Meant for people opening an addiction or mental health program in South Dakota, adding a level of care to a program already running, or working out which of the state’s two departments their file will sit with.
Additional South Dakota Licensing Guides
- South Dakota Drug and Alcohol Inpatient Treatment Licensing
- South Dakota Drug and Alcohol Outpatient Treatment Licensing
- South Dakota Mental Health Inpatient Licensing
- South Dakota Mental Health Outpatient Licensing
- South Dakota License Reinstatement
A State That Accredits Programs and Names the National Accreditors in Its Code
The statute and rule language in this section was read on the South Dakota Legislature’s official site. Any conclusion we draw from that text is flagged as ours.
South Dakota does something few states do. Its substance use disorder statute, SDCL 34-20A-2, defines an “accredited prevention or treatment facility” so that it reaches an agency holding accreditation from The Joint Commission, from CARF (the Commission on Accreditation of Rehabilitation Facilities) or from the Council on Accreditation (COA), along with one that passed an Indian Health Service quality assurance review. The condition is paperwork: proof of the accreditation, with its recommendations, progress reports and related correspondence, has to be “submitted to the department in a timely manner.” Then SDCL 34-20A-44, which tells the Department of Social Services to inspect accredited facilities, adds a sentence that sets those four routes apart: “This section does not apply to facilities accredited by the Joint Commission, the Commission on Accreditation of Rehabilitation Facilities, an Indian Health Service’s quality assurance review under the Indian Health Service Manual, Professional Standards-Alcohol/Substance Abuse, or the Council on Accreditation.”
That exemption has a limit written right after it. SDCL 34-20A-44.1 keeps the department’s “right of access to all facility premises and relevant records to monitor compliance or investigate complaints” at a nationally accredited facility it does not have to inspect. The DSS rules in ARSD 67:61:02 never mention national accreditation, and neither the department’s portal nor its provider page explains how it handles a CARF or Joint Commission program in practice. So we would not promise anyone a South Dakota operation with no state visit. What the statute does give a nationally accredited program is a recognized status and a narrower inspection duty.
The other surprise is the verb. The DSS Office of Licensing and Accreditation says it “accredits Behavioral Health Providers” offering substance use disorder treatment and prevention programs and community mental health centers. It does not license them. The rule reads “may apply,” and our reading of the full SDCL 34-20A chapter is that it never makes DSS accreditation a condition of running an outpatient program. Accreditation is what the state keys everything else to, though: approval for insurance purposes under SDCL 58-18-7.1 (through 34-20A-2.1) and civil commitments, which a court orders to an “appropriate accredited treatment facility” (34-20A-77). Residential care works differently. The Department of Health licenses inpatient chemical dependency treatment facilities and hospitals, and running one without that license is a Class 1 misdemeanor under SDCL 34-12-18.
Primary Regulatory Agencies
Each role below is described in the words the agency or its governing statute uses.
- South Dakota Department of Social Services (DSS), Office of Licensing and Accreditation, which accredits substance use disorder treatment and prevention programs under ARSD 67:61 and community mental health centers under ARSD 67:62, and monitors compliance with those rules. The DSS Division of Behavioral Health provider page sends applicants to the same portal
- South Dakota Department of Health (DOH), Office of Health Facilities Licensure and Certification, which licenses hospitals under ARSD 44:75 and inpatient chemical dependency treatment facilities under ARSD 44:78, both under SDCL chapter 34-12
- South Dakota Board of Addiction and Prevention Professionals (BAPP), which credentials addiction counselors and prevention specialists under SDCL 36-34 and ARSD 20:80
- Board of Examiners for Counselors and Marriage and Family Therapists, which licenses professional counselors (LPC and LPC-MH) and marriage and family therapists
South Dakota Behavioral Health Licensing Snapshot
Row by row, this restates the statutes and rules named in it.
