Personal care services are medically necessary services contained in the recipient's case service plan and provided in the recipient's residence. Only the following personal care services are covered:

1. (1) Basic personal care and grooming, including bathing, shaving, dressing, and assisting the recipient with hair and teeth care;
2. (2) Assistance with bladder or bowel requirements, but not including the administration of a bowel program;
3. (3) Assistance with medications that are ordinarily self-administered;
4. (4) Assistance with food, nutrition, and diet activities, if they are incidental to a medical need;
5. (5) Household services related to a medical need and essential to the patient's health and comfort; and

6. (6) Maintenance nursing prescribed by a physician.

   Personal care services must be delivered by a licensed nurse, if required in accordance with SDCL chapter 36-9.

   For purposes of this section, a recipient's residence does not include a hospital, penal institution, detention center, school, nursing facility, assisted living center, congregate facility where services are available, other types of group settings, intermediate care facility for individuals with intellectual disabilities, or an institution that treats individuals having mental diseases.

   Cross-References: Covered services must be medically necessary, § 67:16:01:06.02; Practices not prohibited by chapter, SDCL 36-9-28.

Source: 5 SDR 109, effective July 1, 1979; 7 SDR 66, 7 SDR 89, effective July 1, 1981; 16 SDR 235, effective July 5, 1990; 20 SDR 170, effective April 18, 1994; 23 SDR 92, effective December 10, 1996; 28 SDR 96, effective December 30, 2001; 40 SDR 122, effective January 8, 2014 ; 44 SDR 94, effective December 4, 2017 ; 49 SDR 21, effective September 12, 2022 .

General Authority: SDCL 28-6-1 .

Law Implemented: SDCL 28-6-1 (1)(2) .

Prior versions effective: 2017-12-04, 2014-01-08.