1. Program Definition and Services

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. The program aims to support independence and safety, allowing Medicaid waiver participants to remain securely in their homes while promoting autonomy and dignity. Services include:

• In-Home Support: Light housekeeping, meal preparation, grocery shopping, laundry, and essential household tasks delivered directly in the participant’s private or family home
• Residential & Facility Support: [Not Applicable / Independent Living Only] In accordance with state guidelines, standalone homemaker authorizations are restricted to individuals living independently in non-institutional, private residences

2. Regulations

The program is governed by the following regulations:

• Administrative Rules of South Dakota (ARSD) Chapter 67:44:03 (HOPE Waiver Program Criteria)
• Administrative Rules of South Dakota (ARSD) Article 67:16 (South Dakota Medicaid Covered Provider and Fee Schedule Regulations)
• South Dakota Codified Laws (SDCL) Title 22, Chapter 22-46 (Mandatory Abuse and Neglect Reporting for Vulnerable Adults)
• Federal Home and Community-Based Services (HCBS) Waiver Authorities under Section 1915(c) of the Social Security Act

3. Licensing or Certification

South Dakota does not require a standalone facility license for a homemaker agency. Instead, providers must be formally credentialed and enrolled as an active Personal Care or HCBS Waiver Agency with South Dakota Medicaid, and execute a mandatory Purchase of Services contract with the state.

4. Responsible State Agency

The South Dakota Department of Human Services (DHS) , Division of Long-Term Services and Supports (LTSS) and the South Dakota Department of Social Services (DSS)  Medical Services Division are responsible for approving agency applications, managing regional service allocations, and monitoring compliance.

5. Application Process

The application process is initiated by submitting an HCBS Provider Enrollment Request to DHS/LTSS. Once a formal state Purchase of Services contract is executed, the agency completes its enrollment online via the electronic South Dakota Medicaid Provider Enrollment Portal.

6. Required Documentation

While specific documentation requirements vary based on the target waiver, providers typically need to submit:

• A signed copy of the DHS/LTSS Purchase of Services contract
• Agency-specific Homemaker Services Policy & Procedure Manual
• Clear criminal history and background check clearances for all agency owners and staff
• Proof of minimum commercial general liability, professional liability, and workers' compensation insurance

7. Timeline for Approval

The exact timeline for approval fluctuates based on agency capacity. Providers should contact the DHS Division of Long-Term Services and Supports or their regional Medicaid enrollment coordinator for detailed information on current contract processing timeframes.

8. Pre-Application Process

Prospective providers must complete specific foundation tasks before applying. They must register their business entity with the South Dakota Secretary of State, secure a Federal Employer Identification Number (EIN), and obtain an agency Type 2 National Provider Identifier (NPI).

9. Pre-Application Training

The state hosts mandatory administrative, Electronic Visit Verification (EVV), and electronic billing onboarding training. Qualified agency operators receive direct access credentials to the state's case management system, Therapy, once preliminary portal documents are logged.

10. Additional Notes

• Homemaker tasks must follow the designated Healthcare Common Procedure Coding System (HCPCS) code S5130 and be billed in accordance with state-approved limits
• Homemaker services must be explicitly tied to assessed needs and authorized in advance within the participant’s person-centered Individual Support Plan (ISP)
• All agency employees, field supervisors, and household attendants must clear mandatory state background checks prior to being assigned to a participant's home
• Agencies must maintain legible, detailed records of service delivery dates, exact clock-in/clock-out times, and performed household task logs to satisfy Medicaid compliance reviews

Why Choose Waiver Consulting Group?

Starting or expanding your Medicaid waiver-funded agency can feel overwhelming, but it doesn't have to be. At Waiver Consulting Group, we simplify the process by guiding you through licensing, compliance, provider enrollment, policies & procedures, and regulatory approvals in any state.

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