Waivers
A Waiver is a provision in the Federal Medicaid guidelines that allows people who meet specific criteria the opportunity to receive services and supports that enable them to live in their community or at home with their families. There are four types of waivers administered by SCDDSN: Intellectual Disabilities/Related Disabilities (ID/RD) Waiver, Head and Spinal Cord Injuries (HASCI) Waiver, Community Supports Waiver (CSW) and the Pervasive Developmental Disorder (PDD) Waiver.
Section 1915(c) of the Federal Social Security Act enables the SC Department of Health and Human services to collaborate with the South Carolina Department of Disabilities and Special Needs (SCDDSN) to provide Home and Community-Based Waiver programs.
Waiver participants can receive Medicaid-funded services and supports in their own home and other community settings instead of in a nursing facility or institution. The cost of Medicaid Waiver services must be less expensive than or equal to the costs of institutional care.
Contact your Case Manager to be placed on the waiting list for the waiver program for which you best qualify.
Types of Waiver Programs and Programs Offered
HASCI Waiver
The HASCI Waiver is limited to people up to age 60 years, with the following conditions:
traumatic brain injury
spinal cord injury
both traumatic brain injury and spinal cord injury
a similar disability not associated with the process of a progressive degenerative illness, disease, dementia or a neurological disorder related to aging
Persons enrolled prior to age 60 continue to be eligible after their 60th birthday if all other eligibility factors are met.
To qualify for HASCI waiver services a person must:
Be eligible for HASCI Division services
Request HASCI waiver services through his/her Case Manager
Be eligible for Medicaid or already covered by Medicaid
Meet Level of Care criteria for Intermediate Care Facility for the Intellectually Disabled or Nursing Facility
Have urgent circumstances affecting his/her health or functional status and which could be life-threatening
Be dependent on others to provide or assist with critical health needs, basic activities of daily living or require daily monitoring or supervision to avoid institutionalization
Need services not otherwise available within existing community resources, including family, private means and other agencies/programs, or for whom current resources are inadequate to meet the basic needs of the individual to allow him/her to remain in the home
Be able to live safely in a home setting
HASCI Waiver Services
Attendant care/personal care assistance services
Communication services
Habilitation services, including day, prevocational, supported employment, and residential
Occupational therapy
Personal emergency response system
Physical therapy
Prescribed drugs
Private nursing services
Psychological services
Respite care
Specialized Supplies and Assistive Technology
ID/RD Waiver
To qualify for ID/RD Waiver services a person must:
Be eligible for the ID/RD Division services (have an intellectual disability or a related disability)
Be eligible for Medicaid or already covered by Medicaid
Meet Level of Care criteria for Intermediate Care Facility for the Persons with Intellectual Disabilities(ICF/ID)
Have needs that can be met through the provision of ID/RD waiver services
Be given the option of receiving services in his/her home and community or in an Intermediate Care Facility for persons with Intellectual Disabilities(ICF/ID)
ID/RD Waiver Services
Adult Attendant Care Services (limited to 28 hours/week in combination with Adult Companion and Personal Care 2)
Career Preparation
Community Services
Day Activity
Employment Services
Support Center Services
Personal Care I & II services (limited to 6 hours/week of Personal Care 1 – limited to 28 hours/week of Personal Care 2 in combination with Adult Attendant Care and Companion)
Respite Care (limited to 68 hours/month unless approved for an exception by DDSN)
Environmental Modifications (lifetime monetary cap of $7,500 per recipient)
Specialized Medical Equipment, Supplies and Assistive Technology
Adult Companion services (limited to 28 hours/week in combination with Adult Attendant Care and Personal Care 2)
Psychological services
Behavior Support services
Personal Emergency Response System
Residential Habilitation
Prescribed Drugs
Audiological services
Private Vehicle Modifications (lifetime monetary cap of $7500 per vehicle, limit 2 vehicles)
Adult Dental services
Adult Vision services
Nursing services (limited to 56 hours/week of LPN or 42 hours/week of RN)
Adult Day Health Care (including ADHC Nursing and Transportation)
Community Supports Waiver
To qualify for Community Supports Waiver services a person must:
Be eligible for the ID/RD Division services (have an intellectual disability or a related disability)
Be eligible for Medicaid or already covered by Medicaid
Meet Level of Care criteria for Intermediate Care Facility for persons with Intellectual Disabilities (ICF/ID)
Have needs that can be met through the provision of Community Supports waiver services
Be given the option of receiving services in his/her home and community or in an Intermediate Care Facility for persons with Intellectual Disabilities(ICF/ID)
Maintain services within the individual cost limit
Community Supports Waiver (CSW) Services
Adult Day Health Care Services (including ADHC nursing & transportation)
Behavior Support Services
Day Activity
Career Preparation
Community Services
Employment Services
Support Center Services
In-Home Support
Environmental Modification
Personal Care Services
Private Vehicle Modification
Psychological Services
Respite Services
Specialized Medical Supplies, Equipment, Assistive Technology and Appliances
PDD Waiver
The PDD Waiver provides Early Intensive Behavioral Intervention (EIBI) services and Case Management Services to children who have been diagnosed with pervasive developmental disorder, including autism and Asperger’s Syndrome and who meet the ICF-ID level of care criteria. The waiver serves children ages three through ten and is time limited. Services are not provided in a setting where educational services are being provided. The goal of the waiver is to develop skills of children in the areas of cognition, behavior, communication and social interaction.
If a parent/legal guardian is interested in receiving services through the PDD Waiver and his/her child is currently eligible for DDSN services, the parent/legal guardian should contact the child’s Case Manager and request that the child go through the intake process for the PDD Waiver.
***** All Waiver services are subject to change. For an inclusive list of services and criteria, please visit the South Carolina Department of Health and Human Services Website at www.scdhhs.gov