| Primary SUD Regulator | DSS Office of Licensing and Accreditation (accreditation under ARSD 67:61) |
| Mental Health Facility Oversight | DSS accredits community mental health centers (ARSD 67:62). DOH licenses hospitals, including psychiatric care, under ARSD 44:75. DSS designates Appropriate Regional Facilities for involuntary holds (ARSD 67:63) |
| Residential Treatment | DSS accreditation plus a DOH license, because ARSD 67:61:10:03 says each residential facility “seeking accreditation or providing services must be licensed pursuant to article 44:78” |
| Outpatient Treatment | DSS accreditation for early intervention, outpatient and intensive outpatient programs, plus day treatment. We read the rule’s “may apply” wording as making accreditation optional, though state approval for insurance purposes and court commitments both depend on it |
| Withdrawal Management | Clinically managed residential detoxification (ARSD 67:61:17) and medically monitored intensive inpatient treatment (ARSD 67:61:18), both DSS service classes |
| Facility License Required | Yes from DOH for any facility giving a structured inpatient program for alcoholism or drug abuse (SDCL 34-12-1.1, 34-12-2) and for hospitals. No state facility license for outpatient programs or private mental health practices that we found |
| Certificate of Need | None. DOH’s 2025 moratorium report says the state repealed CON in 1988. Only a nursing facility bed moratorium remains |
| National Accreditation | Joint Commission, CARF, COA and IHS-reviewed facilities count as accredited under SDCL 34-20A-2 and fall outside DSS’s statutory inspection duty (34-20A-44), with DSS keeping access rights (34-20A-44.1) |
| Survey and Certificate Length | Provisional accreditation for six months, then a comprehensive survey. Renewal certificates run three years at 90 percent compliance or higher and two years at 70 to 89 percent. Below 70 percent means probation |
| State Fees | DOH annual license for a chemical dependency treatment facility: $150 (16 beds or less), $300 (17 to 50), $450 (51 or more). Hospitals: $1,000 to $5,000 by bed count (SDCL 34-12-6). We found no DSS accreditation fee schedule |
| Key Regulations | SDCL 34-20A and ARSD 67:61 (SUD), SDCL 27A-5 and ARSD 67:62 (community mental health centers), SDCL 34-12 with ARSD 44:78 and 44:75 (DOH facilities), ARSD 67:63 (Appropriate Regional Facilities), SDCL 36-34 and ARSD 20:80 (addiction counselors) |
Which Department Touches Which South Dakota Program
This grid is our own arrangement of the rules. No state document puts the two departments side by side.
| Program | DSS (accreditation) | DOH (license) |
|---|---|---|
| Early intervention, outpatient and intensive outpatient SUD | ARSD 67:61:12 to 67:61:14 | None |
| Day treatment | ARSD 67:61:15 | None unless residential services are attached |
| Clinically managed low-intensity residential | ARSD 67:61:16 | Yes under 67:61:10:03, though 44:78 describes only Level III.7 (confirm with DOH) |
| Clinically managed residential detoxification | ARSD 67:61:17 | Same open question as low-intensity residential |
| Medically monitored intensive inpatient | ARSD 67:61:18 | Yes, ARSD 44:78 (Level III.7) |
| Community mental health center | ARSD 67:62 | None |
| Private outpatient mental health practice | None found | None found. Clinicians hold individual licenses |
| Psychiatric hospital or unit | None | Yes, hospital license under ARSD 44:75 |
South Dakota’s rules borrow ASAM’s program names without citing ASAM in the eligibility sections we read, and the DOH rule is the only place a level number shows up (“Level III.7”). A residential program that wants a level an outsider can verify has a separate route in CARF’s ASAM Level of Care Certification, which covers adult residential Levels 3.1, 3.5 and 3.7. South Dakota has no separate 3.5 service class, so by our reading the fit is 3.1 for low-intensity residential and 3.7 for medically monitored intensive inpatient. The CARF and ASAM pages describe residential levels only and say nothing about withdrawal management, so a residential detox program should not expect this certification to cover it. The certification will not appear on a DSS certificate or DOH license, and nothing we read requires it. A referral coordinator can still confirm it through CARF’s provider search, which filters on “ASAM Level of Care 3.7” and 3.1.
Programs Covered
- Outpatient and intensive outpatient substance use disorder treatment, including early intervention
- Day treatment
- Clinically managed low-intensity residential treatment
- Clinically managed residential detoxification and medically monitored intensive inpatient treatment
- Community mental health centers and private outpatient mental health practices
- Psychiatric hospitals and hospital psychiatric units
Key Licensing Requirements
Drawn from ARSD 67:61, 67:62 and 44:78 and the two departments’ own application pages.
- An inquiry through the DSS “Become a Provider” form, after which DSS supplies accreditation application forms on request (ARSD 67:61:02:04)
- A complete application, because ARSD 67:61:02:04 has DSS return an incomplete one without considering it
- For residential SUD and hospitals, a written request to DOH, which sends application forms “when eligibility for licensure or certification is evident,” and a building that meets construction, electrical and plumbing requirements for its use
- Policies and procedures written to the current ARSD 67:61, which DSS approves “as part of the accreditation process” (67:61:02:05)
- Counselors holding BAPP certification or licensure, or recognition as a trainee or supervisee, before they perform any addiction counseling (67:61:05:03)
- Proof of any Joint Commission, CARF or COA accreditation sent to DSS on time, if you rely on SDCL 34-20A-2
Frequently Asked Questions
What does it cost to get licensed in South Dakota?
