South Dakota Disability Services: Waivers, Housing, and Legal Help

South Dakota disability services run through a single statewide intake point called Dakota at Home, reachable at 833-663-9673, which connects people of any age, income, or disability type to Medicaid waivers, vocational rehabilitation, children’s early intervention, housing assistance, assistive technology, and free legal advocacy.¹ Most programs are administered by the South Dakota Department of Human Services, with children’s services handled by the Department of Education and cash disability benefits filed through the federal Social Security Administration.

Where to Start: Dakota at Home

Dakota at Home is the state’s designated Aging and Disability Resource Center and functions as a “No Wrong Door” for long-term services and supports. Intake specialists offer free, unbiased information and referrals, plus options counseling that helps you figure out what you may qualify for and plan care in the least restrictive setting.¹

You can call 833-663-9673, email DakotaAtHome@state.sd.us, or search the online directory at dakotaathome.sd.gov by region. A separate pathway exists for reporting abuse, neglect, or exploitation of vulnerable adults.¹

Medicaid Waivers for Home and Community Care

South Dakota runs four Medicaid Home and Community-Based Services waivers, which let people receive care in their homes and communities rather than in institutional settings.²

CHOICES

CHOICES is the comprehensive waiver for people with intellectual and developmental disabilities. Services are delivered through Community Support Provider organizations and can include residential support, day services, career exploration, supported employment, assistive technology, and behavioral support.³

Family Support 360

Family Support 360 is a self-directed waiver. The individual or legal guardian chooses their own support staff and schedule. Covered services include personal care, companion services, supported employment, adaptive equipment, home and vehicle modifications, specialized therapies, and nutritional supplements.³

HOPE

The HOPE waiver serves adults 18 and older with a qualifying disability, and people 65 and older, who need a nursing facility level of care but want to stay in a home or community setting. Services may include in-home care, respite, nutrition and meal support, adult day services, assisted living, and community living homes.⁴

Assistive Daily Living Services

ADLS is the fourth HCBS waiver operating in the state.²

How to Apply

For developmental disability waivers, call Dakota at Home at 833-663-9673 (Option 2) or email DDDIntakeProcess@state.sd.us. A first step is selecting a case management provider, which must be a separate entity from your service provider so that planning stays person-centered.⁵

Vocational Rehabilitation and Employment

The Division of Rehabilitation Services (DRS) helps people with disabilities prepare for, find, and keep a job. It runs 11 local offices across the state and administrative offices in Pierre.⁶ Applying involves an initial submission followed by a staff contact to complete the second part of the form. Eligibility is determined within 60 days. If you disagree with an eligibility or service decision, you can request an administrative review, mediation, or a fair hearing in writing within 30 days.⁷

Service to the Blind and Visually Impaired (SBVI) operates alongside DRS with services tailored to vision loss. That includes low-tech aids such as large print materials and talking clocks, and high-tech devices like video magnification and Braille computer programs. SBVI can purchase assistive technology as part of your established plan.⁸

Assistive Technology

DakotaLink has been the state’s assistive technology program since 1995. It operates as a one-stop resource with four regional offices and six certified rehabilitation technicians, offering individual assessments, equipment sales and training, an equipment loan and reuse program, and a low-interest loan fund for buying devices.⁹

For people enrolled in Division of Developmental Disabilities programs, the division supplies additional technology: remote monitoring through sensors and cameras, smart home devices such as iPads and Amazon Alexa units for medication reminders and daily activity prompts, and specialized apps for communication and therapy.¹⁰

Services for Children

Children’s disability services are divided by age under the federal Individuals with Disabilities Education Act.

Birth to Three

Birth to Three is voluntary early intervention for children from birth to 36 months who have developmental delays or medical conditions needing special attention. Services are family-focused and delivered in the child’s natural environment, and cover screenings, evaluations, service coordination, and individualized supports based on family goals.¹¹ The South Dakota Department of Education administers the program statewide, with the University of South Dakota Center for Disabilities running regional services in southeastern counties.¹² The program’s number is 800-305-3064.

School-Age Special Education

Once a child is school-age, the Department of Education’s Special Education Programs office ensures a free appropriate public education, oversees the Individualized Education Program (IEP) process, and handles dispute resolution and parental rights.¹³ Starting at age 14, the Transition Services Liaison Project and the “iTransition South Dakota” app help students plan for life after high school, including supported decision-making as an alternative to guardianship.¹⁴

Housing

The South Dakota Housing Development Authority runs several programs relevant to people with disabilities. Section 811 Project Rental Assistance provides rental help specifically for individuals with disabilities in privately owned properties.¹⁵ The Governor’s House Program offers energy-efficient pre-built homes for people who are elderly, disabled, or on a budget, though you must supply your own lot, foundation, and utility connections.¹⁶

Federal Housing Choice Vouchers (Section 8) and the HUD Homeownership Voucher Program, which can cover mortgage payments, taxes, insurance, and maintenance, are applied for through local Public Housing Authorities rather than the state agency directly. The 211 Helpline Center serves as a general contact point for local housing help.¹⁵

Social Security Disability in South Dakota

South Dakotans apply for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) through the Social Security Administration online, by phone at 1-800-772-1213, or at local field offices in Aberdeen, Huron, Rapid City, Sioux Falls, and Watertown. Field offices confirm non-medical eligibility and forward the case to South Dakota’s Disability Determination Services office for the medical review.¹⁷

