South Dakota – Medical Homes

Federal Support: On November 21, 2013, CMS approved a Section 2703 health home state plan amendment, creating health homes for Medicaid enrollees with a) two chronic health conditions; b) one chronic health condition and the risk of developing another; or c) one serious mental illness. The SPA became effective as of July 2, 2013. To learn more about Section 2703 Health Homes, visit the CMS Health Homes webpage.

Last Updated: April 2014

Forming Partnerships
In April 2012, in response to a 2011 Final Report from the state’s Medicaid Solutions Workgroup, the South Dakota Department of Social Services convened a Health Home Workgroup to guide the implementation and evaluation of ACA Section 2703 health homes in the state. The South Dakota Health Home Workgroup included legislators, representatives from state government including the Department of Social Services, Department of Health, and Bureau of Human Resources, and other stakeholders representing providers, tribes, the South Dakota State Medical Association, the South Dakota Council of Mental Health Centers, and the South Dakota Association of Health Care Organizations. A full membership list is available on the Workgroup’s website.
The group ended its work in October 2012 after developing two draft models for Health Homes to serve Medicaid enrollees in the state. The first model, led by primary care providers, will serve patients with chronic conditions; the second will be led by Community Mental Health Centers and will serve patients with severe mental illness, emotional disturbance, or substance abuse disorders. South Dakota Department of Social Services also proposed a set of health home outcome measures and a payment model, and has identified a Health Home application process.