South Dakota Disability Waiver Services: Respite Care, Personal Care, and Home Modifications

Once a young adult qualifies for one of South Dakota's developmental disability waivers, the next question is what services actually look like day to day. The specific supports available depend on which waiver the family chose — CHOICES or Family Support 360 — and each one structures service delivery differently. Understanding the details before you're on a waiver helps you make a more informed choice during the application process.

Services Under Family Support 360

Family Support 360 is the self-directed waiver. The family works with a regional Family Support Service Coordinator to identify needs and fund services. Financial management runs through Consumer Direct Care Network South Dakota, the state's contracted fiscal agent, under an Agency with Choice model. Here's what's covered:

Personal care services: Assistance with daily living activities like bathing, dressing, grooming, toileting, and meal preparation. The waiver covers hiring a caregiver to provide these supports in the home or community.

Companion care: A caregiver provides supervision, socialization, and assistance with community activities. This is different from personal care in that it focuses on engagement and safety rather than hands-on physical assistance. Parents of adult beneficiaries (18+) can be paid for providing companion care through this waiver — a significant benefit that many families don't realize is available.

Respite care: Temporary relief for the primary caregiver. Respite can be provided in the home or in a community setting and gives families the flexibility to handle appointments, take breaks, or manage other family responsibilities. This is one of the most requested services and often the first one families use after enrollment.

Home modifications: Physical changes to the home that are necessary for the individual's health, welfare, or safety. This can include wheelchair ramps, bathroom grab bars, widened doorways, or specialized flooring. Modifications must be tied to the individual's assessed needs and approved through the service plan.

Services Under CHOICES

CHOICES covers more intensive, provider-organized supports:

Residential habilitation: Supervised living arrangements including group homes and shared living. The community support provider manages staffing, and the individual participates in person-centered planning to shape their daily schedule and goals.

Day services: Structured daytime programming focused on community integration, skill-building, and social interaction. Programs vary by provider and region.

Supported employment: Job coaching, workplace support, and career exploration services delivered through community support providers. The goal is competitive integrated employment — real jobs in community settings at prevailing wages.

Group supported employment: Work in group settings within a community business, with ongoing support from a job coach shared among multiple participants.

The Self-Directed Model

Family Support 360's self-directed structure gives families significant control. Through Consumer Direct Care Network, families can recruit, hire, and schedule their own caregivers. This is particularly valuable in rural parts of South Dakota where agency staffing is limited — families can hire local community members, neighbors, or family friends who already have a relationship with the young adult.

The Agency with Choice model handles payroll, taxes, and insurance for the hired workers, so the family isn't functioning as an employer in a legal sense. The Family Support Coordinator helps set up the fiscal management relationship and monitors the service plan.

Eligibility Requirements

Both waivers use the same financial and clinical eligibility criteria: monthly income under $2,982 (300% of the SSI Federal Benefit Rate), assets under $2,000, and an ICF/IID level of care determination based on the ICAP assessment. Only the individual's income counts — parental income is not considered.

The South Dakota IEP Transition to Adulthood Guide includes a waiver comparison worksheet that evaluates these service categories against your family's daily support needs and living arrangements.

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