Federal, exists in every state
Medicaid services at home and waiver programs
Home-care waivers pay for approved services when a child meets that waiver’s disability and care rules.
What it is
Home-care waivers pay for approved services when a child meets that waiver’s disability and care rules.
South Dakota’s child-serving waivers require intellectual or developmental disability criteria that leukemia alone does not meet. Medicaid can review skilled nursing through its ordinary benefits and the under-21 well-child rule. The Disabled Children’s Program is an eligibility route, not a waiver.
Waiver rules
- CHOICES requires intellectual or developmental disability and intermediate-care-facility level of care. Family Support 360 requires an examination establishing intellectual or developmental disability.
- Assistive Daily Living Services requires age 18 or older and quadriplegia. HOPE serves adults aged 18–64 with disabilities and people 65 or older.
- CHOICES and Family Support 360 assess qualifying intellectual or developmental disabilities, functional needs and facility-level care. DHS also checks Medicaid eligibility. DHS confirms current openings, waiting lists, priorities, assessment steps, individual budgets and any family charges. Ordinary Medicaid nursing and the Disabled Children’s Program do not require an intellectual or developmental disability.
What you get
- Approved home services when the specific program’s care and eligibility rules are met.
If you decide to apply
- Ask the discharge team which Medicaid service fits your child’s daily care needs.
- Bring a description of the tasks, how often they happen and which need a nurse.
South Dakota Department of Human Services: CHOICES or Family Support 360; your discharge planner can help
Good to know
A waiver assessment, Medicaid nursing approval and finding an available nurse are separate steps.
Official sources
“Which home-care route fits our child, what are its limits, and could you help us arrange the right assessment?”
Why I’m asking: I want to understand help at home without assuming that leukemia qualifies for a waiver.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Register the child on the list, keep the task log, and answer the assessment call when it comes.
Your social worker
Names the waiver that takes medically fragile children in this state and helps with the registration form.
The care team
Documents the nursing-level tasks and the risk if care stops.
- Who decides
- The state waiver agency after a level-of-care assessment
- Ask your social worker
- “Which home-care program fits my child, and can we register today? Can Medicaid start home-nursing hours while we wait?”
How to apply
First step: Ask the discharge team which state home-care service or waiver fits your child's assessed needs, and how to apply.
- Register on the list this week.
- Ask the Medicaid plan for EPSDT nursing hours while you wait.
- Keep a two-week task log for the assessment.
Where it starts: State application or interest list. Assessment when a slot opens
What to gather
- A two-week log of daily tasks: what, how often, how long
- Doctor's letter naming nursing, equipment or safety needs
- Medicaid ID if the child has one
How long: Application steps, assessment timing and waiting-list availability depend on the specific state program. Ask for its current process.
What a yes looks like
A service plan with approved hours and a case manager's name.
What a no looks like, and the next move
“Does not meet level of care” or “no slot”: ask for Medicaid's rule that a child under 21 gets what is medically needed nursing through the Medicaid plan instead, and stay on the list.
Watch out
- If a suitable waiver has a waiting list, ask how and when to register and how priority is determined.
- For a child already on Medicaid, Medicaid's rule that a child under 21 gets what is medically needed home nursing can start long before a waiver slot opens. Ask for both.
- The assessment considers the child's actual care needs under the specific program's rules. No diagnosis or item of equipment guarantees approval.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 7, 2026.
What it is worth
Nursing hours, respite, personal care, equipment, home changes and a case manager. The value is the approved hours.
Covers: Case management · Respite · Personal care · Nursing (some waivers) · Adaptive equipment · Home and vehicle modifications · Caregiver training
What it costs the family: Medicaid-delivered. Patient liability depends on the state.
The eligibility facts, as published
- State specific
- yes
- Institutional level of care
- yes
- Target population
- medically fragile or technology-dependent children in most states
Decisions this site cannot make: Level of care · Service-plan necessity · Financial eligibility (child-only in institutional-deeming waivers)
Expect friction on: Interest lists · Provider shortages · Reassessment
The trap: Ask which waiver, if any, serves your child's needs and whether it has a waiting list. Request covered Medicaid services separately while any waiver application is reviewed.
What changes by state: Which waiver takes medically fragile children, the list length (Texas runs years), and whether parents' income is ignored.
Where I read this
- Home and Community-Based Services 1915(c) — Centers for Medicare & Medicaid Services, read August 27, 2026
- Full List of Medicaid Waivers and Programs — Kids’ Waivers, read August 27, 2026
- Early and Periodic Screening, Diagnostic, and Treatment — Centers for Medicare & Medicaid Services, read August 27, 2026