The state’s own charges are small. A DOH-licensed chemical dependency treatment facility pays an annual fee of $150 for 16 beds or less, $300 for 17 to 50 and $450 for 51 or more (SDCL 34-12-6). A hospital pays $1,000 to $5,000 a year depending on beds. SDCL 34-20A-27 lets DSS set fees for its inspections, but we found no fee schedule for DSS accreditation. Payroll and the building are where the money goes, and the staffing answer below puts numbers on the first of those.
How long does South Dakota licensing take?
No rule sets a start-to-finish clock, so these are our estimates: about 4 to 8 months for an outpatient SUD program and 9 to 15 months for residential. The rule-based pieces are a provisional accreditation that lasts six months (extendable up to three more with DSS approval), a comprehensive survey before it ends, a survey report within 30 days, and a plan of correction 30 days after that. Residential adds DOH licensure and its building and fire safety review on top.
What catches South Dakota applicants off guard?
Treating DSS accreditation as the whole job for a residential program. ARSD 67:61:10:03 sends every residential facility to DOH for a 44:78 license as well, and the DOH rule text describes only Level III.7, so a low-intensity residential or detox operator needs DOH’s answer on its own site early. The second is working from old rule text. Several ARSD 67:61 sections changed on July 1 and October 11, 2026, and the incident rule 67:61:02:21 is now titled Event notification.
Can you guarantee a South Dakota accreditation or license?
No. DSS scores the comprehensive survey and DOH inspects the building, and neither answers to us. What preparation changes is the starting score: policies written to the current ARSD 67:61, a staff roster that already meets BAPP credential rules, and a DOH file opened before the lease is signed.
How many staff will a South Dakota program need at opening?
South Dakota’s substance abuse, behavioral disorder and mental health counselors earn a $53,650 median according to BLS (OEWS, May 2025), short of the $59,350 national figure, and half of the state’s counselors earn between $45,650 (25th percentile) and $62,660 (75th percentile). Our arithmetic puts a three-counselor team at $160,950 a year at that median, and that is before a clinical director, a medical director agreement or benefits. South Dakota’s rules let you build that team before everyone holds a full credential. ARSD 67:61:05:03 allows an addiction counselor trainee or supervisee who has BAPP recognition to perform counseling, and the 2026 changes to SDCL 36-34 added supervisee titles. A Licensed Addiction Counselor acting as clinical director, supervising recognized trainees and supervisees at reduced wages while they log the supervised hours their next BAPP credential calls for, commonly lands counselor payroll 40 to 60 percent lower than a roster where everyone is fully credentialed. On the nursing side, residential medication administration runs under a registered nurse’s supervision (67:61:08:06), so pairing one RN with several LPNs runs cheaper than staffing nurses at the RN level only. Your levels of care and census set the final count.
Licensing
Is DSS accreditation required to open an outpatient SUD program?
We found nothing in SDCL 34-20A or ARSD 67:61 that makes it a condition of operating. ARSD 67:61:02:03 says an agency “may apply,” and 67:61:02:04 frames the application as one for an agency “seeking to operate an accredited” program. On that wording we treat accreditation as voluntary. Insurance approval under SDCL 58-18-7.1 and civil commitments under 34-20A-77 both hinge on it, though, which gives a program good reason to pursue it. We would not tell anyone it is illegal to operate without it, and we would not tell them it is safe to skip, either. Ask DSS how it views your model before you open.
Does a Joint Commission or CARF accreditation replace DSS accreditation?
By statute, a facility accredited by The Joint Commission, CARF, COA or an IHS review counts as an “accredited prevention or treatment facility” once proof goes to DSS (SDCL 34-20A-2), and it falls outside the department’s inspection duty (34-20A-44). The department still keeps access to the premises and records for monitoring and complaints (34-20A-44.1). How DSS handles that status day to day is not written in its rules. Call the Office of Licensing and Accreditation (605.773.3165) and get its expectations for your program on record before you rely on that status.
How do I start a DSS application?
Through the Office of Licensing and Accreditation constituent portal, whose inquiry form is for anyone wanting to “inquire about becoming a licensed or accredited program.” There is no downloadable application posted. Mail goes to 700 Governors Drive, Pierre, SD 57501. The Division of Behavioral Health takes questions at 605.367.5236 and dssbh@state.sd.us.