Approval rates in the state track close to national averages. In 2024, South Dakota’s initial approval rate was 38.8 percent, against a national average of 39.5 percent. The reconsideration approval rate was 10.3 percent, compared with 15.1 percent nationally. Hearing-level data for South Dakota is not separately reported, because administrative law judge hearings are handled through offices in Billings, Montana, and Fargo, North Dakota.¹⁸ Nationally, wait times for an initial determination peaked at 7.7 months in August 2024 and stayed above seven months through mid-2025.¹⁹

ABLE Accounts

South Dakota does not run its own ABLE program, but state law since July 2016 allows residents to open accounts through other states’ programs.²⁰ ABLE accounts let qualified people with disabilities save money without losing eligibility for means-tested benefits like SSI and Medicaid, which otherwise impose a $2,000 asset limit. Starting January 2026, eligibility expanded to people whose disability began before age 46, up from age 26.²¹

The first $100,000 in an ABLE account is excluded from the SSI resource limit, and Medicaid eligibility continues even if the balance temporarily goes above that. Funds can be spent on qualified disability expenses including education, housing, transportation, job training, assistive technology, and health care. State-by-state program comparisons are available at ablenrc.org.²¹

Free Legal Help: Disability Rights South Dakota

Disability Rights South Dakota is the federally designated Protection and Advocacy organization for the state, operating as a private nonprofit since 1977. It provides free legal services, advocacy, training, and systemic monitoring for South Dakotans with disabilities of any age. Focus areas for fiscal year 2026 include abuse and neglect response, community access and integration, special education, employment discrimination, and voting accessibility.²²

The organization prefers collaborative solutions but is authorized to litigate when necessary. Offices are in Pierre, Sioux Falls, and Rapid City. The phone number is 800-658-4782.²³ Partners in Policymaking and South Dakota Advocates for Change train individuals in self-advocacy and engagement with the legislative process.²⁴

Recent Changes Worth Knowing

The 2026 Legislature created the Developmental Disability Service Delivery Committee through Senate Bill 15, introduced by Senate President Pro Tempore Chris Karr. The committee reviews the state’s Medicaid waiver programs and oversees the Department of Human Services’ operation of them, and is authorized to meet through 2029.²⁵²⁶

House Bill 1138, which would have required licensure of non-medical home care agencies, was vetoed by the governor during the 2026 session. A legislative override attempt failed.²⁷

In January 2026, South Dakota joined Texas and seven other states in filing an amended complaint in Texas v. Kennedy, a federal lawsuit challenging a 2024 U.S. Department of Health and Human Services rule about the integration mandate under Section 504 of the Rehabilitation Act. The states argue the rule exceeds federal authority by requiring recipients of federal funding to serve people with disabilities in the most integrated setting and by treating “serious risk of institutionalization” as actionable discrimination. The case is pending in the U.S. District Court for the Northern District of Texas.²⁸²⁹

On the budget side, the governor’s recommended fiscal year 2027 spending plan includes a $35.3 million increase for Medicaid and program utilization, driven by the CHOICES waiver, assisted living, in-home services, and intermediate care facilities. Several agency-requested increases were not funded: $16.7 million in provider inflation adjustments, $28.7 million in targeted provider increases, and a $1.3 million adult day services expansion were all zeroed out. The homemaker fee share for participants is proposed to rise from 5 percent to 10 percent.³⁰

1
South Dakota DHS. Dakota at Home
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South Dakota DSS. Home and Community-Based Services
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South Dakota Legislature. CHOICES and FS360 Waiver Overview
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South Dakota DHS. HOPE Waiver
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South Dakota DHS. Division of Developmental Disabilities
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South Dakota DHS. Find DRS Offices
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South Dakota DHS. VR Application Form
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South Dakota DHS. Assistive Technology for People Who Are Blind or Visually Impaired
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DakotaLink. DakotaLink – South Dakota Assistive Technology Program
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South Dakota DHS. Assistive Technology for People With Developmental Disabilities
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South Dakota DOE. Birth to Three
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University of South Dakota. Birth to Three Program
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South Dakota DOE. Special Education Programs
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Disability Rights South Dakota. Special Education Resources
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SD Housing. Rental Assistance
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SDHDA. Homebuying With a Disability
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South Dakota Dakota at Home. Social Security Disability Insurance Resources
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Citizens Disability. South Dakota and Social Security Disability
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Urban Institute. SSA Disability Claims Backlog
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South Dakota Investment Council. ABLE Accounts
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Social Security Administration. Spotlight on ABLE Accounts
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Disability Rights South Dakota. Who We Are
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South Dakota Dakota at Home. Disability Rights South Dakota
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Disability Rights South Dakota. Disability Rights South Dakota
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South Dakota Searchlight. Legislators Plan to Learn About Disability Care
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South Dakota Legislature. Senate Bill 15
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South Dakota Legislature. Bills Vetoed by Governor – 2026 Session
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National Health Law Program. Texas and Eight Other States Renew Attack on Section 504
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Disability Rights Education and Defense Fund. First Amended Complaint – Texas v. Kennedy
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South Dakota Legislature. DHS FY 2027 Governor’s Budget Recommendation