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South Dakota Medicaid Billing and Policy Manual - CHOICES Waiver (Individualized Support Plan / Case Management requirements)

South Dakotasub-regulatorySouth Dakota Department of Social Services (DSS), Division of Medical Services

What this rule requires your agency to do

  • 1The provider/case manager must develop a 24-hour individual back-up plan with paid and natural supports as part of case management services. (CHOICES Waiver Manual, Case Management)(South Dakota Medicaid Billing and Policy Manual - CHOICES Waiver (Individualized Support Plan / Case Management requirements))
  • 2The case manager must provide ongoing monitoring of the participant's provision of services, health, welfare, and the implementation of the participant's ISP at least quarterly. (CHOICES Waiver Manual, Case Management)(South Dakota Medicaid Billing and Policy Manual - CHOICES Waiver (Individualized Support Plan / Case Management requirements))
  • 3The case manager must initiate a comprehensive assessment and periodic reassessment of individual needs to develop, revise, and update the participant's ISP. (CHOICES Waiver Manual)(South Dakota Medicaid Billing and Policy Manual - CHOICES Waiver (Individualized Support Plan / Case Management requirements))
  • 4The ISP team (service coordinator, participant, participant's parent/guardian if applicable, and anyone else the participant desires) must review the plan at least annually, or more frequently as requested by the participant or as circumstances dictate. (CHOICES Waiver Manual)(South Dakota Medicaid Billing and Policy Manual - CHOICES Waiver (Individualized Support Plan / Case Management requirements))

Applies to: home and community-based services (HCBS) waiver, personal care / attendant-type supports for waiver participants

The South Dakota Medicaid CHOICES Waiver provider manual establishes the Individualized Support Plan (ISP) as the person-centered planning document for HCBS participants. It sets requirements for who develops the ISP (case manager and ISP team), the frequency of monitoring and review, comprehensive assessment/reassessment, and a mandatory 24-hour backup plan. These govern plan-of-care/service-plan content and oversight for waiver participants receiving personal care and related supports.

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.