RESPITE CARE SERVICES PROVIDER IN SOUTH DAKOTA
OFFERING RELIEF FOR PRIMARY CAREGIVERS WHILE PROMOTING CONTINUITY, SAFETY, AND COMFORT FOR INDIVIDUALS WITH DISABILITIES OR COMPLEX NEEDS

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Respite Care Services in South Dakota provide temporary relief to families or primary caregivers of individuals with disabilities, chronic conditions, or age-related limitations. These services ensure that individuals continue receiving appropriate supervision and support during caregiver absences. Respite is available through the state’s Home and Community-Based Services (HCBS) Waivers, including the Family Support 360 Waiver, CHOICES Waiver, Shared Living, and Aging and Disability Resource Center (ADRC) programs. Both in-home and out-of-home models are supported.

1. GOVERNING AGENCIES

Agency: South Dakota Department of Human Services (DHS) – Division of Developmental Disabilities (DDD)
Role: Administers the CHOICES and Family Support 360 Waivers; oversees service authorizations, quality assurance, and provider approvals.

Agency: South Dakota Department of Social Services (DSS) – Division of Long Term Services and Supports (LTSS)
Role: Manages respite services for older adults under Medicaid HCBS programs.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures federal compliance with HCBS rules governing respite and caregiver support.

2. RESPITE CARE SERVICES OVERVIEW

Respite provides temporary, substitute care to waiver participants when their regular caregiver is unavailable due to planned or emergency reasons.

Approved providers may deliver:

In-Home Respite: Supervision and support in the individual’s home

Out-of-Home Respite: Care in a licensed setting (e.g., residential facility or group home)

Hourly or Daily Support: Based on the participant’s ISP and caregiver needs

Emergency Respite Options (with pre-approval or crisis plan)

Monitoring and Documentation: Daily logs, service verification, and communication with case managers

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Dakota Secretary of State

Obtain EIN and Type 2 NPI

Enroll as a provider with the Division of Developmental Disabilities (DDD) or LTSS

If offering out-of-home respite, meet facility licensure requirements through DSS

Develop a Respite Care Services Policy & Procedure Manual

Maintain insurance coverage (liability, workers’ comp, etc.)

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Form your business, obtain EIN/NPI
Step 2: Submit provider application to DHS-DDD (for ID/DD waivers) or DSS-LTSS (for aging waivers)
Step 3: Provide staff credentials, documentation samples, and safety protocols
Step 4: Undergo provider readiness verification
Step 5: Begin accepting service authorizations and referrals from case managers

5. REQUIRED DOCUMENTATION

EIN, NPI, and business registration

Provider approval from DDD or DSS

Facility license (if out-of-home services are offered)

Insurance certificates

Respite Services Policy & Procedure Manual, including:

Participant intake and care instructions

Emergency and contact protocols

Service delivery documentation templates

Participant rights and HIPAA compliance

Incident reporting and backup caregiver plans

Billing forms and verification processes

6. STAFFING REQUIREMENTS

Role: Respite Worker / Direct Support Staff
Requirements:

Background check, CPR/First Aid, basic caregiving or disability services training

Familiarity with participant needs, behavior plans, and emergency protocols

Role: Clinical Supervisor (for skilled respite services)
Requirements: RN or licensed provider as required by participant’s ISP

All staff must complete:

Orientation on participant dignity, abuse prevention, and rights

HIPAA and confidentiality training

Documentation and Medicaid compliance education

Annual performance and safety reviews

7. MEDICAID WAIVER PROGRAMS

Respite care is authorized under:

CHOICES Waiver – For adults with intellectual and developmental disabilities

Family Support 360 Waiver – For children and adults with disabilities in family homes

Shared Living Program – May allow respite through alternate family care

LTSS HCBS Waiver – For older adults needing relief services for caregivers

State Plan Medicaid or EPSDT (under 21) – May cover pediatric respite with medical necessity

8. TIMELINE TO LAUNCH

Phase: Business Setup & Policy Development
Timeline: 1–2 months

Phase: Medicaid Enrollment & Provider Approval
Timeline: 2–3 months

Phase: Staff Hiring, Training & Background Checks
Timeline: 30–60 days

Phase: Service Launch
Timeline: Upon referral and plan authorization

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9. CONTACT INFORMATION

South Dakota Department of Human Services – Division of Developmental Disabilities
Website: https://dhs.sd.gov

South Dakota Department of Social Services – LTSS
Website: https://dss.sd.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SD RESPITE CARE PROVIDER

WCG supports providers in launching safe, flexible, and person-centered respite care programs that promote continuity for individuals and peace of mind for families.

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Scope of Work:

Medicaid enrollment assistance (DDD or LTSS)

Respite Care Policy & Procedure Manual development

Staff credentialing trackers and orientation tools

Participant care planning templates

Daily documentation logs and communication forms

Medicaid billing templates and incident tracking

RESIDENTIAL HABILITATION SERVICES PROVIDER IN SOUTH DAKOTA
DELIVERING 24/7 SUPPORT IN RESIDENTIAL SETTINGS TO PROMOTE INDEPENDENCE, SKILL DEVELOPMENT, AND COMMUNITY LIVING FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES

Residential Habilitation Services in South Dakota are designed to provide individuals with intellectual and developmental disabilities (IDD) the support they need to live as independently as possible in a structured, home-like environment. These services are covered under the CHOICES Waiver administered by the South Dakota Department of Human Services (DHS). Residential habilitation focuses on personal care, supervision, and training in daily living skills in agency-operated settings such as group homes or supervised apartments.

1. GOVERNING AGENCIES

Agency: South Dakota Department of Human Services (DHS) – Division of Developmental Disabilities (DDD)
Role: Authorizes and monitors Residential Habilitation providers under the CHOICES Waiver, including quality reviews and licensing oversight.

Agency: South Dakota Department of Social Services (DSS)**
Role: May provide regulatory guidance for residential facilities and funding coordination in special circumstances.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Enforces HCBS federal compliance and person-centered planning regulations for waiver-funded residential services.

2. RESIDENTIAL HABILITATION SERVICES OVERVIEW

Residential Habilitation supports individuals with disabilities who require 24-hour care and supervision in a provider-operated home. Services include help with daily living, social skills, and behavior support to ensure meaningful integration in the community.

Approved providers may deliver:

24-Hour Supervision and Support

Assistance with ADLs and Personal Hygiene

Meal Preparation and Nutrition Monitoring

Behavioral Support Plan Implementation

Skill-Building Activities: Cooking, money management, cleaning, etc.

Community Participation and Transportation Support

Medication Management (non-skilled)

Plan of Care Implementation and Documentation

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your organization with the South Dakota Secretary of State

Obtain EIN and Type 2 NPI

Apply to DHS-DDD for enrollment as a Residential Habilitation provider

Comply with facility and staffing standards for 24/7 care homes

Prepare for site visits and readiness reviews by DHS

Develop a Residential Habilitation Policy & Procedure Manual

Maintain general liability, workers’ comp, and participant risk coverage

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Form your legal entity, obtain EIN and NPI
Step 2: Apply to the Division of Developmental Disabilities as a CHOICES Waiver provider
Step 3: Submit facility information, staff training materials, and policy documentation
Step 4: Participate in site inspection and service readiness assessment
Step 5: Upon approval, receive referrals through participant case managers

5. REQUIRED DOCUMENTATION

Business formation documents, EIN, and NPI

Facility lease or ownership documentation

Insurance certificates (liability, workers’ comp, etc.)

Residential Habilitation Policy & Procedure Manual including:

Participant admission and transition policies

ADL support routines and daily schedule templates

Incident reporting, emergency response, and behavioral intervention plans

HIPAA compliance and participant rights protocols

Staff shift reports, attendance logs, and plan-of-care implementation records

Health and safety checklists and medication logs

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP)
Requirements:

Background check, CPR/First Aid, abuse prevention training

DHS-required training in ADLs, documentation, and participant safety

Ongoing in-service education on residential support

Role: House Manager / Site Coordinator
Requirements: Supervises DSPs, monitors service delivery, reports incidents

Role: Behavior Support Professional (if needed)
Requirements: Delivers or oversees behavior interventions per participant plan

All staff must complete:

HIPAA and participant rights training

Medication management and safety drills

Emergency preparedness and documentation protocols

Annual evaluations and skills verification

7. MEDICAID WAIVER PROGRAMS

Residential Habilitation is authorized under:

CHOICES Waiver – Primary HCBS waiver for adults with IDD requiring 24-hour supervision

Family Support 360 (in rare transitions) – May be used when shifting from family-based to agency-based settings

State Plan Medicaid – May cover limited nursing or medical services in combination with habilitation (as needed)

8. TIMELINE TO LAUNCH

Phase: Business & Facility Setup
Timeline: 2–4 months

Phase: Medicaid Provider Enrollment & Site Readiness
Timeline: 3–5 months

Phase: Staff Hiring, Training & Compliance Checks
Timeline: 1–2 months

Phase: Service Launch
Timeline: Begins after approval, referrals, and person-centered service planning

9. CONTACT INFORMATION

South Dakota Department of Human Services – Division of Developmental Disabilities
Website: https://dhs.sd.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SD RESIDENTIAL HABILITATION PROVIDER

WCG helps agencies build compliant and person-centered residential habilitation programs that empower individuals with disabilities to live fuller, more independent lives.

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Scope of Work:

Medicaid provider enrollment assistance

Residential Habilitation Policy & Procedure Manual development

Facility readiness checklist and licensing support

DSP training templates and care documentation tools

Participant transition forms and ISP coordination worksheets

Incident tracking, billing templates, and quality assurance logs

SUPPORTED EMPLOYMENT SERVICES PROVIDER IN SOUTH DAKOTA
PROMOTING COMPETITIVE, INTEGRATED EMPLOYMENT FOR INDIVIDUALS WITH DISABILITIES THROUGH INDIVIDUALIZED JOB SUPPORT AND COACHING

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Supported Employment Services in South Dakota help individuals with intellectual and developmental disabilities (IDD) gain and maintain meaningful employment in the community. These services are authorized under the CHOICES Waiver, administered by the South Dakota Department of Human Services (DHS), and focus on person-centered employment planning, job coaching, and long-term support in competitive work environments.

1. GOVERNING AGENCIES

Agency: South Dakota Department of Human Services (DHS) – Division of Developmental Disabilities (DDD)
Role: Approves and monitors providers under the CHOICES Waiver, ensuring services align with Employment First principles.

Agency: South Dakota Division of Rehabilitation Services (DRS)**
Role: Coordinates pre-employment services and may fund initial job placement before waiver-funded supports begin.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Oversees HCBS compliance and ensures employment is the primary goal of adult waiver services.

