Current through Register Vol. 51, page 43, September 23, 2024
CHOICES waiver services shall be tailored to the preferences and
priorities of each participant. Each participant must receive at least one of
the following waiver services each month:
(1) Case management to include:
(a) Developing the individualized support
plan (ISP) utilizing the state's standardized ISP;
(b) Promoting and documenting participant
involvement in the ISP monitoring process;
(c) Documenting the team meeting and making
sure scheduling facilitates participation of all members;
(d) Observing, monitoring, and documenting
the implementation of the ISP at least quarterly;
(e) Meeting minimally, for one face-to-face
visit per quarter with each participant;
(f) Ensuring implementation and revisions of
the ISP;
(g) Reviewing critical
incident reports;
(h) Reviewing
instances of abuse/neglect/exploitation (ANE), participant health and safety or
other pertinent information;
(i)
Submitting monthly quality reports summarizing case management
activities;
(j) Assisting
participants in finding paid and unpaid natural supports;
(k) Arranging, reviewing, and approving
assessments;
(l) Administering the
inventory for client and agency planning (ICAP):
(m) Conducting person centered
planning;
(n) Assisting
participants in selecting services and supports;
(o) Assisting participants to identify
individual budgets;
(p) Assessing
individual eligibility status and referring individuals to necessary
eligibility resources;
(q)
Assisting individuals to access integrated community employment;
(r) Ensuring human rights committee
(HRC)/behavior (BSC) has afforded due process; and
(s) Developing emergency backup plans in the
event the case manager is out of the office or is unavailable when the
participant or their family is in need of case management services;
or
(2) Day services to
include:
(a) Services to assist the
participant to gain opportunities for meaningful life experiences, in
coordination with the participant's personal goals and supports, and agreed
upon by the ISP team;
(b) Services
not limited to fixed site facilities; and
(c) Services that pay no wages for
participation in activities; or
(3) Career exploration to include:
(a) Services that are designed to assist
participants in identifying and developing skills that prepare them for
integrated competitive jobs and compensation at or above minimum wage, but not
less than customary wage and level of benefits paid by the employer for similar
work performed by employees without disabilities;
(b) Services that are time limited;
and
(c) Services intended to result
in paid employment and work experience to further career development and
individual integrated community-based employment; or
(4) Residential habilitation to include:
(a) Services provided to a participant living
in their own home, including those living with other family members;
and
(b) Assistance with
acquisition, retention, or improvement in:
(i)
Activities of daily living;
(ii)
Food preparation;
(iii) Money
management;
(iv) Safety skills;
and
(v) Social and adaptive skills
necessary to enable the participant to reside in a non-institutional setting;
or
(5)
Supported employment to include services that are intensive with ongoing
supports which enable the participant for whom competitive employment, at or
above the minimum wage, is unlikely absent the provision of supports and who,
because of their disabilities, need supports to perform in a regular work
setting; or
(6) Medical equipment
and drugs may include devices, controls, or appliances, specified in the ISP
which enable a participant to increase the participant's ability to perform
activities of daily living, or to perceive, control, or communicate with the
environment in which they live; or
(7) Nursing services limited to those nursing
services which are not available under the Medicaid state plan and are limited
to:
(a) Screenings and assessments;
(b) Nursing diagnosis treatment;
(c) Staff training;
(d) Monitoring of medical care and related
services;
(e) Policy and procedure
development; and
(f) Review and
response to medical emergencies, tuberculin tests, and phlebotomy for hepatitis
screening; or
(8) Other
medically related services to include:
(a)
Speech, hearing, and language services;
(b) Direct therapies, treatment, and services
limited to those not available under the Medicaid state plan and provided by:
(i) Physicians;
(ii) Psychiatrists;
(iii) Physician assistants;
(iv) Speech, physical, or occupational
therapists;
(v)
Pharmacists;
(vi)
Optometrists;
(vii) Dentists or
dental hygienists;
(viii)
Audiologists;
(ix)
Podiatrists;
(x) Chiropractors;
or
(xi) Dietitians;
(c) Services, therapies, and
treatments provided directly to the participant as indicated in the ISP;
and
(d) Evaluations, program
design, direct services, staff training, policy, and procedure review unless
covered by the Medicaid state plan.
General Authority: SDCL
27B-2-26(3)(9).
Law Implemented: SDCL
27B-2-26(3)(9).
