South Dakota - Prevocational Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The South Dakota Department of Human Services (DHS) Division of Developmental Disabilities funds general work readiness training through the CHOICES Waiver under the service names Small Group Vocational Support and Career Exploration, having retired the legacy "Prevocational Services" terminology. These services provide time-limited training in attendance, task completion, safety, and workplace behavior for individuals with intellectual or developmental disabilities meeting an ICF/IID level of care.

Prospective agencies must first obtain certification as a Community Support Provider (CSP) from the DHS Division of Developmental Disabilities before they can submit a billing application. Once CSP certification is granted, the agency enrolls through the Department of Social Services (DSS) Provider Enrollment (PE) Portal to receive a Billing NPI (BNPI) and access the Therap case management system for service authorizations.

1. Service Definition and Scope

South Dakota does not use the term "Prevocational Services" in its current approved 1915(c) waivers. Instead, the state covers time-limited work readiness training under the CHOICES Waiver (0044.R09.00) through two distinct services: Small Group Vocational Support and Career Exploration. These services are designed to develop general, non-job-task-specific strengths and skills that contribute to employability in competitive integrated employment.

Services focus on teaching concepts such as attendance, task completion, problem solving, workplace safety, and interpersonal relations. The state requires these services to be delivered in compliance with the HCBS Settings Final Rule, ensuring participants are integrated in and have full access to the greater community.

• Target Population: Individuals with intellectual or developmental disabilities ages 0 or older meeting an ICF/IID level of care.
• Service Name 1: Small Group Vocational Support (training and support in groups of 2 to 8 individuals).
• Service Name 2: Career Exploration (time-limited activities to identify career interests and aptitudes).
• Setting Requirement: Must comply with 42 CFR §441.301(c)(4) and (5) regarding community integration.
• Exclusion: Services cannot duplicate vocational rehabilitation services funded under the Rehabilitation Act of 1973 or IDEA.

2. Regulatory and Oversight Agencies

The South Dakota Department of Human Services (DHS) operates the CHOICES Waiver and manages the programmatic certification of providers. Within DHS, the Division of Developmental Disabilities (DDD) is the primary oversight body for vocational and day services.

The South Dakota Department of Social Services (DSS) serves as the State Medicaid Agency. DSS handles the financial enrollment of providers, claims adjudication, and maintenance of the Medicaid Management Information System (MMIS).

• Operating Agency: South Dakota Department of Human Services (DHS) (https://dhs.sd.gov/)
• Program Division: DHS Division of Developmental Disabilities (DDD) (https://dhs.sd.gov/en/developmental-disabilities)
• Medicaid Agency: South Dakota Department of Social Services (DSS) (https://dss.sd.gov/)
• Enrollment Portal: SD Medicaid Provider Enrollment (PE) Portal (https://app-dss-sw85pc05dmsproviderenroll.azurewebsites.net/)
• Case Management System: Therap Services (https://www.therapservices.net/)

3. Gatekeeping Prerequisites: Who Can Even Apply

South Dakota strictly controls the network of providers authorized to deliver CHOICES Waiver day and vocational services. An applicant cannot simply enroll as a Medicaid provider for these services; they must first be designated by the state.

The structural precondition blocking immediate application is the requirement to be certified as a Community Support Provider (CSP) by the DHS Division of Developmental Disabilities. The state periodically reviews network adequacy and may not accept new CSP applications if the existing network is deemed sufficient to meet participant needs.

• Primary Prerequisite: Certification as a Community Support Provider (CSP) by SD DHS.
• Network Status: Closed or restricted network; new CSP applications are subject to DHS network adequacy reviews.
• Waiver Requirement: Must be specifically approved to provide services under the SD CHOICES Waiver (0044.R09.00).
• Entity Type: Must be an organizational entity (Type 2 NPI) with a Federal Employer Identification Number (FEIN).

4. Licensure and Certification Requirements

Providers must adhere to the Administrative Rules of South Dakota (ARSD) Article 46:11, which governs the certification of Community Support Providers. This includes rigorous standards for governance, financial stability, and service delivery.

Certification involves a comprehensive review of the agency's policies, procedures, and physical locations to ensure compliance with state standards and the federal HCBS Settings Final Rule.

• Regulatory Citation: ARSD Article 46:11 (Community Support Providers).
• Facility Standards: Must meet federal Medicaid requirements for Home and Community-Based Settings (42 CFR §441.301(c)(4) and (5)).
• Policy Requirement: Must maintain written policies addressing Participant Care Plans, Grievance Procedures, and HCBS Settings Final Rule Staff Training.
• Unannounced Visits: Agencies must conduct at least one unannounced monitoring visit for every staff member annually.

5. Medicaid Provider Enrollment

Once CSP certification is obtained, the agency must enroll through the SD Medicaid Provider Enrollment (PE) Portal. The agency enrolls using an Organizational (Type 2) NPI, which serves as the Billing NPI (BNPI).

South Dakota does not charge an application fee for Medicaid enrollment. However, enrollment records and all supporting documentation must be completed and received within 30 days of starting data capture in the portal, or the application will be denied.

