CHAPTER 67:46:08
\r\n\r\n\r\nLONG-TERM CARE\r\nNOTICE REQUIREMENTS
\r\n\r\n\r\n\r\nSection
\r\n\r\n67:46:08:01 Required timely and adequate notice.
\r\n\r\n67:46:08:02 Adequate notice to applicants.
\r\n\r\n67:46:08:03 Suspension of timely notice and the\r\napplication of adequate notice.
\r\n\r\n67:46:08:04 Repealed.
\r\n\r\n67:46:08:05 Notice\r\nof right to request waiver of period of ineligibility -- Assets transferred at\r\nless than fair market value -- Ineligibility due to home equity limit.
\r\n\r\n\r\n\r\n67:46:08:01. Required\r\ntimely and adequate notice. Timely and adequate notice shall be mailed to\r\neach recipient detailing the reason for a proposed action which may result in\r\ntermination or reduction of payment or inability to authorize payment. The\r\nnotice shall inform the recipient of any changes in federal or state law\r\nrequiring automatic grant adjustments for classes of recipients and of a change\r\nin the manner or form of payment to a protective, vendor, or two-party\r\npayment. This notice shall state the specific regulations supporting the\r\naction taken and explain the individual's right to and procedure for requesting\r\na fair hearing, the right to be represented by others at the hearing, and the\r\ntime in which a hearing may be requested. This timely notice shall be mailed\r\nten days before the date of action, which is the date when the recipient would\r\nnormally receive an assistance check or, in the case of a Medicaid recipient,\r\nten days before the intended change would be effective. In cases of probable\r\nfraud, notice of a proposed action which may result in termination or reduction\r\nof payment or inability to authorize payment shall be considered timely if\r\nmailed at least five days before the action would become effective. This notice\r\nshall also explain the circumstances under which assistance may be continued if\r\na hearing is requested. Timely and adequate notice is not required when the\r\nrecipient of a one-person case has died.
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Source: 2 SDR 74,\r\neffective May 13, 1976; 7 SDR 66, 7 SDR 89, effective July 1, 1981; 8 SDR 170,\r\neffective June 21, 1982; transferred from § 67:16:22:01, effective August\r\n23, 1992;\r\n43 SDR 31, effective September 12, 2016.
\r\n\r\nGeneral Authority: SDCL 28-6-1.
\r\n\r\nLaw Implemented: SDCL 28-6-1.
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67:46:08:02. Adequate\r\nnotice to applicants. A written notice to applicants for services under\r\nthis article shall be sent at the time the decision is made approving or\r\nrejecting each application. This written notice shall include a statement of\r\nwhat action the agency intends to take, the reasons for the intended agency\r\naction, the specific regulations supporting such action, and an explanation of\r\nthe individual's right to and procedure for requesting a fair hearing, the\r\nright to be represented by others at the hearing, and the time in which a hearing\r\nmay be requested. This notice shall explain the individual's right under the\r\nCivil Rights Act of 1964. Nothing in this section shall be construed as\r\nindicating that the department will pay for legal fees for representing\r\napplicants at conferences or hearings held according to this section.
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Source: 8 SDR 170,\r\neffective June 21, 1982; transferred from § 67:16:22:01.01, effective\r\nAugust 23, 1992;\r\n43 SDR 31, effective September 12, 2016.
\r\n\r\nGeneral Authority: SDCL 28-6-1.
\r\n\r\nLaw Implemented: SDCL 28-6-1.
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67:46:08:03. Suspension of timely\r\nnotice and the application of adequate notice. The department may dispense\r\nwith timely notice as provided in § 67:46:08:01 and mail adequate notice\r\nto a recipient of long-term care assistance no later than the effective date of\r\nthe intended change in any of the following situations:
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(1) The department has factual\r\ninformation confirming the death of a recipient;
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(2) The department receives a clear\r\nwritten statement signed by a recipient that the recipient no longer wishes\r\nassistance or that gives information which requires termination or reduction of\r\nassistance, and the recipient has indicated, in writing, that the recipient\r\nunderstands that this is the consequence of supplying such information;
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(3) The change requires an adjustment\r\nto the budget and has no impact on the recipient's eligibility for benefits;
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(4) The recipient's whereabouts are\r\nunknown and mail from the department directed to the recipient has been\r\nreturned by the post office or facility indicating no known forwarding address;
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(5) The recipient has been accepted for\r\nassistance in a nursing facility in a different state and that fact has been\r\nestablished by the department;
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(6) A decision is made by the medical\r\nreview team indicating a change in the level of care required by the recipient;\r\nand
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(7) The recipient has been admitted to\r\nan institution where the recipient is ineligible for further services.
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Source: 2 SDR 74, effective May 13, 1976; 7\r\nSDR 66, 7 SDR 89, effective July 1, 1981; 8 SDR 170, effective June 21, 1982;\r\ntransferred from § 67:16:22:02, effective August 23, 1992; 41 SDR 93,\r\neffective December 3, 2014.
\r\n\r\nGeneral Authority: SDCL 28-6-1.
\r\n\r\nLaw Implemented: SDCL 28-6-1.
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67:46:08:04. Right to a conference. A recipient of\r\nlong-term care whose assistance is being rejected, terminated, suspended, held,\r\nor reduced may request a conference or a hearing. The conference may not\r\ninterfere with any time schedule established for requesting a fair hearing.
\r\n\r\n\r\nSource:\r\n2 SDR 74, effective May 13, 1976; 7 SDR 66, 7 SDR 89, effective July 1, 1981; 8\r\nSDR 170, effective June 21, 1982; transferred from ยง 67:16:22:03,\r\neffective August 23, 1992.
\r\n\r\nGeneral\r\nAuthority: SDCL 28-6-1.
\r\n\r\nLaw\r\nImplemented: SDCL 28-6-1.
\r\n\r\n\r\nCross-Reference:\r\nFair hearings, ch 67:17:02.
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