South Dakota Medicaid waiver guide
Learn how South Dakota Medicaid waiver services work, which state agency to start with, how the application process usually begins, and where to search for home and community-based services.
Last reviewed July 2026. See something out of date? Use the “Suggest an edit” button to let us know.
South Dakota's main program is the CHOICES Waiver — Community, Hope, Opportunity, Independence, Careers, Empowerment, Success — serving children and adults with intellectual and developmental disabilities. The Division of Developmental Disabilities is now the single point of contact, and everything starts with one call to Dakota at Home. The structural detail worth knowing up front: your first real decision is choosing a case management provider, and that provider cannot be the same organization that delivers your services. South Dakota built that separation in deliberately so your plan is not written by the people who will be paid to fulfill it.
Search by state, city, or ZIP code to compare provider profiles, services, contact details, and verified status.
Children and adults with intellectual and developmental disabilities
People with a developmental or intellectual disability who are South Dakota Medicaid recipients
You must have a diagnosed developmental or intellectual disability and be a South Dakota Medicaid recipient. Your case management provider gathers and submits the proof needed to determine whether you qualify, so choosing one is effectively the first step in establishing eligibility rather than something that happens afterward.
A diagnosed developmental or intellectual disability is the clinical requirement. Your case manager gathers and submits the proof.
You must be a South Dakota Medicaid recipient. Waiver services are Medicaid-funded, so this runs alongside the disability determination.
CHOICES serves both children and adults, so there is no age threshold to wait for before calling.
Selecting a case management provider is the first step, not a later formality — they assemble the documentation that determines whether you qualify.
South Dakota does not publish a standing statewide waiting list for CHOICES the way many states do. The pace is set by the eligibility determination, Medicaid enrollment, and finding providers with capacity — which in a rural state can be the real constraint. A proposed waiver amendment would let providers approved and in good standing in other states offer CHOICES services, specifically to widen the pool available to South Dakotans.
Dial 1-833-663-9673 and choose option 2 to reach DDD. The Division is now the single point of contact for people seeking services, so this one call replaces hunting for the right office.
Open linkThis is your first step and it matters. Your case management provider cannot be the same organization as your service provider, which South Dakota requires so your plan is unbiased. They gather the proof for eligibility, build your person-centered plan, and advocate when things go wrong.
Your case manager gathers and submits the required proof of a diagnosed developmental or intellectual disability, alongside your South Dakota Medicaid status.
Your case manager helps make a person-centered plan for supports and services, then identifies, applies for, and accesses what you need from available providers and resources.
CSPs deliver the direct services and are located throughout the state. Because your case manager is independent of them, you can ask candidly which providers would actually suit you.
Exact covered services depend on the waiver, assessed need, Medicaid rules, funding, and state program requirements. Confirm services, availability, and payment acceptance with the state, support coordinator, and provider.
South Dakota's model gives you meaningful control at two points: you choose your case management provider, and that provider is structurally independent of the organizations delivering your services. Ask your case manager what self-directed options exist within your plan and how assistive technology can substitute for staff support where you would prefer independence.
Approved waiver services are paid by South Dakota Medicaid. Once enrolled, there is generally little or no direct cost for covered services.
CHOICES explicitly covers devices such as tablets, smart home technology, and wayfinding tools that can prompt medication, walk through daily tasks, and make a home more accessible. For some people this buys more independence than additional staffed hours would.
In residential settings the waiver pays for services, not room and board, which is typically covered by the person's own income such as SSI.
South Dakota provides early intervention for infants and toddlers separately, but CHOICES itself serves children as well as adults — you do not have to wait for adulthood to seek waiver services.
School districts provide special education under an IEP. Waiver services are separate and additional, and assistive technology under the waiver can complement what school provides.
Career exploration prepares people for work, and supported employment aims at ongoing paid work at or above minimum wage in an integrated setting. Raise employment goals early in person-centered planning rather than after other services settle.
Provider capacity, not eligibility, is often the practical constraint in South Dakota. A proposed waiver amendment would let out-of-state providers in good standing serve South Dakotans, specifically to widen that pool — worth asking about if local options are thin.
If eligibility or a waiver service is denied, reduced, or ended, you have the right to appeal within the deadline printed on your notice. Your case management provider's role explicitly includes advocating and problem-solving, so involve them early. Disability Rights South Dakota is the state's protection and advocacy organization and has served South Dakotans since 1977.
Protection & Advocacy organization for South Dakota
1-800-658-4782Visit siteCall and choose option 2 to reach the Division of Developmental Disabilities
1-833-663-9673Visit siteServices, how to apply, case management, and Community Service Providers
Visit siteFree advocacy — 605-224-8294 locally, drsd@drsdlaw.org
1-800-658-4782Visit siteMedicaid eligibility and enrollment
Visit siteLocal help & referrals — dial 211
Visit siteOne call: Dakota at Home at 1-833-663-9673, option 2. The Division of Developmental Disabilities is now the single point of contact for people seeking services, so you do not need to work out which office handles what.
Because in South Dakota the case manager assembles the proof that determines whether you qualify, builds your person-centered plan, and advocates for you. Choosing one is the first step, not paperwork that comes later.
No, and that is deliberate. South Dakota requires your case management provider to be a different organization from your service provider so you get an unbiased plan that meets your needs rather than one shaped by who gets paid to deliver it.
Yes, and substantially. Individual assistive technology includes tablets, smart home devices, and wayfinding tools that can remind someone to take medication, give step-by-step instructions for daily activities, and make a home more accessible. For some people that provides more independence than extra staffed hours.
Provider capacity is often the real constraint in rural South Dakota. DDD has proposed a waiver amendment allowing providers approved and in good standing in other states to deliver CHOICES services, specifically to widen the pool. Ask your case manager whether that applies to your situation.
You must have a diagnosed developmental or intellectual disability and be a South Dakota Medicaid recipient. Your case management provider gathers and submits the proof needed to determine whether you qualify, so choosing one is effectively the first step in establishing eligibility rather than something that happens afterward.
call dakota at home, choose a case management provider — and choose carefully, establish eligibility, build a person-centered plan, then enroll and choose providers. Start with South Dakota Division of Developmental Disabilities.
Covered services vary by waiver and assessed need, and commonly include in-home supports, respite, supported employment, day services, behavior support, residential supports. Confirm specifics with the state and provider.
South Dakota does not publish a standing statewide waiting list for CHOICES the way many states do. The pace is set by the eligibility determination, Medicaid enrollment, and finding providers with capacity — which in a rural state can be the real constraint. A proposed waiver amendment would let providers approved and in good standing in other states offer CHOICES services, specifically to widen the pool available to South Dakotans.
Approved waiver services are generally covered by Medicaid at little or no direct cost once enrolled, though some enrollees may owe a monthly patient responsibility based on income.
Services, the case management requirement, Community Service Providers, and how to apply.
South DakotaSouth Dakota's DD services and the single point of contact.
South DakotaSouth Dakota's guide to planning supports and navigating the system.
South DakotaFree protection and advocacy services, including appeals help.
South DakotaFind waiver providers and services in South Dakota on Waiverly.
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