• System of Record: Provider Enrollment (PE) Portal.
• Application Fee: $0 (No application fee is charged by SD Medicaid).
• Timeframe: Enrollment records must be completed within 30 days of starting data capture.
• Required Form 1: Provider Agreement (https://dss.sd.gov/docs/medicaid/providers/enrollment/provider_agreement.pdf).
• Required Form 2: Disclosure Form (https://dss.sd.gov/docs/medicaid/providers/enrollment/Disclosure.pdf).
• Financial Requirement: Letter from a financial institution to support electronic funds transfer (EFT) payments.

6. Staffing, Training and Background Checks

Agencies must ensure that all staff providing vocational support meet state-defined competency and background check requirements. Staff must be trained on the specific needs of the participants they serve as outlined in the Individualized Support Plan (ISP).

South Dakota mandates annual training on the HCBS Settings Final Rule for all agency staff and volunteers to ensure services promote community integration and participant rights.

• Background Checks: Required fingerprint-based criminal background checks through the South Dakota Division of Criminal Investigation (DCI).
• Mandatory Training: Annual staff training on the HCBS Settings Final Rule.
• System Training: Staff must complete Therap system training provided by a Therap representative once the agency account is set up.
• Competency: Staff must demonstrate competency in implementing the participant's ISP and vocational goals.

7. Documentation, Policies and Records

Providers are required to use the Therap case management system to receive referrals, acknowledge Service Authorizations, and document service delivery. The agency's Therap account must maintain accurate staff and agency information at all times.

Documentation must clearly link the vocational activities provided to the goals specified in the participant's ISP. Any modification to the HCBS Settings Final Rule requirements must be individualized, justified, and documented in the ISP.

• Electronic Record System: Therap Services is the mandatory system for LTSS HCBS Providers.
• Service Authorization: Providers must acknowledge and maintain Therap Service Auths prior to service delivery.
• Care Logs: Providers must maintain detailed care logs to verify services rendered, which may be requested by the state.
• Transition Notice: Providers must give at least 30 days' notice to DHS/LTSS for any address change, ownership change, or contract termination.

8. Billing, Rates and Claims

Billing for Small Group Vocational Support and Career Exploration is processed through the DSS MMIS based on the authorizations generated in Therap. Providers may only receive payment for services they are explicitly enrolled and authorized to provide.

The state's reimbursement is considered payment in full; providers may not bill the participant for any additional fees. Travel time is included in the non-billable time reported in cost reports and is factored into the service rate.

• Billing Identifier: Claims must be submitted using the agency's Billing NPI (BNPI).
• Authorization Requirement: Services must match the active Therap Service Auth exactly to be paid.
• Participant Billing: Prohibited; state reimbursement is payment in full.
• Interpreter Services: Providers must use the DHS-approved vendor (e.g., ISI for ASL) using the provided access code to avoid incurring expenses.
• Timely Filing: Providers should complete enrollment actions at least 45 days prior to timely filing deadlines to avoid claim denials.

9. Approval Sequence and Timeline

The approval process begins with contacting the DHS Division of Developmental Disabilities to inquire about CSP network needs and certification requirements. If permitted to apply, the agency undergoes the rigorous CSP certification review.

Following DHS certification, the agency submits its enrollment via the DSS PE Portal. Once DSS approves the Medicaid enrollment, the agency is granted access to Therap, completes required system training, and can begin accepting participant referrals.

• Step 1: Contact DHS DDD regarding CSP network status and certification application.
• Step 2: Complete CSP certification review and obtain official DHS approval.
• Step 3: Initiate enrollment in the DSS PE Portal and email supporting documents to [email protected].
• Step 4: Complete PE Portal data capture within the strict 30-day window.
• Step 5: Complete Therap system setup and mandatory staff training.

10. Common Denials and Survey Findings

Applications in the PE Portal are frequently rejected if the provider fails to submit all required documentation (such as the Provider Agreement and Disclosure form) within the 30-day data capture window.

During compliance surveys, agencies often face citations for failing to conduct the required annual unannounced staff monitoring visits or for lacking documented annual staff training on the HCBS Settings Final Rule.

• Enrollment Denial: Failure to complete the PE Portal record and submit documents within 30 days.
• Survey Citation: Missing documentation of annual unannounced staff monitoring visits.
• Survey Citation: Lack of evidence for annual HCBS Settings Final Rule staff training.
• Claim Denial: Billing for units that exceed the amount specified in the Therap Service Auth.
• Claim Denial: Providing services without the participant present, unless a specific exception was authorized by the Case Management Specialist.

11. Key Contacts and Resources

Providers should direct Medicaid enrollment questions to the DSS Provider Enrollment team and programmatic or certification questions to the DHS Division of Developmental Disabilities.

The PE Portal and the LTSS Provider Policy Manual are the primary resources for maintaining compliance and understanding billing procedures.

• Medicaid Enrollment Email: [email protected]
• Medicaid Enrollment Phone: 866-718-0084
• DSS Online Portal Support: [email protected]
• DHS Division of Developmental Disabilities: https://dhs.sd.gov/en/developmental-disabilities
• SD Medicaid Provider Enrollment Portal: https://app-dss-sw85pc05dmsproviderenroll.azurewebsites.net/

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