South Carolina Community Supports Waiver

What is a Medicaid Waiver?
Medicaid Waivers, also known as Home and Community Based Services (HCBS) Waivers and Waiver Funded Services, allow qualifying program participants to receive services out of the nursing homes. Medicaid’s standard benefit is to pay for nursing home residential care. However, when available, Medicaid Waivers help to provide more options for individuals. The cost of the care outside of a nursing home needs to be less than the cost of care in a nursing home.

Waiver Description

The South Carolina Community Supports Waiver assists individuals with Intellectual Disabilities or a Related Disability (ID/RD), regardless of age, who have income and assets that meet Medicaid eligibility criteria. The objective of this statewide waiver is to provide South Carolinians with an opportunity to self-direct care in the home, with emphasis on keeping the participant integrated in the community. A member of the eligible participant’s family may provide care. However, a spouse or legal guardian of an adult cannot be paid for providing personal care services or those that are similar in nature. 

 This waiver offers similar services to another South Carolina Medicaid waiver called the Community Choices Waiver.  This other waiver may be more appropriate for seniors as a major difference between the two is that participants in the Community Supports Waiver must demonstrate a need for an ICF/ID level of care (Intermediate Care Facility for individuals with Intellectual Disability).


Eligibility Guidelines

The Community Supports Waiver evaluates candidates both on their functional needs and their financial situation. This waiver serves children and adults, as well as the elderly. There is no maximum age.

Functional Need Requirements

The South Carolina Department of Disabilities and Special Needs (SCDDSN) must determine that the individual meets the criteria for having an intellectual disability or related disability, such as epilepsy, and requires a level of care present in an Intermediate Care Facility for individuals with Intellectual Disabilities (ICF/IID).

Financial Requirements

For non-married applicants, aged 65 and older, they cannot have income exceeding 300% of the Supplemental Security Income limit, also known as the Federal Benefit Rate (FBR). As of 2018, this means an applicant’s gross monthly income cannot exceed $2,250. Married applicants should not count their spouse’s income, if they are not also applying for their Medicaid benefits.

The applicant’s countable resources cannot be greater than $2,000. Married applicants’ spouses may hold additional cash, investments, savings, or retirement accounts.   

The state does not count the value of a home where the applicant or his/her spouse lives, if it is valued under $572,000. Jewelry, clothing, furniture, and irrevocable funeral trusts are some of the items that are not counted when calculating the total assets. For further information about spending down, asset exemptions, and planning for long term care benefits, families should consult a Medicaid planning attorney or related professional. 

Persons ineligible for Medicaid might still receive assistance under SC Older Americans Act services. Read more.

Benefits and Services
  • Adult Day Health Care / Adult Day Care - daytime supervision including nursing care and transportation assistance
  • Case Management
  • Community Services
  • Environmental Modifications - modifications to the home and / or vehicle to accommodate for one's disability.
  • In-Home Support
  • Incontinence Supplies
  • Medical Equipment, Assistive Technology and Appliances - this includes Personal Emergency Response System (PERS) and other devices that help the elderly remain living in their homes.
  • Personal Care - includes support for different levels of personal care, such as hygiene, mobility, toiletry, laundry, grocery shopping, medication management, and transportation 
  • In-home and Out-of-home Respite Care - temporary caregiving relief services for the primary caregiver 
  • Behavior Support Services – assessment and intervention of problematic behaviors


How to Apply / Learn More

To apply for the Community Supports Waiver, contact the local county office of South Carolina Disabilities and Special Needs Board or visit their website. They can also be reached by calling (800) 289-7012. A service coordination provider assists each participant with his/her application.

According to press reports, waiting lists have been persistent in South Carolina’s waiver programs, including the Community Supports Waiver program. It is likely that new, at-home applicants need to wait for a slot to open. If placed on a waiting list, applications are processed on a first come, first serve basis. The only exception is if a Medicaid enrollee is living in a nursing home. In these cases, they are likely to be prioritized.