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Access to Services at Human Services Center

Access to Psychiatric Treatment Services for Adults

Individuals 18 years of age or older are admitted to the South Dakota Human Services Center (HSC) by voluntary application for admission or through an involuntary commitment process.  The criteria for voluntary and involuntary admission are defined in state statute.  Individuals with exceptional medical problems requiring care beyond reasonable capacity of HSC are not eligible for admission.  Voluntary admissions are accepted on a bed availability basis.

Pre-admission arrangements are made by calling 605.668.3138 or 605.668.3100 after 9 p.m. and on weekends. Information is required pertaining to the individual’s presenting problems, psychiatric treatment history, medical history, family contacts and insurance provider. If the individual is being referred from a treatment facility, the treatment records should be faxed to 605.668.3429.  Additional records may be requested prior to granting medical clearance for admission.  For further explanation of required records and medical clearance:

HSC Medical Clearance Form
Medical Clearance General Guidelines
Pre-Admission Request Form

Voluntary Adult Admission

Any individual 18 years of age or older who understands the nature of voluntary inpatient treatment and signs the voluntary application for treatment can be considered for admission if the following requirements are met:
  1. If, after examination, the staff psychiatrist determines the individual is clinically suitable for treatment.
  2. A less restrictive treatment alternative is inappropriate or unavailable.
  3. The individual needs and will likely benefit from treatment which is available at the facility.
  4. The individual understands the types of treatment available.
  5. The individual does not have any medical needs which are beyond the capacity of HSC.

Ways to Initiate Voluntary Admission

  1. Self-admission: Must be capable of providing informed consent.
  2. By Guardian or Power of Attorney (POA): Substituted consent by Guardian or POA is authorized if supporting documents are available.
  3. By Next of Kin: Consent by next of kin is authorized for a period up to 14 days or longer providing a petition for guardianship has been filed within 14 days of admission.

If possible, individuals are encouraged to utilize less restrictive outpatient services of the community mental health centers in their county of residence prior to seeking voluntary inpatient services at HSC.  Referral sources are informed of bed availability. All individuals presenting for voluntary admission will be assessed to determine if they meet criteria for admission.  Voluntary admissions are encouraged to arrive between the hours of 8 a.m. and 4:30 p.m.  State law requires a voluntary admission fee of $600. If the individual is unable to pay, they should be encouraged to contact the county welfare office in their county of residence or county auditor.  The individual should be encouraged to bring a copy of their insurance, Medicaid and/or Medicare card.

INVOLUNTARY ADMISSIONS

Any individual 18 years of age or older can be admitted to HSC on an involuntary basis pursuant to the state statutes pertaining to mental health, developmental disability and criminal code. Examples of involuntary commitments include the following:
  • Emergency Mental Illness Commitment
  • 90 Day Mental Illness Commitment
  • Emergency Developmental Disability Commitment
  • Tribal Mental Illness Commitment
  • Transfer from Department of Corrections (DOC)
  • Forensic Evaluation for assessment of competency and insanity
  • Court Ordered Treatment for competency restoration

EMERGENCY MENTAL ILLNESS COMMITMENT CRITERIA

If an individual is a danger to themselves or others due to a severe mental illness, they could be subject to an involuntary mental illness commitment if they meet the following criteria:
  1. The individual has a severe mental illness.
  2. Due to the severe mental illness, the individual is a danger to self or others or has a chronic disability.
  3. The individual needs and is likely to benefit from treatment. 

HOW TO INITIATE AN EMERGENCY MENTAL ILLNESS COMMITMENT

  1. Any person 18 years of age or older can petition for a commitment when an individual is alleged to have a mental illness and immediate intervention is required for protection from self-harm and harm to others or is committable pursuant to a chronic disability.  A petition can be obtained by contacting the States Attorney’s office or law enforcement in the county where the individual is found.  Upon completion of the petition, the petition is submitted to the States Attorney or the Mental Illness County Board Chair in the county where the individual is found.  See HSC Forms for example of the petition and chronic disability form: 
  2. Upon review of the petition, the Mental Illness Board Chair determines whether there is probable cause.
  3. If the individual is believed to meet criteria for commitment, the Mental Illness Board Chair signs an Emergency Warrant for Detention which authorizes law enforcement to take the individual into custody.
  4. Law enforcement takes the individual into protective custody and advises the individual both orally and in writing of their rights.  See notification of rights
  5. Within 24 hours after apprehension the individual must be evaluated by a Qualified Mental Health Professional or be released. The examiner must advise the individual of the nature and purpose of the examination, including the fact that it is being performed to determine whether custody should continue and that the information in the examination may be used as evidence in an involuntary commitment hearing.  See HSC Forms for an example of a Qualified Mental Health Professional Certificate.
  6. Once the examination is completed, the Mental Illness Board Chair determines whether the individual meets criteria for involuntary commitment.  If so, the individual is transported by law enforcement to an appropriate regional facility, including HSC, pending a hearing.  If commitment criteria are not met, the individual is immediately released.
  7. If the individual is found to meet commitment criteria, he/she is entitled to a hearing within five days after being taken into custody; within six days if there is a Saturday and Sunday involved; or seven days if a holiday is involved in that time period.