2. SUPPORTED EMPLOYMENT SERVICES OVERVIEW

Supported Employment Services assist individuals with disabilities in preparing for, finding, and keeping a paid job in the community. Services are tailored to individual goals and may be provided on-site at the job location or through community-based coaching.

Approved providers may deliver:

Job Development & Placement Assistance

On-the-Job Coaching and Training

Job Task Adaptation and Skill Development

Employment Goal Planning & Career Counseling

Social Skills and Communication Support

Coordination with Employers and Co-Workers

Follow-Along Services to Ensure Long-Term Success

Documentation of Progress and Outcomes

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Dakota Secretary of State

Obtain EIN and Type 2 NPI

Apply to DHS-DDD as a CHOICES Waiver Supported Employment provider

Establish community partnerships and employer contacts

Develop a Supported Employment Services Policy & Procedure Manual

Obtain liability and workers’ compensation insurance

Prepare service tracking tools and documentation systems

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Establish business entity and secure EIN/NPI
Step 2: Apply to DHS-DDD with employment program outline and staffing plan
Step 3: Submit sample forms, documentation, and participant tracking templates
Step 4: Complete provider readiness review
Step 5: Start service delivery with approved participants and ISPs

5. REQUIRED DOCUMENTATION

EIN, NPI, and business registration

Insurance certificates (liability, workers’ comp, and auto if applicable)

Supported Employment Policy & Procedure Manual including:

Intake and employment planning forms

Job coaching documentation and follow-up visit notes

Employer communication templates

Participant satisfaction and goal tracking

Risk mitigation, emergency response, and confidentiality policies

Billing and service verification records

6. STAFFING REQUIREMENTS

Role: Employment Specialist / Job Coach
Requirements:

High school diploma or higher; experience in vocational training or disability employment services

Background check, CPR/First Aid, and job coaching training

Understanding of DDD goals and Employment First practices

Role: Employment Program Coordinator (Recommended)
Requirements: Supervises job coaches, develops community employment relationships, oversees compliance

All staff must complete:

HIPAA and participant rights training

Workplace safety and employer communication skills

Documentation and ISP alignment protocols

Annual training and competency assessments

7. MEDICAID WAIVER PROGRAMS

Supported Employment Services are available through:

CHOICES Waiver – For adults with IDD seeking employment

Can coordinate with:

Pre-Vocational Services (prior to placement)

Day Habilitation (for non-work days)

Vocational Rehabilitation Services (for initial job placement, before waiver billing begins)

8. TIMELINE TO LAUNCH

Phase: Business Formation & Manual Development
Timeline: 1–2 months

Phase: DHS-DDD Enrollment & Readiness
Timeline: 2–3 months

Phase: Staff Training & Employer Engagement
Timeline: 1–2 months

Phase: Participant Match & Job Placement
Timeline: Ongoing as referrals are received

9. CONTACT INFORMATION

South Dakota Department of Human Services – Division of Developmental Disabilities (DDD)
Website: https://dhs.sd.gov

South Dakota Division of Rehabilitation Services (DRS)
Website: https://dhs.sd.gov/rehabservices.aspx

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SD SUPPORTED EMPLOYMENT PROVIDER

WCG helps providers launch compliant, person-centered employment programs that match individuals with meaningful jobs and promote long-term work success.

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Scope of Work:

Provider enrollment and CHOICES Waiver navigation

Supported Employment Policy & Procedure Manual creation

Job coaching documentation and employer outreach templates

Goal tracking forms and progress reports

Staff training checklists and evaluation tools

Billing records and quality assurance systems

PERSONAL CARE SERVICES PROVIDER IN SOUTH DAKOTA
SUPPORTING DAILY INDEPENDENCE THROUGH NON-SKILLED ASSISTANCE WITH ACTIVITIES OF DAILY LIVING FOR INDIVIDUALS WITH DISABILITIES OR AGE-RELATED NEEDS

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Personal Care Services (PCS) in South Dakota help individuals with disabilities, chronic conditions, or age-related limitations complete essential activities of daily living (ADLs). These non-skilled services are delivered in the individual’s home or residence and are authorized under Medicaid State Plan benefits and Home and Community-Based Services (HCBS) Waivers, such as the CHOICES Waiver, Family Support 360, and Long-Term Services and Supports (LTSS) programs.

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1. GOVERNING AGENCIES

Agency: South Dakota Department of Social Services (DSS) – Division of Long-Term Services and Supports (LTSS)
Role: Administers personal care services under the Medicaid State Plan and for older adults through HCBS waivers.

Agency: South Dakota Department of Human Services (DHS) – Division of Developmental Disabilities (DDD)
Role: Oversees PCS delivery under the CHOICES and Family Support 360 Waivers.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures federal regulatory compliance with Medicaid-funded personal care services.

2. PERSONAL CARE SERVICES OVERVIEW

PCS are non-medical supports designed to help individuals remain in their homes by assisting with basic personal hygiene and daily living tasks.

Approved providers may offer:

Bathing and Grooming Assistance

Dressing and Toileting Help

Meal Preparation and Feeding Support

Mobility and Transfer Assistance

Medication Reminders (not administration)

Light Housekeeping related to ADLs

Documentation: Daily care logs, time records, and communication with case managers

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Dakota Secretary of State

Obtain EIN and Type 2 NPI

Enroll with DSS or DHS-DDD as a Medicaid PCS provider

Hire qualified Personal Care Aides with proper background checks and training

Develop a Personal Care Services Policy & Procedure Manual

Carry liability and workers’ compensation insurance

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and obtain EIN/NPI
Step 2: Apply to DSS-LTSS or DHS-DDD based on target population
Step 3: Submit staff credentials, policy manual, and service documentation samples
Step 4: Complete readiness review and approval
Step 5: Begin accepting service authorizations from waiver case managers

5. REQUIRED DOCUMENTATION

EIN, NPI, business registration

Medicaid provider approval confirmation

Liability and workers’ comp insurance certificates

Personal Care Services Policy & Procedure Manual including:

Participant intake and ADL assessment templates

Daily service logs and timekeeping procedures

Participant rights and HIPAA policies

Emergency backup plans and critical incident response

Billing procedures and service verification forms

6. STAFFING REQUIREMENTS

Role: Personal Care Aide / Direct Support Staff
Requirements:

Background check, CPR/First Aid

Training in ADLs, abuse prevention, and participant rights

Documentation and service verification procedures

Role: Supervisor (Optional, depending on waiver)
Requirements: Coordinates schedules, documentation reviews, and quality checks

All staff must complete:

HIPAA and participant confidentiality training

Abuse and neglect prevention

Emergency response procedures

Annual in-service evaluations

7. MEDICAID WAIVER PROGRAMS

Personal Care Services are authorized through:

CHOICES Waiver – For adults with intellectual/developmental disabilities

Family Support 360 Waiver – For children and adults in family homes

LTSS HCBS Waiver – For seniors and adults with physical limitations

Medicaid State Plan PCS – For medically eligible individuals needing ADL support

TEFRA / EPSDT (under 21) – For children with disabilities who need in-home support

8. TIMELINE TO LAUNCH

Phase: Business Setup & Manual Development
Timeline: 1–2 months

Phase: Medicaid Enrollment & Staff Credentialing
Timeline: 2–3 months

Phase: Training & Documentation Readiness
Timeline: 30–60 days

Phase: Launch Services
Timeline: Upon approval and participant referral

9. CONTACT INFORMATION

South Dakota Department of Social Services – LTSS Division
Website: https://dss.sd.gov

South Dakota Department of Human Services – Division of Developmental Disabilities (DDD)
Website: https://dhs.sd.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SD PERSONAL CARE SERVICES PROVIDER

WCG helps providers build Medicaid-compliant PCS programs that improve quality of life for individuals while reducing the burden on family caregivers.

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Scope of Work:

Medicaid provider enrollment and credentialing support

Personal Care Services Policy & Procedure Manual development

Staff training tools and service verification forms

Participant intake and care planning templates

Daily care log sheets and incident reporting documents

HIPAA, compliance, and billing resources

ADAPTIVE EQUIPMENT SERVICES PROVIDER IN SOUTH DAKOTA
SUPPORTING SAFETY, INDEPENDENCE, AND DAILY FUNCTION THROUGH SPECIALIZED EQUIPMENT FOR INDIVIDUALS WITH DISABILITIES

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Adaptive Equipment Services in South Dakota provide Medicaid-funded evaluation, acquisition, customization, and maintenance of assistive devices that enable individuals with disabilities to perform daily living tasks, improve mobility, or communicate more effectively. These services are covered under multiple waiver programs including the CHOICES Waiver, Family Support 360 Waiver, and the Medically Fragile Waiver, and are authorized by the South Dakota Department of Human Services (DHS).

1. GOVERNING AGENCIES

Agency: South Dakota Department of Human Services (DHS) – Division of Developmental Disabilities (DDD)
Role: Authorizes adaptive equipment under waiver programs and ensures provider compliance.

Agency: South Dakota Department of Social Services (DSS) – Medical Services Division
Role: Manages funding and Medicaid billing policies for covered durable medical equipment (DME) and adaptive devices.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Regulates federal Medicaid requirements for adaptive equipment and DME services under HCBS waivers and State Plan benefits.

2. ADAPTIVE EQUIPMENT SERVICES OVERVIEW

Adaptive equipment includes any item, device, or product system that is used to increase, maintain, or improve the functional capabilities of individuals with disabilities.

