Administrative Assistant Century Business Products Inc.Administrative AssistantSioux Falls, SD$18–$22 / hourIn this role, you'll support daily office operations, provide exceptional customer service, and work alongside our leadership and accounting teams to help deliver an outstanding experience for both our customers and employees. We foster a collaborative, supportive work environment where professionalism, teamwork, and exceptional customer service are valued every day.
NewAdministrative Assistant Maguire Iron, Inc.Administrative AssistantSioux Falls, SDThe above statements are intended to describe the general nature and level of work being performed and not an exhaustive list of all responsibilities, duties, and skills required of team members. For over 100 years, Maguire has been an industry leader in the fabrication, construction, and maintenance of water storage tanks and elevated water towers.
Medical Administrative Assistant / Exercise Tech ProActive Physical TherapyMedical Administrative Assistant / Exercise TechSioux Falls, SDFull timeYour responsibilities extend to managing patient accounts related to scanning into the electronic medical records, taking over the counter collections payments, and account reconciliation. Join ProActive Physical Therapy as a key member of our team, where your dynamic energy and friendly demeanor will contribute to the seamless flow of patient interactions.
Project Coordinator / Administrative Assistant - Sioux Falls Hausmann ConstructionProject Coordinator / Administrative Assistant - Sioux FallsSioux Falls, SDThe Project Coordinator / Administrative Assistant will support the Project Management team from the beginning of a project by assisting with the preparation of contracts and related documents, along with compliance tracking and proper project documentation from all project participants. This position will also support the work of management and other staff members by providing administrative assistance through answering phones, handling mail, coordinating events, ordering office supplies and general office management.
Administrative Assistant-Academic & Student Services Harrisburg School DistrictAdministrative Assistant-Academic & Student ServicesHarrisburg, SDThis position supports district initiatives related to curriculum, assessment, school improvement, accreditation, special education, student support services, Career and Technical Education (CTE), workforce development, grants, professional development, communications, and strategic partnerships. The Administrative Assistant serves as a central point of coordination for department operations, communications, records management, compliance activities, and stakeholder engagement while helping ensure the efficient and effective delivery of district programs and services.
NewAdministrative Assistant II CNAAdministrative Assistant IISioux Falls, South DakotaPerforms a combination of duties in accordance with departmental guidelines: Assists management in the coordination of organizational administration activities which may include but would not be limited to: accounts payable, cost center updates, desk assignments, customer issues etc., and within scope of authority, resolves problems and issues independently and proactively. CNA seeks to offer a comprehensive and competitive benefits package to our employees that helps them — and their family members — achieve their physical, financial, emotional and social wellbeing goals.
Administrative Assistant II CNA Financial CorpAdministrative Assistant IISioux Falls, SDPerforms a combination of duties in accordance with departmental guidelines: Assists management in the coordination of organizational administration activities which may include but would not be limited to performance reviews, cost center updates, customer issues etc., and within scope of authority, resolves problems and issues independently and proactively. CNA seeks to offer a comprehensive and competitive benefits package to our employees that helps them - and their family members - achieve their physical, financial, emotional and social wellbeing goals.
NewAdministrative Assistant MaguireAdministrative AssistantSioux Falls, SDThe above statements are intended to describe the general nature and level of work being performed and not an exhaustive list of all responsibilities, duties, and skills required of team members. For over 100 years, Maguire has been an industry leader in the fabrication, construction, and maintenance of water storage tanks and elevated water towers.
Medical Administrative Assistant Exercise Tech US Physical Therapy IncMedical Administrative Assistant Exercise TechSioux Falls, SDYour responsibilities extend to managing patient accounts related to scanning into the electronic medical records, taking over the counter collections payments, and account reconciliation. Join ProActive Physical Therapy as a key member of our team, where your dynamic energy and friendly demeanor will contribute to the seamless flow of patient interactions.
