Respite Care in South Dakota: A 2026 Guide for Family Caregivers

If you are caring for an aging parent or spouse in South Dakota and running on empty, funded respite care can give you a real break without draining your savings.

Caregiving takes a quiet toll on your own health. Federal data from the U.S. Centers for Disease Control and Prevention (CDC) show that nearly 1 in 5 family caregivers reports fair or poor health, and depressive symptoms are roughly twice as common among caregivers as in the general population. Respite is not stepping away from the person you love. It is often what makes it possible to keep caring for them at home.1

In South Dakota, funded respite for family caregivers comes from four main places: Medicaid personal care and HOPE Waiver respite through the Department of Social Services (DSS), free grants through the National Family Caregiver Support Program (NFCSP) via the state's 10 Area Agencies on Aging (AAAs), the Department of Veterans Affairs (VA) for veterans' families, and adult day or short-term facility respite arranged through your AAA. The fastest route to what you qualify for is the statewide South Dakota Elder Care line at 1-866-854-5465.2

In This Guide

• Key Takeaways
• Does South Dakota Medicaid Pay for Respite Care?
• Funded Respite Options in South Dakota
• What Respite Care Costs in South Dakota
• When the Free Help Is Capped or Waitlisted
• How to Start in South Dakota
• Frequently Asked Questions
• Learn More

Does South Dakota Medicaid Pay for Respite Care?

Yes. For many South Dakota families the first question is whether Medicaid will cover a break, and it can. South Dakota Medicaid, administered by the Department of Social Services (DSS), Division of Long Term Services and Supports, funds in-home care through two pathways. The Personal Care Services (PCS) state plan benefit covers personal care assistance for Medicaid-eligible adults who need help with activities of daily living, and family members may be eligible as paid personal care providers.2

For adults who need a nursing-facility level of care, the Medicaid HOPE Waiver (Home and Community Based Options and Person-Centered Excellence) goes further: it covers adult day care, personal care, homemaker services, and respite and caregiver services so a family caregiver can rest. People with Alzheimer's disease or a related dementia may qualify if they meet that nursing-facility level-of-care standard. Respite is authorized inside the member's care plan based on assessed need, not paid as a flat statewide amount.2

Whether a spouse specifically may be hired as the paid caregiver depends on the individual's authorized care plan and must be confirmed with DSS at 1-800-597-1603. If you need emergency respite today, call the South Dakota Elder Care line at 1-866-854-5465 or dial 211.2

Funded Respite Options in South Dakota

1. Medicaid PCS and HOPE Waiver Respite

If your loved one is already on South Dakota Medicaid, this is usually the deepest source of funded respite you have. The Personal Care Services state plan benefit covers personal care assistance for Medicaid-eligible adults, and the HOPE Waiver adds adult day care, homemaker services, and respite for members who need a nursing-facility level of care, both administered by DSS. Family members may be eligible as paid personal care providers under either pathway.2

How much you get: Respite is authorized through your loved one's care plan rather than set as a flat statewide amount, so the number of hours depends on assessed need. Ask the DSS case manager what the care plan can include.

How to access: Contact DSS at 1-800-597-1603 to ask about PCS or HOPE Waiver eligibility, family-member hiring rules, and how to have personal care, adult day, or respite services authorized in the care plan.2

Best for: Medicaid-eligible South Dakota families who want scheduled in-home breaks.

2. NFCSP Grants Through South Dakota's 10 Area Agencies on Aging

You do not have to be on Medicaid, or wait for a waiver slot, to get help here. If your income is above the Medicaid line but you are still stretched thin, this is the path built for you. The National Family Caregiver Support Program (NFCSP), funded under Title III-E of the Older Americans Act, flows through DSS Aging Services to South Dakota's 10 regional Area Agencies on Aging, which provide in-home respite, adult day help, caregiver training, and individual counseling.3,2

Who qualifies: Family caregivers of adults age 60 and older; caregivers of any age caring for someone with Alzheimer's disease or a related dementia; and older relatives age 55 and older caring for children under 18. Eligibility turns on your caregiving relationship, and there is no income test for NFCSP respite.3

How much you get: NFCSP funds are limited, and each Area Agency on Aging sets its own respite hours and any per-caregiver caps, so the amount varies by region and is rationed at the local level. Supplemental services are provided on a limited basis. Ask your AAA for its current limit and whether there is a wait.3

How to access: Call the South Dakota Elder Care line at 1-866-854-5465, or the Eldercare Locator at 1-800-677-1116, to reach your regional AAA.6

Best for: Any South Dakota family caregiver, regardless of income, especially while a Medicaid waiver decision is pending. NFCSP is consistently underused statewide.

