This spring and summer seasons have flown by at lightning speed in my household. I’ve treasured every moment with my family between my personal job and working for you on the Community Support Providers State and Federal Efficiencies Interim Committee, Interim Appropriations Committee, the Special Session for the Prison Project, and other issues that have arisen in our district. I would like to give you a brief recap on the conclusion of the Community Support Providers Committee that I served on.

We held three meetings for the Community Support Providers State and Federal Efficiencies Interim Committee between June 18th and September 9th. Right now, you may be thinking, ‘what is a Community Support provider?’ Community Support Providers, or “CSPs” for short, partner with the State to fulfil our Constitutional duty to care for those who are intellectually or developmentally disabled. We are blessed enough to have one in District 21! Community Connections Inc in Winner does a phenomenal job. In South Dakota, within the Department of Human Services (DHS), there is the Division of Developmental Disabilities (DDD). The DDD is tasked with administering the services that are largely funded by Federal Medicaid dollars through waivers. There are several different waivers that South Dakota has, and I would like to touch on just a few of them. These services are important to give people utilizing them the best opportunity to stay in our communities and find their niche with the least amount of restrictive care possible, depending on each individuals needs. Family Support 360 gives support to family or at home caregivers to ensure the least restrictive care possible. The CHOICES waiver is what a lot of CSPs are funded by, with individuals receiving day, residential, or employment services, to foster the most independent life possible. The third waiver is the ICF waiver, which is utilized by children or adults who need more intensive care, with the hope of building independence. It is vital that caregivers are supported and funded to keep as many individuals out of institutions as possible and help them build skills to be part of their community. This Summer Study was created to address areas where efficiencies could be found within the framework of the current system. With it being 84.66% Reliant on Medicaid funds currently, and the current rate methodology that was implemented in FY2024 and funded at 100% dropping to 98% funding now in FY25, we need to conservatively and responsibly address some issues. The SDDC, which is the state institution costs us $886/person/ day, while CSPs average about $236.65/person/day. Not only is it a humanitarian responsibility to keep as many people out of an institution and living as independently as possible, it is a conservative one.

The committee concluded with three recommendations: 1. Recommend that DHS collaborate with CSPs, case management organizations, families, and other stakeholders to update the guidance document CHOICES Case Managers & CSPs Roles & Responsibilities. 2. Recommend that the DHS work with CSPs, case management organizations, families, and other stakeholders to address and reduce overlaps and redundancies between state policy reviews and Council of Quality and Leadership (CQL) accreditation. 3. Recommend that the DHS include, either through a waiver amendment or during the next renewal cycle for the CHOICES waiver, a day rate for day services in addition to the current fifteen-minute billing rate option. Additionally, a unanimous vote approved Draft 141, which is a bill the committee will recommend during session to establish a legislative oversight committee to ensure our recommendations are carried out and kept in mind for future legislative bodies. The committee also voted to send a letter to our federal delegation expressing concern over two federal rules—the HCBS Settings Rule and proposed Medicaid Access Rule updates—which are barriers to implementing cost-effective care while maintaining high standards. This committee highlighted one of many areas where government rules and regulations, though well intentioned, drive up administrative costs and require more workforce to produce equivalent care for the individuals being served. If you are ever in Winner, stop by Community Connections Inc and say hi to the folks there, get involved, and most of all give a great big thank you to the wonderful people who work day in and day out to provide the highest quality care for a modest wage while jumping through all of the governments burdensome hoops!

I pray the Lord will bless and keep each of you, -Senator Mykala VoitaMykala. Voita@sdlegislature.gov