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South Dakota - Personal Emergency Response System — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The South Dakota Department of Human Services (DHS) Division of Long Term Services and Supports (LTSS) authorizes Personal Emergency Response System (PERS) vendors through the HOPE (Home and Community-Based Options and Person Centered Excellence) Waiver. This service provides 24-hour electronic monitoring and dispatch for individuals aged 65 and older, as well as adults with disabilities, who live alone or are at risk of falls.

South Dakota does not issue a distinct facility or agency license for PERS providers through the Department of Health. Instead, the structural precondition to operate is securing a Medicaid Provider Agreement through the Department of Social Services (DSS) while simultaneously meeting DHS LTSS provider provisions as an enrolled Home and Community-Based Services (HCBS) waiver vendor.

1. Service Definition and Scope

In South Dakota, a Personal Emergency Response System (PERS) is defined as an electronic device that enables a participant to secure help in an emergency. The system connects to a 24-hour response center when a button is pushed.

Under the HOPE Waiver, PERS is utilized to maintain the independence and safety of participants in their own homes. It cannot be billed separately if the participant resides in an Assisted Living facility, as emergency response is bundled into the facility's tiered daily rate, unless specifically authorized by an LTSS Service Coordinator via a third-party enrolled HOPE Waiver provider.

2. Regulatory and Oversight Agencies

The South Dakota Department of Social Services (DSS) manages the state's Medicaid program, including the Medicaid Management Information System (MMIS) and all baseline provider enrollment functions.

The South Dakota Department of Human Services (DHS) Division of Long Term Services and Supports (LTSS) operates the HOPE Waiver, establishes the specific provider provisions, and authorizes individual participant service plans.

3. Gatekeeping Prerequisites: Who Can Even Apply

South Dakota operates an open enrollment model for HCBS waiver vendors. There are no competitive procurement (RFP) requirements, closed networks, or moratoria restricting new PERS providers from entering the market.

Furthermore, South Dakota does not require a Certificate of Need (CON) for PERS vendors. Any business entity that can meet the Medicaid enrollment standards and DHS LTSS provider provisions is eligible to submit an application at any time.

4. Licensure and Certification Requirements

Because PERS is an equipment and monitoring service rather than direct medical care, the South Dakota Department of Health does not issue a specific health facility or agency license for it.

Providers are approved strictly through the Medicaid enrollment process and must agree to the DHS LTSS Assisted Living and HCBS Provider Provisions, which mandate compliance with all applicable local, state, and federal safety and equipment standards.

5. Medicaid Provider Enrollment

Prospective PERS providers must apply through the DSS Provider Enrollment portal. The process requires submitting standard federal and state disclosures, financial routing information, and agreeing to Medicaid rules.

Vendors must submit their applications electronically and provide supporting documentation, including a letter from a financial institution to establish Electronic Funds Transfer (EFT) for claims payment.

6. Staffing, Training and Background Checks

While PERS vendors do not provide hands-on personal care, they must ensure that any staff entering a participant's home for installation, as well as response center dispatchers, are properly vetted.

South Dakota Medicaid requires all enrolled providers to verify the exclusion status of their owners, managing employees, and agents against federal databases to ensure no excluded individuals are billing the program.

7. Documentation, Policies and Records

PERS providers must maintain detailed records of equipment installation, monthly testing, and any emergency dispatch events. These records are subject to audit by DHS LTSS and DSS Program Integrity.

Services cannot be initiated or billed without a formal, written authorization from a DHS LTSS Service Coordinator, which dictates the scope and duration of the approved service.

8. Billing, Rates and Claims

PERS services are reimbursed on a fee-for-service basis through the South Dakota MMIS. Rates are standardized and published by DHS LTSS.

Reimbursement is typically divided into a one-time installation fee and a recurring monthly rental/monitoring fee. Providers must look up the current allowable rates on the HOPE Waiver Fee Schedule.

9. Approval Sequence and Timeline

The approval process begins with establishing a legal business entity and obtaining a National Provider Identifier (NPI), if applicable, before submitting the Medicaid enrollment application to DSS.

The DSS review process can take up to 3 months. Once DSS approves the Medicaid Provider Agreement, the provider coordinates with DHS LTSS to be added to the list of approved HOPE Waiver vendors.

10. Common Denials and Survey Findings

Medicaid enrollment applications are frequently delayed or denied due to missing financial documentation, such as the required bank letter for EFT, or incomplete ownership disclosure forms.

During program integrity reviews, a common finding is the provider's failure to conduct and document the required monthly checks of the OIG LEIE and SAM exclusion databases for all managing employees.

11. Key Contacts and Resources

Prospective providers should utilize the official state portals for the most current fee schedules, provider agreements, and waiver manuals.

The DSS Provider Enrollment team handles all application logistics, while DHS LTSS manages waiver policy and participant authorizations.

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