S.D. Admin. R. 67:54:03:04

Current through Register Vol. 51, page 57, November 12, 2024

Section 67:54:03:04 - Determination of need for ICF-IID services - Initial level of care and annual redetermination

An individual is in need of ICF/IID services if the Inventory for Client and Agency Planning (ICAP) completed under § 67:54:03:05 shows that the individual has a substantial functional limitation in three or more of the following functional areas:

(1) Self-care -- the daily activities enabling a person to meet basic life needs for food, hygiene, and appearance;

(2) Receptive and expressive language -- communication involving verbal and nonverbal behavior that enables a person to understand others and to express ideas and information to others;

(3) Learning/general cognitive competence -- the ability to acquire new behaviors, perceptions, and information and to apply the experiences to new situations;

(4) Mobility -- the ability to use fine or gross motor skills to move from one place to another with or without mechanical aids;

(5) Self-direction -- the management of one's social and personal life; the ability to make decisions affecting and protecting one's self-interests;

(6) Capacity for independent living -- based on age, the ability to live without extraordinary assistance; and

(7) Economic self-sufficiency -- the maintenance of financial support.

The utilization review team must annually redetermine that the individual continues to need ICF/IID services.

S.D. Admin. R. 67:54:03:04

18 SDR 224, effective 7/13/1992; 21 SDR 34, effective 8/29/1994; 26 SDR 150, effective 5/21/2000; 40 SDR 122, effective 1/8/2014.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.

Inventory for Client and Agency Planning (ICAP), 1986, published by Riverside Publishing Company, 425 Spring Lake, Itasca, Illinois 60134-2079; 25 response booklets $45.