3. Adult Day Services and Short-Term Facility Respite

If what you need back is a reliable set of weekday hours, adult day is often the answer. Adult day services provide structured daytime care in a community setting, typically 4 to 8 hours per weekday, with meals, activities, supervision, and often nursing oversight. For caregivers of people with dementia, consistent attendance can steady behavior and hand you predictable time to work, rest, or manage the rest of life.7

Short-term facility respite places the care recipient in an assisted living community or nursing facility for days to several weeks. Many South Dakota senior living facilities offer short-stay arrangements; contact facilities in your area for pricing.

Who pays: NFCSP grants through your regional AAA can offset adult day costs; the South Dakota HOPE Waiver covers adult day care within an authorized care plan; long-term care insurance often covers adult day under a home and community-based rider; and private pay is the fallback.2

Finding programs: Call the South Dakota Elder Care line at 1-866-854-5465 or dial 211 for referrals near you.

Best for: Caregivers who need dependable daytime coverage a few days a week.

4. VA Respite for Veterans

If you are caring for a veteran, start here, because the VA benefit can be both generous and fast. Veterans enrolled in VA health care can access respite through their VA medical center, including in-home aide services, adult day health care, and short stays in a VA facility. The Sioux Falls VA Health Care System and the VA Black Hills Health Care System in Hot Springs serve veterans throughout South Dakota.4

PCAFC respite: An approved Primary Family Caregiver in the Program of Comprehensive Assistance for Family Caregivers (PCAFC) receives at least 30 days of respite care per year as part of the benefit, along with caregiver training and counseling. A spouse can serve as the caregiver.4

How to access: Call the VA Caregiver Support Line at 1-855-260-3274, or contact the Caregiver Support Coordinator at the veteran's VA medical center.8

Best for: Families of veterans enrolled in VA health care.

What Respite Care Costs in South Dakota

When no program covers the break, you can still hire help and pay privately, and it helps to know the going rate before you call around. Adult day is usually the most affordable structured option: the national median for adult day health care is $95 per day, about $24,700 a year at five days a week, in the CareScout 2025 Cost of Care Survey. South Dakota rates vary by center, so confirm the daily rate with programs near you.7

Hiring an in-home aide privately runs high in South Dakota. In the CareScout 2025 Cost of Care Survey, a non-medical in-home caregiver in South Dakota had a median cost of about $44 an hour, roughly $101,244 a year at 44 hours a week, well above the national figure. Short-term facility respite is more affordable here: a stay in an assisted living community, a common form of short-term respite, runs about $4,900 a month ($58,800 a year) in South Dakota, among the lowest in the country and below the national median of about $6,200 a month, prorated for a short stay. These are industry-survey medians, not fixed rates, and they rise as care needs grow.9

Knowing these numbers is exactly why the funded options above matter. A few hours of paid respite each week adds up quickly, which is why the Medicaid, NFCSP, and VA paths exist, so the cost does not fall entirely on your family.

When the Free Help Is Capped or Waitlisted

The free routes are not unlimited. NFCSP funds are finite and rationed at each Area Agency on Aging, so your local AAA may cap respite hours or hold a waitlist, and a HOPE Waiver respite authorization can take time to be added to a care plan. Do not wait empty-handed while that plays out.3

Three bridges can cover the gap. First, ask your AAA about the federal Lifespan Respite Care Program, which Congress funds to expand access to short-term and emergency respite; you can also search the National Respite Locator at archrespite.org. Second, use 211 for emergency respite and local referrals when a crisis leaves no time to wait. Third, private pay, at roughly the adult day and facility rates above, can bridge a few weeks until a waiver or grant comes through.10

How to Start in South Dakota

Learn More

Find personalized help navigating respite care options in South Dakota at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.