S.D. Admin. R. 67:62:15:15

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

Section 67:62:15:15 - Individuals not requiring swing bed or nursing facility services but requiring mental health services - 30 month determination

If the individual is determined not eligible for swing bed or nursing home services, but requires mental health services, the Department of Social Services and Department of Human Services, in consultation with the individual's family or legal representative and caregivers, must:

(1) If the individual has continuously resided in a Medicaid certified swing bed or nursing facility at least 30 months prior to a determination of eligibility and determined not eligible for swing bed or nursing home services, but who require mental health services, the Department of Social Services, in consultation with the individual's family or legal representative and caregivers, must;

(a) Offer the choice of remaining in the facility or receiving services in an alternative setting;

(b) Inform the individual of the institutional and non-institutional alternatives covered under the state Medicaid plan;

(c) Clarify the effect on the individual's eligibility for Medicaid services under the state plan if the individual chooses to leave the Medicaid certified swing bed or nursing facility, including the effect on readmission to the Medicaid certified swing bed or nursing facility; and

(d) Provide, or arrange the provision of, mental health services for the mental illness; or

(2) If the individual has been residing in the Medicaid certified swing bed or nursing facility less than 30 months prior to a determination of eligibility and determined not eligible for swing bed or nursing home services, but who requires mental health services, the Department of Social Services, in consultation with the individual's family or legal representative and caregivers, must;

(a) Arrange for the safe and orderly discharge of the individual from the facility;

(b) Prepare and orient the individual for discharge; and

(c) Provide, or arrange for the provision of, mental health services for the mental illness.

S.D. Admin. R. 67:62:15:15

43 SDR 80, effective 12/5/2016

General Authority: SDCL 1-36-25(4).

Law Implemented: SDCL 1-36-25(4).