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

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.

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

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.

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

Continue To Our Client Portal To Get Started

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.