South Dakota Foster Care Medical, Financial, and Reference Requirements Explained

The paperwork side of South Dakota foster care licensing is where many applicants stall. Not because the requirements are unreasonable — they're not — but because nobody explains exactly what's needed until a caseworker asks for it and you realize you need to schedule a doctor's appointment that's 3 weeks out.

This post breaks down three categories of documentation that are part of every South Dakota foster care application: medical/physical requirements, financial documentation, and reference letters. Get these started early because they're all on the critical path.

Medical and Physical Examination Requirements

Under ARSD 67:42:05, every adult household member aged 18 or older must undergo a physical examination by a licensed physician before a foster home license is issued. The examination serves one purpose: confirming that the adult is free from communicable diseases or physical conditions that would impair their ability to care for a child.

What the physician needs to assess:

The physician fills out a DSS medical form (provided by your licensing specialist) that covers:

• Current physical health status and any chronic conditions
• Confirmation of no communicable diseases (tuberculosis is specifically mentioned; many counties require a TB test, either a skin test or blood test)
• No conditions that would physically prevent caring for a child — significant mobility limitations, conditions requiring extensive ongoing treatment, etc.
• Mental health history: if a household member has a history of mental illness or emotional instability, DSS may require a psychological evaluation in addition to the physical

The form is not a comprehensive medical history. It's a fitness-for-care attestation. Most primary care physicians are familiar with it.

What to schedule:

Make appointments for all adults in the household simultaneously. "Getting physicals scheduled" is one of those tasks that takes 3-6 weeks if you call your doctor's office cold. Schedule within the first week of starting the licensing process.

If a household member doesn't have a primary care physician — common in rural South Dakota — urgent care clinics and some community health centers can complete the DSS physical form. Call ahead to confirm they're familiar with the process.

Tuberculosis testing:

Not universally required but frequently expected, particularly in the initial licensing phase. TB skin tests (PPD) require two appointments — one to receive the test, one to read it 48-72 hours later. Blood tests (IGRA) can be read in a single visit. If your regional DSS office requires TB testing, ask which format they accept.

Mental health evaluations:

These are triggered at DSS discretion, not as a standard requirement. If a household member discloses a significant mental health history in the autobiographical statement or initial interview, the licensing specialist may request an evaluation by a licensed mental health professional. The evaluation asks whether the condition is being managed and whether it would interfere with safe caregiving.

Financial Requirements: What DSS Needs to See

South Dakota does not have an income minimum for foster parents. You are not required to earn a specific dollar amount. What you must demonstrate is financial self-sufficiency — that your income covers your existing family's needs independent of any foster care reimbursement payments.

This matters because foster care maintenance payments are reimbursements, not wages. They're not guaranteed income, and DSS needs to know that your household can function financially without depending on them.

Documentation typically required:

• Most recent federal tax return (Form 1040): This is the primary document. It shows total household income, filing status, and existing dependents.
• Recent pay stubs: If your income situation has changed since the last tax return — new job, promotion, layoff — recent pay stubs provide current context.
• Self-employment documentation: If you're self-employed, a tax return with Schedule C plus a profit/loss statement for the current year. The licensing specialist is looking for stability, not a specific income level.
• Social Security or disability income documentation: If household income includes Social Security, disability payments, or retirement income, provide the benefit letter from the relevant agency.

The financial review is not a credit check. DSS is not evaluating your savings account, your debt level, or your net worth. They're looking at whether your income flow covers your costs.

What disqualifies financially:

There's no hard number. The licensing specialist makes a judgment call. A family with modest income and no debt that covers its bills is fine. A family with income that clearly cannot support the existing household members — active bankruptcy, documented inability to pay basic bills — presents a concern. When in doubt, be direct with your licensing specialist about your financial situation during the initial interview.

Reference Letters: Who to Ask and What's Required

DSS requires three references for each foster care application. The requirements:

• At least one reference from a family member (relative)
• At least one reference from a non-relative (friend, neighbor, coworker, employer, clergy)
• References must be adults who know you personally — character references, not professional credentials
• References cannot include anyone who currently receives services from DSS

Who makes a strong reference:

Someone who can speak to your character, your relationship with children, and your ability to handle stress and responsibility. A neighbor who has watched you handle emergencies calmly, a church leader who knows your family over many years, a coworker who can speak to your reliability — these are better references than a distant relative who sees you once a year.

DSS contacts references by phone or sends a written reference form. The questions typically cover:

• How long have you known the applicant?
• How would you describe their relationship with children?
• Are you aware of any concerns about their ability to care for a foster child?
• Would you recommend them as a foster parent?

Practical steps:

Ask references before submitting their names. Give them a heads-up that DSS will contact them and what the questions cover. References who are surprised by a DSS phone call sometimes give hesitant answers not because they have concerns, but because they weren't prepared.

Do not list references who are currently going through their own crises, who you haven't spoken to in years, or who you suspect might have ambivalent feelings about your fostering plans. Three solid references who respond promptly and positively moves your home study forward faster than a larger list of uncertain ones.

Pulling It Together: The Document Checklist

When gathering for the home study, the complete document picture looks like this:

Medical:

• Physical examination form (completed by physician) for each adult 18+
• TB test results if required by your regional office
• Pet vaccination records (current rabies vaccination for all pets)
• Psychological evaluation if requested (not standard)

Financial:

• Most recent Form 1040 (federal tax return)
• Recent pay stubs (last 2-3 months) if income has changed
• Self-employment: Schedule C + current year profit/loss statement
• Benefit letters for Social Security, disability, or retirement income

References:

• Three references with name, relationship, phone, and address
• At least one family member, at least one non-relative
• References notified in advance and prepared to respond promptly

Other application documents (not covered here but also required):

• Completed DSS application form
• Autobiographical statement (narrative)
• Fingerprint cards submitted for DCI/FBI checks
• Central Registry check form

Starting medical appointments and collecting financial documents in week 1-2 of the process — simultaneously with submitting fingerprints and signing up for PRIDE training — is what keeps the licensing timeline in the 4-month range rather than drifting toward 6-9 months.

The South Dakota Foster Care Licensing Guide includes a document tracking checklist that maps every required item to the step in the licensing sequence where it's needed. If paperwork organization is where you tend to lose momentum, a consolidated checklist is what prevents the "I thought I sent that" moment two months into the process.

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