Approved services may include:

Functional Assessments for Equipment Needs

Procurement and Delivery of Devices

Customization and Fitting of Equipment

Instruction and Training on Device Use

Maintenance, Repairs, and Adjustments

Coordination with Therapists or Prescribers (e.g., OT, PT, SLP)

Billing Documentation and Medical Necessity Forms

Examples of covered equipment:

Adaptive utensils and dressing tools

Bath/shower chairs and lifts

Communication devices (e.g., speech-generating devices)

Adaptive keyboards or computer access systems

Wheelchair modifications and positioning aids

Environmental control units (ECUs)

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with South Dakota Secretary of State

Obtain EIN and Type 2 NPI

Apply to DHS-DDD or DSS as a Medicaid waiver provider or DME supplier

Partner with licensed professionals for assessments (e.g., OT, PT, SLP if required)

Maintain liability insurance and service warranty documentation

Develop an Adaptive Equipment Services Policy & Procedure Manual

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Register entity and obtain EIN/NPI
Step 2: Apply for Medicaid DME enrollment or waiver provider approval
Step 3: Submit sample invoices, assessment templates, and repair logs
Step 4: Complete DHS or DSS onboarding process
Step 5: Begin fulfilling equipment requests authorized in participant service plans

5. REQUIRED DOCUMENTATION

Business registration, EIN, NPI

Medicaid/DME supplier enrollment or waiver provider letter

Insurance policies and warranties

Adaptive Equipment Services Policy & Procedure Manual including:

Equipment request and order workflow

Coordination with therapy providers

Medical necessity and justification forms

Delivery logs and user training documentation

Repair/maintenance tracking

HIPAA and participant rights protections

Medicaid billing and service tracking forms

6. STAFFING REQUIREMENTS

Role: Equipment Specialist / Provider Technician
Requirements: Knowledge of DME/adaptive devices, background check, documentation training

Role (optional): Licensed Therapist (OT, PT, or SLP)
Requirements: May perform assessments or justify medical necessity for certain devices

All staff must complete:

HIPAA and safety protocol training

Documentation, delivery, and reporting procedures

Product-specific training for device setup and user instruction

Infection control and maintenance standards

7. MEDICAID WAIVER PROGRAMS

Adaptive Equipment is covered under:

CHOICES Waiver – For adults with IDD

Family Support 360 Waiver – For children and adults with disabilities in family homes

Medically Fragile Waiver – For individuals with complex health needs

State Plan Medicaid DME Benefit – For qualifying durable medical equipment when prescribed

8. TIMELINE TO LAUNCH

Phase: Business Registration & Manual Creation
Timeline: 1–2 months

Phase: Medicaid Enrollment or DME Licensing
Timeline: 2–3 months

Phase: Equipment Partner Sourcing & Documentation Prep
Timeline: 30–60 days

Phase: Begin Service Delivery
Timeline: Upon receiving service authorizations

9. CONTACT INFORMATION

South Dakota Department of Human Services – Division of Developmental Disabilities (DDD)
Website: https://dhs.sd.gov

South Dakota Department of Social Services (DSS)
Website: https://dss.sd.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SD ADAPTIVE EQUIPMENT PROVIDER

WCG helps equipment providers, therapists, and entrepreneurs launch compliant adaptive equipment programs to meet the functional needs of South Dakota Medicaid participants.

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Scope of Work:

DME or waiver-based provider enrollment

Adaptive Equipment Policy & Procedure Manual development

Equipment request, delivery, and repair form templates

Justification and medical necessity letter formats

Coordination workflows for therapists and prescribers

Medicaid billing and warranty tracking systems

SKILLED NURSING SERVICES PROVIDER IN SOUTH DAKOTA
DELIVERING MEDICALLY NECESSARY CARE THROUGH LICENSED NURSING PROFESSIONALS IN HOME AND COMMUNITY SETTINGS

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Skilled Nursing Services in South Dakota offer direct medical care to individuals with chronic conditions, complex needs, or disabilities. These services are delivered by licensed Registered Nurses (RNs) or Licensed Practical Nurses (LPNs) and are covered through the State Plan Medicaid Home Health Benefit, as well as the Medically Fragile Waiver, CHOICES Waiver, and Long-Term Services and Supports (LTSS) Waiver. Skilled nursing ensures that individuals can receive ongoing medical oversight and clinical interventions while remaining in their homes or community settings.

1. GOVERNING AGENCIES

Agency: South Dakota Department of Social Services (DSS) – Division of Long-Term Services and Supports (LTSS)
Role: Administers Medicaid State Plan Home Health and LTSS Waiver programs.

Agency: South Dakota Department of Human Services (DHS) – Division of Developmental Disabilities (DDD)
Role: Oversees waiver-based nursing services under the CHOICES Waiver.

Agency: South Dakota Board of Nursing
Role: Licenses RNs and LPNs, enforces nursing practice standards.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Regulates Medicaid-funded home health and waiver-based nursing services at the federal level.

2. SKILLED NURSING SERVICES OVERVIEW

These are medically necessary services that must be provided by a licensed nurse under the direction of a physician or authorized provider.

Approved providers may deliver:

Medication Administration (e.g., injections, IV therapy)

Wound Care and Dressing Changes

Tube Feedings and Tracheostomy Care

Chronic Disease Monitoring (e.g., diabetes, seizures, respiratory conditions)

Vital Signs and Symptom Monitoring

Care Plan Development and Implementation

Nursing Documentation and Health Status Reporting

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your agency with the South Dakota Secretary of State

Obtain EIN and Type 2 NPI

Apply to become a Medicaid Home Health or waiver-based skilled nursing provider through DSS or DHS-DDD

Employ or contract licensed RNs and/or LPNs with active South Dakota licensure

Develop a Skilled Nursing Policy & Procedure Manual

Maintain malpractice, liability, and workers’ compensation insurance

Comply with HIPAA and infection control protocols

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Form your business entity and obtain NPI/EIN
Step 2: Apply through DSS for State Plan Home Health enrollment, or through DHS for CHOICES or LTSS Waiver provider approval
Step 3: Submit nursing staff credentials, supervision plan, and sample documentation
Step 4: Complete provider orientation and readiness review
Step 5: Begin service delivery once authorized and listed as an approved provider

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI

Active nursing licenses for all clinical staff

Professional and general liability insurance

Skilled Nursing Policy & Procedure Manual including:

Care plan development protocols

Medication administration policies and safety checks

Infection control, emergency procedures, and supervision plans

Daily nursing notes and progress documentation

Participant rights, HIPAA protocols, and critical incident reporting

Medicaid billing logs and service verification forms

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)
Requirements: Active South Dakota RN license; oversees plan of care, supervises LPNs, provides complex medical interventions

Role: Licensed Practical Nurse (LPN)
Requirements: Active SD license; may provide services under RN supervision

Role: Nursing Supervisor (if agency-based model)
Requirements: Experienced RN responsible for compliance, case review, and quality assurance

All staff must complete:

HIPAA and participant confidentiality training

Skills assessment, CPR certification, and infection control training

Annual competency reviews and emergency drills

Documentation, medication safety, and care coordination protocols

7. MEDICAID WAIVER PROGRAMS

Skilled Nursing Services are authorized through:

Medically Fragile Waiver – For individuals with high medical needs

CHOICES Waiver – For adults with IDD who require ongoing medical oversight

Long-Term Services and Supports (LTSS) Waiver – For aging adults needing intermittent nursing care

State Plan Medicaid Home Health Benefit – Physician-ordered home-based skilled nursing for qualifying beneficiaries

EPSDT (under 21) – For medically necessary skilled nursing for children

8. TIMELINE TO LAUNCH

Phase: Business Formation & Licensing
Timeline: 1–2 months

Phase: Medicaid Enrollment & Credential Submission
Timeline: 2–3 months

Phase: Staff Hiring, Training & Documentation Prep
Timeline: 1–2 months

Phase: Begin Services
Timeline: Once referrals and service authorizations are approved

9. CONTACT INFORMATION

South Dakota Department of Social Services – LTSS Division
Website: https://dss.sd.gov

South Dakota Department of Human Services – Division of Developmental Disabilities (DDD)
Website: https://dhs.sd.gov

South Dakota Board of Nursing
Website: https://doh.sd.gov/boards/nursing

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SD SKILLED NURSING PROVIDER

WCG helps licensed clinicians and agency founders establish high-quality, compliant skilled nursing services through streamlined policy, enrollment, and documentation support.

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Scope of Work:

Medicaid enrollment for State Plan and waiver-based nursing

Skilled Nursing Policy & Procedure Manual development

Staff credentialing checklists and clinical supervision forms

Daily nursing note templates and care plan tools

Billing documentation and compliance audit support

HIPAA, safety, and infection control training tools

DAY HABILITATION SERVICES PROVIDER IN SOUTH DAKOTA
SUPPORTING SKILL-BUILDING, COMMUNITY PARTICIPATION, AND PERSONAL GROWTH FOR ADULTS WITH DISABILITIES IN A STRUCTURED, NON-RESIDENTIAL SETTING

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Day Habilitation Services in South Dakota are designed to help individuals with intellectual and developmental disabilities (IDD) build life skills, participate in their communities, and achieve personal goals in a safe and supportive group environment. These services are authorized under the CHOICES Waiver, administered by the South Dakota Department of Human Services (DHS). Day habilitation typically takes place in a provider-operated setting, Monday through Friday, with a focus on independence, socialization, and community inclusion.

1. GOVERNING AGENCIES

Agency: South Dakota Department of Human Services (DHS) – Division of Developmental Disabilities (DDD)
Role: Oversees the CHOICES Waiver, including day habilitation provider approval, monitoring, and compliance enforcement.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Regulates federal HCBS waiver compliance and person-centered planning requirements for habilitation services.

2. DAY HABILITATION SERVICES OVERVIEW

Day habilitation supports individuals in developing and maintaining self-help, socialization, and adaptive skills needed to live successfully in their communities. Services are offered outside of a residential setting and may include both on-site activities and community-based outings.

Approved providers may deliver:

Daily Living Skills Training: Cooking, cleaning, hygiene, money management

Communication and Social Skill Development

Community Inclusion Activities: Volunteerism, shopping, recreational events

Health and Wellness Education

Behavioral Support Integration (if part of plan)

Transportation to and from habilitation site

Service Documentation, Progress Tracking, and Coordination with ISPs

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Dakota Secretary of State

Obtain EIN and Type 2 NPI

Apply to DHS-DDD for approval as a Day Habilitation provider under the CHOICES Waiver

Secure or lease a facility that meets ADA, safety, and accessibility standards

Develop a Day Habilitation Services Policy & Procedure Manual

Obtain required insurance (liability, workers’ comp, vehicle coverage if transporting participants)

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Form your legal business, obtain EIN/NPI
Step 2: Submit provider application to DHS-DDD for Day Habilitation
Step 3: Provide facility details, safety protocols, and staff training documentation
Step 4: Undergo readiness review and site inspection by DHS
Step 5: Begin service delivery after receiving participant referrals and plan authorizations

5. REQUIRED DOCUMENTATION

EIN, NPI, and business registration

Facility use agreement or ownership documentation

Insurance certificates (general, workers’ comp, auto if applicable)

Day Habilitation Policy & Procedure Manual including:

Daily routine and staffing ratios

Safety and emergency preparedness plans

Participant health, rights, and behavior support procedures

Service delivery forms and progress note templates

Transportation policies and documentation protocols

Staff training logs and supervision plans

6. STAFFING REQUIREMENTS

Role: Day Habilitation Direct Support Professional (DSP)
Requirements:

Background check, CPR/First Aid, and training in daily living skills, safety, and participant support

Familiarity with ISP goals and behavior plans

Role: Program Coordinator or Site Supervisor
Requirements:

Experience in IDD services, staff management, and program development

Optional Role: Community Integration Specialist
Requirements: Plans and supports community-based activities

All staff must complete:

Orientation on HIPAA and participant rights

Abuse prevention and documentation training

Emergency response and safety drills

Annual performance evaluations and competency checks

7. MEDICAID WAIVER PROGRAMS

Day Habilitation is reimbursable under:

CHOICES Waiver – For adults with intellectual and developmental disabilities

Limited use under Family Support 360 Waiver – May support short-term skill-building activities

State or Local DD Funds – May supplement non-waiver services based on regional availability

8. TIMELINE TO LAUNCH

Phase: Business Formation & Facility Identification
Timeline: 1–2 months

Phase: Provider Enrollment & Site Readiness
Timeline: 3–4 months

Phase: Staff Recruitment & Training
Timeline: 1–2 months

Phase: Launch of Services
Timeline: Begins after provider approval and participant referrals

9. CONTACT INFORMATION

South Dakota Department of Human Services – Division of Developmental Disabilities
Website: https://dhs.sd.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SD DAY HABILITATION PROVIDER

WCG supports new day habilitation providers with regulatory readiness, policy development, and a focus on meaningful, individualized service delivery.

