How to Apply for South Dakota Developmental Center Services

The South Dakota Developmental Center (SDDC) will provide supports and services for individuals with a developmental disability who meet the established eligibility criteria when suitable community supports and services are not available. Individuals admitted to SDDC must be in need of active treatment and be likely to benefit from placement at SDDC. SDDC will provide services to any individual who is developmentally disabled, in need of, but not otherwise receiving services, regardless of age, sex, race, national origin or ability to pay.

• Who is eligible?
• What services are available at SDDC?
• How is application made to SDDC?

Who is eligible?

INDIVIDUALS WHO ARE ELIGIBLE:

• Individuals who are eligible for admission to an ICF/MR, and
• Have a developmental disability, and
• Are eligible for Title XIX ICF/MR funding, and
• Are eligible for and in need of ICF-MR/DD services.

ADDITIONAL TURTLE CREEK YOUTH PROGRAM CRITERIA:

• Individual must have unsuccessfully received treatment in a less-restrictive environment
• Individual must display behaviors that are dangerous or cause concern for the safety of the individual or others

CRITERIA 1: ELIGIBILITY FOR ICF/MR

The primary purpose of an Intermediate Care Facility for the Mentally Retarded (ICF/MR) is to furnish health or rehabilitative services to persons with mental retardation or other related conditions.

Persons with other related conditions means individuals who have a severe, chronic disability that meets all of the following conditions:

1. It is attributable to—

1. Cerebral palsy or epilepsy; or
2. Any other condition, other than mental illness, found to be closely related to mental retardation because this condition results in impairment of general intellectual functioning or adaptive behavior similar to that of mentally retarded persons, and requires treatment or services similar to those required for these persons.

2. It is manifested before the person reaches age 22.
3. It is likely to continue indefinitely.
4. It results in substantial functional limitations in three or more of the following areas of major life activity:

1. Self-care
2. Understanding and use of language
3. Learning
4. Mobility
5. Self-direction
6. Capacity for independent living

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CRITERIA 2: DEVELOPMENTAL DISABILITY

A "developmental disability" is any severe, chronic disability of a person that:

1. Is attributable to a mental or physical impairment or combination of mental and physical impairments;
2. Is manifested before the age twenty-two;
3. Is likely to continue indefinitely;
4. Results in substantial functional limitations in three or more of the following areas of major life activity:

1. Self-care
2. Receptive and expressive language
3. Learning
4. Mobility
5. Self-direction
6. Capacity for independent living
7. Economic self sufficiency; and

5. Reflects the person’s need for an array of generic services, met through a system of individualized planning and supports over an extended time, including those of a life-long duration.

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CRITERIA 3: QUALIFICATION FOR TITLE XIX ICF/MR FUNDING

CHILDREN/ADOLESCENTS

To qualify for SSI, a child’s disability must:

be included in the medical listing of impairments, in Part B of Social Security Administration Publication No. 64-039

• The medical listing describes impairments that can cause marked and severe functional limitations in a child. Most of the impairments are permanent or expected to result in death.

OR

meet the MEDICAL EQUIVALENCE or FUNCTIONAL EQUIVALENCE of a medical listing.

Medical Equivalence:

• A person is eligible when the medical findings are at least equal in severity and duration to the medical listings.
• This is done by comparing the symptoms, signs and laboratory findings of the impairment(s) with the corresponding medical criteria shown for any medical listing.
• Severe means that an impairment, or combination of impairments, has more than a minimal impact on a child’s functioning.
• Careful consideration must be paid to the combined effects of ALL of an individual’s physical or mental impairments.

• The evaluator will consider the medical opinion given by one or more medical or psychological consultants designated by the Commissioner.

Functional Equivalence:

• Determining functional equivalence is done by comparing any functional limitation resulting from an impairment(s) with the disabling functional limitations of any medical listing.

• The following four methods are used for determining whether a child’s impairment has the same disabling functional limitations as a medical listing:

1. Limitations of specific functions. If a child’s impairment or combination of impairments, causes extreme (see definition below) disabling limitation of a specific function or a combination of specific functions that is described in a listing, then the child’s impairment or combination or impairments is functionally equivalent to that listing.
   
2. Broad functional limitations based on the areas of functioning in the mental disorders listings. They include:

1. Cognition/communication (birth – 18)
2. Motor (birth – 18)
3. Social (birth – 18)
4. Responsiveness to stimuli (birth to age 1 only)
5. Personal (age 3 to 18 only)
6. Concentration, persistence or pace (age 3 to 18 only)

3. If there are extreme limitations in one area of functioning or marked limitations (see definition below) in two areas of functioning, the impairment will be found functionally equivalent in severity to a listed impairment.
   
4. Episodic impairment(s). The functioning limitation(s) of a chronic impairment, which is characterized by frequent illnesses or attacks, will be compared to any medical listing with similar episodic criteria, to determine if the impairment(s) has such a serious impact on the functioning over time that it is functionally equivalent in severity to a medical listing. Examples include paranoid schizophrenia, bipolar disorder, and panic disorder.
   
5. Limitations resulting from the effects of medication or the nature of the treatment that are debilitating or that contribute to functional limitations.
   The functional limitation(s) resulting from treatment (medication, surgery) of an impairment(s) will be compared to any medical listing with similar functional limitations to determine if the impairment(s) has such a serious impact on the functioning over time that it is functionally equivalent in severity to a medical listing.

