Elder Care

Caring for older adults is about more than just services. It's about dignity, independence, and honoring lifelong contributions. These are deeply rooted South Dakota values. We believe in strong families, personal responsibility, and taking care of our own. But the reality is that long-term care is expensive—and getting more expensive every year. In South Dakota, the average cost of nursing home care now exceeds $100,000 annually, far beyond what most families can manage on their own.

This year's legislative session took on some significant issues—property tax relief, funding for a new state prison, and the rising need for affordable child care. These big, important challenges deserved serious attention—and they got it.

But running beneath nearly every discussion was a familiar theme: how to keep government efficient, responsive, and within budget. That's a responsibility we take seriously. And as we look ahead, another looming issue will test those values—and if we're not proactive, it could grow into a fiscal and human crisis. That issue is South Dakota's rapidly aging population.

By 2035, nearly 1 in 5 South Dakotans will be 65 or older. That's a full 20% of our population. This isn't just a statistic—it's a reality that touches every single one of us, whether it's a parent, a neighbor, or ourselves.

More seniors mean a greater need for in-home care, transportation, health services, housing, and social connection—especially in rural areas. Many seniors live alone and are socially isolated, which can worsen both physical and mental health outcomes. Health conditions like Alzheimer’s and other dementia related diseases, heart disease, arthritis, diabetes, and mobility issues only increase the demand for long-term care and adaptive services.

Alzheimer's is one of the most urgent and difficult pieces of this broader challenge. More than 18,000 South Dakotans are currently living with Alzheimer's. The disease doesn't just impact individuals—it deeply affects families and caregivers who often step in to provide care. Across our state, there are more than 30,000  caregivers stretched to the breaking point, who provide care to older adults—often without formal training, support, respite or compensation.  The care they provide  is valued at nearly $900 million annually.

That's where the government has stepped in—not to take the place of families, but to ensure no one is left behind. Medicaid is the largest funder of long-term care in South Dakota, helping cover the cost of nursing homes and some home- and community-based services. The program is jointly funded, with the federal government covering about 58% of the total cost. To qualify, seniors must meet strict income and asset requirements—often after spending down a lifetime of savings.

Today, Medicaid accounts for about 21% of South Dakota's state budget, and 43% of that spending goes directly to long-term care. Now consider this: if the federal government reduces its share of the cost, South Dakota would be forced to contribute more to maintain current service levels. That would put pressure on other parts of the budget or risk cuts to care.

And let's be honest—no one wants to deny care to our parents and grandparents. And none of us will want to be denied that care when we need it ourselves.

The challenge we face is balancing compassion with fiscal responsibility. That means having honest conversations now, before we reach a breaking point, and exploring creative ways to care for our aging population while respecting the limits of our resources.

This issue is worth more than a budget line or committee debate. We should consider a more in-depth examination with a summer study of  South Dakota's long-term care model by bringing together families, providers, agencies, and lawmakers to better understand the scope of the problem and explore what's working in other states.

Elder care doesn't begin and end with nursing homes—it's about building systems that support people where they are, with dignity and choice.

The South Dakota Department of Human Services offers a range of programs through its Long-Term Services and Supports (LTSS) division to help older adults live safely and independently. As we look to expand options and raise awareness around elder care, partnering more closely with the Department of Human Services will be key to identifying gaps, strengthening services, and making sure families across the state know what support is available.

Other states already facing these same challenges are testing creative solutions that could offer a roadmap for South Dakota. As we consider our long-term strategy, it's worth looking closely at what's working elsewhere and asking how we can adapt those ideas to fit our communities, budget, and values.

For example, some states have expanded funding for Home and Community-Based Services (HCBS) to reduce waitlists and raise wages for caregivers—helping more seniors stay in their homes rather than move to costly nursing facilities. Others have introduced caregiver tax credits to support unpaid family members who are doing the hard work of caring for loved ones without compensation or training.

There are also promising approaches to affordable senior housing designed to support aging in place. In rural areas like ours, we can learn from states with improved access to transportation and telehealth, meaning seniors don't have to travel long distances to get care or attend appointments.

Some states have incentivized careers in elder care with scholarships, loan forgiveness, and specialized training programs focused on geriatrics and in-home care to address workforce shortages. 

And finally, several states are working to keep people living independently and with dignity through creative building and design of multisector plans for aging that bring together healthcare, housing, transportation, and community design.

South Dakota doesn't need to reinvent the wheel, but we need to start turning it. By studying these efforts and tailoring them to meet our state's needs, we can build a thoughtful, sustainable plan that ensures our aging population is supported in the years ahead.

This wasn't an issue I came into the legislature deeply informed on. But constituents in District 17 helped me see just how serious—and how urgent—this challenge is. Costs are rising, and if we don't act, the quality and availability of care will suffer. We're sent to Pierre to understand and respond to the state's challenges—and this one is too big to ignore.

Let's learn from other states, find practical solutions, and build a plan that works for South Dakota. We need to be bold, collaborative, and grounded in the values that make our state strong.

As we move forward, I want to hear from you. What are your ideas for improving care and supporting South Dakota's aging population? Your voice helps shape how we move forward—because the solutions we need will come from listening, learning, and leading together.

Thank you for allowing me to serve as your representative. Please share your thoughts or concerns. You can reach me at chris.kassin@sdlegislature.gov or by call/text at (605) 670-9698.

To stay informed, you can also sign up for updates at www.chriskassin.com.

I'll continue talking about this every chance I get—and keep working to find solutions that protect our people, our values, and our future.