Determination of need for ICF/IID services -- Initial level of care and annual redetermination.
Effective Jan 8, 201440 SDR 122Source: 18 SDR 224, effective July 13, 1992; 21 SDR 34, effective August 29, 1994; 26 SDR 150, effective May 21, 2000; 40 SDR 122, effective January 8, 2014. | General Authority: SDCL 28-6-1. | Law Implemented: SDCL 28-6-1.
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.
Reference: Inventory for Client and Agency Planning (ICAP), 1986, published by Riverside Publishing Company, 425 Spring Lake, Itasca, Illinois 60134-2079; 25 response booklets $45.
Source: 18 SDR 224, effective July 13, 1992; 21 SDR 34, effective August 29, 1994; 26 SDR 150, effective May 21, 2000; 40 SDR 122, effective January 8, 2014.
General Authority: SDCL 28-6-1.
Law Implemented: SDCL 28-6-1.