Funding of Services
Certified agencies receive funding through state general funds and/or federal funds. The funding sources include:
ICF/MR-Intermediate Care Facility for the Mentally Retarded:
A Medicaid program that provides funding for services to people with
developmental disabilities at the South Dakota Developmental Center
in Redfield. ICF/MR is based on a medical model with federal requirements
regarding safety and sanitation, plan development, professional services, etc.
ICF/MR 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/MR
funding is the cost for room and board services.
For more information regarding the Centers for Medicare and Medicaid Services (CMS)
ICF/MR information site, please visit the CMS website at
HCBS Waiver-Home and Community Based Service Waiver:
The HCBS program is based on a waiver of federal regulations pertaining to the ICF/MR
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/MR 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/MR 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 of the of the Social Security Act is commonly referred to as Medicaid. In
addition to ICF/MR 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