CHAPTER 67:40:19
\r\n\r\n\r\n\r\n
HOME AND COMMUNITY-BASED\r\nSERVICES
\r\n\r\n\r\n\r\nSection
\r\n\r\n67:40:19:01 Definitions.
\r\n\r\n67:40:19:02 Eligibility determination -- Assessment.
\r\n\r\n67:40:19:03 Individual care plan.
\r\n\r\n67:40:19:04 In-home services and adult day services.
\r\n\r\n67:40:19:05 Congregate nutrition services.
\r\n\r\n67:40:19:05.01 Home nutrition services.
\r\n\r\n\r\n\r\n67:40:19:01. Definitions. Terms\r\nused in this chapter mean:
\r\n\r\n\r\n\r\n
(1) "Activities of daily living,"\r\ntasks performed routinely by an individual to maintain physical functioning and\r\npersonal care, including transferring, moving about, dressing, grooming, toileting,\r\nand eating;
\r\n\r\n\r\n\r\n
(2) "Adult day service," the\r\nprovision of regular care and supervision to adults away from their home for\r\npart of a 24-hour day;
\r\n\r\n\r\n\r\n
(3) "Assistive device," an\r\nitem used to increase, maintain, or improve functional capabilities;
\r\n\r\n\r\n\r\n
(4) "Community transportation\r\nservices," transportation provided for individuals age 60 and older for\r\nmedical appointments, shopping and banking, senior center activities, nutrition\r\nprograms, adult day service programs, and other necessary errands;
\r\n\r\n\r\n\r\n
(5) "Congregate nutrition service,"\r\nmeals provided to certain individuals in a group setting;
\r\n\r\n\r\n\r\n
(6) "Economic resources," the\r\nindividual's own resources together with other types of assistance, financial\r\nor otherwise, which are available to an individual and would help maintain the\r\nindividual in the individual's own home;
\r\n\r\n\r\n\r\n
(7) "Health status," the\r\nindividual's medical condition based on a diagnosis of the individual's\r\nexisting illnesses or disabilities, the medical care and medication needed in\r\nresponse to the diagnosis, and an assessment of the individual's ability to\r\nperform daily tasks;
\r\n\r\n\r\n\r\n
(8) "Home," the individual's\r\nresidence which may not include a hospital, penal institution, detention\r\ncenter, school, nursing facility, assisted living facility, intermediate care\r\nfacility for individuals with intellectual disabilities, or an institution that\r\ntreats individuals who have mental diseases;
\r\n\r\n\r\n\r\n
(9) "Home environment," the\r\nindividual's dwelling unit, building, or house and its furnishings and the\r\nneighborhood in which the individual resides;
\r\n\r\n\r\n\r\n
(10) "Homemaker service," the\r\nperformance of nonmedical household tasks designed to allow an individual who\r\nneeds assistance performing household tasks to remain in the individual's home.\r\nHomemaker services may include cleaning identified household areas, preparing\r\nlight meals, shopping for essential items, washing dishes, dusting, floor care,\r\nor laundry;
\r\n\r\n\r\n\r\n
(11) "In-home service," a\r\nservice provided in the home which may include respite care, homemaker service,\r\nmaintenance nursing, personal care services, meals and nutritional supplements,\r\nor providing a personal emergency response system, telehealth services,\r\nassistive devices, medical supplies, or medical equipment;
\r\n\r\n\r\n\r\n
(12) "Instrumental activities of\r\ndaily living," activities that reflect an individual's ability to live\r\nindependently, including managing money, use of transportation, shopping,\r\nhousekeeping, and preparing meals;
\r\n\r\n\r\n\r\n
(13) "Maintenance nursing,"\r\nperiodic evaluation and counseling by a licensed nurse to promote and maintain\r\nthe individual's optimal health. Maintenance nursing may include injections,\r\nmonitoring and setting up medications, physical assessments, monitoring patient\r\nstatus, foot care, drawing blood, changing dressing, and health education;
\r\n\r\n\r\n\r\n
(14) "Meals and nutritional\r\nsupplements," nutrition meals or nutritional supplements that enhance an\r\nindividual's diet;
\r\n\r\n\r\n\r\n
(15) "Medical equipment,"\r\nequipment needed to assist an individual in living safely at home;
\r\n\r\n\r\n\r\n
(16) "Medical supplies,"\r\nexpendable or reusable supplies related to the needs of incontinence, diabetes,\r\nor wound care;
\r\n\r\n\r\n\r\n
(17) "Personal care services,"\r\npersonal hygiene tasks provided according to a recipient's case service plan\r\nand provided by an individual who is qualified to provide the services;
\r\n\r\n\r\n\r\n
(18) "Personal emergency response\r\nsystem," an electronic device that enables individuals to secure help in\r\nan emergency;
\r\n\r\n\r\n\r\n
(19) "Respite care,"\r\ntemporary substitute supports or living arrangements for an individual that\r\nprovide a period of relief to the primary caregiver on an intermittent,\r\noccasional, or emergency basis;
\r\n\r\n\r\n\r\n
(20) "Social resources,"\r\nsupport or assistance available to an individual from the individual's family,\r\nfriends, neighbors, or community organizations such as churches, civic groups,\r\nor senior centers, or other agencies providing services to residents of the\r\ncommunity; and
\r\n\r\n\r\n\r\n
(21) "Telehealth services," a\r\nhome based health monitoring system used to collect and transmit an individual's\r\nclinical data for monitoring and interpretation.
