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developmental disabilities

funding of services

Certified agencies receive funding through state general funds and/or federal funds. The funding sources include:

ICF/IID-Intermediate Care Facility for Individuals with Intellectual Disabilities:

A Medicaid program that provides funding for services to people with developmental disabilities at the South Dakota Developmental Center in Redfield. ICF/IID is based on a medical model with federal requirements regarding safety and sanitation, plan development, professional services, etc.

ICF/IID funding can be used to serve adults and children. This program requires a non-federal match which is usually about 1/3 of the reimbursement rate. Federal regulations are the basis for both financial eligibility and eligibility based on disability. Included in the funding provided by ICF/IID funding is the cost for room and board services.

For more information regarding the Centers for Medicare and Medicaid Services (CMS) ICF/IID information site, please visit the CMS website.

HCBS Waiver-Home and Community Based Service Waiver:

The HCBS program is based on a waiver of federal regulations pertaining to the ICF/IID program. A state must submit and receive approval from the federal government to maintain their HCBS program. South Dakota began participating in this program in 1981. The waiver provides an alternative to the ICF/IID program. All 19 community support providers participate in the HCBS program.

HCBS funding can be used to serve children and adults. This program also requires a non-federal match of approximately 1/3 of the reimbursement rate. People usually use Supplemental Security Income (SSI) for room and board costs. Examples of services that are provided under the HCBS waiver program include case management, training and habilitation services, prevocational training, and supported employment.

CTS-Community Training Services:

CTS is the only funding source available for services that is strictly state general funds. It is the smallest funding program, but also the most flexible. CTS is typically utilized for individuals that need less intensive services or who do not meet the financial eligibility for ICF/IID or HCBS funded services. The three main services that are provided under the CTS program are prevocational training, community living training and expanded follow along/support.

Title XIX/Medicaid:

Title XIX of the of the Social Security Act is commonly referred to as Medicaid. In addition to ICF/IID and HCBS, Medicaid encompasses an array of services including care provided in nursing facilities, health benefits, etc. Eligibility for Medicaid is determined by local Department of Social Services offices. For further information regarding Title XIX/Medicaid, please visit the South Dakota DSS website.

Money Follows the Person:

Money Follows the Person (MFP) is a federal rebalancing demonstration grant aimed at assisting Medicaid-eligible people in transitioning from facilities to their homes and communities. The focus is on building home and community-based service capacity to allow recipients to live in the least restrictive environment.

Purpose of funds: MFP funding provides services that are not otherwise provided through Medicaid. For example, MFP funds can be used to purchase household items or non-medical transportation. The South Dakota MFP Operational Protocol, the document outlining the full MFP project, can be found at

Who is served: South Dakota residents that are Medicaid eligible, have resided in an institutional setting for 90 days or more (nursing homes, ICF/IIDs), and are willing and able to be supported in the community through the provisions of a home and community-based services waiver and additional MFP.