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South Dakota - Integrated Employment — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

South Dakota funds integrated employment through the "Career & Employment" service under the 1915(c) CHOICES Waiver, overseen by the Department of Human Services (DHS) Division of Developmental Disabilities (DDD). Approval requires an agency to first achieve certification as a Community Support Provider (CSP) or Organized Health Care Delivery System (OHCDS) under Administrative Rules of South Dakota (ARSD) 46:11:02 before submitting a Medicaid enrollment application to the Department of Social Services (DSS).

The state does not issue a standalone license for supported employment; instead, the CSP certification acts as the comprehensive structural gate for all CHOICES waiver day and employment services. Agencies must secure a provider agreement with DHS/DDD and enroll via the DSS Provider Enrollment (PE) Portal using an Organizational (Type 2) NPI.

1. Service Definition and Scope

Career & Employment services in South Dakota focus on achieving sustained paid employment at or above minimum wage in an integrated setting in the general workforce. The service encompasses job development, placement, and ongoing support to meet the participant's personal and career goals as outlined in their Individualized Support Plan (ISP).

This service is designed to ensure individuals in Medicaid's HCBS waiver programs receive services and supports in the most integrated setting and have full access to the benefits of community living.

2. Regulatory and Oversight Agencies

Two primary state departments manage the approval and oversight of Career & Employment providers. The Department of Human Services (DHS) handles programmatic certification and waiver operation, while the Department of Social Services (DSS) acts as the State Medicaid Agency managing enrollment and claims.

DHS/DDD is responsible for assuring each CSP/OHCDS meets certification requirements, while DSS maintains the Provider Enrollment (PE) Portal.

3. Gatekeeping Prerequisites: Who Can Even Apply

South Dakota restricts the provision of CHOICES Waiver Career & Employment services exclusively to agencies that have obtained comprehensive certification as a Community Support Provider (CSP) or Organized Health Care Delivery System (OHCDS). There is no pathway for an independent job coach or standalone employment agency to enroll directly with Medicaid for this service without this overarching agency certification.

An applicant must secure this certification and a formal provider agreement with DHS/DDD before DSS will process any Medicaid enrollment application for waiver services.

4. Licensure and Certification Requirements

The state does not issue a specific "supported employment license." Instead, agencies must complete the CSP/OHCDS certification process through DHS/DDD, which evaluates the agency's capacity to deliver waiver services in compliance with ARSD Title 46.

Certification is verified biennially by DHS/DDD to ensure ongoing compliance with state rules and the federal HCBS Settings Rule.

5. Medicaid Provider Enrollment

Once certified by DHS/DDD, the agency must enroll as a billing provider through the DSS Provider Enrollment (PE) Portal. The process requires an Organizational (Type 2) NPI and must be completed within 30 days of initiating data capture in the portal.

South Dakota Medicaid does not charge an application fee for enrollment. Supporting documentation, including the provider agreement and disclosure forms, must be submitted to complete the record.

6. Staffing, Training and Background Checks

Direct support professionals delivering Career & Employment services must meet training standards set by DHS/DDD. Agencies are responsible for ensuring all employees are trained on the minimum requirements necessary to address the individual participant's needs.

Training and documentation requirements are strictly governed by ARSD 46:11:04:15.01 and are verified during the biennial certification review.

7. Documentation, Policies and Records

Providers must maintain thorough and timely documentation demonstrating full compliance with programmatic requirements, ARSD Article 46:04 and 46:11, and DHS/DSS policies.

This includes tracking progress toward the employment goals specified in the participant's ISP and maintaining case notes that justify the units billed.

8. Billing, Rates and Claims

Claims are processed through the DSS MMIS using the agency's Billing NPI (BNPI) and PE System ID. Payments are made exclusively via electronic funds transfer, requiring a letter from a financial institution during enrollment.

Providers must ensure their online enrollment records accurately reflect business operations to maintain eligibility to render and bill for services.

9. Approval Sequence and Timeline

The approval sequence begins with establishing the agency as a legal entity and applying for CSP/OHCDS certification through DHS/DDD. Only after securing this certification and a provider agreement can the agency submit its Medicaid enrollment via the PE Portal.

Failure to complete the PE Portal data capture within 30 days of initiation will result in the rejection of the enrollment application.

10. Common Denials and Survey Findings

Applications are frequently delayed or denied if the agency attempts to enroll in Medicaid before securing the prerequisite CSP/OHCDS certification. The PE Portal will automatically reject applications left incomplete after 30 days.

During biennial reviews, DHS/DDD commonly cites providers for inadequate documentation of staff training or failure to maintain case notes that align with the participant's ISP goals.

11. Key Contacts and Resources

Providers should utilize the official portals and contact emails provided by DHS and DSS for guidance on certification and enrollment. The PE Portal serves as the central hub for all Medicaid billing enrollment activities.

Supporting documentation for enrollment should be sent directly to the DSS Provider Enrollment email address.

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