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South Dakota Structured Family Caregiving

South Dakota's Structured Family Caregiving program pays family caregivers a daily stipend through the HOPE (Home & Community Based Options and Person Centered Excellence) Medicaid waiver to provide in-home care to seniors and adults with disabilities as an alternative to nursing facility placement. The caregiver must live with the care recipient. Spouses may serve as caregivers. Three payment tiers based on acuity (effective 7/1/2025): Base $80.87/day, Tier 1 $101.09/day, Tier 2 $113.22/day. Minimum 50% must be paid to the caregiver.

Pays family caregivers a tax-free daily stipend for providing in-home care to Medicaid-eligible seniors and adults with disabilities who require a nursing facility level of care. Three payment tiers based on acuity (effective 7/1/2025): Base $80.87/day, Tier 1 $101.09/day, Tier 2 $113.22/day. Minimum 50% of the daily rate must be paid to the caregiver, resulting in approximately $40.44-$56.61/day ($283-$396/week, $1,213-$1,698/month). The caregiver must live with the care recipient. Spouses may serve as caregivers. Available through the HOPE waiver. Income eligibility is determined through Medicaid, not this program directly.

Some details for this program are still being verified. Check the official source for the most current information.

Eligibility

  • Asset limit of $2,000
  • Care recipient must be at least 21 years old
  • U.S. citizenship or qualified immigrant status required
  • Care recipient must have a qualifying disability or need for assistance
  • Caregiver must live with the care recipient
  • Must be a resident of SD
  • Must be Medicaid-eligible
  • No income test required
  • Must require a nursing facility level of care

Services

Pays family caregivers a tax-free daily stipend for providing in-home care to Medicaid-eligible seniors and adults with disabilities who require a nursing facility level of care. Three payment tiers based on acuity (effective 7/1/2025): Base $80.87/day, Tier 1 $101.09/day, Tier 2 $113.22/day. Minimum 50% of the daily rate must be paid to the caregiver, resulting in approximately $40.44-$56.61/day ($283-$396/week, $1,213-$1,698/month). The caregiver must live with the care recipient. Spouses may serve as caregivers. Available through the HOPE waiver. Income eligibility is determined through Medicaid, not this program directly.

How to apply

Apply online or find more information at the official program page.

  • medicaid (depends_on): Care recipient must be Medicaid-eligible
  • hcbs-waivers (companion): SFC is available through the South Dakota HOPE waiver