Administrative Assistant & Bookkeeper Johnson Hardwood Company LLCAdministrative Assistant & BookkeeperSioux Falls, SDJoin Johnson Hardwood Company, where you'll play a vital role in supporting our daily office and bookkeeping operations in Sioux Falls, SD. Office Support: Assist with employee timekeeping and trucking compliance; prepare and process correspondence, reports, and documentation; maintain filing systems.
Senior Administrative Assistant Sanford HealthSenior Administrative AssistantSioux Falls, SD$19–$28 / hourFacility: GSS National Campus Location: Sioux Falls, SD Address: 4800 W 57th St, Sioux Falls, SD 57108, USA Shift: 8 Hours - Day Shifts Job Schedule: Full time Weekly Hours: 40.00 Salary Range: $19.00 - $28.00. Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland.
Administrative Assistant West Central School DistrictAdministrative AssistantHARTFORD, SDWest Central School District is located just a short drive from Sioux Falls. This position qualifies for the following benefits: Health, Dental, Vision, FSA, HSA, Employer matching retirement (6%), Employee Assistance Program, Life Insurance.
Administrative Office Assistant LSS of South DakotaAdministrative Office AssistantSioux Falls, SD$16–$18 / hourAt LSS , we are committed to upholding the following values in all aspects of our work: Compassionate – We engage with empathy and provide non-judgmental services. Responsibilities include answering and directing phone calls, taking messages, providing general information, and connecting individuals with appropriate team members.
Administrative Specialist Interstates IncAdministrative SpecialistSioux Falls, SDWhether you're bending conduit, wiring panels, writing code, supporting projects, or helping things run behind the scenes, you'll be part of a crew that works hard, shares laughs, and takes pride in doing quality work. In this role, you'll help keep schedules, meetings, projects, and communications running smoothly so teams can stay focused on delivering meaningful results.
Exec Admin Assistant (DC) TriWest Healthcare AllianceExec Admin Assistant (DC)Sioux Falls, SDFull timeThe EAA will also support the President and CEO as needed and assist senior executives traveling within the D.C. area, collaborating closely with the Assistant to the President and other Executive Administrative Assistants. The Executive Administrative Assistant (EAA) provides executive-level administrative support to the Chief Compliance and Legal Officer (CCLO) and other senior executives with primary responsibilities in the Washington, D.C. area.
Executive Assistant - Clinic Administration - Full Time Sanford HealthExecutive Assistant - Clinic Administration - Full TimeSioux Falls, SD$19–$30.50 / hourThis role serves as a trusted partner to executive leadership by managing complex schedules, coordinating high-level meetings and events, supporting strategic initiatives, and facilitating communication across departments and stakeholders. Manages complex priorities, coordinates key initiatives, and serves as a trusted partner who anticipates needs, facilitates communication, and helps ensure strategic goals are achieved.
Senior Executive Assistant - Foundation - Full Time Sanford HealthSenior Executive Assistant - Foundation - Full TimeSioux Falls, SD$21.50–$34.50 / hourFacility: Sanford House Location: Sioux Falls, SD Address: 2335 East 60th St N, Sioux Falls, SD 57104, USA Shift: Day Job Schedule: Full time Weekly Hours: 40.00 Salary Range: $21.50 - $34.50. Must be able to create a friendly, cooperative impression and positive image of the organization when dealing with employees, visitors, patients, board and medical staff members.
Executive Assistant & Event Coordinator South Dakota Farm BureauExecutive Assistant & Event CoordinatorSioux Falls, SDSouth Dakota Farm Bureau’s Administrative Assistant & Event Coordinator is not a traditional administrative role – it is high trust position supporting CEO leadership, board governance, fellow team members and coordinating the organization’s most important moments. This role offers a unique opportunity to work at the intersection of leadership and member engagement, becoming part of a collaborative, mission-driven team working on behalf of farmers, ranchers and rural communities across the state.
Registered Nurse (RN) or Licensed Practical Nurse (LPN) or Medical Assistant | Cancer Institute Float Avera HealthRegistered Nurse (RN) or Licensed Practical Nurse (LPN) or Medical Assistant | Cancer Institute FloatSioux Falls, SD$20–$41.25 / hourStudent Loan Repayment: This Registered Nurse (RN) position may be eligible for Avera's Student Loan Repayment Program, which helps you pay off your loans and save money. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds.
