Lynne A. Valenti
Cabinet Secretary

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Adult Foster Care

Adult Foster Care homes provide room, board and general supervision of personal care services in a family home. Adult Foster Care can meet the needs of adults who require periodic or regular assistance with activities of daily living, but do not require nursing services. Examples of "activities of daily living" include: dressing, bathing, eating, brushing teeth, or combing hair.

Adult Foster Care homes may serve Individuals who pay privately for services and individuals who are supported by state payment. The Department of Social Services is responsible for case management services to individuals age 60 and over and receiving state payment. If the individual is under the age of 60, the Department of Human Services' Division of Developmental Disabilities is responsible for payment and case management.

Individuals Appropriate for Adult Foster Care

  • Oriented to time, person and place and not a danger to themselves or others in the adult foster care home.
  • Unable to live independently.
  • Require minimal supervision and/or assistance in completing one or more of the following: dressing, personal hygiene, transportation, ambulation, nutrition, health supervision.
  • Capable of taking action for self-preservation in case of fire or storm with direction.
  • Usually has control of bowel and bladder, but may have stress incontinence and/or capable of meeting their own needs when incontinent.

Individuals Not Appropriate for Adult Foster Care

  • Consistently not oriented to time, person and place to such a degree they pose a danger to themselves or others in the home.
  • Unable or unwilling to meet own personal hygiene needs under minimal supervision.
  • Has a communicable disease or infectious condition which pose a threat to the health or safety of other residents of the home.
  • Chronically disruptive and unable or unwilling to comply with adult foster care rules.
  • Behavior poses a threat to other residents.
  • Unable to self-medicate on one's own or with the assistance of supervision or monitoring.
  • Require a complex, therapeutic diet.
  • Require any other type of care which can only be provided safely by or under the supervision of a licensed practical nurse or a registered nurse.


Adult Foster Care providers must provide the following services and items:

  • shelter,
  • at least three meals a day,
  • assistance with personal care,
  • companionship,
  • assistance with activities of daily living,
  • expendable items used by the clients in small quantities such as facial and toilet tissue and personal items such as towels and soap, laundry services, non-medical transportation and socialization.


The the Department of Social Services Medical Review Team must determine an individual is in need of Adult Foster Care Level of Care.

Licensure Requirements

South Dakota law SDCL 28-1-45 (13) requires Adult Foster Care providers to be licensed if they receive reimbursement from state funds. The purpose for licensing these homes is to ensure a safe environment by establishing minimum standards designed to prevent unsanitary living conditions, exploitation and neglect. The Department of Health's Office of Licensure and Certification is responsible for licensing Adult Foster Care homes. The Administrative Rules for licensure of Adult Foster Care are located in Chapter 44:04:19.