The skyline of South Dakota’s healthcare landscape has changed overnight. In late January 2026, Governor Larry Rhoden signed a historic bill authorizing $189.4 million in federal funding for the Rural Health Transformation (RHT) Program. This isn’t just a budget increase; it is a full-scale digital mandate aimed at bridging the gap between urban centers like Sioux Falls and the frontier communities that define the Mount Rushmore State.
For Home Health Care Providers South Dakota, this influx of capital comes with strings attached namely, a push for universal digital adoption and a significant shift in licensing requirements for non-medical agencies.
1. The RHT Program: Modernizing the Frontier
The Rural Health Transformation Program, funded by the “One Big Beautiful Bill Act,” allocates nearly $380 per rural resident to modernize infrastructure. For decades, rural agencies have struggled with patchy connectivity and outdated record-keeping. That era is ending.
A massive portion of this $189 million is dedicated to “Connecting Technology and Data.” Agencies are now expected to move beyond paper files and into a fully integrated EHR ecosystem. The state’s goal is to ensure that a patient’s data flows seamlessly from a remote home in Harding County to a specialist in Rapid City without a single fax machine involved.
2. HB 1138 and the New Licensure Mandate
Perhaps the most significant legislative change for professionals is House Bill 1138, introduced in the 2026 session. This bill moves to require the licensure of non-medical home care agencies, a sector that previously operated with less formal oversight.
Under these new rules, “non-medical home care services” including companionship, housekeeping, and assistance with daily living now require an official state license. To qualify, owners must provide:
- Proof of Training: Documentation that all aides have completed at least 10 hours of specialized training, including 2 hours dedicated specifically to Alzheimer’s and dementia care.
- Background Checks: Mandatory criminal history checks for all owners and contractors.
- Record Integrity: A requirement to maintain digital records of all services provided, accessible to the Department of Health upon request.
Using a platform like myEZhome care software is no longer just about convenience; it is about having the reporting tools necessary to prove your agency meets these new South Dakota standards during your annual license renewal.
3. High-Tech Care in Low-Connectivity Zones
One of the primary pillars of the South Dakota revolution is the expansion of telehealth and remote monitoring. With the RHT funding, the state is establishing regional “Obstetrics Hubs” and “Spoke Sites” to ensure that maternal care reaches every corner of the state.
For home health agencies, this means your field staff will increasingly act as the “hands” for remote physicians. Documentation must be precise, real-time, and, most importantly, hipaa compliant. In 2026, a breach of patient data isn’t just a fine; it could disqualify an agency from receiving the new rural sustainability grants being distributed by the DOH.
4. Workforce Stability and EVV Integration
South Dakota is also fighting the workforce shortage with $62.5 million of the total fund dedicated specifically to recruitment and retention. This includes tiered sign-on bonuses and relocation stipends for those moving to frontier counties.
However, with increased funding comes increased accountability. The state’s reliance on EVV (Electronic Visit Verification) is at an all-time high. To receive Medicaid reimbursements under the new payment models, agencies must provide high-fidelity data GPS location, exact timestamps, and verified task lists for every single home visit.
5. Preparing Your Agency for the Transformation
The transition to a “Digital South Dakota” requires a mindset shift for agency owners. The state is looking for “facility readiness” when awarding its next round of Quality Grants.
By partnering with myEZcare, agencies can meet the 2026 technology mandates head-on. Whether it is automating the 10-hour training certifications required by HB 1138 or ensuring your telehealth notes are audit-ready, your software should be the engine of your compliance, not a hurdle.
South Dakota 2026 FAQ
Does HB 1138 apply to independent contractors?
Yes. If you provide non-medical home care services for consideration, you generally fall under the new licensure requirements, including the mandatory 10 hours of training.
What is the “One Big Beautiful Bill Act”?
This is the federal legislation passed in 2025 that provided the $50 billion nationwide for rural health, from which South Dakota secured its $189.4 million allocation.
Are there grants available for upgrading my EHR?
Yes. The “Connect Technology and Data” initiative includes funding specifically for “facility optimization” and the adoption of certified electronic health record systems.
Is Alzheimer’s training a one-time requirement?
The current bill requires the training for initial licensure; however, most industry experts expect annual continuing education (CE) requirements to follow as the Department of Health finalizes the rules.
How do the “Obstetrics Hubs” affect home care?
Home care agencies will likely be tapped to provide the “Spoke” services visiting mothers in their homes and using remote monitoring tools to send data back to the central Hub.