\r\n\r\n\r\n\r\n
Source: 40 SDR 122, effective January 7,\r\n2014.
\r\n\r\nGeneral Authority: SDCL 28-1-45.
\r\n\r\nLaw Implemented: SDCL 28-1-44.
\r\n\r\n\r\n\r\n
67:40:19:02. Eligibility\r\ndetermination -- Assessment. An individual may receive necessary services\r\nunder this chapter if the individual is age 60 or older or age 18 or older with\r\na disability.
\r\n\r\n\r\n\r\n
The department shall assess an individual's need\r\nfor services and shall reassess the individual's condition and the continued\r\nneed for services at least once every 12 months. The department shall consider\r\nthe individual's ability to complete the tasks necessary to live safely at\r\nhome, the ability to cooperate and follow the individual care plan, and whether\r\nother resources are available to provide the needed services. The assessment\r\nmust also consider information provided about the individual in the following\r\nareas:
\r\n\r\n\r\n\r\n
(1) Health status;
\r\n\r\n(2) Social resources;
\r\n\r\n(3) Home environment;
\r\n\r\n(4) Activities of daily living;
\r\n\r\n(5) Instrumental activities of daily\r\nliving; and
\r\n\r\n(6) Economic resources.
\r\n\r\n\r\n\r\n
Source: 40 SDR 122, effective January 7,\r\n2014.
\r\n\r\nGeneral Authority: SDCL 28-1-45.
\r\n\r\nLaw Implemented: SDCL 28-1-44.
\r\n\r\n\r\n\r\n
67:40:19:03. Individual care plan.\r\nThe department and the individual shall develop an individual care plan for\r\neach individual eligible for services based on the individual's assessment. The\r\nplan must contain:
\r\n\r\n\r\n\r\n
(1) The services or supports\r\nauthorized;
\r\n\r\n(2) The number of service hours\r\nauthorized;
\r\n\r\n(3) The tasks assigned to the provider;\r\nand
\r\n\r\n(4) The amount of any copay, if\r\napplicable.
\r\n\r\n\r\n\r\n
Source: 40 SDR 122, effective January 7,\r\n2014.
\r\n\r\nGeneral Authority: SDCL 28-1-45.
\r\n\r\nLaw Implemented: SDCL 28-1-44.
\r\n\r\n\r\n\r\n
67:40:19:04. In-home services and\r\nadult day services. In-home services or adult day services may be provided\r\nto an individual who demonstrates a need for long-term supports and services\r\nthrough the assessment and meets the following criteria:
\r\n\r\n\r\n\r\n
(1) The individual is residing at home;
\r\n\r\n(2) The individual is age 60 or older\r\nor is age 18 or older with a disability; and
\r\n\r\n(3) The individual is not eligible for\r\nother programs which provide the same type of service.
\r\n\r\n\r\n\r\n
Source: 40 SDR 122, effective January 7, 2014.
\r\n\r\nGeneral Authority: SDCL 28-1-45.
\r\n\r\nLaw Implemented: SDCL 28-1-44.
\r\n\r\n\r\n\r\n
67:40:19:05. Congregate nutrition\r\nservices. Congregate nutrition services may be provided to the following\r\nindividuals:
\r\n\r\n\r\n\r\n
(1) An individual age 60 or older;
\r\n\r\n(2) The spouse of an individual age 60\r\nor older, regardless of age, if the couple is living together;
\r\n\r\n(3) An individual with a disability who\r\nresides with an individual age 60 or older; and
\r\n\r\n(4) An individual with a disability who\r\nresides in a housing facility where congregate nutrition services are provided.
\r\n\r\n\r\n\r\n
Source: 40 SDR 122, effective January 7,\r\n2014.
\r\n\r\nGeneral Authority: SDCL 28-1-45.
\r\n\r\nLaw Implemented: SDCL 28-1-44.
\r\n\r\n\r\n\r\n
67:40:19:05.01. Home nutrition\r\nservices. Home nutrition services may be provided to the following\r\nindividuals:
\r\n\r\n\r\n\r\n
(1) An individual age 60 or older who\r\nis unable to leave home due to illness or disability;
\r\n\r\n(2) Regardless of age, an individual\r\nliving with a spouse age 60 or over unable to leave home due to illness or\r\ndisability; or
\r\n\r\n(3) An individual with a disability who\r\nresides with an individual age 60 or over unable to leave home due to illness\r\nor disability.
\r\n\r\n\r\n\r\n
Source: 40 SDR 122, effective January 7,\r\n2014.
\r\n\r\nGeneral Authority: SDCL 28-1-45.
\r\n\r\nLaw Implemented: SDCL 28-1-44.
\r\n\r\n\r\n\r\n