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Scope of Work:

Provider enrollment and CHOICES Waiver application guidance

Day Habilitation Policy & Procedure Manual development

Facility compliance and staff training support

Participant daily log and progress tracking forms

Behavior support integration documentation

Transportation policies and safety tools

Billing and audit readiness systems

ADULT DAY SERVICES PROVIDER IN SOUTH DAKOTA
SUPPORTING INDEPENDENCE, SOCIALIZATION, AND HEALTH MONITORING FOR ADULTS IN COMMUNITY SETTINGS

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Adult Day Services (ADS) in South Dakota offer structured programming and care for adults with physical, cognitive, or behavioral health conditions who require supervision or assistance during the day. These services provide a safe, supportive, and stimulating environment while allowing caregivers respite and helping participants avoid institutional care.

Adult day services are available through South Dakota Medicaid’s Home and Community-Based Services (HCBS), primarily under the HOPE Waiver for older adults and individuals with disabilities. Services must be tied to a participant’s assessed needs and incorporated into their Individualized Care Plan (ICP).

1. GOVERNING AGENCIES

Agency: South Dakota Department of Human Services – Division of Long-Term Services and Supports (LTSS)
Role: Oversees adult day service standards, program administration, and participant assessments.

Agency: South Dakota Department of Social Services – Medical Services Division
Role: Administers Medicaid, handles provider enrollment, claims processing, and payment.

Agency: Department of Health – Office of Health Protection
Role: Licenses adult day care centers and ensures compliance with health and safety standards.

Agency: Local Case Management Agencies
Role: Coordinate care plans, conduct needs assessments, and authorize services.

2. ADULT DAY SERVICES OVERVIEW

Adult day services offer non-residential, community-based care and supervision during daytime hours for adults who need support.

Core services may include:

Supervision and safety monitoring

Structured activities (recreational, educational, social)

Personal care assistance (e.g., toileting, grooming)

Medication reminders or administration (by licensed staff)

Meals and nutritional support (including special diets)

Health monitoring and wellness checks

Transportation to/from the center (if included in the plan)

Cognitive stimulation activities for memory care participants

Caregiver updates and participant progress reports

Services must be person-centered, tailored to individual needs, and conducted in a group setting that fosters interaction and skill-building.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Dakota Secretary of State

Obtain a Federal EIN and Type 2 NPI

Secure Adult Day Services licensure from the Department of Health

Enroll with South Dakota Medicaid as a provider under the HOPE Waiver

Develop a comprehensive Adult Day Services Policy & Procedure Manual

Hire qualified staff to meet participant-to-staff ratios and care needs

Ensure the facility meets ADA compliance, safety, and sanitation standards

Maintain liability, workers’ compensation, and general insurance coverage

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Register business and obtain EIN/NPI
Step 2: Apply for Adult Day Services license with the Department of Health
Step 3: Submit application for Medicaid provider enrollment under the HOPE Waiver
Step 4: Provide required documentation (staff credentials, P&P Manual, safety procedures)
Step 5: Undergo site visit and compliance inspection (if applicable)
Step 6: Begin service delivery once participant plans are approved

5. REQUIRED DOCUMENTATION

Licensure and Medicaid provider number

Adult Day Services Policy & Procedure Manual including:

Daily schedule of activities and structured programming

Medication administration and safety monitoring policies

Participant intake, assessment, and care plan forms

Incident reporting and emergency preparedness protocols

Infection control and sanitation procedures

Staffing ratio policy and supervision procedures

Participant rights, HIPAA compliance, and confidentiality documentation

Nutrition and special diet guidelines

Staff qualifications, CPR/First Aid certification, and background checks

6. STAFFING REQUIREMENTS

Role: Program Director
Requirements:

Experience in gerontology, social services, nursing, or related fields

Responsible for program oversight, compliance, and staff training

Role: Direct Care Staff / Activity Assistants
Requirements:

Age 18+, high school diploma or GED

Background check and abuse registry clearance

CPR/First Aid certification

Experience working with older adults or individuals with disabilities

Role: Nurse (if providing skilled tasks or medication)
Requirements:

Licensed Practical Nurse (LPN) or Registered Nurse (RN) in South Dakota

Responsible for medication administration and health monitoring

All staff must complete:

HIPAA and confidentiality training

Abuse and neglect prevention

Activity planning and personal care techniques

Annual emergency drills and infection control review

7. MEDICAID PROGRAMS THAT COVER ADULT DAY SERVICES

HOPE Waiver (Home and Community-Based Options and Person Centered Excellence): Covers adult day services for Medicaid-eligible adults age 65+ and individuals with physical disabilities

State Plan Services (limited): Some personal care elements may be included under other programs

Veterans Affairs (VA) / Non-Medicaid Options: May reimburse similar services via alternate payer sources for eligible veterans

Note: Adult day services must be authorized by the care manager and included in the participant’s ICP. Services must demonstrate a direct benefit to health, safety, or caregiver support.

8. TIMELINE TO LAUNCH

Phase: Business Registration & Facility Preparation
Timeline: 2–4 weeks

Phase: Licensure & Manual Development
Timeline: 30–60 days

Phase: Medicaid Enrollment & Staff Hiring
Timeline: 1–2 months

Phase: Service Launch
Timeline: Upon ICP approval and participant assignment

9. CONTACT INFORMATION

South Dakota Department of Health – Adult Day Services Licensing
Website: https://doh.sd.gov

South Dakota Department of Human Services – LTSS
Website: https://dhs.sd.gov/ltss/

Medicaid Provider Enrollment
Website: https://dss.sd.gov/medicaid/providers/

South Dakota Secretary of State – Business Services
Website: https://sdsos.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SOUTH DAKOTA ADULT DAY SERVICES PROVIDER

WCG provides full support for launching and managing adult day programs that meet South Dakota Medicaid standards while creating engaging, meaningful day services for aging and disabled participants.

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Scope of Work:

Medicaid and licensing enrollment

Adult Day Services Policy & Procedure Manual

Activity schedule and care documentation templates

Staffing and supervision logs

Medication and incident reporting procedures

Compliance checklists and billing guidance

ASSISTIVE TECHNOLOGY SERVICES PROVIDER IN SOUTH DAKOTA
ENHANCING FUNCTIONAL INDEPENDENCE THROUGH PERSONALIZED DEVICES, TOOLS, AND SUPPORTIVE TECHNOLOGY SOLUTIONS

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Assistive Technology (AT) Services in South Dakota include the assessment, customization, acquisition, and training of devices that help individuals with disabilities perform tasks they would otherwise be unable to do. These services are authorized under the CHOICES Waiver, Family Support 360 Waiver, Medically Fragile Waiver, and may also be accessed through State Plan Medicaid or school-based supports. The goal is to increase independence, access to communication, and participation in daily life.

1. GOVERNING AGENCIES

Agency: South Dakota Department of Human Services (DHS) – Division of Developmental Disabilities (DDD)
Role: Oversees waiver-funded AT services and monitors provider compliance.

Agency: South Dakota Department of Social Services (DSS) – Medical Services Division
Role: Manages Medicaid billing for AT devices and services under State Plan or waiver benefits.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Establishes federal standards for coverage, documentation, and utilization of AT under HCBS and Medicaid State Plan.

2. ASSISTIVE TECHNOLOGY SERVICES OVERVIEW

Assistive Technology includes both low-tech and high-tech tools that help individuals improve functional capabilities at home, school, work, or in the community.

Covered services may include:

Assistive Technology Assessments

Device Selection, Acquisition, and Customization

Equipment Setup and Installation

Participant and Caregiver Training

Maintenance, Troubleshooting, and Repair Support

Coordination with Therapists and Case Managers

Documentation for Medical Necessity and Medicaid Billing

Common AT devices:

Speech-generating devices

Adaptive switches, keyboards, and input devices

Environmental control units (ECUs)

Smart home integrations for safety and independence

Apps and tablets with specialized accessibility features

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Dakota Secretary of State

Obtain EIN and Type 2 NPI

Apply through DHS-DDD or DSS to become a Medicaid AT provider under the appropriate waiver

Partner with or employ AT professionals (e.g., OT, SLP, ATP) to perform assessments and training

Maintain liability insurance and documentation systems

Develop an Assistive Technology Services Policy & Procedure Manual

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Register business, obtain EIN and NPI
Step 2: Submit waiver provider application (CHOICES, FS360, Medically Fragile) to DHS or enroll as DME provider via DSS
Step 3: Provide service descriptions, assessment protocols, and sample documentation
Step 4: Complete readiness review and staff credentialing
Step 5: Begin delivering services as authorized in participant service plans

5. REQUIRED DOCUMENTATION

Business registration, EIN, and NPI

Provider approval letter from DHS or DSS

Insurance certificates

Assistive Technology Policy & Procedure Manual including:

Device evaluation and justification templates

Training logs and instructional checklists

Participant rights and safety policies

Equipment tracking and maintenance logs

HIPAA and confidentiality protocols

Medicaid billing forms and session verification tools

6. STAFFING REQUIREMENTS

Role: Assistive Technology Professional (ATP) / Consultant
Requirements: Certification (RESNA preferred), or background in OT, PT, SLP, or engineering with AT experience

Role: Installation/Support Technician (optional)
Requirements: Trained in AT systems setup and troubleshooting; background check

All staff must complete:

HIPAA and participant safety training

Documentation and Medicaid billing orientation

Annual competency and device update training

7. MEDICAID WAIVER PROGRAMS

Assistive Technology Services are available through:

CHOICES Waiver – For adults with IDD

Family Support 360 Waiver – For children and adults with developmental disabilities in family homes

Medically Fragile Waiver – For individuals with high medical needs

State Plan Medicaid – May cover devices when ordered by a physician

Early Intervention (Birth–3) – Through local school-based or early childhood programs

8. TIMELINE TO LAUNCH

Phase: Business Registration & Team Setup
Timeline: 1–2 months

Phase: Medicaid Enrollment & Documentation Prep
Timeline: 2–3 months

Phase: Device Cataloging & Assessment Tools Setup
Timeline: 1 month

Phase: Begin Participant Services
Timeline: Once approved and referrals are received

9. CONTACT INFORMATION

South Dakota Department of Human Services – Division of Developmental Disabilities (DDD)
Website: https://dhs.sd.gov

South Dakota Department of Social Services (DSS)
Website: https://dss.sd.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

RESNA – Rehabilitation Engineering and Assistive Technology Society of North America
Website: https://www.resna.org

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SD ASSISTIVE TECHNOLOGY PROVIDER

WCG helps AT providers, therapists, and tech entrepreneurs launch compliant and scalable AT service programs for Medicaid-eligible individuals across South Dakota.

