALLY-MANAGED LOW-INTENSITY
RESIDENTIAL TREATMENT PROGRAM
Section
67:61:16:01 Eligibility criteria.
67:61:16:02 Services provided.
67:61:16:03 Intensity of services.
67:61:16:04 Admission medical examination.
67:61:16:05 Reimbursable services.
67:61:16:06 Nonreimbursable services.
67:61:16:01. Eligibility criteria. To be eligible for clinically-managed, low-intensity residential treatment program services:
(1) The client must be at risk of or experiencing minimal withdrawal;
(2) The client must have either no or very stable biomedical conditions;
(3) The client must have either no or very stable emotional, behavioral, or cognitive conditions;
(4) The client must require a structured environment to promote progress through the stages of change;
(5) The client must require structure to reinforce recovery and relapse prevention skills; and
(6) The client's recovery environment poses a threat to safety or engagement in treatment.
Source: 43 SDR 80, effective December 5, 2016; 50 SDR 63, effective November 27, 2023.
General Authority: SDCL 1-36-25, 34-20A-27.
Law Implemented: SDCL 34-20A-27.
67:61:16:02. Services provided. A clinically-managed, low-intensity residential treatment program must provide:
(1) An integrated assessment, pursuant to § 67:61:07:05;
(2) Individual, group, and family counseling providing:
(a) Education regarding alcohol and drug abuse and dependence, including the biomedical effects of drug and alcohol use and abuse and the importance of medical care and treatment in recovery; and
(b) Education regarding tuberculosis and the human immunodeficiency virus, how each is transmitted, and how to safeguard against transmission;
(3) Arts and crafts or work therapy, provided clients may not be required to participate in more than forty hours of work therapy per week;
(4) Housing and dietary services;
(5) Medical care including tuberculosis and human immunodeficiency virus services, pursuant to 42 U.S.C. § 300x-24, in effect on December 13, 2016; and
(6) Discharge planning providing:
(a) Continued care planning and counseling;
(b) Referral to and coordination of care with other resources that will assist a client's recovery, including education, vocational, medical, legal, social, mental health, employment, and other related alcohol and drug services; and
(c) Referral to and coordination of medical services including information detailing the availability of tuberculosis and human immunodeficiency virus services, pursuant to 42 U.S.C. § 300x-24, in effect on December 13, 2016.
Source: 43 SDR 80, effective December 5, 2016; 50 SDR 63, effective November 27, 2023.
General Authority: SDCL 1-36-25, 34-20A-27.
Law Implemented: SDCL 34-20A-27.
67:61:16:03. Intensity of services. A clinically-managed, low-intensity residential treatment program must provide each client a minimum of five hours of any combination of individual, group, or family counseling each week.
Source: 43 SDR 80, effective December 5, 2016; 50 SDR 63, effective November 27, 2023.
General Authority: SDCL 1-36-25, 34-20A-27.
Law Implemented: SDCL 34-20A-27.
67:61:16:04. Admission medical examination. A person admitted to a clinically-managed, low-intensity residential treatment program shall have received a medical examination conducted by or under the supervision of a licensed physician, within the three months before admission. The agency shall require that the results of the examination be provided to the program, before or at the time of admission.
If an examination has not been conducted or the results are not available, the program shall ensure that a medical examination occurs within five calendar days after admission. The results of all medical examinations must be placed in the case record.
The program staff shall consider the client's medical health in the development of the treatment plan.
Source: 43 SDR 80, effective December 5, 2016; 50 SDR 63, effective November 27, 2023.
General Authority: SDCL 1-36-25, 34-20A-27.
Law Implemented: SDCL 34-20A-27.
67:61:16:05. Reimbursable services. Reimbursable services are limited to face-to-face contacts for the purpose of providing services pursuant to § 67:61:16:02. Room and board is reimbursed through a per diem rate.
Documentation that the client was at the facility at the time of the daily census must be available to support billing.
Reimbursable services for eligible Medicaid clients are limited to services provided under chapter 67:16:48.
Source: 43 SDR 80, effective December 5, 2016; 48 SDR 14, effective August 22, 2021.
General Authority: SDCL 34-20A-27(1)(4).
Law Implemented: SDCL 34-20A-27.
67:61:16:06. Nonreimbursable services. The following are nonreimbursable under this chapter:
(1) Billing for a client that exceeds the accredited bed capacity established by the department;
(2) Driving under the influence and driving while intoxicated education courses;
(3) Services that are solely recreational in nature;
(4) Time spent preparing paperwork from client assessments or clinical documentation;
(5) Time spent traveling; and
(6) Community twelve-step programs.
Source: 43 SDR 80, effective December 5, 2016; 50 SDR 63, effective November 27, 2023.
General Authority: SDCL 1-36-25, 34-20A-27.
Law Implemented: SDCL 34-20A-27.