Facility
Which residential programs need a Department of Health license?
SDCL 34-12-2 bars running a health care facility without a DOH license, and 34-12-1.1 counts a “chemical dependency treatment facility,” meaning “any facility that provides a structured inpatient treatment program for alcoholism or drug abuse,” as one. DSS’s ARSD 67:61:10:03 points the same direction for every residential facility. The DOH rule itself, ARSD 44:78:01:10, describes its facilities only as “Level III.7 medically-monitored intensive inpatient treatment programs.” Our reading is that low-intensity residential and residential detox sites should plan on a DOH license too, but DOH’s page does not say so. Julie Jenssen (605-773-3901) in the Office of Health Facilities Licensure and Certification is the person to settle it with.
Is there a Certificate of Need?
No. DOH’s November 2025 nursing facility moratorium report says the moratorium was enacted in 1988, “the same year the state’s Certificate of Need was repealed.” The moratorium covers nursing facilities, and we read nothing in it that reaches hospitals or chemical dependency facilities.
What does DOH inspect at a 44:78 facility?
The rule lists “licensure, physical environment and safety, fire safety, construction standards, and accessibility.” ARSD 44:78:03:02 adds a staffing floor: two staff members on duty at all times, and in a multilevel building at least one on every floor where beds are occupied.
Staffing
What does a Licensed Addiction Counselor need in South Dakota?
BAPP’s rules were rewritten effective October 11, 2026, and the new chapters set the bar. ARSD 20:80:15:10 calls for a master’s degree in a behavioral science field plus at least three semester hours in each of a list of addiction-specific courses. Under 20:80:16:03 the applicant needs 2,000 hours of work experience in a related field, at least 100 of them under a board-approved plan of supervision and at least 100 in each of the twelve core functions. Section 20:80:17:03 then requires a passing score on one of the listed exams, such as the IC&RC Alcohol and Drug Counselor Examination. BAPP’s licensing page still describes the older requirements, so go by the rule. BAPP’s renewal page says Certified Addiction Counselors, Licensed Addiction Counselors and Certified Prevention Specialists renew every two years, with the next cycle opening October 1, 2027.
What did the 2026 counselor law change?
HB 1029, signed February 17, 2026 and requested by BAPP itself, revised SDCL 36-34. The codified sections now carry SL 2026, chapter 163, which we take to be that bill. It added peer support specialist and supervisee titles and wrote fee amounts into SDCL 36-34-13, including a $50 application fee and a $400 renewal fee for CAC, CPS and LAC credentials. With no effective date in the act, the general rule in SDCL 2-14-16 points to July 1, 2026. BAPP’s rewrite of its own rules, ARSD 20:80, took effect October 11, 2026 (53 SDR 40), replacing chapters 20:80:01 to 20:80:10 with new chapters 20:80:11 to 20:80:21.
Does a residential program need nurses on site around the clock?
Not under the rules we read. ARSD 67:61:04:09, amended effective October 11, 2026, requires medically monitored intensive inpatient programs to operate around the clock and says “Nursing staff must be on-call twenty-four hours a day, seven days a week.” Low-intensity residential programs must keep a staff member trained in first aid and CPR on duty at all times and a counselor, supervisee or trainee available eight hours a day, five days a week, plus on call.
Operations
What has to be reported to DSS after an incident?
Under ARSD 67:61:02:21, now titled “Event notification,” an accredited agency has 24 hours to report a client death that the client’s illness or underlying condition does not primarily explain, as well as permanent harm, severe temporary harm or any intervention needed to keep a client alive, and a follow-up is due within 72 hours. The rule wants fires, evacuations and utility losses reported as soon as possible, along with any critical equipment that stays down past 24 hours. Community mental health centers follow the parallel rule, 67:62:02:19. A DOH-licensed facility has separate duties to DOH on top of these.
Does South Dakota require programs to offer medication for opioid use disorder?
We found no rule in the ARSD 67:61 sections we read that requires it. Buprenorphine prescriptions need only a standard DEA registration under DEA’s January 12, 2023 letter, and the prescriber also needs a South Dakota controlled substance registration. Opioid treatment programs are outside this guide, so a program that wants methadone available for clients coordinates with a separately licensed OTP.
Enforcement
What happens when a survey score comes in low?
Below 70 percent compliance, DSS places the agency on probation for up to six months under ARSD 67:61:02:08. The agency cannot accept new clients until its plan of correction is approved (67:61:02:13), and a final survey decides between a one-year certificate, suspension and revocation.
Can a South Dakota accreditation decision be appealed?