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Scope of Work:

Medicaid enrollment for waiver-based or DME services

Assistive Technology Policy & Procedure Manual development

AT assessment forms, caregiver training checklists, and service logs

Inventory, repair, and equipment tracking systems

Medicaid documentation and billing templates

Partnerships with therapists and referral sources

BEHAVIOR SUPPORT SERVICES PROVIDER IN SOUTH DAKOTA
PROVIDING PERSON-CENTERED STRATEGIES TO REDUCE CHALLENGING BEHAVIORS AND PROMOTE SKILL DEVELOPMENT IN HOME AND COMMUNITY SETTINGS

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Behavior Support Services in South Dakota are designed to help individuals with intellectual and developmental disabilities (IDD) develop positive behavioral skills and reduce challenging behaviors that interfere with daily life. These services are authorized under the CHOICES Waiver and Family Support 360 Waiver, administered by the South Dakota Department of Human Services (DHS). Providers work with individuals, families, and staff to develop functional behavior assessments (FBAs), implement behavior support plans (BSPs), and deliver consistent training and monitoring.

1. GOVERNING AGENCIES

Agency: South Dakota Department of Human Services (DHS) – Division of Developmental Disabilities (DDD)
Role: Oversees waiver services, including behavior support provider enrollment, compliance, and training requirements.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Enforces federal HCBS requirements including person-centered planning and behavior intervention oversight.

2. BEHAVIOR SUPPORT SERVICES OVERVIEW

These services include professional evaluation, planning, implementation, and monitoring of strategies to address behavioral concerns that may interfere with learning, relationships, or health and safety.

Approved providers may offer:

Functional Behavior Assessments (FBAs)

Behavior Support Plan (BSP) Development

Direct Implementation of Interventions

Staff and Family Training on Behavior Strategies

Data Collection and Progress Monitoring

Crisis Intervention and De-escalation Planning

Collaboration with Case Managers and Therapists

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Dakota Secretary of State

Obtain EIN and Type 2 NPI

Apply to DHS-DDD for approval as a Behavior Support provider

Employ or contract qualified professionals with relevant credentials (e.g., BCBA, LP, LCSW, or MS-level behavior specialists)

Develop a Behavior Support Services Policy & Procedure Manual

Maintain appropriate insurance coverage

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and secure EIN/NPI
Step 2: Submit a provider application to DHS-DDD with credentials and sample plans
Step 3: Complete any required training modules or policy reviews
Step 4: Participate in provider readiness review
Step 5: Begin service delivery after approval and ISP authorization

5. REQUIRED DOCUMENTATION

EIN, NPI, business registration

DHS provider approval documentation

Proof of credentials and licensure for all behavior support professionals

Behavior Support Services Policy & Procedure Manual including:

Assessment and plan development protocols

Behavior data tracking forms and documentation standards

Staff training logs and coaching protocols

Crisis response policies and reporting templates

Participant rights, HIPAA compliance, and confidentiality safeguards

Billing records and service verification forms

6. STAFFING REQUIREMENTS

Role: Behavior Support Professional
Requirements:

Licensed or credentialed in behavioral health or psychology (e.g., BCBA, LPC, LP, LMSW, M.Ed., or related MS degree)

Background check, CPR/First Aid, abuse prevention training

FBA and BSP development experience

Role: Behavioral Technician or DSP (if used for plan implementation)
Requirements:

High school diploma, hands-on training in behavior support, and supervision by qualified professional

All staff must complete:

HIPAA and participant dignity training

Crisis de-escalation and emergency protocols

Annual skills assessments and supervision reviews

Documentation and compliance protocols

7. MEDICAID WAIVER PROGRAMS

Behavior Support is an authorized service under:

CHOICES Waiver – For adults with intellectual and developmental disabilities

Family Support 360 Waiver – For children and adults in family-based settings

School Transition Programs – May incorporate behavior support for adolescents with IDD

EPSDT (Medicaid under 21) – May fund behavioral services under medical necessity

8. TIMELINE TO LAUNCH

Phase: Business Setup & Manual Development
Timeline: 1–2 months

Phase: Medicaid Provider Enrollment & Credential Review
Timeline: 2–3 months

Phase: Staff Hiring or Contracting Professionals
Timeline: 30–60 days

Phase: Begin Delivering Services
Timeline: Once ISP authorizations and participant referrals are received

9. CONTACT INFORMATION

South Dakota Department of Human Services – Division of Developmental Disabilities (DDD)
Website: https://dhs.sd.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SD BEHAVIOR SUPPORT PROVIDER

WCG helps professionals launch behavior support programs with clinically sound, Medicaid-compliant processes that prioritize participant progress and safety.

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Scope of Work:

Medicaid provider application and enrollment support

Behavior Support Services Policy & Procedure Manual development

Functional Behavior Assessment (FBA) and BSP templates

Staff training checklists and implementation tracking tools

Crisis planning and documentation resources

Audit-readiness and compliance coaching

HOME MODIFICATION SERVICES PROVIDER IN SOUTH DAKOTA
CREATING SAFE, ACCESSIBLE LIVING ENVIRONMENTS FOR INDIVIDUALS WITH DISABILITIES AND COMPLEX MEDICAL NEEDS

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Home Modification Services in South Dakota support individuals with disabilities or medically complex conditions by making physical changes to their homes that promote safety, accessibility, and independence. These services are available under the CHOICES Waiver, Family Support 360 Waiver, and Medically Fragile Waiver, and are authorized by the South Dakota Department of Human Services (DHS). Modifications must be necessary to support the participant’s health, daily functioning, or care plan goals.

1. GOVERNING AGENCIES

Agency: South Dakota Department of Human Services (DHS) – Division of Developmental Disabilities (DDD)
Role: Authorizes Home Modification services and ensures compliance under applicable HCBS waivers.

Agency: South Dakota Department of Social Services (DSS) – Medical Services Division
Role: Oversees Medicaid funding and waiver rules impacting home modifications.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Sets federal guidelines for allowable modifications under Medicaid waiver programs.

2. HOME MODIFICATION SERVICES OVERVIEW

Home modifications are permanent or semi-permanent physical changes to a residence that improve accessibility, ensure safety, and reduce dependence on caregivers.

Covered services may include:

Wheelchair ramps, handrails, and widened doorways

Accessible showers, grab bars, and roll-under sinks

Ceiling lifts or stair lifts

Lowered cabinets, switches, and thermostats

Non-slip flooring and barrier removal

Exterior lighting or motion-sensor safety features

Pre-modification assessments and post-installation inspections

Documentation of medical necessity and homeowner consent

Modifications must relate directly to the participant’s needs as documented in their Individual Service Plan (ISP).

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your contracting or construction business with the South Dakota Secretary of State

Obtain EIN and Type 2 NPI

Apply through DHS-DDD to become a Home Modification services provider under an HCBS waiver

Maintain general liability and workers’ compensation insurance

Employ or subcontract licensed builders or specialists (e.g., electricians, plumbers, if needed)

Develop a Home Modification Services Policy & Procedure Manual

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Form your business and obtain EIN/NPI
Step 2: Apply through DHS-DDD for enrollment under CHOICES, FS360, or Medically Fragile Waiver
Step 3: Submit samples of consent forms, modification plans, and documentation tools
Step 4: Complete provider orientation and compliance verification
Step 5: Begin offering modifications upon ISP authorization and funding approval

5. REQUIRED DOCUMENTATION

Business license, EIN, NPI

Proof of insurance and bonding

Licenses for subcontractors (if applicable)

Home Modification Services Policy & Procedure Manual including:

Intake process and medical justification procedures

Homeowner permission and contractor agreement forms

Pre- and post-modification inspection reports

Cost estimate and Medicaid billing templates

Participant satisfaction surveys and safety verification forms

HIPAA compliance protocols and confidentiality agreements

6. STAFFING REQUIREMENTS

Role: Home Modification Project Coordinator
Requirements: Experience with residential modifications, disability-related construction, or occupational therapy preferred

Role: Licensed Contractor/Subcontractor (e.g., electrician, plumber, installer)
Requirements: Active South Dakota licensure, background check, proof of insurance

All staff/subcontractors must complete:

HIPAA and safety training

Disability sensitivity and accessibility standards orientation

Documentation and billing training (for coordinators)

7. MEDICAID WAIVER PROGRAMS

Home Modification Services are available under:

CHOICES Waiver – For adults with intellectual/developmental disabilities

Family Support 360 Waiver – For children and adults with disabilities in family homes

Medically Fragile Waiver – For individuals with complex medical needs

EPSDT (under 21) – Some medically necessary home modifications may be accessed under EPSDT with physician order

8. TIMELINE TO LAUNCH

Phase: Business Formation & Licensing
Timeline: 1–2 months

Phase: Provider Application & Documentation Submission
Timeline: 2–3 months

Phase: Staff and Contractor Setup
Timeline: 1–2 months

Phase: Begin Modifications
Timeline: Upon approval of specific participant plans and funding

9. CONTACT INFORMATION

South Dakota Department of Human Services – Division of Developmental Disabilities (DDD)
Website: https://dhs.sd.gov

South Dakota Department of Social Services (DSS)
Website: https://dss.sd.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SD HOME MODIFICATION PROVIDER

WCG helps builders, handymen, and occupational therapy consultants launch Medicaid-compliant home modification services to support accessibility and safe aging-in-place.

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Scope of Work:

DHS waiver provider enrollment assistance

Home Modification Services Policy & Procedure Manual development

Consent and contractor agreement forms

Cost estimate templates and inspection logs

HIPAA training and documentation checklists

Billing documentation and pre/post project protocols

SPECIALIZED THERAPY SERVICES PROVIDER IN SOUTH DAKOTA
DELIVERING LICENSED THERAPEUTIC INTERVENTIONS TO SUPPORT FUNCTIONAL INDEPENDENCE AND ENHANCED QUALITY OF LIFE

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Specialized Therapy Services in South Dakota include clinical interventions provided by licensed professionals such as physical therapists (PTs), occupational therapists (OTs), and speech-language pathologists (SLPs). These services are covered through the State Plan Medicaid Home Health Benefit, as well as the CHOICES Waiver, Medically Fragile Waiver, and Family Support 360 Waiver. The goal is to help individuals achieve developmental milestones, regain or improve functional skills, and live more independently in their homes and communities.