Please see HSC Forms for diagrams which provide a step-by-step outline of the commitment process involving initiation by law enforcement or petition filed with the States Attorney or Board Chair.

Referrals from Nursing Homes

The services of the Human Services Center (HSC) are available for adults of all ages that need mental health treatment.  Residents of nursing homes are a unique patient population that requires special mention.  Some conditions can interfere with their ability to effectively communicate and advocate for themselves.  It is important that cognitive and communication difficulties are recognized and appropriately addressed in the community setting.  Nursing home patients can also have lifelong mental health issues that can become more apparent and decompensate while in residential care; these disorders are often responsive to psychiatric treatment.

It is common for persons with dementia to develop “challenging behaviors,” also known as neuropsychiatric symptoms.  These may include repetitive calling out, aggressive behavior (particularly during bathing or toileting), and delusions (believing that someone is stealing from them or trying to hurt them.)  These symptoms may represent an attempt at communicating an unmet need (i.e. pain, infection, boredom, loneliness, or fear.)  When a patient is becoming more challenging to care for, their personal physician may complete a thorough evaluation for underlying medical problems or medication toxicities that may be contributing.  If possible, the patient’s family, caregivers, and nursing staff should visit to discuss the challenging behaviors and develop different treatment approaches to meet the patient’s need.  The first line treatment for persons with neuropsychiatric symptoms due to dementia include behavioral interventions which should be attempted prior to moving a patient from their home environment.

There are several options available if a community nursing home is having difficulty meeting the needs of a resident.  One option is to contact Long Term Services & Support for assistance in finding a different facility or providing extra resources to help meet the person’s needs.  An additional option is to contact the Clinical Review Team at HSC, a team of professionals that can work with the nursing home to help them find the best approach for the resident.

See Clinical Review Summary Form

Short-term psychiatric hospitalization is not the best choice for patients with dementia, as it removes a patient from familiar settings and can aggravate confusion and fear.  Occasionally, when other options have failed, this may unfortunately become necessary.  In this case, the following checklist should be utilized:

  1. A petition for emergency psychiatric hospitalization can be completed and submitted by the person who is requesting transfer to HSC.

    Petition for Emergency Commitment

  2. This petition should be forwarded to the Chair of the County Board of Mental Illness. Please call your local County States Attorney’s Office for a listing of Board Chairs. If the Chair feels it is appropriate, a mental health hold will be initiated.

  3. Contact the resident’s physician, nurse practitioner, or physician assistant and ask for an evaluation within 24 hours.  Acute medical problems, delirium, medication toxicities, exacerbation of chronic medical issues, and pain management should all be evaluated.  Environmental factors that are influencing the patient’s behavior should also be evaluated.  The medical provider is a “Qualified Mental Health Professional” (QMHP) under South Dakota statute 27A-1-3 and should complete the QMHP petition.  It is critical that the medical provider make a judgment based on the medical and mental status evaluation about the most appropriate treatment options for the patient. 

  4. Contact the HSC Admissions Office at 605.668.3138 (after hours 605.668.3100) to inform them of the referral.  The legal paperwork, medical provider assessment, medication lists, recent laboratory/radiology tests should all be forwarded to Admissions Office (Fax to 605.668.3429).  The information will be reviewed by the admissions nurse.  If there are concerns about HSC’s ability to meet the patient’s needs, the admissions nurse will ask for HSC physician review.  If the physician has concerns about the proposed transfer, a direct conversation will be initiated between providers, to ensure that both parties agree the patient is safe for transfer to HSC.

  5. HSC is not intended to be a permanent placement for challenging situations.  The nursing home that is referring the patient retains a responsibility to the patient under federal law and is expected to accept the resident back to the facility after a time of stabilization.  

    Reference F201 through F206 from the CMS State Operations Manual

  6. Transfer of nursing home patients should occur between the hours of 8 a.m. and 4 p.m. on weekdays, preferably by vehicle with a person who is familiar to the patient; if possible it would be helpful for the person to be accompanied by the guardian or Durable Power of Attorney (DPOA).

Access to Psychiatric Treatment Services for Adolescents

The Human Services Center Adolescent Psychiatric Program provides inpatient psychiatric treatment to adolescents (ages 12 through 17) with mental illness or severe emotional disturbance.  All HSC adolescent psychiatric units are Medicaid certified.  The goal of the adolescent program is to develop and initiate individualized treatment and discharge plans, provide effective treatment, and to support the patient in transition to home or another appropriate placement setting. Length of hospitalization is based on the needs of the individual patient.

