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Health Care Guidelines 


Preface to Guidelines  Table of Contents 

The SCDDSN Health Care Guidelines are intended to offer health care professionals “best practice” advice to provide a high standard of care to persons with disabilities. These guidelines cover a broad area of health care issues to include issues that are especially important to persons with disabilities. These guidelines were originally developed for use by SCDDSN’s regional centers in 1996. Since their original implementation with the regional centers, a significant improvement in the quality of health care provided has been witnessed.

Although developed for use at the regional centers, these guidelines could be of benefit to consumers served in any setting. While most applicable to services provided in an ICF/ID, there could be value in incorporating aspects of these guidelines into other services as well.

The Health Care Guidelines are clinical tools to consult in practice but are not directives. They are not obligatory to utilize but are focused on clinical and administrative information to be consulted in the manner of textbooks not as requirements for practice.

Questions regarding the South Carolina Department of Disabilities and Special Needs Health Care Guidelines should be directed to the SCDDSN’s Medical Consultant at (803) 898-9808.



January 2006

In 1995, a task force comprised of knowledgeable and committed professionals was formed to develop a comprehensive set of guidelines that would provide a “best practices” resource for healthcare professionals serving individuals residing in the SCDDSN Regional Centers. In May of 1996 the first edition of the SCDDSN Healthcare Guidelines was published. These guidelines were thoroughly reviewed and revised in the interim period with a 2 nd and 3 rd edition being published in 1998 and 2001 respectively. The 3 rd edition was modified to be utilized by healthcare professionals serving individuals residing in the DSN Board/community provider ICFs/ID as well as the SCDDSN Regional Centers. Testimony from consumers, family and staff has resoundingly acknowledged the positive impact these guidelines have had on the health of our consumers. These guidelines have once again been reviewed and revised to keep pace with the rapid advances being made in the healthcare arena. A 4 th edition of the SCDDSN Healthcare Guidelines has now been published.

On behalf of all whose lives have been positively affected by these Healthcare Guidelines, we want to offer our sincerest appreciation to those skilled professionals whose focused efforts have produced the Healthcare Guidelines and those dedicated individuals who have utilized the knowledge contained in these Healthcare Guidelines to improve the quality of healthcare provided to our consumers.

The chairperson who guided the task force in the development of the 4th edition of the Healthcare Guidelines, as in all previous editions, was Deborah Natvig, RN, Ph.D. Dr. Natvig’s visionary leadership and tireless efforts have been directly responsible for enhancing the quality of life for thousands of South Carolinians with disabilities. Assisting Dr. Natvig in the development of the 4th edition of the Healthcare Guidelines were:

  • Ron Childs, MHA, FACHE – Health Services Administrator, Midlands Center
  • Graeme Johnson , MD – DDSN Medical Consultant and USC School of Medicine Developmental Pediatrician
  • Anita Linder, RN, MSN, ANP – DDSN Nursing Consultant
  • Anna Leitner, RN – Midlands Center
  • Numerous other Regional Center and DSN Board healthcare professionals

It is our hope that the 4 th edition of the SCDDSN Healthcare Guidelines will build upon the improvements in our healthcare delivery system which were facilitated by the previous editions.


1. Introduction and Summary of Changes in 4th Edition

2. Acute Illness

3. Cancer Screening

4. Cardiovascular Screening – (Coronary Heart Disease, Stroke, and Hypertension) - (formerly Coronary Heart Disease and Stroke Screening)

5. Conscious Sedation

6. Dental Services

7. Diabetes Screening

8.Dysphagia and Associated Disorders

9. Genetic Services

10. Health Care Coordination

11. Hydration Management

12. Medical Documentation

13. Medical Management of Epilepsy

14. Musculoskeletal Health

15. Nursing Documentation

16. Nursing Management of Seizures

17. Ocular Health

18. Preventive Health Care Recommendations for Adults – New Guideline

19. Prolonged Seizure Activity

20. Psychotropic Medication

21. Referral To and Discharge From Acute Care Facilities - (formerly Discharge and Transfer To and From Acute Care Facilities)

22. Skin IntegrityNew Guideline

23. Reference Section - Monitoring Information