South Dakota Medicaid Waivers & Home and Community Based Programs Overview
- Waiver Policy Analyst
- Dec 13, 2024
- 2 min read
South Dakota, known as The Mount Rushmore State, has a well-structured Medicaid Waiver and Home and Community-Based Services (HCBS) system designed to provide long-term care alternatives for seniors, individuals with disabilities, and those with chronic health conditions.
Administered by the South Dakota Department of Social Services (DSS), Division of Long-Term Services and Supports (LTSS), and the Division of Developmental Disabilities (DDD), the state’s Medicaid waiver programs allow eligible individuals to receive services in their homes or community settings rather than institutional care.
Key waiver programs include the Home and Community-Based Services (HCBS) Waiver for the Elderly and Disabled (AD Waiver), which provides personal care, respite, and home modifications for seniors and adults with physical disabilities, and the Family Support 360 Waiver, which offers residential, habilitative, and employment support for individuals with intellectual and developmental disabilities (IDD).
Other major programs include the Assistive Daily Living Services (ADLS) Waiver, which supports individuals with quadriplegia, and the Children’s Care Coordination Program, which provides specialized services for medically fragile children. South Dakota also offers Self-Directed Services, allowing waiver participants more control over their care and caregiver selection.
Regulatory oversight in South Dakota is managed through DSS, LTSS, and DDD, with additional provider licensing and compliance enforcement by the South Dakota Department of Health (DOH), Office of Health Facilities Licensure and Certification. The state operates under both fee-for-service and managed care models, ensuring HCBS services are accessible across its rural and tribal communities.
South Dakota has also implemented Electronic Visit Verification (EVV) for personal care services, reinforcing compliance and service integrity in home-based care programs. Providers must navigate Medicaid enrollment, waiver-specific service authorizations, and stringent quality assurance measures to successfully participate in the state’s HCBS programs.
With a strong emphasis on rural healthcare access, person-centered planning, and cost-effective service delivery, South Dakota’s Medicaid waiver system ensures that individuals receive high-quality, sustainable long-term care while maintaining independence, dignity, and inclusion in their communities.
Explore Policy and Procedure manual for licensing and certification for your state Medicaid Waiver and HCBS programs here.