S.D. Admin. R. 67:54:06:04

Current through Register Vol. 51, page 54, October 28, 2024

Section 67:54:06:04 - Eligibility - Provider agency

To be eligible to receive reimbursements for services provided under this chapter, a provider agency must meet the following requirements:

(1) Must have experience in delivering services to individuals with severe disabilities;

(2) Must have a process for gathering consumer input;

(3) Must have a contract with the Department of Human Services to provide assistive daily living services;

(4) Must be a Medicaid provider and have a signed provider agreement with the Department of Social Services;

(5) Must have available the following array of services:

(a) Personal attendant services;

(b) Case management services;

(c) Consumer preparation services; and

(d) Ancillary services;

(6) Must ensure a choice of providers by either employing individuals who are qualified to provide the assistive daily living services contained in a consumer's case service plan or maintaining directories of qualified service providers; and

(7) Must have a grievance procedure in place under which a consumer may appeal to the provider agency any decision or action by the service provider or the provider agency that adversely affects the consumer. The procedure must be in writing and the provider agency must provide the consumer with a copy of the grievance procedure at the time services begin and must assist the consumer in submitting a grievance, if requested. If a written document of the procedure is not an appropriate format for the consumer involved, the provider agency must also provide the information to the consumer in a format that is appropriate for the consumer. For purposes of this subdivision, a provider agency may limit its assistance to referral of the consumer to another agency, organization, or individual that can advocate for or represent the consumer during the grievance process.

S.D. Admin. R. 67:54:06:04

21 SDR 230, effective 7/13/1995; 26 SDR 99, effective 1/30/2000; 30 SDR 135, effective 3/16/2004.

General Authority: SDCL 28-6-1(2).

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

Provider requirements, ch 67:16:33.