---
title: "South Dakota Home Care Medicaid | Funding LTC Marketplace"
url: https://fundingltcmarketplace.com/states/south-dakota/home-care-medicaid/
description: "HOPE is South Dakota’s older-adult and disability HCBS waiver within a four-waiver state system."
last_updated: 2026-10-20
author: George A. Mellendorf, CLTC, LTCP (Central States Insurance Services, Inc.)
publisher: Funding LTC Marketplace
note: Educational content; not legal, tax or financial advice. Markdown copy of the HTML page at the URL above.
---
South Dakota · Home & Community Care

# South Dakota Home Care Medicaid

Last updated 2026-10-20

The Home and Community-Based Options and Person-Centered Excellence waiver — known as HOPE — is South Dakota's main channel for keeping older adults and people with disabilities out of institutional care. It's a joint program run by the Department of Human Services' Long Term Services and Supports division together with DSS.

HOPE targets South Dakotans age 65 and older, plus adults with a qualifying disability, who need a nursing-facility level of care but can safely be supported in a community setting instead. Getting enrolled runs through several steps: a Home Care Assessment, an LTSS referral and assessment, a Medical Review Team level-of-care review, standard DSS financial eligibility, and finally an individual support plan with authorization.

## Sources and official resources

- [South Dakota DSS: Medicaid Coverage Groups](https://dss.sd.gov/economicassistance/medical_programs.aspx)
- [CMS: 2026 SSI and Spousal Impoverishment Standards](https://www.medicaid.gov/federal-policy-guidance/downloads/cib04272026.pdf)

Rules and figures change. Confirm current details with the agency before you act.

[← Back to the full South Dakota guide](https://fundingltcmarketplace.com/states/south-dakota/)