DEFINITIONS:

Marked Limitation:

• When standardized tests are used as the measure of functional abilities, a valid score that is two standard deviations or more below the norm for the test, (but less than three standard deviations);
• For children from birth to age three, functioning at more than one-half but not more than two-thirds of chronological age;
• For a child age 3 to 18, when the degree of limitation interferes seriously with the child’s ability to function.

Extreme Limitation:

• When standardized tests are used as the measure of functional abilities, a valid score that is three standard deviations or more below the norm for the test;
• For children from birth to age three, functioning at one-half their chronological age or less;
• For a child age 3 to 18, when there is no meaningful functioning in a given area.

CRITERIA 3: QUALIFICATION FOR TITLE XIX ICF/MR FUNDING

ADULTS

To qualify for SSI, an adult’s disability must:

be included in the medical listing of impairments, in Part A of Social Security Administration Publication No. 64-039

• The medical listing describes impairments that can cause marked functional limitations in persons age 18 and over.

• Disability is defined as "the inability to engage in substantial gainful activity by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months."

• Medical criteria as listed in Part A must be satisfied.

• Categories which are most likely to qualify an individual for admission are as follows:

• Section 11.00 Neurological Disorders

• 11.02 Epilepsy – Major motor seizures
• 11.03 Epilepsy – Minor motor seizures
• 11.07 Cerebral Palsy

• Section 12.00 Mental Disorders

• 12.05 Mental Retardation and Autism

• Other conditions may be considered if there are marked functional limitations imposed by the impairment. The degree of limitation must seriously interfere with the ability to function independently, appropriately, and effectively in the following areas:

1. Activities of daily living
2. Social Functioning
3. Concentration, persistence, and pace
4. Deterioration or decompensation in work or work-like settings

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CRITERIA 4: ELIGIBILITY AND NEED FOR ICF-MR/DD SERVICES

• To be eligible for ICF-MR/DD services under Medicaid, the following criteria must be met:

1. The individual must be eligible for Medicaid under article 67:16
2. The individual must be developmentally disabled
3. The utilization review team must have determined that the individual is in need of ICF- MR/DD services pursuant to 67:54:03:04

• To be determined in need of ICF-MR/DD services, the individual must have a substantial functional limitation in three or more of the following functional areas as determined by a completed Inventory for Client and Agency Planning (ICAP):

1. Self-care
2. Receptive and expressive language
3. Learning/general cognitive competence
4. Mobility
5. Self-direction
6. Capacity for independent living
7. Economic self-sufficiency

This determination is reviewed annually to redetermine if individual continues to need ICF-MR/DD services.

• If subsequent additional adaptive behavior testing reveals results inconsistent with ICAP testing results completed prior to admission to SDDC, within thirty (30) days of admission to SDDC or annually thereafter, results of the two or more testings will be compared for inconsistencies to determine/redetermin e eligibility/need for ICF-MR/DD services at SDDC.

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What services are available?

The South Dakota Developmental Center currently provides individualized services to individuals with developmental disabilities. The focus of services is to gradually transition individuals into a less restrictive setting. The services are divided into three program areas.

Program One serves approximately 75 male individuals with challenging behaviors. Individuals have a wide variety of abilities ranging from those requiring intense staff involvement for most daily living needs to those who are fully capable of completing all of these tasks independently.

Program Two , also known as the Turtle Creek Youth Program, serves 40 male and female adolescents with challenging behaviors within five structured living areas and two semi-independent living areas. Education is provided through the Redfield Public School. Focus is on preparing the youth to live productive lives within a community setting.

Program Three serves approximately 80 male and female individuals with a variety of behavioral issues, as well as individuals who require a great deal of assistance in their activities of daily

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How is application made to SDDC?

First Step: A telephone call to needs to be made to the Department of Human Services, Division of Developmental Disabilities, 1-605-773-3438 requesting to speak with someone about services for an individual with specific needs.

Second Step: The Division of Developmental Disabilities Program Specialist assigned to the telephone call will request an Application For Admission be completed and submitted to the Division of Developmental Disabilities accompanied by information in the form of evaluations, testing reports, etc., which substantiate the individual’s needs for services.

Third Step: The Application For Admission may be downloaded in either Microsoft Word 97 or Adobe Acrobat format. Print the application, complete and sign the and mail to the Division of Developmental Disabilities:

Department of Human Services
Division of Developmental Disabilities
East Highway 34, Hillsview Plaza
c/o 500 East Capitol Avenue
Pierre, SD 57501-5070

FAX: 1-605-773-5483

Fourth Step: The questions asked in the Application For Admission are self-explanatory. Be sure answers are as thorough as possible. Attach all supplemental information Application For Admission requests, i.e., birth certificate, guardianship papers, Social Security card, Medicaid card, etc.

Fifth Step: The Division of Developmental Disabilities Program Specialist contacts the SDDC Registrar, 1-605-472-4356, informing the facility of a pending admission requiring the services provided by SDDC.

Sixth Step: Dialogue is established between SDDC Registrar and applicant to establish date/time of intake to SDDC for a 30-day evaluation.

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