Registered Nurse (RN) or Licensed Practical Nurse (LPN) or Medical Assistant | Neurology Clinic Avera HealthRegistered Nurse (RN) or Licensed Practical Nurse (LPN) or Medical Assistant | Neurology ClinicSioux Falls, SD$20–$41.25 / hourRequired Education, License/Certification, or Work Experience: Certified Clinical Medical Assistant (CCMA) - National Healthcareer Association (NHA) Upon Hire or Certified Medical Assistant (CMA) - American Medical Certification Association (AMCA) Upon Hire or Certified Medical Assistant (CMA) - American Association of Medical Assistants (AAMA) Upon Hire or Registered Medical Assistant (RMA) - American Medical Technologists (AMT) Upon Hire or National Certified Medical Assistant (NCMA) - National Center for Competency Testing (NCCT) Upon Hire. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds.
Registered Nurse (RN) or Licensed Practical Nurse or Medical Assistant | Cancer Institute Float Pool Avera HealthRegistered Nurse (RN) or Licensed Practical Nurse or Medical Assistant | Cancer Institute Float PoolSioux Falls, SD$20–$41.25 / hourRequired Education, License/Certification, or Work Experience: Certified Clinical Medical Assistant (CCMA) - National Healthcareer Association (NHA) Upon Hire or Certified Medical Assistant (CMA) - American Medical Certification Association (AMCA) Upon Hire or Certified Medical Assistant (CMA) - American Association of Medical Assistants (AAMA) Upon Hire or Registered Medical Assistant (RMA) - American Medical Technologists (AMT) Upon Hire or National Certified Medical Assistant (NCMA) - National Center for Competency Testing (NCCT) Upon Hire. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds.
Medical Assistant | Radiation Oncology Clinic Avera HealthMedical Assistant | Radiation Oncology ClinicSioux Falls, SD$20–$28 / hourTo perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. Required Education, License/Certification, or Work Experience: Certified Clinical Medical Assistant (CCMA) - National Healthcareer Association (NHA) Upon Hire or.
Registered Nurse (RN) or Licensed Practical Nurse (LPN) or Medical Assistant | Salem Harrisburg and Tea Clinic Float Avera HealthRegistered Nurse (RN) or Licensed Practical Nurse (LPN) or Medical Assistant | Salem Harrisburg and Tea Clinic FloatSD$20–$41.25 / hourMust have one of the following certifications: • Certified Clinical Medical Assistant (CCMA) - National Healthcareer Association (NHA) • Certified Medical Assistant (CMA) - American Medical Certification Association (AMCA) • Certified Medical Assistant (CMA) - American Association of Medical Assistants (AAMA) • Registered Medical Assistant (RMA) - American Medical Technologists (AMT) • National Certified Medical Assistant (NCMA) - National Center for Competency Testing (NCCT). To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds.
Registered Nurse (RN) or Licensed Practical Nurse (LPN) or Medical Assistant | Tea Clinic Lab Avera HealthRegistered Nurse (RN) or Licensed Practical Nurse (LPN) or Medical Assistant | Tea Clinic LabSD$20–$41.25 / hourTo perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. Required Education, License/Certification, or Work Experience: Certified Clinical Medical Assistant (CCMA) - National Healthcareer Association (NHA) Upon Hire or.
Nurse Practitioner or Physician Assistant | Hospitalist | PRN Avera HealthNurse Practitioner or Physician Assistant | Hospitalist | PRNSioux Falls, SDTo perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. Required Education, License/Certification, or Work Experience: Certified Nurse Practitioner (CNP) - Board of Nursing Must be licensed and qualified to practice in the state based off job assignment Upon Hire and.
