S.D. Admin. R. 67:46:09:04

Current through Register Vol. 51, page 67, December 16, 2024

Section 67:46:09:04 - Eligibility requirements

To be eligible, all of the following requirements must be met:

(1) The child is under the age of 19;

(2) A physician designated by the department has determined that the child is disabled according to 20 C.F.R. §§ 416.924 to 416.924b, inclusive, or determined disabled by the social security administration within the last year. The social security administration's disability determination is binding on eligibility or continued eligibility for services. If supplemental security income or social security disability is denied because the social security administration determined that the child was not disabled, the child is not eligible for assistance;

(3) The child would be eligible for Medicaid if the child was in a medical institution;

(4) The child requires one of the levels of care listed in § 67:46:09:06;

(5) The estimated cost of monthly health care outside the medical institution does not exceed the medical institution's cost of care according to § 67:46:09:12; and

(6) The child meets the income and resource requirements contained in chapters 67:46:04 and 67:46:05.

S.D. Admin. R. 67:46:09:04

19 SDR 26, effective 8/23/1992; 41 SDR 93, effective 12/3/2014; 44 SDR 94, effective 12/4/2017

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.

How we determine disability for children, 20 C.F.R. § 416.924 (July 15, 2011); Considerations in determining disability for children, 20 C.F.R. § 416.924a (September 11, 2000); Age as a factor of evaluation in the sequential evaluation process for children, 20 C.F.R. § 416.924b (October 19, 2007).