South Carolina Medicaid Waivers & Home and Community Based Programs Overview

South Carolina, known as The Palmetto State, has a well-developed Medicaid Waiver and Home and Community-Based Services (HCBS) system designed to provide long-term care alternatives for seniors, individuals with disabilities, and those with chronic health conditions.

Administered by the South Carolina Department of Health and Human Services (SCDHHS) in collaboration with the South Carolina Department of Disabilities and Special Needs (SCDDSN), the state’s Medicaid waiver programs allow eligible individuals to receive services in their homes or community settings rather than institutional care.

Key waiver programs include the Community Choices Waiver (CCW), which provides personal care, respite, and home modifications for seniors and adults with physical disabilities, and the Intellectual Disability/Related Disabilities (ID/RD) Waiver, which offers residential, habilitative, and employment support for individuals with intellectual and developmental disabilities (IDD). Other significant programs include the Medically Complex Children’s Waiver (MCC), the Head and Spinal Cord Injury (HASCI) Waiver, and the Pervasive Developmental Disorder (PDD) Waiver, all of which provide specialized, person-centered care. South Carolina also offers Self-Directed Services, allowing waiver participants greater flexibility in managing their care and selecting caregivers.

Regulatory oversight in South Carolina is managed through SCDHHS and SCDDSN, with additional provider licensing and compliance enforcement by the South Carolina Department of Health and Environmental Control (DHEC). The state operates under both fee-for-service and managed care models, with HCBS services coordinated through South Carolina Healthy Connections Medicaid Managed Care Organizations (MCOs) to enhance service delivery and cost-effectiveness.

South Carolina has also implemented Electronic Visit Verification (EVV) for personal care services, ensuring compliance and service integrity. Providers must navigate Medicaid enrollment, waiver-specific service authorizations, and strict quality assurance measures to participate successfully in the state’s HCBS programs. With a strong emphasis on community-based care, person-centered planning, and expanding access in rural areas, South Carolina’s Medicaid waiver system ensures that individuals receive high-quality, sustainable long-term care while promoting independence, dignity, and inclusion in their communities.

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