Nurse Practitioner or Physician Assistant | Oncology Service Line Avera HealthNurse Practitioner or Physician Assistant | Oncology Service LineSioux Falls, SDLocation: Avera Cancer Institute-Sioux Falls Worker Type: Regular Work Shift: Primarily days with possible weekends/evenings/holidays (United States of America) Position Highlights .9 FTE (FT Benefit Eligible) Will support 6 regional ACI sites Can be based out of Sioux Falls, Aberdeen, Mitchell, Pierre and Yankton Varying weekday schedule with no weeknight or weekend call Physician Assistant (PA)- Must be licensed and qualified to practice in the state based off job assignment. Upon Hire and Federal Drug Enforcement Admin - US Department of Justice Drug Enforcement Admin State and federal based on state of practice Upon Hire and Certified Physician Assistant - National Commission on Certification of Physician Assistants (NCCPA) Upon Hire You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients.
Nurse Practitioner or Physician Assistant | Psychiatry | Seasonal Avera HealthNurse Practitioner or Physician Assistant | Psychiatry | SeasonalSioux Falls, SDTo perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. Required Education, License/Certification, or Work Experience: Certified Nurse Practitioner (CNP) - Board of Nursing Must be licensed and qualified to practice in the state based off job assignment.
Executive Assistant LifeScapeExecutive AssistantSioux Falls, South DakotaYou'll support executive decision-making, coordinate critical projects, manage confidential information with discretion, and collaborate with teams across the organization to help move strategic priorities forward. LifeScape will be an innovative organization, providing exceptional services and creative solutions for people with varied needs and complex care across their life span.
Senior Executive Assistant to the President Southeast Technical CollegeSenior Executive Assistant to the PresidentSioux Falls, SD$75,977–$88,421 / yearServe as the President's administrative liaison to the South Dakota Board of Technical Education, Sioux Falls School Board, and STC Council, maintaining discretion, confidentiality, and compliance with board governance and public notice requirements. Serve as the first point of contact for the President's Office, providing high-level executive support, professionally representing the President and the College to internal and external stakeholders, and managing the day-to-day operations of the President's Office.
Medical Assistant/LPN City of Sioux FallsMedical Assistant/LPNSioux Falls, SD$21.42–$23.09 / hourCertified or registered by the American Association of Medical Assistants (AAMA), American Medical Technologists (AMT) or other national accrediting body with a minimum of one (1) year's medical assistance experience preferred; or any such combination of education, experience, and training as may be acceptable to the hiring authority. Perform basic pharmaceutical calculations (addition, subtraction, multiplication, division) and ability to understand inventory controls with a strong attention to detail.
Medical Assistant Shah Medical ClinicMedical AssistantSioux Falls, SDBenefits of Joining Our Team: As a Medical Assistant at Shah Medical Clinic, you will have the opportunity to work in a supportive and collaborative environment where your skills and dedication will be valued. If you are passionate about helping others and making a difference in the lives of patients, we encourage you to apply for the Medical Assistant position at Shah Medical Clinic.
In-Home Nurse Practitioner or Physician Assistant Part Time - Sioux Falls CVS Health CorpIn-Home Nurse Practitioner or Physician Assistant Part Time - Sioux FallsSioux Falls, SD$37.66–$81.11 / hourSignify Health, part of CVS Health, is seeking a Part Time Clinician (Nurse Practitioner or Physician Assistant) to provide In-Home Health Evaluations, engaging with people in the comfort of their own homes and helping bridge gaps in care. You'll play a critical role in building trusted relationships to make people healthier, helping bring flexible, comprehensive and personalized health evaluations right to people's front doors.
Admissions Assistant Acadia Healthcare Co IncAdmissions AssistantSDComplete paperwork necessary to admit patient to the assigned program and explain forms prior to patient signing, notify clinical lead of patient's arrival and escort the patient and documentation to appropriate location within the facility. Keystone Treatment Center is seeking a dedicated Admissions Assistant to join our mission-driven team supporting individuals seeking Substance Use Disorder (SUD) treatment.
