Provider Resources

Visit the Accreditation page for more information

Accreditation Resources

If you are interested in becoming, and not currently accredited, please email your request to DSSLicAccred@state.sd.us.

If you are an accredited agency looking to renew your accreditation, please complete the Accreditation Renewal Application.

Financial Eligibility FAQ

Fillable Form Instructions

Multi-Program Eligibility Chart

Forms

• 102a Hardship Consideration Form
• 102b Hardship Consideration Form
• Federal Poverty Level Guidelines
• Financial Eligibility Fillable Form | Printable
• Hardship Consideration Refusal Form

Mental Health Services

• IMPACT Application

Substance Use Services

• 3rd Party Release of Information (ROI)
• Substance Use Disorder High Intensity Referral Form

Visit the Indigent Medication Page

Indigent Medication Resources

• Application | Printable
• Update - Extension Request Form | Printable
• Participating Pharmacies and Clinics

STARS Launchpad

STARS Resources

• STARS Billing Manual
• STARS Companion Guide
• STARS User Manual
• STARS Online Tutorial

• FY22 Data Collection and Billing Guidelines
• FY22 Prevention Reimbursement Guidelines
• Impact (MOSAIX) User Guide
• Participant Level Instrument

Behavioral Health Treatment Outcomes Program Manual

FY24 Access to Services Guide

South Dakota Administrative Rules

• Chapter 67:61 Substance Use Disorders
• Chapter 67:16:48 Covered Medical Services – Treatment of Substance Use Disorders
• Chapter 67:62 Mental Health
• Chapter 67:16:13 Covered Medical Services – Community Mental Health Centers Services
• Chapter 67:63 Appropriate Regional Facilities 

South Dakota Codified Laws

• Chapter 27A Mentally Ill Persons
• Chapter 34-20A Treatment and Prevention of Alcohol and Drug Abuse

Resources

• Addiction Technology Transfer Center
• Great Plains Telehealth Resource and Assistance Center
• Helpline Center Professional Training Calendar
• Mental Health Technology Transfer Center
• Prevention Technology Transfer Center
• South Dakota Suicide Prevention
• SAMHSA Guidance on Harm Reduction

The Behavioral Health Voucher Program (BHVP) for Child Care Providers (CCP) through 605 Strong was designed to serve employees of South Dakota licensed and registered child care providers with mental health services. There are 17 clinics participating in the program. The program runs from August 1, 2023, through September 30, 2024 or sooner if all funding has been successfully allocated.

Contact Sage Project Consultants, Contracted BHVP Program Administrator, for more information.

Program Processes for Enrolled Providers

• Access the portal to issue a voucher by contacting: vouchers@sageprojectconsultants.com
• BHVP Quality Service Review Policy
• BHVP Treatment Protocols

Initial Appointment/Assessment Information
The forms below are downloadable and required for BHVP CCP clients. The forms specifically comply with the BHVP CCP and its funding source. Electronic versions of these forms are allowed.

• Consent Form for Adults
• Procedure for Informed Consent
• Release of Information

Data Collection
Data Collection is required at initial appointment/intake and discharge.

• Online Form
• Paper Form
  • Intake
  • Discharge

Receipt and Invoice Information

• Voucher Receipt Form
• Treatment Services Rate Sheet

• Submit invoices to: vouchers@sageprojectconsultants.com