Home & Community-Based Services: State-Only Funded Programs in South Dakota

States may be required to contribute match funding to some federally funded long-term care (LTC) programs and to different extents. In FY 2003 states spent 21.4% of total state expenditure on Medicaid (NASBO, 2004). Total expenditures for HCBS are increasing and totaled $16.4 billion in FY 2001, with states paying between 1.7% and 13.3% of total health care expenditures on HCBS in FY 2001 (Milbank 2003). Medicaid spending grew quickly in the early 2000s, forcing state legislatures and officials to investigate ways to contain Medicaid costs rather than expanding services (Coleman et al 2003).

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Program Name: Long-Term Care Alternatives Program⁴

Administrative Agency: Dept of Social Services

Population Served: Elderly & physically disabled Adults

Annual Expenditure: $2,807,363 FY02 Appropriation

Funding Source: General Revenue

Number of People Served: 1,308 FY02

Eligibility Criteria: No income limit. Nursing home level of care. Income & asset limits. Asset limit FY02 $40,000 (individual)

Further Information: Cost control: Cost caps $850/mth. Service limits: $35/mth rental emergency response system, $35/mth medication management device rental. Co-pay on sliding fee scale. Cost share between the incremental mthly income & cost of a care plan. A $250 expenditure allowed if the household is paying privately for additional services & for medical deductions that exceed $35 in out-of-pocket expenses. Quality control: 6 mth review of clients, annual provider evaluation, meetings with providers and families.

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