NewMortgage Assistant Plains Commerce BankMortgage AssistantSioux Falls, South DakotaWe offer a competitive benefits package that includes Medical, Dental and Vision; FSA or Dependent Care; Supplemental Accident, Hospital, or Critical Illness Plans; Employer paid Life Insurance, Short Term Disability, and Long-Term Disability; and Additional Voluntary Life Insurance Options. Mortgage Assistant Position Purpose: To provide administrative and customer support to the Mortgage team while helping ensure a smooth and exceptional experience throughout the loan process.
Assistant Manager SONIC Drive-In - Sioux FallsAssistant ManagerSioux Falls, SDPrior experience as restaurant assistant manager, general manager, supervisor, shift lead, crew lead, team lead is highly desirable. ZippyApp is the Common Employment Application for online and mobile that allows you to apply for jobs with one click, and is being accepted at a growing number of businesses each day.
Secretary / Office Assistant IMKOSecretary / Office AssistantSioux Falls, SD$20–$22 / hourThis role is ideal for someone who thrives in a fast-paced environment, stays organized, and enjoys keeping things running smoothly behind the scenes. Pay: $20–$22/hour (based on experience)We are seeking a reliable and detail-oriented Secretary to support daily office operations.
Assistant Coach, Women's Volleyball Augustana UniversityAssistant Coach, Women's VolleyballSioux Falls, SDCurrently with 21 NCAA Division II sports programs and 1 NCAA Division I program, Augustana Athletics is focused on building champions in the classroom, in competition and in the community, highlighted by three team national championships over the last five seasons. Augustana University has, for more than 150 years, provided a strong student-centric education based on its five core values: Christian faith, liberal arts, excellence, community and service.
Assistant Coach, Women's Softball Augustana UniversityAssistant Coach, Women's SoftballSioux Falls, SDCurrently with 21 NCAA Division II sports programs, Augustana Athletics is focused on building champions in the classroom, in competition and in the community, highlighted by three team national championships since 2016. With the addition of the $70 million Midco Arena, Augustana Athletics has launched the first collegiate hockey program in South Dakota in 2023 and is also the first athletics program to compete at Division I that calls Sioux Falls home.
NewAssistant Coach, Men's Wrestling Augustana UniversityAssistant Coach, Men's WrestlingSioux Falls, SDCurrently with 21 NCAA Division II sports programs, Augustana Athletics is focused on building champions in the classroom, in competition and in the community, highlighted by three team national championships since 2016. With the addition of the $70 million Midco Arena, Augustana Athletics launched the first collegiate hockey program in South Dakota in 2023 and is also the first athletics program to compete at Division I that calls Sioux Falls home.
NewEstimating Assistant MaguireEstimating AssistantSioux Falls, SDFor over 100 years, Maguire Iron has been an industry leader in the fabrication, construction, and maintenance of water storage tanks and elevated water towers. The above statements are intended to describe the general nature and level of work being performed and not an exhaustive list of all responsibilities, duties, and skills required of team members.
Admissions Assistant Keystone Treatment Center - CantonAdmissions AssistantCanton, South DakotaFull timeComplete paperwork necessary to admit patient to the assigned program and explain forms prior to patient signing, notify clinical lead of patient’s arrival and escort the patient and documentation to appropriate location within the facility. Keystone Treatment Center is seeking a dedicated Admissions Assistant to join our mission-driven team supporting individuals seeking Substance Use Disorder (SUD) treatment.
Assistant General Manager CRAVE American Kitchen & Sushi BarAssistant General ManagerSioux Falls, South DakotaWe anticipate our guests needs, recommend exciting new dishes, introduce them to new flavors, and work extremely hard to make sure that our guests dining experience at CRAVE becomes a fantastic memory of time spent with friends and family. Duties and Responsibilities: Primary duties and responsibilities include, but are not limited to, the following: Assist General Manager in overseeing and managing all areas of the restaurant and make final decisions on matters of importance to guest service.
