Black Hills Advocate helps a variety of people including people who are aging, people who are caregivers for a loved one or families with aging parents who live in the Black Hills. Black Hills Advocate also assists people who are facing illness; either short term or long term. They also facilitate a culture of transparency between patient and provider. Black Hills Advocate provide services including accompaniment to doctor/hospital visits, coordination of all health care providers, maintain portfolio of medical history, communicate with client's accountants, attorneys & financial planners, process monthly bill paying & bank statement reconciliation, implement financial planning strategies, assist with completion of health insurance & financial assistance applications, research treatment options, assist with advance directives (Health Care or Financial POA, Living Will, etc.), perform wellness visits at home or extended care facilities, coordinate end-of-life requests & after care planning, provide Guardianship & Conservatorship, advocate for patient's rights & medical needs, and assist with level of care choices & placement.

The Department of Human Services Guardianship Program provides guardianship and/or conservatorship services as a last resort to qualified individuals age 18 or older with an intellectual or developmental disability as defined in SDCL 27B-1-18 or qualified individuals in the Long Terms Services and Supports program. The South Dakota Department of Human Services may be appointed as a guardian, a conservator, or both, for adults with developmental disabilities under its care or to whom it is providing services or financial assistance, but only if there is no individual, nonprofit corporation, bank or trust company, or other public agency that is qualified to serve, as defined in SDCL 29A-5-110, or qualified individuals in the Long Terms Services and Supports program. The department also provides financial assistance for qualified individuals who are willing and qualified to serve as a guardian and/or conservator of up to $1,500.00 for the establishment of a guardianship or conservatorship through the Guardianship Establishment Program. Limited amount of funds for this program are available each year on a first come first served basis for qualified individuals.