1. GOVERNING AGENCIES

Agency: South Dakota Department of Social Services (DSS) – Medical Services Division
Role: Administers State Plan Medicaid therapy benefits and reimburses Medicaid-authorized therapy claims.

Agency: South Dakota Department of Human Services (DHS) – Division of Developmental Disabilities (DDD)
Role: Oversees therapy services authorized under the CHOICES and Family Support 360 Waivers.

Agency: South Dakota Board of Examiners for PT, OT, and SLPs
Role: Licenses and regulates therapy professionals.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Enforces federal Medicaid therapy service guidelines and provider compliance.

2. SPECIALIZED THERAPY SERVICES OVERVIEW

These services address medical and developmental needs through direct, goal-driven therapeutic interventions.

Approved providers may offer:

Physical Therapy (PT): Mobility training, strength, balance, and gait intervention

Occupational Therapy (OT): Fine motor skills, daily living activities, sensory integration

Speech-Language Pathology (SLP): Communication skills, feeding therapy, and augmentative communication support

Therapy Assessments & Plan of Care Development

Collaboration with Case Managers and Direct Care Providers

Therapy Documentation, Progress Reporting, and Re-Evaluations

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Dakota Secretary of State

Obtain EIN and Type 2 NPI

Apply to DSS (for State Plan therapy) or DHS-DDD (for waiver therapy) as an authorized provider

Employ or contract only licensed PTs, OTs, or SLPs

Maintain liability, malpractice, and workers’ compensation insurance

Develop a Specialized Therapy Services Policy & Procedure Manual

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Register business and obtain EIN/NPI
Step 2: Submit Medicaid enrollment application to DSS or waiver application to DHS-DDD
Step 3: Provide therapy credentials, sample care plans, and documentation templates
Step 4: Complete provider onboarding or readiness review
Step 5: Begin delivering services upon participant authorization

5. REQUIRED DOCUMENTATION

EIN, NPI, and business registration

Professional licenses for all therapists (PT, OT, SLP)

Liability and malpractice insurance

Specialized Therapy Services Policy & Procedure Manual including:

Intake and assessment procedures

Plan of care development and clinical goal setting

Progress tracking and discharge criteria

Coordination with other providers and family members

HIPAA compliance and documentation standards

Medicaid billing and session verification forms

6. STAFFING REQUIREMENTS

Role: Licensed Therapist (PT, OT, SLP)
Requirements: Active South Dakota license in appropriate discipline; background check; CPR/First Aid

Role: Therapy Program Coordinator (optional)
Requirements: Supervises therapists, ensures compliance and ISP integration

All staff must complete:

HIPAA and participant rights training

Documentation standards and Medicaid billing training

Clinical continuing education (as required by license)

Annual evaluations and protocol refreshers

7. MEDICAID WAIVER PROGRAMS

Specialized Therapy Services are covered through:

CHOICES Waiver – For adults with IDD

Family Support 360 Waiver – For children and adults with disabilities in family homes

Medically Fragile Waiver – For individuals with complex health needs

State Plan Medicaid Home Health Benefit – For medically necessary therapy ordered by a physician

EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) – For youth under 21 with developmental needs

8. TIMELINE TO LAUNCH

Phase: Business Registration & Licensing
Timeline: 1–2 months

Phase: Medicaid Enrollment & Documentation Submission
Timeline: 2–3 months

Phase: Staff Contracting and Care Plan Templates
Timeline: 30–60 days

Phase: Service Launch
Timeline: Begins after receiving plan authorizations

9. CONTACT INFORMATION

South Dakota Department of Social Services (DSS) – Medical Services Division
Website: https://dss.sd.gov

South Dakota Department of Human Services – Division of Developmental Disabilities (DDD)
Website: https://dhs.sd.gov

South Dakota Licensing Boards (PT, OT, SLP)
Website: https://doh.sd.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SD SPECIALIZED THERAPY PROVIDER

WCG supports therapy providers with streamlined enrollment, compliant documentation systems, and best practices for outcome-based, participant-centered therapy delivery.

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Scope of Work:

Medicaid therapy enrollment support (State Plan and Waiver)

Therapy Services Policy & Procedure Manual development

Clinical assessment and progress note templates

Coordination forms for multi-provider teams

Session verification logs and billing documents

HIPAA and compliance training resources

PRE-VOCATIONAL SERVICES PROVIDER IN SOUTH DAKOTA
BUILDING WORK READINESS THROUGH STRUCTURED TRAINING AND SKILL DEVELOPMENT FOR INDIVIDUALS WITH DISABILITIES

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Pre-Vocational Services in South Dakota are designed to help individuals with intellectual and developmental disabilities (IDD) prepare for employment by developing work habits, skills, and behaviors essential for success in a job setting. These services are offered under the CHOICES Waiver, administered by the South Dakota Department of Human Services (DHS). The goal is to support participants in progressing toward competitive, integrated employment through individualized, goal-oriented activities in facility-based or community-integrated environments.

1. GOVERNING AGENCIES

Agency: South Dakota Department of Human Services (DHS) – Division of Developmental Disabilities (DDD)
Role: Administers the CHOICES Waiver, including enrollment and monitoring of Pre-Vocational Services providers.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures HCBS compliance and promotes the federal expectation of employment as the preferred outcome.

2. PRE-VOCATIONAL SERVICES OVERVIEW

Pre-Vocational Services help participants learn foundational skills needed to enter the workforce. These are not job-specific, but rather focused on general employment readiness.

Approved providers may offer:

Workplace Behavior Training: Punctuality, cooperation, dress code, following instructions

Task Completion and Time Management Exercises

Social Skills and Team Collaboration Activities

Hands-on Simulated Work Tasks (e.g., packaging, sorting, light assembly)

Career Exploration and Goal Development

Transportation Training (if part of vocational goal)

Service Documentation and Progress Reporting

Note: Pre-Vocational Services must be time-limited and individualized, with a clear progression toward employment or supported work.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Dakota Secretary of State

Obtain EIN and Type 2 NPI

Apply to DHS-DDD to become a CHOICES Waiver provider of Pre-Vocational Services

Secure or lease a facility that meets accessibility and safety requirements (if site-based)

Develop a Pre-Vocational Services Policy & Procedure Manual

Obtain necessary insurance (liability, workers’ comp, and auto if transporting)

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Establish your business entity, obtain EIN and NPI
Step 2: Submit provider application to DHS-DDD for CHOICES Waiver services
Step 3: Submit detailed program plans, curriculum, and staff qualifications
Step 4: Undergo readiness review, including site inspection (if applicable)
Step 5: Begin receiving referrals and implementing Individual Support Plans (ISPs)

5. REQUIRED DOCUMENTATION

Business registration, EIN, NPI

Facility documentation (if using a physical site)

Provider approval letter from DHS-DDD

Insurance certificates

Pre-Vocational Services Policy & Procedure Manual including:

Training curriculum and individualized service plan goals

Safety, behavior management, and confidentiality policies

Documentation templates (attendance, daily progress, skills tracking)

Incident reporting procedures and billing documentation

Discharge and transition-to-employment planning tools

6. STAFFING REQUIREMENTS

Role: Vocational Instructor / Job Skills Coach
Requirements:

High school diploma or higher; experience in employment readiness, workforce training, or disability services

Background check, CPR/First Aid certification, and DDD-required training

Role: Program Supervisor
Requirements:

Oversight of vocational programming, staff coordination, and ISP alignment

All staff must complete:

HIPAA and participant rights training

Abuse prevention and emergency procedures

ISP-driven training goal implementation

Annual performance reviews and in-service refreshers

7. MEDICAID WAIVER PROGRAMS

Pre-Vocational Services are covered under:

CHOICES Waiver – For adults with IDD pursuing employment readiness

May coordinate with:

Supported Employment Services

Day Habilitation (when transitioning)

Vocational Rehabilitation Programs (non-Medicaid-funded)

8. TIMELINE TO LAUNCH

Phase: Business Registration & Program Planning
Timeline: 1–2 months

Phase: DHS Enrollment & Curriculum Submission
Timeline: 2–3 months

Phase: Facility Setup (if needed) & Staff Onboarding
Timeline: 1–2 months

Phase: Begin Participant Services
Timeline: Once ISPs are received and provider is authorized

9. CONTACT INFORMATION

South Dakota Department of Human Services – Division of Developmental Disabilities (DDD)
Website: https://dhs.sd.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SD PRE-VOCATIONAL SERVICES PROVIDER

WCG equips providers with tools to create structured, goal-driven pre-vocational programs that empower participants to move toward competitive employment.

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Scope of Work:

Medicaid provider enrollment guidance and program planning

Pre-Vocational Services Policy & Procedure Manual development

Daily training activity templates and attendance logs

ISP goal tracking tools and progress documentation

Transition planning forms and career readiness milestones

Billing tools and audit prep resources

HOMEMAKER SERVICES PROVIDER IN SOUTH DAKOTA
SUPPORTING INDEPENDENCE AND SAFETY THROUGH NON-MEDICAL HOUSEHOLD ASSISTANCE FOR INDIVIDUALS WITH DISABILITIES AND AGE-RELATED LIMITATIONS

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Homemaker Services in South Dakota offer essential non-medical support to individuals who need help managing household tasks due to disability, aging, or chronic illness. These services allow Medicaid waiver participants to remain safely in their homes while promoting autonomy and dignity. Homemaker support is authorized through several Home and Community-Based Services (HCBS) Waivers, including the CHOICES Waiver, Family Support 360, and Long-Term Services and Supports (LTSS) Waiver for the elderly.

1. GOVERNING AGENCIES

Agency: South Dakota Department of Human Services (DHS) – Division of Developmental Disabilities (DDD)
Role: Approves and monitors homemaker service providers under the CHOICES and Family Support 360 Waivers.

Agency: South Dakota Department of Social Services (DSS) – Division of Long-Term Services and Supports (LTSS)
Role: Manages homemaker services for older adults under the state’s aging-related HCBS waiver.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Oversees federal compliance for all Medicaid-funded HCBS services.

2. HOMEMAKER SERVICES OVERVIEW

Homemaker services include routine household tasks that the individual is unable to complete alone due to functional limitations. These supports are not medical in nature but are critical to maintaining a clean, safe, and habitable environment.

