South Dakota home care license requirements
Bottom line: No — No license (HB 1138 vetoed 2026); Medicaid via DHS LTSS.
WATCH Watch item: HB 1138 licensing bill vetoed; override failed Mar 30, 2026. Governor directed DOH to develop a new framework.
- License required?
- No
- License / pathway
- No license (HB 1138 vetoed 2026); Medicaid via DHS LTSS
- Fees (initial / renewal)
- N/A (no license)
From the 50-state summary. Fees shown as stated in the state entry; see each entry for conditions, conflicts, and sources.
South Dakota requirements, item by item
Bracketed numbers link to the official sources at the bottom of this page.
Not confirmed in official sources — check with the state agency We could not confirm this item on an official state source during our review, so we did not estimate it.
| Item | What the guide found |
|---|---|
| License required? | Not required / N/A — No. The SD Department of Health states that non-medical providers of in-home care (bathing, light housekeeping, meal preparation) are not regulated by the Department. HB 1138 (2026), which would have created a non-medical home care agency license starting Jan 1, 2027, passed both chambers but was vetoed; the House veto-override vote failed on Mar 30, 2026. [1][2][3] |
| License type / name | No state license. For Medicaid-funded in-home services (homemaker, personal care, adult companion, chore): DHS Division of Long Term Services and Supports (LTSS) enrollment approval and a purchase-of-services contract, then South Dakota Medicaid provider enrollment. [4] |
| Licensing agency | Private pay: none (not regulated by SD DOH). Medicaid pathway: SD Department of Human Services, Long Term Services and Supports (LTSS). [1][4] |
| Agency website | South Dakota Department of Health: https://doh.sd.gov/healthcare-professionals/health-facility-licensure/facility-types/home-health-agencies-hha/ [1] |
| Initial application / license fee | Not required / N/A — No state license, so no license fee. (HB 1138 would have capped a new license fee at $100; the bill did not become law.) [1][2] |
| Renewal fee | Not required / N/A — No state license, so no renewal fee. [1] |
| Renewal cycle | Not required / N/A — No state license. LTSS enrollment chart lists In-Home services with an annual review cycle. [4] |
| Typical approval timeline | No license-processing timeline is stated. For the Medicaid LTSS enrollment pathway, LTSS coordinates an onsite review within 10 business days after the enrollment request is submitted. [4] |
| Administrator qualifications | Not confirmed in official sources — check with the state agency |
| Caregiver background checks | Medicaid LTSS in-home providers must, at minimum, conduct a State fingerprint background check of all employees working directly with participants (an alternative check may be used with State approval). No state requirement for private-pay agencies identified. [5][6] |
| Caregiver training hours | Medicaid LTSS in-home pathway: aides must complete at least 6 hours of training annually; new employees must complete required training within 30 days of hire. No private-pay requirement identified. [5] |
| Registry checks | Not confirmed in official sources — check with the state agency |
| General liability insurance | Not confirmed in official sources — check with the state agency |
| Workers' compensation | Not confirmed in official sources — check with the state agency |
| Bonding (surety / dishonesty) | Not confirmed in official sources — check with the state agency |
| Rule changes 2025–2026 | HB 1138 (2026) "An Act to require the licensure of non-medical home care agencies": passed House 2/19/2026 and Senate 3/5/2026; vetoed by Gov. Rhoden (announced 3/25/2026); House override failed 36-27 on 3/30/2026 (veto sustained). The Governor directed the Department of Health to work with stakeholders on "a more effective framework." [2][3][7] |
Source notes and conflicts
The undated Department of Health page says non-medical in-home providers are not regulated, while HB 1138 text states a new license requirement effective January 1, 2027. Some supplied bill materials describe an Act, but the 304120.pdf facts explicitly say the text does not establish that the bill was enacted. An earlier amendment specified 10 training hours, whereas the later House-engrossed/final bill text specifies 8 hours. Medicaid LTSS requirements are a separate provider pathway, not evidence of a general agency license.
Sources
- Home Health Agencies (HHA) | South Dakota Department of ...
https://doh.sd.gov/healthcare-professionals/health-facility-licensure/facility-types/home-health-agencies-hha/ - SD Legislature – 2026 HB 1138 bill history
https://sdlegislature.gov/Session/Bill/26906 - SD Governor news release, Mar 25, 2026 (veto of HB 1138)
https://news.sd.gov/news?id=news_kb_article_view&sys_id=a9ae1b52977336507fc1b480f053af92 - [PDF] LTSS HCBS Provider Enrollment Manual | South Dakota ...
https://dhs.sd.gov/content/dam/digital/united-states/south-dakota/sdo/pdf/long-term-services-and-supports/provider-portal/hcbs-provider-enrollment/LTSS-HCBS-Provider-Enrollment-Manual.pdf - LTSS Provider Policy Manual
https://dhs.sd.gov/content/dam/digital/united-states/south-dakota/sdo/pdf/long-term-services-and-supports/provider-portal/training/LTSS-Provider-Policy-Manual.pdf - In Home Provider Provisions - South Dakota DHS
https://dhs.sd.gov/content/dam/digital/united-states/south-dakota/sdo/pdf/long-term-services-and-supports/provider-portal/In-Home-Provider-Provisions.pdf - SD Attorney General – 2026 Legislative Summary
https://atg.sd.gov/docs/2026%20Legislative%20Summary.Final%20April%202026.pdf
Limits: fees and forms change often. Agencies sometimes post conflicting figures (a statute vs. an older form); those conflicts are shown, not resolved by guessing. Confirm the current fee with the agency before filing. This guide is a research reference, not legal advice.
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