Psychiatrist or Prescribing Nurse Practitioner or Physician Assistant - 1099 Contractor - Sioux Falls, SD (Spanish-speaking) Lyra Health IncPsychiatrist or Prescribing Nurse Practitioner or Physician Assistant - 1099 Contractor - Sioux Falls, SD (Spanish-speaking)Sioux Falls, SDRequirements: Board certified MD, DO in psychiatry, graduate from an accredited (CCNE) Psychiatric-Mental Health Nurse Practitioner (PMHNP) program; OR graduate from an accredited PA program (ARC-PA) with certification through PANCE with preference for Certificate of Added Qualifications in psychiatry, post-graduate fellowship in psychiatry, or other academic psychiatry certificate program completion, including a Doctor of Medical Science with Psychiatry concentration. We are looking for contract Psychiatrists, nurse practitioners (NPs) or certified physician assistants (PA-C) who are passionate about whole-person, whole family mental health care and working within a connected network to provide patients with easily accessible, culturally responsive, high-quality mental health care.
Department Assistant, QE9646 South Dakota Board Of RegentsDepartment Assistant, QE9646Sioux Falls, SD$19.27–$20 / hourLogo Institution The University of South Dakota Working Title Department Assistant, QE9646 Posting Number CSA02745P Department USD-Center for Disabilities Physical Location of Position (City) Sioux Falls Posting Text. Posting Date 06/24/2026 Closing Date Open Until Filled Yes First Consideration Date 07/08/2026 Advertised Salary $19.27 to $20.00, depending on qualifications and experience Duration of the Term 12 months If Other, describe duration NA Appointment Percent 100 Work Hours.
Licensed Dental Assistant South Dakota Board Of RegentsLicensed Dental AssistantSioux Falls, SD$21.50–$23.49 / hourDepartment Description and Cultural Expectations The University of South Dakota Department of Dental Hygiene is a leading dental hygiene program committed to providing high-quality patient care, student education, and innovative dental services. Institution: The University of South Dakota Working Title: Licensed Dental Assistant Posting Number: CSA02550P Department: USD-Dental Hygiene Physical Location of Position: Sioux Falls.
NewEstimating Assistant Maguire Iron, Inc.Estimating AssistantSioux Falls, SDFor over 100 years, Maguire Iron has been an industry leader in the fabrication, construction, and maintenance of water storage tanks and elevated water towers. The above statements are intended to describe the general nature and level of work being performed and not an exhaustive list of all responsibilities, duties, and skills required of team members.
Child Nutrition Registered Dietician/Assistant Director Brandon Valley School District 49-2Child Nutrition Registered Dietician/Assistant DirectorBrandon, SDRequires excellent computation skills for performing a variety of formulations including quantity food extension, caloric content, nutrient analysis, labor costs, staff meals per labor hours, menu cost, and portion/serving size costs. Occasional work in kitchens, where there may be frequent standing, walking, bending, carrying and reaching, as well as exposure to: Cleaning chemicals, fumes and mechanical/electrical hazards.
Assistant Operations Coordinator Mustang Disaster CleanUpAssistant Operations CoordinatorSioux Falls, SDMustang Disaster CleanUp is looking for a full-time Assistant Operations Coordinator to help keep our team running smoothly while delivering an outstanding experience for our customers. You’ll be in the office, but you will also work closely with the field teams (even assisting them IN the field periodically) — helping coordinate jobs, solve problems, and keep everything on track.
Assistant Finance Manager Harrisburg School DistrictAssistant Finance ManagerHarrisburg, SDCoordinate District purchasing processes, including receiving purchase requests, maintaining purchase orders, placing orders, tracking deliveries, paying invoices, and maintaining documentation. The role ensures the district maintains accurate, transparent, and legally compliant financial practices while supporting administrators, staff, and the school board.
Nurse Practitioner or Physician Assistant | Hospitalist | PRN AveraNurse Practitioner or Physician Assistant | Hospitalist | PRNSioux Falls, South DakotaTo perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. Effectively contributes to the health education of individuals and groups and applies appropriate methods designed to increase each person’s motivation to assume responsibility for their own health care.