Approved providers may offer:

Light Housekeeping: Vacuuming, sweeping, dusting, cleaning kitchen and bathroom surfaces

Laundry Assistance: Washing, drying, folding, and putting away clothes

Meal Preparation: Planning and preparing meals based on dietary needs

Bed Making and Linen Changes

Grocery Shopping and Errand Running (when authorized)

Documentation: Service logs, timesheets, and communication with case managers

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Dakota Secretary of State

Obtain EIN and Type 2 NPI

Enroll as a homemaker service provider through DHS-DDD (for disabilities waivers) or DSS-LTSS (for aging-related waivers)

Hire trained and screened staff to deliver in-home non-medical services

Develop a Homemaker Services Policy & Procedure Manual

Carry general liability and worker’s compensation insurance

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Establish your business and obtain EIN/NPI
Step 2: Submit a provider application to DHS-DDD or DSS-LTSS
Step 3: Provide staff documentation, background check records, and sample service logs
Step 4: Complete readiness review or training (if required)
Step 5: Begin receiving referrals through waiver case managers or service coordinators

5. REQUIRED DOCUMENTATION

EIN, NPI, and business registration

Medicaid provider approval confirmation

Liability and workers’ comp insurance

Homemaker Services Policy & Procedure Manual including:

Task checklists and care protocols

Emergency and backup plans

Documentation logs and billing procedures

Participant confidentiality and rights protocols

Service frequency and care scope documentation

Communication and incident reporting templates

6. STAFFING REQUIREMENTS

Role: Homemaker / Direct Support Staff
Requirements:

Background check, basic training in home management

CPR/First Aid (recommended)

Understanding of waiver participant rights and safety

All staff must complete:

HIPAA and abuse prevention training

Documentation and timesheet logging procedures

Emergency protocol training

Annual performance and safety reviews

7. MEDICAID WAIVER PROGRAMS

Homemaker services are billable under:

CHOICES Waiver – For adults with intellectual or developmental disabilities

Family Support 360 Waiver – For children and adults with disabilities in family homes

LTSS HCBS Waiver – For elderly adults requiring support to remain at home

State Plan Personal Care – May cover limited home support based on medical necessity

8. TIMELINE TO LAUNCH

Phase: Business Formation & Manual Creation
Timeline: 1–2 months

Phase: Provider Enrollment & Readiness Review
Timeline: 2–3 months

Phase: Staff Hiring & Training
Timeline: 1–2 months

Phase: Service Launch
Timeline: Upon receiving participant referrals and plan authorizations

9. CONTACT INFORMATION

South Dakota Department of Human Services – Division of Developmental Disabilities (DDD)
Website: https://dhs.sd.gov

South Dakota Department of Social Services – LTSS
Website: https://dss.sd.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SD HOMEMAKER SERVICES PROVIDER

WCG helps entrepreneurs and agencies build Medicaid-compliant homemaker service programs that keep participants healthy, safe, and at home.

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Scope of Work:

Medicaid enrollment support with DDD or DSS

Homemaker Services Policy & Procedure Manual development

Daily task checklist templates and service verification logs

Staff onboarding and training documentation

Participant satisfaction tracking forms

Billing and audit preparation tools

CASE MANAGEMENT SERVICES PROVIDER IN SOUTH DAKOTA
GUIDING INDIVIDUALS AND FAMILIES THROUGH PERSONALIZED CARE COORDINATION, GOAL PLANNING, AND COMMUNITY SUPPORT ACCESS

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Case Management Services in South Dakota help individuals with disabilities and complex medical needs navigate their support systems, access appropriate services, and maintain stability in home and community settings. These services are available through the CHOICES Waiver, Family Support 360 Waiver, Medically Fragile Waiver, and Long-Term Services and Supports (LTSS) programs. Case Managers act as key liaisons between participants, providers, and state agencies, ensuring services align with each individual’s goals and Medicaid regulations.

1. GOVERNING AGENCIES

Agency: South Dakota Department of Human Services (DHS) – Division of Developmental Disabilities (DDD)
Role: Authorizes and oversees waiver-based case management services, primarily under CHOICES and FS360.

Agency: South Dakota Department of Social Services (DSS) – Division of LTSS
Role: Oversees case management for older adults and medically fragile individuals under LTSS programs.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Establishes federal requirements for person-centered planning, documentation, and HCBS service oversight.

2. CASE MANAGEMENT SERVICES OVERVIEW

Case Management is a targeted support service that includes assessment, planning, service coordination, monitoring, and advocacy on behalf of the participant.

Core responsibilities include:

Initial Assessments and Reassessments

Individualized Service Plan (ISP) Development and Updates

Service Authorization Requests and Monitoring

Referral and Linkage to Medical, Behavioral, and Community Services

Crisis Prevention and Intervention Planning

Documentation and Ongoing Progress Tracking

Facilitating Team Meetings and ISP Reviews

Services must be person-centered, driven by participant choice, and regularly updated.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Dakota Secretary of State

Obtain EIN and Type 2 NPI

Apply through DHS-DDD or DSS as a Medicaid case management provider

Ensure all case managers meet education and experience requirements

Maintain liability and professional insurance coverage

Develop a Case Management Services Policy & Procedure Manual

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and obtain EIN/NPI
Step 2: Submit provider application to DHS (for CHOICES, FS360) or DSS (for LTSS/Medically Fragile)
Step 3: Provide sample ISPs, documentation templates, and staff credentials
Step 4: Complete DHS or DSS orientation and compliance readiness review
Step 5: Begin receiving referrals and service authorizations

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, NPI

Proof of insurance (liability/professional)

Staff resumes, background checks, and qualification verifications

Case Management Services Policy & Procedure Manual including:

Intake and person-centered assessment procedures

ISP development and participant goal planning

Contact tracking and monitoring schedules

Critical incident reporting and resolution procedures

HIPAA compliance, documentation standards, and billing protocols

Team meeting facilitation guides and participant rights forms

6. STAFFING REQUIREMENTS

Role: Case Manager / Service Coordinator
Requirements:

Bachelor's degree in human services or related field

At least 1 year of experience with disability services (may vary by program)

Clean background check and valid driver's license

All staff must complete:

Person-centered planning training

HIPAA and participant confidentiality training

Medicaid documentation and billing procedures

Crisis prevention/intervention training

Annual refreshers and quality assurance reviews

7. MEDICAID WAIVER PROGRAMS

Case Management Services are available under:

CHOICES Waiver – For adults with intellectual/developmental disabilities

Family Support 360 Waiver – For children and adults with disabilities living at home

Medically Fragile Waiver – For individuals with complex medical conditions

LTSS Case Management – For seniors and adults needing long-term services and supports

State Plan Targeted Case Management (TCM) – For qualifying populations (varies by age and condition)

8. TIMELINE TO LAUNCH

Phase: Business Formation & Staffing
Timeline: 1–2 months

Phase: Medicaid Provider Enrollment & Manual Development
Timeline: 2–3 months

Phase: Case Manager Hiring & Training
Timeline: 30–60 days

Phase: Begin Service Delivery
Timeline: After receiving provider approval and service referrals

9. CONTACT INFORMATION

South Dakota Department of Human Services – Division of Developmental Disabilities (DDD)
Website: https://dhs.sd.gov

South Dakota Department of Social Services – LTSS Division
Website: https://dss.sd.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SD CASE MANAGEMENT PROVIDER

WCG helps case managers, human service agencies, and support coordinators launch compliant, person-centered case management operations across South Dakota’s Medicaid waiver landscape.

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Scope of Work:

Medicaid enrollment for CHOICES, FS360, and LTSS case management

Policy & Procedure Manual development

ISP templates and person-centered planning tools

Staff credentialing trackers and orientation guides

Service tracking logs and billing documentation templates

HIPAA compliance and team facilitation training

NON-MEDICAL TRANSPORTATION SERVICES PROVIDER IN SOUTH DAKOTA
CONNECTING INDIVIDUALS WITH DISABILITIES TO COMMUNITY LIFE THROUGH SAFE AND DEPENDABLE TRANSPORTATION

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Non-Medical Transportation (NMT) Services in South Dakota support individuals with disabilities by providing rides to and from waiver-authorized programs, employment, and community activities that promote inclusion and independence. These services are available under the CHOICES Waiver, Family Support 360 Waiver, and Medically Fragile Waiver, and are authorized by the South Dakota Department of Human Services (DHS).

1. GOVERNING AGENCIES

Agency: South Dakota Department of Human Services (DHS) – Division of Developmental Disabilities (DDD)
Role: Oversees waiver-funded transportation services and authorizes provider enrollment.

Agency: South Dakota Department of Public Safety (DPS) – Driver Licensing and Vehicle Regulations
Role: Enforces driver background checks, insurance, and vehicle safety compliance.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Establishes federal standards for transportation services within Medicaid waiver programs.

2. NON-MEDICAL TRANSPORTATION SERVICES OVERVIEW

Non-Medical Transportation (NMT) enables participants to access day programs, community events, supported employment, and other services in their Individual Service Plan (ISP).

Approved providers may offer:

One-way or round-trip rides to and from authorized waiver services

Transportation to community activities or job sites

Vehicle assistance for wheelchair users or mobility-impaired riders

Escort support during transit (if needed)

Tracking logs and service documentation

Coordination with case managers and direct service staff

Note: NMT must be tied to a specific service goal in the participant’s approved plan and does not include emergency or medical transportation (which is billed separately).

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Dakota Secretary of State

Obtain EIN and Type 2 NPI

Apply to DHS-DDD as a CHOICES or FS360 Waiver transportation provider

Maintain commercial vehicle insurance, liability, and workers’ compensation coverage

Ensure all drivers have clean driving records and background checks

Develop a Transportation Services Policy & Procedure Manual

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Register business and secure EIN/NPI
Step 2: Apply through DHS-DDD as a transportation service provider
Step 3: Submit vehicle safety plan, staff credentials, and policy manual
Step 4: Complete site or readiness review (if required)
Step 5: Start services for authorized participants once approved

5. REQUIRED DOCUMENTATION

Business license, EIN, and NPI

Vehicle insurance and inspection records

Commercial driver licenses (if applicable)

Transportation Services Policy & Procedure Manual including:

Trip documentation and daily mileage logs

Emergency protocols and accident response procedures

Participant safety and accessibility standards

Escort policy (if applicable)

HIPAA compliance and confidentiality policy

Medicaid billing and verification forms

6. STAFFING REQUIREMENTS

Role: Transportation Driver
Requirements: Valid driver’s license, clean driving record, background check, CPR/First Aid preferred

Role: Transportation Coordinator (optional)
Requirements: Oversees routing, scheduling, safety compliance, and service documentation

All staff must complete:

HIPAA and passenger rights training

Defensive driving and disability awareness training

Emergency preparedness and accident reporting protocols

Annual driving record reviews and in-service refreshers

7. MEDICAID WAIVER PROGRAMS

Non-Medical Transportation is covered through:

CHOICES Waiver – For adults with IDD accessing day programs or supported employment

Family Support 360 Waiver – For children and adults in family home settings

Medically Fragile Waiver – For individuals who need safe access to community-based supports

Not covered by Medicaid State Plan – Separate from emergency/medical transport benefits

8. TIMELINE TO LAUNCH

Phase: Business Formation & Vehicle Readiness
Timeline: 1–2 months

Phase: Medicaid Provider Enrollment
Timeline: 2–3 months

Phase: Staff Hiring & Safety Training
Timeline: 30–60 days

Phase: Begin Transportation Services
Timeline: Upon approval and participant referral

9. CONTACT INFORMATION

South Dakota Department of Human Services – Division of Developmental Disabilities (DDD)
Website: https://dhs.sd.gov

South Dakota Department of Public Safety – Driver Licensing and Inspection
Website: https://dps.sd.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SD NON-MEDICAL TRANSPORTATION PROVIDER

WCG supports transportation providers in launching safe, compliant, and efficient non-medical transit services that help Medicaid waiver participants thrive in the community.

