An HCBS waiver is a Medicaid long-term care option which allows persons who are eligible to receive Medicaid, and who meet specific medical criteria, the opportunity to receive additional services and supports that enable them to live in the community or at home with their families.

Waiver participants can receive Medicaid funded services and supports in their own home and other community settings instead of a nursing facility or institution.  The cost of Medicaid waiver services must be less expensive than or equal to the cost of institutional care. 

As the State Medicaid Agency, the Department of Health and Human Services (DHHS) has administrative oversight for the 5 HCBS waivers in SC. 

Three of the waivers are operated by the Division of  Community Long Term Care (CLTC):

·  Community Choices,

· HIV/AIDS, and

· Mechanical Ventilator Waivers

Two waivers are operated by the SC Department of Disabilities and Special Needs (DDSN):

· Head and Spinal Cord Injury (HASCI), and

· Mental Retardation and Related Disabilities (MR/RD)

Community Long Term (CLTC) operates home and community-based waiver programs for persons eligible for nursing home care but who  choose to receive their services in the community.

           The CLTC program began statewide in 1983 after a three-year pilot program in the Upstate to meet the long term needs of the elderly or disabled person who was not able to care for himself or herself independently. 

 

Currently, CLTC administers and operates three Medicaid waiver programs:

· Community Choices waiver,

· HIV/AIDS Waiver, and

· Mechanical Ventilator Dependent Waiver.

What are Medicaid Home and Community – Based Services (HCBS)? Waivers?  

Community Long-Term Care Waivers

Text Box: Community Choices
Text Box: HIV/AIDS Waiver

This waiver allows elderly and disabled persons 18+ who meet the nursing facility level of care to remain at home.  Services offered include:

 

 

 

 

 

 

 

 

 

Contact Information: (803) 898-2725    

Elderly/Disabled contact information

This waiver allows persons with HIV/AIDS who meet the hospital level of care to remain living at home and in the community.  Services provided include:

 

 

 

 

 

 

 

Contact Information:  (803) 898-2725 or contact the local DHHS Regional Office

HIV / AIDS contact information

Text Box: Mechanical Ventilator Waiver

This waiver allows persons who are 21+ and who meet nursing home level of care and dependent on a life sustaining ventilator to remain living at home and in the community.  Services provided include:

 

 

 

 

 

 

 

 

Contact Information:  (803) 898-2725.

 

Mechanical Ventilator contact information

What are the Home and Community-Based Waiver programs operated by DDSN?

 

The SC Department of Disabilities and Special Needs (DDSN) operates two HCBS waivers; the Mental Retardation and Related Disabilities (MR/RD) waiver, and the Head and Spinal Cord Injury (HASCI) waiver.  Through a process of case management and an individualized service plan, waiver participants are able to successfully remain at home at a substantially less cost to Medicaid  than the cost of institutional care.

 

How Do I Apply for The HASCI or MR/RD Waivers?

 

HASCI & MR/RD Waiver Services are provided based on identified needs of participants and within certain limits.  Enrollment in both waivers is based on a limited number of waiver slots available each year. Waiting lists are kept and families should apply for these services now so you will have them when you need them.  For more information about the waiver call (Department of Disabilities and Special Needs) DDSN at 1-800-376-4636 or in Columbia 803-898-9600 and ask for your local contact number for your local Disabilities and Special Needs board and request to apply for the waiver.

Department of Disabilities and Special Needs Waivers

Text Box: Head and Spinal Cord Injury Waiver

The HASCI Waiver is limited to people up to age 65.  Participants on this waiver before age 65 remain eligible for waivered services after their 65th birthday if all other eligibility factors are met. Waiver Services are limited to individuals with:

· Head injury,

· Spinal cord injury.

· Both, or

· a similar disability not associated with the process of a progressive degenerative illness, disease, dementia or a neurological disorder related to aging, regardless of the age of onset.

 

To qualify for HASCI Waiver services, a person must:

· Be eligible for Medicaid or already covered by Medicaid;

· Meet level of care criteria for Intermediate Care facility for the Mentally Retarded (ICF/MR) or Nursing Facility;

· Have urgent circumstances affecting his/her health or functional status;

· Be dependent on others to provide or assist with critical health needs, basic ADLS or requires daily monitoring or supervision in order to avoid institutionalization; and

· Need services not otherwise available within existing community resources, including family, private means and other agencies/programs, or for who current resources are inadequate to meet the basic needs of the individual which would allow them to remain in the community.