Adolescents can be admitted by:

  • Involuntary mental illness commitment;
  • Involuntary tribal court commitment (patients are committed by the Tribal Court to Indian Health Services to be placed in an appropriate facility);
  • Voluntary by guardian (this can be a parent or a court appointed legal guardian such as the Department of Social Services or Bureau of Indian Affairs Social Services);
  • Inter-departmental transfer from the Department of Corrections;
  • Juvenile court order;
  • Inter-institutional transfer from the South Dakota Developmental Center in Redfield.

Pre-admission arrangements are made by calling 605.668.3100 and asking for the adolescent admissions social worker. It will be necessary to have information available regarding the adolescent’s presenting problem, psychiatric and medical history, as well as guardianship documentation.  Prior to admission, all adolescents must be evaluated by a Qualified Mental Health Professional (QMHP) and diagnosed with a severe emotional disturbance.  It must be determined that the adolescent would likely benefit from inpatient psychiatric treatment and has mental health needs which cannot be met in a less restrictive environment.  If the adolescent has medical concerns, medical clearance by a physician is necessary for admission.

For involuntary and juvenile court order commitments, the petition, order of detainment, QMHP and medical clearance (if applicable) are required.  For Voluntary by Guardian commitments for a child who has been adopted or is in the legal guardianship of a person other than their parent, a court order is required. 

Access to Inpatient Chemical Dependency Treatment for Adults

Gateway Treatment Program

The first step for accessing inpatient chemical dependency treatment for adults is working with community alcohol and drug providers to have an assessment completed.  This assessment will help determine what problem areas exist and help determine the appropriate level of services.  If it shows a need for inpatient care the counselor that completed your assessment at the community alcohol and drug agency will then work with treatment centers availability.  If an opening is available and it is determined that the person meets criteria to be at the Gateway Program at HSC, a referral will be sent to the Division of Community Behavioral Health. 

Once approved, medical clearance will need to be obtained; the admissions chemical dependency counselor at HSC will work to verify all medications and medical conditions through doctor’s records, etc.  Once clearance has been obtained, an admission date will be given based on availability. 

The admission fee of $600 will need to be paid upon admission.  Arrangements for payment of this fee can be made with the HSC Business Office at 605.668.3108 or seek assistance with the local county welfare office.  For specific questions pertaining to this process please call the Admissions Chemical Dependency Counselor at 605.668.3218. 

When seeking help for someone who may not be willing to enter treatment voluntarily please see the Involuntary Chemical Dependency Commitment process below. 

Chemical Dependency Involuntary Commitment

Step 1 – Petition for Involuntary Commitment

  1. Who May Apply:  Any responsible person, for example, spouse, relative, friend, or physician
  2. Where To Apply:  Clerk of Courts in the county in which the person resides or is currently present. 
  3. Legal Investigation and Petition:  The Clerk of Courts will take written application completed by any responsible person and present to the judge who will appoint an attorney to represent the applicant (now referred to as Petitioner).  Within five days, the attorney completes and submits a petition and report to the courts alleging:
    1. That the person to be committed (now referred to as respondent) is an alcoholic or drug abuser who habitually lacks self-control as to the use of alcoholic beverages or other drugs; AND
      1. Has threatened, attempted, or inflicted physical harm on themselves or on another and that unless committed is likely to inflict harm on themselves or another; OR
      2. Is incapacitated by the effects of alcohol or drugs; OR
      3. Is pregnant and abusing alcohol or drugs.

**A refusal to undergo treatment does not constitute evidence of lack of judgment as to the need for treatment.**

  1. Chemical Dependency Counselor’s Certificate:  Must be completed within two days prior to the filing of the petition. It must support the allegations in the petition, and include treatment recommendations that can include:  inpatient treatment, outpatient treatment, day treatment, or halfway house services.  (If respondent refuses to meet with the Counselor for completion of the certificate this shall be documented in the petition).
  2. Petition, Attorney’s Report, and Counselor’s Certificate must be filed with the courts and the courts will set a hearing date within 10 days.

Step 2 – Judicial Hearing for Involuntary Commitment

  1. Right to Attorney:  Respondent has the right to have his/her own attorney. 
  2. Testimony in Court:  Petitioner and Counselor may be asked to testify at the court hearing.
  3. Decision:  Courts will determine if commitment criteria are met based on testimony of petitioner and the Chemical Dependency Counselor.

Step 3- Commitment

  1. Treatment services will be arranged by the counselor completing the Chemical Dependency Certificate based on their prior recommendations.
  2. The involuntary commitment period is for up to 90 days and this can include inpatient, halfway house, or outpatient services. 

For further information on this process please see the Roadmap of South Dakota’s Substance Abuse Involuntary Commitment on the Division Behavioral Health’s website. 

General Information

Contact Information

South Dakota Human Services Center
3515 Broadway Ave
PO Box 7600
Yankton, SD 57078-7600
605.668.3100

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