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Scope of Work:

DHS waiver provider enrollment and business setup

Transportation Policy & Procedure Manual development

Vehicle checklists and daily trip log templates

Staff onboarding, safety training tools, and incident forms

HIPAA-compliant scheduling and billing support systems

Participant ride authorization and documentation trackers

HOME HEALTH SERVICES PROVIDER IN SOUTH DAKOTA
DELIVERING SKILLED CARE IN THE COMFORT OF HOME TO PROMOTE SAFETY, STABILITY, AND QUALITY OF LIFE

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Home Health Services in South Dakota provide skilled nursing and therapeutic care to individuals in their homes under the State Plan Medicaid Home Health Benefit and select Home and Community-Based Services (HCBS) Waiver Programs, such as the Medically Fragile Waiver. These services support individuals recovering from illness, managing chronic conditions, or requiring clinical oversight to remain safely at home.

1. GOVERNING AGENCIES

Agency: South Dakota Department of Social Services (DSS) – Medical Services Division
Role: Manages Medicaid Home Health Services and reimbursement protocols.

Agency: South Dakota Department of Health (DOH) – Office of Health Protection
Role: Licenses and inspects home health agencies operating in the state.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Regulates federal standards for Medicaid and Medicare-certified home health care.

2. HOME HEALTH SERVICES OVERVIEW

Home Health Services include medically necessary, intermittent skilled care delivered by licensed professionals in the individual’s home or community residence.

Covered services include:

Skilled Nursing: Wound care, injections, medication management, IV therapy

Home Health Aide Services: Personal care under nursing supervision

Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (SLP)

Medical Social Services (when applicable)

Clinical Assessments and Ongoing Re-evaluations

Care Plan Development and Coordination with Providers

Medicaid Documentation and Billing Support

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with South Dakota Secretary of State

Obtain EIN and Type 2 NPI

Obtain South Dakota Home Health Agency License from DOH

Enroll in Medicaid through DSS as a Home Health provider

If Medicare-certified, maintain CMS accreditation

Develop a Home Health Services Policy & Procedure Manual

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Register entity and obtain EIN/NPI
Step 2: Apply for a Home Health Agency License via DOH
Step 3: Complete Medicaid enrollment through DSS with required credentials
Step 4: Submit policy manual, staff rosters, and service area documentation
Step 5: Undergo state inspection and readiness verification (as applicable)
Step 6: Begin serving participants once approved and referrals are received

5. REQUIRED DOCUMENTATION

Business registration, EIN, NPI

DOH Home Health Agency License

Proof of professional liability, workers’ comp, and general insurance

Staff licensure and background checks

Home Health Services Policy & Procedure Manual including:

Care planning, reassessment, and physician communication

Medication management, wound care, and infection control

Personal care aide protocols

Emergency preparedness and after-hours response

HIPAA compliance and clinical documentation standards

Billing and claim submission templates

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN) / Clinical Supervisor
Requirements: South Dakota RN license, skilled care experience, supervisory training

Role: Home Health Aide (HHA)
Requirements: Certified through approved training program; supervised by RN

Role: Licensed Therapists (PT, OT, SLP)
Requirements: Active state license in discipline; documentation competency

Role: Medical Social Worker (optional)
Requirements: MSW and licensure (if needed for high-risk or transitional cases)

All staff must complete:

HIPAA, infection control, and safety training

Skills assessments and competency evaluations

Emergency procedures and documentation training

Annual continuing education and license renewals

7. MEDICAID WAIVER PROGRAMS & STATE PLAN COVERAGE

Home Health Services are covered through:

State Plan Medicaid Home Health Benefit – Requires physician order and care plan

Medically Fragile Waiver – For individuals needing ongoing skilled nursing at home

EPSDT (for youth under 21) – May cover extended home health with physician documentation

Other HCBS Waivers (limited use) – Home health may be authorized in exceptional cases

8. TIMELINE TO LAUNCH

Phase: Business Registration & Licensing Prep
Timeline: 1–2 months

Phase: DOH Licensing & Policy Manual Development
Timeline: 2–3 months

Phase: Medicaid Enrollment & Readiness Review
Timeline: 1–2 months

Phase: Begin Home Health Service Delivery
Timeline: Upon license issuance and provider number activation

9. CONTACT INFORMATION

South Dakota Department of Health – Office of Health Protection
Website: https://doh.sd.gov

South Dakota Department of Social Services – Medical Services Division
Website: https://dss.sd.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SD HOME HEALTH PROVIDER

WCG helps RNs, therapy practices, and health entrepreneurs launch fully licensed and Medicaid-approved home health agencies to deliver skilled care in homes across South Dakota.

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Scope of Work:

DOH licensure application support

Medicaid Home Health enrollment and documentation setup

Home Health Policy & Procedure Manual creation

Clinical forms for care planning, medication tracking, and daily notes

Staff credentialing logs and scheduling tools

HIPAA compliance training and survey readiness assistance

MEAL & NUTRITION SERVICES PROVIDER IN SOUTH DAKOTA
PROMOTING HEALTH, DIGNITY, AND INDEPENDENCE THROUGH NUTRITIONAL SUPPORT FOR INDIVIDUALS WITH DISABILITIES AND AGING POPULATIONS

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Meal and Nutrition Services in South Dakota ensure that eligible individuals receive safe, nourishing meals that meet their dietary needs and support their ability to remain at home. These services are available under the CHOICES Waiver, Family Support 360 Waiver, Medically Fragile Waiver, and State-funded Nutrition Programs for Older Adults. Meals may be delivered to the home or provided in a congregate setting and are tailored to the individual's health conditions, preferences, and cultural needs.

1. GOVERNING AGENCIES

Agency: South Dakota Department of Human Services (DHS) – Division of Developmental Disabilities (DDD)
Role: Authorizes waiver-funded meals and nutrition services for participants under CHOICES and FS360.

Agency: South Dakota Department of Social Services (DSS) – Division of Adult Services and Aging
Role: Coordinates State-funded meals and nutrition programs for eligible older adults.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Oversees federal Medicaid standards for waiver-based nutrition and meal delivery services.

2. MEAL & NUTRITION SERVICES OVERVIEW

These services ensure participants maintain adequate nutrition and hydration, particularly when they are unable to prepare meals independently or require specific dietary management.

Services may include:

Home-Delivered Meals (frozen or hot, per schedule)

Congregate Meals at licensed adult day or community centers

Nutrition Education and Meal Planning Support

Special Diet Meals (diabetic, renal, pureed, allergen-free, etc.)

Grocery Shopping Support (when allowed under the plan)

Dietary Consultation with Licensed Dietitians (optional)

Meal Logs, Delivery Documentation, and Care Coordination

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the South Dakota Secretary of State

Obtain EIN and Type 2 NPI

Apply through DHS or DSS depending on waiver or state nutrition program

Comply with state and local food safety regulations

Develop a Meal & Nutrition Services Policy & Procedure Manual

If preparing meals, follow South Dakota Department of Health Food Service Licensing rules

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Register business and obtain EIN/NPI
Step 2: Apply to DHS-DDD (for CHOICES/FS360) or DSS (for State Aging Services) as a food service or meal provider
Step 3: Submit menus, nutrition protocols, and delivery plans
Step 4: Provide proof of food safety certification and inspection (if applicable)
Step 5: Receive participant referrals and begin meal service

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, NPI

Food safety certification/license (if preparing meals)

Meal & Nutrition Services Policy & Procedure Manual including:

Meal prep and delivery protocols

Nutritional standards and diet accommodations

Temperature monitoring and food safety logs

Documentation and verification of meals delivered

HIPAA-compliant participant logs and feedback forms

Billing forms tied to waiver service codes

6. STAFFING REQUIREMENTS

Role: Meal Prep Staff / Delivery Driver
Requirements: Food handler certification, background check, CPR/First Aid (preferred)

Role: Nutrition Coordinator / Dietary Consultant (optional)
Requirements: Licensed Dietitian (if offering meal planning or education)

All staff must complete:

HIPAA and participant privacy training

Food safety and handling training

Emergency protocols for missed deliveries or dietary errors

Documentation and waiver billing orientation

7. MEDICAID WAIVER PROGRAMS

Meal and Nutrition Services are offered through:

CHOICES Waiver – Home-delivered or day program meals for adults with IDD

Family Support 360 Waiver – Meals for children/adults living with family

Medically Fragile Waiver – Meals prescribed by physician or dietitian

State Aging Services Nutrition Program – For seniors through DSS

EPSDT (under 21) – Nutritional support when part of care plan

8. TIMELINE TO LAUNCH

Phase: Business Registration & Food Safety Planning
Timeline: 1–2 months

Phase: Provider Enrollment & Policy Manual Completion
Timeline: 1–2 months

Phase: Staff Hiring, Training & Menu Prep
Timeline: 30–45 days

Phase: Begin Meal Delivery
Timeline: After service authorization or DSS referral

9. CONTACT INFORMATION

South Dakota Department of Human Services – Division of Developmental Disabilities (DDD)
Website: https://dhs.sd.gov

South Dakota Department of Social Services – Adult Services and Aging
Website: https://dss.sd.gov

South Dakota Department of Health – Food Licensing
Website: https://doh.sd.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SD MEAL & NUTRITION PROVIDER

WCG helps meal providers, day centers, and home-delivery kitchens launch and scale compliant Medicaid-funded nutrition services throughout South Dakota.

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Scope of Work:

Business registration and DHS/DSS provider enrollment

Policy Manual for meal service and delivery operations

Menu planning guides and nutrition compliance checklists

Delivery logs, special diet forms, and billing tools

Food safety protocols and inspection readiness

HIPAA documentation and participant satisfaction templates