Yes. A suspension or revocation notice starts a 15-day clock before it bites, and the agency has the same 15 days to ask in writing for reconsideration. An appeal to the DSS secretary must go by certified mail within 15 days and request a fair hearing under SDCL chapter 1-26. ARSD 67:61:02:18 sets that hearing within 45 days of the request. The full path back after a revocation is covered in South Dakota License Reinstatement.
What’s Included and What Isn’t
What we help with in South Dakota
Preparing ARSD 67:61 and 67:62 accreditation applications and policies, opening the DOH file for a residential or inpatient site, readying a program for the DSS comprehensive survey, and preparing for Joint Commission or CARF accreditation where the SDCL 34-20A-2 route makes sense.
What falls outside that scope
We do not handle CMS, Medicare or Medicaid enrollment, billing or state funding contracts, and we do not do marketing. If you need help on that side, ask and we can suggest where to look.
Author: A. Ant, CADC-II, Licensing & Accreditation Expert
Disclaimer: This content is provided for general informational purposes only and should not be construed as legal, regulatory, or licensing advice. Requirements change frequently. Consult qualified professionals for guidance specific to your situation.
Sources
- SDCL chapter 34-20A, including 34-20A-2, 2.1, 27, 44, 44.1 and 77: SDCL 34-20A (checked October 15, 2026)
- SDCL chapter 34-12, including 34-12-1.1, 34-12-2, 34-12-6 and 34-12-18: SDCL 34-12 (checked October 15, 2026)
- ARSD 67:61:02 (accreditation, event notification, enforcement): ARSD 67:61:02 (checked October 15, 2026)
- ARSD 67:61:04 (staffing and hours of operation): ARSD 67:61:04 (checked October 15, 2026)
- ARSD 67:61:05:03 (counselor qualifications): ARSD 67:61:05 (checked October 15, 2026)
- ARSD 67:61:08 (medication control in residential programs): ARSD 67:61:08 (checked October 15, 2026)
- ARSD 67:61:10:03 (residential facilities licensed under 44:78): ARSD 67:61:10:03 (checked October 15, 2026)
- ARSD article 67:61, chapter list (service classes 12 to 18), via Justia: ARSD 67:61 (checked October 15, 2026)
- ARSD 67:62:02 (community mental health center accreditation and event reporting): ARSD 67:62:02 (checked October 15, 2026)
- ARSD article 44:78 (inpatient chemical dependency treatment facilities): ARSD 44:78 (checked October 15, 2026)
- ARSD 44:75:01 (hospital licensure, including the 44:75:01:01 facility definition): ARSD 44:75:01 (checked October 15, 2026)
- ARSD 67:63:03:05 (Appropriate Regional Facilities): ARSD 67:63:03:05 (checked October 15, 2026)
- SDCL 36-34 as amended by SL 2026, chapter 163, and HB 1029 action log: SDCL 36-34 and 2026 HB 1029 (checked October 15, 2026)
- SDCL 2-14-16 (effective date of acts): SDCL 2-14-16 (checked October 15, 2026)
- ARSD article 20:80 (addiction and prevention professionals, as amended 53 SDR 40, effective October 11, 2026), including 20:80:15:10, 20:80:16:03 and 20:80:17:03: ARSD 20:80 (checked October 15, 2026)
- DSS Office of Licensing and Accreditation: Behavioral Health and Become a Provider inquiry (checked October 15, 2026)
- DSS Division of Behavioral Health: Providers and Staff Directory, February 2026 (PDF) (checked October 15, 2026)
- DOH, Healthcare Facility Licensure and contacts: Healthcare Facility Licensure and Contacts (checked October 15, 2026)
- DOH, 2025 Nursing Facility Moratorium Report (CON repeal): Moratorium report (PDF) (checked October 15, 2026)
- DOH, Controlled Substance Registration: Controlled Substance Registration (checked October 15, 2026)
- BAPP: Board home, Licensing and Renewal (checked October 15, 2026)
- Board of Examiners for Counselors and Marriage and Family Therapists: FAQ (checked October 15, 2026)
- DEA Diversion Control Division, Dear Registrant letter, January 12, 2023: DEA letter (PDF) (checked October 15, 2026)
- CARF, ASAM Level of Care Certification: Level of Care Certification (checked October 15, 2026)
- ASAM, Level of Care Certification: ASAM Level of Care Certification (checked October 15, 2026)
- CARF provider search: Find a Provider (checked October 15, 2026)
- U.S. Bureau of Labor Statistics, OEWS May 2025, SOC 21-1018: South Dakota OEWS and national estimates (checked October 15, 2026)