Key issues 2019


The workforce crisis continues in South Dakota and across the nation. At the heart of the crisis, is recruitment and retention of quality direct care staff. The crisis is characterized by high turnover rates, low wages, stressful environments, and demographic changes. Click on the links below to see how the crisis has affected SD providers and a more national perspective on the crisis from the American Network for Community Options and Resources (ANCOR) and the President’s Committee for People with Intellectual Disabilities. The bottom line is that wages matter and the direct care staff that provide these important services deserve a living wage.

Our providers are heavily reliant on Medicaid funding (77.59%) which is a federal and state cost share and private insurance does not cover the critical services we provide. In simple terms, our revenue streams are finite and reliant on a single source of revenue. Providers are also not allowed to adjust reimbursement rates to compensate for economic and labor market fluctuations. Labor market fluctuations and operational costs continually increase and if providers are to stay ahead of the curve, funding adequacy is an absolute necessity. Our reimbursement rates have to match the actual cost of services delivered.

Adequate Funding of Services

All people are susceptible to crisis and the people we provide services to are no different in this respect. What is different, is the individual's and the CSP's ability in accessing quality crisis services. When a person receiving services by a CSP experiences a behavioral or mental illness related crisis, often times they are turned away by the major hospital systems leaving families and CSPs in extremely difficult circumstances. If CSPs are to continue providing community based services, then access to community services is imperative. The alternative is for CSPs to provide crisis care. However, in order for this to occur - reimbursement rates and service infrastructure and capacity will require increases. Simply put, as the funding system continues to erode, so does our capacity.

Crisis Services and Supports