 

HASCI waiver Services include:

 

Text Box: Mental Retardation/Related Disabilities Waiver

To qualify for MR/RD waiver services, a person must:

· Be eligible for MR/RD services (have mental retardation or related disability);

· Be eligible for Medicaid or already covered by Medicaid;

· Meet level of care criteria for Intermediate Care facility for the Mentally Retarded (ICF/MR);

· Have needs that can be met through the provision of MR/RD waiver services; and

· Choose to receive services through the waiver rather than in an ICF/MR facility.

 

Waiver Services are available based on individual need and may include specialized medical equipment, supplies and assisted technology as well as the following:

 

 

 

 

 

 

 

 

 

 

 

 

*lifetime monetary cap of $7,500 per recipient

**lifetime monetary cap of $7,500 per recipient up to 2 vehicles

Text Box: 	Through the state Medicaid Program, there are several waivers to the basic eligibility requirements.  Due to Julie Beckett’s unparalleled advocacy for her daughter, Katie, she received the first Medicaid waiver in the nation in 1982. "Katie Beckett" waivers have enabled many families to provide care for their children in their homes and communities, rather than in hospitals or institutions.  Julie is also the co-founder of Family Voices.  Thanks to the Becketts, Medicaid may provide your child’s primary coverage or provide secondary coverage for what your own insurance does not pay.  
	The following Medicaid Home and Community-Based Services (HCBS) Waivers available in South Carolina are described below:
 Community Long-Term Care (CLTC) Waivers:  
  Community Choices, 
  HIV/AIDS, and 
  Mechanical Ventilator Waivers
Department of Disabilities and Special Needs (DDSN) Waivers:  
  Head and Spinal Cord Injury (HASCI), and 
  Mental Retardation and Related Disabilities (MR/RD) 
 Pervasive Developmental Disorder Program (PDD)
Text Box: Medicaid Waivers

Strengthening Families:

Resources for Partnering for

Healthy Development of Children and Youth

South Carolina Department of Disabilities and Special Needs, in collaboration with the South Carolina Department of Health and Human Services, developed a new pilot Medicaid Waiver program that serves children diagnosed with a Pervasive Developmental Disorder (PDD).  To qualify, the child must be between 3 and 10 years of age, have been diagnosed by 8 years old and currently enrolled in the DDSN system. If a child qualifies, the Intermediate Care Facility/ Mental Retardation (ICF/MR) process is then assessed.  When a child has completed all levels of qualification for services they will be able to receive services from the program, when space is available. Services offered through the PDD Program are Case Management and Early Intensive Behavioral Intervention (EIBI).

 

           To apply for the PDD Program contact your DDSN service coordinator, early interventionist, or call the toll free number, 1-800-576-4658. You can also visit www.state.sc.us/ddsn for more information.  To get the complete history on the program visit: http://www.state.sc.us/ddsn/PervasiveDevDisorder/PDDIntro.pdf  To apply for services visit:  http://www.state.sc.us/ddsn/PervasiveDevDisorder/ApplyforServices.pdf

Text Box: Pervasuve Developmental Disorders

Adult Attendant Care Services

Adult Companion Services                     

Adult Day Health Care Nursing

Adult Dental Services                            

Adult Vision Services

Audiology services

Behavioral Support Services    

Day Habilitation

Environmental modifications*

Nursing Services                                    

Occupational Therapy                             

Personal-care services

Physical therapy

Prescribed drugs                                    

Prevocational Services

Private vehicle modification**

Psychological services                            

Residential Habilitation

Respite Care

Speech/language pathology

Supported Employment Services

 

Behavior Support Services

Day habilitation

Environmental Modifications

Health Education for consumer directed care

Medicaid Waiver Nursing

Occupational Therapy

Peer guidance for consumer-directed care

Personal Emergency Response System (PERS)

Physical Therapy

Prescribed drugs

Prevocational Services

Private Vehicle Modifications

Psychological Services

Residential habilitation

Respite Care

Speech, Hearing and Language Services

Supplies, equipment & Assistive Tech

Supported Employment Services          

Attendant

Environmental Modification

Institutional Respite Care

Personal Care I/II

Personal Emergency Response Systems (PERS)

Prescription Drugs – 2 above State Plan

Private Duty Nursing

Specialized Medical Supplies

Attendant Care

Case Management

Companion        

Environmental Modification

Home Delivered Meals

Limited Incontinent Supplies

Nutritional Supplements

Personal Care I/II

Prescription Drugs

Private Duty Nursing

Adult Day Health Care

Adult Day Health Care Nursing

Attendant Care

Case Management

Chore Services (Opt 4 only)

Companion

Environmental Modification

Home Delivered Meals

Institutional Respite Care

Limited Incontinence Supplies

Limited Nutritional Supplements

Nursing Home Transition Services

Personal Care I/II

Personal Emergency Response Systems (PERS)

Respite in a Community Residential Care Facility